[{"chapter": 25, "intro": " Chapter Outline 25.1   The Stock Market Crash of 1929 25.2   President Hoover\u2019s Response 25.3   The Depths of the Great Depression 25.4   Assessing the Hoover Years on the Eve of the New Deal Introduction \n\n On March 4, 1929, at his presidential inauguration, Herbert Hoover stated, \u201cI have no fears for the future of our country. It is bright with hope.\u201d Most Americans shared his optimism. They believed that the prosperity of the 1920s would continue, and that the country was moving closer to a land of abundance for all. Little could Hoover imagine that barely a year into his presidency, shantytowns known as \u201cHoovervilles\u201d would emerge on the fringes of most major cities ( Figure 25.1 ), newspapers covering the homeless would be called \u201cHoover blankets,\u201d and pants pockets, turned inside-out to show their emptiness, would become \u201cHoover flags.\u201d \n\n The stock market crash of October 1929 set the Great Depression into motion, but other factors were at the root of the problem, propelled onward by a series of both human-made and natural catastrophes. Anticipating a short downturn and living under an ethos of free enterprise and individualism, Americans suffered mightily in the first years of the Depression. As conditions worsened and the government failed to act, they grew increasingly desperate for change. While Hoover could not be blamed for the Great Depression, his failure to address the nation\u2019s hardships would remain his legacy. ", "chapter_text": " 25.1   The Stock Market Crash of 1929 Learning Objectives By the end of this section, you will be able to: \n\n Identify the causes of the stock market crash of 1929 \n\n Assess the underlying weaknesses in the economy that resulted in America\u2019s spiraling from prosperity to depression so quickly \n\n Explain how a stock market crash might contribute to a nationwide economic disaster \n\n Herbert  Hoover  became president at a time of ongoing prosperity in the country. Americans hoped he would continue to lead the country through still more economic growth, and neither he nor the country was ready for the unraveling that followed. But Hoover\u2019s moderate policies, based upon a strongly held belief in the spirit of American individualism, were not enough to stem the ever-growing problems, and the economy slipped further and further into the Great Depression. While it is misleading to view the stock market crash of 1929 as the sole cause of the Great Depression, the dramatic events of that October did play a role in the downward spiral of the American economy. The crash, which took place less than a year after Hoover was inaugurated, was the most extreme sign of the economy\u2019s weakness. Multiple factors contributed to the crash, which in turn caused a consumer panic that drove the economy even further downhill, in ways that neither Hoover nor the financial industry was able to restrain. Hoover, like many others at the time, thought and hoped that the country would right itself with limited government intervention. This was not the case, however, and millions of Americans sank into grinding poverty. \n\n THE EARLY DAYS OF HOOVER\u2019S PRESIDENCY \n\n Upon his inauguration, President Hoover set forth an agenda that he hoped would continue the \u201cCoolidge prosperity\u201d of the previous administration. While accepting the Republican Party\u2019s presidential nomination in 1928, Hoover commented, \u201cGiven the chance to go forward with the policies of the last eight years, we shall soon with the help of God be in sight of the day when poverty will be banished from this nation forever.\u201d In the spirit of normalcy that defined the Republican ascendancy of the 1920s, Hoover planned to immediately overhaul federal regulations with the intention of allowing the nation\u2019s economy to grow unfettered by any controls. The role of the government, he contended, should be to create a partnership with the American people, in which the latter would rise (or fall) on their own merits and abilities. He felt the less government intervention in their lives, the better. \n\n Yet, to listen to Hoover\u2019s later reflections on Franklin Roosevelt\u2019s first term in office, one could easily mistake his vision for America for the one held by his successor. Speaking in 1936 before an audience in Denver, Colorado, he acknowledged that it was always his intent as president to ensure \u201ca nation built of home owners and farm owners. We want to see more and more of them insured against death and accident, unemployment and old age,\u201d he declared. \u201cWe want them all secure.\u201d  1  Such humanitarianism was not uncommon to Hoover. Throughout his early career in public service, he was committed to relief for people around the world. In 1900, he coordinated relief efforts for foreign nationals trapped in China during the Boxer Rebellion. At the outset of World War I, he led the food relief effort in Europe, specifically helping millions of Belgians who faced German forces. President Woodrow Wilson subsequently appointed him head of the U.S. Food Administration to coordinate rationing efforts in America as well as to secure essential food items for the Allied forces and citizens in Europe. 1 Herbert Hoover, address delivered in Denver, Colorado, 30 October 1936, compiled in Hoover,  Addresses Upon the American Road, 1933-1938  (New York, 1938), p. 216. This particular quotation is frequently misidentified as part of Hoover\u2019s inaugural address in 1932. \n\n Hoover\u2019s first months in office hinted at the reformist, humanitarian spirit that he had displayed throughout his career. He continued the civil service reform of the early twentieth century by expanding opportunities for employment throughout the federal government. In response to the Teapot Dome Affair, which had occurred during the Harding administration, he invalidated several private oil leases on public lands. He directed the Department of Justice, through its Bureau of Investigation, to crack down on organized crime, resulting in the arrest and imprisonment of Al Capone. By the summer of 1929, he had signed into law the creation of a Federal Farm Board to help farmers with government price supports, expanded tax cuts across all income classes, and set aside federal funds to clean up slums in major American cities. To directly assist several overlooked populations, he created the Veterans Administration and expanded veterans\u2019 hospitals, established the Federal Bureau of Prisons to oversee incarceration conditions nationwide, and reorganized the Bureau of Indian Affairs to further protect Native Americans. Just prior to the stock market crash, he even proposed the creation of an old-age pension program, promising fifty dollars monthly to all Americans over the age of sixty-five\u2014a proposal remarkably similar to the social security benefit that would become a hallmark of Roosevelt\u2019s subsequent New Deal programs. As the summer of 1929 came to a close, Hoover remained a popular successor to Calvin \u201cSilent Cal\u201d Coolidge, and all signs pointed to a highly successful administration. \n\n THE GREAT CRASH \n\n The promise of the Hoover administration was cut short when the stock market lost almost one-half its value in the fall of 1929, plunging many Americans into financial ruin. However, as a singular event, the stock market crash itself did not cause the Great Depression that followed. In fact, only approximately 10 percent of American households held stock investments and speculated in the market; yet nearly a third would lose their lifelong savings and jobs in the ensuing depression. The connection between the crash and the subsequent decade of hardship was complex, involving underlying weaknesses in the economy that many policymakers had long ignored. \n\n What Was the Crash? \n\n To understand the crash, it is useful to address the decade that preceded it. The prosperous 1920s ushered in a feeling of euphoria among middle-class and wealthy Americans, and people began to speculate on wilder investments. The government was a willing partner in this endeavor: The Federal Reserve followed a brief postwar recession in 1920\u20131921 with a policy of setting interest rates artificially low, as well as easing the reserve requirements on the nation\u2019s largest banks. As a result, the money supply in the U.S. increased by nearly 60 percent, which convinced even more Americans of the safety of investing in questionable schemes. They felt that prosperity was boundless and that extreme risks were likely tickets to wealth. Named for Charles Ponzi, the original \u201cPonzi schemes\u201d emerged early in the 1920s to encourage novice investors to divert funds to unfounded ventures, which in reality simply used new investors\u2019 funds to pay off older investors as the schemes grew in size.  Speculation , where investors purchased into high-risk schemes that they hoped would pay off quickly, became the norm. Several banks, including deposit institutions that originally avoided investment loans, began to offer easy credit, allowing people to invest, even when they lacked the money to do so. An example of this mindset was the  Florida land boom  of the 1920s: Real estate developers touted Florida as a tropical paradise and investors went all in, buying land they had never seen with money they didn\u2019t have and selling it for even higher prices. \n\n Americana Selling Optimism and Risk Advertising offers a useful window into the popular perceptions and beliefs of an era. By seeing how businesses were presenting their goods to consumers, it is possible to sense the hopes and aspirations of people at that moment in history. Maybe companies are selling patriotism or pride in technological advances. Maybe they are pushing idealized views of parenthood or safety. In the 1920s, advertisers were selling opportunity and euphoria, further feeding the notions of many Americans that prosperity would never end. \n\n In the decade before the Great Depression, the optimism of the American public was seemingly boundless. Advertisements from that era show large new cars, timesaving labor devices, and, of course, land. This advertisement for California real estate illustrates how realtors in the West, much like the ongoing Florida land boom, used a combination of the hard sell and easy credit ( Figure 25.3 ). \u201cBuy now!!\u201d the ad shouts. \u201cYou are sure to make money on these.\u201d In great numbers, people did. With easy access to credit and hard-pushing advertisements like this one, many felt that they could not afford to miss out on such an opportunity. Unfortunately, overspeculation in California and hurricanes along the Gulf Coast and in Florida conspired to burst this land bubble, and would-be millionaires were left with nothing but the ads that once pulled them in. \n\n The Florida land boom went bust in 1925\u20131926. A combination of negative press about the speculative nature of the boom, IRS investigations into the questionable financial practices of several land brokers, and a railroad embargo that limited the delivery of construction supplies into the region significantly hampered investor interest. The subsequent Great Miami Hurricane of 1926 drove most land developers into outright bankruptcy. However, speculation continued throughout the decade, this time in the stock market. Buyers purchased stock \u201con margin\u201d\u2014buying for a small down payment with borrowed money, with the intention of quickly selling at a much higher price before the remaining payment came due\u2014which worked well as long as prices continued to rise. Speculators were aided by retail stock brokerage firms, which catered to average investors anxious to play the market but lacking direct ties to investment banking houses or larger brokerage firms. When prices began to fluctuate in the summer of 1929, investors sought excuses to continue their speculation. When fluctuations turned to outright and steady losses, everyone started to sell. As September began to unfold, the Dow Jones Industrial Average peaked at a value of 381 points, or roughly ten times the stock market\u2019s value, at the start of the 1920s. \n\n Several warning signs portended the impending crash but went unheeded by Americans still giddy over the potential fortunes that speculation might promise. A brief downturn in the market on September 18, 1929, raised questions among more-seasoned investment bankers, leading some to predict an end to high stock values, but did little to stem the tide of investment. Even the collapse of the London Stock Exchange on September 20 failed to fully curtail the optimism of American investors. However, when the New York Stock Exchange lost 11 percent of its value on October 24\u2014often referred to as \u201cBlack Thursday\u201d\u2014key American investors sat up and took notice. In an effort to forestall a much-feared panic, leading banks, including Chase National, National City, J.P. Morgan, and others, conspired to purchase large amounts of blue chip stocks (including U.S. Steel) in order to keep the prices artificially high. Even that effort failed in the growing wave of stock sales. Nevertheless, Hoover delivered a radio address on Friday in which he assured the American people, \u201cThe fundamental business of the country . . . is on a sound and prosperous basis.\u201d As newspapers across the country began to cover the story in earnest, investors anxiously awaited the start of the following week. When the Dow Jones Industrial Average lost another 13 percent of its value on Monday morning, many knew the end of stock market speculation was near. The evening before the infamous crash was ominous. Jonathan Leonard, a newspaper reporter who regularly covered the stock market beat, wrote of how Wall Street \u201clit up like a Christmas tree.\u201d Brokers and businessmen who feared the worst the next day crowded into restaurants and speakeasies (a place where alcoholic beverages were illegally sold). After a night of heavy drinking, they retreated to nearby hotels or flop-houses (cheap boarding houses), all of which were overbooked, and awaited sunrise. Children from nearby slums and tenement districts played stickball in the streets of the financial district, using wads of ticker tape for balls. Although they all awoke to newspapers filled with predictions of a financial turnaround, as well as technical reasons why the decline might be short-lived, the crash on Tuesday morning, October 29, caught few by surprise. \n\n No one even heard the opening bell on Wall Street that day, as shouts of \u201cSell! Sell!\u201d drowned it out. In the first three minutes alone, nearly three million shares of stock, accounting for $2 million of wealth, changed hands. The volume of Western Union telegrams tripled, and telephone lines could not meet the demand, as investors sought any means available to dump their stock immediately. Rumors spread of investors jumping from their office windows. Fistfights broke out on the trading floor, where one broker fainted from physical exhaustion. Stock trades happened at such a furious pace that runners had nowhere to store the trade slips, and so they resorted to stuffing them into trash cans. Although the stock exchange\u2019s board of governors briefly considered closing the exchange early, they subsequently chose to let the market run its course, lest the American public panic even further at the thought of closure. When the final bell rang, errand boys spent hours sweeping up tons of paper, tickertape, and sales slips. Among the more curious finds in the rubbish were torn suit coats, crumpled eyeglasses, and one broker\u2019s artificial leg. Outside a nearby brokerage house, a policeman allegedly found a discarded birdcage with a live parrot squawking, \u201cMore margin! More margin!\u201d \n\n On  Black Tuesday , October 29, stock holders traded over sixteen million shares and lost over $14 billion in wealth in a single day. To put this in context, a trading day of three million shares was considered a busy day on the stock market. People unloaded their stock as quickly as they could, never minding the loss. Banks, facing debt and seeking to protect their own assets, demanded payment for the loans they had provided to individual investors. Those individuals who could not afford to pay found their stocks sold immediately and their life savings wiped out in minutes, yet their debt to the bank still remained ( Figure 25.4 ). \n\n The financial outcome of the crash was devastating. Between September 1 and November 30, 1929, the stock market lost over one-half its value, dropping from $64 billion to approximately $30 billion. Any effort to stem the tide was, as one historian noted, tantamount to bailing Niagara Falls with a bucket. The crash affected many more than the relatively few Americans who invested in the stock market. While only 10 percent of households had investments, over 90 percent of all banks had invested in the stock market. Many banks failed due to their dwindling cash reserves. This was in part due to the Federal Reserve lowering the limits of cash reserves that banks were traditionally required to hold in their vaults, as well as the fact that many banks invested in the stock market themselves. Eventually, thousands of banks closed their doors after losing all of their assets, leaving their customers penniless. While a few savvy investors got out at the right time and eventually made fortunes buying up discarded stock, those success stories were rare. Housewives who speculated with grocery money, bookkeepers who embezzled company funds hoping to strike it rich and pay the funds back before getting caught, and bankers who used customer deposits to follow speculative trends all lost. While the stock market crash was the trigger, the lack of appropriate economic and banking safeguards, along with a public psyche that pursued wealth and prosperity at all costs, allowed this event to spiral downward into a depression. \n\n Causes of the Crash \n\n The crash of 1929 did not occur in a vacuum, nor did it cause the Great Depression. Rather, it was a tipping point where the underlying weaknesses in the economy, specifically in the nation\u2019s banking system, came to the fore. It also represented both the end of an era characterized by blind faith in American exceptionalism and the beginning of one in which citizens began increasingly to question some long-held American values. A number of factors played a role in bringing the stock market to this point and contributed to the downward trend in the market, which continued well into the 1930s. In addition to the Federal Reserve\u2019s questionable policies and misguided banking practices, three primary reasons for the collapse of the stock market were international economic woes, poor income distribution, and the psychology of public confidence. \n\n After World War I, both America\u2019s allies and the defeated nations of Germany and Austria contended with disastrous economies. The Allies owed large amounts of money to U.S. banks, which had advanced them money during the war effort. Unable to repay these debts, the Allies looked to reparations from Germany and Austria to help. The economies of those countries, however, were struggling badly, and they could not pay their reparations, despite the loans that the U.S. provided to assist with their payments. The U.S. government refused to forgive these loans, and American banks were in the position of extending additional private loans to foreign governments, who used them to repay their debts to the U.S. government, essentially shifting their obligations to private banks. When other countries began to default on this second wave of private bank loans, still more strain was placed on U.S. banks, which soon sought to liquidate these loans at the first sign of a stock market crisis. \n\n Poor income distribution among Americans compounded the problem. A strong stock market relies on today\u2019s buyers becoming tomorrow\u2019s sellers, and therefore it must always have an influx of new buyers. In the 1920s, this was not the case. Eighty percent of American families had virtually no savings, and only one-half to 1 percent of Americans controlled over a third of the wealth. This scenario meant that there were no new buyers coming into the marketplace, and nowhere for sellers to unload their stock as the speculation came to a close. In addition, the vast majority of Americans with limited savings lost their accounts as local banks closed, and likewise lost their jobs as investment in business and industry came to a screeching halt. \n\n Finally, one of the most important factors in the crash was the contagion effect of panic. For much of the 1920s, the public felt confident that prosperity would continue forever, and therefore, in a self-fulfilling cycle, the market continued to grow. But once the panic began, it spread quickly and with the same cyclical results; people were worried that the market was going down, they sold their stock, and the market continued to drop. This was partly due to Americans\u2019 inability to weather market volatility, given the limited cash surpluses they had on hand, as well as their psychological concern that economic recovery might never happen. \n\n IN THE AFTERMATH OF THE CRASH \n\n After the crash, Hoover announced that the economy was \u201cfundamentally sound.\u201d On the last day of trading in 1929, the New York Stock Exchange held its annual wild and lavish party, complete with confetti, musicians, and illegal alcohol. The U.S. Department of Labor predicted that 1930 would be \u201ca splendid employment year.\u201d These sentiments were not as baseless as it may seem in hindsight. Historically, markets cycled up and down, and periods of growth were often followed by downturns that corrected themselves. But this time, there was no market correction; rather, the abrupt shock of the crash was followed by an even more devastating depression. Investors, along with the general public, withdrew their money from banks by the thousands, fearing the banks would go under. The more people pulled out their money in  bank runs , the closer the banks came to insolvency ( Figure 25.5 ). \n\n The contagion effect of the crash grew quickly. With investors losing billions of dollars, they invested very little in new or expanded businesses. At this time, two industries had the greatest impact on the country\u2019s economic future in terms of investment, potential growth, and employment: automotive and construction. After the crash, both were hit hard. In November 1929, fewer cars were built than in any other month since November 1919. Even before the crash, widespread saturation of the market meant that few Americans bought them, leading to a slowdown. Afterward, very few could afford luxury cars, like Stutz, Deusenberg, and Pierce-Arrow, so these car companies gradually went out of business in the 1930s. In construction, the drop-off was even more dramatic. It would be another thirty years before a new hotel or theater was built in New York City. The Empire State Building itself stood half empty for years after being completed in 1931. \n\n The damage to major industries led to, and reflected, limited purchasing by both consumers and businesses. Even those Americans who continued to make a modest income during the Great Depression lost the drive for conspicuous consumption that they exhibited in the 1920s. People with less money to buy goods could not help businesses grow; in turn, businesses with no market for their products could not hire workers or purchase raw materials. Employers began to lay off workers. The country\u2019s gross national product declined by over 25 percent within a year, and wages and salaries declined by $4 billion. Unemployment tripled, from 1.5 million at the end of 1929 to 4.5 million by the end of 1930. By mid-1930, the slide into economic chaos had begun but was nowhere near complete. \n\n THE NEW REALITY FOR AMERICANS \n\n For most Americans, the crash affected daily life in myriad ways. In the immediate aftermath, there was a run on the banks, where citizens took their money out, if they could get it, and hid their savings under mattresses, in bookshelves, or anywhere else they felt was safe. Some went so far as to exchange their dollars for gold and ship it out of the country. A number of banks failed outright, and others, in their attempts to stay solvent, called in loans that people could not afford to repay. Working-class Americans saw their wages drop: Even Henry Ford, the champion of a high minimum wage, began lowering wages by as much as a dollar a day. Southern cotton planters paid workers only twenty cents for every one hundred pounds of cotton picked, meaning that the  strongest  picker might earn sixty cents for a fourteen-hour day of work. Cities struggled to collect property taxes and subsequently laid off teachers and police. The new hardships that people faced were not always immediately apparent; many communities felt the changes but could not necessarily look out their windows and see anything different. Men who lost their jobs didn\u2019t stand on street corners begging; they disappeared. They might be found keeping warm by a trashcan bonfire or picking through garbage at dawn, but mostly, they stayed out of public view. As the effects of the crash continued, however, the results became more evident. Those living in cities grew accustomed to seeing long breadlines of unemployed men waiting for a meal ( Figure 25.6 ). Companies fired workers and tore down employee housing to avoid paying property taxes. The landscape of the country had changed. \n\n The hardships of the Great Depression threw family life into disarray. Both marriage and birth rates declined in the decade after the crash. The most vulnerable members of society\u2014children, women, minorities, and the working class\u2014struggled the most. Parents often sent children out to beg for food at restaurants and stores to save themselves from the disgrace of begging. Many children dropped out of school, and even fewer went to college. Childhood, as it had existed in the prosperous twenties, was over. And yet, for many children living in rural areas where the affluence of the previous decade was not fully developed, the Depression was not viewed as a great challenge. School continued. Play was simple and enjoyed. Families adapted by growing more in gardens, canning, and preserving, wasting little food if any. Home-sewn clothing became the norm as the decade progressed, as did creative methods of shoe repair with cardboard soles. Yet, one always knew of stories of the \u201cother\u201d families who suffered more, including those living in cardboard boxes or caves. By one estimate, as many as 200,000 children moved about the country as vagrants due to familial disintegration. \n\n Women\u2019s lives, too, were profoundly affected. Some wives and mothers sought employment to make ends meet, an undertaking that was often met with strong resistance from husbands and potential employers. Many men derided and criticized women who worked, feeling that jobs should go to unemployed men. Some campaigned to keep companies from hiring married women, and an increasing number of school districts expanded the long-held practice of banning the hiring of married female teachers. Despite the pushback, women entered the workforce in increasing numbers, from ten million at the start of the Depression to nearly thirteen million by the end of the 1930s. This increase took place in spite of the twenty-six states that passed a variety of laws to prohibit the employment of married women. Several women found employment in the emerging  pink collar  occupations, viewed as traditional women\u2019s work, including jobs as telephone operators, social workers, and secretaries. Others took jobs as maids and housecleaners, working for those fortunate few who had maintained their wealth. \n\n White women\u2019s forays into domestic service came at the expense of minority women, who had even fewer employment options. Unsurprisingly, African American men and women experienced unemployment, and the grinding poverty that followed, at double and triple the rates of their White counterparts. By 1932, unemployment among African Americans reached near 50 percent. In rural areas, where large numbers of African Americans continued to live despite the Great Migration of 1910\u20131930, depression-era life represented an intensified version of the poverty that they traditionally experienced. Subsistence farming allowed many African Americans who lost either their land or jobs working for White landholders to survive, but their hardships increased. Life for African Americans in urban settings was equally trying, with Blacks and working-class Whites living in close proximity and competing for scarce jobs and resources. \n\n Life for all rural Americans was difficult. Farmers largely did not experience the widespread prosperity of the 1920s. Although continued advancements in farming techniques and agricultural machinery led to increased agricultural production, decreasing demand (particularly in the previous markets created by World War I) steadily drove down commodity prices. As a result, farmers could barely pay the debt they owed on machinery and land mortgages, and even then could do so only as a result of generous lines of credit from banks. While factory workers may have lost their jobs and savings in the crash, many farmers also lost their homes, due to the thousands of farm foreclosures sought by desperate bankers. Between 1930 and 1935, nearly 750,000 family farms disappeared through foreclosure or bankruptcy. Even for those who managed to keep their farms, there was little market for their crops. Unemployed workers had less money to spend on food, and when they did purchase goods, the market excess had driven prices so low that farmers could barely piece together a living. A now-famous example of the farmer\u2019s plight is that, when the price of coal began to exceed that of corn, farmers would simply burn corn to stay warm in the winter. \n\n As the effects of the Great Depression worsened, wealthier Americans had particular concern for \u201cthe deserving poor\u201d\u2014those who had lost all of their money due to no fault of their own. This concept gained greater attention beginning in the Progressive Era of the late nineteenth and early twentieth centuries, when early social reformers sought to improve the quality of life for all Americans by addressing the poverty that was becoming more prevalent, particularly in emerging urban areas. By the time of the Great Depression, social reformers and humanitarian agencies had determined that the \u201cdeserving poor\u201d belonged to a different category from those who had speculated and lost. However, the sheer volume of Americans who fell into this group meant that charitable assistance could not begin to reach them all. Some fifteen million \u201cdeserving poor,\u201d or a full one-third of the labor force, were struggling by 1932. The country had no mechanism or system in place to help so many; however, Hoover remained adamant that such relief should rest in the hands of private agencies, not with the federal government ( Figure 25.7 ). \n\n Unable to receive aid from the government, Americans thus turned to private charities; churches, synagogues, and other religious organizations; and state aid. But these organizations were not prepared to deal with the scope of the problem. Private aid organizations showed declining assets as well during the Depression, with fewer Americans possessing the ability to donate to such charities. Likewise, state governments were particularly ill-equipped. Governor Franklin D. Roosevelt was the first to institute a Department of Welfare in New York in 1929. City governments had equally little to offer. In New York City in 1932, family allowances were $2.39 per week, and only one-half of the families who qualified actually received them. In Detroit, allowances fell to fifteen cents a day per person, and eventually ran out completely. In most cases, relief was only in the form of food and fuel; organizations provided nothing in the way of rent, shelter, medical care, clothing, or other necessities. There was no infrastructure to support the elderly, who were the most vulnerable, and this population largely depended on their adult children to support them, adding to families\u2019 burdens ( Figure 25.8 ). \n\n During this time, local community groups, such as police and teachers, worked to help the neediest. New York City police, for example, began contributing 1 percent of their salaries to start a food fund that was geared to help those found starving on the streets. In 1932, New York City schoolteachers also joined forces to try to help; they contributed as much as $250,000 per month from their own salaries to help needy children. Chicago teachers did the same, feeding some eleven thousand students out of their own pockets in 1931, despite the fact that many of them had not been paid a salary in months. These noble efforts, however, failed to fully address the level of desperation that the American public was facing. \n 25.2   President Hoover\u2019s Response Learning Objectives By the end of this section, you will be able to: \n\n Explain Herbert Hoover\u2019s responses to the Great Depression and how they reflected his political philosophy \n\n Identify the local, city, and state efforts to combat the Great Depression \n\n Analyze the frustration and anger that a majority of Americans directed at Herbert Hoover \n\n President Hoover was unprepared for the scope of the depression crisis, and his limited response did not begin to help the millions of Americans in need. The steps he took were very much in keeping with his philosophy of limited government, a philosophy that many had shared with him until the upheavals of the Great Depression made it clear that a more direct government response was required. But Hoover was stubborn in his refusal to give \u201chandouts,\u201d as he saw direct government aid. He called for a spirit of volunteerism among America\u2019s businesses, asking them to keep workers employed, and he exhorted the American people to tighten their belts and make do in the spirit of \u201crugged individualism.\u201d While Hoover\u2019s philosophy and his appeal to the country were very much in keeping with his character, it was not enough to keep the economy from plummeting further into economic chaos. \n\n The steps Hoover did ultimately take were too little, too late. He created programs for putting people back to work and helping beleaguered local and state charities with aid. But the programs were small in scale and highly specific as to who could benefit, and they only touched a small percentage of those in need. As the situation worsened, the public grew increasingly unhappy with Hoover. He left office with one of the lowest approval ratings of any president in history. \n\n THE INITIAL REACTION \n\n In the immediate aftermath of Black Tuesday, Hoover sought to reassure Americans that all was well. Reading his words after the fact, it is easy to find fault. In 1929 he said, \u201cAny lack of confidence in the economic future or the strength of business in the United States is foolish.\u201d In 1930, he stated, \u201cThe worst is behind us.\u201d In 1931, he pledged federal aid should he ever witness starvation in the country; but as of that date, he had yet to see such need in America, despite the very real evidence that children and the elderly were starving to death. Yet Hoover was neither intentionally blind nor unsympathetic. He simply held fast to a belief system that did not change as the realities of the Great Depression set in. \n\n Hoover believed strongly in the ethos of  American individualism : that hard work brought its own rewards. His life story testified to that belief. Hoover was born into poverty, made his way through college at Stanford University, and eventually made his fortune as an engineer. This experience, as well as his extensive travels in China and throughout Europe, shaped his fundamental conviction that the very existence of American civilization depended upon the moral fiber of its citizens, as evidenced by their ability to overcome all hardships through individual effort and resolve. The idea of government handouts to Americans was repellant to him. Whereas Europeans might need assistance, such as his hunger relief work in Belgium during and after World War I, he believed the American character to be different. In a 1931 radio address, he said, \u201cThe spread of government destroys initiative and thus destroys character.\u201d Likewise, Hoover was not completely unaware of the potential harm that wild stock speculation might create if left unchecked. As secretary of commerce, Hoover often warned President Coolidge of the dangers that such speculation engendered. In the weeks before his inauguration, he offered many interviews to newspapers and magazines, urging Americans to curtail their rampant stock investments, and even encouraged the Federal Reserve to raise the discount rate to make it more costly for local banks to lend money to potential speculators. However, fearful of creating a panic, Hoover never issued a stern warning to discourage Americans from such investments. Neither Hoover, nor any other politician of that day, ever gave serious thought to outright government regulation of the stock market. This was even true in his personal choices, as Hoover often lamented poor stock advice he had once offered to a friend. When the stock nose-dived, Hoover bought the shares from his friend to assuage his guilt, vowing never again to advise anyone on matters of investment. \n\n In keeping with these principles, Hoover\u2019s response to the crash focused on two very common American traditions: He asked individuals to tighten their belts and work harder, and he asked the business community to voluntarily help sustain the economy by retaining workers and continuing production. He immediately summoned a conference of leading industrialists to meet in Washington, DC, urging them to maintain their current wages while America rode out this brief economic panic. The crash, he assured business leaders, was not part of a greater downturn; they had nothing to worry about. Similar meetings with utility companies and railroad executives elicited promises for billions of dollars in new construction projects, while labor leaders agreed to withhold demands for wage increases and workers continued to labor. Hoover also persuaded Congress to pass a $160 million tax cut to bolster American incomes, leading many to conclude that the president was doing all he could to stem the tide of the panic. In April 1930, the  New York Times  editorial board concluded that \u201cNo one in his place could have done more.\u201d However, these modest steps were not enough. By late 1931, when it became clear that the economy would not improve on its own, Hoover recognized the need for some government intervention. He created the President\u2019s Emergency Committee for Employment (PECE), later renamed the President\u2019s Organization of Unemployment Relief (POUR). In keeping with Hoover\u2019s distaste of what he viewed as handouts, this organization did  not  provide direct federal relief to people in need. Instead, it assisted state and private relief agencies, such as the Red Cross, Salvation Army, YMCA, and Community Chest. Hoover also strongly urged people of means to donate funds to help the poor, and he himself gave significant private donations to worthy causes. But these private efforts could not alleviate the widespread effects of poverty. Congress pushed for a more direct government response to the hardship. In 1930\u20131931, it attempted to pass a $60 million bill to provide relief to drought victims by allowing them access to food, fertilizer, and animal feed. Hoover stood fast in his refusal to provide food, resisting any element of direct relief. The final bill of $47 million provided for everything  except  food but did not come close to adequately addressing the crisis. Again in 1931, Congress proposed the Federal Emergency Relief Bill, which would have provided $375 million to states to help provide food, clothing, and shelter to the homeless. But Hoover opposed the bill, stating that it ruined the balance of power between states and the federal government, and in February 1932, it was defeated by fourteen votes. However, the president\u2019s adamant opposition to direct-relief federal government programs should not be viewed as one of indifference or uncaring toward the suffering American people. His personal sympathy for those in need was boundless. Hoover was one of only two presidents to reject his salary for the office he held. Throughout the Great Depression, he donated an average of $25,000 annually to various relief organizations to assist in their efforts. Furthermore, he helped to raise $500,000 in private funds to support the White House Conference on Child Health and Welfare in 1930. Rather than indifference or heartlessness, Hoover\u2019s steadfast adherence to a philosophy of individualism as the path toward long-term American recovery explained many of his policy decisions. \u201cA voluntary deed,\u201d he repeatedly commented, \u201cis infinitely more precious to our national ideal and spirit than a thousand-fold poured from the Treasury.\u201d \n\n As conditions worsened, however, Hoover eventually relaxed his opposition to federal relief and formed the Reconstruction Finance Corporation (RFC) in 1932, in part because it was an election year and Hoover hoped to keep his office. Although not a form of direct relief to the American people in greatest need, the RFC was much larger in scope than any preceding effort, setting aside $2 billion in taxpayer money to rescue banks, credit unions, and insurance companies. The goal was to boost confidence in the nation\u2019s financial institutions by ensuring that they were on solid footing. This model was flawed on a number of levels. First, the program only lent money to banks with sufficient collateral, which meant that most of the aid went to large banks. In fact, of the first $61 million loaned, $41 million went to just three banks. Small town and rural banks got almost nothing. Furthermore, at this time, confidence in financial institutions was not the primary concern of most Americans. They needed food and jobs. Many had no money to put into the banks, no matter how confident they were that the banks were safe. \n\n Hoover\u2019s other attempt at federal assistance also occurred in 1932, when he endorsed a bill by Senator Robert Wagner of New York. This was the Emergency Relief and Construction Act. This act authorized the RFC to expand beyond loans to financial institutions and allotted $1.5 billion to states to fund local public works projects. This program failed to deliver the kind of help needed, however, as Hoover severely limited the types of projects it could fund to those that were ultimately self-paying (such as toll bridges and public housing) and those that required skilled workers. While well intended, these programs maintained the status quo, and there was still no direct federal relief to the individuals who so desperately needed it. \n\n PUBLIC REACTION TO HOOVER \n\n Hoover\u2019s steadfast resistance to government aid cost him the reelection and has placed him squarely at the forefront of the most unpopular presidents, according to public opinion, in modern American history. His name became synonymous with the poverty of the era: \u201cHoovervilles\u201d became the common name for homeless shantytowns ( Figure 25.9 ) and \u201cHoover blankets\u201d for the newspapers that the homeless used to keep warm. A \u201cHoover flag\u201d was a pants pocket\u2014empty of all money\u2014turned inside out. By the 1932 election, hitchhikers held up signs reading: \u201cIf you don\u2019t give me a ride, I\u2019ll vote for Hoover.\u201d Americans did not necessarily believe that Hoover caused the Great Depression. Their anger stemmed instead from what appeared to be a willful refusal to help regular citizens with direct aid that might allow them to recover from the crisis. \n\n FRUSTRATION AND PROTEST: A BAD SITUATION GROWS WORSE FOR HOOVER \n\n Desperation and frustration often create emotional responses, and the Great Depression was no exception. Throughout 1931\u20131932, companies trying to stay afloat sharply cut worker wages, and, in response, workers protested in increasingly bitter strikes. As the Depression unfolded, over 80 percent of automotive workers lost their jobs. Even the typically prosperous Ford Motor Company laid off two-thirds of its workforce. \n\n In 1932, a major strike at the Ford Motor Company factory near Detroit resulted in over sixty injuries and four deaths. Often referred to as the  Ford Hunger March , the event unfolded as a planned demonstration among unemployed Ford workers who, to protest their desperate situation, marched nine miles from Detroit to the company\u2019s River Rouge plant in Dearborn. At the Dearborn city limits, local police launched tear gas at the roughly three thousand protestors, who responded by throwing stones and clods of dirt. When they finally reached the gates of the plant, protestors faced more police and firemen, as well as private security guards. As the firemen turned hoses onto the protestors, the police and security guards opened fire. In addition to those killed and injured, police arrested fifty protestors. One week later, sixty thousand mourners attended the public funerals of the four victims of what many protesters labeled police brutality. The event set the tone for worsening labor relations in the U.S. \n\n Farmers also organized and protested, often violently. The most notable example was the Farm Holiday Association. Led by Milo Reno, this organization held significant sway among farmers in Iowa, Nebraska, Wisconsin, Minnesota, and the Dakotas. Although they never comprised a majority of farmers in any of these states, their public actions drew press attention nationwide. Among their demands, the association sought a federal government plan to set agricultural prices artificially high enough to cover the farmers\u2019 costs, as well as a government commitment to sell any farm surpluses on the world market. To achieve their goals, the group called for  farm holidays , during which farmers would neither sell their produce nor purchase any other goods until the government met their demands. However, the greatest strength of the association came from the unexpected and seldom-planned actions of its members, which included barricading roads into markets, attacking nonmember farmers, and destroying their produce. Some members even raided small town stores, destroying produce on the shelves. Members also engaged in \u201cpenny auctions,\u201d bidding pennies on foreclosed farm land and threatening any potential buyers with bodily harm if they competed in the sale. Once they won the auction, the association returned the land to the original owner. In Iowa, farmers threatened to hang a local judge if he signed any more farm foreclosures. At least one death occurred as a direct result of these protests before they waned following the election of Franklin Roosevelt. \n\n One of the most notable protest movements occurred toward the end of Hoover\u2019s presidency and centered on the Bonus Expeditionary Force, or  Bonus Army , in the spring of 1932. In this protest, approximately fifteen thousand World War I veterans marched on Washington to demand early payment of their veteran bonuses, which were not due to be paid until 1945. The group camped out in vacant federal buildings and set up camps in Anacostia Flats near the Capitol building ( Figure 25.10 ). \n\n Many veterans remained in the city in protest for nearly two months, although the U.S. Senate officially rejected their request in July. By the middle of that month, Hoover wanted them gone. He ordered the police to empty the buildings and clear out the camps, and in the exchange that followed, police fired into the crowd, killing two veterans. Fearing an armed uprising, Hoover then ordered General Douglas MacArthur, along with his aides, Dwight Eisenhower and George Patton, to forcibly remove the veterans from Anacostia Flats. The ensuing raid proved catastrophic, as the military burned down the shantytown and injured dozens of people, including a twelve-week-old infant who was killed when accidentally struck by a tear gas canister ( Figure 25.11 ). \n\n As Americans bore witness to photographs and newsreels of the U.S. Army forcibly removing veterans, Hoover\u2019s popularity plummeted even further. By the summer of 1932, he was largely a defeated man. His pessimism and failure mirrored that of the nation\u2019s citizens. America was a country in desperate need: in need of a charismatic leader to restore public confidence as well as provide concrete solutions to pull the economy out of the Great Depression. \n 25.3   The Depths of the Great Depression Learning Objectives By the end of this section, you will be able to: \n\n Identify the challenges that everyday Americans faced as a result of the Great Depression and analyze the government\u2019s initial unwillingness to provide assistance \n\n Explain the particular challenges that African Americans faced during the crisis \n\n Identify the unique challenges that farmers in the Great Plains faced during this period \n\n From industrial strongholds to the rural Great Plains, from factory workers to farmers, the Great Depression affected millions. In cities, as industry slowed, then sometimes stopped altogether, workers lost jobs and joined breadlines, or sought out other charitable efforts. With limited government relief efforts, private charities tried to help, but they were unable to match the pace of demand. In rural areas, farmers suffered still more. In some parts of the country, prices for crops dropped so precipitously that farmers could not earn enough to pay their mortgages, losing their farms to foreclosure. In the Great Plains, one of the worst droughts in history left the land barren and unfit for growing even minimal food to live on. \n\n The country\u2019s most vulnerable populations, such as children, the elderly, and those subject to discrimination, like African Americans, were the hardest hit. Most White Americans felt entitled to what few jobs were available, leaving African Americans unable to find work, even in the jobs once considered their domain. In all, the economic misery was unprecedented in the country\u2019s history. \n\n STARVING TO DEATH \n\n By the end of 1932, the Great Depression had affected some sixty million people, most of whom wealthier Americans perceived as the \u201cdeserving poor.\u201d Yet, at the time, federal efforts to help those in need were extremely limited, and national charities had neither the capacity nor the will to elicit the large-scale response required to address the problem. The American Red Cross did exist, but Chairman John Barton Payne contended that unemployment was not an \u201cAct of God\u201d but rather an \u201cAct of Man,\u201d and therefore refused to get involved in widespread direct relief efforts. Clubs like the Elks tried to provide food, as did small groups of individually organized college students. Religious organizations remained on the front lines, offering food and shelter. In larger cities, breadlines and soup lines became a common sight. At one count in 1932, there were as many as eighty-two breadlines in New York City. \n\n Despite these efforts, however, people were destitute and ultimately starving. Families would first run through any savings, if they were lucky enough to have any. Then, the few who had insurance would cash out their policies. Cash surrender payments of individual insurance policies tripled in the first three years of the Great Depression, with insurance companies issuing total payments in excess of $1.2 billion in 1932 alone. When those funds were depleted, people would borrow from family and friends, and when they could get no more, they would simply stop paying rent or mortgage payments. When evicted, they would move in with relatives, whose own situation was likely only a step or two behind. The added burden of additional people would speed along that family\u2019s demise, and the cycle would continue. This situation spiraled downward, and did so quickly. Even as late as 1939, over 60 percent of rural households, and 82 percent of farm families, were classified as \u201cimpoverished.\u201d In larger urban areas, unemployment levels exceeded the national average, with over half a million unemployed workers in Chicago, and nearly a million in New York City. Breadlines and soup kitchens were packed, serving as many as eighty-five thousand meals daily in New York City alone. Over fifty thousand New York citizens were homeless by the end of 1932. \n\n Children, in particular, felt the brunt of poverty. Many in coastal cities would roam the docks in search of spoiled vegetables to bring home. Elsewhere, children begged at the doors of more well-off neighbors, hoping for stale bread, table scraps, or raw potato peelings. Said one childhood survivor of the Great Depression, \u201cYou get used to hunger. After the first few days it doesn\u2019t even hurt; you just get weak.\u201d In 1931 alone, there were at least twenty documented cases of starvation; in 1934, that number grew to 110. In rural areas where such documentation was lacking, the number was likely far higher. And while the middle class did not suffer from starvation, they experienced hunger as well. \n\n By the time Hoover left office in 1933, the poor survived not on relief efforts, but because they had learned to be poor. A family with little food would stay in bed to save fuel and avoid burning calories. People began eating parts of animals that had normally been considered waste. They scavenged for scrap wood to burn in the furnace, and when electricity was turned off, it was not uncommon to try and tap into a neighbor\u2019s wire. Family members swapped clothes; sisters might take turns going to church in the one dress they owned. As one girl in a mountain town told her teacher, who had said to go home and get food, \u201cI can\u2019t. It\u2019s my sister\u2019s turn to eat.\u201d \n\n BLACK AND POOR: AFRICAN AMERICANS AND THE GREAT DEPRESSION \n\n Most African Americans did not participate in the land boom and stock market speculation that preceded the crash, but that did not stop the effects of the Great Depression from hitting them particularly hard. Subject to continuing racial discrimination, Blacks nationwide fared even worse than their hard-hit White counterparts. As the prices for cotton and other agricultural products plummeted, farm owners paid workers less or simply laid them off. Landlords evicted sharecroppers, and even those who owned their land outright had to abandon it when there was no way to earn any income. \n\n In cities, African Americans fared no better. Unemployment was rampant, and many Whites felt that any available jobs belonged to Whites first. In some Northern cities, Whites would conspire to have African American workers fired to allow White workers access to their jobs. Even jobs traditionally held by Black workers, such as household servants or janitors, were now going to Whites. By 1932, approximately one-half of all Black Americans were unemployed. Racial violence also began to rise. In the South, lynching became more common again, with twenty-eight documented lynchings in 1933, compared to eight in 1932. Since communities were preoccupied with their own hardships, and organizing civil rights efforts was a long, difficult process, many resigned themselves to, or even ignored, this culture of racism and violence. Occasionally, however, an incident was notorious enough to gain national attention. \n\n One such incident was the case of the  Scottsboro Boys  ( Figure 25.12 ). In 1931, nine Black boys, who had been riding the rails, were arrested for vagrancy and disorderly conduct after an altercation with some White travelers on the train. Two young White women, who had been dressed as boys and traveling with a group of White boys, came forward and said that the Black boys had raped them. The case, which was tried in Scottsboro, Alabama, illuminated decades of racial hatred and illustrated the injustice of the court system. Despite significant evidence that the women had not been raped at all, along with one of the women subsequently recanting her testimony, the all-White jury quickly convicted the boys and sentenced all but one of them to death. The verdict broke through the veil of indifference toward the plight of African Americans, and protests erupted among newspaper editors, academics, and social reformers in the North. The Communist Party of the United States offered to handle the case and sought retrial; the NAACP later joined in this effort. In all, the case was tried three separate times. The series of trials and retrials, appeals, and overturned convictions shone a spotlight on a system that provided poor legal counsel and relied on all-White juries. In October 1932, the U.S. Supreme Court agreed with the Communist Party\u2019s defense attorneys that the defendants had been denied adequate legal representation at the original trial, and that due process as provided by the Fourteenth Amendment had been denied as a result of the exclusion of any potential Black jurors. Eventually, most of the accused received lengthy prison terms and subsequent parole, but avoided the death penalty. The Scottsboro case ultimately laid some of the early groundwork for the modern American civil rights movement. Alabama granted posthumous pardons to all defendants in 2013. \n\n ENVIRONMENTAL CATASTROPHE MEETS ECONOMIC HARDSHIP: THE DUST BOWL \n\n Despite the widely held belief that rural Americans suffered less in the Great Depression due to their ability to at least grow their own food, this was not the case. Farmers, ranchers, and their families suffered more than any group other than African Americans during the Depression. \n\n From the turn of the century through much of World War I, farmers in the Great Plains experienced prosperity due to unusually good growing conditions, high commodity prices, and generous government farming policies that led to a rush for land. As the federal government continued to purchase all excess produce for the war effort, farmers and ranchers fell into several bad practices, including mortgaging their farms and borrowing money against future production in order to expand. However, after the war, prosperity rapidly dwindled, particularly during the recession of 1921. Seeking to recoup their losses through economies of scale in which they would expand their production even further to take full advantage of their available land and machinery, farmers plowed under native grasses to plant acre after acre of wheat, with little regard for the long-term repercussions to the soil. Regardless of these misguided efforts, commodity prices continued to drop, finally plummeting in 1929, when the price of wheat dropped from two dollars to forty cents per bushel. \n\n Exacerbating the problem was a massive drought that began in 1931 and lasted for eight terrible years. Dust storms roiled through the Great Plains, creating huge, choking clouds that piled up in doorways and filtered into homes through closed windows. Even more quickly than it had boomed, the land of agricultural opportunity went bust, due to widespread overproduction and overuse of the land, as well as to the harsh weather conditions that followed, resulting in the creation of the  Dust Bowl  ( Figure 25.13 ). \n\n Livestock died, or had to be sold, as there was no money for feed. Crops intended to feed the family withered and died in the drought. Terrifying dust storms became more and more frequent, as \u201cblack blizzards\u201d of dirt blew across the landscape and created a new illness known as \u201cdust pneumonia.\u201d In 1935 alone, over 850 million tons of topsoil blew away. To put this number in perspective, geologists estimate that it takes the earth five hundred years to naturally regenerate one inch of topsoil; yet, just one significant dust storm could destroy a similar amount. In their desperation to get more from the land, farmers had stripped it of the delicate balance that kept it healthy. Unaware of the consequences, they had moved away from such traditional practices as crop rotation and allowing land to regain its strength by permitting it to lie fallow between plantings, working the land to death. \n\n For farmers, the results were catastrophic. Unlike most factory workers in the cities, in most cases, farmers lost their homes when they lost their livelihood. Most farms and ranches were originally mortgaged to small country banks that understood the dynamics of farming, but as these banks failed, they often sold rural mortgages to larger eastern banks that were less concerned with the specifics of farm life. With the effects of the drought and low commodity prices, farmers could not pay their local banks, which in turn lacked funds to pay the large urban banks. Ultimately, the large banks foreclosed on the farms, often swallowing up the small country banks in the process. It is worth noting that of the five thousand banks that closed between 1930 and 1932, over 75 percent were country banks in locations with populations under 2,500. Given this dynamic, it is easy to see why farmers in the Great Plains remained wary of big city bankers. \n\n For farmers who survived the initial crash, the situation worsened, particularly in the Great Plains where years of overproduction and rapidly declining commodity prices took their toll. Prices continued to decline, and as farmers tried to stay afloat, they produced still more crops, which drove prices even lower. Farms failed at an astounding rate, and farmers sold out at rock-bottom prices. One farm in Shelby, Nebraska was mortgaged at $4,100 and sold for $49.50. One-fourth of the entire state of Mississippi was auctioned off  in a single day  at a foreclosure auction in April 1932. Not all farmers tried to keep their land. Many, especially those who had arrived only recently, in an attempt to capitalize on the earlier prosperity, simply walked away ( Figure 25.14 ). In hard-hit Oklahoma, thousands of farmers packed up what they could and walked or drove away from the land they thought would be their future. They, along with other displaced farmers from throughout the Great Plains, became known as  Okies . Okies were an emblem of the failure of the American breadbasket to deliver on its promise, and their story was made famous in John Steinbeck\u2019s novel,  The Grapes of Wrath . \n\n My Story Caroline Henderson on the Dust Bowl \n\n Now we are facing a fourth year of failure. There can be no wheat for us in 1935 in spite of all our careful and expensive work in preparing ground, sowing and re-sowing our allocated acreage. Native grass pastures are permanently damaged, in many cases hopelessly ruined, smothered under by drifted sand. Fences are buried under banks of thistles and hard packed earth or undermined by the eroding action of the wind and lying flat on the ground. Less traveled roads are impassable, covered deep under by sand or the finer silt-like loam. Orchards, groves and hedge-rows cultivated for many years with patient care are dead or dying . . . Impossible it seems not to grieve that the work of hands should prove so perishable. \u2014Caroline Henderson, Shelton, Oklahoma, 1935 \n\n Much like other farm families whose livelihoods were destroyed by the Dust Bowl, Caroline Henderson describes a level of hardship that many Americans living in Depression-ravaged cities could never understand. Despite their hard work, millions of Americans were losing both their produce and their homes, sometimes in as little as forty-eight hours, to environmental catastrophes. Lacking any other explanation, many began to question what they had done to incur God\u2019s wrath. Note in particular Henderson\u2019s references to \u201cdead,\u201d \u201cdying,\u201d and \u201cperishable,\u201d and contrast those terms with her depiction of the \u201ccareful and expensive work\u201d undertaken by their own hands. Many simply could not understand how such a catastrophe could have occurred. \n\n CHANGING VALUES, CHANGING CULTURE \n\n In the decades before the Great Depression, and particularly in the 1920s, American culture largely reflected the values of individualism, self-reliance, and material success through competition. Novels like F. Scott Fitzgerald\u2019s  The Great Gatsby  and Sinclair Lewis\u2019s  Babbit  portrayed wealth and the self-made man in America, albeit in a critical fashion. In film, many silent movies, such as Charlie Chaplin\u2019s  The Gold Rush , depicted the rags-to-riches fable that Americans so loved. With the shift in U.S. fortunes, however, came a shift in values, and with it, a new cultural reflection. The arts revealed a new emphasis on the welfare of the whole and the importance of community in preserving family life. While box office sales briefly declined at the beginning of the Depression, they quickly rebounded. Movies offered a way for Americans to think of better times, and people were willing to pay twenty-five cents for a chance to escape, at least for a few hours. \n\n Even more than escapism, other films at the close of the decade reflected on the sense of community and family values that Americans struggled to maintain throughout the entire Depression. John Ford\u2019s screen version of Steinbeck\u2019s  The Grapes of Wrath  came out in 1940, portraying the haunting story of the Joad family\u2019s exodus from their Oklahoma farm to California in search of a better life. Their journey leads them to realize that they need to join a larger social movement\u2014communism\u2014dedicated to bettering the lives of all people. Tom Joad says, \u201cWell, maybe it's like Casy says, a fella ain\u2019t got a soul of his own, but on\u2019y a piece of a soul\u2014the one big soul that belongs to ever\u2019body.\u201d The greater lesson learned was one of the strength of community in the face of individual adversity. \n\n Another trope was that of the hard-working everyman against greedy banks and corporations. This was perhaps best portrayed in the movies of Frank Capra, whose  Mr. Smith Goes to Washington  was emblematic of his work. In this 1939 film, Jimmy Stewart plays a legislator sent to Washington to finish out the term of a deceased senator. While there, he fights corruption to ensure the construction of a boy\u2019s camp in his hometown rather than a dam project that would only serve to line the pockets of a few. He ultimately engages in a two-day filibuster, standing up to the power players to do what\u2019s right. The Depression era was a favorite of Capra\u2019s to depict in his films, including  It\u2019s a Wonderful Life , released in 1946. In this film, Jimmy Stewart runs a family-owned savings and loan, which at one point faces a bank run similar to those seen in 1929\u20131930. In the end, community support helps Stewart retain his business and home against the unscrupulous actions of a wealthy banker who sought to bring ruin to his family. Americana \u201cBrother, Can You Spare a Dime?\u201d They used to tell me I was building a dream, and so I followed the mob \n\nWhen there was earth to plow or guns to bear, I was always there, right on the job \n\nThey used to tell me I was building a dream, with peace and glory ahead \n\nWhy should I be standing in line, just waiting for bread? \n\nOnce I built a railroad, I made it run, made it race against time \n\nOnce I built a railroad, now it\u2019s done, Brother, can you spare a dime? \n\nOnce I built a tower up to the sun, brick and rivet and lime \n\nOnce I built a tower, now it\u2019s done, Brother, can you spare a dime? \n\n\u2014Jay Gorney and \u201cYip\u201d Harburg \n\n \u201cBrother, Can You Spare a Dime?\u201d first appeared in 1932, written for the Broadway musical  New Americana  by Jay Gorney, a composer who based the song\u2019s music on a Russian lullaby, and Edgar Yipsel \u201cYip\u201d Harburg, a lyricist who would go on to win an Academy Award for the song \u201cOver the Rainbow\u201d from  The Wizard of Oz  (1939). With its lyrics speaking to the plight of the common man during the Great Depression and the refrain appealing to the same sense of community later found in the films of Frank Capra, \u201cBrother, Can You Spare a Dime?\u201d quickly became the  de facto  anthem of the Great Depression. Recordings by Bing Crosby, Al Jolson, and Rudy Vallee all enjoyed tremendous popularity in the 1930s. \n\n Finally, there was a great deal of pure escapism in the popular culture of the Depression. Even the songs found in films reminded many viewers of the bygone days of prosperity and happiness, from Al Dubin and Henry Warren\u2019s hit \u201cWe\u2019re in the Money\u201d to the popular \u201cHappy Days are Here Again.\u201d The latter eventually became the theme song of Franklin Roosevelt\u2019s 1932 presidential campaign. People wanted to forget their worries and enjoy the madcap antics of the Marx Brothers, the youthful charm of Shirley Temple, the dazzling dances of Fred Astaire and Ginger Rogers ( Figure 25.15 ), or the comforting morals of the  Andy Hardy  series. The Hardy series\u2014nine films in all, produced by MGM from 1936 to 1940\u2014starred Judy Garland and Mickey Rooney, and all followed the adventures of a small-town judge and his son. No matter what the challenge, it was never so big that it could not be solved with a musical production put on by the neighborhood kids, bringing together friends and family members in a warm display of community values. \n\n All of these movies reinforced traditional American values, which suffered during these hard times, in part due to declining marriage and birth rates, and increased domestic violence. At the same time, however, they reflected an increased interest in sex and sexuality. While the birth rate was dropping, surveys in  Fortune  magazine in 1936\u20131937 found that two-thirds of college students favored birth control, and that 50 percent of men and 25 percent of women admitted to premarital sex, continuing a trend among younger Americans that had begun to emerge in the 1920s. Contraceptive sales soared during the decade, and again, culture reflected this shift. Blonde bombshell Mae West was famous for her sexual innuendoes, and her flirtatious persona was hugely popular, although it got her banned on radio broadcasts throughout the Midwest. Whether West or Garland, Chaplin or Stewart, American film continued to be a barometer of American values, and their challenges, through the decade. \n 25.4   Assessing the Hoover Years on the Eve of the New Deal Learning Objectives By the end of this section, you will be able to: \n\n Identify the successes and failures of Herbert Hoover\u2019s presidency \n\n Determine the fairness and accuracy of assessments of Hoover\u2019s presidency \n\n As so much of the Hoover presidency is circumscribed by the onset of the Great Depression, one must be careful in assessing his successes and failures, so as not to attribute all blame to Hoover. Given the suffering that many Americans endured between the fall of 1929 and Franklin Roosevelt\u2019s inauguration in the spring of 1933, it is easy to lay much of the blame at Hoover\u2019s doorstep ( Figure 25.16 ). However, the extent to which Hoover was constrained by the economic circumstances unfolding well before he assumed office offers a few mitigating factors. Put simply, Hoover did not cause the stock market crash. However, his stubborn adherence to a questionable belief in \u201cAmerican individualism,\u201d despite mounting evidence that people were starving, requires that some blame be attributed to his policies (or lack thereof) for the depth and length of the Depression. Yet, Hoover\u2019s presidency was much more than simply combating the Depression. To assess the extent of his inability to provide meaningful national leadership through the darkest months of the Depression, his other policies require consideration. \n\n HOOVER\u2019S FOREIGN POLICY \n\n Although it was a relatively quiet period for U.S. diplomacy, Hoover did help to usher in a period of positive relations, specifically with several Latin American neighbors. This would establish the basis for Franklin Roosevelt\u2019s \u201cGood Neighbor\u201d policy. After a goodwill tour of Central American countries immediately following his election in 1928, Hoover shaped the subsequent  Clark Memorandum \u2014released in 1930\u2014which largely repudiated the previous Roosevelt Corollary, establishing a basis for unlimited American military intervention throughout Latin America. To the contrary, through the memorandum, Hoover asserted that greater emphasis should be placed upon the older Monroe Doctrine, in which the U.S. pledged assistance to her Latin American neighbors should any European powers interfere in Western Hemisphere affairs. Hoover further strengthened relations to the south by withdrawing American troops from Haiti and Nicaragua. Additionally, he outlined with Secretary of State Henry Stimson the Hoover-Stimson Doctrine, which announced that the United States would never recognize claims to territories seized by force (a direct response to the recent Japanese invasion of Manchuria). Other diplomatic overtures met with less success for Hoover. Most notably, in an effort to support the American economy during the early stages of the Depression, the president signed into law the  Smoot-Hawley Tariff  in 1930. The law, which raised tariffs on thousands of imports, was intended to increase sales of American-made goods, but predictably angered foreign trade partners who in turn raised their tariffs on American imports, thus shrinking international trade and closing additional markets to desperate American manufacturers. As a result, the global depression worsened further. A similar attempt to spur the world economy, known as the  Hoover Moratorium , likewise met with great opposition and little economic benefit. Issued in 1931, the moratorium called for a halt to World War I reparations to be paid by Germany to France, as well as forgiveness of Allied war debts to the U.S. \n\n HOOVER AND CIVIL RIGHTS \n\n Holding true to his belief in individualism, Hoover saw little need for significant civil rights legislation during his presidency, including any overtures from the NAACP to endorse federal anti-lynching legislation. He felt African Americans would benefit more from education and assimilation than from federal legislation or programs; yet he failed to recognize that, at this time in history, federal legislation and programs were required to ensure equal opportunities. \n\n Hoover did give special attention to the improvement of Native American conditions, beginning with his selection of Charles Curtis as his vice-presidential running mate in the 1928 election. Curtis, of the Kaw Tribe, became the country\u2019s first Native American to hold so high an elected office. Hoover subsequently appointed Charles Rhoads as the new commissioner of the Bureau of Indian Affairs and advocated, with Rhoads\u2019 assistance, for Native American self-sufficiency and full assimilation as Americans under the Indian Citizenship Act of 1924. During Hoover\u2019s presidency, federal expenditures for Native American schools and health care doubled. \n\n A FINAL ASSESSMENT \n\n Herbert Hoover\u2019s presidency, embarked upon with much promise following his election in November 1928, produced a legacy of mixed reactions. Some Americans blamed him for all of the economic and social woes from which they suffered for the next decade; all blamed him for simply not responding to their needs. As contemporary commentator and actor Will Rogers said at the time, \u201cIf an American was lucky enough to find an apple to eat in the Depression and bit into it only to find a worm, they would blame Hoover for the worm.\u201d Likewise, subsequent public opinion polls of presidential popularity, as well as polls of professional historians, routinely rate Hoover in the bottom seven of all U.S. presidents in terms of overall success. \n\n However, Hoover the president was a product of his time. Americans sought a president in 1928 who would continue the policies of normalcy with which many associated the prosperity they enjoyed. They wanted a president who would forego government interference and allow industrial capitalism to grow unfettered. Hoover, from his days as the secretary of commerce, was the ideal candidate. In fact, he was  too  ideal when the Great Depression actually hit. Holding steadfast to his philosophy of \u201cAmerican individualism,\u201d Hoover proved largely incapable of shifting into economic crisis mode when Americans came to realize that prosperity could not last forever. Desperate to help, but unwilling to compromise on his philosophy, Hoover could not manage a comprehensive solution to the worldwide depression that few foresaw. Only when reelection was less than a year away did a reluctant Hoover initiate significant policies, but even then, they did not provide direct relief. By the start of 1932, unemployment hovered near 25 percent, and thousands of banks and factories were closing their doors. Combined with Hoover\u2019s ill-timed response to the Bonus Army crisis, his political fate was sealed. Americans would look to the next president for a solution. \u201cDemocracy is a harsh employer,\u201d Hoover concluded, as he awaited all but certain defeat in the November election of 1932 ( Figure 25.17 ). ", "questions": [{"question": {"question_id": "fs-idp44026224", "question_text": "Which of the following is a cause of the stock market crash of 1929?", "question_choices": ["too many people invested in the market", "investors made risky investments with borrowed money", "the federal government invested heavily in business stock", "World War I created optimal conditions for an eventual crash"], "cloze_format": "___ is a cause of the stock market crash of 1929.", "normal_format": "Which of the following is a cause of the stock market crash of 1929?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Buyers purchased stock \u201c on margin \u201d \u2014 buying for a small down payment with borrowed money , with the intention of quickly selling at a much higher price before the remaining payment came due \u2014 which worked well as long as prices continued to rise .", "hl_context": "The Florida land boom went bust in 1925 \u2013 1926 . A combination of negative press about the speculative nature of the boom , IRS investigations into the questionable financial practices of several land brokers , and a railroad embargo that limited the delivery of construction supplies into the region significantly hampered investor interest . The subsequent Great Miami Hurricane of 1926 drove most land developers into outright bankruptcy . However , speculation continued throughout the decade , this time in the stock market . <hl> Buyers purchased stock \u201c on margin \u201d \u2014 buying for a small down payment with borrowed money , with the intention of quickly selling at a much higher price before the remaining payment came due \u2014 which worked well as long as prices continued to rise . <hl> Speculators were aided by retail stock brokerage firms , which catered to average investors anxious to play the market but lacking direct ties to investment banking houses or larger brokerage firms . When prices began to fluctuate in the summer of 1929 , investors sought excuses to continue their speculation . When fluctuations turned to outright and steady losses , everyone started to sell . As September began to unfold , the Dow Jones Industrial Average peaked at a value of 381 points , or roughly ten times the stock market \u2019 s value , at the start of the 1920s ."}, {"question": {"question_id": "fs-idp15223728", "question_text": "Which of the following groups would not be considered \u201cthe deserving poor\u201d by social welfare groups and humanitarians in the 1930s?", "question_choices": ["vagrant children", "unemployed workers", "stock speculators", "single mothers"], "cloze_format": "___ are a group that would not be considered \u201cthe deserving poor\u201d by social welfare groups and humanitarians in the 1930s.", "normal_format": "Which of the following groups would not be considered \u201cthe deserving poor\u201d by social welfare groups and humanitarians in the 1930s?"}, "answer": {"ans_text": "stock speculators", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "As the effects of the Great Depression worsened , wealthier Americans had particular concern for \u201c the deserving poor \u201d \u2014 those who had lost all of their money due to no fault of their own .", "hl_context": "<hl> As the effects of the Great Depression worsened , wealthier Americans had particular concern for \u201c the deserving poor \u201d \u2014 those who had lost all of their money due to no fault of their own . <hl> This concept gained greater attention beginning in the Progressive Era of the late nineteenth and early twentieth centuries , when early social reformers sought to improve the quality of life for all Americans by addressing the poverty that was becoming more prevalent , particularly in emerging urban areas . By the time of the Great Depression , social reformers and humanitarian agencies had determined that the \u201c deserving poor \u201d belonged to a different category from those who had speculated and lost . However , the sheer volume of Americans who fell into this group meant that charitable assistance could not begin to reach them all . Some fifteen million \u201c deserving poor , \u201d or a full one-third of the labor force , were struggling by 1932 . The country had no mechanism or system in place to help so many ; however , Hoover remained adamant that such relief should rest in the hands of private agencies , not with the federal government ( Figure 25.7 ) ."}, {"question": {"question_id": "fs-idm56883472", "question_text": "Which of the following protests was directly related to federal policies, and thus had the greatest impact in creating a negative public perception of the Hoover presidency?", "question_choices": ["the Farm Holiday Association", "the Ford Motor Company labor strikes", "the Bonus Expeditionary Force", "the widespread appearance of \u201cHooverville\u201d shantytowns"], "cloze_format": "___ was directly related to federal policies, and thus had the greates impact in creating a negative public perception of the Hoover presidency.", "normal_format": "Which of the following protests was directly related to federal policies, and thus had the greatest impact in creating a negative public perception of the Hoover presidency?"}, "answer": {"ans_text": "the Bonus Expeditionary Force", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "One of the most notable protest movements occurred toward the end of Hoover \u2019 s presidency and centered on the Bonus Expeditionary Force , or Bonus Army , in the spring of 1932 .", "hl_context": "<hl> One of the most notable protest movements occurred toward the end of Hoover \u2019 s presidency and centered on the Bonus Expeditionary Force , or Bonus Army , in the spring of 1932 . <hl> In this protest , approximately fifteen thousand World War I veterans marched on Washington to demand early payment of their veteran bonuses , which were not due to be paid until 1945 . The group camped out in vacant federal buildings and set up camps in Anacostia Flats near the Capitol building ( Figure 25.10 ) ."}, {"question": {"question_id": "fs-idm38885392", "question_text": "Which of the following groups or bodies did not offer direct relief to needy people?", "question_choices": ["the federal government", "local police and schoolteachers", "churches and synagogues", "wealthy individuals"], "cloze_format": "___ did not offer direct relief to needy people.", "normal_format": "Which of the following groups or bodies did not offer direct relief to needy people?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "He created the President \u2019 s Emergency Committee for Employment ( PECE ) , later renamed the President \u2019 s Organization of Unemployment Relief ( POUR ) . In keeping with Hoover \u2019 s distaste of what he viewed as handouts , this organization did not provide direct federal relief to people in need .", "hl_context": "In keeping with these principles , Hoover \u2019 s response to the crash focused on two very common American traditions : He asked individuals to tighten their belts and work harder , and he asked the business community to voluntarily help sustain the economy by retaining workers and continuing production . He immediately summoned a conference of leading industrialists to meet in Washington , DC , urging them to maintain their current wages while America rode out this brief economic panic . The crash , he assured business leaders , was not part of a greater downturn ; they had nothing to worry about . Similar meetings with utility companies and railroad executives elicited promises for billions of dollars in new construction projects , while labor leaders agreed to withhold demands for wage increases and workers continued to labor . Hoover also persuaded Congress to pass a $ 160 million tax cut to bolster American incomes , leading many to conclude that the president was doing all he could to stem the tide of the panic . In April 1930 , the New York Times editorial board concluded that \u201c No one in his place could have done more . \u201d However , these modest steps were not enough . By late 1931 , when it became clear that the economy would not improve on its own , Hoover recognized the need for some government intervention . <hl> He created the President \u2019 s Emergency Committee for Employment ( PECE ) , later renamed the President \u2019 s Organization of Unemployment Relief ( POUR ) . <hl> <hl> In keeping with Hoover \u2019 s distaste of what he viewed as handouts , this organization did not provide direct federal relief to people in need . <hl> Instead , it assisted state and private relief agencies , such as the Red Cross , Salvation Army , YMCA , and Community Chest . Hoover also strongly urged people of means to donate funds to help the poor , and he himself gave significant private donations to worthy causes . But these private efforts could not alleviate the widespread effects of poverty . Congress pushed for a more direct government response to the hardship . In 1930 \u2013 1931 , it attempted to pass a $ 60 million bill to provide relief to drought victims by allowing them access to food , fertilizer , and animal feed . Hoover stood fast in his refusal to provide food , resisting any element of direct relief . The final bill of $ 47 million provided for everything except food but did not come close to adequately addressing the crisis . Again in 1931 , Congress proposed the Federal Emergency Relief Bill , which would have provided $ 375 million to states to help provide food , clothing , and shelter to the homeless . But Hoover opposed the bill , stating that it ruined the balance of power between states and the federal government , and in February 1932 , it was defeated by fourteen votes . However , the president \u2019 s adamant opposition to direct-relief federal government programs should not be viewed as one of indifference or uncaring toward the suffering American people . His personal sympathy for those in need was boundless . Hoover was one of only two presidents to reject his salary for the office he held . Throughout the Great Depression , he donated an average of $ 25,000 annually to various relief organizations to assist in their efforts . Furthermore , he helped to raise $ 500,000 in private funds to support the White House Conference on Child Health and Welfare in 1930 . Rather than indifference or heartlessness , Hoover \u2019 s steadfast adherence to a philosophy of individualism as the path toward long-term American recovery explained many of his policy decisions . \u201c A voluntary deed , \u201d he repeatedly commented , \u201c is infinitely more precious to our national ideal and spirit than a thousand-fold poured from the Treasury . \u201d"}, {"question": {"question_id": "fs-idp14613120", "question_text": "Which of the following hardships did African Americans not typically face during the Great Depression?", "question_choices": ["lower farm wages in the South", "the belief that White workers needed jobs more than their Black counterparts", "White workers taking historically \u201cBlack\u201d jobs, such as maids and janitors", "widespread race riots in large urban centers"], "cloze_format": "African Americans did not typically face ___ during the Great Depression.", "normal_format": "Which of the following hardships did African Americans not typically face during the Great Depression?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Unemployment was rampant , and many Whites felt that any available jobs belonged to Whites first . In some Northern cities , Whites would conspire to have African American workers fired to allow White workers access to their jobs . Even jobs traditionally held by Black workers , such as household servants or janitors , were now going to Whites . By 1932 , approximately one-half of all Black Americans were unemployed . Racial violence also began to rise . In the South , lynching became more common again , with twenty-eight documented lynchings in 1933 , compared to eight in 1932 . As the prices for cotton and other agricultural products plummeted , farm owners paid workers less or simply laid them off .", "hl_context": "In cities , African Americans fared no better . <hl> Unemployment was rampant , and many Whites felt that any available jobs belonged to Whites first . <hl> <hl> In some Northern cities , Whites would conspire to have African American workers fired to allow White workers access to their jobs . <hl> <hl> Even jobs traditionally held by Black workers , such as household servants or janitors , were now going to Whites . <hl> <hl> By 1932 , approximately one-half of all Black Americans were unemployed . <hl> <hl> Racial violence also began to rise . <hl> <hl> In the South , lynching became more common again , with twenty-eight documented lynchings in 1933 , compared to eight in 1932 . <hl> Since communities were preoccupied with their own hardships , and organizing civil rights efforts was a long , difficult process , many resigned themselves to , or even ignored , this culture of racism and violence . Occasionally , however , an incident was notorious enough to gain national attention . Most African Americans did not participate in the land boom and stock market speculation that preceded the crash , but that did not stop the effects of the Great Depression from hitting them particularly hard . Subject to continuing racial discrimination , Blacks nationwide fared even worse than their hard-hit White counterparts . <hl> As the prices for cotton and other agricultural products plummeted , farm owners paid workers less or simply laid them off . <hl> Landlords evicted sharecroppers , and even those who owned their land outright had to abandon it when there was no way to earn any income ."}, {"question": {"question_id": "fs-idp53718096", "question_text": "Which of the following was not a key factor in the conditions that led to the Dust Bowl?", "question_choices": ["previous overcultivation of farmland", "decreasing American demand for farm produce", "unfavorable weather conditions", "poor farming techniques regarding proper irrigation and acreage rotation"], "cloze_format": "___ was not a key factor in the conditions that led to the Dust Bowl.", "normal_format": "Which of the following was not a key factor in the conditions that led to the Dust Bowl?"}, "answer": {"ans_text": "decreasing American demand for farm produce", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Livestock died , or had to be sold , as there was no money for feed . Crops intended to feed the family withered and died in the drought . In their desperation to get more from the land , farmers had stripped it of the delicate balance that kept it healthy . Unaware of the consequences , they had moved away from such traditional practices as crop rotation and allowing land to regain its strength by permitting it to lie fallow between plantings , working the land to death . Dust storms roiled through the Great Plains , creating huge , choking clouds that piled up in doorways and filtered into homes through closed windows . Even more quickly than it had boomed , the land of agricultural opportunity went bust , due to widespread overproduction and overuse of the land , as well as to the harsh weather conditions that followed , resulting in the creation of the Dust Bowl ( Figure 25.13 ) .", "hl_context": "<hl> Livestock died , or had to be sold , as there was no money for feed . <hl> <hl> Crops intended to feed the family withered and died in the drought . <hl> Terrifying dust storms became more and more frequent , as \u201c black blizzards \u201d of dirt blew across the landscape and created a new illness known as \u201c dust pneumonia . \u201d In 1935 alone , over 850 million tons of topsoil blew away . To put this number in perspective , geologists estimate that it takes the earth five hundred years to naturally regenerate one inch of topsoil ; yet , just one significant dust storm could destroy a similar amount . <hl> In their desperation to get more from the land , farmers had stripped it of the delicate balance that kept it healthy . <hl> <hl> Unaware of the consequences , they had moved away from such traditional practices as crop rotation and allowing land to regain its strength by permitting it to lie fallow between plantings , working the land to death . <hl> Exacerbating the problem was a massive drought that began in 1931 and lasted for eight terrible years . <hl> Dust storms roiled through the Great Plains , creating huge , choking clouds that piled up in doorways and filtered into homes through closed windows . <hl> <hl> Even more quickly than it had boomed , the land of agricultural opportunity went bust , due to widespread overproduction and overuse of the land , as well as to the harsh weather conditions that followed , resulting in the creation of the Dust Bowl ( Figure 25.13 ) . <hl>"}, {"question": {"question_id": "fs-idp28530624", "question_text": "Which assessment of Herbert Hoover\u2019s presidency is most accurate?", "question_choices": ["Hoover\u2019s policies caused the stock market crash and subsequent depression.", "Although he did not cause the stock market crash, Hoover deserves criticism for his inadequate response to it.", "Hoover pledged a great deal of direct federal aid to unemployed Americans, overtaxing the federal budget and worsening the financial crisis.", "Hoover disapproved of American capitalism and therefore attempted to forestall any concrete solutions to the Depression."], "cloze_format": "____ is most accurate of Herbert Hoover's presidency.", "normal_format": "Which assessment of Herbert Hoover\u2019s presidency is most accurate?"}, "answer": {"ans_text": "Although he did not cause the stock market crash, Hoover deserves criticism for his inadequate response to it.", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Put simply , Hoover did not cause the stock market crash . However , his stubborn adherence to a questionable belief in \u201c American individualism , \u201d despite mounting evidence that people were starving , requires that some blame be attributed to his policies ( or lack thereof ) for the depth and length of the Depression .", "hl_context": "As so much of the Hoover presidency is circumscribed by the onset of the Great Depression , one must be careful in assessing his successes and failures , so as not to attribute all blame to Hoover . Given the suffering that many Americans endured between the fall of 1929 and Franklin Roosevelt \u2019 s inauguration in the spring of 1933 , it is easy to lay much of the blame at Hoover \u2019 s doorstep ( Figure 25.16 ) . However , the extent to which Hoover was constrained by the economic circumstances unfolding well before he assumed office offers a few mitigating factors . <hl> Put simply , Hoover did not cause the stock market crash . <hl> <hl> However , his stubborn adherence to a questionable belief in \u201c American individualism , \u201d despite mounting evidence that people were starving , requires that some blame be attributed to his policies ( or lack thereof ) for the depth and length of the Depression . <hl> Yet , Hoover \u2019 s presidency was much more than simply combating the Depression . To assess the extent of his inability to provide meaningful national leadership through the darkest months of the Depression , his other policies require consideration ."}, {"question": {"question_id": "fs-idp56198112", "question_text": "Which of the following phrases best characterizes Herbert Hoover\u2019s foreign policy agenda?", "question_choices": ["interventionist, in terms of unwanted interference in other nations\u2019 affairs", "militaristic, in terms of strengthening American armed forces", "isolationist, in terms of preventing America\u2019s interaction with other nations", "mutual respect, in terms of being available to support others when called upon, but not interfering unnecessarily in their affairs"], "cloze_format": "___ best characterizes Herbert Hoover's foreign policy agenda.", "normal_format": "Which of the following phrases best characterizes Herbert Hoover\u2019s foreign policy agenda?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "After a goodwill tour of Central American countries immediately following his election in 1928 , Hoover shaped the subsequent Clark Memorandum \u2014 released in 1930 \u2014 which largely repudiated the previous Roosevelt Corollary , establishing a basis for unlimited American military intervention throughout Latin America . To the contrary , through the memorandum , Hoover asserted that greater emphasis should be placed upon the older Monroe Doctrine , in which the U . S . pledged assistance to her Latin American neighbors should any European powers interfere in Western Hemisphere affairs .", "hl_context": "Although it was a relatively quiet period for U . S . diplomacy , Hoover did help to usher in a period of positive relations , specifically with several Latin American neighbors . This would establish the basis for Franklin Roosevelt \u2019 s \u201c Good Neighbor \u201d policy . <hl> After a goodwill tour of Central American countries immediately following his election in 1928 , Hoover shaped the subsequent Clark Memorandum \u2014 released in 1930 \u2014 which largely repudiated the previous Roosevelt Corollary , establishing a basis for unlimited American military intervention throughout Latin America . <hl> <hl> To the contrary , through the memorandum , Hoover asserted that greater emphasis should be placed upon the older Monroe Doctrine , in which the U . S . pledged assistance to her Latin American neighbors should any European powers interfere in Western Hemisphere affairs . <hl> Hoover further strengthened relations to the south by withdrawing American troops from Haiti and Nicaragua . Additionally , he outlined with Secretary of State Henry Stimson the Hoover-Stimson Doctrine , which announced that the United States would never recognize claims to territories seized by force ( a direct response to the recent Japanese invasion of Manchuria ) . Other diplomatic overtures met with less success for Hoover . Most notably , in an effort to support the American economy during the early stages of the Depression , the president signed into law the Smoot-Hawley Tariff in 1930 . The law , which raised tariffs on thousands of imports , was intended to increase sales of American-made goods , but predictably angered foreign trade partners who in turn raised their tariffs on American imports , thus shrinking international trade and closing additional markets to desperate American manufacturers . As a result , the global depression worsened further . A similar attempt to spur the world economy , known as the Hoover Moratorium , likewise met with great opposition and little economic benefit . Issued in 1931 , the moratorium called for a halt to World War I reparations to be paid by Germany to France , as well as forgiveness of Allied war debts to the U . S ."}], "summary": " Summary 25.1   The Stock Market Crash of 1929 \n\n The prosperous decade leading up to the stock market crash of 1929, with easy access to credit and a culture that encouraged speculation and risk-taking, put into place the conditions for the country\u2019s fall. The stock market, which had been growing for years, began to decline in the summer and early fall of 1929, precipitating a panic that led to a massive stock sell-off in late October. In one month, the market lost close to 40 percent of its value. Although only a small percentage of Americans had invested in the stock market, the crash affected everyone. Banks lost millions and, in response, foreclosed on business and personal loans, which in turn pressured customers to pay back their loans, whether or not they had the cash. As the pressure mounted on individuals, the effects of the crash continued to spread. The state of the international economy, the inequitable income distribution in the United States, and, perhaps most importantly, the contagion effect of panic all played roles in the continued downward spiral of the economy. \n\n In the immediate aftermath of the crash, the government was confident that the economy would rebound. But several factors led it to worsen instead. One significant issue was the integral role of automobiles and construction in American industry. With the crash, there was no money for either auto purchases or major construction projects; these industries therefore suffered, laying off workers, cutting wages, and reducing benefits. Affluent Americans considered the deserving poor\u2014those who lost their money due to no fault of their own\u2014to be especially in need of help. But at the outset of the Great Depression, there were few social safety nets in place to provide them with the necessary relief. While some families retained their wealth and middle-class lifestyle, many more were plunged quite suddenly into poverty and often homelessness. Children dropped out of school, mothers and wives went into domestic service, and the fabric of American society changed inexorably. \n\n 25.2   President Hoover\u2019s Response \n\n President Hoover\u2019s deeply held philosophy of American individualism, which he maintained despite extraordinary economic circumstances, made him particularly unsuited to deal with the crisis of the Great Depression. He greatly resisted government intervention, considering it a path to the downfall of American greatness. His initial response of asking Americans to find their own paths to recovery and seeking voluntary business measures to stimulate the economy could not stem the tide of the Depression. Ultimately, Hoover did create some federal relief programs, such as the Reconstruction Finance Corporation (RFC), which sought to boost public confidence in financial institutions by ensuring that they were on solid footing. When this measure did little to help impoverished individuals, he signed the Emergency Relief Act, which allowed the RFC to invest in local public works projects. But even this was too little, too late. The severe limits on the types of projects funded and type of workers used meant that most Americans saw no benefit. \n\n The American public ultimately responded with anger and protest to Hoover\u2019s apparent inability to create solutions. Protests ranged from factory strikes to farm riots, culminating in the notorious Bonus Army protest in the spring of 1932. Veterans from World War I lobbied to receive their bonuses immediately, rather than waiting until 1945. The government denied them, and in the ensuing chaos, Hoover called in the military to disrupt the protest. The violence of this act was the final blow for Hoover, whose popularity was already at an all-time low. \n\n 25.3   The Depths of the Great Depression \n\n The Great Depression affected huge segments of the American population\u2014sixty million people by one estimate. But certain groups were hit harder than the rest. African Americans faced discrimination in finding employment, as White workers sought even low-wage jobs like housecleaning. Southern Blacks moved away from their farms as crop prices failed, migrating en masse to Northern cities, which had little to offer them. Rural Americans were also badly hit. The eight-year drought that began shortly after the stock market crash exacerbated farmers\u2019 and ranchers\u2019 problems. The cultivation of greater amounts of acreage in the preceding decades meant that land was badly overworked, and the drought led to massive and terrible dust storms, creating the region\u2019s nickname, the Dust Bowl. Some farmers tried to remain and buy up more land as neighbors went broke; others simply fled their failed farms and moved away, often to the large-scale migrant farms found in California, to search for a better life that few ever found. Maltreated by Californians who wished to avoid the unwanted competition for jobs that these \u201cOkies\u201d represented, many of the Dust Bowl farmers were left wandering as a result. \n\n There was very little in the way of public assistance to help the poor. While private charities did what they could, the scale of the problem was too large for them to have any lasting effects. People learned to survive as best they could by sending their children out to beg, sharing clothing, and scrounging wood to feed the furnace. Those who could afford it turned to motion pictures for escape. Movies and books during the Great Depression reflected the shift in American cultural norms, away from rugged individualism toward a more community-based lifestyle. \n\n 25.4   Assessing the Hoover Years on the Eve of the New Deal \n\n In Hoover, Americans got the president they had wanted, at least at first. He was third in a line of free-market Republican presidents, elected to continue the policies that had served the economy so well. But when the stock market crashed in 1929, and the underlying weaknesses in the economy came to the fore, Hoover did not act with clear intentionality and speed. His record as a president will likely always bear the taint of his unwillingness to push through substantial government aid, but, despite that failing, his record is not without minor accomplishments. Hoover\u2019s international policies, particularly in regard to Latin America, served the country well. And while his attitude toward civil rights mirrored his conviction that government intervention was a negative force, he did play a key role changing living conditions for Native Americans. In all, it was his\u2014and the country\u2019s\u2014bad luck that his presidency ultimately required a very different philosophy than the one that had gotten him elected. ", "keyterm": "", "bname": "u.s._history"}, {"chapter": 7, "intro": " Chapter Outline 7.1   Common Sense: From Monarchy to an American Republic 7.2   How Much Revolutionary Change? 7.3   Debating Democracy 7.4   The Constitutional Convention and Federal Constitution Introduction \n\n After the Revolutionary War, the ideology that \u201call men are created equal\u201d failed to match up with reality, as the revolutionary generation could not solve the contradictions of freedom and slavery in the new United States. Trumbull\u2019s 1780 painting of George Washington ( Figure 7.1 ) hints at some of these contradictions. What attitude do you think Trumbull was trying to convey? Why did Trumbull include Washington\u2019s slave Billy Lee, and what does Lee represent in this painting? \n\n During the 1770s and 1780s, Americans took bold steps to define American equality. Each state held constitutional conventions and crafted state constitutions that defined how government would operate and who could participate in political life. Many elite revolutionaries recoiled in horror from the idea of majority rule\u2014the basic principle of democracy\u2014fearing that it would effectively create a \u201cmob rule\u201d that would bring about the ruin of the hard-fought struggle for independence. Statesmen everywhere believed that a republic should replace the British monarchy: a government where the important affairs would be entrusted only to representative men of learning and refinement. ", "chapter_text": " 7.1   Common Sense: From Monarchy to an American Republic Learning Objectives By the end of this section, you will be able to: \n\n Compare and contrast monarchy and republican government \n\n Describe the tenets of republicanism \n\n While monarchies dominated eighteenth-century Europe, American revolutionaries were determined to find an alternative to this method of government. Radical pamphleteer Thomas Paine, whose enormously popular essay  Common Sense  was first published in January 1776, advocated a republic: a state without a king. Six months later, Jefferson\u2019s Declaration of Independence affirmed the break with England but did not suggest what form of government should replace monarchy, the only system most English colonists had ever known. In the late eighteenth century, republics were few and far between. Genoa, Venice, and the Dutch Republic provided examples of states without monarchs, but many European Enlightenment thinkers questioned the stability of a republic. Nonetheless, after their break from Great Britain, Americans turned to republicanism for their new government. \n\n REPUBLICANISM AS A POLITICAL PHILOSOPHY \n\n Monarchy  rests on the practice of dynastic succession, in which the monarch\u2019s child or other relative inherits the throne. Contested dynastic succession produced chronic conflict and warfare in Europe. In the eighteenth century, well-established monarchs ruled most of Europe and, according to tradition, were obligated to protect and guide their subjects. However, by the mid-1770s, many American colonists believed that George III, the king of Great Britain, had failed to do so. Patriots believed the British monarchy under George III had been corrupted and the king turned into a tyrant who cared nothing for the traditional liberties afforded to members of the British Empire. The disaffection from monarchy explains why a republic appeared a better alternative to the revolutionaries. \n\n American revolutionaries looked to the past for inspiration for their break with the British monarchy and their adoption of a republican form of government. The Roman Republic provided guidance. Much like the Americans in their struggle against Britain, Romans had thrown off monarchy and created a republic in which Roman citizens would appoint or select the leaders who would represent them. \n\n While republicanism offered an alternative to monarchy, it was also an alternative to  democracy , a system of government characterized by  majority rule , where the majority of citizens have the power to make decisions binding upon the whole. To many revolutionaries, especially wealthy landowners, merchants, and planters, democracy did not offer a good replacement for monarchy. Indeed,  conservative Whigs  defined themselves in opposition to democracy, which they equated with anarchy. In the tenth in a series of essays later known as  The Federalist Papers , Virginian James Madison wrote: \u201cDemocracies have ever been spectacles of turbulence and contention; have ever been found incompatible with personal security or the rights of property; and have in general been as short in their lives as they have been violent in their deaths.\u201d Many shared this perspective and worked hard to keep democratic tendencies in check. It is easy to understand why democracy seemed threatening: majority rule can easily overpower minority rights, and the wealthy few had reason to fear that a hostile and envious majority could seize and redistribute their wealth. \n\n While many now assume the United States was founded as a democracy, history, as always, is more complicated. Conservative Whigs believed in government by a patrician class, a ruling group composed of a small number of privileged families.  Radical Whigs  favored broadening the popular participation in political life and pushed for democracy. The great debate after independence was secured centered on this question: Who should rule in the new American republic? \n\n REPUBLICANISM AS A SOCIAL PHILOSOPHY \n\n According to political theory, a republic requires its citizens to cultivate virtuous behavior; if the people are virtuous, the republic will survive. If the people become corrupt, the republic will fall. Whether republicanism succeeded or failed in the United States would depend on civic virtue and an educated citizenry. Revolutionary leaders agreed that the ownership of property provided one way to measure an individual\u2019s virtue, arguing that property holders had the greatest stake in society and therefore could be trusted to make decisions for it. By the same token, non-property holders, they believed, should have very little to do with government. In other words, unlike a democracy, in which the mass of non-property holders could exercise the political right to vote, a republic would limit political rights to property holders. In this way, republicanism exhibited a bias toward the elite, a preference that is understandable given the colonial legacy. During colonial times, wealthy planters and merchants in the American colonies had looked to the British ruling class, whose social order demanded deference from those of lower rank, as a model of behavior. Old habits died hard. \n\n Defining American Benjamin Franklin\u2019s Thirteen Virtues for Character Development In the 1780s, Benjamin Franklin carefully defined thirteen virtues to help guide his countrymen in maintaining a virtuous republic. His choice of thirteen is telling since he wrote for the citizens of the thirteen new American republics. These virtues were: \n\n 1. Temperance. Eat not to dullness; drink not to elevation. \n\n2. Silence. Speak not but what may benefit others or yourself; avoid trifling conversation. \n\n3. Order. Let all your things have their places; let each part of your business have its time. \n\n4. Resolution. Resolve to perform what you ought; perform without fail what you resolve. \n\n5. Frugality. Make no expense but to do good to others or yourself; i.e., waste nothing. \n\n6. Industry. Lose no time; be always employ\u2019d in something useful; cut off all unnecessary actions. \n\n7. Sincerity. Use no hurtful deceit; think innocently and justly, and, if you speak, speak accordingly. \n\n8. Justice. Wrong none by doing injuries, or omitting the benefits that are your duty. \n\n9. Moderation. Avoid extremes; forbear resenting injuries so much as you think they deserve. \n\n10. Cleanliness. Tolerate no uncleanliness in body, cloaths, or habitation. \n\n11. Tranquillity. Be not disturbed at trifles, or at accidents common or unavoidable. \n\n12. Chastity. Rarely use venery but for health or offspring, never to dullness, weakness, or the injury of your own or another\u2019s peace or reputation. \n\n13. Humility. Imitate Jesus and Socrates. \n\n Franklin\u2019s thirteen virtues suggest that hard work and good behavior will bring success. What factors does Franklin ignore? How would he likely address a situation in which children inherit great wealth rather than working for it? How do Franklin\u2019s values help to define the notion of republican virtue? \n\n George Washington served as a role model par excellence for the new republic, embodying the exceptional talent and public virtue prized under the political and social philosophy of republicanism. He did not seek to become the new king of America; instead he retired as commander in chief of the Continental Army and returned to his Virginia estate at Mount Vernon to resume his life among the planter elite. Washington modeled his behavior on that of the Roman aristocrat Cincinnatus, a representative of the patrician or ruling class, who had also retired from public service in the Roman Republic and returned to his estate to pursue agricultural life. \n\n The aristocratic side of republicanism\u2014and the belief that the true custodians of public virtue were those who had served in the military\u2014found expression in the Society of the Cincinnati, of which Washington was the first president general ( Figure 7.3 ). Founded in 1783, the society admitted only officers of the Continental Army and the French forces, not militia members or minutemen. Following the rule of primogeniture, the eldest sons of members inherited their fathers\u2019 memberships. The society still exists today and retains the motto  Omnia relinquit servare rempublicam  (\u201cHe relinquished everything to save the Republic\u201d). \n 7.2   How Much Revolutionary Change? Learning Objectives By the end of this section, you will be able to: \n\n Describe the status of women in the new republic \n\n Describe the status of non-Whites in the new republic \n\n Elite republican revolutionaries did not envision a completely new society; traditional ideas and categories of race and gender, order and decorum remained firmly entrenched among members of their privileged class. Many Americans rejected the elitist and aristocratic republican order, however, and advocated radical changes. Their efforts represented a groundswell of sentiment for greater equality, a part of the democratic impulse unleashed by the Revolution. \n\n THE STATUS OF WOMEN \n\n In eighteenth-century America, as in Great Britain, the legal status of married women was defined as  coverture , meaning a married woman (or  feme covert ) had no legal or economic status independent of her husband. She could not conduct business or buy and sell property. Her husband controlled any property she brought to the marriage, although he could not sell it without her agreement. Married women\u2019s status as  femes covert  did not change as a result of the Revolution, and wives remained economically dependent on their husbands. The women of the newly independent nation did not call for the right to vote, but some, especially the wives of elite republican statesmen, began to agitate for equality under the law between husbands and wives, and for the same educational opportunities as men. \n\n Some women hoped to overturn coverture. From her home in Braintree, Massachusetts, Abigail Adams ( Figure 7.4 ) wrote to her husband, Whig leader John Adams, in 1776, \u201cIn the new code of laws which I suppose it will be necessary for you to make, I desire you would remember the ladies and be more generous and favorable to them than your ancestor. Do not put such unlimited power in the husbands. Remember, all men would be tyrants if they could.\u201d Abigail Adams ran the family homestead during the Revolution, but she did not have the ability to conduct business without her husband\u2019s consent. Elsewhere in the famous 1776 letter quoted above, she speaks of the difficulties of running the homestead when her husband is away. Her frustration grew when her husband responded in an April 1776 letter: \u201cAs to your extraordinary Code of Laws, I cannot but laugh. We have been told that our Struggle has loosened the bands of Government every where. That Children and Apprentices were disobedient\u2014that schools and Colledges were grown turbulent\u2014that Indians slighted their Guardians and Negroes grew insolent to their Masters. But your Letter was the first Intimation that another Tribe more numerous and powerfull than all the rest were grown discontented. . . . Depend on it, We know better than to repeal our Masculine systems.\u201d \n\n Another privileged member of the revolutionary generation, Mercy Otis Warren, also challenged gender assumptions and traditions during the revolutionary era ( Figure 7.5 ). Born in Massachusetts, Warren actively opposed British reform measures before the outbreak of fighting in 1775 by publishing anti-British works. In 1812, she published a three-volume history of the Revolution, a project she had started in the late 1770s. By publishing her work, Warren stepped out of the female sphere and into the otherwise male-dominated sphere of public life. \n\n Inspired by the Revolution, Judith Sargent Murray of Massachusetts advocated women\u2019s economic independence and equal educational opportunities for men and women ( Figure 7.5 ). Murray, who came from a well-to-do family in Gloucester, questioned why boys were given access to education as a birthright while girls had very limited educational opportunities. She began to publish her ideas about educational equality beginning in the 1780s, arguing that God had made the minds of women and men equal. \n\n Murray\u2019s more radical ideas championed woman\u2019s economic independence. She argued that a woman\u2019s education should be extensive enough to allow her to maintain herself\u2014and her family\u2014if there was no male breadwinner. Indeed, Murray was able to make money of her own from her publications. Her ideas were both radical and traditional, however: Murray also believed that women were much better at raising children and maintaining the morality and virtue of the family than men. \n\n Adams, Murray, and Warren all came from privileged backgrounds. All three were fully literate, while many women in the American republic were not. Their literacy and station allowed them to push for new roles for women in the atmosphere of unique possibility created by the Revolution and its promise of change. Female authors who published their work provide evidence of how women in the era of the American Revolution challenged traditional gender roles. \n\n Overall, the Revolution reconfigured women\u2019s roles by undermining the traditional expectations of wives and mothers, including subservience. In the home, the separate domestic sphere assigned to women, women were expected to practice republican virtues, especially frugality and simplicity. Republican motherhood meant that women, more than men, were responsible for raising good children, instilling in them all the virtue necessary to ensure the survival of the republic. The Revolution also opened new doors to educational opportunities for women. Men understood that the republic needed women to play a substantial role in upholding republicanism and ensuring the survival of the new nation. Benjamin Rush, a Whig educator and physician from Philadelphia, strongly advocated for the education of girls and young women as part of the larger effort to ensure that republican virtue and republican motherhood would endure. \n\n THE MEANING OF RACE \n\n By the time of the Revolution, slavery had been firmly in place in America for over one hundred years. In many ways, the Revolution served to reinforce the assumptions about race among White Americans. They viewed the new nation as a White republic; Black people were enslaved, and Native Americans had no place. Racial hatred of Black people increased during the Revolution because many enslaved people fled their enslavers for the freedom offered by the British. The same was true for Native Americans who allied themselves with the British; Jefferson wrote in the Declaration of Independence that separation from the Empire was necessary because George III had incited \u201cthe merciless Indian savages\u201d to destroy the White inhabitants on the frontier. Similarly, Thomas Paine argued in  Common Sense  that Great Britain was guilty of inciting \u201cthe Indians and Negroes to destroy us.\u201d For his part, Benjamin Franklin wrote in the 1780s that, in time, alcoholism would wipe out the Natives, leaving the land free for White settlers. \n\n My Story Phillis Wheatley: \u201cOn Being Brought from Africa to America\u201d Phillis Wheatley ( Figure 7.6 ) was born in Africa in 1753 and sold to the Wheatley family of Boston; her African name is lost to posterity. Although most enslaved people in the eighteenth century had no opportunities to learn to read and write, Wheatley achieved full literacy and went on to become one of the best-known poets of the time, although many doubted her authorship of her poems because of her race. \n\n Wheatley\u2019s poems reflected her deep Christian beliefs. In the poem below, how do her views on Christianity affect her views on slavery? \n\n Twas mercy brought me from my Pagan land, \n\nTaught my benighted soul to understand \n\nThat there\u2019s a God, that there\u2019s a Saviour too: \n\nOnce I redemption neither sought nor knew. \n\nSome view our sable race with scornful eye, \n\n\u201cTheir colour is a diabolic dye.\u201d \n\nRemember, Christians, Negroes, black as Cain, \n\nMay be refin\u2019d, and join th\u2019 angelic train. \n\n\u2014Phillis Wheatley, \u201cOn Being Brought from Africa to America\u201d \n\n Slavery \n\n Slavery offered the most glaring contradiction between the idea of equality stated in the Declaration of Independence (\u201call men are created equal\u201d) and the reality of race relations in the late eighteenth century. \n\n Racism shaped White views of Black people. Although he penned the Declaration of Independence, Thomas Jefferson enslaved more than one hundred people, of whom he freed only a few either during his lifetime or in his will ( Figure 7.7 ). He thought Black people were inferior to White, dismissing Phillis Wheatley by arguing, \u201cReligion indeed has produced a Phillis Wheatley; but it could not produce a poet.\u201d Some White slaveholders raped the people they enslaved, or forced them into long-term sexual relationships, as most historians agree that Jefferson did with Sally Hemings. Together, they had several children. \n\n Jefferson understood the contradiction fully, and his writings reveal hard-edged racist assumptions. In his  Notes on the State of Virginia  in the 1780s, Jefferson urged the end of slavery in Virginia and the removal of Black people from that state. He wrote: \u201cIt will probably be asked, Why not retain and incorporate the Blacks into the state, and thus save the expense of supplying, by importation of White settlers, the vacancies they will leave? Deep rooted prejudices entertained by the Whites; ten thousand recollections, by the Blacks, of the injuries they have sustained; new provocations; the real distinctions which nature has made; and many other circumstances, will divide us into parties, and produce convulsions which will probably never end but in the extermination of the one or the other race. \u2014To these objections, which are political, may be added others, which are physical and moral.\u201d Jefferson envisioned an \u201cempire of liberty\u201d for White farmers and relied on the argument of sending Black people out of the United States, even if doing so would completely destroy the slaveholders\u2019 wealth in their human property. \n\n Many Southerners strongly objected to Jefferson\u2019s views on abolishing slavery and removing Black people from America. When Jefferson was a candidate for president in 1796, an anonymous \u201cSouthern Planter\u201d wrote, \u201cIf this wild project succeeds, under the auspices of Thomas Jefferson, President of the United States, and three hundred thousand slaves are set free in Virginia, farewell to the safety, prosperity, the importance, perhaps the very existence of the Southern States\u201d ( Figure 7.8 ). Slaveholders and many other Americans protected and defended the institution. \n\n Freedom \n\n While racial thinking permeated the new country, and slavery existed in all the new states, the ideals of the Revolution generated a movement toward the abolition of slavery. Private  manumissions , by which slaveholders freed the enslaved, provided one pathway from bondage. Slaveholders in Virginia freed some ten thousand people. In Massachusetts, the Wheatley family manumitted Phillis in 1773 when she was twenty-one. Other revolutionaries formed societies dedicated to abolishing slavery. One of the earliest efforts began in 1775 in Philadelphia, where Dr. Benjamin Rush and other Philadelphia Quakers formed what became the Pennsylvania Abolition Society. Similarly, wealthy New Yorkers formed the New York Manumission Society in 1785. This society worked to educate Black children and devoted funds to protect free Black people from kidnapping. \n\n Slavery persisted in the North, however, and the example of Massachusetts highlights the complexity of the situation. The 1780 Massachusetts constitution technically freed all enslaved people. Nonetheless, several hundred individuals remained enslaved in the state. In the 1780s, a series of court decisions undermined slavery in Massachusetts when several people, citing assault by their enslavers, successfully sought their freedom in court. These individuals refused to be treated as having slave status in the wake of the American Revolution. Despite these legal victories, about eleven hundred people continued to be held in the New England states in 1800. The contradictions illustrate the difference between the letter and the spirit of the laws abolishing slavery in Massachusetts. In all, over thirty-six thousand people remained enslaved in the North, with the highest concentrations in New Jersey and New York. New York only gradually phased out slavery, with the last individuals emancipated in the late 1820s. \n\n Native Americans \n\n The 1783 Treaty of Paris, which ended the war for independence, did not address Native peoples at all. All lands held by the British east of the Mississippi and south of the Great Lakes (except Spanish Florida) now belonged to the new American republic ( Figure 7.9 ). Though the treaty remained silent on the issue, much of the territory now included in the boundaries of the United States remained under the control of Native peoples. Earlier in the eighteenth century, a \u201cmiddle ground\u201d had existed between powerful Native groups in the West and British and French imperial zones, a place where the various groups interacted and accommodated each other. As had happened in the French and Indian War and Pontiac\u2019s Rebellion, the Revolutionary War turned the middle ground into a battle zone that no one group controlled. \n\n During the Revolution, a complex situation existed among Native groups. Many villages remained neutral. Some native groups, such as the Delaware, split into factions, with some supporting the British while other Delaware maintained their neutrality. The Iroquois Confederacy, a longstanding alliance of tribes, also split up: the Mohawk, Cayuga, Onondaga, and Seneca fought on the British side, while the Oneida and Tuscarora supported the revolutionaries. Ohio River Valley tribes such as the Shawnee, Miami, and Mungo had been fighting for years against colonial expansion west; these groups supported the British. Some native peoples who had previously allied with the French hoped the conflict between the colonies and Great Britain might lead to French intervention and the return of French rule. Few Native Americans sided with the American revolutionaries, because almost all revolutionaries in the middle ground viewed them as an enemy to be destroyed. This racial hatred toward Native peoples found expression in the American massacre of ninety-six Christian Delawares in 1782. Most of the dead were women and children. \n\n After the war, the victorious Americans turned a deaf ear to Native American claims to what the revolutionaries saw as their hard-won land, and they moved aggressively to assert control over western New York and Pennsylvania. In response, Mohawk leader Joseph Brant helped to form the Western Confederacy, an alliance of native peoples who pledged to resist American intrusion into what was then called the Northwest. The Northwest Indian War (1785\u20131795) ended with the defeat of the Natives and their claims. Under the Treaty of Greenville (1795), the United States gained dominion over land in Ohio. \n\n RELIGION AND THE STATE \n\n Prior to the Revolution, several colonies had official, tax-supported churches. After the Revolution, some questioned the validity of state-authorized churches; the limitation of public office-holding to those of a particular faith; and the payment of taxes to support churches. In other states, especially in New England where the older Puritan heritage cast a long shadow, religion and state remained intertwined. \n\n During the colonial era in Virginia, the established church had been the Church of England, which did not tolerate Catholics, Baptists, or followers or other religions. In 1786, as a revolutionary response against the privileged status of the Church of England, Virginia\u2019s lawmakers approved the Virginia Statute for Religious Freedom, which ended the Church of England\u2019s hold and allowed religious liberty. Under the statute, no one could be forced to attend or support a specific church or be prosecuted for his or her beliefs. \n\n Pennsylvania\u2019s original constitution limited officeholders in the state legislature to those who professed a belief in both the Old and the New Testaments. This religious test prohibited Jews from holding that office, as the New Testament is not part of Jewish belief. In 1790, however, Pennsylvania removed this qualification from its constitution. \n\n The New England states were slower to embrace freedom of religion. In the former Puritan colonies, the Congregational Church (established by seventeenth-century Puritans) remained the church of most inhabitants. Massachusetts, Connecticut, and New Hampshire all required the public support of Christian churches. Article III of the Massachusetts constitution blended the goal of republicanism with the goal of promoting Protestant Christianity. It reads:  \n\n As the happiness of a people, and the good order and preservation of civil government, essentially depend upon piety, religion and morality; and as these cannot be generally diffused through a community, but by the institution of the public worship of GOD, and of public instructions in piety, religion and morality: Therefore, to promote their happiness and to secure the good order and preservation of their government, the people of this Commonwealth have a right to invest their legislature with power to authorize and require, and the legislature shall, from time to time, authorize and require, the several towns, parishes, precincts, and other bodies-politic, or religious societies, to make suitable provision, at their own expense, for the institution of the public worship of GOD, and for the support and maintenance of public protestant teachers of piety, religion and morality, in all cases where such provision shall not be made voluntarily. . . . \n\nAnd every denomination of Christians, demeaning themselves peaceably, and as good subjects of the Commonwealth, shall be equally under the protection of the law: And no subordination of any one sect or denomination to another shall ever be established by law. \n 7.3   Debating Democracy Learning Objectives By the end of this section, you will be able to: \n\n Explain the development of state constitutions \n\n Describe the features of the Articles of Confederation \n\n Analyze the causes and consequences of Shays\u2019 Rebellion \n\n The task of creating republican governments in each of the former colonies, now independent states, presented a new opportunity for American revolutionaries to define themselves anew after casting off British control. On the state and national levels, citizens of the new United States debated who would hold the keys to political power. The states proved to be a laboratory for how much democracy, or majority rule, would be tolerated. \n\n THE STATE CONSTITUTIONS \n\n In 1776, John Adams urged the thirteen independent colonies\u2014soon to be states\u2014to write their own state constitutions. Enlightenment political thought profoundly influenced Adams and other revolutionary leaders seeking to create viable republican governments. The ideas of the French philosopher  Montesquieu , who had advocated the separation of powers in government, guided Adams\u2019s thinking. Responding to a request for advice on proper government from North Carolina, Adams wrote  Thoughts on Government , which influenced many state legislatures. Adams did not advocate democracy; rather, he wrote, \u201cthere is no good government but what is republican.\u201d Fearing the potential for tyranny with only one group in power, he suggested a system of  checks and balances  in which three separate branches of government\u2014executive, legislative, and judicial\u2014would maintain a balance of power. He also proposed that each state remain sovereign, as its own republic. The state constitutions of the new United States illustrate different approaches to addressing the question of how much democracy would prevail in the thirteen republics. Some states embraced democratic practices, while others adopted far more aristocratic and republican ones. \n\n The 1776 Pennsylvania constitution and the 1784 New Hampshire constitution both provide examples of democratic tendencies. In Pennsylvania, the requirement to own property in order to vote was eliminated, and if a man was twenty-one or older, had paid taxes, and had lived in the same location for one year, he could vote ( Figure 7.10 ). This opened voting to most free White male citizens of Pennsylvania. The 1784 New Hampshire constitution allowed every small town and village to send representatives to the state government, making the lower house of the legislature a model of democratic government. \n\n Conservative Whigs, who distrusted the idea of majority rule, recoiled from the abolition of property qualifications for voting and office holding in Pennsylvania. Conservative Whig John Adams reacted with horror to the 1776 Pennsylvania constitution, declaring that it was \u201cso democratical that it must produce confusion and every evil work.\u201d In his mind and those of other conservative Whigs, this constitution simply put too much power in the hands of men who had no business exercising the right to vote. Pennsylvania\u2019s constitution also eliminated the executive branch (there was no governor) and the upper house. Instead, Pennsylvania had a one-house\u2014a  unicameral \u2014legislature. \n\n The Maryland and South Carolina constitutions provide examples of efforts to limit the power of a democratic majority. Maryland\u2019s, written in 1776, restricted office holding to the wealthy planter class. A man had to own at least \u00a35,000 worth of personal property to be the governor of Maryland, and possess an estate worth \u00a31,000 to be a state senator. This latter qualification excluded over 90 percent of the White males in Maryland from political office. The 1778 South Carolina constitution also sought to protect the interests of the wealthy. Governors and lieutenant governors of the state had to have \u201ca settled plantation or freehold in their and each of their own right of the value of at least ten thousand pounds currency, clear of debt.\u201d This provision limited high office in the state to its wealthiest inhabitants. Similarly, South Carolina state senators had to own estates valued at \u00a32,000. \n\n John Adams wrote much of the 1780 Massachusetts constitution, which reflected his fear of too much democracy. It therefore created two legislative chambers, an upper and lower house, and a strong governor with broad veto powers. Like South Carolina, Massachusetts put in place office-holding requirements: To be governor under the new constitution, a candidate had to own an estate worth at least \u00a31,000. To serve in the state senate, a man had to own an estate worth at least \u00a3300 and have at least \u00a3600 in total wealth. To vote, he had to be worth at least sixty pounds. To further keep democracy in check, judges were appointed, not elected. One final limit was the establishment of the state capitol in the commercial center of Boston, which made it difficult for farmers from the western part of the state to attend legislative sessions. \n\n THE ARTICLES OF CONFEDERATION \n\n Most revolutionaries pledged their greatest loyalty to their individual states. Recalling the experience of British reform efforts imposed in the 1760s and 1770s, they feared a strong national government and took some time to adopt the  Articles of Confederation , the first national constitution. In June 1776, the Continental Congress prepared to announce independence and began to think about the creation of a new government to replace royal authority. Reaching agreement on the Articles of Confederation proved difficult as members of the Continental Congress argued over western land claims. Connecticut, for example, used its colonial charter to assert its claim to western lands in Pennsylvania and the Ohio Territory ( Figure 7.11 ). \n\n Members of the Continental Congress also debated what type of representation would be best and tried to figure out how to pay the expenses of the new government. In lieu of creating a new federal government, the Articles of Confederation created a \u201cleague of friendship\u201d between the states. Congress readied the Articles in 1777 but did not officially approve them until 1781 ( Figure 7.12 ). The delay of four years illustrates the difficulty of getting the thirteen states to agree on a plan of national government. Citizens viewed their respective states as sovereign republics and guarded their prerogatives against other states. \n\n The Articles of Confederation authorized a unicameral legislature, a continuation of the earlier Continental Congress. The people could not vote directly for members of the national Congress; rather, state legislatures decided who would represent the state. In practice, the national Congress was composed of state delegations. There was no president or executive office of any kind, and there was no national judiciary (or Supreme Court) for the United States. \n\n Passage of any law under the Articles of Confederation proved difficult. It took the consensus of nine states for any measure to pass, and amending the Articles required the consent of all the states, also extremely difficult to achieve. Further, any acts put forward by the Congress were non-binding; states had the option to enforce them or not. This meant that while the Congress had power over Native American affairs and foreign policy, individual states could choose whether or not to comply. \n\n The Congress did not have the power to tax citizens of the United States, a fact that would soon have serious consequences for the republic. During the Revolutionary War, the Continental Congress had sent requisitions for funds to the individual former colonies (now revolutionary states). These states already had an enormous financial burden because they had to pay for militias as well as supply them. In the end, the states failed to provide even half the funding requested by the Congress during the war, which led to a national debt in the tens of millions by 1784. \n\n By the 1780s, some members of the Congress were greatly concerned about the financial health of the republic, and they argued that the national government needed greater power, especially the power to tax. This required amending the Articles of Confederation with the consent of all the states. Those who called for a stronger federal government were known as nationalists. The nationalist group that pushed for the power to tax included Washington\u2019s chief of staff, Alexander Hamilton; Virginia planter James Madison; Pennsylvania\u2019s wealthy merchant Robert Morris (who served under the Confederation government as superintendent of finance in the early 1780s); and Pennsylvania lawyer James Wilson. Two New Yorkers, Gouverneur Morris and James Duane, also joined the effort to address the debt and the weakness of the Confederation government. \n\n These men proposed a 5 percent tax on imports coming into the United States, a measure that would have yielded enough revenue to clear the debt. However, their proposal failed to achieve unanimous support from the states when Rhode Island rejected it. Plans for a national bank also failed to win unanimous support. The lack of support illustrates the Americans\u2019 deep suspicion of a powerful national government, a suspicion that originated from the unilateral and heavy-handed reform efforts that the British Parliament imposed on the colonies in the 1760s and 1770s. Without revenue, the Congress could not pay back American creditors who had lent it money. However, it did manage to make interest payments to foreign creditors in France and the Dutch Republic, fearful that defaulting on those payments would destroy the republic\u2019s credit and leave it unable to secure loans. \n\n One soldier in the Continental Army, Joseph Plumb Martin, recounted how he received no pay in paper money after 1777 and only one month\u2019s payment in specie, or hard currency, in 1781. Like thousands of other soldiers, Martin had fought valiantly against the British and helped secure independence, but had not been paid for his service. In the 1780s and beyond, men like Martin would soon express their profound dissatisfaction with their treatment. Their anger found expression in armed uprisings and political divisions. \n\n Establishing workable foreign and commercial policies under the Articles of Confederation also proved difficult. Each state could decide for itself whether to comply with treaties between the Congress and foreign countries, and there were no means of enforcement. Both Great Britain and Spain understood the weakness of the Confederation Congress, and they refused to make commercial agreements with the United States because they doubted they would be enforced. Without stable commercial policies, American exporters found it difficult to do business, and British goods flooded U.S. markets in the 1780s, in a repetition of the economic imbalance that existed before the Revolutionary War. \n\n The Confederation Congress under the Articles did achieve success through a series of directives called land ordinances, which established rules for the settlement of western lands in the public domain and the admission of new states to the republic. The ordinances were designed to prepare the land for sale to citizens and raise revenue to boost the failing economy of the republic. In the land ordinances, the Confederation Congress created the Mississippi and Southwest Territories and stipulated that slavery would be permitted there. The system of dividing the vast domains of the United States stands as a towering achievement of the era, a blueprint for American western expansion. \n\n The Ordinance of 1784, written by Thomas Jefferson and the first of what were later called the Northwest Ordinances, directed that new states would be formed from a huge area of land below the Great Lakes, and these new states would have equal standing with the original states. The Ordinance of 1785 called for the division of this land into rectangular plots in order to prepare for the government sale of land. Surveyors would divide the land into townships of six square miles, and the townships would be subdivided into thirty-six plots of 640 acres each, which could be further subdivided. The price of an acre of land was set at a minimum of one dollar, and the land was to be sold at public auction under the direction of the Confederation. \n\n The Ordinance of 1787 officially turned the land into an incorporated territory called the Northwest Territory and prohibited slavery north of the Ohio River ( Figure 7.13 ). The map of the 1787 Northwest Territory shows how the public domain was to be divided by the national government for sale. Townships of thirty-six square miles were to be surveyed. Each had land set aside for schools and other civic purposes. Smaller parcels could then be made: a 640-acre section could be divided into quarter-sections of 160 acres, and then again into sixteen sections of 40 acres. The geometric grid pattern established by the ordinance is still evident today on the American landscape. Indeed, much of the western United States, when viewed from an airplane, is composed of an orderly grid system. \n\n The land ordinances proved to be the great triumph of the Confederation Congress. The Congress would appoint a governor for the territories, and when the population in the territory reached five thousand free adult settlers, those citizens could create their own legislature and begin the process of moving toward statehood. When the population reached sixty thousand, the territory could become a new state. \n\n SHAYS\u2019 REBELLION \n\n Despite Congress\u2019s victory in creating an orderly process for organizing new states and territories, land sales failed to produce the revenue necessary to deal with the dire economic problems facing the new country in the 1780s. Each state had issued large amounts of paper money and, in the aftermath of the Revolution, widespread internal devaluation of that currency occurred as many lost confidence in the value of state paper money and the Continental dollar. A period of extreme inflation set in. Added to this dilemma was American citizens\u2019 lack of specie (gold and silver currency) to conduct routine business. Meanwhile, demobilized soldiers, many of whom had spent their formative years fighting rather than learning a peacetime trade, searched desperately for work. \n\n The economic crisis came to a head in 1786 and 1787 in western Massachusetts, where farmers were in a difficult position: they faced high taxes and debts, which they found nearly impossible to pay with the worthless state and Continental paper money. For several years after the peace in 1783, these indebted citizens had petitioned the state legislature for redress. Many were veterans of the Revolutionary War who had returned to their farms and families after the fighting ended and now faced losing their homes. \n\n Their petitions to the state legislature raised economic and political issues for citizens of the new state. How could people pay their debts and state taxes when paper money proved unstable? Why was the state government located in Boston, the center of the merchant elite? Why did the 1780 Massachusetts constitution cater to the interests of the wealthy? To the indebted farmers, the situation in the 1780s seemed hauntingly familiar; the revolutionaries had routed the British, but a new form of seemingly corrupt and self-serving government had replaced them. \n\n In 1786, when the state legislature again refused to address the petitioners\u2019 requests, Massachusetts citizens took up arms and closed courthouses across the state to prevent foreclosure (seizure of land in lieu of overdue loan payments) on farms in debt. The farmers wanted their debts forgiven, and they demanded that the 1780 constitution be revised to address citizens beyond the wealthy elite who could serve in the legislature. \n\n Many of the rebels were veterans of the war for independence, including Captain Daniel Shays from Pelham ( Figure 7.14 ). Although Shays was only one of many former officers in the Continental Army who took part in the revolt, authorities in Boston singled him out as a ringleader, and the uprising became known as Shays\u2019 Rebellion. The Massachusetts legislature responded to the closing of the courthouses with a flurry of legislation, much of it designed to punish the rebels. The government offered the rebels clemency if they took an oath of allegiance. Otherwise, local officials were empowered to use deadly force against them without fear of prosecution. Rebels would lose their property, and if any militiamen refused to defend the state, they would be executed. \n\n Despite these measures, the rebellion continued. To address the uprising, Governor James Bowdoin raised a private army of forty-four hundred men, funded by wealthy Boston merchants, without the approval of the legislature. The climax of Shays\u2019 Rebellion came in January 1787, when the rebels attempted to seize the federal armory in Springfield, Massachusetts. A force loyal to the state defeated them there, although the rebellion continued into February. \n\n Shays\u2019 Rebellion resulted in eighteen deaths overall, but the uprising had lasting effects. To men of property, mostly conservative Whigs, Shays\u2019 Rebellion strongly suggested the republic was falling into anarchy and chaos. The other twelve states had faced similar economic and political difficulties, and continuing problems seemed to indicate that on a national level, a democratic impulse was driving the population. Shays\u2019 Rebellion convinced George Washington to come out of retirement and lead the convention called for by Alexander Hamilton to amend the Articles of Confederation in order to deal with insurgencies like the one in Massachusetts and provide greater stability in the United States. \n 7.4   The Constitutional Convention and Federal Constitution Learning Objectives By the end of this section, you will be able to: \n\n Identify the central issues of the 1787 Constitutional Convention and their solutions \n\n Describe the conflicts over the ratification of the federal constitution \n\n The economic problems that plagued the thirteen states of the Confederation set the stage for the creation of a strong central government under a federal constitution. Although the original purpose of the convention was to amend the Articles of Confederation, some\u2014though not all\u2014delegates moved quickly to create a new framework for a more powerful national government. This proved extremely controversial. Those who attended the convention split over the issue of robust, centralized government and questions of how Americans would be represented in the federal government. Those who opposed the proposal for a stronger federal government argued that such a plan betrayed the Revolution by limiting the voice of the American people. \n\n THE CONSTITUTIONAL CONVENTION \n\n There had been earlier efforts to address the Confederation\u2019s perilous state. In early 1786, Virginia\u2019s James Madison advocated a meeting of states to address the widespread economic problems that plagued the new nation. Heeding Madison\u2019s call, the legislature in Virginia invited all thirteen states to meet in Annapolis, Maryland, to work on solutions to the issue of commerce between the states. Eight states responded to the invitation. But the resulting 1786 Annapolis Convention failed to provide any solutions because only five states sent delegates. These delegates did, however, agree to a plan put forward by Alexander Hamilton for a second convention to meet in May 1787 in Philadelphia. Shays\u2019 Rebellion gave greater urgency to the planned convention. In February 1787, in the wake of the uprising in western Massachusetts, the Confederation Congress authorized the Philadelphia convention. This time, all the states except Rhode Island sent delegates to Philadelphia to confront the problems of the day. \n\n The stated purpose of the Philadelphia Convention in 1787 was to amend the Articles of Confederation. Very quickly, however, the attendees decided to create a new framework for a national government. That framework became the United States Constitution, and the Philadelphia convention became known as the Constitutional Convention of 1787. Fifty-five men met in Philadelphia in secret; historians know of the proceedings only because James Madison kept careful notes of what transpired. The delegates knew that what they were doing would be controversial; Rhode Island refused to send delegates, and New Hampshire\u2019s delegates arrived late. Two delegates from New York, Robert Yates and John Lansing, left the convention when it became clear that the Articles were being put aside and a new plan of national government was being drafted. They did not believe the delegates had the authority to create a strong national government. \n\n THE QUESTION OF REPRESENTATION \n\n One issue that the delegates in Philadelphia addressed was the way in which representatives to the new national government would be chosen. Would individual citizens be able to elect representatives? Would representatives be chosen by state legislatures? How much representation was appropriate for each state? \n\n James Madison put forward a proposition known as the  Virginia Plan , which called for a strong national government that could overturn state laws ( Figure 7.15 ). The plan featured a  bicameral  or two-house legislature, with an upper and a lower house. The people of the states would elect the members of the lower house, whose numbers would be determined by the population of the state. State legislatures would send delegates to the upper house. The number of representatives in the upper chamber would also be based on the state\u2019s population. This  proportional representation  gave the more populous states, like Virginia, more political power. The Virginia Plan also called for an executive branch and a judicial branch, both of which were absent under the Articles of Confederation. The lower and upper house together were to appoint members to the executive and judicial branches. Under this plan, Virginia, the most populous state, would dominate national political power and ensure its interests, including slavery, would be safe. \n\n The Virginia Plan\u2019s call for proportional representation alarmed the representatives of the smaller states. William Paterson introduced a  New Jersey Plan  to counter Madison\u2019s scheme, proposing that all states have equal votes in a unicameral national legislature. He also addressed the economic problems of the day by calling for the Congress to have the power to regulate commerce, to raise revenue though taxes on imports and through postage, and to enforce Congressional requisitions from the states. \n\n Roger Sherman from Connecticut offered a compromise to break the deadlock over the thorny question of representation. His  Connecticut Compromise , also known as the Great Compromise, outlined a different bicameral legislature in which the upper house, the Senate, would have equal representation for all states; each state would be represented by two senators chosen by the state legislatures. Only the lower house, the House of Representatives, would have proportional representation. \n\n THE QUESTION OF SLAVERY \n\n The question of slavery stood as a major issue at the Constitutional Convention because slaveholders wanted enslaved residents to be counted along with White people, termed \u201cfree inhabitants,\u201d when determining a state\u2019s total population. This, in turn, would augment the number of representatives accorded to those states in the lower house. Some northerners, however, such as New York\u2019s Gouverneur Morris, hated slavery and did not even want the term included in the new national plan of government. Slaveholders argued that slavery imposed great burdens upon them and that, because they carried this liability, they deserved special consideration; enslaved people needed to be counted for purposes of representation. \n\n The issue of counting or not counting enslaved people for purposes of representation connected directly to the question of taxation. Beginning in 1775, the Second Continental Congress asked states to pay for war by collecting taxes and sending the tax money to the Congress. The amount each state had to deliver in tax revenue was determined by a state\u2019s total population, including both free and enslaved individuals. States routinely fell far short of delivering the money requested by Congress under the plan. In April 1783, the Confederation Congress amended the earlier system of requisition by having the enslaved population count as three-fifths of the White population. In this way, slaveholders gained a significant tax break. The delegates in Philadelphia adopted this same three-fifths formula in the summer of 1787. \n\n Under the  three-fifths compromise  in the 1787 Constitution, three out of every five enslaved people would be counted when determining a state's population. Article 1, Section 2 stipulated that \u201cRepresentatives and direct Taxes shall be apportioned among the several states . . . according to their respective Number, which shall be determined by adding to the whole number of free Persons, including those bound for service for a Term of Years [White servants], and excluding Indians not taxed, three fifths of all other persons.\u201d Since representation in the House of Representatives was based on the population of a state, the three-fifths compromise gave extra political power to slave states, although not as much as if the total population, both free and enslaved, had been used. Significantly, no direct federal income tax was immediately imposed. (The Sixteenth Amendment, ratified in 1913, put in place a federal income tax.) Northerners agreed to the three-fifths compromise because the Northwest Ordinance of 1787, passed by the Confederation Congress, banned slavery in the future states of the northwest. Northern delegates felt this ban balanced political power between states with enslaved people and those without. The three-fifths compromise gave an advantage to slaveholders; they added three-fifths of their human property to their state\u2019s population, allowing them to send representatives based in part on the number of people they enslaved. \n\n THE QUESTION OF DEMOCRACY \n\n Many of the delegates to the Constitutional Convention had serious reservations about democracy, which they believed promoted anarchy. To allay these fears, the Constitution blunted democratic tendencies that appeared to undermine the republic. Thus, to avoid giving the people too much direct power, the delegates made certain that senators were chosen by the state legislatures, not elected directly by the people (direct elections of senators came with the Seventeenth Amendment to the Constitution, ratified in 1913). As an additional safeguard, the delegates created the  Electoral College , the mechanism for choosing the president. Under this plan, each state has a certain number of electors, which is its number of senators (two) plus its number of representatives in the House of Representatives. Critics, then as now, argue that this process prevents the direct election of the president. \n\n THE FIGHT OVER RATIFICATION \n\n The draft constitution was finished in September 1787. The delegates decided that in order for the new national government to be implemented, each state must first hold a special ratifying convention. When nine of the thirteen had approved the plan, the constitution would go into effect. \n\n When the American public learned of the new constitution, opinions were deeply divided, but most people were opposed. To salvage their work in Philadelphia, the architects of the new national government began a campaign to sway public opinion in favor of their blueprint for a strong central government. In the fierce debate that erupted, the two sides articulated contrasting visions of the American republic and of democracy. Supporters of the 1787 Constitution, known as  Federalists , made the case that a centralized republic provided the best solution for the future. Those who opposed it, known as  Anti-Federalists , argued that the Constitution would consolidate all power in a national government, robbing the states of the power to make their own decisions. To them, the Constitution appeared to mimic the old corrupt and centralized British regime, under which a far-off government made the laws. Anti-Federalists argued that wealthy aristocrats would run the new national government, and that the elite would not represent ordinary citizens; the rich would monopolize power and use the new government to formulate policies that benefited their class\u2014a development that would also undermine local state elites. They also argued that the Constitution did not contain a bill of rights. \n\n New York\u2019s ratifying convention illustrates the divide between the Federalists and Anti-Federalists. When one Anti-Federalist delegate named Melancton Smith took issue with the scheme of representation as being too limited and not reflective of the people, Alexander Hamilton responded: \n\n It has been observed by an honorable gentleman [Smith], that a pure democracy, if it were practicable, would be the most perfect government. Experience has proven, that no position in politics is more false than this. The ancient democracies, in which the people themselves deliberated, never possessed one feature of good government. Their very character was tyranny; their figure deformity: When they assembled, the field of debate presented an ungovernable mob, not only incapable of deliberation, but prepared for every enormity. In these assemblies, the enemies of the people brought forward their plans of ambition systematically. They were opposed by their enemies of another party; and it became a matter of contingency, whether the people subjected themselves to be led blindly by one tyrant or by another.  \n\n The Federalists, particularly John Jay, Alexander Hamilton, and James Madison, put their case to the public in a famous series of essays known as  The Federalist Papers . These were first published in New York and subsequently republished elsewhere in the United States. \n\n Defining American James Madison on the Benefits of Republicanism The tenth essay in  The Federalist Papers , often called Federalist No. 10, is one of the most famous. Written by James Madison ( Figure 7.16 ), it addresses the problems of political parties (\u201cfactions\u201d). Madison argued that there were two approaches to solving the problem of political parties: a republican government and a democracy. He argued that a large republic provided the best defense against what he viewed as the tumult of direct democracy. Compromises would be reached in a large republic and citizens would be represented by representatives of their own choosing. \n\n From this view of the subject, it may be concluded, that a pure Democracy, by which I mean a Society consisting of a small number of citizens, who assemble and administer the Government in person, can admit of no cure for the mischiefs of faction. A common passion or interest will, in almost every case, be felt by a majority of the whole; a communication and concert result from the form of Government itself; and there is nothing to check the inducements to sacrifice the weaker party, or an obnoxious individual. Hence it is, that such Democracies have ever been spectacles of turbulence and contention; have ever been found incompatible with personal security, or the rights of property; and have in general been as short in their lives, as they have been violent in their deaths. Theoretic politicians, who have patronized this species of Government, have erroneously supposed, that by reducing mankind to a perfect equality in their political rights, they would, at the same time, be perfectly equalized and assimilated in their possessions, their opinions, and their passions. \n\nA Republic, by which I mean a Government in which the scheme of representation takes place, opens a different prospect, and promises the cure for which we are seeking. Let us examine the points in which it varies from pure Democracy, and we shall comprehend both the nature of the cure, and the efficacy which it must derive from the Union. \n\nThe two great points of difference, between a Democracy and a Republic, are, first, the delegation of the Government, in the latter, to a small number of citizens elected by the rest: Secondly, the greater number of citizens, and greater sphere of country, over which the latter may be extended. \n\n Does Madison recommend republicanism or democracy as the best form of government? What arguments does he use to prove his point? \n\n Including all the state ratifying conventions around the country, a total of fewer than two thousand men voted on whether to adopt the new plan of government. In the end, the Constitution only narrowly won approval ( Figure 7.17 ). In New York, the vote was thirty in favor to twenty-seven opposed. In Massachusetts, the vote to approve was 187 to 168, and some claim supporters of the Constitution resorted to bribes in order to ensure approval. Virginia ratified by a vote of eighty-nine to seventy-nine, and Rhode Island by thirty-four to thirty-two. The opposition to the Constitution reflected the fears that a new national government, much like the British monarchy, created too much centralized power and, as a result, deprived citizens in the various states of the ability to make their own decisions. ", "questions": [{"question": {"question_id": "fs-idp52780880", "question_text": "To what form of government did the American revolutionaries turn after the war for independence?", "question_choices": ["republicanism", "monarchy", "democracy", "oligarchy"], "cloze_format": "The American revolutionaries turned to ___ after the war for independence.", "normal_format": "To what form of government did the American revolutionaries turn after the war for independence?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "Nonetheless , after their break from Great Britain , Americans turned to republicanism for their new government .", "hl_context": "While monarchies dominated eighteenth-century Europe , American revolutionaries were determined to find an alternative to this method of government . Radical pamphleteer Thomas Paine , whose enormously popular essay Common Sense was first published in January 1776 , advocated a republic : a state without a king . Six months later , Jefferson \u2019 s Declaration of Independence affirmed the break with England but did not suggest what form of government should replace monarchy , the only system most English colonists had ever known . In the late eighteenth century , republics were few and far between . Genoa , Venice , and the Dutch Republic provided examples of states without monarchs , but many European Enlightenment thinkers questioned the stability of a republic . <hl> Nonetheless , after their break from Great Britain , Americans turned to republicanism for their new government . <hl>"}, {"question": {"question_id": "fs-idm55206352", "question_text": "Which of the following was not one of Franklin\u2019s thirteen virtues?", "question_choices": ["sincerity", "temperance", "mercy", "tranquility"], "cloze_format": "___ was not one of Franklin's thirteen virtues.", "normal_format": "Which of the following was not one of Franklin\u2019s thirteen virtues?"}, "answer": {"ans_text": "mercy", "ans_choice": 2}, "bloom": null, "hl_sentences": "Tranquillity . Be not disturbed at trifles , or at accidents common or unavoidable . Sincerity . Use no hurtful deceit ; think innocently and justly , and , if you speak , speak accordingly . Temperance . Eat not to dullness ; drink not to elevation . Defining American Benjamin Franklin \u2019 s Thirteen Virtues for Character Development In the 1780s , Benjamin Franklin carefully defined thirteen virtues to help guide his countrymen in maintaining a virtuous republic . His choice of thirteen is telling since he wrote for the citizens of the thirteen new American republics . These virtues were :", "hl_context": "11 . <hl> Tranquillity . <hl> <hl> Be not disturbed at trifles , or at accidents common or unavoidable . <hl> 7 . <hl> Sincerity . <hl> <hl> Use no hurtful deceit ; think innocently and justly , and , if you speak , speak accordingly . <hl> 1 . <hl> Temperance . <hl> <hl> Eat not to dullness ; drink not to elevation . <hl> <hl> Defining American Benjamin Franklin \u2019 s Thirteen Virtues for Character Development In the 1780s , Benjamin Franklin carefully defined thirteen virtues to help guide his countrymen in maintaining a virtuous republic . <hl> <hl> His choice of thirteen is telling since he wrote for the citizens of the thirteen new American republics . <hl> <hl> These virtues were : <hl>"}, {"question": {"question_id": "fs-idm120754928", "question_text": "Which of the following figures did not actively challenge the status of women in the early American republic?", "question_choices": ["Abigail Adams", "Phillis Wheatley", "Mercy Otis Warren", "Judith Sargent Murray"], "cloze_format": "___ did not actively challenge the status of women in the early American republic.", "normal_format": "Which of the following figures did not actively challenge the status of women in the early American republic?"}, "answer": {"ans_text": "Phillis Wheatley", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Adams , Murray , and Warren all came from privileged backgrounds . All three were fully literate , while many women in the American republic were not . Female authors who published their work provide evidence of how women in the era of the American Revolution challenged traditional gender roles . Inspired by the Revolution , Judith Sargent Murray of Massachusetts advocated women \u2019 s economic independence and equal educational opportunities for men and women ( Figure 7.5 ) . Another privileged member of the revolutionary generation , Mercy Otis Warren , also challenged gender assumptions and traditions during the revolutionary era ( Figure 7.5 ) . Some women hoped to overturn coverture . From her home in Braintree , Massachusetts , Abigail Adams ( Figure 7.4 ) wrote to her husband , Whig leader John Adams , in 1776 , \u201c In the new code of laws which I suppose it will be necessary for you to make , I desire you would remember the ladies and be more generous and favorable to them than your ancestor .", "hl_context": "<hl> Adams , Murray , and Warren all came from privileged backgrounds . <hl> <hl> All three were fully literate , while many women in the American republic were not . <hl> Their literacy and station allowed them to push for new roles for women in the atmosphere of unique possibility created by the Revolution and its promise of change . <hl> Female authors who published their work provide evidence of how women in the era of the American Revolution challenged traditional gender roles . <hl> <hl> Inspired by the Revolution , Judith Sargent Murray of Massachusetts advocated women \u2019 s economic independence and equal educational opportunities for men and women ( Figure 7.5 ) . <hl> Murray , who came from a well-to-do family in Gloucester , questioned why boys were given access to education as a birthright while girls had very limited educational opportunities . She began to publish her ideas about educational equality beginning in the 1780s , arguing that God had made the minds of women and men equal . <hl> Another privileged member of the revolutionary generation , Mercy Otis Warren , also challenged gender assumptions and traditions during the revolutionary era ( Figure 7.5 ) . <hl> Born in Massachusetts , Warren actively opposed British reform measures before the outbreak of fighting in 1775 by publishing anti-British works . In 1812 , she published a three-volume history of the Revolution , a project she had started in the late 1770s . By publishing her work , Warren stepped out of the female sphere and into the otherwise male-dominated sphere of public life . <hl> Some women hoped to overturn coverture . <hl> <hl> From her home in Braintree , Massachusetts , Abigail Adams ( Figure 7.4 ) wrote to her husband , Whig leader John Adams , in 1776 , \u201c In the new code of laws which I suppose it will be necessary for you to make , I desire you would remember the ladies and be more generous and favorable to them than your ancestor . <hl> Do not put such unlimited power in the husbands . Remember , all men would be tyrants if they could . \u201d Abigail Adams ran the family homestead during the Revolution , but she did not have the ability to conduct business without her husband \u2019 s consent . Elsewhere in the famous 1776 letter quoted above , she speaks of the difficulties of running the homestead when her husband is away . Her frustration grew when her husband responded in an April 1776 letter : \u201c As to your extraordinary Code of Laws , I cannot but laugh . We have been told that our Struggle has loosened the bands of Government every where . That Children and Apprentices were disobedient \u2014 that schools and Colledges were grown turbulent \u2014 that Indians slighted their Guardians and Negroes grew insolent to their Masters . But your Letter was the first Intimation that another Tribe more numerous and powerfull than all the rest were grown discontented . . . . Depend on it , We know better than to repeal our Masculine systems . \u201d"}, {"question": {"question_id": "fs-idm171674192", "question_text": "Which state had the clearest separation of church and state?", "question_choices": ["New Hampshire", "Pennsylvania", "Virginia", "New York"], "cloze_format": "___ had the clearest separation of church and state. ", "normal_format": "Which state had the clearest separation of church and state?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "In 1786 , as a revolutionary response against the privileged status of the Church of England , Virginia \u2019 s lawmakers approved the Virginia Statute for Religious Freedom , which ended the Church of England \u2019 s hold and allowed religious liberty . After the Revolution , some questioned the validity of state-authorized churches ; the limitation of public office-holding to those of a particular faith ; and the payment of taxes to support churches . In other states , especially in New England where the older Puritan heritage cast a long shadow , religion and state remained intertwined .", "hl_context": "During the colonial era in Virginia , the established church had been the Church of England , which did not tolerate Catholics , Baptists , or followers or other religions . <hl> In 1786 , as a revolutionary response against the privileged status of the Church of England , Virginia \u2019 s lawmakers approved the Virginia Statute for Religious Freedom , which ended the Church of England \u2019 s hold and allowed religious liberty . <hl> Under the statute , no one could be forced to attend or support a specific church or be prosecuted for his or her beliefs . Prior to the Revolution , several colonies had official , tax-supported churches . <hl> After the Revolution , some questioned the validity of state-authorized churches ; the limitation of public office-holding to those of a particular faith ; and the payment of taxes to support churches . <hl> <hl> In other states , especially in New England where the older Puritan heritage cast a long shadow , religion and state remained intertwined . <hl>"}, {"question": {"question_id": "fs-idp38489120", "question_text": "Which of the following states had the most democratic constitution in the 1780s?", "question_choices": ["Pennsylvania", "Massachusetts", "South Carolina", "Maryland"], "cloze_format": "___ had the most democratic constitution in the 1780s.", "normal_format": "Which of the following states had the most democratic constitution in the 1780s?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Conservative Whig John Adams reacted with horror to the 1776 Pennsylvania constitution , declaring that it was \u201c so democratical that it must produce confusion and every evil work . \u201d In his mind and those of other conservative Whigs , this constitution simply put too much power in the hands of men who had no business exercising the right to vote . The 1784 New Hampshire constitution allowed every small town and village to send representatives to the state government , making the lower house of the legislature a model of democratic government .", "hl_context": "Conservative Whigs , who distrusted the idea of majority rule , recoiled from the abolition of property qualifications for voting and office holding in Pennsylvania . <hl> Conservative Whig John Adams reacted with horror to the 1776 Pennsylvania constitution , declaring that it was \u201c so democratical that it must produce confusion and every evil work . \u201d In his mind and those of other conservative Whigs , this constitution simply put too much power in the hands of men who had no business exercising the right to vote . <hl> Pennsylvania \u2019 s constitution also eliminated the executive branch ( there was no governor ) and the upper house . Instead , Pennsylvania had a one-house \u2014 a unicameral \u2014 legislature . The 1776 Pennsylvania constitution and the 1784 New Hampshire constitution both provide examples of democratic tendencies . In Pennsylvania , the requirement to own property in order to vote was eliminated , and if a man was twenty-one or older , had paid taxes , and had lived in the same location for one year , he could vote ( Figure 7.10 ) . This opened voting to most free White male citizens of Pennsylvania . <hl> The 1784 New Hampshire constitution allowed every small town and village to send representatives to the state government , making the lower house of the legislature a model of democratic government . <hl>"}, {"question": {"question_id": "fs-idm129691088", "question_text": "Under the Articles of Confederation, what power did the national Confederation Congress have?", "question_choices": ["the power to tax", "the power to enforce foreign treaties", "the power to enforce commercial trade agreements", "the power to create land ordinances"], "cloze_format": "The national Confederation Congress had ___ under the Articles of Confederation.", "normal_format": "Under the Articles of Confederation, what power did the national Confederation Congress have?"}, "answer": {"ans_text": "the power to create land ordinances", "ans_choice": 3}, "bloom": null, "hl_sentences": "The Confederation Congress under the Articles did achieve success through a series of directives called land ordinances , which established rules for the settlement of western lands in the public domain and the admission of new states to the republic .", "hl_context": "<hl> The Confederation Congress under the Articles did achieve success through a series of directives called land ordinances , which established rules for the settlement of western lands in the public domain and the admission of new states to the republic . <hl> The ordinances were designed to prepare the land for sale to citizens and raise revenue to boost the failing economy of the republic . In the land ordinances , the Confederation Congress created the Mississippi and Southwest Territories and stipulated that slavery would be permitted there . The system of dividing the vast domains of the United States stands as a towering achievement of the era , a blueprint for American western expansion ."}, {"question": {"question_id": "fs-idm38231440", "question_text": "Which plan resolved the issue of representation for the U.S. Constitution?", "question_choices": ["the Rhode Island Agreement", "the New Jersey Plan", "the Connecticut Compromise", "the Virginia Plan"], "cloze_format": "___ resolved the issue of representation for the U.S. Constitution.", "normal_format": "Which plan resolved the issue of representation for the U.S. Constitution?"}, "answer": {"ans_text": "the Connecticut Compromise", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Roger Sherman from Connecticut offered a compromise to break the deadlock over the thorny question of representation . His Connecticut Compromise , also known as the Great Compromise , outlined a different bicameral legislature in which the upper house , the Senate , would have equal representation for all states ; each state would be represented by two senators chosen by the state legislatures .", "hl_context": "<hl> Roger Sherman from Connecticut offered a compromise to break the deadlock over the thorny question of representation . <hl> <hl> His Connecticut Compromise , also known as the Great Compromise , outlined a different bicameral legislature in which the upper house , the Senate , would have equal representation for all states ; each state would be represented by two senators chosen by the state legislatures . <hl> Only the lower house , the House of Representatives , would have proportional representation ."}, {"question": {"question_id": "fs-idm14830704", "question_text": "How was the U.S. Constitution ratified?", "question_choices": ["by each state at special ratifying conventions", "at the Constitutional Convention of 1787", "at the Confederation Convention", "by popular referendum in each state"], "cloze_format": "The U.S. Constitution ratified ___.", "normal_format": "How was the U.S. Constitution ratified?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "The delegates decided that in order for the new national government to be implemented , each state must first hold a special ratifying convention . When nine of the thirteen had approved the plan , the constitution would go into effect .", "hl_context": "The draft constitution was finished in September 1787 . <hl> The delegates decided that in order for the new national government to be implemented , each state must first hold a special ratifying convention . <hl> <hl> When nine of the thirteen had approved the plan , the constitution would go into effect . <hl>"}], "summary": " Summary 7.1   Common Sense: From Monarchy to an American Republic \n\n The guiding principle of republicanism was that the people themselves would appoint or select the leaders who would represent them. The debate over how much democracy (majority rule) to incorporate in the governing of the new United States raised questions about who was best qualified to participate in government and have the right to vote. Revolutionary leaders argued that property holders had the greatest stake in society and favored a republic that would limit political rights to property holders. In this way, republicanism exhibited a bias toward the elite. George Washington served as a role model for the new republic, embodying the exceptional talent and public virtue prized in its political and social philosophy. \n\n 7.2   How Much Revolutionary Change? \n\n After the Revolution, the balance of power between women and men and between Whites, Blacks, and Native Americans remained largely unchanged. Yet revolutionary principles, including the call for universal equality in the Declaration of Independence, inspired and emboldened many. Abigail Adams and others pressed for greater rights for women, while the Pennsylvania Abolition Society and New York Manumission Society worked toward the abolition of slavery. Nonetheless, for Blacks, women, and Native peoples, the revolutionary ideals of equality fell far short of reality. In the new republic, full citizenship\u2014including the right to vote\u2014did not extend to non-Whites or to women. \n\n 7.3   Debating Democracy \n\n The late 1770s and 1780s witnessed one of the most creative political eras as each state drafted its own constitution. The Articles of Confederation, a weak national league among the states, reflected the dominant view that power should be located in the states and not in a national government. However, neither the state governments nor the Confederation government could solve the enormous economic problems resulting from the long and costly Revolutionary War. The economic crisis led to Shays\u2019 Rebellion by residents of western Massachusetts, and to the decision to revise the Confederation government. \n\n 7.4   The Constitutional Convention and Federal Constitution \n\n The economic crisis of the 1780s, shortcomings of the Articles of Confederation, and outbreak of Shays\u2019 Rebellion spurred delegates from twelve of the thirteen states to gather for the Constitutional Convention of 1787. Although the stated purpose of the convention was to modify the Articles of Confederation, their mission shifted to the building of a new, strong federal government. Federalists like James Madison and Alexander Hamilton led the charge for a new United States Constitution, the document that endures as the oldest written constitution in the world, a testament to the work done in 1787 by the delegates in Philadelphia. ", "keyterm": "", "bname": "u.s._history"}, {"chapter": 19, "intro": "Learning Objectives 19.1   The Social Construction of Health \n\n Define the term medical sociology \n\n Understand the difference between the cultural meaning of illness, the social construction of illness, and the social construction of medical knowledge \n\n 19.2   Global Health \n\n Define social epidemiology \n\n Apply theories of social epidemiology to an understanding of global health issues \n\n Understand the differences between high-income and low-income nations \n\n 19.3   Health in the United States \n\n Understand how social epidemiology can be applied to health in the United States \n\n Explain disparities of health based on gender, socioeconomic status, race, and ethnicity \n\n Give an overview of mental health and disability issues in the United States \n\n Explain the terms stigma and medicalization \n\n 19.4   Comparative Health and Medicine \n\n Explain the different types of health care available in the United States \n\n Compare the health care system of the United States with that of other countries \n\n 19.5   Theoretical Perspectives on Health and Medicine \n\n Apply functionalist, conflict theorist, and interactionist perspectives to health issues \n\n Introduction to Health and Medicine \n\n In 2010, a pertussis (whooping cough) outbreak in California sickened 9,143 people and resulted in 10 infant deaths: the worst outbreak in 63 years (Centers for Disease Control 2011b). Researchers, suspecting that the primary cause of the outbreak was the waning strength of pertussis vaccines in older children, recommended a booster vaccination for 11\u201312-year-olds and also for pregnant women (Zacharyczuk 2011). Pertussis is most serious for babies; one in five needs to be hospitalized, and since they are too young for the vaccine themselves, it is crucial that people around them be immunized (Centers for Disease Control 2011b). Several states, including California, have been requiring the pertussis booster for older children in recent yearswith the hope of staving off another outbreak.  \n\n But what of people who do not want their children to have this vaccine, or any other? That question is at the heart of a debate that has been simmering for years. Vaccines are biological preparations that improve immunity against a certain disease. Vaccines have contributed to the eradication and weakening of numerous infectious diseases, including smallpox, polio, mumps, chicken pox, and meningitis.  \n\n However, many people express concern about potential negative side effects from vaccines. These concerns range from fears about overloading the child\u2019s immune system to controversial reports about devastating side effects of the vaccines. One misapprehension is that the vaccine itself might cause the disease it is supposed to be immunizing against. Another commonly circulated concern is that vaccinations, specifically the MMR vaccine (MMR stands for measles, mumps, and rubella), are linked to autism. The autism connection has been particularly controversial. In 1998, a British physician named Andrew Wakefield published a study in Great Britain\u2019s  Lancet  magazine that linked the MMR vaccine to autism. The report received a lot of media attention, resulting in British immunization rates decreasing from 91 percent in 1997 to almost 80 percent by 2003, accompanied by a subsequent rise in measles cases (Devlin 2008). A prolonged investigation by the British Medical Journal proved that not only was the link in the study nonexistent, but that Dr. Wakefield had falsified data in order to support his claims (CNN 2011). Dr. Wakefield was discredited and stripped of his license, but the doubt still lingers in many parents\u2019 minds. \n\n In the United States, many parents still believe in the now discredited MMR-autism link and refuse to vaccinate their children. Other parents choose not to vaccinate for various reasons like religious or health beliefs. In one instance, a boy whose parents opted not to vaccinate returned home to the U.S. after a trip abroad; no one yet knew he was infected with measles. The boy exposed 839 people to the disease and caused 11 additional cases of measles, all in other unvaccinated children, including one infant who had to be hospitalized. According to a study published in  Pediatrics  (2010), the outbreak cost the public sector $10,376 per diagnosed case. The study further showed that the intentional non-vaccination of those infected occurred in students from private schools, public charter schools, and public schools in upper-socioeconomic areas (Sugerman et al. 2010). \n\n Should parents be forced to immunize their children? What might sociologists make of the fact that most of the families who chose not to vaccinate were of a higher socioeconomic group? How does this story of vaccines in a high-income region compare to that in a low-income region, like sub-Saharan Africa, where populations are often eagerly seeking vaccines rather than refusing them?  \n\n The sociology of health encompasses social epidemiology, disease, mental health, disability, and medicalization. The way that we perceive health and illness is in constant evolution. As we learn to control existing diseases, new diseases develop. As our society evolves to be more global, the way that diseases spread evolves with it.  \n\n What does \u201chealth\u201d mean to you? Do you believe that there are too many people taking medications in American society? Are you skeptical about people claiming they are \u201caddicted\u201d to gambling or \u201caddicted\u201d to sex? Can you think of anything that was historically considered a disease, but is now considered within a range of normality? Or anything that has recently become known as a disease, whereas before it was considered evidence of laziness or other character flaws? Do you believe all children should receive vaccinations? These are questions examined in the sociology of health. \n\n Sociologists may also understand these issues more fully by considering them through one of the main theoretical perspectives of the discipline. The functionalist perspective is a macroanalytical perspective that looks at the big picture, focusing on the way that all aspects of society are integral to the continued health and viability of the whole. For those working within the functionalist perspective, the focus is on how healthy individuals have the most to contribute to the stability of society. Functionalists might study the most efficient way to restore \u201csick\u201d individuals to a healthy state. The conflict perspective is another macroanalytical perspective that focuses on the creation and reproduction of inequality. Someone applying the conflict perspective might focus on inequalities within the health system itself, looking at disparities in race, ethnicity, gender, and age. Someone applying the interactionist perspective to health might focus on how people understand their health, and how their health affects their relationships with the people in their lives. ", "chapter_text": "19.1   The Social Construction of Health \n\n If sociology is the systematic study of human behavior in society,  medical sociology  is the systematic study of how humans manage issues of health and illness, disease and disorders, and health care for both the sick and the healthy. Medical sociologists study the physical, mental, and social components of health and illness. Major topics for medical sociologists include the doctor/patient relationship, the structure and socioeconomics of health care, and how culture impacts attitudes toward disease and wellness. \n\n The social construction of health is a major research topic within medical sociology. At first glance, the concept of a social construction of health does not seem to make sense. After all, if disease is a measurable, physiological problem, then there can be no question of socially constructing disease, right? Well, it\u2019s not that simple. The idea of the social construction of health emphasizes the socio-cultural aspects of the discipline\u2019s approach to physical, objectively definable phenomena. Sociologists Conrad and Barker (2010) offer a comprehensive framework for understanding the major findings of the last 50 years of development in this concept. Their summary categorizes the findings in the field under three subheadings: the cultural meaning of illness, the social construction of the illness experience, and the social construction of medical knowledge. \n\n The Cultural Meaning of Illness Many medical sociologists contend that illnesses have both a biological and an experiential component, and that these components exist independently of each other. Our culture, not our biology, dictates which illnesses are stigmatized and which are not, which are considered disabilities and which are not, and which are deemed contestable (meaning some medical professionals may find the existence of this ailment questionable) as opposed to definitive (illnesses that are unquestionably recognized in the medical profession) (Conrad and Barker 2010).  \n\n For instance, sociologist Erving Goffman (1963) described how social stigmas hinder individuals from fully integrating into society. The  stigmatization of illness  often has the greatest effect on the patient and the kind of care he or she receives. Many contend that our society and even our health care institutions discriminate against certain diseases\u2014like mental disorders, AIDS, venereal diseases, and skin disorders (Sartorius 2007). Facilities for these diseases may be sub-par; they may be segregated from other health care areas or relegated to a poorer environment. The stigma may keep people from seeking help for their illness, making it worse than it needs to be.  \n\n Contested illnesses  are those that are questioned or questionable by some medical professionals. Disorders like fibromyalgia or chronic fatigue syndrome may be either true illnesses or only in the patients\u2019 heads, depending on the opinion of the medical professional. This dynamic can affect how a patient seeks treatment and what kind of treatment he or she receives. \n\n The Social Construction of the Illness Experience The idea of the social construction of the illness experience is based on the concept of reality as a social construction. In other words, there is no objective reality; there are only our own perceptions of it. The social construction of the illness experience deals with such issues as the way some patients control the manner in which they reveal their disease and the lifestyle adaptations patients develop to cope with their illnesses. \n\n In terms of constructing the illness experience, culture and individual personality both play a significant role. For some people, a long-term illness can have the effect of making their world smaller, more defined by the illness than anything else. For others, illness can be a chance for discovery, for re-imaging a new self (Conrad and Barker 2007). Culture plays a huge role in how an individual experiences illness. Widespread diseases like AIDS or breast cancer have specific cultural markers that have changed over the years and that govern how individuals\u2014and society\u2014view them. \n\n Today, many institutions of wellness acknowledge the degree to which individual perceptions shape the nature of health and illness. Regarding physical activity, for instance, the Centers for Disease Control (CDC) recommends that individuals use a standard level of exertion to assess their physical activity. This Rating of Perceived Exertion (RPE) gives a more complete view of an individual\u2019s actual exertion level, since heart-rate or pulse measurements may be affected by medication or other issues (Centers for Disease Control 2011a). Similarly, many medical professionals use a comparable scale for perceived pain to help determine pain management strategies. \n\n The Social Construction of Medical Knowledge Conrad and Barker show how medical knowledge is socially constructed; that is, it can both reflect and reproduce inequalities in gender, class, race, and ethnicity. Conrad and Barker (2011) use the example of the social construction of women\u2019s health and how medical knowledge has changed significantly in the course of a few generations. For instance, in the early 19 th  century, pregnant women were discouraged from driving or dancing for fear of harming the unborn child, much as they are discouraged from smoking or drinking alcohol today.  \n\n Social Policy and Debate Has Breast Cancer Awareness Gone Too Far? \n\n Every October, the world turns pink. Football and baseball players wear pink accessories. Skyscrapers and large public buildings are lit with pink lights at night. And for retailers, shoppers can choose from a huge array of pink products. In 2011, people wanting to support the fight against breast cancer could purchase any of the following pink products: KitchenAid mixers, Master Lock padlocks and bike chains, Wilson tennis rackets, Fiat cars, and Smith & Wesson handguns. You read that correctly. The goal of all these pink products is to raise awareness and money for breast cancer. However, the relentless creep of pink has many people wondering if the pink marketing juggernaut has gone too far. \n\n Pink has been associated with breast cancer since 1991, when the Susan G. Komen Foundation handed out pink ribbons at its 1991 Race for the Cure event. Since then, the pink ribbon has appeared on countless products, and then by extension, the color pink has come to represent support for a cure of the disease. No one can argue about the Susan G. Komen Foundation\u2019s mission\u2014find a cure for breast cancer\u2014or the fact that the group has raised millions of dollars for research and care. However, some people question if, or how much, all these products really help in the fight against breast cancer (Begos 2011). The advocacy group Breast Cancer Action (BCA) position themselves as watchdogs of other agencies fighting breast cancer. They accept no funding from entities, like those in the pharmaceutical industry, with potential profit connections to this health industry. They\u2019ve developed a trademarked \u201cThink Before You Pink\u201d campaign to provoke consumer questioning of the end contributions made to breast cancer by companies hawking pink wares. They do not advise against \u201cpink\u201d purchases; they just want consumers to be informed about how much money is involved, where it comes from, and where it will go. For instance, what percentage of each purchase goes to breast cancer causes? BCA does not judge how much is enough, but it informs customers and then encourages them to consider whether they feel the amount is enough (Think Before You Pink 2012).  \n\n BCA also suggests that consumers make sure that the product they are buying does not actually  contribute  to breast cancer, a phenomenon they call \u201cpinkwashing.\u201d This issue made national headlines in 2010, when the Susan G. Komen Foundation partnered with Kentucky Fried Chicken (KFC) on a promotion called \u201cBuckets for the Cure.\u201d For every bucket of grilled or regular fried chicken, KFC would donate 50 cents to the Komen Foundation, with the goal of reaching $8 million: the largest single donation received by the foundation. However, some critics saw the partnership as an unholy alliance. Higher body fat and eating fatty foods has been linked to increased cancer risks, and detractors, including BCA, called the Komen Foundation out on this apparent contradiction of goals. Komen\u2019s response was that the program did a great deal to raise awareness in low-income communities, where Komen previously had little outreach (Hutchison 2010). \n\n What do you think? Are fundraising and awareness important enough to trump issues of health? What other examples of \u201cpinkwashing\u201d can you think of?  \n19.2   Global Health \n\n Social epidemiology  is the study of the causes and distribution of diseases. Social epidemiology can reveal how social problems are connected to the health of different populations. These epidemiological studies show that the health problems of high-income nations differ greatly from those of low-income nations. Some diseases, like cancer, are universal. But others, like obesity, heart disease, respiratory disease, and diabetes are much more common in high-income countries, and are a direct result of a sedentary lifestyle combined with poor diet. High-income nations also have a higher incidence of depression (Bromet et al. 2011). In contrast, low-income nations suffer significantly from malaria and tuberculosis. \n\n How does health differ around the world? Some theorists differentiate among three types of countries: core nations, semi-peripheral nations, and peripheral nations. Core nations are those that we think of as highly developed or industrialized, semi-peripheral nations are those that are often called developing or newly industrialized, and peripheral nations are those that are relatively undeveloped. While the most pervasive issue in the U.S. health care system is affordable access to health care, other core countries have different issues, and semi-peripheral and peripheral nations are faced with a host of additional concerns. Reviewing the status of global health offers insight into the various ways that politics and wealth shape access to health care, and it shows which populations are most affected by health disparities.  \n\n Health in High-Income Nations Obesity, which is on the rise in high-income nations, has been linked to many diseases, including cardiovascular problems, musculoskeletal problems, diabetes, and respiratory issues. According to the Organization for Economic Cooperation and Development (2011), obesity rates are rising in all countries, with the greatest gains being made in the highest-income countries. The United States has the highest obesity rate. Wallace Huffman and his fellow researchers (2006) contend that several factors are contributing to the rise in obesity in developed countries:  \n\n Improvements in technology and reduced family size have led to a reduction of work to be done in household production. \n\n Unhealthy market goods, including processed foods, sweetened drinks, and sweet and salty snacks are replacing home-produced goods.  \n\n  Leisure activities are growing more sedentary, for example, computer games, web surfing, and television viewing. \n\n More workers are shifting from active work (agriculture and manufacturing) to service industries. \n\n Increased access to passive transportation has led to more driving and less walking. \n\n Obesity and weight issues have significant societal costs, including lower life expectancies and higher shared healthcare costs. \n\n High-income countries also have higher rates of depression than less affluent nations. A recent study (Bromet et al. 2011) shows that the average lifetime prevalence of major depressive episodes in the 10 highest-income countries in the study was 14.6 percent; this compared to 11.1 percent in the eight low- and middle-income countries. The researchers speculate that the higher rate of depression may be linked to the greater income inequality that exists in the highest-income nations. \n\n Health in Low-Income Nations In peripheral nations with low per capita income, it is not the cost of health care that is the most pressing concern. Rather, low-income countries must manage such problems as infectious disease, high infant mortality rates, scarce medical personnel, and inadequate water and sewer systems. Such issues, which high-income countries rarely even think about, are central to the lives of most people in low-income nations. Due to such health concerns, low-income nations have higher rates of infant mortality and lower average life spans.  \n\n One of the biggest contributors to medical issues in low-income countries is the lack of access to clean water and basic sanitation resources. According to a 2011 UNICEF report, almost half of the developing world\u2019s population lacks improved sanitation facilities. The World Health Organization (WHO) tracks health-related data for 193 countries. In their 2011 World Health Statistics report, they document the following statistics: \n\n Globally, the rate of mortality for children under five was 60 per 1,000 live births. In low-income countries, however, that rate is almost double at 117 per 1,000 live births. In high-income countries, that rate is significantly lower than seven per 1,000 live births. \n\n The most frequent causes of death for children under five were pneumonia and diarrheal diseases, accounting for 18 percent and 15 percent, respectively. These deaths could be easily avoidable with cleaner water and more coverage of available medical care. \n\n The availability of doctors and nurses in low-income countries is one-tenth that of nations with a high income. Challenges in access to medical education and access to patients exacerbate this issue for would-be medical professionals in low-income countries (World Health Organization 2011). \n19.3   Health in the United States \n\n Health in the United States is a complex and often contradictory issue. One the one hand, as one of the wealthiest nations, the United States fares well in health comparisons with the rest of the world. However, the United States also lags behind almost every industrialized country in terms of providing care to  all  its citizens. The following sections look at different aspects of health in America. \n\n Health by Race and Ethnicity When looking at the social epidemiology of the United States, it is hard to miss the disparities among races. The discrepancy between black and white Americans shows the gap clearly; IN 2008, the average life expectancy for white males was approximately five years longer than for black males: 75.9 compared to 70.9. An even stronger disparity was found in 2007: the infant mortality rate for blacks was nearly twice that of whites at 13.2 compared to 5.6 per 1,000 live births (U.S. Census Bureau 2011). According to a report from the Henry J. Kaiser Foundation (2007), African Americans also have higher incidence of several other diseases and causes of mortality, from cancer to heart disease to diabetes. In a similar vein, it is important to note that ethnic minorities, including Mexican Americans and Native Americans, also have higher rates of these diseases and causes of mortality than whites. \n\n Lisa Berkman (2009) notes that this gap started to narrow during the Civil Rights movement in the 1960s, but it began widening again in the early 1980s. What accounts for these perpetual disparities in health among different ethnic groups? Much of the answer lies in the level of health care that these groups receive. The National Healthcare Disparities Report (2010) shows that even after adjusting for insurance differences, racial and ethnic minority groups receive poorer quality of care and less access to care than dominant groups. The Report identified these racial inequalities in care: \n\n  Black Americans, American Indians, and Alaskan Natives received inferior care than Caucasian Americans for about 40 percent of measures \n\n Asian ethnicities received inferior care for about 20 percent of measures \n\n Among whites, Hispanic whites received 60 percent inferior care of measures compared to non-Hispanic whites (Agency for Health Research and Quality 2010). When considering access to care, the figures were comparable. \n\n Health by Socioeconomic Status Discussions of health by race and ethnicity often overlap with discussions of health by socioeconomic status, since the two concepts are intertwined in the United States. As the Agency for Health Research and Quality (2010) notes, \u201cracial and ethnic minorities are more likely than non-Hispanic whites to be poor or near poor,\u201d so many of the data pertaining to subordinate groups is also likely to be pertinent to low socioeconomic groups. Marilyn Winkleby and her research associates (1992) state that \u201cone of the strongest and most consistent predictors of a person's morbidity and mortality experience is that person's socioeconomic status (SES). This finding persists across all diseases with few exceptions, continues throughout the entire lifespan, and extends across numerous risk factors for disease.\u201d \n\n It is important to remember that economics are only part of the SES picture; research suggests that education also plays an important role. Phelan and Link (2003) note that many behavior-influenced diseases like lung cancer (from smoking), coronary artery disease (from poor eating and exercise habits), and AIDS initially were widespread across SES groups. However, once information linking habits to disease was disseminated, these diseases decreased in high SES groups and increased in low SES groups. This illustrates the important role of education initiatives regarding a given disease, as well as possible inequalities in how those initiatives effectively reach different SES groups. \n\n Health by Gender Women are affected adversely both by unequal access to and institutionalized sexism in the health care industry. According a recent report from the Kaiser Family Foundation, women experienced a decline in their ability to see needed specialists between 2001 and 2008. In 2008, one quarter of females questioned the quality of her health care (Ranji and Salganico 2011). In this report, we also see the explanatory value of intersection theory. Feminist sociologist Patricia Hill Collins developed this theory, which suggests we cannot separate the effects of race, class, gender, sexual orientation, and other attributes. Further examination of the lack of confidence in the health care system by women, as identified in the Kaiser study, found, for example, women categorized as low income were more likely (32 percent compared to 23 percent) to express concerns about health care quality, illustrating the multiple layers of disadvantage caused by race and sex. \n\n We can see an example of institutionalized sexism in the way that women are more likely than men to be diagnosed with certain kinds of mental disorders. Psychologist Dana Becker notes that 75 percent of all diagnoses of Borderline Personality Disorder (BPD) are for women according to the  Diagnostic Statistical Manual of Mental Disorders . This diagnosis is characterized by instability of identity, of mood, and of behavior, and Becker argues that it has been used as a catch-all diagnosis for too many women. She further decries the pejorative connotation of the diagnosis, saying that it predisposes many people, both within and outside of the profession of psychotherapy, against women who have been so diagnosed (Becker). Many critics also point to the medicalization of women\u2019s issues as an example of institutionalized sexism.  Medicalization  refers to the process by which previously normal aspects of life are redefined as deviant and needing medical attention to remedy. Historically and contemporaneously, many aspects of women\u2019s lives have been medicalized, including menstruation, pre-menstrual syndrome, pregnancy, childbirth, and menopause. The medicalization of pregnancy and childbirth has been particularly contentious in recent decades, with many women opting against the medical process and choosing a more natural childbirth. Fox and Worts (1999) find that all women experience pain and anxiety during the birth process, but that social support relieves both as effectively as medical support. In other words, medical interventions are no more effective than social ones at helping with the difficulties of pain and childbirth. Fox and Worts further found that women with supportive partners ended up with less medical intervention and fewer cases of postpartum depression. Of course, access to quality birth care outside of the standard medical models may not be readily available to women of all social classes.  \n\n Sociology in the Real World Medicalization of Sleeplessness How is your \u201csleep hygiene?\u201d Sleep hygiene refers to the lifestyle and sleep habits that contribute to sleeplessness. Bad habits that can lead to sleeplessness include inconsistent bedtimes, lack of exercise, late-night employment, napping during the day, and sleep environments that include noise, lights, or screen time (National Institutes of Health 2011a). \n\n According to the National Institute of Health, examining sleep hygiene is the first step in trying to solve a problem with sleeplessness.  \n\n For many Americans, however, making changes in sleep hygiene does not seem to be enough. According to a 2006 report from the Institute of Medicine, sleeplessness is an underrecognized public health problem affecting up to 70 million people. It is interesting to note that in the months (or years) after this report was released, advertising by the pharmaceutical companies behind Ambien, Lunesta, and Sepracor (three sleep aids) averaged $188 million weekly promoting these drugs (Gellene 2009). \n\n According to a study in the  American Journal of Public Health  (2011), prescriptions for sleep medications increased dramatically from 1993 to 2007. While complaints of sleeplessness during doctor\u2019s office visits more than doubled during this time, insomnia diagnoses increased more than sevenfold, from about 840,000 to 6.1 million. The authors of the study conclude that sleeplessness has been medicalized as insomnia, and that \u201cinsomnia may be a public health concern, but potential overtreatment with marginally effective, expensive medications with nontrivial side effects raises definite population health concerns\u201d (Moloney, Konrad, and Zimmer 2011). Indeed, a study published in 2004 in the  Archives of Internal Medicine  shows that cognitive behavioral therapy, not medication, was the most effective sleep intervention (Jacobs, Pace-Schott, Stickgold, and Otto 2004).  \n\n A century ago, people who couldn\u2019t sleep were told to count sheep. Now, they pop a pill, and all those pills add up to a very lucrative market for the pharmaceutical industry. Is this industry behind the medicalization of sleeplessness, or are they just responding to a need? \n\n Mental Health and Disability The treatment received by those defined as mentally ill or disabled varies greatly from country to country. In post-millennial America, those of us who have never experienced such a disadvantage take for granted the rights our society guarantees for each citizen. We do not think about the relatively recent nature of the protections, unless, of course, we know someone constantly inconvenienced by the lack of accommodations or misfortune of suddenly experiencing a temporary disability. \n\n Mental Health People with mental disorders (a condition that makes it more difficult to cope with everyday life) and people with mental illness (a severe, lasting mental disorder that requires long term treatment) experience a wide range of effects. \n\n According to the National Institute of Mental Health (NIMH), the most common mental disorders in the United States are  anxiety disorders . Almost 18 percent of American adults are likely to be affected in a single year, and 28 percent are likely to be affected over the course of a lifetime (National Institute of Mental Health 2005). It is important to distinguish between occasional feelings of anxiety and a true anxiety disorder. Anxiety is a normal reaction to stress that we all feel at some point, but anxiety disorders are feelings of worry and fearfulness that last for months at a time. Anxiety disorders include obsessive compulsive disorder (OCD), panic disorders, posttraumatic stress disorder (PTSD), and both social and specific phobias. \n\n The second most common mental disorders in the United States are  mood disorders ; roughly 10 percent of American adults are likely to be affected yearly, while 21 percent are likely to be affected over the course of a lifetime (National Institute of Mental Health 2005). Major mood disorders are depression, bipolar disorder, and dysthymic disorder. Like anxiety, depression might seem like something that everyone experiences at some point, and it is true that most people feel sad or \u201cblue\u201d at times in their lives. A true depressive episode, however, is more than just feeling sad for a short period. It is a long-term, debilitating illness that usually needs treatment to cure. And bipolar disorder is characterized by dramatic shifts in energy and mood, often affecting the individual\u2019s ability to carry out day-to-day tasks. Bipolar disorder used to be called manic depression because of the way that people would swing between manic and depressive episodes. \n\n Depending on what definition is used, there is some overlap between mood disorders and  personality disorders , which affect nine percent of Americans yearly. The American Psychological Association publishes the  Diagnostic and Statistical Manual on Mental Disorders  (DSM), and their definition of personality disorders is changing in the fifth edition, which is being revised in 2011 and 2012. In the  DSM-IV , personality disorders represent \u201can enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it\u201d (National Institute of Mental Health). In other words, personality disorders cause people to behave in ways that are seen as abnormal to society but seem normal to them. The  DSM-V  proposes broadening this definition by offering five broad personality trait domains to describe personality disorders, some related to the level or type of their disconnect with society. As their application evolves, we will see how their definitions help scholars across disciplines understand the intersection of health issues and how they are defined by social institutions and cultural norms.  \n\n Another fairly commonly diagnosed mental disorder is Attention-Deficit/Hyperactivity Disorder (ADHD), which statistics suggest affects nine percent of children and eight percent of adults on a lifetime basis (National Institute of Mental Health 2005). ADHD is one of the most common childhood disorders, and it is marked by difficulty paying attention, difficulty controlling behavior, and hyperactivity. According to the American Psychological Association (APA), ADHD responds positively to stimulant drugs like Ritalin, which helps people stay focused. However, there is some social debate over whether such drugs are being overprescribed (American Psychological Association). In fact, some critics question whether this disorder is really as widespread as it seems, or if it is a case of overdiagnosis. Autism Spectrum Disorders (ASD) have gained a lot of attention in recent years. The term ASD encompasses a group of developmental brain disorders that are characterized by \u201cdeficits in social interaction, verbal and nonverbal communication, and engagement in repetitive behaviors or interests\u201d (National Institute of Mental Health). As with the personality disorders described above, the  Diagnostic and Statistical Manual on Mental Disorders \u2019 description of these is in the process of being revised.  The National Institute of Mental Health (NIMH) distinguishes between serious mental illness and other disorders. The key feature of serious mental illness is that it results in \u201cserious functional impairment, which substantially interferes with or limits one or more major life activities\u201d (National Institute of Mental Health). Thus, the characterization of \u201cserious\u201d refers to the effect of the illness (functional impairment), not the illness itself. Although the view is not widely held, there are some researchers who argue that mental illness is a myth. For example, to Thomas Scheff (1963), residual deviance\u2014a violation of social norms not covered by any specific behavioral expectation\u2014is what actually results in people being labeled mentally ill. In  The Myth of Mental Illness: Foundations of a Theory of Personal Conduct  (1961), Thomas Szasz asks if there is such a thing as mental illness, and then argues that there is not. Rather, mental illness is a deviation from what others view as normal, with no basis in biological disease. Szasz calls for greater personal responsibility and less reliance on institutions. \n\n Disability Disability  refers to a reduction in one\u2019s ability to perform everyday tasks. The World Health Organization makes a distinction between the various terms used to describe handicaps that\u2019s important to the sociological perspective. They use the term  impairment  to describe the physical limitations, while reserving the term disability to refer to the social limitation.  Before the passage of the Americans with Disabilities Act (ADA) in 1990, Americans with disabilities were often excluded from opportunities and social institutions many of us take for granted. This occurred not only through employment and other kinds of discrimination, but through casual acceptance by most Americans of a world designed for the convenience of the able-bodied. Imagine being in a wheelchair and trying to use a sidewalk without the benefit of wheelchair accessible curbs. Imagine as a blind person trying to access information without the widespread availability of Braille. Imagine having limited motor control and being faced with a difficult-to-grasp round door handle. Issues like these are what the ADA tries to address. Ramps on sidewalks, Braille instructions, and more accessible door levers are all accommodations to help people with disabilities. \n\n People with disabilities can be stigmatized by their illness.  Stigmatization  means that their identity is spoiled; they are labeled as different, discriminated against, and sometimes even shunned. They are labeled (as an interactionist might point out) and ascribed a master status (as a functionalist might note), becoming \u201cthe blind girl\u201d or \u201cthe boy in the wheelchair\u201d instead of someone afforded a full identity by society. This can be especially true for people who are disabled due to mental illness or disorders.  \n\n As discussed in the section on mental health, many mental health disorders can be debilitating, affecting a person\u2019s ability to cope with everyday life. This can affect social status, housing, and especially employment. According to the Bureau of Labor Statistics (2011), people with a disability had a higher rate of unemployment thaN people without a disability in 2010: 14.8 percent to 9.4 percent. This unemployment rate refers only to people actively looking for a job. In fact, eight out of 10 people with a disability are considered \u201cout of the labor force;\u201d that is, they do not have jobs and are not looking for them. The combination of this population and the high unemployment rate leads to an employment-population ratio of 18.6 percent among those with disabilities. The employment-population ratio for people without disabilities was much higher, at 63.5 percent (U.S. Bureau of Labor Statistics 2011).  \n\n Sociology in the Real World Obesity: The Last Acceptable Prejudice What is your reaction to the picture above? Compassion? Fear? Disgust? Many people will look at this picture and make negative assumptions about the man based on his weight. According to a study from the Yale Rudd Center for Food Policy and Obesity, large people are the object of \u201cwidespread negative stereotypes that overweight and obese persons are lazy, unmotivated, lacking in self-discipline, less competent, noncompliant, and sloppy\u201d (Puhl and Heuer 2009).  \n\n Historically, both in the United States and elsewhere, it was considered acceptable to discriminate against people based on prejudiced opinions. Even after slavery was abolished in 1865, the next 100 years of American history saw institutionalized racism and prejudice against black people. In an example of  stereotype interchangeability ,  the same insults that are flung today at the overweight and obese population (lazy, for instance), have been flung at various racial and ethnic groups in earlier history. Of course, no one gives voice to these kinds of views in public now, except when talking about obese people. Why is it considered acceptable to feel prejudice toward\u2014even to hate\u2014obese people? Puhl and Heuer suggest that these feelings stem from the perception that obesity is preventable through self-control, better diet, and more exercise. Highlighting this contention is the fact that studies have shown that people\u2019s perceptions of obesity are more positive when they think the obesity was caused by non-controllable factors like biology (a thyroid condition, for instance) or genetics. \n\n Even with some understanding of non-controllable factors that might affect obesity, obese people are still subject to stigmatization. Puhl and Heuer\u2019s study is one of many that document discrimination at work, in the media, and even in the medical profession. Obese people are less likely to get into college than thinner people, and they are less likely to succeed at work.  \n\n Stigmatization of obese people comes in many forms, from the seemingly benign to the potentially illegal. In movies and television show, overweight people are often portrayed negatively, or as stock characters who are the butt of jokes. One study found that in children\u2019s movies \u201cobesity was equated with negative traits (evil, unattractive, unfriendly, cruel) in 64 percent of the most popular children's videos. In 72 percent of the videos, characters with thin bodies had desirable traits, such as kindness or happiness\u201d (Hines and Thompson 2007). In movies and television for adults, the negative portrayal is often meant to be funny. \u201cFat suits\u201d\u2014inflatable suits that make people look obese\u2014are commonly used in a way that perpetuates negative stereotypes. Think about the way you have seen obese people portrayed in movies and on television; now think of any other subordinate group being openly denigrated in such a way. It is difficult to find a parallel example. \n19.4   Comparative Health and Medicine \n\n There are broad, structural differences among the health care systems of different countries. In core nations, those differences might arise in the administration of health care, while the care itself is similar. In peripheral and semi-peripheral countries, a lack of basic health care administration can be the defining feature of the system. Most countries rely on some combination of modern and traditional medicine. In core countries with large investments in technology, research, and equipment, the focus is usually on modern medicine, with traditional (also called alternative or complementary) medicine playing a secondary role. In the United States, for instance, the American Medical Association (AMA) resolved to support the incorporation of complementary and alternative medicine in medical education. In developing countries, even quickly modernizing ones like China, traditional medicine (often understood as \u201ccomplementary\u201d by the western world) may still play a larger role. \n\n American Health Care \n\n United States health care coverage can broadly be divided into two main categories:  public health care  (government-funded) and  private health care  (privately funded).  The two main publicly funded health care programs are Medicare, which provides health services to people over 65 years old as well as people who meet other standards for disability, and Medicaid, which provides services to people with very low incomes who meet other eligibility requirements. Other government-funded programs include service agencies focused on Native Americans (the Indian Health Service), Veterans (the Veterans Health Administration), and children (the Children\u2019s Health Insurance Program). A controversial issue in 2011 was a proposed constitutional amendment requiring a balanced federal budget, which would almost certainly require billions of dollars in cuts to these programs. As discussed below, the United States already has a significant problem with lack of health care coverage for many individuals; if these budget cuts pass, the already heavily burdened programs are sure to suffer, and so are the people they serve (Kogan 2011). \n\n The U.S. Census (2011) divides private insurance into employment-based insurance and direct-purchase insurance. Employment-based insurance is health plan coverage that is provided in whole or in part by an employer or union; it can cover just the employee, or the employee and his or her family. Direct purchase insurance is coverage that an individual buys directly from a private company. \n\n With all these insurance options, insurance coverage must be almost universal, right? Unfortunately, the U.S. Census Current Population Survey of 2010 and 2011 shows that 16 percent of Americans have no health insurance at all. Equally alarming, a study by the Commonwealth Fund shows that in 2010, 81 million adults were either uninsured or  underinsured ; that is, people who pay at least ten percent of their income on health care costs not covered by insurance or, for low-income adults, those whose medical expenses or deductibles are at least five percent of their income (Schoen, Doty, Robertson, and Collins 2011). The Commonwealth study further reports that while underinsurance has historically been an issue that low-income families faced, today it is affecting middle-income families more and more. \n\n Why are so many people uninsured or underinsured? Skyrocketing health care costs are part of the issue. Many people cannot afford private health insurance, but their income level is not low enough to meet eligibility standards for government supported insurance. Further, even for those who are eligible for Medicaid, the program is less than perfect. Many physicians refuse to accept Medicaid patients, citing low payments and extensive paperwork (Washington University Center for Health Policy N.d.).  \n\n Health care in the United States is a complex issue, and it will only get more so with the continued enactment of the Patient Protection and Affordable Care Act (PPACA) of 2010. This Act, sometimes called \u201cObamaCare\u201d for its most noted advocate, President Barack Obama, represents large-scale federal reform of the United States\u2019 health care system. Most of the provisions of the Act will take effect by 2014, but some were effective immediately on passage. The PPACA aims to address some of the biggest flaws of the current health care system. It expands eligibility to programs like Medicaid and CHIP, helps guarantee insurance coverage for people with pre-existing conditions, and establishes regulations to make sure that the premium funds collected by insurers and care providers go directly to medical care. It also includes an  individual mandate , which requires everyone to have insurance coverage by 2014 or pay a penalty. A series of provisions, including significant subsidies, are intended to address the discrepancies in income that are currently contributing to high rates of uninsurance and underinsurance. \n\n The PPACA has been incredibly contentious. Private insurance companies have been among the strongest opponents of the law. But many Americans are also concerned that the PPACA will actually result in their medical bills increasing. In particular, some people oppose the individual mandate on the grounds that the federal government should not require them to have health care. A coalition of 26 states and the National Federation of Independent Businesses brought suit against the federal government, citing a violation of state sovereignty and concerns about costs of administering the program.  \n\n Health Care Elsewhere \n\n Clearly, health care in the United States has some areas for improvement. But how does it compare to health care in other countries? Many Americans are fond of saying that this country has the best health care in the world, and while it is true that the United States has a higher quality of care available than many peripheral or semi-peripheral nations, it is not necessarily the \u201cbest in the world.\u201d In a report on how American health care compares to that of other countries, researchers found that the United States does \u201crelatively well in some areas\u2014such as cancer care\u2014and less well in others\u2014such as mortality from conditions amenable to prevention and treatment\u201d (Docteur and Berenson 2009).  \n\n One critique of the Patient Protection and Affordable Care Act is that it will create a system of socialized medicine, a term that for many Americans has negative connotations lingering from the Cold War era and earlier. Under a  socialized medicine  system, the government owns and runs the system. It employs the doctors, nurses, and other staff, and it owns and runs the hospitals (Klein 2009). The best example of socialized medicine is in Great Britain, where the National Health System (NHS) gives free health care to all its residents. And despite some Americans\u2019 knee-jerk reaction to any health care changes that hint of socialism, the United States has one socialized system with the Veterans Health Administration. \n\n It is important to distinguish between socialized medicine, in which the government owns the health care system, and  universal health care , which is simply a system that guarantees health care coverage for everyone. Germany, Singapore, and Canada all have universal health care. People often look to Canada\u2019s universal health care system, Medicare, as a model for the system. In Canada, health care is publicly funded and is administered by the separate provincial and territorial governments. However, the care itself comes from private providers. This is the main difference between universal health care and socialized medicine. The Canada Health Act of 1970 required that all health insurance plans must be \u201cavailable to all eligible Canadian residents, comprehensive in coverage, accessible, portable among provinces, and publicly administered\u201d (International Health Systems Canada 2010). \n\n Heated discussions about socialization of medicine and managed care options seem frivolous when compared with the issues of health care systems in developing or underdeveloped countries. In many countries, per capita income is so low, and governments are so fractured, that health care as we know it is virtually non-existent. Care that people in developed countries take for granted\u2014like hospitals, health care workers, immunizations, antibiotics and other medications, and even sanitary water for drinking and washing\u2014are unavailable to much of the population. Organizations like Doctors Without Borders, UNICEF, and the World Health Organization have played an important role in helping these countries get their most basic health needs met.  \n\n WHO, which is the health arm of the United Nations, set eight Millennium Development Goals (MDGs) in 2000 with the aim of reaching these goals by 2015. Some of the goals deal more broadly with the socioeconomic factors that influence health, but MDGs 4, 5, and 6 all relate specifically to large-scale health concerns, the likes of which most Americans will never contemplate. MDG 4 is to reduce child mortality, MDG 5 aims to improve maternal health, and MDG 6 strives to combat HIV/AIDS, malaria, and other diseases. The goals may not seem particularly dramatic, but the numbers behind them show how serious they are.  \n\n For MDG 4, the WHO reports that 2009 infant mortality rates in \u201cchildren under 5 years old in the WHO African Region (127 per 1000 live births) and in low-income countries (117 per 1000 live births) [had dropped], but they were still higher than the 1990 global level of 89 per 1000 live births\u201d (World Health Organization 2011). The fact that these deaths could have been avoided through appropriate medicine and clean drinking water shows the importance of health care.  \n\n Much progress has been made on MDG 5, with maternal deaths decreasing by 34 percent. However, almost all maternal deaths occurred in developing countries, with the African region still experiencing high numbers (World Health Organization 2011).  \n\n On MDG 6, the WHO is seeing some decreases in per capita incidence rates of malaria, tuberculosis, HIV/AIDS, and other diseases. However, the decreases are often offset by population increases (World Health Organization 2011). Again, the lowest-income countries, especially in the African region, experience the worst problems with disease. \n19.5   Theoretical Perspectives on Health and Medicine \n\n Each of the three major theoretical perspectives approaches the topics of health, illness, and medicine differently. You may prefer just one of the theories that follow, or you may find that combining theories and perspectives provides a fuller picture of how we experience health and wellness. \n\n Functionalism \n\n According to the functionalist perspective, health is vital to the stability of the society, and therefore sickness is a sanctioned form of deviance. Talcott Parsons (1951) was the first to discuss this in terms of the  sick role : patterns of expectations that define appropriate behavior for the sick and for those who take care of them. \n\n According to Parsons, the sick person has a specific role with both rights and responsibilities. To start with, she has not chosen to be sick and should not be treated as responsible for her condition. The sick person also has the right of being exempt from normal social roles; she is not required to fulfill the obligation of a well person and can avoid her normal responsibilities without censure. However, this exemption is temporary and relative to the severity of the illness. The exemption also requires  legitimation  by a physician; that is, a physician must certify that the illness is genuine. \n\n  The responsibility of the sick person is twofold: to try to get well and to seek technically competent help from a physician. If the sick person stays ill longer than is appropriate (malingers), she may be stigmatized. \n\n Parsons argues that since the sick are unable to fulfill their normal societal roles, their sickness weakens the society. Therefore, it is sometimes necessary for various forms of social control to bring the behavior of a sick person back in line with normal expectations. In this model of health, doctors serve as gatekeepers, deciding who is healthy and who is sick\u2014a relationship in which the doctor has all the power. But is it appropriate to allow doctors so much power over deciding who is sick? And what about people who are sick, but are unwilling to leave their positions for any number of reasons (personal/social obligations, financial need, or lack of insurance, for instance).  \n\n Conflict Perspective \n\n Theorists using the conflict perspective suggest that issues with the healthcare system, as with most other social problems, are rooted in capitalist society. According to conflict theorists, capitalism and the pursuit of profit lead to the  commodification  of health: the changing of something not generally thought of as a commodity into something that can be bought and sold in a marketplace. In this view, people with money and power\u2014the dominant group\u2014are the ones who make decisions about how the health care system will be run. They therefore ensure that they will have health care coverage, while simultaneously ensuring that subordinate groups stay subordinate through lack of access. This creates significant health care\u2014and health\u2014disparities between the dominant and subordinate groups.  \n\n Alongside the health disparities created by class inequalities, there are a number of health disparities created by racism, sexism, ageism, and heterosexism. When health is a commodity, the poor are more likely to experience illness caused by poor diet, to live and work in unhealthy environments, and are less likely to challenge the system. In the United States, a disproportionate number of racial minorities also have less economic power, so they bear a great deal of the burden of poor health. It is not only the poor who suffer from the conflict between dominant and subordinate groups. For many years now, homosexual couples have been denied spousal benefits, either in the form of health insurance or in terms of medical responsibility. Further adding to the issue, doctors hold a disproportionate amount of power in the doctor/patient relationship, which provides them with extensive social and economic benefits. \n\n While conflict theorists are accurate in pointing out certain inequalities in the health care system, they do not give enough credit to medical advances that would not have been made without an economic structure to support and reward researchers: a structure dependent on profitability. Additionally, in their criticism of the power differential between doctor and patient, they are perhaps dismissive of the hard-won medical expertise possessed by doctors and not patients, which renders a truly egalitarian relationship more elusive. \n\n Symbolic Interactionism \n\n According to theorists working in this perspective, health and illness are both socially constructed. As we discussed in the beginning of the chapter, interactionists focus on the specific meanings and causes people attribute to illness. The term  medicalization of deviance  refers to the process that changes \u201cbad\u201d behavior into \u201csick\u201d behavior. A related process is  demedicalization , in which \u201csick\u201d behavior is normalized again. Medicalization and demedicalization affect who responds to the patient, how people respond to the patient, and how people view the personal responsibility of the patient (Conrad and Schneider 1992). \n\n An example of medicalization is illustrated by the history of how our society views alcohol and alcoholism. During the 19th century, people who drank too much were considered bad, lazy people. They were called drunks, and it was not uncommon for them to be arrested or run out of a town. Drunks were not treated in a sympathetic way because, at that time, it was thought that it was their own fault that they could not stop drinking. During the latter half of the 20th century, however, people who drank too much were increasingly defined as alcoholics: people with a disease or a genetic predisposition to addiction who were not responsible for their drinking. With alcoholism defined as a disease and not a personal choice, alcoholics came to be viewed with more compassion and understanding. Thus, \u201cbadness\u201d was transformed into \u201csickness.\u201d \n\n There are numerous examples of demedicalization in history as well. During the Civil War era, slaves who frequently ran away from their owners were diagnosed with a mental disorder called  drapetomania . This has since been reinterpreted as a completely appropriate response to being enslaved. A more recent example is homosexuality, which was labeled a mental disorder or a sexual orientation disturbance by the American Psychological Association until 1973.  \n\n While interactionism does acknowledge the subjective nature of diagnosis, it is important to remember who most benefits when a behavior becomes defined as illness. Pharmaceutical companies make billions treating illnesses such as fatigue, insomnia, and hyperactivity that may not actually be illnesses in need of treatment, but opportunities for companies to make more money. ", "questions": [{"question": {"question_id": "sq1901_ex01", "question_text": "Who determines which illnesses are stigmatized?", "question_choices": ["Therapists", "The patients themselves", "Society", "All of the above"], "cloze_format": "___ determine which illnesses are stigmatized.", "normal_format": "Who determines which illnesses are stigmatized?"}, "answer": {"ans_text": "Society", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Stigmatization means that their identity is spoiled ; they are labeled as different , discriminated against , and sometimes even shunned . They are labeled ( as an interactionist might point out ) and ascribed a master status ( as a functionalist might note ) , becoming \u201c the blind girl \u201d or \u201c the boy in the wheelchair \u201d instead of someone afforded a full identity by society . For instance , sociologist Erving Goffman ( 1963 ) described how social stigmas hinder individuals from fully integrating into society . The stigmatization of illness often has the greatest effect on the patient and the kind of care he or she receives . Many contend that our society and even our health care institutions discriminate against certain diseases \u2014 like mental disorders , AIDS , venereal diseases , and skin disorders ( Sartorius 2007 ) . Our culture , not our biology , dictates which illnesses are stigmatized and which are not , which are considered disabilities and which are not , and which are deemed contestable ( meaning some medical professionals may find the existence of this ailment questionable ) as opposed to definitive ( illnesses that are unquestionably recognized in the medical profession ) ( Conrad and Barker 2010 ) .", "hl_context": "People with disabilities can be stigmatized by their illness . <hl> Stigmatization means that their identity is spoiled ; they are labeled as different , discriminated against , and sometimes even shunned . <hl> <hl> They are labeled ( as an interactionist might point out ) and ascribed a master status ( as a functionalist might note ) , becoming \u201c the blind girl \u201d or \u201c the boy in the wheelchair \u201d instead of someone afforded a full identity by society . <hl> This can be especially true for people who are disabled due to mental illness or disorders . <hl> For instance , sociologist Erving Goffman ( 1963 ) described how social stigmas hinder individuals from fully integrating into society . <hl> <hl> The stigmatization of illness often has the greatest effect on the patient and the kind of care he or she receives . <hl> <hl> Many contend that our society and even our health care institutions discriminate against certain diseases \u2014 like mental disorders , AIDS , venereal diseases , and skin disorders ( Sartorius 2007 ) . <hl> Facilities for these diseases may be sub-par ; they may be segregated from other health care areas or relegated to a poorer environment . The stigma may keep people from seeking help for their illness , making it worse than it needs to be . The Cultural Meaning of Illness Many medical sociologists contend that illnesses have both a biological and an experiential component , and that these components exist independently of each other . <hl> Our culture , not our biology , dictates which illnesses are stigmatized and which are not , which are considered disabilities and which are not , and which are deemed contestable ( meaning some medical professionals may find the existence of this ailment questionable ) as opposed to definitive ( illnesses that are unquestionably recognized in the medical profession ) ( Conrad and Barker 2010 ) . <hl>"}, {"question": {"question_id": "sq1901_ex02", "question_text": "Chronic fatigue syndrome is an example of _______________.", "question_choices": ["a stigmatized disease", "a contested illness", "a disability", "demedicalization"], "cloze_format": "Chronic fatigue syndrome is an example of _______________.", "normal_format": "What is chronic fatigue syndrome an example of?"}, "answer": {"ans_text": "a contested illness", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": "3", "hl_sentences": "Contested illnesses are those that are questioned or questionable by some medical professionals . Disorders like fibromyalgia or chronic fatigue syndrome may be either true illnesses or only in the patients \u2019 heads , depending on the opinion of the medical professional .", "hl_context": "<hl> Contested illnesses are those that are questioned or questionable by some medical professionals . <hl> <hl> Disorders like fibromyalgia or chronic fatigue syndrome may be either true illnesses or only in the patients \u2019 heads , depending on the opinion of the medical professional . <hl> This dynamic can affect how a patient seeks treatment and what kind of treatment he or she receives ."}, {"question": {"question_id": "sq1901_ex03", "question_text": "The Rating of Perceived Exertion (RPE) is an example of ________________", "question_choices": ["the social construction of health", "medicalization", "disability accommodations", "a contested illness"], "cloze_format": "The Rating of Perceived Exertion (RPE) is an example of ________________", "normal_format": "What is the Rating of Perceived Exertion (RPE) an example of?"}, "answer": {"ans_text": "the social construction of health", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": "3", "hl_sentences": "Today , many institutions of wellness acknowledge the degree to which individual perceptions shape the nature of health and illness . Regarding physical activity , for instance , the Centers for Disease Control ( CDC ) recommends that individuals use a standard level of exertion to assess their physical activity . This Rating of Perceived Exertion ( RPE ) gives a more complete view of an individual \u2019 s actual exertion level , since heart-rate or pulse measurements may be affected by medication or other issues ( Centers for Disease Control 2011a ) . The Social Construction of the Illness Experience The idea of the social construction of the illness experience is based on the concept of reality as a social construction . In other words , there is no objective reality ; there are only our own perceptions of it . The social construction of the illness experience deals with such issues as the way some patients control the manner in which they reveal their disease and the lifestyle adaptations patients develop to cope with their illnesses . The idea of the social construction of health emphasizes the socio-cultural aspects of the discipline \u2019 s approach to physical , objectively definable phenomena .", "hl_context": "<hl> Today , many institutions of wellness acknowledge the degree to which individual perceptions shape the nature of health and illness . <hl> <hl> Regarding physical activity , for instance , the Centers for Disease Control ( CDC ) recommends that individuals use a standard level of exertion to assess their physical activity . <hl> <hl> This Rating of Perceived Exertion ( RPE ) gives a more complete view of an individual \u2019 s actual exertion level , since heart-rate or pulse measurements may be affected by medication or other issues ( Centers for Disease Control 2011a ) . <hl> Similarly , many medical professionals use a comparable scale for perceived pain to help determine pain management strategies . <hl> The Social Construction of the Illness Experience The idea of the social construction of the illness experience is based on the concept of reality as a social construction . <hl> <hl> In other words , there is no objective reality ; there are only our own perceptions of it . <hl> <hl> The social construction of the illness experience deals with such issues as the way some patients control the manner in which they reveal their disease and the lifestyle adaptations patients develop to cope with their illnesses . <hl> The social construction of health is a major research topic within medical sociology . At first glance , the concept of a social construction of health does not seem to make sense . After all , if disease is a measurable , physiological problem , then there can be no question of socially constructing disease , right ? Well , it \u2019 s not that simple . <hl> The idea of the social construction of health emphasizes the socio-cultural aspects of the discipline \u2019 s approach to physical , objectively definable phenomena . <hl> Sociologists Conrad and Barker ( 2010 ) offer a comprehensive framework for understanding the major findings of the last 50 years of development in this concept . Their summary categorizes the findings in the field under three subheadings : the cultural meaning of illness , the social construction of the illness experience , and the social construction of medical knowledge ."}, {"question": {"question_id": "sq1902_ex01", "question_text": "What is social epidemiology?", "question_choices": ["The study of why some diseases are stigmatized and others are not", "The study of why diseases spread", "The study of the mental health of a society", "The study of the causes and distribution of diseases"], "cloze_format": "Social epidemiology is ___ .", "normal_format": "What is social epidemiology?"}, "answer": {"ans_text": "The study of the causes and distribution of diseases", "ans_choice": 3}, "bloom": "1", "hl_sentences": "Social epidemiology is the study of the causes and distribution of diseases .", "hl_context": "<hl> Social epidemiology is the study of the causes and distribution of diseases . <hl> Social epidemiology can reveal how social problems are connected to the health of different populations . These epidemiological studies show that the health problems of high-income nations differ greatly from those of low-income nations . Some diseases , like cancer , are universal . But others , like obesity , heart disease , respiratory disease , and diabetes are much more common in high-income countries , and are a direct result of a sedentary lifestyle combined with poor diet . High-income nations also have a higher incidence of depression ( Bromet et al . 2011 ) . In contrast , low-income nations suffer significantly from malaria and tuberculosis ."}, {"question": {"question_id": "sq1902_ex03", "question_text": "Many deaths in high-income nations are linked to __________________", "question_choices": ["lung cancer", "obesity", "mental illness", "lack of clean water"], "cloze_format": "Many deaths in high-income nations are linked to __________________", "normal_format": "What are many deaths in high-income nations linked to?"}, "answer": {"ans_text": "obesity", "ans_choice": 1}, "bloom": "1", "hl_sentences": "Health in High-Income Nations Obesity , which is on the rise in high-income nations , has been linked to many diseases , including cardiovascular problems , musculoskeletal problems , diabetes , and respiratory issues . According to the Organization for Economic Cooperation and Development ( 2011 ) , obesity rates are rising in all countries , with the greatest gains being made in the highest-income countries . But others , like obesity , heart disease , respiratory disease , and diabetes are much more common in high-income countries , and are a direct result of a sedentary lifestyle combined with poor diet .", "hl_context": "<hl> Health in High-Income Nations Obesity , which is on the rise in high-income nations , has been linked to many diseases , including cardiovascular problems , musculoskeletal problems , diabetes , and respiratory issues . <hl> <hl> According to the Organization for Economic Cooperation and Development ( 2011 ) , obesity rates are rising in all countries , with the greatest gains being made in the highest-income countries . <hl> The United States has the highest obesity rate . Wallace Huffman and his fellow researchers ( 2006 ) contend that several factors are contributing to the rise in obesity in developed countries : Social epidemiology is the study of the causes and distribution of diseases . Social epidemiology can reveal how social problems are connected to the health of different populations . These epidemiological studies show that the health problems of high-income nations differ greatly from those of low-income nations . Some diseases , like cancer , are universal . <hl> But others , like obesity , heart disease , respiratory disease , and diabetes are much more common in high-income countries , and are a direct result of a sedentary lifestyle combined with poor diet . <hl> High-income nations also have a higher incidence of depression ( Bromet et al . 2011 ) . In contrast , low-income nations suffer significantly from malaria and tuberculosis ."}, {"question": {"question_id": "sq1902_ex04", "question_text": "According to the World Health Organization, what was the most frequent cause of death for children under five in low income countries?", "question_choices": ["Starvation", "Thirst", "Pneumonia and diarrheal diseases", "All of the above"], "cloze_format": "According to the World Health Organization, the most frequent cause of death for children under five in low income countries was ___ .", "normal_format": "According to the World Health Organization, what was the most frequent cause of death for children under five in low income countries?"}, "answer": {"ans_text": "Pneumonia and diarrheal diseases", "ans_choice": 2}, "bloom": null, "hl_sentences": "The most frequent causes of death for children under five were pneumonia and diarrheal diseases , accounting for 18 percent and 15 percent , respectively .", "hl_context": "<hl> The most frequent causes of death for children under five were pneumonia and diarrheal diseases , accounting for 18 percent and 15 percent , respectively . <hl> These deaths could be easily avoidable with cleaner water and more coverage of available medical care ."}, {"question": {"question_id": "sq1901_01", "question_text": "Which of the following statements is not true?", "question_choices": ["The life expectancy of black males in the United States is approximately five years shorter than for white males.", "The infant mortality rate for blacks in the United States is almost double than it is for white.", "Blacks have lower cancer rates than whites.", "Hispanics have worse access to care than non-Hispanic whites."], "cloze_format": "It is a false statement that ___ .", "normal_format": "Which of the following statements is not true?"}, "answer": {"ans_text": "Blacks have lower cancer rates than whites.", "ans_choice": 2}, "bloom": "1", "hl_sentences": "Among whites , Hispanic whites received 60 percent inferior care of measures compared to non-Hispanic whites ( Agency for Health Research and Quality 2010 ) . When considering access to care , the figures were comparable . The discrepancy between black and white Americans shows the gap clearly ; IN 2008 , the average life expectancy for white males was approximately five years longer than for black males : 75.9 compared to 70.9 . An even stronger disparity was found in 2007 : the infant mortality rate for blacks was nearly twice that of whites at 13.2 compared to 5.6 per 1,000 live births ( U . S . Census Bureau 2011 ) . According to a report from the Henry J . Kaiser Foundation ( 2007 ) , African Americans also have higher incidence of several other diseases and causes of mortality , from cancer to heart disease to diabetes . Globally , the rate of mortality for children under five was 60 per 1,000 live births . In low-income countries , however , that rate is almost double at 117 per 1,000 live births .", "hl_context": "<hl> Among whites , Hispanic whites received 60 percent inferior care of measures compared to non-Hispanic whites ( Agency for Health Research and Quality 2010 ) . <hl> <hl> When considering access to care , the figures were comparable . <hl> Health by Race and Ethnicity When looking at the social epidemiology of the United States , it is hard to miss the disparities among races . <hl> The discrepancy between black and white Americans shows the gap clearly ; IN 2008 , the average life expectancy for white males was approximately five years longer than for black males : 75.9 compared to 70.9 . <hl> <hl> An even stronger disparity was found in 2007 : the infant mortality rate for blacks was nearly twice that of whites at 13.2 compared to 5.6 per 1,000 live births ( U . S . Census Bureau 2011 ) . <hl> <hl> According to a report from the Henry J . Kaiser Foundation ( 2007 ) , African Americans also have higher incidence of several other diseases and causes of mortality , from cancer to heart disease to diabetes . <hl> In a similar vein , it is important to note that ethnic minorities , including Mexican Americans and Native Americans , also have higher rates of these diseases and causes of mortality than whites . <hl> Globally , the rate of mortality for children under five was 60 per 1,000 live births . <hl> <hl> In low-income countries , however , that rate is almost double at 117 per 1,000 live births . <hl> In high-income countries , that rate is significantly lower than seven per 1,000 live births ."}, {"question": {"question_id": "sq1901_02", "question_text": "The process by which aspects of life that were considered bad or deviant are redefined as sickness and needing medical attention to remedy is called:", "question_choices": ["deviance", "medicalization", "demedicalization", "intersection theory"], "cloze_format": "The process by which aspects of life that were considered bad or deviant are redefined as sickness and needing medical attention to remedy is called ___.", "normal_format": "What is called the process by which aspects of life that were considered bad or deviant are redefined as sickness and need medical attention to remedy?"}, "answer": {"ans_text": "medicalization", "ans_choice": 1}, "bloom": null, "hl_sentences": "Medicalization refers to the process by which previously normal aspects of life are redefined as deviant and needing medical attention to remedy .", "hl_context": "We can see an example of institutionalized sexism in the way that women are more likely than men to be diagnosed with certain kinds of mental disorders . Psychologist Dana Becker notes that 75 percent of all diagnoses of Borderline Personality Disorder ( BPD ) are for women according to the Diagnostic Statistical Manual of Mental Disorders . This diagnosis is characterized by instability of identity , of mood , and of behavior , and Becker argues that it has been used as a catch-all diagnosis for too many women . She further decries the pejorative connotation of the diagnosis , saying that it predisposes many people , both within and outside of the profession of psychotherapy , against women who have been so diagnosed ( Becker ) . Many critics also point to the medicalization of women \u2019 s issues as an example of institutionalized sexism . <hl> Medicalization refers to the process by which previously normal aspects of life are redefined as deviant and needing medical attention to remedy . <hl> Historically and contemporaneously , many aspects of women \u2019 s lives have been medicalized , including menstruation , pre-menstrual syndrome , pregnancy , childbirth , and menopause . The medicalization of pregnancy and childbirth has been particularly contentious in recent decades , with many women opting against the medical process and choosing a more natural childbirth . Fox and Worts ( 1999 ) find that all women experience pain and anxiety during the birth process , but that social support relieves both as effectively as medical support . In other words , medical interventions are no more effective than social ones at helping with the difficulties of pain and childbirth . Fox and Worts further found that women with supportive partners ended up with less medical intervention and fewer cases of postpartum depression . Of course , access to quality birth care outside of the standard medical models may not be readily available to women of all social classes ."}, {"question": {"question_id": "sq1901_03", "question_text": "What are the most commonly diagnosed mental disorders in the United States?", "question_choices": ["ADHD", "Mood disorders", "Autism spectrum disorders", "Anxiety disorders"], "cloze_format": "___ is/are the most commonly diagnosed mental disorders in the United States?", "normal_format": "What are the most commonly diagnosed mental disorders in the United States?"}, "answer": {"ans_text": "Anxiety disorders", "ans_choice": 3}, "bloom": "1", "hl_sentences": "According to the National Institute of Mental Health ( NIMH ) , the most common mental disorders in the United States are anxiety disorders .", "hl_context": "<hl> According to the National Institute of Mental Health ( NIMH ) , the most common mental disorders in the United States are anxiety disorders . <hl> Almost 18 percent of American adults are likely to be affected in a single year , and 28 percent are likely to be affected over the course of a lifetime ( National Institute of Mental Health 2005 ) . It is important to distinguish between occasional feelings of anxiety and a true anxiety disorder . Anxiety is a normal reaction to stress that we all feel at some point , but anxiety disorders are feelings of worry and fearfulness that last for months at a time . Anxiety disorders include obsessive compulsive disorder ( OCD ) , panic disorders , posttraumatic stress disorder ( PTSD ) , and both social and specific phobias ."}, {"question": {"question_id": "sq1901_05", "question_text": "The high unemployment rate among the disabled may be a result of ____________.", "question_choices": ["medicalization", "obesity", "stigmatization", "all of the above"], "cloze_format": "The high unemployment rate among the disabled may be a result of ____________.", "normal_format": "What may the high unemployment rate among the disabled be a result of?"}, "answer": {"ans_text": "stigmatization", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "As discussed in the section on mental health , many mental health disorders can be debilitating , affecting a person \u2019 s ability to cope with everyday life . This can affect social status , housing , and especially employment . According to the Bureau of Labor Statistics ( 2011 ) , people with a disability had a higher rate of unemployment thaN people without a disability in 2010 : 14.8 percent to 9.4 percent . People with disabilities can be stigmatized by their illness . Stigmatization means that their identity is spoiled ; they are labeled as different , discriminated against , and sometimes even shunned . This can be especially true for people who are disabled due to mental illness or disorders .", "hl_context": "<hl> As discussed in the section on mental health , many mental health disorders can be debilitating , affecting a person \u2019 s ability to cope with everyday life . <hl> <hl> This can affect social status , housing , and especially employment . <hl> <hl> According to the Bureau of Labor Statistics ( 2011 ) , people with a disability had a higher rate of unemployment thaN people without a disability in 2010 : 14.8 percent to 9.4 percent . <hl> This unemployment rate refers only to people actively looking for a job . In fact , eight out of 10 people with a disability are considered \u201c out of the labor force ; \u201d that is , they do not have jobs and are not looking for them . The combination of this population and the high unemployment rate leads to an employment-population ratio of 18.6 percent among those with disabilities . The employment-population ratio for people without disabilities was much higher , at 63.5 percent ( U . S . Bureau of Labor Statistics 2011 ) . <hl> People with disabilities can be stigmatized by their illness . <hl> <hl> Stigmatization means that their identity is spoiled ; they are labeled as different , discriminated against , and sometimes even shunned . <hl> They are labeled ( as an interactionist might point out ) and ascribed a master status ( as a functionalist might note ) , becoming \u201c the blind girl \u201d or \u201c the boy in the wheelchair \u201d instead of someone afforded a full identity by society . <hl> This can be especially true for people who are disabled due to mental illness or disorders . <hl>"}, {"question": {"question_id": "fs-id1844852", "question_text": "Which public health care system offers insurance primarily to people over 65?", "question_choices": ["Medicaid", "Medicare", "Veterans Health Administration", "All of the above"], "cloze_format": "___ is a public health care system that offers insurance primarily to people over 65.", "normal_format": "Which public health care system offers insurance primarily to people over 65?"}, "answer": {"ans_text": "Medicare", "ans_choice": 1}, "bloom": null, "hl_sentences": "The two main publicly funded health care programs are Medicare , which provides health services to people over 65 years old as well as people who meet other standards for disability , and Medicaid , which provides services to people with very low incomes who meet other eligibility requirements .", "hl_context": "United States health care coverage can broadly be divided into two main categories : public health care ( government-funded ) and private health care ( privately funded ) . <hl> The two main publicly funded health care programs are Medicare , which provides health services to people over 65 years old as well as people who meet other standards for disability , and Medicaid , which provides services to people with very low incomes who meet other eligibility requirements . <hl> Other government-funded programs include service agencies focused on Native Americans ( the Indian Health Service ) , Veterans ( the Veterans Health Administration ) , and children ( the Children \u2019 s Health Insurance Program ) . A controversial issue in 2011 was a proposed constitutional amendment requiring a balanced federal budget , which would almost certainly require billions of dollars in cuts to these programs . As discussed below , the United States already has a significant problem with lack of health care coverage for many individuals ; if these budget cuts pass , the already heavily burdened programs are sure to suffer , and so are the people they serve ( Kogan 2011 ) ."}, {"question": {"question_id": "fs-id1703410", "question_text": "Which program is an example of socialized medicine?", "question_choices": ["Canada\u2019s system", "The United States\u2019 Veterans Health Administration", "The United States\u2019 new system under the Patient Protection and Affordable Care Act", "Medicaid"], "cloze_format": "The program that is an example of socialized medicine is ___.", "normal_format": "Which program is an example of socialized medicine?"}, "answer": {"ans_text": "The United States\u2019 Veterans Health Administration", "ans_choice": 1}, "bloom": "3", "hl_sentences": "Under a socialized medicine system , the government owns and runs the system . And despite some Americans \u2019 knee-jerk reaction to any health care changes that hint of socialism , the United States has one socialized system with the Veterans Health Administration .", "hl_context": "One critique of the Patient Protection and Affordable Care Act is that it will create a system of socialized medicine , a term that for many Americans has negative connotations lingering from the Cold War era and earlier . <hl> Under a socialized medicine system , the government owns and runs the system . <hl> It employs the doctors , nurses , and other staff , and it owns and runs the hospitals ( Klein 2009 ) . The best example of socialized medicine is in Great Britain , where the National Health System ( NHS ) gives free health care to all its residents . <hl> And despite some Americans \u2019 knee-jerk reaction to any health care changes that hint of socialism , the United States has one socialized system with the Veterans Health Administration . <hl>"}, {"question": {"question_id": "fs-id1889359", "question_text": "What will the individual mandate provision of the 2010 U.S. health care reform do?", "question_choices": ["Require everyone to buy insurance from the government", "Require everyone to sign up for Medicaid", "Require everyone to have insurance or pay a penalty", "None of the above"], "cloze_format": "The individual mandate provision of the 2010 U.S. health care reform will ___ .", "normal_format": "What will the individual mandate provision of the 2010 U.S. health care reform do?"}, "answer": {"ans_text": "Require everyone to have insurance or pay a penalty", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Health care in the United States is a complex issue , and it will only get more so with the continued enactment of the Patient Protection and Affordable Care Act ( PPACA ) of 2010 . It also includes an individual mandate , which requires everyone to have insurance coverage by 2014 or pay a penalty .", "hl_context": "<hl> Health care in the United States is a complex issue , and it will only get more so with the continued enactment of the Patient Protection and Affordable Care Act ( PPACA ) of 2010 . <hl> This Act , sometimes called \u201c ObamaCare \u201d for its most noted advocate , President Barack Obama , represents large-scale federal reform of the United States \u2019 health care system . Most of the provisions of the Act will take effect by 2014 , but some were effective immediately on passage . The PPACA aims to address some of the biggest flaws of the current health care system . It expands eligibility to programs like Medicaid and CHIP , helps guarantee insurance coverage for people with pre-existing conditions , and establishes regulations to make sure that the premium funds collected by insurers and care providers go directly to medical care . <hl> It also includes an individual mandate , which requires everyone to have insurance coverage by 2014 or pay a penalty . <hl> A series of provisions , including significant subsidies , are intended to address the discrepancies in income that are currently contributing to high rates of uninsurance and underinsurance ."}, {"question": {"question_id": "fs-id1892417", "question_text": "Great Britain\u2019s health care system is an example of ______________", "question_choices": ["socialized medicine", "private health care", "single-payer private health care", "universal private health care"], "cloze_format": "Great Britain\u2019s health care system is an example of ______________", "normal_format": "What is Great Britain's health care system an example of?"}, "answer": {"ans_text": "socialized medicine", "ans_choice": 0}, "bloom": null, "hl_sentences": "The best example of socialized medicine is in Great Britain , where the National Health System ( NHS ) gives free health care to all its residents .", "hl_context": "One critique of the Patient Protection and Affordable Care Act is that it will create a system of socialized medicine , a term that for many Americans has negative connotations lingering from the Cold War era and earlier . Under a socialized medicine system , the government owns and runs the system . It employs the doctors , nurses , and other staff , and it owns and runs the hospitals ( Klein 2009 ) . <hl> The best example of socialized medicine is in Great Britain , where the National Health System ( NHS ) gives free health care to all its residents . <hl> And despite some Americans \u2019 knee-jerk reaction to any health care changes that hint of socialism , the United States has one socialized system with the Veterans Health Administration ."}, {"question": {"question_id": "fs-id1248891", "question_text": "What group created the Millennium Development Goals?", "question_choices": ["UNICEF", "The Kaiser Family Foundation", "Doctors without Borders", "The World Health Organization"], "cloze_format": "The group that created the Millennium Development Goals was ___ .", "normal_format": "What group created the Millennium Development Goals?"}, "answer": {"ans_text": "The World Health Organization", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": "3", "hl_sentences": "WHO , which is the health arm of the United Nations , set eight Millennium Development Goals ( MDGs ) in 2000 with the aim of reaching these goals by 2015 . The World Health Organization ( WHO ) tracks health-related data for 193 countries .", "hl_context": "<hl> WHO , which is the health arm of the United Nations , set eight Millennium Development Goals ( MDGs ) in 2000 with the aim of reaching these goals by 2015 . <hl> Some of the goals deal more broadly with the socioeconomic factors that influence health , but MDGs 4 , 5 , and 6 all relate specifically to large-scale health concerns , the likes of which most Americans will never contemplate . MDG 4 is to reduce child mortality , MDG 5 aims to improve maternal health , and MDG 6 strives to combat HIV / AIDS , malaria , and other diseases . The goals may not seem particularly dramatic , but the numbers behind them show how serious they are . One of the biggest contributors to medical issues in low-income countries is the lack of access to clean water and basic sanitation resources . According to a 2011 UNICEF report , almost half of the developing world \u2019 s population lacks improved sanitation facilities . <hl> The World Health Organization ( WHO ) tracks health-related data for 193 countries . <hl> In their 2011 World Health Statistics report , they document the following statistics :"}, {"question": {"question_id": "fs-id1530786", "question_text": "Which of the following is not part of the rights and responsibilities of a sick person under the functionalist perspective?", "question_choices": ["The sick person is not responsible for his condition.", "The sick person must try to get better.", "The sick person can take as long as she wants to get better.", "The sick person is exempt from the normal duties of society."], "cloze_format": "The statement that is not part of the rights and responsibilities of a sick person under the functionalist perspective is that ___ .", "normal_format": "Which of the following is not part of the rights and responsibilities of a sick person under the functionalist perspective?"}, "answer": {"ans_text": "The sick person can take as long as she wants to get better.", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": "3", "hl_sentences": "The responsibility of the sick person is twofold : to try to get well and to seek technically competent help from a physician . According to Parsons , the sick person has a specific role with both rights and responsibilities . To start with , she has not chosen to be sick and should not be treated as responsible for her condition . The sick person also has the right of being exempt from normal social roles ; she is not required to fulfill the obligation of a well person and can avoid her normal responsibilities without censure .", "hl_context": "<hl> The responsibility of the sick person is twofold : to try to get well and to seek technically competent help from a physician . <hl> If the sick person stays ill longer than is appropriate ( malingers ) , she may be stigmatized . <hl> According to Parsons , the sick person has a specific role with both rights and responsibilities . <hl> <hl> To start with , she has not chosen to be sick and should not be treated as responsible for her condition . <hl> <hl> The sick person also has the right of being exempt from normal social roles ; she is not required to fulfill the obligation of a well person and can avoid her normal responsibilities without censure . <hl> However , this exemption is temporary and relative to the severity of the illness . The exemption also requires legitimation by a physician ; that is , a physician must certify that the illness is genuine ."}, {"question": {"question_id": "fs-id1843080", "question_text": "The class, race, and gender inequalities in our healthcare system support the _____________ perspective.", "question_choices": ["conflict", "interactionist", "functionalist", "all of the above"], "cloze_format": "The class, race, and gender inequalities in our healthcare system support the _____________ perspective.", "normal_format": "Which perspective supports the class, race, and gender inequalities in our healthcare system?"}, "answer": {"ans_text": "conflict", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "The conflict perspective is another macroanalytical perspective that focuses on the creation and reproduction of inequality . Someone applying the conflict perspective might focus on inequalities within the health system itself , looking at disparities in race , ethnicity , gender , and age .", "hl_context": "Sociologists may also understand these issues more fully by considering them through one of the main theoretical perspectives of the discipline . The functionalist perspective is a macroanalytical perspective that looks at the big picture , focusing on the way that all aspects of society are integral to the continued health and viability of the whole . For those working within the functionalist perspective , the focus is on how healthy individuals have the most to contribute to the stability of society . Functionalists might study the most efficient way to restore \u201c sick \u201d individuals to a healthy state . <hl> The conflict perspective is another macroanalytical perspective that focuses on the creation and reproduction of inequality . <hl> <hl> Someone applying the conflict perspective might focus on inequalities within the health system itself , looking at disparities in race , ethnicity , gender , and age . <hl> Someone applying the interactionist perspective to health might focus on how people understand their health , and how their health affects their relationships with the people in their lives ."}, {"question": {"question_id": "fs-id17034103", "question_text": "The removal of homosexuality from the DSM is an example of ____________.", "question_choices": ["medicalization ", "deviance", "interactionist theory", "demedicalization"], "cloze_format": "The removal of homosexuality from the DSM is an example of ____________.", "normal_format": "What is the removal of homosexuality from the DSM an example of?"}, "answer": {"ans_text": "demedicalization", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "There are numerous examples of demedicalization in history as well . A more recent example is homosexuality , which was labeled a mental disorder or a sexual orientation disturbance by the American Psychological Association until 1973 . A related process is demedicalization , in which \u201c sick \u201d behavior is normalized again . The American Psychological Association publishes the Diagnostic and Statistical Manual on Mental Disorders ( DSM ) , and their definition of personality disorders is changing in the fifth edition , which is being revised in 2011 and 2012 .", "hl_context": "<hl> There are numerous examples of demedicalization in history as well . <hl> During the Civil War era , slaves who frequently ran away from their owners were diagnosed with a mental disorder called drapetomania . This has since been reinterpreted as a completely appropriate response to being enslaved . <hl> A more recent example is homosexuality , which was labeled a mental disorder or a sexual orientation disturbance by the American Psychological Association until 1973 . <hl> According to theorists working in this perspective , health and illness are both socially constructed . As we discussed in the beginning of the chapter , interactionists focus on the specific meanings and causes people attribute to illness . The term medicalization of deviance refers to the process that changes \u201c bad \u201d behavior into \u201c sick \u201d behavior . <hl> A related process is demedicalization , in which \u201c sick \u201d behavior is normalized again . <hl> Medicalization and demedicalization affect who responds to the patient , how people respond to the patient , and how people view the personal responsibility of the patient ( Conrad and Schneider 1992 ) . Depending on what definition is used , there is some overlap between mood disorders and personality disorders , which affect nine percent of Americans yearly . <hl> The American Psychological Association publishes the Diagnostic and Statistical Manual on Mental Disorders ( DSM ) , and their definition of personality disorders is changing in the fifth edition , which is being revised in 2011 and 2012 . <hl> In the DSM-IV , personality disorders represent \u201c an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it \u201d ( National Institute of Mental Health ) . In other words , personality disorders cause people to behave in ways that are seen as abnormal to society but seem normal to them . The DSM-V proposes broadening this definition by offering five broad personality trait domains to describe personality disorders , some related to the level or type of their disconnect with society . As their application evolves , we will see how their definitions help scholars across disciplines understand the intersection of health issues and how they are defined by social institutions and cultural norms ."}], "summary": "", "keyterm": "", "bname": "introduction_to_sociology"}, {"chapter": 5, "intro": "Learning Objectives 5.1   Theories of Self Development \n\n Understand the difference between psychological and sociological theories of self development \n\n Explain the process of moral development \n\n 5.2   Why Socialization Matters \n\n Understand the importance of socialization both for individuals and society \n\n Explain the nature versus nurture debate \n\n 5.3   Agents of Socialization \n\n Learn the roles of families and peer groups in socialization \n\n Understand how we are socialized through formal institutions like schools, workplaces, and the government \n\n 5.4   Socialization Across the Life Course \n\n Explain how socialization occurs and recurs throughout life \n\n Understand how people are socialized into new roles at age-related transition points \n\n Describe when and how resocialization occurs \n\n Introduction to Socialization \n\n In the summer of 2005, police detective Mark Holste followed an investigator from the Department of Children and Families to a home in Plant City, Florida. They were there to look into a statement from the neighbor concerning a shabby house on Old Sydney Road. A small girl was reported peering from one of its broken windows. This seemed odd because no one in the neighborhood had seen a young child in or around the home, which had been inhabited for the past three years by a woman, her boyfriend, and two adult sons. \n\n Who was the mystery girl in the window? \n\n Entering the house, Detective Holste and his team were shocked. It was the worst mess they\u2019d ever seen, infested with cockroaches, smeared with feces and urine from both people and pets, and filled with dilapidated furniture and ragged window coverings. \n\n Detective Holste headed down a hallway and entered a small room. That\u2019s where he found the little girl, with big, vacant eyes, staring into the darkness. A newspaper report later described the detective\u2019s first encounter with the child: \u201cShe lay on a torn, moldy mattress on the floor. She was curled on her side . . . her ribs and collarbone jutted out . . . her black hair was matted, crawling with lice. Insect bites, rashes and sores pocked her skin . . . She was naked\u2014except for a swollen diaper. \u2026 Her name, her mother said, was Danielle. She was almost seven years old\u201d (DeGregory 2008). \n\n Detective Holste immediately carried Danielle out of the home. She was taken to a hospital for medical treatment and evaluation. Through extensive testing, doctors determined that, although she was severely malnourished, Danielle was able to see, hear, and vocalize normally. Still, she wouldn\u2019t look anyone in the eyes, didn\u2019t know how to chew or swallow solid food, didn\u2019t cry, didn\u2019t respond to stimuli that would typically cause pain, and didn\u2019t know how to communicate either with words or simple gestures such as nodding \u201cyes\u201d or \u201cno.\u201d Likewise, although tests showed she had no chronic diseases or genetic abnormalities, the only way she could stand was with someone holding onto her hands, and she \u201cwalked sideways on her toes, like a crab\u201d (DeGregory 2008). \n\n What had happened to Danielle? Put simply: beyond the basic requirements for survival, she had been neglected. Based on their investigation, social workers concluded that she had been left almost entirely alone in rooms like the one where she was found. Without regular interaction\u2014the holding, hugging, talking, the explanations and demonstrations given to most young children\u2014she had not learned to walk or to speak, to eat or to interact, to play or even to understand the world around her. From a sociological point of view, Danielle had not had been socialized. \n\n Socialization  is the process through which people are taught to be proficient members of a society. It describes the ways that people come to understand societal norms and expectations, to accept society\u2019s beliefs, and to be aware of societal values.  Socialization  is not the same as  socializing  (interacting with others, like family, friends, and coworkers); to be precise, it is a sociological process that occurs through socializing. As Danielle\u2019s story illustrates, even the most basic of human activities are learned. You may be surprised to know that even physical tasks like sitting, standing, and walking had not automatically developed for Danielle as she grew. And without socialization, Danielle hadn\u2019t learned about the material culture of her society (the tangible objects a culture uses): for example, she couldn\u2019t hold a spoon, bounce a ball, or use a chair for sitting. She also hadn\u2019t learned its nonmaterial culture, such as its beliefs, values, and norms. She had no understanding of the concept of \u201cfamily,\u201d didn\u2019t know cultural expectations for using a bathroom for elimination, and had no sense of modesty. Most importantly, she hadn\u2019t learned to use the symbols that make up language\u2014through which we learn about who we are, how we fit with other people, and the natural and social worlds in which we live. Sociologists have long been fascinated by circumstances like Danielle\u2019s\u2014in which a child receives sufficient human support to survive, but virtually no social interaction\u2014because they highlight how much we depend on social interaction to provide the information and skills that we need to be part of society or even to develop a \u201cself.\u201d \n\n The necessity for early social contact was demonstrated by the research of Harry and Margaret Harlow. From 1957 to 1963, the Harlows conducted a series of experiments studying how rhesus monkeys, which behave a lot like people, are affected by isolation as babies. They studied monkeys raised under two types of \u201csubstitute\u201d mothering circumstances: a mesh and wire sculpture, or a soft terrycloth \u201cmother.\u201d The monkeys systematically preferred the company of a soft, terrycloth substitute mother (closely resembling a rhesus monkey) that was unable to feed them, to a mesh and wire mother that provided sustenance via a feeding tube. This demonstrated that while food was important, social comfort was of greater value (Harlow and Harlow 1962; Harlow 1971). Later experiments testing more severe isolation revealed that such deprivation of social contact led to significant developmental and social challenges later in life. \n\n In the following sections, we will examine the importance of the complex process of socialization and how it takes place through interaction with many individuals, groups, and social institutions. We will explore how socialization is not only critical to children as they develop, but how it is a lifelong process through which we become prepared for new social environments and expectations in every stage of our lives. But first, we will turn to scholarship about self development, the process of coming to recognize a sense of self, a \u201cself\u201d that is then able to be socialized. ", "chapter_text": "5.1   Theories of Self Development \n\n When we are born, we have a genetic makeup and biological traits. However, who we are as human beings develops through social interaction. Many scholars, both in the fields of psychology and in sociology, have described the process of self development as a precursor to understanding how that \u201cself\u201d becomes socialized. \n\n Psychological Perspectives on Self-Development \n\n Psychoanalyst Sigmund Freud (1856\u20131939) was one of the most influential modern scientists to put forth a theory about how people develop a sense of self. He believed that personality and sexual development were closely linked, and he divided the maturation process into psychosexual stages: oral, anal, phallic, latency, and genital. He posited that people\u2019s self development is closely linked to early stages of development, like breastfeeding, toilet training, and sexual awareness (Freud 1905). \n\n According to Freud, failure to properly engage in or disengage from a specific stage results in emotional and psychological consequences throughout adulthood. An adult with an oral fixation may indulge in overeating or binge drinking. An anal fixation may produce a neat freak (hence the term \u201canal retentive\u201d), while a person stuck in the phallic stage may be promiscuous or emotionally immature. Although no solid empirical evidence supports Freud\u2019s theory, his ideas continue to contribute to the work of scholars in a variety of disciplines. \n\n Sociological Research Sociology or Psychology: What\u2019s the Difference? You might be wondering: if sociologists and psychologists are both interested in people and their behavior, how are these two disciplines different? What do they agree on, and where do their ideas diverge? The answers are complicated, but the distinction is important to scholars in both fields. \n\n As a general difference, we might say that while both disciplines are interested in human behavior, psychologists are focused on how the mind influences that behavior, while sociologists study the role of society in shaping behavior. Psychologists are interested in people\u2019s mental development and how their minds process their world. Sociologists are more likely to focus on how different aspects of society contribute to an individual\u2019s relationship with his world. Another way to think of the difference is that psychologists tend to look inward (mental health, emotional processes), while sociologists tend to look outward (social institutions, cultural norms, interactions with others) to understand human behavior. \n\n Emile Durkheim (1958\u20131917) was the first to make this distinction in research, when he attributed differences in suicide rates among people to social causes (religious differences) rather than to psychological causes (like their mental wellbeing) (Durkheim 1897). Today, we see this same distinction. For example, a sociologist studying how a couple gets to the point of their first kiss on a date might focus her research on cultural norms for dating, social patterns of sexual activity over time, or how this process is different for seniors than for teens. A psychologist would more likely be interested in the person\u2019s earliest sexual awareness or the mental processing of sexual desire. \n\n Sometimes sociologists and psychologists have collaborated to increase knowledge. In recent decades, however, their fields have become more clearly separated as sociologists increasingly focus on large societal issues and patterns, while psychologists remain honed in on the human mind. Both disciplines make valuable contributions through different approaches that provide us with different types of useful insights. \n\n Psychologist Erik Erikson (1902\u20131994) created a theory of personality development based, in part, on the work of Freud. However, Erikson believed the personality continued to change over time and was never truly finished. His theory includes eight stages of development, beginning with birth and ending with death. According to Erikson, people move through these stages throughout their lives. In contrast to Freud\u2019s focus on psychosexual stages and basic human urges, Erikson\u2019s view of self development gave credit to more social aspects, like the way we negotiate between our own base desires and what is socially accepted (Erikson 1982). \n\n Jean Piaget (1896\u20131980) was a psychologist who specialized in child development, focusing specifically on the role of social interactions in their development. He recognized that the development of self evolved through a negotiation between the world as it exists in one\u2019s mind and the world that exists as it is experienced socially (Piaget 1954). All three of these thinkers have contributed to our modern understanding of self development. \n\n Sociological Theories of Self Development \n\n One of the pioneering contributors to sociological perspectives was Charles Cooley (1864\u20131929). He asserted that people\u2019s self understanding is constructed, in part, by their perception of how others view them\u2014a process termed \u201cthe looking glass self\u201d (Cooley 1902). \n\n Later, George Herbert Mead (1863\u20131931) studied the  self , a person\u2019s distinct identity that is developed through social interaction. In order to engage in this process of \u201cself,\u201d an individual has to be able to view him or herself through the eyes of others. That\u2019s not an ability that we are born with (Mead 1934). The case of Danielle, for example, illustrates what happens when social interaction is absent from early experience: she had no ability to see herself as others would see her. From Mead\u2019s point of view, she had no \u201cself.\u201d How do we get from being newborns to being humans with \u201cselves?\u201d Mead believed that there is a specific path of development that all people go through. During the preparatory stage, children are only capable of imitation: they have no ability to imagine how others see things. They copy the actions of people with whom they regularly interact, such as their mothers and fathers. This is followed by the play stage, during which children begin to take on the role that one other person might have. Thus, children might try on a parent\u2019s point of view by acting out \u201cgrownup\u201d behavior, like playing \u201cdress up\u201d and acting out the \u201cmom\u201d role, or talking on a toy telephone the way they see their father do. \n\n During the game stage, children learn to consider several roles at the same time and how those roles interact with each other. They learn to understand interactions involving different people with a variety of purposes. For example, a child at this is likely to be aware of the different responsibilities of people in a restaurant who together make for a smooth dining experience (someone seats you, another takes your order, someone else cooks the food, while yet another clears away dirty dishes). \n\n Finally, children develop, understand, and learn the idea of the  generalized other , the common behavioral expectations of general society. By this stage of development, an individual is able to imagine how he or she is viewed by one or many others\u2014and thus, from a sociological perspective, to have a \u201cself\u201d (Mead 1934; Mead 1964). Kohlberg\u2019s Theory of Moral Development \n\n Moral development  is an important part of the socialization process. The term refers to the way people learn what society considered to be \u201cgood\u201d and \u201cbad,\u201d which is important for a smoothly functioning society. Moral development prevents people from acting on unchecked urges, instead considering what is right for society and good for others. Lawrence Kohlberg (1927\u20131987) was interested in how people learn to decide what is right and what is wrong. To understand this topic, he developed a theory of moral development that includes three levels: preconventional, conventional, and postconventional. In the preconventional stage, young children, who lack a higher level of cognitive ability, experience the world around them only through their senses. It isn\u2019t until the teen years that the conventional theory develops, when youngsters become increasingly aware of others\u2019 feelings and take those into consideration when determining what\u2019s \u201cgood\u201d and \u201cbad.\u201d The final stage, called postconventional, is when people begin to think of morality in abstract terms, such as Americans believing that everyone has the right to life, liberty, and the pursuit of happiness. At this stage, people also recognize that legality and morality do not always match up evenly (Kohlberg 1981). When hundreds of thousands of Egyptians turned out in 2011 to protest government corruption, they were using postconventional morality. They understood that although their government was legal, it was not morally correct. \n\n Gilligan\u2019s Theory of Moral Development and Gender \n\n Another sociologist, Carol Gilligan (1936\u2013), recognized that Kohlberg\u2019s theory might show gender bias since his research was only conducted on male subjects. Would females study subjects have responded differently? Would a female social scientist notice different patterns when analyzing the research? To answer the first question, she set out to study differences between how boys and girls developed morality. Gilligan\u2019s research demonstrated that boys and girls do, in fact, have different understandings of morality. Boys tend to have a justice perspective, placing emphasis on rules and laws. Girls, on the other hand, have a care and responsibility perspective; they consider people\u2019s reasons behind behavior that seems morally wrong. \n\n Gilligan also recognized that Kohlberg\u2019s theory rested on the assumption that the justice perspective was the right, or better, perspective. Gilligan, in contrast, theorized that neither perspective was \u201cbetter\u201d: the two norms of justice served different purposes. Ultimately, she explained that boys are socialized for a work environment where rules make operations run smoothly, while girls are socialized for a home environment where flexibility allows for harmony in caretaking and nurturing (Gilligan 1982; Gilligan 1990). \n\n Sociology in the Real World What a Pretty Little Lady! \u201cWhat a cute dress!\u201d \u201cI like the ribbons in your hair.\u201d \u201cWow, you look so pretty today.\u201d \n\n According to Lisa Bloom, author of  Think: Straight Talk for Women to Stay Smart in a Dumbed Down World , most of us use pleasantries like these when we first meet little girls. \u201cSo what?\u201d you might ask. \n\n Bloom asserts that we are too focused on the appearance of young girls, and as a result, our society is socializing them to believe that how they look is of vital importance. And Bloom may be on to something. How often do you tell a little boy how attractive his outfit is, how nice looking his shoes are, or how handsome he looks today? To support her assertions, Bloom cites, as one example, that about 50 percent of girls ages three to six worry about being fat (Bloom 2011). We\u2019re talking kindergarteners who are concerned about their body image. Sociologists are acutely interested in of this type of gender socialization, where societal expectations of how boys and girls should  be \u2014how they should behave, what toys and colors they should like, and how important their attire is\u2014are reinforced. \n\n One solution to this type of gender socialization is being experimented with at the Egalia preschool in Sweden, where children develop in a genderless environment. All of the children at Egalia are referred to with neutral terms like \u201cfriend\u201d instead of \u201che\u201d or \u201cshe.\u201d Play areas and toys are consciously set up to eliminate any reinforcement of gender expectations (Haney 2011). Egalia strives to eliminate all societal gender norms from these children\u2019s preschool world. \n\n Extreme? Perhaps. So what is the middle ground? Bloom suggests that we start with simple steps: when introduced to a young girl, ask about her favorite book or what she likes. In short, engage her mind \u2026 not her outward appearance (Bloom 2011). \n5.2   Why Socialization Matters \n\n Socialization is critical both to individuals and to the societies in which they live. It illustrates how completely intertwined human beings and their social worlds are. First, it is through teaching culture to new members that a society perpetuates itself. If new generations of a society don\u2019t learn its way of life, it ceases to exist. Whatever is distinctive about a culture must be transmitted to those who join it in order for a society to survive. For American culture to continue, for example, children in the United States must learn about cultural values related to democracy: they have to learn the norms of voting, as well as how to use material objects such as voting machines. Of course, some would argue that it\u2019s just as important in American culture for the younger generation to learn the etiquette of eating in a restaurant or the rituals of tailgate parties at football games. In fact, there are many ideas and objects that Americans teach children in hopes of keeping the society\u2019s way of life going through another generation. \n\n Socialization is just as essential to us as individuals. Social interaction provides the means via which we gradually become able to see ourselves through the eyes of others, learning who we are and how we fit into the world around us. In addition, to function successfully in society, we have to learn the basics of both material land nonmaterial culture, everything from how to dress ourselves to what\u2019s suitable attire for a specific occasion; from when we sleep to what we sleep on; and from what\u2019s considered appropriate to eat for dinner to how to use the stove to prepare it. Most importantly, we have to learn language\u2014whether it\u2019s the dominant language or one common in a subculture, whether it\u2019s verbal or through signs\u2014in order to communicate and to think. As we saw with Danielle, without socialization we literally have no self. \n\n Nature versus Nurture \n\n Some experts assert that who we are is a result of  nurture \u2014the relationships and caring that surround us. Others argue that who we are is based entirely in genetics. According to this belief, our temperaments, interests, and talents are set before birth. From this perspective, then, who we are depends on  nature . \n\n One way that researchers attempt to prove the impact of nature is by studying twins. Some studies followed identical twins who were raised separately. The pairs shared the same genetics, but, in some cases, were socialized in different ways. Instances of this type of situation are rare, but studying the degree to which identical twins raised apart are the same and different can give researchers insight into how our temperaments, preferences, and abilities are shaped by our genetic makeup versus our social environment. \n\n For example, in 1968, twin girls born to a mentally ill mother were put up for adoption. However, they were also separated from each other and raised in different households. The parents, and certainly the babies, did not realize they were one of five pairs of twins who were made subjects of a scientific study (Flam 2007). \n\n In 2003, the two women, then age 35, reunited. Elyse Schein and Paula Bernstein sat together in awe, feeling like they were looking into a mirror. Not only did they look alike, but they behaved alike, using the same hand gestures and facial expressions (Spratling 2007). Studies like these point to the genetic roots of our temperament and behavior. \n\n Though genetics and hormones play an important role in human behavior, sociology\u2019s larger concern is the effect that society has on human behavior, the \u201cnurture\u201d side of the nature versus nurture debate. What race were the twins? From what social class were their parents? What about gender? Religion? All of these factors affect the lives of the twins as much as their genetic makeup and are critical to consider as we look at life through the sociological lens. \n\n The Life of Chris Langan, the Smartest Man You\u2019ve Never Heard Of Bouncer. Firefighter. Factory worker. Cowboy. Chris Langan spent the majority of his adult life just getting by with jobs like these. He had no college degree, few resources, and a past filled with much disappointment. Chris Langan also had an IQ of over 195, nearly 100 points higher than the average person (Brabham 2001). So why didn\u2019t Chris become a neurosurgeon, professor, or aeronautical engineer? According to Macolm Gladwell (2008) in his book  Outliers: The Story of Success , Chris didn\u2019t possess the set of social skills necessary to succeed on such a high level\u2014skills that aren\u2019t innate, but learned. \n\n Gladwell looked to a recent study conducted by sociologist Annette Lareau in which she closely shadowed 12 families from various economic backgrounds and examined their parenting techniques. Parents from lower income families followed a strategy of \u201caccomplishment of natural growth,\u201d which is to say they let their children develop on their own with a large amount of independence; parents from higher income families, however, \u201cactively fostered and accessed a child\u2019s talents, opinions, and skills\u201d (Gladwell 2008). These parents were more likely to engage in analytical conversation, encourage active questioning of the establishment, and foster development of negotiation skills. The parents were also able to introduce their children to a wide range of activities, from sports to music to accelerated academic programs. When one middle class child was denied entry to a gifted and talented program, the mother petitioned the school and arranged additional testing until her daughter was admitted. Lower income parents, however, were more likely to unquestioningly obey authorities such as school boards. Their children were not being socialized to comfortably confront the system and speak up (Gladwell 2008). \n\n What does this have to do with Chris Langan, deemed by some as the smartest man in the world (Brabham 2001)? Chris was born in severe poverty, moving across the country with an abusive and alcoholic stepfather. Chris\u2019s genius went greatly unnoticed. After accepting a full scholarship to Reed College, his funding was revoked after his mother failed to fill out necessary paperwork. Unable to successfully make his case to the administration, Chris, who had received straight A\u2019s the previous semester, was given F\u2019s on his transcript and forced to drop out. After enrolling in Montana State, an administrator\u2019s refusal to rearrange his class schedule left him unable to find the means necessary to travel the 16 miles to attend classes. What Chris had in brilliance, he lacked practical intelligence, or what psychologist Robert Sternberg defines as \u201cknowing what to say to whom, knowing when to say it, and knowing how to say it for maximum effect\u201d (Sternberg et al. 2000). Such knowledge was never part of his socialization. \n\n Chris gave up on school and began working an array of blue-collar jobs, pursuing his intellectual interests on the side. Though he\u2019s recently garnered attention from work on his \u201cCognitive Theoretic Model of the Universe,\u201d he remains weary and resistant of the educational system. \n\n As Gladwell concluded, \u201cHe\u2019d had to make his way alone, and no one\u2014not rock stars, not professional athletes, not software billionaires, and not even geniuses\u2014ever makes it alone\u201d (2008). \n\n Sociologists all recognize the importance of socialization for healthy individual and societal development. But how do scholars working in the three major theoretical paradigms approach this topic? Structural functionalists would say that socialization is essential to society, both because it trains members to operate successfully within it and because it perpetuates culture by transmitting it to new generations. Without socialization, a society\u2019s culture would perish as members died off. A conflict theorist might argue that socialization reproduces inequality from generation to generation by conveying different expectations and norms to those with different social characteristics. For example, individuals are socialized differently by gender, social class, and race. As in the illustration of Chris Langan, this creates different (unequal) opportunities. An interactionist studying socialization is concerned with face-to-face exchanges and symbolic communication. For example, dressing baby boys in blue and baby girls in pink is one small way that messages are conveyed about differences in gender roles. \n5.3   Agents of Socialization \n\n Socialization helps people learn to function successfully in their social worlds. How does the process of socialization occur? How do we learn to use the objects of our society\u2019s material culture? How do we come to adopt the beliefs, values, and norms that represent its nonmaterial culture? This learning takes place through interaction with various agents of socialization, like peer groups and families, plus both formal and informal social institutions. \n\n Social Group Agents \n\n Social groups often provide the first experiences of socialization. Families, and later peer groups, communicate expectations and reinforce norms. People first learn to use the tangible objects of material culture in these settings, as well as being introduced to the beliefs and values of society. \n\n Family \n\n Family is the first agent of socialization. Mothers and fathers, siblings and grandparents, plus members of an extended family, all teach a child what he or she needs to know. For example, they show the child how to use objects (such as clothes, computers, eating utensils, books, bikes); how to relate to others (some as \u201cfamily,\u201d others as \u201cfriends,\u201d still others as \u201cstrangers\u201d or \u201cteachers\u201d or \u201cneighbors\u201d); and how the world works (what is \u201creal\u201d and what is \u201cimagined\u201d). As you are aware, either from your own experience as a child or your role in helping to raise one, socialization involves teaching and learning about an unending array of objects and ideas. \n\n It is important to keep in mind, however, that families do not socialize children in a vacuum. Many social factors impact how a family raises its children. For example, we can use sociological imagination to recognize that individual behaviors are affected by the historical period in which they take place. Sixty years ago, it would not have been considered especially strict for a father to hit his son with a wooden spoon or a belt if he misbehaved, but today that same action might be considered child abuse. \n\n Sociologists recognize that race, social class, religion, and other societal factors play an important role in socialization. For example, poor families usually emphasize obedience and conformity when raising their children, while wealthy families emphasize judgment and creativity (National Opinion Research Center 2008).This may be because working-class parents have less education and more repetitive-task jobs for which the ability to follow rules and to conform helps. Wealthy parents tend to have better educations and often work in managerial positions or in careers that require creative problem solving, so they teach their children behaviors that would be beneficial in these positions. This means that children are effectively socialized and raised to take the types of jobs that their parents already have, thus reproducing the class system (Kohn 1977). Likewise, children are socialized to abide by gender norms, perceptions of race, and class-related behaviors. \n\n In Sweden, for instance, stay-at-home fathers are an accepted part of the social landscape. A government policy provides subsidized time off work\u2014480 days for families with newborns\u2014with the option of the paid leave being shared between both mothers and fathers. As one stay-at-home dad says, being home to take care of his baby son \u201cis a real fatherly thing to do. I think that\u2019s very masculine\u201d (Associated Press 2011). How do America\u2019s policies\u2014and our society\u2019s expected gender roles\u2014compare? How will Swedish children raised this way be socialized to parental gender norms? How might that be different from parental gender norms in the United States? \n\n Peer Groups A  peer group  is made up of people who are similar in age and social status and who share interests. Peer group socialization begins in the earliest years, such as when kids on a playground teach younger children the norms about taking turns or the rules of a game or how to shoot a basket. As children grow into teenagers, this process continues. Peer groups are important to adolescents in a new way, as they begin to develop an identity separate from their parents and exert independence. Additionally, peer groups provide their own opportunities for socialization since kids usually engage in different types of activities with their peers than they do with their families. Peer groups provide adolescents\u2019 first major socialization experience outside the realm of their families. Interestingly, studies have shown that although friendships rank high in adolescents\u2019 priorities, this is balanced by parental influence. \n\n Institutional Agents \n\n The social institutions of our culture also inform our socialization. Formal institutions\u2014like schools, workplaces, and the government\u2014teach people how to behave in and navigate these systems. Other institutions, like the media, contribute to socialization by inundating us with messages about norms and expectations. \n\n School \n\n Most American children spend about seven hours a day, 180 days a year, in school, which makes it hard to deny the importance school has on their socialization (U.S. Department of Education 2004). Students are not only in school to study math, reading, science, and other subjects\u2014the manifest function of this system. Schools also serve a latent function in society by socializing children into behaviors like teamwork, following a schedule, and using textbooks. \n\n School and classroom rituals, led by teachers serving as role models and leaders, regularly reinforce what society expects from children. Sociologists describe this aspect of schools as the  hidden curriculum , the informal teaching done by schools. \n\n For example, in the United States, schools have built a sense of competition into the way grades are awarded and the way teachers evaluate students (Bowles and Gintis 1976). When children participate in a relay race or a math contest, they learn that there are winners and losers in society. When children are required to work together on a project, they practice teamwork with other people in cooperative situations. The hidden curriculum prepares children for the adult world. Children learn how to deal with bureaucracy, rules, expectations, waiting their turn, and sitting still for hours during the day. Schools in different cultures socialize children differently in order to prepare them to function well in those cultures. The latent functions of teamwork and dealing with bureaucracy are features of American culture. \n\n Schools also socialize children by teaching them about citizenship and national pride. In the United States, children are taught to say the Pledge of Allegiance. Most districts require classes about U.S. history and geography. As academic understanding of history evolves, textbooks in the United States have been scrutinized and revised to update attitudes toward other cultures as well as perspectives on historical events; thus, children are socialized to a different national or world history than earlier textbooks may have done. For example, information about the mistreatment of African Americans and Native American Indians more accurately reflects those events than in textbooks of the past. \n\n Big Picture Controversial Textbooks On August 13, 2001, 20 South Korean men gathered in Seoul. Each chopped off one of his own fingers because of textbooks. These men took drastic measures to protest eight middle school textbooks approved by Tokyo for use in Japanese middle schools. According to the Korean government (and other East Asian nations), the textbooks glossed over negative events in Japan\u2019s history at the expense of other Asian countries. \n\n In the early 1900s, Japan was one of Asia\u2019s more aggressive nations. Korea was held as a colony by the Japanese between 1910 and 1945. Today, Koreans argue that the Japanese are whitewashing that colonial history through these textbooks. One major criticism is that they do not mention that, during World War II, the Japanese forced Korean women into sexual slavery. The textbooks describe the women as having been \u201cdrafted\u201d to work, a euphemism that downplays the brutality of what actually occurred. Some Japanese textbooks dismiss an important Korean independence demonstration in 1919 as a \u201criot.\u201d In reality, Japanese soldiers attacked peaceful demonstrators, leaving roughly 6,000 dead and 15,000 wounded (Crampton 2002). \n\n Although it may seem extreme that people are so enraged about how events are described in a textbook that they would resort to dismemberment, the protest affirms that textbooks are a significant tool of socialization in state-run education systems. \n\n The Workplace \n\n Just as children spend much of their day at school, many American adults at some point invest a significant amount of time at a place of employment. Although socialized into their culture since birth, workers require new socialization into a workplace, both in terms of material culture (such as how to operate the copy machine) and nonmaterial culture (such as whether it\u2019s okay to speak directly to the boss or how the refrigerator is shared). \n\n Different jobs require different types of socialization. In the past, many people worked a single job until retirement. Today, the trend is to switch jobs at least once a decade. Between the ages of 18 and 44, the average baby boomer of the younger set held 11 different jobs (U.S. Bureau of Labor Statistics 2010). This means that people must become socialized to, and socialized by, a variety of work environments. \n\n Religion \n\n While some religions may tend toward being an informal institution, this section focuses on practices related to formal institutions. Religion is an important avenue of socialization for many people. The United States is full of synagogues, temples, churches, mosques, and similar religious communities where people gather to worship and learn. Like other institutions, these places teach participants how to interact with the religion\u2019s material culture (like a mezuzah, a prayer rug, or a communion wafer). For some people, important ceremonies related to family structure\u2014like marriage and birth\u2014are connected to religious celebrations. Many of these institutions uphold gender norms and contribute to their enforcement through socialization. From ceremonial rites of passage that reinforce the family unit, to power dynamics which reinforce gender roles, religion fosters a shared set of socialized values that are passed on through society. \n\n Government \n\n Although we do not think about it, many of the rites of passage people go through today are based on age norms established by the government. To be defined as an \u201cadult\u201d usually means being 18 years old, the age at which a person becomes legally responsible for themselves. And 65 is the start of \u201cold age\u201d since most people become eligible for senior benefits at that point. \n\n Each time we embark on one of these new categories\u2014senior, adult, taxpayer\u2014we must be socialized into this new role. Seniors must learn the ropes of Medicare, Social Security benefits, and getting a senior discount where they shop. When American males turn 18, they must register with the Selective Service System within 30 days to be entered into a database for possible military service. These government dictates mark the points at which we require socialization into a new category. \n\n Mass Media \n\n Mass media  refers to the distribution of impersonal information to a wide audience, such as what happens via television, newspapers, radio, and the Internet. With the average person spending over four hours a day in front of the TV (and children averaging even more screen time), media greatly influences social norms (Roberts, Foehr, and Rideout 2005). People learn about objects of material culture (like new technology and transportation options), as well as nonmaterial culture\u2014what is true (beliefs), what is important (values), and what is expected (norms). \n\n Sociology in the Real World Girls and Movies Pixar is one of the largest producers of children\u2019s movies in the world and has released large box office draws, such as  Toy Story ,  Cars ,  The Incredibles , and  Up . What Pixar has never before produced is a movie with a female lead role. This will change with Pixar\u2019s newest movie  Brave , which is due out in 2012. Before  Brave , women in Pixar served as supporting characters and love interests. In  Up , for example, the only human female character dies within the first 10 minutes of the film. For the millions of girls watching Pixar films, there are few strong characters or roles for them to relate to. If they do not see possible versions of themselves, they may come to view women as secondary to the lives of men. \n\n The animated films of Pixar\u2019s parent company, Disney, have many female lead roles. Disney is well known for films with female leads, such as  Snow White ,  Cinderella ,  The Little Mermaid , and  Mulan . Many of Disney\u2019s movies star a female, and she is nearly always a princess figure. If she is not a princess to begin with, she typically ends the movie by marrying a prince or, in the case of Mulan, a military general. Although not all \u201cprincesses\u201d in Disney movies play a passive role in their lives, they typically find themselves needing to be rescued by a man, and the happy ending they all search for includes marriage. \n\n Alongside this prevalence of princesses, many parents are expressing concern about the culture of princesses that Disney has created. Peggy Orenstein addresses this problem in her popular book,  Cinderella Ate My Daughter . Orenstein wonders why every little girl is expected to be a \u201cprincess\u201d and why pink has become an all-consuming obsession for many young girls. Another mother wondered what she did wrong when her three-year-old daughter refused to do \u201cnon-princessy\u201d things, including running and jumping. The effects of this princess culture can have negative consequences for girls throughout life. An early emphasis on beauty and sexiness can lead to eating disorders, low self-esteem, and risky sexual behavior among older girls. \n\n What should we expect from Pixar\u2019s new movie, the first starring a female character? Although  Brave  features a female lead, she is still a princess. Will this film offer any new type of role model for young girls? (O\u2019Connor 2011; Barnes 2010; Rose 2011). \n5.4   Socialization Across the Life Course \n\n Socialization isn\u2019t a one-time or even a short-term event. We aren\u2019t \u201cstamped\u201d by some socialization machine as we move along a conveyor belt and thereby socialized once and for all. In fact, socialization is a lifelong process. In the United States, socialization throughout the life course is determined greatly by age norms and \u201ctime-related rules and regulations\u201d (Setterson 2002). As we grow older, we encounter age-related transition points that require socialization into a new role, such as becoming school age, entering the workforce, or retiring. For example, the U.S. government mandates that all children attend school. Child labor laws, enacted in the early 20th century, nationally declared that childhood be a time of learning, not of labor. In countries such as Niger and Sierra Leone, however, child labor remains common and socially acceptable, with little legislation to regulate such practices (UNICEF 2011). \n\n Big Picture Gap Year: How Different Societies Socialize Young Adults Have you ever heard of gap year? It\u2019s a common custom in British society. When teens finish their secondary schooling (aka high school in the United States), they often take a year \u201coff\u201d before entering college. Frequently, they might take a job, travel, or find other ways to experience another culture. Prince William, the Duke of Cambridge, spent his gap year practicing survival skills in Belize, teaching English in Chile, and working on a dairy farm in the United Kingdom (Prince of Wales 2012a). His brother, Prince Harry, advocated for AIDS orphans in Africa and worked as a jackeroo (a novice ranch hand) in Australia (Prince of Wales 2012b). \n\n In the United States, this life transition point is socialized quite differently, and taking a year off is generally frowned upon. Instead, American youth are encouraged to pick career paths by their mid-teens, to select a college and a major by their late teens, and to have completed all collegiate schooling or technical training for their career by their early 20s. \n\n In yet other nations, this phase of the life course is tied into conscription, a term that describes compulsory military service. Egypt, Switzerland, Turkey, and Singapore all have this system in place. Youth in these nations (often only the males) are expected to undergo a number of months or years of military training and service. \n\n How might your life be different if you lived in one of these other countries? Can you think of similar social norms\u2014related to life age-transition points\u2014that vary from country to country? \n\n Many of life\u2019s social expectations are made clear and enforced on a cultural level. Through interacting with others and watching others interact, the expectation to fulfill roles becomes clear. While in elementary or middle school, the prospect of having a boyfriend or girlfriend may have been considered undesirable. The socialization that takes place in high school changes the expectation. By observing the excitement and importance attached to dating and relationships within the high school social scene, it quickly becomes apparent that one is now expected not only to be a child and a student, but a significant other as well. Graduation from formal education\u2014high school, vocational school, or college\u2014involves socialization into a new set of expectations. \n\n Educational expectations vary not only from culture to culture, but from class to class. While middle or upper class families may expect their daughter or son to attend a four-year university after graduating from high school, other families may expect their child to immediately begin working full-time, as many within their family have done before. \n\n Sociology in the Real World The Long Road to Adulthood for Millennials 2008 was a year of financial upheaval in the United States. Rampant foreclosures and bank failures set off a chain of events sparking government distrust, loan defaults, and large-scale unemployment. How has this affected America\u2019s young adults? \n\n Millennials, sometimes also called Gen Y, is a term that describes the generation born during the early eighties to early nineties. While the recession was in full swing, many were in the process of entering, attending, or graduating from high school and college. With employment prospects at historical lows, large numbers of graduates were unable to find work, sometimes moving back in with their parents and struggling to pay back student loans. \n\n According to the  New York Times , this economic stall is causing the Millennials to postpone what most Americans consider to be adulthood: \u201cThe traditional cycle seems to have gone off course, as young people remain untethered to romantic partners or to permanent homes, going back to school for lack of better options, traveling, avoiding commitments, competing ferociously for unpaid internships or temporary (and often grueling) Teach for America jobs, forestalling the beginning of adult life\u201d (Henig 2010). \n\n The five milestones, Henig writes, that define adulthood, are \u201ccompleting school, leaving home, becoming financially independent, marrying, and having a child\u201d (Henig 2010). These social milestones are taking longer for Millennials to attain, if they\u2019re attained at all. Sociologists wonder what long-term impact this generation\u2019s situation may have on society as a whole. \n\n In the process of socialization, adulthood brings a new set of challenges and expectations, as well as new roles to fill. As the aging process moves forward, social roles continue to evolve. Pleasures of youth, such as wild nights out and serial dating, become less acceptable in the eyes of society. Responsibility and commitment are emphasized as pillars of adulthood, and men and women are expected to \u201csettle down.\u201d During this period, many people enter into marriage or a civil union, bring children into their families, and focus on a career path. They become partners or parents instead of students or significant others. \n\n Just as young children pretend to be doctors or lawyers, play house, and dress up, adults also engage  anticipatory socialization , the preparation for future life roles. Examples would include a couple who cohabitate before marriage, or soon-to-be parents who read infant care books and prepare their home for the new arrival. As part of anticipatory socialization, adults who are financially able begin planning for their retirement, saving money and looking into future health care options. The transition into any new life role, despite the social structure that supports it, can be difficult. \n\n Resocialization \n\n In the process of  resocialization , old behaviors that were helpful in a previous role are removed because they are no longer of use. Resocialization is necessary when a person moves to a senior care center, goes to boarding school, or serves time in jail. In the new environment, the old rules no longer apply. The process of resocialization is typically more stressful than normal socialization because people have to unlearn behaviors that have become customary to them. \n\n The most common way resocialization occurs is in a total institution where people are isolated from society and are forced to follow someone else\u2019s rules. A ship at sea is a total institution, as are religious convents, prisons, or some cult organizations. They are places cut off from a larger society. The 7.1 million Americans who lived in prisons or penitentiaries at the end of 2010 are also members of this type of institution (U.S. Department of Justice 2011). As another example, every branch of the military is a total institution. \n\n Many individuals are resocialized into an institution through a two-part process. First, members entering an institution must leave behind their old identity through what is known as a degradation ceremony. In a  degradation ceremony , new members lose the aspects of their old identity and are given new identities. The process is sometimes gentle. To enter a senior care home, an elderly person often must leave a family home and give up many belongings which were part of his or her long-standing identity. Though caretakers guide the elderly compassionately, the process can still be one of loss. In many cults, this process is also gentle and happens in an environment of support and caring. \n\n In other situations, the degradation ceremony can be more extreme. New prisoners lose freedom, rights (including the right to privacy), and personal belongings. When entering the army, soldiers have their hair cut short. Their old clothes are removed and they wear matching uniforms. These individuals must give up any markers of their former identity in order to be resocialized into an identity as a \u201csoldier.\u201d \n\n After new members of an institution are stripped of their old identity, they build a new one that matches the new society. In the military, soldiers go through basic training together, where they learn new rules and bond with one another. They follow structured schedules set by their leaders. Soldiers must keep their areas clean for inspection, learn to march in correct formations, and salute when in the presence of superiors. \n\n Learning to deal with life after having lived in a total institution requires yet another process of resocialization. In the U.S. military, soldiers learn discipline and a capacity for hard work. They set aside personal goals to achieve a mission, and they take pride in the accomplishments of their units. Many soldiers who leave the military transition these skills into excellent careers. Others find themselves lost upon leaving, uncertain about the outside world, and what to do next. The process of resocialization to civilian life is not a simple one. ", "questions": [{"question": {"question_id": "fs-id1884634", "question_text": "Socialization, as a sociological term, describes:", "question_choices": ["how people interact during social situations", "how people learn societal norms, beliefs, and values", "a person\u2019s internal mental state when in a group setting", "the difference between introverts and extroverts"], "cloze_format": "Socialization, as a sociological term, describes ___.", "normal_format": "What does Socialization, as a sociological term, describe?"}, "answer": {"ans_text": "how people learn societal norms, beliefs, and values", "ans_choice": 1}, "bloom": "1", "hl_sentences": "Socialization helps people learn to function successfully in their social worlds . How do we come to adopt the beliefs , values , and norms that represent its nonmaterial culture ? Socialization is the process through which people are taught to be proficient members of a society . It describes the ways that people come to understand societal norms and expectations , to accept society \u2019 s beliefs , and to be aware of societal values .", "hl_context": "<hl> Socialization helps people learn to function successfully in their social worlds . <hl> How does the process of socialization occur ? How do we learn to use the objects of our society \u2019 s material culture ? <hl> How do we come to adopt the beliefs , values , and norms that represent its nonmaterial culture ? <hl> This learning takes place through interaction with various agents of socialization , like peer groups and families , plus both formal and informal social institutions . <hl> Socialization is the process through which people are taught to be proficient members of a society . <hl> <hl> It describes the ways that people come to understand societal norms and expectations , to accept society \u2019 s beliefs , and to be aware of societal values . <hl> Socialization is not the same as socializing ( interacting with others , like family , friends , and coworkers ); to be precise , it is a sociological process that occurs through socializing . As Danielle \u2019 s story illustrates , even the most basic of human activities are learned . You may be surprised to know that even physical tasks like sitting , standing , and walking had not automatically developed for Danielle as she grew . And without socialization , Danielle hadn \u2019 t learned about the material culture of her society ( the tangible objects a culture uses ): for example , she couldn \u2019 t hold a spoon , bounce a ball , or use a chair for sitting . She also hadn \u2019 t learned its nonmaterial culture , such as its beliefs , values , and norms . She had no understanding of the concept of \u201c family , \u201d didn \u2019 t know cultural expectations for using a bathroom for elimination , and had no sense of modesty . Most importantly , she hadn \u2019 t learned to use the symbols that make up language \u2014 through which we learn about who we are , how we fit with other people , and the natural and social worlds in which we live . Sociologists have long been fascinated by circumstances like Danielle \u2019 s \u2014 in which a child receives sufficient human support to survive , but virtually no social interaction \u2014 because they highlight how much we depend on social interaction to provide the information and skills that we need to be part of society or even to develop a \u201c self . \u201d"}, {"question": {"question_id": "fs-id2184316", "question_text": "The Harlows\u2019 study on rhesus monkeys showed that:", "question_choices": ["rhesus monkeys raised by other primate species are poorly socialized", "monkeys can be adequately socialized by imitating humans", "food is more important than social comfort", "social comfort is more important than food"], "cloze_format": "The Harlows\u2019 study on rhesus monkeys showed that ___.", "normal_format": "What did show the Harlows\u2019 study on rhesus monkeys?"}, "answer": {"ans_text": "social comfort is more important than food", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "This demonstrated that while food was important , social comfort was of greater value ( Harlow and Harlow 1962 ; Harlow 1971 ) .", "hl_context": "The necessity for early social contact was demonstrated by the research of Harry and Margaret Harlow . From 1957 to 1963 , the Harlows conducted a series of experiments studying how rhesus monkeys , which behave a lot like people , are affected by isolation as babies . They studied monkeys raised under two types of \u201c substitute \u201d mothering circumstances : a mesh and wire sculpture , or a soft terrycloth \u201c mother . \u201d The monkeys systematically preferred the company of a soft , terrycloth substitute mother ( closely resembling a rhesus monkey ) that was unable to feed them , to a mesh and wire mother that provided sustenance via a feeding tube . <hl> This demonstrated that while food was important , social comfort was of greater value ( Harlow and Harlow 1962 ; Harlow 1971 ) . <hl> Later experiments testing more severe isolation revealed that such deprivation of social contact led to significant developmental and social challenges later in life ."}, {"question": {"question_id": "fs-id1497823", "question_text": "What occurs in Lawrence Kohlberg\u2019s conventional level?", "question_choices": ["Children develop the ability to have abstract thoughts.", "Morality is developed by pain and pleasure.", "Children begin to consider what society considers moral and immoral.", "Parental beliefs have no influence on children\u2019s morality."], "cloze_format": "___ occurs in Lawrence Kohlberg\u2019s conventional level.", "normal_format": "What occurs in Lawrence Kohlberg\u2019s conventional level?"}, "answer": {"ans_text": "Children begin to consider what society considers moral and immoral.", "ans_choice": 2}, "bloom": "2", "hl_sentences": "It isn \u2019 t until the teen years that the conventional theory develops , when youngsters become increasingly aware of others \u2019 feelings and take those into consideration when determining what \u2019 s \u201c good \u201d and \u201c bad . \u201d The final stage , called postconventional , is when people begin to think of morality in abstract terms , such as Americans believing that everyone has the right to life , liberty , and the pursuit of happiness . Finally , children develop , understand , and learn the idea of the generalized other , the common behavioral expectations of general society . By this stage of development , an individual is able to imagine how he or she is viewed by one or many others \u2014 and thus , from a sociological perspective , to have a \u201c self \u201d ( Mead 1934 ; Mead 1964 ) .", "hl_context": "Moral development is an important part of the socialization process . The term refers to the way people learn what society considered to be \u201c good \u201d and \u201c bad , \u201d which is important for a smoothly functioning society . Moral development prevents people from acting on unchecked urges , instead considering what is right for society and good for others . Lawrence Kohlberg ( 1927 \u2013 1987 ) was interested in how people learn to decide what is right and what is wrong . To understand this topic , he developed a theory of moral development that includes three levels : preconventional , conventional , and postconventional . In the preconventional stage , young children , who lack a higher level of cognitive ability , experience the world around them only through their senses . <hl> It isn \u2019 t until the teen years that the conventional theory develops , when youngsters become increasingly aware of others \u2019 feelings and take those into consideration when determining what \u2019 s \u201c good \u201d and \u201c bad . \u201d The final stage , called postconventional , is when people begin to think of morality in abstract terms , such as Americans believing that everyone has the right to life , liberty , and the pursuit of happiness . <hl> At this stage , people also recognize that legality and morality do not always match up evenly ( Kohlberg 1981 ) . When hundreds of thousands of Egyptians turned out in 2011 to protest government corruption , they were using postconventional morality . They understood that although their government was legal , it was not morally correct . <hl> Finally , children develop , understand , and learn the idea of the generalized other , the common behavioral expectations of general society . <hl> <hl> By this stage of development , an individual is able to imagine how he or she is viewed by one or many others \u2014 and thus , from a sociological perspective , to have a \u201c self \u201d ( Mead 1934 ; Mead 1964 ) . <hl> Kohlberg \u2019 s Theory of Moral Development"}, {"question": {"question_id": "fs-id2756410", "question_text": "What did Carol Gilligan believe earlier researchers into morality had overlooked?", "question_choices": ["The justice perspective", "Sympathetic reactions to moral situations", "The perspective of females", "How social environment affects how morality develops"], "cloze_format": "Carol Gilligan believed earlier researchers into morality had overlooked ___.", "normal_format": "What did Carol Gilligan believe earlier researchers into morality had overlooked?"}, "answer": {"ans_text": "The perspective of females", "ans_choice": 2}, "bloom": "3", "hl_sentences": "Another sociologist , Carol Gilligan ( 1936 \u2013 ) , recognized that Kohlberg \u2019 s theory might show gender bias since his research was only conducted on male subjects .", "hl_context": "<hl> Another sociologist , Carol Gilligan ( 1936 \u2013 ) , recognized that Kohlberg \u2019 s theory might show gender bias since his research was only conducted on male subjects . <hl> Would females study subjects have responded differently ? Would a female social scientist notice different patterns when analyzing the research ? To answer the first question , she set out to study differences between how boys and girls developed morality . Gilligan \u2019 s research demonstrated that boys and girls do , in fact , have different understandings of morality . Boys tend to have a justice perspective , placing emphasis on rules and laws . Girls , on the other hand , have a care and responsibility perspective ; they consider people \u2019 s reasons behind behavior that seems morally wrong ."}, {"question": {"question_id": "fs-id1445857", "question_text": "What is one way to distinguish between psychology and sociology?", "question_choices": ["Psychology focuses on the mind, while sociology focuses on society.", "Psychologists are interested in mental health, while sociologists are interested in societal functions.", "Psychologists look inward to understand behavior while sociologists look outward.", "All of the above"], "cloze_format": "One way to distinguish between psychology and sociology is ___ .", "normal_format": "What is one way to distinguish between psychology and sociology?"}, "answer": {"ans_text": "All of the above", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": "4", "hl_sentences": "As a general difference , we might say that while both disciplines are interested in human behavior , psychologists are focused on how the mind influences that behavior , while sociologists study the role of society in shaping behavior . Psychologists are interested in people \u2019 s mental development and how their minds process their world . Sociologists are more likely to focus on how different aspects of society contribute to an individual \u2019 s relationship with his world . Another way to think of the difference is that psychologists tend to look inward ( mental health , emotional processes ) , while sociologists tend to look outward ( social institutions , cultural norms , interactions with others ) to understand human behavior .", "hl_context": "<hl> As a general difference , we might say that while both disciplines are interested in human behavior , psychologists are focused on how the mind influences that behavior , while sociologists study the role of society in shaping behavior . <hl> <hl> Psychologists are interested in people \u2019 s mental development and how their minds process their world . <hl> <hl> Sociologists are more likely to focus on how different aspects of society contribute to an individual \u2019 s relationship with his world . <hl> <hl> Another way to think of the difference is that psychologists tend to look inward ( mental health , emotional processes ) , while sociologists tend to look outward ( social institutions , cultural norms , interactions with others ) to understand human behavior . <hl>"}, {"question": {"question_id": "fs-id1832345", "question_text": "How did nearly complete isolation as a child affect Danielle\u2019s verbal abilities?", "question_choices": ["She could not communicate at all.", "She never learned words, but she did learn signs.", "She could not understand much, but she could use gestures.", "She could understand and use basic language like \u201cyes\u201d and \u201cno.\u201d"], "cloze_format": "The nearly complete isolation as a child affected Danielle\u2019s verbal abilities because ___.", "normal_format": "How did nearly complete isolation as a child affect Danielle\u2019s verbal abilities?"}, "answer": {"ans_text": "She could not communicate at all.", "ans_choice": 0}, "bloom": "3", "hl_sentences": "Still , she wouldn \u2019 t look anyone in the eyes , didn \u2019 t know how to chew or swallow solid food , didn \u2019 t cry , didn \u2019 t respond to stimuli that would typically cause pain , and didn \u2019 t know how to communicate either with words or simple gestures such as nodding \u201c yes \u201d or \u201c no . \u201d Likewise , although tests showed she had no chronic diseases or genetic abnormalities , the only way she could stand was with someone holding onto her hands , and she \u201c walked sideways on her toes , like a crab \u201d ( DeGregory 2008 ) .", "hl_context": "Detective Holste immediately carried Danielle out of the home . She was taken to a hospital for medical treatment and evaluation . Through extensive testing , doctors determined that , although she was severely malnourished , Danielle was able to see , hear , and vocalize normally . <hl> Still , she wouldn \u2019 t look anyone in the eyes , didn \u2019 t know how to chew or swallow solid food , didn \u2019 t cry , didn \u2019 t respond to stimuli that would typically cause pain , and didn \u2019 t know how to communicate either with words or simple gestures such as nodding \u201c yes \u201d or \u201c no . \u201d Likewise , although tests showed she had no chronic diseases or genetic abnormalities , the only way she could stand was with someone holding onto her hands , and she \u201c walked sideways on her toes , like a crab \u201d ( DeGregory 2008 ) . <hl>"}, {"question": {"question_id": "fs-id1203146", "question_text": "From a sociological perspective, which factor does not greatly influence a person\u2019s socialization?", "question_choices": ["Gender", "Class", "Blood type", "Race"], "cloze_format": "From a sociological perspective, the factor that does not greatly influence a person\u2019s socialization is ___.", "normal_format": "From a sociological perspective, which factor does not greatly influence a person\u2019s socialization?"}, "answer": {"ans_text": "Blood type", "ans_choice": 2}, "bloom": null, "hl_sentences": "Sociologists recognize that race , social class , religion , and other societal factors play an important role in socialization . What race were the twins ? From what social class were their parents ? What about gender ?", "hl_context": "<hl> Sociologists recognize that race , social class , religion , and other societal factors play an important role in socialization . <hl> For example , poor families usually emphasize obedience and conformity when raising their children , while wealthy families emphasize judgment and creativity ( National Opinion Research Center 2008 ) . This may be because working-class parents have less education and more repetitive-task jobs for which the ability to follow rules and to conform helps . Wealthy parents tend to have better educations and often work in managerial positions or in careers that require creative problem solving , so they teach their children behaviors that would be beneficial in these positions . This means that children are effectively socialized and raised to take the types of jobs that their parents already have , thus reproducing the class system ( Kohn 1977 ) . Likewise , children are socialized to abide by gender norms , perceptions of race , and class-related behaviors . Though genetics and hormones play an important role in human behavior , sociology \u2019 s larger concern is the effect that society has on human behavior , the \u201c nurture \u201d side of the nature versus nurture debate . <hl> What race were the twins ? <hl> <hl> From what social class were their parents ? <hl> <hl> What about gender ? <hl> Religion ? All of these factors affect the lives of the twins as much as their genetic makeup and are critical to consider as we look at life through the sociological lens ."}, {"question": {"question_id": "fs-id2738288", "question_text": "Chris Langan\u2019s story illustrates that:", "question_choices": ["children raised in one-parent households tend to have higher IQs.", "intelligence is more important than socialization.", "socialization can be more important than intelligence.", "neither socialization nor intelligence affects college admissions."], "cloze_format": "Chris Langan\u2019s story illustrates that ___.", "normal_format": "What does Chris Langan\u2019s story illustrate?"}, "answer": {"ans_text": "socialization can be more important than intelligence.", "ans_choice": 2}, "bloom": "2", "hl_sentences": "What Chris had in brilliance , he lacked practical intelligence , or what psychologist Robert Sternberg defines as \u201c knowing what to say to whom , knowing when to say it , and knowing how to say it for maximum effect \u201d ( Sternberg et al . Such knowledge was never part of his socialization . Chris Langan also had an IQ of over 195 , nearly 100 points higher than the average person ( Brabham 2001 ) . According to Macolm Gladwell ( 2008 ) in his book Outliers : The Story of Success , Chris didn \u2019 t possess the set of social skills necessary to succeed on such a high level \u2014 skills that aren \u2019 t innate , but learned .", "hl_context": "What does this have to do with Chris Langan , deemed by some as the smartest man in the world ( Brabham 2001 ) ? Chris was born in severe poverty , moving across the country with an abusive and alcoholic stepfather . Chris \u2019 s genius went greatly unnoticed . After accepting a full scholarship to Reed College , his funding was revoked after his mother failed to fill out necessary paperwork . Unable to successfully make his case to the administration , Chris , who had received straight A \u2019 s the previous semester , was given F \u2019 s on his transcript and forced to drop out . After enrolling in Montana State , an administrator \u2019 s refusal to rearrange his class schedule left him unable to find the means necessary to travel the 16 miles to attend classes . <hl> What Chris had in brilliance , he lacked practical intelligence , or what psychologist Robert Sternberg defines as \u201c knowing what to say to whom , knowing when to say it , and knowing how to say it for maximum effect \u201d ( Sternberg et al . <hl> 2000 ) . <hl> Such knowledge was never part of his socialization . <hl> The Life of Chris Langan , the Smartest Man You \u2019 ve Never Heard Of Bouncer . Firefighter . Factory worker . Cowboy . Chris Langan spent the majority of his adult life just getting by with jobs like these . He had no college degree , few resources , and a past filled with much disappointment . <hl> Chris Langan also had an IQ of over 195 , nearly 100 points higher than the average person ( Brabham 2001 ) . <hl> So why didn \u2019 t Chris become a neurosurgeon , professor , or aeronautical engineer ? <hl> According to Macolm Gladwell ( 2008 ) in his book Outliers : The Story of Success , Chris didn \u2019 t possess the set of social skills necessary to succeed on such a high level \u2014 skills that aren \u2019 t innate , but learned . <hl>"}, {"question": {"question_id": "fs-id2768730", "question_text": "Why are wealthy parents more likely than poor parents to socialize their children toward creativity and problem solving?", "question_choices": ["Wealthy parents are socializing their children toward the skills of white-collar employment.", "Wealthy parents are not concerned about their children rebelling against their rules.", "Wealthy parents never engage in repetitive tasks.", "Wealthy parents are more concerned with money than with a good education."], "cloze_format": "The reason that wealthy parents are more likely than poor parents to socialize their children toward creativity and problem solving is that ___ .", "normal_format": "Why are wealthy parents more likely than poor parents to socialize their children toward creativity and problem solving?"}, "answer": {"ans_text": "Wealthy parents are socializing their children toward the skills of white-collar employment.", "ans_choice": 0}, "bloom": null, "hl_sentences": "Wealthy parents tend to have better educations and often work in managerial positions or in careers that require creative problem solving , so they teach their children behaviors that would be beneficial in these positions .", "hl_context": "Sociologists recognize that race , social class , religion , and other societal factors play an important role in socialization . For example , poor families usually emphasize obedience and conformity when raising their children , while wealthy families emphasize judgment and creativity ( National Opinion Research Center 2008 ) . This may be because working-class parents have less education and more repetitive-task jobs for which the ability to follow rules and to conform helps . <hl> Wealthy parents tend to have better educations and often work in managerial positions or in careers that require creative problem solving , so they teach their children behaviors that would be beneficial in these positions . <hl> This means that children are effectively socialized and raised to take the types of jobs that their parents already have , thus reproducing the class system ( Kohn 1977 ) . Likewise , children are socialized to abide by gender norms , perceptions of race , and class-related behaviors ."}, {"question": {"question_id": "fs-id1552355", "question_text": "How do schools prepare children to one day enter the workforce?", "question_choices": ["With a standardized curriculum", "Through the hidden curriculum", "By socializing them in teamwork", "All of the above"], "cloze_format": "Schools prepare children to one day enter the workforce ___ .", "normal_format": "How do schools prepare children to one day enter the workforce?"}, "answer": {"ans_text": "All of the above", "ans_choice": 3}, "bloom": "1", "hl_sentences": "When children are required to work together on a project , they practice teamwork with other people in cooperative situations . The hidden curriculum prepares children for the adult world . Most American children spend about seven hours a day , 180 days a year , in school , which makes it hard to deny the importance school has on their socialization ( U . S . Department of Education 2004 ) . Students are not only in school to study math , reading , science , and other subjects \u2014 the manifest function of this system .", "hl_context": "For example , in the United States , schools have built a sense of competition into the way grades are awarded and the way teachers evaluate students ( Bowles and Gintis 1976 ) . When children participate in a relay race or a math contest , they learn that there are winners and losers in society . <hl> When children are required to work together on a project , they practice teamwork with other people in cooperative situations . <hl> <hl> The hidden curriculum prepares children for the adult world . <hl> Children learn how to deal with bureaucracy , rules , expectations , waiting their turn , and sitting still for hours during the day . Schools in different cultures socialize children differently in order to prepare them to function well in those cultures . The latent functions of teamwork and dealing with bureaucracy are features of American culture . <hl> Most American children spend about seven hours a day , 180 days a year , in school , which makes it hard to deny the importance school has on their socialization ( U . S . Department of Education 2004 ) . <hl> <hl> Students are not only in school to study math , reading , science , and other subjects \u2014 the manifest function of this system . <hl> Schools also serve a latent function in society by socializing children into behaviors like teamwork , following a schedule , and using textbooks ."}, {"question": {"question_id": "fs-id2299587", "question_text": "Which one of the following is not a way people are socialized by religion?", "question_choices": ["People learn the material culture of their religion.", "Life stages and roles are connected to religious celebration.", "An individual\u2019s personal internal experience of a divine being leads to their faith.", "Places of worship provide a space for shared group experiences."], "cloze_format": "People are not socialized by religion in a way that ___.", "normal_format": "Which one of the following is not a way people are socialized by religion?"}, "answer": {"ans_text": "An individual\u2019s personal internal experience of a divine being leads to their faith.", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "The United States is full of synagogues , temples , churches , mosques , and similar religious communities where people gather to worship and learn . Like other institutions , these places teach participants how to interact with the religion \u2019 s material culture ( like a mezuzah , a prayer rug , or a communion wafer ) . For some people , important ceremonies related to family structure \u2014 like marriage and birth \u2014 are connected to religious celebrations .", "hl_context": "While some religions may tend toward being an informal institution , this section focuses on practices related to formal institutions . Religion is an important avenue of socialization for many people . <hl> The United States is full of synagogues , temples , churches , mosques , and similar religious communities where people gather to worship and learn . <hl> <hl> Like other institutions , these places teach participants how to interact with the religion \u2019 s material culture ( like a mezuzah , a prayer rug , or a communion wafer ) . <hl> <hl> For some people , important ceremonies related to family structure \u2014 like marriage and birth \u2014 are connected to religious celebrations . <hl> Many of these institutions uphold gender norms and contribute to their enforcement through socialization . From ceremonial rites of passage that reinforce the family unit , to power dynamics which reinforce gender roles , religion fosters a shared set of socialized values that are passed on through society ."}, {"question": {"question_id": "fs-id1310992", "question_text": "Which of the following is a manifest function of schools?", "question_choices": ["Understanding when to speak up and when to be silent", "Learning to read and write", "Following a schedule", "Knowing locker room etiquette"], "cloze_format": "___ is a manifest function of schools.", "normal_format": "Which of the following is a manifest function of schools?"}, "answer": {"ans_text": "Learning to read and write", "ans_choice": 1}, "bloom": "1", "hl_sentences": "Students are not only in school to study math , reading , science , and other subjects \u2014 the manifest function of this system .", "hl_context": "Most American children spend about seven hours a day , 180 days a year , in school , which makes it hard to deny the importance school has on their socialization ( U . S . Department of Education 2004 ) . <hl> Students are not only in school to study math , reading , science , and other subjects \u2014 the manifest function of this system . <hl> Schools also serve a latent function in society by socializing children into behaviors like teamwork , following a schedule , and using textbooks ."}, {"question": {"question_id": "fs-id2080335", "question_text": "Which of the following is typically the earliest agent of socialization?", "question_choices": ["School", "Family", "Mass media", "Workplace"], "cloze_format": "The earliest agent of socialization is typically ___.", "normal_format": "Which of the following is typically the earliest agent of socialization?"}, "answer": {"ans_text": "Family", "ans_choice": 1}, "bloom": "1", "hl_sentences": "Family is the first agent of socialization .", "hl_context": "<hl> Family is the first agent of socialization . <hl> Mothers and fathers , siblings and grandparents , plus members of an extended family , all teach a child what he or she needs to know . For example , they show the child how to use objects ( such as clothes , computers , eating utensils , books , bikes ); how to relate to others ( some as \u201c family , \u201d others as \u201c friends , \u201d still others as \u201c strangers \u201d or \u201c teachers \u201d or \u201c neighbors \u201d ); and how the world works ( what is \u201c real \u201d and what is \u201c imagined \u201d ) . As you are aware , either from your own experience as a child or your role in helping to raise one , socialization involves teaching and learning about an unending array of objects and ideas ."}, {"question": {"question_id": "fs-id1872415", "question_text": "Which of the following is not an age-related transition point when Americans must be socialized to new roles?", "question_choices": ["Infancy", "School age", "Adulthood", "Senior citizen"], "cloze_format": "___ is not an age-related transition point when Americans must be socialized to new roles.", "normal_format": "Which of the following is not an age-related transition point when Americans must be socialized to new roles?"}, "answer": {"ans_text": "Infancy", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "As we grow older , we encounter age-related transition points that require socialization into a new role , such as becoming school age , entering the workforce , or retiring . Socialization is the process through which people are taught to be proficient members of a society . It describes the ways that people come to understand societal norms and expectations , to accept society \u2019 s beliefs , and to be aware of societal values .", "hl_context": "Socialization isn \u2019 t a one-time or even a short-term event . We aren \u2019 t \u201c stamped \u201d by some socialization machine as we move along a conveyor belt and thereby socialized once and for all . In fact , socialization is a lifelong process . In the United States , socialization throughout the life course is determined greatly by age norms and \u201c time-related rules and regulations \u201d ( Setterson 2002 ) . <hl> As we grow older , we encounter age-related transition points that require socialization into a new role , such as becoming school age , entering the workforce , or retiring . <hl> For example , the U . S . government mandates that all children attend school . Child labor laws , enacted in the early 20th century , nationally declared that childhood be a time of learning , not of labor . In countries such as Niger and Sierra Leone , however , child labor remains common and socially acceptable , with little legislation to regulate such practices ( UNICEF 2011 ) . <hl> Socialization is the process through which people are taught to be proficient members of a society . <hl> <hl> It describes the ways that people come to understand societal norms and expectations , to accept society \u2019 s beliefs , and to be aware of societal values . <hl> Socialization is not the same as socializing ( interacting with others , like family , friends , and coworkers ); to be precise , it is a sociological process that occurs through socializing . As Danielle \u2019 s story illustrates , even the most basic of human activities are learned . You may be surprised to know that even physical tasks like sitting , standing , and walking had not automatically developed for Danielle as she grew . And without socialization , Danielle hadn \u2019 t learned about the material culture of her society ( the tangible objects a culture uses ): for example , she couldn \u2019 t hold a spoon , bounce a ball , or use a chair for sitting . She also hadn \u2019 t learned its nonmaterial culture , such as its beliefs , values , and norms . She had no understanding of the concept of \u201c family , \u201d didn \u2019 t know cultural expectations for using a bathroom for elimination , and had no sense of modesty . Most importantly , she hadn \u2019 t learned to use the symbols that make up language \u2014 through which we learn about who we are , how we fit with other people , and the natural and social worlds in which we live . Sociologists have long been fascinated by circumstances like Danielle \u2019 s \u2014 in which a child receives sufficient human support to survive , but virtually no social interaction \u2014 because they highlight how much we depend on social interaction to provide the information and skills that we need to be part of society or even to develop a \u201c self . \u201d"}, {"question": {"question_id": "fs-id1883855", "question_text": "Which of the following is true regarding American socialization of recent high school graduates?", "question_choices": ["They are expected to take a year \u201coff\u201d before college.", "They are required to serve in the military for one year.", "They are expected to enter college, trade school, or the workforce shortly after graduation.", "They are required to move away from their parents."], "cloze_format": "It is true regarding American socialization of recent high school graduates that ___.", "normal_format": "Which of the following is true regarding American socialization of recent high school graduates?"}, "answer": {"ans_text": "They are expected to enter college, trade school, or the workforce shortly after graduation.", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "While middle or upper class families may expect their daughter or son to attend a four-year university after graduating from high school , other families may expect their child to immediately begin working full-time , as many within their family have done before .", "hl_context": "Educational expectations vary not only from culture to culture , but from class to class . <hl> While middle or upper class families may expect their daughter or son to attend a four-year university after graduating from high school , other families may expect their child to immediately begin working full-time , as many within their family have done before . <hl>"}], "summary": "", "keyterm": "", "bname": "introduction_to_sociology"}, {"chapter": 12, "intro": " Chapter Outline 12.1   What Is Social Psychology? 12.2   Self-presentation 12.3   Attitudes and Persuasion 12.4   Conformity, Compliance, and Obedience 12.5   Prejudice and Discrimination 12.6   Aggression 12.7   Prosocial Behavior Introduction \n\n Humans are diverse, and sometimes our differences make it challenging for us to get along with one another. A poignant example is that of Trayvon  Martin , a 17-year-old African American who was shot by a neighborhood watch volunteer, George  Zimmerman , in a predominantly White neighborhood in 2012. Zimmerman grew suspicious of the boy dressed in a hoodie and pursued Martin. A physical altercation ended with Zimmerman fatally shooting Martin. Zimmerman claimed that he acted in self-defense; Martin was unarmed. A Florida jury found Zimmerman not guilty of second degree murder nor of manslaughter. \n\n Several groups protested what they deemed racial profiling and brutality against an unarmed Black male. Zimmerman, who has a Peruvian mother and a German father, was accused of being racist. Some media coverage was criticized for inflaming racial politics in their coverage.\n\n            In spite of conflicts such as these, people also to work together to create positive change. For example, after the 9/11 terrorist attacks, people rallied together and charitable donations skyrocket (Brown & Minty, 2006). This chapter explores how the presence of other people influences the behavior of individuals, dyads, and groups. Social factors can determine whether human behavior tends toward conflict or harmony.\n\n         ", "chapter_text": " 12.1   What Is Social Psychology? Learning Objectives By the end of this section, you will be able to:\n\n Define social psychology \n\n Describe situational versus dispositional influences on behavior \n\n Describe the fundamental attribution error \n\n Social psychology  examines how people affect one another, and it looks at the power of the situation. Social psychologists assert that an individual\u2019s thoughts, feelings, and behaviors are very much influenced by social situations. Essentially, people will change their behavior to align with the social situation at hand. If we are in a new situation or are unsure how to behave, we will take our cues from other individuals. \n\n The field of social psychology studies topics at both the intra- and interpersonal levels.  Intrapersonal  topics (those that pertain to the individual) include emotions and attitudes, the self, and social cognition (the ways in which we think about ourselves and others).  Interpersonal  topics (those that pertain to dyads and groups) include helping behavior ( Figure 12.2 ), aggression, prejudice and discrimination, attraction and close relationships, and group processes and intergroup relationships. \n\n Social psychologists focus on how people construe or interpret situations and how these interpretations influence their thoughts, feelings, and behaviors (Ross & Nisbett, 1991). Thus, social psychology studies individuals in a social context and how situational variables interact to influence behavior. In this chapter, we discuss the intrapersonal processes of self-presentation, cognitive dissonance and attitude change, and the interpersonal processes of conformity and obedience, aggression and altruism, and, finally, love and attraction. \n\n Situational and Dispositional Influences on Behavior \n\n Behavior is a product of both the situation (e.g., cultural influences, social roles, and the presence of bystanders) and of the person (e.g., personality characteristics). Subfields of psychology tend to focus on one influence or behavior over others.  Situationism  is the view that our behavior and actions are determined by our immediate environment and surroundings. In contrast,  dispositionism  holds that our behavior is determined by internal factors (Heider, 1958). An  internal factor  is an attribute of a person and includes personality traits and temperament. Social psychologists have tended to take the situationist perspective, whereas personality psychologists have promoted the dispositionist perspective. Modern approaches to social psychology, however, take both the situation and the individual into account when studying human behavior (Fiske, Gilbert, & Lindzey, 2010). In fact, the field of social-personality psychology has emerged to study the complex interaction of internal and situational factors that affect human behavior (Mischel, 1977; Richard, Bond, & Stokes-Zoota, 2003). \n\n Fundamental Attribution Error \n\n In the United States, the predominant culture tends to favor a dispositional approach in explaining human behavior. Why do you think this is? We tend to think that people are in control of their own behaviors, and, therefore, any behavior change must be due to something internal, such as their personality, habits, or temperament. According to some social psychologists, people tend to overemphasize internal factors as explanations\u2014or attributions\u2014for the behavior of other people. They tend to assume that the behavior of another person is a  trait  of that person, and to underestimate the power of the situation on the behavior of others. They tend to fail to recognize when the behavior of another is due to situational variables, and thus to the person\u2019s  state . This erroneous assumption is called the  fundamental attribution error  (Ross, 1977; Riggio & Garcia, 2009). To better understand, imagine this scenario: Greg returns home from work, and upon opening the front door his wife happily greets him and inquires about his day. Instead of greeting his wife, Greg yells at her, \u201cLeave me alone!\u201d Why did Greg yell at his wife? How would someone committing the fundamental attribution error explain Greg\u2019s behavior? The most common response is that Greg is a mean, angry, or unfriendly person (his traits). This is an internal or dispositional explanation. However, imagine that Greg was just laid off from his job due to company downsizing. Would your explanation for Greg\u2019s behavior change? Your revised explanation might be that Greg was frustrated and disappointed for losing his job; therefore, he was in a bad mood (his state). This is now an external or situational explanation for Greg\u2019s behavior. \n\n The fundamental attribution error is so powerful that people often overlook obvious situational influences on behavior. A classic example was demonstrated in a series of experiments known as the quizmaster study (Ross, Amabile, & Steinmetz, 1977). Student participants were randomly assigned to play the role of a questioner (the quizmaster) or a contestant in a quiz game. Questioners developed difficult questions to which they knew the answers, and they presented these questions to the contestants. The contestants answered the questions correctly only 4 out of 10 times ( Figure 12.3 ). After the task, the questioners and contestants were asked to rate their own general knowledge compared to the average student. Questioners did not rate their general knowledge higher than the contestants, but the contestants rated the questioners\u2019 intelligence higher than their own. In a second study, observers of the interaction also rated the questioner as having more general knowledge than the contestant. The obvious influence on performance is the situation. The questioners wrote the questions, so of course they had an advantage. Both the contestants and observers made an internal attribution for the performance. They concluded that the questioners must be more intelligent than the contestants. \n\n As demonstrated in the example above, the fundamental attribution error is considered a powerful influence in how we explain the behaviors of others. However, it should be noted that some researchers have suggested that the fundamental attribution error may not be as powerful as it is often portrayed. In fact, a recent review of more than 173 published studies suggests that several factors (e.g., high levels of idiosyncrasy of the character and how well hypothetical events are explained) play a role in determining just how influential the fundamental attribution error is (Malle, 2006). \n\n Is the Fundamental Attribution Error a Universal Phenomenon? You may be able to think of examples of the fundamental attribution error in your life. Do people in all cultures commit the fundamental attribution error? Research suggests that they do not. People from an  individualistic culture , that is, a culture that focuses on individual achievement and autonomy, have the greatest tendency to commit the fundamental attribution error. Individualistic cultures, which tend to be found in western countries such as the United States, Canada, and the United Kingdom, promote a focus on the individual. Therefore, a person\u2019s disposition is thought to be the primary explanation for her behavior. In contrast, people from a  collectivistic culture , that is, a culture that focuses on communal relationships with others, such as family, friends, and community ( Figure 12.4 ), are less likely to commit the fundamental attribution error (Markus & Kitayama, 1991; Triandis, 2001). \n\n Why do you think this is the case? Collectivistic cultures, which tend to be found in east Asian countries and in Latin American and African countries, focus on the group more than on the individual (Nisbett, Peng, Choi, & Norenzayan, 2001). This focus on others provides a broader perspective that takes into account both situational and cultural influences on behavior; thus, a more nuanced explanation of the causes of others\u2019 behavior becomes more likely.  Table 12.1  summarizes compares individualistic and collectivist cultures. \n\n Individualistic Culture \n\n Collectivistic Culture \n\n Achievement oriented \n\n Relationship oriented \n\n Focus on autonomy \n\n Focus on group autonomy \n\n Dispositional perspective \n\n Situational perspective \n\n Independent \n\n Interdependent \n\n Analytic thinking style \n\n Holistic thinking style \n\n Table  12.1   Characteristics of Individualistic and Collectivistic Cultures \n\n Actor-Observer Bias \n\n Returning to our earlier example, Greg knew that he lost his job, but an observer would not know. So a na\u00efve observer would tend to attribute Greg\u2019s hostile behavior to Greg\u2019s disposition rather than to the true, situational cause. Why do you think we underestimate the influence of the situation on the behaviors of others? One reason is that we often don\u2019t have all the information we need to make a situational explanation for another person\u2019s behavior. The only information we might have is what is observable. Due to this lack of information we have a tendency to assume the behavior is due to a dispositional, or internal, factor. When it comes to explaining our own behaviors, however, we have much more information available to us. If you came home from school or work angry and yelled at your dog or a loved one, what would your explanation be? You might say you were very tired or feeling unwell and needed quiet time\u2014a situational explanation. The  actor-observer bias  is the phenomenon of attributing other people\u2019s behavior to internal factors (fundamental attribution error) while attributing our own behavior to situational forces (Jones & Nisbett, 1971; Nisbett, Caputo, Legant, & Marecek, 1973; Choi & Nisbett, 1998). As actors of behavior, we have more information available to explain our own behavior. However as observers, we have less information available; therefore, we tend to default to a dispositionist perspective. \n\n One study on the actor-observer bias investigated reasons male participants gave for why they liked their girlfriend (Nisbett et al., 1973). When asked why participants liked their own girlfriend, participants focused on internal, dispositional qualities of their girlfriends (for example, her pleasant personality). The participants\u2019 explanations rarely included causes internal to themselves, such as dispositional traits (for example, \u201cI need companionship.\u201d). In contrast, when speculating why a male friend likes his girlfriend, participants were equally likely to give dispositional and external explanations. This supports the idea that actors tend to provide few internal explanations but many situational explanations for their own behavior. In contrast, observers tend to provide more dispositional explanations for a friend\u2019s behavior ( Figure 12.5 ). \n\n Self-Serving Bias \n\n Following an outcome, self-serving bias are those attributions that enable us to see ourselves in favorable light (for example, making internal attributions for success and external attributions for failures). When you do well at a task, for example acing an exam, it is in your best interest to make a dispositional attribution for your behavior (\u201cI\u2019m smart,\u201d) instead of a situational one (\u201cThe exam was easy,\u201d). The tendency of an individual to take credit by making dispositional or internal attributions for positive outcomes but situational or external attributions for negative outcomes is known as the  self-serving bias  (Miller & Ross, 1975). This bias serves to protect self-esteem. You can imagine that if people always made situational attributions for their behavior, they would never be able to take credit and feel good about their accomplishments. \n\n We can understand self-serving bias by digging more deeply into  attribution , a belief about the cause of a result. One model of attribution proposes three main dimensions: locus of control (internal versus external), stability (stable versus unstable), and controllability (controllable versus uncontrollable). In this context, stability refers the extent to which the circumstances that result in a given outcome are changeable. The circumstances are considered stable if they are unlikely to change. Controllability refers to the extent to which the circumstances that are associated with a given outcome can be controlled. Obviously, those things that we have the power to control would be labeled controllable (Weiner, 1979). \n\n Consider the example of how we explain our favorite sports team\u2019s wins. Research shows that we make internal, stable, and controllable attributions for our team\u2019s victory ( Figure 12.6 ) (Grove, Hanrahan, & McInman, 1991). For example, we might tell ourselves that our team is talented (internal), consistently works hard (stable), and uses effective strategies (controllable). In contrast, we are more likely to make external, unstable, and uncontrollable attributions when our favorite team loses. For example, we might tell ourselves that the other team has more experienced players or that the referees were unfair (external), the other team played at home (unstable), and the cold weather affected our team\u2019s performance (uncontrollable). \n\n Just-World Hypothesis One consequence of westerners\u2019 tendency to provide dispositional explanations for behavior is victim blame (Jost & Major, 2001). When people experience bad fortune, others tend to assume that they somehow are responsible for their own fate. A common ideology, or worldview, in the United States is the just-world hypothesis. The  just-world hypothesis  is the belief that people get the outcomes they deserve (Lerner & Miller, 1978). In order to maintain the belief that the world is a fair place, people tend to think that good people experience positive outcomes, and bad people experience negative outcomes (Jost, Banaji, & Nosek, 2004; Jost & Major, 2001). The ability to think of the world as a fair place, where people get what they deserve, allows us to feel that the world is predictable and that we have some control over our life outcomes (Jost et al., 2004; Jost & Major, 2001). For example, if you want to experience positive outcomes, you just need to work hard to get ahead in life. \n\n Can you think of a negative consequence of the just-world hypothesis? One negative consequence is people\u2019s tendency to blame poor individuals for their plight. What common explanations are given for why people live in poverty? Have you heard statements such as, \u201cThe poor are lazy and just don\u2019t want to work\u201d or \u201cPoor people just want to live off the government\u201d? What types of explanations are these, dispositional or situational? These dispositional explanations are clear examples of the fundamental attribution error. Blaming poor people for their poverty ignores situational factors that impact them, such as high unemployment rates, recession, poor educational opportunities, and the familial cycle of poverty ( Figure 12.7 ). Other research shows that people who hold just-world beliefs have negative attitudes toward people who are unemployed and people living with AIDS (Sutton & Douglas, 2005). In the United States and other countries, victims of sexual assault may find themselves blamed for their abuse. Victim advocacy groups, such as Domestic Violence Ended (DOVE), attend court in support of victims to ensure that blame is directed at the perpetrators of sexual violence, not the victims. \n 12.2   Self-presentation Learning Objectives By the end of this section, you will be able to:\n\n Describe social roles and how they influence behavior \n\n Explain what social norms are and how they influence behavior \n\n Define script \n\n Describe the findings of Zimbardo\u2019s Stanford prison experiment \n\n As you\u2019ve learned, social psychology is the study of how people affect one another\u2019s thoughts, feelings, and behaviors. We have discussed situational perspectives and social psychology\u2019s emphasis on the ways in which a person\u2019s environment, including culture and other social influences, affect behavior. In this section, we examine situational forces that have a strong influence on human behavior including social roles, social norms, and scripts. We discuss how humans use the social environment as a source of information, or cues, on how to behave. Situational influences on our behavior have important consequences, such as whether we will help a stranger in an emergency or how we would behave in an unfamiliar environment. \n\n Social Roles \n\n One major social determinant of human behavior is our social roles. A  social role  is a pattern of behavior that is expected of a person in a given setting or group (Hare, 2003). Each one of us has several social roles. You may be, at the same time, a student, a parent, an aspiring teacher, a son or daughter, a spouse, and a lifeguard. How do these social roles influence your behavior? Social roles are defined by culturally shared knowledge. That is, nearly everyone in a given culture knows what behavior is expected of a person in a given role. For example, what is the social role for a student? If you look around a college classroom you will likely see students engaging in studious behavior, taking notes, listening to the professor, reading the textbook, and sitting quietly at their desks ( Figure 12.8 ). Of course you may see students deviating from the expected studious behavior such as texting on their phones or using Facebook on their laptops, but in all cases, the students that you observe are attending class\u2014a part of the social role of students. \n\n Social roles, and our related behavior, can vary across different settings. How do you behave when you are engaging in the role of son or daughter and attending a family function? Now imagine how you behave when you are engaged in the role of employee at your workplace. It is very likely that your behavior will be different. Perhaps you are more relaxed and outgoing with your family, making jokes and doing silly things. But at your workplace you might speak more professionally, and although you may be friendly, you are also serious and focused on getting the work completed. These are examples of how our social roles influence and often dictate our behavior to the extent that identity and personality can vary with context (that is, in different social groups) (Malloy, Albright, Kenny, Agatstein & Winquist, 1997). \n\n Social Norms \n\n As discussed previously, social roles are defined by a culture\u2019s shared knowledge of what is expected behavior of an individual in a specific role. This shared knowledge comes from social norms. A  social norm  is a group\u2019s expectation of what is appropriate and acceptable behavior for its members\u2014how they are supposed to behave and think (Deutsch & Gerard, 1955; Berkowitz, 2004). How are we expected to act? What are we expected to talk about? What are we expected to wear? In our discussion of social roles we noted that colleges have social norms for students\u2019 behavior in the role of student and workplaces have social norms for employees\u2019 behaviors in the role of employee. Social norms are everywhere including in families, gangs, and on social media outlets. What are some social norms on Facebook? \n\n Connect the Concepts Tweens, Teens, and Social Norms My 11-year-old daughter, Jessica, recently told me she needed shorts and shirts for the summer, and that she wanted me to take her to a store at the mall that is popular with preteens and teens to buy them. I have noticed that many girls have clothes from that store, so I tried teasing her. I said, \u201cAll the shirts say \u2018Aero\u2019 on the front. If you are wearing a shirt like that and you have a substitute teacher, and the other girls are all wearing that type of shirt, won\u2019t the substitute teacher think you are all named \u2018Aero\u2019?\u201d \n\n My daughter replied, in typical 11-year-old fashion, \u201cMom, you are not funny. Can we please go shopping?\u201d \n\n I tried a different tactic. I asked Jessica if having clothing from that particular store will make her popular. She replied, \u201cNo, it will not make me popular. It is what the popular kids wear. It will make me feel happier.\u201d How can a label or name brand make someone feel happier?\n\nThink back to what you\u2019ve learned about  lifespan development . What is it about pre-teens and young teens that make them want to fit in ( Figure 12.9 )? Does this change over time? Think back to your high school experience, or look around your college campus. What is the main name brand clothing you see? What messages do we get from the media about how to fit in?\n\n Scripts \n\n Because of social roles, people tend to know what behavior is expected of them in specific, familiar settings. A  script  is a person\u2019s knowledge about the sequence of events expected in a specific setting (Schank & Abelson, 1977). How do you act on the first day of school, when you walk into an elevator, or are at a restaurant? For example, at a restaurant in the United States, if we want the server\u2019s attention, we try to make eye contact. In Brazil, you would make the sound \u201cpsst\u201d to get the server\u2019s attention. You can see the cultural differences in scripts. To an American, saying \u201cpsst\u201d to a server might seem rude, yet to a Brazilian, trying to make eye contact might not seem an effective strategy. Scripts are important sources of information to guide behavior in given situations. Can you imagine being in an unfamiliar situation and not having a script for how to behave? This could be uncomfortable and confusing. How could you find out about social norms in an unfamiliar culture? \n\n Zimbardo\u2019s Stanford Prison Experiment The famous  Stanford prison experiment , conducted by social psychologist Philip  Zimbardo  and his colleagues at Stanford University, demonstrated the power of social roles, social norms, and scripts. In the summer of 1971, an advertisement was placed in a California newspaper asking for male volunteers to participate in a study about the psychological effects of prison life. More than 70 men volunteered, and these volunteers then underwent psychological testing to eliminate candidates who had underlying psychiatric issues, medical issues, or a history of crime or drug abuse. The pool of volunteers was whittled down to 24 healthy male college students. Each student was paid $15 per day and was randomly assigned to play the role of either a prisoner or a guard in the study. Based on what you have learned about research methods, why is it important that participants were randomly assigned? \n\n A mock prison was constructed in the basement of the psychology building at Stanford. Participants assigned to play the role of prisoners were \u201carrested\u201d at their homes by Palo Alto police officers, booked at a police station, and subsequently taken to the mock prison. The experiment was scheduled to run for several weeks. To the surprise of the researchers, both the \u201cprisoners\u201d and \u201cguards\u201d assumed their roles with zeal. In fact, on day 2, some of the prisoners revolted, and the guards quelled the rebellion by threatening the prisoners with night sticks. In a relatively short time, the guards came to harass the prisoners in an increasingly sadistic manner, through a complete lack of privacy, lack of basic comforts such as mattresses to sleep on, and through degrading chores and late-night counts. \n\n The prisoners, in turn, began to show signs of severe anxiety and hopelessness\u2014they began tolerating the guards\u2019 abuse. Even the Stanford professor who designed the study and was the head researcher, Philip Zimbardo, found himself acting as if the prison was real and his role, as prison supervisor, was real as well. After only six days, the experiment had to be ended due to the participants\u2019 deteriorating behavior. Zimbardo explained,\n\n At this point it became clear that we had to end the study. We had created an overwhelmingly powerful situation\u2014a situation in which prisoners were withdrawing and behaving in pathological ways, and in which some of the guards were behaving sadistically. Even the \u201cgood\u201d guards felt helpless to intervene, and none of the guards quit while the study was in progress. Indeed, it should be noted that no guard ever came late for his shift, called in sick, left early, or demanded extra pay for overtime work. (Zimbardo, 2013) \n\n The Stanford prison experiment demonstrated the power of social roles, norms, and scripts in affecting human behavior. The guards and prisoners enacted their social roles by engaging in behaviors appropriate to the roles: The guards gave orders and the prisoners followed orders. Social norms require guards to be authoritarian and prisoners to be submissive. When prisoners rebelled, they violated these social norms, which led to upheaval. The specific acts engaged by the guards and the prisoners derived from scripts. For example, guards degraded the prisoners by forcing them do push-ups and by removing all privacy. Prisoners rebelled by throwing pillows and trashing their cells. Some prisoners became so immersed in their roles that they exhibited symptoms of mental breakdown; however, according to Zimbardo, none of the participants suffered long term harm (Alexander, 2001). \n\n The Stanford Prison Experiment has some parallels with the abuse of prisoners of war by U.S. Army troops and CIA personnel at the Abu Ghraib prison in 2003 and 2004. The offenses at Abu  Ghraib  were documented by photographs of the abuse, some taken by the abusers themselves ( Figure 12.10 ). \n\n Link to Learning \n\n Visit this  website  to hear an NPR interview with Philip  Zimbardo  where he discusses the parallels between the Stanford prison experiment and the Abu Ghraib prison in Iraq. \n 12.3   Attitudes and Persuasion Learning Objectives By the end of this section, you will be able to:\n\n Define attitude \n\n Describe how people\u2019s attitudes are internally changed through cognitive dissonance \n\n Explain how people\u2019s attitudes are externally changed through persuasion \n\n Describe the peripheral and central routes to persuasion \n\n Social psychologists have documented how the power of the situation can influence our behaviors. Now we turn to how the power of the situation can influence our attitudes and beliefs.  Attitude  is our evaluation of a person, an idea, or an object. We have attitudes for many things ranging from products that we might pick up in the supermarket to people around the world to political policies. Typically, attitudes are favorable or unfavorable: positive or negative (Eagly & Chaiken, 1993). And, they have three components: an affective component (feelings), a behavioral component (the effect of the attitude on behavior), and a cognitive component (belief and knowledge) (Rosenberg & Hovland, 1960). \n\n For example, you may hold a positive attitude toward recycling. This attitude should result in positive feelings toward recycling (such as \u201cIt makes me feel good to recycle\u201d or \u201cI enjoy knowing that I make a small difference in reducing the amount of waste that ends up in landfills\u201d). Certainly, this attitude should be reflected in our behavior: You actually recycle as often as you can. Finally, this attitude will be reflected in favorable thoughts (for example, \u201cRecycling is good for the environment\u201d or \u201cRecycling is the responsible thing to do\u201d). \n\n Our attitudes and beliefs are not only influenced by external forces, but also by internal influences that we control. Like our behavior, our attitudes and thoughts are not always changed by situational pressures, but they can be consciously changed by our own free will. In this section we discuss the conditions under which we would want to change our own attitudes and beliefs. \n\n What is Cognitive Dissonance? Social psychologists have documented that feeling good about ourselves and maintaining positive self-esteem is a powerful motivator of human behavior (Tavris & Aronson, 2008). In the United States, members of the predominant culture typically think very highly of themselves and view themselves as good people who are above average on many desirable traits (Ehrlinger, Gilovich, & Ross, 2005). Often, our behavior, attitudes, and beliefs are affected when we experience a threat to our self-esteem or positive self-image. Psychologist Leon Festinger (1957) defined  cognitive dissonance  as psychological discomfort arising from holding two or more inconsistent attitudes, behaviors, or cognitions (thoughts, beliefs, or opinions). Festinger\u2019s theory of cognitive dissonance states that when we experience a conflict in our behaviors, attitudes, or beliefs that runs counter to our positive self-perceptions, we experience psychological discomfort (dissonance). For example, if you believe smoking is bad for your health but you continue to smoke, you experience conflict between your belief and behavior ( Figure 12.11 ). Later research documented that only conflicting cognitions that threaten individuals\u2019 positive self-image cause dissonance (Greenwald & Ronis, 1978). Additional research found that dissonance is not only psychologically uncomfortable but also can cause physiological arousal (Croyle & Cooper, 1983) and activate regions of the brain important in emotions and cognitive functioning (van Veen, Krug, Schooler, & Carter, 2009). When we experience cognitive dissonance, we are motivated to decrease it because it is psychologically, physically, and mentally uncomfortable. We can reduce  cognitive dissonance  by bringing our cognitions, attitudes, and behaviors in line\u2014that is, making them harmonious. This can be done in different ways, such as: \n\n changing our discrepant behavior (e.g., stop smoking), \n\n changing our cognitions through rationalization or denial (e.g., telling ourselves that health risks can be reduced by smoking filtered cigarettes), \n\n adding a new cognition (e.g., \u201cSmoking suppresses my appetite so I don\u2019t become overweight, which is good for my health.\u201d). \n\n A classic example of cognitive dissonance is John, a 20-year-old who enlists in the military. During boot camp he is awakened at 5:00 a.m., is chronically sleep deprived, yelled at, covered in sand flea bites, physically bruised and battered, and mentally exhausted ( Figure 12.12 ). It gets worse. Recruits that make it to week 11 of boot camp have to do 54 hours of continuous training. \n\n Not surprisingly, John is miserable. No one likes to be miserable. In this type of situation, people can change their beliefs, their attitudes, or their behaviors. The last option, a change of behaviors, is not available to John. He has signed on to the military for four years, and he cannot legally leave. \n\n If John keeps thinking about how miserable he is, it is going to be a very long four years. He will be in a constant state of cognitive dissonance. As an alternative to this misery, John can change his beliefs or attitudes. He can tell himself, \u201cI am becoming stronger, healthier, and sharper. I am learning discipline and how to defend myself and my country. What I am doing is really important.\u201d If this is his belief, he will realize that he is becoming stronger through his challenges. He then will feel better and not experience cognitive dissonance, which is an uncomfortable state. \n\n The Effect of Initiation \n\n The military example demonstrates the observation that a difficult  initiation  into a group influences us to like the group  more , due to the justification of effort. We do not want to have wasted time and effort to join a group that we eventually leave. A classic experiment by Aronson and Mills (1959) demonstrated this justification of effort effect. College students volunteered to join a campus group that would meet regularly to discuss the psychology of sex. Participants were randomly assigned to one of three conditions: no initiation, an easy initiation, and a difficult initiation into the group. After participating in the first discussion, which was deliberately made very boring, participants rated how much they liked the group. Participants who underwent a difficult initiation process to join the group rated the group more favorably than did participants with an easy initiation or no initiation ( Figure 12.13 ). \n\n Similar effects can be seen in a more recent study of how student effort affects course evaluations. Heckert, Latier, Ringwald-Burton, and Drazen (2006) surveyed 463 undergraduates enrolled in courses at a midwestern university about the amount of effort that their courses required of them. In addition, the students were also asked to evaluate various aspects of the course. Given what you\u2019ve just read, it will come as no surprise that those courses that were associated with the highest level of effort were evaluated as being more valuable than those that did not. Furthermore, students indicated that they learned more in courses that required more effort, regardless of the grades that they received in those courses (Heckert et al., 2006). \n\n Besides the classic military example and group initiation, can you think of other examples of  cognitive dissonance ? Here is one: Marco and Maria live in Fairfield County, Connecticut, which is one of the wealthiest areas in the United States and has a very high cost of living. Marco telecommutes from home and Maria does not work outside of the home. They rent a very small house for more than $3000 a month. Maria shops at consignment stores for clothes and economizes where she can. They complain that they never have any money and that they cannot buy anything new. When asked why they do not move to a less expensive location, since Marco telecommutes, they respond that Fairfield County is beautiful, they love the beaches, and they feel comfortable there. How does the theory of cognitive dissonance apply to Marco and Maria\u2019s choices? \n\n Persuasion \n\n In the previous section we discussed that the motivation to reduce cognitive dissonance leads us to change our attitudes, behaviors, and/or cognitions to make them consonant.  Persuasion  is the process of changing our attitude toward something based on some kind of communication. Much of the persuasion we experience comes from outside forces. How do people convince others to change their attitudes, beliefs, and behaviors ( Figure 12.14 )? What communications do you receive that attempt to persuade you to change your attitudes, beliefs, and behaviors? \n\n A subfield of social psychology studies persuasion and social influence, providing us with a plethora of information on how humans can be persuaded by others. \n\n Yale Attitude Change Approach \n\n The topic of persuasion has been one of the most extensively researched areas in social psychology (Fiske et al., 2010). During the Second World War, Carl  Hovland  extensively researched persuasion for the U.S. Army. After the war, Hovland continued his exploration of persuasion at Yale University. Out of this work came a model called the  Yale attitude change approach , which describes the conditions under which people tend to change their attitudes. Hovland demonstrated that certain features of the source of a persuasive message, the content of the message, and the characteristics of the audience will influence the persuasiveness of a message (Hovland, Janis, & Kelley, 1953). \n\n Features of the source of the persuasive message include the credibility of the speaker (Hovland & Weiss, 1951) and the physical attractiveness of the speaker (Eagly & Chaiken, 1975; Petty, Wegener, & Fabrigar, 1997). Thus, speakers who are credible, or have expertise on the topic, and who are deemed as trustworthy are more persuasive than less credible speakers. Similarly, more attractive speakers are more persuasive than less attractive speakers. The use of famous actors and athletes to advertise products on television and in print relies on this principle. The immediate and long term impact of the persuasion also depends, however, on the credibility of the messenger (Kumkale & Albarrac\u00edn, 2004). \n\n Features of the message itself that affect persuasion include subtlety (the quality of being important, but not obvious) (Petty & Cacioppo, 1986; Walster & Festinger, 1962); sidedness (that is, having more than one side) (Crowley & Hoyer, 1994; Igou & Bless, 2003; Lumsdaine & Janis, 1953); timing (Haugtvedt & Wegener, 1994; Miller & Campbell, 1959), and whether both sides are presented. Messages that are more subtle are more persuasive than direct messages. Arguments that occur first, such as in a debate, are more influential if messages are given back-to-back. However, if there is a delay after the first message, and before the audience needs to make a decision, the last message presented will tend to be more persuasive (Miller & Campbell, 1959). \n\n Features of the audience that affect persuasion are attention (Albarrac\u00edn & Wyer, 2001; Festinger & Maccoby, 1964), intelligence, self-esteem (Rhodes & Wood, 1992), and age (Krosnick & Alwin, 1989). In order to be persuaded, audience members must be paying attention. People with lower intelligence are more easily persuaded than people with higher intelligence; whereas people with moderate self-esteem are more easily persuaded than people with higher or lower self-esteem (Rhodes & Wood, 1992). Finally, younger adults aged 18\u201325 are more persuadable than older adults. \n\n Elaboration Likelihood Model \n\n An especially popular model that describes the dynamics of persuasion is the elaboration likelihood model of persuasion (Petty & Cacioppo, 1986). The  elaboration likelihood model  considers the variables of the attitude change approach\u2014that is, features of the source of the persuasive message, contents of the message, and characteristics of the audience are used to determine when attitude change will occur. According to the elaboration likelihood model of persuasion, there are two main routes that play a role in delivering a persuasive message: central and peripheral ( Figure 12.15 ). \n\n The  central route  is logic driven and uses data and facts to convince people of an argument\u2019s worthiness. For example, a car company seeking to persuade you to purchase their model will emphasize the car\u2019s safety features and fuel economy. This is a direct route to persuasion that focuses on the quality of the information. In order for the central route of persuasion to be effective in changing attitudes, thoughts, and behaviors, the argument must be strong and, if successful, will result in lasting attitude change. \n\n The central route to persuasion works best when the target of persuasion, or the audience, is analytical and willing to engage in processing of the information. From an advertiser\u2019s perspective, what products would be best sold using the central route to persuasion? What audience would most likely be influenced to buy the product? One example is buying a computer. It is likely, for example, that small business owners might be especially influenced by the focus on the computer\u2019s quality and features such as processing speed and memory capacity. \n\n The  peripheral route  is an indirect route that uses peripheral cues to associate positivity with the message (Petty & Cacioppo, 1986). Instead of focusing on the facts and a product\u2019s quality, the peripheral route relies on association with positive characteristics such as positive emotions and celebrity endorsement. For example, having a popular athlete advertise athletic shoes is a common method used to encourage young adults to purchase the shoes. This route to attitude change does not require much effort or information processing. This method of persuasion may promote positivity toward the message or product, but it typically results in less permanent attitude or behavior change. The audience does not need to be analytical or motivated to process the message. In fact, a peripheral route to persuasion may not even be noticed by the audience, for example in the strategy of product placement. Product placement refers to putting a product with a clear brand name or brand identity in a TV show or movie to promote the product (Gupta & Lord, 1998). For example, one season of the reality series  American Idol  prominently showed the panel of judges drinking out of cups that displayed the Coca-Cola logo. What other products would be best sold using the peripheral route to persuasion? Another example is clothing: A retailer may focus on celebrities that are wearing the same style of clothing. \n\n Foot-in-the-door Technique \n\n Researchers have tested many persuasion strategies that are effective in selling products and changing people\u2019s attitude, ideas, and behaviors. One effective strategy is the foot-in-the-door technique (Cialdini, 2001; Pliner, Hart, Kohl, & Saari, 1974). Using the  foot-in-the-door technique , the persuader gets a person to agree to bestow a small favor or to buy a small item, only to later request a larger favor or purchase of a bigger item. The foot-in-the-door technique was demonstrated in a study by Freedman and Fraser (1966) in which participants who agreed to post small sign in their yard or sign a petition were more likely to agree to put a large sign in their yard than people who declined the first request ( Figure 12.16 ). Research on this technique also illustrates the principle of consistency (Cialdini, 2001): Our past behavior often directs our future behavior, and we have a desire to maintain consistency once we have a committed to a behavior. A common application of foot-in-the-door is when teens ask their parents for a small permission (for example, extending curfew by a half hour) and then asking them for something larger. Having granted the smaller request increases the likelihood that parents will acquiesce with the later, larger request. \n\n How would a store owner use the foot-in-the-door technique to sell you an expensive product? For example, say that you are buying the latest model smartphone, and the salesperson suggests you purchase the best data plan. You agree to this. The salesperson then suggests a bigger purchase\u2014the three-year extended warranty. After agreeing to the smaller request, you are more likely to also agree to the larger request. You may have encountered this if you have bought a car. When salespeople realize that a buyer intends to purchase a certain model, they might try to get the customer to pay for many or most available options on the car. \n 12.4   Conformity, Compliance, and Obedience Learning Objectives By the end of this section, you will be able to:\n\n Explain the Asch effect \n\n Define conformity and types of social influence \n\n Describe Stanley Milgram\u2019s experiment and its implications \n\n Define groupthink, social facilitation, and social loafing \n\n In this section, we discuss additional ways in which people influence others. The topics of conformity, social influence, obedience, and group processes demonstrate the power of the social situation to change our thoughts, feelings, and behaviors. We begin this section with a discussion of a famous social psychology experiment that demonstrated how susceptible humans are to outside social pressures. \n\n Conformity \n\n Solomon  Asch  conducted several experiments in the 1950s to determine how people are affected by the thoughts and behaviors of other people. In one study, a group of participants was shown a series of printed line segments of different lengths: a, b, and c ( Figure 12.17 ). Participants were then shown a fourth line segment: x. They were asked to identify which line segment from the first group (a, b, or c) most closely resembled the fourth line segment in length. \n\n Each group of participants had only one true, na\u00efve subject. The remaining members of the group were confederates of the researcher. A  confederate  is a person who is aware of the experiment and works for the researcher. Confederates are used to manipulate social situations as part of the research design, and the true, na\u00efve participants believe that confederates are, like them, uninformed participants in the experiment. In Asch\u2019s study, the confederates identified a line segment that was obviously shorter than the target line\u2014a wrong answer. The na\u00efve participant then had to identify aloud the line segment that best matched the target line segment. \n\n How often do you think the true participant aligned with the confederates\u2019 response? That is, how often do you think the group influenced the participant, and the participant gave the wrong answer? Asch (1955) found that 76% of participants conformed to group pressure at least once by indicating the incorrect line.  Conformity  is the change in a person\u2019s behavior to go along with the group, even if he does not agree with the group. Why would people give the wrong answer? What factors would increase or decrease someone giving in or conforming to group pressure? \n\n The  Asch effect  is the influence of the group majority on an individual\u2019s judgment. What factors make a person more likely to yield to group pressure? Research shows that the size of the majority, the presence of another dissenter, and the public or relatively private nature of responses are key influences on conformity. \n\n The size of the majority: The greater the number of people in the majority, the more likely an individual will conform. There is, however, an upper limit: a point where adding more members does not increase conformity. In Asch\u2019s study, conformity increased with the number of people in the majority\u2014up to seven individuals. At numbers beyond seven, conformity leveled off and decreased slightly (Asch, 1955). \n\n The presence of another dissenter: If there is at least one dissenter, conformity rates drop to near zero (Asch, 1955). \n\n The public or private nature of the responses: When responses are made publicly (in front of others), conformity is more likely; however, when responses are made privately (e.g., writing down the response), conformity is less likely (Deutsch & Gerard, 1955).\n\n The finding that conformity is more likely to occur when responses are public than when they are private is the reason government elections require voting in secret, so we are not coerced by others ( Figure 12.18 ). The  Asch effect  can be easily seen in children when they have to publicly vote for something. For example, if the teacher asks whether the children would rather have extra recess, no homework, or candy, once a few children vote, the rest will comply and go with the majority. In a different classroom, the majority might vote differently, and most of the children would comply with that majority. When someone\u2019s vote changes if it is made in public versus private, this is known as compliance. Compliance can be a form of conformity. Compliance is going along with a request or demand, even if you do not agree with the request. In Asch\u2019s studies, the participants complied by giving the wrong answers, but privately did not accept that the obvious wrong answers were correct. \n\n Now that you have learned about the Asch line experiments, why do you think the participants conformed? The correct answer to the line segment question was obvious, and it was an easy task. Researchers have categorized the motivation to conform into two types: normative social influence and informational social influence (Deutsch & Gerard, 1955). \n\n In  normative social influence , people conform to the group norm to fit in, to feel good, and to be accepted by the group. However, with  informational social influence , people conform because they believe the group is competent and has the correct information, particularly when the task or situation is ambiguous. What type of social influence was operating in the Asch conformity studies? Since the line judgment task was unambiguous, participants did not need to rely on the group for information. Instead, participants complied to fit in and avoid ridicule, an instance of normative social influence. \n\n An example of informational social influence may be what to do in an emergency situation. Imagine that you are in a movie theater watching a film and what seems to be smoke comes in the theater from under the emergency exit door. You are not certain that it is smoke\u2014it might be a special effect for the movie, such as a fog machine. When you are uncertain you will tend to look at the behavior of others in the theater. If other people show concern and get up to leave, you are likely to do the same. However, if others seem unconcerned, you are likely to stay put and continue watching the movie ( Figure 12.19 ). \n\n How would you have behaved if you were a participant in Asch\u2019s study? Many students say they would not conform, that the study is outdated, and that people nowadays are more independent. To some extent this may be true. Research suggests that overall rates of conformity may have reduced since the time of Asch\u2019s research. Furthermore, efforts to replicate Asch\u2019s study have made it clear that many factors determine how likely it is that someone will demonstrate conformity to the group. These factors include the participant\u2019s age, gender, and socio-cultural background (Bond & Smith, 1996; Larsen, 1990; Walker & Andrade, 1996). \n\n Link to Learning \n\n Watch this  video  to see a replication of the Asch experiment. \n\n Stanley Milgram\u2019s Experiment \n\n Conformity is one effect of the influence of others on our thoughts, feelings, and behaviors. Another form of social influence is obedience to authority.  Obedience  is the change of an individual\u2019s behavior to comply with a demand by an authority figure. People often comply with the request because they are concerned about a consequence if they do not comply. To demonstrate this phenomenon, we review another classic social psychology experiment. \n\n Stanley  Milgram  was a social psychology professor at Yale who was influenced by the trial of Adolf Eichmann, a Nazi war criminal. Eichmann\u2019s defense for the atrocities he committed was that he was \u201cjust following orders.\u201d Milgram (1963) wanted to test the validity of this defense, so he designed an experiment and initially recruited 40 men for his experiment. The volunteer participants were led to believe that they were participating in a study to improve learning and memory. The participants were told that they were to teach other students (learners) correct answers to a series of test items. The participants were shown how to use a device that they were told delivered electric shocks of different intensities to the learners. The participants were told to shock the learners if they gave a wrong answer to a test item\u2014that the shock would help them to learn. The participants gave (or believed they gave) the learners shocks, which increased in 15-volt increments, all the way up to 450 volts. The participants did not know that the learners were confederates and that the confederates did not actually receive shocks. In response to a string of incorrect answers from the learners, the participants obediently and repeatedly shocked them. The confederate learners cried out for help, begged the participant teachers to stop, and even complained of heart trouble. Yet, when the researcher told the participant-teachers to continue the shock, 65% of the participants continued the shock to the maximum voltage and to the point that the learner became unresponsive ( Figure 12.20 ). What makes someone obey authority to the point of potentially causing serious harm to another person? \n\n Several variations of the original  Milgram  experiment were conducted to test the boundaries of obedience. When certain features of the situation were changed, participants were less likely to continue to deliver shocks (Milgram, 1965). For example, when the setting of the experiment was moved to an office building, the percentage of participants who delivered the highest shock dropped to 48%. When the learner was in the same room as the teacher, the highest shock rate dropped to 40%. When the teachers\u2019 and learners\u2019 hands were touching, the highest shock rate dropped to 30%. When the researcher gave the orders by phone, the rate dropped to 23%. These variations show that when the humanity of the person being shocked was increased, obedience decreased. Similarly, when the authority of the experimenter decreased, so did obedience. \n\n This case is still very applicable today. What does a person do if an authority figure orders something done? What if the person believes it is incorrect, or worse, unethical? In a study by Martin and Bull (2008), midwives privately filled out a questionnaire regarding best practices and expectations in delivering a baby. Then, a more senior midwife and supervisor asked the junior midwives to do something they had previously stated they were opposed to. Most of the junior midwives were obedient to authority, going against their own beliefs. \n\n Groupthink \n\n When in group settings, we are often influenced by the thoughts, feelings, and behaviors around us. Whether it is due to normative or informational social influence, groups have power to influence individuals. Another phenomenon of group conformity is groupthink.  Groupthink  is the modification of the opinions of members of a group to align with what they believe is the group consensus (Janis, 1972). In group situations, the group often takes action that individuals would not perform outside the group setting because groups make more extreme decisions than individuals do. Moreover, groupthink can hinder opposing trains of thought. This elimination of diverse opinions contributes to faulty decision by the group. \n\n Dig Deeper Groupthink in the U.S. Government There have been several instances of groupthink in the U.S. government. One example occurred when the United States led a small coalition of nations to invade Iraq in March 2003. This invasion occurred because a small group of advisors and former President George W. Bush were convinced that Iraq represented a significant terrorism threat with a large stockpile of weapons of mass destruction at its disposal. Although some of these individuals may have had some doubts about the credibility of the information available to them at the time, in the end, the group arrived at a consensus that Iraq had weapons of mass destruction and represented a significant threat to national security. It later came to light that Iraq did not have weapons of mass destruction, but not until the invasion was well underway. As a result, 6000 American soldiers were killed and many more civilians died. How did the Bush administration arrive at their conclusions? Here is a video of Colin Powell discussing the information he had, 10 years after his famous United Nations speech, \n\n https://www.openstax.org/l/GroupThink  (\"CNN Official Interview: Colin Powell now regrets UN speech about WMDs,\" 2010). Do you see evidence of groupthink? \n\n Why does groupthink occur? There are several causes of groupthink, which makes it preventable. When the group is highly cohesive, or has a strong sense of connection, maintaining group harmony may become more important to the group than making sound decisions. If the group leader is directive and makes his opinions known, this may discourage group members from disagreeing with the leader. If the group is isolated from hearing alternative or new viewpoints, groupthink may be more likely. How do you know when groupthink is occurring? \n\n There are several symptoms of groupthink including the following: \n\n perceiving the group as invulnerable or invincible\u2014believing it can do no wrong \n\n believing the group is morally correct \n\n self-censorship by group members, such as withholding information to avoid disrupting the group consensus \n\n the quashing of dissenting group members\u2019 opinions \n\n the shielding of the group leader from dissenting views \n\n perceiving an illusion of unanimity among group members \n\n holding stereotypes or negative attitudes toward the out-group or others\u2019 with differing viewpoints (Janis, 1972) \n\n Given the causes and symptoms of groupthink, how can it be avoided? There are several strategies that can improve group decision making including seeking outside opinions, voting in private, having the leader withhold position statements until all group members have voiced their views, conducting research on all viewpoints, weighing the costs and benefits of all options, and developing a contingency plan (Janis, 1972; Mitchell & Eckstein, 2009). \n\n Group Polarization \n\n Another phenomenon that occurs within group settings is group polarization.  Group polarization  (Teger & Pruitt, 1967) is the strengthening of an original group attitude after the discussion of views within a group. That is, if a group initially favors a viewpoint, after discussion the group consensus is likely a stronger endorsement of the viewpoint. Conversely, if the group was initially opposed to a viewpoint, group discussion would likely lead to stronger opposition. Group polarization explains many actions taken by groups that would not be undertaken by individuals. Group polarization can be observed at political conventions, when platforms of the party are supported by individuals who, when not in a group, would decline to support them. A more everyday example is a group\u2019s discussion of how attractive someone is. Does your opinion change if you find someone attractive, but your friends do not agree? If your friends vociferously agree, might you then find this person even more attractive? \n\n Social Facilitation \n\n Not all intergroup interactions lead to the negative outcomes we have described. Sometimes being in a group situation can improve performance.  Social facilitation  occurs when an individual performs better when an audience is watching than when the individual performs the behavior alone. This typically occurs when people are performing a task for which they are skilled. Can you think of an example in which having an audience could improve performance? One common example is sports. Skilled basketball players will be more likely to make a free throw basket when surrounded by a cheering audience than when playing alone in the gym ( Figure 12.21 ). However, there are instances when even skilled athletes can have difficulty under pressure. For example, if an athlete is less skilled or nervous about making a free throw, having an audience may actually hinder rather than help. In sum, social facilitation is likely to occur for easy tasks, or tasks at which we are skilled, but worse performance may occur when performing in front of others, depending on the task. \n\n Social Loafing Another way in which a group presence can affect our performance is social loafing.  Social loafing  is the exertion of less effort by a person working together with a group. Social loafing occurs when our individual performance cannot be evaluated separately from the group. Thus, group performance declines on easy tasks (Karau & Williams, 1993). Essentially individual group members loaf and let other group members pick up the slack. Because each individual\u2019s efforts cannot be evaluated, individuals become less motivated to perform well. For example, consider a group of people cooperating to clean litter from the roadside. Some people will exert a great amount of effort, while others will exert little effort. Yet the entire job gets done, and it may not be obvious who worked hard and who didn\u2019t. \n\n As a college student you may have experienced social loafing while working on a group project. Have you ever had to contribute more than your fair share because your fellow group members weren\u2019t putting in the work? This may happen when a professor assigns a group grade instead of individual grades. If the professor doesn\u2019t know how much effort each student contributed to a project, some students may be inclined to let more conscientious students do more of the work. The chance of social loafing in student work groups increases as the size of the group increases (Shepperd & Taylor, 1999). \n\n Interestingly, the opposite of social loafing occurs when the task is complex and difficult (Bond & Titus, 1983; Geen, 1989). Remember the previous discussion of choking under pressure? This happens when you perform a difficult task and your individual performance can be evaluated. In a group setting, such as the student work group, if your individual performance cannot be evaluated, there is less pressure for you to do well, and thus less anxiety or physiological arousal (Latan\u00e9, Williams, & Harkens, 1979). This puts you in a relaxed state in which you can perform your best, if you choose (Zajonc, 1965). If the task is a difficult one, many people feel motivated and believe that their group needs their input to do well on a challenging project (Jackson & Williams, 1985). Given what you learned about social loafing, what advice would you give a new professor about how to design group projects? If you suggested that individuals\u2019 efforts should not be evaluated, to prevent the anxiety of choking under pressure, but that the task must be challenging, you have a good understanding of the concepts discussed in this section. Alternatively, you can suggest that individuals\u2019 efforts should be evaluated, but the task should be easy so as to facilitate performance. Good luck trying to convince your professor to only assign easy projects. \n\n Table 12.2  summarizes the types of social influence you have learned about in this chapter. \n\n Type of Social Influence \n\n Description \n\n Conformity \n\n Changing your behavior to go along with the group even if you do not agree with the group \n\n Compliance \n\n Going along with a request or demand \n\n Normative social influence \n\n Conformity to a group norm to fit in, feel good, and be accepted by the group \n\n Informational social influence \n\n Conformity to a group norm prompted by the belief that the group is competent and has the correct information \n\n Obedience \n\n Changing your behavior to please an authority figure or to avoid aversive consequences  \n\n Groupthink \n\n Group members modify their opinions to match what they believe is the group consensus \n\n Group polarization \n\n Strengthening of the original group attitude after discussing views within a group \n\n Social facilitation \n\n Improved performance when an audience is watching versus when the individual performs the behavior alone \n\n Social loafing \n\n Exertion of less effort by a person working in a group because individual performance cannot be evaluated separately from the group, thus causing performance decline on easy tasks \n\n Table  12.2   Types of Social Influence \n 12.5   Prejudice and Discrimination Learning Objectives By the end of this section, you will be able to:\n\n Define and distinguish among prejudice, stereotypes, and discrimination \n\n Provide examples of prejudice, stereotypes, and discrimination \n\n Explain why prejudice and discrimination exist \n\n Human conflict can result in crime, war, and mass murder, such as genocide. Prejudice and discrimination often are root causes of human conflict, which explains how strangers come to hate one another to the extreme of causing others harm. Prejudice and discrimination affect everyone. In this section we will examine the definitions of prejudice and discrimination, examples of these concepts, and causes of these biases. \n\n Understanding Prejudice and Discrimination As we discussed in the opening story of Trayvon Martin, humans are very diverse and although we share many similarities, we also have many differences. The social groups we belong to help form our identities (Tajfel, 1974). These differences may be difficult for some people to reconcile, which may lead to prejudice toward people who are different.  Prejudice  is a negative attitude and feeling toward an individual based solely on one\u2019s membership in a particular social group (Allport, 1954; Brown, 2010). Prejudice is common against people who are members of an unfamiliar cultural group. Thus, certain types of education, contact, interactions, and building relationships with members of different cultural groups can reduce the tendency toward prejudice. In fact, simply imagining interacting with members of different cultural groups might affect prejudice. Indeed, when experimental participants were asked to imagine themselves positively interacting with someone from a different group, this led to an increased positive attitude toward the other group and an increase in positive traits associated with the other group. Furthermore, imagined social interaction can reduce anxiety associated with inter-group interactions (Crisp & Turner, 2009). What are some examples of social groups that you belong to that contribute to your identity? Social groups can include gender, race, ethnicity, nationality, social class, religion, sexual orientation, profession, and many more. And, as is true for social roles, you can simultaneously be a member of more than one social group. An example of prejudice is having a negative attitude toward people who are not born in the United States. Although people holding this prejudiced attitude do not know all people who were not born in the United States, they dislike them due to their status as foreigners. \n\n Can you think of a prejudiced attitude you have held toward a group of people? How did your prejudice develop? Prejudice often begins in the form of a  stereotype \u2014that is, a specific belief or assumption about individuals based solely on their membership in a group, regardless of their individual characteristics. Stereotypes become overgeneralized and applied to all members of a group. For example, someone holding prejudiced attitudes toward older adults, may believe that older adults are slow and incompetent (Cuddy, Norton, & Fiske, 2005; Nelson, 2004). We cannot possibly know each individual person of advanced age to know that all older adults are slow and incompetent. Therefore, this negative belief is overgeneralized to all members of the group, even though many of the individual group members may in fact be spry and intelligent. Another example of a well-known stereotype involves beliefs about racial differences among athletes. As Hodge, Burden, Robinson, and Bennett (2008) point out, Black male athletes are often believed to be more athletic, yet less intelligent, than their White male counterparts. These beliefs persist despite a number of high profile examples to the contrary. Sadly, such beliefs often influence how these athletes are treated by others and how they view themselves and their own capabilities. Whether or not you agree with a stereotype, stereotypes are generally well-known within in a given culture (Devine, 1989). \n\n Sometimes people will act on their prejudiced attitudes toward a group of people, and this behavior is known as discrimination.  Discrimination  is negative action toward an individual as a result of one\u2019s membership in a particular group (Allport, 1954; Dovidio & Gaertner, 2004). As a result of holding negative beliefs (stereotypes) and negative attitudes (prejudice) about a particular group, people often treat the target of prejudice poorly, such as excluding older adults from their circle of friends. An example of a psychologist experiencing gender discrimination is found in the life and studies of Mary Whiton Calkins. Calkins was given special permission to attend graduate seminars at Harvard (at that time in the late 1880s, Harvard did not accept women) and at one point was the sole student of the famous psychologist William James. She passed all the requirements needed for a PhD and was described by psychologist Hugo M\u00fcnsterberg as \u201cone of the strongest professors of psychology in this country.\u201d However, Harvard refused to grant Calkins a PhD because she was a woman (Harvard University, 2019). \n\n  Table 12.3  summarizes the characteristics of stereotypes, prejudice, and discrimination. Have you ever been the target of discrimination? If so, how did this negative treatment make you feel? \n\n Item \n\n Function \n\n Connection \n\n Example \n\n Stereotype \n\n Cognitive; thoughts about people \n\n Overgeneralized beliefs about people may lead to prejudice. \n\n \u201cYankees fans are arrogant and obnoxious.\u201d \n\n Prejudice \n\n Affective; feelings about people, both positive and negative \n\n Feelings may influence treatment of others, leading to discrimination. \n\n \u201cI hate Yankees fans; they make me angry.\u201d \n\n Discrimination \n\n Behavior; positive or negative treatment of others \n\n Holding stereotypes and harboring prejudice may lead to excluding, avoiding, and biased treatment of group members. \n\n \u201cI would never hire nor become friends with a person if I knew he or she were a Yankees fan.\u201d \n\n Table  12.3   Connecting Stereotypes, Prejudice, and Discrimination So far, we\u2019ve discussed stereotypes, prejudice, and discrimination as negative thoughts, feelings, and behaviors because these are typically the most problematic. However, it is important to also point out that people can hold positive thoughts, feelings, and behaviors toward individuals based on group membership; for example, they would show preferential treatment for people who are like themselves\u2014that is, who share the same gender, race, or favorite sports team. \n\n Link to Learning \n\n This  video  demonstrates the concepts of prejudice, stereotypes, and discrimination. In the video, a social experiment is conducted in a park where three people try to steal a bike out in the open. The race and gender of the thief is varied: a White male teenager, a Black male teenager, and a White female. Does anyone try to stop them? The treatment of the teenagers in the video demonstrates the concept of racism. \n\n Types of Prejudice and Discrimination \n\n When we meet strangers we automatically process three pieces of information about them: their race, gender, and age (Ito & Urland, 2003). Why are these aspects of an unfamiliar person so important? Why don\u2019t we instead notice whether their eyes are friendly, whether they are smiling, their height, the type of clothes they are wearing? Although these secondary characteristics are important in forming a first impression of a stranger, the social categories of race, gender, and age provide a wealth of information about an individual. This information, however, often is based on stereotypes. We may have different expectations of strangers depending on their race, gender, and age. What stereotypes and prejudices do you hold about people who are from a race, gender, and age group different from your own? \n\n Racism \n\n Racism  is  prejudice  and  discrimination  against an individual based solely on one\u2019s membership in a specific racial group (such as toward African Americans, Asian Americans, Latinos, Native Americans, European Americans). What are some stereotypes of various racial or ethnic groups? Research suggests cultural stereotypes for Asian Americans include cold, sly, and intelligent; for Latinos, cold and unintelligent; for European Americans, cold and intelligent; and for African Americans, aggressive, athletic, and more likely to be law breakers (Devine & Elliot, 1995; Fiske, Cuddy, Glick, & Xu, 2002; Sommers & Ellsworth, 2000; Dixon & Linz, 2000). \n\n Racism exists for many racial and ethnic groups. For example, Blacks are significantly more likely to have their vehicles searched during traffic stops than Whites, particularly when Blacks are driving in predominately White neighborhoods, (a phenomenon often termed \u201cDWB,\u201d or \u201cdriving while Black.\u201d) (Rojek, Rosenfeld, & Decker, 2012) \n\n Mexican Americans and other Latino groups also are targets of racism from the police and other members of the community. For example, when purchasing items with a personal check, Latino shoppers are more likely than White shoppers to be asked to show formal identification (Dovidio et al., 2010). \n\n In one case of alleged harassment by the police, several East Haven, Connecticut, police officers were arrested on federal charges due to reportedly continued harassment and brutalization of Latinos. When the accusations came out, the mayor of East Haven was asked, \u201cWhat are you doing for the Latino community today?\u201d The Mayor responded, \u201cI might have tacos when I go home, I\u2019m not quite sure yet\u201d (\u201cEast Haven Mayor,\u201d 2012) This statement undermines the important issue of racial profiling and police harassment of Latinos, while belittling Latino culture by emphasizing an interest in a food product stereotypically associated with Latinos. \n\n Racism is prevalent toward many other groups in the United States including Native Americans, Arab Americans, Jewish Americans, and Asian Americans. Have you witnessed racism toward any of these racial or ethnic groups? Are you aware of racism in your community? \n\n One reason modern forms of racism, and prejudice in general, are hard to detect is related to the dual attitudes model (Wilson, Lindsey, & Schooler, 2000). Humans have two forms of attitudes: explicit attitudes, which are conscious and controllable, and implicit attitudes, which are unconscious and uncontrollable (Devine, 1989; Olson & Fazio, 2003). Because holding egalitarian views is socially desirable (Plant & Devine, 1998), most people do not show extreme racial bias or other prejudices on measures of their explicit attitudes. However, measures of implicit attitudes often show evidence of mild to strong racial bias or other prejudices (Greenwald, McGee, & Schwartz, 1998; Olson & Fazio, 2003). \n\n Sexism \n\n Sexism  is  prejudice  and  discrimination  toward individuals based on their sex. Typically, sexism takes the form of men holding biases against women, but either sex can show sexism toward their own or their opposite sex. Like racism, sexism may be subtle and difficult to detect. Common forms of sexism in modern society include gender role expectations, such as expecting women to be the caretakers of the household. Sexism also includes people\u2019s expectations for how members of a gender group should behave. For example, women are expected to be friendly, passive, and nurturing, and when women behave in an unfriendly, assertive, or neglectful manner they often are disliked for violating their gender role (Rudman, 1998). Research by Laurie Rudman (1998) finds that when female job applicants self-promote, they are likely to be viewed as competent, but they may be disliked and are less likely to be hired because they violated gender expectations for modesty. Sexism can exist on a societal level such as in hiring, employment opportunities, and education. Women are less likely to be hired or promoted in male-dominated professions such as engineering, aviation, and construction ( Figure 12.23 ) (Blau, Ferber, & Winkler, 2010; Ceci & Williams, 2011). Have you ever experienced or witnessed sexism? Think about your family members\u2019 jobs or careers. Why do you think there are differences in the jobs women and men have, such as more women nurses but more male surgeons (Betz, 2008)? \n\n Ageism \n\n People often form judgments and hold expectations about people based on their age. These judgments and expectations can lead to  ageism , or  prejudice  and  discrimination  toward individuals based solely on their age. Typically, ageism occurs against older adults, but ageism also can occur toward younger adults. Think of expectations you hold for older adults. How could someone\u2019s expectations influence the feelings they hold toward individuals from older age groups? Ageism is widespread in U.S. culture (Nosek, 2005), and a common ageist attitude toward older adults is that they are incompetent, physically weak, and slow (Greenberg, Schimel, & Martens, 2002) and some people consider older adults less attractive. Some cultures, however, including some Asian, Latino, and African American cultures, both outside and within the United States afford older adults respect and honor. \n\n Ageism can also occur toward younger adults. What expectations do you hold toward younger people? Does society expect younger adults to be immature and irresponsible? How might these two forms of ageism affect a younger and older adult who are applying for a sales clerk position? \n\n Homophobia \n\n Another form of prejudice is  homophobia :  prejudice  and  discrimination  of individuals based solely on their sexual orientation. Like ageism,  homophobia  is a widespread prejudice in U.S. society that is tolerated by many people (Herek & McLemore, 2013; Nosek, 2005). Negative feelings often result in discrimination, such as the exclusion of lesbian, gay, bisexual, and transgender (LGBT) people from social groups and the avoidance of LGBT neighbors and co-workers. This discrimination also extends to employers deliberately declining to hire qualified LGBT job applicants. Have you experienced or witnessed homophobia? If so, what stereotypes, prejudiced attitudes, and discrimination were evident? \n\n Dig Deeper Research into Homophobia Some people are quite passionate in their hatred for nonheterosexuals in our society. In some cases, people have been tortured and/or murdered simply because they were not heterosexual. This passionate response has led some researchers to question what motives might exist for homophobic people. Adams, Wright, & Lohr (1996) conducted a study investigating this issue and their results were quite an eye-opener. \n\n In this experiment, male college students were given a scale that assessed how homophobic they were; those with extreme scores were recruited to participate in the experiment. In the end, 64 men agreed to participate and were split into 2 groups: homophobic men and nonhomophobic men. Both groups of men were fitted with a penile plethysmograph, an instrument that measures changes in blood flow to the penis and serves as an objective measurement of sexual arousal. \n\n All men were shown segments of sexually explicit videos. One of these videos involved a sexual interaction between a man and a woman (heterosexual clip). One video displayed two females engaged in a sexual interaction (homosexual female clip), and the final video displayed two men engaged in a sexual interaction (homosexual male clip). Changes in penile tumescence were recorded during all three clips, and a subjective measurement of sexual arousal was also obtained. While both groups of men became sexually aroused to the heterosexual and female homosexual video clips, only those men who were identified as homophobic showed sexual arousal to the homosexual male video clip. While all men reported that their erections indicated arousal for the heterosexual and female homosexual clips, the homophobic men indicated that they were not sexually aroused (despite their erections) to the male homosexual clips. Adams et al. (1996) suggest that these findings may indicate that homophobia is related to homosexual arousal that the homophobic individuals either deny or are unaware. \n\n Why Do Prejudice and Discrimination Exist? \n\n Prejudice  and  discrimination  persist in society due to social learning and conformity to social norms. Children learn prejudiced attitudes and beliefs from society: their parents, teachers, friends, the media, and other sources of socialization, such as Facebook (O\u2019Keeffe & Clarke-Pearson, 2011). If certain types of prejudice and discrimination are acceptable in a society, there may be normative pressures to conform and share those prejudiced beliefs, attitudes, and behaviors. For example, public and private schools are still somewhat segregated by social class. Historically, only children from wealthy families could afford to attend private schools, whereas children from middle- and low-income families typically attended public schools. If a child from a low-income family received a merit scholarship to attend a private school, how might the child be treated by classmates? Can you recall a time when you held prejudiced attitudes or beliefs or acted in a discriminatory manner because your group of friends expected you to? \n\n Stereotypes and Self-Fulfilling Prophecy \n\n When we hold a  stereotype  about a person, we have expectations that he or she will fulfill that stereotype. A  self-fulfilling prophecy  is an expectation held by a person that alters his or her behavior in a way that tends to make it true. When we hold stereotypes about a person, we tend to treat the person according to our expectations. This treatment can influence the person to act according to our stereotypic expectations, thus confirming our stereotypic beliefs. Research by Rosenthal and Jacobson (1968) found that disadvantaged students whose teachers expected them to perform well had higher grades than disadvantaged students whose teachers expected them to do poorly. \n\n Consider this example of cause and effect in a self-fulfilling prophecy: If an employer expects an openly gay male job applicant to be incompetent, the potential employer might treat the applicant negatively during the interview by engaging in less conversation, making little eye contact, and generally behaving coldly toward the applicant (Hebl, Foster, Mannix, & Dovidio, 2002). In turn, the job applicant will perceive that the potential employer dislikes him, and he will respond by giving shorter responses to interview questions, making less eye contact, and generally disengaging from the interview. After the interview, the employer will reflect on the applicant\u2019s behavior, which seemed cold and distant, and the employer will conclude, based on the applicant\u2019s poor performance during the interview, that the applicant was in fact incompetent. Thus, the employer\u2019s stereotype\u2014gay men are incompetent and do not make good employees\u2014is reinforced. Do you think this job applicant is likely to be hired? Treating individuals according to stereotypic beliefs can lead to prejudice and discrimination. \n\n Another dynamic that can reinforce stereotypes is confirmation bias. When interacting with the target of our prejudice, we tend to pay attention to information that is consistent with our stereotypic expectations and ignore information that is inconsistent with our expectations. In this process, known as  confirmation bias , we seek out information that supports our stereotypes and ignore information that is inconsistent with our stereotypes (Wason & Johnson-Laird, 1972). In the job interview example, the employer may not have noticed that the job applicant was friendly and engaging, and that he provided competent responses to the interview questions in the beginning of the interview. Instead, the employer focused on the job applicant\u2019s performance in the later part of the interview, after the applicant changed his demeanor and behavior to match the interviewer\u2019s negative treatment. \n\n Have you ever fallen prey to the self-fulfilling prophecy or confirmation bias, either as the source or target of such bias? How might we stop the cycle of the self-fulfilling prophecy? Social class stereotypes of individuals tend to arise when information about the individual is ambiguous. If information is unambiguous, stereotypes do not tend to arise (Baron et al., 1995). \n\n In-Groups and Out-Groups \n\n As discussed previously in this section, we all belong to a gender, race, age, and social economic group. These groups provide a powerful source of our identity and self-esteem (Tajfel & Turner, 1979). These groups serve as our in-groups. An  in-group  is a group that we identify with or see ourselves as belonging to. A group that we don\u2019t belong to, or an  out-group , is a group that we view as fundamentally different from us. For example, if you are female, your gender in-group includes all females, and your gender out-group includes all males ( Figure 12.24 ). People often view gender groups as being fundamentally different from each other in personality traits, characteristics, social roles, and interests. Because we often feel a strong sense of belonging and emotional connection to our in-groups, we develop in-group bias: a preference for our own group over other groups. This  in-group bias  can result in prejudice and discrimination because the out-group is perceived as different and is less preferred than our in-group. \n\n Despite the group dynamics that seem only to push groups toward conflict, there are forces that promote reconciliation between groups: the expression of empathy, of acknowledgment of past suffering on both sides, and the halt of destructive behaviors. \n\n One function of prejudice is to help us feel good about ourselves and maintain a positive self-concept. This need to feel good about ourselves extends to our in-groups: We want to feel good and protect our in-groups. We seek to resolve threats individually and at the in-group level. This often happens by blaming an out-group for the problem.  Scapegoating  is the act of blaming an out-group when the in-group experiences frustration or is blocked from obtaining a goal (Allport, 1954). \n 12.6   Aggression Learning Objectives By the end of this section, you will be able to:\n\n Define aggression \n\n Define cyberbullying \n\n Describe the bystander effect \n\n Throughout this chapter we have discussed how people interact and influence one another\u2019s thoughts, feelings, and behaviors in both positive and negative ways. People can work together to achieve great things, such as helping each other in emergencies: recall the heroism displayed during the 9/11 terrorist attacks. People also can do great harm to one another, such as conforming to group norms that are immoral and obeying authority to the point of murder: consider the mass conformity of Nazis during WWII. In this section we will discuss a negative side of human behavior\u2014aggression. \n\n Aggression \n\n Humans engage in  aggression  when they seek to cause harm or pain to another person. Aggression takes two forms depending on one\u2019s motives: hostile or instrumental.  Hostile aggression  is motivated by feelings of anger with intent to cause pain; a fight in a bar with a stranger is an example of hostile aggression. In contrast,  instrumental aggression  is motivated by achieving a goal and does not necessarily involve intent to cause pain (Berkowitz, 1993); a contract killer who murders for hire displays instrumental aggression. \n\n There are many different theories as to why aggression exists. Some researchers argue that aggression serves an evolutionary function (Buss, 2004). Men are more likely than women to show aggression (Wilson & Daly, 1985). From the perspective of evolutionary psychology, human male aggression, like that in nonhuman primates, likely serves to display dominance over other males, both to protect a mate and to perpetuate the male\u2019s genes ( Figure 12.25 ). Sexual jealousy is part of male aggression; males endeavor to make sure their mates are not copulating with other males, thus ensuring their own paternity of the female\u2019s offspring. Although aggression provides an obvious evolutionary advantage for men, women also engage in aggression. Women typically display instrumental forms of aggression, with their aggression serving as a means to an end (Dodge & Schwartz, 1997). For example, women may express their aggression covertly, for example, by communication that impairs the social standing of another person. Another theory that explains one of the functions of human aggression is  frustration aggression theory  (Dollard, Doob, Miller, Mowrer, & Sears, 1939). This theory states that when humans are prevented from achieving an important goal, they become frustrated and aggressive. \n\n Bullying A modern form of aggression is bullying. As you learn in your study of child development, socializing and playing with other children is beneficial for children\u2019s psychological development. However, as you may have experienced as a child, not all play behavior has positive outcomes. Some children are aggressive and want to play roughly. Other children are selfish and do not want to share toys. One form of negative social interactions among children that has become a national concern is bullying.  Bullying  is repeated negative treatment of another person, often an adolescent, over time (Olweus, 1993). A one-time incident in which one child hits another child on the playground would not be considered bullying: Bullying is repeated behavior. The negative treatment typical in bullying is the attempt to inflict harm, injury, or humiliation, and bullying can include physical or verbal attacks. However, bullying doesn\u2019t have to be physical or verbal, it can be psychological. Research finds gender differences in how girls and boys bully others (American Psychological Association, 2010; Olweus, 1993). Boys tend to engage in direct, physical aggression such as physically harming others. Girls tend to engage in indirect, social forms of aggression such as spreading rumors, ignoring, or socially isolating others. Based on what you have learned about child development and social roles, why do you think boys and girls display different types of bullying behavior? \n\n Bullying involves three parties: the bully, the victim, and witnesses or bystanders. The act of bullying involves an imbalance of power with the bully holding more power\u2014physically, emotionally, and/or socially over the victim. The experience of bullying can be positive for the bully, who may enjoy a boost to self-esteem. However, there are several negative consequences of bullying for the victim, and also for the bystanders. How do you think bullying negatively impacts adolescents? Being the victim of bullying is associated with decreased mental health, including experiencing anxiety and depression (APA, 2010). Victims of bullying may underperform in schoolwork (Bowen, 2011). Bullying also can result in the victim committing suicide (APA, 2010). How might bullying negatively affect witnesses? \n\n Although there is not one single personality profile for who becomes a bully and who becomes a victim of  bullying  (APA, 2010), researchers have identified some patterns in children who are at a greater risk of being bullied (Olweus, 1993):\n\n Children who are emotionally reactive are at a greater risk for being bullied. Bullies may be attracted to children who get upset easily because the bully can quickly get an emotional reaction from them. \n\n Children who are different from others are likely to be targeted for bullying. Children who are overweight, cognitively impaired, or racially or ethnically different from their peer group may be at higher risk. \n\n Gay, lesbian, bisexual, and transgender teens are at very high risk of being bullied and hurt due to their sexual orientation. \n\n Cyberbullying \n\n With the rapid growth of technology, and widely available mobile technology and social networking media, a new form of bullying has emerged: cyberbullying (Hoff & Mitchell, 2009).  Cyberbullying , like bullying, is repeated behavior that is intended to cause psychological or emotional harm to another person. What is unique about cyberbullying is that it is typically covert, concealed, done in private, and the bully can remain anonymous. This anonymity gives the bully power, and the victim may feel helpless, unable to escape the harassment, and unable to retaliate (Spears, Slee, Owens, & Johnson, 2009). \n\n Cyberbullying can take many forms, including harassing a victim by spreading rumors, creating a website defaming the victim, and ignoring, insulting, laughing at, or teasing the victim (Spears et al., 2009). In cyberbullying, it is more common for girls to be the bullies and victims because cyberbullying is nonphysical and is a less direct form of bullying ( Figure 12.26 ) (Hoff & Mitchell, 2009). Interestingly, girls who become cyberbullies often have been the victims of cyberbullying at one time (Vandebosch & Van Cleemput, 2009). The effects of cyberbullying are just as harmful as traditional bullying and include the victim feeling frustration, anger, sadness, helplessness, powerlessness, and fear. Victims will also experience lower self-esteem (Hoff & Mitchell, 2009; Spears et al., 2009). Furthermore, recent research suggests that both cyberbullying victims and perpetrators are more likely to experience suicidal ideation, and they are more likely to attempt suicide than individuals who have no experience with cyberbullying (Hinduja & Patchin, 2010). What features of technology make cyberbullying easier and perhaps more accessible to young adults? What can parents, teachers, and social networking websites, like Facebook, do to prevent cyberbullying? \n\n The Bystander Effect \n\n The discussion of bullying highlights the problem of witnesses not intervening to help a victim. This is a common occurrence, as the following well-publicized event demonstrates. In 1964, in Queens, New York, a 19-year-old woman named Kitty  Genovese  was attacked by a person with a knife near the back entrance to her apartment building and again in the hallway inside her apartment building. When the attack occurred, she screamed for help numerous times and eventually died from her stab wounds. This story became famous because reportedly numerous residents in the apartment building heard her cries for help and did nothing\u2014neither helping her nor summoning the police\u2014though these have facts been disputed. \n\n Based on this case, researchers Latan\u00e9 and Darley (1968) described a phenomenon called the bystander effect. The  bystander effect  is a phenomenon in which a witness or bystander does not volunteer to help a victim or person in distress. Instead, they just watch what is happening. Social psychologists hold that we make these decisions based on the social situation, not our own personality variables. Why do you think the bystanders didn\u2019t help Genovese? What are the benefits to helping her? What are the risks? It is very likely you listed more costs than benefits to helping. In this situation, bystanders likely feared for their own lives\u2014if they went to her aid the attacker might harm them. However, how difficult would it have been to make a phone call to the police from the safety of their apartments? Why do you think no one helped in any way? Social psychologists claim that diffusion of responsibility is the likely explanation.  Diffusion of responsibility  is the tendency for no one in a group to help because the responsibility to help is spread throughout the group (Bandura, 1999). Because there were many witnesses to the attack on Genovese, as evidenced by the number of lit apartment windows in the building, individuals assumed someone else must have already called the police. The responsibility to call the police was diffused across the number of witnesses to the crime. Have you ever passed an accident on the freeway and assumed that a victim or certainly another motorist has already reported the accident? In general, the greater the number of bystanders, the less likely any one person will help. \n 12.7   Prosocial Behavior Learning Objectives By the end of this section, you will be able to:\n\n Describe altruism \n\n Describe conditions that influence the formation of relationships \n\n Identify what attracts people to each other \n\n Describe the triangular theory of love \n\n Explain social exchange theory in relationships \n\n You\u2019ve learned about many of the negative behaviors of social psychology, but the field also studies many positive social interactions and behaviors. What makes people like each other? With whom are we friends? Whom do we date? Researchers have documented several features of the situation that influence whether we form relationships with others. There are also universal traits that humans find attractive in others. In this section we discuss conditions that make forming relationships more likely, what we look for in friendships and romantic relationships, the different types of love, and a theory explaining how our relationships are formed, maintained, and terminated. \n\n Prosocial Behavior and Altruism \n\n Do you voluntarily help others? Voluntary behavior with the intent to help other people is called  prosocial behavior . Why do people help other people? Is personal benefit such as feeling good about oneself the only reason people help one another? Research suggests there are many other reasons.  Altruism  is people\u2019s desire to help others even if the costs outweigh the benefits of helping. In fact, people acting in altruistic ways may disregard the personal costs associated with helping ( Figure 12.27 ). For example, news accounts of the 9/11 terrorist attacks on the World Trade Center in New York reported an employee in the first tower helped his co-workers make it to the exit stairwell. After helping a co-worker to safety he went back in the burning building to help additional co-workers. In this case the costs of helping were great, and the hero lost his life in the destruction (Stewart, 2002). \n\n Some researchers suggest that altruism operates on empathy.  Empathy  is the capacity to understand another person\u2019s perspective, to feel what he or she feels. An empathetic person makes an emotional connection with others and feels compelled to help (Batson, 1991). Other researchers argue that altruism is a form of selfless helping that is not motivated by benefits or feeling good about oneself. Certainly, after helping, people feel good about themselves, but some researchers argue that this is a consequence of altruism, not a cause. Other researchers argue that helping is always self-serving because our egos are involved, and we receive benefits from helping (Cialdini, Brown, Lewis, Luce, & Neuberg 1997). It is challenging to determine experimentally the true motivation for helping, whether is it largely self-serving (egoism) or selfless (altruism). Thus, a debate on whether pure altruism exists continues. Link to Learning \n\n See this excerpt from the popular TV series  Friends  episode  for a discussion of the egoism versus altruism debate. \n\n Forming Relationships \n\n What do you think is the single most influential factor in determining with whom you become friends and whom you form romantic relationships? You might be surprised to learn that the answer is simple: the people with whom you have the most contact. This most important factor is proximity. You are more likely to be friends with people you have regular contact with. For example, there are decades of research that shows that you are more likely to become friends with people who live in your dorm, your apartment building, or your immediate neighborhood than with people who live farther away (Festinger, Schachler, & Back, 1950). It is simply easier to form relationships with people you see often because you have the opportunity to get to know them. \n\n Similarity is another factor that influences who we form relationships with. We are more likely to become friends or lovers with someone who is similar to us in background, attitudes, and lifestyle. In fact, there is no evidence that opposites attract. Rather, we are attracted to people who are most like us ( Figure 12.28 ) (McPherson, Smith-Lovin, & Cook, 2001). Why do you think we are attracted to people who are similar to us? Sharing things in common will certainly make it easy to get along with others and form connections. When you and another person share similar music taste, hobbies, food preferences, and so on, deciding what to do with your time together might be easy.  Homophily  is the tendency for people to form social networks, including friendships, marriage, business relationships, and many other types of relationships, with others who are similar (McPherson et al., 2001). \n\n But, homophily limits our exposure to diversity (McPherson et al., 2001). By forming relationships only with people who are similar to us, we will have homogenous groups and will not be exposed to different points of view. In other words, because we are likely to spend time with those who are most like ourselves, we will have limited exposure to those who are different than ourselves, including people of different races, ethnicities, social-economic status, and life situations. \n\n Once we form relationships with people, we desire reciprocity.  Reciprocity  is the give and take in relationships. We contribute to relationships, but we expect to receive benefits as well. That is, we want our relationships to be a two way street. We are more likely to like and engage with people who like us back. Self-disclosure is part of the two way street.  Self-disclosure  is the sharing of personal information (Laurenceau, Barrett, & Pietromonaco, 1998). We form more intimate connections with people with whom we disclose important information about ourselves. Indeed, self-disclosure is a characteristic of healthy intimate relationships, as long as the information disclosed is consistent with our own views (Cozby, 1973). \n\n Attraction \n\n We have discussed how proximity and similarity lead to the formation of relationships, and that reciprocity and self-disclosure are important for relationship maintenance. But, what features of a person do we find attractive? We don\u2019t form relationships with everyone that lives or works near us, so how is it that we decide which specific individuals we will select as friends and lovers? \n\n Researchers have documented several characteristics in men and women that humans find attractive. First we look for friends and lovers who are physically attractive. People differ in what they consider attractive, and attractiveness is culturally influenced. Research, however, suggests that some universally attractive features in women include large eyes, high cheekbones, a narrow jaw line, a slender build (Buss, 1989), and a lower waist-to-hip ratio (Singh, 1993). For men, attractive traits include being tall, having broad shoulders, and a narrow waist (Buss, 1989). Both men and women with high levels of facial and body symmetry are generally considered more attractive than asymmetric individuals (Fink, Neave, Manning, & Grammer, 2006; Penton-Voak et al., 2001; Rikowski & Grammer, 1999). Social traits that people find attractive in potential female mates include warmth, affection, and social skills; in males, the attractive traits include achievement, leadership qualities, and job skills (Regan & Berscheid, 1997). Although humans want mates who are physically attractive, this does not mean that we look for the most attractive person possible. In fact, this observation has led some to propose what is known as the matching hypothesis which asserts that people tend to pick someone they view as their equal in physical attractiveness and social desirability (Taylor, Fiore, Mendelsohn, & Cheshire, 2011). For example, you and most people you know likely would say that a very attractive movie star is out of your league. So, even if you had proximity to that person, you likely would not ask them out on a date because you believe you likely would be rejected. People weigh a potential partner\u2019s attractiveness against the likelihood of success with that person. If you think you are particularly unattractive (even if you are not), you likely will seek partners that are fairly unattractive (that is, unattractive in physical appearance or in behavior). \n\n Sternberg\u2019s Triangular Theory of Love \n\n We typically love the people with whom we form relationships, but the type of love we have for our family, friends, and lovers differs. Robert Sternberg (1986) proposed that there are three components of love: intimacy, passion, and commitment. These three components form a triangle that defines multiple types of love: this is known as Sternberg\u2019s  triangular theory of love  ( Figure 12.29 ). Intimacy is the sharing of details and intimate thoughts and emotions. Passion is the physical attraction\u2014the flame in the fire. Commitment is standing by the person\u2014the \u201cin sickness and health\u201d part of the relationship. \n\n Sternberg (1986) states that a healthy relationship will have all three components of love\u2014intimacy, passion, and commitment\u2014which is described as  consummate love  ( Figure 12.30 ). However, different aspects of love might be more prevalent at different life stages. Other forms of love include liking, which is defined as having intimacy but no passion or commitment. Infatuation is the presence of passion without intimacy or commitment. Empty love is having commitment without intimacy or passion.  Companionate love , which is characteristic of close friendships and family relationships, consists of intimacy and commitment but no passion.  Romantic love  is defined by having passion and intimacy, but no commitment. Finally, fatuous love is defined by having passion and commitment, but no intimacy, such as a long term sexual love affair. Can you describe other examples of relationships that fit these different types of love? \n\n Social Exchange Theory \n\n We have discussed why we form relationships, what attracts us to others, and different types of love. But what determines whether we are satisfied with and stay in a relationship? One theory that provides an explanation is social exchange theory. According to  social exchange theory , we act as na\u00efve economists in keeping a tally of the ratio of costs and benefits of forming and maintaining a relationship with others ( Figure 12.31 ) (Rusbult & Van Lange, 2003). \n\n People are motivated to maximize the benefits of social exchanges, or relationships, and minimize the costs. People prefer to have more benefits than costs, or to have nearly equal costs and benefits, but most people are dissatisfied if their social exchanges create more costs than benefits. Let\u2019s discuss an example. If you have ever decided to commit to a romantic relationship, you probably considered the advantages and disadvantages of your decision. What are the benefits of being in a committed romantic relationship? You may have considered having companionship, intimacy, and passion, but also being comfortable with a person you know well. What are the costs of being in a committed romantic relationship? You may think that over time boredom from being with only one person may set in; moreover, it may be expensive to share activities such as attending movies and going to dinner. However, the benefits of dating your romantic partner presumably outweigh the costs, or you wouldn\u2019t continue the relationship. ", "questions": [{"question": {"question_id": "fs-idm141864576", "question_text": "As a field, social psychology focuses on ________ in predicting human behavior.", "question_choices": ["personality traits", "genetic predispositions", "biological forces", "situational factors"], "cloze_format": "As a field, social psychology focuses on ________ in predicting human behavior.", "normal_format": "As a field, what does social psychology focus on in predicting human behavior?"}, "answer": {"ans_text": "situational factors", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "In this section , we examine situational forces that have a strong influence on human behavior including social roles , social norms , and scripts .", "hl_context": "As you \u2019 ve learned , social psychology is the study of how people affect one another \u2019 s thoughts , feelings , and behaviors . We have discussed situational perspectives and social psychology \u2019 s emphasis on the ways in which a person \u2019 s environment , including culture and other social influences , affect behavior . <hl> In this section , we examine situational forces that have a strong influence on human behavior including social roles , social norms , and scripts . <hl> We discuss how humans use the social environment as a source of information , or cues , on how to behave . Situational influences on our behavior have important consequences , such as whether we will help a stranger in an emergency or how we would behave in an unfamiliar environment ."}, {"question": {"question_id": "fs-idm127141376", "question_text": "Making internal attributions for your successes and making external attributions for your failures is an example of ________.", "question_choices": ["actor-observer bias", "fundamental attribution error", "self-serving bias", "just-world hypothesis"], "cloze_format": "Making internal attributions for your successes and making external attributions for your failures is an example of ________.", "normal_format": "Making internal attributions for your successes and making external attributions for your failures is an example of what?"}, "answer": {"ans_text": "self-serving bias", "ans_choice": 2}, "bloom": null, "hl_sentences": "Following an outcome , self-serving bias are those attributions that enable us to see ourselves in favorable light ( for example , making internal attributions for success and external attributions for failures ) . The tendency of an individual to take credit by making dispositional or internal attributions for positive outcomes but situational or external attributions for negative outcomes is known as the self-serving bias ( Miller & Ross , 1975 ) .", "hl_context": "<hl> Following an outcome , self-serving bias are those attributions that enable us to see ourselves in favorable light ( for example , making internal attributions for success and external attributions for failures ) . <hl> When you do well at a task , for example acing an exam , it is in your best interest to make a dispositional attribution for your behavior ( \u201c I \u2019 m smart , \u201d ) instead of a situational one ( \u201c The exam was easy , \u201d ) . <hl> The tendency of an individual to take credit by making dispositional or internal attributions for positive outcomes but situational or external attributions for negative outcomes is known as the self-serving bias ( Miller & Ross , 1975 ) . <hl> This bias serves to protect self-esteem . You can imagine that if people always made situational attributions for their behavior , they would never be able to take credit and feel good about their accomplishments ."}, {"question": {"question_id": "fs-idm101444480", "question_text": "Collectivistic cultures are to ________ as individualistic cultures are to ________.", "question_choices": ["dispositional; situational", "situational; dispositional", "autonomy; group harmony", "just-world hypothesis; self-serving bias"], "cloze_format": "Collectivistic cultures are to ________ as individualistic cultures are to ________.", "normal_format": " Collectivistic cultures compared to individualistic cultures are like to what?"}, "answer": {"ans_text": "situational; dispositional", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Individualistic cultures , which tend to be found in western countries such as the United States , Canada , and the United Kingdom , promote a focus on the individual . Therefore , a person \u2019 s disposition is thought to be the primary explanation for her behavior . In contrast , people from a collectivistic culture , that is , a culture that focuses on communal relationships with others , such as family , friends , and community ( Figure 12.4 ) , are less likely to commit the fundamental attribution error ( Markus & Kitayama , 1991 ; Triandis , 2001 ) .", "hl_context": "Is the Fundamental Attribution Error a Universal Phenomenon ? You may be able to think of examples of the fundamental attribution error in your life . Do people in all cultures commit the fundamental attribution error ? Research suggests that they do not . People from an individualistic culture , that is , a culture that focuses on individual achievement and autonomy , have the greatest tendency to commit the fundamental attribution error . <hl> Individualistic cultures , which tend to be found in western countries such as the United States , Canada , and the United Kingdom , promote a focus on the individual . <hl> <hl> Therefore , a person \u2019 s disposition is thought to be the primary explanation for her behavior . <hl> <hl> In contrast , people from a collectivistic culture , that is , a culture that focuses on communal relationships with others , such as family , friends , and community ( Figure 12.4 ) , are less likely to commit the fundamental attribution error ( Markus & Kitayama , 1991 ; Triandis , 2001 ) . <hl>"}, {"question": {"question_id": "fs-idm149519632", "question_text": "According to the actor-observer bias, we have more information about ________.", "question_choices": ["situational influences on behavior", "influences on our own behavior", "influences on others\u2019 behavior", "dispositional influences on behavior"], "cloze_format": "According to the actor-observer bias, we have more information about ________.", "normal_format": "According to the actor-observer bias, what do we have more information about?"}, "answer": {"ans_text": "influences on our own behavior", "ans_choice": 1}, "bloom": null, "hl_sentences": "When it comes to explaining our own behaviors , however , we have much more information available to us . The actor-observer bias is the phenomenon of attributing other people \u2019 s behavior to internal factors ( fundamental attribution error ) while attributing our own behavior to situational forces ( Jones & Nisbett , 1971 ; Nisbett , Caputo , Legant , & Marecek , 1973 ; Choi & Nisbett , 1998 ) . As actors of behavior , we have more information available to explain our own behavior .", "hl_context": "Returning to our earlier example , Greg knew that he lost his job , but an observer would not know . So a na\u00efve observer would tend to attribute Greg \u2019 s hostile behavior to Greg \u2019 s disposition rather than to the true , situational cause . Why do you think we underestimate the influence of the situation on the behaviors of others ? One reason is that we often don \u2019 t have all the information we need to make a situational explanation for another person \u2019 s behavior . The only information we might have is what is observable . Due to this lack of information we have a tendency to assume the behavior is due to a dispositional , or internal , factor . <hl> When it comes to explaining our own behaviors , however , we have much more information available to us . <hl> If you came home from school or work angry and yelled at your dog or a loved one , what would your explanation be ? You might say you were very tired or feeling unwell and needed quiet time \u2014 a situational explanation . <hl> The actor-observer bias is the phenomenon of attributing other people \u2019 s behavior to internal factors ( fundamental attribution error ) while attributing our own behavior to situational forces ( Jones & Nisbett , 1971 ; Nisbett , Caputo , Legant , & Marecek , 1973 ; Choi & Nisbett , 1998 ) . <hl> <hl> As actors of behavior , we have more information available to explain our own behavior . <hl> However as observers , we have less information available ; therefore , we tend to default to a dispositionist perspective ."}, {"question": {"question_id": "fs-idm105336208", "question_text": "A(n) ________ is a set of group expectations for appropriate thoughts and behaviors of its members.", "question_choices": ["social role", "social norm", "script", "attribution"], "cloze_format": "A(n) ________ is a set of group expectations for appropriate thoughts and behaviors of its members.", "normal_format": "Which is a set of group expectations for appropriate thoughts and behaviors of its members?"}, "answer": {"ans_text": "social norm", "ans_choice": 1}, "bloom": null, "hl_sentences": "A social norm is a group \u2019 s expectation of what is appropriate and acceptable behavior for its members \u2014 how they are supposed to behave and think ( Deutsch & Gerard , 1955 ; Berkowitz , 2004 ) .", "hl_context": "As discussed previously , social roles are defined by a culture \u2019 s shared knowledge of what is expected behavior of an individual in a specific role . This shared knowledge comes from social norms . <hl> A social norm is a group \u2019 s expectation of what is appropriate and acceptable behavior for its members \u2014 how they are supposed to behave and think ( Deutsch & Gerard , 1955 ; Berkowitz , 2004 ) . <hl> How are we expected to act ? What are we expected to talk about ? What are we expected to wear ? In our discussion of social roles we noted that colleges have social norms for students \u2019 behavior in the role of student and workplaces have social norms for employees \u2019 behaviors in the role of employee . Social norms are everywhere including in families , gangs , and on social media outlets . What are some social norms on Facebook ?"}, {"question": {"question_id": "fs-idp5095712", "question_text": "On his first day of soccer practice, Jose suits up in a t-shirt, shorts, and cleats and runs out to the field to join his teammates. Jose\u2019s behavior is reflective of ________.", "question_choices": ["a script", "social influence", "good athletic behavior", "normative behavior"], "cloze_format": "On his first day of soccer practice, Jose suits up in a t-shirt, shorts, and cleats and runs out to the field to join his teammates. Jose\u2019s behavior is reflective of ________.", "normal_format": "On his first day of soccer practice, Jose suits up in a t-shirt, shorts, and cleats and runs out to the field to join his teammates. What is Jose\u2019s behavior reflective of? "}, "answer": {"ans_text": "a script", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "A script is a person \u2019 s knowledge about the sequence of events expected in a specific setting ( Schank & Abelson , 1977 ) . Scripts are important sources of information to guide behavior in given situations .", "hl_context": "Because of social roles , people tend to know what behavior is expected of them in specific , familiar settings . <hl> A script is a person \u2019 s knowledge about the sequence of events expected in a specific setting ( Schank & Abelson , 1977 ) . <hl> How do you act on the first day of school , when you walk into an elevator , or are at a restaurant ? For example , at a restaurant in the United States , if we want the server \u2019 s attention , we try to make eye contact . In Brazil , you would make the sound \u201c psst \u201d to get the server \u2019 s attention . You can see the cultural differences in scripts . To an American , saying \u201c psst \u201d to a server might seem rude , yet to a Brazilian , trying to make eye contact might not seem an effective strategy . <hl> Scripts are important sources of information to guide behavior in given situations . <hl> Can you imagine being in an unfamiliar situation and not having a script for how to behave ? This could be uncomfortable and confusing . How could you find out about social norms in an unfamiliar culture ?"}, {"question": {"question_id": "fs-idm33716848", "question_text": "When it comes to buying clothes, teenagers often follow social norms; this is likely motivated by ________.", "question_choices": ["following parents\u2019 rules", "saving money", "fitting in", "looking good"], "cloze_format": "When it comes to buying clothes, teenagers often follow social norms; this is likely motivated by ________.", "normal_format": "When it comes to buying clothes, teenagers often follow social norms; how is this likely motivated? "}, "answer": {"ans_text": "fitting in", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "A social norm is a group \u2019 s expectation of what is appropriate and acceptable behavior for its members \u2014 how they are supposed to behave and think ( Deutsch & Gerard , 1955 ; Berkowitz , 2004 ) . What are we expected to wear ?", "hl_context": "As discussed previously , social roles are defined by a culture \u2019 s shared knowledge of what is expected behavior of an individual in a specific role . This shared knowledge comes from social norms . <hl> A social norm is a group \u2019 s expectation of what is appropriate and acceptable behavior for its members \u2014 how they are supposed to behave and think ( Deutsch & Gerard , 1955 ; Berkowitz , 2004 ) . <hl> How are we expected to act ? What are we expected to talk about ? <hl> What are we expected to wear ? <hl> In our discussion of social roles we noted that colleges have social norms for students \u2019 behavior in the role of student and workplaces have social norms for employees \u2019 behaviors in the role of employee . Social norms are everywhere including in families , gangs , and on social media outlets . What are some social norms on Facebook ?"}, {"question": {"question_id": "fs-idm75772528", "question_text": "In the Stanford prison experiment, even the lead researcher succumbed to his role as a prison supervisor. This is an example of the power of ________ influencing behavior.", "question_choices": ["scripts", "social norms", "conformity", "social roles"], "cloze_format": "In the Stanford prison experiment, even the lead researcher succumbed to his role as a prison supervisor. This is an example of the power of ________ influencing behavior.", "normal_format": "In the Stanford prison experiment, even the lead researcher succumbed to his role as a prison supervisor. In this example, the power of what influencing behavior?"}, "answer": {"ans_text": "social roles", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The Stanford prison experiment demonstrated the power of social roles , norms , and scripts in affecting human behavior . The guards and prisoners enacted their social roles by engaging in behaviors appropriate to the roles : The guards gave orders and the prisoners followed orders . Even the Stanford professor who designed the study and was the head researcher , Philip Zimbardo , found himself acting as if the prison was real and his role , as prison supervisor , was real as well .", "hl_context": "<hl> The Stanford prison experiment demonstrated the power of social roles , norms , and scripts in affecting human behavior . <hl> <hl> The guards and prisoners enacted their social roles by engaging in behaviors appropriate to the roles : The guards gave orders and the prisoners followed orders . <hl> Social norms require guards to be authoritarian and prisoners to be submissive . When prisoners rebelled , they violated these social norms , which led to upheaval . The specific acts engaged by the guards and the prisoners derived from scripts . For example , guards degraded the prisoners by forcing them do push-ups and by removing all privacy . Prisoners rebelled by throwing pillows and trashing their cells . Some prisoners became so immersed in their roles that they exhibited symptoms of mental breakdown ; however , according to Zimbardo , none of the participants suffered long term harm ( Alexander , 2001 ) . The prisoners , in turn , began to show signs of severe anxiety and hopelessness \u2014 they began tolerating the guards \u2019 abuse . <hl> Even the Stanford professor who designed the study and was the head researcher , Philip Zimbardo , found himself acting as if the prison was real and his role , as prison supervisor , was real as well . <hl> After only six days , the experiment had to be ended due to the participants \u2019 deteriorating behavior . Zimbardo explained ,"}, {"question": {"question_id": "fs-idp68537200", "question_text": "Attitudes describe our ________ of people, objects, and ideas.", "question_choices": ["treatment", "evaluations", "cognitions", "knowledge"], "cloze_format": "Attitudes describe our ________ of people, objects, and ideas.", "normal_format": "What do attitudes describe about people, objects, and ideas?"}, "answer": {"ans_text": "evaluations", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Attitude is our evaluation of a person , an idea , or an object .", "hl_context": "Social psychologists have documented how the power of the situation can influence our behaviors . Now we turn to how the power of the situation can influence our attitudes and beliefs . <hl> Attitude is our evaluation of a person , an idea , or an object . <hl> We have attitudes for many things ranging from products that we might pick up in the supermarket to people around the world to political policies . Typically , attitudes are favorable or unfavorable : positive or negative ( Eagly & Chaiken , 1993 ) . And , they have three components : an affective component ( feelings ) , a behavioral component ( the effect of the attitude on behavior ) , and a cognitive component ( belief and knowledge ) ( Rosenberg & Hovland , 1960 ) ."}, {"question": {"question_id": "fs-idp214604608", "question_text": "Cognitive dissonance causes discomfort because it disrupts our sense of ________.", "question_choices": ["dependency", "unpredictability", "consistency", "power"], "cloze_format": "Cognitive dissonance causes discomfort because it disrupts our sense of ________.", "normal_format": "Cognitive dissonance causes discomfort because what does it disrupt of our sense?"}, "answer": {"ans_text": "consistency", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Psychologist Leon Festinger ( 1957 ) defined cognitive dissonance as psychological discomfort arising from holding two or more inconsistent attitudes , behaviors , or cognitions ( thoughts , beliefs , or opinions ) .", "hl_context": "What is Cognitive Dissonance ? Social psychologists have documented that feeling good about ourselves and maintaining positive self-esteem is a powerful motivator of human behavior ( Tavris & Aronson , 2008 ) . In the United States , members of the predominant culture typically think very highly of themselves and view themselves as good people who are above average on many desirable traits ( Ehrlinger , Gilovich , & Ross , 2005 ) . Often , our behavior , attitudes , and beliefs are affected when we experience a threat to our self-esteem or positive self-image . <hl> Psychologist Leon Festinger ( 1957 ) defined cognitive dissonance as psychological discomfort arising from holding two or more inconsistent attitudes , behaviors , or cognitions ( thoughts , beliefs , or opinions ) . <hl> Festinger \u2019 s theory of cognitive dissonance states that when we experience a conflict in our behaviors , attitudes , or beliefs that runs counter to our positive self-perceptions , we experience psychological discomfort ( dissonance ) . For example , if you believe smoking is bad for your health but you continue to smoke , you experience conflict between your belief and behavior ( Figure 12.11 ) . Later research documented that only conflicting cognitions that threaten individuals \u2019 positive self-image cause dissonance ( Greenwald & Ronis , 1978 ) . Additional research found that dissonance is not only psychologically uncomfortable but also can cause physiological arousal ( Croyle & Cooper , 1983 ) and activate regions of the brain important in emotions and cognitive functioning ( van Veen , Krug , Schooler , & Carter , 2009 ) . When we experience cognitive dissonance , we are motivated to decrease it because it is psychologically , physically , and mentally uncomfortable . We can reduce cognitive dissonance by bringing our cognitions , attitudes , and behaviors in line \u2014 that is , making them harmonious . This can be done in different ways , such as :"}, {"question": {"question_id": "fs-idp77568624", "question_text": "In order for the central route to persuasion to be effective, the audience must be ________ and ________.", "question_choices": ["analytical; motivated", "attentive; happy", "intelligent; unemotional", "gullible; distracted"], "cloze_format": "In order for the central route to persuasion to be effective, the audience must be ________ and ________.", "normal_format": "In order for the central route to persuasion to be effective, what does the audience must be?"}, "answer": {"ans_text": "analytical; motivated", "ans_choice": 0}, "bloom": null, "hl_sentences": "The central route to persuasion works best when the target of persuasion , or the audience , is analytical and willing to engage in processing of the information .", "hl_context": "<hl> The central route to persuasion works best when the target of persuasion , or the audience , is analytical and willing to engage in processing of the information . <hl> From an advertiser \u2019 s perspective , what products would be best sold using the central route to persuasion ? What audience would most likely be influenced to buy the product ? One example is buying a computer . It is likely , for example , that small business owners might be especially influenced by the focus on the computer \u2019 s quality and features such as processing speed and memory capacity ."}, {"question": {"question_id": "fs-idp56942096", "question_text": "Examples of cues used in peripheral route persuasion include all of the following except ________.", "question_choices": ["celebrity endorsement", "positive emotions", "attractive models", "factual information"], "cloze_format": "Examples of cues used in peripheral route persuasion include all of the following except ________.", "normal_format": "Which of the following is not an example of cues used in peripheral route persuasion?"}, "answer": {"ans_text": "factual information", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The peripheral route is an indirect route that uses peripheral cues to associate positivity with the message ( Petty & Cacioppo , 1986 ) . Instead of focusing on the facts and a product \u2019 s quality , the peripheral route relies on association with positive characteristics such as positive emotions and celebrity endorsement . For example , having a popular athlete advertise athletic shoes is a common method used to encourage young adults to purchase the shoes . This route to attitude change does not require much effort or information processing .", "hl_context": "<hl> The peripheral route is an indirect route that uses peripheral cues to associate positivity with the message ( Petty & Cacioppo , 1986 ) . <hl> <hl> Instead of focusing on the facts and a product \u2019 s quality , the peripheral route relies on association with positive characteristics such as positive emotions and celebrity endorsement . <hl> <hl> For example , having a popular athlete advertise athletic shoes is a common method used to encourage young adults to purchase the shoes . <hl> <hl> This route to attitude change does not require much effort or information processing . <hl> This method of persuasion may promote positivity toward the message or product , but it typically results in less permanent attitude or behavior change . The audience does not need to be analytical or motivated to process the message . In fact , a peripheral route to persuasion may not even be noticed by the audience , for example in the strategy of product placement . Product placement refers to putting a product with a clear brand name or brand identity in a TV show or movie to promote the product ( Gupta & Lord , 1998 ) . For example , one season of the reality series American Idol prominently showed the panel of judges drinking out of cups that displayed the Coca-Cola logo . What other products would be best sold using the peripheral route to persuasion ? Another example is clothing : A retailer may focus on celebrities that are wearing the same style of clothing ."}, {"question": {"question_id": "fs-idp60391584", "question_text": "In the Asch experiment, participants conformed due to ________ social influence.", "question_choices": ["informational", "normative", "inspirational", "persuasive"], "cloze_format": "In the Asch experiment, participants conformed due to ________ social influence.", "normal_format": "In the Asch experiment, participants conformed due to which social influence?"}, "answer": {"ans_text": "normative", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "What type of social influence was operating in the Asch conformity studies ? Since the line judgment task was unambiguous , participants did not need to rely on the group for information . Instead , participants complied to fit in and avoid ridicule , an instance of normative social influence . Now that you have learned about the Asch line experiments , why do you think the participants conformed ? Researchers have categorized the motivation to conform into two types : normative social influence and informational social influence ( Deutsch & Gerard , 1955 ) .", "hl_context": "In normative social influence , people conform to the group norm to fit in , to feel good , and to be accepted by the group . However , with informational social influence , people conform because they believe the group is competent and has the correct information , particularly when the task or situation is ambiguous . <hl> What type of social influence was operating in the Asch conformity studies ? <hl> <hl> Since the line judgment task was unambiguous , participants did not need to rely on the group for information . <hl> <hl> Instead , participants complied to fit in and avoid ridicule , an instance of normative social influence . <hl> <hl> Now that you have learned about the Asch line experiments , why do you think the participants conformed ? <hl> The correct answer to the line segment question was obvious , and it was an easy task . <hl> Researchers have categorized the motivation to conform into two types : normative social influence and informational social influence ( Deutsch & Gerard , 1955 ) . <hl>"}, {"question": {"question_id": "fs-idp93018544", "question_text": "Under what conditions will informational social influence be more likely?", "question_choices": ["when individuals want to fit in", "when the answer is unclear", "when the group has expertise", "both b and c"], "cloze_format": "Informational social influence will be more likely under the conditions ___.", "normal_format": "Under what conditions will informational social influence be more likely?"}, "answer": {"ans_text": "both b and c", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "You are not certain that it is smoke \u2014 it might be a special effect for the movie , such as a fog machine . When you are uncertain you will tend to look at the behavior of others in the theater . In normative social influence , people conform to the group norm to fit in , to feel good , and to be accepted by the group . However , with informational social influence , people conform because they believe the group is competent and has the correct information , particularly when the task or situation is ambiguous .", "hl_context": "An example of informational social influence may be what to do in an emergency situation . Imagine that you are in a movie theater watching a film and what seems to be smoke comes in the theater from under the emergency exit door . <hl> You are not certain that it is smoke \u2014 it might be a special effect for the movie , such as a fog machine . <hl> <hl> When you are uncertain you will tend to look at the behavior of others in the theater . <hl> If other people show concern and get up to leave , you are likely to do the same . However , if others seem unconcerned , you are likely to stay put and continue watching the movie ( Figure 12.19 ) . <hl> In normative social influence , people conform to the group norm to fit in , to feel good , and to be accepted by the group . <hl> <hl> However , with informational social influence , people conform because they believe the group is competent and has the correct information , particularly when the task or situation is ambiguous . <hl> What type of social influence was operating in the Asch conformity studies ? Since the line judgment task was unambiguous , participants did not need to rely on the group for information . Instead , participants complied to fit in and avoid ridicule , an instance of normative social influence ."}, {"question": {"question_id": "fs-idp116065600", "question_text": "Social loafing occurs when ________.", "question_choices": ["individual performance cannot be evaluated", "the task is easy", "both a and b", "none of the above"], "cloze_format": "Social loafing occurs when ________.", "normal_format": "When does social loafing occurs?"}, "answer": {"ans_text": "both a and b", "ans_choice": 2}, "bloom": null, "hl_sentences": "Social loafing is the exertion of less effort by a person working together with a group . Social loafing occurs when our individual performance cannot be evaluated separately from the group . Thus , group performance declines on easy tasks ( Karau & Williams , 1993 ) .", "hl_context": "Social Loafing Another way in which a group presence can affect our performance is social loafing . <hl> Social loafing is the exertion of less effort by a person working together with a group . <hl> <hl> Social loafing occurs when our individual performance cannot be evaluated separately from the group . <hl> <hl> Thus , group performance declines on easy tasks ( Karau & Williams , 1993 ) . <hl> Essentially individual group members loaf and let other group members pick up the slack . Because each individual \u2019 s efforts cannot be evaluated , individuals become less motivated to perform well . For example , consider a group of people cooperating to clean litter from the roadside . Some people will exert a great amount of effort , while others will exert little effort . Yet the entire job gets done , and it may not be obvious who worked hard and who didn \u2019 t ."}, {"question": {"question_id": "fs-idp10271104", "question_text": "If group members modify their opinions to align with a perceived group consensus, then ________ has occurred.", "question_choices": ["group cohesion", "social facilitation", "groupthink", "social loafing"], "cloze_format": "If group members modify their opinions to align with a perceived group consensus, then ________ has occurred.", "normal_format": "What has occurred if group members modify their opinions to align with a perceived group consensus?"}, "answer": {"ans_text": "groupthink", "ans_choice": 2}, "bloom": null, "hl_sentences": "Groupthink is the modification of the opinions of members of a group to align with what they believe is the group consensus ( Janis , 1972 ) .", "hl_context": "When in group settings , we are often influenced by the thoughts , feelings , and behaviors around us . Whether it is due to normative or informational social influence , groups have power to influence individuals . Another phenomenon of group conformity is groupthink . <hl> Groupthink is the modification of the opinions of members of a group to align with what they believe is the group consensus ( Janis , 1972 ) . <hl> In group situations , the group often takes action that individuals would not perform outside the group setting because groups make more extreme decisions than individuals do . Moreover , groupthink can hinder opposing trains of thought . This elimination of diverse opinions contributes to faulty decision by the group ."}, {"question": {"question_id": "fs-idm2071600", "question_text": "Prejudice is to ________ as discrimination is to ________.", "question_choices": ["feelings; behavior", "thoughts; feelings", "feelings; thoughts", "behavior; feelings"], "cloze_format": "Prejudice is to ________ as discrimination is to ________.", "normal_format": "Prejudice is to what as discrimination is to?"}, "answer": {"ans_text": "feelings; behavior", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Feelings may influence treatment of others , leading to discrimination . Prejudice", "hl_context": "<hl> Feelings may influence treatment of others , leading to discrimination . <hl> <hl> Prejudice <hl>"}, {"question": {"question_id": "fs-idp162520672", "question_text": "Which of the following is not a type of prejudice?", "question_choices": ["homophobia", "racism", "sexism", "individualism"], "cloze_format": "___ is not a type of prejudice.", "normal_format": "Which of the following is not a type of prejudice?"}, "answer": {"ans_text": "individualism", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Another form of prejudice is homophobia : prejudice and discrimination of individuals based solely on their sexual orientation . Sexism is prejudice and discrimination toward individuals based on their sex .", "hl_context": "<hl> Another form of prejudice is homophobia : prejudice and discrimination of individuals based solely on their sexual orientation . <hl> Like ageism , homophobia is a widespread prejudice in U . S . society that is tolerated by many people ( Herek & McLemore , 2013 ; Nosek , 2005 ) . Negative feelings often result in discrimination , such as the exclusion of lesbian , gay , bisexual , and transgender ( LGBT ) people from social groups and the avoidance of LGBT neighbors and co-workers . This discrimination also extends to employers deliberately declining to hire qualified LGBT job applicants . Have you experienced or witnessed homophobia ? If so , what stereotypes , prejudiced attitudes , and discrimination were evident ? <hl> Sexism is prejudice and discrimination toward individuals based on their sex . <hl> Typically , sexism takes the form of men holding biases against women , but either sex can show sexism toward their own or their opposite sex . Like racism , sexism may be subtle and difficult to detect . Common forms of sexism in modern society include gender role expectations , such as expecting women to be the caretakers of the household . Sexism also includes people \u2019 s expectations for how members of a gender group should behave . For example , women are expected to be friendly , passive , and nurturing , and when women behave in an unfriendly , assertive , or neglectful manner they often are disliked for violating their gender role ( Rudman , 1998 ) . Research by Laurie Rudman ( 1998 ) finds that when female job applicants self-promote , they are likely to be viewed as competent , but they may be disliked and are less likely to be hired because they violated gender expectations for modesty . Sexism can exist on a societal level such as in hiring , employment opportunities , and education . Women are less likely to be hired or promoted in male-dominated professions such as engineering , aviation , and construction ( Figure 12.23 ) ( Blau , Ferber , & Winkler , 2010 ; Ceci & Williams , 2011 ) . Have you ever experienced or witnessed sexism ? Think about your family members \u2019 jobs or careers . Why do you think there are differences in the jobs women and men have , such as more women nurses but more male surgeons ( Betz , 2008 ) ?"}, {"question": {"question_id": "fs-idp12317824", "question_text": "________ occurs when the out-group is blamed for the in-group\u2019s frustration.", "question_choices": ["stereotyping", "in-group bias", "scapegoating", "ageism"], "cloze_format": "________ occurs when the out-group is blamed for the in-group\u2019s frustration.", "normal_format": "What occurs when the out-group is blamed for the in-group\u2019s frustration?"}, "answer": {"ans_text": "scapegoating", "ans_choice": 2}, "bloom": null, "hl_sentences": "Scapegoating is the act of blaming an out-group when the in-group experiences frustration or is blocked from obtaining a goal ( Allport , 1954 ) .", "hl_context": "One function of prejudice is to help us feel good about ourselves and maintain a positive self-concept . This need to feel good about ourselves extends to our in-groups : We want to feel good and protect our in-groups . We seek to resolve threats individually and at the in-group level . This often happens by blaming an out-group for the problem . <hl> Scapegoating is the act of blaming an out-group when the in-group experiences frustration or is blocked from obtaining a goal ( Allport , 1954 ) . <hl> 12.6 Aggression Learning Objectives By the end of this section , you will be able to :"}, {"question": {"question_id": "fs-idp196415264", "question_text": "When we seek out information that supports our stereotypes we are engaged in ________.", "question_choices": ["scapegoating", "confirmation bias", "self-fulfilling prophecy", "in-group bias"], "cloze_format": "When we seek out information that supports our stereotypes we are engaged in ________.", "normal_format": "What are we engaged in when we seek out information that supports our stereotypes?"}, "answer": {"ans_text": "confirmation bias", "ans_choice": 1}, "bloom": null, "hl_sentences": "How might we stop the cycle of the self-fulfilling prophecy ? Social class stereotypes of individuals tend to arise when information about the individual is ambiguous . If information is unambiguous , stereotypes do not tend to arise ( Baron et al . , 1995 ) . In this process , known as confirmation bias , we seek out information that supports our stereotypes and ignore information that is inconsistent with our stereotypes ( Wason & Johnson-Laird , 1972 ) .", "hl_context": "Have you ever fallen prey to the self-fulfilling prophecy or confirmation bias , either as the source or target of such bias ? <hl> How might we stop the cycle of the self-fulfilling prophecy ? <hl> <hl> Social class stereotypes of individuals tend to arise when information about the individual is ambiguous . <hl> <hl> If information is unambiguous , stereotypes do not tend to arise ( Baron et al . , 1995 ) . <hl> Another dynamic that can reinforce stereotypes is confirmation bias . When interacting with the target of our prejudice , we tend to pay attention to information that is consistent with our stereotypic expectations and ignore information that is inconsistent with our expectations . <hl> In this process , known as confirmation bias , we seek out information that supports our stereotypes and ignore information that is inconsistent with our stereotypes ( Wason & Johnson-Laird , 1972 ) . <hl> In the job interview example , the employer may not have noticed that the job applicant was friendly and engaging , and that he provided competent responses to the interview questions in the beginning of the interview . Instead , the employer focused on the job applicant \u2019 s performance in the later part of the interview , after the applicant changed his demeanor and behavior to match the interviewer \u2019 s negative treatment ."}, {"question": {"question_id": "fs-idp135484976", "question_text": "Typically, bullying from boys is to ________ as bullying from girls is to ________.", "question_choices": ["emotional harm; physical harm", "physical harm; emotional harm", "psychological harm; physical harm", "social exclusion; verbal taunting"], "cloze_format": "Typically, bullying from boys is to ________ as bullying from girls is to ________.", "normal_format": "Typically, bullying from boys and bullying from girls is to what respectively? "}, "answer": {"ans_text": "physical harm; emotional harm", "ans_choice": 1}, "bloom": null, "hl_sentences": "Boys tend to engage in direct , physical aggression such as physically harming others . Girls tend to engage in indirect , social forms of aggression such as spreading rumors , ignoring , or socially isolating others .", "hl_context": "Bullying A modern form of aggression is bullying . As you learn in your study of child development , socializing and playing with other children is beneficial for children \u2019 s psychological development . However , as you may have experienced as a child , not all play behavior has positive outcomes . Some children are aggressive and want to play roughly . Other children are selfish and do not want to share toys . One form of negative social interactions among children that has become a national concern is bullying . Bullying is repeated negative treatment of another person , often an adolescent , over time ( Olweus , 1993 ) . A one-time incident in which one child hits another child on the playground would not be considered bullying : Bullying is repeated behavior . The negative treatment typical in bullying is the attempt to inflict harm , injury , or humiliation , and bullying can include physical or verbal attacks . However , bullying doesn \u2019 t have to be physical or verbal , it can be psychological . Research finds gender differences in how girls and boys bully others ( American Psychological Association , 2010 ; Olweus , 1993 ) . <hl> Boys tend to engage in direct , physical aggression such as physically harming others . <hl> <hl> Girls tend to engage in indirect , social forms of aggression such as spreading rumors , ignoring , or socially isolating others . <hl> Based on what you have learned about child development and social roles , why do you think boys and girls display different types of bullying behavior ?"}, {"question": {"question_id": "fs-idp72112448", "question_text": "Which of the following adolescents is least likely to be targeted for bullying?", "question_choices": ["a child with a physical disability", "a transgender adolescent", "an emotionally sensitive boy", "the captain of the football team"], "cloze_format": "The adolescent that is least likely to be targeted for bullying is ___ .", "normal_format": "Which of the following adolescents is least likely to be targeted for bullying?"}, "answer": {"ans_text": "the captain of the football team", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Children who are different from others are likely to be targeted for bullying . Children who are overweight , cognitively impaired , or racially or ethnically different from their peer group may be at higher risk . Children who are emotionally reactive are at a greater risk for being bullied .", "hl_context": "<hl> Children who are different from others are likely to be targeted for bullying . <hl> <hl> Children who are overweight , cognitively impaired , or racially or ethnically different from their peer group may be at higher risk . <hl> <hl> Children who are emotionally reactive are at a greater risk for being bullied . <hl> Bullies may be attracted to children who get upset easily because the bully can quickly get an emotional reaction from them ."}, {"question": {"question_id": "fs-idm24094144", "question_text": "The bystander effect likely occurs due to ________.", "question_choices": ["desensitization to violence", "people not noticing the emergency", "diffusion of responsibility", "emotional insensitivity"], "cloze_format": "The bystander effect likely occurs due to ________.", "normal_format": "Due to what does the bystander effect likely occur?"}, "answer": {"ans_text": "diffusion of responsibility", "ans_choice": 2}, "bloom": null, "hl_sentences": "The bystander effect is a phenomenon in which a witness or bystander does not volunteer to help a victim or person in distress . Diffusion of responsibility is the tendency for no one in a group to help because the responsibility to help is spread throughout the group ( Bandura , 1999 ) .", "hl_context": "Based on this case , researchers Latan\u00e9 and Darley ( 1968 ) described a phenomenon called the bystander effect . <hl> The bystander effect is a phenomenon in which a witness or bystander does not volunteer to help a victim or person in distress . <hl> Instead , they just watch what is happening . Social psychologists hold that we make these decisions based on the social situation , not our own personality variables . Why do you think the bystanders didn \u2019 t help Genovese ? What are the benefits to helping her ? What are the risks ? It is very likely you listed more costs than benefits to helping . In this situation , bystanders likely feared for their own lives \u2014 if they went to her aid the attacker might harm them . However , how difficult would it have been to make a phone call to the police from the safety of their apartments ? Why do you think no one helped in any way ? Social psychologists claim that diffusion of responsibility is the likely explanation . <hl> Diffusion of responsibility is the tendency for no one in a group to help because the responsibility to help is spread throughout the group ( Bandura , 1999 ) . <hl> Because there were many witnesses to the attack on Genovese , as evidenced by the number of lit apartment windows in the building , individuals assumed someone else must have already called the police . The responsibility to call the police was diffused across the number of witnesses to the crime . Have you ever passed an accident on the freeway and assumed that a victim or certainly another motorist has already reported the accident ? In general , the greater the number of bystanders , the less likely any one person will help . 12.7 Prosocial Behavior Learning Objectives By the end of this section , you will be able to :"}, {"question": {"question_id": "fs-idp50874224", "question_text": "Altruism is a form of prosocial behavior that is motivated by ________.", "question_choices": ["feeling good about oneself", "selfless helping of others", "earning a reward", "showing bravery to bystanders"], "cloze_format": "Altruism is a form of prosocial behavior that is motivated by ________.", "normal_format": "Altruism is a form of prosocial behavior that is motivated by which of the following?"}, "answer": {"ans_text": "selfless helping of others", "ans_choice": 1}, "bloom": null, "hl_sentences": "Other researchers argue that altruism is a form of selfless helping that is not motivated by benefits or feeling good about oneself . Altruism is people \u2019 s desire to help others even if the costs outweigh the benefits of helping .", "hl_context": "Some researchers suggest that altruism operates on empathy . Empathy is the capacity to understand another person \u2019 s perspective , to feel what he or she feels . An empathetic person makes an emotional connection with others and feels compelled to help ( Batson , 1991 ) . <hl> Other researchers argue that altruism is a form of selfless helping that is not motivated by benefits or feeling good about oneself . <hl> Certainly , after helping , people feel good about themselves , but some researchers argue that this is a consequence of altruism , not a cause . Other researchers argue that helping is always self-serving because our egos are involved , and we receive benefits from helping ( Cialdini , Brown , Lewis , Luce , & Neuberg 1997 ) . It is challenging to determine experimentally the true motivation for helping , whether is it largely self-serving ( egoism ) or selfless ( altruism ) . Thus , a debate on whether pure altruism exists continues . Link to Learning Do you voluntarily help others ? Voluntary behavior with the intent to help other people is called prosocial behavior . Why do people help other people ? Is personal benefit such as feeling good about oneself the only reason people help one another ? Research suggests there are many other reasons . <hl> Altruism is people \u2019 s desire to help others even if the costs outweigh the benefits of helping . <hl> In fact , people acting in altruistic ways may disregard the personal costs associated with helping ( Figure 12.27 ) . For example , news accounts of the 9/11 terrorist attacks on the World Trade Center in New York reported an employee in the first tower helped his co-workers make it to the exit stairwell . After helping a co-worker to safety he went back in the burning building to help additional co-workers . In this case the costs of helping were great , and the hero lost his life in the destruction ( Stewart , 2002 ) ."}, {"question": {"question_id": "fs-idm220832", "question_text": "After moving to a new apartment building, research suggests that Sam will be most likely to become friends with ________.", "question_choices": ["his next door neighbor", "someone who lives three floors up in the apartment building", "someone from across the street", "his new postal delivery person"], "cloze_format": "After moving to a new apartment building, research suggests that Sam will be most likely to become friends with ________.", "normal_format": "After moving to a new apartment building, research suggests that Sam will be most likely to become friends with whom?"}, "answer": {"ans_text": "his next door neighbor", "ans_choice": 0}, "bloom": null, "hl_sentences": "For example , there are decades of research that shows that you are more likely to become friends with people who live in your dorm , your apartment building , or your immediate neighborhood than with people who live farther away ( Festinger , Schachler , & Back , 1950 ) .", "hl_context": "What do you think is the single most influential factor in determining with whom you become friends and whom you form romantic relationships ? You might be surprised to learn that the answer is simple : the people with whom you have the most contact . This most important factor is proximity . You are more likely to be friends with people you have regular contact with . <hl> For example , there are decades of research that shows that you are more likely to become friends with people who live in your dorm , your apartment building , or your immediate neighborhood than with people who live farther away ( Festinger , Schachler , & Back , 1950 ) . <hl> It is simply easier to form relationships with people you see often because you have the opportunity to get to know them ."}, {"question": {"question_id": "fs-idp19122032", "question_text": "What trait do both men and women tend to look for in a romantic partner?", "question_choices": ["sense of humor", "social skills", "leadership potential", "physical attractiveness"], "cloze_format": "Both men and women tend to look for ___ in a romantic partner.", "normal_format": "What trait do both men and women tend to look for in a romantic partner?"}, "answer": {"ans_text": "physical attractiveness", "ans_choice": 3}, "bloom": null, "hl_sentences": "Researchers have documented several characteristics in men and women that humans find attractive .", "hl_context": "<hl> Researchers have documented several characteristics in men and women that humans find attractive . <hl> First we look for friends and lovers who are physically attractive . People differ in what they consider attractive , and attractiveness is culturally influenced . Research , however , suggests that some universally attractive features in women include large eyes , high cheekbones , a narrow jaw line , a slender build ( Buss , 1989 ) , and a lower waist-to-hip ratio ( Singh , 1993 ) . For men , attractive traits include being tall , having broad shoulders , and a narrow waist ( Buss , 1989 ) . Both men and women with high levels of facial and body symmetry are generally considered more attractive than asymmetric individuals ( Fink , Neave , Manning , & Grammer , 2006 ; Penton-Voak et al . , 2001 ; Rikowski & Grammer , 1999 ) . Social traits that people find attractive in potential female mates include warmth , affection , and social skills ; in males , the attractive traits include achievement , leadership qualities , and job skills ( Regan & Berscheid , 1997 ) . Although humans want mates who are physically attractive , this does not mean that we look for the most attractive person possible . In fact , this observation has led some to propose what is known as the matching hypothesis which asserts that people tend to pick someone they view as their equal in physical attractiveness and social desirability ( Taylor , Fiore , Mendelsohn , & Cheshire , 2011 ) . For example , you and most people you know likely would say that a very attractive movie star is out of your league . So , even if you had proximity to that person , you likely would not ask them out on a date because you believe you likely would be rejected . People weigh a potential partner \u2019 s attractiveness against the likelihood of success with that person . If you think you are particularly unattractive ( even if you are not ) , you likely will seek partners that are fairly unattractive ( that is , unattractive in physical appearance or in behavior ) ."}, {"question": {"question_id": "fs-idm30269440", "question_text": "According to the triangular theory of love, what type of love is defined by passion and intimacy but no commitment?", "question_choices": ["consummate love", "empty love", "romantic love", "liking"], "cloze_format": "According to the triangular theory of love, ____ is defined by passion and intimacy but no commitment.", "normal_format": "According to the triangular theory of love, what type of love is defined by passion and intimacy but no commitment?"}, "answer": {"ans_text": "romantic love", "ans_choice": 2}, "bloom": null, "hl_sentences": "Romantic love is defined by having passion and intimacy , but no commitment .", "hl_context": "Sternberg ( 1986 ) states that a healthy relationship will have all three components of love \u2014 intimacy , passion , and commitment \u2014 which is described as consummate love ( Figure 12.30 ) . However , different aspects of love might be more prevalent at different life stages . Other forms of love include liking , which is defined as having intimacy but no passion or commitment . Infatuation is the presence of passion without intimacy or commitment . Empty love is having commitment without intimacy or passion . Companionate love , which is characteristic of close friendships and family relationships , consists of intimacy and commitment but no passion . <hl> Romantic love is defined by having passion and intimacy , but no commitment . <hl> Finally , fatuous love is defined by having passion and commitment , but no intimacy , such as a long term sexual love affair . Can you describe other examples of relationships that fit these different types of love ?"}, {"question": {"question_id": "fs-idp74771792", "question_text": "According to social exchange theory, humans want to maximize the ________ and minimize the ________ in relationships.", "question_choices": ["intimacy; commitment", "benefits; costs", "costs; benefits", "passion; intimacy"], "cloze_format": "According to social exchange theory, humans want to maximize the ________ and minimize the ________ in relationships.", "normal_format": "According to social exchange theory, humans want to maximize and minimize what in relationships respectively? "}, "answer": {"ans_text": "benefits; costs", "ans_choice": 1}, "bloom": null, "hl_sentences": "However , the benefits of dating your romantic partner presumably outweigh the costs , or you wouldn \u2019 t continue the relationship .", "hl_context": "People are motivated to maximize the benefits of social exchanges , or relationships , and minimize the costs . People prefer to have more benefits than costs , or to have nearly equal costs and benefits , but most people are dissatisfied if their social exchanges create more costs than benefits . Let \u2019 s discuss an example . If you have ever decided to commit to a romantic relationship , you probably considered the advantages and disadvantages of your decision . What are the benefits of being in a committed romantic relationship ? You may have considered having companionship , intimacy , and passion , but also being comfortable with a person you know well . What are the costs of being in a committed romantic relationship ? You may think that over time boredom from being with only one person may set in ; moreover , it may be expensive to share activities such as attending movies and going to dinner . <hl> However , the benefits of dating your romantic partner presumably outweigh the costs , or you wouldn \u2019 t continue the relationship . <hl>"}], "summary": " Summary 12.1   What Is Social Psychology? \n\n Social psychology is the subfield of psychology that studies the power of the situation to influence individuals\u2019 thoughts, feelings, and behaviors. Psychologists categorize the causes of human behavior as those due to internal factors, such as personality, or those due to external factors, such as cultural and other social influences. Behavior is better explained, however, by using both approaches. Lay people tend to over-rely on dispositional explanations for behavior and ignore the power of situational influences, a perspective called the fundamental attribution error. People from individualistic cultures are more likely to display this bias versus people from collectivistic cultures. Our explanations for our own and others behaviors can be biased due to not having enough information about others\u2019 motivations for behaviors and by providing explanations that bolster our self-esteem. \n\n 12.2   Self-presentation \n\n Human behavior is largely influenced by our social roles, norms, and scripts. In order to know how to act in a given situation, we have shared cultural knowledge of how to behave depending on our role in society. Social norms dictate the behavior that is appropriate or inappropriate for each role. Each social role has scripts that help humans learn the sequence of appropriate behaviors in a given setting. The famous Stanford prison experiment is an example of how the power of the situation can dictate the social roles, norms, and scripts we follow in a given situation, even if this behavior is contrary to our typical behavior. \n\n 12.3   Attitudes and Persuasion \n\n Attitudes are our evaluations or feelings toward a person, idea, or object and typically are positive or negative. Our attitudes and beliefs are influenced not only by external forces, but also by internal influences that we control. An internal form of attitude change is cognitive dissonance or the tension we experience when our thoughts, feelings, and behaviors are in conflict. In order to reduce dissonance, individuals can change their behavior, attitudes, or cognitions, or add a new cognition. External forces of persuasion include advertising; the features of advertising that influence our behaviors include the source, message, and audience. There are two primary routes to persuasion. The central route to persuasion uses facts and information to persuade potential consumers. The peripheral route uses positive association with cues such as beauty, fame, and positive emotions. \n\n 12.4   Conformity, Compliance, and Obedience \n\n The power of the situation can lead people to conform, or go along with the group, even in the face of inaccurate information. Conformity to group norms is driven by two motivations, the desire to fit in and be liked and the desire to be accurate and gain information from the group. Authority figures also have influence over our behaviors, and many people become obedient and follow orders even if the orders are contrary to their personal values. Conformity to group pressures can also result in groupthink, or the faulty decision-making process that results from cohesive group members trying to maintain group harmony. Group situations can improve human behavior through facilitating performance on easy tasks, but inhibiting performance on difficult tasks. The presence of others can also lead to social loafing when individual efforts cannot be evaluated. \n\n 12.5   Prejudice and Discrimination \n\n As diverse individuals, humans can experience conflict when interacting with people who are different from each other. Prejudice, or negative feelings and evaluations, is common when people are from a different social group (i.e., out-group). Negative attitudes toward out-groups can lead to discrimination. Prejudice and discrimination against others can be based on gender, race, ethnicity, social class, sexual orientation, or a variety of other social identities. In-group\u2019s who feel threatened may blame the out-groups for their plight, thus using the out-group as a scapegoat for their frustration. \n\n 12.6   Aggression \n\n Aggression is seeking to cause another person harm or pain. Hostile aggression is motivated by feelings of anger with intent to cause pain, and instrumental aggression is motivated by achieving a goal and does not necessarily involve intent to cause pain Bullying is an international public health concern that largely affects the adolescent population. Bullying is repeated behaviors that are intended to inflict harm on the victim and can take the form of physical, psychological, emotional, or social abuse. Bullying has negative mental health consequences for youth including suicide. Cyberbullying is a newer form of bullying that takes place in an online environment where bullies can remain anonymous and victims are helpless to address the harassment. Despite the social norm of helping others in need, when there are many bystanders witnessing an emergency, diffusion of responsibility will lead to a lower likelihood of any one person helping. \n\n 12.7   Prosocial Behavior \n\n Altruism is a pure form of helping others out of empathy, which can be contrasted with egoistic motivations for helping. Forming relationships with others is a necessity for social beings. We typically form relationships with people who are close to us in proximity and people with whom we share similarities. We expect reciprocity and self-disclosure in our relationships. We also want to form relationships with people who are physically attractive, though standards for attractiveness vary by culture and gender. There are many types of love that are determined by various combinations of intimacy, passion, and commitment; consummate love, which is the ideal form of love, contains all three components. When determining satisfaction and whether to maintain a relationship, individuals often use a social exchange approach and weigh the costs and benefits of forming and maintaining a relationship. ", "keyterm": "", "bname": "psychology"}, {"chapter": 13, "intro": " Chapter Objectives After studying this chapter, you will be able to: \n\n Relate the developmental processes of the embryonic nervous system to the adult structures \n\n Name the major regions of the adult nervous system \n\n Locate regions of the cerebral cortex on the basis of anatomical landmarks common to all human brains \n\n Describe the regions of the spinal cord in cross-section \n\n List the cranial nerves in order of anatomical location and provide the central and peripheral connections \n\n List the spinal nerves by vertebral region and by which nerve plexus each supplies \n\n Introduction  The nervous system is responsible for controlling much of the body, both through somatic (voluntary) and autonomic (involuntary) functions. The structures of the nervous system must be described in detail to understand how many of these functions are possible. There is a physiological concept known as localization of function that states that certain structures are specifically responsible for prescribed functions. It is an underlying concept in all of anatomy and physiology, but the nervous system illustrates the concept very well. Fresh, unstained nervous tissue can be described as gray or white matter, and within those two types of tissue it can be very hard to see any detail. However, as specific regions and structures have been described, they were related to specific functions. Understanding these structures and the functions they perform requires a detailed description of the anatomy of the nervous system, delving deep into what the central and peripheral structures are. The place to start this study of the nervous system is the beginning of the individual human life, within the womb. The embryonic development of the nervous system allows for a simple framework on which progressively more complicated structures can be built. With this framework in place, a thorough investigation of the nervous system is possible. ", "chapter_text": " 13.1   The Embryologic Perspective  Learning Objectives By the end of this section, you will be able to: \n\n Describe the growth and differentiation of the neural tube \n\n Relate the different stages of development to the adult structures of the central nervous system \n\n Explain the expansion of the ventricular system of the adult brain from the central canal of the neural tube \n\n Describe the connections of the diencephalon and cerebellum on the basis of patterns of embryonic development \n\n The brain is a complex organ composed of gray parts and white matter, which can be hard to distinguish. Starting from an embryologic perspective allows you to understand more easily how the parts relate to each other. The embryonic nervous system begins as a very simple structure\u2014essentially just a straight line, which then gets increasingly complex. Looking at the development of the nervous system with a couple of early snapshots makes it easier to understand the whole complex system. \n\n Many structures that appear to be adjacent in the adult brain are not connected, and the connections that exist may seem arbitrary. But there is an underlying order to the system that comes from how different parts develop. By following the developmental pattern, it is possible to learn what the major regions of the nervous system are. \n\n The Neural Tube \n\n To begin, a sperm cell and an egg cell fuse to become a fertilized egg. The fertilized egg cell, or zygote, starts dividing to generate the cells that make up an entire organism. Sixteen days after fertilization, the developing embryo\u2019s cells belong to one of three germ layers that give rise to the different tissues in the body. The endoderm, or inner tissue, is responsible for generating the lining tissues of various spaces within the body, such as the mucosae of the digestive and respiratory systems. The mesoderm, or middle tissue, gives rise to most of the muscle and connective tissues. Finally the ectoderm, or outer tissue, develops into the integumentary system (the skin) and the nervous system. It is probably not difficult to see that the outer tissue of the embryo becomes the outer covering of the body. But how is it responsible for the nervous system? \n\n As the embryo develops, a portion of the ectoderm differentiates into a specialized region of neuroectoderm, which is the precursor for the tissue of the nervous system. Molecular signals induce cells in this region to differentiate into the neuroepithelium, forming a  neural plate . The cells then begin to change shape, causing the tissue to buckle and fold inward ( Figure 13.2 ). A  neural groove  forms, visible as a line along the dorsal surface of the embryo. The ridge-like edge on either side of the neural groove is referred as the  neural fold . As the neural folds come together and converge, the underlying structure forms into a tube just beneath the ectoderm called the  neural tube . Cells from the neural folds then separate from the ectoderm to form a cluster of cells referred to as the  neural crest , which runs lateral to the neural tube. The neural crest migrates away from the nascent, or embryonic, central nervous system (CNS) that will form along the neural groove and develops into several parts of the peripheral nervous system (PNS), including the enteric nervous tissue. Many tissues that are not part of the nervous system also arise from the neural crest, such as craniofacial cartilage and bone, and melanocytes. \n\n At this point, the early nervous system is a simple, hollow tube. It runs from the anterior end of the embryo to the posterior end. Beginning at 25 days, the anterior end develops into the brain, and the posterior portion becomes the spinal cord. This is the most basic arrangement of tissue in the nervous system, and it gives rise to the more complex structures by the fourth week of development. \n\n Primary Vesicles \n\n As the anterior end of the neural tube starts to develop into the brain, it undergoes a couple of enlargements; the result is the production of sac-like vesicles. Similar to a child\u2019s balloon animal, the long, straight neural tube begins to take on a new shape. Three vesicles form at the first stage, which are called  primary vesicles . These vesicles are given names that are based on Greek words, the main root word being  enkephalon , which means \u201cbrain\u201d (en- = \u201cinside\u201d; kephalon = \u201chead\u201d). The prefix to each generally corresponds to its position along the length of the developing nervous system. \n\n The  prosencephalon  (pros- = \u201cin front\u201d) is the forward-most vesicle, and the term can be loosely translated to mean  forebrain . The  mesencephalon  (mes- = \u201cmiddle\u201d) is the next vesicle, which can be called the  midbrain . The third vesicle at this stage is the  rhombencephalon . The first part of this word is also the root of the word rhombus, which is a geometrical figure with four sides of equal length (a square is a rhombus with 90\u00b0 angles). Whereas prosencephalon and mesencephalon translate into the English words forebrain and midbrain, there is not a word for \u201cfour-sided-figure-brain.\u201d However, the third vesicle can be called the  hindbrain . One way of thinking about how the brain is arranged is to use these three regions\u2014forebrain, midbrain, and hindbrain\u2014which are based on the primary vesicle stage of development ( Figure 13.3 a ). \n\n Secondary Vesicles \n\n The brain continues to develop, and the vesicles differentiate further (see  Figure 13.3 b ). The three primary vesicles become five  secondary vesicles . The prosencephalon enlarges into two new vesicles called the  telencephalon  and the  diencephalon . The telecephalon will become the cerebrum. The diencephalon gives rise to several adult structures; two that will be important are the thalamus and the hypothalamus. In the embryonic diencephalon, a structure known as the eye cup develops, which will eventually become the retina, the nervous tissue of the eye called the retina. This is a rare example of nervous tissue developing as part of the CNS structures in the embryo, but becoming a peripheral structure in the fully formed nervous system. \n\n The mesencephalon does not differentiate into any finer divisions. The midbrain is an established region of the brain at the primary vesicle stage of development and remains that way. The rest of the brain develops around it and constitutes a large percentage of the mass of the brain. Dividing the brain into forebrain, midbrain, and hindbrain is useful in considering its developmental pattern, but the midbrain is a small proportion of the entire brain, relatively speaking. \n\n The rhombencephalon develops into the  metencephalon  and  myelencephalon . The metencephalon corresponds to the adult structure known as the pons and also gives rise to the cerebellum. The cerebellum (from the Latin meaning \u201clittle brain\u201d) accounts for about 10 percent of the mass of the brain and is an important structure in itself. The most significant connection between the cerebellum and the rest of the brain is at the pons, because the pons and cerebellum develop out of the same vesicle. The myelencephalon corresponds to the adult structure known as the medulla oblongata. The structures that come from the mesencephalon and rhombencephalon, except for the cerebellum, are collectively considered the  brain stem , which specifically includes the midbrain, pons, and medulla. \n\n Interactive Link \n\n Watch this  animation  to examine the development of the brain, starting with the neural tube. As the anterior end of the neural tube develops, it enlarges into the primary vesicles that establish the forebrain, midbrain, and hindbrain. Those structures continue to develop throughout the rest of embryonic development and into adolescence. They are the basis of the structure of the fully developed adult brain. How would you describe the difference in the relative sizes of the three regions of the brain when comparing the early (25th embryonic day) brain and the adult brain? \n\n Spinal Cord Development \n\n While the brain is developing from the anterior neural tube, the spinal cord is developing from the posterior neural tube. However, its structure does not differ from the basic layout of the neural tube. It is a long, straight cord with a small, hollow space down the center. The neural tube is defined in terms of its anterior versus posterior portions, but it also has a dorsal\u2013ventral dimension. As the neural tube separates from the rest of the ectoderm, the side closest to the surface is dorsal, and the deeper side is ventral. \n\n As the spinal cord develops, the cells making up the wall of the neural tube proliferate and differentiate into the neurons and glia of the spinal cord. The dorsal tissues will be associated with sensory functions, and the ventral tissues will be associated with motor functions. \n\n Relating Embryonic Development to the Adult Brain Embryonic development can help in understanding the structure of the adult brain because it establishes a framework on which more complex structures can be built. First, the neural tube establishes the anterior\u2013posterior dimension of the nervous system, which is called the  neuraxis . The embryonic nervous system in mammals can be said to have a standard arrangement. Humans (and other primates, to some degree) make this complicated by standing up and walking on two legs. The anterior\u2013posterior dimension of the neuraxis overlays the superior\u2013inferior dimension of the body. However, there is a major curve between the brain stem and forebrain, which is called the  cephalic flexure . Because of this, the neuraxis starts in an inferior position\u2014the end of the spinal cord\u2014and ends in an anterior position, the front of the cerebrum. If this is confusing, just imagine a four-legged animal standing up on two legs. Without the flexure in the brain stem, and at the top of the neck, that animal would be looking straight up instead of straight in front ( Figure 13.4 ). \n\n In summary, the primary vesicles help to establish the basic regions of the nervous system: forebrain, midbrain, and hindbrain. These divisions are useful in certain situations, but they are not equivalent regions. The midbrain is small compared with the hindbrain and particularly the forebrain. The secondary vesicles go on to establish the major regions of the adult nervous system that will be followed in this text. The telencephalon is the cerebrum, which is the major portion of the human brain. The diencephalon continues to be referred to by this Greek name, because there is no better term for it (dia- = \u201cthrough\u201d). The diencephalon is between the cerebrum and the rest of the nervous system and can be described as the region through which all projections have to pass between the cerebrum and everything else. The brain stem includes the midbrain, pons, and medulla, which correspond to the mesencephalon, metencephalon, and myelencephalon. The cerebellum, being a large portion of the brain, is considered a separate region.  Table 13.1  connects the different stages of development to the adult structures of the CNS. One other benefit of considering embryonic development is that certain connections are more obvious because of how these adult structures are related. The retina, which began as part of the diencephalon, is primarily connected to the diencephalon. The eyes are just inferior to the anterior-most part of the cerebrum, but the optic nerve extends back to the thalamus as the optic tract, with branches into a region of the hypothalamus. There is also a connection of the optic tract to the midbrain, but the mesencephalon is adjacent to the diencephalon, so that is not difficult to imagine. The cerebellum originates out of the metencephalon, and its largest white matter connection is to the pons, also from the metencephalon. There are connections between the cerebellum and both the medulla and midbrain, which are adjacent structures in the secondary vesicle stage of development. In the adult brain, the cerebellum seems close to the cerebrum, but there is no direct connection between them. \n\n Another aspect of the adult CNS structures that relates to embryonic development is the ventricles\u2014open spaces within the CNS where cerebrospinal fluid circulates. They are the remnant of the hollow center of the neural tube. The four ventricles and the tubular spaces associated with them can be linked back to the hollow center of the embryonic brain (see  Table 13.1 ). Stages of Embryonic Development \n\n Neural tube \n\n Primary vesicle stage \n\n Secondary vesicle stage \n\n Adult structures \n\n Ventricles \n\n Anterior neural tube \n\n Prosencephalon \n\n Telencephalon \n\n Cerebrum \n\n Lateral ventricles \n\n Anterior neural tube \n\n Prosencephalon \n\n Diencephalon \n\n Diencephalon \n\n Third ventricle \n\n Anterior neural tube \n\n Mesencephalon \n\n Mesencephalon \n\n Midbrain \n\n Cerebral aqueduct \n\n Anterior neural tube \n\n Rhombencephalon \n\n Metencephalon \n\n Pons cerebellum \n\n Fourth ventricle \n\n Anterior neural tube \n\n Rhombencephalon \n\n Myelencephalon \n\n Medulla \n\n Fourth ventricle \n\n Posterior neural tube \n\n Spinal cord \n\n Central canal \n\n Table  13.1     \n\n Disorders of the... Nervous System \n\nEarly formation of the nervous system depends on the formation of the neural tube. A groove forms along the dorsal surface of the embryo, which becomes deeper until its edges meet and close off to form the tube. If this fails to happen, especially in the posterior region where the spinal cord forms, a developmental defect called spina bifida occurs. The closing of the neural tube is important for more than just the proper formation of the nervous system. The surrounding tissues are dependent on the correct development of the tube. The connective tissues surrounding the CNS can be involved as well. \n\n There are three classes of this disorder: occulta, meningocele, and myelomeningocele ( Figure 13.5 ). The first type, spina bifida occulta, is the mildest because the vertebral bones do not fully surround the spinal cord, but the spinal cord itself is not affected. No functional differences may be noticed, which is what the word occulta means; it is hidden spina bifida. The other two types both involve the formation of a cyst\u2014a fluid-filled sac of the connective tissues that cover the spinal cord called the meninges. \u201cMeningocele\u201d means that the meninges protrude through the spinal column but nerves may not be involved and few symptoms are present, though complications may arise later in life. \u201cMyelomeningocele\u201d means that the meninges protrude and spinal nerves are involved, and therefore severe neurological symptoms can be present. \n\n Often surgery to close the opening or to remove the cyst is necessary. The earlier that surgery can be performed, the better the chances of controlling or limiting further damage or infection at the opening. For many children with meningocele, surgery will alleviate the pain, although they may experience some functional loss. Because the myelomeningocele form of spina bifida involves more extensive damage to the nervous tissue, neurological damage may persist, but symptoms can often be handled. Complications of the spinal cord may present later in life, but overall life expectancy is not reduced. \n\n Interactive Link \n\n Watch this  video  to learn about the white matter in the cerebrum that develops during childhood and adolescence. This is a composite of MRI images taken of the brains of people from 5 years of age through 20 years of age, demonstrating how the cerebrum changes. As the color changes to blue, the ratio of gray matter to white matter changes. The caption for the video describes it as \u201cless gray matter,\u201d which is another way of saying \u201cmore white matter.\u201d If the brain does not finish developing until approximately 20 years of age, can teenagers be held responsible for behaving badly? \n 13.2   The Central Nervous System  Learning Objectives By the end of this section, you will be able to: \n\n Name the major regions of the adult brain \n\n Describe the connections between the cerebrum and brain stem through the diencephalon, and from those regions into the spinal cord \n\n Recognize the complex connections within the subcortical structures of the basal nuclei \n\n Explain the arrangement of gray and white matter in the spinal cord \n\n The brain and the spinal cord are the central nervous system, and they represent the main organs of the nervous system. The spinal cord is a single structure, whereas the adult brain is described in terms of four major regions: the cerebrum, the diencephalon, the brain stem, and the cerebellum. A person\u2019s conscious experiences are based on neural activity in the brain. The regulation of homeostasis is governed by a specialized region in the brain. The coordination of reflexes depends on the integration of sensory and motor pathways in the spinal cord. \n\n The Cerebrum \n\n The iconic gray mantle of the human brain, which appears to make up most of the mass of the brain, is the  cerebrum  ( Figure 13.6 ). The wrinkled portion is the  cerebral cortex , and the rest of the structure is beneath that outer covering. There is a large separation between the two sides of the cerebrum called the  longitudinal fissure . It separates the cerebrum into two distinct halves, a right and left  cerebral hemisphere . Deep within the cerebrum, the white matter of the  corpus callosum  provides the major pathway for communication between the two hemispheres of the cerebral cortex. \n\n Many of the higher neurological functions, such as memory, emotion, and consciousness, are the result of cerebral function. The complexity of the cerebrum is different across vertebrate species. The cerebrum of the most primitive vertebrates is not much more than the connection for the sense of smell. In mammals, the cerebrum comprises the outer gray matter that is the cortex (from the Latin word meaning \u201cbark of a tree\u201d) and several deep nuclei that belong to three important functional groups. The  basal nuclei  are responsible for cognitive processing, the most important function being that associated with planning movements. The  basal forebrain  contains nuclei that are important in learning and memory. The  limbic cortex  is the region of the cerebral cortex that is part of the  limbic system , a collection of structures involved in emotion, memory, and behavior. \n\n Cerebral Cortex \n\n The cerebrum is covered by a continuous layer of gray matter that wraps around either side of the forebrain\u2014the cerebral cortex. This thin, extensive region of wrinkled gray matter is responsible for the higher functions of the nervous system. A  gyrus  (plural = gyri) is the ridge of one of those wrinkles, and a  sulcus  (plural = sulci) is the groove between two gyri. The pattern of these folds of tissue indicates specific regions of the cerebral cortex. \n\n The head is limited by the size of the birth canal, and the brain must fit inside the cranial cavity of the skull. Extensive folding in the cerebral cortex enables more gray matter to fit into this limited space. If the gray matter of the cortex were peeled off of the cerebrum and laid out flat, its surface area would be roughly equal to one square meter. \n\n The folding of the cortex maximizes the amount of gray matter in the cranial cavity. During embryonic development, as the telencephalon expands within the skull, the brain goes through a regular course of growth that results in everyone\u2019s brain having a similar pattern of folds. The surface of the brain can be mapped on the basis of the locations of large gyri and sulci. Using these landmarks, the cortex can be separated into four major regions, or lobes ( Figure 13.7 ). The  lateral sulcus  that separates the  temporal lobe  from the other regions is one such landmark. Superior to the lateral sulcus are the  parietal lobe  and  frontal lobe , which are separated from each other by the  central sulcus . The posterior region of the cortex is the  occipital lobe , which has no obvious anatomical border between it and the parietal or temporal lobes on the lateral surface of the brain. From the medial surface, an obvious landmark separating the parietal and occipital lobes is called the  parieto-occipital sulcus . The fact that there is no obvious anatomical border between these lobes is consistent with the functions of these regions being interrelated. \n\n Different regions of the cerebral cortex can be associated with particular functions, a concept known as localization of function. In the early 1900s, a German neuroscientist named Korbinian Brodmann performed an extensive study of the microscopic anatomy\u2014the cytoarchitecture\u2014of the cerebral cortex and divided the cortex into 52 separate regions on the basis of the histology of the cortex. His work resulted in a system of classification known as  Brodmann\u2019s areas , which is still used today to describe the anatomical distinctions within the cortex ( Figure 13.8 ). The results from Brodmann\u2019s work on the anatomy align very well with the functional differences within the cortex. Areas 17 and 18 in the occipital lobe are responsible for primary visual perception. That visual information is complex, so it is processed in the temporal and parietal lobes as well. \n\n The temporal lobe is associated with primary auditory sensation, known as Brodmann\u2019s areas 41 and 42 in the superior temporal lobe. Because regions of the temporal lobe are part of the limbic system, memory is an important function associated with that lobe. Memory is essentially a sensory function; memories are recalled sensations such as the smell of Mom\u2019s baking or the sound of a barking dog. Even memories of movement are really the memory of sensory feedback from those movements, such as stretching muscles or the movement of the skin around a joint. Structures in the temporal lobe are responsible for establishing long-term memory, but the ultimate location of those memories is usually in the region in which the sensory perception was processed. \n\n The main sensation associated with the parietal lobe is  somatosensation , meaning the general sensations associated with the body. Posterior to the central sulcus is the  postcentral gyrus , the primary somatosensory cortex, which is identified as Brodmann\u2019s areas 1, 2, and 3. All of the tactile senses are processed in this area, including touch, pressure, tickle, pain, itch, and vibration, as well as more general senses of the body such as  proprioception  and  kinesthesia , which are the senses of body position and movement, respectively. \n\n Anterior to the central sulcus is the frontal lobe, which is primarily associated with motor functions. The  precentral gyrus  is the primary motor cortex. Cells from this region of the cerebral cortex are the upper motor neurons that instruct cells in the spinal cord to move skeletal muscles. Anterior to this region are a few areas that are associated with planned movements. The  premotor area  is responsible for thinking of a movement to be made. The  frontal eye fields  are important in eliciting eye movements and in attending to visual stimuli.  Broca\u2019s area  is responsible for the production of language, or controlling movements responsible for speech; in the vast majority of people, it is located only on the left side. Anterior to these regions is the  prefrontal lobe , which serves cognitive functions that can be the basis of personality, short-term memory, and consciousness. The prefrontal lobotomy is an outdated mode of treatment for personality disorders (psychiatric conditions) that profoundly affected the personality of the patient. \n\n Subcortical structures Beneath the cerebral cortex are sets of nuclei known as  subcortical nuclei  that augment cortical processes. The nuclei of the basal forebrain serve as the primary location for acetylcholine production, which modulates the overall activity of the cortex, possibly leading to greater attention to sensory stimuli. Alzheimer\u2019s disease is associated with a loss of neurons in the basal forebrain. The  hippocampus  and  amygdala  are medial-lobe structures that, along with the adjacent cortex, are involved in long-term memory formation and emotional responses. The basal nuclei are a set of nuclei in the cerebrum responsible for comparing cortical processing with the general state of activity in the nervous system to influence the likelihood of movement taking place. For example, while a student is sitting in a classroom listening to a lecture, the basal nuclei will keep the urge to jump up and scream from actually happening. (The basal nuclei are also referred to as the basal ganglia, although that is potentially confusing because the term ganglia is typically used for peripheral structures.) \n\n The major structures of the basal nuclei that control movement are the  caudate ,  putamen , and  globus pallidus , which are located deep in the cerebrum. The caudate is a long nucleus that follows the basic C-shape of the cerebrum from the frontal lobe, through the parietal and occipital lobes, into the temporal lobe. The putamen is mostly deep in the anterior regions of the frontal and parietal lobes. Together, the caudate and putamen are called the  striatum . The globus pallidus is a layered nucleus that lies just medial to the putamen; they are called the lenticular nuclei because they look like curved pieces fitting together like lenses. The globus pallidus has two subdivisions, the external and internal segments, which are lateral and medial, respectively. These nuclei are depicted in a frontal section of the brain in  Figure 13.9 . \n\n The basal nuclei in the cerebrum are connected with a few more nuclei in the brain stem that together act as a functional group that forms a motor pathway. Two streams of information processing take place in the basal nuclei. All input to the basal nuclei is from the cortex into the striatum ( Figure 13.10 ). The  direct pathway  is the projection of axons from the striatum to the globus pallidus internal segment (GPi) and the  substantia nigra pars reticulata  (SNr). The GPi/SNr then projects to the thalamus, which projects back to the cortex. The  indirect pathway  is the projection of axons from the striatum to the globus pallidus external segment (GPe), then to the subthalamic nucleus (STN), and finally to GPi/SNr. The two streams both target the GPi/SNr, but one has a direct projection and the other goes through a few intervening nuclei. The direct pathway causes the  disinhibition  of the thalamus (inhibition of one cell on a target cell that then inhibits the first cell), whereas the indirect pathway causes, or reinforces, the normal inhibition of the thalamus. The thalamus then can either excite the cortex (as a result of the direct pathway) or fail to excite the cortex (as a result of the indirect pathway). \n\n The switch between the two pathways is the  substantia nigra pars compacta , which projects to the striatum and releases the neurotransmitter dopamine. Dopamine receptors are either excitatory (D1-type receptors) or inhibitory (D2-type receptors). The direct pathway is activated by dopamine, and the indirect pathway is inhibited by dopamine. When the substantia nigra pars compacta is firing, it signals to the basal nuclei that the body is in an active state, and movement will be more likely. When the substantia nigra pars compacta is silent, the body is in a passive state, and movement is inhibited. To illustrate this situation, while a student is sitting listening to a lecture, the substantia nigra pars compacta would be silent and the student less likely to get up and walk around. Likewise, while the professor is lecturing, and walking around at the front of the classroom, the professor\u2019s substantia nigra pars compacta would be active, in keeping with his or her activity level. \n\n Interactive Link \n\n Watch this  video  to learn about the basal nuclei (also known as the basal ganglia), which have two pathways that process information within the cerebrum. As shown in this video, the direct pathway is the shorter pathway through the system that results in increased activity in the cerebral cortex and increased motor activity. The direct pathway is described as resulting in \u201cdisinhibition\u201d of the thalamus. What does disinhibition mean? What are the two neurons doing individually to cause this? \n\n Interactive Link \n\n Watch this  video  to learn about the basal nuclei (also known as the basal ganglia), which have two pathways that process information within the cerebrum. As shown in this video, the indirect pathway is the longer pathway through the system that results in decreased activity in the cerebral cortex, and therefore less motor activity. The indirect pathway has an extra couple of connections in it, including disinhibition of the subthalamic nucleus. What is the end result on the thalamus, and therefore on movement initiated by the cerebral cortex? \n\n Everyday Connection The Myth of Left Brain/Right Brain \n\nThere is a persistent myth that people are \u201cright-brained\u201d or \u201cleft-brained,\u201d which is an oversimplification of an important concept about the cerebral hemispheres. There is some lateralization of function, in which the left side of the brain is devoted to language function and the right side is devoted to spatial and nonverbal reasoning. Whereas these functions are predominantly associated with those sides of the brain, there is no monopoly by either side on these functions. Many pervasive functions, such as language, are distributed globally around the cerebrum. \n\n Some of the support for this misconception has come from studies of split brains. A drastic way to deal with a rare and devastating neurological condition (intractable epilepsy) is to separate the two hemispheres of the brain. After sectioning the corpus callosum, a split-brained patient will have trouble producing verbal responses on the basis of sensory information processed on the right side of the cerebrum, leading to the idea that the left side is responsible for language function. \n\n However, there are well-documented cases of language functions lost from damage to the right side of the brain. The deficits seen in damage to the left side of the brain are classified as aphasia, a loss of speech function; damage on the right side can affect the use of language. Right-side damage can result in a loss of ability to understand figurative aspects of speech, such as jokes, irony, or metaphors. Nonverbal aspects of speech can be affected by damage to the right side, such as facial expression or body language, and right-side damage can lead to a \u201cflat affect\u201d in speech, or a loss of emotional expression in speech\u2014sounding like a robot when talking. \n\n The Diencephalon \n\n The diencephalon is the one region of the adult brain that retains its name from embryologic development. The etymology of the word diencephalon translates to \u201cthrough brain.\u201d It is the connection between the cerebrum and the rest of the nervous system, with one exception. The rest of the brain, the spinal cord, and the PNS all send information to the cerebrum through the diencephalon. Output from the cerebrum passes through the diencephalon. The single exception is the system associated with  olfaction , or the sense of smell, which connects directly with the cerebrum. In the earliest vertebrate species, the cerebrum was not much more than olfactory bulbs that received peripheral information about the chemical environment (to call it smell in these organisms is imprecise because they lived in the ocean). \n\n The diencephalon is deep beneath the cerebrum and constitutes the walls of the third ventricle. The diencephalon can be described as any region of the brain with \u201cthalamus\u201d in its name. The two major regions of the diencephalon are the thalamus itself and the hypothalamus ( Figure 13.11 ). There are other structures, such as the  epithalamus , which contains the pineal gland, or the  subthalamus , which includes the subthalamic nucleus that is part of the basal nuclei. \n\n Thalamus \n\n The  thalamus  is a collection of nuclei that relay information between the cerebral cortex and the periphery, spinal cord, or brain stem. All sensory information, except for the sense of smell, passes through the thalamus before processing by the cortex. Axons from the peripheral sensory organs, or intermediate nuclei, synapse in the thalamus, and thalamic neurons project directly to the cerebrum. It is a requisite synapse in any sensory pathway, except for olfaction. The thalamus does not just pass the information on, it also processes that information. For example, the portion of the thalamus that receives visual information will influence what visual stimuli are important, or what receives attention. \n\n The cerebrum also sends information down to the thalamus, which usually communicates motor commands. This involves interactions with the cerebellum and other nuclei in the brain stem. The cerebrum interacts with the basal nuclei, which involves connections with the thalamus. The primary output of the basal nuclei is to the thalamus, which relays that output to the cerebral cortex. The cortex also sends information to the thalamus that will then influence the effects of the basal nuclei. \n\n Hypothalamus \n\n Inferior and slightly anterior to the thalamus is the  hypothalamus , the other major region of the diencephalon. The hypothalamus is a collection of nuclei that are largely involved in regulating homeostasis. The hypothalamus is the executive region in charge of the autonomic nervous system and the endocrine system through its regulation of the anterior pituitary gland. Other parts of the hypothalamus are involved in memory and emotion as part of the limbic system. \n\n Brain Stem \n\n The midbrain and hindbrain (composed of the pons and the medulla) are collectively referred to as the brain stem ( Figure 13.12 ). The structure emerges from the ventral surface of the forebrain as a tapering cone that connects the brain to the spinal cord. Attached to the brain stem, but considered a separate region of the adult brain, is the cerebellum. The midbrain coordinates sensory representations of the visual, auditory, and somatosensory perceptual spaces. The pons is the main connection with the cerebellum. The pons and the medulla regulate several crucial functions, including the cardiovascular and respiratory systems and rates. \n\n The cranial nerves connect through the brain stem and provide the brain with the sensory input and motor output associated with the head and neck, including most of the special senses. The major ascending and descending pathways between the spinal cord and brain, specifically the cerebrum, pass through the brain stem. \n\n Midbrain \n\n One of the original regions of the embryonic brain, the midbrain is a small region between the thalamus and pons. It is separated into the  tectum  and  tegmentum , from the Latin words for roof and floor, respectively. The cerebral aqueduct passes through the center of the midbrain, such that these regions are the roof and floor of that canal. \n\n The tectum is composed of four bumps known as the colliculi (singular = colliculus), which means \u201clittle hill\u201d in Latin. The  inferior colliculus  is the inferior pair of these enlargements and is part of the auditory brain stem pathway. Neurons of the inferior colliculus project to the thalamus, which then sends auditory information to the cerebrum for the conscious perception of sound. The  superior colliculus  is the superior pair and combines sensory information about visual space, auditory space, and somatosensory space. Activity in the superior colliculus is related to orienting the eyes to a sound or touch stimulus. If you are walking along the sidewalk on campus and you hear chirping, the superior colliculus coordinates that information with your awareness of the visual location of the tree right above you. That is the correlation of auditory and visual maps. If you suddenly feel something wet fall on your head, your superior colliculus integrates that with the auditory and visual maps and you know that the chirping bird just relieved itself on you. You want to look up to see the culprit, but do not. \n\n The tegmentum is continuous with the gray matter of the rest of the brain stem. Throughout the midbrain, pons, and medulla, the tegmentum contains the nuclei that receive and send information through the cranial nerves, as well as regions that regulate important functions such as those of the cardiovascular and respiratory systems. \n\n Pons \n\n The word pons comes from the Latin word for bridge. It is visible on the anterior surface of the brain stem as the thick bundle of white matter attached to the cerebellum. The pons is the main connection between the cerebellum and the brain stem. The bridge-like white matter is only the anterior surface of the pons; the gray matter beneath that is a continuation of the tegmentum from the midbrain. Gray matter in the tegmentum region of the pons contains neurons receiving descending input from the forebrain that is sent to the cerebellum. \n\n Medulla \n\n The medulla is the region known as the myelencephalon in the embryonic brain. The initial portion of the name, \u201cmyel,\u201d refers to the significant white matter found in this region\u2014especially on its exterior, which is continuous with the white matter of the spinal cord. The tegmentum of the midbrain and pons continues into the medulla because this gray matter is responsible for processing cranial nerve information. A diffuse region of gray matter throughout the brain stem, known as the  reticular formation , is related to sleep and wakefulness, such as general brain activity and attention. \n\n The Cerebellum \n\n The  cerebellum , as the name suggests, is the \u201clittle brain.\u201d It is covered in gyri and sulci like the cerebrum, and looks like a miniature version of that part of the brain ( Figure 13.13 ). The cerebellum is largely responsible for comparing information from the cerebrum with sensory feedback from the periphery through the spinal cord. It accounts for approximately 10 percent of the mass of the brain. \n\n Descending fibers from the cerebrum have branches that connect to neurons in the pons. Those neurons project into the cerebellum, providing a copy of motor commands sent to the spinal cord. Sensory information from the periphery, which enters through spinal or cranial nerves, is copied to a nucleus in the medulla known as the  inferior olive . Fibers from this nucleus enter the cerebellum and are compared with the descending commands from the cerebrum. If the primary motor cortex of the frontal lobe sends a command down to the spinal cord to initiate walking, a copy of that instruction is sent to the cerebellum. Sensory feedback from the muscles and joints, proprioceptive information about the movements of walking, and sensations of balance are sent to the cerebellum through the inferior olive and the cerebellum compares them. If walking is not coordinated, perhaps because the ground is uneven or a strong wind is blowing, then the cerebellum sends out a corrective command to compensate for the difference between the original cortical command and the sensory feedback. The output of the cerebellum is into the midbrain, which then sends a descending input to the spinal cord to correct the messages going to skeletal muscles. \n\n The Spinal Cord \n\n The description of the CNS is concentrated on the structures of the brain, but the spinal cord is another major organ of the system. Whereas the brain develops out of expansions of the neural tube into primary and then secondary vesicles, the spinal cord maintains the tube structure and is only specialized into certain regions. As the spinal cord continues to develop in the newborn, anatomical features mark its surface. The anterior midline is marked by the  anterior median fissure , and the posterior midline is marked by the  posterior median sulcus . Axons enter the posterior side through the  dorsal (posterior) nerve root , which marks the  posterolateral sulcus  on either side. The axons emerging from the anterior side do so through the  ventral (anterior) nerve root . Note that it is common to see the terms dorsal (dorsal = \u201cback\u201d) and ventral (ventral = \u201cbelly\u201d) used interchangeably with posterior and anterior, particularly in reference to nerves and the structures of the spinal cord. You should learn to be comfortable with both. \n\n On the whole, the posterior regions are responsible for sensory functions and the anterior regions are associated with motor functions. This comes from the initial development of the spinal cord, which is divided into the  basal plate  and the  alar plate . The basal plate is closest to the ventral midline of the neural tube, which will become the anterior face of the spinal cord and gives rise to motor neurons. The alar plate is on the dorsal side of the neural tube and gives rise to neurons that will receive sensory input from the periphery. \n\n The length of the spinal cord is divided into regions that correspond to the regions of the vertebral column. The name of a spinal cord region corresponds to the level at which spinal nerves pass through the intervertebral foramina. Immediately adjacent to the brain stem is the cervical region, followed by the thoracic, then the lumbar, and finally the sacral region. The spinal cord is not the full length of the vertebral column because the spinal cord does not grow significantly longer after the first or second year, but the skeleton continues to grow. The nerves that emerge from the spinal cord pass through the intervertebral foramina at the respective levels. As the vertebral column grows, these nerves grow with it and result in a long bundle of nerves that resembles a horse\u2019s tail and is named the  cauda equina . The sacral spinal cord is at the level of the upper lumbar vertebral bones. The spinal nerves extend from their various levels to the proper level of the vertebral column. \n\n Gray Horns \n\n In cross-section, the gray matter of the spinal cord has the appearance of an ink-blot test, with the spread of the gray matter on one side replicated on the other\u2014a shape reminiscent of a bulbous capital \u201cH.\u201d As shown in  Figure 13.14 , the gray matter is subdivided into regions that are referred to as horns. The  posterior horn  is responsible for sensory processing. The  anterior horn  sends out motor signals to the skeletal muscles. The  lateral horn , which is only found in the thoracic, upper lumbar, and sacral regions, contains cell bodies of motor neurons of the autonomic nervous system. \n\n Some of the largest neurons of the spinal cord are the multipolar motor neurons in the anterior horn. The fibers that cause contraction of skeletal muscles are the axons of these neurons. The motor neuron that causes contraction of the big toe, for example, is located in the sacral spinal cord. The axon that has to reach all the way to the belly of that muscle may be a meter in length. The neuronal cell body that maintains that long fiber must be quite large, possibly several hundred micrometers in diameter, making it one of the largest cells in the body. \n\n White Columns \n\n Just as the gray matter is separated into horns, the white matter of the spinal cord is separated into columns.  Ascending tracts  of nervous system fibers in these columns carry sensory information up to the brain, whereas  descending tracts  carry motor commands from the brain. Looking at the spinal cord longitudinally, the columns extend along its length as continuous bands of white matter. Between the two posterior horns of gray matter are the  posterior columns . Between the two anterior horns, and bounded by the axons of motor neurons emerging from that gray matter area, are the  anterior columns . The white matter on either side of the spinal cord, between the posterior horn and the axons of the anterior horn neurons, are the  lateral columns . The posterior columns are composed of axons of ascending tracts. The anterior and lateral columns are composed of many different groups of axons of both ascending and descending tracts\u2014the latter carrying motor commands down from the brain to the spinal cord to control output to the periphery. \n\n Interactive Link \n\n Watch this  video  to learn about the gray matter of the spinal cord that receives input from fibers of the dorsal (posterior) root and sends information out through the fibers of the ventral (anterior) root. As discussed in this video, these connections represent the interactions of the CNS with peripheral structures for both sensory and motor functions. The cervical and lumbar spinal cords have enlargements as a result of larger populations of neurons. What are these enlargements responsible for? \n\n Disorders of the... Basal Nuclei \n\nParkinson\u2019s disease is a disorder of the basal nuclei, specifically of the substantia nigra, that demonstrates the effects of the direct and indirect pathways. Parkinson\u2019s disease is the result of neurons in the substantia nigra pars compacta dying. These neurons release dopamine into the striatum. Without that modulatory influence, the basal nuclei are stuck in the indirect pathway, without the direct pathway being activated. The direct pathway is responsible for increasing cortical movement commands. The increased activity of the indirect pathway results in the hypokinetic disorder of Parkinson\u2019s disease. \n\n Parkinson\u2019s disease is neurodegenerative, meaning that neurons die that cannot be replaced, so there is no cure for the disorder. Treatments for Parkinson\u2019s disease are aimed at increasing dopamine levels in the striatum. Currently, the most common way of doing that is by providing the amino acid L-DOPA, which is a precursor to the neurotransmitter dopamine and can cross the blood-brain barrier. With levels of the precursor elevated, the remaining cells of the substantia nigra pars compacta can make more neurotransmitter and have a greater effect. Unfortunately, the patient will become less responsive to L-DOPA treatment as time progresses, and it can cause increased dopamine levels elsewhere in the brain, which are associated with psychosis or schizophrenia. \n\n Interactive Link \n\n Visit this  site  for a thorough explanation of Parkinson\u2019s disease. \n\n Interactive Link \n\nCompared with the nearest evolutionary relative, the chimpanzee, the human has a brain that is huge. At a point in the past, a common ancestor gave rise to the two species of humans and chimpanzees. That evolutionary history is long and is still an area of intense study. But something happened to increase the size of the human brain relative to the chimpanzee. Read this  article  in which the author explores the current understanding of why this happened. \n\n According to one hypothesis about the expansion of brain size, what tissue might have been sacrificed so energy was available to grow our larger brain? Based on what you know about that tissue and nervous tissue, why would there be a trade-off between them in terms of energy use? \n 13.3   Circulation and the Central Nervous System  Learning Objectives By the end of this section, you will be able to: \n\n Describe the vessels that supply the CNS with blood \n\n Name the components of the ventricular system and the regions of the brain in which each is located \n\n Explain the production of cerebrospinal fluid and its flow through the ventricles \n\n Explain how a disruption in circulation would result in a stroke \n\n The CNS is crucial to the operation of the body, and any compromise in the brain and spinal cord can lead to severe difficulties. The CNS has a privileged blood supply, as suggested by the blood-brain barrier. The function of the tissue in the CNS is crucial to the survival of the organism, so the contents of the blood cannot simply pass into the central nervous tissue. To protect this region from the toxins and pathogens that may be traveling through the blood stream, there is strict control over what can move out of the general systems and into the brain and spinal cord. Because of this privilege, the CNS needs specialized structures for the maintenance of circulation. This begins with a unique arrangement of blood vessels carrying fresh blood into the CNS. Beyond the supply of blood, the CNS filters that blood into cerebrospinal fluid (CSF), which is then circulated through the cavities of the brain and spinal cord called ventricles. \n\n Blood Supply to the Brain \n\n A lack of oxygen to the CNS can be devastating, and the cardiovascular system has specific regulatory reflexes to ensure that the blood supply is not interrupted. There are multiple routes for blood to get into the CNS, with specializations to protect that blood supply and to maximize the ability of the brain to get an uninterrupted perfusion. \n\n Arterial Supply \n\n The major artery carrying recently oxygenated blood away from the heart is the aorta. The very first branches off the aorta supply the heart with nutrients and oxygen. The next branches give rise to the  common carotid arteries , which further branch into the  internal carotid arteries . The external carotid arteries supply blood to the tissues on the surface of the cranium. The bases of the common carotids contain stretch receptors that immediately respond to the drop in blood pressure upon standing. The  orthostatic reflex  is a reaction to this change in body position, so that blood pressure is maintained against the increasing effect of gravity (orthostatic means \u201cstanding up\u201d). Heart rate increases\u2014a reflex of the sympathetic division of the autonomic nervous system\u2014and this raises blood pressure. \n\n The internal carotid artery enters the cranium through the  carotid canal  in the temporal bone. A second set of vessels that supply the CNS are the  vertebral arteries , which are protected as they pass through the neck region by the transverse foramina of the cervical vertebrae. The vertebral arteries enter the cranium through the  foramen magnum  of the occipital bone. Branches off the left and right vertebral arteries merge into the  anterior spinal artery  supplying the anterior aspect of the spinal cord, found along the anterior median fissure. The two vertebral arteries then merge into the  basilar artery , which gives rise to branches to the brain stem and cerebellum. The left and right internal carotid arteries and branches of the basilar artery all become the  circle of Willis , a confluence of arteries that can maintain perfusion of the brain even if narrowing or a blockage limits flow through one part ( Figure 13.15 ). \n\n Interactive Link \n\n Watch this  animation  to see how blood flows to the brain and passes through the circle of Willis before being distributed through the cerebrum. The circle of Willis is a specialized arrangement of arteries that ensure constant perfusion of the cerebrum even in the event of a blockage of one of the arteries in the circle. The animation shows the normal direction of flow through the circle of Willis to the middle cerebral artery. Where would the blood come from if there were a blockage just posterior to the middle cerebral artery on the left? \n\n Venous Return \n\n After passing through the CNS, blood returns to the circulation through a series of  dural sinuses  and veins ( Figure 13.16 ). The  superior sagittal sinus  runs in the groove of the longitudinal fissure, where it absorbs CSF from the meninges. The superior sagittal sinus drains to the confluence of sinuses, along with the  occipital sinuses  and  straight sinus , to then drain into the  transverse sinuses . The transverse sinuses connect to the  sigmoid sinuses , which then connect to the  jugular veins . From there, the blood continues toward the heart to be pumped to the lungs for reoxygenation. \n\n Protective Coverings of the Brain and Spinal Cord \n\n The outer surface of the CNS is covered by a series of membranes composed of connective tissue called the  meninges , which protect the brain. The  dura mater  is a thick fibrous layer and a strong protective sheath over the entire brain and spinal cord. It is anchored to the inner surface of the cranium and vertebral cavity. The  arachnoid mater  is a membrane of thin fibrous tissue that forms a loose sac around the CNS. Beneath the arachnoid is a thin, filamentous mesh called the  arachnoid trabeculae , which looks like a spider web, giving this layer its name. Directly adjacent to the surface of the CNS is the  pia mater , a thin fibrous membrane that follows the convolutions of gyri and sulci in the cerebral cortex and fits into other grooves and indentations ( Figure 13.17 ). \n\n Dura Mater \n\n Like a thick cap covering the brain, the dura mater is a tough outer covering. The name comes from the Latin for \u201ctough mother\u201d to represent its physically protective role. It encloses the entire CNS and the major blood vessels that enter the cranium and vertebral cavity. It is directly attached to the inner surface of the bones of the cranium and to the very end of the vertebral cavity. \n\n There are infoldings of the dura that fit into large crevasses of the brain. Two infoldings go through the midline separations of the cerebrum and cerebellum; one forms a shelf-like tent between the occipital lobes of the cerebrum and the cerebellum, and the other surrounds the pituitary gland. The dura also surrounds and supports the venous sinuses. \n\n Arachnoid Mater \n\n The middle layer of the meninges is the arachnoid, named for the spider-web\u2013like trabeculae between it and the pia mater. The arachnoid defines a sac-like enclosure around the CNS. The trabeculae are found in the  subarachnoid space , which is filled with circulating CSF. The arachnoid emerges into the dural sinuses as the  arachnoid granulations , where the CSF is filtered back into the blood for drainage from the nervous system. \n\n The subarachnoid space is filled with circulating CSF, which also provides a liquid cushion to the brain and spinal cord. Similar to clinical blood work, a sample of CSF can be withdrawn to find chemical evidence of neuropathology or metabolic traces of the biochemical functions of nervous tissue. \n\n Pia Mater \n\n The outer surface of the CNS is covered in the thin fibrous membrane of the pia mater. It is thought to have a continuous layer of cells providing a fluid-impermeable membrane. The name pia mater comes from the Latin for \u201ctender mother,\u201d suggesting the thin membrane is a gentle covering for the brain. The pia extends into every convolution of the CNS, lining the inside of the sulci in the cerebral and cerebellar cortices. At the end of the spinal cord, a thin filament extends from the inferior end of CNS at the upper lumbar region of the vertebral column to the sacral end of the vertebral column. Because the spinal cord does not extend through the lower lumbar region of the vertebral column, a needle can be inserted through the dura and arachnoid layers to withdraw CSF. This procedure is called a  lumbar puncture  and avoids the risk of damaging the central tissue of the spinal cord. Blood vessels that are nourishing the central nervous tissue are between the pia mater and the nervous tissue. \n\n Disorders of the... Meninges \n\nMeningitis is an inflammation of the meninges, the three layers of fibrous membrane that surround the CNS. Meningitis can be caused by infection by bacteria or viruses. The particular pathogens are not special to meningitis; it is just an inflammation of that specific set of tissues from what might be a broader infection. Bacterial meningitis can be caused by  Streptococcus ,  Staphylococcus , or the tuberculosis pathogen, among many others. Viral meningitis is usually the result of common enteroviruses (such as those that cause intestinal disorders), but may be the result of the herpes virus or West Nile virus. Bacterial meningitis tends to be more severe. \n\n The symptoms associated with meningitis can be fever, chills, nausea, vomiting, light sensitivity, soreness of the neck, or severe headache. More important are the neurological symptoms, such as changes in mental state (confusion, memory deficits, and other dementia-type symptoms). A serious risk of meningitis can be damage to peripheral structures because of the nerves that pass through the meninges. Hearing loss is a common result of meningitis. \n\n The primary test for meningitis is a lumbar puncture. A needle inserted into the lumbar region of the spinal column through the dura mater and arachnoid membrane into the subarachnoid space can be used to withdraw the fluid for chemical testing. Fatality occurs in 5 to 40 percent of children and 20 to 50 percent of adults with bacterial meningitis. Treatment of bacterial meningitis is through antibiotics, but viral meningitis cannot be treated with antibiotics because viruses do not respond to that type of drug. Fortunately, the viral forms are milder. \n\n Interactive Link \n\n Watch this  video  that describes the procedure known as the lumbar puncture, a medical procedure used to sample the CSF. Because of the anatomy of the CNS, it is a relative safe location to insert a needle. Why is the lumbar puncture performed in the lower lumbar area of the vertebral column? \n\n The Ventricular System \n\n Cerebrospinal fluid (CSF) circulates throughout and around the CNS. In other tissues, water and small molecules are filtered through capillaries as the major contributor to the interstitial fluid. In the brain, CSF is produced in special structures to perfuse through the nervous tissue of the CNS and is continuous with the interstitial fluid. Specifically, CSF circulates to remove metabolic wastes from the interstitial fluids of nervous tissues and return them to the blood stream. The  ventricles  are the open spaces within the brain where CSF circulates. In some of these spaces, CSF is produced by filtering of the blood that is performed by a specialized membrane known as a choroid plexus. The CSF circulates through all of the ventricles to eventually emerge into the subarachnoid space where it will be reabsorbed into the blood. \n\n The Ventricles \n\n There are four ventricles within the brain, all of which developed from the original hollow space within the neural tube, the  central canal . The first two are named the  lateral ventricles  and are deep within the cerebrum. These ventricles are connected to the  third ventricle  by two openings called the  interventricular foramina . The third ventricle is the space between the left and right sides of the diencephalon, which opens into the  cerebral aqueduct  that passes through the midbrain. The aqueduct opens into the  fourth ventricle , which is the space between the cerebellum and the pons and upper medulla ( Figure 13.18 ). \n\n As the telencephalon enlarges and grows into the cranial cavity, it is limited by the space within the skull. The telencephalon is the most anterior region of what was the neural tube, but cannot grow past the limit of the frontal bone of the skull. Because the cerebrum fits into this space, it takes on a C-shaped formation, through the frontal, parietal, occipital, and finally temporal regions. The space within the telencephalon is stretched into this same C-shape. The two ventricles are in the left and right sides, and were at one time referred to as the first and second ventricles. The interventricular foramina connect the frontal region of the lateral ventricles with the third ventricle. \n\n The third ventricle is the space bounded by the medial walls of the hypothalamus and thalamus. The two thalami touch in the center in most brains as the massa intermedia, which is surrounded by the third ventricle. The cerebral aqueduct opens just inferior to the epithalamus and passes through the midbrain. The tectum and tegmentum of the midbrain are the roof and floor of the cerebral aqueduct, respectively. The aqueduct opens up into the fourth ventricle. The floor of the fourth ventricle is the dorsal surface of the pons and upper medulla (that gray matter making a continuation of the tegmentum of the midbrain). The fourth ventricle then narrows into the central canal of the spinal cord. \n\n The ventricular system opens up to the subarachnoid space from the fourth ventricle. The single  median aperture  and the pair of  lateral apertures  connect to the subarachnoid space so that CSF can flow through the ventricles and around the outside of the CNS. Cerebrospinal fluid is produced within the ventricles by a type of specialized membrane called a  choroid plexus . Ependymal cells (one of the types of glial cells described in the introduction to the nervous system) surround blood capillaries and filter the blood to make CSF. The fluid is a clear solution with a limited amount of the constituents of blood. It is essentially water, small molecules, and electrolytes. Oxygen and carbon dioxide are dissolved into the CSF, as they are in blood, and can diffuse between the fluid and the nervous tissue. \n\n Cerebrospinal Fluid Circulation The choroid plexuses are found in all four ventricles. Observed in dissection, they appear as soft, fuzzy structures that may still be pink, depending on how well the circulatory system is cleared in preparation of the tissue. The CSF is produced from components extracted from the blood, so its flow out of the ventricles is tied to the pulse of cardiovascular circulation. \n\n From the lateral ventricles, the CSF flows into the third ventricle, where more CSF is produced, and then through the cerebral aqueduct into the fourth ventricle where even more CSF is produced. A very small amount of CSF is filtered at any one of the plexuses, for a total of about 500 milliliters daily, but it is continuously made and pulses through the ventricular system, keeping the fluid moving. From the fourth ventricle, CSF can continue down the central canal of the spinal cord, but this is essentially a cul-de-sac, so more of the fluid leaves the ventricular system and moves into the subarachnoid space through the median and lateral apertures. \n\n Within the subarachnoid space, the CSF flows around all of the CNS, providing two important functions. As with elsewhere in its circulation, the CSF picks up metabolic wastes from the nervous tissue and moves it out of the CNS. It also acts as a liquid cushion for the brain and spinal cord. By surrounding the entire system in the subarachnoid space, it provides a thin buffer around the organs within the strong, protective dura mater. The arachnoid granulations are outpocketings of the arachnoid membrane into the dural sinuses so that CSF can be reabsorbed into the blood, along with the metabolic wastes. From the dural sinuses, blood drains out of the head and neck through the jugular veins, along with the rest of the circulation for blood, to be reoxygenated by the lungs and wastes to be filtered out by the kidneys ( Table 13.2 ). \n\n Interactive Link \n\n Watch this  animation  that shows the flow of CSF through the brain and spinal cord, and how it originates from the ventricles and then spreads into the space within the meninges, where the fluids then move into the venous sinuses to return to the cardiovascular circulation. What are the structures that produce CSF and where are they found? How are the structures indicated in this animation? \n\n Components of CSF Circulation \n\n Lateral ventricles \n\n Third ventricle \n\n Cerebral aqueduct \n\n Fourth ventricle \n\n Central canal \n\n Subarachnoid space \n\n Location in CNS \n\n Cerebrum \n\n Diencephalon \n\n Midbrain \n\n Between pons/upper medulla and cerebellum \n\n Spinal cord \n\n External to entire CNS \n\n Blood vessel structure \n\n Choroid plexus \n\n Choroid plexus \n\n None \n\n Choroid plexus \n\n None \n\n Arachnoid granulations \n\n Table  13.2     Disorders of the... Central Nervous System \n\nThe supply of blood to the brain is crucial to its ability to perform many functions. Without a steady supply of oxygen, and to a lesser extent glucose, the nervous tissue in the brain cannot keep up its extensive electrical activity. These nutrients get into the brain through the blood, and if blood flow is interrupted, neurological function is compromised. \n\n The common name for a disruption of blood supply to the brain is a stroke. It is caused by a blockage to an artery in the brain. The blockage is from some type of embolus: a blood clot, a fat embolus, or an air bubble. When the blood cannot travel through the artery, the surrounding tissue that is deprived starves and dies. Strokes will often result in the loss of very specific functions. A stroke in the lateral medulla, for example, can cause a loss in the ability to swallow. Sometimes, seemingly unrelated functions will be lost because they are dependent on structures in the same region. Along with the swallowing in the previous example, a stroke in that region could affect sensory functions from the face or extremities because important white matter pathways also pass through the lateral medulla. Loss of blood flow to specific regions of the cortex can lead to the loss of specific higher functions, from the ability to recognize faces to the ability to move a particular region of the body. Severe or limited memory loss can be the result of a temporal lobe stroke. \n\n Related to strokes are transient ischemic attacks (TIAs), which can also be called \u201cmini-strokes.\u201d These are events in which a physical blockage may be temporary, cutting off the blood supply and oxygen to a region, but not to the extent that it causes cell death in that region. While the neurons in that area are recovering from the event, neurological function may be lost. Function can return if the area is able to recover from the event. \n\n Recovery from a stroke (or TIA) is strongly dependent on the speed of treatment. Often, the person who is present and notices something is wrong must then make a decision. The mnemonic  F A S T  helps people remember what to look for when someone is dealing with sudden losses of neurological function. If someone complains of feeling \u201cfunny,\u201d check these things quickly: Look at the person\u2019s face. Does he or she have problems moving  F ace muscles and making regular facial expressions? Ask the person to raise his or her  A rms above the head. Can the person lift one arm but not the other? Has the person\u2019s  S peech changed? Is he or she slurring words or having trouble saying things? If any of these things have happened, then it is  T ime to call for help. Sometimes, treatment with blood-thinning drugs can alleviate the problem, and recovery is possible. If the tissue is damaged, the amazing thing about the nervous system is that it is adaptable. With physical, occupational, and speech therapy, victims of strokes can recover, or more accurately relearn, functions. \n 13.4   The Peripheral Nervous System  Learning Objectives By the end of this section, you will be able to: \n\n Describe the structures found in the PNS \n\n Distinguish between somatic and autonomic structures, including the special peripheral structures of the enteric nervous system \n\n Name the twelve cranial nerves and explain the functions associated with each \n\n Describe the sensory and motor components of spinal nerves and the plexuses that they pass through \n\n The PNS is not as contained as the CNS because it is defined as everything that is not the CNS. Some peripheral structures are incorporated into the other organs of the body. In describing the anatomy of the PNS, it is necessary to describe the common structures, the nerves and the ganglia, as they are found in various parts of the body. Many of the neural structures that are incorporated into other organs are features of the digestive system; these structures are known as the  enteric nervous system  and are a special subset of the PNS. \n\n Ganglia A ganglion is a group of neuron cell bodies in the periphery. Ganglia can be categorized, for the most part, as either sensory ganglia or autonomic ganglia, referring to their primary functions. The most common type of sensory ganglion is a  dorsal (posterior) root ganglion . These ganglia are the cell bodies of neurons with axons that are sensory endings in the periphery, such as in the skin, and that extend into the CNS through the dorsal nerve root. The ganglion is an enlargement of the nerve root. Under microscopic inspection, it can be seen to include the cell bodies of the neurons, as well as bundles of fibers that are the posterior nerve root ( Figure 13.19 ). The cells of the dorsal root ganglion are unipolar cells, classifying them by shape. Also, the small round nuclei of satellite cells can be seen surrounding\u2014as if they were orbiting\u2014the neuron cell bodies. \n\n Interactive Link \n\n View the  University of Michigan WebScope  to explore the tissue sample in greater detail. If you zoom in on the dorsal root ganglion, you can see smaller satellite glial cells surrounding the large cell bodies of the sensory neurons. From what structure do satellite cells derive during embryologic development? Another type of sensory ganglion is a  cranial nerve ganglion . This is analogous to the dorsal root ganglion, except that it is associated with a  cranial nerve  instead of a  spinal nerve . The roots of cranial nerves are within the cranium, whereas the ganglia are outside the skull. For example, the  trigeminal ganglion  is superficial to the temporal bone whereas its associated nerve is attached to the mid-pons region of the brain stem. The neurons of cranial nerve ganglia are also unipolar in shape with associated satellite cells. \n\n The other major category of ganglia are those of the autonomic nervous system, which is divided into the sympathetic and parasympathetic nervous systems. The  sympathetic chain ganglia  constitute a row of ganglia along the vertebral column that receive central input from the lateral horn of the thoracic and upper lumbar spinal cord. Superior to the chain ganglia are three  paravertebral ganglia  in the cervical region. Three other autonomic ganglia that are related to the sympathetic chain are the  prevertebral ganglia , which are located outside of the chain but have similar functions. They are referred to as prevertebral because they are anterior to the vertebral column. The neurons of these autonomic ganglia are multipolar in shape, with dendrites radiating out around the cell body where synapses from the spinal cord neurons are made. The neurons of the chain, paravertebral, and prevertebral ganglia then project to organs in the head and neck, thoracic, abdominal, and pelvic cavities to regulate the sympathetic aspect of homeostatic mechanisms. \n\n Another group of autonomic ganglia are the  terminal ganglia  that receive input from cranial nerves or sacral spinal nerves and are responsible for regulating the parasympathetic aspect of homeostatic mechanisms. These two sets of ganglia, sympathetic and parasympathetic, often project to the same organs\u2014one input from the chain ganglia and one input from a terminal ganglion\u2014to regulate the overall function of an organ. For example, the heart receives two inputs such as these; one increases heart rate, and the other decreases it. The terminal ganglia that receive input from cranial nerves are found in the head and neck, as well as the thoracic and upper abdominal cavities, whereas the terminal ganglia that receive sacral input are in the lower abdominal and pelvic cavities. \n\n Terminal ganglia below the head and neck are often incorporated into the wall of the target organ as a  plexus . A plexus, in a general sense, is a network of fibers or vessels. This can apply to nervous tissue (as in this instance) or structures containing blood vessels (such as a choroid plexus). For example, the  enteric plexus  is the extensive network of axons and neurons in the wall of the small and large intestines. The enteric plexus is actually part of the enteric nervous system, along with the  gastric plexuses  and the  esophageal plexus . Though the enteric nervous system receives input originating from central neurons of the autonomic nervous system, it does not require CNS input to function. In fact, it operates independently to regulate the digestive system. \n\n Nerves Bundles of axons in the PNS are referred to as nerves. These structures in the periphery are different than the central counterpart, called a tract. Nerves are composed of more than just nervous tissue. They have connective tissues invested in their structure, as well as blood vessels supplying the tissues with nourishment. The outer surface of a nerve is a surrounding layer of fibrous connective tissue called the  epineurium . Within the nerve, axons are further bundled into  fascicles , which are each surrounded by their own layer of fibrous connective tissue called  perineurium . Finally, individual axons are surrounded by loose connective tissue called the  endoneurium  ( Figure 13.21 ). These three layers are similar to the connective tissue sheaths for muscles. Nerves are associated with the region of the CNS to which they are connected, either as cranial nerves connected to the brain or spinal nerves connected to the spinal cord. \n\n Interactive Link \n\n View the  University of Michigan WebScope  to explore the tissue sample in greater detail. With what structures in a skeletal muscle are the endoneurium, perineurium, and epineurium comparable? Cranial Nerves \n\n The nerves attached to the brain are the cranial nerves, which are primarily responsible for the sensory and motor functions of the head and neck (one of these nerves targets organs in the thoracic and abdominal cavities as part of the parasympathetic nervous system). There are twelve cranial nerves, which are designated CNI through CNXII for \u201cCranial Nerve,\u201d using Roman numerals for 1 through 12. They can be classified as sensory nerves, motor nerves, or a combination of both, meaning that the axons in these nerves originate out of sensory ganglia external to the cranium or motor nuclei within the brain stem. Sensory axons enter the brain to synapse in a nucleus. Motor axons connect to skeletal muscles of the head or neck. Three of the nerves are solely composed of sensory fibers; five are strictly motor; and the remaining four are mixed nerves. \n\n Learning the cranial nerves is a tradition in anatomy courses, and students have always used mnemonic devices to remember the nerve names. A traditional mnemonic is the rhyming couplet, \u201cOn Old Olympus\u2019 Towering Tops/A Finn And German Viewed Some Hops,\u201d in which the initial letter of each word corresponds to the initial letter in the name of each nerve. The names of the nerves have changed over the years to reflect current usage and more accurate naming. An exercise to help learn this sort of information is to generate a mnemonic using words that have personal significance. The names of the cranial nerves are listed in  Table 13.3  along with a brief description of their function, their source (sensory ganglion or motor nucleus), and their target (sensory nucleus or skeletal muscle). They are listed here with a brief explanation of each nerve ( Figure 13.23 ). The  olfactory nerve  and  optic nerve  are responsible for the sense of smell and vision, respectively. The  oculomotor nerve  is responsible for eye movements by controlling four of the  extraocular muscles . It is also responsible for lifting the upper eyelid when the eyes point up, and for pupillary constriction. The  trochlear nerve  and the  abducens nerve  are both responsible for eye movement, but do so by controlling different extraocular muscles. The  trigeminal nerve  is responsible for cutaneous sensations of the face and controlling the muscles of mastication. The  facial nerve  is responsible for the muscles involved in facial expressions, as well as part of the sense of taste and the production of saliva. The  vestibulocochlear nerve  is responsible for the senses of hearing and balance. The  glossopharyngeal nerve  is responsible for controlling muscles in the oral cavity and upper throat, as well as part of the sense of taste and the production of saliva. The  vagus nerve  is responsible for contributing to homeostatic control of the organs of the thoracic and upper abdominal cavities. The  spinal accessory nerve  is responsible for controlling the muscles of the neck, along with cervical spinal nerves. The  hypoglossal nerve  is responsible for controlling the muscles of the lower throat and tongue. \n\n Three of the cranial nerves also contain autonomic fibers, and a fourth is almost purely a component of the autonomic system. The oculomotor, facial, and glossopharyngeal nerves contain fibers that contact autonomic ganglia. The oculomotor fibers initiate pupillary constriction, whereas the facial and glossopharyngeal fibers both initiate salivation. The vagus nerve primarily targets autonomic ganglia in the thoracic and upper abdominal cavities. \n\n Interactive Link \n\n Visit this  site  to read about a man who wakes with a headache and a loss of vision. His regular doctor sent him to an ophthalmologist to address the vision loss. The ophthalmologist recognizes a greater problem and immediately sends him to the emergency room. Once there, the patient undergoes a large battery of tests, but a definite cause cannot be found. A specialist recognizes the problem as meningitis, but the question is what caused it originally. How can that be cured? The loss of vision comes from swelling around the optic nerve, which probably presented as a bulge on the inside of the eye. Why is swelling related to meningitis going to push on the optic nerve? \n\n Another important aspect of the cranial nerves that lends itself to a mnemonic is the functional role each nerve plays. The nerves fall into one of three basic groups. They are sensory, motor, or both (see  Table 13.3 ). The sentence, \u201cSome Say Marry Money But My Brother Says Brains Beauty Matter More,\u201d corresponds to the basic function of each nerve. The first, second, and eighth nerves are purely sensory: the olfactory (CNI), optic (CNII), and vestibulocochlear (CNVIII) nerves. The three eye-movement nerves are all motor: the oculomotor (CNIII), trochlear (CNIV), and abducens (CNVI). The spinal accessory (CNXI) and hypoglossal (CNXII) nerves are also strictly motor. The remainder of the nerves contain both sensory and motor fibers. They are the trigeminal (CNV), facial (CNVII), glossopharyngeal (CNIX), and vagus (CNX) nerves. The nerves that convey both are often related to each other. The trigeminal and facial nerves both concern the face; one concerns the sensations and the other concerns the muscle movements. The facial and glossopharyngeal nerves are both responsible for conveying gustatory, or taste, sensations as well as controlling salivary glands. The vagus nerve is involved in visceral responses to taste, namely the gag reflex. This is not an exhaustive list of what these combination nerves do, but there is a thread of relation between them. \n\n Cranial Nerves \n\n Mnemonic \n\n # \n\n Name \n\n Function (S/M/B) \n\n Central connection (nuclei) \n\n Peripheral connection (ganglion or muscle) \n\n On \n\n I \n\n Olfactory \n\n Smell (S) \n\n Olfactory bulb \n\n Olfactory epithelium \n\n Old \n\n II \n\n Optic \n\n Vision (S) \n\n Hypothalamus/thalamus/midbrain \n\n Retina (retinal ganglion cells) \n\n Olympus\u2019 \n\n III \n\n Oculomotor \n\n Eye movements (M) \n\n Oculomotor nucleus \n\n Extraocular muscles (other 4), levator palpebrae superioris, ciliary ganglion (autonomic) \n\n Towering \n\n IV \n\n Trochlear \n\n Eye movements (M) \n\n Trochlear nucleus \n\n Superior oblique muscle \n\n Tops \n\n V \n\n Trigeminal \n\n Sensory/motor \u2013 face (B) \n\n Trigeminal nuclei in the midbrain, pons, and medulla \n\n Trigeminal \n\n A \n\n VI \n\n Abducens \n\n Eye movements (M) \n\n Abducens nucleus \n\n Lateral rectus muscle \n\n Finn \n\n VII \n\n Facial \n\n Motor \u2013 face, Taste (B) \n\n Facial nucleus, solitary nucleus, superior salivatory nucleus \n\n Facial muscles, Geniculate ganglion, Pterygopalatine ganglion (autonomic) \n\n And \n\n VIII \n\n Auditory (Vestibulocochlear) \n\n Hearing/balance (S) \n\n Cochlear nucleus, Vestibular nucleus/cerebellum \n\n Spiral ganglion (hearing), Vestibular ganglion (balance) \n\n German \n\n IX \n\n Glossopharyngeal \n\n Motor \u2013 throat Taste (B) \n\n Solitary nucleus, inferior salivatory nucleus, nucleus ambiguus \n\n Pharyngeal muscles, Geniculate ganglion, Otic ganglion (autonomic) \n\n Viewed \n\n X \n\n Vagus \n\n Motor/sensory \u2013 viscera (autonomic) (B) \n\n Medulla \n\n Terminal ganglia serving thoracic and upper abdominal organs (heart and small intestines) \n\n Some \n\n XI \n\n Spinal Accessory \n\n Motor \u2013 head and neck (M) \n\n Spinal accessory nucleus \n\n Neck muscles \n\n Hops \n\n XII \n\n Hypoglossal \n\n Motor \u2013 lower throat (M) \n\n Hypoglossal nucleus \n\n Muscles of the larynx and lower pharynx \n\n Table  13.3     \n\n Spinal Nerves The nerves connected to the spinal cord are the spinal nerves. The arrangement of these nerves is much more regular than that of the cranial nerves. All of the spinal nerves are combined sensory and motor axons that separate into two nerve roots. The sensory axons enter the spinal cord as the dorsal nerve root. The motor fibers, both somatic and autonomic, emerge as the ventral nerve root. The dorsal root ganglion for each nerve is an enlargement of the spinal nerve. \n\n There are 31 spinal nerves, named for the level of the spinal cord at which each one emerges. There are eight pairs of cervical nerves designated C1 to C8, twelve thoracic nerves designated T1 to T12, five pairs of lumbar nerves designated L1 to L5, five pairs of sacral nerves designated S1 to S5, and one pair of coccygeal nerves. The nerves are numbered from the superior to inferior positions, and each emerges from the vertebral column through the intervertebral foramen at its level. The first nerve, C1, emerges between the first cervical vertebra and the occipital bone. The second nerve, C2, emerges between the first and second cervical vertebrae. The same occurs for C3 to C7, but C8 emerges between the seventh cervical vertebra and the first thoracic vertebra. For the thoracic and lumbar nerves, each one emerges between the vertebra that has the same designation and the next vertebra in the column. The sacral nerves emerge from the sacral foramina along the length of that unique vertebra. \n\n Spinal nerves extend outward from the vertebral column to innervate the periphery. The nerves in the periphery are not straight continuations of the spinal nerves, but rather the reorganization of the axons in those nerves to follow different courses. Axons from different spinal nerves will come together into a  systemic nerve . This occurs at four places along the length of the vertebral column, each identified as a  nerve plexus , whereas the other spinal nerves directly correspond to nerves at their respective levels. In this instance, the word plexus is used to describe networks of nerve fibers with no associated cell bodies. \n\n Of the four nerve plexuses, two are found at the cervical level, one at the lumbar level, and one at the sacral level ( Figure 13.24 ). The  cervical plexus  is composed of axons from spinal nerves C1 through C5 and branches into nerves in the posterior neck and head, as well as the  phrenic nerve , which connects to the diaphragm at the base of the thoracic cavity. The other plexus from the cervical level is the  brachial plexus . Spinal nerves C4 through T1 reorganize through this plexus to give rise to the nerves of the arms, as the name brachial suggests. A large nerve from this plexus is the  radial nerve  from which the  axillary nerve  branches to go to the armpit region. The radial nerve continues through the arm and is paralleled by the  ulnar nerve  and the  median nerve . The  lumbar plexus  arises from all the lumbar spinal nerves and gives rise to nerves enervating the pelvic region and the anterior leg. The  femoral nerve  is one of the major nerves from this plexus, which gives rise to the  saphenous nerve  as a branch that extends through the anterior lower leg. The  sacral plexus  comes from the lower lumbar nerves L4 and L5 and the sacral nerves S1 to S4. The most significant systemic nerve to come from this plexus is the  sciatic nerve , which is a combination of the  tibial nerve  and the  fibular nerve . The sciatic nerve extends across the hip joint and is most commonly associated with the condition  sciatica , which is the result of compression or irritation of the nerve or any of the spinal nerves giving rise to it. \n\n These plexuses are described as arising from spinal nerves and giving rise to certain systemic nerves, but they contain fibers that serve sensory functions or fibers that serve motor functions. This means that some fibers extend from cutaneous or other peripheral sensory surfaces and send action potentials into the CNS. Those are axons of sensory neurons in the dorsal root ganglia that enter the spinal cord through the dorsal nerve root. Other fibers are the axons of motor neurons of the anterior horn of the spinal cord, which emerge in the ventral nerve root and send action potentials to cause skeletal muscles to contract in their target regions. For example, the radial nerve contains fibers of cutaneous sensation in the arm, as well as motor fibers that move muscles in the arm. \n\n Spinal nerves of the thoracic region, T2 through T11, are not part of the plexuses but rather emerge and give rise to the  intercostal nerves  found between the ribs, which articulate with the vertebrae surrounding the spinal nerve. \n\n Aging and the... Nervous System \n\nAnosmia is the loss of the sense of smell. It is often the result of the olfactory nerve being severed, usually because of blunt force trauma to the head. The sensory neurons of the olfactory epithelium have a limited lifespan of approximately one to four months, and new ones are made on a regular basis. The new neurons extend their axons into the CNS by growing along the existing fibers of the olfactory nerve. The ability of these neurons to be replaced is lost with age. Age-related anosmia is not the result of impact trauma to the head, but rather a slow loss of the sensory neurons with no new neurons born to replace them. \n\n Smell is an important sense, especially for the enjoyment of food. There are only five tastes sensed by the tongue, and two of them are generally thought of as unpleasant tastes (sour and bitter). The rich sensory experience of food is the result of odor molecules associated with the food, both as food is moved into the mouth, and therefore passes under the nose, and when it is chewed and molecules are released to move up the pharynx into the posterior nasal cavity. Anosmia results in a loss of the enjoyment of food. \n\n As the replacement of olfactory neurons declines with age, anosmia can set in. Without the sense of smell, many sufferers complain of food tasting bland. Often, the only way to enjoy food is to add seasoning that can be sensed on the tongue, which usually means adding table salt. The problem with this solution, however, is that this increases sodium intake, which can lead to cardiovascular problems through water retention and the associated increase in blood pressure. ", "questions": [{"question": {"question_id": "fs-id1211731", "question_text": "Aside from the nervous system, which other organ system develops out of the ectoderm?", "question_choices": ["digestive", "respiratory", "integumentary", "urinary"], "cloze_format": "Aside from the nervous system, the other organ system that develops out of the ectoderm is the ___.\n", "normal_format": "Aside from the nervous system, which other organ system develops out of the ectoderm?"}, "answer": {"ans_text": "integumentary", "ans_choice": 2}, "bloom": null, "hl_sentences": "Finally the ectoderm , or outer tissue , develops into the integumentary system ( the skin ) and the nervous system .", "hl_context": "To begin , a sperm cell and an egg cell fuse to become a fertilized egg . The fertilized egg cell , or zygote , starts dividing to generate the cells that make up an entire organism . Sixteen days after fertilization , the developing embryo \u2019 s cells belong to one of three germ layers that give rise to the different tissues in the body . The endoderm , or inner tissue , is responsible for generating the lining tissues of various spaces within the body , such as the mucosae of the digestive and respiratory systems . The mesoderm , or middle tissue , gives rise to most of the muscle and connective tissues . <hl> Finally the ectoderm , or outer tissue , develops into the integumentary system ( the skin ) and the nervous system . <hl> It is probably not difficult to see that the outer tissue of the embryo becomes the outer covering of the body . But how is it responsible for the nervous system ?"}, {"question": {"question_id": "fs-id1954936", "question_text": "Which primary vesicle of the embryonic nervous system does not differentiate into more vesicles at the secondary stage?", "question_choices": ["prosencephalon", "mesencephalon", "diencephalon", "rhombencephalon"], "cloze_format": "The primary vesicle of the embryonic nervous system that does not differentiate into more vesicles at the secondary stage is the ___.", "normal_format": "Which primary vesicle of the embryonic nervous system does not differentiate into more vesicles at the secondary stage?"}, "answer": {"ans_text": "mesencephalon", "ans_choice": 1}, "bloom": "1", "hl_sentences": "The mesencephalon does not differentiate into any finer divisions . The midbrain is an established region of the brain at the primary vesicle stage of development and remains that way .", "hl_context": "<hl> The mesencephalon does not differentiate into any finer divisions . <hl> <hl> The midbrain is an established region of the brain at the primary vesicle stage of development and remains that way . <hl> The rest of the brain develops around it and constitutes a large percentage of the mass of the brain . Dividing the brain into forebrain , midbrain , and hindbrain is useful in considering its developmental pattern , but the midbrain is a small proportion of the entire brain , relatively speaking ."}, {"question": {"question_id": "fs-id1119780", "question_text": "Which adult structure(s) arises from the diencephalon?", "question_choices": ["thalamus, hypothalamus, retina", "midbrain, pons, medulla", "pons and cerebellum", "cerebrum"], "cloze_format": "The adult structure(s) that arises from the diencephalon is ___.", "normal_format": "Which adult structure(s) arises from the diencephalon?"}, "answer": {"ans_text": "thalamus, hypothalamus, retina", "ans_choice": 0}, "bloom": "1", "hl_sentences": "The diencephalon gives rise to several adult structures ; two that will be important are the thalamus and the hypothalamus . In the embryonic diencephalon , a structure known as the eye cup develops , which will eventually become the retina , the nervous tissue of the eye called the retina .", "hl_context": "The brain continues to develop , and the vesicles differentiate further ( see Figure 13.3 b ) . The three primary vesicles become five secondary vesicles . The prosencephalon enlarges into two new vesicles called the telencephalon and the diencephalon . The telecephalon will become the cerebrum . <hl> The diencephalon gives rise to several adult structures ; two that will be important are the thalamus and the hypothalamus . <hl> <hl> In the embryonic diencephalon , a structure known as the eye cup develops , which will eventually become the retina , the nervous tissue of the eye called the retina . <hl> This is a rare example of nervous tissue developing as part of the CNS structures in the embryo , but becoming a peripheral structure in the fully formed nervous system ."}, {"question": {"question_id": "fs-id1494511", "question_text": "Which non-nervous tissue develops from the neuroectoderm?", "question_choices": ["respiratory mucosa", "vertebral bone", "digestive lining", "craniofacial bone"], "cloze_format": "The non-nervous tissue that develops from the neuroectoderm is the ___.", "normal_format": "Which non-nervous tissue develops from the neuroectoderm?"}, "answer": {"ans_text": "craniofacial bone", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "As the embryo develops , a portion of the ectoderm differentiates into a specialized region of neuroectoderm , which is the precursor for the tissue of the nervous system . Many tissues that are not part of the nervous system also arise from the neural crest , such as craniofacial cartilage and bone , and melanocytes .", "hl_context": "<hl> As the embryo develops , a portion of the ectoderm differentiates into a specialized region of neuroectoderm , which is the precursor for the tissue of the nervous system . <hl> Molecular signals induce cells in this region to differentiate into the neuroepithelium , forming a neural plate . The cells then begin to change shape , causing the tissue to buckle and fold inward ( Figure 13.2 ) . A neural groove forms , visible as a line along the dorsal surface of the embryo . The ridge-like edge on either side of the neural groove is referred as the neural fold . As the neural folds come together and converge , the underlying structure forms into a tube just beneath the ectoderm called the neural tube . Cells from the neural folds then separate from the ectoderm to form a cluster of cells referred to as the neural crest , which runs lateral to the neural tube . The neural crest migrates away from the nascent , or embryonic , central nervous system ( CNS ) that will form along the neural groove and develops into several parts of the peripheral nervous system ( PNS ) , including the enteric nervous tissue . <hl> Many tissues that are not part of the nervous system also arise from the neural crest , such as craniofacial cartilage and bone , and melanocytes . <hl>"}, {"question": {"question_id": "fs-id1233440", "question_text": "Which structure is associated with the embryologic development of the peripheral nervous system?", "question_choices": ["neural crest", "neuraxis", "rhombencephalon", "neural tube"], "cloze_format": "The structure that is associated with the embryologic development of the peripheral nervous system is the ___.", "normal_format": "Which structure is associated with the embryologic development of the peripheral nervous system?"}, "answer": {"ans_text": "neural crest", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "The neural crest migrates away from the nascent , or embryonic , central nervous system ( CNS ) that will form along the neural groove and develops into several parts of the peripheral nervous system ( PNS ) , including the enteric nervous tissue .", "hl_context": "As the embryo develops , a portion of the ectoderm differentiates into a specialized region of neuroectoderm , which is the precursor for the tissue of the nervous system . Molecular signals induce cells in this region to differentiate into the neuroepithelium , forming a neural plate . The cells then begin to change shape , causing the tissue to buckle and fold inward ( Figure 13.2 ) . A neural groove forms , visible as a line along the dorsal surface of the embryo . The ridge-like edge on either side of the neural groove is referred as the neural fold . As the neural folds come together and converge , the underlying structure forms into a tube just beneath the ectoderm called the neural tube . Cells from the neural folds then separate from the ectoderm to form a cluster of cells referred to as the neural crest , which runs lateral to the neural tube . <hl> The neural crest migrates away from the nascent , or embryonic , central nervous system ( CNS ) that will form along the neural groove and develops into several parts of the peripheral nervous system ( PNS ) , including the enteric nervous tissue . <hl> Many tissues that are not part of the nervous system also arise from the neural crest , such as craniofacial cartilage and bone , and melanocytes ."}, {"question": {"question_id": "fs-id1052419", "question_text": "Which lobe of the cerebral cortex is responsible for generating motor commands?", "question_choices": ["temporal", "parietal", "occipital", "frontal"], "cloze_format": "The lobe of the cerebral cortex that is responsible for generating motor commands the ___ lobe.", "normal_format": "Which lobe of the cerebral cortex is responsible for generating motor commands?"}, "answer": {"ans_text": "frontal", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "Anterior to the central sulcus is the frontal lobe , which is primarily associated with motor functions . Cells from this region of the cerebral cortex are the upper motor neurons that instruct cells in the spinal cord to move skeletal muscles .", "hl_context": "<hl> Anterior to the central sulcus is the frontal lobe , which is primarily associated with motor functions . <hl> The precentral gyrus is the primary motor cortex . <hl> Cells from this region of the cerebral cortex are the upper motor neurons that instruct cells in the spinal cord to move skeletal muscles . <hl> Anterior to this region are a few areas that are associated with planned movements . The premotor area is responsible for thinking of a movement to be made . The frontal eye fields are important in eliciting eye movements and in attending to visual stimuli . Broca \u2019 s area is responsible for the production of language , or controlling movements responsible for speech ; in the vast majority of people , it is located only on the left side . Anterior to these regions is the prefrontal lobe , which serves cognitive functions that can be the basis of personality , short-term memory , and consciousness . The prefrontal lobotomy is an outdated mode of treatment for personality disorders ( psychiatric conditions ) that profoundly affected the personality of the patient ."}, {"question": {"question_id": "fs-id1311379", "question_text": "What region of the diencephalon coordinates homeostasis?", "question_choices": ["thalamus", "epithalamus", "hypothalamus", "subthalamus"], "cloze_format": "The ___ is the region of the diencephalon coordinates homeostasis.", "normal_format": "What region of the diencephalon coordinates homeostasis?"}, "answer": {"ans_text": "hypothalamus", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "Inferior and slightly anterior to the thalamus is the hypothalamus , the other major region of the diencephalon . The hypothalamus is a collection of nuclei that are largely involved in regulating homeostasis .", "hl_context": "<hl> Inferior and slightly anterior to the thalamus is the hypothalamus , the other major region of the diencephalon . <hl> <hl> The hypothalamus is a collection of nuclei that are largely involved in regulating homeostasis . <hl> The hypothalamus is the executive region in charge of the autonomic nervous system and the endocrine system through its regulation of the anterior pituitary gland . Other parts of the hypothalamus are involved in memory and emotion as part of the limbic system ."}, {"question": {"question_id": "fs-id1481306", "question_text": "What level of the brain stem is the major input to the cerebellum?", "question_choices": ["midbrain", "pons", "medulla", "spinal cord"], "cloze_format": "The level of the brain stem that is the major input to the cerebellum is the ___.", "normal_format": "What level of the brain stem is the major input to the cerebellum?"}, "answer": {"ans_text": "pons", "ans_choice": 1}, "bloom": "1", "hl_sentences": "The pons is the main connection between the cerebellum and the brain stem .", "hl_context": "The word pons comes from the Latin word for bridge . It is visible on the anterior surface of the brain stem as the thick bundle of white matter attached to the cerebellum . <hl> The pons is the main connection between the cerebellum and the brain stem . <hl> The bridge-like white matter is only the anterior surface of the pons ; the gray matter beneath that is a continuation of the tegmentum from the midbrain . Gray matter in the tegmentum region of the pons contains neurons receiving descending input from the forebrain that is sent to the cerebellum ."}, {"question": {"question_id": "fs-id1085828", "question_text": "What region of the spinal cord contains motor neurons that direct the movement of skeletal muscles?", "question_choices": ["anterior horn", "posterior horn", "lateral horn", "alar plate"], "cloze_format": "The ___ is a region of the spinal cord that contains motor neurons that direct the movement of skeletal muscles.", "normal_format": "What region of the spinal cord contains motor neurons that direct the movement of skeletal muscles?"}, "answer": {"ans_text": "anterior horn", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "Some of the largest neurons of the spinal cord are the multipolar motor neurons in the anterior horn . The fibers that cause contraction of skeletal muscles are the axons of these neurons .", "hl_context": "<hl> Some of the largest neurons of the spinal cord are the multipolar motor neurons in the anterior horn . <hl> <hl> The fibers that cause contraction of skeletal muscles are the axons of these neurons . <hl> The motor neuron that causes contraction of the big toe , for example , is located in the sacral spinal cord . The axon that has to reach all the way to the belly of that muscle may be a meter in length . The neuronal cell body that maintains that long fiber must be quite large , possibly several hundred micrometers in diameter , making it one of the largest cells in the body ."}, {"question": {"question_id": "fs-id1455480", "question_text": "Brodmann\u2019s areas map different regions of the ________ to particular functions.", "question_choices": ["cerebellum", "cerebral cortex", "basal forebrain", "corpus callosum"], "cloze_format": "Brodmann\u2019s areas map different regions of the ________ to particular functions.", "normal_format": "Brodmann\u2019s areas map different regions of what to particular functions?"}, "answer": {"ans_text": "cerebral cortex", "ans_choice": 1}, "bloom": "1", "hl_sentences": "In the early 1900s , a German neuroscientist named Korbinian Brodmann performed an extensive study of the microscopic anatomy \u2014 the cytoarchitecture \u2014 of the cerebral cortex and divided the cortex into 52 separate regions on the basis of the histology of the cortex . His work resulted in a system of classification known as Brodmann \u2019 s areas , which is still used today to describe the anatomical distinctions within the cortex ( Figure 13.8 ) . The results from Brodmann \u2019 s work on the anatomy align very well with the functional differences within the cortex .", "hl_context": "Different regions of the cerebral cortex can be associated with particular functions , a concept known as localization of function . <hl> In the early 1900s , a German neuroscientist named Korbinian Brodmann performed an extensive study of the microscopic anatomy \u2014 the cytoarchitecture \u2014 of the cerebral cortex and divided the cortex into 52 separate regions on the basis of the histology of the cortex . <hl> <hl> His work resulted in a system of classification known as Brodmann \u2019 s areas , which is still used today to describe the anatomical distinctions within the cortex ( Figure 13.8 ) . <hl> <hl> The results from Brodmann \u2019 s work on the anatomy align very well with the functional differences within the cortex . <hl> Areas 17 and 18 in the occipital lobe are responsible for primary visual perception . That visual information is complex , so it is processed in the temporal and parietal lobes as well ."}, {"question": {"question_id": "fs-id1432212", "question_text": "What blood vessel enters the cranium to supply the brain with fresh, oxygenated blood?", "question_choices": ["common carotid artery", "jugular vein", "internal carotid artery", "aorta"], "cloze_format": "The blood vessel that enters the cranium to supply the brain with fresh, oxygenated blood is the ___.", "normal_format": "What blood vessel enters the cranium to supply the brain with fresh, oxygenated blood?"}, "answer": {"ans_text": "internal carotid artery", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The internal carotid artery enters the cranium through the carotid canal in the temporal bone . The two vertebral arteries then merge into the basilar artery , which gives rise to branches to the brain stem and cerebellum . The major artery carrying recently oxygenated blood away from the heart is the aorta . The next branches give rise to the common carotid arteries , which further branch into the internal carotid arteries .", "hl_context": "<hl> The internal carotid artery enters the cranium through the carotid canal in the temporal bone . <hl> A second set of vessels that supply the CNS are the vertebral arteries , which are protected as they pass through the neck region by the transverse foramina of the cervical vertebrae . The vertebral arteries enter the cranium through the foramen magnum of the occipital bone . Branches off the left and right vertebral arteries merge into the anterior spinal artery supplying the anterior aspect of the spinal cord , found along the anterior median fissure . <hl> The two vertebral arteries then merge into the basilar artery , which gives rise to branches to the brain stem and cerebellum . <hl> The left and right internal carotid arteries and branches of the basilar artery all become the circle of Willis , a confluence of arteries that can maintain perfusion of the brain even if narrowing or a blockage limits flow through one part ( Figure 13.15 ) . <hl> The major artery carrying recently oxygenated blood away from the heart is the aorta . <hl> The very first branches off the aorta supply the heart with nutrients and oxygen . <hl> The next branches give rise to the common carotid arteries , which further branch into the internal carotid arteries . <hl> The external carotid arteries supply blood to the tissues on the surface of the cranium . The bases of the common carotids contain stretch receptors that immediately respond to the drop in blood pressure upon standing . The orthostatic reflex is a reaction to this change in body position , so that blood pressure is maintained against the increasing effect of gravity ( orthostatic means \u201c standing up \u201d ) . Heart rate increases \u2014 a reflex of the sympathetic division of the autonomic nervous system \u2014 and this raises blood pressure ."}, {"question": {"question_id": "fs-id1398237", "question_text": "Which layer of the meninges surrounds and supports the sinuses that form the route through which blood drains from the CNS?", "question_choices": ["dura mater", "arachnoid mater", "subarachnoid", "pia mater"], "cloze_format": "The layer of the meninges that surrounds and supports the sinuses that form the route through which blood drains from the CNS the ___.", "normal_format": "Which layer of the meninges surrounds and supports the sinuses that form the route through which blood drains from the CNS?"}, "answer": {"ans_text": "dura mater", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "The dura also surrounds and supports the venous sinuses . Like a thick cap covering the brain , the dura mater is a tough outer covering . It encloses the entire CNS and the major blood vessels that enter the cranium and vertebral cavity .", "hl_context": "There are infoldings of the dura that fit into large crevasses of the brain . Two infoldings go through the midline separations of the cerebrum and cerebellum ; one forms a shelf-like tent between the occipital lobes of the cerebrum and the cerebellum , and the other surrounds the pituitary gland . <hl> The dura also surrounds and supports the venous sinuses . <hl> <hl> Like a thick cap covering the brain , the dura mater is a tough outer covering . <hl> The name comes from the Latin for \u201c tough mother \u201d to represent its physically protective role . <hl> It encloses the entire CNS and the major blood vessels that enter the cranium and vertebral cavity . <hl> It is directly attached to the inner surface of the bones of the cranium and to the very end of the vertebral cavity ."}, {"question": {"question_id": "fs-id1205727", "question_text": "What type of glial cell is responsible for filtering blood to produce CSF at the choroid plexus?", "question_choices": ["ependymal cell", "astrocyte", "oligodendrocyte", "Schwann cell"], "cloze_format": "The  type of glial cell that is responsible for filtering blood to produce CSF at the choroid plexus is the ___.", "normal_format": "What type of glial cell is responsible for filtering blood to produce CSF at the choroid plexus?"}, "answer": {"ans_text": "ependymal cell", "ans_choice": 0}, "bloom": null, "hl_sentences": "Cerebrospinal fluid is produced within the ventricles by a type of specialized membrane called a choroid plexus . Ependymal cells ( one of the types of glial cells described in the introduction to the nervous system ) surround blood capillaries and filter the blood to make CSF .", "hl_context": "The ventricular system opens up to the subarachnoid space from the fourth ventricle . The single median aperture and the pair of lateral apertures connect to the subarachnoid space so that CSF can flow through the ventricles and around the outside of the CNS . <hl> Cerebrospinal fluid is produced within the ventricles by a type of specialized membrane called a choroid plexus . <hl> <hl> Ependymal cells ( one of the types of glial cells described in the introduction to the nervous system ) surround blood capillaries and filter the blood to make CSF . <hl> The fluid is a clear solution with a limited amount of the constituents of blood . It is essentially water , small molecules , and electrolytes . Oxygen and carbon dioxide are dissolved into the CSF , as they are in blood , and can diffuse between the fluid and the nervous tissue ."}, {"question": {"question_id": "fs-id1259435", "question_text": "Which portion of the ventricular system is found within the diencephalon?", "question_choices": ["lateral ventricles", "third ventricle", "cerebral aqueduct", "fourth ventricle"], "cloze_format": "The portion of the ventricular system that is found within the diencephalon is called the ___ .", "normal_format": "Which portion of the ventricular system is found within the diencephalon?"}, "answer": {"ans_text": "third ventricle", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "The third ventricle is the space between the left and right sides of the diencephalon , which opens into the cerebral aqueduct that passes through the midbrain .", "hl_context": "There are four ventricles within the brain , all of which developed from the original hollow space within the neural tube , the central canal . The first two are named the lateral ventricles and are deep within the cerebrum . These ventricles are connected to the third ventricle by two openings called the interventricular foramina . <hl> The third ventricle is the space between the left and right sides of the diencephalon , which opens into the cerebral aqueduct that passes through the midbrain . <hl> The aqueduct opens into the fourth ventricle , which is the space between the cerebellum and the pons and upper medulla ( Figure 13.18 ) ."}, {"question": {"question_id": "fs-id1113573", "question_text": "What condition causes a stroke?", "question_choices": ["inflammation of meninges", "lumbar puncture", "infection of cerebral spinal fluid", "disruption of blood to the brain"], "cloze_format": "The condition that causes a stroke is ___.", "normal_format": "What condition causes a stroke?"}, "answer": {"ans_text": "disruption of blood to the brain", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "The common name for a disruption of blood supply to the brain is a stroke .", "hl_context": "<hl> The common name for a disruption of blood supply to the brain is a stroke . <hl> It is caused by a blockage to an artery in the brain . The blockage is from some type of embolus : a blood clot , a fat embolus , or an air bubble . When the blood cannot travel through the artery , the surrounding tissue that is deprived starves and dies . Strokes will often result in the loss of very specific functions . A stroke in the lateral medulla , for example , can cause a loss in the ability to swallow . Sometimes , seemingly unrelated functions will be lost because they are dependent on structures in the same region . Along with the swallowing in the previous example , a stroke in that region could affect sensory functions from the face or extremities because important white matter pathways also pass through the lateral medulla . Loss of blood flow to specific regions of the cortex can lead to the loss of specific higher functions , from the ability to recognize faces to the ability to move a particular region of the body . Severe or limited memory loss can be the result of a temporal lobe stroke ."}, {"question": {"question_id": "fs-id2091911", "question_text": "What type of ganglion contains neurons that control homeostatic mechanisms of the body?", "question_choices": ["sensory ganglion", "dorsal root ganglion", "autonomic ganglion", "cranial nerve ganglion"], "cloze_format": "A ___ is a type of ganglion that contains neurons that control homeostatic mechanisms of the body.", "normal_format": "What type of ganglion contains neurons that control homeostatic mechanisms of the body?"}, "answer": {"ans_text": "autonomic ganglion", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "The neurons of these autonomic ganglia are multipolar in shape , with dendrites radiating out around the cell body where synapses from the spinal cord neurons are made . The neurons of the chain , paravertebral , and prevertebral ganglia then project to organs in the head and neck , thoracic , abdominal , and pelvic cavities to regulate the sympathetic aspect of homeostatic mechanisms .", "hl_context": "The other major category of ganglia are those of the autonomic nervous system , which is divided into the sympathetic and parasympathetic nervous systems . The sympathetic chain ganglia constitute a row of ganglia along the vertebral column that receive central input from the lateral horn of the thoracic and upper lumbar spinal cord . Superior to the chain ganglia are three paravertebral ganglia in the cervical region . Three other autonomic ganglia that are related to the sympathetic chain are the prevertebral ganglia , which are located outside of the chain but have similar functions . They are referred to as prevertebral because they are anterior to the vertebral column . <hl> The neurons of these autonomic ganglia are multipolar in shape , with dendrites radiating out around the cell body where synapses from the spinal cord neurons are made . <hl> <hl> The neurons of the chain , paravertebral , and prevertebral ganglia then project to organs in the head and neck , thoracic , abdominal , and pelvic cavities to regulate the sympathetic aspect of homeostatic mechanisms . <hl>"}, {"question": {"question_id": "fs-id1493258", "question_text": "Which ganglion is responsible for cutaneous sensations of the face?", "question_choices": ["otic ganglion", "vestibular ganglion", "geniculate ganglion", "trigeminal ganglion"], "cloze_format": "The ganglion that is responsible for cutaneous sensations of the face is the ___ .", "normal_format": "Which ganglion is responsible for cutaneous sensations of the face?"}, "answer": {"ans_text": "trigeminal ganglion", "ans_choice": 3}, "bloom": "1", "hl_sentences": "The trigeminal nerve is responsible for cutaneous sensations of the face and controlling the muscles of mastication .", "hl_context": "Learning the cranial nerves is a tradition in anatomy courses , and students have always used mnemonic devices to remember the nerve names . A traditional mnemonic is the rhyming couplet , \u201c On Old Olympus \u2019 Towering Tops / A Finn And German Viewed Some Hops , \u201d in which the initial letter of each word corresponds to the initial letter in the name of each nerve . The names of the nerves have changed over the years to reflect current usage and more accurate naming . An exercise to help learn this sort of information is to generate a mnemonic using words that have personal significance . The names of the cranial nerves are listed in Table 13.3 along with a brief description of their function , their source ( sensory ganglion or motor nucleus ) , and their target ( sensory nucleus or skeletal muscle ) . They are listed here with a brief explanation of each nerve ( Figure 13.23 ) . The olfactory nerve and optic nerve are responsible for the sense of smell and vision , respectively . The oculomotor nerve is responsible for eye movements by controlling four of the extraocular muscles . It is also responsible for lifting the upper eyelid when the eyes point up , and for pupillary constriction . The trochlear nerve and the abducens nerve are both responsible for eye movement , but do so by controlling different extraocular muscles . <hl> The trigeminal nerve is responsible for cutaneous sensations of the face and controlling the muscles of mastication . <hl> The facial nerve is responsible for the muscles involved in facial expressions , as well as part of the sense of taste and the production of saliva . The vestibulocochlear nerve is responsible for the senses of hearing and balance . The glossopharyngeal nerve is responsible for controlling muscles in the oral cavity and upper throat , as well as part of the sense of taste and the production of saliva . The vagus nerve is responsible for contributing to homeostatic control of the organs of the thoracic and upper abdominal cavities . The spinal accessory nerve is responsible for controlling the muscles of the neck , along with cervical spinal nerves . The hypoglossal nerve is responsible for controlling the muscles of the lower throat and tongue ."}, {"question": {"question_id": "fs-id2168882", "question_text": "What is the name for a bundle of axons within a nerve?", "question_choices": ["fascicle", "tract", "nerve root", "epineurium"], "cloze_format": "The name for a bundle of axons within a nerve is ___.", "normal_format": "What is the name for a bundle of axons within a nerve?"}, "answer": {"ans_text": "fascicle", "ans_choice": 0}, "bloom": "1", "hl_sentences": "Within the nerve , axons are further bundled into fascicles , which are each surrounded by their own layer of fibrous connective tissue called perineurium .", "hl_context": "Nerves Bundles of axons in the PNS are referred to as nerves . These structures in the periphery are different than the central counterpart , called a tract . Nerves are composed of more than just nervous tissue . They have connective tissues invested in their structure , as well as blood vessels supplying the tissues with nourishment . The outer surface of a nerve is a surrounding layer of fibrous connective tissue called the epineurium . <hl> Within the nerve , axons are further bundled into fascicles , which are each surrounded by their own layer of fibrous connective tissue called perineurium . <hl> Finally , individual axons are surrounded by loose connective tissue called the endoneurium ( Figure 13.21 ) . These three layers are similar to the connective tissue sheaths for muscles . Nerves are associated with the region of the CNS to which they are connected , either as cranial nerves connected to the brain or spinal nerves connected to the spinal cord ."}, {"question": {"question_id": "fs-id2007793", "question_text": "Which cranial nerve does not control functions in the head and neck?", "question_choices": ["olfactory", "trochlear", "glossopharyngeal", "vagus"], "cloze_format": "The ___ cranial nerve does not control functions in the head and neck.", "normal_format": "Which cranial nerve does not control functions in the head and neck?"}, "answer": {"ans_text": "vagus", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The olfactory nerve and optic nerve are responsible for the sense of smell and vision , respectively . The trochlear nerve and the abducens nerve are both responsible for eye movement , but do so by controlling different extraocular muscles . The glossopharyngeal nerve is responsible for controlling muscles in the oral cavity and upper throat , as well as part of the sense of taste and the production of saliva . The vagus nerve is responsible for contributing to homeostatic control of the organs of the thoracic and upper abdominal cavities .", "hl_context": "Learning the cranial nerves is a tradition in anatomy courses , and students have always used mnemonic devices to remember the nerve names . A traditional mnemonic is the rhyming couplet , \u201c On Old Olympus \u2019 Towering Tops / A Finn And German Viewed Some Hops , \u201d in which the initial letter of each word corresponds to the initial letter in the name of each nerve . The names of the nerves have changed over the years to reflect current usage and more accurate naming . An exercise to help learn this sort of information is to generate a mnemonic using words that have personal significance . The names of the cranial nerves are listed in Table 13.3 along with a brief description of their function , their source ( sensory ganglion or motor nucleus ) , and their target ( sensory nucleus or skeletal muscle ) . They are listed here with a brief explanation of each nerve ( Figure 13.23 ) . <hl> The olfactory nerve and optic nerve are responsible for the sense of smell and vision , respectively . <hl> The oculomotor nerve is responsible for eye movements by controlling four of the extraocular muscles . It is also responsible for lifting the upper eyelid when the eyes point up , and for pupillary constriction . <hl> The trochlear nerve and the abducens nerve are both responsible for eye movement , but do so by controlling different extraocular muscles . <hl> The trigeminal nerve is responsible for cutaneous sensations of the face and controlling the muscles of mastication . The facial nerve is responsible for the muscles involved in facial expressions , as well as part of the sense of taste and the production of saliva . The vestibulocochlear nerve is responsible for the senses of hearing and balance . <hl> The glossopharyngeal nerve is responsible for controlling muscles in the oral cavity and upper throat , as well as part of the sense of taste and the production of saliva . <hl> <hl> The vagus nerve is responsible for contributing to homeostatic control of the organs of the thoracic and upper abdominal cavities . <hl> The spinal accessory nerve is responsible for controlling the muscles of the neck , along with cervical spinal nerves . The hypoglossal nerve is responsible for controlling the muscles of the lower throat and tongue ."}, {"question": {"question_id": "fs-id1272771", "question_text": "Which of these structures is not under direct control of the peripheral nervous system?", "question_choices": ["trigeminal ganglion", "gastric plexus", "sympathetic chain ganglia", "cervical plexus"], "cloze_format": "The structure that is not under direct control of the peripheral nervous system is the ___ .", "normal_format": "Which of these structures is not under direct control of the peripheral nervous system?"}, "answer": {"ans_text": "gastric plexus", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "The enteric plexus is actually part of the enteric nervous system , along with the gastric plexuses and the esophageal plexus .", "hl_context": "Terminal ganglia below the head and neck are often incorporated into the wall of the target organ as a plexus . A plexus , in a general sense , is a network of fibers or vessels . This can apply to nervous tissue ( as in this instance ) or structures containing blood vessels ( such as a choroid plexus ) . For example , the enteric plexus is the extensive network of axons and neurons in the wall of the small and large intestines . <hl> The enteric plexus is actually part of the enteric nervous system , along with the gastric plexuses and the esophageal plexus . <hl> Though the enteric nervous system receives input originating from central neurons of the autonomic nervous system , it does not require CNS input to function . In fact , it operates independently to regulate the digestive system ."}], "summary": "", "keyterm": "", "bname": "anatomy_and_physiology"}, {"chapter": 9, "intro": " Chapter Outline 9.1   Employment, Worker Protection, and Immigration Law 9.2   Labor Law 9.3   Equal Opportunity in Employment Introduction \n\n Learning Outcome Analyze various laws governing employer/employee relationships. ", "chapter_text": " 9.1   Employment, Worker Protection, and Immigration Law \n\n Compared to other countries in the West, stringent and extensive employee protections came fairly late to the United States. Up until 1959, for example, employers had the right to fire a worker without giving any reason. This concept, which was was known as  at-will employment , was applicable in all states. The concept of at-will employment does, however, continue today, and all employees are considered to be at-will unless they are employed under a collective bargaining agreement, or\u00a0under a contract for a set duration. Employers can still fire employees for any reason, but they cannot be fired for illegal reasons, as set out in the U.S. or state constitutions, federal law, state statutes, or public policy. In this section, some of the main employee rights and company responsibilities will be introduced. \n\n Health and Safety \n\n Workers have the right to be safe at work, and companies have responsibilities to employees in the event that they are harmed\u00a0while undertaking work on behalf of the employer. The  Occupational Safety and Health Act , passed in 1970, is the main legislative action that governs health and safety in the workplace. The Act established the  Occupational Safety and Health Administration  (OSHA), which is a federal agency whose role is to \u201cassure safe and healthy working conditions for working men and women by setting and enforcing standards and by providing training, outreach, education and assistance.\u201d Private employers and federal government agencies are all covered under OSHA protection, although the self-employed and workers at state and local governments in most states are not covered. OSHA has adopted thousands of regulations to enforce the Occupational Safety and Health Act. It imposes a number of record-keeping and reporting requirements on private employers. In addition, employers are required to inform employees of their health and safety rights by posting appropriate notices in the workplace. \n\n  \t\t\t\t\t\t\tType of OSHA Standard\n\n  \t\t\t\t\t\t \n\n  \t\t\t\t\t\t\tDescription\n\n  \t\t\t\t\t\t \n\n  \t\t\t\t\t\t\tExample\n\n  \t\t\t\t\t\t \n\n\t\t\t\t\t\t\tSpecific Duty Standards\n\n\t\t\t\t\t\t \n\n\t\t\t\t\t\t\tStandards that apply to specific types of work, procedures, work conditions, and equipment\n\n\t\t\t\t\t\t \n\n\t\t\t\t\t\t\tSafe handling of compressed gas cylinders\n\n\t\t\t\t\t\t \n\n\t\t\t\t\t\t\tGeneral Duty Standards\n\n\t\t\t\t\t\t \n\n\t\t\t\t\t\t\tStandards that apply to all employers and that impose a duty to protect workers from known hazards\n\n\t\t\t\t\t\t \n\n\t\t\t\t\t\t\tStandards pertaining to indoor air quality and workplace violence\n\n\t\t\t\t\t\t \n\n Table  9.1     \n\n Workers\u2019 Compensation Acts  help employees claim compensation for injuries that occur on the job. States require employers to either purchase workers\u2019 compensation insurance, or have the ability to self-insure against compensation claims. Workers\u2019 compensation insurance covers a range of different injuries, including physical injuries, mental illnesses that can be shown to be employment-related, and stress. \n\n Under the terms of the Acts, a  Workers\u2019 Compensation Agency  is established at the state level to provide judicial and administrative services to help in the resolution of claims for compensation. In the event of a claim, a three-step process is put into place: \n\n The worker files a claim with the agency. \n\n The agency establishes the legitimacy of the claim. \n\n If the injury is determined to be legitimate, compensation benefits are paid accordingly. \n\n It is important to note that workers\u2019 compensation is understood to be an  exclusive remedy . This term means that workers cannot sue the employer in court for further damages beyond that which is paid out under the compensation claim. An exception is made when the employer intentionally injures the worker, however. Furthermore, workers have the right to sue any third party involved in the cause of the injury to recover additional damages. \n\n Case Insight \n\n In the case  Chad A. Kelley v. Marsha P. Ryan, Administrator, Ohio Bureau of Workers\u2019 Compensation, and Coca-Cola Enterprises , Chad A. Kelley attended a team-building event held by his employer, Coca-Cola, to celebrate the launch of a new product. All employees attending the event were required to canoe down a river, which Kelley, with colleagues, achieved without incident. Employees waiting on the river bank began to splash one another, and according to witnesses, Kelley said that it would take more than some splashing to get him wet. Consequently, several colleagues tried to throw Kelley into the water, which led him to sustain neck injuries. The Ohio Bureau of Workers\u2019 Compensation denied Kelley\u2019s claim for benefits, however, arguing that Kelley had instigated \u201chorseplay\u201d that removed the incident from the scope and course of employment. In 2009, an appellate court ruled that this conclusion was incorrect and that the employer was, in fact, responsible. Kelley was entitled to the compensation. \n\n Fair Labor Standards Act \n\n The Fair Labor Standards Act (FLSA) sets out provisions that delineate fair labor and unfair labor. There are three main categories covered in the Act: \n\n Child labor \n\n Minimum wage provisions \n\n Overtime pay requirements \n\n The FLSA prohibits oppressive  child labor  as well as the shipping of goods produced by firms that make use of oppressive labor. The FLSA sets the minimum age for non-agricultural work as 14. However, there are some exceptions. People under the age of 14 who are classed as minors may deliver newspapers, perform babysitting or chores around the home, and can work in businesses owned by their families, as long as the work is not deemed to be hazardous. In addition, minors may perform in television, radio, movie, or theatrical productions. Once an employee becomes 18, child labor regulations no longer apply. \n\n Under the terms of the FLSA, employees in covered industries, with the exception of apprentices and students, must be paid the federal minimum wage. Congress is responsible for reviewing the level of the minimum wage on a periodic basis and raising it to compensate for increases in the cost of living caused by inflation. In 2009, Congress raised the federal minimum wage to $7.25 an hour. This increase was the first in almost a decade (although in 2014, President Obama signed an executive order that increased the minimum wage to $10.10 for those employed on new federal contracts). \n\n FLSA also mandates that employees who work more than 40 hours in a week should receive overtime pay that is equal to at least one and one-half times their regular wage for every additional hour worked. Four categories of employees are excluded from this provision, however: executives, administrative employees, professional employees, and outside salespersons. \n\n Family and Medical Leave Act \n\n The Family and Medical Leave Act (FMLA), enacted in 1993, guarantees all eligible workers up to 12 weeks of unpaid leave during any 12-month period for family and medical emergencies. The FMLA applies to all public and private employers with 50 or more employees, covers employees who have worked for the employer for at least one year, and applies to employees who have worked at least 25 hours a week for each of 12 months prior to the leave. The events that qualify workers for leave\u00a0are: \n\n The birth of a child \n\n The adoption of a child \n\n The placement of a foster child in the employee\u2019s care \n\n The care of a seriously ill spouse, parent, or child \n\n Any serious health condition that prevents the worker from being able to perform any of the essential functions of the job \n\n Once the employee returns to work, he or she must be restored to the same or equivalent position.  Social Security  benefits also provide benefits to certain employees and their dependents. The types of benefits that fall under Social Security regulations include disability benefits, Medicare benefits, survivors\u2019 benefits, and retirement benefits. \n\n Ending Employment \n\n There are are also several regulations that cover workers who are terminated or who lose their employment. These are summarized in the following table. \n\n                Regulation\n\n               \n\n                Description\n\n               \n\n\t\t\t\t\t\t\tConsolidated Omnibus Budget Reconciliation Act (COBRA)\n\n\t\t\t\t\t\t \n\n\t\t\t\t\t\t\tMandates that employees who are terminated must be provided with the opportunity to continue to participate in group health insurance, so long as they agree to pay the group rate premium. The employer is required to notify employees of their COBRA rights.\n\n\t\t\t\t\t\t \n\n\t\t\t\t\t\t\tEmployee Retirement Income Security Act (ERISA)\n\n\t\t\t\t\t\t \n\n\t\t\t\t\t\t\tThis Act covers any pension plan offered by employers to their workers, and is designed to prevent abuses and fraudulent use of those plans. Under the terms of ERISA, employers are required to keep certain records pertaining to the plans, and to report on those records at regular intervals. The Act also provides for  vesting , which occurs when an employee has a nonforfeitable right to receive pension benefits.\n\n\t\t\t\t\t\t \n\n\t\t\t\t\t\t\tUnemployment compensation\n\n\t\t\t\t\t\t \n\n\t\t\t\t\t\t\tUnemployment compensation programs are paid to those who become temporarily unemployed, and are funded by employers through employment taxes. Workers who quit voluntarily or who are terminated for bad conduct are not eligible for compensation. In addition, in order to qualify for the benefits, applicants must demonstrate that they are available for work.\n\n\t\t\t\t\t\t \n\n Table  9.2     \n\n Immigration Law \n\n There are vast areas of immigration law that are applicable to employment. The U.S. Citizenship and Immigration Service (USCIS) administers a range of different immigration programs that enable U.S. employers to employ foreign national workers. For example, under the EB-1 visa, U.S. employers can employ foreign nationals who have  extraordinary ability  for certain types of work. Under the terms of the Immigration Reform and Control Act (IRCA), employers are required to examine evidence of employees\u2019 identity and complete mandatory paperwork for each employee. There are serious financial and criminal penalties for employers who knowingly hire undocumented workers. \n 9.2   Labor Law \n\n Labor relations  is the general term used to describe the relationship between employers and employees, as well as governance of that relationship. It refers to the micro-level interactions that take place between workers and individual managers, as well as the macro-level relations that occur between the external institutions that are tasked with governing such relations. This understanding of labor relations acknowledges the fact that there is a plurality of interests that must be taken into account in the processes and procedures of negotiation, bargaining, and dispute settlement relating to the workplace. It also recognizes that employees and employers\u2019 representatives are fundamental to the process of industrial relations, and that the state plays a key role in the development of labor laws, the regulation of collective bargaining, and the administration of disputes. There has been considerable flux and development in the nature of U.S. labor over the past century. However, the most substantial changes have occurred since the 1950s. Changes have been particularly evident in the role that the state has been expected to play in employment relations between workers, their representatives, and their employers. This section introduces some of the key milestones in labor relations in the United States, and describes the role played by  trade unions  in governing the relationship between employers and employees. \n\n What Is a Trade Union? \n\n A trade union, or labor union, is an organized group of workers who come together to lobby employers about conditions affecting their work. There currently are around 60 unions representing 14 million workers across the United States. Unions are organized according to the type of work that workers do. For example, the American Federation of Teachers is the labor union for teaching personnel, while the the International Association of Fire Fighters covers fire fighters. Many unions in the United States are organized as  local unions . This type of union is a locally (i.e., company or region) based group of workers who organize under a charter from a national union. For example, Affiliated Property Craftspersons Local 44 is the Los Angeles union of entertainment professional craftpersons, chartered under the International Alliance of Theatrical Stage Employees. \n\n Timeline of Developments in Labor Law \n\n 1886.  The American Federation of Labor was formed in Columbus, Ohio. This group was a national federation of labor unions who came together to bolster their power in industrial unionism. The AFL was the largest union grouping in the United States well into the twentieth century. However, the Federation was craft-dominated, such that only craft workers like artisans and silversmiths were allowed to belong. \n\n 1932.  The Norris-LaGuardia Act was passed. This Act prohibited  yellow-dog contracts , or contracts that prevented workers from joining labor unions. In addition, federal courts were barred from issuing injunctions to prevent groups of workers from engaging in boycotts, strikes, and picketing. \n\n 1935.  The Congress of Industrial Organizations was established. This establishment extended the union movement because it allowed semi-skilled and unskilled workers to become members. \n\n 1935.  The Wagner Act, or  National Labor Relations Act , was passed. This Act is the major statute of United States labor law. The Act established that employees have the right to form, assist, and join labor organizations, to engage in collective bargaining with employers, and to engage in concerted activity to promote those rights. \n\n 1947.  The Labor-Management Relations Act, also known as the Taft-Hartley Act, imposed restrictions on the power of labor unions. It made changes to union election rules and outlined and provided remedies for six unfair practices by labor unions (see box below). \n\n 1959 . The Labor Management Reporting and Disclosure Act, or Landrum-Griffin Act, was passed, which regulates the internal affairs of trade unions, as well as their officials\u2019 relationships with employers. All union members are granted equal rights to vote for candidates, take part in membership meetings, and nominate candidates for office. \n\n 1988 . The Worker Adjustment and Retraining Notification (WARN) Act requires that employers with more than 100 employees give workers at least 60 days notice before engaging in layoffs or plant closings. \n\n          Amendments of the Taft\u00adHartley Act\n\n         \n\n          Description\n\n         \n\n        1\n\n       \n\n        Protects employees from unfair coercion by unions that could lead to discrimination against employees.\n\n       \n\n        2\n\n       \n\n        States that employers cannot refuse to hire prospective workers because they refuse to join a union. This amendment also grants the employer the right to sign an agreement with a union that requires the employee to join the union before the employee\u2019s 30th day of employment.\n\n       \n\n        3\n\n       \n\n        Unions must bargain in good faith with employers.\n\n       \n\n        4\n\n       \n\n        Prevents unions from engaging in secondary boycotts.\n\n       \n\n        5\n\n       \n\n        Prevents unions from taking advantage of either employers or members. For example, unions cannot charge members excessive membership dues or cause employers to pay for work that has not been performed.\n\n       \n\n        6\n\n       \n\n        Grants employers the right to free speech. Expressed opinions about labor issues do not constitute unfair labor practices, as long as the employer does not threaten to withhold benefits from, or engage in, retribution against the worker.\n\n       \n\n Table  9.3     \n\n The National Labor Relations Board \n\n The National Labor Relations Board (NLRB) was established to administer, interpret, and enforce the terms of the National Labor Relations Act. It has jurisdiction over all workers, except for government employees and employees in the transportation industry, who are governed under a separate statute (The Railway Labor Act). Other workers not covered by the NLRB include agricultural workers, confidential employees (employees who develop or present management\u2019s position or who have access to confidential information related to bargaining employees), independent contractors, and those employed by a spouse or a parent. The NLRB has three main functions: \n\n To monitor the conduct of unions and employers during elections to determine whether employees wish to be represented by a union \n\n To remedy and prevent unfair labor practices by unions or employers \n\n To establish rules interpreting the NLRA \n\n Organizing a Union \n\n For a union to be formed and organized, the union must identify an  appropriate bargaining unit.  This term is used to describe the group of workers that the union is looking to represent. Under the terms of the  inaccessibility exception,  employees and union officials have the right to engage in union solicitation on the firm\u2019s property if they cannot otherwise access employees to communicate with them. The next stage is to run an election. There are three types of elections: \n\n Consent election.  This election is held when there are not any substantial issues under dispute between the union and the employer. Both parties agree to waive the pre-election hearing. \n\n Contest election . This election is for a union that is contested by the employer. The NLRB is required to supervise this kind of election. \n\n A  decertification election  is held when employees indicate that they wish to vote out the union or join another. \n\n In order to try to bolster their power, elected unions often attempt to install a  union security agreement.  This agreement pertains to the extent to which the union can demand that employees join the union, and whether the employer will be required to collect fees and dues on behalf of the union. A  closed shop  is a workplace where union membership is a requirement for employment. A  union shop  is a place of employment where the employee is required to join the union within a specified number of days after being hired. An  agency shop  is a workplace that does not require the employee to join the union, but where agency fees to the union must be paid. Union security agreements are the outcome of collective bargaining agreements. \n\n Collective Bargaining \n\n Collective bargaining involves the union and the employer negotiating contract terms. The outcome is known as a  collective bargaining agreement.  The types of terms that are usually negotiated are wages and salaries, hours, and the terms and conditions of employment. If union members dispute working conditions, unfair labor practices, or economic benefits, they have the right to participate in a cessation of work activities, known as a  strike . There is a mandatory cooling off period of sixty days before a strike can commence. Some collective bargaining agreements include no-strike clauses. Although strikes are permitted according to the NRLA, some strikes are illegal: \n\n Violent strikes \n\n Sit-down strikes \n\n Wildcat (unauthorized) strikes \n\n Intermittent, or partial strikes \n\n In addition to striking, union members have the right to picket. This process involves walking in front of the employer\u2019s premises with signs that advertise the strike and the union\u2019s demands. Picketing is lawful as long as it does not: \n\n Involve violence \n\n Prevent customers from entering the premises \n\n Prevent non-striking workers from entering the premises \n\n Prevent the business from receiving deliveries or pickups \n\n Secondary boycott picketing  occurs when the union pickets the employer\u2019s customers or suppliers. This type of picketing is legal if it is product picketing, but illegal if the picket is directed against a neutral business. \n 9.3   Equal Opportunity in Employment \n\n A Landmark Case \n\n In 1982, the financial services company Price Waterhouse announced a vacancy for the position of partner. Ann Hopkins, an employee of the company at the time, applied, but after an assessment, was passed over. Hopkins sued the company, arguing that she had billed more than $34 million in consulting contracts for the firm, far more than any of the other 87 candidates, who were all male. In rejecting her application, the partners at the company argued that Hopkins was \u201ctoo macho\u201d and that she should \u201cwalk more femininely, talk more femininely, dress more femininely, wear makeup, have her hair styled and wear jewelry.\u201d In the landmark legal suit that followed, Hopkins was awarded $371,000 in back pay, and Price Waterhouse was forced to make her a partner. \n\n Laws Governing Equal Opportunity in Employment \n\n Employees are protected in the workplace by a number of laws enacted at both the federal and state levels. Federal laws are usually considered to be the minimum level of protection, and state laws can provide employees with more, but not less, protection. In this section, the major laws pertaining to equal opportunity are discussed. \n\n Civil Rights Act of 1964 \u2013 Title VII (Amended By the Civil Rights Act of 1991) \n\n The Civil Rights Act provides broad provisions pertaining to citizens\u2019 civil rights. Title VII of the Civil Rights Act deals with discrimination in employment. It bans employers from discriminating against employees in their hiring, firing, and promotion practices on the basis of sex, national origin, color, religion, or race. All employers who are engaged in commercial activity and who employ 15 or more employees for 20 consecutive weeks in a year are covered by the Act. The Act also sets out the two main ways in which discrimination can be proven: disparate treatment and disparate impact. \n\n Disparate treatment  means that the employee believes that he or she has been discriminated against on the basis of one of the protected classes set out in the CRA. Proving that the employer engaged in disparate treatment is a three-step process: \n\n The employee (plaintiff) is required to demonstrate a  prima facie  (accepted as correct unless proven otherwise) case of discrimination. \n\n The employer (defendant) must show legitimate, non-discriminatory business reasons for undertaking the action. \n\n The employee must demonstrate that the reason given by the employer is a mere pretext. \n\n A trier of fact, usually a jury, will use the evidence presented to determine whether discrimination did in fact occur. If the jury finds for the employee-plaintiff, damages can be awarded, such as what occurred in the landmark Ann Hopkins case, described in the opening box. If the jury finds for the employer-defendant, no damages are assessed. \n\n        Damages Permissible Under Title VII of the CRA\n\n       \n\n        Up to two years of back pay\n\n       \n\n        Compensatory damages\n\n       \n\n        Punitive damages\n\n       \n\n        Remedial seniority\n\n       \n\n        Costs (e.g., attorney fees and court costs)\n\n       \n\n        Court orders (e.g., reinstatement)\n\n       \n\n Table  9.4     \n\n Disparate impact  cases are cases of unintentional discrimination. This type of case occurs when the employer engages in a practice that has a disproportionately injurious impact on a protected class. Disparate impact cases are difficult to prove. The burden of responsibility is on the employee-plaintiff to statistically establish that the action impacts the protected class. The defendant can avoid liability by demonstrating that the practice is a business responsibility. The burden of proof then shifts to the employee to prove that the alleged business necessity is a mere pretext. These steps were established in  Griggs v. Duke Power Co.  Duke Power required all job applicants to have a high school diploma and to reach a certain minimum score on a professional intelligence test. Willie Griggs, the plaintiff, established that the rule was racially discriminatory because only 12 percent of black men in the state had high school diplomas (compared to 34 percent of white men), and only 6 percent of blacks had passed similar intelligence tests, compared to 58 percent of whites. Duke Power tried to argue that the provisions were necessary to upgrade the quality of the workforce, but the court did not agree that this defense was an adequate business-related justification, and the plaintiff was successful. Sexual harassment  is also protected under Title VII. This type of harassment is defined as unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature. Two types of sexual harassment are recognized.  Quid pro quo  occurs when a manager makes a sexual demand on a worker, and this demand is perceived as a condition of employment. Actions that create a  hostile work environment  are another type of sexual harassment. These issues have been used in cases of discrimination based on race and religion as well as sex. Since the 1997 case  Oncale v. Sundowner Offshore Services Inc. , it has been established that sexual harassment undertaken by a member of one sex against a member of the same sex is actionable under Title VII. In some limited circumstances, employers may also be liable for harassment of employees by non-employees, e.g., customers. The employer is liable if it does nothing to prevent and remedy harassment targeted at one of its employees. The  Pregnancy Discrimination Act  of 1987 expanded the definition of sex discrimination to include discrimination based on pregnancy, childbirth, or medical conditions related to the same. \n\n Defenses to Title VII Claims \n\n        Defense\n\n         \n\n          Description\n\n         \n\n        The Bona Fide Occupational Qualification Defense (BFOQ)\n\n       \n\n        Using this defense, the employer can discriminate if it is deemed to be necessary for the performance of the job. Necessity, however, must be determined on the basis of actual qualifications, rather than stereotypes about the abilities of a certain class. For example, an employer is not expected to hire a man as a model for women\u2019s clothes. Hires on the basis of sexual privacy are covered under BFOQ. However, there are no BFOQs for discrimination on the basis of race or color.\n\n       \n\n        The Merit Defense\n\n       \n\n        This defense is used when decisions pertaining to hiring or promotion are made on the basis of the results of test scores. However, tests must be validated in accordance with professional standards and must be manifestly related to job performance.\n\n       \n\n        The Seniority Defense System\n\n       \n\n        This defense system occurs when employees are given preferential treatment because of their length of tenure. As long as the system does not have its genesis in discrimination, and is not used to discriminate and applies to all persons equally, it is lawful.\n\n       \n\n Table  9.5     \n\n The Equal Pay Act \n\n The Equal Pay Act (EPA) is a United States federal law that seeks to equalize the salaries and wages paid to employed women with the levels paid to men for work of an equal nature and quantity. The Act amended the Fair Labor Standard Act of 1938 and was a key element of President F. Kennedy\u2019s New Frontier program. Under the terms of the EPA, women and men performing jobs that demand \u201cequal skill, effort, and responsibility, and which are performed under similar working conditions\u201d must be paid the same. The Act protects the rights of both sexes. An individual who seeks to establish a case under the Act must demonstrate that: \n\n An employer pays one sex more than another \n\n Both sexes perform an equal amount of work that demands equal levels of skill, effort and responsibility \n\n Working conditions for both sexes are equivalent \n\n An employer that is accused of discrimination under the EPA can present one of four  affirmative defenses . An employer may legally pay employees of one sex more than another sex if wages are based on a system of seniority, a system of merit, a system that distinguishes payment on the basis of quality and quantity of production (e.g., certain piece rates), or if payment is differentiated on \u201cany other factor other than sex.\u201d Of these four defenses, the \u201cfactor other than sex\u201d defense has been invoked most frequently and has been the subject of intense debate and controversy. Critics have argued that this defense enables employers to fabricate other reasons for the wage gap. \n\n Americans with Disabilities Act \n\n The Americans with Disabilities Act (ADA) prevents employers from discriminating against workers on the basis of their physical or mental disabilities. In addition, employers are required to make reasonable accommodations to known disabilities, as long as such accommodations do not impose an undue burden on the business. To bring a successful ADA claim, the plaintiff is required to demonstrate that he or she: \n\n Has a disability \n\n Suffered an adverse employment decision because of that disability \n\n Was otherwise qualified for the position \n\n ADA is enforced in a similar way to Title VII, and remedies for ADA violations are also similar. \n\n Age Discrimination Act \n\n Passed in 1967, this Act prohibits employers from making discriminatory employment decisions against people age 40 or older. This Act applies to all employers with 20 or more employees. ", "questions": [{"question": {"question_id": "fs-2123253156", "question_text": "Employers are required provide a work environment that is safe and healthy for their employees by which law?", "question_choices": ["FLSA.", "WCA.", "OSHA.", "FMLA."], "cloze_format": "To ___ is a possible remedy to buyers under the UCC.", "normal_format": "Which of the followings are possible remedies to buyers under the UCC?"}, "answer": {"ans_text": "OSHA.", "ans_choice": 2}, "bloom": null, "hl_sentences": "The Act established the Occupational Safety and Health Administration ( OSHA ) , which is a federal agency whose role is to \u201c assure safe and healthy working conditions for working men and women by setting and enforcing standards and by providing training , outreach , education and assistance . \u201d Private employers and federal government agencies are all covered under OSHA protection , although the self-employed and workers at state and local governments in most states are not covered .", "hl_context": "Workers have the right to be safe at work , and companies have responsibilities to employees in the event that they are harmed while undertaking work on behalf of the employer . The Occupational Safety and Health Act , passed in 1970 , is the main legislative action that governs health and safety in the workplace . <hl> The Act established the Occupational Safety and Health Administration ( OSHA ) , which is a federal agency whose role is to \u201c assure safe and healthy working conditions for working men and women by setting and enforcing standards and by providing training , outreach , education and assistance . \u201d Private employers and federal government agencies are all covered under OSHA protection , although the self-employed and workers at state and local governments in most states are not covered . <hl> OSHA has adopted thousands of regulations to enforce the Occupational Safety and Health Act . It imposes a number of record-keeping and reporting requirements on private employers . In addition , employers are required to inform employees of their health and safety rights by posting appropriate notices in the workplace ."}, {"question": {"question_id": "fs-21232531516", "question_text": "How many weeks of unpaid leave does the Family Medical Leave Act guarantee to eligible workers?", "question_choices": ["12.", "16.", "25.", "40."], "cloze_format": "The number of weeks of unpaid leave the Family Medical Leave Act guarantees to eligible workers is ___.", "normal_format": "How many weeks of unpaid leave does the Family Medical Leave Act guarantee to eligible workers?"}, "answer": {"ans_text": "a", "ans_choice": 0}, "bloom": null, "hl_sentences": "The Family and Medical Leave Act ( FMLA ) , enacted in 1993 , guarantees all eligible workers up to 12 weeks of unpaid leave during any 12 - month period for family and medical emergencies .", "hl_context": "<hl> The Family and Medical Leave Act ( FMLA ) , enacted in 1993 , guarantees all eligible workers up to 12 weeks of unpaid leave during any 12 - month period for family and medical emergencies . <hl> The FMLA applies to all public and private employers with 50 or more employees , covers employees who have worked for the employer for at least one year , and applies to employees who have worked at least 25 hours a week for each of 12 months prior to the leave . The events that qualify workers for leave are :"}, {"question": {"question_id": "fs-2123231516", "question_text": "What regulation protects employees who are terminated from their employment?", "question_choices": ["COBRA.", "ERISA.", "Unemployment Compensation.", "All of the above."], "cloze_format": "The regulation that protects employees who are terminated from their employment is ___.", "normal_format": "What regulation protects employees who are terminated from their employment?"}, "answer": {"ans_text": "Unemployment Compensation.", "ans_choice": 2}, "bloom": null, "hl_sentences": "Unemployment compensation programs are paid to those who become temporarily unemployed , and are funded by employers through employment taxes .", "hl_context": "<hl> Unemployment compensation programs are paid to those who become temporarily unemployed , and are funded by employers through employment taxes . <hl> Workers who quit voluntarily or who are terminated for bad conduct are not eligible for compensation . In addition , in order to qualify for the benefits , applicants must demonstrate that they are available for work ."}, {"question": {"question_id": "fs-21232315176", "question_text": "The Fair Labor Standards Act (FLSA) covers which category?", "question_choices": ["Child Labor.", "Minimum wage.", "Overtime pay.", "All of the above."], "cloze_format": "The Fair Labor Standards Act (FLSA) covers the category of ___.", "normal_format": "The Fair Labor Standards Act (FLSA) covers which category?"}, "answer": {"ans_text": "d", "ans_choice": 3}, "bloom": null, "hl_sentences": "Overtime pay requirements Minimum wage provisions Child labor The Fair Labor Standards Act ( FLSA ) sets out provisions that delineate fair labor and unfair labor . There are three main categories covered in the Act :", "hl_context": "<hl> Overtime pay requirements <hl> <hl> Minimum wage provisions <hl> <hl> Child labor <hl> <hl> The Fair Labor Standards Act ( FLSA ) sets out provisions that delineate fair labor and unfair labor . <hl> <hl> There are three main categories covered in the Act : <hl>"}, {"question": {"question_id": "fs-21232531560", "question_text": "What is the function of the National Labor Relations Board?", "question_choices": ["To monitor the conduct of the unions and employers during union elections.", "To remedy and prevent unfair labor practices by unions or employers.", "To establish rules interpreting the NLRA.", "All of the above."], "cloze_format": "The function of the National Labor Relations Board is ___ .", "normal_format": "What is the function of the National Labor Relations Board?"}, "answer": {"ans_text": "To establish rules interpreting the NLRA.", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "To establish rules interpreting the NLRA The National Labor Relations Board", "hl_context": "<hl> To establish rules interpreting the NLRA <hl> <hl> The National Labor Relations Board <hl>"}, {"question": {"question_id": "fs-212325325156", "question_text": "_____ is a place of employment where the employee is required to join the union within a specified number of days after being hired.", "question_choices": ["A closed shop.", "A union shop.", "An agency shop.", "A secure shop."], "cloze_format": "_____ is a place of employment where the employee is required to join the union within a specified number of days after being hired.", "normal_format": "What is a place of employment where the employee is required to join the union within a specified number of days after being hired?"}, "answer": {"ans_text": "b", "ans_choice": 1}, "bloom": null, "hl_sentences": "A union shop is a place of employment where the employee is required to join the union within a specified number of days after being hired .", "hl_context": "In order to try to bolster their power , elected unions often attempt to install a union security agreement . This agreement pertains to the extent to which the union can demand that employees join the union , and whether the employer will be required to collect fees and dues on behalf of the union . A closed shop is a workplace where union membership is a requirement for employment . <hl> A union shop is a place of employment where the employee is required to join the union within a specified number of days after being hired . <hl> An agency shop is a workplace that does not require the employee to join the union , but where agency fees to the union must be paid . Union security agreements are the outcome of collective bargaining agreements ."}, {"question": {"question_id": "fs-2123253251596", "question_text": "Which of the following practices are illegal?", "question_choices": ["Picketing.", "No strike clause.", "Sit-Down strike.", "A secure shop."], "cloze_format": "___ is an illegal practice.", "normal_format": "Which of the following practices are illegal?"}, "answer": {"ans_text": "Sit-Down strike.", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Sit-down strikes Although strikes are permitted according to the NRLA , some strikes are illegal :", "hl_context": "<hl> Sit-down strikes <hl> Collective bargaining involves the union and the employer negotiating contract terms . The outcome is known as a collective bargaining agreement . The types of terms that are usually negotiated are wages and salaries , hours , and the terms and conditions of employment . If union members dispute working conditions , unfair labor practices , or economic benefits , they have the right to participate in a cessation of work activities , known as a strike . There is a mandatory cooling off period of sixty days before a strike can commence . Some collective bargaining agreements include no-strike clauses . <hl> Although strikes are permitted according to the NRLA , some strikes are illegal : <hl>"}, {"question": {"question_id": "fs-212325318356", "question_text": "The following is valid defense under Title VII:", "question_choices": ["Quid Pro Quo.", "No Merit Defense.", "BFOQ", "All of the above."], "cloze_format": "___ is valid defense under Title VII.", "normal_format": "Which of the following is valid defense under Title VII?"}, "answer": {"ans_text": "c", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The Bona Fide Occupational Qualification Defense ( BFOQ ) Defenses to Title VII Claims", "hl_context": "<hl> The Bona Fide Occupational Qualification Defense ( BFOQ ) <hl> <hl> Defenses to Title VII Claims <hl>"}, {"question": {"question_id": "fs-2123215318356", "question_text": "To bring a successful claim under the Americans with Disability Act (\u201cADA\u201d), the plaintiff must prove all of the following except:", "question_choices": ["He or she suffered an adverse employment decision because of a disability.", "The disability was not a mental disability.", "He or she was qualified for a position.", "He or she has a disability."], "cloze_format": "To bring a successful claim under the Americans with Disability Act (\u201cADA\u201d), the plaintiff must prove all of the following except ___", "normal_format": "To bring a successful claim under the Americans with Disability Act (\u201cADA\u201d), the plaintiff must prove all of the following except:"}, "answer": {"ans_text": "The disability was not a mental disability.", "ans_choice": 1}, "bloom": null, "hl_sentences": "Was otherwise qualified for the position Suffered an adverse employment decision because of that disability Has a disability The Americans with Disabilities Act ( ADA ) prevents employers from discriminating against workers on the basis of their physical or mental disabilities . To bring a successful ADA claim , the plaintiff is required to demonstrate that he or she :", "hl_context": "<hl> Was otherwise qualified for the position <hl> <hl> Suffered an adverse employment decision because of that disability <hl> <hl> Has a disability <hl> <hl> The Americans with Disabilities Act ( ADA ) prevents employers from discriminating against workers on the basis of their physical or mental disabilities . <hl> In addition , employers are required to make reasonable accommodations to known disabilities , as long as such accommodations do not impose an undue burden on the business . <hl> To bring a successful ADA claim , the plaintiff is required to demonstrate that he or she : <hl>"}, {"question": {"question_id": "fs-2123215356", "question_text": "The Age Discrimination Act only applies to employers with 20 or more employees.", "question_choices": ["True.", "False."], "cloze_format": "It is ___ that the Age Discrimination Act only applies to employers with 20 or more employees.", "normal_format": "The Age Discrimination Act only applies to employers with 20 or more employees."}, "answer": {"ans_text": "a", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Passed in 1967 , this Act prohibits employers from making discriminatory employment decisions against people age 40 or older . This Act applies to all employers with 20 or more employees .", "hl_context": "<hl> Passed in 1967 , this Act prohibits employers from making discriminatory employment decisions against people age 40 or older . <hl> <hl> This Act applies to all employers with 20 or more employees . <hl>"}], "summary": "", "keyterm": "", "bname": "business_law_i_essentials"}, {"chapter": 17, "intro": "Learning Objectives 17.1   Power and Authority \n\n Define and differentiate between power and authority \n\n Identify and describe the three types of authority \n\n 17.2   Forms of Government \n\n Define common forms of government, such as monarchy, oligarchy, dictatorship, and democracy \n\n Compare common forms of government and identify real-life examples of each \n\n 17.3   Politics in the United States \n\n Explain the significance of \u201cone person, one vote\u201d in determining American policy \n\n Discuss how voter participation affects politics in the United States \n\n Explore the influence of race, gender, and class issues on the voting process \n\n 17.4   Theoretical Perspectives on Government and Power \n\n Understand how functionalists, conflict theorists, and interactionists view government and politics \n\n Introduction to Government and Politics \n\n Dubbed the \u201cwedding of the century\u201d by journalists, dignitaries, and commoners alike, the April 29, 2011, nuptials of Prince William and Catherine Middleton ignited a media frenzy months before the ceremony even took place. Thousands of journalists reported on the ceremony, and the  New York Times  estimated that 3 billion viewers watched the bride and groom exchange vows (Lyall 2011). In the weeks leading up to the event, speculation about the wedding was a frequent topic of conversation on televised news shows as well as in everyday conversation. When the morning of the wedding finally arrived, nearly a million British citizens lined its procession route to catch a glimpse of the royals making their way to the palace. \n\n The popularity of Will and Kate, the Duke and Duchess of Cambridge, did not diminish when the ceremony concluded. Competing tabloids began to feature headlines that proclaimed divorce, pregnancy, and other sensational events in the couple\u2019s life, while others focused on the particulars of Kate\u2019s hairstyles, dresses, and hats. Still other media focused their attention on the philanthropic endeavors of the duke and duchess, who frequently use their influence to promote charitable endeavors. \n\n Despite their appeal and link to a long-standing monarchy, William and Kate, along with the other British royals, do not enjoy the same power their predecessors commanded in history. Instead, their role is largely symbolic. While Henry VIII, for instance, had the authority to order executions and make important state decisions based on what some might consider personal whims, today\u2019s monarchs are more akin to celebrities who possess the wealth and fame to support their favorite causes. ", "chapter_text": "17.1   Power and Authority \n\n From the time of King Henry VIII to the time of Will and Kate, the role of the royal family in the British government has shifted dramatically. Between those two eras\u2014and across the Atlantic\u2014former British subjects in what is now the United States fought for an alternative system of government . . . one that left no room for royalty. Despite these differences, governments play the same fundamental role: in some fashion, they exert control over the people they govern. The nature of that control\u2014what we will define as power and authority\u2014is an important part of society. \n\n Sociologists have a distinctive approach to studying governmental power and authority that differs from the perspective of political scientists. For the most part, political scientists focus on studying how power is distributed in different types of political systems. They would observe, for example, that the United States\u2019 political system is divided into three distinct branches (legislative, executive, and judicial), and they would explore how public opinion affects political parties, elections, and the political process in general. Sociologists, however, tend to be more interested in the influences of governmental power on society and in how social conflicts arise from the distribution of power. Sociologists also examine how the use of power affects local, state, national, and global agendas, which in turn affect people differently based on status, class, and socioeconomic standing. \n\n What Is Power? \n\n For centuries, philosophers, politicians, and social scientists have explored and commented on the nature of power. Pittacus (c. 640-568 B.C.E.) opined, \u201cThe measure of a man is what he does with power,\u201d and Lord Acton perhaps more famously asserted, \u201cPower tends to corrupt; absolute power corrupts absolutely\u201d (1887). Indeed, the concept of power can have decidedly negative connotations, and the term itself is difficult to define. Many scholars adopt the definition developed by German sociologist Max Weber, who said that  power  is the ability to exercise one\u2019s will over others (Weber 1922). Power affects more than personal relationships; it shapes larger dynamics like social groups, professional organizations, and governments. Similarly, a government\u2019s power is not necessarily limited to control of its own citizens. A dominant nation, for instance, will often use its clout to influence or support other governments or to seize control of other nation states. Efforts by the U.S. government to wield power in other countries have included joining with other nations to form the Allied forces during World War II, entering Iraq in 2002 to topple Saddam Hussein\u2019s regime, and imposing sanctions on the government of North Korea in the hopes of constraining its development of nuclear weapons. Endeavors to gain power and influence do not necessarily lead to violence, exploitation, or abuse. Leaders such as Martin Luther King Jr. and Mohandas Gandhi, for example, commanded powerful movements that affected positive change without military force. Both men organized nonviolent protests to combat corruption and injustice and succeeded in inspiring major reform. They relied on a variety of nonviolent protest strategies such as rallies, sit-ins, marches, petitions, and boycotts. \n\n Modern technology has made such forms of nonviolent reform easier to implement. Today, protesters can use cell phones and the internet to disseminate information and plans to masses of protesters in a rapid and efficient manner. In Tunisia in 2011, for example, a nonviolent popular uprising led to the president\u2019s resignation, ushered in the end of one-party rule, and paved the way for efforts at reform. The success of the Tunisian uprising, broadcast worldwide via Twitter feeds and other social media, was an inspiration to political activists in other countries as well (a spread of demonstrations that the media called the \u201cArab Spring\u201d). Notice that, in this example, the users of power were the citizens rather than their governments. They found they had power because they were able to exercise their will over their own leader. Thus, government power does not necessarily equate with absolute power. \n\n Big Picture Did Facebook and Twitter  Cause  the Arab Spring? Recent movements and protests that were organized to reform governments and install democratic ideals in northern African and the Middle East have been collectively labeled \u201cArab Spring\u201d by journalists. In describing the dramatic reform and protests in these regions, journalists have noted the use of internet vehicles like Facebook, Twitter, and YouTube, some even implying that this technology has been instrumental in spurring these reforms. In a nation with a strong capacity for media censorship, social sites provided an opportunity for citizens to circumvent authoritarian restrictions (Zuckerman 2011). \n\n As discontents in northern Africa used the Internet to communicate, it provided them with an invaluable tool: anonymity. John Pollock (2011), in an authoritative analysis published in MIT\u2019s  Technology Review , gave readers an intriguing introduction to two transformative revolutionaries named \u201cFoetus\u201d and \u201cWaterman,\u201d who are leaders in the Tunisian rebel group Takriz. Both men relied heavily on the internet to communicate and even went so far as to call it the \u201cGPS\u201d for the revolution (Pollock 2011). Before the internet, meetings of protestors led by dissidents like Foetus and Waterman often required participants to assemble in person, placing them at risk of being raided by government officials. Thus, leaders would more likely have been jailed, tortured\u2014and perhaps even killed\u2014before movements could gain momentum. \n\n The Internet also enabled widespread publicity about the atrocities being committed in the Arab region. The fatal beating of Khaled Said, a young Egyptian computer programmer, provides a prime example. Said, who possessed videos highlighting acts of police corruption in Egypt, was brutally killed by law enforcement officers in the streets of Alexandria. After Said\u2019s beating, Said\u2019s brother used his cell phone to capture photos of his brother\u2019s grisly corpse and uploaded them to Facebook. The photos were then used to start a protest group called \u201cWe Are All Khaled Said,\u201d which now has more than a million members (Pollock 2011). Numerous other videos and images, similarly appalling, were posted on social media sites to build awareness and incite activism among local citizens and the larger global community. \n\n Types of Authority \n\n The protesters in Tunisia and the civil rights protesters of Martin Luther King\u2019s day had influence apart from their position in a government. Their influence came, in part, from their ability to advocate for what many people held as important values. Government leaders might have this kind of influence as well, but they also have the advantage of wielding power associated with their position in the government. As this example indicates, there is more than one type of authority in a community. \n\n Authority  refers to accepted power\u2014that is, power that people agree to follow. People listen to authority figures because they feel that these individuals are worthy of respect. Generally speaking, people perceive the objectives and demands of an authority figure as reasonable and beneficial, or true. \n\n A citizen\u2019s interaction with a police officer is a good example of how people react to authority in everyday life. For instance, a person who sees the flashing red and blue lights of a police car in his rearview mirror usually pulls to the side of the road without hesitation. Such a driver most likely assumes that the police officer behind him serves as a legitimate source of authority and has the right to pull him over. As part of her official duties, the police officer then has the power to issue a speeding ticket if the driver was driving too fast. If the same officer, however, were to command the driver to follow her home and mow her lawn, the driver would likely protest that the officer does not have the authority to make such a request. \n\n Not all authority figures are police officers or elected officials or government authorities. Besides formal offices, authority can arise from tradition and personal qualities. Economist and sociologist Max Weber realized this when he examined individual action as it relates to authority, as well as large-scale structures of authority and how they relate to a society\u2019s economy. Based on this work, Weber developed a classification system for authority. His three types of authority are traditional authority, charismatic authority and legal-rational authority (Weber 1922). \n\n Traditional \n\n Charismatic \n\n Legal-Rational \n\n Legitimized by long-standing custom \n\n Based on a leader\u2019s personal qualities \n\n Authority resides in the office, not the person \n\n Historic personality \n\n Dynamic personality \n\n Bureaucratic officials \n\n Patriarchy (traditional positions of authority) \n\n Napoleon, Jesus Christ, Mother Teresa, Martin Luther King, Jr. \n\n U.S. presidency and Congress \n\nModern British Parliament \n\n Table  17.1   Weber\u2019s Three Types of Authority   Max Weber identified and explained three distinct types of authority: Traditional Authority \n\n According to Weber, the power of  traditional authority  is accepted because that has traditionally been the case; its legitimacy exists because it has been accepted for a long time. Britain\u2019s Queen Elizabeth, for instance, occupies a position that she inherited based on the traditional rules of succession for the monarchy. People adhere to traditional authority because they are invested in the past and feel obligated to perpetuate it. In this type of authority, a ruler typically has no real force to carry out his will or maintain his position but depends primarily on a group\u2019s respect. \n\n A more modern form of traditional authority is  patrimonialism , which is traditional domination that is facilitated by an administration and military that are purely personal instruments of the master (Eisenberg 1998). In this form of authority, all officials are personal favorites appointed by the ruler. These officials have no rights, and their privileges can be withdrawn or augmented based on the caprices of the leader. The political organization of ancient Egypt typified such a system: when the royal household decreed that a pyramid be built, every Egyptian was forced to work toward its construction. \n\n Traditional authority can be intertwined with race, class, and gender. In most societies, for instance, men are more likely to be privileged than women and thus are more likely to hold roles of authority. Similarly, members of dominant racial groups or upper-class families also win respect more readily. In the United States, the Kennedy family, which has spawned many prominent politicians, exemplifies this model. \n\n Charismatic Authority \n\n The power of  charismatic authority  is accepted because followers are drawn to the leader\u2019s personal qualities. The appeal of a charismatic leader can be extraordinary, inspiring followers to make unusual sacrifices or to persevere in the midst of great hardship and persecution. Charismatic leaders usually emerge in times of crisis and offer innovative or radical solutions. They may even offer a vision of a new world order. Hitler\u2019s rise to power in the postwar economic depression of Germany is an example. \n\n Charismatic leaders tend to hold power for short durations, and according to Weber, they are just as likely to be tyrannical as they are heroic. Diverse male leaders such as Hitler, Napoleon, Jesus Christ, C\u00e9sar Ch\u00e1vez, Malcolm X, and Winston Churchill are all considered charismatic leaders. Because so few women have held dynamic positions of leadership throughout history, the list of charismatic female leaders is comparatively short. Many historians consider figures such as Joan of Arc, Margaret Thatcher, and Mother Teresa to be charismatic leaders. \n\n Rational-Legal Authority \n\n According to Weber, power made legitimate by laws, written rules, and regulations is termed  rational-legal authority . In this type of authority, power is vested in a particular rationale, system, or ideology and not necessarily in the person implementing the specifics of that doctrine. A nation that follows a constitution is applying this type of authority. On a smaller scale, you might encounter rational-legal authority in the workplace via the standards set forth in the employee handbook, which provides a different type of authority than that of your boss.  \n\n Of course, ideals are seldom replicated in the real world. Few governments or leaders can be neatly categorized. Some leaders, like Mohandas K. Gandhi for instance, can be considered charismatic  and  legal-rational authority figures. Similarly, a leader or government can start out exemplifying one type of authority and gradually evolve or change into another type. \n17.2   Forms of Government \n\n Most people generally agree that  anarchy , or the absence of organized government, does not facilitate a desirable living environment for society, but it is much harder for individuals to agree upon the particulars of how a population should be governed. Throughout history, various forms of government have evolved to suit the needs of changing populations and mindsets, each with pros and cons. Today, members of Western society hold that democracy is the most just and stable form of government, although former British Prime Minister Winston Churchill once declared to the House of Commons, \u201cIndeed it has been said that democracy is the worst form of government except for all those other forms that have been tried from time to time\u201d (Shapiro 2006). \n\n Monarchy \n\n Even though people in the United States tend to be most aware of Great Britain\u2019s royals, many other nations also recognize kings, queens, princes, princesses, and other figures with official royal titles. From one country to another, the power held by these positions varies. Strictly speaking, a  monarchy  is a government in which a single person (a monarch) rules until that individual dies or abdicates the throne. Usually, a monarch claims the rights to title by way of hereditary succession or as a result of some sort of divine appointment or calling. As mentioned previously, the monarchies of most modern nations are ceremonial remnants of tradition, and individuals who hold titles in such sovereignties are often aristocratic figureheads. \n\n A few nations today, however, are run by governments wherein a monarch has absolute or unmitigated power. Such nations are called  absolute monarchies . Although governments and regimes are constantly changing across the global landscape, it is generally safe to say that most modern absolute monarchies are concentrated in the Middle East and Africa. The small, oil-rich nation of Oman, for instance, is an example of an absolute monarchy. In this nation, Sultan Qaboos bin Said Al Said has ruled since the 1970s. Recently, living conditions and opportunities for Oman\u2019s citizens have improved, but many citizens who live under the reign of an absolute ruler must contend with oppressive or unfair policies that are installed based on the unchecked whims or political agendas of that leader. \n\n In today\u2019s global political climate, monarchies far more often take the form of  constitutional monarchies , governments of nations that recognize monarchs but require these figures to abide by the laws of a greater constitution. Many countries that are now constitutional monarchies evolved from governments that were once considered absolute monarchies. In most cases, constitutional monarchies, such as Great Britain and Canada, feature elected prime ministers whose leadership role is far more involved and significant than that of its titled monarchs. In spite of their limited authority, monarchs endure in such governments because people enjoy their ceremonial significance and the pageantry of their rites. \n\n Oligarchy \n\n The power in an  oligarchy  is held by a small, elite group. Unlike in a monarchy, members of an oligarchy do not necessarily achieve their status based on ties to noble ancestry. Rather, they may ascend to positions of power because of military might, economic power, or similar circumstances. \n\n The concept of oligarchy is somewhat elusive; rarely does a society openly define itself as an oligarchy. Generally, the word carries negative connotations and conjures notions of a corrupt group whose members make unfair policy decisions in order to maintain their privileged positions. Many modern nations that claim to be democracies are really oligarchies. In fact, some prominent journalists have labeled the United States an oligarchy, pointing to the influence of large corporations and Wall Street executives on American policy (Krugman 2011). Other political analysts assert that all democracies are really just \u201celected oligarchies,\u201d or systems in which citizens must vote for an individual who is part of a pool of candidates who come from the society\u2019s elite ruling class (Winters 2011).  \n\n Oligarchies have existed throughout history, and today many consider Russia an example of oligarchic political structure. After the fall of communism, groups of business owners captured control of this nation\u2019s natural resources and have used the opportunity to expand their wealth and political influence. Once an oligarchic power structure is established, it can be very difficult for middle- and lower-class citizens to advance their socioeconomic status. \n\n Is the United States an Oligarchy? \n\n During the famed Gilded Age of American history, prominent socialite Mrs. Stuyvesant Fish organized and hosted a lavish dinner party in honor of her pampered dog, who arrived at the function sporting a $15,000 diamond collar (PBS Online 1999). Such absurd luxuries were fairly commonplace among the ultra-rich during this era of American history, which saw the rise and dominance of such families as the Vanderbilts, Rockefellers, and Carnegies. As the super-rich reveled in their wealth, however, most Americans scraped by, living below what was considered the poverty level. \n\n Interestingly, some scholars now believe that the United States has embarked on a second Gilded Age and have offered hard data to back up their assertions. Such camps point to the fact that the \u201c400 wealthiest American families now own more than the \u2018lower\u2019 150 million Americans put together\u201d (Schulz 2011). Much of this current generation\u2019s wealth is concentrated among corporate executives and Wall Street tycoons. \n\n Many of the super-rich use their economic clout to purchase more than luxury items. Specifically, wealthy individuals and corporations are major political donors. Because their campaign contributions have the potential to influence policy decisions and the election of candidates, the economic power of this segment of society is used for acquiring political power. As this dynamic continues, it supports the view that the concentration of wealth in the United States has contributed to making it like an oligarchy (Krugman 2011). \n\n These patterns of wealth distribution and political contributions have spurred lively debate in recent years. Some see great wealth as a fair reward for hard work and talent, believing that political contributions are part of free expression in a democratic society. Others maintain that the concentration of wealth is a signal that too many people\u2019s economic opportunities are limited. Another concern is that lack of equal power in making monetary donations will translate into an uneven distribution of political power\u2014a situation that raises questions of the fairness of a \u201crepresentational\u201d system. These viewpoints underlay many of the recent political debates about tax policy, campaign finance reform, and government budgets in the United States. \n\n Dictatorship \n\n Power in a  dictatorship  is held by a single person (or a very small group) that wields complete and absolute authority over a government or populace after the dictator rises to power, usually through economic or military might. Similar to many absolute monarchies, dictatorships may often be corrupt and seek to limit and even eradicate the liberties of the general population. Many dictators start out as military leaders and are more conditioned to violence if they face opposition than non-military figureheads. \n\n Dictators use a variety of means to perpetuate their authority. Intimidation and brutality are often foremost among their tactics; individuals are not likely to rebel against a regime if they know they will be hurt. Some dictators also possess the personal appeal that Max Weber identified with a charismatic leader. Subjects of such a dictator may believe that the leader has special ability or authority and may be willing to submit to his or her authority. Popular images of the late Kim Jong-Il, as well as his successor, Kim Jong-Un, exemplify this type of charismatic dictatorship. \n\n Many dictatorships do not align themselves strictly with any particular belief system or ideology; the goal of this type of regime is usually limited to preserving the authority of the dictator at its helm. The  totalitarian dictatorship  describes a more ambitious and oppressive style of dictatorship that attempts to control all aspects of its subjects\u2019 lives. Communist regimes, for instance, are often totalitarian in nature. They may attempt to regulate how many children citizens bear, what religious beliefs they hold, and so forth. They may also demand that citizens publicly demonstrate their faith in the regime by participating in public marches and demonstrations. \n\n Some \u201cbenevolent\u201d dictators, such as Napoleon and Anwar Sadat, are credited with advancing their people or exercising a modest level of evenhandedness, but many end up grossly abusing their power. Joseph Stalin, Adolf Hitler, Kim Jong-Il, Saddam Hussein, and Zimbabwe\u2019s Robert Mugabe, for instance, are heads of state who earned a reputation for leading through fear and intimidation. Hitler, for example, is responsible for the genocide of millions of Jews and other groups, while Mugabe has been accused of ruthless land acquisition. \n\n Democracy \n\n A  democracy  is a form of government that strives to provide all citizens with an equal voice, or vote, in determining state policy, regardless of their level of socioeconomic status. Another important fundamental of the democratic state is the establishment and governance of a just and comprehensive constitution that delineates the roles and responsibilities of leaders and citizens alike. \n\n Democracies, in general, assure certain basic rights to their citizens. First and foremost, citizens are free to organize political parties and hold elections. Leaders, once elected, must abide by the terms of the given nation\u2019s constitution and are limited in the powers they can exercise, as well as in the length of the duration of their terms. Most democratic societies also champion freedom of individual speech, the press, and assembly, and they prohibit unlawful imprisonment. Of course, even in a democratic society, the government constrains citizens from total freedom to act however they wish. A democratically elected government does this by passing laws and writing regulations that, at least ideally, reflect the will of the majority of its people. \n\n Although the United States champions the democratic ideology, it is not a \u201cpure\u201d democracy. In a purely democratic society, all citizens would vote on all proposed legislation, and this is not how laws are passed in the United States. There is a practical reason for this: a pure democracy would be hard to implement. Thus, the United States is a constitution-based federal republic in which citizens elect representatives to make policy decisions on their behalf. The term  representative democracy , which is virtually synonymous with  republic , can also be used to describe a government in which citizens elect representatives to promote policies that favor their interests. In the United States, representatives are elected at local and state levels, and the votes of the Electoral College determine who will hold the office of president. Each of the three branches of the United States government\u2014the executive, judicial, and legislative\u2014is held in check by the other branches. \n17.3   Politics in the United States \n\n In describing a nation\u2019s politics, it\u2019s important to define the term. Some associate \u201cpolitics\u201d with power, others with freedom. Some with corruption, others with rhetoric. How do sociologists understand politics? To sociologists,  politics  is a means of studying a nation or group\u2019s underlying social norms and values. A group\u2019s political structure and practices provide insight into its distribution of power and wealth, as well as its larger philosophical and cultural beliefs. A cursory sociological analysis of U.S. politics might, for instance, suggest that Americans\u2019 desire to promote equality and democracy on a theoretical level is at odds with the nation\u2019s real-life capitalist orientation. \n\n The famous phrase \u201cby the people, for the people\u201d is at the heart of American politics and sums up the most essential part of this nation\u2019s political system: the notion that citizens willingly and freely elect representatives they believe will look out for their interests. Although many Americans take for granted the right of citizens to hold free elections, it is a vital foundation of any democracy. However, at the time the U.S. government was formed, African Americans and women were denied voting privileges. History details the struggles that each of these minority groups undertook to secure rights that had been granted to their white male counterparts. Nevertheless, their history (and the earlier history of the struggle for American independence from British rule) has failed to inspire some Americans to show up at the polls or even to register to vote. \n\n Naturally, citizens must participate in the democratic process in order for their voices to be heard. Sociologists understand voting to be at the heart of the U.S. political process because it is a fundamental political behavior in a democracy. Problems with the democratic process, which include more than limited voter turnout, require us to more closely examine complex social issues. \n\n Voter Participation \n\n Voter participation is essential to the success of the American political system. Although many Americans are quick to complain about laws and political leadership, roughly half of the population does not vote in any given election year (United States Elections Project 2010). Some years have seen even lower turnouts; in 2010, for instance, only 37.8 percent of the population participated in the electoral process (United States Elections Project 2011). Poor turnout can skew election results, particularly if one age or socioeconomic group is more diligent in its efforts to make it to the polls. \n\n Certain voting advocacy groups work to improve turnout. Rock the Vote, for example, targets and reaches out to America\u2019s youngest potential voters to educate and equip them to share their voice at the polls. Public service promos from celebrity musicians support their cause. Native Vote is an organization that strives to inform American Indians about upcoming elections and encourages their participation. America\u2019s Hispanic population is reached out to by the National Council of La Raza, which strives to improve voter turnout among the Latino population. According to the Pew Research Center, the portion of minority race voters has been increasing steadily over the past few decades (Lopez and Taylor 2009). Race, Gender, and Class Issues \n\n Although recent records have shown more minorities voting now than ever before, this trend is still fairly new. Historically, African Americans and other minorities have been underrepresented at the polls. Black men were not allowed to vote at all until after the Civil War, and black women gained the right to vote along with other women only with the ratification of the Nineteenth Amendment in 1920. For years, African Americans who were brave enough to vote were discouraged by discriminatory legislation, passed in many southern states, which required poll taxes and literacy tests of prospective voters. Literacy tests were not outlawed until 1965, when President Lyndon Johnson signed the Voting Rights Act. \n\n The 1960s saw other important reforms in U.S. voting. Shortly before the Voting Rights Act was passed, the 1964 U.S. Supreme Court case  Reynolds v. Sims  changed the nature of elections. This landmark decision reaffirmed the notion of \u201c one person, one vote ,\u201d a concept holding that each person\u2019s vote should be counted equally. Before this decision, unequal distributions of population enabled small groups of people in sparsely populated rural areas to have as much voting power as densely populated urban areas. After  Reynolds v. Sims , districts were redrawn so that they would include equal numbers of voters. \n\n Evidence suggests that legal protection of voting rights does not directly translate into equal voting power. Relative to their presence in the U.S. population, women and racial/ethnic minorities are underrepresented in the U.S. Congress. White males still dominate both houses. For example, there is only a single Native American legislator currently in Congress. And until the inauguration of Barack Obama in 2009, all U.S. presidents were white men. \n\n Like race and ethnicity, social class also has impacted voting practices. Voting rates among lower-educated, lower-paid workers are less than for people with higher socioeconomic status, fostering a system in which people with more power and access to resources have the means to perpetuate their power. Several explanations have been offered to account for this difference (Raymond 2010). Workers in low-paying service jobs might find it harder to get to the polls because they lack flexibility in their work hours and quality daycare to look after children while they vote. Because a larger share of racial and ethnic minorities is employed in such positions, social class may be linked to race and ethnicity in influencing voting rates. Attitudes play a role as well. Some people of low socioeconomic status or minority race/ethnicity doubt their vote will count or voice will be heard because they have seen no evidence of their political power in their communities. Many believe that what they already have is all they can achieve. \n\n In the American democracy, there are means to power and voice aside from holding political office. As suggested earlier in the discussion on oligarchy, money can carry a lot of influence. Free speech, a right available to all, can also be an influence. People can participate in a democracy through volunteering time toward political advocacy, writing to their elected officials, or sharing views in public forums like blogs or letters to the editor, forming or joining cause-related political organizations like PACs (political action committees) and interest groups, participating in public demonstrations, and even running for local office. \n17.4   Theoretical Perspectives on Government and Power \n\n Sociologists rely on organizational frameworks or paradigms to make sense of their study of sociology; already there are many widely recognized schemas for evaluating sociological data and observations. Each paradigm looks at the study of sociology through a unique lens. The sociological examination of government and power can thus be evaluated using a variety of perspectives that help the evaluator gain a broader perspective. Functionalism, conflict theory, and symbolic interactionism are a few of the more widely recognized philosophical stances in practice today. \n\n Functionalism \n\n According to functionalism, the government has four main purposes: planning and directing society, meeting social needs, maintaining law and order, and managing international relations. According to functionalism, all aspects of society serve a purpose. \n\n Functionalists view government and politics as a way to enforce norms and regulate conflict. Functionalists see active social change, such as the sit-in on Wall Street, as undesirable because it forces change and, as a result, undesirable things that might have to be compensated for. Functionalists seek consensus and order in society. Dysfunction creates social problems that lead to social change. For instance, functionalists would see monetary political contributions as a way of keeping people connected to the democratic process. This would be in opposition to a conflict theorist who would see this financial contribution as a way for the rich to perpetuate their own wealth. \n\n Conflict Theory \n\n Philosopher and social scientist Karl Marx was a seminal force in developing the conflict theory perspective. He was a proponent of conflict, in general, because he felt that it was the only means of promoting positive change for the underprivileged. Marx did not agree with Durkheim\u2019s notions of cooperation and interdependence; he instead saw society as a stage for exploitation and strife. \n\n G. William Domhoff, a contemporary sociologist, is a modern-day proponent of Marx\u2019s theories and has written numerous commentaries on the existence of a modern-day power elite in American society. Domhoff (2011) has devoted a considerable amount of energy to his effort of pointing out the power elite\u2019s influence on policy and society in general. \n\n Domhoff\u2019s 1967 publication  Who Rules America?  established his reputation as controversial and bold social scientist. Drawing on powerful ideas already explored by Mills and Marx, Domhoff pointed out uncomfortable realities about the American political and social systems. Today Domhoff is still a vocal participant in the field of sociology, publishing current books, teaching in the University of California system, and maintaining a website that offers a sampling of his professional work and studies on topics related to sociology. \n\n Domhoff\u2019s research helped to popularize the concept of the power elite. His theories describe the members of the power elite maintaining their position by collectively following the same social patterns, such as vacationing at a handful of destinations, joining elite clubs, and attending select schools. He also pointed out that the existence of a power elite stands in contrast to an important American ideal: that all Americans have a voice in their government. Domhoff acknowledges that all Americans can potentially exert political influence, but he asserts that our current social and political systems make it easier for the wealthiest citizens to shape policy. \n\n Conflict Theory in Action \n\n Even before there were modern nation-states, political conflicts arose among competing societies or factions of people. Vikings attacked continental European tribes in search of loot, and, later, European explorers landed on foreign shores to claim the resources of indigenous groups. Conflicts also arose among competing groups within individual sovereignties, as evidenced by the bloody French Revolution. Nearly all conflicts in the past and present, however, are spurred by basic desires: the drive to protect or gain territory and wealth, and the need to preserve liberty and autonomy. \n\n According to sociologist and philosopher Karl Marx, such conflicts are necessary, albeit ugly, steps toward a more egalitarian society. Marx saw a historical pattern in which revolutionaries toppled elite power structures, after which wealth and authority were more evenly dispersed among the population, and the overall social order advances. In this pattern of change through conflict, people tend to gain greater personal freedom and economic stability (1848). \n\n Modern-day life is not without a multitude of political conflicts: discontents in Egypt overthrow dictator Hosni Mubarak, disenchanted American Tea Partiers call for government realignment, and Occupy Wall Street protesters decry corporate greed. Indeed, the study of any given conflict offers a window of insight into the social structure of its surrounding culture, as well as insight into the larger human condition \n\n Many current American conflicts are concentrated internally. The United States the government, for instance, has almost shut down because Republicans and Democrats could not agree on budget issues. This conflict continues to be at the center of American politics. Similarly, over the last few years the philosophical differences between the Democratic and Republican parties have remained on the forefront. Frustration with the traditional two-party system helped to spawn the formation of the Tea Party, a grassroots movement with a strong conservative and libertarian bent. \n\n Symbolic Interactionism \n\n Other sociologists study government and power by relying on the framework of symbolic interactionism, which is grounded in the works of Max Weber and George H. Mead. \n\n Symbolic interactionism, as it pertains to government, focuses its attention on figures, emblems, or individuals that represent power and authority. Many diverse entities in larger society can be considered symbolic: trees, doves, wedding rings. Images that represent the power and authority of the United States include the White House, the eagle, and the American flag. The Seal of the President of the United States, along with the office in general incites respect and reverence in many Americans. \n\n Symbolic interactionists are not interested in large structures such as the government. As micro-sociologists, they are more interested in the face-to-face aspects of politics. In reality, much of politics consists of face-to-face backroom meetings and lobbyist efforts. What the public often sees is the front porch of politics that is sanitized by the media through gatekeeping. \n\n Symbolic interactionists are most interested in the interaction between these small groups who make decisions, or in the case of some recent congressional committees, demonstrate the inability to make any decisions at all. The heart of politics is the result of interaction between individuals and small groups over periods of time. These meetings produce new meanings and perspectives that individuals use to make sure there are future interactions. ", "questions": [{"question": {"question_id": "fs-id1366727", "question_text": "Which statement best expresses the difference between power and authority?", "question_choices": ["Authority involves intimidation.", "Authority is more subtle than power.", "Authority is based on the perceived legitimacy of the individual in power.", "Authority is inherited, but power is seized by military force."], "cloze_format": "___ is the statement that best expresses the difference between power and authority.", "normal_format": "Which statement best expresses the difference between power and authority?"}, "answer": {"ans_text": "Authority is based on the perceived legitimacy of the individual in power.", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Authority refers to accepted power \u2014 that is , power that people agree to follow . People listen to authority figures because they feel that these individuals are worthy of respect .", "hl_context": "<hl> Authority refers to accepted power \u2014 that is , power that people agree to follow . <hl> <hl> People listen to authority figures because they feel that these individuals are worthy of respect . <hl> Generally speaking , people perceive the objectives and demands of an authority figure as reasonable and beneficial , or true ."}, {"question": {"question_id": "fs-id3025239", "question_text": "Malcolm X used his public speaking abilities and magnetism to inspire African Americans to stand up against injustice in an extremely hostile environment. He is an example of a(n) __________ leader.", "question_choices": ["traditional", "charismatic", "legal-rational", "illegitimate"], "cloze_format": "Malcolm X used his public speaking abilities and magnetism to inspire African Americans to stand up against injustice in an extremely hostile environment. He is an example of a(n) __________ leader.", "normal_format": "Malcolm X used his public speaking abilities and magnetism to inspire African Americans to stand up against injustice in an extremely hostile environment. Of which leader is he an example?"}, "answer": {"ans_text": "charismatic", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Charismatic leaders tend to hold power for short durations , and according to Weber , they are just as likely to be tyrannical as they are heroic . Diverse male leaders such as Hitler , Napoleon , Jesus Christ , C\u00e9sar Ch\u00e1vez , Malcolm X , and Winston Churchill are all considered charismatic leaders .", "hl_context": "<hl> Charismatic leaders tend to hold power for short durations , and according to Weber , they are just as likely to be tyrannical as they are heroic . <hl> <hl> Diverse male leaders such as Hitler , Napoleon , Jesus Christ , C\u00e9sar Ch\u00e1vez , Malcolm X , and Winston Churchill are all considered charismatic leaders . <hl> Because so few women have held dynamic positions of leadership throughout history , the list of charismatic female leaders is comparatively short . Many historians consider figures such as Joan of Arc , Margaret Thatcher , and Mother Teresa to be charismatic leaders ."}, {"question": {"question_id": "fs-id1947604", "question_text": "Which current world figure has the least amount of political power?", "question_choices": ["President Barack Obama", "Queen Elizabeth II", "British Prime Minister David Cameron", "North Korean leader Kim Jong-Un"], "cloze_format": "The current world figure that has the least amount of political power is ___.", "normal_format": "Which current world figure has the least amount of political power?"}, "answer": {"ans_text": "Queen Elizabeth II", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "Britain \u2019 s Queen Elizabeth , for instance , occupies a position that she inherited based on the traditional rules of succession for the monarchy . In this type of authority , a ruler typically has no real force to carry out his will or maintain his position but depends primarily on a group \u2019 s respect .", "hl_context": "According to Weber , the power of traditional authority is accepted because that has traditionally been the case ; its legitimacy exists because it has been accepted for a long time . <hl> Britain \u2019 s Queen Elizabeth , for instance , occupies a position that she inherited based on the traditional rules of succession for the monarchy . <hl> People adhere to traditional authority because they are invested in the past and feel obligated to perpetuate it . <hl> In this type of authority , a ruler typically has no real force to carry out his will or maintain his position but depends primarily on a group \u2019 s respect . <hl>"}, {"question": {"question_id": "fs-id1306686", "question_text": "Which statement best expresses why there have been so few charismatic female leaders throughout history?", "question_choices": ["Women have different leadership styles than men.", "Women are not interested in leading at all.", "Few women have had the opportunity to hold leadership roles over the courseof history.", "Male historians have refused to acknowledge the contributions of femaleleaders in their records."], "cloze_format": "The best explanation of racism as a social fact is that ___ .", "normal_format": "Which of the following is the best explanation of racism as a social fact?"}, "answer": {"ans_text": "Few women have had the opportunity to hold leadership roles over the courseof history.", "ans_choice": 2}, "bloom": "4", "hl_sentences": "Charismatic leaders tend to hold power for short durations , and according to Weber , they are just as likely to be tyrannical as they are heroic . Because so few women have held dynamic positions of leadership throughout history , the list of charismatic female leaders is comparatively short .", "hl_context": "<hl> Charismatic leaders tend to hold power for short durations , and according to Weber , they are just as likely to be tyrannical as they are heroic . <hl> Diverse male leaders such as Hitler , Napoleon , Jesus Christ , C\u00e9sar Ch\u00e1vez , Malcolm X , and Winston Churchill are all considered charismatic leaders . <hl> Because so few women have held dynamic positions of leadership throughout history , the list of charismatic female leaders is comparatively short . <hl> Many historians consider figures such as Joan of Arc , Margaret Thatcher , and Mother Teresa to be charismatic leaders ."}, {"question": {"question_id": "fs-id1384484", "question_text": "Many constitutional monarchies started out as:", "question_choices": ["oligarchies", "absolute monarchies", "dictatorships", "democracies"], "cloze_format": "Many constitutional monarchies started out as ___.", "normal_format": "What did many constitutional monarchies begin as?"}, "answer": {"ans_text": "absolute monarchies", "ans_choice": 1}, "bloom": "1", "hl_sentences": "Many countries that are now constitutional monarchies evolved from governments that were once considered absolute monarchies .", "hl_context": "In today \u2019 s global political climate , monarchies far more often take the form of constitutional monarchies , governments of nations that recognize monarchs but require these figures to abide by the laws of a greater constitution . <hl> Many countries that are now constitutional monarchies evolved from governments that were once considered absolute monarchies . <hl> In most cases , constitutional monarchies , such as Great Britain and Canada , feature elected prime ministers whose leadership role is far more involved and significant than that of its titled monarchs . In spite of their limited authority , monarchs endure in such governments because people enjoy their ceremonial significance and the pageantry of their rites ."}, {"question": {"question_id": "fs-id3654460", "question_text": "Which nation is an absolute monarchy?", "question_choices": ["Oman", "Great Britain", "Denmark", "Australia"], "cloze_format": "___ is a nation that is an absolute monarchy.", "normal_format": "Which nation is an absolute monarchy?"}, "answer": {"ans_text": "Oman", "ans_choice": 0}, "bloom": "1", "hl_sentences": "Although governments and regimes are constantly changing across the global landscape , it is generally safe to say that most modern absolute monarchies are concentrated in the Middle East and Africa . The small , oil-rich nation of Oman , for instance , is an example of an absolute monarchy .", "hl_context": "A few nations today , however , are run by governments wherein a monarch has absolute or unmitigated power . Such nations are called absolute monarchies . <hl> Although governments and regimes are constantly changing across the global landscape , it is generally safe to say that most modern absolute monarchies are concentrated in the Middle East and Africa . <hl> <hl> The small , oil-rich nation of Oman , for instance , is an example of an absolute monarchy . <hl> In this nation , Sultan Qaboos bin Said Al Said has ruled since the 1970s . Recently , living conditions and opportunities for Oman \u2019 s citizens have improved , but many citizens who live under the reign of an absolute ruler must contend with oppressive or unfair policies that are installed based on the unchecked whims or political agendas of that leader ."}, {"question": {"question_id": "fs-id2109896", "question_text": "Which of the following present and former government leaders is generally considered a dictator?", "question_choices": ["David Cameron", "Barack Obama", "Qaboos bin Said Al Said", "Kim Jong-Un"], "cloze_format": "A present or former government leader that is generally considered a dictator is ___ .", "normal_format": "Which of the following present and former government leaders is generally considered a dictator?"}, "answer": {"ans_text": "Kim Jong-Un", "ans_choice": 3}, "bloom": "1", "hl_sentences": "Dictators use a variety of means to perpetuate their authority . Popular images of the late Kim Jong-Il , as well as his successor , Kim Jong-Un , exemplify this type of charismatic dictatorship .", "hl_context": "<hl> Dictators use a variety of means to perpetuate their authority . <hl> Intimidation and brutality are often foremost among their tactics ; individuals are not likely to rebel against a regime if they know they will be hurt . Some dictators also possess the personal appeal that Max Weber identified with a charismatic leader . Subjects of such a dictator may believe that the leader has special ability or authority and may be willing to submit to his or her authority . <hl> Popular images of the late Kim Jong-Il , as well as his successor , Kim Jong-Un , exemplify this type of charismatic dictatorship . <hl>"}, {"question": {"question_id": "fs-id2879285", "question_text": "A(n) _________________ is an extremely oppressive government that seeks to control all aspects of its citizens\u2019 lives.", "question_choices": ["oligarchy", "totalitarian dictatorship", "anarchy", "absolute monarchy"], "cloze_format": "A(n) _________________ is an extremely oppressive government that seeks to control all aspects of its citizens\u2019 lives.", "normal_format": "What is an extremely oppressive government that seeks to control all aspects of its citizens\u2019 lives?"}, "answer": {"ans_text": "totalitarian dictatorship", "ans_choice": 1}, "bloom": "1", "hl_sentences": "The totalitarian dictatorship describes a more ambitious and oppressive style of dictatorship that attempts to control all aspects of its subjects \u2019 lives .", "hl_context": "Many dictatorships do not align themselves strictly with any particular belief system or ideology ; the goal of this type of regime is usually limited to preserving the authority of the dictator at its helm . <hl> The totalitarian dictatorship describes a more ambitious and oppressive style of dictatorship that attempts to control all aspects of its subjects \u2019 lives . <hl> Communist regimes , for instance , are often totalitarian in nature . They may attempt to regulate how many children citizens bear , what religious beliefs they hold , and so forth . They may also demand that citizens publicly demonstrate their faith in the regime by participating in public marches and demonstrations ."}, {"question": {"question_id": "fs-id16815590", "question_text": "Which is not a characteristic of a democracy?", "question_choices": ["People vote to elect officials.", "A king or queen holds the majority of governmental control.", "One goal of this type of government is to protect citizens\u2019 basic rights.", "A constitution typically outlines the foundational ideas of how this government should operate."], "cloze_format": "The statement that is not a characteristic of a democracy is that ___ .", "normal_format": "Which is not a characteristic of a democracy?"}, "answer": {"ans_text": "A king or queen holds the majority of governmental control.", "ans_choice": 1}, "bloom": "1", "hl_sentences": "Democracies , in general , assure certain basic rights to their citizens . First and foremost , citizens are free to organize political parties and hold elections . Leaders , once elected , must abide by the terms of the given nation \u2019 s constitution and are limited in the powers they can exercise , as well as in the length of the duration of their terms .", "hl_context": "<hl> Democracies , in general , assure certain basic rights to their citizens . <hl> <hl> First and foremost , citizens are free to organize political parties and hold elections . <hl> <hl> Leaders , once elected , must abide by the terms of the given nation \u2019 s constitution and are limited in the powers they can exercise , as well as in the length of the duration of their terms . <hl> Most democratic societies also champion freedom of individual speech , the press , and assembly , and they prohibit unlawful imprisonment . Of course , even in a democratic society , the government constrains citizens from total freedom to act however they wish . A democratically elected government does this by passing laws and writing regulations that , at least ideally , reflect the will of the majority of its people ."}, {"question": {"question_id": "fs-id1175506", "question_text": "Which statement best expresses why the United States is not a \u201ctrue\u201d democracy?", "question_choices": ["Many politicians are corrupt.", "Special-interest groups fund political campaigns.", "Citizens elect representatives who vote on their behalf to make policy.", "Ancient Greece was the only true democracy."], "cloze_format": "The statement that best expresses why the United States is not a \u201ctrue\u201d democracy is that ___.", "normal_format": "Which statement best expresses why the United States is not a \u201ctrue\u201d democracy?"}, "answer": {"ans_text": "Citizens elect representatives who vote on their behalf to make policy.", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Although the United States champions the democratic ideology , it is not a \u201c pure \u201d democracy . In a purely democratic society , all citizens would vote on all proposed legislation , and this is not how laws are passed in the United States . Thus , the United States is a constitution-based federal republic in which citizens elect representatives to make policy decisions on their behalf .", "hl_context": "<hl> Although the United States champions the democratic ideology , it is not a \u201c pure \u201d democracy . <hl> <hl> In a purely democratic society , all citizens would vote on all proposed legislation , and this is not how laws are passed in the United States . <hl> There is a practical reason for this : a pure democracy would be hard to implement . <hl> Thus , the United States is a constitution-based federal republic in which citizens elect representatives to make policy decisions on their behalf . <hl> The term representative democracy , which is virtually synonymous with republic , can also be used to describe a government in which citizens elect representatives to promote policies that favor their interests . In the United States , representatives are elected at local and state levels , and the votes of the Electoral College determine who will hold the office of president . Each of the three branches of the United States government \u2014 the executive , judicial , and legislative \u2014 is held in check by the other branches . 17.3 Politics in the United States"}, {"question": {"question_id": "fs-id2842276", "question_text": "In the past, Southern states discouraged African Americans from voting by requiring them to take a _____________________ test.", "question_choices": ["blood", "literacy", "lie detector", "citizenship"], "cloze_format": "In the past, Southern states discouraged African Americans from voting by requiring them to take a _____________________ test.", "normal_format": "In the past, Southern states discouraged African Americans from voting by requiring them to take which test?"}, "answer": {"ans_text": "literacy", "ans_choice": 1}, "bloom": "1", "hl_sentences": "For years , African Americans who were brave enough to vote were discouraged by discriminatory legislation , passed in many southern states , which required poll taxes and literacy tests of prospective voters .", "hl_context": "Although recent records have shown more minorities voting now than ever before , this trend is still fairly new . Historically , African Americans and other minorities have been underrepresented at the polls . Black men were not allowed to vote at all until after the Civil War , and black women gained the right to vote along with other women only with the ratification of the Nineteenth Amendment in 1920 . <hl> For years , African Americans who were brave enough to vote were discouraged by discriminatory legislation , passed in many southern states , which required poll taxes and literacy tests of prospective voters . <hl> Literacy tests were not outlawed until 1965 , when President Lyndon Johnson signed the Voting Rights Act ."}, {"question": {"question_id": "fs-id2855254", "question_text": "Which president signed the Voting Rights Act?", "question_choices": ["Lyndon Johnson", "John F. Kennedy Jr.", "Barack Obama", "Franklin D. Roosevelt"], "cloze_format": "President ___ signed the Voting Rights Act.", "normal_format": "Which president signed the Voting Rights Act?"}, "answer": {"ans_text": "Lyndon Johnson", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Literacy tests were not outlawed until 1965 , when President Lyndon Johnson signed the Voting Rights Act .", "hl_context": "Although recent records have shown more minorities voting now than ever before , this trend is still fairly new . Historically , African Americans and other minorities have been underrepresented at the polls . Black men were not allowed to vote at all until after the Civil War , and black women gained the right to vote along with other women only with the ratification of the Nineteenth Amendment in 1920 . For years , African Americans who were brave enough to vote were discouraged by discriminatory legislation , passed in many southern states , which required poll taxes and literacy tests of prospective voters . <hl> Literacy tests were not outlawed until 1965 , when President Lyndon Johnson signed the Voting Rights Act . <hl>"}, {"question": {"question_id": "fs-id2907072", "question_text": "Which factor does not influence voting practices?", "question_choices": ["Race", "Social class", "Ethnicity", "Voting booths"], "cloze_format": "The factor that does not influence voting practices is ___ .", "normal_format": "Which factor does not influence voting practices?"}, "answer": {"ans_text": "Voting booths", "ans_choice": 3}, "bloom": "1", "hl_sentences": "Like race and ethnicity , social class also has impacted voting practices .", "hl_context": "<hl> Like race and ethnicity , social class also has impacted voting practices . <hl> Voting rates among lower-educated , lower-paid workers are less than for people with higher socioeconomic status , fostering a system in which people with more power and access to resources have the means to perpetuate their power . Several explanations have been offered to account for this difference ( Raymond 2010 ) . Workers in low-paying service jobs might find it harder to get to the polls because they lack flexibility in their work hours and quality daycare to look after children while they vote . Because a larger share of racial and ethnic minorities is employed in such positions , social class may be linked to race and ethnicity in influencing voting rates . Attitudes play a role as well . Some people of low socioeconomic status or minority race / ethnicity doubt their vote will count or voice will be heard because they have seen no evidence of their political power in their communities . Many believe that what they already have is all they can achieve ."}, {"question": {"question_id": "fs-id1277494", "question_text": "The U.S. Supreme Court case _________________ led to the revision of voting districts to account for differences in population density.", "question_choices": ["Roe v. Wade", "Reynolds v. Sims", "Brown v. Board of Education", "Marbury v. Madison"], "cloze_format": "The U.S. Supreme Court case _________________ led to the revision of voting districts to account for differences in population density.", "normal_format": "Which U.S. Supreme Court case led to the revision of voting districts to account for differences in population density?"}, "answer": {"ans_text": "Reynolds v. Sims", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "Shortly before the Voting Rights Act was passed , the 1964 U . S . Supreme Court case Reynolds v . Sims changed the nature of elections .", "hl_context": "The 1960s saw other important reforms in U . S . voting . <hl> Shortly before the Voting Rights Act was passed , the 1964 U . S . Supreme Court case Reynolds v . Sims changed the nature of elections . <hl> This landmark decision reaffirmed the notion of \u201c one person , one vote , \u201d a concept holding that each person \u2019 s vote should be counted equally . Before this decision , unequal distributions of population enabled small groups of people in sparsely populated rural areas to have as much voting power as densely populated urban areas . After Reynolds v . Sims , districts were redrawn so that they would include equal numbers of voters ."}, {"question": {"question_id": "fs-id1591493", "question_text": "Which statement best explains the meaning of \u201cone person, one vote\u201d?", "question_choices": ["One person should not be allowed to vote twice.", "A voter deserves one chance to vote.", "A voter should vote only once a year.", "Each voter\u2019s vote should count equally."], "cloze_format": "The statement that best explains the meaning of \u201cone person, one vote\u201d is that ___.", "normal_format": "Which statement best explains the meaning of \u201cone person, one vote\u201d?"}, "answer": {"ans_text": "Each voter\u2019s vote should count equally.", "ans_choice": 3}, "bloom": "1", "hl_sentences": "This landmark decision reaffirmed the notion of \u201c one person , one vote , \u201d a concept holding that each person \u2019 s vote should be counted equally .", "hl_context": "The 1960s saw other important reforms in U . S . voting . Shortly before the Voting Rights Act was passed , the 1964 U . S . Supreme Court case Reynolds v . Sims changed the nature of elections . <hl> This landmark decision reaffirmed the notion of \u201c one person , one vote , \u201d a concept holding that each person \u2019 s vote should be counted equally . <hl> Before this decision , unequal distributions of population enabled small groups of people in sparsely populated rural areas to have as much voting power as densely populated urban areas . After Reynolds v . Sims , districts were redrawn so that they would include equal numbers of voters ."}, {"question": {"question_id": "fs-id2614429", "question_text": "Which concept corresponds best to functionalism?", "question_choices": ["Happiness", "Interdependence", "Revolution", "Symbolism"], "cloze_format": "The concept that corresponds best to functionalism is ___.", "normal_format": "Which concept corresponds best to functionalism?"}, "answer": {"ans_text": "Interdependence", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "Functionalists view government and politics as a way to enforce norms and regulate conflict . Functionalists see active social change , such as the sit-in on Wall Street , as undesirable because it forces change and , as a result , undesirable things that might have to be compensated for . Functionalists seek consensus and order in society . Dysfunction creates social problems that lead to social change . For instance , functionalists would see monetary political contributions as a way of keeping people connected to the democratic process . According to functionalism , the government has four main purposes : planning and directing society , meeting social needs , maintaining law and order , and managing international relations .", "hl_context": "<hl> Functionalists view government and politics as a way to enforce norms and regulate conflict . <hl> <hl> Functionalists see active social change , such as the sit-in on Wall Street , as undesirable because it forces change and , as a result , undesirable things that might have to be compensated for . <hl> <hl> Functionalists seek consensus and order in society . <hl> <hl> Dysfunction creates social problems that lead to social change . <hl> <hl> For instance , functionalists would see monetary political contributions as a way of keeping people connected to the democratic process . <hl> This would be in opposition to a conflict theorist who would see this financial contribution as a way for the rich to perpetuate their own wealth . <hl> According to functionalism , the government has four main purposes : planning and directing society , meeting social needs , maintaining law and order , and managing international relations . <hl> According to functionalism , all aspects of society serve a purpose ."}, {"question": {"question_id": "fs-id1386009", "question_text": "Which sociologist is not associated with conflict theory?", "question_choices": ["C. Wright Mills", "G. William Domhoff", "Karl Marx", "George H. Mead"], "cloze_format": "The sociologist that is not associated with conflict theory is called ___.", "normal_format": "Which sociologist is not associated with conflict theory?"}, "answer": {"ans_text": "George H. Mead", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "Other sociologists study government and power by relying on the framework of symbolic interactionism , which is grounded in the works of Max Weber and George H . Mead .", "hl_context": "<hl> Other sociologists study government and power by relying on the framework of symbolic interactionism , which is grounded in the works of Max Weber and George H . Mead . <hl>"}, {"question": {"question_id": "fs-id2110997", "question_text": "Karl Marx believed social structures evolve out of:", "question_choices": ["supply and demand", "enlightenment", "competition", "cooperation"], "cloze_format": "Karl Marx believed social structures evolve out of ___ .", "normal_format": "What did Karl Marx believe social structures evolve out of?"}, "answer": {"ans_text": "competition", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "According to sociologist and philosopher Karl Marx , such conflicts are necessary , albeit ugly , steps toward a more egalitarian society . In this pattern of change through conflict , people tend to gain greater personal freedom and economic stability ( 1848 ) . Philosopher and social scientist Karl Marx was a seminal force in developing the conflict theory perspective . He was a proponent of conflict , in general , because he felt that it was the only means of promoting positive change for the underprivileged . Marx did not agree with Durkheim \u2019 s notions of cooperation and interdependence ; he instead saw society as a stage for exploitation and strife .", "hl_context": "<hl> According to sociologist and philosopher Karl Marx , such conflicts are necessary , albeit ugly , steps toward a more egalitarian society . <hl> Marx saw a historical pattern in which revolutionaries toppled elite power structures , after which wealth and authority were more evenly dispersed among the population , and the overall social order advances . <hl> In this pattern of change through conflict , people tend to gain greater personal freedom and economic stability ( 1848 ) . <hl> <hl> Philosopher and social scientist Karl Marx was a seminal force in developing the conflict theory perspective . <hl> <hl> He was a proponent of conflict , in general , because he felt that it was the only means of promoting positive change for the underprivileged . <hl> <hl> Marx did not agree with Durkheim \u2019 s notions of cooperation and interdependence ; he instead saw society as a stage for exploitation and strife . <hl>"}, {"question": {"question_id": "fs-id1428708", "question_text": "The Arab Spring, Occupy Wall Street protests, and the Tea Party movement have the following in common:", "question_choices": ["They sought to destroy central government.", "They are examples of conflict theory in action.", "They can only occur in a representative democracy.", "They used violence as the means of achieving their goals."], "cloze_format": "The Arab Spring, Occupy Wall Street protests, and the Tea Party movement have in common that ___ .", "normal_format": "What do the Arab Spring, Occupy Wall Street protests, and the Tea Party movement have in common?"}, "answer": {"ans_text": "They are examples of conflict theory in action.", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "Modern-day life is not without a multitude of political conflicts : discontents in Egypt overthrow dictator Hosni Mubarak , disenchanted American Tea Partiers call for government realignment , and Occupy Wall Street protesters decry corporate greed . Indeed , the study of any given conflict offers a window of insight into the social structure of its surrounding culture , as well as insight into the larger human condition", "hl_context": "<hl> Modern-day life is not without a multitude of political conflicts : discontents in Egypt overthrow dictator Hosni Mubarak , disenchanted American Tea Partiers call for government realignment , and Occupy Wall Street protesters decry corporate greed . <hl> <hl> Indeed , the study of any given conflict offers a window of insight into the social structure of its surrounding culture , as well as insight into the larger human condition <hl>"}, {"question": {"question_id": "fs-id1472328", "question_text": "Which is not one of functionalism\u2019s four main purposes of government?", "question_choices": ["Maintaining law and order", "Meeting social needs", "Equally distributing resources", "Planning and directing society"], "cloze_format": "___ is not one of functionalism\u2019s four main purposes of government.", "normal_format": "Which is not one of functionalism\u2019s four main purposes of government?"}, "answer": {"ans_text": "Equally distributing resources", "ans_choice": 2}, "bloom": "1", "hl_sentences": "According to functionalism , the government has four main purposes : planning and directing society , meeting social needs , maintaining law and order , and managing international relations .", "hl_context": "<hl> According to functionalism , the government has four main purposes : planning and directing society , meeting social needs , maintaining law and order , and managing international relations . <hl> According to functionalism , all aspects of society serve a purpose ."}, {"question": {"question_id": "fs-id2375309", "question_text": "Sociologist G. William Domhoff\u2019s Who Rules America? asserts that wealth is often necessary to exert the most influence over social and political systems. This is a ____ perspective.", "question_choices": ["conflict theory", "symbolic interactionism", "functionalism", "feminist"], "cloze_format": "Sociologist G. William Domhoff\u2019s Who Rules America? asserts that wealth is often necessary to exert the most influence over social and political systems. This is a ____ perspective.", "normal_format": "Sociologist G. William Domhoff\u2019s Who Rules America? asserts that wealth is often necessary to exert the most influence over social and political systems. Which perspective is this?"}, "answer": {"ans_text": "conflict theory", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Domhoff acknowledges that all Americans can potentially exert political influence , but he asserts that our current social and political systems make it easier for the wealthiest citizens to shape policy . G . William Domhoff , a contemporary sociologist , is a modern-day proponent of Marx \u2019 s theories and has written numerous commentaries on the existence of a modern-day power elite in American society . Domhoff ( 2011 ) has devoted a considerable amount of energy to his effort of pointing out the power elite \u2019 s influence on policy and society in general . Philosopher and social scientist Karl Marx was a seminal force in developing the conflict theory perspective .", "hl_context": "Domhoff \u2019 s research helped to popularize the concept of the power elite . His theories describe the members of the power elite maintaining their position by collectively following the same social patterns , such as vacationing at a handful of destinations , joining elite clubs , and attending select schools . He also pointed out that the existence of a power elite stands in contrast to an important American ideal : that all Americans have a voice in their government . <hl> Domhoff acknowledges that all Americans can potentially exert political influence , but he asserts that our current social and political systems make it easier for the wealthiest citizens to shape policy . <hl> <hl> G . William Domhoff , a contemporary sociologist , is a modern-day proponent of Marx \u2019 s theories and has written numerous commentaries on the existence of a modern-day power elite in American society . <hl> <hl> Domhoff ( 2011 ) has devoted a considerable amount of energy to his effort of pointing out the power elite \u2019 s influence on policy and society in general . <hl> <hl> Philosopher and social scientist Karl Marx was a seminal force in developing the conflict theory perspective . <hl> He was a proponent of conflict , in general , because he felt that it was the only means of promoting positive change for the underprivileged . Marx did not agree with Durkheim \u2019 s notions of cooperation and interdependence ; he instead saw society as a stage for exploitation and strife ."}, {"question": {"question_id": "fs-id2638614", "question_text": "Which of the following paradigms would consider movements such as Occupy Wall Street undesirable and unnecessarily forcing social change?", "question_choices": ["Symbolic interactionism", "Functionalism", "Feminism", "Conflict theory"], "cloze_format": "The  paradigm that would consider movements such as Occupy Wall Street undesirable and unnecessarily forcing social change is ___.", "normal_format": "Which of the following paradigms would consider movements such as Occupy Wall Street undesirable and unnecessarily forcing social change?"}, "answer": {"ans_text": "Functionalism", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Functionalists view government and politics as a way to enforce norms and regulate conflict . Functionalists see active social change , such as the sit-in on Wall Street , as undesirable because it forces change and , as a result , undesirable things that might have to be compensated for .", "hl_context": "<hl> Functionalists view government and politics as a way to enforce norms and regulate conflict . <hl> <hl> Functionalists see active social change , such as the sit-in on Wall Street , as undesirable because it forces change and , as a result , undesirable things that might have to be compensated for . <hl> Functionalists seek consensus and order in society . Dysfunction creates social problems that lead to social change . For instance , functionalists would see monetary political contributions as a way of keeping people connected to the democratic process . This would be in opposition to a conflict theorist who would see this financial contribution as a way for the rich to perpetuate their own wealth ."}], "summary": "", "keyterm": "", "bname": "introduction_to_sociology"}, {"chapter": 10, "intro": " Chapter Outline 10.1   A New Political Style: From John Quincy Adams to Andrew Jackson 10.2   The Rise of American Democracy 10.3   The Nullification Crisis and the Bank War 10.4   Indian Removal 10.5   The Tyranny and Triumph of the Majority Introduction \n\n The most extraordinary political development in the years before the Civil War was the rise of American democracy. Whereas the founders envisioned the United States as a republic, not a democracy, and had placed safeguards such as the Electoral College in the 1787 Constitution to prevent simple majority rule, the early 1820s saw many Americans embracing majority rule and rejecting old forms of deference that were based on elite ideas of virtue, learning, and family lineage. \n\n A new breed of politicians learned to harness the magic of the many by appealing to the resentments, fears, and passions of ordinary citizens to win elections. The charismatic Andrew Jackson gained a reputation as a fighter and defender of American expansion, emerging as the quintessential figure leading the rise of American democracy. In the image above ( Figure 10.1 ), crowds flock to the White House to celebrate his inauguration as president. While earlier inaugurations had been reserved for Washington\u2019s political elite, Jackson\u2019s was an event for the people, so much so that the pushing throngs caused thousands of dollars of damage to White House property. Characteristics of modern American democracy, including the turbulent nature of majority rule, first appeared during the Age of Jackson. ", "chapter_text": " 10.1   A New Political Style: From John Quincy Adams to Andrew Jackson Learning Objectives By the end of this section, you will be able to: \n\n Explain and illustrate the new style of American politics in the 1820s \n\n Describe the policies of John Quincy Adams\u2019s presidency and explain the political divisions that resulted \n\n In the 1820s, American political culture gave way to the democratic urges of the citizenry. Political leaders and parties rose to popularity by championing the will of the people, pushing the country toward a future in which a wider swath of citizens gained a political voice. However, this expansion of political power was limited to White men; women, free Black people, and Native Americans remained\u2014or grew increasingly\u2014disenfranchised by the American political system. \n\n THE DECLINE OF FEDERALISM \n\n The first party system in the United States shaped the political contest between the Federalists and the Democratic-Republicans. The Federalists, led by Washington, Hamilton, and Adams, dominated American politics in the 1790s. After the election of Thomas Jefferson\u2014the Revolution of 1800\u2014the Democratic-Republicans gained ascendance. The gradual decline of the Federalist Party is evident in its losses in the presidential contests that occurred between 1800 and 1820. After 1816, in which Democratic-Republican James Monroe defeated his Federalist rival Rufus King, the Federalists never ran another presidential candidate. \n\n Before the 1820s, a  code of deference  had underwritten the republic\u2019s political order. Deference was the practice of showing respect for individuals who had distinguished themselves through military accomplishments, educational attainment, business success, or family pedigree. Such individuals were members of what many Americans in the early republic agreed was a natural aristocracy. Deference shown to them dovetailed with republicanism and its emphasis on virtue, the ideal of placing the common good above narrow self-interest. Republican statesmen in the 1780s and 1790s expected and routinely received deferential treatment from others, and ordinary Americans deferred to their \u201csocial betters\u201d as a matter of course. \n\n For the generation who lived through the American Revolution, for instance, George Washington epitomized republican virtue, entitling him to great deference from his countrymen. His judgment and decisions were considered beyond reproach. An Anglican minister named Mason Locke Weems wrote the classic tale of Washington\u2019s unimpeachable virtue in his 1800 book,  The Life of Washington . Generations of nineteenth-century American children read its fictional story of a youthful Washington chopping down one of his father\u2019s cherry trees and, when confronted by his father, confessing: \u201cI cannot tell a lie\u201d ( Figure 10.3 ). The story spoke to Washington\u2019s unflinching honesty and integrity, encouraging readers to remember the deference owed to such towering national figures. \n\n Washington and those who celebrated his role as president established a standard for elite, virtuous leadership that cast a long shadow over subsequent presidential administrations. The presidents who followed Washington shared the first president\u2019s pedigree. With the exception of John Adams, who was from Massachusetts, all the early presidents\u2014Thomas Jefferson, James Madison, and James Monroe\u2014were members of Virginia\u2019s elite slaveholder aristocracy. \n\n DEMOCRATIC REFORMS \n\n In the early 1820s, deference to pedigree began to wane in American society. A new type of deference\u2014to the will of the majority and not to a ruling class\u2014took hold. The spirit of democratic reform became most evident in the widespread belief that all White men, regardless of whether they owned property, had the right to participate in elections. \n\n Before the 1820s, many state constitutions had imposed property qualifications for voting as a means to keep democratic tendencies in check. However, as Federalist ideals fell out of favor, ordinary men from the middle and lower classes increasingly questioned the idea that property ownership was an indication of virtue. They argued for  universal manhood suffrage , or voting rights for all White male adults. \n\n New states adopted constitutions that did not contain property qualifications for voting, a move designed to stimulate migration across their borders. Vermont and Kentucky, admitted to the Union in 1791 and 1792 respectively, granted the right to vote to all White men regardless of whether they owned property or paid taxes. Ohio\u2019s state constitution placed a minor taxpaying requirement on voters but otherwise allowed for expansive White male suffrage. Alabama, admitted to the Union in 1819, eliminated property qualifications for voting in its state constitution. Two other new states, Indiana (1816) and Illinois (1818), also extended the right to vote to White men regardless of property. Initially, the new state of Mississippi (1817) restricted voting to White male property holders, but in 1832 it eliminated this provision. \n\n In Connecticut, Federalist power largely collapsed in 1818 when the state held a constitutional convention. The new constitution granted the right to vote to all White men who paid taxes or served in the militia. Similarly, New York amended its state constitution in 1821\u20131822 and removed the property qualifications for voting. \n\n Expanded voting rights did not extend to women, Native, or free Black people in the North. Indeed, race replaced property qualifications as the criterion for voting rights. American democracy had a decidedly racist orientation; a White majority limited the rights of Black minorities. New Jersey explicitly restricted the right to vote to White men only. Connecticut passed a law in 1814 taking the right to vote away from free Black men and restricting suffrage to White men only. By the 1820s, 80 percent of the White male population could vote in New York State elections. No other state had expanded suffrage so dramatically. At the same time, however, New York effectively disenfranchised free Black men in 1822 (Black men had had the right to vote under the 1777 constitution) by requiring that \u201cmen of color\u201d must possess property over the value of $250. \n\n PARTY POLITICS AND THE ELECTION OF 1824 \n\n In addition to expanding White men\u2019s right to vote, democratic currents also led to a new style of political party organization, most evident in New York State in the years after the War of 1812. Under the leadership of Martin Van Buren, New York\u2019s \u201cBucktail\u201d Republican faction (so named because members wore a deer\u2019s tail on their hats, a symbol of membership in the Tammany Society) gained political power by cultivating loyalty to the will of the majority, not to an elite family or renowned figure. The  Bucktails  emphasized a pragmatic approach. For example, at first they opposed the Erie Canal project, but when the popularity of the massive transportation venture became clear, they supported it. \n\n One of the Bucktails\u2019 greatest achievements in New York came in the form of revisions to the state constitution in the 1820s. Under the original constitution, a Council of Appointments selected local officials such as sheriffs and county clerks. The Bucktails replaced this process with a system of direct elections, which meant thousands of jobs immediately became available to candidates who had the support of the majority. In practice, Van Buren\u2019s party could nominate and support their own candidates based on their loyalty to the party. In this way, Van Buren helped create a political machine of disciplined party members who prized loyalty above all else, a harbinger of future patronage politics in the United States. This system of rewarding party loyalists is known as the  spoils system  (from the expression, \u201cTo the victor belong the spoils\u201d). Van Buren\u2019s political machine helped radically transform New York politics. \n\n Party politics also transformed the national political landscape, and the election of 1824 proved a turning point in American politics. With tens of thousands of new voters, the older system of having members of Congress form congressional caucuses to determine who would run no longer worked. The new voters had regional interests and voted on them. For the first time, the popular vote mattered in a presidential election. Electors were chosen by popular vote in eighteen states, while the six remaining states used the older system in which state legislatures chose electors. \n\n With the caucus system defunct, the presidential election of 1824 featured five candidates, all of whom ran as Democratic-Republicans (the Federalists having ceased to be a national political force). The crowded field included John Quincy Adams, the son of the second president, John Adams. Candidate Adams had broken with the Federalists in the early 1800s and served on various diplomatic missions, including the mission to secure peace with Great Britain in 1814. He represented New England. A second candidate, John C. Calhoun from South Carolina, had served as secretary of war and represented the slaveholding South. He dropped out of the presidential race to run for vice president. A third candidate, Henry Clay, the Speaker of the House of Representatives, hailed from Kentucky and represented the western states. He favored an active federal government committed to internal improvements, such as roads and canals, to bolster national economic development and settlement of the West. William H. Crawford, a slaveholder from Georgia, suffered a stroke in 1823 that left him largely incapacitated, but he ran nonetheless and had the backing of the New York machine headed by Van Buren. Andrew Jackson, the famed \u201chero of New Orleans,\u201d rounded out the field. Jackson had very little formal education, but he was popular for his military victories in the War of 1812 and in wars against the Creek and the Seminole. He had been elected to the Senate in 1823, and his popularity soared as pro-Jackson newspapers sang the praises of the courage and daring of the Tennessee slaveholder ( Figure 10.4 ). \n\n Results from the eighteen states where the popular vote determined the electoral vote gave Jackson the election, with 152,901 votes to Adams\u2019s 114,023, Clay\u2019s 47,217, and Crawford\u2019s 46,979. The Electoral College, however, was another matter. Of the 261 electoral votes, Jackson needed 131 or better to win but secured only 99. Adams won 84, Crawford 41, and Clay 37. Because Jackson did not receive a majority vote from the Electoral College, the election was decided following the terms of the Twelfth Amendment, which stipulated that when a candidate did not receive a majority of electoral votes, the election went to the House of Representatives, where each state would provide one vote. House Speaker Clay did not want to see his rival, Jackson, become president and therefore worked within the House to secure the presidency for Adams, convincing many to cast their vote for the New Englander. Clay\u2019s efforts paid off; despite not having won the popular vote, John Quincy Adams was certified by the House as the next president. Once in office, he elevated Henry Clay to the post of secretary of state. \n\n Jackson and his supporters cried foul. To them, the election of Adams reeked of anti-democratic corruption. So too did the appointment of Clay as secretary of state. John C. Calhoun labeled the whole affair a \u201c corrupt bargain \u201d ( Figure 10.5 ). Everywhere, Jackson supporters vowed revenge against the anti-majoritarian result of 1824. \n\n THE PRESIDENCY OF JOHN QUINCY ADAMS \n\n Secretary of State Clay championed what was known as the  American System  of high tariffs, a national bank, and federally sponsored internal improvements of canals and roads. Once in office, President Adams embraced Clay\u2019s American System and proposed a national university and naval academy to train future leaders of the republic. The president\u2019s opponents smelled elitism in these proposals and pounced on what they viewed as the administration\u2019s catering to a small privileged class at the expense of ordinary citizens. \n\n Clay also envisioned a broad range of internal transportation improvements. Using the proceeds from land sales in the West, Adams endorsed the creation of roads and canals to facilitate commerce and the advance of settlement in the West. Many in Congress vigorously opposed federal funding of internal improvements, citing among other reasons that the Constitution did not give the federal government the power to fund these projects. However, in the end, Adams succeeded in extending the Cumberland Road into Ohio (a federal highway project). He also broke ground for the Chesapeake and Ohio Canal on July 4, 1828. \n\n Tariffs, which both Clay and Adams promoted, were not a novel idea; since the birth of the republic they had been seen as a way to advance domestic manufacturing by making imports more expensive. Congress had approved a tariff in 1789, for instance, and Alexander Hamilton had proposed a protective tariff in 1790. Congress also passed tariffs in 1816 and 1824. Clay spearheaded the drive for the federal government to impose high tariffs to help bolster domestic manufacturing. If imported goods were more expensive than domestic goods, then people would buy American-made goods. \n\n President Adams wished to promote manufacturing, especially in his home region of New England. To that end, in 1828 he proposed a high tariff on imported goods, amounting to 50 percent of their value. The tariff raised questions about how power should be distributed, causing a fiery debate between those who supported states\u2019 rights and those who supported the expanded power of the federal government ( Figure 10.6 ). Those who championed states\u2019 rights denounced the 1828 measure as the  Tariff of Abominations , clear evidence that the federal government favored one region, in this case the North, over another, the South. They made their case by pointing out that the North had an expanding manufacturing base while the South did not. Therefore, the South imported far more manufactured goods than the North, causing the tariff to fall most heavily on the southern states. \n\n The 1828 tariff generated additional fears among southerners. In particular, it suggested to them that the federal government would unilaterally take steps that hurt the South. This line of reasoning led some southerners to fear that the very foundation of the South\u2014slavery\u2014could come under attack from a hostile northern majority in Congress. The spokesman for this southern view was President Adams\u2019s vice president, John C. Calhoun. \n\n Defining American John C. Calhoun on the Tariff of 1828 Vice President John C. Calhoun, angry about the passage of the Tariff of 1828, anonymously wrote a report titled \u201cSouth Carolina Exposition and Protest\u201d (later known as \u201cCalhoun\u2019s Exposition\u201d) for the South Carolina legislature. As a native of South Carolina, Calhoun articulated the fear among many southerners that the federal government could exercise undue power over the states. \n\nIf it be conceded, as it must be by every one who is the least conversant with our institutions, that the sovereign powers delegated are divided between the General and State Governments, and that the latter hold their portion by the same tenure as the former, it would seem impossible to deny to the States the right of deciding on the infractions of their powers, and the proper remedy to be applied for their correction. The right of judging, in such cases, is an essential attribute of sovereignty, of which the States cannot be divested without losing their sovereignty itself, and being reduced to a subordinate corporate condition. In fact, to divide power, and to give to one of the parties the exclusive right of judging of the portion allotted to each, is, in reality, not to divide it at all; and to reserve such exclusive right to the General Government (it matters not by what department) to be exercised, is to convert it, in fact, into a great consolidated government, with unlimited powers, and to divest the States, in reality, of all their rights, It is impossible to understand the force of terms, and to deny so plain a conclusion.  \n\n\u2014John C. Calhoun, \u201cSouth Carolina Exposition and Protest,\u201d 1828\n\n What is Calhoun\u2019s main point of protest? What does he say about the sovereignty of the states? \n 10.2   The Rise of American Democracy Learning Objectives By the end of this section, you will be able to: \n\n Describe the key points of the election of 1828 \n\n Explain the scandals of Andrew Jackson\u2019s first term in office \n\n A turning point in American political history occurred in 1828, which witnessed the election of Andrew Jackson over the incumbent John Quincy Adams. While democratic practices had been in ascendance since 1800, the year also saw the further unfolding of a democratic spirit in the United States. Supporters of Jackson called themselves Democrats or the Democracy, giving birth to the Democratic Party. Political authority appeared to rest with the majority as never before. \n\n THE CAMPAIGN AND ELECTION OF 1828 \n\n During the 1800s, democratic reforms made steady progress with the abolition of property qualifications for voting and the birth of new forms of political party organization. The 1828 campaign pushed new democratic practices even further and highlighted the difference between the Jacksonian expanded electorate and the older, exclusive Adams style. A slogan of the day, \u201cAdams who can write/Jackson who can fight,\u201d captured the contrast between Adams the aristocrat and Jackson the frontiersman. \n\n The 1828 campaign differed significantly from earlier presidential contests because of the party organization that promoted Andrew Jackson. Jackson and his supporters reminded voters of the \u201ccorrupt bargain\u201d of 1824. They framed it as the work of a small group of political elites deciding who would lead the nation, acting in a self-serving manner and ignoring the will of the majority ( Figure 10.7 ). From Nashville, Tennessee, the Jackson campaign organized supporters around the nation through editorials in partisan newspapers and other publications. Pro-Jackson newspapers heralded the \u201chero of New Orleans\u201d while denouncing Adams. Though he did not wage an election campaign filled with public appearances, Jackson did give one major campaign speech in New Orleans on January 8, the anniversary of the defeat of the British in 1815. He also engaged in rounds of discussion with politicians who came to his home, the Hermitage, in Nashville. \n\n At the local level, Jackson\u2019s supporters worked to bring in as many new voters as possible. Rallies, parades, and other rituals further broadcast the message that Jackson stood for the common man against the corrupt elite backing Adams and Clay. Democratic organizations called Hickory Clubs, a tribute to Jackson\u2019s nickname, Old Hickory, also worked tirelessly to ensure his election. \n\n In November 1828, Jackson won an overwhelming victory over Adams, capturing 56 percent of the popular vote and 68 percent of the electoral vote. As in 1800, when Jefferson had won over the Federalist incumbent John Adams, the presidency passed to a new political party, the Democrats. The election was the climax of several decades of expanding democracy in the United States and the end of the older politics of deference. \n\n SCANDAL IN THE PRESIDENCY \n\n Amid revelations of widespread fraud, including the disclosure that some $300,000 was missing from the Treasury Department, Jackson removed almost 50 percent of appointed civil officers, which allowed him to handpick their replacements. This replacement of appointed federal officials is called  rotation in office . Lucrative posts, such as postmaster and deputy postmaster, went to party loyalists, especially in places where Jackson\u2019s support had been weakest, such as New England. Some Democratic newspaper editors who had supported Jackson during the campaign also gained public jobs. \n\n Jackson\u2019s opponents were angered and took to calling the practice the spoils system, after the policies of Van Buren\u2019s Bucktail Republican Party. The rewarding of party loyalists with government jobs resulted in spectacular instances of corruption. Perhaps the most notorious occurred in New York City, where a Jackson appointee made off with over $1 million. Such examples seemed proof positive that the Democrats were disregarding merit, education, and respectability in decisions about the governing of the nation. \n\n In addition to dealing with rancor over rotation in office, the Jackson administration became embroiled in a personal scandal known as the  Petticoat affair . This incident exacerbated the division between the president\u2019s team and the insider class in the nation\u2019s capital, who found the new arrivals from Tennessee lacking in decorum and propriety. At the center of the storm was Margaret (\u201cPeggy\u201d) O\u2019Neal, a well-known socialite in Washington, DC ( Figure 10.8 ). O\u2019Neal cut a striking figure and had connections to the republic\u2019s most powerful men. She married John Timberlake, a naval officer, and they had three children. Rumors abounded, however, about her involvement with John Eaton, a U.S. senator from Tennessee who had come to Washington in 1818. \n\n Timberlake committed suicide in 1828, setting off a flurry of rumors that he had been distraught over his wife\u2019s reputed infidelities. Eaton and Mrs. Timberlake married soon after, with the full approval of President Jackson. The so-called Petticoat affair divided Washington society. Many Washington socialites snubbed the new Mrs. Eaton as a woman of low moral character. Among those who would have nothing to do with her was Vice President John C. Calhoun\u2019s wife, Floride. Calhoun fell out of favor with President Jackson, who defended Peggy Eaton and derided those who would not socialize with her, declaring she was \u201cas chaste as a virgin.\u201d (Jackson had personal reasons for defending Eaton: he drew a parallel between Eaton\u2019s treatment and that of his late wife, Rachel, who had been subjected to attacks on her reputation related to her first marriage, which had ended in divorce.) Martin Van Buren, who defended the Eatons and organized social gatherings with them, became close to Jackson, who came to rely on a group of informal advisers that included Van Buren and was dubbed the  Kitchen Cabinet . This select group of presidential supporters highlights the importance of party loyalty to Jackson and the Democratic Party. \n 10.3   The Nullification Crisis and the Bank War Learning Objectives By the end of this section, you will be able to: \n\n Explain the factors that contributed to the Nullification Crisis \n\n Discuss the origins and creation of the Whig Party \n\n The crisis over the Tariff of 1828 continued into the 1830s and highlighted one of the currents of democracy in the Age of Jackson: namely, that many southerners believed a democratic majority could be harmful to their interests. These southerners saw themselves as an embattled minority and claimed the right of states to nullify federal laws that appeared to threaten state sovereignty. Another undercurrent was the resentment and anger of the majority against symbols of elite privilege, especially powerful financial institutions like the Second Bank of the United States. \n\n THE NULLIFICATION CRISIS \n\n The Tariff of 1828 had driven Vice President Calhoun to pen his \u201cSouth Carolina Exposition and Protest,\u201d in which he argued that if a national majority acted against the interest of a regional minority, then individual states could void\u2014or nullify\u2014federal law. By the early 1830s, the battle over the tariff took on new urgency as the price of cotton continued to fall. In 1818, cotton had been thirty-one cents per pound. By 1831, it had sunk to eight cents per pound. While production of cotton had soared during this time and this increase contributed to the decline in prices, many southerners blamed their economic problems squarely on the tariff for raising the prices they had to pay for imported goods while their own income shrank. \n\n Resentment of the tariff was linked directly to the issue of slavery, because the tariff demonstrated the use of federal power. Some southerners feared the federal government would next take additional action against the South, including the abolition of slavery. The theory of  nullification , or the voiding of unwelcome federal laws, provided wealthy slaveholders, who were a minority in the United States, with an argument for resisting the national government if it acted contrary to their interests. James Hamilton, who served as governor of South Carolina in the early 1830s, denounced the \u201cdespotic majority that oppresses us.\u201d Nullification also raised the specter of secession; aggrieved states at the mercy of an aggressive majority would be forced to leave the Union. \n\n On the issue of nullification, South Carolina stood alone. Other southern states backed away from what they saw as the extremism behind the idea. President Jackson did not make the repeal of the 1828 tariff a priority and denied the nullifiers\u2019 arguments. He and others, including former President Madison, argued that Article 1, Section 8 of the Constitution gave Congress the power to \u201clay and collect taxes, duties, imposts, and excises.\u201d Jackson pledged to protect the Union against those who would try to tear it apart over the tariff issue. \u201cThe union shall be preserved,\u201d he declared in 1830. \n\n To deal with the crisis, Jackson advocated a reduction in tariff rates. The Tariff of 1832, passed in the summer, lowered the rates on some products like imported goods, a move designed to calm southerners. It did not have the desired effect, however, and Calhoun\u2019s nullifiers still claimed their right to override federal law. In November, South Carolina passed the Ordinance of Nullification, declaring the 1828 and 1832 tariffs null and void in the Palmetto State. Jackson responded, however, by declaring in the December 1832 Nullification Proclamation that a state did not have the power to void a federal law. With the states and the federal government at an impasse, civil war seemed a real possibility. The next governor of South Carolina, Robert Hayne, called for a force of ten thousand volunteers ( Figure 10.9 ) to defend the state against any federal action. At the same time, South Carolinians who opposed the nullifiers told Jackson that eight thousand men stood ready to defend the Union. Congress passed the Force Bill of 1833, which gave the federal government the right to use federal troops to ensure compliance with federal law. The crisis\u2014or at least the prospect of armed conflict in South Carolina\u2014was defused by the Compromise Tariff of 1833, which reduced tariff rates considerably. Nullifiers in South Carolina accepted it, but in a move that demonstrated their inflexibility, they nullified the Force Bill. \n\n The Nullification Crisis illustrated the growing tensions in American democracy: an aggrieved minority of elite, wealthy slaveholders taking a stand against the will of a democratic majority; an emerging sectional divide between South and North over slavery; and a clash between those who believed in free trade and those who believed in protective tariffs to encourage the nation\u2019s economic growth. These tensions would color the next three decades of politics in the United States. \n\n THE BANK WAR \n\n Congress established the Bank of the United States in 1791 as a key pillar of Alexander Hamilton\u2019s financial program, but its twenty-year charter expired in 1811. Congress, swayed by the majority\u2019s hostility to the bank as an institution catering to the wealthy elite, did not renew the charter at that time. In its place, Congress approved a new national bank\u2014the Second Bank of the United States\u2014in 1816. It too had a twenty-year charter, set to expire in 1836. \n\n The Second Bank of the United States was created to stabilize the banking system. More than two hundred banks existed in the United States in 1816, and almost all of them issued paper money. In other words, citizens faced a bewildering welter of paper money with no standard value. In fact, the problem of paper money had contributed significantly to the Panic of 1819. \n\n In the 1820s, the national bank moved into a magnificent new building in Philadelphia. However, despite Congress\u2019s approval of the Second Bank of the United States, a great many people continued to view it as tool of the wealthy, an anti-democratic force. President Jackson was among them; he had faced economic crises of his own during his days speculating in land, an experience that had made him uneasy about paper money. To Jackson, hard currency\u2014that is, gold or silver\u2014was the far better alternative. The president also personally disliked the bank\u2019s director, Nicholas Biddle. \n\n A large part of the allure of mass democracy for politicians was the opportunity to capture the anger and resentment of ordinary Americans against what they saw as the privileges of a few. One of the leading opponents of the bank was Thomas Hart Benton, a senator from Missouri, who declared that the bank served \u201cto make the rich richer, and the poor poorer.\u201d The self-important statements of Biddle, who claimed to have more power than President Jackson, helped fuel sentiments like Benton\u2019s. In the reelection campaign of 1832, Jackson\u2019s opponents in Congress, including Henry Clay, hoped to use their support of the bank to their advantage. In January 1832, they pushed for legislation that would re-charter it, even though its charter was not scheduled to expire until 1836. When the bill for re-chartering passed and came to President Jackson, he used his executive authority to veto the measure. \n\n The defeat of the Second Bank of the United States demonstrates Jackson\u2019s ability to focus on the specific issues that aroused the democratic majority. Jackson understood people\u2019s anger and distrust toward the bank, which stood as an emblem of special privilege and big government. He skillfully used that perception to his advantage, presenting the bank issue as a struggle of ordinary people against a rapacious elite class who cared nothing for the public and pursued only their own selfish ends. As Jackson portrayed it, his was a battle for small government and ordinary Americans. His stand against what bank opponents called the \u201c monster bank \u201d proved very popular, and the Democratic press lionized him for it ( Figure 10.10 ). In the election of 1832, Jackson received nearly 53 percent of the popular vote against his opponent Henry Clay. \n\n Jackson\u2019s veto was only one part of the war on the \u201cmonster bank.\u201d In 1833, the president removed the deposits from the national bank and placed them in state banks. Biddle, the bank\u2019s director, retaliated by restricting loans to the state banks, resulting in a reduction of the money supply. The financial turmoil only increased when Jackson issued an executive order known as the Specie Circular, which required that western land sales be conducted using gold or silver only. Unfortunately, this policy proved a disaster when the Bank of England, the source of much of the hard currency borrowed by American businesses, dramatically cut back on loans to the United States. Without the flow of hard currency from England, American depositors drained the gold and silver from their own domestic banks, making hard currency scarce. Adding to the economic distress of the late 1830s, cotton prices plummeted, contributing to a financial crisis called the Panic of 1837. This economic panic would prove politically useful for Jackson\u2019s opponents in the coming years and Van Buren, elected president in 1836, would pay the price for Jackson\u2019s hard-currency preferences. \n\n WHIGS \n\n Jackson\u2019s veto of the bank and his Specie Circular helped galvanize opposition forces into a new political party, the  Whigs , a faction that began to form in 1834. The name was significant; opponents of Jackson saw him as exercising tyrannical power, so they chose the name Whig after the eighteenth-century political party that resisted the monarchical power of King George III. One political cartoon dubbed the president \u201cKing Andrew the First\u201d and displayed Jackson standing on the Constitution, which has been ripped to shreds ( Figure 10.11 ). \n\n Whigs championed an active federal government committed to internal improvements, including a national bank. They made their first national appearance in the presidential election of 1836, a contest that pitted Jackson\u2019s handpicked successor, Martin Van Buren, against a field of several Whig candidates. Indeed, the large field of Whig candidates indicated the new party\u2019s lack of organization compared to the Democrats. This helped Van Buren, who carried the day in the Electoral College. As the effects of the Panic of 1837 continued to be felt for years afterward, the Whig press pinned the blame for the economic crisis on Van Buren and the Democrats. \n 10.4   Indian Removal Learning Objectives By the end of this section, you will be able to: \n\n Explain the legal wrangling that surrounded the Indian Removal Act \n\n Describe how depictions of Natives in popular culture helped lead to Native removal \n\n Pro-Jackson newspapers touted the president as a champion of opening land for White settlement and moving native inhabitants beyond the boundaries of \u201cAmerican civilization.\u201d In this effort, Jackson reflected majority opinion: most Americans believed Native peoples had no place in the White republic. Jackson\u2019s animosity toward Native Americans ran deep. He had fought against the Creek in 1813 and against the Seminole in 1817, and his reputation and popularity rested in large measure on his firm commitment to remove Native residents from states in the South. The 1830 Indian Removal Act and subsequent displacement of the Creek, Choctaw, Chickasaw, Seminole, and Cherokee tribes of the Southeast fulfilled the vision of a White nation and became one of the identifying characteristics of the Age of Jackson. \n\n NATIVE AMERICANS IN POPULAR CULTURE \n\n Popular culture in the first half of the nineteenth century reflected the aversion to Native Americans that was pervasive during the Age of Jackson. Jackson skillfully played upon this racial hatred to engage the United States in a policy of ethnic cleansing, eradicating the Native presence from the land to make way for White civilization. \n\n In an age of mass democracy, powerful anti-Native sentiments found expression in mass culture, shaping popular perceptions. James Fenimore Cooper\u2019s very popular historical novel,  The Last of the Mohicans , published in 1826 as part of his Leatherstocking series, told the tale of Nathaniel \u201cNatty\u201d Bumppo (aka Hawkeye), who lived among Native Americans but had been born to White parents. Cooper provides a romantic version of the French and Indian War in which Natty helps the British against the French and the feral, bloodthirsty Huron. Natty endures even as his Native American friends die, including the noble Uncas, the last Mohican, in a narrative that dovetailed with most people\u2019s approval of Native removal. \n\n Native Americans also made frequent appearances in art. George Catlin produced many paintings of Native peoples, which he offered as true representations despite routinely emphasizing their supposed \"savage\" nature.  The Cutting Scene, Mandan O-kee-pa Ceremony  ( Figure 10.12 ) is one example. Scholars have long questioned the accuracy of this portrayal of a rite of passage among the Mandan people. Accuracy aside, the painting captured the imaginations of White viewers, reinforcing their disgust at the savagery of Native Americans. \n\n Americana The Paintings of George Catlin George Catlin seized upon the public fascination with the supposedly exotic and savage Native American, seeing an opportunity to make money by painting them in a way that conformed to popular White stereotypes ( Figure 10.13 ). In the late 1830s, he toured major cities with his Indian Gallery, a collection of paintings of Native peoples. Though he hoped his exhibition would be profitable, it did not bring him financial security. \n\n Catlin routinely painted Native Americans in a supposedly aboriginal state. In  Attacking the Grizzly Bear , the hunters do not have rifles and instead rely on spears. Such a portrayal stretches credibility as Native peoples had long been exposed to and adopted European weapons. Indeed, the painting\u2019s depiction of Native people riding horses, which were introduced by the Spanish, makes clear that, as much as Catlin and White viewers wanted to believe in the primitive and savage Native, the reality was otherwise. \n\n In  Wi-j\u00fan-jon, Pigeon's Egg Head (The Light) Going To and Returning From Washington , the viewer is shown a before and after portrait of Wi-j\u00fan-jon, who tried to emulate White dress and manners after going to Washington, DC. What differences do you see between these two representations of Wi-j\u00fan-jon? Do you think his attempt to imitate Whites was successful? Why or why not? What do you think Catlin was trying to convey with this depiction of Wi-j\u00fan-jon\u2019s assimilation? \n\n THE INDIAN REMOVAL ACT \n\n In his first message to Congress, Jackson had proclaimed that Native American groups living independently within states, as sovereign entities, presented a major problem for state sovereignty. This message referred directly to the situation in Georgia, Mississippi, and Alabama, where the Creek, Choctaw, Chickasaw, Seminole, and Cherokee peoples stood as obstacles to White settlement. These groups were known as the  Five Civilized Tribes , because they had largely adopted Anglo-American culture, speaking English and practicing Christianity. Some held enslaved people like their White counterparts. \n\n White people especially resented the Cherokee in Georgia, coveting the tribe\u2019s rich agricultural lands in the northern part of the state. The impulse to remove the Cherokee only increased when gold was discovered on their lands. Ironically, while White people insisted the Cherokee and other Native peoples could never be good citizens because of their savage ways, the Cherokee had arguably gone farther than any other indigenous group in adopting White culture. The  Cherokee Phoenix , the newspaper of the Cherokee, began publication in 1828 ( Figure 10.14 ) in English and the Cherokee language. Although the Cherokee followed the lead of their White neighbors by farming and owning property, as well as embracing Christianity and enslaving people, this proved of little consequence in an era when Whites perceived all Native Americans as incapable of becoming full citizens of the republic. \n\n Jackson\u2019s anti-Native stance struck a chord with a majority of White citizens, many of whom shared a hatred of non-Whites that spurred Congress to pass the 1830  Indian Removal Act . The act called for the removal of the Five Civilized Tribes from their home in the southeastern United States to land in the West, in present-day Oklahoma. Jackson declared in December 1830, \u201cIt gives me pleasure to announce to Congress that the benevolent policy of the Government, steadily pursued for nearly thirty years, in relation to the removal of the Native Americans beyond the White settlements is approaching to a happy consummation. Two important tribes have accepted the provision made for their removal at the last session of Congress, and it is believed that their example will induce the remaining tribes also to seek the same obvious advantages.\u201d \n\n The Cherokee decided to fight the federal law, however, and took their case to the Supreme Court. Their legal fight had the support of anti-Jackson members of Congress, including Henry Clay and Daniel Webster, and they retained the legal services of former attorney general William Wirt. In  Cherokee Nation v. Georgia , Wirt argued that the Cherokee constituted an independent foreign nation, and that an injunction (a stop) should be placed on Georgia laws aimed at eradicating them. In 1831, the Supreme Court found the Cherokee did not meet the criteria for being a foreign nation. \n\n Another case involving the Cherokee also found its way to the highest court in the land. This legal struggle\u2014 Worcester v. Georgia \u2014asserted the rights of non-natives to live on Native American lands. Samuel Worcester was a Christian missionary and federal postmaster of New Echota, the capital of the Cherokee nation. A Congregationalist, he had gone to live among the Cherokee in Georgia to further the spread of Christianity, and he strongly opposed Native American removal. \n\n By living among the Cherokee, Worcester had violated a Georgia law forbidding White people, unless they were agents of the federal government, to live in Native American territory. Worcester was arrested, but because his federal job as postmaster gave him the right to live there, he was released. Jackson supporters then succeeded in taking away Worcester\u2019s job, and he was re-arrested. This time, a court sentenced him and nine others for violating the Georgia state law banning Whites from living on Native land. Worcester was sentenced to four years of hard labor. When the case of  Worcester v. Georgia  came before the Supreme Court in 1832, Chief Justice John Marshall ruled in favor of Worcester, finding that the Cherokee constituted \u201cdistinct political communities\u201d with sovereign rights to their own territory. \n\n Defining American Chief Justice John Marshall\u2019s Ruling in  Worcester v. Georgia In 1832, Chief Justice of the Supreme Court John Marshall ruled in favor of Samuel Worcester in  Worcester v. Georgia . In doing so, he established the principle of tribal sovereignty. Although this judgment contradicted  Cherokee Nation v. Georgia , it failed to halt the Indian Removal Act. In his opinion, Marshall wrote the following: \n\n From the commencement of our government Congress has passed acts to regulate trade and intercourse with the Indians; which treat them as nations, respect their rights, and manifest a firm purpose to afford that protection which treaties stipulate. All these acts, and especially that of 1802, which is still in force, manifestly consider the several Indian nations as distinct political communities, having territorial boundaries, within which their authority is exclusive, and having a right to all the lands within those boundaries, which is not only acknowledged, but guaranteed by the United States. . . . \n\nThe Cherokee Nation, then, is a distinct community, occupying its own territory, with boundaries accurately described, in which the laws of Georgia can have no force, and which the citizens of Georgia have no right to enter but with the assent of the Cherokees themselves or in conformity with treaties and with the acts of Congress. The whole intercourse between the United States and this nation is, by our Constitution and laws, vested in the government of the United States. \n\nThe act of the State of Georgia under which the plaintiff in error was prosecuted is consequently void, and the judgment a nullity. . . . The Acts of Georgia are repugnant to the Constitution, laws, and treaties of the United States.\n\n How does this opinion differ from the outcome of  Cherokee Nation v. Georgia  just one year earlier? Why do you think the two outcomes were different? \n\n The Supreme Court did not have the power to enforce its ruling in  Worcester v. Georgia , however, and it became clear that the Cherokee would be compelled to move. Those who understood that the only option was removal traveled west, but the majority stayed on their land. In order to remove them, the president relied on the U.S. military. In a series of forced marches, some fifteen thousand Cherokee were finally relocated to Oklahoma. This forced migration, known as the  Trail of Tears , caused the deaths of as many as four thousand Cherokee ( Figure 10.15 ). The Creek, Choctaw, Chickasaw, and Seminole peoples were also compelled to go. The removal of the Five Civilized Tribes provides an example of the power of majority opinion in a democracy. \n\n BLACK HAWK\u2019S WAR \n\n The policy of removal led some Native Americans to actively resist. In 1832, the Fox and the Sauk, led by Sauk chief Black Hawk (Makataimeshekiakiah), moved back across the Mississippi River to reclaim their ancestral home in northern Illinois. A brief war in 1832, Black Hawk\u2019s War, ensued. White settlers panicked at the return of the N peoples, and militias and federal troops quickly mobilized. At the Bad Axe Massacre, they killed over two hundred men, women, and children. Some seventy White settlers and soldiers also lost their lives in the conflict ( Figure 10.16 ). The war, which lasted only a matter of weeks, illustrates how much White people on the frontier hated and feared Native Americans during the Age of Jackson. \n 10.5   The Tyranny and Triumph of the Majority Learning Objectives By the end of this section, you will be able to: \n\n Explain Alexis de Tocqueville\u2019s analysis of American democracy \n\n Describe the election of 1840 and its outcome \n\n To some observers, the rise of democracy in the United States raised troubling questions about the new power of the majority to silence minority opinion. As the will of the majority became the rule of the day, everyone outside of mainstream, White American opinion, especially Native American and Black people, were vulnerable to the wrath of the majority. Some worried that the rights of those who opposed the will of the majority would never be safe. Mass democracy also shaped political campaigns as never before. The 1840 presidential election marked a significant turning point in the evolving style of American democratic politics. \n\n ALEXIS DE TOCQUEVILLE \n\n Perhaps the most insightful commentator on American democracy was the young French aristocrat Alexis de Tocqueville, whom the French government sent to the United States to report on American prison reforms ( Figure 10.17 ). Tocqueville marveled at the spirit of democracy that pervaded American life. Given his place in French society, however, much of what he saw of American democracy caused him concern. \n\n Tocqueville\u2019s experience led him to believe that democracy was an unstoppable force that would one day overthrow monarchy around the world. He wrote and published his findings in 1835 and 1840 in a two-part work entitled  Democracy in America . In analyzing the democratic revolution in the United States, he wrote that the major benefit of democracy came in the form of equality before the law. A great deal of the social revolution of democracy, however, carried negative consequences. Indeed, Tocqueville described a new type of tyranny, the  tyranny of the majority , which overpowers the will of minorities and individuals and was, in his view, unleashed by democracy in the United States. \n\n In this excerpt from  Democracy in America , Alexis de Tocqueville warns of the dangers of democracy when the majority will can turn to tyranny: \n\nWhen an individual or a party is wronged in the United States, to whom can he apply for redress? If to public opinion, public opinion constitutes the majority; if to the legislature, it represents the majority, and implicitly obeys its injunctions; if to the executive power, it is appointed by the majority, and remains a passive tool in its hands; the public troops consist of the majority under arms; the jury is the majority invested with the right of hearing judicial cases; and in certain States even the judges are elected by the majority. However iniquitous or absurd the evil of which you complain may be, you must submit to it as well as you can. \n\nThe authority of a king is purely physical, and it controls the actions of the subject without subduing his private will; but the majority possesses a power which is physical and moral at the same time; it acts upon the will as well as upon the actions of men, and it represses not only all contest, but all controversy. I know no country in which there is so little true independence of mind and freedom of discussion as in America. \n\n THE 1840 ELECTION \n\n The presidential election contest of 1840 marked the culmination of the democratic revolution that swept the United States. By this time, the  second party system  had taken hold, a system whereby the older Federalist and Democratic-Republican Parties had been replaced by the new Democratic and Whig Parties. Both Whigs and Democrats jockeyed for election victories and commanded the steady loyalty of political partisans. Large-scale presidential campaign rallies and emotional propaganda became the order of the day. Voter turnout increased dramatically under the second party system. Roughly 25 percent of eligible voters had cast ballots in 1828. In 1840, voter participation surged to nearly 80 percent. \n\n The differences between the parties were largely about economic policies. Whigs advocated accelerated economic growth, often endorsing federal government projects to achieve that goal. Democrats did not view the federal government as an engine promoting economic growth and advocated a smaller role for the national government. The membership of the parties also differed: Whigs tended to be wealthier; they were prominent planters in the South and wealthy urban northerners\u2014in other words, the beneficiaries of the market revolution. Democrats presented themselves as defenders of the common people against the elite. \n\n In the 1840 presidential campaign, taking their cue from the Democrats who had lionized Jackson\u2019s military accomplishments, the Whigs promoted William Henry Harrison as a war hero based on his 1811 military service against the Shawnee chief Tecumseh at the Battle of Tippecanoe. John Tyler of Virginia ran as the vice presidential candidate, leading the Whigs to trumpet, \u201cTippecanoe and Tyler too!\u201d as a campaign slogan. \n\n The campaign thrust Harrison into the national spotlight. Democrats tried to discredit him by declaring, \u201cGive him a barrel of hard [alcoholic] cider and settle a pension of two thousand a year on him, and take my word for it, he will sit the remainder of his days in his log cabin.\u201d The Whigs turned the slur to their advantage by presenting Harrison as a man of the people who had been born in a log cabin (in fact, he came from a privileged background in Virginia), and the contest became known as the  log cabin campaign  ( Figure 10.18 ). At Whig political rallies, the faithful were treated to whiskey made by the E. C. Booz Company, leading to the introduction of the word \u201cbooze\u201d into the American lexicon. Tippecanoe Clubs, where booze flowed freely, helped in the marketing of the Whig candidate. \n\n The Whigs\u2019 efforts, combined with their strategy of blaming Democrats for the lingering economic collapse that began with the hard-currency Panic of 1837, succeeded in carrying the day. A mass campaign with political rallies and party mobilization had molded a candidate to fit an ideal palatable to a majority of American voters, and in 1840 Harrison won what many consider the first modern election. ", "questions": [{"question": {"question_id": "fs-idm208670336", "question_text": "Which group saw an expansion of their voting rights in the early nineteenth century?", "question_choices": ["free Black people", "non-property-owning men", "women", "Native Americans"], "cloze_format": "___ saw an expansion of their voting rights in the early nineteenth century.", "normal_format": "Which group saw an expansion of their voting rights in the early nineteenth century?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Expanded voting rights did not extend to women , Native , or free Black people in the North . Indeed , race replaced property qualifications as the criterion for voting rights . However , this expansion of political power was limited to White men ; women , free Black people , and Native Americans remained \u2014 or grew increasingly \u2014 disenfranchised by the American political system .", "hl_context": "<hl> Expanded voting rights did not extend to women , Native , or free Black people in the North . <hl> <hl> Indeed , race replaced property qualifications as the criterion for voting rights . <hl> American democracy had a decidedly racist orientation ; a White majority limited the rights of Black minorities . New Jersey explicitly restricted the right to vote to White men only . Connecticut passed a law in 1814 taking the right to vote away from free Black men and restricting suffrage to White men only . By the 1820s , 80 percent of the White male population could vote in New York State elections . No other state had expanded suffrage so dramatically . At the same time , however , New York effectively disenfranchised free Black men in 1822 ( Black men had had the right to vote under the 1777 constitution ) by requiring that \u201c men of color \u201d must possess property over the value of $ 250 . In the 1820s , American political culture gave way to the democratic urges of the citizenry . Political leaders and parties rose to popularity by championing the will of the people , pushing the country toward a future in which a wider swath of citizens gained a political voice . <hl> However , this expansion of political power was limited to White men ; women , free Black people , and Native Americans remained \u2014 or grew increasingly \u2014 disenfranchised by the American political system . <hl>"}, {"question": {"question_id": "fs-idm6241760", "question_text": "What was the lasting impact of the Bucktail Republican Party in New York?", "question_choices": ["They implemented universal suffrage.", "They pushed for the expansion of the canal system.", "They elevated Martin Van Buren to the national political stage.", "They changed state election laws from an appointee system to a system of open elections."], "cloze_format": "The Bucktail Republican Party in New York ___.", "normal_format": "What was the lasting impact of the Bucktail Republican Party in New York?"}, "answer": {"ans_text": "They changed state election laws from an appointee system to a system of open elections.", "ans_choice": 3}, "bloom": null, "hl_sentences": "One of the Bucktails \u2019 greatest achievements in New York came in the form of revisions to the state constitution in the 1820s . Under the original constitution , a Council of Appointments selected local officials such as sheriffs and county clerks . The Bucktails replaced this process with a system of direct elections , which meant thousands of jobs immediately became available to candidates who had the support of the majority .", "hl_context": "<hl> One of the Bucktails \u2019 greatest achievements in New York came in the form of revisions to the state constitution in the 1820s . <hl> <hl> Under the original constitution , a Council of Appointments selected local officials such as sheriffs and county clerks . <hl> <hl> The Bucktails replaced this process with a system of direct elections , which meant thousands of jobs immediately became available to candidates who had the support of the majority . <hl> In practice , Van Buren \u2019 s party could nominate and support their own candidates based on their loyalty to the party . In this way , Van Buren helped create a political machine of disciplined party members who prized loyalty above all else , a harbinger of future patronage politics in the United States . This system of rewarding party loyalists is known as the spoils system ( from the expression , \u201c To the victor belong the spoils \u201d ) . Van Buren \u2019 s political machine helped radically transform New York politics ."}, {"question": {"question_id": "fs-idp107852496", "question_text": "Who won the popular vote in the election of 1824?", "question_choices": ["Andrew Jackson", "Martin Van Buren", "Henry Clay", "John Quincy Adams"], "cloze_format": "___ won the popular vote in the election of 1824.", "normal_format": "Who won the popular vote in the election of 1824?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Results from the eighteen states where the popular vote determined the electoral vote gave Jackson the election , with 152,901 votes to Adams \u2019 s 114,023 , Clay \u2019 s 47,217 , and Crawford \u2019 s 46,979 . With the caucus system defunct , the presidential election of 1824 featured five candidates , all of whom ran as Democratic-Republicans ( the Federalists having ceased to be a national political force ) . The crowded field included John Quincy Adams , the son of the second president , John Adams . A second candidate , John C . Calhoun from South Carolina , had served as secretary of war and represented the slaveholding South . A third candidate , Henry Clay , the Speaker of the House of Representatives , hailed from Kentucky and represented the western states . William H . Crawford , a slaveholder from Georgia , suffered a stroke in 1823 that left him largely incapacitated , but he ran nonetheless and had the backing of the New York machine headed by Van Buren . Andrew Jackson , the famed \u201c hero of New Orleans , \u201d rounded out the field .", "hl_context": "<hl> Results from the eighteen states where the popular vote determined the electoral vote gave Jackson the election , with 152,901 votes to Adams \u2019 s 114,023 , Clay \u2019 s 47,217 , and Crawford \u2019 s 46,979 . <hl> The Electoral College , however , was another matter . Of the 261 electoral votes , Jackson needed 131 or better to win but secured only 99 . Adams won 84 , Crawford 41 , and Clay 37 . Because Jackson did not receive a majority vote from the Electoral College , the election was decided following the terms of the Twelfth Amendment , which stipulated that when a candidate did not receive a majority of electoral votes , the election went to the House of Representatives , where each state would provide one vote . House Speaker Clay did not want to see his rival , Jackson , become president and therefore worked within the House to secure the presidency for Adams , convincing many to cast their vote for the New Englander . Clay \u2019 s efforts paid off ; despite not having won the popular vote , John Quincy Adams was certified by the House as the next president . Once in office , he elevated Henry Clay to the post of secretary of state . <hl> With the caucus system defunct , the presidential election of 1824 featured five candidates , all of whom ran as Democratic-Republicans ( the Federalists having ceased to be a national political force ) . <hl> <hl> The crowded field included John Quincy Adams , the son of the second president , John Adams . <hl> Candidate Adams had broken with the Federalists in the early 1800s and served on various diplomatic missions , including the mission to secure peace with Great Britain in 1814 . He represented New England . <hl> A second candidate , John C . Calhoun from South Carolina , had served as secretary of war and represented the slaveholding South . <hl> He dropped out of the presidential race to run for vice president . <hl> A third candidate , Henry Clay , the Speaker of the House of Representatives , hailed from Kentucky and represented the western states . <hl> He favored an active federal government committed to internal improvements , such as roads and canals , to bolster national economic development and settlement of the West . <hl> William H . Crawford , a slaveholder from Georgia , suffered a stroke in 1823 that left him largely incapacitated , but he ran nonetheless and had the backing of the New York machine headed by Van Buren . <hl> <hl> Andrew Jackson , the famed \u201c hero of New Orleans , \u201d rounded out the field . <hl> Jackson had very little formal education , but he was popular for his military victories in the War of 1812 and in wars against the Creek and the Seminole . He had been elected to the Senate in 1823 , and his popularity soared as pro-Jackson newspapers sang the praises of the courage and daring of the Tennessee slaveholder ( Figure 10.4 ) ."}, {"question": {"question_id": "fs-idp218663888", "question_text": "What was the actual result of Jackson\u2019s policy of \u201crotation in office\u201d?", "question_choices": ["an end to corruption in Washington", "a replacement of Adams\u2019s political loyalists with Jackson\u2019s political loyalists", "the filling of government posts with officials the people chose themselves", "the creation of the Kitchen Cabinet"], "cloze_format": "Jakson's policy of \"rotation in office\" resulted in ___.", "normal_format": "What was the actual result of Jackson\u2019s policy of \u201crotation in office\u201d?"}, "answer": {"ans_text": "a replacement of Adams\u2019s political loyalists with Jackson\u2019s political loyalists", "ans_choice": 1}, "bloom": null, "hl_sentences": "This replacement of appointed federal officials is called rotation in office . Lucrative posts , such as postmaster and deputy postmaster , went to party loyalists , especially in places where Jackson \u2019 s support had been weakest , such as New England .", "hl_context": "Amid revelations of widespread fraud , including the disclosure that some $ 300,000 was missing from the Treasury Department , Jackson removed almost 50 percent of appointed civil officers , which allowed him to handpick their replacements . <hl> This replacement of appointed federal officials is called rotation in office . <hl> <hl> Lucrative posts , such as postmaster and deputy postmaster , went to party loyalists , especially in places where Jackson \u2019 s support had been weakest , such as New England . <hl> Some Democratic newspaper editors who had supported Jackson during the campaign also gained public jobs ."}, {"question": {"question_id": "fs-idp25471552", "question_text": "The election of 1828 brought in the first presidency of which political party?", "question_choices": ["the Democrats", "the Democratic-Republicans", "the Republicans", "the Bucktails"], "cloze_format": "___ won their first presidency ever in the election of 1828.", "normal_format": "The election of 1828 brought in the first presidency of which political party?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "In November 1828 , Jackson won an overwhelming victory over Adams , capturing 56 percent of the popular vote and 68 percent of the electoral vote . As in 1800 , when Jefferson had won over the Federalist incumbent John Adams , the presidency passed to a new political party , the Democrats . A turning point in American political history occurred in 1828 , which witnessed the election of Andrew Jackson over the incumbent John Quincy Adams . While democratic practices had been in ascendance since 1800 , the year also saw the further unfolding of a democratic spirit in the United States . Supporters of Jackson called themselves Democrats or the Democracy , giving birth to the Democratic Party .", "hl_context": "<hl> In November 1828 , Jackson won an overwhelming victory over Adams , capturing 56 percent of the popular vote and 68 percent of the electoral vote . <hl> <hl> As in 1800 , when Jefferson had won over the Federalist incumbent John Adams , the presidency passed to a new political party , the Democrats . <hl> The election was the climax of several decades of expanding democracy in the United States and the end of the older politics of deference . <hl> A turning point in American political history occurred in 1828 , which witnessed the election of Andrew Jackson over the incumbent John Quincy Adams . <hl> <hl> While democratic practices had been in ascendance since 1800 , the year also saw the further unfolding of a democratic spirit in the United States . <hl> <hl> Supporters of Jackson called themselves Democrats or the Democracy , giving birth to the Democratic Party . <hl> Political authority appeared to rest with the majority as never before ."}, {"question": {"question_id": "fs-idm301856784", "question_text": "South Carolina threatened to nullify which federal act?", "question_choices": ["the abolition of slavery", "the expansion of the transportation infrastructure", "the protective tariff on imported goods", "the rotation in office that expelled several federal officers"], "cloze_format": "South Carolina threatened to nullify ___.", "normal_format": "South Carolina threatened to nullify which federal act?"}, "answer": {"ans_text": "the protective tariff on imported goods", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "To deal with the crisis , Jackson advocated a reduction in tariff rates . The Tariff of 1832 , passed in the summer , lowered the rates on some products like imported goods , a move designed to calm southerners . It did not have the desired effect , however , and Calhoun \u2019 s nullifiers still claimed their right to override federal law . In November , South Carolina passed the Ordinance of Nullification , declaring the 1828 and 1832 tariffs null and void in the Palmetto State .", "hl_context": "<hl> To deal with the crisis , Jackson advocated a reduction in tariff rates . <hl> <hl> The Tariff of 1832 , passed in the summer , lowered the rates on some products like imported goods , a move designed to calm southerners . <hl> <hl> It did not have the desired effect , however , and Calhoun \u2019 s nullifiers still claimed their right to override federal law . <hl> <hl> In November , South Carolina passed the Ordinance of Nullification , declaring the 1828 and 1832 tariffs null and void in the Palmetto State . <hl> Jackson responded , however , by declaring in the December 1832 Nullification Proclamation that a state did not have the power to void a federal law . With the states and the federal government at an impasse , civil war seemed a real possibility . The next governor of South Carolina , Robert Hayne , called for a force of ten thousand volunteers ( Figure 10.9 ) to defend the state against any federal action . At the same time , South Carolinians who opposed the nullifiers told Jackson that eight thousand men stood ready to defend the Union . Congress passed the Force Bill of 1833 , which gave the federal government the right to use federal troops to ensure compliance with federal law . The crisis \u2014 or at least the prospect of armed conflict in South Carolina \u2014 was defused by the Compromise Tariff of 1833 , which reduced tariff rates considerably . Nullifiers in South Carolina accepted it , but in a move that demonstrated their inflexibility , they nullified the Force Bill ."}, {"question": {"question_id": "fs-idm168826480", "question_text": "How did President Jackson respond to Congress\u2019s re-chartering of the Second Bank of the United States?", "question_choices": ["He vetoed it.", "He gave states the right to implement it or not.", "He signed it into law.", "He wrote a counterproposal."], "cloze_format": "President Jackson ___ to Congress's re-chartering of the Second Bank of the United States.", "normal_format": "How did President Jackson respond to Congress\u2019s re-chartering of the Second Bank of the United States?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "In January 1832 , they pushed for legislation that would re-charter it , even though its charter was not scheduled to expire until 1836 . When the bill for re-chartering passed and came to President Jackson , he used his executive authority to veto the measure . However , despite Congress \u2019 s approval of the Second Bank of the United States , a great many people continued to view it as tool of the wealthy , an anti-democratic force .", "hl_context": "A large part of the allure of mass democracy for politicians was the opportunity to capture the anger and resentment of ordinary Americans against what they saw as the privileges of a few . One of the leading opponents of the bank was Thomas Hart Benton , a senator from Missouri , who declared that the bank served \u201c to make the rich richer , and the poor poorer . \u201d The self-important statements of Biddle , who claimed to have more power than President Jackson , helped fuel sentiments like Benton \u2019 s . In the reelection campaign of 1832 , Jackson \u2019 s opponents in Congress , including Henry Clay , hoped to use their support of the bank to their advantage . <hl> In January 1832 , they pushed for legislation that would re-charter it , even though its charter was not scheduled to expire until 1836 . <hl> <hl> When the bill for re-chartering passed and came to President Jackson , he used his executive authority to veto the measure . <hl> In the 1820s , the national bank moved into a magnificent new building in Philadelphia . <hl> However , despite Congress \u2019 s approval of the Second Bank of the United States , a great many people continued to view it as tool of the wealthy , an anti-democratic force . <hl> President Jackson was among them ; he had faced economic crises of his own during his days speculating in land , an experience that had made him uneasy about paper money . To Jackson , hard currency \u2014 that is , gold or silver \u2014 was the far better alternative . The president also personally disliked the bank \u2019 s director , Nicholas Biddle ."}, {"question": {"question_id": "fs-idp266332768", "question_text": "How did most Whites in the United States view Native Americans in the 1820s?", "question_choices": ["as savages", "as being in touch with nature", "as enslaved people", "as shamans"], "cloze_format": "Most Whites in the United States viewed the Native Americans in the 1820s as ___.", "normal_format": "How did most Whites in the United States view Native Americans in the 1820s?"}, "answer": {"ans_text": "as savages", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Indeed , the painting \u2019 s depiction of Native people riding horses , which were introduced by the Spanish , makes clear that , as much as Catlin and White viewers wanted to believe in the primitive and savage Native , the reality was otherwise . Native Americans also made frequent appearances in art . George Catlin produced many paintings of Native peoples , which he offered as true representations despite routinely emphasizing their supposed \" savage \" nature .", "hl_context": "Catlin routinely painted Native Americans in a supposedly aboriginal state . In Attacking the Grizzly Bear , the hunters do not have rifles and instead rely on spears . Such a portrayal stretches credibility as Native peoples had long been exposed to and adopted European weapons . <hl> Indeed , the painting \u2019 s depiction of Native people riding horses , which were introduced by the Spanish , makes clear that , as much as Catlin and White viewers wanted to believe in the primitive and savage Native , the reality was otherwise . <hl> <hl> Native Americans also made frequent appearances in art . <hl> <hl> George Catlin produced many paintings of Native peoples , which he offered as true representations despite routinely emphasizing their supposed \" savage \" nature . <hl> The Cutting Scene , Mandan O-kee-pa Ceremony ( Figure 10.12 ) is one example . Scholars have long questioned the accuracy of this portrayal of a rite of passage among the Mandan people . Accuracy aside , the painting captured the imaginations of White viewers , reinforcing their disgust at the savagery of Native Americans ."}, {"question": {"question_id": "fs-idp23525536", "question_text": "The 1830 Indian Removal Act is best understood as ________.", "question_choices": ["an example of President Jackson forcing Congress to pursue an unpopular policy", "an illustration of the widespread hatred of Native Americans during the Age of Jackson", "an example of laws designed to integrate Native Americans into American life", "an effort to deprive the Cherokee of their enslaved property"], "cloze_format": "The 1830 Indian Removal Act is best understood as ________.", "normal_format": "The 1830 Indian Removal Act is best understood as which of the following?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Jackson \u2019 s anti-Native stance struck a chord with a majority of White citizens , many of whom shared a hatred of non-Whites that spurred Congress to pass the 1830 Indian Removal Act . The act called for the removal of the Five Civilized Tribes from their home in the southeastern United States to land in the West , in present-day Oklahoma . Pro-Jackson newspapers touted the president as a champion of opening land for White settlement and moving native inhabitants beyond the boundaries of \u201c American civilization . \u201d In this effort , Jackson reflected majority opinion : most Americans believed Native peoples had no place in the White republic . Jackson \u2019 s animosity toward Native Americans ran deep . He had fought against the Creek in 1813 and against the Seminole in 1817 , and his reputation and popularity rested in large measure on his firm commitment to remove Native residents from states in the South . The 1830 Indian Removal Act and subsequent displacement of the Creek , Choctaw , Chickasaw , Seminole , and Cherokee tribes of the Southeast fulfilled the vision of a White nation and became one of the identifying characteristics of the Age of Jackson .", "hl_context": "<hl> Jackson \u2019 s anti-Native stance struck a chord with a majority of White citizens , many of whom shared a hatred of non-Whites that spurred Congress to pass the 1830 Indian Removal Act . <hl> <hl> The act called for the removal of the Five Civilized Tribes from their home in the southeastern United States to land in the West , in present-day Oklahoma . <hl> Jackson declared in December 1830 , \u201c It gives me pleasure to announce to Congress that the benevolent policy of the Government , steadily pursued for nearly thirty years , in relation to the removal of the Native Americans beyond the White settlements is approaching to a happy consummation . Two important tribes have accepted the provision made for their removal at the last session of Congress , and it is believed that their example will induce the remaining tribes also to seek the same obvious advantages . \u201d <hl> Pro-Jackson newspapers touted the president as a champion of opening land for White settlement and moving native inhabitants beyond the boundaries of \u201c American civilization . \u201d In this effort , Jackson reflected majority opinion : most Americans believed Native peoples had no place in the White republic . <hl> <hl> Jackson \u2019 s animosity toward Native Americans ran deep . <hl> <hl> He had fought against the Creek in 1813 and against the Seminole in 1817 , and his reputation and popularity rested in large measure on his firm commitment to remove Native residents from states in the South . <hl> <hl> The 1830 Indian Removal Act and subsequent displacement of the Creek , Choctaw , Chickasaw , Seminole , and Cherokee tribes of the Southeast fulfilled the vision of a White nation and became one of the identifying characteristics of the Age of Jackson . <hl>"}, {"question": {"question_id": "fs-idm227000432", "question_text": "The winner of the 1840 election was ________.", "question_choices": ["a Democrat", "a Democratic-Republican", "an Anti-Federalist", "a Whig"], "cloze_format": "The winner of the 1840 election was ________.", "normal_format": "Who was the winner of the 1840 election?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The Whigs \u2019 efforts , combined with their strategy of blaming Democrats for the lingering economic collapse that began with the hard-currency Panic of 1837 , succeeded in carrying the day . A mass campaign with political rallies and party mobilization had molded a candidate to fit an ideal palatable to a majority of American voters , and in 1840 Harrison won what many consider the first modern election . In the 1840 presidential campaign , taking their cue from the Democrats who had lionized Jackson \u2019 s military accomplishments , the Whigs promoted William Henry Harrison as a war hero based on his 1811 military service against the Shawnee chief Tecumseh at the Battle of Tippecanoe .", "hl_context": "<hl> The Whigs \u2019 efforts , combined with their strategy of blaming Democrats for the lingering economic collapse that began with the hard-currency Panic of 1837 , succeeded in carrying the day . <hl> <hl> A mass campaign with political rallies and party mobilization had molded a candidate to fit an ideal palatable to a majority of American voters , and in 1840 Harrison won what many consider the first modern election . <hl> <hl> In the 1840 presidential campaign , taking their cue from the Democrats who had lionized Jackson \u2019 s military accomplishments , the Whigs promoted William Henry Harrison as a war hero based on his 1811 military service against the Shawnee chief Tecumseh at the Battle of Tippecanoe . <hl> John Tyler of Virginia ran as the vice presidential candidate , leading the Whigs to trumpet , \u201c Tippecanoe and Tyler too ! \u201d as a campaign slogan ."}, {"question": {"question_id": "fs-idm207481456", "question_text": "Which of the following did not characterize political changes in the 1830s?", "question_choices": ["higher voter participation", "increasing political power of free Black voters", "stronger partisan ties", "political battles between Whigs and Democrats"], "cloze_format": "___ did not characterize political changes in the 1830s.", "normal_format": "Which of the following did not characterize political changes in the 1830s?"}, "answer": {"ans_text": "increasing political power of free Black voters", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Both Whigs and Democrats jockeyed for election victories and commanded the steady loyalty of political partisans . Large-scale presidential campaign rallies and emotional propaganda became the order of the day . Voter turnout increased dramatically under the second party system . Roughly 25 percent of eligible voters had cast ballots in 1828 . In 1840 , voter participation surged to nearly 80 percent .", "hl_context": "The presidential election contest of 1840 marked the culmination of the democratic revolution that swept the United States . By this time , the second party system had taken hold , a system whereby the older Federalist and Democratic-Republican Parties had been replaced by the new Democratic and Whig Parties . <hl> Both Whigs and Democrats jockeyed for election victories and commanded the steady loyalty of political partisans . <hl> <hl> Large-scale presidential campaign rallies and emotional propaganda became the order of the day . <hl> <hl> Voter turnout increased dramatically under the second party system . <hl> <hl> Roughly 25 percent of eligible voters had cast ballots in 1828 . <hl> <hl> In 1840 , voter participation surged to nearly 80 percent . <hl>"}], "summary": " Summary 10.1   A New Political Style: From John Quincy Adams to Andrew Jackson \n\n The early 1800s saw an age of deference give way to universal manhood suffrage and a new type of political organization based on loyalty to the party. The election of 1824 was a fight among Democratic-Republicans that ended up pitting southerner Andrew Jackson against northerner John Quincy Adams. When Adams won through political negotiations in the House of Representatives, Jackson\u2019s supporters derided the election as a \u201ccorrupt bargain.\u201d The Tariff of 1828 further stirred southern sentiment, this time against a perceived bias in the federal government toward northeastern manufacturers. At the same time, the tariff stirred deeper fears that the federal government might take steps that could undermine the system of slavery. \n\n 10.2   The Rise of American Democracy \n\n The Democratic-Republicans\u2019 \u201ccorrupt bargain\u201d that brought John Quincy Adams and Henry Clay to office in 1824 also helped to push them out of office in 1828. Jackson used it to highlight the cronyism of Washington politics. Supporters presented him as a true man of the people fighting against the elitism of Clay and Adams. Jackson rode a wave of populist fervor all the way to the White House, ushering in the ascendency of a new political party: the Democrats. Although Jackson ran on a platform of clearing the corruption out of Washington, he rewarded his own loyal followers with plum government jobs, thus continuing and intensifying the cycle of favoritism and corruption. \n\n 10.3   The Nullification Crisis and the Bank War \n\n Andrew Jackson\u2019s election in 1832 signaled the rise of the Democratic Party and a new style of American politics. Jackson understood the views of the majority, and he skillfully used the popular will to his advantage. He adroitly navigated through the Nullification Crisis and made headlines with what his supporters viewed as his righteous war against the bastion of money, power, and entrenched insider interests, the Second Bank of the United States. His actions, however, stimulated opponents to fashion an opposition party, the Whigs. \n\n 10.4   Indian Removal \n\n Popular culture in the Age of Jackson emphasized the perceived savagery of the Native peoples and shaped domestic policy. Popular animosity found expression in the Indian Removal Act. Even the U.S. Supreme Court\u2019s ruling in favor of the Cherokee in Georgia offered no protection against the forced removal of the Five Civilized Tribes from the Southeast, mandated by the 1830 Indian Removal Act and carried out by the U.S. military. \n\n 10.5   The Tyranny and Triumph of the Majority \n\n American culture of the 1830s reflected the rise of democracy. The majority exercised a new type of power that went well beyond politics, leading Alexis de Tocqueville to write about the \u201ctyranny of the majority.\u201d Very quickly, politicians among the Whigs and Democrats learned to master the magic of the many by presenting candidates and policies that catered to the will of the majority. In the 1840 \u201clog cabin campaign,\u201d both sides engaged in the new democratic electioneering. The uninhibited expression during the campaign inaugurated a new political style. ", "keyterm": "", "bname": "u.s._history"}, {"chapter": 25, "intro": " Chapter Outline 25.1   Anatomy of the Circulatory and Lymphatic Systems 25.2   Bacterial Infections of the Circulatory and Lymphatic Systems 25.3   Viral Infections of the Circulatory and Lymphatic Systems 25.4   Parasitic Infections of the Circulatory and Lymphatic Systems Introduction Yellow fever was once common in the southeastern US, with annual outbreaks of more than 25,000 infections in New Orleans in the mid-1800s. 1  In the early 20th century, efforts to eradicate the virus that causes  yellow fever  were successful thanks to vaccination programs and effective control (mainly through the insecticide dichlorodiphenyltrichloroethane [DDT]) of  Aedes aegypti , the mosquito that serves as a vector. Today, the virus has been largely eradicated in North America. 1 Centers for Disease Control and Prevention. \u201cThe History of Yellow Fever.\u201d http://www.cdc.gov/travel-training/local/HistoryEpidemiologyandVaccination/page27568.html Elsewhere, efforts to contain yellow fever have been less successful. Despite mass vaccination campaigns in some regions, the risk for yellow fever epidemics is rising in dense urban cities in Africa and South America. 2  In an increasingly globalized society, yellow fever could easily make a comeback in North America, where  A. aegypti  is still present. If these mosquitoes were exposed to infected individuals, new outbreaks would be possible. 2 C.L. Gardner, K.D. Ryman. \u201cYellow Fever: A Reemerging Threat.\u201d  Clinical Laboratory Medicine  30 no. 1 (2010):237\u2013260. Like yellow fever, many of the circulatory and lymphatic diseases discussed in this chapter are emerging or re-emerging worldwide. Despite medical advances, diseases like malaria, Ebola, and others could become endemic in the US given the right circumstances. ", "chapter_text": " 25.1   Anatomy of the Circulatory and Lymphatic Systems \n\n Learning Objectives \n\n Describe the major anatomical features of the circulatory and lymphatic systems \n\n Explain why the circulatory and lymphatic systems lack normal microbiota \n\n Explain how microorganisms overcome defenses of the circulatory and lymphatic systems to cause infection \n\n Describe general signs and symptoms of disease associated with infections of the circulatory and lymphatic systems \n\n Clinical Focus Part 1 Barbara is a 43-year-old patient who has been diagnosed with metastatic inflammatory breast cancer. To facilitate her ongoing chemotherapy, her physician implanted a port attached to a central venous catheter. At a recent checkup, she reported feeling restless and complained that the site of the catheter had become uncomfortable. After removing the dressing, the physician observed that the surgical site appeared red and was warm to the touch, suggesting a localized infection. Barbara\u2019s was also running a fever of 38.2 \u00b0C (100.8 \u00b0F). Her physician treated the affected area with a topical antiseptic and applied a fresh dressing. She also prescribed a course of the antibiotic oxacillin. \n\n Based on this information, what factors likely contributed to Barbara\u2019s condition? \n\n What is the most likely source of the microbes involved? \n\n Jump to the  next  Clinical Focus box. \n\n The circulatory and lymphatic systems are networks of vessels and a pump that transport blood and lymph, respectively, throughout the body. When these systems are infected with a microorganism, the network of vessels can facilitate the rapid dissemination of the microorganism to other regions of the body, sometimes with serious results. In this section, we will examine some of the key anatomical features of the circulatory and lymphatic systems, as well as general signs and symptoms of infection. \n\n The Circulatory System \n\n The circulatory (or cardiovascular) system is a closed network of organs and vessels that moves blood around the body ( Figure 25.2 ). The primary purposes of the  circulatory system  are to deliver nutrients, immune factors, and oxygen to tissues and to carry away waste products for elimination. The  heart  is a four-chambered pump that propels the blood throughout the body. Deoxygenated blood enters the right atrium through the superior vena cava and the inferior vena cava after returning from the body. The blood next passes through the tricuspid valve to enter the right ventricle. When the heart contracts, the blood from the right ventricle is pumped through the pulmonary arteries to the lungs. There, the blood is oxygenated at the alveoli and returns to the heart through the pulmonary veins. The oxygenated blood is received at the left atrium and proceeds through the mitral valve to the left ventricle. When the heart contracts, the oxygenated blood is pumped throughout the body via a series of thick-walled vessels called arteries. The first and largest  artery  is called the aorta. The arteries sequentially branch and decrease in size (and are called arterioles) until they end in a network of smaller vessels called capillaries. The  capillary  beds are located in the interstitial spaces within tissues and release nutrients, immune factors, and oxygen to those tissues. The capillaries connect to a series of vessels called venules, which increase in size to form the  vein s. The veins join together into larger vessels as they transfer blood back to the heart. The largest veins, the superior and inferior vena cava, return the blood to the right atrium. \n\n Other organs play important roles in the circulatory system as well. The  kidneys  filter the blood, removing waste products and eliminating them in the urine. The  liver  also filters the blood and removes damaged or defective red blood cells. The  spleen  filters and stores blood, removes damaged red blood cells, and is a reservoir for immune factors. All of these filtering structures serve as sites for entrapment of microorganisms and help maintain an environment free of microorganisms in the blood. \n\n The Lymphatic System \n\n The  lymphatic system  is also a network of vessels that run throughout the body ( Figure 25.3 ). However, these vessels do not form a full circulating system and are not pressurized by the heart. Rather, the lymphatic system is an open system with the fluid moving in one direction from the extremities toward two drainage points into veins just above the heart. Lymphatic fluids move more slowly than blood because they are not pressurized. Small lymph capillaries interact with blood capillaries in the interstitial spaces in tissues. Fluids from the tissues enter the lymph capillaries and are drained away ( Figure 25.4 ). These fluids, termed  lymph , also contain large numbers of white blood cells. \n\n The lymphatic system contains two types of lymphoid tissues. The  primary lymphoid tissue  includes bone marrow and the thymus. Bone marrow contains the hematopoietic stem cells (HSC) that differentiate and mature into the various types of blood cells and lymphocytes (see  Figure 17.12 ). The  secondary lymphoid tissue s  include the spleen, lymph nodes, and several areas of diffuse lymphoid tissues underlying epithelial membranes. The  spleen , an encapsulated structure, filters blood and captures pathogens and antigens that pass into it ( Figure 25.5 ). The spleen contains specialized macrophages and dendritic cells that are crucial for antigen presentation, a mechanism critical for activation of T lymphocytes and B lymphocytes (see  Major Histocompatibility Complexes and Antigen-Presenting Cells ). Lymph nodes are bean-shaped organs situated throughout the body. These structures contain areas called germinal centers that are rich in B and T lymphocytes. The  lymph nodes  also contain macrophages and dendritic cells for antigen presentation. Lymph from nearby tissues enters the lymph node through afferent lymphatic vessels and encounters these lymphocytes as it passes through; the lymph exits the lymph node through the efferent lymphatic vessels ( Figure 25.5 ). \n\n Link to Learning \n\n The lymphatic system filters fluids that have accumulated in tissues before they are returned to the blood. A brief overview of this process is provided at  this  website. \n\n Check Your Understanding \n\n What is the main function of the lymphatic system? \n\n Infections of the Circulatory System \n\n Under normal circumstances, the circulatory system and the blood should be sterile; the circulatory system has no normal microbiota. Because the system is closed, there are no easy portals of entry into the circulatory system for microbes. Those that are able to breach the body\u2019s physical barriers and enter the bloodstream encounter a host of circulating immune defenses, such as antibodies, complement proteins, phagocytes, and other immune cells. Microbes often gain access to the circulatory system through a break in the skin (e.g., wounds, needles, intravenous catheters, insect bites) or spread to the circulatory system from infections in other body sites. For example, microorganisms causing pneumonia or renal infection may enter the local circulation of the lung or kidney and spread from there throughout the circulatory network. \n\n If microbes in the bloodstream are not quickly eliminated, they can spread rapidly throughout the body, leading to serious, even life-threatening infections. Various terms are used to describe conditions involving microbes in the circulatory system. The term  bacteremia  refers to bacteria in the blood. If bacteria are reproducing in the blood as they spread, this condition is called  septicemia . The presence of viruses in the blood is called  viremia . Microbial toxins can also be spread through the circulatory system, causing a condition termed  toxemia . \n\n Microbes and microbial toxins in the blood can trigger an inflammatory response so severe that the inflammation damages host tissues and organs more than the infection itself. This counterproductive immune response is called  systemic inflammatory response syndrome (SIRS) , and it can lead to the life-threatening condition known as  sepsis . Sepsis is characterized by the production of excess  cytokines  that leads to classic signs of  inflammation  such as fever,  vasodilation , and  edema  (see  Inflammation and Fever ). In a patient with sepsis, the inflammatory response becomes dysregulated and disproportionate to the threat of infection. Critical organs such as the heart, lungs, liver, and kidneys become dysfunctional, resulting in increased heart and respiratory rates, and disorientation. If not treated promptly and effectively, patients with sepsis can go into shock and die. \n\n Certain infections can cause inflammation in the heart and blood vessels. Inflammation of the endocardium, the inner lining of the heart, is called  endocarditis  and can result in damage to the heart valves severe enough to require surgical replacement. Inflammation of the pericardium, the sac surrounding the heart, is called  pericarditis . The term  myocarditis  refers to the inflammation of the heart\u2019s muscle tissue. Pericarditis and myocarditis can cause fluid to accumulate around the heart, resulting in congestive heart failure. Inflammation of blood vessels is called  vasculitis . Although somewhat rare, vasculitis can cause blood vessels to become damaged and rupture; as blood is released, small red or purple spots called  petechiae  appear on the skin. If the damage of tissues or blood vessels is severe, it can result in reduced blood flow to the surrounding tissues. This condition is called  ischemia , and it can be very serious. In severe cases, the affected tissues can die and become necrotic; these situations may require surgical debridement or amputation. \n\n Check Your Understanding \n\n Why does the circulatory system have no normal microbiota? \n\n Explain why the presence of microbes in the circulatory system can lead to serious consequences. \n\n Infections of the Lymphatic System \n\n Like the circulatory system, the lymphatic system does not have a normal microbiota, and the large numbers of immune cells typically eliminate transient microbes before they can establish an infection. Only microbes with an array of virulence factors are able to overcome these defenses and establish infection in the lymphatic system. However, when a localized infection begins to spread, the lymphatic system is often the first place the invading microbes can be detected. \n\n Infections in the lymphatic system also trigger an inflammatory response. Inflammation of lymphatic vessels, called  lymphangitis , can produce visible red streaks under the skin. Inflammation in the lymph nodes can cause them to swell. A swollen lymph node is referred to as a  bubo , and the condition is referred to as  lymphadenitis . \n 25.2   Bacterial Infections of the Circulatory and Lymphatic Systems \n\n Learning Objectives \n\n Identify and compare bacteria that most commonly cause infections of the circulatory and lymphatic systems \n\n Compare the major characteristics of specific bacterial diseases affecting the circulatory and lymphatic systems \n\n Bacteria can enter the circulatory and lymphatic systems through acute infections or breaches of the skin barrier or mucosa. Breaches may occur through fairly common occurrences, such as insect bites or small wounds. Even the act of tooth brushing, which can cause small ruptures in the gums, may introduce bacteria into the circulatory system. In most cases, the bacteremia that results from such common exposures is transient and remains below the threshold of detection. In severe cases, bacteremia can lead to septicemia with dangerous complications such as toxemia, sepsis, and septic shock. In these situations, it is often the immune response to the infection that results in the clinical signs and symptoms rather than the microbes themselves. \n\n Bacterial Sepsis, Septic and Toxic Shock \n\n At low concentrations, pro-inflammatory cytokines such as interleukin 1 ( IL-1 ) and tumor necrosis factor-\u03b1 ( TNF-\u03b1 ) play important roles in the host\u2019s immune defenses. When they circulate systemically in larger amounts, however, the resulting immune response can be life threatening. IL-1 induces  vasodilation  (widening of blood vessels) and reduces the tight junctions between vascular endothelial cells, leading to widespread  edema . As fluids move out of circulation into tissues, blood pressure begins to drop. If left unchecked, the blood pressure can fall below the level necessary to maintain proper kidney and respiratory functions, a condition known as  septic shock . In addition, the excessive release of cytokines during the inflammatory response can lead to the formation of  blood clot s. The loss of blood pressure and occurrence of blood clots can result in multiple organ failure and death. \n\n Bacteria are the most common pathogens associated with the development of sepsis, and septic shock. 3  The most common infection associated with  sepsis  is  bacterial pneumonia  (see  Bacterial Infections of the Respiratory Tract ), accounting for about half of all cases, followed by intra-abdominal infections ( Bacterial Infections of the Gastrointestinal Tract ) and urinary tract infections ( Bacterial Infections of the Urinary System ). 4  Infections associated with superficial wounds, animal bites, and indwelling  catheters  may also lead to sepsis and septic shock. 3 S.P. LaRosa. \u201cSepsis.\u201d 2010. http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/infectious-disease/sepsis/. 4 D.C. Angus, T. Van der Poll. \u201cSevere Sepsis and Septic Shock.\u201d  New England Journal of Medicine  369, no. 9 (2013):840\u2013851. \n\n These initially minor, localized infections can be caused by a wide range of different bacteria, including  Staphylococcus, Streptococcus ,  Pseudomonas ,  Pasteurella, Acinetobacter,  and members of the Enterobacteriaceae. However, if left untreated, infections by these gram-positive and gram-negative pathogens can potentially progress to sepsis, shock, and death. \n\n Toxic Shock Syndrome and Streptococcal Toxic Shock-Like Syndrome \n\n Toxemia associated with infections caused by  Staphylococcus aureus  can cause staphylococcal  toxic shock syndrome (TSS) . Some strains of  S. aureus  produce a superantigen called toxic shock syndrome toxin-1 (TSST-1). TSS may occur as a complication of other localized or systemic infections such as  pneumonia ,  osteomyelitis ,  sinusitis , and skin wounds (surgical, traumatic, or burns). Those at highest risk for staphylococcal TSS are women with preexisting  S. aureus  colonization of the vagina who leave tampons, contraceptive sponges, diaphragms, or other devices in the vagina for longer than the recommended time. \n\n Staphylococcal TSS is characterized by sudden onset of vomiting, diarrhea, myalgia, body temperature higher than 38.9 \u00b0C (102.0 \u00b0F), and rapid-onset hypotension with a systolic blood pressure less than 90 mm Hg for adults; a diffuse erythematous rash that leads to peeling and shedding skin 1 to 2 weeks after onset; and additional involvement of three or more organ systems. 5  The mortality rate associated with staphylococcal TSS is less than 3% of cases. 5 Centers for Disease Control and Prevention. \u201cToxic Shock Syndrome (Other Than Streptococcal) (TSS) 2011 Case Definition.\u201d https://wwwn.cdc.gov/nndss/conditions/toxic-shock-syndrome-other-than-streptococcal/case-definition/2011/. Accessed July 25, 2016. \n\n Diagnosis of staphylococcal TSS is based on clinical signs, symptoms, serologic tests to confirm bacterial species, and the detection of toxin production from staphylococcal isolates. Cultures of skin and blood are often negative; less than 5% are positive in cases of staphylococcal TSS. Treatment for staphylococcal TSS includes decontamination, debridement, vasopressors to elevate blood pressure, and antibiotic therapy with  clindamycin  plus  vancomycin  or  daptomycin  pending susceptibility results. \n\n A syndrome with signs and symptoms similar to staphylococcal TSS can be caused by  Streptococcus pyogenes . This condition, called  streptococcal toxic shock-like syndrome (STSS) , is characterized by more severe pathophysiology than staphylococcal TSS, 6  with about 50% of patients developing  S. pyogenes  bacteremia and  necrotizing fasciitis . In contrast to staphylococcal TSS, STSS is more likely to cause acute respiratory distress syndrome (ARDS), a rapidly progressive disease characterized by fluid accumulation in the lungs that inhibits breathing and causes hypoxemia (low oxygen levels in the blood). STSS is associated with a higher mortality rate (20%\u201360%), even with aggressive therapy. STSS usually develops in patients with a streptococcal soft-tissue infection such as bacterial cellulitis,  necrotizing fasciitis ,  pyomyositis  (pus formation in muscle caused by infection), a recent  influenza A  infection, or  chickenpox . 6 Centers for Disease Control and Prevention. \u201cStreptococcal Toxic Shock Syndrome (STSS) ( Streptococcus pyogenes ) 2010 Case Definition.\u201d https://wwwn.cdc.gov/nndss/conditions/streptococcal-toxic-shock-syndrome/case-definition/2010/. Accessed July 25, 2016. \n\n Check Your Understanding \n\n How can large amounts of pro-inflammatory cytokines lead to septic shock? \n\n Clinical Focus Part 2 Despite oxacillin therapy, Barbara\u2019s condition continued to worsen over the next several days. Her fever increased to 40.1 \u00b0C (104.2 \u00b0F) and she began to experience chills, rapid breathing, and confusion. Her doctor suspected bacteremia by a drug-resistant bacterium and admitted Barbara to the hospital. Cultures of the surgical site and blood revealed  Staphylococcus aureus . Antibiotic susceptibility testing confirmed that the isolate was methicillin-resistant  S. aureus  (MRSA). In response, Barbara\u2019s doctor changed her antibiotic therapy to vancomycin and arranged to have the port and venous catheter removed. \n\n Why did Barbara\u2019s infection not respond to oxacillin therapy? \n\n Why did the physician have the port and catheter removed? \n\n Based on the signs and symptoms described, what are some possible diagnoses for Barbara\u2019s condition? \n\n Jump to the  next  Clinical Focus feature box. Go back to the  previous  Clinical Focus feature box. \n\n Puerperal Sepsis \n\n A type of sepsis called  puerperal sepsis , also known as puerperal infection,  puerperal fever , or childbed fever, is a nosocomial infection associated with the period of puerperium\u2014the time following childbirth during which the mother\u2019s reproductive system returns to a nonpregnant state. Such infections may originate in the genital tract, breast, urinary tract, or a surgical wound. Initially the infection may be limited to the  uterus or other local site of infection, but it can quickly spread, resulting in peritonitis, septicemia, and death. Before the 19th century work of Ignaz  Semmelweis  and the widespread acceptance of germ theory (see  Modern Foundations of Cell Theory ), puerperal sepsis was a major cause of mortality among new mothers in the first few days following childbirth. \n\n Puerperal sepsis is often associated with  Streptococcus pyogenes , but numerous other bacteria can also be responsible. Examples include gram-positive bacterial (e.g.  Streptococcus  spp.,  Staphylococcus  spp., and  Enterococcus  spp.), gram-negative bacteria (e.g.  Chlamydia  spp.,  Escherichia coli ,  Klebsiella  spp., and  Proteus  spp.), as well as anaerobes such as  Peptostreptococcus  spp.,  Bacteroides  spp., and  Clostridium  spp. In cases caused by  S. pyogenes , the bacteria attach to host tissues using  M protein  and produce a carbohydrate capsule to avoid phagocytosis.  S. pyogenes  also produces a variety of  exotoxin s, like  streptococcal pyrogenic exotoxin s A and B, that are associated with virulence and may function as  superantigen s. \n\n Diagnosis of puerperal fever is based on the timing and extent of fever and isolation, and identification of the etiologic agent in blood, wound, or urine specimens. Because there are numerous possible causes, antimicrobial susceptibility testing must be used to determine the best antibiotic for treatment. Nosocomial incidence of puerperal fever can be greatly reduced through the use of antiseptics during delivery and strict adherence to handwashing protocols by doctors, midwives, and nurses. \n\n Infectious Arthritis \n\n Also called  septic arthritis ,  infectious arthritis  can be either an acute or a chronic condition. Infectious arthritis is characterized by inflammation of joint tissues and is most often caused by bacterial pathogens. Most cases of acute infectious arthritis are secondary to bacteremia, with a rapid onset of moderate to severe joint pain and swelling that limits the motion of the affected joint. In adults and young children, the infective pathogen is most often introduced directly through injury, such as a wound or a surgical site, and brought to the joint through the circulatory system. Acute infections may also occur after joint replacement surgery. Acute infectious arthritis often occurs in patients with an immune system impaired by other viral and bacterial infections.  S. aureus  is the most common cause of acute septic arthritis in the general population of adults and young children.  Neisseria gonorrhoeae  is an important cause of acute infectious arthritis in sexually active individuals. \n\n Chronic infectious arthritis is responsible for 5% of all infectious arthritis cases and is more likely to occur in patients with other illnesses or conditions. Patients at risk include those who have an  HIV  infection, a bacterial or fungal infection, prosthetic joints,  rheumatoid arthritis  (RA), or who are undergoing immunosuppressive  chemotherapy . Onset is often in a single joint; there may be little or no pain, aching pain that may be mild, gradual swelling, mild warmth, and minimal or no redness of the joint area. \n\n Diagnosis of infectious arthritis requires the aspiration of a small quantity of synovial fluid from the afflicted joint. Direct microscopic evaluation, culture, antimicrobial susceptibility testing, and polymerase chain reaction ( PCR ) analyses of the synovial fluid are used to identify the potential pathogen. Typical treatment includes administration of appropriate antimicrobial drugs based on antimicrobial susceptibility testing. For nondrug-resistant bacterial strains, \u03b2-lactams such as  oxacillin  and  cefazolin  are often prescribed for staphylococcal infections. Third-generation cephalosporins (e.g.,  ceftriaxone ) are used for increasingly prevalent \u03b2-lactam-resistant  Neisseria  infections. Infections by  Mycobacterium  spp. or fungi are treated with appropriate long-term antimicrobial therapy. Even with treatment, the prognosis is often poor for those infected. About 40% of patients with nongonnococcal infectious arthritis will suffer permanent joint damage and mortality rates range from 5% to 20%. 7  Mortality rates are higher among the elderly. 8 7 M.E. Shirtliff, Mader JT. \u201cAcute Septic Arthritis.\u201d  Clinical Microbiology Reviews  15 no. 4 (2002):527\u2013544. 8 J.R. Maneiro et al. \u201cPredictors of Treatment Failure and Mortality in Native Septic Arthritis.\u201d  Clinical Rheumatology  34, no. 11 (2015):1961\u20131967. \n\n Osteomyelitis \n\n Osteomyelitis is an inflammation of bone tissues most commonly caused by infection. These infections can either be acute or chronic and can involve a variety of different bacteria. The most common causative agent of  osteomyelitis  is  S. aureus . However,  M. tuberculosis ,  Pseudomonas aeruginosa, Streptococcus pyogenes ,  S. agalactiae , species in the Enterobacteriaceae ,  and other microorganisms can also cause osteomyelitis, depending on which bones are involved. In adults, bacteria usually gain direct access to the bone tissues through trauma or a surgical procedure involving  prosthetic joints . In children, the bacteria are often introduced from the bloodstream, possibly spreading from focal infections. The long bones, such as the femur, are more commonly affected in children because of the more extensive vascularization of bones in the young. 9 9 M. Vazquez. \u201cOsteomyelitis in Children.\u201d  Current Opinion in Pediatrics  14, no. 1 (2002):112\u2013115. \n\n The signs and symptoms of osteomyelitis include fever, localized pain, swelling due to edema, and ulcers in soft tissues near the site of infection. The resulting inflammation can lead to tissue damage and bone loss. In addition, the infection may spread to joints, resulting in infectious arthritis, or disseminate into the blood, resulting in  sepsis  and  thrombosis  (formation of blood clots). Like septic arthritis, osteomyelitis is usually diagnosed using a combination of radiography, imaging, and identification of bacteria from blood cultures, or from bone cultures if blood cultures are negative. Parenteral antibiotic therapy is typically used to treat osteomyelitis. Because of the number of different possible etiologic agents, however, a variety of drugs might be used. Broad-spectrum antibacterial drugs such as  nafcillin ,  oxacillin , or  cephalosporin  are typically prescribed for acute osteomyelitis, and  ampicillin  and  piperacillin/tazobactam  for chronic osteomyelitis. In cases of antibiotic resistance,  vancomycin  treatment is sometimes required to control the infection. In serious cases, surgery to remove the site of infection may be required. Other forms of treatment include  hyperbaric oxygen therapy  (see  Using Physical Methods to Control Microorganisms ) and implantation of antibiotic beads or pumps. \n\n Check Your Understanding \n\n What bacterium the most common cause of both septic arthritis and osteomyelitis? \n\n Rheumatic Fever \n\n Infections with  S. pyogenes  have a variety of manifestations and complications generally called sequelae. As mentioned, the bacterium can cause suppurative infections like  puerperal fever . However, this microbe can also cause nonsuppurative sequelae in the form of acute  rheumatic fever  (ARF), which can lead to rheumatic heart disease, thus impacting the circulatory system. Rheumatic fever occurs primarily in children a minimum of 2\u20133 weeks after an episode of untreated or inadequately treated pharyngitis (see  Bacterial Infections of the Respiratory Tract ). At one time, rheumatic fever was a major killer of children in the US; today, however, it is rare in the US because of early diagnosis and treatment of streptococcal pharyngitis with antibiotics. In parts of the world where diagnosis and treatment are not readily available, acute rheumatic fever and rheumatic heart disease are still major causes of mortality in children. 10 10 A. Beaudoin et al. \u201cAcute Rheumatic Fever and Rheumatic Heart Disease Among Children\u2014American Samoa, 2011\u20132012.\u201d  Morbidity and Mortality Weekly Report  64 no. 20 (2015):555\u2013558. \n\n Rheumatic fever is characterized by a variety of diagnostic signs and symptoms caused by nonsuppurative, immune-mediated damage resulting from a  cross-reaction  between patient antibodies to bacterial surface proteins and similar proteins found on cardiac, neuronal, and synovial tissues. Damage to the nervous tissue or joints, which leads to joint pain and swelling, is reversible. However, damage to  heart valves  can be irreversible and is worsened by repeated episodes of acute rheumatic fever, particularly during the first 3\u20135 years after the first rheumatic fever attack. The inflammation of the heart valves caused by cross-reacting antibodies leads to scarring and stiffness of the valve leaflets. This, in turn, produces a characteristic heart murmur. Patients who have previously developed rheumatic fever and who subsequently develop recurrent pharyngitis due to  S. pyogenes  are at high risk for a recurrent attacks of rheumatic fever. \n\n The American Heart Association recommends 11  a treatment regimen consisting of  benzathine benzylpenicillin  every 3 or 4 weeks, depending on the patient\u2019s risk for reinfection. Additional prophylactic antibiotic treatment may be recommended depending on the age of the patient and risk for reinfection. 11 M.A. Gerber et al. \u201cPrevention of Rheumatic Fever and Diagnosis and Treatment of Acute Streptococcal Pharyngitis: A Scientific Statement From the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, the Interdisciplinary Council on Functional Genomics and Translational Biology, and the Interdisciplinary Council on Quality of Care and Outcomes Research: Endorsed by the American Academy of Pediatrics.\u201d  Circulation  119, no. 11 (2009):1541\u20131551. \n\n Bacterial Endocarditis and Pericarditis \n\n The endocardium is a tissue layer that lines the muscles and valves of the heart. This tissue can become infected by a variety of bacteria, including gram-positive cocci such as  Staphylococcus aureus , viridans streptococci, and  Enterococcus faecalis , and the gram-negative so-called  HACEK bacilli :  Haemophilus  spp.,  Actinobacillus actinomycetemcomitans ,  Cardiobacterium hominis ,  Eikenella corrodens , and  Kingella kingae . The resulting inflammation is called endocarditis, which can be described as either acute or subacute. Causative agents typically enter the bloodstream during accidental or intentional breaches in the normal barrier defenses (e.g., dental procedures, body piercings, catheterization, wounds). Individuals with preexisting heart damage, prosthetic valves and other cardiac devices, and those with a history of rheumatic fever have a higher risk for endocarditis. This disease can rapidly destroy the  heart valves  and, if untreated, lead to death in just a few days. \n\n In  subacute bacterial endocarditis , heart valve damage occurs slowly over a period of months. During this time, blood clots form in the heart, and these protect the bacteria from phagocytes. These patches of tissue-associated bacteria are called vegetations. The resulting damage to the heart, in part resulting from the immune response causing fibrosis of heart valves, can necessitate heart valve replacement ( Figure 25.6 ). Outward signs of subacute endocarditis may include a fever. \n\n Diagnosis of infective endocarditis is determined using the combination of blood cultures,  echocardiogram , and clinical symptoms. In both acute and subacute endocarditis, treatment typically involves relatively high doses of intravenous antibiotics as determined by antimicrobial susceptibility testing. Acute endocarditis is often treated with a combination of  ampicillin ,  nafcillin , and  gentamicin  for synergistic coverage of  Staphylococcus  spp. and  Streptococcus  spp. Prosthetic-valve endocarditis is often treated with a combination of  vancomycin ,  rifampin , and gentamicin. Rifampin is necessary to treat individuals with infection of prosthetic valves or other foreign bodies because rifampin can penetrate the biofilm of most of the pathogens that infect these devices. \n\n Staphylcoccus  spp. and  Streptococcus  spp. can also infect and cause inflammation in the tissues surrounding the heart, a condition called acute  pericarditis . Pericarditis is marked by chest pain, difficulty breathing, and a dry cough. In most cases, pericarditis is self-limiting and clinical intervention is not necessary. Diagnosis is made with the aid of a chest radiograph, electrocardiogram, echocardiogram, aspirate of pericardial fluid, or biopsy of pericardium. Antibacterial medications may be prescribed for infections associated with pericarditis; however, pericarditis can also be caused other pathogens, including viruses (e.g., echovirus, influenza virus), fungi (e.g.,  Histoplasma  spp.,  Coccidioides  spp.), and eukaryotic parasites (e.g.,  Toxoplasma  spp.). \n\n Check Your Understanding \n\n Compare acute and subacute bacterial endocarditis. \n\n Gas Gangrene \n\n Traumatic injuries or certain medical conditions, such as diabetes, can cause damage to blood vessels that interrupts blood flow to a region of the body. When blood flow is interrupted, tissues begin to die, creating an anaerobic environment in which anaerobic bacteria can thrive. This condition is called  ischemia . Endospores of the anaerobic bacterium  Clostridium perfringens  (along with a number of other  Clostridium  spp. from the gut) can readily germinate in ischemic tissues and colonize the anaerobic tissues. \n\n The resulting infection, called  gas gangrene , is characterized by rapidly spreading myonecrosis (death of muscle tissue). The patient experiences a sudden onset of excruciating pain at the infection site and the rapid development of a foul-smelling wound containing gas bubbles and a thin, yellowish discharge tinged with a small amount of blood. As the infection progresses, edema and cutaneous blisters containing bluish-purple fluid form. The infected tissue becomes liquefied and begins sloughing off. The margin between necrotic and healthy tissue often advances several inches per hour even with antibiotic therapy. Septic shock and organ failure frequently accompany gas gangrene; when patients develop sepsis, the mortality rate is greater than 50%. \n\n \u03b1-Toxin  and  theta (\u03b8) toxin  are the major virulence factors of  C. perfringens  implicated in gas gangrene. \u03b1-Toxin is a lipase responsible for breaking down cell membranes; it also causes the formation of thrombi (blood clots) in blood vessels, contributing to the spread of ischemia. \u03b8-Toxin forms pores in the patient\u2019s cell membranes, causing cell lysis. The gas associated with gas gangrene is produced by  Clostridium \u2019s fermentation of butyric acid, which produces hydrogen and carbon dioxide that are released as the bacteria multiply, forming pockets of gas in tissues ( Figure 25.7 ). \n\n Gas gangrene is initially diagnosed based on the presence of the clinical signs and symptoms described earlier in this section. Diagnosis can be confirmed through Gram stain and anaerobic cultivation of wound exudate (drainage) and tissue samples on blood agar. Treatment typically involves surgical debridement of any necrotic tissue; advanced cases may require  amputation . Surgeons may also use  vacuum-assisted closure (VAC) , a surgical technique in which vacuum-assisted drainage is used to remove blood or serous fluid from a wound or surgical site to speed recovery. The most common antibiotic treatments include  penicillin G  and  clindamycin . Some cases are also treated with  hyperbaric oxygen therapy  because  Clostridium  spp. are incapable of surviving in oxygen-rich environments. \n\n Tularemia \n\n Infection with the gram-negative bacterium  Francisella tularensis  causes  tularemia  (or  rabbit fever ), a zoonotic infection in humans.  F. tularensis  is a facultative intracellular parasite that primarily causes illness in rabbits, although a wide variety of domesticated animals are also susceptible to infection. Humans can be infected through ingestion of contaminated meat or, more typically, handling of infected animal tissues (e.g., skinning an infected rabbit). Tularemia can also be transmitted by the bites of infected arthropods, including the dog tick ( Dermacentor variabilis ), the lone star tick ( Amblyomma americanum ), the wood tick ( Dermacentor andersoni ), and deer flies ( Chrysops  spp.). Although the disease is not directly communicable between humans, exposure to aerosols of  F. tularensis  can result in life-threatening infections.  F. tularensis  is highly contagious, with an infectious dose of as few as 10 bacterial cells. In addition, pulmonary infections have a 30%\u201360% fatality rate if untreated. 12  For these reasons,  F. tularensis  is currently classified and must be handled as a biosafety level-3 (BSL-3) organism and as a potential biological warfare agent. 12 World Health Organization. \u201cWHO Guidelines on Tularaemia.\u201d 2007. http://www.cdc.gov/tularemia/resources/whotularemiamanual.pdf. Accessed July 26, 2016. \n\n Following introduction through a break in the skin, the bacteria initially move to the lymph nodes, where they are ingested by phagocytes. After escaping from the phagosome, the bacteria grow and multiply intracellularly in the cytoplasm of phagocytes. They can later become disseminated through the blood to other organs such as the liver, lungs, and spleen, where they produce masses of tissue called granulomas ( Figure 25.8 ). After an incubation period of about 3 days, skin lesions develop at the site of infection. Other signs and symptoms include fever, chills, headache, and swollen and painful lymph nodes. \n\n A direct diagnosis of tularemia is challenging because it is so contagious. Once a presumptive diagnosis of tularemia is made, special handling is required to collect and process patients\u2019 specimens to prevent the infection of health-care workers. Specimens suspected of containing  F. tularensis  can only be handled by BSL-2 or BSL-3 laboratories registered with the Federal Select Agent Program, and individuals handling the specimen must wear protective equipment and use a class II biological safety cabinet. \n\n Tularemia is relatively rare in the US, and its signs and symptoms are similar to a variety of other infections that may need to be ruled out before a diagnosis can be made. Direct fluorescent-antibody (DFA) microscopic examination using antibodies specific for  F. tularensis  can rapidly confirm the presence of this pathogen. Culturing this microbe is difficult because of its requirement for the amino acid cysteine, which must be supplied as an extra nutrient in culturing media. Serological tests are available to detect an immune response against the bacterial pathogen. In patients with suspected infection, acute- and convalescent-phase serum samples are required to confirm an active infection. PCR-based tests can also be used for clinical identification of direct specimens from body fluids or tissues as well as cultured specimens. In most cases, diagnosis is based on clinical findings and likely incidents of exposure to the bacterium. The antibiotics streptomycin, gentamycin, doxycycline, and ciprofloxacin are effective in treating tularemia. \n\n Brucellosis \n\n Species in the genus  Brucella  are gram-negative facultative intracellular pathogens that appear as coccobacilli. Several species cause zoonotic infections in animals and humans, four of which have significant human pathogenicity:  B. abortus  from cattle and buffalo,  B. canis  from dogs,  B. suis  from swine, and  B. melitensis  from goats, sheep, and camels. Infections by these pathogens are called brucellosis, also known as undulant fever, \u201cMediterranean fever,\u201d or \u201cMalta fever.\u201d Vaccination of animals has made brucellosis a rare disease in the US, but it is still common in the Mediterranean, south and central Asia, Central and South America, and the Caribbean. Human infections are primarily associated with the ingestion of meat or unpasteurized dairy products from infected animals. Infection can also occur through inhalation of bacteria in aerosols when handling animal products, or through direct contact with skin wounds. In the US, most cases of brucellosis are found in individuals with extensive exposure to potentially infected animals (e.g., slaughterhouse workers, veterinarians). \n\n Two important virulence factors produced by  Brucella  spp. are  urease , which allows ingested bacteria to avoid destruction by stomach acid, and lipopolysaccharide ( LPS ), which allows the bacteria to survive within phagocytes. After gaining entry to tissues, the bacteria are phagocytized by host neutrophils and macrophages. The bacteria then escape from the phagosome and grow within the cytoplasm of the cell. Bacteria phagocytized by macrophages are disseminated throughout the body. This results in the formation of granulomas within many body sites, including bone, liver, spleen, lung, genitourinary tract, brain, heart, eye, and skin. Acute infections can result in undulant (relapsing) fever, but untreated infections develop into chronic disease that usually manifests as acute febrile illness (fever of 40\u201341 \u00b0C [104\u2013105.8 \u00b0F]) with recurring flu-like signs and symptoms. \n\n Brucella  is only reliably found in the blood during the acute fever stage; it is difficult to diagnose by cultivation. In addition,  Brucella  is considered a BSL-3 pathogen and is hazardous to handle in the clinical laboratory without protective clothing and at least a class II biological safety cabinet. Agglutination tests are most often used for serodiagnosis. In addition, enzyme-linked immunosorbent assays (ELISAs) are available to determine exposure to the organism. The antibiotics  doxycycline  or  ciprofloxacin  are typically prescribed in combination with  rifampin ;  gentamicin ,  streptomycin , and  trimethoprim-sulfamethoxazole  (TMP-SMZ) are also effective against  Brucella  infections and can be used if needed. \n\n Check Your Understanding \n\n Compare the pathogenesis of tularemia and brucellosis. \n\n Cat-Scratch Disease \n\n The zoonosis  cat-scratch disease (CSD)  (or cat-scratch fever) is a bacterial infection that can be introduced to the lymph nodes when a human is bitten or scratched by a cat. It is caused by the facultative intracellular gram-negative bacterium  Bartonella henselae . Cats can become infected from flea feces containing  B. henselae  that they ingest while grooming. Humans become infected when flea feces or cat saliva (from claws or licking) containing  B. henselae  are introduced at the site of a bite or scratch. Once introduced into a wound,  B. henselae  infects  red blood cells . \n\n B. henselae  invasion of red blood cells is facilitated by adhesins associated with outer membrane proteins and a secretion system that mediates transport of virulence factors into the host cell. Evidence of infection is indicated if a small nodule with pus forms in the location of the scratch 1 to 3 weeks after the initial injury. The bacteria then migrate to the nearest lymph nodes, where they cause swelling and pain. Signs and symptoms may also include fever, chills, and fatigue. Most infections are mild and tend to be self-limiting. However, immunocompromised patients may develop  bacillary angiomatosis  (BA), characterized by the proliferation of blood vessels, resulting in the formation of tumor-like masses in the skin and internal organs; or  bacillary peliosis  (BP), characterized by multiple cyst-like, blood-filled cavities in the liver and spleen. Most cases of CSD can be prevented by keeping cats free of fleas and promptly cleaning a cat scratch with soap and warm water. \n\n The diagnosis of CSD is difficult because the bacterium does not grow readily in the laboratory. When necessary, immunofluorescence, serological tests, PCR, and gene sequencing can be performed to identify the bacterial species. Given the limited nature of these infections, antibiotics are not normally prescribed. For immunocompromised patients,  rifampin ,  azithromycin ,  ciprofloxacin ,  gentamicin  (intramuscularly), or TMP-SMZ are generally the most effective options. \n\n Rat-Bite Fever \n\n The zoonotic infection  rat-bite fever  can be caused by two different gram-negative bacteria:  Streptobacillus moniliformis , which is more common in North America, and  Spirillum minor , which is more common in Asia. Because of modern sanitation efforts, rat bites are rare in the US. However, contact with fomites, food, or water contaminated by rat feces or body fluids can also cause infections. Signs and symptoms of rat-bite fever include fever, vomiting, myalgia (muscle pain), arthralgia (joint pain), and a maculopapular rash on the hands and feet. An ulcer may also form at the site of a bite, along with some swelling of nearby lymph nodes. In most cases, the infection is self-limiting. Little is known about the virulence factors that contribute to these signs and symptoms of disease. \n\n Cell culture,  MALDI-TOF  mass spectrometry, PCR, or ELISA can be used in the identification of  Streptobacillus moniliformis . The diagnosis  Spirillum minor  may be confirmed by direct microscopic observation of the pathogens in blood using Giemsa or Wright stains, or darkfield microscopy. Serological tests can be used to detect a host immune response to the pathogens after about 10 days. The most commonly used antibiotics to treat these infections are  penicillin  or  doxycycline . \n\n Plague \n\n The gram-negative bacillus  Yersinia pestis  causes the zoonotic infection  plague . This bacterium causes acute febrile disease in animals, usually rodents or other small mammals, and humans. The disease is associated with a high mortality rate if left untreated. Historically,  Y. pestis  has been responsible for several devastating pandemics, resulting in millions of deaths (see  Micro Connections: The History of the Plague ). There are three forms of plague:  bubonic plague  (the most common form, accounting for about 80% of cases),  pneumonic plague , and  septicemic plague . These forms are differentiated by the mode of transmission and the initial site of infection.  Figure 25.9  illustrates these various modes of transmission and infection between animals and humans. \n\n In bubonic plague,  Y. pestis  is transferred by the bite of infected fleas. Since most flea bites occur on the legs and ankles,  Y. pestis  is often introduced into the tissues and blood circulation in the lower extremities. After a 2- to 6-day incubation period, patients experience an abrupt onset fever (39.5\u201341 \u00b0C [103.1\u2013105.8 \u00b0F]), headache, hypotension, and chills. The pathogen localizes in  lymph nodes , where it causes inflammation, swelling, and hemorrhaging that results in purple buboes ( Figure 25.10 ). Buboes often form in lymph nodes of the groin first because these are the nodes associated with the lower limbs; eventually, through circulation in the blood and lymph, lymph nodes throughout the body become infected and form buboes. The average mortality rate for bubonic plague is about 55% if untreated and about 10% with antibiotic treatment. \n\n Septicemic plague occurs when  Y. pestis  is directly introduced into the bloodstream through a cut or wound and circulates through the body. The incubation period for septicemic plague is 1 to 3 days, after which patients develop fever, chills, extreme weakness, abdominal pain, and shock. Disseminated intravascular coagulation (DIC) can also occur, resulting in the formation of  thrombi  that obstruct blood vessels and promote  ischemia  and  necrosis  in surrounding tissues ( Figure 25.10 ). Necrosis occurs most commonly in extremities such as fingers and toes, which become blackened. Septicemic plague can quickly lead to death, with a mortality rate near 100% when it is untreated. Even with antibiotic treatment, the mortality rate is about 50%. \n\n Pneumonic plague occurs when  Y. pestis  causes an infection of the lungs. This can occur through inhalation of aerosolized droplets from an infected individual or when the infection spreads to the lungs from elsewhere in the body in patients with bubonic or septicemic plague. After an incubation period of 1 to 3 days, signs and symptoms include fever, headache, weakness, and a rapidly developing pneumonia with shortness of breath, chest pain, and cough producing bloody or watery mucus. The pneumonia may result in rapid respiratory failure and shock. Pneumonic plague is the only form of plague that can be spread from person to person by infectious aerosol droplet. If untreated, the mortality rate is near 100%; with antibiotic treatment, the mortality rate is about 50%. \n\n The high mortality rate for the plague is, in part, a consequence of it being unusually well equipped with virulence factors. To date, there are at least 15 different major virulence factors that have been identified from  Y. pestis  and, of these, eight are involved with adherence to host cells. In addition, the F1 component of the  Y. pestis  capsule is a virulence factor that allows the bacterium to avoid phagocytosis. F1 is produced in large quantities during mammalian infection and is the most immunogenic component. 13  Successful use of virulence factors allows the bacilli to disseminate from the area of the bite to regional lymph nodes and eventually the entire blood and lymphatic systems. 13 MOH Key Laboratory of Systems Biology of Pathogens. \u201cVirulence Factors of Pathogenic Bacteria,  Yersinia .\u201d http://www.mgc.ac.cn/cgi-bin/VFs/genus.cgi?Genus=Yersinia. Accessed September 9, 2016. \n\n Culturing and direct microscopic examination of a sample of fluid from a bubo, blood, or sputum is the best way to identify  Y. pestis  and confirm a presumptive diagnosis of plague. Specimens may be stained using either a Gram, Giemsa, Wright, or Wayson's staining technique ( Figure 25.11 ). The bacteria show a characteristic bipolar staining pattern, resembling safety pins, that facilitates presumptive identification. Direct fluorescent antibody tests (rapid test of outer-membrane antigens) and serological tests like ELISA can be used to confirm the diagnosis. The confirmatory method for identifying  Y. pestis  isolates in the US is bacteriophage lysis. \n\n Prompt antibiotic therapy can resolve most cases of bubonic plague, but septicemic and pneumonic plague are more difficult to treat because of their shorter incubation stages. Survival often depends on an early and accurate diagnosis and an appropriate choice of antibiotic therapy. In the US, the most common antibiotics used to treat patients with plague are  gentamicin ,  fluoroquinolones ,  streptomycin ,  levofloxacin ,  ciprofloxacin , and  doxycycline . \n\n Check Your Understanding \n\n Compare bubonic plague, septicemic plague, and pneumonic plague. \n\n Micro Connections The History of the Plague The first recorded pandemic of plague, the  Justinian plague , occurred in the sixth century CE. It is thought to have originated in central Africa and spread to the Mediterranean through trade routes. At its peak, more than 5,000 people died per day in Constantinople alone. Ultimately, one-third of that city\u2019s population succumbed to plague. 14  The impact of this outbreak probably contributed to the later fall of Emperor Justinian. 14 Rosen, William. Justinian\u2019s Flea: Plague, Empire, and the Birth of Europe. Viking Adult; pg 3; ISBN 978-0-670-03855-8. \n\n The second major pandemic, dubbed the  Black Death , occurred during the 14th century. This time, the infections are thought to have originated somewhere in Asia before being transported to Europe by trade, soldiers, and war refugees. This outbreak killed an estimated one-quarter of the population of Europe (25 million, primarily in major cities). In addition, at least another 25 million are thought to have been killed in Asia and Africa. 15  This second pandemic, associated with strain  Yersinia pestis  biovar Medievalis, cycled for another 300 years in Europe and Great Britain, and was called the Great Plague in the 1660s. 15 Benedictow, Ole J. 2004. The Black Death 1346-1353: The Complete History. Woodbridge: Boydell Press. \n\n The most recent pandemic occurred in the 1890s with  Yersinia pestis  biovar Orientalis. This outbreak originated in the Yunnan province of China and spread worldwide through trade. It is at this time that plague made its way to the US. The etiologic agent of plague was discovered by Alexandre Yersin (1863\u20131943) during this outbreak as well. The overall number of deaths was lower than in prior outbreaks, perhaps because of improved sanitation and medical support. 16  Most of the deaths attributed to this final pandemic occurred in India. 16 Centers for Disease Control and Prevention. \u201cPlague: History.\u201d http://www.cdc.gov/plague/history/. Accessed September 15, 2016. \n\n Link to Learning \n\n Visit this  link  to see a video describing how similar the genome of the Black Death bacterium is to today\u2019s strains of bubonic plague. \n\n Zoonotic Febrile Diseases \n\n A wide variety of zoonotic febrile diseases (diseases that cause fever) are caused by pathogenic bacteria that require arthropod vectors. These pathogens are either obligate intracellular species of  Anaplasma, Bartonella ,  Ehrlichia, Orientia,  and  Rickettsia , or spirochetes in the genus  Borrelia . Isolation and identification of pathogens in this group are best performed in  BSL-3  laboratories because of the low infective dose associated with the diseases. \n\n Anaplasmosis \n\n The zoonotic tickborne disease  human granulocytic anaplasmosis (HGA)  is caused by the obligate intracellular pathogen  Anaplasma phagocytophilum . HGA is endemic primarily in the central and northeastern US and in countries in Europe and Asia. \n\n HGA is usually a mild febrile disease that causes flu-like symptoms in immunocompetent patients; however, symptoms are severe enough to require hospitalization in at least 50% of infections and, of those patients, less than 1% will die of HGA. 17  Small mammals such as white-footed mice, chipmunks, and voles have been identified as reservoirs of  A. phagocytophilum , which is transmitted by the bite of an  Ixodes  tick . Five major virulence factors 18  have been reported in  Anaplasma ; three are adherence factors and two are factors that allow the pathogen to avoid the human immune response. Diagnostic approaches include locating intracellular microcolonies of  Anaplasma  through microscopic examination of neutrophils or eosinophils stained with Giemsa or Wright stain, PCR for detection of  A. phagocytophilum , and serological tests to detect antibody titers against the pathogens. The primary antibiotic used for treatment is  doxycycline . 17 J.S. Bakken et al. \u201cDiagnosis and Management of Tickborne Rickettsial Diseases: Rocky Mountain Spotted Fever, Ehrlichioses, and Anaplasmosis\u2013United States. A Practical Guide for Physicians and Other Health Care and Public Health Professionals.\u201d  MMWR Recommendations and Reports  55 no. RR04 (2006):1\u201327. 18 MOH Key Laboratory of Systems Biology of Pathogens, \u201cVirulence Factors of Pathogenic Bacteria, Anaplasma\u201d 2016. http://www.mgc.ac.cn/cgi-bin/VFs/jsif/main.cgi. Accessed July, 26, 2016. \n\n Ehrlichiosis \n\n Human monocytotropic ehrlichiosis (HME) is a zoonotic tickborne disease caused by the BSL-2, obligate intracellular pathogen  Ehrlichia chaffeensis . Currently, the geographic distribution of HME is primarily the eastern half of the US, with a few cases reported in the West, which corresponds with the known geographic distribution of the primary vector, the lone star tick ( Amblyomma americanum ). Symptoms of HME are similar to the flu-like symptoms observed in anaplasmosis, but a rash is more common, with 60% of children and less than 30% of adults developing petechial, macula, and maculopapular rashes. 19  Virulence factors allow  E. chaffeensis  to adhere to and infect monocytes, forming intracellular microcolonies in monocytes that are diagnostic for the HME. Diagnosis of HME can be confirmed with PCR and serologic tests. The first-line treatment for adults and children of all ages with HME is  doxycycline . 19 Centers for Disease Control and Prevention. \u201cEhrlichiosis, Symptoms, Diagnosis, and Treatment.\u201d 2016. https://www.cdc.gov/ehrlichiosis/symptoms/index.html. Accessed July 29, 2016. \n\n Epidemic Typhus \n\n The disease  epidemic typhus  is caused by  Rickettsia prowazekii  and is transmitted by body lice,  Pediculus humanus . Flying squirrels are animal reservoirs of  R. prowazekii  in North America and can also be sources of lice capable of transmitting the pathogen. Epidemic typhus is characterized by a high fever and body aches that last for about 2 weeks. A rash develops on the abdomen and chest and radiates to the extremities. Severe cases can result in death from shock or damage to heart and brain tissues. Infected humans are an important reservoir for this bacterium because  R. prowazekii  is the only  Rickettsia  that can establish a chronic carrier state in humans. \n\n Epidemic typhus has played an important role in human history, causing large outbreaks with high mortality rates during times of war or adversity. During  World War I , epidemic typhus killed more than 3 million people on the Eastern front. 20  With the advent of effective insecticides and improved personal hygiene, epidemic typhus is now quite rare in the US. In the developing world, however, epidemics can lead to mortality rates of up to 40% in the absence of treatment. 21  In recent years, most outbreaks have taken place in Burundi, Ethiopia, and Rwanda. For example, an outbreak in Burundi refugee camps in 1997 resulted in 45,000 illnesses in a population of about 760,000 people. 22 20 Drali, R., Brouqui, P. and Raoult, D. \u201cTyphus in World War I.\u201d  Microbiology Today  41 (2014) 2:58\u201361.  21 Centers for Disease Control and Prevention.  CDC Health Information for International Travel 2014: The Yellow Book . Oxford University Press, 2013. http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/rickettsial-spotted-typhus-fevers-related-infections-anaplasmosis-ehrlichiosis. Accessed July 26, 2016. 22 World Health Organization. \u201cTyphus.\u201d 1997. http://www.who.int/mediacentre/factsheets/fs162/en/. Accessed July 26, 2016. \n\n A rapid diagnosis is difficult because of the similarity of the primary symptoms with those of many other diseases. Molecular and immunohistochemical diagnostic tests are the most useful methods for establishing a diagnosis during the acute stage of illness when therapeutic decisions are critical. PCR to detect distinctive genes from  R. prowazekii  can be used to confirm the diagnosis of epidemic typhus, along with immunofluorescent staining of tissue biopsy specimens. Serology is usually used to identify rickettsial infections. However, adequate antibody titers take up to 10 days to develop. Antibiotic therapy is typically begun before the diagnosis is complete. The most common drugs used to treat patients with epidemic typhus are  doxycycline  or  chloramphenicol . \n\n Murine (Endemic) Typhus \n\n Murine typhus (also known as endemic typhus) is caused by  Rickettsia typhi  and is transmitted by the bite of the rat flea,  Xenopsylla cheopis , with infected rats as the main reservoir. Clinical signs and symptoms of  murine typhus  include a rash and chills accompanied by headache and fever that last about 12 days. Some patients also exhibit a cough and pneumonia-like symptoms. Severe illness can develop in immunocompromised patients, with seizures, coma, and renal and respiratory failure. \n\n Clinical diagnosis of murine typhus can be confirmed from a biopsy specimen from the rash. Diagnostic tests include indirect immunofluorescent antibody (IFA) staining, PCR for  R. typhi , and acute and convalescent serologic testing. Primary treatment is  doxycycline , with  chloramphenicol  as the second choice. \n\n Rocky Mountain Spotted Fever \n\n The disease  Rocky Mountain spotted fever  (RMSF) is caused by  Rickettsia rickettsii  and is transmitted by the bite of a hard-bodied tick such as the American dog tick ( Dermacentor variabilis ), Rocky Mountain wood tick ( D. andersoni ), or brown dog tick ( Rhipicephalus sanguineus ). \n\n This disease is endemic in North and South America and its incidence is coincident with the arthropod vector range. Despite its name, most cases in the US do not occur in the Rocky Mountain region but in the Southeast; North Carolina, Oklahoma, Arkansas, Tennessee, and Missouri account for greater than 60% of all cases. 23  The map in  Figure 25.12  shows the distribution of prevalence in the US in 2010. 23 Centers for Disease Control and Prevention. \u201cRocky Mountain Spotted Fever (RMSF): Statistics and Epidemiology.\u201d http://www.cdc.gov/rmsf/stats/index.html. Accessed Sept 16, 2016. \n\n Signs and symptoms of RMSF include a high fever, headache, body aches, nausea, and vomiting. A  petechial rash  (similar in appearance to measles) begins on the hands and wrists, and spreads to the trunk, face, and extremities ( Figure 25.13 ). If untreated, RMSF is a serious illness that can be fatal in the first 8 days even in otherwise healthy patients. Ideally, treatment should begin before petechiae develop, because this is a sign of progression to severe disease; however, the rash usually does not appear until day 6 or later after onset of symptoms and only occurs in 35%\u201360% of patients with the infection. Increased vascular permeability associated with petechiae formation can result in fatality rates of 3% or greater, even in the presence of clinical support. Most deaths are due to  hypotension  and cardiac arrest or from ischemia following blood coagulation. \n\n Diagnosis can be challenging because the disease mimics several other diseases that are more prevalent. The diagnosis of RMSF is made based on symptoms, fluorescent antibody staining of a biopsy specimen from the rash, PCR for  Rickettsia rickettsii , and acute and convalescent serologic testing. Primary treatment is  doxycycline , with  chloramphenicol  as the second choice. \n\n Lyme Disease \n\n Lyme disease  is caused by the spirochete  Borrelia burgdorferi  that is transmitted by the bite of a hard-bodied, black-legged  Ixodes  tick.  I. scapularis  is the biological vector transmitting  B. burgdorferi  in the eastern and north-central US and  I. pacificus  transmits  B. burgdorferi  in the western US ( Figure 25.15 ). Different species of  Ixodes  ticks are responsible for  B. burgdorferi  transmission in Asia and Europe. In the US, Lyme disease is the most commonly reported vectorborne illness. In 2014, it was the fifth most common Nationally Notifiable disease. 24 24 Centers for Disease Control and Prevention. \u201cLyme Disease. Data and Statistics.\u201d 2015. http://www.cdc.gov/lyme/stats/index.html. Accessed July 26, 2016. \n\n Ixodes  ticks have complex life cycles and deer, mice, and even birds can act as reservoirs. Over 2 years, the ticks pass through four developmental stages and require a blood meal from a host at each stage. In the spring, tick eggs hatch into six-legged larvae. These larvae do not carry  B. burgdorferi  initially. They may acquire the spirochete when they take their first blood meal (typically from a mouse). The larvae then overwinter and molt into eight-legged nymphs in the following spring. Nymphs take blood meals primarily from small rodents, but may also feed on humans, burrowing into the skin. The feeding period can last several days to a week, and it typically takes 24 hours for an infected nymph to transmit enough  B. burgdorferi  to cause infection in a human host. Nymphs ultimately mature into male and female adult ticks, which tend to feed on larger animals like deer or, occasionally, humans. The adults then mate and produce eggs to continue the cycle ( Figure 25.14 ). \n\n The symptoms of Lyme disease follow three stages: early localized, early disseminated, and late stage. During the early-localized stage, approximately 70%\u201380% 25  of cases may be characterized by a bull's-eye rash, called erythema migrans, at the site of the initial tick bite. The rash forms 3 to 30 days after the tick bite (7 days is the average) and may also be warm to the touch ( Figure 25.15 ). 26  This diagnostic sign is often overlooked if the tick bite occurs on the scalp or another less visible location. Other early symptoms include flu-like symptoms such as malaise, headache, fever, and muscle stiffness. If the patient goes untreated, the second early-disseminated stage of the disease occurs days to weeks later. The symptoms at this stage may include severe headache, neck stiffness, facial paralysis, arthritis, and carditis. The late-stage manifestations of the disease may occur years after exposure. Chronic inflammation causes damage that can eventually cause severe arthritis, meningitis, encephalitis, and altered mental states. The disease may be fatal if untreated. 25 Centers for Disease Control and Prevention. \u201cSigns and Symptoms of Untreated Lyme Disease.\u201d 2015. http://www.cdc.gov/lyme/signs_symptoms/index.html. Accessed July 27, 2016. 26 Centers for Disease Control and Prevention. \u201cTicks. Symptoms of Tickborne Illness.\u201d 2015. http://www.cdc.gov/ticks/symptoms.html. Accessed July 27, 2016. \n\n A presumptive diagnosis of  Lyme disease  can be made based solely on the presence of a bull\u2019s-eye rash at the site of infection, if it is present, in addition to other associated symptoms ( Figure 25.15 ). In addition, indirect immunofluorescent antibody (IFA) labeling can be used to visualize bacteria from blood or skin biopsy specimens. Serological tests like ELISA can also be used to detect serum antibodies produced in response to infection. During the early stage of infection (about 30 days), antibacterial drugs such as amoxicillin and doxycycline are effective. In the later stages,  penicillin G ,  chloramphenicol , or  ceftriaxone  can be given intravenously. \n\n Relapsing Fever \n\n Borrelia  spp. also can cause  relapsing fever . Two of the most common species are  B. recurrentis , which causes epidemics of louseborne relapsing fever, and  B. hermsii , which causes tickborne relapsing fevers. These  Borrelia  species are transmitted by the body louse  Pediculus humanus  and the soft-bodied tick  Ornithodoros hermsi , respectively. Lice acquire the spirochetes from human reservoirs, whereas ticks acquire them from rodent reservoirs. Spirochetes infect humans when  Borrelia  in the vector\u2019s saliva or excreta enter the skin rapidly as the vector bites. \n\n In both louse- and tickborne relapsing fevers, bacteremia usually occurs after the initial exposure, leading to a sudden high fever (39\u201343 \u00b0C [102.2\u2013109.4 \u00b0F) typically accompanied by headache and muscle aches. After about 3 days, these symptoms typically subside, only to return again after about a week. After another 3 days, the symptoms subside again but return a week later, and this cycle may repeat several times unless it is disrupted by antibiotic treatment. Immune evasion through bacterial antigenic variation is responsible for the cyclical nature of the symptoms in these diseases. \n\n The diagnosis of relapsing fever can be made by observation of spirochetes in blood, using  darkfield microscopy  ( Figure 25.16 ). For louseborne relapsing fever,  doxycycline  or  erythromycin  are the first-line antibiotics. For tickborne relapsing fever,  tetracycline  or erythromycin are the first-line antibiotics. \n\n Trench Fever \n\n The louseborne disease  trench fever  was first characterized as a specific disease during World War I, when approximately 1 million soldiers were infected. Today, it is primarily limited to areas of the developing world where poor sanitation and hygiene lead to infestations of lice (e.g., overpopulated urban areas and refugee camps). Trench fever is caused by the gram-negative bacterium  Bartonella quintana , which is transmitted when feces from infected body lice,  Pediculus humanus  var  corporis , are rubbed into the louse bite, abraded skin, or the conjunctiva. The symptoms typically follow a 5-day course marked by a high fever, body aches, conjunctivitis, ocular pain, severe headaches, and severe bone pain in the shins, neck, and back. Diagnosis can be made using blood cultures; serological tests like ELISA can be used to detect antibody titers to the pathogen and PCR can also be used. The first-line antibiotics are  doxycycline ,  macrolide antibiotics , and  ceftriaxone . \n\n Check Your Understanding \n\n What is the vector associated with epidemic typhus? \n\n Describe the life cycle of the deer tick and how it spreads Lyme disease. \n\n Micro Connections Tick Tips Many of the diseases covered in this chapter involve arthropod vectors. Of these,  ticks  are probably the most commonly encountered in the US. Adult ticks have eight legs and two body segments, the cephalothorax and the head ( Figure 25.17 ). They typically range from 2 mm to 4 mm in length, and feed on the blood of the host by attaching themselves to the skin. \n\n Unattached ticks should be removed and eliminated as soon as they are discovered. When removing a tick that has already attached itself, keep the following guidelines in mind to reduce the chances of exposure to pathogens: \n\n Use blunt tweezers to gently pull near the site of attachment until the tick releases its hold on the skin. \n\n Avoid crushing the tick's body and do not handle the tick with bare fingers. This could release bacterial pathogens and actually increase your exposure. The tick can be killed by drowning in water or alcohol, or frozen if it may be needed later for identification and analysis. \n\n Disinfect the area thoroughly by swabbing with an antiseptic such as isopropanol. \n\n Monitor the site of the bite for rashes or other signs of infection. \n\n Many ill-advised home remedies for tick removal have become popular in recent years, propagated by social media and pseudojournalism. Health professionals should discourage patients from resorting to any of the following methods, which are NOT recommended: \n\n using chemicals (e.g., petroleum jelly or fingernail polish) to dislodge an attached tick, because it can cause the tick to release fluid, which can increase the chance of infection \n\n using hot objects (matches or cigarette butts) to dislodge an attached tick \n\n squeezing the tick's body with fingers or tweezers \n\n Disease Profile Bacterial Infections of the Circulatory and Lymphatic Systems Although the circulatory system is a closed system, bacteria can enter the bloodstream through several routes. Wounds, animal bites, or other breaks in the skin and mucous membranes can result in the rapid dissemination of bacterial pathogens throughout the body. Localized infections may also spread to the bloodstream, causing serious and often fatal systemic infections.  Figure 25.18  and  Figure 25.19  summarize the major characteristics of bacterial infections of the circulatory and lymphatic systems. \n 25.3   Viral Infections of the Circulatory and Lymphatic Systems \n\n Learning Objectives \n\n Identify common viral pathogens that cause infections of the circulatory and lymphatic systems \n\n Compare the major characteristics of specific viral diseases affecting the circulatory and lymphatic systems \n\n Viral pathogens of the circulatory system vary tremendously both in their virulence and distribution worldwide. Some of these pathogens are practically global in their distribution. Fortunately, the most ubiquitous viruses tend to produce the mildest forms of disease. In the majority of cases, those infected remain asymptomatic. On the other hand, other viruses are associated with life-threatening diseases that have impacted human history. \n\n Infectious Mononucleosis and Burkitt Lymphoma \n\n Human herpesvirus 4, also known as  Epstein-Barr virus  (EBV), has been associated with a variety of human diseases, such as mononucleosis and Burkitt lymphoma. Exposure to the  human herpesvirus 4 (HHV-4)  is widespread and nearly all people have been exposed at some time in their childhood, as evidenced by serological tests on populations. The virus primarily resides within  B lymphocyte s and, like all herpes viruses, can remain dormant in a latent state for a long time. \n\n When uninfected young adults are exposed to EBV, they may experience  infectious mononucleosis . The virus is mainly spread through contact with body fluids (e.g., saliva, blood, and semen). The main symptoms include pharyngitis, fever, fatigue, and lymph node swelling. Abdominal pain may also occur as a result of spleen and liver enlargement in the second or third week of infection. The disease typically is self-limiting after about a month. The main symptom, extreme fatigue, can continue for several months, however. Complications in immunocompetent patients are rare but can include jaundice, anemia, and possible rupture of the spleen caused by enlargement. \n\n In patients with  malaria  or  HIV ,  Epstein-Barr virus  can lead to a fast-growing malignant cancer known as  Burkitt lymphoma  ( Figure 25.20 ). This condition is a form of non-Hodgkin lymphoma that produces solid tumors chiefly consisting of aberrant B cells. Burkitt lymphoma is more common in Africa, where prevalence of HIV and malaria is high, and it more frequently afflicts children. Repeated episodes of viremia caused by reactivation of the virus are common in immunocompromised individuals. In some patients with AIDS, EBV may induce the formation of malignant B-cell lymphomas or oral hairy leukoplakia. Immunodeficiency-associated Burkitt lymphoma primarily occurs in patients with HIV. HIV infection, similar to malaria, leads to polyclonal B-cell activation and permits poorly controlled proliferation of EBV +  B cells, leading to the formation of lymphomas. \n\n Infectious mononucleosis is typically diagnosed based on the initial clinical symptoms and a test for antibodies to EBV-associated antigens. Because the disease is self-limiting, antiviral treatments are rare for mononucleosis. Cases of Burkitt lymphoma are diagnosed from a biopsy specimen from a lymph node or tissue from a suspected tumor. Staging of the cancer includes computed tomography (CT) scans of the chest, abdomen, pelvis, and cytologic and histologic evaluation of biopsy specimens. Because the tumors grow so rapidly, staging studies must be expedited and treatment must be initiated promptly. An intensive alternating regimen of  cyclophosphamide ,  vincristine ,  doxorubicin ,  methotrexate ,  ifosfamide ,  etoposide , and  cytarabine  (CODOX-M/IVAC) plus  rituximab  results in a cure rate greater than 90% for children and adults. \n\n Cytomegalovirus Infections \n\n Also known as  cytomegalovirus (CMV) ,  human herpesvirus 5 (HHV-5)  is a virus with high infection rates in the human population. It is currently estimated that 50% of people in the US have been infected by the time they reach adulthood. 27  CMV is the major cause of non-Epstein-Barr infectious mononucleosis in the general human population. It is also an important pathogen in immunocompromised hosts, including patients with AIDS, neonates, and transplant recipients. However, the vast majority of CMV infections are asymptomatic. In adults, if symptoms do occur, they typically include fever, fatigue, swollen glands, and pharyngitis. 27 Centers for Disease Control and Prevention. \u201cCytomegalovirus (CMV) and Congenital CMV Infection: About CMV.\u201d 2016. http://www.cdc.gov/cmv/transmission.html. Accessed July 28, 2016. \n\n CMV can be transmitted between individuals through contact with body fluids such as saliva or urine. Common modes of transmission include sexual contact, nursing, blood transfusions, and organ transplants. In addition, pregnant women with active infections frequently pass this virus to their fetus, resulting in congenital CMV infections, which occur in approximately one in every 150 infants in US. 28  Infants can also be infected during passage through the birth canal or through breast milk and saliva from the mother. 28 Centers for Disease Control and Prevention. \u201cCytomegalovirus (CMV) and Congenital CMV Infection: Babies Born with CMV (Congenital CMV Infection).\u201d 2016. http://www.cdc.gov/cmv/congenital-infection.html. Accessed July 28, 2016. \n\n Perinatal infections tend to be milder but can occasionally cause lung, spleen, or liver damage. Serious symptoms in newborns include growth retardation, jaundice, deafness, blindness, and mental retardation if the virus crosses the placenta during the embryonic state when the body systems are developing in utero. However, a majority (approximately 80%) of infected infants will never have symptoms or experience long-term problems. 29  Diagnosis of CMV infection during  pregnancy  is usually achieved by serology; CMV is the \u201cC\u201d in prenatal  TORCH  screening. 29 ibid. \n\n Many patients receiving blood transfusions and nearly all those receiving  kidney transplants  ultimately become infected with CMV. Approximately 60% of transplant recipients will have CMV infection and more than 20% will develop symptomatic disease. 30  These infections may result from CMV-contaminated tissues but also may be a consequence of immunosuppression required for transplantation causing reactivation of prior CMV infections. The resulting viremia can lead to fever and  leukopenia , a decrease in the number of white blood cells in the bloodstream. Serious consequences may include liver damage, transplant rejection, and death. For similar reasons, many patients with  AIDS  develop active CMV infections that can manifest as encephalitis or progressive retinitis leading to blindness. 31 30 E. Cordero et al. \u201cCytomegalovirus Disease in Kidney Transplant Recipients: Incidence, Clinical Profile, and Risk Factors.\u201d  Transplantation Proceedings  44 no. 3 (2012):694\u2013700. 31 L.M. Mofenson et al. \u201cGuidelines for the Prevention and Treatment of Opportunistic Infections Among HIV-Exposed and HIV-Infected Children: Recommendations From CDC, the National Institutes of Health, the HIV Medicine Association of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the American Academy of Pediatrics.\u201d  MMWR Recommendations and Reports  58 no. RR-11 (2009):1\u2013166. \n\n Diagnosis of a localized CMV infection can be achieved through direct microscopic evaluation of tissue specimens stained with routine stains (e.g., Wright-Giemsa, hematoxylin and eosin, Papanicolaou) and immunohistochemical stains. Cells infected by CMV produce characteristic inclusions with an \"owl's eye\" appearance; this sign is less sensitive than molecular methods like PCR but more predictive of localized disease ( Figure 25.21 ). For more severe CMV infection, tests such as enzyme immunoassay (EIA), indirect immunofluorescence antibody (IFA) tests, and PCR, which are based on detection of CMV antigen or DNA, have a higher sensitivity and can determine viral load. Cultivation of the virus from saliva or urine is still the method for detecting CMV in newborn babies up to 3 weeks old. Ganciclovir,  valganciclovir ,  foscarnet , and  cidofovir  are the first-line antiviral drugs for serious CMV infections. \n\n Check Your Understanding \n\n Compare the diseases caused by HHV-4 and HHV-5. \n\n Arthropod-Borne Viral Diseases \n\n There are a number of arthropod-borne viruses, or  arbovirus es , that can cause human disease. Among these are several important hemorrhagic fevers transmitted by mosquitoes. We will discuss three that pose serious threats: yellow fever, chikungunya fever, and dengue fever. \n\n Yellow Fever \n\n Yellow fever was once common in the US and caused several serious outbreaks between 1700 and 1900. 32  Through vector control efforts, however, this disease has been eliminated in the US. Currently,  yellow fever  occurs primarily in tropical and subtropical areas in South America and Africa. It is caused by the yellow fever virus of the genus  Flavivirus  (named for the Latin word  flavus  meaning  yellow ), which is transmitted to humans by mosquito vectors. Sylvatic yellow fever occurs in tropical jungle regions of Africa and Central and South America, where the virus can be transmitted from infected monkeys to humans by the mosquitoes  Aedes africanus  or  Haemagogus  spp. In urban areas, the  Aedes aegypti  mosquito is mostly responsible for transmitting the virus between humans. 32 Centers for Disease Control and Prevention. \u201cHistory Timeline Transcript.\u201d http://www.cdc.gov/travel-training/local/HistoryEpidemiologyandVaccination/HistoryTimelineTranscript.pdf. Accessed July 28, 2016. \n\n Most individuals infected with yellow fever virus have no illness or only mild disease. Onset of milder symptoms is sudden, with dizziness, fever of 39\u201340 \u00b0C (102\u2013104 \u00b0F), chills, headache, and myalgias. As symptoms worsen, the face becomes flushed, and nausea, vomiting, constipation, severe fatigue, restlessness, and irritability are common. Mild disease may resolve after 1 to 3 days. However, approximately 15% of cases progress to develop moderate to severe yellow fever disease. 33 33 Centers for Disease Control and Prevention. \u201cYellow Fever, Symptoms and Treatment.\u201d 2015 http://www.cdc.gov/yellowfever/symptoms/index.html. Accessed July 28, 2016. \n\n In moderate or severe disease, the fever falls suddenly 2 to 5 days after onset, but recurs several hours or days later. Symptoms of  jaundice , petechial rash, mucosal hemorrhages, oliguria (scant urine), epigastric tenderness with bloody vomit, confusion, and apathy also often occur for approximately 7 days of moderate to severe disease. After more than a week, patients may have a rapid recovery and no sequelae. \n\n In its most severe form, called malignant yellow fever, symptoms include delirium, bleeding, seizures, shock, coma, and multiple organ failure; in some cases, death occurs. Patients with malignant yellow fever also become severely immunocompromised, and even those in recovery may become susceptible to bacterial superinfections and pneumonia. Of the 15% of patients who develop moderate or severe disease, up to half may die. \n\n Diagnosis of yellow fever is often based on clinical signs and symptoms and, if applicable, the patient\u2019s travel history, but infection can be confirmed by culture, serologic tests, and PCR. There are no effective treatments for patients with yellow fever. Whenever possible, patients with yellow fever should be hospitalized for close observation and given supportive care. Prevention is the best method of controlling yellow fever. Use of mosquito netting, window screens, insect repellents, and insecticides are all effective methods of reducing exposure to mosquito vectors. An effective vaccine is also available, but in the US, it is only administered to those traveling to areas with endemic yellow fever. In West Africa, the World Health Organization (WHO) launched a  Yellow Fever Initiative  in 2006 and, since that time, significant progress has been made in combating yellow fever. More than 105 million people have been vaccinated, and no outbreaks of yellow fever were reported in West Africa in 2015. \n\n Micro Connections Yellow Fever: Altering the Course of History Yellow fever originated in Africa and is still most prevalent there today. This disease is thought to have been translocated to the Americas by the slave trade in the 16th century. 34  Since that time,  yellow fever  has been associated with many severe outbreaks, some of which had important impacts upon historic events. 34 J.T. Cathey, J.S. Marr. \u201cYellow fever, Asia and the East African Slave Trade.\u201d  Transactions of the Royal Society of Tropical Medicine and Hygiene  108, no. 5 (2014):252\u2013257. \n\n Yellow fever virus was once an important cause of disease in the US. In the summer of 1793, there was a serious outbreak in Philadelphia (then the US capitol). It is estimated that 5,000 people (10% of the city\u2019s population) died. All of the government officials, including George Washington, fled the city in the face of this epidemic. The disease only abated when autumn frosts killed the mosquito vector population. \n\n In 1802, Napoleon Bonaparte sent an army of 40,000 to Hispaniola to suppress a slave revolution. This was seen by many as a part of a plan to use the Louisiana Territory as a granary as he reestablished France as a global power. Yellow fever, however, decimated his army and they were forced to withdraw. Abandoning his aspirations in the New World, Napoleon sold the Louisiana Territory to the US for $15 million in 1803. \n\n The most famous historic event associated with yellow fever is probably the construction of the Panama Canal. The French began work on the canal in the early 1880s. However, engineering problems, malaria, and yellow fever forced them to abandon the project. The US took over the task in 1904 and opened the canal a decade later. During those 10 years, yellow fever was a constant adversary. In the first few years of work, greater than 80% of the American workers in Panama were hospitalized with yellow fever. It was the work of Carlos Finlay and Walter Reed that turned the tide. Taken together, their work demonstrated that the disease was transmitted by mosquitoes. Vector control measures succeeded in reducing both yellow fever and malaria rates and contributed to the ultimate success of the project. \n\n Dengue Fever \n\n The disease  dengue fever , also known as  breakbone fever , is caused by four serotypes of dengue virus called dengue 1\u20134. These are  Flavivirus   species that are transmitted to humans by  A. aegypti  or  A. albopictus  mosquitoes. The disease is distributed worldwide but is predominantly located in tropical regions. The WHO estimates that 50 million to 100 million infections occur yearly, including 500,000 dengue hemorrhagic fever (DHF) cases and 22,000 deaths, most among children. 35  Dengue fever is primarily a self-limiting disease characterized by abrupt onset of high fever up to 40 \u00b0C (104 \u00b0F), intense headaches, rash, slight nose or gum bleeding, and extreme muscle, joint, and bone pain, causing patients to feel as if their bones are breaking, which is the reason this disease is also referred to as breakbone fever. As the body temperature returns to normal, in some patients, signs of dengue hemorrhagic fever may develop that include drowsiness, irritability, severe abdominal pain, severe nose or gum bleeding, persistent vomiting, vomiting blood, and black tarry stools, as the disease progresses to DHF or dengue shock syndrome (DSS). Patients who develop DHF experience circulatory system failure caused by increased blood vessel permeability. Patients with dengue fever can also develop DSS from vascular collapse because of the severe drop in blood pressure. Patients who develop DHF or DSS are at greater risk for death without prompt appropriate supportive treatment. About 30% of patients with severe hemorrhagic disease with poor supportive treatment die, but mortality can be less than 1% with experienced support. 36 35 Centers for Disease Control and Prevention. \u201cDengue, Epidemiology.\u201d 2014. http://www.cdc.gov/dengue/epidemiology/index.html. Accessed July 28, 2016. 36 C.R. Pringle \u201cDengue.\u201d MSD Manual: Consumer Version. https://www.msdmanuals.com/home/infections/viral-infections/dengue. 2016. Accessed Sept 15, 2016. \n\n Diagnostic tests for dengue fever include serologic testing, ELISA, and reverse transcriptase-polymerase chain reaction (RT-PCR) of blood. There are no specific treatments for dengue fever, nor is there a vaccine. Instead, supportive clinical care is provided to treat the symptoms of the disease. The best way to limit the impact of this viral pathogen is vector control. \n\n Chikungunya Fever \n\n The arboviral disease  chikungunya fever  is caused by chikungunya virus (CHIKV), which is transmitted to humans by  A. aegypti  and  A. albopictus  mosquitoes. Until 2013, the disease had not been reported outside of Africa, Asia, and a few European countries; however, CHIKV has now spread to mosquito populations in North and South America. Chikungunya fever is characterized by high fever, joint pain, rash, and blisters, with joint pain persisting for several months. These infections are typically self-limiting and rarely fatal. \n\n The diagnostic approach for chikungunya fever is similar to that for dengue fever. Viruses can be cultured directly from patient serum during early infections. IFA, EIA, ELISA, PCR, and RT-PCR are available to detect CHIKV antigens and patient antibody response to the infection. There are no specific treatments for this disease except to manage symptoms with fluids, analgesics, and bed rest. As with most arboviruses, the best strategy for combating the disease is vector control. \n\n Link to Learning \n\n Use this  interactive map  to explore the global distribution of dengue. \n\n Check Your Understanding \n\n Name three arboviral diseases and explain why they are so named. \n\n What is the best method for controlling outbreaks of arboviral diseases? \n\n Ebola Virus Disease \n\n The Ebola virus disease (EVD) is a highly contagious disease caused by species of  Ebolavirus , a  BSL-4   filovirus  ( Figure 25.22 ). Transmission to humans occurs through direct contact with body fluids (e.g., blood, saliva, sweat, urine, feces, or vomit), and indirect contact by contaminated fomites. Infected patients can easily transmit Ebola virus to others if appropriate containment and use of personal protective equipment is not available or used. Handling and working with patients with EVD is extremely hazardous to the general population and health-care workers. In almost every EVD outbreak there have been Ebola infections among health-care workers. This ease of Ebola virus transmission was recently demonstrated in the Ebola epidemic in Guinea, Liberia, and Sierra Leone in 2014, in which more than 28,000 people in 10 countries were infected and more than 11,000 died. 37 37 HealthMap. \u201c2014 Ebola Outbreaks.\u201d http://www.healthmap.org/ebola/#timeline. Accessed July 28, 2016. \n\n After infection, the initial symptoms of Ebola are unremarkable: fever, severe headache, myalgia, cough, chest pain, and pharyngitis. As the disease progresses, patients experience abdominal pain, diarrhea, and vomiting. Hemorrhaging begins after about 3 days, with bleeding occurring in the gastrointestinal tract, skin, and many other sites. This often leads to delirium, stupor, and coma, accompanied by shock, multiple organ failure, and death. The mortality rates of EVD often range from 50% to 90%. \n\n The initial diagnosis of Ebola is difficult because the early symptoms are so similar to those of many other illnesses. It is possible to directly detect the virus from patient samples within a few days after symptoms begin, using antigen-capture ELISA, immunoglobulin M (IgM) ELISA, PCR, and virus isolation. There are currently no effective, approved treatments for Ebola other than supportive care and proper isolation techniques to contain its spread. \n\n Check Your Understanding \n\n How is Ebola transmitted? \n\n Hantavirus \n\n The genus  Hantavirus  consists of at least four serogroups with nine viruses causing two major clinical (sometimes overlapping) syndromes:  hantavirus pulmonary syndrome  (HPS) in North America and  hemorrhagic fever with renal syndrome  (HFRS) in other continents. Hantaviruses are found throughout the world in wild rodents that shed the virus in their urine and feces. Transmission occurs between rodents and to humans through inhalation of aerosols of the rodent urine and feces. Hantaviruses associated with outbreaks in the US and Canada are transmitted by the deer mouse, white-footed mouse, or cotton rat. \n\n HPS begins as a nonspecific flu-like illness with headache, fever, myalgia, nausea, vomiting, diarrhea, and abdominal pain. Patients rapidly develop pulmonary edema and hypotension resulting in pneumonia, shock, and death, with a mortality rate of up to 50%. 38  This virus can also cause HFRS, which has not been reported in the US. The initial symptoms of this condition include high fever, headache, chills, nausea, inflammation or redness of the eyes, or a rash. Later symptoms are hemorrhaging, hypotension, kidney failure, shock, and death. The mortality rate of HFRS can be as high as 15%. 39 38 World Health Organization. \u201cHantavirus Diseases.\u201d 2016. http://www.who.int/ith/diseases/hantavirus/en/. Accessed July 28, 2016. 39 ibid. \n\n ELISA, Western blot, rapid immunoblot strip assay (RIBA), and RT-PCR detect host antibodies or viral proteins produced during infection. Immunohistological staining may also be used to detect the presence of viral antigens. There are no clinical treatments other than general supportive care available for HPS infections. Patients with HFRS can be treated with  ribavirin . 40 40 Centers for Disease Control and Prevention. \u201cHantavirus: Treatment.\u201d 2012. http://www.cdc.gov/hantavirus/technical/hps/treatment.html. Accessed July 28, 2016. \n\n Check Your Understanding \n\n Compare the two Hantavirus diseases discussed in this section. \n\n Human Immunodeficiency Virus \n\n Human T-lymphotropic viruses (HTLV), also called human immunodeficiency viruses (HIV) are  retroviruses  that are the causative agent of acquired immune deficiency syndrome ( AIDS ). There are two main variants of  human immunodeficiency virus (HIV) . HIV-1 ( Figure 25.23 ) occurs in human populations worldwide, whereas HIV-2 is concentrated in West Africa. Currently, the most affected region in the world is sub-Saharan Africa, with an estimated 25.6 million people living with HIV in 2015. 41  Sub-Saharan Africa also accounts for two-thirds of the global total of new HIV infections ( Figure 25.24 ). 42 41 World Health Organization. \u201cHIV/AIDS: Fact Sheet.\u201d 2016.http://www.who.int/mediacentre/factsheets/fs360/en/. Accessed July 28, 2016. 42 ibid. \n\n HIV is spread through direct contact with body fluids. Casual contact and insect vectors are not sufficient for disease transmission; common modes of transmission include sexual contact and sharing of needles by intravenous (IV) drug users. It generally takes many years before the effects of an HIV infection are detected. HIV infections are not dormant during this period: virions are continually produced, and the immune system continually attempts to clear the viral infection, while the virus persistently infects additional  CD4 T cells . Over time, the CD4 T-cell population is devastated, ultimately leading to AIDS. \n\n When people are infected with HIV, their disease progresses through three stages based on CD4 T-cell counts and the presence of clinical symptoms ( Figure 25.25 ). \n\n Stage 1: Acute HIV infection.  Two to 4 weeks after infection with HIV, patients may experience a flu-like illness, which can last for a few weeks. Patients with acute HIV infection have more than 500 cells/\u03bcL CD4 T cells and a large amount of virus in their blood. Patients are very contagious during this stage. To confirm acute infection, either a fourth-generation antibody-antigen test or a  nucleic acid test  (NAT) must be performed. \n\n Stage 2: Clinical latency.  During this period, HIV enters a period of dormancy. Patients have between 200 and 499 cells/\u03bcL CD4 T cells; HIV is still active but reproduces at low levels, and patients may not experience any symptoms of illness. For patients who are not taking medicine to treat HIV, this period can last a decade or longer. For patients receiving  antiretroviral therapy , the stage may last for several decades, and those with low levels of the virus in their blood are much less likely to transmit HIV than those who are not virally suppressed. Near the end of the latent stage, the patient\u2019s viral load starts to increase and the CD4 T-cell count begins to decrease, leading to the development of symptoms and increased susceptibility to opportunistic infections. \n\n Stage 3: Acquired immunodeficiency syndrome (AIDS).  Patients are diagnosed with  AIDS  when their CD4 T-cell count drops below 200 cells/\u03bcL or when they develop certain opportunistic illnesses. During this stage, the immune system becomes severely damaged by HIV. Common symptoms of AIDS include chills, fever, sweats, swollen lymph glands, weakness, and weight loss; in addition, patients often develop rare cancers such as  Kaposi\u2019s sarcoma  and opportunistic infections such as  Pneumocystis  pneumonia ,  tuberculosis ,  cryptosporidiosis , and  toxoplasmosis . This is a fatal progression that, in the terminal stages, includes wasting syndrome and dementia complex. Patients with AIDS have a high viral load and are highly infectious; they typically survive about 3 years without treatment. \n\n The initial diagnosis of HIV is performed using a serological test for antibody production against the pathogen. Positive test results are confirmed by Western blot or PCR tests. It can take weeks or months for the body to produce antibodies in response to an infection. There are fourth-generation tests that detect HIV antibodies and HIV antigens that are present even before the body begins producing antibodies. Nucleic acid tests (NATs) are a third type of test that is relatively expensive and uncommon; NAT can detect HIV in blood and determine the viral load. \n\n As a consequence of provirus formation, it is currently not possible to eliminate HIV from an infected patient\u2019s body. Elimination by specific antibodies is ineffective because the virus mutates rapidly\u2014a result of the error-prone reverse transcriptase and the inability to correct errors. Antiviral treatments, however, can greatly extend life expectancy. To combat the problem of drug resistance, combinations of antiretroviral drugs called antiretroviral therapy (ART), sometimes called highly active ART or combined ART, are used. There are several different targets for antiviral drug action (and a growing list of drugs for each of these targets). One class of drugs inhibits HIV entry; other classes inhibit reverse transcriptase by blocking viral RNA-dependent and DNA-dependent DNA polymerase activity; and still others inhibit one of the three HIV enzymes needed to replicate inside human cells. \n\n Check Your Understanding \n\n Why is it not yet possible to cure HIV infections? \n\n Eye on Ethics HIV, AIDS, and Education When the first outbreaks of  AIDS  in the US occurred in the early 1980s, very little was known about the disease or its origins. Erroneously, the disease quickly became stigmatized as one associated with what became identified as at-risk behaviors such as sexual promiscuity, homosexuality, and IV drug use, even though mounting evidence indicated the disease was also contracted through transfusion of blood and blood products or by fetuses of infected mothers. In the mid-1980s, scientists elucidated the identity of the virus, its mode of transmission, and mechanisms of pathogenesis. Campaigns were undertaken to educate the public about how  HIV  spreads to stem infection rates and encourage behavioral changes that reduced the risk for infection. Approaches to this campaign, however, emphasized very different strategies. Some groups favored educational programs that emphasized sexual abstinence, monogamy, heterosexuality, and \u201cjust say no to drugs.\u201d Other groups placed an emphasis on \u201csafe sex\u201d in sex education programs and advocated social services programs that passed out free condoms to anyone, including sexually active minors, and provided needle exchange programs for IV drug users. \n\n These are clear examples of the intersection between disease and cultural values. As a future health professional, what is your responsibility in terms of educating patients about behaviors that put them at risk for HIV or other diseases while possibly setting your own personal opinions aside? You will no doubt encounter patients whose cultural and moral values differ from your own. Is it ethical for you to promote your own moral agenda to your patients? How can you advocate for practical disease prevention while still respecting the personal views of your patients? \n\n Disease Profile Viral Diseases of the Circulatory and Lymphatic Systems Many viruses are able to cause systemic, difficult-to-treat infections because of their ability to replicate within the host. Some of the more common viruses that affect the circulatory system are summarized in  Figure 25.26 . \n 25.4   Parasitic Infections of the Circulatory and Lymphatic Systems \n\n Learning Objectives \n\n Identify common parasites that cause infections of the circulatory and lymphatic systems \n\n Compare the major characteristics of specific parasitic diseases affecting the circulatory and lymphatic systems \n\n Some protozoa and parasitic flukes are also capable of causing infections of the human circulatory system. Although these infections are rare in the US, they continue to cause widespread suffering in the developing world today. Fungal infections of the circulatory system are very rare. Therefore, they are not discussed in this chapter. \n\n Malaria \n\n Despite more than a century of intense research and clinical advancements,  malaria  remains one of the most important infectious diseases in the world today. Its widespread distribution places more than half of the world\u2019s population in jeopardy. In 2015, the WHO estimated there were about 214 million cases of malaria worldwide, resulting in about 438,000 deaths; about 88% of cases and 91% of deaths occurred in Africa. 43  Although malaria is not currently a major threat in the US, the possibility of its reintroduction is a concern. Malaria is caused by several protozoan parasites in the genus  Plasmodium :  P. falciparum, P. knowlesi, P. malariae, P. ovale,  and  P. vivax. Plasmodium  primarily infect red blood cells and are transmitted through the bite of  Anopheles  mosquito es. 43 World Health Organization. \u201cWorld Malaria Report 2015: Summary.\u201d 2015. http://www.who.int/malaria/publications/world-malaria-report-2015/report/en/. Accessed July 28, 2016. \n\n Currently,  P. falciparum  is the most common and most lethal cause of malaria, often called falciparum malaria. Falciparum malaria is widespread in highly populated regions of Africa and Asia, putting many people at risk for the most severe form of the disease. \n\n The classic signs and symptoms of malaria are cycles of extreme fever and chills. The sudden, violent symptoms of malaria start with malaise, abrupt chills, and fever (39\u201341\u00b0 C [102.2\u2013105.8 \u00b0F]), rapid and faint pulse, polyuria, headache, myalgia, nausea, and vomiting. After 2 to 6 hours of these symptoms, the fever falls, and profuse sweating occurs for 2 to 3 hours, followed by extreme fatigue. These symptoms are a result of  Plasmodium  emerging from red blood cells synchronously, leading to simultaneous rupture of a large number of red blood cells, resulting in damage to the spleen, liver, lymph nodes, and bone marrow. The organ damage resulting from hemolysis causes patients to develop sludge blood (i.e., blood in which the red blood cells agglutinate into clumps) that can lead to lack of oxygen, necrosis of blood vessels, organ failure, and death. \n\n In established infections, malarial cycles of fever and chills typically occur every 2 days in the disease described as  tertian malaria , which is caused by  P. vivax  and  P. ovale . The cycles occur every 3 days in the disease described as  quartan malaria , which is caused by  P. malariae . These intervals may vary among cases. \n\n Plasmodium  has a complex life cycle that includes several developmental stages alternately produced in mosquitoes and humans ( Figure 25.27 ). When an infected mosquito takes a blood meal, sporozoites in the mosquito salivary gland are injected into the host\u2019s blood. These parasites circulate to the liver, where they develop into schizonts. The schizonts then undergo  schizogony , resulting in the release of many merozoites at once. The merozoites move to the bloodstream and infect red blood cells. Inside red blood cells, merozoites develop into trophozoites that produce more merozoites. The synchronous release of merozoites from red blood cells in the evening leads to the symptoms of malaria. \n\n In addition, some trophozoites alternatively develop into male and female gametocytes. The gametocytes are taken up when the mosquito takes a blood meal from an infected individual. Sexual sporogony occurs in the gut of the mosquito. The gametocytes fuse to form zygotes in the insect gut. The zygotes become motile and elongate into an ookinete. This form penetrates the midgut wall and develops into an oocyst. Finally, the oocyst releases new sporozoites that migrate to the mosquito salivary glands to complete the life cycle. \n\n Diagnosis of malaria is by microscopic observation of developmental forms of  Plasmodium  in blood smears and rapid EIA assays that detect  Plasmodium  antigens or enzymes ( Figure 25.28 ). Drugs such as  chloroquine ,  atovaquone  ,  artemether , and  lumefantrine  may be prescribed for both acute and prophylactic therapy, although some  Plasmodium  spp. have shown resistance to antimalarial drugs. Use of insecticides and insecticide-treated bed nets can limit the spread of malaria. Despite efforts to develop a vaccine for malaria, none is currently available. \n\n Link to Learning \n\n Visit this  site  to learn how the parasite  Plasmodium  infects red blood cells. \n\n The  Nothing But Nets campaign , an initiative of the United Nations Foundation, has partnered with the Bill and Melinda Gates Foundation to make mosquito bed nets available in developing countries in Africa. Visit their  website  to learn more about their efforts to prevent malaria. \n\n Check Your Understanding \n\n Why is malaria one of the most important infectious diseases? \n\n Toxoplasmosis \n\n The disease  toxoplasmosis  is caused by the protozoan  Toxoplasma gondii .  T. gondii  is found in a wide variety of birds and mammals, 44  and human infections are common. The Centers for Disease Control and Prevention (CDC) estimates that 22.5% of the population 12 years and older has been infected with  T. gondii ; but immunocompetent individuals are typically asymptomatic, however. 45  Domestic cats are the only known definitive hosts for the sexual stages of  T. gondii  and, thus, are the main reservoirs of infection. Infected cats shed  T. gondii  oocysts in their feces, and these oocysts typically spread to humans through contact with fecal matter on cats\u2019 bodies, in litter boxes, or in garden beds where outdoor cats defecate. 44 A.M. Tenter et al.. \u201c Toxoplasma gondii : From Animals to Humans.\u201d  International Journal for Parasitology  30 no. 12-13 (2000):1217\u20131258. 45 Centers for Disease Control and Prevention. \u201cParasites - Toxoplasmosis (Toxoplasma Infection). Epidemiology & Risk Factors.\u201d 2015 http://www.cdc.gov/parasites/toxoplasmosis/epi.html. Accessed July 28, 2016. \n\n T. gondii  has a complex  life cycle  that involves multiple hosts. The  T. gondii  life cycle begins when unsporulated oocysts are shed in the cat\u2019s feces. These oocysts take 1\u20135 days to sporulate in the environment and become infective. Intermediate hosts in nature include birds and rodents, which become infected after ingesting soil, water, or plant material contaminated with the infective oocysts. Once ingested ,  the oocysts transform into tachyzoites that localize in the bird or rodent neural and muscle tissue, where they develop into tissue cysts. Cats may become infected after consuming birds and rodents harboring tissue cysts. Cats and other animals may also become infected directly by ingestion of sporulated oocysts in the environment. Interestingly,  Toxoplasma  infection appears to be able to modify the host\u2019s behavior. Mice infected by  Toxoplasma  lose their fear of cat pheromones. As a result, they become easier prey for cats, facilitating the transmission of the parasite to the cat definitive host 46  ( Figure 25.29 ). 46 J. Flegr. \u201cEffects of  Toxoplasma  on Human Behavior.\u201d  Schizophrenia Bulletin  33, no. 3 (2007):757\u2013760. \n\n Toxoplasma  infections in humans are extremely common, but most infected people are asymptomatic or have subclinical symptoms. Some studies suggest that the parasite may be able to influence the personality and psychomotor performance of infected humans, similar to the way it modifies behavior in other mammals. 47  When symptoms do occur, they tend to be mild and similar to those of mononucleosis. However, asymptomatic toxoplasmosis can become problematic in certain situations. Cysts can lodge in a variety of human tissues and lie dormant for years. Reactivation of these quiescent infections can occur in immunocompromised patients following transplantation, cancer therapy, or the development of an immune disorder such as  AIDS . In patients with AIDS who have toxoplasmosis, the immune system cannot combat the growth of  T. gondii  in body tissues; as a result, these cysts can cause encephalitis, retinitis, pneumonitis, cognitive disorders, and seizures that can eventually be fatal. 47 Ibid \n\n Toxoplasmosis can also pose a risk during  pregnancy  because tachyzoites can cross the placenta and cause serious infections in the developing fetus. The extent of fetal damage resulting from toxoplasmosis depends on the severity of maternal disease, the damage to the placenta, the gestational age of the fetus when infected, and the virulence of the organism. Congenital toxoplasmosis often leads to fetal loss or premature birth and can result in damage to the central nervous system, manifesting as mental retardation, deafness, or blindness. Consequently, pregnant women are advised by the CDC to take particular care in preparing meat, gardening, and caring for pet cats. 48  Diagnosis of toxoplasmosis infection during pregnancy is usually achieved by serology including  TORCH  testing (the \u201cT\u201d in TORCH stands for toxoplasmosis). Diagnosis of congenital infections can also be achieved by detecting  T. gondii  DNA in amniotic fluid, using molecular methods such as PCR. 48 Centers for Disease Control and Prevention. \u201cParasites - Toxoplasmosis (Toxoplasma infection). Toxoplasmosis Frequently Asked Questions (FAQs).\u201d 2013. http://www.cdc.gov/parasites/toxoplasmosis/gen_info/faqs.html. Accessed July 28, 2016. \n\n In adults, diagnosis of toxoplasmosis can include observation of tissue cysts in tissue specimens. Tissue cysts may be observed in Giemsa- or Wright-stained biopsy specimens, and CT, magnetic resonance imaging, and lumbar puncture can also be used to confirm infection ( Figure 25.30 ). \n\n Preventing infection is the best first-line defense against toxoplasmosis. Preventive measures include washing hands thoroughly after handling raw meat, soil, or cat litter, and avoiding consumption of vegetables possibly contaminated with cat feces. All meat should be cooked to an internal temperature of 73.9\u201376.7 \u00b0C (165\u2013170 \u00b0F). \n\n Most immunocompetent patients do not require clinical intervention for  Toxoplasma  infections. However, neonates, pregnant women, and immunocompromised patients can be treated with  pyrimethamine  and  sulfadiazine \u2014except during the first trimester of pregnancy, because these drugs can cause birth defects.  Spiramycin  has been used safely to reduce transmission in pregnant women with primary infection during the first trimester because it does not cross the placenta. \n\n Check Your Understanding \n\n How does  T. gondii  infect humans? \n\n Babesiosis \n\n Babesiosis is a rare zoonotic infectious disease caused by  Babesia  spp . These parasitic protozoans infect various wild and domestic animals and can be transmitted to humans by black-legged  Ixodes  ticks. In humans,  Babesia  infect red blood cells and replicate inside the cell until it ruptures. The  Babesia  released from the ruptured red blood cell continue the growth cycle by invading other red blood cells. Patients may be asymptomatic, but those who do have symptoms often initially experience malaise, fatigue, chills, fever, headache, myalgia, and arthralgia. In rare cases, particularly in asplenic (absence of the spleen) patients, the elderly, and patients with  AIDS ,  babesiosis  may resemble falciparum malaria, with high fever, hemolytic anemia, hemoglobinuria (hemoglobin or blood in urine), jaundice, and renal failure, and the infection can be fatal. Previously acquired asymptomatic Babesia infection may become symptomatic if a splenectomy is performed. \n\n Diagnosis is based mainly on the microscopic observation of parasites in blood smears ( Figure 25.31 ). Serologic and antibody detection by IFA can also be performed and PCR-based tests are available. Many people do not require clinical intervention for Babesia infections, however, serious infections can be cleared with a combination of  atovaquone  and  azithromycin  or a combination of  clindamycin  and  quinine . \n\n Chagas Disease \n\n Also called  American trypanosomiasis , Chagas disease is a zoonosis classified as a  neglected tropical disease  (NTD). It is caused by the flagellated protozoan  Trypanosoma cruzi  and is most commonly transmitted to animals and people through the feces of triatomine bugs. The  triatomine bug  is nicknamed the kissing bug because it frequently bites humans on the face or around the eyes; the insect often defecates near the bite and the infected fecal matter may be rubbed into the bite wound by the bitten individual ( Figure 25.32 ). The bite itself is painless and, initially, many people show no signs of the disease. Alternative modes of transmission include contaminated blood transfusions, organ transplants from infected donors, and congenital transmission from mother to fetus. \n\n Chagas disease is endemic throughout much of Mexico, Central America, and South America, where, according to WHO, an estimated 6 million to 7 million people are infected. 49  Currently, Chagas disease is not endemic in the US, even though triatomine bugs are found in the southern half of the country. 49 World Health Organization. \u201cChagas disease (American trypanosomiasis). Fact Sheet.\u201d 2016. http://www.who.int/mediacentre/factsheets/fs340/en/. Accessed July 29, 2016. \n\n Triatomine bugs typically are active at night, when they take blood meals by biting the faces and lips of people or animals as they sleep and often defecate near the site of the bite. Infection occurs when the host rubs the feces into their eyes, mouth, the bite wound, or another break in the skin. The protozoan then enters the blood and invades tissues of the heart and central nervous system, as well as macrophages and monocytes. Nonhuman reservoirs of  T. cruzi  parasites include wild animals and domesticated animals such as dogs and cats, which also act as reservoirs of the pathogen. 50 50 C.E. Reisenman et al. \u201cInfection of Kissing Bugs With  Trypanosoma cruzi , Tucson, Arizona, USA.\u201d  Emerging Infectious Diseases  16 no. 3 (2010):400\u2013405. \n\n There are three phases of Chagas disease: acute, intermediate, and chronic. These phases can be either asymptomatic or life-threatening depending on the immunocompetence status of the patient. \n\n In acute phase disease, symptoms include fever, headache, myalgia, rash, vomiting, diarrhea, and enlarged spleen, liver, and lymph nodes. In addition, a localized nodule called a chagoma may form at the portal of entry, and swelling of the eyelids or the side of the face, called Roma\u00f1a's sign, may occur near the bite wound. Symptoms of the acute phase may resolve spontaneously, but if untreated, the infection can persist in tissues, causing irreversible damage to the heart or brain. In rare cases, young children may die of  myocarditis  or  meningoencephalitis  during the acute phase of Chagas disease. \n\n Following the acute phase is a prolonged intermediate phase during which few or no parasites are found in the blood and most people are asymptomatic. Many patients will remain asymptomatic for life; however, decades after exposure, an estimated 20%\u201330% of infected people will develop chronic disease that can be debilitating and sometimes life threatening. In the chronic phase, patients may develop painful swelling of the colon, leading to severe twisting, constipation, and bowel obstruction; painful swelling of the esophagus, leading to dysphagia and malnutrition; and  flaccid cardiomegaly  (enlargement of the heart), which can lead to heart failure and sudden death. \n\n Diagnosis can be confirmed through several different tests, including direct microscopic observation of trypanosomes in the blood, IFA, EIAs, PCR, and culturing in artificial media. In endemic regions, xenodiagnoses may be used; this method involves allowing uninfected kissing bugs to feed on the patient and then examining their feces for the presence of  T. cruzi . \n\n The medications  nifurtimox  and  benznidazole  are effective treatments during the acute phase of Chagas disease. The efficacy of these drugs is much lower when the disease is in the chronic phase. Avoiding exposure to the pathogen through vector control is the most effective method of limiting this disease. \n\n Check Your Understanding \n\n How do kissing bugs infect humans with  Trypanosoma cruzi ? \n\n Leishmaniasis \n\n Although it is classified as an NTD,  leishmaniasis  is relatively widespread in tropical and subtropical regions, affecting people in more than 90 countries. It is caused by approximately 20 different species of  Leishmania , protozoan parasites that are transmitted by  sand fly  vectors such as  Phlebotomus  spp. and  Lutzomyia  spp. Dogs, cats, sheep, horses, cattle rodents, and humans can all serve as reservoirs. \n\n The  Leishmania  protozoan is phagocytosed by macrophages but uses virulence factors to avoid destruction within the phagolysosome. The virulence factors inhibit the phagolysosome enzymes that would otherwise destroy the parasite. The parasite reproduces within the macrophage, lyses it, and the progeny infect new macrophages (see  Micro Connections: When Phagocytosis Fails ). \n\n The three major clinical forms of leishmaniasis are cutaneous (oriental sore, Delhi boil, Aleppo boil), visceral (kala-azar, Dumdum fever), and mucosal (espundia). The most common form of disease is  cutaneous leishmaniasis , which is characterized by the formation of sores at the site of the insect bite that may start out as papules or nodules before becoming large ulcers ( Figure 25.33 ). \n\n It may take  visceral leishmaniasis  months and sometimes years to develop, leading to enlargement of the lymph nodes, liver, spleen, and bone marrow. The damage to these body sites triggers fever, weight loss, and swelling of the spleen and liver. It also causes a decrease in the number of red blood cells (anemia), white blood cells (leukopenia), and platelets (thrombocytopenia), causing the patient to become immunocompromised and more susceptible to fatal infections of the lungs and gastrointestinal tract. \n\n The mucosal form of leishmaniasis is one of the less common forms of the disease. It causes a lesion similar to the cutaneous form but  mucosal leishmaniasis  is associated with mucous membranes of the mouth, nares, or pharynx, and can be destructive and disfiguring. Mucosal leishmaniasis occurs less frequently when the original cutaneous (skin) infection is promptly treated. \n\n Definitive diagnosis of leishmaniasis is made by visualizing organisms in Giemsa-stained smears, by isolating  Leishmania  protozoans in cultures, or by PCR-based assays of aspirates from infected tissues. Specific DNA probes or analysis of cultured parasites can help to distinguish  Leishmania  species that are causing simple cutaneous leishmaniasis from those capable of causing mucosal leishmaniasis. \n\n Cutaneous leishmaniasis is usually not treated. The lesions will resolve after weeks (or several months), but may result in scarring. Recurrence rates are low for this disease. More serious infections can be treated with  stibogluconate  (antimony gluconate),  amphotericin B , and  miltefosine . \n\n Check Your Understanding \n\n Compare the mucosal and cutaneous forms of leishmaniasis. \n\n Schistosomiasis \n\n Schistosomiasis (bilharzia) is an NTD caused by blood flukes in the genus  Schistosoma  that are native to the Caribbean, South America, Middle East, Asia, and Africa. Most human  schistosomiasis  cases are caused by  Schistosoma mansoni, S. haematobium , or  S. japonicum .  Schistosoma  are the only  trematodes  that invade through the skin; all other trematodes infect by ingestion. WHO estimates that at least 258 million people required preventive treatment for schistosomiasis in 2014. 51 51 World Health Organization. \u201cSchistosomiasis. Fact Sheet.\u201d 2016. http://www.who.int/mediacentre/factsheets/fs115/en/. Accessed July 29, 2016. \n\n Infected human hosts shed  Schistosoma  eggs in urine and feces, which can contaminate freshwater habitats of snails that serve as intermediate hosts. The eggs hatch in the water, releasing miracidia, an intermediate growth stage of the  Schistosoma  that infect the snails. The miracidia mature and multiply inside the snails, transforming into cercariae that leave the snail and enter the water, where they can penetrate the skin of swimmers and bathers. The cercariae migrate through human tissue and enter the bloodstream, where they mature into adult male and female worms that mate and release fertilized eggs. The eggs travel through the bloodstream and penetrate various body sites, including the bladder or intestine, from which they are excreted in urine or stool to start the life cycle over again ( Figure 5.22 ). \n\n A few days after infection, patients may develop a rash or itchy skin associated with the site of cercariae penetration. Within 1\u20132 months of infection, symptoms may develop, including fever, chills, cough, and myalgia, as eggs that are not excreted circulate through the body. After years of infection, the eggs become lodged in tissues and trigger inflammation and scarring that can damage the liver, central nervous system, intestine, spleen, lungs, and bladder. This may cause abdominal pain, enlargement of the liver, blood in the urine or stool, and problems passing urine. Increased risk for bladder cancer is also associated with chronic  Schistosoma  infection. In addition, children who are repeatedly infected can develop malnutrition, anemia, and learning difficulties. \n\n Diagnosis of schistosomiasis is made by the microscopic observation of eggs in feces or urine, intestine or bladder tissue specimens, or serologic tests. The drug  praziquantel  is effective for the treatment of all schistosome infections. Improving wastewater management and educating at-risk populations to limit exposure to contaminated water can help control the spread of the disease. \n\n Cercarial Dermatitis \n\n The cercaria of some species of  Schistosoma  can only transform into adult worms and complete their life cycle in animal hosts such as migratory birds and mammals. The cercaria of these worms are still capable of penetrating human skin, but they are unable to establish a productive infection in human tissue. Still, the presence of the cercaria in small blood vessels triggers an immune response, resulting in itchy raised bumps called  cercarial dermatitis  (also known as swimmer\u2019s itch or clam digger's itch). Although it is uncomfortable, cercarial dermatitis is typically self-limiting and rarely serious. Antihistamines and antipruritics can be used to limit inflammation and itching, respectively. \n\n Check Your Understanding \n\n How do schistosome infections in humans occur? \n\n Disease Profile Common Eukaryotic Pathogens of the Human Circulatory System Protozoan and helminthic infections are prevalent in the developing world. A few of the more important parasitic infections are summarized in  Figure 25.34 . \n\n Clinical Focus Resolution Despite continued antibiotic treatment and the removal of the venous catheter, Barbara\u2019s condition further declined. She began to show signs of shock and her blood pressure dropped to 77/50 mmHg. Anti-inflammatory drugs and drotrecogin-\u03b1 were administered to combat  sepsis . However, by the seventh day of hospitalization, Barbara experienced hepatic and renal failure and died. \n\n Staphylococcus aureus  most likely formed a biofilm on the surface of Barbara\u2019s catheter. From there, the bacteria were chronically shed into her circulation and produced the initial clinical symptoms. The chemotherapeutic therapies failed in large part because of the drug-resistant  MRSA  isolate. Virulence factors like  leukocidin  and  hemolysins  also interfered with her immune response. Barbara\u2019s ultimate decline may have been a consequence of the production of  enterotoxin s and  toxic shock syndrome toxin (TSST) , which can initiate toxic shock. \n\n Venous catheters are common life-saving interventions for many patients requiring long-term administration of medication or fluids. However, they are also common sites of bloodstream infections. The World Health Organization estimates that there are up to 80,000  catheter-related bloodstream infection s each year in the US, resulting in about 20,000 deaths. 52 52 World Health Organization. \u201cPatient Safety, Preventing Bloodstream Infections From Central Line Venous Catheters.\u201d 2016. http://www.who.int/patientsafety/implementation/bsi/en/. Accessed July 29, 2016. \n\n Go back to the  previous  Clinical Focus box. ", "questions": [{"question": {"question_id": "fs-id1167663931110", "question_text": "Which term refers to an inflammation of the blood vessels?", "question_choices": ["lymphangitis", "endocarditis", "pericarditis", "vasculitis"], "cloze_format": "The term that refers to an inflammation of the blood vessels is ___.", "normal_format": "Which term refers to an inflammation of the blood vessels?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "bloom": null, "hl_sentences": "Inflammation of blood vessels is called vasculitis .", "hl_context": "Certain infections can cause inflammation in the heart and blood vessels . Inflammation of the endocardium , the inner lining of the heart , is called endocarditis and can result in damage to the heart valves severe enough to require surgical replacement . Inflammation of the pericardium , the sac surrounding the heart , is called pericarditis . The term myocarditis refers to the inflammation of the heart \u2019 s muscle tissue . Pericarditis and myocarditis can cause fluid to accumulate around the heart , resulting in congestive heart failure . <hl> Inflammation of blood vessels is called vasculitis . <hl> Although somewhat rare , vasculitis can cause blood vessels to become damaged and rupture ; as blood is released , small red or purple spots called petechiae appear on the skin . If the damage of tissues or blood vessels is severe , it can result in reduced blood flow to the surrounding tissues . This condition is called ischemia , and it can be very serious . In severe cases , the affected tissues can die and become necrotic ; these situations may require surgical debridement or amputation ."}, {"question": {"question_id": "fs-id1167663634591", "question_text": "Which of the following is located in the interstitial spaces within tissues and releases nutrients, immune factors, and oxygen to those tissues?", "question_choices": ["lymphatics", "arterioles", "capillaries", "veins"], "cloze_format": "___ are located in the interstitial spaces within tissues and releases nutrients, immune factors, and oxygen to those tissues.", "normal_format": "Which of the following is located in the interstitial spaces within tissues and releases nutrients, immune factors, and oxygen to those tissues?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The capillary beds are located in the interstitial spaces within tissues and release nutrients , immune factors , and oxygen to those tissues .", "hl_context": "The circulatory ( or cardiovascular ) system is a closed network of organs and vessels that moves blood around the body ( Figure 25.2 ) . The primary purposes of the circulatory system are to deliver nutrients , immune factors , and oxygen to tissues and to carry away waste products for elimination . The heart is a four-chambered pump that propels the blood throughout the body . Deoxygenated blood enters the right atrium through the superior vena cava and the inferior vena cava after returning from the body . The blood next passes through the tricuspid valve to enter the right ventricle . When the heart contracts , the blood from the right ventricle is pumped through the pulmonary arteries to the lungs . There , the blood is oxygenated at the alveoli and returns to the heart through the pulmonary veins . The oxygenated blood is received at the left atrium and proceeds through the mitral valve to the left ventricle . When the heart contracts , the oxygenated blood is pumped throughout the body via a series of thick-walled vessels called arteries . The first and largest artery is called the aorta . The arteries sequentially branch and decrease in size ( and are called arterioles ) until they end in a network of smaller vessels called capillaries . <hl> The capillary beds are located in the interstitial spaces within tissues and release nutrients , immune factors , and oxygen to those tissues . <hl> The capillaries connect to a series of vessels called venules , which increase in size to form the vein s . The veins join together into larger vessels as they transfer blood back to the heart . The largest veins , the superior and inferior vena cava , return the blood to the right atrium ."}, {"question": {"question_id": "fs-id1167663991745", "question_text": "Which of these conditions results in the formation of a bubo?", "question_choices": ["lymphangitis", "lymphadenitis", "ischemia", "vasculitis"], "cloze_format": "The ___ condition results in the formation of a bubo.", "normal_format": "Which of these conditions results in the formation of a bubo?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "A swollen lymph node is referred to as a bubo , and the condition is referred to as lymphadenitis .", "hl_context": "Infections in the lymphatic system also trigger an inflammatory response . Inflammation of lymphatic vessels , called lymphangitis , can produce visible red streaks under the skin . Inflammation in the lymph nodes can cause them to swell . <hl> A swollen lymph node is referred to as a bubo , and the condition is referred to as lymphadenitis . <hl> 25.2 Bacterial Infections of the Circulatory and Lymphatic Systems"}, {"question": {"question_id": "fs-id1167663937364", "question_text": "Which of the following is where are most microbes filtered out of the fluids that accumulate in the body tissues?", "question_choices": ["spleen", "lymph nodes", "pericardium", "blood capillaries"], "cloze_format": "Most microbes filtered out of the fluids that accumulate in the body tissues are in the ___.", "normal_format": "Which of the following is where are most microbes filtered out of the fluids that accumulate in the body tissues?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Lymph nodes are bean-shaped organs situated throughout the body . These structures contain areas called germinal centers that are rich in B and T lymphocytes . The lymph nodes also contain macrophages and dendritic cells for antigen presentation . Lymph from nearby tissues enters the lymph node through afferent lymphatic vessels and encounters these lymphocytes as it passes through ; the lymph exits the lymph node through the efferent lymphatic vessels ( Figure 25.5 ) .", "hl_context": "The lymphatic system contains two types of lymphoid tissues . The primary lymphoid tissue includes bone marrow and the thymus . Bone marrow contains the hematopoietic stem cells ( HSC ) that differentiate and mature into the various types of blood cells and lymphocytes ( see Figure 17.12 ) . The secondary lymphoid tissue s include the spleen , lymph nodes , and several areas of diffuse lymphoid tissues underlying epithelial membranes . The spleen , an encapsulated structure , filters blood and captures pathogens and antigens that pass into it ( Figure 25.5 ) . The spleen contains specialized macrophages and dendritic cells that are crucial for antigen presentation , a mechanism critical for activation of T lymphocytes and B lymphocytes ( see Major Histocompatibility Complexes and Antigen-Presenting Cells ) . <hl> Lymph nodes are bean-shaped organs situated throughout the body . <hl> <hl> These structures contain areas called germinal centers that are rich in B and T lymphocytes . <hl> <hl> The lymph nodes also contain macrophages and dendritic cells for antigen presentation . <hl> <hl> Lymph from nearby tissues enters the lymph node through afferent lymphatic vessels and encounters these lymphocytes as it passes through ; the lymph exits the lymph node through the efferent lymphatic vessels ( Figure 25.5 ) . <hl>"}, {"question": {"question_id": "fs-id1167661616954", "question_text": "Which of the following diseases is caused by a spirochete?", "question_choices": ["tularemia", "relapsing fever", "rheumatic fever", "Rocky Mountain spotted fever"], "cloze_format": "The disease that is caused by a spirochete is ___.", "normal_format": "Which of the following diseases is caused by a spirochete?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "The diagnosis of relapsing fever can be made by observation of spirochetes in blood , using darkfield microscopy ( Figure 25.16 ) .", "hl_context": "<hl> The diagnosis of relapsing fever can be made by observation of spirochetes in blood , using darkfield microscopy ( Figure 25.16 ) . <hl> For louseborne relapsing fever , doxycycline or erythromycin are the first-line antibiotics . For tickborne relapsing fever , tetracycline or erythromycin are the first-line antibiotics ."}, {"question": {"question_id": "fs-id1167663585884", "question_text": "Which of the following diseases is transmitted by body lice?", "question_choices": ["tularemia", "bubonic plague", "murine typhus", "epidemic typhus"], "cloze_format": "The disease that is transmitted by body lice is ___.", "normal_format": "Which of the following diseases is transmitted by body lice?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The disease epidemic typhus is caused by Rickettsia prowazekii and is transmitted by body lice , Pediculus humanus .", "hl_context": "<hl> The disease epidemic typhus is caused by Rickettsia prowazekii and is transmitted by body lice , Pediculus humanus . <hl> Flying squirrels are animal reservoirs of R . prowazekii in North America and can also be sources of lice capable of transmitting the pathogen . Epidemic typhus is characterized by a high fever and body aches that last for about 2 weeks . A rash develops on the abdomen and chest and radiates to the extremities . Severe cases can result in death from shock or damage to heart and brain tissues . Infected humans are an important reservoir for this bacterium because R . prowazekii is the only Rickettsia that can establish a chronic carrier state in humans ."}, {"question": {"question_id": "fs-id1167661553267", "question_text": "What disease is most associated with Clostridium perfringens?", "question_choices": ["endocarditis", "osteomyelitis", "gas gangrene", "rat bite fever"], "cloze_format": "The ___ disease is most associated with Clostridium perfringens.", "normal_format": "What disease is most associated with Clostridium perfringens?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "\u03b1-Toxin and theta ( \u03b8 ) toxin are the major virulence factors of C . perfringens implicated in gas gangrene . The gas associated with gas gangrene is produced by Clostridium \u2019 s fermentation of butyric acid , which produces hydrogen and carbon dioxide that are released as the bacteria multiply , forming pockets of gas in tissues ( Figure 25.7 ) .", "hl_context": "<hl> \u03b1-Toxin and theta ( \u03b8 ) toxin are the major virulence factors of C . perfringens implicated in gas gangrene . <hl> \u03b1-Toxin is a lipase responsible for breaking down cell membranes ; it also causes the formation of thrombi ( blood clots ) in blood vessels , contributing to the spread of ischemia . \u03b8-Toxin forms pores in the patient \u2019 s cell membranes , causing cell lysis . <hl> The gas associated with gas gangrene is produced by Clostridium \u2019 s fermentation of butyric acid , which produces hydrogen and carbon dioxide that are released as the bacteria multiply , forming pockets of gas in tissues ( Figure 25.7 ) . <hl>"}, {"question": {"question_id": "fs-id1167661292060", "question_text": "Which bacterial pathogen causes plague?", "question_choices": ["Yersinia pestis", "Bacillus moniliformis", "Bartonella quintana", "Rickettsia rickettsii"], "cloze_format": "The bacterial pathogen that causes plague is ___ .", "normal_format": "Which bacterial pathogen causes plague?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "The gram-negative bacillus Yersinia pestis causes the zoonotic infection plague .", "hl_context": "<hl> The gram-negative bacillus Yersinia pestis causes the zoonotic infection plague . <hl> This bacterium causes acute febrile disease in animals , usually rodents or other small mammals , and humans . The disease is associated with a high mortality rate if left untreated . Historically , Y . pestis has been responsible for several devastating pandemics , resulting in millions of deaths ( see Micro Connections : The History of the Plague ) . There are three forms of plague : bubonic plague ( the most common form , accounting for about 80 % of cases ) , pneumonic plague , and septicemic plague . These forms are differentiated by the mode of transmission and the initial site of infection . Figure 25.9 illustrates these various modes of transmission and infection between animals and humans ."}, {"question": {"question_id": "fs-id1167661251020", "question_text": "Which of the following viruses is most widespread in the human population?", "question_choices": ["human immunodeficiency virus", "Ebola virus", "Epstein-Barr virus", "hantavirus"], "cloze_format": "The virus that is most widespread in the human population is the ___ .", "normal_format": "Which of the following viruses is most widespread in the human population?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Human herpesvirus 4 , also known as Epstein-Barr virus ( EBV ) , has been associated with a variety of human diseases , such as mononucleosis and Burkitt lymphoma . Exposure to the human herpesvirus 4 ( HHV - 4 ) is widespread and nearly all people have been exposed at some time in their childhood , as evidenced by serological tests on populations .", "hl_context": "<hl> Human herpesvirus 4 , also known as Epstein-Barr virus ( EBV ) , has been associated with a variety of human diseases , such as mononucleosis and Burkitt lymphoma . <hl> <hl> Exposure to the human herpesvirus 4 ( HHV - 4 ) is widespread and nearly all people have been exposed at some time in their childhood , as evidenced by serological tests on populations . <hl> The virus primarily resides within B lymphocyte s and , like all herpes viruses , can remain dormant in a latent state for a long time ."}, {"question": {"question_id": "fs-id1167661257310", "question_text": "Which of these viruses is spread through mouse urine or feces?", "question_choices": ["Epstein-Barr", "hantavirus", "human immunodeficiency virus", "cytomegalovirus"], "cloze_format": "(The) ___ is a virus that is spread through mouse urine or feces.", "normal_format": "Which of these viruses is spread through mouse urine or feces?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The genus Hantavirus consists of at least four serogroups with nine viruses causing two major clinical ( sometimes overlapping ) syndromes : hantavirus pulmonary syndrome ( HPS ) in North America and hemorrhagic fever with renal syndrome ( HFRS ) in other continents . Hantaviruses are found throughout the world in wild rodents that shed the virus in their urine and feces . Transmission occurs between rodents and to humans through inhalation of aerosols of the rodent urine and feces .", "hl_context": "<hl> The genus Hantavirus consists of at least four serogroups with nine viruses causing two major clinical ( sometimes overlapping ) syndromes : hantavirus pulmonary syndrome ( HPS ) in North America and hemorrhagic fever with renal syndrome ( HFRS ) in other continents . <hl> <hl> Hantaviruses are found throughout the world in wild rodents that shed the virus in their urine and feces . <hl> <hl> Transmission occurs between rodents and to humans through inhalation of aerosols of the rodent urine and feces . <hl> Hantaviruses associated with outbreaks in the US and Canada are transmitted by the deer mouse , white-footed mouse , or cotton rat ."}, {"question": {"question_id": "fs-id1167663931900", "question_text": "A patient at a clinic has tested positive for HIV. Her blood contained 700/\u00b5L CD4 T cells and she does not have any apparent illness. Her infection is in which stage?", "question_choices": ["1", "2", "3"], "cloze_format": "A patient at a clinic has tested positive for HIV. Her blood contained 700/\u00b5L CD4 T cells and she does not have any apparent illness. Her infection is in the ___ stage.", "normal_format": "A patient at a clinic has tested positive for HIV. Her blood contained 700/\u00b5L CD4 T cells and she does not have any apparent illness. Her infection is in which stage?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "Stage 1 : Acute HIV infection . Two to 4 weeks after infection with HIV , patients may experience a flu-like illness , which can last for a few weeks . Patients with acute HIV infection have more than 500 cells / \u03bcL CD4 T cells and a large amount of virus in their blood .", "hl_context": "<hl> Stage 1 : Acute HIV infection . <hl> <hl> Two to 4 weeks after infection with HIV , patients may experience a flu-like illness , which can last for a few weeks . <hl> <hl> Patients with acute HIV infection have more than 500 cells / \u03bcL CD4 T cells and a large amount of virus in their blood . <hl> Patients are very contagious during this stage . To confirm acute infection , either a fourth-generation antibody-antigen test or a nucleic acid test ( NAT ) must be performed ."}, {"question": {"question_id": "fs-id1167661308618", "question_text": "Which of the following diseases is caused by a helminth?", "question_choices": ["leishmaniasis", "malaria", "Chagas disease", "schistosomiasis"], "cloze_format": "The disease that is caused by a helminth is ___.", "normal_format": "Which of the following diseases is caused by a helminth?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Disease Profile Common Eukaryotic Pathogens of the Human Circulatory System Protozoan and helminthic infections are prevalent in the developing world . A few of the more important parasitic infections are summarized in Figure 25.34 . Schistosomiasis ( bilharzia ) is an NTD caused by blood flukes in the genus Schistosoma that are native to the Caribbean , South America , Middle East , Asia , and Africa .", "hl_context": "<hl> Disease Profile Common Eukaryotic Pathogens of the Human Circulatory System Protozoan and helminthic infections are prevalent in the developing world . <hl> <hl> A few of the more important parasitic infections are summarized in Figure 25.34 . <hl> <hl> Schistosomiasis ( bilharzia ) is an NTD caused by blood flukes in the genus Schistosoma that are native to the Caribbean , South America , Middle East , Asia , and Africa . <hl> Most human schistosomiasis cases are caused by Schistosoma mansoni , S . haematobium , or S . japonicum . Schistosoma are the only trematodes that invade through the skin ; all other trematodes infect by ingestion . WHO estimates that at least 258 million people required preventive treatment for schistosomiasis in 2014 . 51 51 World Health Organization . \u201c Schistosomiasis . Fact Sheet . \u201d 2016 . http://www.who.int/mediacentre/factsheets/fs115/en/ . Accessed July 29 , 2016 ."}, {"question": {"question_id": "fs-id1167663603943", "question_text": "Which of these is the most common form of leishmaniasis?", "question_choices": ["cutaneous", "mucosal", "visceral", "intestinal"], "cloze_format": "___ is the most common form of leishmaniasis.", "normal_format": "Which of these is the most common form of leishmaniasis?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "The three major clinical forms of leishmaniasis are cutaneous ( oriental sore , Delhi boil , Aleppo boil ) , visceral ( kala-azar , Dumdum fever ) , and mucosal ( espundia ) . The most common form of disease is cutaneous leishmaniasis , which is characterized by the formation of sores at the site of the insect bite that may start out as papules or nodules before becoming large ulcers ( Figure 25.33 ) .", "hl_context": "<hl> The three major clinical forms of leishmaniasis are cutaneous ( oriental sore , Delhi boil , Aleppo boil ) , visceral ( kala-azar , Dumdum fever ) , and mucosal ( espundia ) . <hl> <hl> The most common form of disease is cutaneous leishmaniasis , which is characterized by the formation of sores at the site of the insect bite that may start out as papules or nodules before becoming large ulcers ( Figure 25.33 ) . <hl>"}, {"question": {"question_id": "fs-id1167663612092", "question_text": "Which of the following is a causative agent of malaria?", "question_choices": ["Trypanosoma cruzi", "Toxoplasma gondii", "Plasmodium falciparum", "Schistosoma mansoni"], "cloze_format": "___ is a causative agent of malaria.", "normal_format": "Which of the following is a causative agent of malaria?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "bloom": null, "hl_sentences": "Currently , P . falciparum is the most common and most lethal cause of malaria , often called falciparum malaria . Falciparum malaria is widespread in highly populated regions of Africa and Asia , putting many people at risk for the most severe form of the disease .", "hl_context": "<hl> Currently , P . falciparum is the most common and most lethal cause of malaria , often called falciparum malaria . <hl> <hl> Falciparum malaria is widespread in highly populated regions of Africa and Asia , putting many people at risk for the most severe form of the disease . <hl>"}], "summary": " Summary 25.1   Anatomy of the Circulatory and Lymphatic Systems \n\n The  circulatory system  moves blood throughout the body and has no normal microbiota. \n\n The  lymphatic system  moves fluids from the interstitial spaces of tissues toward the circulatory system and filters the lymph. It also has no normal microbiota. \n\n The circulatory and lymphatic systems are home to many components of the host immune defenses. \n\n Infections of the circulatory system may occur after a break in the skin barrier or they may enter the bloodstream at the site of a localized infection. Pathogens or toxins in the bloodstream can spread rapidly throughout the body and can provoke systemic and sometimes fatal inflammatory responses such as  SIRS ,  sepsis , and  endocarditis . \n\n Infections of the lymphatic system can cause  lymphangitis  and  lymphadenitis . \n\n 25.2   Bacterial Infections of the Circulatory and Lymphatic Systems \n\n Bacterial infections of the circulatory system are almost universally serious. Left untreated, most have high mortality rates. \n\n Bacterial pathogens usually require a breach in the immune defenses to colonize the circulatory system. Most often, this involves a wound or the bite of an arthropod vector, but it can also occur in hospital settings and result in nosocomial infections. \n\n Sepsis  from both gram-negative and gram-positive bacteria , puerperal fever, rheumatic fever, endocarditis, gas gangrene, osteomyelitis,  and  toxic shock syndrome  are typically a result of injury or introduction of bacteria by medical or surgical intervention. \n\n Tularemia, brucellosis, cat-scratch fever, rat-bite fever,  and  bubonic plague  are zoonotic diseases transmitted by biological vectors \n\n Ehrlichiosis, anaplasmosis, endemic  and  murine typhus, Rocky Mountain spotted fever, Lyme disease, relapsing fever,  and  trench fever  are transmitted by arthropod vectors. \n\n Because their symptoms are so similar to those of other diseases, many bacterial infections of the circulatory system are difficult to diagnose. \n\n Standard antibiotic therapies are effective for the treatment of most bacterial infections of the circulatory system, unless the bacterium is resistant, in which case synergistic treatment may be required. \n\n The systemic immune response to a bacteremia, which involves the release of excessive amounts of cytokines, can sometimes be more damaging to the host than the infection itself. \n\n 25.3   Viral Infections of the Circulatory and Lymphatic Systems \n\n Human herpesviruses such  Epstein-Barr virus  (HHV-4) and  cytomegalovirus  (HHV-5) are widely distributed. The former is associated with infectious mononucleosis and Burkitt lymphoma, and the latter can cause serious congenital infections as well as serious disease in immunocompromised adults. \n\n Arboviral diseases such as y ellow fever, dengue fever,  and  chikungunya fever  are characterized by high fevers and vascular damage that can often be fatal.  Ebola virus disease  is a highly contagious and often fatal infection spread through contact with bodily fluids. \n\n Although there is a vaccine available for yellow fever, treatments for patients with yellow fever, dengue, chikungunya fever, and Ebola virus disease are limited to supportive therapies. \n\n Patients infected with  human immunodeficiency virus (HIV)  progress through three stages of disease, culminating in  AIDS .  Antiretroviral therapy (ART)  uses various combinations of drugs to suppress viral loads, extending the period of latency and reducing the likelihood of transmission. \n\n Vector control and animal reservoir control remain the best defenses against most viruses that cause diseases of the circulatory system. \n\n 25.4   Parasitic Infections of the Circulatory and Lymphatic Systems \n\n Malaria  is a protozoan parasite that remains an important cause of death primarily in the tropics. Several species in the genus  Plasmodium  are responsible for malaria and all are transmitted by  Anopheles  mosquitoes.  Plasmodium  infects and destroys human red blood cells, leading to organ damage, anemia, blood vessel necrosis, and death. Malaria can be treated with various antimalarial drugs and prevented through vector control. \n\n Toxoplasmosis  is a widespread protozoal infection that can cause serious infections in the immunocompromised and in developing fetuses. Domestic cats are the definitive host. \n\n Babesiosis is a generally asymptomatic infection of red blood cells that can causes malaria-like symptoms in elderly, immunocompromised, or asplenic patients. \n\n Chagas disease  is a tropical disease transmitted by triatomine bugs. The trypanosome infects heart, neural tissues, monocytes, and phagocytes, often remaining latent for many years before causing serious and sometimes fatal damage to the digestive system and heart. \n\n Leishmaniasis  is caused by the protozoan  Leishmania  and is transmitted by sand flies. Symptoms are generally mild, but serious cases may cause organ damage, anemia, and loss of immune competence. \n\n Schistosomiasis  is caused by a fluke transmitted by snails. The fluke moves throughout the body in the blood stream and chronically infects various tissues, leading to organ damage. ", "keyterm": "", "bname": "microbiology"}, {"chapter": 14, "intro": " Chapter Outline 14.1   Historical Basis of Modern Understanding 14.2   DNA Structure and Sequencing 14.3   Basics of DNA Replication 14.4   DNA Replication in Prokaryotes 14.5   DNA Replication in Eukaryotes 14.6   DNA Repair Introduction The three letters \u201cDNA\u201d have now become synonymous with crime solving, paternity testing, human identification, and genetic testing. DNA can be retrieved from hair, blood, or saliva. Each person\u2019s DNA is unique, and it is possible to detect differences between individuals within a species on the basis of these unique features. DNA analysis has many practical applications beyond forensics. In humans, DNA testing is applied to numerous uses: determining paternity, tracing genealogy, identifying pathogens, archeological research, tracing disease outbreaks, and studying human migration patterns. In the medical field, DNA is used in diagnostics, new vaccine development, and cancer therapy. It is now possible to determine predisposition to diseases by looking at genes. Each human cell has 23 pairs of chromosomes: one set of chromosomes is inherited from the mother and the other set is inherited from the father. There is also a mitochondrial genome, inherited exclusively from the mother, which can be involved in inherited genetic disorders. On each chromosome, there are thousands of genes that are responsible for determining the genotype and phenotype of the individual. A gene is defined as a sequence of DNA that codes for a functional product. The human haploid genome contains 3 billion base pairs and has between 20,000 and 25,000 functional genes. ", "chapter_text": "14.1   Historical Basis of Modern Understanding Learning Objectives By the end of this section, you will be able to:\n\n Explain transformation of DNA \n\n Describe the key experiments that helped identify that DNA is the genetic material \n\n State and explain Chargaff\u2019s rules \n\n Modern understandings of DNA have evolved from the discovery of nucleic acid to the development of the double-helix model. In the 1860s, Friedrich Miescher ( Figure 14.2 ), a physician by profession, was the first person to isolate phosphate-rich chemicals from white blood cells or leukocytes. He named these chemicals (which would eventually be known as RNA and DNA) nuclein because they were isolated from the nuclei of the cells. \n\n Link to Learning \n\n To see Miescher conduct an experiment step-by-step, click through  this review  of how he discovered the key role of DNA and proteins in the nucleus. \n\n A half century later, British bacteriologist Frederick Griffith was perhaps the first person to show that hereditary information could be transferred from one cell to another \u201chorizontally,\u201d rather than by descent. In 1928, he reported the first demonstration of bacterial  transformation , a process in which external DNA is taken up by a cell, thereby changing morphology and physiology. He was working with  Streptococcus pneumoniae,  the bacterium that causes pneumonia. Griffith worked with two strains, rough (R) and smooth (S). The R strain is non-pathogenic (does not cause disease) and is called rough because its outer surface is a cell wall and lacks a capsule; as a result, the cell surface appears uneven under the microscope. The S strain is pathogenic (disease-causing) and has a capsule outside its cell wall. As a result, it has a smooth appearance under the microscope. Griffith injected the live R strain into mice and they survived. In another experiment, when he injected mice with the heat-killed S strain, they also survived. In a third set of experiments, a mixture of live R strain and heat-killed S strain were injected into mice, and\u2014to his surprise\u2014the mice died. Upon isolating the live bacteria from the dead mouse, only the S strain of bacteria was recovered. When this isolated S strain was injected into fresh mice, the mice died. Griffith concluded that something had passed from the heat-killed S strain into the live R strain and transformed it into the pathogenic S strain, and he called this the transforming principle ( Figure 14.3 ). These experiments are now famously known as Griffith's transformation experiments. \n\n Scientists Oswald Avery, Colin MacLeod, and Maclyn McCarty (1944) were interested in exploring this transforming principle further. They isolated the S strain from the dead mice and isolated the proteins and nucleic acids, namely RNA and DNA, as these were possible candidates for the molecule of heredity. They conducted a systematic elimination study. They used enzymes that specifically degraded each component and then used each mixture separately to transform the R strain. They found that when DNA was degraded, the resulting mixture was no longer able to transform the bacteria, whereas all of the other combinations were able to transform the bacteria. This led them to conclude that DNA was the transforming principle. \n\n Career Connection Forensic Scientists and DNA Analysis \n\n DNA evidence was used for the first time to solve an immigration case. The story started with a teenage boy returning to London from Ghana to be with his mother. Immigration authorities at the airport were suspicious of him, thinking that he was traveling on a forged passport. After much persuasion, he was allowed to go live with his mother, but the immigration authorities did not drop the case against him. All types of evidence, including photographs, were provided to the authorities, but deportation proceedings were started nevertheless. Around the same time, Dr. Alec Jeffreys of Leicester University in the United Kingdom had invented a technique known as DNA fingerprinting. The immigration authorities approached Dr. Jeffreys for help. He took DNA samples from the mother and three of her children, plus an unrelated mother, and compared the samples with the boy\u2019s DNA. Because the biological father was not in the picture, DNA from the three children was compared with the boy\u2019s DNA. He found a match in the boy\u2019s DNA for both the mother and his three siblings. He concluded that the boy was indeed the mother\u2019s son. \n\n Forensic scientists analyze many items, including documents, handwriting, firearms, and biological samples. They analyze the DNA content of hair, semen, saliva, and blood, and compare it with a database of DNA profiles of known criminals. Analysis includes DNA isolation, sequencing, and sequence analysis; most forensic DNA analysis involves polymerase chain reaction (PCR) amplification of short tandem repeat (STR) loci and electrophoresis to determine the length of the PCR-amplified fragment. Only mitochondrial DNA is sequenced for forensics. Forensic scientists are expected to appear at court hearings to present their findings. They are usually employed in crime labs of city and state government agencies. Geneticists experimenting with DNA techniques also work for scientific and research organizations, pharmaceutical industries, and college and university labs. Students wishing to pursue a career as a forensic scientist should have at least a bachelor's degree in chemistry, biology, or physics, and preferably some experience working in a laboratory. \n\n Experiments conducted by Martha Chase and Alfred Hershey in 1952 provided confirmatory evidence that DNA was the genetic material and not proteins. Chase and Hershey were studying a bacteriophage, which is a virus that infects bacteria. Viruses typically have a simple structure: a protein coat, called the capsid, and a nucleic acid core that contains the genetic material, either DNA or RNA. The bacteriophage infects the host bacterial cell by attaching to its surface, and then it injects its nucleic acids inside the cell. The phage DNA makes multiple copies of itself using the host machinery, and eventually the host cell bursts, releasing a large number of bacteriophages. Hershey and Chase labeled one batch of phage with radioactive sulfur,  35 S, to label the protein coat. Another batch of phage were labeled with radioactive phosphorus,  32 P. Because phosphorous is found in DNA, but not protein, the DNA and not the protein would be tagged with radioactive phosphorus. \n\n Each batch of phage was allowed to infect the cells separately. After infection, the phage bacterial suspension was put in a blender, which caused the phage coat to be detached from the host cell. The phage and bacterial suspension was spun down in a centrifuge. The heavier bacterial cells settled down and formed a pellet, whereas the lighter phage particles stayed in the supernatant. In the tube that contained phage labeled with  35 S, the supernatant contained the radioactively labeled phage, whereas no radioactivity was detected in the pellet. In the tube that contained the phage labeled with  32 P, the radioactivity was detected in the pellet that contained the heavier bacterial cells, and no radioactivity was detected in the supernatant.  Hershey and Chase concluded that it was the phage DNA that was injected\n\ninto the cell and carried information to produce more phage particles, thus providing evidence that DNA was the genetic material and not proteins ( Figure 14.4 ). Around this same time, Austrian biochemist Erwin Chargaff examined the content of DNA in different species and found that the amounts of adenine, thymine, guanine, and cytosine were not found in equal quantities, and that it varied from species to species, but not between individuals of the same species. He found that the amount of adenine equals the amount of thymine, and the amount of cytosine equals the amount of guanine, or A = T and G = C. This is also known as Chargaff\u2019s rules. This finding proved immensely useful when Watson and Crick were getting ready to propose their DNA double helix model. \n14.2   DNA Structure and Sequencing Learning Objectives By the end of this section, you will be able to:\n\n Describe the structure of DNA \n\n Explain the Sanger method of DNA sequencing \n\n Discuss the similarities and differences between eukaryotic and prokaryotic DNA \n\n The building blocks of DNA are nucleotides. The important components of the nucleotide are a nitrogenous base, deoxyribose (5-carbon sugar), and a phosphate group ( Figure 14.5 ). The nucleotide is named depending on the nitrogenous base. The nitrogenous base can be a purine such as adenine (A) and guanine (G), or a pyrimidine such as cytosine (C) and thymine (T). \n\n The nucleotides combine with each other by covalent bonds known as phosphodiester bonds or linkages. The purines have a double ring structure with a six-membered ring fused to a five-membered ring. Pyrimidines are smaller in size; they have a single six-membered ring structure. The carbon atoms of the five-carbon sugar are numbered 1', 2', 3', 4', and 5' (1' is read as \u201cone prime\u201d). The phosphate residue is attached to the hydroxyl group of the 5' carbon of one sugar of one nucleotide and the hydroxyl group of the 3' carbon of the sugar of the next nucleotide, thereby forming a 5'-3' phosphodiester bond. \n\n In the 1950s, Francis Crick and James Watson worked together to determine the structure of DNA at the University of Cambridge, England. Other scientists like Linus Pauling and Maurice Wilkins were also actively exploring this field. Pauling had discovered the secondary structure of proteins using X-ray crystallography. In Wilkins\u2019 lab, researcher Rosalind Franklin was using X-ray diffraction methods to understand the structure of DNA. Watson and Crick were able to piece together the puzzle of the DNA molecule on the basis of Franklin's data because Crick had also studied X-ray diffraction ( Figure 14.6 ). In 1962, James Watson, Francis Crick, and Maurice Wilkins were awarded the Nobel Prize in Medicine. Unfortunately, by then Franklin had died, and Nobel prizes are not awarded posthumously. \n\n Watson and Crick proposed that DNA is made up of two strands that are twisted around each other to form a right-handed helix. Base pairing takes place between a purine and pyrimidine; namely, A pairs with T and G pairs with C. Adenine and thymine are complementary base pairs, and cytosine and guanine are also complementary base pairs. The base pairs are stabilized by hydrogen bonds; adenine and thymine form two hydrogen bonds and cytosine and guanine form three hydrogen bonds. The two strands are anti-parallel in nature; that is, the 3' end of one strand faces the 5' end of the other strand. The sugar and phosphate of the nucleotides form the backbone of the structure, whereas the nitrogenous bases are stacked inside. Each base pair is separated from the other base pair by a distance of 0.34 nm, and each turn of the helix measures 3.4 nm. Therefore, ten base pairs are present per turn of the helix. The diameter of the DNA double helix is 2 nm, and it is uniform throughout. Only the pairing between a purine and pyrimidine can explain the uniform diameter. The twisting of the two strands around each other results in the formation of uniformly spaced major and minor grooves ( Figure 14.7 ). \n\n DNA Sequencing Techniques \n\n Until the 1990s, the sequencing of DNA (reading the sequence of DNA) was a relatively expensive and long process. Using radiolabeled nucleotides also compounded the problem through safety concerns. With currently available technology and automated machines, the process is cheap, safer, and can be completed in a matter of hours. Fred Sanger developed the sequencing method used for the human genome sequencing project, which is widely used today ( Figure 14.8 ). \n\n Link to Learning \n\n Visit  this site  to watch a video explaining the DNA sequence reading technique that resulted from Sanger\u2019s work. \n\n The method is known as the dideoxy chain termination method. The sequencing method is based on the use of chain terminators, the dideoxynucleotides (ddNTPs). The dideoxynucleotides, or ddNTPSs, differ from the deoxynucleotides by the lack of a free 3' OH group on the five-carbon sugar. If a ddNTP is added to a growing a DNA strand, the chain is not extended any further because the free 3' OH group needed to add another nucleotide is not available. By using a predetermined ratio of deoxyribonucleotides to dideoxynucleotides, it is possible to generate DNA fragments of different sizes. \n\n The DNA sample to be sequenced is denatured or separated into two strands by heating it to high temperatures. The DNA is divided into four tubes in which a primer, DNA polymerase, and all four nucleotides (A, T, G, and C) are added. In addition to each of the four tubes, limited quantities of one of the four dideoxynucleotides are added to each tube respectively. The tubes are labeled as A, T, G, and C according to the ddNTP added. For detection purposes, each of the four dideoxynucleotides carries a different fluorescent label. Chain elongation continues until a fluorescent dideoxy nucleotide is incorporated, after which no further elongation takes place. After the reaction is over, electrophoresis is performed. Even a difference in length of a single base can be detected. The sequence is read from a laser scanner. For his work on DNA sequencing, Sanger received a Nobel Prize in chemistry in 1980. \n\n Link to Learning \n\n Sanger\u2019s genome sequencing has led to a race to sequence human genomes at a rapid speed and low cost, often referred to as the $1000 in one day sequence. Learn more by selecting the Sequencing at Speed animation  here . \n\n Gel  electrophoresis  is a technique used to separate DNA fragments of different sizes. Usually the gel is made of a chemical called agarose. Agarose powder is added to a buffer and heated. After cooling, the gel solution is poured into a casting tray. Once the gel has solidified, the DNA is loaded on the gel and electric current is applied. The DNA has a net negative charge and moves from the negative electrode toward the positive electrode. The electric current is applied for sufficient time to let the DNA separate according to size; the smallest fragments will be farthest from the well (where the DNA was loaded), and the heavier molecular weight fragments will be closest to the well. Once the DNA is separated, the gel is stained with a DNA-specific dye for viewing it ( Figure 14.9 ). \n\n Evolution Connection Neanderthal Genome: How Are We Related? \n\n The first draft sequence of the Neanderthal genome was recently published by Richard E. Green et al. in 2010. 1  Neanderthals are the closest ancestors of present-day humans. They were known to have lived in Europe and Western Asia before they disappeared from fossil records approximately 30,000 years ago. Green\u2019s team studied almost 40,000-year-old fossil remains that were selected from sites across the world. Extremely sophisticated means of sample preparation and DNA sequencing were employed because of the fragile nature of the bones and heavy microbial contamination. In their study, the scientists were able to sequence some four billion base pairs. The Neanderthal sequence was compared with that of present-day humans from across the world. After comparing the sequences, the researchers found that the Neanderthal genome had 2 to 3 percent greater similarity to people living outside Africa than to people in Africa. While current theories have suggested that all present-day humans can be traced to a small ancestral population in Africa, the data from the Neanderthal genome may contradict this view. Green and his colleagues also discovered DNA segments among people in Europe and Asia that are more similar to Neanderthal sequences than to other contemporary human sequences. Another interesting observation was that Neanderthals are as closely related to people from Papua New Guinea as to those from China or France. This is surprising because Neanderthal fossil remains have been located only in Europe and West Asia. Most likely, genetic exchange took place between Neanderthals and modern humans as modern humans emerged out of Africa, before the divergence of Europeans, East Asians, and Papua New Guineans. 1 Richard E. Green et al., \u201cA Draft Sequence of the Neandertal Genome,\u201d  Science  328 (2010): 710-22. Several genes seem to have undergone changes from Neanderthals during the evolution of present-day humans. These genes are involved in cranial structure, metabolism, skin morphology, and cognitive development. One of the genes that is of particular interest is  RUNX2 , which is different in modern day humans and Neanderthals. This gene is responsible for the prominent frontal bone, bell-shaped rib cage, and dental differences seen in Neanderthals. It is speculated that an evolutionary change in  RUNX2  was important in the origin of modern-day humans, and this affected the cranium and the upper body. \n\n Link to Learning \n\n Watch  Svante P\u00e4\u00e4bo\u2019s talk  explaining the Neanderthal genome research at the 2011 annual TED (Technology, Entertainment, Design) conference. \n\n DNA Packaging in Cells \n\n When comparing prokaryotic cells to eukaryotic cells, prokaryotes are much simpler than eukaryotes in many of their features ( Figure 14.10 ). Most prokaryotes contain a single, circular chromosome that is found in an area of the cytoplasm called the nucleoid. \n\n Visual Connection \n\n In eukaryotic cells, DNA and RNA synthesis occur in a separate compartment from protein synthesis. In prokaryotic cells, both processes occur together. What advantages might there be to separating the processes? What advantages might there be to having them occur together? \n\n The size of the genome in one of the most well-studied prokaryotes,  E.coli,  is 4.6 million base pairs (approximately 1.1 mm, if cut and stretched out). So how does this fit inside a small bacterial cell? The DNA is twisted by what is known as supercoiling. Supercoiling means that DNA is either under-wound (less than one turn of the helix per 10 base pairs) or over-wound (more than 1 turn per 10 base pairs) from its normal relaxed state. Some proteins are known to be involved in the supercoiling; other proteins and enzymes such as DNA gyrase help in maintaining the supercoiled structure. \n\n Eukaryotes, whose chromosomes each consist of a linear DNA molecule, employ a different type of packing strategy to fit their DNA inside the nucleus ( Figure 14.11 ). At the most basic level, DNA is wrapped around proteins known as histones to form structures called nucleosomes. The histones are evolutionarily conserved proteins that are rich in basic amino acids and form an octamer. The DNA (which is negatively charged because of the phosphate groups) is wrapped tightly around the histone core. This nucleosome is linked to the next one with the help of a linker DNA. This is also known as the \u201cbeads on a string\u201d structure. This is further compacted into a 30 nm fiber, which is the diameter of the structure. At the metaphase stage, the chromosomes are at their most compact, are approximately 700 nm in width, and are found in association with scaffold proteins. \n\n In interphase, eukaryotic chromosomes have two distinct regions that can be distinguished by staining. The tightly packaged region is known as heterochromatin, and the less dense region is known as euchromatin. Heterochromatin usually contains genes that are not expressed, and is found in the regions of the centromere and telomeres. The euchromatin usually contains genes that are transcribed, with DNA packaged around nucleosomes but not further compacted. \n14.3   Basics of DNA Replication Learning Objectives By the end of this section, you will be able to:\n\n Explain how the structure of DNA reveals the replication process \n\n Describe the Meselson and Stahl experiments \n\n The elucidation of the structure of the double helix provided a hint as to how DNA divides and makes copies of itself. This model suggests that the two strands of the double helix separate during replication, and each strand serves as a template from which the new complementary strand is copied. What was not clear was how the replication took place. There were three models suggested ( Figure 14.12 ): conservative, semi-conservative, and dispersive. \n\n In conservative replication, the parental DNA remains together, and the newly formed daughter strands are together. The semi-conservative method suggests that each of the two parental DNA strands act as a template for new DNA to be synthesized; after replication, each double-stranded DNA includes one parental or \u201cold\u201d strand and one \u201cnew\u201d strand. In the dispersive model, both copies of DNA have double-stranded segments of parental DNA and newly synthesized DNA interspersed. \n\n Meselson and Stahl were interested in understanding how DNA replicates. They grew  E. coli  for several generations in a medium containing a \u201cheavy\u201d isotope of nitrogen ( 15 N) that gets incorporated into nitrogenous bases, and eventually into the DNA ( Figure 14.13 ). \n\n The  E. coli  culture was then shifted into medium containing  14 N and allowed to grow for one generation. The cells were harvested and the DNA was isolated. The DNA was centrifuged at high speeds in an ultracentrifuge. Some cells were allowed to grow for one more life cycle in  14 N and spun again. During the density gradient centrifugation, the DNA is loaded into a gradient (typically a salt such as cesium chloride or sucrose) and spun at high speeds of 50,000 to 60,000 rpm. Under these circumstances, the DNA will form a band according to its density in the gradient. DNA grown in  15 N will band at a higher density position than that grown in  14 N. Meselson and Stahl noted that after one generation of growth in  14 N after they had been shifted from  15 N, the single band observed was intermediate in position in between DNA of cells grown exclusively in  15 N and  14 N. This suggested either a semi-conservative or dispersive mode of replication. The DNA harvested from cells grown for two generations in  14 N formed two bands: one DNA band was at the intermediate position between  15 N and  14 N, and the other corresponded to the band of  14 N DNA. These results could only be explained if DNA replicates in a semi-conservative manner. Therefore, the other two modes were ruled out. \n\n During DNA replication, each of the two strands that make up the double helix serves as a template from which new strands are copied. The new strand will be complementary to the parental or \u201cold\u201d strand. When two daughter DNA copies are formed, they have the same sequence and are divided equally into the two daughter cells. \n\n Link to Learning \n\n Click through  this tutorial  on DNA replication. \n14.4   DNA Replication in Prokaryotes Learning Objectives By the end of this section, you will be able to:\n\n Explain the process of DNA replication in prokaryotes \n\n Discuss the role of different enzymes and proteins in supporting this process \n\n DNA replication has been extremely well studied in prokaryotes primarily because of the small size of the genome and the mutants that are available.  E. coli  has 4.6 million base pairs in a single circular chromosome and all of it gets replicated in approximately 42 minutes, starting from a single origin of replication and proceeding around the circle in both directions. This means that approximately 1000 nucleotides are added per second. The process is quite rapid and occurs without many mistakes. \n\n DNA replication employs a large number of proteins and enzymes, each of which plays a critical role during the process. One of the key players is the enzyme DNA polymerase, also known as DNA pol, which adds nucleotides one by one to the growing DNA chain that are complementary to the template strand. The addition of nucleotides requires energy; this energy is obtained from the nucleotides that have three phosphates attached to them, similar to ATP which has three phosphate groups attached. When the bond between the phosphates is broken, the energy released is used to form the phosphodiester bond between the incoming nucleotide and the growing chain. In prokaryotes, three main types of polymerases are known: DNA pol I, DNA pol II, and DNA pol III. It is now known that DNA pol III is the enzyme required for DNA synthesis; DNA pol I and DNA pol II are primarily required for repair. \n\n How does the replication machinery know where to begin? It turns out that there are specific nucleotide sequences called origins of replication where replication begins. In  E. coli,  which has a single origin of replication on its one chromosome (as do most prokaryotes), it is approximately 245 base pairs long and is rich in AT sequences. The origin of replication is recognized by certain proteins that bind to this site. An enzyme called  helicase  unwinds the DNA by breaking the hydrogen bonds between the nitrogenous base pairs. ATP hydrolysis is required for this process. As the DNA opens up, Y-shaped structures called  replication forks  are formed. Two replication forks are formed at the origin of replication and these get extended bi- directionally as replication proceeds.  Single-strand binding proteins  coat the single strands of DNA near the replication fork to prevent the single-stranded DNA from winding back into a double helix. DNA polymerase is able to add nucleotides only in the 5' to 3' direction (a new DNA strand can be only extended in this direction). It also requires a free 3'-OH group to which it can add nucleotides by forming a phosphodiester bond between the 3'-OH end and the 5' phosphate of the next nucleotide. This essentially means that it cannot add nucleotides if a free 3'-OH group is not available. Then how does it add the first nucleotide? The problem is solved with the help of a primer that provides the free 3'-OH end. Another enzyme, RNA  primase , synthesizes an RNA primer that is about five to ten nucleotides long and complementary to the DNA. Because this sequence primes the DNA synthesis, it is appropriately called the  primer . DNA polymerase can now extend this RNA primer, adding nucleotides one by one that are complementary to the template strand ( Figure 14.14 ). \n\n Visual Connection \n\n You isolate a cell strain in which the joining together of Okazaki fragments is impaired and suspect that a mutation has occurred in an enzyme found at the replication fork. Which enzyme is most likely to be mutated? \n\n The replication fork moves at the rate of 1000 nucleotides per second. DNA polymerase can only extend in the 5' to 3' direction, which poses a slight problem at the replication fork. As we know, the DNA double helix is anti-parallel; that is, one strand is in the 5' to 3' direction and the other is oriented in the 3' to 5' direction. One strand, which is complementary to the 3' to 5' parental DNA strand, is synthesized continuously towards the replication fork because the polymerase can add nucleotides in this direction. This continuously synthesized strand is known as the  leading strand . The other strand, complementary to the 5' to 3' parental DNA, is extended away from the replication fork, in small fragments known as  Okazaki fragments , each requiring a primer to start the synthesis. Okazaki fragments are named after the Japanese scientist who first discovered them. The strand with the Okazaki fragments is known as the  lagging strand . \n\n The leading strand can be extended by one primer alone, whereas the lagging strand needs a new primer for each of the short Okazaki fragments. The overall direction of the lagging strand will be 3' to 5', and that of the leading strand 5' to 3'. A protein called the  sliding clamp  holds the DNA polymerase in place as it continues to add nucleotides. The sliding clamp is a ring-shaped protein that binds to the DNA and holds the polymerase in place.  Topoisomerase  prevents the over-winding of the DNA double helix ahead of the replication fork as the DNA is opening up; it does so by causing temporary nicks in the DNA helix and then resealing it. As synthesis proceeds, the RNA primers are replaced by DNA. The primers are removed by the exonuclease activity of DNA pol I, and the gaps are filled in by deoxyribonucleotides. The nicks that remain between the newly synthesized DNA (that replaced the RNA primer) and the previously synthesized DNA are sealed by the enzyme DNA  ligase  that catalyzes the formation of phosphodiester linkage between the 3'-OH end of one nucleotide and the 5' phosphate end of the other fragment. \n\n Once the chromosome has been completely replicated, the two DNA copies move into two different cells during cell division. The process of DNA replication can be summarized as follows: \n\n DNA unwinds at the origin of replication. \n\n Helicase opens up the DNA-forming replication forks; these are extended bidirectionally. \n\n Single-strand binding proteins coat the DNA around the replication fork to prevent rewinding of the DNA. \n\n Topoisomerase binds at the region ahead of the replication fork to prevent supercoiling. \n\n Primase synthesizes RNA primers complementary to the DNA strand. \n\n DNA polymerase starts adding nucleotides to the 3'-OH end of the primer. \n\n Elongation of both the lagging and the leading strand continues. \n\n RNA primers are removed by exonuclease activity. \n\n Gaps are filled by DNA pol by adding dNTPs. \n\n The gap between the two DNA fragments is sealed by DNA ligase, which helps in the formation of phosphodiester bonds. \n\n Table 14.1  summarizes the enzymes involved in prokaryotic DNA replication and the functions of each. \n\n Prokaryotic DNA Replication: Enzymes and Their Function \n\n Enzyme/protein Specific Function \n\n DNA pol I Exonuclease activity removes RNA primer and replaces with newly synthesized DNA \n\n DNA pol II Repair function \n\n DNA pol III Main enzyme that adds nucleotides in the 5'-3' direction \n\n Helicase Opens the DNA helix by breaking hydrogen bonds between the nitrogenous bases \n\n Ligase Seals the gaps between the Okazaki fragments to create one continuous DNA strand \n\n Primase Synthesizes RNA primers needed to start replication \n\n Sliding Clamp Helps to hold the DNA polymerase in place when nucleotides are being added \n\n Topoisomerase Helps relieve the stress on DNA when unwinding by causing breaks and then resealing the DNA \n\n Single-strand binding proteins (SSB) Binds to single-stranded DNA to avoid DNA rewinding back. \n\n Table  14.1     \n\n Link to Learning \n\n Review the full process of DNA replication  here . \n14.5   DNA Replication in Eukaryotes Learning Objectives By the end of this section, you will be able to:\n\n Discuss the similarities and differences between DNA replication in eukaryotes and prokaryotes \n\n State the role of telomerase in DNA replication \n\n Eukaryotic genomes are much more complex and larger in size than prokaryotic genomes. The human genome has three billion base pairs per haploid set of chromosomes, and 6 billion base pairs are replicated during the S phase of the cell cycle. There are multiple origins of replication on the eukaryotic chromosome; humans can have up to 100,000 origins of replication. The rate of replication is approximately 100 nucleotides per second, much slower than prokaryotic replication. In yeast, which is a eukaryote, special sequences known as Autonomously Replicating Sequences (ARS) are found on the chromosomes. These are equivalent to the origin of replication in  E. coli . \n\n The number of DNA polymerases in eukaryotes is much more than prokaryotes: 14 are known, of which five are known to have major roles during replication and have been well studied. They are known as pol  \u03b1 , pol  \u03b2 , pol  \u03b3 , pol  \u03b4 , and pol  \u03b5 . \n\n The essential steps of replication are the same as in prokaryotes. Before replication can start, the DNA has to be made available as template. Eukaryotic DNA is bound to basic proteins known as histones to form structures called nucleosomes. The chromatin (the complex between DNA and proteins) may undergo some chemical modifications, so that the DNA may be able to slide off the proteins or be accessible to the enzymes of the DNA replication machinery. At the origin of replication, a pre-replication complex is made with other initiator proteins. Other proteins are then recruited to start the replication process ( Table 14.2 ). \n\n  A helicase using the energy from ATP hydrolysis opens up the DNA helix. Replication forks are formed at each replication origin as the DNA unwinds. The opening of the double helix causes over-winding, or supercoiling, in the DNA ahead of the replication fork. These are resolved with the action of topoisomerases. Primers are formed by the enzyme primase, and using the primer, DNA pol can start synthesis. While the leading strand is continuously synthesized by the enzyme pol  \u03b4 , the lagging strand is synthesized by pol  \u03b5 . A sliding clamp protein known as PCNA (Proliferating Cell Nuclear Antigen) holds the DNA pol in place so that it does not slide off the DNA. RNase H removes the RNA primer, which is then replaced with DNA nucleotides. The Okazaki fragments in the lagging strand are joined together after the replacement of the RNA primers with DNA. The gaps that remain are sealed by DNA ligase, which forms the phosphodiester bond. \n\n Telomere replication \n\n Unlike prokaryotic chromosomes, eukaryotic chromosomes are linear. As you\u2019ve learned, the enzyme DNA pol can add nucleotides only in the 5' to 3' direction. In the leading strand, synthesis continues until the end of the chromosome is reached. On the lagging strand, DNA is synthesized in short stretches, each of which is initiated by a separate primer. When the replication fork reaches the end of the linear chromosome, there is no place for a primer to be made for the DNA fragment to be copied at the end of the chromosome. These ends thus remain unpaired, and over time these ends may get progressively shorter as cells continue to divide. \n\n The ends of the linear chromosomes are known as  telomeres , which have repetitive sequences that code for no particular gene. In a way, these telomeres protect the genes from getting deleted as cells continue to divide. In humans, a six base pair sequence, TTAGGG, is repeated 100 to 1000 times. The discovery of the enzyme telomerase ( Figure 14.16 ) helped in the understanding of how chromosome ends are maintained. The  telomerase  enzyme contains a catalytic part and a built-in RNA template. It attaches to the end of the chromosome, and complementary bases to the RNA template are added on the 3' end of the DNA strand. Once the 3' end of the lagging strand template is sufficiently elongated, DNA polymerase can add the nucleotides complementary to the ends of the chromosomes. Thus, the ends of the chromosomes are replicated. \n\n Telomerase is typically active in germ cells and adult stem cells. It is not active in adult somatic cells. For her discovery of telomerase and its action, Elizabeth Blackburn ( Figure 14.16 ) received the Nobel Prize for Medicine and Physiology in 2009. \n\n Telomerase and Aging \n\n Cells that undergo cell division continue to have their telomeres shortened because most somatic cells do not make telomerase. This essentially means that telomere shortening is associated with aging. With the advent of modern medicine, preventative health care, and healthier lifestyles, the human life span has increased, and there is an increasing demand for people to look younger and have a better quality of life as they grow older. \n\n In 2010, scientists found that telomerase can reverse some age-related conditions in mice. This may have potential in regenerative medicine. 2  Telomerase-deficient mice were used in these studies; these mice have tissue atrophy, stem cell depletion, organ system failure, and impaired tissue injury responses. Telomerase reactivation in these mice caused extension of telomeres, reduced DNA damage, reversed neurodegeneration, and improved the function of the testes, spleen, and intestines. Thus, telomere reactivation may have potential for treating age-related diseases in humans. 2 Jaskelioff et al., \u201cTelomerase reactivation reverses tissue degeneration in aged telomerase-deficient mice,\u201d  Nature  469 (2011): 102-7. \n\n Cancer is characterized by uncontrolled cell division of abnormal cells. The cells accumulate mutations, proliferate uncontrollably, and can migrate to different parts of the body through a process called metastasis. Scientists have observed that cancerous cells have considerably shortened telomeres and that telomerase is active in these cells. Interestingly, only after the telomeres were shortened in the cancer cells did the telomerase become active. If the action of telomerase in these cells can be inhibited by drugs during cancer therapy, then the cancerous cells could potentially be stopped from further division. \n\n Difference between Prokaryotic and Eukaryotic Replication \n\n Property Prokaryotes Eukaryotes \n\n Origin of replication Single Multiple \n\n Rate of replication 1000 nucleotides/s 50 to 100 nucleotides/s \n\n DNA polymerase types 5 14 \n\n Telomerase Not present Present \n\n RNA primer removal DNA pol I RNase H \n\n Strand elongation DNA pol III Pol \u03b4, pol \u03b5 \n\n Sliding clamp Sliding clamp PCNA \n\n Table  14.2     \n14.6   DNA Repair Learning Objectives By the end of this section, you will be able to:\n\n Discuss the different types of mutations in DNA \n\n Explain DNA repair mechanisms \n\n DNA replication is a highly accurate process, but mistakes can occasionally occur, such as a DNA polymerase inserting a wrong base. Uncorrected mistakes may sometimes lead to serious consequences, such as cancer. Repair mechanisms correct the mistakes. In rare cases, mistakes are not corrected, leading to mutations; in other cases, repair enzymes are themselves mutated or defective. \n\n Most of the mistakes during DNA replication are promptly corrected by DNA polymerase by proofreading the base that has been just added ( Figure 14.17 ). In  proofreading , the DNA pol reads the newly added base before adding the next one, so a correction can be made. The polymerase checks whether the newly added base has paired correctly with the base in the template strand. If it is the right base, the next nucleotide is added. If an incorrect base has been added, the enzyme makes a cut at the phosphodiester bond and releases the wrong nucleotide. This is performed by the exonuclease action of DNA pol III. Once the incorrect nucleotide has been removed, a new one will be added again. \n\n Some errors are not corrected during replication, but are instead corrected after replication is completed; this type of repair is known as  mismatch repair  ( Figure 14.18 ). The enzymes recognize the incorrectly added nucleotide and excise it; this is then replaced by the correct base. If this remains uncorrected, it may lead to more permanent damage. How do mismatch repair enzymes recognize which of the two bases is the incorrect one? In  E. coli , after replication, the nitrogenous base adenine acquires a methyl group; the parental DNA strand will have methyl groups, whereas the newly synthesized strand lacks them. Thus, DNA polymerase is able to remove the wrongly incorporated bases from the newly synthesized, non-methylated strand. In eukaryotes, the mechanism is not very well understood, but it is believed to involve recognition of unsealed nicks in the new strand, as well as a short-term continuing association of some of the replication proteins with the new daughter strand after replication has completed. \n\n In another type of repair mechanism,  nucleotide excision repair , enzymes replace incorrect bases by making a cut on both the 3' and 5' ends of the incorrect base ( Figure 14.19 ). The segment of DNA is removed and replaced with the correctly paired nucleotides by the action of DNA pol. Once the bases are filled in, the remaining gap is sealed with a phosphodiester linkage catalyzed by DNA ligase. This repair mechanism is often employed when UV exposure causes the formation of pyrimidine dimers. \n\n A well-studied example of mistakes not being corrected is seen in people suffering from xeroderma pigmentosa ( Figure 14.20 ). Affected individuals have skin that is highly sensitive to UV rays from the sun. When individuals are exposed to UV, pyrimidine dimers, especially those of thymine, are formed; people with xeroderma pigmentosa are not able to repair the damage. These are not repaired because of a defect in the nucleotide excision repair enzymes, whereas in normal individuals, the thymine dimers are excised and the defect is corrected. The thymine dimers distort the structure of the DNA double helix, and this may cause problems during DNA replication. People with xeroderma pigmentosa may have a higher risk of contracting skin cancer than those who dont have the condition. Errors during DNA replication are not the only reason why mutations arise in DNA.  Mutations , variations in the nucleotide sequence of a genome, can also occur because of damage to DNA. Such mutations may be of two types: induced or spontaneous.  Induced mutations  are those that result from an exposure to chemicals, UV rays, x-rays, or some other environmental agent.  Spontaneous mutations  occur without any exposure to any environmental agent; they are a result of natural reactions taking place within the body. \n\n Mutations may have a wide range of effects. Some mutations are not expressed; these are known as  silent mutations .  Point mutations  are those mutations that affect a single base pair. The most common nucleotide mutations are substitutions, in which one base is replaced by another. These can be of two types, either transitions or transversions.  Transition substitution  refers to a purine or pyrimidine being replaced by a base of the same kind; for example, a purine such as adenine may be replaced by the purine guanine.  Transversion substitution  refers to a purine being replaced by a pyrimidine, or vice versa; for example, cytosine, a pyrimidine, is replaced by adenine, a purine. Mutations can also be the result of the addition of a base, known as an insertion, or the removal of a base, also known as deletion. Sometimes a piece of DNA from one chromosome may get translocated to another chromosome or to another region of the same chromosome; this is also known as translocation. These mutation types are shown in  Figure 14.21 . \n\n Visual Connection \n\n A frameshift mutation that results in the insertion of three nucleotides is often less deleterious than a mutation that results in the insertion of one nucleotide. Why? \n\n Mutations in repair genes have been known to cause cancer. Many mutated repair genes have been implicated in certain forms of pancreatic cancer, colon cancer, and colorectal cancer. Mutations can affect either somatic cells or germ cells. If many mutations accumulate in a somatic cell, they may lead to problems such as the uncontrolled cell division observed in cancer. If a mutation takes place in germ cells, the mutation will be passed on to the next generation, as in the case of hemophilia and xeroderma pigmentosa. ", "questions": [{"question": {"question_id": "fs-id2897046", "question_text": "If DNA of a particular species was analyzed and it was found that it contains 27 percent A, what would be the percentage of C?", "question_choices": ["27 percent", "30 percent", "23 percent", "54 percent"], "cloze_format": "If DNA of a particular species was analyzed and it was found that it contains 27 percent A, the percentage of C would be ___ .", "normal_format": "If DNA of a particular species was analyzed and it was found that it contains 27 percent A, what would be the percentage of C?"}, "answer": {"ans_text": "23 percent", "ans_choice": 2}, "bloom": "3", "hl_sentences": "Around this same time , Austrian biochemist Erwin Chargaff examined the content of DNA in different species and found that the amounts of adenine , thymine , guanine , and cytosine were not found in equal quantities , and that it varied from species to species , but not between individuals of the same species . He found that the amount of adenine equals the amount of thymine , and the amount of cytosine equals the amount of guanine , or A = T and G = C . This is also known as Chargaff \u2019 s rules .", "hl_context": "into the cell and carried information to produce more phage particles , thus providing evidence that DNA was the genetic material and not proteins ( Figure 14.4 ) . <hl> Around this same time , Austrian biochemist Erwin Chargaff examined the content of DNA in different species and found that the amounts of adenine , thymine , guanine , and cytosine were not found in equal quantities , and that it varied from species to species , but not between individuals of the same species . <hl> <hl> He found that the amount of adenine equals the amount of thymine , and the amount of cytosine equals the amount of guanine , or A = T and G = C . This is also known as Chargaff \u2019 s rules . <hl> This finding proved immensely useful when Watson and Crick were getting ready to propose their DNA double helix model . 14.2 DNA Structure and Sequencing Learning Objectives By the end of this section , you will be able to :"}, {"question": {"question_id": "fs-id1435268", "question_text": "The experiments by Hershey and Chase helped confirm that DNA was the hereditary material on the basis of the finding that:", "question_choices": ["radioactive phage were found in the pellet", "radioactive cells were found in the supernatant", "radioactive sulfur was found inside the cell", "radioactive phosphorus was found in the cell"], "cloze_format": "The experiments by Hershey and Chase helped confirm that DNA was the hereditary material on the basis of the finding that ___.", "normal_format": "What was the basis for the finding that helped Hershey and Chase to confirm that DNA was the hereditary material?"}, "answer": {"ans_text": "radioactive phosphorus was found in the cell", "ans_choice": 3}, "bloom": null, "hl_sentences": "Experiments conducted by Martha Chase and Alfred Hershey in 1952 provided confirmatory evidence that DNA was the genetic material and not proteins . Hershey and Chase labeled one batch of phage with radioactive sulfur , 35 S , to label the protein coat . Another batch of phage were labeled with radioactive phosphorus , 32 P . Because phosphorous is found in DNA , but not protein , the DNA and not the protein would be tagged with radioactive phosphorus .", "hl_context": "<hl> Experiments conducted by Martha Chase and Alfred Hershey in 1952 provided confirmatory evidence that DNA was the genetic material and not proteins . <hl> Chase and Hershey were studying a bacteriophage , which is a virus that infects bacteria . Viruses typically have a simple structure : a protein coat , called the capsid , and a nucleic acid core that contains the genetic material , either DNA or RNA . The bacteriophage infects the host bacterial cell by attaching to its surface , and then it injects its nucleic acids inside the cell . The phage DNA makes multiple copies of itself using the host machinery , and eventually the host cell bursts , releasing a large number of bacteriophages . <hl> Hershey and Chase labeled one batch of phage with radioactive sulfur , 35 S , to label the protein coat . <hl> <hl> Another batch of phage were labeled with radioactive phosphorus , 32 P . Because phosphorous is found in DNA , but not protein , the DNA and not the protein would be tagged with radioactive phosphorus . <hl>"}, {"question": {"question_id": "fs-id2709296", "question_text": "DNA double helix does not have which of the following?", "question_choices": ["antiparallel configuration", "complementary base pairing", "major and minor grooves", "uracil"], "cloze_format": "DNA double helix does not have ___ .", "normal_format": "DNA double helix does not have which of the following?"}, "answer": {"ans_text": "uracil", "ans_choice": 3}, "bloom": "1", "hl_sentences": "Watson and Crick proposed that DNA is made up of two strands that are twisted around each other to form a right-handed helix . Base pairing takes place between a purine and pyrimidine ; namely , A pairs with T and G pairs with C . Adenine and thymine are complementary base pairs , and cytosine and guanine are also complementary base pairs .", "hl_context": "<hl> Watson and Crick proposed that DNA is made up of two strands that are twisted around each other to form a right-handed helix . <hl> <hl> Base pairing takes place between a purine and pyrimidine ; namely , A pairs with T and G pairs with C . Adenine and thymine are complementary base pairs , and cytosine and guanine are also complementary base pairs . <hl> The base pairs are stabilized by hydrogen bonds ; adenine and thymine form two hydrogen bonds and cytosine and guanine form three hydrogen bonds . The two strands are anti-parallel in nature ; that is , the 3 ' end of one strand faces the 5 ' end of the other strand . The sugar and phosphate of the nucleotides form the backbone of the structure , whereas the nitrogenous bases are stacked inside . Each base pair is separated from the other base pair by a distance of 0.34 nm , and each turn of the helix measures 3.4 nm . Therefore , ten base pairs are present per turn of the helix . The diameter of the DNA double helix is 2 nm , and it is uniform throughout . Only the pairing between a purine and pyrimidine can explain the uniform diameter . The twisting of the two strands around each other results in the formation of uniformly spaced major and minor grooves ( Figure 14.7 ) ."}, {"question": {"question_id": "fs-id2688539", "question_text": "In eukaryotes, what is the DNA wrapped around?", "question_choices": ["single-stranded binding proteins", "sliding clamp", "polymerase", "histones"], "cloze_format": "In eukaryotes, the DNA is wrapped around ___.", "normal_format": "In eukaryotes, what is the DNA wrapped around?"}, "answer": {"ans_text": "histones", "ans_choice": 3}, "bloom": null, "hl_sentences": "Eukaryotic DNA is bound to basic proteins known as histones to form structures called nucleosomes . At the most basic level , DNA is wrapped around proteins known as histones to form structures called nucleosomes .", "hl_context": "The essential steps of replication are the same as in prokaryotes . Before replication can start , the DNA has to be made available as template . <hl> Eukaryotic DNA is bound to basic proteins known as histones to form structures called nucleosomes . <hl> The chromatin ( the complex between DNA and proteins ) may undergo some chemical modifications , so that the DNA may be able to slide off the proteins or be accessible to the enzymes of the DNA replication machinery . At the origin of replication , a pre-replication complex is made with other initiator proteins . Other proteins are then recruited to start the replication process ( Table 14.2 ) . Eukaryotes , whose chromosomes each consist of a linear DNA molecule , employ a different type of packing strategy to fit their DNA inside the nucleus ( Figure 14.11 ) . <hl> At the most basic level , DNA is wrapped around proteins known as histones to form structures called nucleosomes . <hl> The histones are evolutionarily conserved proteins that are rich in basic amino acids and form an octamer . The DNA ( which is negatively charged because of the phosphate groups ) is wrapped tightly around the histone core . This nucleosome is linked to the next one with the help of a linker DNA . This is also known as the \u201c beads on a string \u201d structure . This is further compacted into a 30 nm fiber , which is the diameter of the structure . At the metaphase stage , the chromosomes are at their most compact , are approximately 700 nm in width , and are found in association with scaffold proteins ."}, {"question": {"question_id": "fs-id2956539", "question_text": "Meselson and Stahl's experiments proved that DNA replicates by which mode?", "question_choices": ["conservative", "semi-conservative", "dispersive", "none of the above"], "cloze_format": "Meselson and Stahl's experiments proved that DNA replicates by the ___ mode.", "normal_format": "Meselson and Stahl's experiments proved that DNA replicates by which mode?"}, "answer": {"ans_text": "semi-conservative", "ans_choice": 1}, "bloom": null, "hl_sentences": "DNA grown in 15 N will band at a higher density position than that grown in 14 N . Meselson and Stahl noted that after one generation of growth in 14 N after they had been shifted from 15 N , the single band observed was intermediate in position in between DNA of cells grown exclusively in 15 N and 14 N . This suggested either a semi-conservative or dispersive mode of replication .", "hl_context": "The E . coli culture was then shifted into medium containing 14 N and allowed to grow for one generation . The cells were harvested and the DNA was isolated . The DNA was centrifuged at high speeds in an ultracentrifuge . Some cells were allowed to grow for one more life cycle in 14 N and spun again . During the density gradient centrifugation , the DNA is loaded into a gradient ( typically a salt such as cesium chloride or sucrose ) and spun at high speeds of 50,000 to 60,000 rpm . Under these circumstances , the DNA will form a band according to its density in the gradient . <hl> DNA grown in 15 N will band at a higher density position than that grown in 14 N . Meselson and Stahl noted that after one generation of growth in 14 N after they had been shifted from 15 N , the single band observed was intermediate in position in between DNA of cells grown exclusively in 15 N and 14 N . This suggested either a semi-conservative or dispersive mode of replication . <hl> The DNA harvested from cells grown for two generations in 14 N formed two bands : one DNA band was at the intermediate position between 15 N and 14 N , and the other corresponded to the band of 14 N DNA . These results could only be explained if DNA replicates in a semi-conservative manner . Therefore , the other two modes were ruled out ."}, {"question": {"question_id": "fs-id2300016", "question_text": "If the sequence of the 5'-3' strand is AATGCTAC, then the complementary sequence has the following sequence:", "question_choices": ["3'-AATGCTAC-5'", "3'-CATCGTAA-5'", "3'-TTACGATG-5'", "3'-GTAGCATT-5'"], "cloze_format": "If the sequence of the 5'-3' strand is AATGCTAC, then the complementary sequence has the sequence of ___ .", "normal_format": "Which of the following is the complementary sequence if the 5'-3' strand's sequence is AATGCTAC?"}, "answer": {"ans_text": "3'-TTACGATG-5'", "ans_choice": 2}, "bloom": null, "hl_sentences": "DNA polymerase can only extend in the 5 ' to 3 ' direction , which poses a slight problem at the replication fork . As we know , the DNA double helix is anti-parallel ; that is , one strand is in the 5 ' to 3 ' direction and the other is oriented in the 3 ' to 5 ' direction . One strand , which is complementary to the 3 ' to 5 ' parental DNA strand , is synthesized continuously towards the replication fork because the polymerase can add nucleotides in this direction .", "hl_context": "The replication fork moves at the rate of 1000 nucleotides per second . <hl> DNA polymerase can only extend in the 5 ' to 3 ' direction , which poses a slight problem at the replication fork . <hl> <hl> As we know , the DNA double helix is anti-parallel ; that is , one strand is in the 5 ' to 3 ' direction and the other is oriented in the 3 ' to 5 ' direction . <hl> <hl> One strand , which is complementary to the 3 ' to 5 ' parental DNA strand , is synthesized continuously towards the replication fork because the polymerase can add nucleotides in this direction . <hl> This continuously synthesized strand is known as the leading strand . The other strand , complementary to the 5 ' to 3 ' parental DNA , is extended away from the replication fork , in small fragments known as Okazaki fragments , each requiring a primer to start the synthesis . Okazaki fragments are named after the Japanese scientist who first discovered them . The strand with the Okazaki fragments is known as the lagging strand ."}, {"question": {"question_id": "fs-id13419000", "question_text": "Which of the following components is not involved during the formation of the replication fork?", "question_choices": ["single-strand binding proteins", "helicase", "origin of replication", "ligase"], "cloze_format": "The component that is not involved during the formation of the replication fork is ___.", "normal_format": "Which of the following components is not involved during the formation of the replication fork?"}, "answer": {"ans_text": "ligase", "ans_choice": 3}, "bloom": "2", "hl_sentences": "The origin of replication is recognized by certain proteins that bind to this site . An enzyme called helicase unwinds the DNA by breaking the hydrogen bonds between the nitrogenous base pairs . ATP hydrolysis is required for this process . As the DNA opens up , Y-shaped structures called replication forks are formed . Two replication forks are formed at the origin of replication and these get extended bi - directionally as replication proceeds . Single-strand binding proteins coat the single strands of DNA near the replication fork to prevent the single-stranded DNA from winding back into a double helix .", "hl_context": "How does the replication machinery know where to begin ? It turns out that there are specific nucleotide sequences called origins of replication where replication begins . In E . coli , which has a single origin of replication on its one chromosome ( as do most prokaryotes ) , it is approximately 245 base pairs long and is rich in AT sequences . <hl> The origin of replication is recognized by certain proteins that bind to this site . <hl> <hl> An enzyme called helicase unwinds the DNA by breaking the hydrogen bonds between the nitrogenous base pairs . <hl> <hl> ATP hydrolysis is required for this process . <hl> <hl> As the DNA opens up , Y-shaped structures called replication forks are formed . <hl> <hl> Two replication forks are formed at the origin of replication and these get extended bi - directionally as replication proceeds . <hl> <hl> Single-strand binding proteins coat the single strands of DNA near the replication fork to prevent the single-stranded DNA from winding back into a double helix . <hl> DNA polymerase is able to add nucleotides only in the 5 ' to 3 ' direction ( a new DNA strand can be only extended in this direction ) . It also requires a free 3 ' - OH group to which it can add nucleotides by forming a phosphodiester bond between the 3 ' - OH end and the 5 ' phosphate of the next nucleotide . This essentially means that it cannot add nucleotides if a free 3 ' - OH group is not available . Then how does it add the first nucleotide ? The problem is solved with the help of a primer that provides the free 3 ' - OH end . Another enzyme , RNA primase , synthesizes an RNA primer that is about five to ten nucleotides long and complementary to the DNA . Because this sequence primes the DNA synthesis , it is appropriately called the primer . DNA polymerase can now extend this RNA primer , adding nucleotides one by one that are complementary to the template strand ( Figure 14.14 ) ."}, {"question": {"question_id": "fs-id2075108", "question_text": "Which of the following does the enzyme primase synthesize?", "question_choices": ["DNA primer", "RNA primer", "Okazaki fragments", "phosphodiester linkage"], "cloze_format": "The ___ does the enzyme primase synthesize.", "normal_format": "Which of the following does the enzyme primase synthesize?"}, "answer": {"ans_text": "RNA primer", "ans_choice": 1}, "bloom": "1", "hl_sentences": "Another enzyme , RNA primase , synthesizes an RNA primer that is about five to ten nucleotides long and complementary to the DNA .", "hl_context": "How does the replication machinery know where to begin ? It turns out that there are specific nucleotide sequences called origins of replication where replication begins . In E . coli , which has a single origin of replication on its one chromosome ( as do most prokaryotes ) , it is approximately 245 base pairs long and is rich in AT sequences . The origin of replication is recognized by certain proteins that bind to this site . An enzyme called helicase unwinds the DNA by breaking the hydrogen bonds between the nitrogenous base pairs . ATP hydrolysis is required for this process . As the DNA opens up , Y-shaped structures called replication forks are formed . Two replication forks are formed at the origin of replication and these get extended bi - directionally as replication proceeds . Single-strand binding proteins coat the single strands of DNA near the replication fork to prevent the single-stranded DNA from winding back into a double helix . DNA polymerase is able to add nucleotides only in the 5 ' to 3 ' direction ( a new DNA strand can be only extended in this direction ) . It also requires a free 3 ' - OH group to which it can add nucleotides by forming a phosphodiester bond between the 3 ' - OH end and the 5 ' phosphate of the next nucleotide . This essentially means that it cannot add nucleotides if a free 3 ' - OH group is not available . Then how does it add the first nucleotide ? The problem is solved with the help of a primer that provides the free 3 ' - OH end . <hl> Another enzyme , RNA primase , synthesizes an RNA primer that is about five to ten nucleotides long and complementary to the DNA . <hl> Because this sequence primes the DNA synthesis , it is appropriately called the primer . DNA polymerase can now extend this RNA primer , adding nucleotides one by one that are complementary to the template strand ( Figure 14.14 ) ."}, {"question": {"question_id": "fs-id1406784", "question_text": "In which direction does DNA replication take place?", "question_choices": ["5'-3'", "3'-5'", "5'", "3'"], "cloze_format": "DNA replication takes place in the ___ direction.", "normal_format": "In which direction does DNA replication take place?"}, "answer": {"ans_text": "5'-3'", "ans_choice": 0}, "bloom": "1", "hl_sentences": "The replication fork moves at the rate of 1000 nucleotides per second . DNA polymerase can only extend in the 5 ' to 3 ' direction , which poses a slight problem at the replication fork .", "hl_context": "<hl> The replication fork moves at the rate of 1000 nucleotides per second . <hl> <hl> DNA polymerase can only extend in the 5 ' to 3 ' direction , which poses a slight problem at the replication fork . <hl> As we know , the DNA double helix is anti-parallel ; that is , one strand is in the 5 ' to 3 ' direction and the other is oriented in the 3 ' to 5 ' direction . One strand , which is complementary to the 3 ' to 5 ' parental DNA strand , is synthesized continuously towards the replication fork because the polymerase can add nucleotides in this direction . This continuously synthesized strand is known as the leading strand . The other strand , complementary to the 5 ' to 3 ' parental DNA , is extended away from the replication fork , in small fragments known as Okazaki fragments , each requiring a primer to start the synthesis . Okazaki fragments are named after the Japanese scientist who first discovered them . The strand with the Okazaki fragments is known as the lagging strand ."}, {"question": {"question_id": "fs-id2739491", "question_text": "The ends of the linear chromosomes are maintained by", "question_choices": ["helicase", "primase", "DNA pol", "telomerase"], "cloze_format": "The ends of the linear chromosomes are maintained by ___ .", "normal_format": "What maintains the ends of the linear chromosomes?"}, "answer": {"ans_text": "telomerase", "ans_choice": 3}, "bloom": null, "hl_sentences": "The discovery of the enzyme telomerase ( Figure 14.16 ) helped in the understanding of how chromosome ends are maintained .", "hl_context": "The ends of the linear chromosomes are known as telomeres , which have repetitive sequences that code for no particular gene . In a way , these telomeres protect the genes from getting deleted as cells continue to divide . In humans , a six base pair sequence , TTAGGG , is repeated 100 to 1000 times . <hl> The discovery of the enzyme telomerase ( Figure 14.16 ) helped in the understanding of how chromosome ends are maintained . <hl> The telomerase enzyme contains a catalytic part and a built-in RNA template . It attaches to the end of the chromosome , and complementary bases to the RNA template are added on the 3 ' end of the DNA strand . Once the 3 ' end of the lagging strand template is sufficiently elongated , DNA polymerase can add the nucleotides complementary to the ends of the chromosomes . Thus , the ends of the chromosomes are replicated ."}, {"question": {"question_id": "fs-id1951731", "question_text": "During proofreading, which of the following enzymes reads the DNA?", "question_choices": ["primase", "topoisomerase", "DNA pol", "helicase"], "cloze_format": "During proofreading, the enzyme that reads the DNA is ___.", "normal_format": "During proofreading, which of the following enzymes reads the DNA?"}, "answer": {"ans_text": "DNA pol", "ans_choice": 2}, "bloom": "1", "hl_sentences": "Most of the mistakes during DNA replication are promptly corrected by DNA polymerase by proofreading the base that has been just added ( Figure 14.17 ) . In proofreading , the DNA pol reads the newly added base before adding the next one , so a correction can be made .", "hl_context": "<hl> Most of the mistakes during DNA replication are promptly corrected by DNA polymerase by proofreading the base that has been just added ( Figure 14.17 ) . <hl> <hl> In proofreading , the DNA pol reads the newly added base before adding the next one , so a correction can be made . <hl> The polymerase checks whether the newly added base has paired correctly with the base in the template strand . If it is the right base , the next nucleotide is added . If an incorrect base has been added , the enzyme makes a cut at the phosphodiester bond and releases the wrong nucleotide . This is performed by the exonuclease action of DNA pol III . Once the incorrect nucleotide has been removed , a new one will be added again ."}, {"question": {"question_id": "fs-id1414909", "question_text": "The initial mechanism for repairing nucleotide errors in DNA is ________.", "question_choices": ["mismatch repair", "DNA polymerase proofreading", "nucleotide excision repair", "thymine dimers"], "cloze_format": "The initial mechanism for repairing nucleotide errors in DNA is ________.", "normal_format": "What is the initial mechanism for repairing nucleotide errors in DNA?"}, "answer": {"ans_text": "DNA polymerase proofreading", "ans_choice": 1}, "bloom": "1", "hl_sentences": "Most of the mistakes during DNA replication are promptly corrected by DNA polymerase by proofreading the base that has been just added ( Figure 14.17 ) . In proofreading , the DNA pol reads the newly added base before adding the next one , so a correction can be made . The polymerase checks whether the newly added base has paired correctly with the base in the template strand .", "hl_context": "<hl> Most of the mistakes during DNA replication are promptly corrected by DNA polymerase by proofreading the base that has been just added ( Figure 14.17 ) . <hl> <hl> In proofreading , the DNA pol reads the newly added base before adding the next one , so a correction can be made . <hl> <hl> The polymerase checks whether the newly added base has paired correctly with the base in the template strand . <hl> If it is the right base , the next nucleotide is added . If an incorrect base has been added , the enzyme makes a cut at the phosphodiester bond and releases the wrong nucleotide . This is performed by the exonuclease action of DNA pol III . Once the incorrect nucleotide has been removed , a new one will be added again ."}], "summary": "", "keyterm": "", "bname": "biology"}, {"chapter": 4, "intro": "Learning Objectives 4.1   Types of Societies \n\n Describe the difference between pre-industrial, industrial, and postindustrial societies \n\n Understand the role of environment on preindustrial societies \n\n Understand how technology impacts societal development \n\n 4.2   Theoretical Perspectives on Society \n\n Describe Durkhiem\u2019s functionalist view of society \n\n Understand the conflict theorist view of society \n\n Explain Marx\u2019s concepts of class and alienation \n\n Identify how symbolic interactionists understand society \n\n 4.3   Social Constructions of Reality \n\n Understand the sociological concept of reality as a social construct \n\n Define roles and describe their place in people\u2019s daily interactions \n\n Explain how individuals present themselves and perceive themselves in a social context \n\n Introduction to Society and Social Interaction \n\n Early in the morning, a group of male warriors creeps out of the village and heads for the savannah. They must be careful not to wake the other members of the tribe, lest they be accosted by the women or elders. Once they have regrouped on the plains, the warriors begin preparing for the hunt. The eldest members of the group choose the most qualified hunters, known as  ilmeluaya , meaning men who are not afraid of death. Warriors who are not selected are sent home in shame. Once the select group has been chosen, the warriors begin the hunt. They scour the plains for footprints or droppings, and search for dense bushes or tall termite mounds that might conceal their resting prey. The search can take ten minutes to ten hours, but once a lion is found, the warriors quickly move into place. \n\n Selected hunters ring bells and rattle the brush, forcing the lion away from its protected hiding spot. The goal is to face the beast one-on-one on the open savannah. There will be no tricks or cheating, simply warrior against warrior. If all goes as planned, the lion will be brought down with a single spear. \n\n When the warriors return to the village with their trophy, it is the beginning of a weeklong celebration. Although the hunt must be planned in secret, news of the warriors\u2019 success spreads quickly, and all village members come to congratulate the victors. The warrior who wounded the lion first is honored and given a nickname based on his accomplishment. Songs are sung about the warrior, and from now on he will be remembered and acknowledged throughout the community, even among other tribes. \n\n To the Maasai, lion hunting is about more than food and security. It is a way to strengthen the bonds of community and the hierarchy among the hunters. Disputes over power are settled before the hunt, and roles are reinforced at the end, with the bravest warrior receiving the lion\u2019s tail as a trophy (Maasai Association 2011). Although Maasai society is very different from contemporary America, both share the human need to cooperate and live together in order to survive. ", "chapter_text": "4.1   Types of Societies \n\n Maasai villagers, Tehranians, Americans\u2014each is a society. But what does this mean? Exactly what is a society? In sociological terms,  society  refers to a group of people who live in a definable community and share the same culture. On a broader scale, society consists of the people and institutions around us, our shared beliefs, and our cultural ideas. Typically, more advanced societies also share a political authority. \n\n Sociologist Gerhard Lenski (1924\u2013) defined societies in terms of their technological sophistication. As a society advances, so does its use of technology. Societies with rudimentary technology depend on the fluctuations of their environment, while industrialized societies have more control over the impact of their surroundings and thus develop different cultural features. This distinction is so important that sociologists generally classify societies along a spectrum of their level of industrialization, from preindustrial to industrial to postindustrial. \n\n Preindustrial Societies Before the Industrial Revolution and the widespread use of machines, societies were small, rural, and dependent largely on local resources. Economic production was limited to the amount of labor a human being could provide, and there were few specialized occupations. The very first occupation was that of hunter-gatherer. \n\n Hunter-Gatherer \n\n Hunter-gatherer  societies demonstrate the strongest dependence on the environment of the various types of preindustrial societies. As the basic structure of human society until about 10,000\u201312,000 years ago, these groups were based around kinship or tribes. Hunter-gatherers relied on their surroundings for survival\u2014they hunted wild animals and foraged for uncultivated plants for food. When resources became scarce, the group moved to a new area to find sustenance, meaning they were nomadic. These societies were common until several hundred years ago, but today only a few hundred remain in existence, such as indigenous Australian tribes sometimes referred to as \u201caborigines,\u201d or the Bambuti, a group of pygmy hunter-gatherers residing in the Democratic Republic of Congo. Hunter-gatherer groups are quickly disappearing as the world\u2019s population explodes. \n\n Pastoral Changing conditions and adaptations led some societies to rely on the domestication of animals where circumstances permitted. Roughly 7,500 years ago, human societies began to recognize their ability to tame and breed animals and to grow and cultivate their own plants.  Pastoral societies  rely on the domestication of animals as a resource for survival. Unlike earlier hunter-gatherers who depended entirely on existing resources to stay alive, pastoral groups were able to breed livestock for food, clothing, and transportation, creating a surplus of goods. Herding, or pastoral, societies remained nomadic because they were forced to follow their animals to fresh feeding grounds. Around the time that pastoral societies emerged, specialized occupations began to develop, and societies commenced trading with local groups. \n\n Big Picture The Bedouin Throughout Northern Africa and the Arabian Peninsula live the Bedouin, modern-day nomads. While many different tribes of Bedouin exist, they all share similarities. Members migrate from one area to another, usually in conjunction with the seasons, settling near oases in the hot summer months. They tend to herds of goats, camels, and sheep, and they harvest dates in the fall (Kjeilen). \n\n In recent years, there has been increased conflict between the Bedouin society and more modernized societies. National borders are harder to cross now than in the past, making the traditional nomadic lifestyle of the Bedouin difficult. The clash of traditions among Bedouin and other residents has led to discrimination and abuse. Bedouin communities frequently have high poverty and unemployment rates, and their members have little formal education (Immigration and Refugee Board of Canada 2005). \n\n The future of the Bedouin is uncertain. Government restrictions on farming and residence are slowly forcing them to integrate into modern society. Although their ancestors have traversed the deserts for thousands of years, the days of the nomadic Bedouin may be at an end.  \n\n Horticultural \n\n Around the same time that pastoral societies were on the rise, another type of society developed, based on the newly developed capacity for people to grow and cultivate plants. Previously, the depletion of a region\u2019s crops or water supply forced pastoral societies to relocate in search of food sources for their livestock.  Horticultural societies  formed in areas where rainfall and other conditions allowed them to grow stable crops. They were similar to hunter-gatherers in that they largely depended on the environment for survival, but since they didn\u2019t have to abandon their location to follow resources, they were able to start permanent settlements. This created more stability and more material goods and became the basis for the first revolution in human survival. \n\n Agricultural \n\n While pastoral and horticultural societies used small, temporary tools such as digging sticks or hoes,  agricultural societies  relied on permanent tools for survival. Around 3000 B.C.E., an explosion of new technology known as the Agricultural Revolution made farming possible\u2014and profitable. Farmers learned to rotate the types of crops grown on their fields and to reuse waste products such as fertilizer, leading to better harvests and bigger surpluses of food. New tools for digging and harvesting were made of metal, making them more effective and longer lasting. Human settlements grew into towns and cities, and particularly bountiful regions became centers of trade and commerce.  \n\n This is also the age in which people had the time and comfort to engage in more contemplative and thoughtful activities, such as music, poetry, and philosophy. This period became referred to as the \u201cdawn of civilization\u201d by some because of the development of leisure and humanities. Craftspeople were able to support themselves through the production of creative, decorative, or thought-provoking aesthetic objects and writings. \n\n As resources became more plentiful, social classes became more divisive. Those who had more resources could afford better living and developed into a class of nobility. Difference in social standing between men and women increased. As cities expanded, ownership and preservation of resources became a pressing concern.  \n\n Feudal \n\n The ninth century gave rise to  feudal societies . These societies contained a strict hierarchical system of power based around land ownership and protection. The nobility, known as lords, placed vassals in charge of pieces of land. In return for the resources that the land provided, vassals promised to fight for their lords.  \n\n These individual pieces of land, known as fiefdoms, were cultivated by the lower class. In return for maintaining the land, peasants were guaranteed a place to live and protection from outside enemies. Power was handed down through family lines, with peasant families serving lords for generations and generations. Ultimately, the social and economic system of feudalism would fail, replaced by capitalism and the technological advances of the industrial era. \n\n Industrial Society In the 18th century, Europe experienced a dramatic rise in technological invention, ushering in an era known as the Industrial Revolution. What made this period remarkable was the number of new inventions that influenced people\u2019s daily lives. Within a generation, tasks that had until this point required months of labor became achievable in a matter of days. Before the Industrial Revolution, work was largely person- or animal-based, relying on human workers or horses to power mills and drive pumps. In 1782, James Watt and Matthew Boulton created a steam engine that could do the work of 12 horses by itself.  \n\n Steam power began appearing everywhere. Instead of paying artisans to painstakingly spin wool and weave it into cloth, people turned to textile mills that produced fabric quickly at a better price, and often with better quality. Rather than planting and harvesting fields by hand, farmers were able to purchase mechanical seeders and threshing machines that caused agricultural productivity to soar. Products such as paper and glass became available to the average person, and the quality and accessibility of education and health care soared. Gas lights allowed increased visibility in the dark, and towns and cities developed a nightlife.  \n\n One of the results of increased productivity and technology was the rise of urban centers. Workers flocked to factories for jobs, and the populations of cities became increasingly diverse. The new generation became less preoccupied with maintaining family land and traditions, and more focused on acquiring wealth and achieving upward mobility for themselves and their family. People wanted their children and their children\u2019s children to continue to rise to the top, and as capitalism increased, so did social mobility.  \n\n It was during the 18th and 19th centuries of the Industrial Revolution that sociology was born. Life was changing quickly and the long-established traditions of the agricultural eras did not apply to life in the larger cities. Masses of people were moving to new environments and often found themselves faced with horrendous conditions of filth, overcrowding, and poverty. Social scientists emerged to study the relationship between the individual members of society and society as a whole. \n\n It was during this time that power moved from the hands of the aristocracy and \u201cold money\u201d to business-savvy newcomers who amassed fortunes in their lifetimes. Families such as the Rockefellers and the Vanderbilts became the new power players, using their influence in business to control aspects of government as well. Eventually, concerns over the exploitation of workers led to the formation of labor unions and laws that set mandatory conditions for employees. Although the introduction of new technology at the end of the 19th  century ended the industrial age, much of our social structure and social ideas\u2014like family, childhood, and time standardization\u2014have a basis in industrial society. \n\n Postindustrial Society Information societies , sometimes known as postindustrial or digital societies, are a recent development. Unlike industrial societies that are rooted in the production of material goods, information societies are based on the production of information and services.  \n\n Digital technology is the steam engine of information societies, and computer moguls such as Steve Jobs and Bill Gates are its John D. Rockefellers and Cornelius Vanderbilts. Since the economy of information societies is driven by knowledge and not material goods, power lies with those in charge of storing and distributing information. Members of a postindustrial society are likely to be employed as sellers of services\u2014software programmers or business consultants, for example\u2014instead of producers of goods. Social classes are divided by access to education, since without technical skills, people in an information society lack the means for success. \n4.2   Theoretical Perspectives on Society \n\n While many sociologists have contributed to research on society and social interaction, three thinkers form the base of modern-day perspectives. \u00c9mile Durkheim, Karl Marx, and Max Weber developed different theoretical approaches to help us understand the way societies function. \n\n \u00c9mile Durkheim and Functionalism As a functionalist, \u00c9mile Durkheim\u2019s (1858\u20131917) perspective on society stressed the necessary interconnectivity of all of its elements. To Durkheim, society was greater than the sum of its parts. He asserted that individual behavior was not the same as collective behavior, and that studying collective behavior was quite different from studying an individual\u2019s actions. Durkheim called the communal beliefs, morals, and attitudes of a society the  collective conscience . In his quest to understand what causes individuals to act in similar and predictable ways, he wrote, \u201cIf I do not submit to the conventions of society, if in my dress I do not conform to the customs observed in my country and in my class, the ridicule I provoke, the social isolation in which I am kept, produce, although in an attenuated form, the same effects as punishment\u201d (Durkheim 1895). Durkheim also believed that  social integration , or the strength of ties that people have to their social groups, was a key factor in social life. \n\n Following the ideas of Comte and Spencer, Durkheim likened society to that of a living organism, in which each organ plays a necessary role in keeping the being alive. Even the socially deviant members of society are necessary, Durkheim argued, as punishments for deviance affirm established cultural values and norms. That is, punishment of a crime reaffirms our moral consciousness. \u201cA crime is a crime because we condemn it,\u201d Durkheim wrote in 1893. \u201cAn act offends the common consciousness not because it is criminal, but it is criminal because it offends that consciousness\u201d (Durkheim 1893). Durkheim called these elements of society \u201csocial facts.\u201d By this, he meant that social forces were to be considered real and existed outside the individual.  \n\n As an observer of his social world, Durkheim was not entirely satisfied with the direction of society in his day. His primary concern was that the cultural glue that held society together was failing, and that people were becoming more divided. In his book  The Division of Labor in Society  (1893), Durkheim argued that as society grew more complex, social order made the transition from mechanical to organic. \n\n Pre-industrial societies, Durkheim explained, were held together by  mechanical solidarity , a type of social order maintained by the collective consciousness of a culture. Societies with mechanical solidarity act in a mechanical fashion; things are done mostly because they have always been done that way. This type of thinking was common in preindustrial societies where strong bonds of kinship and a low division of labor created shared morals and values among people, such as hunter-gatherer groups. When people tend to do the same type of work, Durkheim argued, they tend to think and act alike. \n\n In industrial societies, mechanical solidarity is replaced with  organic solidarity , social order based around an acceptance of economic and social differences. In capitalist societies, Durkheim wrote, division of labor becomes so specialized that everyone is doing different things. Instead of punishing members of a society for failure to assimilate to common values, organic solidarity allows people with differing values to coexist. Laws exist as formalized morals and are based on restitution rather than revenge.  \n\n While the transition from mechanical to organic solidarity is, in the long run, advantageous for a society, Durkheim noted that it can be a time of chaos and \u201cnormlessness.\u201d One of the outcomes of the transition is something he called social  anomie . Anomie\u2014literally, \u201cwithout law\u201d\u2014is a situation in which society no longer has the support of a firm collective consciousness. Collective norms are weakened. People, while more interdependent to accomplish complex tasks, are also alienated from each other. Anomie is experienced in times of social uncertainty, such as war, or a great upturn or downturn in the economy. As societies reach an advanced stage of organic solidarity, they avoid anomie by redeveloping a set of shared norms. According to Durkheim, once a society achieves organic solidarity, it has finished its development.  \n\n Karl Marx and Conflict Theory Karl Marx (1818\u20131883) is certainly among the most significant social thinkers in recent history. While there are many critics of his work, it is still widely respected and influential. For Marx, society\u2019s constructions were predicated upon the idea of \u201cbase and superstructure.\u201d This term refers to the idea that a society\u2019s economic character forms its base, upon which rests the culture and social institutions, the superstructure. For Marx, it is the base (economy) that determines what a society will be like. \n\n Additionally, Marx saw conflict in society as the primary means of change. Economically, he saw conflict existing between the owners of the means of production\u2014the  bourgeoisie \u2014and the laborers, called the  proletariat .  Marx maintained that these conflicts appeared consistently throughout history during times of social revolution. These revolutions or \u201cclass antagonisms\u201d as he called them, were a result of one class dominating another. Most recently, with the end of feudalism, a new revolutionary class he called the bourgeoisie dominated the proletariat laborers. The bourgeoisie were revolutionary in the sense that they represented a radical change in the structure of society. In Marx\u2019s words, \u201cSociety as a whole is more and more splitting up into two great hostile camps, into two great classes directly facing each other\u2014Bourgeoisie and Proletariat\u201d (Marx and Engels 1848). \n\n In the mid-19th century, as industrialization was booming, labor became more and more exploitative of the working class. The large manufacturers of steel were particularly ruthless, and their facilities became popularly dubbed \u201csatanic mills\u201d based on a poem by William Blake. Marx\u2019s colleague and friend, Frederick Engels, wrote  The Condition of the Working-Class in England  in 1844, which described in detail the horrid conditions. \n\n Such is the Old Town of Manchester, and on re-reading my description, I am forced to admit that instead of being exaggerated, it is far from black enough to convey a true impression of the filth, ruin, and uninhabitableness, the defiance of all considerations of cleanliness, ventilation, and health which characterise the construction of this single district, containing at least twenty to thirty thousand inhabitants. And such a district exists in the heart of the second city of England, the first manufacturing city of the world. Add to that the long hours, the use of child labor, and exposure to extreme conditions of heat, cold, and toxic chemicals, and it is no wonder that Marx and Engels referred to capitalism as the \u201cdictatorship of the bourgeoisie.\u201d  \n\n For Marx, what we do defines who we are. In historical terms, in spite of the persistent nature of one class dominating another, some element of humanity existed. There was at least some connection between the worker and the product, augmented by the natural conditions of seasons and the rise and fall of the sun, such as we see in an agricultural society. But with the bourgeoisie revolution and the rise of industry and capitalism, the worker now worked for wages alone. His relationship to his efforts was no longer of a human nature, but based on artificial conditions.  \n\n Marx described modern society in terms of alienation.  Alienation  refers to the condition in which the individual is isolated and divorced from his or her society, work, or the sense of self. Marx defined four specific types of alienation. \n\n Alienation from the product of one\u2019s labor . An industrial worker does not have the opportunity to relate to the product he is laboring on. Instead of training for years as a watchmaker, an unskilled worker can get a job at a watch factory pressing buttons to seal pieces together. The worker does not care if he is making watches or cars, simply that the job exists. In the same way, a worker may not even know or care what product he is contributing to. A worker on a Ford assembly line may spend all day installing windows on car doors without ever seeing the rest of the car. A cannery worker can spend a lifetime cleaning fish without ever knowing what product they are used for. \n\n Alienation from the process of one\u2019s labor.  A worker does not control the conditions of her job because she does not own the means of production. If a person is hired to work in a fast food restaurant, she is expected to make the food the way she is taught. All ingredients must be combined in a particular order and in a particular quantity; there is no room for creativity or change. An employee at Burger King cannot decide to change the spices used on the fries in the same way that an employee on a Ford assembly line cannot decide to place a car\u2019s headlights in a different position. Everything is decided by the bourgeoisie who then dictate orders to the laborers.  \n\n Alienation from others.  Workers compete, rather than cooperate. Employees vie for time slots, bonuses, and job security. Even when a worker clocks out at night and goes home, the competition does not end. As Marx commented in  The Communist Manifesto (1848), \u201cNo sooner is the exploitation of the laborer by the manufacturer, so far at an end, that he receives his wages in cash, than he is set upon by the other portion of the bourgeoisie, the landlord, the shopkeeper, the pawnbroker.\u201d  \n\n Alienation from one\u2019s self.  A final outcome of industrialization is a loss of connectivity between a worker and her occupation. Because there is nothing that ties a worker to her labor, there is no longer a sense of self. Instead of being able to take pride in an identity such as being a watchmaker, automobile builder, or chef, a person is simply a cog in the machine.  \n\n Taken as a whole, then, alienation in modern society means that an individual has no control over his life. Even in feudal societies, a person controlled the manner of his labor as to when and how it was carried out. But why, then, does the modern working class not rise up and rebel? (Indeed, Marx predicted that this would be the ultimate outcome and collapse of capitalism.) \n\n Another idea that Marx developed is the concept of  false consciousness . False consciousness is a condition in which the beliefs, ideals, or ideology of a person are not in the person\u2019s own best interest. In fact, it is the ideology of the dominant class (here, the bourgeoisie capitalists) that is imposed upon the proletariat. Ideas such as the emphasis of competition over cooperation, or of hard work being its own reward, clearly benefit the owners of industry. Therefore, workers are less likely to question their place in society and assume individual responsibility for existing conditions.  \n\n In order for society to overcome false consciousness, Marx proposed that it be replaced with  class consciousness , the awareness of one\u2019s rank in society. Instead of existing as a \u201cclass in itself,\u201d the proletariat must become a \u201cclass for itself\u201d in order to produce social change (Marx and Engels 1848), meaning that instead of just being an inert strata of society, the class could become an advocate for social improvements. Only once society entered this state of political consciousness would it be ready for a social revolution. \n\n Max Weber and Symbolic Interactionism While Karl Marx may be one of the best-known thinkers of the 19th century, Max Weber is certainly one of the greatest influences in the field of sociology. Like the other social thinkers discussed here, he was concerned with the important changes taking place in Western society with the advent of industrialization. And, like Marx and Durkheim, he feared that industrialization would have negative effects on individuals.  \n\n Weber\u2019s primary focus on the structure of society lay in the elements of class, status, and power. Similar to Marx, Weber saw class as economically determined. Society, he believed, was split between owners and laborers. Status, on the other hand, was based on noneconomic factors such as education, kinship, and religion. Both status and class determined an individual\u2019s power, or influence over ideas. Unlike Marx, Weber believed that these ideas formed the base of society. \n\n Weber\u2019s analysis of modern society centered on the concept of  rationalization . A rational society is one built around logic and efficiency rather than morality or tradition. To Weber, capitalism is entirely rational. Although this leads to efficiency and merit-based success, it can have negative effects when taken to the extreme. In some modern societies, this is seen when rigid routines and strict design lead to a mechanized work environment and a focus on producing identical products in every location. \n\n Another example of the extreme conditions of rationality can be found in Charlie Chaplin\u2019s classic film  Modern Times  (1936). Chaplin\u2019s character performs a routine task to the point where he cannot stop his motions even while away from the job. Indeed, today we even have a recognized medical condition that results from such tasks, known as \u201crepetitive stress syndrome.\u201d  \n\n Weber was also unlike his predecessors in that he was more interested in how individuals experienced societal divisions than in the divisions themselves. The symbolic interactionism theory, the third of the three most recognized theories of sociology, is based on Weber\u2019s early ideas that emphasize the viewpoint of the individual and how that individual relates to society. For Weber, the culmination of industrialization, rationalization, and the like results in what he referred to as the  iron cage , in which the individual is trapped by institutions and bureaucracy. This leads to a sense of \u201cdisenchantment of the world,\u201d a phrase Weber used to describe the final condition of humanity. Indeed a dark prediction, but one that has, at least to some degree, been borne out (Gerth and Mills 1918). In a rationalized, modern society, we have supermarkets instead of family-owned stores. We have chain restaurants instead of local eateries. Superstores that offer a multitude of merchandise have replaced independent businesses that focused on one product line, such as hardware, groceries, automotive repair, or clothing. Shopping malls offer retail stores, restaurants, fitness centers, even condominiums. This change may be rational, but is it universally desirable? \n\n Sociological Research The Protestant Work Ethic In a series of essays in 1904, Weber presented the idea of the  Protestant work ethic , a new attitude toward work based on the Calvinist principle of predestination. In the 16th century, Europe was shaken by the Protestant Revolution. Religious leaders such as Martin Luther and John Calvin argued against the Catholic Church\u2019s belief in salvation through obedience. While Catholic leaders emphasized the importance of religious dogma and performing good deeds as a gateway to heaven, Protestants believed that inner grace, or faith in God, was enough to achieve salvation.  \n\n John Calvin in particular popularized the Christian concept of predestination, the idea that all events\u2014including salvation\u2014have already been decided by God. Because followers were never sure whether they had been chosen to enter Heaven or Hell, they looked for signs in their everyday lives. If a person was hard-working and successful, he was likely to be one of the chosen. If a person was lazy or simply indifferent, he was likely to be one of the damned.  \n\n Weber argued that this mentality encouraged people to work hard for personal gain; after all, why should one help the unfortunate if they were already damned? Over time, the Protestant work ethic spread and became the foundation for capitalism. \n4.3   Social Constructions of Reality \n\n Until now, we\u2019ve primarily discussed the differences between societies. Rather than discuss their problems and configurations, we\u2019ll now explore how society came to be and how sociologists view social interaction.  \n\n In 1966 sociologists Peter Berger and Thomas Luckmann wrote a book called  The Social Construction of Reality . In it, they argued that society is created by humans and human interaction, which they call  habitualization . Habitualization describes how \u201cany action that is repeated frequently becomes cast into a pattern, which can then be \u2026 performed again in the future in the same manner and with the same economical effort\u201d (Berger and Luckmann 1966). Not only do we construct our own society, but we accept it as it is because others have created it before us. Society is, in fact, \u201chabit.\u201d  \n\n For example, your school exists as a school and not just as a building because you and others agree that it is a school. If your school is older than you are, it was created by the agreement of others before you. In a sense, it exists by consensus, both prior and current. This is an example of the process of  institutionalization , the act of implanting a convention or norm into society. Bear in mind that the institution, while socially constructed, is still quite real. \n\n Another way of looking at this concept is through W.I. Thomas\u2019s notable  Thomas theorem  which states, \u201cIf men define situations as real, they are real in their consequences\u201d (Thomas and Thomas 1928). That is, people\u2019s behavior can be determined by their subjective construction of reality rather than by objective reality. For example, a teenager who is repeatedly given a label\u2014overachiever, player, bum\u2014might live up to the term even though it initially wasn\u2019t a part of his character. Like Berger and Luckmann\u2019s description of habitualization, Thomas states that our moral codes and social norms are created by \u201csuccessive definitions of the situation.\u201d This concept is defined by sociologist Robert K. Merton as a  self-fulfilling prophecy . Merton explains that with a self-fulfilling prophecy, even a false idea can become true if it is acted upon. One example he gives is of a \u201cbank run.\u201d Say for some reason, a number of people falsely fear that their bank is soon to be bankrupt. Because of this false notion, people run to their bank and demand all their cash at once. As banks rarely, if ever, have that much money on hand, the bank does indeed run out of money, fulfilling the customers\u2019 prophecy. Here, reality is constructed by an idea. \n\n Symbolic interactionists offer another lens through which to analyze the social construction of reality. With a theoretical perspective focused on the symbols (like language, gestures, and artifacts) that people use to interact, this approach is interested in how people interpret those symbols in daily interactions. For example, we might feel fright at seeing a person holding a gun, unless, of course, it turns out to be a police officer. Interactionists also recognize that language and body language reflect our values. One has only to learn a foreign tongue to know that not every English word can be easily translated into another language. The same is true for gestures. While Americans might recognize a \u201cthumbs up\u201d as meaning \u201cgreat,\u201d in Germany it would mean \u201cone\u201d and in Japan it would mean \u201cfive.\u201d Thus, our construction of reality is influenced by our symbolic interactions. \n\n Roles and Status As you can imagine, people employ many types of behaviors in day-to-day life.  Roles  are patterns of behavior that we recognize in each other that are representative of a person\u2019s social status. Currently, while reading this text, you are playing the role of a student. However, you also play other roles in your life, such as \u201cdaughter,\u201d \u201cneighbor,\u201d or \u201cemployee.\u201d These various roles are each associated with a different status.  \n\n Sociologists use the term  status  to describe the responsibilities and benefits a person experiences according to their rank and role in society. Some statuses are  ascribed \u2014those you do not select, such as son, elderly person, or female. Others, called  achieved statuses , are obtained by choice, such as a high school dropout, self-made millionaire, or nurse. As a daughter or son, you occupy a different status than as a neighbor or employee. One person can be associated with a multitude of roles and statuses. Even a single status such as \u201cstudent\u201d has a complex  role-set , or array of roles, attached to it (Merton 1957).  \n\n If too much is required of a single role, individuals can experience  role strain . Consider the duties of a parent: cooking, cleaning, driving, problem-solving, acting as a source of moral guidance\u2014the list goes on. Similarly, a person can experience  role conflict  when one or more roles are contradictory. A parent who also has a full-time career can experience role conflict on a daily basis. When there is a deadline at the office but a sick child needs to be picked up from school, which comes first? When you are working toward a promotion but your children want you to come to their school play, which do you choose? Being a college student can conflict with being an employee, being an athlete, or even being a friend. Our roles in life have a great effect on our decisions and who we become. \n\n Presentation of Self Of course, it is impossible to look inside a person\u2019s head and study what role they are playing. All we can observe is behavior, or role performance.  Role performance  is how a person expresses his or her role. Sociologist Erving Goffman presented the idea that a person is like an actor on a stage. Calling his theory dramaturgy, Goffman believed that we use \u201cimpression management\u201d to present ourselves to others as we hope to be perceived. Each situation is a new scene, and individuals perform different roles depending on who is present (Goffman 1959). Think about the way you behave around your coworkers versus the way you behave around your grandparents versus the way you behave with a blind date. Even if you\u2019re not consciously trying to alter your personality, your grandparents, coworkers, and date probably see different sides of you. \n\n As in a play, the setting matters as well. If you have a group of friends over to your house for dinner, you are playing the role of a host. It is agreed upon that you will provide food and seating and probably be stuck with a lot of the cleanup at the end of the night. Similarly, your friends are playing the roles of guests, and they are expected to respect your property and any rules you may set forth (\u201cDon\u2019t leave the door open or the cat will get out.\u201d). In any scene, there needs to be a shared reality between players. In this case, if you view yourself as a guest and others view you as a host, there are likely to be problems.  \n\n Impression management is a critical component of symbolic interactionism. For example, a judge in a courtroom has many \u201cprops\u201d to create an impression of fairness, gravity, and control\u2014like her robe and gavel. Those entering the courtroom are expected to adhere to the scene being set. Just imagine the \u201cimpression\u201d that can be made by how a person dresses. This is the reason that attorneys frequently select the hairstyle and apparel for witnesses and defendants in courtroom proceedings.  \n\n Goffman\u2019s dramaturgy ideas expand on the ideas of Charles Cooley and the  looking-glass self . According to Cooley, we base our image on what we think other people see (Cooley 1902). We imagine how we must appear to others, then react to this speculation. We don certain clothes, prepare our hair in a particular manner, wear makeup, use cologne, and the like\u2014all with the notion that our presentation of ourselves is going to affect how others perceive us. We expect a certain reaction, and, if lucky, we get the one we desire and feel good about it. But more than that, Cooley believed that our sense of self is based upon this idea: we imagine how we look to others, draw conclusions based upon their reactions to us, and then we develop our personal sense of self. In other words, people\u2019s reactions to us are like a mirror in which we are reflected. ", "questions": [{"question": {"question_id": "sq0401_exercise01", "question_text": "Which of the following fictional societies is an example of a pastoral society?", "question_choices": ["The Deswan people, who live in small tribes and base their economy on the production and trade of textiles", "The Rositian Clan, a small community of farmers who have lived on their family\u2019s land for centuries", "The Hunti, a wandering group of nomads who specialize in breeding and training horses", "The Amaganda, an extended family of warriors who serve a single noble family"], "cloze_format": "A fictional society that is an example of a pastoral society is ___ .", "normal_format": "Which of the following fictional societies is an example of a pastoral society?"}, "answer": {"ans_text": "The Hunti, a wandering group of nomads who specialize in breeding and training horses", "ans_choice": 2}, "bloom": "3", "hl_sentences": "Pastoral societies rely on the domestication of animals as a resource for survival .", "hl_context": "Pastoral Changing conditions and adaptations led some societies to rely on the domestication of animals where circumstances permitted . Roughly 7,500 years ago , human societies began to recognize their ability to tame and breed animals and to grow and cultivate their own plants . <hl> Pastoral societies rely on the domestication of animals as a resource for survival . <hl> Unlike earlier hunter-gatherers who depended entirely on existing resources to stay alive , pastoral groups were able to breed livestock for food , clothing , and transportation , creating a surplus of goods . Herding , or pastoral , societies remained nomadic because they were forced to follow their animals to fresh feeding grounds . Around the time that pastoral societies emerged , specialized occupations began to develop , and societies commenced trading with local groups ."}, {"question": {"question_id": "sq0401_exercise02", "question_text": "Which of the following occupations is a person of power most likely to have in an information society?", "question_choices": ["Software engineer", "Coal miner", "Children\u2019s book author", "Sharecropper"], "cloze_format": "The occupation that is a person of power most likely to have in an information society is a ___.", "normal_format": "Which of the following occupations is a person of power most likely to have in an information society?"}, "answer": {"ans_text": "Software engineer", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Since the economy of information societies is driven by knowledge and not material goods , power lies with those in charge of storing and distributing information . Social classes are divided by access to education , since without technical skills , people in an information society lack the means for success .", "hl_context": "Digital technology is the steam engine of information societies , and computer moguls such as Steve Jobs and Bill Gates are its John D . Rockefellers and Cornelius Vanderbilts . <hl> Since the economy of information societies is driven by knowledge and not material goods , power lies with those in charge of storing and distributing information . <hl> Members of a postindustrial society are likely to be employed as sellers of services \u2014 software programmers or business consultants , for example \u2014 instead of producers of goods . <hl> Social classes are divided by access to education , since without technical skills , people in an information society lack the means for success . <hl> 4.2 Theoretical Perspectives on Society"}, {"question": {"question_id": "sq0401_exercise03", "question_text": "Which of the following societies were the first to have permanent residents?", "question_choices": ["Industrial", "Hunter-gatherer", "Horticultural", "Feudal"], "cloze_format": "The  society that was the first to have permanent residents was the ___.", "normal_format": "Which of the following societies were the first to have permanent residents?"}, "answer": {"ans_text": "Feudal", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "These individual pieces of land , known as fiefdoms , were cultivated by the lower class . In return for maintaining the land , peasants were guaranteed a place to live and protection from outside enemies . The ninth century gave rise to feudal societies . These societies contained a strict hierarchical system of power based around land ownership and protection . Feudal", "hl_context": "<hl> These individual pieces of land , known as fiefdoms , were cultivated by the lower class . <hl> <hl> In return for maintaining the land , peasants were guaranteed a place to live and protection from outside enemies . <hl> Power was handed down through family lines , with peasant families serving lords for generations and generations . Ultimately , the social and economic system of feudalism would fail , replaced by capitalism and the technological advances of the industrial era . <hl> The ninth century gave rise to feudal societies . <hl> <hl> These societies contained a strict hierarchical system of power based around land ownership and protection . <hl> The nobility , known as lords , placed vassals in charge of pieces of land . In return for the resources that the land provided , vassals promised to fight for their lords . <hl> Feudal <hl>"}, {"question": {"question_id": "sq_exercise01", "question_text": "Organic solidarity is most likely to exist in which of the following types of societies?", "question_choices": ["Hunter-gatherer", "Industrial", "Agricultural", "Feudal"], "cloze_format": "Organic solidarity is most likely to exist in ___ societies.", "normal_format": "Organic solidarity is most likely to exist in which of the following types of societies?"}, "answer": {"ans_text": "Industrial", "ans_choice": 1}, "bloom": "1", "hl_sentences": "In industrial societies , mechanical solidarity is replaced with organic solidarity , social order based around an acceptance of economic and social differences .", "hl_context": "<hl> In industrial societies , mechanical solidarity is replaced with organic solidarity , social order based around an acceptance of economic and social differences . <hl> In capitalist societies , Durkheim wrote , division of labor becomes so specialized that everyone is doing different things . Instead of punishing members of a society for failure to assimilate to common values , organic solidarity allows people with differing values to coexist . Laws exist as formalized morals and are based on restitution rather than revenge ."}, {"question": {"question_id": "sq_exercise02", "question_text": "According to Marx, the _____ own the means of production in a society.", "question_choices": ["proletariat", "vassals", "bourgeoisie", "anomie"], "cloze_format": "According to Marx, the _____ own the means of production in a society.", "normal_format": "According to Marx, which owns the means of production in a society?"}, "answer": {"ans_text": "bourgeoisie", "ans_choice": 2}, "bloom": "1", "hl_sentences": "Additionally , Marx saw conflict in society as the primary means of change . Economically , he saw conflict existing between the owners of the means of production \u2014 the bourgeoisie \u2014 and the laborers , called the proletariat .", "hl_context": "<hl> Additionally , Marx saw conflict in society as the primary means of change . <hl> <hl> Economically , he saw conflict existing between the owners of the means of production \u2014 the bourgeoisie \u2014 and the laborers , called the proletariat . <hl> Marx maintained that these conflicts appeared consistently throughout history during times of social revolution . These revolutions or \u201c class antagonisms \u201d as he called them , were a result of one class dominating another . Most recently , with the end of feudalism , a new revolutionary class he called the bourgeoisie dominated the proletariat laborers . The bourgeoisie were revolutionary in the sense that they represented a radical change in the structure of society . In Marx \u2019 s words , \u201c Society as a whole is more and more splitting up into two great hostile camps , into two great classes directly facing each other \u2014 Bourgeoisie and Proletariat \u201d ( Marx and Engels 1848 ) ."}, {"question": {"question_id": "sq_exercise03", "question_text": "Which of the following best depicts Marx\u2019s concept of alienation from the process of one\u2019s labor?", "question_choices": ["A supermarket cashier always scans store coupons before company coupons because she was taught to do it that way.", "A businessman feels that he deserves a raise, but is nervous to ask his manager for one; instead, he comforts himself with the idea that hard work is its own reward.", "An associate professor is afraid that she won\u2019t be given tenure and starts spreading rumors about one of her associates to make herself look better.", "A construction worker is laid off and takes a job at a fast food restaurant temporarily, although he has never had an interest in preparing food before. "], "cloze_format": "___ best depicts Marx\u2019s concept of alienation from the process of one\u2019s labor.", "normal_format": "Which of the following best depicts Marx\u2019s concept of alienation from the process of one\u2019s labor?"}, "answer": {"ans_text": "A supermarket cashier always scans store coupons before company coupons because she was taught to do it that way.", "ans_choice": 0}, "bloom": "3", "hl_sentences": "Alienation from the process of one \u2019 s labor . A worker does not control the conditions of her job because she does not own the means of production . Alienation from the product of one \u2019 s labor . An industrial worker does not have the opportunity to relate to the product he is laboring on . In the same way , a worker may not even know or care what product he is contributing to .", "hl_context": "<hl> Alienation from the process of one \u2019 s labor . <hl> <hl> A worker does not control the conditions of her job because she does not own the means of production . <hl> If a person is hired to work in a fast food restaurant , she is expected to make the food the way she is taught . All ingredients must be combined in a particular order and in a particular quantity ; there is no room for creativity or change . An employee at Burger King cannot decide to change the spices used on the fries in the same way that an employee on a Ford assembly line cannot decide to place a car \u2019 s headlights in a different position . Everything is decided by the bourgeoisie who then dictate orders to the laborers . <hl> Alienation from the product of one \u2019 s labor . <hl> <hl> An industrial worker does not have the opportunity to relate to the product he is laboring on . <hl> Instead of training for years as a watchmaker , an unskilled worker can get a job at a watch factory pressing buttons to seal pieces together . The worker does not care if he is making watches or cars , simply that the job exists . <hl> In the same way , a worker may not even know or care what product he is contributing to . <hl> A worker on a Ford assembly line may spend all day installing windows on car doors without ever seeing the rest of the car . A cannery worker can spend a lifetime cleaning fish without ever knowing what product they are used for ."}, {"question": {"question_id": "sq_exercise04", "question_text": "The Protestant work ethic is based on the concept of predestination, which states that ________.", "question_choices": ["performing good deeds in life is the only way to secure a spot in Heaven", "salvation is only achievable through obedience to God", "no person can be saved before he or she accepts Jesus Christ as his or her savior", "God has already chosen those who will be saved and those who will be damned "], "cloze_format": "The Protestant work ethic is based on the concept of predestination, which states that ________.", "normal_format": "The Protestant work ethic is based on the concept of predestination, what does it state?"}, "answer": {"ans_text": "God has already chosen those who will be saved and those who will be damned ", "ans_choice": 3}, "bloom": null, "hl_sentences": "John Calvin in particular popularized the Christian concept of predestination , the idea that all events \u2014 including salvation \u2014 have already been decided by God .", "hl_context": "<hl> John Calvin in particular popularized the Christian concept of predestination , the idea that all events \u2014 including salvation \u2014 have already been decided by God . <hl> Because followers were never sure whether they had been chosen to enter Heaven or Hell , they looked for signs in their everyday lives . If a person was hard-working and successful , he was likely to be one of the chosen . If a person was lazy or simply indifferent , he was likely to be one of the damned ."}, {"question": {"question_id": "sq_exercise05", "question_text": "The concept of the iron cage was popularized by which of the following sociological thinkers?", "question_choices": ["Max Weber", "Karl Marx", "\u00c9mile Durkheim", "Friedrich Engels"], "cloze_format": "The concept of the iron cage was popularized by the sociological thinker ___ .", "normal_format": "The concept of the iron cage was popularized by which of the following sociological thinkers?"}, "answer": {"ans_text": "Max Weber", "ans_choice": 0}, "bloom": "1", "hl_sentences": "For Weber , the culmination of industrialization , rationalization , and the like results in what he referred to as the iron cage , in which the individual is trapped by institutions and bureaucracy .", "hl_context": "Weber was also unlike his predecessors in that he was more interested in how individuals experienced societal divisions than in the divisions themselves . The symbolic interactionism theory , the third of the three most recognized theories of sociology , is based on Weber \u2019 s early ideas that emphasize the viewpoint of the individual and how that individual relates to society . <hl> For Weber , the culmination of industrialization , rationalization , and the like results in what he referred to as the iron cage , in which the individual is trapped by institutions and bureaucracy . <hl> This leads to a sense of \u201c disenchantment of the world , \u201d a phrase Weber used to describe the final condition of humanity . Indeed a dark prediction , but one that has , at least to some degree , been borne out ( Gerth and Mills 1918 ) . In a rationalized , modern society , we have supermarkets instead of family-owned stores . We have chain restaurants instead of local eateries . Superstores that offer a multitude of merchandise have replaced independent businesses that focused on one product line , such as hardware , groceries , automotive repair , or clothing . Shopping malls offer retail stores , restaurants , fitness centers , even condominiums . This change may be rational , but is it universally desirable ?"}, {"question": {"question_id": "sq_exercise06", "question_text": "\u00c9mile Durkheim\u2019s ideas about society can best be described as ________.", "question_choices": ["functionalist", "conflict theorist", "symbolic interactionist", "rationalist"], "cloze_format": "\u00c9mile Durkheim\u2019s ideas about society can best be described as ________.", "normal_format": "How can \u00c9mile Durkheim\u2019s ideas about society best be described as?"}, "answer": {"ans_text": "functionalist", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "\u00c9mile Durkheim and Functionalism As a functionalist , \u00c9mile Durkheim \u2019 s ( 1858 \u2013 1917 ) perspective on society stressed the necessary interconnectivity of all of its elements .", "hl_context": "<hl> \u00c9mile Durkheim and Functionalism As a functionalist , \u00c9mile Durkheim \u2019 s ( 1858 \u2013 1917 ) perspective on society stressed the necessary interconnectivity of all of its elements . <hl> To Durkheim , society was greater than the sum of its parts . He asserted that individual behavior was not the same as collective behavior , and that studying collective behavior was quite different from studying an individual \u2019 s actions . Durkheim called the communal beliefs , morals , and attitudes of a society the collective conscience . In his quest to understand what causes individuals to act in similar and predictable ways , he wrote , \u201c If I do not submit to the conventions of society , if in my dress I do not conform to the customs observed in my country and in my class , the ridicule I provoke , the social isolation in which I am kept , produce , although in an attenuated form , the same effects as punishment \u201d ( Durkheim 1895 ) . Durkheim also believed that social integration , or the strength of ties that people have to their social groups , was a key factor in social life ."}, {"question": {"question_id": "sq0403_ex02", "question_text": "According to Peter Berger and Thomas Luckmann, society is based on ________.", "question_choices": ["habitual actions", "status", "institutionalization", "role performance"], "cloze_format": "According to Peter Berger and Thomas Luckmann, society is based on ________.", "normal_format": "According to Peter Berger and Thomas Luckmann, what is society based on?"}, "answer": {"ans_text": "habitual actions", "ans_choice": 0}, "bloom": "1", "hl_sentences": "That is , people \u2019 s behavior can be determined by their subjective construction of reality rather than by objective reality . Like Berger and Luckmann \u2019 s description of habitualization , Thomas states that our moral codes and social norms are created by \u201c successive definitions of the situation . \u201d This concept is defined by sociologist Robert K . Merton as a self-fulfilling prophecy . In 1966 sociologists Peter Berger and Thomas Luckmann wrote a book called The Social Construction of Reality . In it , they argued that society is created by humans and human interaction , which they call habitualization .", "hl_context": "Another way of looking at this concept is through W . I . Thomas \u2019 s notable Thomas theorem which states , \u201c If men define situations as real , they are real in their consequences \u201d ( Thomas and Thomas 1928 ) . <hl> That is , people \u2019 s behavior can be determined by their subjective construction of reality rather than by objective reality . <hl> For example , a teenager who is repeatedly given a label \u2014 overachiever , player , bum \u2014 might live up to the term even though it initially wasn \u2019 t a part of his character . <hl> Like Berger and Luckmann \u2019 s description of habitualization , Thomas states that our moral codes and social norms are created by \u201c successive definitions of the situation . \u201d This concept is defined by sociologist Robert K . Merton as a self-fulfilling prophecy . <hl> Merton explains that with a self-fulfilling prophecy , even a false idea can become true if it is acted upon . One example he gives is of a \u201c bank run . \u201d Say for some reason , a number of people falsely fear that their bank is soon to be bankrupt . Because of this false notion , people run to their bank and demand all their cash at once . As banks rarely , if ever , have that much money on hand , the bank does indeed run out of money , fulfilling the customers \u2019 prophecy . Here , reality is constructed by an idea . <hl> In 1966 sociologists Peter Berger and Thomas Luckmann wrote a book called The Social Construction of Reality . <hl> <hl> In it , they argued that society is created by humans and human interaction , which they call habitualization . <hl> Habitualization describes how \u201c any action that is repeated frequently becomes cast into a pattern , which can then be \u2026 performed again in the future in the same manner and with the same economical effort \u201d ( Berger and Luckmann 1966 ) . Not only do we construct our own society , but we accept it as it is because others have created it before us . Society is , in fact , \u201c habit . \u201d"}], "summary": "", "keyterm": "", "bname": "introduction_to_sociology"}, {"chapter": 1, "intro": " Chapter Outline 1.1   What Is Psychology? 1.2   History of Psychology 1.3   Contemporary Psychology 1.4   Careers in Psychology Introduction \n\n Clive Wearing is an accomplished musician who lost his ability to form new memories when he became sick at the age of 46. While he can remember how to play the piano perfectly, he cannot remember what he ate for breakfast just an hour ago (Sacks, 2007). James Wannerton experiences a taste sensation that is associated with the sound of words. His former girlfriend\u2019s name tastes like rhubarb (Mundasad, 2013). John Nash is a brilliant mathematician and Nobel Prize winner. However, while he was a professor at MIT, he would tell people that the  New York Times  contained coded messages from extraterrestrial beings that were intended for him. He also began to hear voices and became suspicious of the people around him. Soon thereafter, Nash was diagnosed with schizophrenia and admitted to a state-run mental institution (O\u2019Connor & Robertson, 2002). Nash was the subject of the 2001 movie  A Beautiful Mind . Why did these people have these experiences? How does the human brain work? And what is the connection between the brain\u2019s internal processes and people\u2019s external behaviors? This textbook will introduce you to various ways that the field of psychology has explored these questions. ", "chapter_text": " 1.1   What Is Psychology? Learning Objectives By the end of this section, you will be able to:\n\n Understand the etymology of the word \u201cpsychology\u201d \n\n Define psychology \n\n Understand the merits of an education in psychology \n\n In Greek mythology, Psyche was a mortal woman whose beauty was so great that it rivaled that of the goddess Aphrodite. Aphrodite became so jealous of Psyche that she sent her son, Eros, to make Psyche fall in love with the ugliest man in the world. However, Eros accidentally pricked himself with the tip of his arrow and fell madly in love with Psyche himself. He took Psyche to his palace and showered her with gifts, yet she could never see his face. While visiting Psyche, her sisters roused suspicion in Psyche about her mysterious lover, and eventually, Psyche betrayed Eros\u2019 wishes to remain unseen to her ( Figure 1.2 ). Because of this betrayal, Eros abandoned Psyche. When Psyche appealed to Aphrodite to reunite her with Eros, Aphrodite gave her a series of impossible tasks to complete. Psyche managed to complete all of these trials; ultimately, her perseverance paid off as she was reunited with Eros and was ultimately transformed into a goddess herself (Ashliman, 2001; Greek Myths & Greek Mythology, 2014). \n\n Psyche comes to represent the human soul\u2019s triumph over the misfortunes of life in the pursuit of true happiness (Bulfinch, 1855); in fact, the Greek word  psyche  means soul, and it is often represented as a butterfly. The word  psychology  was coined at a time when the concepts of soul and mind were not as clearly distinguished (Green, 2001). The root  ology  denotes scientific study of, and  psychology  refers to the scientific study of the mind. Since science studies only observable phenomena and the mind is not directly observable, we expand this definition to the scientific study of mind and behavior. The scientific study of any aspect of the world uses the scientific method to acquire knowledge. To apply the scientific method, a researcher with a question about how or why something happens will propose a tentative explanation, called a hypothesis, to explain the phenomenon. A hypothesis is not just any explanation; it should fit into the context of a scientific theory. A scientific theory is a broad explanation or group of explanations for some aspect of the natural world that is consistently supported by evidence over time. A theory is the best understanding that we have of that part of the natural world. Armed with the hypothesis, the researcher then makes observations or, better still, carries out an experiment to test the validity of the hypothesis. That test and its results are then published so that others can check the results or build on them. It is necessary that any explanation in science be testable, which means that the phenomenon must be perceivable and measurable. For example, that a bird sings because it is happy is not a testable hypothesis, since we have no way to measure the happiness of a bird. We must ask a different question, perhaps about the brain state of the bird, since this can be measured. In general, science deals only with matter and energy, that is, those things that can be measured, and it cannot arrive at knowledge about values and morality. This is one reason why our scientific understanding of the mind is so limited, since thoughts, at least as we experience them, are neither matter nor energy. The scientific method is also a form of empiricism. An  empirical method  for acquiring knowledge is one based on observation, including experimentation, rather than a method based only on forms of logical argument or previous authorities. \n\n It was not until the late 1800s that psychology became accepted as its own academic discipline. Before this time, the workings of the mind were considered under the auspices of philosophy. Given that any behavior is, at its roots, biological, some areas of psychology take on aspects of a natural science like biology. No biological organism exists in isolation, and our behavior is influenced by our interactions with others. Therefore, psychology is also a social science. \n\n Merits of an Education in Psychology \n\n Often, students take their first psychology course because they are interested in helping others and want to learn more about themselves and why they act the way they do. Sometimes, students take a psychology course because it either satisfies a general education requirement or is required for a program of study such as nursing or pre-med. Many of these students develop such an interest in the area that they go on to declare psychology as their major. As a result, psychology is one of the most popular majors on college campuses across the United States (Johnson & Lubin, 2011). A number of well-known individuals were psychology majors. Just a few famous names on this list are Facebook\u2019s creator Mark Zuckerberg, television personality and political satirist Jon Stewart, actress Natalie Portman, and filmmaker Wes Craven (Halonen, 2011). About 6 percent of all bachelor degrees granted in the United States are in the discipline of psychology (U.S. Department of Education, 2013). \n\n An education in psychology is valuable for a number of reasons. Psychology students hone critical thinking skills and are trained in the use of the scientific method. Critical thinking is the active application of a set of skills to information for the understanding and evaluation of that information. The evaluation of information\u2014assessing its reliability and usefulness\u2014 is an important skill in a world full of competing \u201cfacts,\u201d many of which are designed to be misleading. For example, critical thinking involves maintaining an attitude of skepticism, recognizing internal biases, making use of logical thinking, asking appropriate questions, and making observations. Psychology students also can develop better communication skills during the course of their undergraduate coursework (American Psychological Association, 2011). Together, these factors increase students\u2019 scientific literacy and prepare students to critically evaluate the various sources of information they encounter. In addition to these broad-based skills, psychology students come to understand the complex factors that shape one\u2019s behavior. They appreciate the interaction of our biology, our environment, and our experiences in determining who we are and how we will behave. They learn about basic principles that guide how we think and behave, and they come to recognize the tremendous diversity that exists across individuals and across cultural boundaries (American Psychological Association, 2011). \n\n Link to Learning \n\n Watch a brief  video  that describes some of the questions a student should consider before deciding to major in psychology. \n 1.2   History of Psychology Learning Objectives By the end of this section, you will be able to:\n\n Understand the importance of Wundt and James in the development of psychology \n\n Appreciate Freud\u2019s influence on psychology \n\n Understand the basic tenets of Gestalt psychology \n\n Appreciate the important role that behaviorism played in psychology\u2019s history \n\n Understand basic tenets of humanism \n\n Understand how the cognitive revolution shifted psychology\u2019s focus back to the mind \n\n Psychology is a relatively young science with its experimental roots in the 19th century, compared, for example, to human physiology, which dates much earlier. As mentioned, anyone interested in exploring issues related to the mind generally did so in a philosophical context prior to the 19th century. Two men, working in the 19th century, are generally credited as being the founders of psychology as a science and academic discipline that was distinct from philosophy. Their names were Wilhelm Wundt and William James. This section will provide an overview of the shifts in paradigms that have influenced psychology from Wundt and James through today. \n\n Wundt and Structuralism \n\n Wilhelm  Wundt  (1832\u20131920) was a German scientist who was the first person to be referred to as a psychologist. His famous book entitled  Principles of Physiological Psychology  was published in 1873. Wundt viewed psychology as a scientific study of conscious experience, and he believed that the goal of psychology was to identify components of consciousness and how those components combined to result in our conscious experience. Wundt used  introspection  (he called it \u201cinternal perception\u201d), a process by which someone examines their own conscious experience as objectively as possible, making the human mind like any other aspect of nature that a scientist observed. Wundt\u2019s version of introspection used only very specific experimental conditions in which an external stimulus was designed to produce a scientifically observable (repeatable) experience of the mind (Danziger, 1980). The first stringent requirement was the use of \u201ctrained\u201d or practiced observers, who could immediately observe and report a reaction. The second requirement was the use of repeatable stimuli that always produced the same experience in the subject and allowed the subject to expect and thus be fully attentive to the inner reaction. These experimental requirements were put in place to eliminate \u201cinterpretation\u201d in the reporting of internal experiences and to counter the argument that there is no way to know that an individual is observing their mind or consciousness accurately, since it cannot be seen by any other person. This attempt to understand the structure or characteristics of the mind was known as  structuralism . Wundt established his psychology laboratory at the University at Leipzig in 1879 ( Figure 1.3 ). In this laboratory, Wundt and his students conducted experiments on, for example, reaction times. A subject, sometimes in a room isolated from the scientist, would receive a stimulus such as a light, image, or sound. The subject\u2019s reaction to the stimulus would be to push a button, and an apparatus would record the time to reaction. Wundt could measure reaction time to one-thousandth of a second (Nicolas & Ferrand, 1999). \n\n However, despite his efforts to train individuals in the process of introspection, this process remained highly subjective, and there was very little agreement between individuals. As a result, structuralism fell out of favor with the passing of Wundt\u2019s student, Edward Titchener, in 1927 (Gordon, 1995). \n\n James and Functionalism \n\n William  James  (1842\u20131910) was the first American psychologist who espoused a different perspective on how psychology should operate ( Figure 1.4 ). James was introduced to Darwin\u2019s theory of evolution by natural selection and accepted it as an explanation of an organism\u2019s characteristics. Key to that theory is the idea that natural selection leads to organisms that are adapted to their environment, including their behavior. Adaptation means that a trait of an organism has a function for the survival and reproduction of the individual, because it has been naturally selected. As James saw it, psychology\u2019s purpose was to study the function of behavior in the world, and as such, his perspective was known as  functionalism . Functionalism focused on how mental activities helped an organism fit into its environment. Functionalism has a second, more subtle meaning in that functionalists were more interested in the operation of the whole mind rather than of its individual parts, which were the focus of structuralism. Like Wundt, James believed that introspection could serve as one means by which someone might study mental activities, but James also relied on more objective measures, including the use of various recording devices, and examinations of concrete products of mental activities and of anatomy and physiology (Gordon, 1995). \n\n Freud and Psychoanalytic Theory \n\n Perhaps one of the most influential and well-known figures in psychology\u2019s history was Sigmund  Freud  ( Figure 1.5 ). Freud (1856\u20131939) was an Austrian neurologist who was fascinated by patients suffering from \u201chysteria\u201d and neurosis. Hysteria was an ancient diagnosis for disorders, primarily of women with a wide variety of symptoms, including physical symptoms and emotional disturbances, none of which had an apparent physical cause. Freud theorized that many of his patients\u2019 problems arose from the unconscious mind. In Freud\u2019s view, the unconscious mind was a repository of feelings and urges of which we have no awareness. Gaining access to the unconscious, then, was crucial to the successful resolution of the patient\u2019s problems. According to Freud, the unconscious mind could be accessed through dream analysis, by examinations of the first words that came to people\u2019s minds, and through seemingly innocent slips of the tongue.  Psychoanalytic theory  focuses on the role of a person\u2019s unconscious, as well as early childhood experiences, and this particular perspective dominated clinical psychology for several decades (Thorne & Henley, 2005). \n\n Freud\u2019s ideas were influential, and you will learn more about them when you study lifespan development, personality, and therapy. For instance, many therapists believe strongly in the unconscious and the impact of early childhood experiences on the rest of a person\u2019s life. The method of psychoanalysis, which involves the patient talking about their experiences and selves, while not invented by Freud, was certainly popularized by him and is still used today. Many of Freud\u2019s other ideas, however, are controversial. Drew Westen (1998) argues that many of the criticisms of Freud\u2019s ideas are misplaced, in that they attack his older ideas without taking into account later writings. Westen also argues that critics fail to consider the success of the broad ideas that Freud introduced or developed, such as the importance of childhood experiences in adult motivations, the role of unconscious versus conscious motivations in driving our behavior, the fact that motivations can cause conflicts that affect behavior, the effects of mental representations of ourselves and others in guiding our interactions, and the development of personality over time. Westen identifies subsequent research support for all of these ideas. \n\n More modern iterations of Freud\u2019s clinical approach have been empirically demonstrated to be effective (Knekt et al., 2008; Shedler, 2010). Some current practices in psychotherapy involve examining unconscious aspects of the self and relationships, often through the relationship between the therapist and the client. Freud\u2019s historical significance and contributions to clinical practice merit his inclusion in a discussion of the historical movements within psychology. \n\n Wertheimer, Koffka, K\u00f6hler, and Gestalt Psychology \n\n Max Wertheimer (1880\u20131943), Kurt Koffka (1886\u20131941), and Wolfgang K\u00f6hler (1887\u20131967) were three German psychologists who immigrated to the United States in the early 20th century to escape Nazi Germany. These men are credited with introducing psychologists in the United States to various Gestalt principles. The word  Gestalt  roughly translates to \u201cwhole;\u201d a major emphasis of Gestalt psychology deals with the fact that although a sensory experience can be broken down into individual parts, how those parts relate to each other as a whole is often what the individual responds to in perception. For example, a song may be made up of individual notes played by different instruments, but the real nature of the song is perceived in the combinations of these notes as they form the melody, rhythm, and harmony. In many ways, this particular perspective would have directly contradicted Wundt\u2019s ideas of structuralism (Thorne & Henley, 2005). \n\n Unfortunately, in moving to the United States, these men were forced to abandon much of their work and were unable to continue to conduct research on a large scale. These factors along with the rise of behaviorism (described next) in the United States prevented principles of Gestalt psychology from being as influential in the United States as they had been in their native Germany (Thorne & Henley, 2005). Despite these issues, several Gestalt principles are still very influential today. Considering the human individual as a whole rather than as a sum of individually measured parts became an important foundation in humanistic theory late in the century. The ideas of Gestalt have continued to influence research on sensation and perception. Structuralism, Freud, and the Gestalt psychologists were all concerned in one way or another with describing and understanding inner experience. But other researchers had concerns that inner experience could be a legitimate subject of scientific inquiry and chose instead to exclusively study behavior, the objectively observable outcome of mental processes. \n\n Pavlov, Watson, Skinner, and Behaviorism \n\n Early work in the field of behavior was conducted by the Russian physiologist Ivan  Pavlov  (1849\u20131936). Pavlov studied a form of learning behavior called a conditioned reflex, in which an animal or human produced a reflex (unconscious) response to a stimulus and, over time, was conditioned to produce the response to a different stimulus that the experimenter associated with the original stimulus. The reflex Pavlov worked with was salivation in response to the presence of food. The salivation reflex could be elicited using a second stimulus, such as a specific sound, that was presented in association with the initial food stimulus several times. Once the response to the second stimulus was \u201clearned,\u201d the food stimulus could be omitted. Pavlov\u2019s \u201cclassical conditioning\u201d is only one form of learning behavior studied by behaviorists. \n\n John B.  Watson  (1878\u20131958) was an influential American psychologist whose most famous work occurred during the early 20th century at Johns Hopkins University ( Figure 1.6 ). While Wundt and James were concerned with understanding conscious experience, Watson thought that the study of consciousness was flawed. Because he believed that objective analysis of the mind was impossible, Watson preferred to focus directly on observable behavior and try to bring that behavior under control. Watson was a major proponent of shifting the focus of psychology from the mind to behavior, and this approach of observing and controlling behavior came to be known as  behaviorism . A major object of study by behaviorists was learned behavior and its interaction with inborn qualities of the organism. Behaviorism commonly used animals in experiments under the assumption that what was learned using animal models could, to some degree, be applied to human behavior. Indeed, Tolman (1938) stated, \u201cI believe that everything important in psychology (except \u2026 such matters as involve society and words) can be investigated in essence through the continued experimental and theoretical analysis of the determiners of rat behavior at a choice-point in a maze.\u201d \n\n Behaviorism dominated experimental psychology for several decades, and its influence can still be felt today (Thorne & Henley, 2005). Behaviorism is largely responsible for establishing psychology as a scientific discipline through its objective methods and especially experimentation. In addition, it is used in behavioral and cognitive-behavioral therapy. Behavior modification is commonly used in classroom settings. Behaviorism has also led to research on environmental influences on human behavior. B. F.  Skinner  (1904\u20131990) was an American psychologist ( Figure 1.7 ). Like Watson, Skinner was a behaviorist, and he concentrated on how behavior was affected by its consequences. Therefore, Skinner spoke of reinforcement and punishment as major factors in driving behavior. As a part of his research, Skinner developed a chamber that allowed the careful study of the principles of modifying behavior through reinforcement and punishment. This device, known as an operant conditioning chamber (or more familiarly, a Skinner box), has remained a crucial resource for researchers studying behavior (Thorne & Henley, 2005). \n\n The  Skinner box  is a chamber that isolates the subject from the external environment and has a behavior indicator such as a lever or a button. When the animal pushes the button or lever, the box is able to deliver a positive reinforcement of the behavior (such as food) or a punishment (such as a noise) or a token conditioner (such as a light) that is correlated with either the positive reinforcement or punishment. \n\n Skinner\u2019s focus on positive and negative reinforcement of learned behaviors had a lasting influence in psychology that has waned somewhat since the growth of research in cognitive psychology. Despite this, conditioned learning is still used in human behavioral modification. Skinner\u2019s two widely read and controversial popular science books about the value of operant conditioning for creating happier lives remain as thought-provoking arguments for his approach (Greengrass, 2004). \n\n Maslow, Rogers, and Humanism \n\n During the early 20th century, American psychology was dominated by behaviorism and psychoanalysis. However, some psychologists were uncomfortable with what they viewed as limited perspectives being so influential to the field. They objected to the pessimism and determinism (all actions driven by the unconscious) of Freud. They also disliked the reductionism, or simplifying nature, of behaviorism. Behaviorism is also deterministic at its core, because it sees human behavior as entirely determined by a combination of genetics and environment. Some psychologists began to form their own ideas that emphasized personal control, intentionality, and a true predisposition for \u201cgood\u201d as important for our self-concept and our behavior. Thus, humanism emerged.  Humanism  is a perspective within psychology that emphasizes the potential for good that is innate to all humans. Two of the most well-known proponents of humanistic psychology are Abraham Maslow and Carl Rogers (O\u2019Hara, n.d.). \n\n Abraham  Maslow  (1908\u20131970) was an American psychologist who is best known for proposing a hierarchy of human needs in motivating behavior ( Figure 1.8 ). Although this concept will be discussed in more detail in a later chapter, a brief overview will be provided here. Maslow asserted that so long as basic needs necessary for survival were met (e.g., food, water, shelter), higher-level needs (e.g., social needs) would begin to motivate behavior. According to Maslow, the highest-level needs relate to self-actualization, a process by which we achieve our full potential. Obviously, the focus on the positive aspects of human nature that are characteristic of the humanistic perspective is evident (Thorne & Henley, 2005). Humanistic psychologists rejected, on principle, the research approach based on reductionist experimentation in the tradition of the physical and biological sciences, because it missed the \u201cwhole\u201d human being. Beginning with Maslow and Rogers, there was an insistence on a humanistic research program. This program has been largely qualitative (not measurement-based), but there exist a number of quantitative research strains within humanistic psychology, including research on happiness, self-concept, meditation, and the outcomes of humanistic psychotherapy (Friedman, 2008). \n\n Carl  Rogers  (1902\u20131987) was also an American psychologist who, like Maslow, emphasized the potential for good that exists within all people ( Figure 1.9 ). Rogers used a therapeutic technique known as client-centered therapy in helping his clients deal with problematic issues that resulted in their seeking psychotherapy. Unlike a psychoanalytic approach in which the therapist plays an important role in interpreting what conscious behavior reveals about the unconscious mind, client-centered therapy involves the patient taking a lead role in the therapy session. Rogers believed that a therapist needed to display three features to maximize the effectiveness of this particular approach: unconditional positive regard, genuineness, and empathy. Unconditional positive regard refers to the fact that the therapist accepts their client for who they are, no matter what he or she might say. Provided these factors, Rogers believed that people were more than capable of dealing with and working through their own issues (Thorne & Henley, 2005). \n\n Humanism has been influential to psychology as a whole. Both Maslow and Rogers are well-known names among students of psychology (you will read more about both men later in this text), and their ideas have influenced many scholars. Furthermore, Rogers\u2019 client-centered approach to therapy is still commonly used in psychotherapeutic settings today (O\u2019hara, n.d.) \n\n Link to Learning \n\n View a brief  video  of Carl Rogers describing his therapeutic approach. \n\n The Cognitive Revolution \n\n Behaviorism\u2019s emphasis on objectivity and focus on external behavior had pulled psychologists\u2019 attention away from the mind for a prolonged period of time. The early work of the humanistic psychologists redirected attention to the individual human as a whole, and as a conscious and self-aware being. By the 1950s, new disciplinary perspectives in linguistics, neuroscience, and computer science were emerging, and these areas revived interest in the mind as a focus of scientific inquiry. This particular perspective has come to be known as the cognitive revolution (Miller, 2003). By 1967, Ulric Neisser published the first textbook entitled  Cognitive Psychology , which served as a core text in cognitive psychology courses around the country (Thorne & Henley, 2005). \n\n Although no one person is entirely responsible for starting the cognitive revolution, Noam Chomsky was very influential in the early days of this movement ( Figure 1.10 ). Chomsky (1928\u2013), an American linguist, was dissatisfied with the influence that behaviorism had had on psychology. He believed that psychology\u2019s focus on behavior was short-sighted and that the field had to re-incorporate mental functioning into its purview if it were to offer any meaningful contributions to understanding behavior (Miller, 2003). \n\n European psychology had never really been as influenced by behaviorism as had American psychology; and thus, the cognitive revolution helped reestablish lines of communication between European psychologists and their American counterparts. Furthermore, psychologists began to cooperate with scientists in other fields, like anthropology, linguistics, computer science, and neuroscience, among others. This interdisciplinary approach often was referred to as the cognitive sciences, and the influence and prominence of this particular perspective resonates in modern-day psychology (Miller, 2003). \n\n Dig Deeper Feminist Psychology The science of psychology has had an impact on human wellbeing, both positive and negative. The dominant influence of Western, white, and male academics in the early history of psychology meant that psychology developed with the biases inherent in those individuals, which often had negative consequences for members of society that were not white or male. Women, members of ethnic minorities in both the United States and other countries, and individuals with sexual orientations other than heterosexual had difficulties entering the field of psychology and therefore influencing its development. They also suffered from the attitudes of white, male psychologists, who were not immune to the nonscientific attitudes prevalent in the society in which they developed and worked. Until the 1960s, the science of psychology was largely a \u201cwomanless\u201d psychology (Crawford & Marecek, 1989), meaning that few women were able to practice psychology, so they had little influence on what was studied. In addition, the experimental subjects of psychology were mostly men, which resulted from underlying assumptions that gender had no influence on psychology and that women were not of sufficient interest to study. \n\n An article by Naomi Weisstein, first published in 1968 (Weisstein, 1993), stimulated a feminist revolution in psychology by presenting a critique of psychology as a science. She also specifically criticized male psychologists for constructing the psychology of women entirely out of their own cultural biases and without careful experimental tests to verify any of their characterizations of women. Weisstein used, as examples, statements by prominent psychologists in the 1960s, such as this quote by Bruno Bettleheim: \u201c. . . we must start with the realization that, as much as women want to be good scientists or engineers, they want first and foremost to be womanly companions of men and to be mothers.\u201d Weisstein\u2019s critique formed the foundation for the subsequent development of a feminist psychology that attempted to be free of the influence of male cultural biases on our knowledge of the psychology of women and, indeed, of both genders. Crawford & Marecek (1989) identify several feminist approaches to psychology that can be described as feminist psychology. These include re-evaluating and discovering the contributions of women to the history of psychology, studying psychological gender differences, and questioning the male bias present across the practice of the scientific approach to knowledge. \n\n Multicultural Psychology \n\n Culture has important impacts on individuals and social psychology, yet the effects of  culture  on psychology are under-studied. There is a risk that psychological theories and data derived from white, American settings could be assumed to apply to individuals and social groups from other cultures and this is unlikely to be true (Betancourt & L\u00f3pez, 1993). One weakness in the field of cross-cultural psychology is that in looking for differences in psychological attributes across cultures, there remains a need to go beyond simple descriptive statistics (Betancourt & L\u00f3pez, 1993). In this sense, it has remained a descriptive science, rather than one seeking to determine cause and effect. For example, a study of characteristics of individuals seeking treatment for a binge eating disorder in Hispanic American, African American, and Caucasian American individuals found significant differences between groups (Franko et al., 2012). The study concluded that results from studying any one of the groups could not be extended to the other groups, and yet potential causes of the differences were not measured. This history of multicultural psychology in the United States is a long one. The role of African American psychologists in researching the cultural differences between African American individual and social psychology is but one example. In 1920, Cecil Sumner was the first African American to receive a PhD in psychology in the United States. Sumner established a psychology degree program at Howard University, leading to the education of a new generation of African American psychologists (Black, Spence, and Omari, 2004). Much of the work of early African American psychologists (and a general focus of much work in first half of the 20th century in psychology in the United States) was dedicated to testing and intelligence testing in particular (Black et al., 2004). That emphasis has continued, particularly because of the importance of testing in determining opportunities for children, but other areas of exploration in African American psychology research include learning style, sense of community and belonging, and spiritualism (Black et al., 2004). Two famous African American researchers and psychologists are Mamie Phipps Clark and her husband, Kenneth Clark. They are best known for their studies conducted on African American children and internalized racism, research that was instrumental in the  Brown v. Board of Education  Supreme Court desegregation case. The Clarks applied their research to social services and opened the first child guidance center in Harlem (American Psychological Association, 2019).\n\n Listen to the podcast below describing the Clarks' research and impact on the Supreme Court decision. Link to Learning \n\n Listen to a  podcast  about the influence of an African American\u2019s psychology research on the historic  Brown v. Board of Education  civil rights case. The American Psychological Association has several ethnically based organizations for professional psychologists that facilitate interactions among members. Since psychologists belonging to specific ethnic groups or cultures have the most interest in studying the psychology of their communities, these organizations provide an opportunity for the growth of research on the impact of culture on individual and social psychology. \n 1.3   Contemporary Psychology Learning Objectives By the end of this section, you will be able to:\n\n Appreciate the diversity of interests and foci within psychology \n\n Understand basic interests and applications in each of the described areas of psychology \n\n Demonstrate familiarity with some of the major concepts or important figures in each of the described areas of psychology \n\n Contemporary psychology is a diverse field that is influenced by all of the historical perspectives described in the preceding section. Reflective of the discipline\u2019s diversity is the diversity seen within the  American Psychological Association (APA) . The APA is a professional organization representing psychologists in the United States. The APA is the largest organization of psychologists in the world, and its mission is to advance and disseminate psychological knowledge for the betterment of people. There are 56 divisions within the APA, representing a wide variety of specialties that range from Societies for the Psychology of Religion and Spirituality to Exercise and Sport Psychology to Behavioral Neuroscience and Comparative Psychology. Reflecting the diversity of the field of psychology itself, members, affiliate members, and associate members span the spectrum from students to doctoral-level psychologists, and come from a variety of places including educational settings, criminal justice, hospitals, the armed forces, and industry (American Psychological Association, 2014). The Association for Psychological Science (APS) was founded in 1988 and seeks to advance the scientific orientation of psychology. Its founding resulted from disagreements between members of the scientific and clinical branches of psychology within the APA. The APS publishes five research journals and engages in education and advocacy with funding agencies. A significant proportion of its members are international, although the majority is located in the United States. Other organizations provide networking and collaboration opportunities for professionals of several ethnic or racial groups working in psychology, such as the National Latina/o Psychological Association (NLPA), the Asian American Psychological Association (AAPA), the Association of Black Psychologists (ABPsi), and the Society of Indian Psychologists (SIP). Most of these groups are also dedicated to studying psychological and social issues within their specific communities. This section will provide an overview of the major subdivisions within psychology today in the order in which they are introduced throughout the remainder of this textbook. This is not meant to be an exhaustive listing, but it will provide insight into the major areas of research and practice of modern-day psychologists. \n\n Link to Learning \n\n Please visit this  website  to learn about the divisions within the APA. \n\n Student  resources  are also provided by the APA. \n\n Biopsychology and Evolutionary Psychology \n\n As the name suggests,  biopsychology  explores how our biology influences our behavior. While biological psychology is a broad field, many biological psychologists want to understand how the structure and function of the nervous system is related to behavior ( Figure 1.11 ). As such, they often combine the research strategies of both psychologists and physiologists to accomplish this goal (as discussed in Carlson, 2013). \n\n The research interests of biological psychologists span a number of domains, including but not limited to, sensory and motor systems, sleep, drug use and abuse, ingestive behavior, reproductive behavior, neurodevelopment, plasticity of the nervous system, and biological correlates of psychological disorders. Given the broad areas of interest falling under the purview of biological psychology, it will probably come as no surprise that individuals from all sorts of backgrounds are involved in this research, including biologists, medical professionals, physiologists, and chemists. This interdisciplinary approach is often referred to as neuroscience, of which biological psychology is a component (Carlson, 2013). \n\n While biopsychology typically focuses on the immediate causes of behavior based in the physiology of a human or other animal, evolutionary psychology seeks to study the ultimate biological causes of behavior. To the extent that a behavior is impacted by genetics, a behavior, like any anatomical characteristic of a human or animal, will demonstrate adaption to its surroundings. These surroundings include the physical environment and, since interactions between organisms can be important to survival and reproduction, the social environment. The study of behavior in the context of evolution has its origins with Charles Darwin, the co-discoverer of the theory of evolution by natural selection. Darwin was well aware that behaviors should be adaptive and wrote books titled,  The Descent of Man  (1871) and  The Expression of the Emotions in Man and Animals  (1872), to explore this field. \n\n Evolutionary psychology, and specifically, the  evolutionary psychology  of humans, has enjoyed a resurgence in recent decades. To be subject to evolution by natural selection, a behavior must have a significant genetic cause. In general, we expect all human cultures to express a behavior if it is caused genetically, since the genetic differences among human groups are small. The approach taken by most evolutionary psychologists is to predict the outcome of a behavior in a particular situation based on evolutionary theory and then to make observations, or conduct experiments, to determine whether the results match the theory. It is important to recognize that these types of studies are not strong evidence that a behavior is adaptive, since they lack information that the behavior is in some part genetic and not entirely cultural (Endler, 1986). Demonstrating that a trait, especially in humans, is naturally selected is extraordinarily difficult; perhaps for this reason, some evolutionary psychologists are content to assume the behaviors they study have genetic determinants (Confer et al., 2010). \n\n One other drawback of evolutionary psychology is that the traits that we possess now evolved under environmental and social conditions far back in human history, and we have a poor understanding of what these conditions were. This makes predictions about what is adaptive for a behavior difficult. Behavioral traits need not be adaptive under current conditions, only under the conditions of the past when they evolved, about which we can only hypothesize. \n\n There are many areas of human behavior for which evolution can make predictions. Examples include memory, mate choice, relationships between kin, friendship and cooperation, parenting, social organization, and status (Confer et al., 2010). \n\n Evolutionary psychologists have had success in finding experimental correspondence between observations and expectations. In one example, in a study of mate preference differences between men and women that spanned 37 cultures, Buss (1989) found that women valued earning potential factors greater than men, and men valued potential reproductive factors (youth and attractiveness) greater than women in their prospective mates. In general, the predictions were in line with the predictions of evolution, although there were deviations in some cultures. \n\n Sensation and Perception \n\n Scientists interested in both physiological aspects of sensory systems as well as in the psychological experience of sensory information work within the area of  sensation  and  perception  ( Figure 1.12 ). As such, sensation and perception research is also quite interdisciplinary. Imagine walking between buildings as you move from one class to another. You are inundated with sights, sounds, touch sensations, and smells. You also experience the temperature of the air around you and maintain your balance as you make your way. These are all factors of interest to someone working in the domain of sensation and perception. \n\n As described in a later chapter that focuses on the results of studies in sensation and perception, our experience of our world is not as simple as the sum total of all of the sensory information (or sensations) together. Rather, our experience (or perception) is complex and is influenced by where we focus our attention, our previous experiences, and even our cultural backgrounds. \n\n Cognitive Psychology \n\n As mentioned in the previous section, the cognitive revolution created an impetus for psychologists to focus their attention on better understanding the mind and mental processes that underlie behavior. Thus,  cognitive psychology  is the area of psychology that focuses on studying cognitions, or thoughts, and their relationship to our experiences and our actions. Like biological psychology, cognitive psychology is broad in its scope and often involves collaborations among people from a diverse range of disciplinary backgrounds. This has led some to coin the term cognitive science to describe the interdisciplinary nature of this area of research (Miller, 2003). \n\n Cognitive psychologists have research interests that span a spectrum of topics, ranging from attention to problem solving to language to memory. The approaches used in studying these topics are equally diverse. Given such diversity, cognitive psychology is not captured in one chapter of this text per se; rather, various concepts related to cognitive psychology will be covered in relevant portions of the chapters in this text on sensation and perception, thinking and intelligence, memory, lifespan development, social psychology, and therapy. \n\n Link to Learning \n\n View a  brief video  recapping some of the major concepts explored by cognitive psychologists. \n\n Developmental Psychology \n\n Developmental psychology  is the scientific study of development across a lifespan. Developmental psychologists are interested in processes related to physical maturation. However, their focus is not limited to the physical changes associated with aging, as they also focus on changes in cognitive skills, moral reasoning, social behavior, and other psychological attributes. \n\n Early developmental psychologists focused primarily on changes that occurred through reaching adulthood, providing enormous insight into the differences in physical, cognitive, and social capacities that exist between very young children and adults. For instance, research by Jean  Piaget  ( Figure 1.13 ) demonstrated that very young children do not demonstrate object permanence. Object permanence refers to the understanding that physical things continue to exist, even if they are hidden from us. If you were to show an adult a toy, and then hide it behind a curtain, the adult knows that the toy still exists. However, very young infants act as if a hidden object no longer exists. The age at which object permanence is achieved is somewhat controversial (Munakata, McClelland, Johnson, and Siegler, 1997). \n\n While Piaget was focused on cognitive changes during infancy and childhood as we move to adulthood, there is an increasing interest in extending research into the changes that occur much later in life. This may be reflective of changing population demographics of developed nations as a whole. As more and more people live longer lives, the number of people of advanced age will continue to increase. Indeed, it is estimated that there were just over 40 million people aged 65 or older living in the United States in 2010. However, by 2020, this number is expected to increase to about 55 million. By the year 2050, it is estimated that nearly 90 million people in this country will be 65 or older (Department of Health and Human Services, n.d.). \n\n Personality Psychology \n\n Personality psychology  focuses on patterns of thoughts and behaviors that make each individual unique. Several individuals (e.g., Freud and Maslow) that we have already discussed in our historical overview of psychology, and the American psychologist Gordon Allport, contributed to early theories of personality. These early theorists attempted to explain how an individual\u2019s personality develops from his or her given perspective. For example, Freud proposed that personality arose as conflicts between the conscious and unconscious parts of the mind were carried out over the lifespan. Specifically, Freud theorized that an individual went through various psychosexual stages of development. According to Freud, adult personality would result from the resolution of various conflicts that centered on the migration of erogenous (or sexual pleasure-producing) zones from the oral (mouth) to the anus to the phallus to the genitals. Like many of Freud\u2019s theories, this particular idea was controversial and did not lend itself to experimental tests (Person, 1980). \n\n More recently, the study of personality has taken on a more quantitative approach. Rather than explaining how personality arises, research is focused on identifying  personality traits , measuring these traits, and determining how these traits interact in a particular context to determine how a person will behave in any given situation. Personality traits are relatively consistent patterns of thought and behavior, and many have proposed that five trait dimensions are sufficient to capture the variations in personality seen across individuals. These five dimensions are known as the \u201cBig Five\u201d or the  Five Factor model , and include dimensions of conscientiousness, agreeableness, neuroticism, openness, and extraversion ( Figure 1.14 ). Each of these traits has been demonstrated to be relatively stable over the lifespan (e.g., Rantanen, Mets\u00e4pelto, Feldt, Pulkinnen, and Kokko, 2007; Soldz & Vaillant, 1999; McCrae & Costa, 2008) and is influenced by genetics (e.g., Jang, Livesly, and Vernon, 1996). \n\n Social Psychology \n\n Social psychology  focuses on how we interact with and relate to others. Social psychologists conduct research on a wide variety of topics that include differences in how we explain our own behavior versus how we explain the behaviors of others, prejudice, and attraction, and how we resolve interpersonal conflicts. Social psychologists have also sought to determine how being among other people changes our own behavior and patterns of thinking. \n\n There are many interesting examples of social psychological research, and you will read about many of these in a later chapter of this textbook. Until then, you will be introduced to one of the most controversial psychological studies ever conducted. Stanley  Milgram  was an American social psychologist who is most famous for research that he conducted on obedience. After the holocaust, in 1961, a Nazi war criminal, Adolf Eichmann, who was accused of committing mass atrocities, was put on trial. Many people wondered how German soldiers were capable of torturing prisoners in concentration camps, and they were unsatisfied with the excuses given by soldiers that they were simply following orders. At the time, most psychologists agreed that few people would be willing to inflict such extraordinary pain and suffering, simply because they were obeying orders. Milgram decided to conduct research to determine whether or not this was true ( Figure 1.15 ). As you will read later in the text, Milgram found that nearly two-thirds of his participants were willing to deliver what they believed to be lethal shocks to another person, simply because they were instructed to do so by an authority figure (in this case, a man dressed in a lab coat). This was in spite of the fact that participants received payment for simply showing up for the research study and could have chosen not to inflict pain or more serious consequences on another person by withdrawing from the study. No one was actually hurt or harmed in any way, Milgram\u2019s experiment was a clever ruse that took advantage of research confederates, those who pretend to be participants in a research study who are actually working for the researcher and have clear, specific directions on how to behave during the research study (Hock, 2009). Milgram\u2019s and others\u2019 studies that involved deception and potential emotional harm to study participants catalyzed the development of ethical guidelines for conducting psychological research that discourage the use of deception of research subjects, unless it can be argued not to cause harm and, in general, requiring informed consent of participants. \n\n Industrial-Organizational Psychology \n\n Industrial-Organizational psychology  (I-O psychology) is a subfield of psychology that applies psychological theories, principles, and research findings in industrial and organizational settings. I-O psychologists are often involved in issues related to personnel management, organizational structure, and workplace environment. Businesses often seek the aid of I-O psychologists to make the best hiring decisions as well as to create an environment that results in high levels of employee productivity and efficiency. In addition to its applied nature, I-O psychology also involves conducting scientific research on behavior within I-O settings (Riggio, 2013). \n\n Health Psychology \n\n Health psychology  focuses on how health is affected by the interaction of biological, psychological, and sociocultural factors. This particular approach is known as the  biopsychosocial model  ( Figure 1.16 ). Health psychologists are interested in helping individuals achieve better health through public policy, education, intervention, and research. Health psychologists might conduct research that explores the relationship between one\u2019s genetic makeup, patterns of behavior, relationships, psychological stress, and health. They may research effective ways to motivate people to address patterns of behavior that contribute to poorer health (MacDonald, 2013). \n\n Sport and Exercise Psychology \n\n Researchers in  sport and exercise psychology  study the psychological aspects of sport performance, including motivation and performance anxiety, and the effects of sport on mental and emotional wellbeing. Research is also conducted on similar topics as they relate to physical exercise in general. The discipline also includes topics that are broader than sport and exercise but that are related to interactions between mental and physical performance under demanding conditions, such as fire fighting, military operations, artistic performance, and surgery. \n\n Clinical Psychology \n\n Clinical psychology  is the area of psychology that focuses on the diagnosis and treatment of psychological disorders and other problematic patterns of behavior. As such, it is generally considered to be a more applied area within psychology; however, some clinicians are also actively engaged in scientific research.  Counseling psychology  is a similar discipline that focuses on emotional, social, vocational, and health-related outcomes in individuals who are considered psychologically healthy. \n\n As mentioned earlier, both Freud and Rogers provided perspectives that have been influential in shaping how clinicians interact with people seeking psychotherapy. While aspects of the psychoanalytic theory are still found among some of today\u2019s therapists who are trained from a psychodynamic perspective, Roger\u2019s ideas about client-centered  therapy  have been especially influential in shaping how many clinicians operate. Furthermore, both behaviorism and the cognitive revolution have shaped clinical practice in the forms of behavioral therapy, cognitive therapy, and cognitive-behavioral therapy ( Figure 1.17 ). Issues related to the diagnosis and treatment of psychological disorders and problematic patterns of behavior will be discussed in detail in later chapters of this textbook. \n\n By far, this is the area of psychology that receives the most attention in popular media, and many people mistakenly assume that all psychology is clinical psychology. \n\n Forensic Psychology \n\n Forensic psychology  is a branch of psychology that deals questions of psychology as they arise in the context of the justice system. For example, forensic psychologists (and forensic psychiatrists) will assess a person\u2019s competency to stand trial, assess the state of mind of a defendant, act as consultants on child custody cases, consult on sentencing and treatment recommendations, and advise on issues such as eyewitness testimony and children\u2019s testimony (American Board of Forensic Psychology, 2014). In these capacities, they will typically act as expert witnesses, called by either side in a court case to provide their research- or experience-based opinions. As expert witnesses, forensic psychologists must have a good understanding of the law and provide information in the context of the legal system rather than just within the realm of psychology. Forensic psychologists are also used in the jury selection process and witness preparation. They may also be involved in providing psychological treatment within the criminal justice system. Criminal profilers are a relatively small proportion of psychologists that act as consultants to law enforcement. \n\n Link to Learning \n\n The APA provides  career information  about various areas of psychology. \n 1.4   Careers in Psychology Learning Objectives By the end of this section, you will be able to:\n\n Understand educational requirements for careers in academic settings \n\n Understand the demands of a career in an academic setting \n\n Understand career options outside of academic settings \n\n Psychologists can work in many different places doing many different things. In general, anyone wishing to continue a career in psychology at a 4-year institution of higher education will have to earn a doctoral degree in psychology for some specialties and at least a master\u2019s degree for others. In most areas of psychology, this means earning a PhD in a relevant area of psychology. Literally,  PhD  refers to a doctor of philosophy degree, but here, philosophy does not refer to the field of philosophy per se. Rather, philosophy in this context refers to many different disciplinary perspectives that would be housed in a traditional college of liberal arts and sciences. The requirements to earn a PhD vary from country to country and even from school to school, but usually, individuals earning this degree must complete a dissertation. A  dissertation  is essentially a long research paper or bundled published articles describing research that was conducted as a part of the candidate\u2019s doctoral training. In the United States, a dissertation generally has to be defended before a committee of expert reviewers before the degree is conferred ( Figure 1.18 ). \n\n Once someone earns her PhD, she may seek a faculty appointment at a college or university. Being on the faculty of a college or university often involves dividing time between teaching, research, and service to the institution and profession. The amount of time spent on each of these primary responsibilities varies dramatically from school to school, and it is not uncommon for faculty to move from place to place in search of the best personal fit among various academic environments. The previous section detailed some of the major areas that are commonly represented in psychology departments around the country; thus, depending on the training received, an individual could be anything from a biological psychologist to a clinical psychologist in an academic setting ( Figure 1.19 ). \n\n Other Careers in Academic Settings \n\n Often times, schools offer more courses in psychology than their full-time faculty can teach. In these cases, it is not uncommon to bring in an adjunct faculty member or instructor. Adjunct faculty members and instructors usually have an advanced degree in psychology, but they often have primary careers outside of academia and serve in this role as a secondary job. Alternatively, they may not hold the doctoral degree required by most 4-year institutions and use these opportunities to gain experience in teaching. Furthermore, many 2-year colleges and schools need faculty to teach their courses in psychology. In general, many of the people who pursue careers at these institutions have master\u2019s degrees in psychology, although some PhDs make careers at these institutions as well. \n\n Some people earning PhDs may enjoy research in an academic setting. However, they may not be interested in teaching. These individuals might take on faculty positions that are exclusively devoted to conducting research. This type of position would be more likely an option at large, research-focused universities. \n\n In some areas in psychology, it is common for individuals who have recently earned their PhD to seek out positions in  postdoctoral training programs  that are available before going on to serve as faculty. In most cases, young scientists will complete one or two postdoctoral programs before applying for a full-time faculty position. Postdoctoral training programs allow young scientists to further develop their research programs and broaden their research skills under the supervision of other professionals in the field. \n\n Career Options Outside of Academic Settings \n\n Individuals who wish to become practicing clinical psychologists have another option for earning a doctoral degree, which is known as a PsyD. A  PsyD  is a doctor of psychology degree that is increasingly popular among individuals interested in pursuing careers in clinical psychology. PsyD programs generally place less emphasis on research-oriented skills and focus more on application of psychological principles in the clinical context (Norcorss & Castle, 2002). \n\n Regardless of whether earning a PhD or PsyD, in most states, an individual wishing to practice as a licensed clinical or counseling psychologist may complete postdoctoral work under the supervision of a licensed psychologist. Within the last few years, however, several states have begun to remove this requirement, which would allow someone to get an earlier start in his career (Munsey, 2009). After an individual has met the state requirements, his credentials are evaluated to determine whether he can sit for the licensure exam. Only individuals that pass this exam can call themselves licensed clinical or counseling psychologists (Norcross, n.d.). Licensed clinical or counseling psychologists can then work in a number of settings, ranging from private clinical practice to hospital settings. It should be noted that clinical psychologists and psychiatrists do different things and receive different types of education. While both can conduct therapy and counseling, clinical psychologists have a PhD or a PsyD, whereas psychiatrists have a doctor of medicine degree (MD). As such, licensed clinical psychologists can administer and interpret psychological tests, while psychiatrists can prescribe medications. Individuals earning a PhD can work in a variety of settings, depending on their areas of specialization. For example, someone trained as a biopsychologist might work in a pharmaceutical company to help test the efficacy of a new drug. Someone with a clinical background might become a forensic psychologist and work within the legal system to make recommendations during criminal trials and parole hearings, or serve as an expert in a court case. \n\n While earning a doctoral degree in psychology is a lengthy process, usually taking between 5\u20136 years of graduate study (DeAngelis, 2010), there are a number of careers that can be attained with a master\u2019s degree in psychology. People who wish to provide psychotherapy can become licensed to serve as various types of professional counselors (Hoffman, 2012). Relevant master\u2019s degrees are also sufficient for individuals seeking careers as school psychologists (National Association of School Psychologists, n.d.), in some capacities related to sport psychology (American Psychological Association, 2014), or as consultants in various industrial settings (Landers, 2011, June 14). Undergraduate coursework in psychology may be applicable to other careers such as psychiatric social work or psychiatric nursing, where assessments and therapy may be a part of the job. \n\n As mentioned in the opening section of this chapter, an undergraduate education in psychology is associated with a knowledge base and skill set that many employers find quite attractive. It should come as no surprise, then, that individuals earning bachelor\u2019s degrees in psychology find themselves in a number of different careers, as shown in  Table 1.1 . Examples of a few such careers can involve serving as case managers, working in sales, working in human resource departments, and teaching in high schools. The rapidly growing realm of healthcare professions is another field in which an education in psychology is helpful and sometimes required. For example, the Medical College Admission Test (MCAT) exam that people must take to be admitted to medical school now includes a section on the psychological foundations of behavior. \n\n Ranking \n\n Occupation \n\n 1 \n\n Mid- and top-level management (executive, administrator) \n\n 2 \n\n Sales \n\n 3 \n\n Social work \n\n 4 \n\n Other management positions \n\n 5 \n\n Human resources (personnel, training) \n\n 6 \n\n Other administrative positions \n\n 7 \n\n Insurance, real estate, business \n\n 8 \n\n Marketing and sales \n\n 9 \n\n Healthcare (nurse, pharmacist, therapist) \n\n 10 \n\n Finance (accountant, auditor) \n\n Table  1.1   Top Occupations Employing Graduates with a BA in Psychology (Fogg, Harrington, Harrington, & Shatkin, 2012) \n\n Link to Learning \n\n Watch a  brief video  describing some of the career options available to people earning bachelor\u2019s degrees in psychology. ", "questions": [{"question": {"question_id": "fs-idp4416400", "question_text": "Which of the following was mentioned as a skill to which psychology students would be exposed?", "question_choices": ["critical thinking", "use of the scientific method", "critical evaluation of sources of information", "all of the above"], "cloze_format": "___ is a skill to which psychology students would be exposed.", "normal_format": "Which of the following was mentioned as a skill to which psychology students would be exposed?"}, "answer": {"ans_text": "all of the above", "ans_choice": 3}, "bloom": null, "hl_sentences": "An education in psychology is valuable for a number of reasons . Psychology students hone critical thinking skills and are trained in the use of the scientific method . Critical thinking is the active application of a set of skills to information for the understanding and evaluation of that information . The evaluation of information \u2014 assessing its reliability and usefulness \u2014 is an important skill in a world full of competing \u201c facts , \u201d many of which are designed to be misleading . Together , these factors increase students \u2019 scientific literacy and prepare students to critically evaluate the various sources of information they encounter .", "hl_context": "<hl> An education in psychology is valuable for a number of reasons . <hl> <hl> Psychology students hone critical thinking skills and are trained in the use of the scientific method . <hl> <hl> Critical thinking is the active application of a set of skills to information for the understanding and evaluation of that information . <hl> <hl> The evaluation of information \u2014 assessing its reliability and usefulness \u2014 is an important skill in a world full of competing \u201c facts , \u201d many of which are designed to be misleading . <hl> For example , critical thinking involves maintaining an attitude of skepticism , recognizing internal biases , making use of logical thinking , asking appropriate questions , and making observations . Psychology students also can develop better communication skills during the course of their undergraduate coursework ( American Psychological Association , 2011 ) . <hl> Together , these factors increase students \u2019 scientific literacy and prepare students to critically evaluate the various sources of information they encounter . <hl> In addition to these broad-based skills , psychology students come to understand the complex factors that shape one \u2019 s behavior . They appreciate the interaction of our biology , our environment , and our experiences in determining who we are and how we will behave . They learn about basic principles that guide how we think and behave , and they come to recognize the tremendous diversity that exists across individuals and across cultural boundaries ( American Psychological Association , 2011 ) ."}, {"question": {"question_id": "fs-idm466592", "question_text": "Psyche is a Greek word meaning ________.", "question_choices": ["essence", "soul", "behavior", "love"], "cloze_format": "Psyche is a Greek word meaning ________.", "normal_format": "What does the Greek word psyche mean?"}, "answer": {"ans_text": "soul", "ans_choice": 1}, "bloom": null, "hl_sentences": "Psyche comes to represent the human soul \u2019 s triumph over the misfortunes of life in the pursuit of true happiness ( Bulfinch , 1855 ); in fact , the Greek word psyche means soul , and it is often represented as a butterfly .", "hl_context": "<hl> Psyche comes to represent the human soul \u2019 s triumph over the misfortunes of life in the pursuit of true happiness ( Bulfinch , 1855 ); in fact , the Greek word psyche means soul , and it is often represented as a butterfly . <hl> The word psychology was coined at a time when the concepts of soul and mind were not as clearly distinguished ( Green , 2001 ) . The root ology denotes scientific study of , and psychology refers to the scientific study of the mind . Since science studies only observable phenomena and the mind is not directly observable , we expand this definition to the scientific study of mind and behavior . The scientific study of any aspect of the world uses the scientific method to acquire knowledge . To apply the scientific method , a researcher with a question about how or why something happens will propose a tentative explanation , called a hypothesis , to explain the phenomenon . A hypothesis is not just any explanation ; it should fit into the context of a scientific theory . A scientific theory is a broad explanation or group of explanations for some aspect of the natural world that is consistently supported by evidence over time . A theory is the best understanding that we have of that part of the natural world . Armed with the hypothesis , the researcher then makes observations or , better still , carries out an experiment to test the validity of the hypothesis . That test and its results are then published so that others can check the results or build on them . It is necessary that any explanation in science be testable , which means that the phenomenon must be perceivable and measurable . For example , that a bird sings because it is happy is not a testable hypothesis , since we have no way to measure the happiness of a bird . We must ask a different question , perhaps about the brain state of the bird , since this can be measured . In general , science deals only with matter and energy , that is , those things that can be measured , and it cannot arrive at knowledge about values and morality . This is one reason why our scientific understanding of the mind is so limited , since thoughts , at least as we experience them , are neither matter nor energy . The scientific method is also a form of empiricism . An empirical method for acquiring knowledge is one based on observation , including experimentation , rather than a method based only on forms of logical argument or previous authorities ."}, {"question": {"question_id": "fs-idp825600", "question_text": "Before psychology became a recognized academic discipline, matters of the mind were undertaken by those in ________.", "question_choices": ["biology", "chemistry", "philosophy", "physics"], "cloze_format": "Before psychology became a recognized academic discipline, matters of the mind were undertaken by those in ________.", "normal_format": "Before psychology became a recognized academic discipline, matters of the mind were undertaken by those in which of the following?"}, "answer": {"ans_text": "philosophy", "ans_choice": 2}, "bloom": null, "hl_sentences": "Two men , working in the 19th century , are generally credited as being the founders of psychology as a science and academic discipline that was distinct from philosophy . It was not until the late 1800s that psychology became accepted as its own academic discipline . Before this time , the workings of the mind were considered under the auspices of philosophy .", "hl_context": "Psychology is a relatively young science with its experimental roots in the 19th century , compared , for example , to human physiology , which dates much earlier . As mentioned , anyone interested in exploring issues related to the mind generally did so in a philosophical context prior to the 19th century . <hl> Two men , working in the 19th century , are generally credited as being the founders of psychology as a science and academic discipline that was distinct from philosophy . <hl> Their names were Wilhelm Wundt and William James . This section will provide an overview of the shifts in paradigms that have influenced psychology from Wundt and James through today . <hl> It was not until the late 1800s that psychology became accepted as its own academic discipline . <hl> <hl> Before this time , the workings of the mind were considered under the auspices of philosophy . <hl> Given that any behavior is , at its roots , biological , some areas of psychology take on aspects of a natural science like biology . No biological organism exists in isolation , and our behavior is influenced by our interactions with others . Therefore , psychology is also a social science ."}, {"question": {"question_id": "fs-idm383392", "question_text": "In the scientific method, a hypothesis is a(n) ________.", "question_choices": ["observation", "measurement", "test", "proposed explanation"], "cloze_format": "In the scientific method, a hypothesis is a(n) ________.", "normal_format": "In the scientific method, what is a hypothesis?"}, "answer": {"ans_text": "proposed explanation", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "To apply the scientific method , a researcher with a question about how or why something happens will propose a tentative explanation , called a hypothesis , to explain the phenomenon . A hypothesis is not just any explanation ; it should fit into the context of a scientific theory .", "hl_context": "Psyche comes to represent the human soul \u2019 s triumph over the misfortunes of life in the pursuit of true happiness ( Bulfinch , 1855 ); in fact , the Greek word psyche means soul , and it is often represented as a butterfly . The word psychology was coined at a time when the concepts of soul and mind were not as clearly distinguished ( Green , 2001 ) . The root ology denotes scientific study of , and psychology refers to the scientific study of the mind . Since science studies only observable phenomena and the mind is not directly observable , we expand this definition to the scientific study of mind and behavior . The scientific study of any aspect of the world uses the scientific method to acquire knowledge . <hl> To apply the scientific method , a researcher with a question about how or why something happens will propose a tentative explanation , called a hypothesis , to explain the phenomenon . <hl> <hl> A hypothesis is not just any explanation ; it should fit into the context of a scientific theory . <hl> A scientific theory is a broad explanation or group of explanations for some aspect of the natural world that is consistently supported by evidence over time . A theory is the best understanding that we have of that part of the natural world . Armed with the hypothesis , the researcher then makes observations or , better still , carries out an experiment to test the validity of the hypothesis . That test and its results are then published so that others can check the results or build on them . It is necessary that any explanation in science be testable , which means that the phenomenon must be perceivable and measurable . For example , that a bird sings because it is happy is not a testable hypothesis , since we have no way to measure the happiness of a bird . We must ask a different question , perhaps about the brain state of the bird , since this can be measured . In general , science deals only with matter and energy , that is , those things that can be measured , and it cannot arrive at knowledge about values and morality . This is one reason why our scientific understanding of the mind is so limited , since thoughts , at least as we experience them , are neither matter nor energy . The scientific method is also a form of empiricism . An empirical method for acquiring knowledge is one based on observation , including experimentation , rather than a method based only on forms of logical argument or previous authorities ."}, {"question": {"question_id": "fs-idm59818416", "question_text": "Based on your reading, which theorist would have been most likely to agree with this statement: Perceptual phenomena are best understood as a combination of their components.", "question_choices": ["William James", "Max Wertheimer", "Carl Rogers", "Noam Chomsky"], "cloze_format": "___ says: 'Perceptual phenomena are best understood as a combination of their components.", "normal_format": "Based on your reading, which theorist would have been most likely to agree with this statement: Perceptual phenomena are best understood as a combination of their components."}, "answer": {"ans_text": "Max Wertheimer", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Max Wertheimer ( 1880 \u2013 1943 ) , Kurt Koffka ( 1886 \u2013 1941 ) , and Wolfgang K\u00f6hler ( 1887 \u2013 1967 ) were three German psychologists who immigrated to the United States in the early 20th century to escape Nazi Germany . These men are credited with introducing psychologists in the United States to various Gestalt principles . The word Gestalt roughly translates to \u201c whole ; \u201d a major emphasis of Gestalt psychology deals with the fact that although a sensory experience can be broken down into individual parts , how those parts relate to each other as a whole is often what the individual responds to in perception .", "hl_context": "<hl> Max Wertheimer ( 1880 \u2013 1943 ) , Kurt Koffka ( 1886 \u2013 1941 ) , and Wolfgang K\u00f6hler ( 1887 \u2013 1967 ) were three German psychologists who immigrated to the United States in the early 20th century to escape Nazi Germany . <hl> <hl> These men are credited with introducing psychologists in the United States to various Gestalt principles . <hl> <hl> The word Gestalt roughly translates to \u201c whole ; \u201d a major emphasis of Gestalt psychology deals with the fact that although a sensory experience can be broken down into individual parts , how those parts relate to each other as a whole is often what the individual responds to in perception . <hl> For example , a song may be made up of individual notes played by different instruments , but the real nature of the song is perceived in the combinations of these notes as they form the melody , rhythm , and harmony . In many ways , this particular perspective would have directly contradicted Wundt \u2019 s ideas of structuralism ( Thorne & Henley , 2005 ) ."}, {"question": {"question_id": "fs-idm92509952", "question_text": "________ is most well-known for proposing his hierarchy of needs.", "question_choices": ["Noam Chomsky", "Carl Rogers", "Abraham Maslow", "Sigmund Freud"], "cloze_format": "________ is most well-known for proposing his hierarchy of needs.", "normal_format": "Who is most well-known for proposing his hierarchy of needs?"}, "answer": {"ans_text": "Abraham Maslow", "ans_choice": 2}, "bloom": null, "hl_sentences": "Abraham Maslow ( 1908 \u2013 1970 ) was an American psychologist who is best known for proposing a hierarchy of human needs in motivating behavior ( Figure 1.8 ) .", "hl_context": "<hl> Abraham Maslow ( 1908 \u2013 1970 ) was an American psychologist who is best known for proposing a hierarchy of human needs in motivating behavior ( Figure 1.8 ) . <hl> Although this concept will be discussed in more detail in a later chapter , a brief overview will be provided here . Maslow asserted that so long as basic needs necessary for survival were met ( e . g . , food , water , shelter ) , higher-level needs ( e . g . , social needs ) would begin to motivate behavior . According to Maslow , the highest-level needs relate to self-actualization , a process by which we achieve our full potential . Obviously , the focus on the positive aspects of human nature that are characteristic of the humanistic perspective is evident ( Thorne & Henley , 2005 ) . Humanistic psychologists rejected , on principle , the research approach based on reductionist experimentation in the tradition of the physical and biological sciences , because it missed the \u201c whole \u201d human being . Beginning with Maslow and Rogers , there was an insistence on a humanistic research program . This program has been largely qualitative ( not measurement-based ) , but there exist a number of quantitative research strains within humanistic psychology , including research on happiness , self-concept , meditation , and the outcomes of humanistic psychotherapy ( Friedman , 2008 ) ."}, {"question": {"question_id": "fs-idm96967936", "question_text": "Rogers believed that providing genuineness, empathy, and ________ in the therapeutic environment for his clients was critical to their being able to deal with their problems.", "question_choices": ["structuralism", "functionalism", "Gestalt", "unconditional positive regard"], "cloze_format": "Rogers believed that providing genuineness, empathy, and ________ in the therapeutic environment for his clients was critical to their being able to deal with their problems.", "normal_format": "Rogers believed that providing genuineness, empathy, and which of the following in the therapeutic environment for his clients was critical to their being able to deal with their problems?"}, "answer": {"ans_text": "unconditional positive regard", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Rogers believed that a therapist needed to display three features to maximize the effectiveness of this particular approach : unconditional positive regard , genuineness , and empathy . Unconditional positive regard refers to the fact that the therapist accepts their client for who they are , no matter what he or she might say .", "hl_context": "Carl Rogers ( 1902 \u2013 1987 ) was also an American psychologist who , like Maslow , emphasized the potential for good that exists within all people ( Figure 1.9 ) . Rogers used a therapeutic technique known as client-centered therapy in helping his clients deal with problematic issues that resulted in their seeking psychotherapy . Unlike a psychoanalytic approach in which the therapist plays an important role in interpreting what conscious behavior reveals about the unconscious mind , client-centered therapy involves the patient taking a lead role in the therapy session . <hl> Rogers believed that a therapist needed to display three features to maximize the effectiveness of this particular approach : unconditional positive regard , genuineness , and empathy . <hl> <hl> Unconditional positive regard refers to the fact that the therapist accepts their client for who they are , no matter what he or she might say . <hl> Provided these factors , Rogers believed that people were more than capable of dealing with and working through their own issues ( Thorne & Henley , 2005 ) ."}, {"question": {"question_id": "fs-idm25931216", "question_text": "The operant conditioning chamber (aka ________ box) is a device used to study the principles of operant conditioning.", "question_choices": ["Skinner", "Watson", "James", "Koffka"], "cloze_format": "The operant conditioning chamber (aka ________ box) is a device used to study the principles of operant conditioning.", "normal_format": "The operant conditioning chamber also known as what box is a device used to study the principles of operant conditioning?"}, "answer": {"ans_text": "Skinner", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The Skinner box is a chamber that isolates the subject from the external environment and has a behavior indicator such as a lever or a button . As a part of his research , Skinner developed a chamber that allowed the careful study of the principles of modifying behavior through reinforcement and punishment . This device , known as an operant conditioning chamber ( or more familiarly , a Skinner box ) , has remained a crucial resource for researchers studying behavior ( Thorne & Henley , 2005 ) .", "hl_context": "<hl> The Skinner box is a chamber that isolates the subject from the external environment and has a behavior indicator such as a lever or a button . <hl> When the animal pushes the button or lever , the box is able to deliver a positive reinforcement of the behavior ( such as food ) or a punishment ( such as a noise ) or a token conditioner ( such as a light ) that is correlated with either the positive reinforcement or punishment . Behaviorism dominated experimental psychology for several decades , and its influence can still be felt today ( Thorne & Henley , 2005 ) . Behaviorism is largely responsible for establishing psychology as a scientific discipline through its objective methods and especially experimentation . In addition , it is used in behavioral and cognitive-behavioral therapy . Behavior modification is commonly used in classroom settings . Behaviorism has also led to research on environmental influences on human behavior . B . F . Skinner ( 1904 \u2013 1990 ) was an American psychologist ( Figure 1.7 ) . Like Watson , Skinner was a behaviorist , and he concentrated on how behavior was affected by its consequences . Therefore , Skinner spoke of reinforcement and punishment as major factors in driving behavior . <hl> As a part of his research , Skinner developed a chamber that allowed the careful study of the principles of modifying behavior through reinforcement and punishment . <hl> <hl> This device , known as an operant conditioning chamber ( or more familiarly , a Skinner box ) , has remained a crucial resource for researchers studying behavior ( Thorne & Henley , 2005 ) . <hl>"}, {"question": {"question_id": "fs-idm1884688", "question_text": "An individual\u2019s consistent pattern of thought and behavior is known as a(n) ________.", "question_choices": ["psychosexual stage", "object permanence", "personality", "perception"], "cloze_format": "An individual\u2019s consistent pattern of thought and behavior is known as a(n) ________.", "normal_format": "What is an individual\u2019s consistent pattern of thought and behavior known as?"}, "answer": {"ans_text": "personality", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Personality traits are relatively consistent patterns of thought and behavior , and many have proposed that five trait dimensions are sufficient to capture the variations in personality seen across individuals . Personality psychology focuses on patterns of thoughts and behaviors that make each individual unique .", "hl_context": "More recently , the study of personality has taken on a more quantitative approach . Rather than explaining how personality arises , research is focused on identifying personality traits , measuring these traits , and determining how these traits interact in a particular context to determine how a person will behave in any given situation . <hl> Personality traits are relatively consistent patterns of thought and behavior , and many have proposed that five trait dimensions are sufficient to capture the variations in personality seen across individuals . <hl> These five dimensions are known as the \u201c Big Five \u201d or the Five Factor model , and include dimensions of conscientiousness , agreeableness , neuroticism , openness , and extraversion ( Figure 1.14 ) . Each of these traits has been demonstrated to be relatively stable over the lifespan ( e . g . , Rantanen , Mets\u00e4pelto , Feldt , Pulkinnen , and Kokko , 2007 ; Soldz & Vaillant , 1999 ; McCrae & Costa , 2008 ) and is influenced by genetics ( e . g . , Jang , Livesly , and Vernon , 1996 ) . <hl> Personality psychology focuses on patterns of thoughts and behaviors that make each individual unique . <hl> Several individuals ( e . g . , Freud and Maslow ) that we have already discussed in our historical overview of psychology , and the American psychologist Gordon Allport , contributed to early theories of personality . These early theorists attempted to explain how an individual \u2019 s personality develops from his or her given perspective . For example , Freud proposed that personality arose as conflicts between the conscious and unconscious parts of the mind were carried out over the lifespan . Specifically , Freud theorized that an individual went through various psychosexual stages of development . According to Freud , adult personality would result from the resolution of various conflicts that centered on the migration of erogenous ( or sexual pleasure-producing ) zones from the oral ( mouth ) to the anus to the phallus to the genitals . Like many of Freud \u2019 s theories , this particular idea was controversial and did not lend itself to experimental tests ( Person , 1980 ) ."}, {"question": {"question_id": "fs-idp480", "question_text": "A researcher interested in what factors make an employee best suited for a given job would most likely identify as a(n) ________ psychologist.", "question_choices": ["personality", "clinical", "social", "I-O"], "cloze_format": "A researcher interested in what factors make an employee best suited for a given job would most likely identify as a(n) ________ psychologist.", "normal_format": "A researcher interested in what factors make an employee best suited for a given job would most likely identify as which type of psychologist?"}, "answer": {"ans_text": "I-O", "ans_choice": 3}, "bloom": null, "hl_sentences": "I-O psychologists are often involved in issues related to personnel management , organizational structure , and workplace environment . Businesses often seek the aid of I-O psychologists to make the best hiring decisions as well as to create an environment that results in high levels of employee productivity and efficiency .", "hl_context": "Industrial-Organizational psychology ( I-O psychology ) is a subfield of psychology that applies psychological theories , principles , and research findings in industrial and organizational settings . <hl> I-O psychologists are often involved in issues related to personnel management , organizational structure , and workplace environment . <hl> <hl> Businesses often seek the aid of I-O psychologists to make the best hiring decisions as well as to create an environment that results in high levels of employee productivity and efficiency . <hl> In addition to its applied nature , I-O psychology also involves conducting scientific research on behavior within I-O settings ( Riggio , 2013 ) ."}, {"question": {"question_id": "fs-idp70150048", "question_text": "If someone wanted to become a psychology professor at a 4-year college, then s/he would probably need a ________ degree in psychology.", "question_choices": ["bachelor of science", "bachelor of art", "master\u2019s", "PhD"], "cloze_format": "If someone wanted to become a psychology professor at a 4-year college, then s/he would probably need a ________ degree in psychology.", "normal_format": "If someone wanted to become a psychology professor at a 4-year college, which degree in psychology would s/he probably need?"}, "answer": {"ans_text": "PhD", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Alternatively , they may not hold the doctoral degree required by most 4 - year institutions and use these opportunities to gain experience in teaching . Psychologists can work in many different places doing many different things . In general , anyone wishing to continue a career in psychology at a 4 - year institution of higher education will have to earn a doctoral degree in psychology for some specialties and at least a master \u2019 s degree for others . In most areas of psychology , this means earning a PhD in a relevant area of psychology . Literally , PhD refers to a doctor of philosophy degree , but here , philosophy does not refer to the field of philosophy per se .", "hl_context": "Often times , schools offer more courses in psychology than their full-time faculty can teach . In these cases , it is not uncommon to bring in an adjunct faculty member or instructor . Adjunct faculty members and instructors usually have an advanced degree in psychology , but they often have primary careers outside of academia and serve in this role as a secondary job . <hl> Alternatively , they may not hold the doctoral degree required by most 4 - year institutions and use these opportunities to gain experience in teaching . <hl> Furthermore , many 2 - year colleges and schools need faculty to teach their courses in psychology . In general , many of the people who pursue careers at these institutions have master \u2019 s degrees in psychology , although some PhDs make careers at these institutions as well . <hl> Psychologists can work in many different places doing many different things . <hl> <hl> In general , anyone wishing to continue a career in psychology at a 4 - year institution of higher education will have to earn a doctoral degree in psychology for some specialties and at least a master \u2019 s degree for others . <hl> <hl> In most areas of psychology , this means earning a PhD in a relevant area of psychology . <hl> <hl> Literally , PhD refers to a doctor of philosophy degree , but here , philosophy does not refer to the field of philosophy per se . <hl> Rather , philosophy in this context refers to many different disciplinary perspectives that would be housed in a traditional college of liberal arts and sciences . The requirements to earn a PhD vary from country to country and even from school to school , but usually , individuals earning this degree must complete a dissertation . A dissertation is essentially a long research paper or bundled published articles describing research that was conducted as a part of the candidate \u2019 s doctoral training . In the United States , a dissertation generally has to be defended before a committee of expert reviewers before the degree is conferred ( Figure 1.18 ) ."}, {"question": {"question_id": "fs-idm39495328", "question_text": "The ________ places less emphasis on research and more emphasis on application of therapeutic skills.", "question_choices": ["PhD", "PsyD", "postdoctoral training program", "dissertation"], "cloze_format": "The ________ places less emphasis on research and more emphasis on application of therapeutic skills.", "normal_format": "Which places less emphasis on research and more emphasis on application of therapeutic skills?"}, "answer": {"ans_text": "PsyD", "ans_choice": 1}, "bloom": null, "hl_sentences": "PsyD programs generally place less emphasis on research-oriented skills and focus more on application of psychological principles in the clinical context ( Norcorss & Castle , 2002 ) .", "hl_context": "Individuals who wish to become practicing clinical psychologists have another option for earning a doctoral degree , which is known as a PsyD . A PsyD is a doctor of psychology degree that is increasingly popular among individuals interested in pursuing careers in clinical psychology . <hl> PsyD programs generally place less emphasis on research-oriented skills and focus more on application of psychological principles in the clinical context ( Norcorss & Castle , 2002 ) . <hl>"}, {"question": {"question_id": "fs-idm31888944", "question_text": "Which of the following degrees would be the minimum required to teach psychology courses in high school?", "question_choices": ["PhD", "PsyD", "master\u2019s degree", "bachelor\u2019s degree"], "cloze_format": "A ___ is minimum required to teach psychology courses in high school.", "normal_format": "Which of the following degrees would be the minimum required to teach psychology courses in high school?"}, "answer": {"ans_text": "bachelor\u2019s degree", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "It should come as no surprise , then , that individuals earning bachelor \u2019 s degrees in psychology find themselves in a number of different careers , as shown in Table 1.1 . Examples of a few such careers can involve serving as case managers , working in sales , working in human resource departments , and teaching in high schools . Furthermore , many 2 - year colleges and schools need faculty to teach their courses in psychology . In general , many of the people who pursue careers at these institutions have master \u2019 s degrees in psychology , although some PhDs make careers at these institutions as well .", "hl_context": "As mentioned in the opening section of this chapter , an undergraduate education in psychology is associated with a knowledge base and skill set that many employers find quite attractive . <hl> It should come as no surprise , then , that individuals earning bachelor \u2019 s degrees in psychology find themselves in a number of different careers , as shown in Table 1.1 . <hl> <hl> Examples of a few such careers can involve serving as case managers , working in sales , working in human resource departments , and teaching in high schools . <hl> The rapidly growing realm of healthcare professions is another field in which an education in psychology is helpful and sometimes required . For example , the Medical College Admission Test ( MCAT ) exam that people must take to be admitted to medical school now includes a section on the psychological foundations of behavior . Often times , schools offer more courses in psychology than their full-time faculty can teach . In these cases , it is not uncommon to bring in an adjunct faculty member or instructor . Adjunct faculty members and instructors usually have an advanced degree in psychology , but they often have primary careers outside of academia and serve in this role as a secondary job . Alternatively , they may not hold the doctoral degree required by most 4 - year institutions and use these opportunities to gain experience in teaching . <hl> Furthermore , many 2 - year colleges and schools need faculty to teach their courses in psychology . <hl> <hl> In general , many of the people who pursue careers at these institutions have master \u2019 s degrees in psychology , although some PhDs make careers at these institutions as well . <hl>"}, {"question": {"question_id": "fs-idp72223280", "question_text": "One would need at least a(n) ________ degree to serve as a school psychologist.", "question_choices": ["associate\u2019s", "bachelor\u2019s", "master\u2019s", "doctoral"], "cloze_format": "One would need at least a(n) ________ degree to serve as a school psychologist.", "normal_format": "One would need at least which degree to serve as a school psychologist?"}, "answer": {"ans_text": "master\u2019s", "ans_choice": 2}, "bloom": null, "hl_sentences": "Relevant master \u2019 s degrees are also sufficient for individuals seeking careers as school psychologists ( National Association of School Psychologists , n . d . ) , in some capacities related to sport psychology ( American Psychological Association , 2014 ) , or as consultants in various industrial settings ( Landers , 2011 , June 14 ) .", "hl_context": "While earning a doctoral degree in psychology is a lengthy process , usually taking between 5 \u2013 6 years of graduate study ( DeAngelis , 2010 ) , there are a number of careers that can be attained with a master \u2019 s degree in psychology . People who wish to provide psychotherapy can become licensed to serve as various types of professional counselors ( Hoffman , 2012 ) . <hl> Relevant master \u2019 s degrees are also sufficient for individuals seeking careers as school psychologists ( National Association of School Psychologists , n . d . ) , in some capacities related to sport psychology ( American Psychological Association , 2014 ) , or as consultants in various industrial settings ( Landers , 2011 , June 14 ) . <hl> Undergraduate coursework in psychology may be applicable to other careers such as psychiatric social work or psychiatric nursing , where assessments and therapy may be a part of the job ."}], "summary": " Summary 1.1   What Is Psychology? \n\n Psychology derives from the roots  psyche  (meaning soul) and  \u2013ology  (meaning scientific study of). Thus, psychology is defined as the scientific study of mind and behavior. Students of psychology develop critical thinking skills, become familiar with the scientific method, and recognize the complexity of behavior. \n\n 1.2   History of Psychology Before the time of Wundt and James, questions about the mind were considered by philosophers. However, both Wundt and James helped create psychology as a distinct scientific discipline. Wundt was a structuralist, which meant he believed that our cognitive experience was best understood by breaking that experience into its component parts. He thought this was best accomplished by introspection. \n\n William James was the first American psychologist, and he was a proponent of functionalism. This particular perspective focused on how mental activities served as adaptive responses to an organism\u2019s environment. Like Wundt, James also relied on introspection; however, his research approach also incorporated more objective measures as well. \n\n Sigmund Freud believed that understanding the unconscious mind was absolutely critical to understand conscious behavior. This was especially true for individuals that he saw who suffered from various hysterias and neuroses. Freud relied on dream analysis, slips of the tongue, and free association as means to access the unconscious. Psychoanalytic theory remained a dominant force in clinical psychology for several decades. \n\n Gestalt psychology was very influential in Europe. Gestalt psychology takes a holistic view of an individual and his experiences. As the Nazis came to power in Germany, Wertheimer, Koffka, and K\u00f6hler immigrated to the United States. Although they left their laboratories and their research behind, they did introduce America to Gestalt ideas. Some of the principles of Gestalt psychology are still very influential in the study of sensation and perception. \n\n One of the most influential schools of thought within psychology\u2019s history was behaviorism. Behaviorism focused on making psychology an objective science by studying overt behavior and deemphasizing the importance of unobservable mental processes. John Watson is often considered the father of behaviorism, and B. F. Skinner\u2019s contributions to our understanding of principles of operant conditioning cannot be underestimated. \n\n As behaviorism and psychoanalytic theory took hold of so many aspects of psychology, some began to become dissatisfied with psychology\u2019s picture of human nature. Thus, a humanistic movement within psychology began to take hold. Humanism focuses on the potential of all people for good. Both Maslow and Rogers were influential in shaping humanistic psychology. \n\n During the 1950s, the landscape of psychology began to change. A science of behavior began to shift back to its roots of focus on mental processes. The emergence of neuroscience and computer science aided this transition. Ultimately, the cognitive revolution took hold, and people came to realize that cognition was crucial to a true appreciation and understanding of behavior. \n\n 1.3   Contemporary Psychology \n\n Psychology is a diverse discipline that is made up of several major subdivisions with unique perspectives. Biological psychology involves the study of the biological bases of behavior. Sensation and perception refer to the area of psychology that is focused on how information from our sensory modalities is received, and how this information is transformed into our perceptual experiences of the world around us. Cognitive psychology is concerned with the relationship that exists between thought and behavior, and developmental psychologists study the physical and cognitive changes that occur throughout one\u2019s lifespan. Personality psychology focuses on individuals\u2019 unique patterns of behavior, thought, and emotion. Industrial and organizational psychology, health psychology, sport and exercise psychology, forensic psychology, and clinical psychology are all considered applied areas of psychology. Industrial and organizational psychologists apply psychological concepts to I-O settings. Health psychologists look for ways to help people live healthier lives, and clinical psychology involves the diagnosis and treatment of psychological disorders and other problematic behavioral patterns. Sport and exercise psychologists study the interactions between thoughts, emotions, and physical performance in sports, exercise, and other activities. Forensic psychologists carry out activities related to psychology in association with the justice system. \n\n 1.4   Careers in Psychology Generally, academic careers in psychology require doctoral degrees. However, there are a number of nonacademic career options for people who have master\u2019s degrees in psychology. While people with bachelor\u2019s degrees in psychology have more limited psychology-related career options, the skills acquired as a function of an undergraduate education in psychology are useful in a variety of work contexts. ", "keyterm": "", "bname": "psychology"}, {"chapter": 6, "intro": "Learning Objectives 6.1   Types of Groups \n\n Understand primary and secondary groups as the two sociological groups \n\n Recognize in-groups and out-groups as subtypes of primary and secondary groups \n\n Define reference groups 6.2   Group Size and Structure \n\n How size influences group dynamics \n\n Different styles of leadership \n\n How conformity is impacted by groups \n\n 6.3   Formal Organizations \n\n Understand the different types of formal organizations \n\n Recognize the characteristics of bureaucracies \n\n Identify the concepts of the McJob and the McDonaldization of society \n\n Introduction to Groups and Organizations \n\n The alternative punk band NOFX is playing outside in Los Angeles. The music is loud, the crowd pumped up and excited. But neither the lyrics nor the people in the audience are quite what you might expect. Mixed in with the punks and young rebel students are members of local unions, from well-dressed teachers to more grizzled labor leaders. The lyrics are not published anywhere but are available on YouTube: \u201cWe\u2019re here to represent/The 99 percent/Occupy, occupy, occupy.\u201d The song: \u201cWouldn\u2019t It Be Nice If Every Movement Had a Theme Song\u201d (Cabrel 2011). Across the country at an Occupy camp in New York, roughly three dozen members of the Facilitation Working Group, a part of the General Assembly, take a steady stream of visitors with requests at their unofficial headquarters. One person wants a grant for $1500 to make herbal medications available to those staying at the park. Another wants to present Native American peace principles derived from the Iroquois Confederacy. Yet another has a spreadsheet that he wants used as an evaluation tool for the facilitators. Numerous groups make up this movement, yet there\u2019s no national leader. What makes a group something more than just a collection of people? How are leadership functions and styles established in a group dynamic?  \n\n Most people have a sense of what it means to be a part of some kind of a group, whether it is a sports team, sorority, school club, or family. Groups connect us to others through commonalities of geography, interests, race, religion, and activities. But for the groups of people protesting from Augusta, Georgia, to Oakland, California, and hundreds of cities in between, their connection within the Occupy Wall Street movement is harder to define. What unites these people? Are the out-of-work doctoral candidates truly aligned with the high school dropouts? Do the urban poor genuinely feel for the campus-based protest against university tuition hikes? \n\n Groups are prevalent in our social lives and provide a significant way we understand and define ourselves\u2014both through groups we feel a connection to and those we don\u2019t. Groups also play an important role in society. As enduring social units, they help foster shared value systems and are key to the structure of society as we know it. There are three primary sociological perspectives for studying groups: Functionalist, Conflict, and Interactionist. We can look at the Occupy movement through the lenses of these methods to better understand the roles and challenges that groups offer. \n\n The Functionalist perspective is a big-picture macro-level view that looks at how different aspects of society are intertwined. This perspective is based on the idea that society is a well-balanced system with all parts necessary to the whole, and it studies the roles these parts play in relation to the whole. In the case of the Occupy Movement, a Functionalist might look at what macro-level needs the movement serves. For example, a Structural Functionalist might ask how the Occupy Wall Street movement forces both haves and have-nots to pay attention to the economy, or the way urbanites are impacted by the influx of protestors who typically reside outside of their region. \n\n The Conflict perspective is another macroanalytical view, one that focuses on the genesis and growth of inequality. A conflict theorist studying the Occupy movement might look at how business interests have manipulated the system over the last 30 years, leading to the gross inequality we see today. Or this perspective might explore how the massive redistribution of wealth from the middle class to the upper class could lead to a two-class system reminiscent of Marxist ideas.  A third perspective is the Symbolic Interaction or Interactionist perspective. This method of analyzing groups takes a micro-level view. Instead of studying the big picture, these researchers look at the day-to-day interactions of groups. Studying these details, the Interactionist looks at issues like leadership style and group dynamics. In the case of the Occupy Movement, Interactionists might ask, \u201cHow does the group dynamic in New York differ from that in Atlanta?\u201d Or, \u201cWhat dictates who becomes the  de facto  leader in different cities\u2014geography, social dynamics, economic circumstances?\u201d ", "chapter_text": "6.1   Types of Groups \n\n Most of us feel comfortable using the word \u201cgroup\u201d without giving it much thought. In everyday use, it can be a generic term, although it carries important clinical and scientific meanings. Moreover, the concept of a group is central to much of how we think about society and human interaction. Often, we might mean different things by using that word. We might say that a group of kids all saw the dog, and it could mean 250 students in a lecture hall or four siblings playing on a front lawn. In everyday conversation, there isn\u2019t a clear distinguishing use. So how can we hone the meaning more precisely for sociological purposes? Defining a Group \n\n The term  group  is an amorphous one and can refer to a wide variety of gatherings, from just two people (think about a \u201cgroup project\u201d in school when you partner with another student), a club, a regular gathering of friends, or people who work together or share a hobby. In short, the term refers to any collection of at least two people who interact with some frequency and who share a sense that their identity is somehow aligned with the group. Of course, every time people are gathered it is not necessarily a group. A rally is usually a one-time event, for instance, and belonging to a political party doesn\u2019t imply interaction with others. People who exist in the same place at the same time, but who do not interact or share a sense of identity\u2014such as a bunch of people standing in line at Starbucks\u2014are considered an  aggregate , or a crowd. Another example of a non-group is people who share similar characteristics but are not tied to one another in any way. These people would be considered a  category , and an example would be that all children born from approximately 1980\u20132000 are referred to as \u201cMillennial.\u201d Why are Millennials a category and not a group? Because while some of them may share a sense of identity, they do not, as a whole, interact frequently with each other. \n\n Interestingly, people within an aggregate or category can become a group. During disasters, people in a neighborhood (an aggregate) who did not know each other might become friendly and depend on each other at the local shelter. After the disaster ends and the people go back to simply living near each other, the feeling of cohesiveness may last since they have all shared an experience. They might remain a group, practicing emergency readiness, coordinating supplies for next time, or taking turns caring for neighbors who need extra help. Similarly, there may be many groups within a single category. Consider teachers, for example. Within this category, groups may exist like teachers\u2019 unions, teachers who coach, or staff members who are involved with the PTA. \n\n Types of Groups \n\n Sociologist Charles Horton Cooley (1864\u20131929) suggested that groups can broadly be divided into two categories:  primary groups  and  secondary groups  (Cooley 1909). According to Cooley, primary groups play the most critical role in our lives. The primary group is usually fairly small and is made up of individuals who generally engage face-to-face in long-term emotional ways. This group serves emotional needs:  expressive functions  rather than pragmatic ones. The primary group is usually made up of significant others, those individuals who have the most impact on our socialization. The best example of a primary group is the family. Secondary groups are often larger and impersonal. They may also be task-focused and time-limited. These groups serve an  instrumental function  rather than an expressive one, meaning that their role is more goal- or task-oriented than emotional. A classroom or office can be an example of a secondary group. Neither primary nor secondary groups are bound by strict definitions or set limits. In fact, people can move from one group to another. A graduate seminar, for example, can start as a secondary group focused on the class at hand, but as the students work together throughout their program, they may find common interests and strong ties that transform them into a primary group. \n\n Best Friends She\u2019s Never Met \n\n Writer Allison Levy worked alone. While she liked the freedom and flexibility of working from home, she sometimes missed having a community of coworkers, both for the practical purpose of brainstorming and the more social \u201cwater cooler\u201d aspect. Levy did what many do in the internet age: she found a group of other writers online through a web forum. Over time, a group of approximately 20 writers, who all wrote for a similar audience, broke off from the larger forum and started a private invitation-only forum. While writers in general represent all genders, ages, and interests, it ended up being a collection of 20- and 30-something women who comprised the new forum; they all wrote fiction for children and young adults. \n\n At first, the writers\u2019 forum was clearly a secondary group united by the members\u2019 professions and work situations. As Levy explained, \u201cOn the internet, you can be present or absent as often as you want. No one is expecting you to show up.\u201d It was a useful place to research information about different publishers and about who had recently sold what, and to track industry trends. But as time passed, Levy found it served a different purpose. Since the group shared other characteristics beyond their writing (such as age and gender), the online conversation naturally turned to matters such as child-rearing, aging parents, health, and exercise. Levy found it was a sympathetic place to talk about any number of subjects, not just writing. Further, when people didn\u2019t post for several days, others expressed concern, asking whether anyone had heard from the missing writers. It reached a point where most members would tell the group if they were traveling or needed to be offline for awhile. The group continued to share. One member on the site who was going through a difficult family illness wrote, \u201cI don\u2019t know where I\u2019d be without you women. It is so great to have a place to vent that I know isn\u2019t hurting anyone.\u201d Others shared similar sentiments. \n\n So is this a primary group? Most of these people have never met each other. They live in Hawaii, Australia, Minnesota, and across the world. They may never meet. Levy wrote recently to the group, saying, \u201cMost of my \u2018real-life\u2019 friends and even my husband don\u2019t really get the writing thing. I don\u2019t know what I\u2019d do without you.\u201d Despite the distance and the lack of physical contact, the group clearly fills an expressive need. \n\n In-Groups and Out-Groups \n\n One of the ways that groups can be powerful is through inclusion, and its inverse, exclusion. In-groups and out-groups are subcategories of primary and secondary groups that help identify this dynamic. Primary groups consist of both in-groups and out-groups, as do secondary groups. The feeling that one belongs in an elite or select group is a heady one, while the feeling of not being allowed in, or of being in competition with a group, can be motivating in a different way. Sociologist William Sumner (1840\u20131910) developed the concepts of  in-group  and  out-group  to explain this phenomenon (Sumner 1906). In short, an in-group is the group that an individual feels she belongs to, and she believes it to be an integral part of who she is. An out-group, conversely, is a group someone doesn\u2019t belong to; often there may be a feeling of disdain or competition in relation to an out-group. Sports teams, unions, and sororities are examples of in-groups and out-groups; people may belong to, or be an outsider to, any of these. While these affiliations can be neutral or even positive, such as the case of a team sport competition, the concept of in-groups and out-groups can also explain some negative human behavior, such as white supremacist movements like the Ku Klux Klan, or the bullying of gay or lesbian students. By defining others as \u201cnot like us\u201d and inferior, in-groups can end up practicing ethnocentrism, racism, sexism, ageism, and heterosexism\u2014manners of judging others negatively based on their culture, race, sex, age, or sexuality. Often, in-groups can form within a secondary group. For instance, a workplace can have cliques of people, from senior executives who play golf together, to engineers who write code together, to young singles who socialize after hours. While these in-groups might show favoritism and affinity for other in-group members, the overall organization may be unable or unwilling to acknowledge it. Therefore, it pays to be wary of the politics of in-groups, since members may exclude others as a form of gaining status within the group. \n\n Big Picture Bullying and Cyberbullying: How Technology Has Changed the Game Most of us know that the old rhyme \u201csticks and stones may break my bones, but words will never hurt me\u201d is inaccurate. Words can hurt, and never is that more apparent than in instances of bullying. Bullying has always existed, often reaching extreme levels of cruelty in children and young adults. People at these stages of life are especially vulnerable to others\u2019 opinions of them, and they\u2019re deeply invested in their peer groups. Today, technology has ushered in a new era of this dynamic. Cyberbullying is the use of interactive media by one person to torment another, and it is on the rise. Cyberbullying can mean sending threatening texts, harassing someone in a public forum (such as Facebook), hacking someone\u2019s account and pretending to be him or her, posting embarrassing images online, and so on. A study by the Cyberbullying Research Center found that 20 percent of middle school students admitted to \u201cseriously thinking about committing suicide\u201d as a result of online bullying (Hinduja and Patchin 2010). Whereas bullying face-to-face requires willingness to interact with your victim, cyberbullying allows bullies to harass others from the privacy of their homes without witnessing the damage firsthand. This form of bullying is particularly dangerous because it\u2019s widely accessible and therefore easier to accomplish. \n\n Cyberbullying, and bullying in general, made international headlines in 2010 when a 15-year-old girl, Phoebe Prince, in South Hadley, Massachusetts, committed suicide after being relentlessly bullied by girls at her school. In the aftermath of her death, the bullies were prosecuted in the legal system and the state passed anti-bullying legislation. This marked a significant change in how bullying, including cyberbullying, is viewed in the United States. Now there are numerous resources for schools, families, and communities to provide education and prevention on this issue. The White House hosted a Bullying Prevention summit in March 2011, and President and First Lady Obama have used Facebook and other social media sites to discuss the importance of the issue. Will it change the behavior of would-be cyberbullies? That remains to be seen. But hopefully communities can work to protect victims before they feel they must resort to extreme measures. \n\n Reference Groups \n\n A  reference group  is a group that people compare themselves to\u2014it provides a standard of measurement. In American society, peer groups are common reference groups. Kids and adults pay attention to what their peers wear, what music they like, what they do with their free time\u2014and they compare themselves to what they see. Most people have more than one reference group, so a middle school boy might not just look at his classmates but also at his older brother\u2019s friends and see a different set of norms. And he might observe the antics of his favorite athletes for yet another set of behaviors. \n\n Some other examples of reference groups can be an individual\u2019s church, synagogue, or mosque; one\u2019s cultural center; workplace; family gathering; and even one\u2019s parents. Often, reference groups convey competing messages. For instance, on television and in movies, young adults often have wonderful apartments, cars, and lively social lives despite not holding a job. In music videos, young women might dance and sing in a sexually aggressive way that suggests experience beyond their years. At all ages, we use reference groups to help guide our behavior and show us social norms. So how important is it to surround yourself with positive reference groups? You may never meet or know a reference group, but it still impacts and influences how you act. Identifying reference groups can help you understand the source of the social identities you aspire to or want to distance yourself from. \n\n Sociology in the Real World College: A World of In-Groups, Out-Groups, and Reference Groups For a student entering college, the sociological study of groups takes on an immediate and practical meaning. After all, when we arrive someplace new, most of us glance around to see how well we fit in or stand out in the ways we want. This is a natural response to a reference group, and on a large campus, there can be many competing groups. Say you are a strong athlete who wants to play intramural sports, but your favorite musicians are a local punk band. You may find yourself engaged with two very different reference groups. \n\n These reference groups can also become your in-groups or out-groups. For instance, different groups on campus might solicit you to join. Are there fraternities and sororities at your school? If so, chances are they will try to convince students\u2014that is, students they deem worthy\u2014to join them. And if you love playing soccer and want to play on a campus team, but you\u2019re wearing shredded jeans, combat boots, and a local band T-shirt, you might have a hard time convincing the soccer team to give you a chance. While most campus groups refrain from insulting competing groups, there is a definite sense of an in-group versus an out-group. \u201cThem?\u201d a member might say. \u201cThey\u2019re all right, but their parties are nowhere near as cool as ours.\u201d Or, \u201cOnly serious engineering geeks join that group.\u201d This immediate categorization into in-groups and out-groups means that students must choose carefully, since whatever group they associate with won\u2019t just define their friends\u2014it may also define their enemies. \n6.2   Group Size and Structure \n\n Dyads, Triads, and Large Groups \n\n A small group is typically one where the collection of people is small enough that all members of the group know each other and share simultaneous interaction, such as a nuclear family, a dyad, or a triad. Georg Simmel (1858\u20131915) wrote extensively about the difference between a  dyad , or two-member group, and a  triad , which is a three-member group (Simmel 1902). In the former, if one person withdraws, the group can no longer exist. One can think of a divorce, which effectively ends the \u201cgroup\u201d of the married couple, or of two best friends never speaking again. In a triad, however, the dynamic is quite different. If one person withdraws, the group lives on. A triad has a different set of relationships. If there are three in the group, two-against-one dynamics can develop and there exists the potential for a majority opinion on any issue. Small groups generally have strong internal cohesiveness and a sense of connection. The challenge, however, is for small groups to achieve large goals. They can struggle to be heard or to be a force for change if they are pushing against larger groups. In short, they are easier to ignore. It is difficult to define exactly when a small group becomes a large group. One step might be when there are too many people to join in a simultaneous discussion. Another might be when a group joins with other groups as part of a movement that unites them. These larger groups may share a geographic space, such as a fraternity or sorority on the same campus, or they might be spread out around the globe. The larger the group, the more attention it can garner, and the more pressure members can put toward whatever goal they wish to achieve. At the same time, the larger the group becomes, the more the risk grows for division and lack of cohesion. \n\n Group Leadership \n\n Often, larger groups require some kind of leadership. In small, primary groups, leadership tends to be informal. After all, most families don\u2019t take a vote on who will rule the group, nor do most groups of friends. This is not to say that  de facto  leaders don\u2019t emerge, but formal leadership is rare. In secondary groups, leadership is usually more overt. There are often clearly outlined roles and responsibilities, with a chain of command to follow. Some secondary groups, like the army, have highly structured and clearly understood chains of command, and many lives depend on those. After all, how well could soldiers function in a battle if they had no idea whom to listen to or if different people were calling out orders? Other secondary groups, like a workplace or a classroom, also have formal leaders, but the styles and functions of leadership can vary significantly. \n\n Leadership function  refers to the main focus or goal of the leader. An  instrumental leader  is one who is goal-oriented and largely concerned with accomplishing set tasks. One can imagine that an army general or a Fortune 500 CEO would be an instrumental leader. In contrast,  expressive leaders  are more concerned with promoting emotional strength and health, and ensuring that people feel supported. Social and religious leaders\u2014rabbis, priests, imams, directors of youth homes and social service programs\u2014are often perceived as expressive leaders. There is a longstanding stereotype that men are more instrumental leaders and women are more expressive leaders. And although gender roles have changed, even today many women and men who exhibit the opposite-gender manner can be seen as deviants and can encounter resistance. Secretary of State and former presidential candidate Hillary Clinton provides an example of how society reacts to a high-profile woman who is an instrumental leader. Despite the stereotype, Boatwright and Forrest (2000) have found that both men and women prefer leaders who use a combination of expressive and instrumental leadership. \n\n In addition to these leadership functions, there are three different  leadership styles .  Democratic leaders  encourage group participation in all decision making. These leaders work hard to build consensus before choosing a course of action and moving forward. This type of leader is particularly common, for example, in a club where the members vote on which activities or projects to pursue. These leaders can be well liked, but there is often a challenge that the work will proceed slowly since consensus building is time-consuming. A further risk is that group members might pick sides and entrench themselves into opposing factions rather than reaching a solution. In contrast, a  laissez-faire leader  (French for \u201cleave it alone\u201d) is hands-off, allowing group members to self-manage and make their own decisions. An example of this kind of leader might be an art teacher who opens the art cupboard, leaves materials on the shelves, and tells students to help themselves and make some art. While this style can work well with highly motivated and mature participants who have clear goals and guidelines, it risks group dissolution and a lack of progress. As the name suggests,  authoritarian leaders  issue orders and assigns tasks. These leaders are clear instrumental leaders with a strong focus on meeting goals. Often, entrepreneurs fall into this mold, like Facebook founder Mark Zuckerberg. Not surprisingly, this type of leader risks alienating the workers. There are times, however, when this style of leadership can be required. In different circumstances, each of these leadership styles can be effective and successful. Consider what leadership style you prefer. Why? Do you like the same style in different areas of your life, such as a classroom, a workplace, and a sports team? \n\n Big Picture Women Leaders and the Hillary Clinton/Sarah Palin Phenomenon The 2008 presidential election marked a dynamic change when two female politicians entered the race. Of the 200 people who have run for president during the country\u2019s history, fewer than 30 have been women. Democratic presidential candidate and former First Lady Hillary Clinton was both famously polarizing and popular. She had almost as many passionate supporters as she did people who reviled her. On the other side of the aisle was Republican vice-presidential candidate Sarah Palin. The former governor of Alaska, Palin was, to some, the perfect example of the modern woman. She juggled her political career with raising a growing family, and relied heavily on the use of social media to spread her message.  So what light did these candidates\u2019 campaigns shed on the possibilities of a female presidency? According to some political analysts, women candidates face a paradox: They must be as tough as their male opponents on issues such as foreign policy or risk appearing weak. However, the stereotypical expectation of women as expressive leaders is still prevalent. Consider that Hillary Clinton\u2019s popularity surged in her 2008 campaign after she cried on the campaign trail. It was enough for the  New York Times  to publish an editorial, \u201cCan Hillary Cry Her Way Back to the White House?\u201d (Dowd 2008). Harsh, but her approval ratings soared afterwards. In fact, many compared it to how politically likable she was in the aftermath of President Clinton\u2019s Monica Lewinsky scandal. Sarah Palin\u2019s expressive qualities were promoted to a greater degree. While she has benefited from the efforts of feminists before her, she self-identified as a traditional woman with traditional values, a point she illustrated by frequently bringing her young children up on stage with her. \n\n So what does this mean for women who would be president, and for those who would vote for them? On the positive side, a recent study of 18- to 25-year-old women that asked whether female candidates in the 2008 election made them believe a woman would be president during their lifetime found that the majority thought they would (Weeks 2011). And the more that young women demand female candidates, the more commonplace female contenders will become. Women as presidential candidates may no longer be a novelty with the focus of their campaign, no matter how obliquely, on their gender. Some, however, remain skeptical. As one political analyst said bluntly, \u201cwomen don\u2019t succeed in politics\u2013\u2013or other professions\u2013\u2013unless they act like men. The standard for running for national office remains distinctly male\u201d (Weeks 2011). \n\n Conformity \n\n We all like to fit in to some degree. Likewise, when we want to stand out, we want to choose how we stand out and for what reasons. For example, a woman who loves cutting-edge fashion and wants to dress in thought-provoking new styles likely wants to be noticed, but most likely she will want to be noticed within a framework of high fashion. She wouldn\u2019t want people to think she was too poor to find proper clothes.  Conformity  is the extent to which an individual complies with group norms or expectations. As you might recall, we use reference groups to assess and understand how to act, to dress, and to behave. Not surprisingly, young people are particularly aware of who conforms and who does not. A high school boy whose mother makes him wear ironed button-down shirts might protest that he will look stupid\u2013\u2013that everyone else wears T-shirts. Another high school boy might like wearing those shirts as a way of standing out. How much do you enjoy being noticed? Do you consciously prefer to conform to group norms so as not to be singled out? Are there people in your class who immediately come to mind when you think about those who don\u2019t want to conform? \n\n Psychologist Solomon Asch (1907\u20131996) conducted experiments that illustrated how great the pressure to conform is, specifically within a small group (1956). After reading the feature, ask yourself what you would do in Asch\u2019s experiment. Would you speak up? What would help you speak up and what would discourage it? \n\n Sociological Research Conforming to Expectations In 1951, psychologist Solomon Asch sat a small group of about eight people around a table. Only one of the people sitting there was the true subject; the rest were associates of the experimenter. However, the subject was led to believe that the others were all, like him, people brought in for an experiment in visual judgments. The group was shown two cards, the first card with a single vertical line, and the second card with three vertical lines differing in length. The experimenter polled the group, asking each participant one at a time which line on the second card matched up with the line on the first card. However, this was not really a test of visual judgment. Rather, it was Asch\u2019s study on the pressures of conformity. He was curious to see what the effect of multiple wrong answers would be on the subject, who presumably was able to tell which lines matched. In order to test this, Asch had each planted respondent answer in a specific way. The subject was seated in such a way that he had to hear almost everyone else\u2019s answers before it was his turn. Sometimes the non-subject members would unanimously choose an answer that was clearly wrong.  \n\n So what was the conclusion? Asch found that 37 out of 50 test subjects responded with an \u201cobviously erroneous\u201d answer at least once. When faced by a unanimous wrong answer from the rest of the group, the subject conformed to a mean of four of the staged answers. Asch revised the study and repeated it, wherein the subject still heard the staged wrong answers, but was allowed to write down his answer rather than speak it aloud. In this version, the number of examples of conformity\u2013\u2013giving an incorrect answer so as not to contradict the group\u2013\u2013fell by two thirds. He also found that group size had an impact on how much pressure the subject felt to conform. \n\n The results showed that speaking up when only one other person gave an erroneous answer was far more common than when five or six people defended the incorrect position. Finally, Asch discovered that people were far more likely to give the correct answer in the face of near-unanimous consent if they had a single ally. If even one person in the group also dissented, the subject conformed only a quarter as often. Clearly, it was easier to be a minority of two than a minority of one. Asch concluded that there are two main causes for conformity: people want to be liked by the group or they believe the group is better informed than they are. He found his study results disturbing. To him, they revealed that intelligent, well-educated people would, with very little coaxing, go along with an untruth. He believed this result highlighted real problems with the education system and values in our society (Asch 1956). \n6.3   Formal Organizations \n\n A complaint of modern life is that society is dominated by large and impersonal secondary organizations. From schools to businesses to healthcare to government, these organizations, referred to as  formal organizations , are highly bureaucratized. Indeed, all formal organizations are, or likely will become,  bureaucracies . A bureaucracy is an ideal type of formal organization. Ideal doesn\u2019t mean \u201cbest\u201d in its sociological usage; it refers to a general model that describes a collection of characteristics, or a type that could describe most examples of the item under discussion. For example, if your professor were to tell the class to picture a car in their minds, most students will picture a car that shares a set of characteristics: four wheels, a windshield, and so on. Everyone\u2019s car will be somewhat different, however. Some might picture a two-door sports car while others picture an SUV. The general idea of the car that everyone shares is the ideal type. We will discuss bureaucracies as an ideal type of organization. \n\n Types of Formal Organizations \n\n Sociologist Amitai Etzioni (1975) posited that formal organizations fall into three categories.  Normative organizations , also called  voluntary organizations , are based on shared interests. As the name suggests, joining them is voluntary and typically done because people find membership rewarding in an intangible way. The Audubon Society or a ski club are examples of normative organizations.  Coercive organizations  are groups that one must be coerced, or pushed, to join. These may include prison or a rehabilitation center. Goffman states that most coercive organizations are  total institutions  (1961). A total institution refers to one in which inmates live a controlled lifestyle and in which total resocialization takes place. The third type is  utilitarian organizations , which, as the name suggests, are joined because of the need for a specific material reward. High school or a workplace would fall into this category\u2014one joined in pursuit of a diploma, the other in order to make money. \n\n Normative or Voluntary \n\n Coercive \n\n Utilitarian \n\n Benefit of Membership \n\n Intangible benefit \n\n Corrective benefit \n\n Tangible benefit \n\n Type of Membership \n\n Volunteer basis \n\n Required \n\n Contractual basis \n\n Feeling of Connectedness \n\n Shared affinity \n\n No affinity \n\n Some affinity \n\n Table  6.1   Table of Formal Organizations   This table shows Etzioni\u2019s three types of formal organizations. (Table courtesy of Etzioni 1975) Bureaucracies \n\n Bureaucracies are an ideal type of formal organization. Pioneer sociologist Max Weber popularly characterized a bureaucracy as having a hierarchy of authority ,  a clear division of labor ,  explicit rules ,  and impersonality (1922). People often complain about bureaucracies\u2013\u2013declaring them slow, rule-bound, difficult to navigate, and unfriendly. Let\u2019s take a look at terms that define a bureaucracy to understand what they mean. Hierarchy of authority  refers to the aspect of bureaucracy that places one individual or office in charge of another, who in turn must answer to her own superiors. For example, as an employee at Walmart, your shift manager assigns you tasks. Your shift manager answers to his store manager, who must answer to her regional manager, and so on in a chain of command, up to the CEO who must answer to the board members, who in turn answer to the stockholders. Everyone in this bureaucracy follows the chain of command. \n\n A  clear division of labor  refers to the fact that within a bureaucracy, each individual has a specialized task to perform. For example, psychology professors teach psychology, but they do not attempt to provide students with financial aid forms. In this case, it is a clear and commonsense division. But what about in a restaurant where food is backed up in the kitchen and a hostess is standing nearby texting on her phone? Her job is to seat customers, not to deliver food. Is this a smart division of labor? \n\n The existence of  explicit rules  refers to the way in which rules are outlined, written down, and standardized. For example, at your college or university, the student guidelines are contained within the Student Handbook. As technology changes and campuses encounter new concerns like cyberbullying, identity theft, and other hot-button issues, organizations are scrambling to ensure their explicit rules cover these emerging topics. \n\n Finally, bureaucracies are also characterized by  impersonality , which takes personal feelings out of professional situations. This characteristic grew, to some extent, out of a desire to protect organizations from nepotism, backroom deals, and other types of favoritism, simultaneously protecting customers and others served by the organization. Impersonality is an attempt by large formal organizations to protect their members. However, the result is often that personal experience is disregarded. For example, you may be late for work because your car broke down, but the manager at Pizza Hut doesn\u2019t care about why you are late, only that you are late. Bureaucracies are, in theory at least,  meritocracies , meaning that hiring and promotion is based on proven and documented skills, rather than on nepotism or random choice. In order to get into a prestigious college, you need to perform well on the SAT and have an impressive transcript. In order to become a lawyer and represent clients, you must graduate law school and pass the state bar exam. Of course, there are many well-documented examples of success by those who did not proceed through traditional meritocracies. Think about technology companies with founders who dropped out of college, or performers who became famous after a YouTube video went viral. How well do you think established meritocracies identify talent? Wealthy families hire tutors, interview coaches, test-prep services, and consultants to help their kids get into the best schools. This starts as early as kindergarten in New York City, where competition for the most highly-regarded schools is especially fierce. Are these schools, many of which have copious scholarship funds that are intended to make the school more democratic, really offering all applicants a fair shake? There are several positive aspects of bureaucracies. They are intended to improve efficiency, ensure equal opportunities, and increase efficiency. And there are times when rigid hierarchies are needed. But remember that many of our bureaucracies grew large at the same time that our school model was developed\u2013\u2013during the Industrial Revolution. Young workers were trained and organizations were built for mass production, assembly line work, and factory jobs. In these scenarios, a clear chain of command was critical. Now, in the information age, this kind of rigid training and adherence to protocol can actually decrease both productivity and efficiency.  \n\n Today\u2019s workplace requires a faster pace, more problem-solving, and a flexible approach to work. Too much adherence to explicit rules and a division of labor can leave an organization behind. And unfortunately, once established, bureaucracies can take on a life of their own. Maybe you have heard the expression \u201ctrying to turn a tanker around mid-ocean,\u201d which refers to the difficulties of changing direction with something large and set in its ways. State governments and current budget crises are examples of this challenge. It is almost impossible to make quick changes, leading states to continue, year after year, with increasingly unbalanced budgets. Finally, bureaucracies, as mentioned, grew as institutions at a time when privileged white males held all the power. While ostensibly based on meritocracy, bureaucracies can perpetuate the existing balance of power by only recognizing the merit in traditionally male and privileged paths.  \n\n Michels (1911) suggested that all large organizations are characterized by the  Iron Rule of Oligarchy ,  wherein an entire organization is ruled by a few elites. Do you think this is true? Can a large organization be collaborative? \n\n The McDonaldization of Society \n\n The  McDonaldization of Society  (Ritzer 1993) refers to the increasing presence of the fast food business model in common social institutions. This business model includes efficiency (the division of labor), predictability, calculability, and control (monitoring). For example, in your average chain grocery store, people at the register check out customers while stockers keep the shelves full of goods and deli workers slice meats and cheese to order (efficiency). Whenever you enter a store within that grocery chain, you receive the same type of goods, see the same store organization, and find the same brands at the same prices (predictability). You will find that goods are sold by the pound, so that you can weigh your fruit and vegetable purchase rather than simply guessing at the price for that bag of onions, while the employees use a timecard to calculate their hours and receive overtime pay (calculability). Finally, you will notice that all store employees are wearing a uniform (and usually a name tag) so that they can be easily identified. There are security cameras to monitor the store, and some parts of the store, such as the stockroom, are generally considered off-limits to customers (control). While McDonaldization has resulted in improved profits and an increased availability of various goods and services to more people worldwide, it has also reduced the variety of goods available in the marketplace while rendering available products uniform, generic, and bland. Think of the difference between a mass-produced shoe and one made by a local cobbler, between a chicken from a family-owned farm versus a corporate grower, or a cup of coffee from the local diner instead of one from Starbucks. \n\n Sociology in the Real World Secrets of the McJob We often talk about bureaucracies disparagingly, and no organization takes more heat than fast food restaurants. The book and movie  Fast Food Nation: The Dark Side of the All-American Meal   by Eric Schossler paints an ugly picture of what goes in, what goes on, and what comes out of fast food chains. From their environmental impact to their role in the US obesity epidemic, fast food chains are connected to numerous societal ills. Furthermore, working at a fast food restaurant is often disparaged, and even referred to dismissively, as a McJob rather than a real job. But business school professor Jerry Newman went undercover and worked behind the counter at seven fast food restaurants to discover what really goes on there. His book,  My Secret Life on the McJob  documents his experience. Newman found, unlike Schossler, that these restaurants have much good alongside the bad. Specifically, he asserted that the employees were honest and hardworking, the management was often impressive, and that the jobs required a lot more skill and effort than most people imagined. In the book, Newman cites a pharmaceutical executive who states that a fast-food service job on an applicant\u2019s r\u00e9sum\u00e9 is a plus because it indicates the employee is reliable and can handle pressure. So what do you think? Are these McJobs and the organizations that offer them still serving a role in the economy and people\u2019s careers? Or are they dead-end jobs that typify all that is negative about large bureaucracies? Have you ever worked in one? Would you? ", "questions": [{"question": {"question_id": "fs-id2717916", "question_text": "What is the largest difference between the Functionalist and Conflict perspectives and the Interactionist perspective?", "question_choices": ["The former two consider long-term repercussions of the group or situation, while the latter focuses on the present.", "The first two are the more common sociological perspective, while the latter is a newer sociological model.", "The first two focus on hierarchical roles within an organization, while the last takes a more holistic view.", "The first two perspectives address large-scale issues facing groups, while the last examines more detailed aspects."], "cloze_format": "The largest difference between the Functionalist and Conflict perspectives and the Interactionist perspective is that ___.", "normal_format": "What is the largest difference between the Functionalist and Conflict perspectives and the Interactionist perspective?"}, "answer": {"ans_text": "The first two perspectives address large-scale issues facing groups, while the last examines more detailed aspects.", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The Conflict perspective is another macroanalytical view , one that focuses on the genesis and growth of inequality . A third perspective is the Symbolic Interaction or Interactionist perspective . This method of analyzing groups takes a micro-level view . The Functionalist perspective is a big-picture macro-level view that looks at how different aspects of society are intertwined .", "hl_context": "<hl> The Conflict perspective is another macroanalytical view , one that focuses on the genesis and growth of inequality . <hl> A conflict theorist studying the Occupy movement might look at how business interests have manipulated the system over the last 30 years , leading to the gross inequality we see today . Or this perspective might explore how the massive redistribution of wealth from the middle class to the upper class could lead to a two-class system reminiscent of Marxist ideas . <hl> A third perspective is the Symbolic Interaction or Interactionist perspective . <hl> <hl> This method of analyzing groups takes a micro-level view . <hl> Instead of studying the big picture , these researchers look at the day-to-day interactions of groups . Studying these details , the Interactionist looks at issues like leadership style and group dynamics . In the case of the Occupy Movement , Interactionists might ask , \u201c How does the group dynamic in New York differ from that in Atlanta ? \u201d Or , \u201c What dictates who becomes the de facto leader in different cities \u2014 geography , social dynamics , economic circumstances ? \u201d <hl> The Functionalist perspective is a big-picture macro-level view that looks at how different aspects of society are intertwined . <hl> This perspective is based on the idea that society is a well-balanced system with all parts necessary to the whole , and it studies the roles these parts play in relation to the whole . In the case of the Occupy Movement , a Functionalist might look at what macro-level needs the movement serves . For example , a Structural Functionalist might ask how the Occupy Wall Street movement forces both haves and have-nots to pay attention to the economy , or the way urbanites are impacted by the influx of protestors who typically reside outside of their region ."}, {"question": {"question_id": "fs-id875536", "question_text": "What role do secondary groups play in society?", "question_choices": ["They are transactional, task-based, and short-term, filling practical needs.", "They provide a social network that allows people to compare themselves to others.", "The members give and receive emotional support.", "They allow individuals to challenge their beliefs and prejudices."], "cloze_format": "The  role that secondary groups play in society is that ___.", "normal_format": "What role do secondary groups play in society?"}, "answer": {"ans_text": "They are transactional, task-based, and short-term, filling practical needs.", "ans_choice": 0}, "bloom": "1", "hl_sentences": "Secondary groups are often larger and impersonal . They may also be task-focused and time-limited . These groups serve an instrumental function rather than an expressive one , meaning that their role is more goal - or task-oriented than emotional .", "hl_context": "Sociologist Charles Horton Cooley ( 1864 \u2013 1929 ) suggested that groups can broadly be divided into two categories : primary groups and secondary groups ( Cooley 1909 ) . According to Cooley , primary groups play the most critical role in our lives . The primary group is usually fairly small and is made up of individuals who generally engage face-to-face in long-term emotional ways . This group serves emotional needs : expressive functions rather than pragmatic ones . The primary group is usually made up of significant others , those individuals who have the most impact on our socialization . The best example of a primary group is the family . <hl> Secondary groups are often larger and impersonal . <hl> <hl> They may also be task-focused and time-limited . <hl> <hl> These groups serve an instrumental function rather than an expressive one , meaning that their role is more goal - or task-oriented than emotional . <hl> A classroom or office can be an example of a secondary group . Neither primary nor secondary groups are bound by strict definitions or set limits . In fact , people can move from one group to another . A graduate seminar , for example , can start as a secondary group focused on the class at hand , but as the students work together throughout their program , they may find common interests and strong ties that transform them into a primary group ."}, {"question": {"question_id": "fs-id2229374", "question_text": "When a high school student gets teased by her basketball team for receiving an academic award, she is dealing with competing ______________.", "question_choices": ["primary groups", "out-groups", "reference groups", "secondary groups"], "cloze_format": "When a high school student gets teased by her basketball team for receiving an academic award, she is dealing with competing ______________.", "normal_format": "When a high school student gets teased by her basketball team for receiving an academic award, she is dealing with competing what?"}, "answer": {"ans_text": "reference groups", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "This is a natural response to a reference group , and on a large campus , there can be many competing groups . Say you are a strong athlete who wants to play intramural sports , but your favorite musicians are a local punk band . You may find yourself engaged with two very different reference groups .", "hl_context": "Sociology in the Real World College : A World of In-Groups , Out-Groups , and Reference Groups For a student entering college , the sociological study of groups takes on an immediate and practical meaning . After all , when we arrive someplace new , most of us glance around to see how well we fit in or stand out in the ways we want . <hl> This is a natural response to a reference group , and on a large campus , there can be many competing groups . <hl> <hl> Say you are a strong athlete who wants to play intramural sports , but your favorite musicians are a local punk band . <hl> <hl> You may find yourself engaged with two very different reference groups . <hl>"}, {"question": {"question_id": "fs-id2862296", "question_text": "Which of the following is NOT an example of an in-group?", "question_choices": ["The Ku Klux Klan", "A fraternity", "A synagogue", "A high school"], "cloze_format": "___ is NOT an example of an in-group.", "normal_format": "Which of the following is NOT an example of an in-group?"}, "answer": {"ans_text": "A high school", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "In short , an in-group is the group that an individual feels she belongs to , and she believes it to be an integral part of who she is . Sports teams , unions , and sororities are examples of in-groups and out-groups ; people may belong to , or be an outsider to , any of these . While these affiliations can be neutral or even positive , such as the case of a team sport competition , the concept of in-groups and out-groups can also explain some negative human behavior , such as white supremacist movements like the Ku Klux Klan , or the bullying of gay or lesbian students . By defining others as \u201c not like us \u201d and inferior , in-groups can end up practicing ethnocentrism , racism , sexism , ageism , and heterosexism \u2014 manners of judging others negatively based on their culture , race , sex , age , or sexuality .", "hl_context": "One of the ways that groups can be powerful is through inclusion , and its inverse , exclusion . In-groups and out-groups are subcategories of primary and secondary groups that help identify this dynamic . Primary groups consist of both in-groups and out-groups , as do secondary groups . The feeling that one belongs in an elite or select group is a heady one , while the feeling of not being allowed in , or of being in competition with a group , can be motivating in a different way . Sociologist William Sumner ( 1840 \u2013 1910 ) developed the concepts of in-group and out-group to explain this phenomenon ( Sumner 1906 ) . <hl> In short , an in-group is the group that an individual feels she belongs to , and she believes it to be an integral part of who she is . <hl> An out-group , conversely , is a group someone doesn \u2019 t belong to ; often there may be a feeling of disdain or competition in relation to an out-group . <hl> Sports teams , unions , and sororities are examples of in-groups and out-groups ; people may belong to , or be an outsider to , any of these . <hl> <hl> While these affiliations can be neutral or even positive , such as the case of a team sport competition , the concept of in-groups and out-groups can also explain some negative human behavior , such as white supremacist movements like the Ku Klux Klan , or the bullying of gay or lesbian students . <hl> <hl> By defining others as \u201c not like us \u201d and inferior , in-groups can end up practicing ethnocentrism , racism , sexism , ageism , and heterosexism \u2014 manners of judging others negatively based on their culture , race , sex , age , or sexuality . <hl> Often , in-groups can form within a secondary group . For instance , a workplace can have cliques of people , from senior executives who play golf together , to engineers who write code together , to young singles who socialize after hours . While these in-groups might show favoritism and affinity for other in-group members , the overall organization may be unable or unwilling to acknowledge it . Therefore , it pays to be wary of the politics of in-groups , since members may exclude others as a form of gaining status within the group ."}, {"question": {"question_id": "fs-id972166", "question_text": "What is a group whose values, norms, and beliefs come to serve as a standard for one's own behavior?", "question_choices": ["Secondary group", "Formal organization", "Reference group", "Primary group"], "cloze_format": "The ___ is a group whose values, norms, and beliefs come to serve as a standard for one's own behavior.", "normal_format": "What is a group whose values, norms, and beliefs come to serve as a standard for one's own behavior?"}, "answer": {"ans_text": "Reference group", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "As you might recall , we use reference groups to assess and understand how to act , to dress , and to behave . At all ages , we use reference groups to help guide our behavior and show us social norms . A reference group is a group that people compare themselves to \u2014 it provides a standard of measurement .", "hl_context": "We all like to fit in to some degree . Likewise , when we want to stand out , we want to choose how we stand out and for what reasons . For example , a woman who loves cutting-edge fashion and wants to dress in thought-provoking new styles likely wants to be noticed , but most likely she will want to be noticed within a framework of high fashion . She wouldn \u2019 t want people to think she was too poor to find proper clothes . Conformity is the extent to which an individual complies with group norms or expectations . <hl> As you might recall , we use reference groups to assess and understand how to act , to dress , and to behave . <hl> Not surprisingly , young people are particularly aware of who conforms and who does not . A high school boy whose mother makes him wear ironed button-down shirts might protest that he will look stupid \u2013 \u2013 that everyone else wears T-shirts . Another high school boy might like wearing those shirts as a way of standing out . How much do you enjoy being noticed ? Do you consciously prefer to conform to group norms so as not to be singled out ? Are there people in your class who immediately come to mind when you think about those who don \u2019 t want to conform ? Some other examples of reference groups can be an individual \u2019 s church , synagogue , or mosque ; one \u2019 s cultural center ; workplace ; family gathering ; and even one \u2019 s parents . Often , reference groups convey competing messages . For instance , on television and in movies , young adults often have wonderful apartments , cars , and lively social lives despite not holding a job . In music videos , young women might dance and sing in a sexually aggressive way that suggests experience beyond their years . <hl> At all ages , we use reference groups to help guide our behavior and show us social norms . <hl> So how important is it to surround yourself with positive reference groups ? You may never meet or know a reference group , but it still impacts and influences how you act . Identifying reference groups can help you understand the source of the social identities you aspire to or want to distance yourself from . <hl> A reference group is a group that people compare themselves to \u2014 it provides a standard of measurement . <hl> In American society , peer groups are common reference groups . Kids and adults pay attention to what their peers wear , what music they like , what they do with their free time \u2014 and they compare themselves to what they see . Most people have more than one reference group , so a middle school boy might not just look at his classmates but also at his older brother \u2019 s friends and see a different set of norms . And he might observe the antics of his favorite athletes for yet another set of behaviors ."}, {"question": {"question_id": "fs-id2304744", "question_text": "A parent who is worrying over her teenager\u2019s dangerous and self-destructive behavior and low self-esteem may wish to look at her child\u2019s:", "question_choices": ["reference group", "in-group", "out-group", "All of the above"], "cloze_format": "A parent who is worrying over her teenager\u2019s dangerous and self-destructive behavior and low self-esteem may wish to look at her child\u2019s is (the) ___.", "normal_format": "What may a parent worrying over her teenager\u2019s dangerous and self-destructive behavior and low self-esteem wish to look at?"}, "answer": {"ans_text": "All of the above", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": "3", "hl_sentences": "Often , reference groups convey competing messages . At all ages , we use reference groups to help guide our behavior and show us social norms . You may never meet or know a reference group , but it still impacts and influences how you act . Identifying reference groups can help you understand the source of the social identities you aspire to or want to distance yourself from . People at these stages of life are especially vulnerable to others \u2019 opinions of them , and they \u2019 re deeply invested in their peer groups . While these affiliations can be neutral or even positive , such as the case of a team sport competition , the concept of in-groups and out-groups can also explain some negative human behavior , such as white supremacist movements like the Ku Klux Klan , or the bullying of gay or lesbian students . By defining others as \u201c not like us \u201d and inferior , in-groups can end up practicing ethnocentrism , racism , sexism , ageism , and heterosexism \u2014 manners of judging others negatively based on their culture , race , sex , age , or sexuality . Often , in-groups can form within a secondary group .", "hl_context": "Some other examples of reference groups can be an individual \u2019 s church , synagogue , or mosque ; one \u2019 s cultural center ; workplace ; family gathering ; and even one \u2019 s parents . <hl> Often , reference groups convey competing messages . <hl> For instance , on television and in movies , young adults often have wonderful apartments , cars , and lively social lives despite not holding a job . In music videos , young women might dance and sing in a sexually aggressive way that suggests experience beyond their years . <hl> At all ages , we use reference groups to help guide our behavior and show us social norms . <hl> So how important is it to surround yourself with positive reference groups ? <hl> You may never meet or know a reference group , but it still impacts and influences how you act . <hl> <hl> Identifying reference groups can help you understand the source of the social identities you aspire to or want to distance yourself from . <hl> Big Picture Bullying and Cyberbullying : How Technology Has Changed the Game Most of us know that the old rhyme \u201c sticks and stones may break my bones , but words will never hurt me \u201d is inaccurate . Words can hurt , and never is that more apparent than in instances of bullying . Bullying has always existed , often reaching extreme levels of cruelty in children and young adults . <hl> People at these stages of life are especially vulnerable to others \u2019 opinions of them , and they \u2019 re deeply invested in their peer groups . <hl> Today , technology has ushered in a new era of this dynamic . Cyberbullying is the use of interactive media by one person to torment another , and it is on the rise . Cyberbullying can mean sending threatening texts , harassing someone in a public forum ( such as Facebook ) , hacking someone \u2019 s account and pretending to be him or her , posting embarrassing images online , and so on . A study by the Cyberbullying Research Center found that 20 percent of middle school students admitted to \u201c seriously thinking about committing suicide \u201d as a result of online bullying ( Hinduja and Patchin 2010 ) . Whereas bullying face-to-face requires willingness to interact with your victim , cyberbullying allows bullies to harass others from the privacy of their homes without witnessing the damage firsthand . This form of bullying is particularly dangerous because it \u2019 s widely accessible and therefore easier to accomplish . One of the ways that groups can be powerful is through inclusion , and its inverse , exclusion . In-groups and out-groups are subcategories of primary and secondary groups that help identify this dynamic . Primary groups consist of both in-groups and out-groups , as do secondary groups . The feeling that one belongs in an elite or select group is a heady one , while the feeling of not being allowed in , or of being in competition with a group , can be motivating in a different way . Sociologist William Sumner ( 1840 \u2013 1910 ) developed the concepts of in-group and out-group to explain this phenomenon ( Sumner 1906 ) . In short , an in-group is the group that an individual feels she belongs to , and she believes it to be an integral part of who she is . An out-group , conversely , is a group someone doesn \u2019 t belong to ; often there may be a feeling of disdain or competition in relation to an out-group . Sports teams , unions , and sororities are examples of in-groups and out-groups ; people may belong to , or be an outsider to , any of these . <hl> While these affiliations can be neutral or even positive , such as the case of a team sport competition , the concept of in-groups and out-groups can also explain some negative human behavior , such as white supremacist movements like the Ku Klux Klan , or the bullying of gay or lesbian students . <hl> <hl> By defining others as \u201c not like us \u201d and inferior , in-groups can end up practicing ethnocentrism , racism , sexism , ageism , and heterosexism \u2014 manners of judging others negatively based on their culture , race , sex , age , or sexuality . <hl> <hl> Often , in-groups can form within a secondary group . <hl> For instance , a workplace can have cliques of people , from senior executives who play golf together , to engineers who write code together , to young singles who socialize after hours . While these in-groups might show favoritism and affinity for other in-group members , the overall organization may be unable or unwilling to acknowledge it . Therefore , it pays to be wary of the politics of in-groups , since members may exclude others as a form of gaining status within the group ."}, {"question": {"question_id": "fs-id3021967", "question_text": "Two people who have just had a baby have turned from a _______ to a _________.", "question_choices": ["primary group; secondary group", "dyad; triad", "couple; family", "de facto group; nuclear family"], "cloze_format": "Two people who have just had a baby have turned from a _______ to a _________.", "normal_format": "From what to what two people who have just had a baby turned into?"}, "answer": {"ans_text": "dyad; triad", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "Georg Simmel ( 1858 \u2013 1915 ) wrote extensively about the difference between a dyad , or two-member group , and a triad , which is a three-member group ( Simmel 1902 ) . In the former , if one person withdraws , the group can no longer exist . One can think of a divorce , which effectively ends the \u201c group \u201d of the married couple , or of two best friends never speaking again . In a triad , however , the dynamic is quite different . If one person withdraws , the group lives on . A triad has a different set of relationships .", "hl_context": "A small group is typically one where the collection of people is small enough that all members of the group know each other and share simultaneous interaction , such as a nuclear family , a dyad , or a triad . <hl> Georg Simmel ( 1858 \u2013 1915 ) wrote extensively about the difference between a dyad , or two-member group , and a triad , which is a three-member group ( Simmel 1902 ) . <hl> <hl> In the former , if one person withdraws , the group can no longer exist . <hl> <hl> One can think of a divorce , which effectively ends the \u201c group \u201d of the married couple , or of two best friends never speaking again . <hl> <hl> In a triad , however , the dynamic is quite different . <hl> <hl> If one person withdraws , the group lives on . <hl> <hl> A triad has a different set of relationships . <hl> If there are three in the group , two-against-one dynamics can develop and there exists the potential for a majority opinion on any issue . Small groups generally have strong internal cohesiveness and a sense of connection . The challenge , however , is for small groups to achieve large goals . They can struggle to be heard or to be a force for change if they are pushing against larger groups . In short , they are easier to ignore . It is difficult to define exactly when a small group becomes a large group . One step might be when there are too many people to join in a simultaneous discussion . Another might be when a group joins with other groups as part of a movement that unites them . These larger groups may share a geographic space , such as a fraternity or sorority on the same campus , or they might be spread out around the globe . The larger the group , the more attention it can garner , and the more pressure members can put toward whatever goal they wish to achieve . At the same time , the larger the group becomes , the more the risk grows for division and lack of cohesion ."}, {"question": {"question_id": "fs-id1430848", "question_text": "Who is more likely to be an expressive leader?", "question_choices": ["The sales manager of a fast-growing cosmetics company", "A high school teacher at a reform school", "The director of a summer camp for chronically ill children", "A manager at a fast-food restaurant"], "cloze_format": "___ is more likely to be an expressive leader.", "normal_format": "Who is more likely to be an expressive leader?"}, "answer": {"ans_text": "The director of a summer camp for chronically ill children", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "Social and religious leaders \u2014 rabbis , priests , imams , directors of youth homes and social service programs \u2014 are often perceived as expressive leaders .", "hl_context": "Leadership function refers to the main focus or goal of the leader . An instrumental leader is one who is goal-oriented and largely concerned with accomplishing set tasks . One can imagine that an army general or a Fortune 500 CEO would be an instrumental leader . In contrast , expressive leaders are more concerned with promoting emotional strength and health , and ensuring that people feel supported . <hl> Social and religious leaders \u2014 rabbis , priests , imams , directors of youth homes and social service programs \u2014 are often perceived as expressive leaders . <hl> There is a longstanding stereotype that men are more instrumental leaders and women are more expressive leaders . And although gender roles have changed , even today many women and men who exhibit the opposite-gender manner can be seen as deviants and can encounter resistance . Secretary of State and former presidential candidate Hillary Clinton provides an example of how society reacts to a high-profile woman who is an instrumental leader . Despite the stereotype , Boatwright and Forrest ( 2000 ) have found that both men and women prefer leaders who use a combination of expressive and instrumental leadership ."}, {"question": {"question_id": "fs-id2804952", "question_text": "Which of the following is NOT an appropriate group for democratic leadership?", "question_choices": ["A fire station", "A college classroom", "A high school prom committee", "A homeless shelter"], "cloze_format": "___  is NOT an appropriate group for democratic leadership.", "normal_format": "Which of the following is NOT an appropriate group for democratic leadership?"}, "answer": {"ans_text": "A fire station", "ans_choice": 0}, "bloom": "1", "hl_sentences": "Democratic leaders encourage group participation in all decision making . These leaders work hard to build consensus before choosing a course of action and moving forward . This type of leader is particularly common , for example , in a club where the members vote on which activities or projects to pursue . These leaders can be well liked , but there is often a challenge that the work will proceed slowly since consensus building is time-consuming . A further risk is that group members might pick sides and entrench themselves into opposing factions rather than reaching a solution .", "hl_context": "In addition to these leadership functions , there are three different leadership styles . <hl> Democratic leaders encourage group participation in all decision making . <hl> <hl> These leaders work hard to build consensus before choosing a course of action and moving forward . <hl> <hl> This type of leader is particularly common , for example , in a club where the members vote on which activities or projects to pursue . <hl> <hl> These leaders can be well liked , but there is often a challenge that the work will proceed slowly since consensus building is time-consuming . <hl> <hl> A further risk is that group members might pick sides and entrench themselves into opposing factions rather than reaching a solution . <hl> In contrast , a laissez-faire leader ( French for \u201c leave it alone \u201d ) is hands-off , allowing group members to self-manage and make their own decisions . An example of this kind of leader might be an art teacher who opens the art cupboard , leaves materials on the shelves , and tells students to help themselves and make some art . While this style can work well with highly motivated and mature participants who have clear goals and guidelines , it risks group dissolution and a lack of progress . As the name suggests , authoritarian leaders issue orders and assigns tasks . These leaders are clear instrumental leaders with a strong focus on meeting goals . Often , entrepreneurs fall into this mold , like Facebook founder Mark Zuckerberg . Not surprisingly , this type of leader risks alienating the workers . There are times , however , when this style of leadership can be required . In different circumstances , each of these leadership styles can be effective and successful . Consider what leadership style you prefer . Why ? Do you like the same style in different areas of your life , such as a classroom , a workplace , and a sports team ?"}, {"question": {"question_id": "fs-id2841617", "question_text": "In Asch\u2019s study on conformity, what contributed to the ability of subjects to resist conforming?", "question_choices": ["A very small group of witnesses", "The presence of an ally", "The ability to keep one\u2019s answer private", "All of the above"], "cloze_format": "In Asch\u2019s study on conformity, ___ contributed to the ability of subjects to resist conforming.", "normal_format": "In Asch\u2019s study on conformity, what contributed to the ability of subjects to resist conforming?"}, "answer": {"ans_text": "All of the above", "ans_choice": 3}, "bloom": "1", "hl_sentences": "Asch revised the study and repeated it , wherein the subject still heard the staged wrong answers , but was allowed to write down his answer rather than speak it aloud . He also found that group size had an impact on how much pressure the subject felt to conform . Sociological Research Conforming to Expectations In 1951 , psychologist Solomon Asch sat a small group of about eight people around a table . However , the subject was led to believe that the others were all , like him , people brought in for an experiment in visual judgments . Rather , it was Asch \u2019 s study on the pressures of conformity .", "hl_context": "So what was the conclusion ? Asch found that 37 out of 50 test subjects responded with an \u201c obviously erroneous \u201d answer at least once . When faced by a unanimous wrong answer from the rest of the group , the subject conformed to a mean of four of the staged answers . <hl> Asch revised the study and repeated it , wherein the subject still heard the staged wrong answers , but was allowed to write down his answer rather than speak it aloud . <hl> In this version , the number of examples of conformity \u2013 \u2013 giving an incorrect answer so as not to contradict the group \u2013 \u2013 fell by two thirds . <hl> He also found that group size had an impact on how much pressure the subject felt to conform . <hl> <hl> Sociological Research Conforming to Expectations In 1951 , psychologist Solomon Asch sat a small group of about eight people around a table . <hl> Only one of the people sitting there was the true subject ; the rest were associates of the experimenter . <hl> However , the subject was led to believe that the others were all , like him , people brought in for an experiment in visual judgments . <hl> The group was shown two cards , the first card with a single vertical line , and the second card with three vertical lines differing in length . The experimenter polled the group , asking each participant one at a time which line on the second card matched up with the line on the first card . However , this was not really a test of visual judgment . <hl> Rather , it was Asch \u2019 s study on the pressures of conformity . <hl> He was curious to see what the effect of multiple wrong answers would be on the subject , who presumably was able to tell which lines matched . In order to test this , Asch had each planted respondent answer in a specific way . The subject was seated in such a way that he had to hear almost everyone else \u2019 s answers before it was his turn . Sometimes the non-subject members would unanimously choose an answer that was clearly wrong ."}, {"question": {"question_id": "fs-id1882979", "question_text": "Which type of group leadership has a communication pattern that flows from the top down?", "question_choices": ["Authoritarian", "Democratic", "Laissez-faire", "Expressive"], "cloze_format": "The type of group leadership that has a communication pattern that flows from the top down is the ___.", "normal_format": "Which type of group leadership has a communication pattern that flows from the top down?"}, "answer": {"ans_text": "Authoritarian", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "As the name suggests , authoritarian leaders issue orders and assigns tasks . These leaders are clear instrumental leaders with a strong focus on meeting goals . Not surprisingly , this type of leader risks alienating the workers .", "hl_context": "In addition to these leadership functions , there are three different leadership styles . Democratic leaders encourage group participation in all decision making . These leaders work hard to build consensus before choosing a course of action and moving forward . This type of leader is particularly common , for example , in a club where the members vote on which activities or projects to pursue . These leaders can be well liked , but there is often a challenge that the work will proceed slowly since consensus building is time-consuming . A further risk is that group members might pick sides and entrench themselves into opposing factions rather than reaching a solution . In contrast , a laissez-faire leader ( French for \u201c leave it alone \u201d ) is hands-off , allowing group members to self-manage and make their own decisions . An example of this kind of leader might be an art teacher who opens the art cupboard , leaves materials on the shelves , and tells students to help themselves and make some art . While this style can work well with highly motivated and mature participants who have clear goals and guidelines , it risks group dissolution and a lack of progress . <hl> As the name suggests , authoritarian leaders issue orders and assigns tasks . <hl> <hl> These leaders are clear instrumental leaders with a strong focus on meeting goals . <hl> Often , entrepreneurs fall into this mold , like Facebook founder Mark Zuckerberg . <hl> Not surprisingly , this type of leader risks alienating the workers . <hl> There are times , however , when this style of leadership can be required . In different circumstances , each of these leadership styles can be effective and successful . Consider what leadership style you prefer . Why ? Do you like the same style in different areas of your life , such as a classroom , a workplace , and a sports team ?"}, {"question": {"question_id": "fs-id1688497", "question_text": "Which is NOT an example of a normative organization?", "question_choices": ["A book club", "A church youth group", "A People for the Ethical Treatment of Animals (PETA) protest group", "A study hall"], "cloze_format": "___ is NOT an example of a normative organization.", "normal_format": "Which is NOT an example of a normative organization?"}, "answer": {"ans_text": "A study hall", "ans_choice": 3}, "bloom": "1", "hl_sentences": "Normative organizations , also called voluntary organizations , are based on shared interests . As the name suggests , joining them is voluntary and typically done because people find membership rewarding in an intangible way .", "hl_context": "Sociologist Amitai Etzioni ( 1975 ) posited that formal organizations fall into three categories . <hl> Normative organizations , also called voluntary organizations , are based on shared interests . <hl> <hl> As the name suggests , joining them is voluntary and typically done because people find membership rewarding in an intangible way . <hl> The Audubon Society or a ski club are examples of normative organizations . Coercive organizations are groups that one must be coerced , or pushed , to join . These may include prison or a rehabilitation center . Goffman states that most coercive organizations are total institutions ( 1961 ) . A total institution refers to one in which inmates live a controlled lifestyle and in which total resocialization takes place . The third type is utilitarian organizations , which , as the name suggests , are joined because of the need for a specific material reward . High school or a workplace would fall into this category \u2014 one joined in pursuit of a diploma , the other in order to make money ."}, {"question": {"question_id": "fs-id3135439", "question_text": "Which of these is an example of a total institution?", "question_choices": ["Jail", "High school", "Political party", "A gym"], "cloze_format": "___ is an example of a total institution.", "normal_format": "Which of these is an example of a total institution?"}, "answer": {"ans_text": "Jail", "ans_choice": 0}, "bloom": null, "hl_sentences": "A total institution refers to one in which inmates live a controlled lifestyle and in which total resocialization takes place .", "hl_context": "Sociologist Amitai Etzioni ( 1975 ) posited that formal organizations fall into three categories . Normative organizations , also called voluntary organizations , are based on shared interests . As the name suggests , joining them is voluntary and typically done because people find membership rewarding in an intangible way . The Audubon Society or a ski club are examples of normative organizations . Coercive organizations are groups that one must be coerced , or pushed , to join . These may include prison or a rehabilitation center . Goffman states that most coercive organizations are total institutions ( 1961 ) . <hl> A total institution refers to one in which inmates live a controlled lifestyle and in which total resocialization takes place . <hl> The third type is utilitarian organizations , which , as the name suggests , are joined because of the need for a specific material reward . High school or a workplace would fall into this category \u2014 one joined in pursuit of a diploma , the other in order to make money ."}, {"question": {"question_id": "fs-id3216022", "question_text": "Why do people join utilitarian organizations?", "question_choices": ["Because they feel an affinity with others there", "Because they receive a tangible benefit from joining", "Because they have no choice", "Because they feel pressured to do so"], "cloze_format": "People join utilitarian organizations ___.", "normal_format": "Why do people join utilitarian organizations?"}, "answer": {"ans_text": "Because they receive a tangible benefit from joining", "ans_choice": 1}, "bloom": "1", "hl_sentences": "The third type is utilitarian organizations , which , as the name suggests , are joined because of the need for a specific material reward .", "hl_context": "Sociologist Amitai Etzioni ( 1975 ) posited that formal organizations fall into three categories . Normative organizations , also called voluntary organizations , are based on shared interests . As the name suggests , joining them is voluntary and typically done because people find membership rewarding in an intangible way . The Audubon Society or a ski club are examples of normative organizations . Coercive organizations are groups that one must be coerced , or pushed , to join . These may include prison or a rehabilitation center . Goffman states that most coercive organizations are total institutions ( 1961 ) . A total institution refers to one in which inmates live a controlled lifestyle and in which total resocialization takes place . <hl> The third type is utilitarian organizations , which , as the name suggests , are joined because of the need for a specific material reward . <hl> High school or a workplace would fall into this category \u2014 one joined in pursuit of a diploma , the other in order to make money ."}, {"question": {"question_id": "fs-id2673528", "question_text": "Which of the following is NOT a characteristic of bureaucracies?", "question_choices": ["Coercion to join", "Hierarchy of authority", "Explicit rules", "Division of labor"], "cloze_format": "___ is NOT a characteristic of bureaucracies.", "normal_format": "Which of the following is NOT a characteristic of bureaucracies?"}, "answer": {"ans_text": "Coercion to join", "ans_choice": 0}, "bloom": "1", "hl_sentences": "Pioneer sociologist Max Weber popularly characterized a bureaucracy as having a hierarchy of authority , a clear division of labor , explicit rules , and impersonality ( 1922 ) .", "hl_context": "Bureaucracies are an ideal type of formal organization . <hl> Pioneer sociologist Max Weber popularly characterized a bureaucracy as having a hierarchy of authority , a clear division of labor , explicit rules , and impersonality ( 1922 ) . <hl> People often complain about bureaucracies \u2013 \u2013 declaring them slow , rule-bound , difficult to navigate , and unfriendly . Let \u2019 s take a look at terms that define a bureaucracy to understand what they mean . Hierarchy of authority refers to the aspect of bureaucracy that places one individual or office in charge of another , who in turn must answer to her own superiors . For example , as an employee at Walmart , your shift manager assigns you tasks . Your shift manager answers to his store manager , who must answer to her regional manager , and so on in a chain of command , up to the CEO who must answer to the board members , who in turn answer to the stockholders . Everyone in this bureaucracy follows the chain of command ."}, {"question": {"question_id": "fs-id2759186", "question_text": "What are some of the intended positive aspects of bureaucracies?", "question_choices": ["Increased productivity", "Increased efficiency", "Equal treatment for all", "All of the above"], "cloze_format": "___ is some of the intended positive aspects of bureaucracies.", "normal_format": "What are some of the intended positive aspects of bureaucracies?"}, "answer": {"ans_text": "All of the above", "ans_choice": 3}, "bloom": "1", "hl_sentences": "There are several positive aspects of bureaucracies . They are intended to improve efficiency , ensure equal opportunities , and increase efficiency .", "hl_context": "Finally , bureaucracies are also characterized by impersonality , which takes personal feelings out of professional situations . This characteristic grew , to some extent , out of a desire to protect organizations from nepotism , backroom deals , and other types of favoritism , simultaneously protecting customers and others served by the organization . Impersonality is an attempt by large formal organizations to protect their members . However , the result is often that personal experience is disregarded . For example , you may be late for work because your car broke down , but the manager at Pizza Hut doesn \u2019 t care about why you are late , only that you are late . Bureaucracies are , in theory at least , meritocracies , meaning that hiring and promotion is based on proven and documented skills , rather than on nepotism or random choice . In order to get into a prestigious college , you need to perform well on the SAT and have an impressive transcript . In order to become a lawyer and represent clients , you must graduate law school and pass the state bar exam . Of course , there are many well-documented examples of success by those who did not proceed through traditional meritocracies . Think about technology companies with founders who dropped out of college , or performers who became famous after a YouTube video went viral . How well do you think established meritocracies identify talent ? Wealthy families hire tutors , interview coaches , test-prep services , and consultants to help their kids get into the best schools . This starts as early as kindergarten in New York City , where competition for the most highly-regarded schools is especially fierce . Are these schools , many of which have copious scholarship funds that are intended to make the school more democratic , really offering all applicants a fair shake ? <hl> There are several positive aspects of bureaucracies . <hl> <hl> They are intended to improve efficiency , ensure equal opportunities , and increase efficiency . <hl> And there are times when rigid hierarchies are needed . But remember that many of our bureaucracies grew large at the same time that our school model was developed \u2013 \u2013 during the Industrial Revolution . Young workers were trained and organizations were built for mass production , assembly line work , and factory jobs . In these scenarios , a clear chain of command was critical . Now , in the information age , this kind of rigid training and adherence to protocol can actually decrease both productivity and efficiency ."}, {"question": {"question_id": "eip-422", "question_text": "What is an advantage of the McDonaldization of society?", "question_choices": ["There is more variety of goods.", "There is less theft.", "There is more worldwide availability of goods.", "There is more opportunity for businesses."], "cloze_format": "An advantage of the McDonaldization of society is that ___ .", "normal_format": "What is an advantage of the McDonaldization of society?"}, "answer": {"ans_text": "There is more worldwide availability of goods.", "ans_choice": 2}, "bloom": "1", "hl_sentences": "While McDonaldization has resulted in improved profits and an increased availability of various goods and services to more people worldwide , it has also reduced the variety of goods available in the marketplace while rendering available products uniform , generic , and bland .", "hl_context": "The McDonaldization of Society ( Ritzer 1993 ) refers to the increasing presence of the fast food business model in common social institutions . This business model includes efficiency ( the division of labor ) , predictability , calculability , and control ( monitoring ) . For example , in your average chain grocery store , people at the register check out customers while stockers keep the shelves full of goods and deli workers slice meats and cheese to order ( efficiency ) . Whenever you enter a store within that grocery chain , you receive the same type of goods , see the same store organization , and find the same brands at the same prices ( predictability ) . You will find that goods are sold by the pound , so that you can weigh your fruit and vegetable purchase rather than simply guessing at the price for that bag of onions , while the employees use a timecard to calculate their hours and receive overtime pay ( calculability ) . Finally , you will notice that all store employees are wearing a uniform ( and usually a name tag ) so that they can be easily identified . There are security cameras to monitor the store , and some parts of the store , such as the stockroom , are generally considered off-limits to customers ( control ) . <hl> While McDonaldization has resulted in improved profits and an increased availability of various goods and services to more people worldwide , it has also reduced the variety of goods available in the marketplace while rendering available products uniform , generic , and bland . <hl> Think of the difference between a mass-produced shoe and one made by a local cobbler , between a chicken from a family-owned farm versus a corporate grower , or a cup of coffee from the local diner instead of one from Starbucks ."}, {"question": {"question_id": "eip-610", "question_text": "What is a disadvantage of the McDonaldization of society?", "question_choices": ["There is less variety of goods.", "There is an increased need for employees with postgraduate degrees.", "There is less competition so prices are higher.", "There are fewer jobs so unemployment increases."], "cloze_format": "A disadvantage of the McDonaldization of society is that ___.", "normal_format": "What is a disadvantage of the McDonaldization of society?"}, "answer": {"ans_text": "There is less variety of goods.", "ans_choice": 0}, "bloom": "1", "hl_sentences": "While McDonaldization has resulted in improved profits and an increased availability of various goods and services to more people worldwide , it has also reduced the variety of goods available in the marketplace while rendering available products uniform , generic , and bland .", "hl_context": "The McDonaldization of Society ( Ritzer 1993 ) refers to the increasing presence of the fast food business model in common social institutions . This business model includes efficiency ( the division of labor ) , predictability , calculability , and control ( monitoring ) . For example , in your average chain grocery store , people at the register check out customers while stockers keep the shelves full of goods and deli workers slice meats and cheese to order ( efficiency ) . Whenever you enter a store within that grocery chain , you receive the same type of goods , see the same store organization , and find the same brands at the same prices ( predictability ) . You will find that goods are sold by the pound , so that you can weigh your fruit and vegetable purchase rather than simply guessing at the price for that bag of onions , while the employees use a timecard to calculate their hours and receive overtime pay ( calculability ) . Finally , you will notice that all store employees are wearing a uniform ( and usually a name tag ) so that they can be easily identified . There are security cameras to monitor the store , and some parts of the store , such as the stockroom , are generally considered off-limits to customers ( control ) . <hl> While McDonaldization has resulted in improved profits and an increased availability of various goods and services to more people worldwide , it has also reduced the variety of goods available in the marketplace while rendering available products uniform , generic , and bland . <hl> Think of the difference between a mass-produced shoe and one made by a local cobbler , between a chicken from a family-owned farm versus a corporate grower , or a cup of coffee from the local diner instead of one from Starbucks ."}], "summary": "", "keyterm": "", "bname": "introduction_to_sociology"}, {"chapter": 4, "intro": " Chapter Outline 4.1   Corporate Law and Corporate Responsibility 4.2   Sustainability: Business and the Environment 4.3   Government and the Private Sector Introduction \n\n Good business leaders know that a commitment to sustainability and corporate social responsibility (CSR) requires a strong foundation, one upon which a company can build and expand its commitment to every aspect of the organization. 1  Companies that truly intend to incorporate CSR into their long-term strategy start by soliciting input from a large and diverse group of stakeholders, followed by a transparent process of implementation, commitment, and enforcement. Corporate social responsibility is more than just another policy; it\u2019s a philosophy, capturing the essence of  nemawashi , or \u201cbuilding strong roots\u201d ( Figure 4.1 ). CSR also demonstrates that a company is willing to commit the financial and human resources necessary to make it a reality, rather than just a talking point. \n\n This chapter looks at sustainability and CSR from the perspective of a diverse constituency, including managers, employees, investors, government regulators, competitors, customers and clients, the community, and the environment. If you were a CEO, would you be willing to commit the time and money to incorporate CSR the right way in your company? Why might some businesses hesitate to use a  nemawashi -style approach? ", "chapter_text": " 4.1   Corporate Law and Corporate Responsibility \n\n Learning Objectives \n\n By the end of this section, you will be able to: \n\n Explain how investors and owners benefit from doing business as a corporate entity \n\n Define the concept of shareholder primacy \n\n Discuss the conflict between shareholder primacy and corporate social responsibility \n\n Corporate law, which enables businesses to take advantage of a legal structure that separates liability from ownership and control, was introduced in most states in the nineteenth century. The separation of ownership and liability means that, unlike sole proprietors and members of partnerships, owners of modern business corporations enjoy the advantage of limited liability for the corporation\u2019s debts and other financial obligations, a concept at the heart of a U.S. economic system built on capitalism. \n\n The Advantages of Corporate Status \n\n The concept of  limited liability  means that the owners (shareholders or stockholders) of corporations, as well as directors and managers, are protected by laws stating that in most circumstances, their losses in case of business failure cannot exceed the amount they paid for their shares of ownership ( Figure 4.2 ). The same protection applies to owners of some other business entities such as  limited liability companies  (LLCs). An LLC is similar to a corporation in that owners have limited liability; however, it is organized and managed more like a partnership. For purposes of granting owners the protection of limited liability, several types of entities are possible within each state, including a corporation, an LLC, a limited liability partnership, and a limited partnership. \n\n Without state incorporation laws, business owners would be subject to personal liability for business losses, which could create several disadvantages. Ownership would be riskier, so owners could have more difficulty selling their ownership interests. They could also be subject to a pro rata share of income taxes. These types of personal financial liability could limit the ability of businesses to raise capital by selling stock. Limited liability, by reducing the amount a shareholder can lose from investing in a corporation by buying its stock, increases the investment\u2019s attractiveness to potential new shareholders. Ultimately, corporate status increases both the potential number of willing investors and the amount of capital they are likely to invest. After all, would you be willing to invest your money in a business if you knew not only that you could lose the capital you invested, but also that you could be sued personally for any and all debts of the business? \n\n Corporate status is conferred upon a business by state law (statute) when a state issues the business a charter of incorporation. The protective shield of  corporate status  enables businesses to socialize their losses in a way that traditional proprietorships and partnerships are not able to do.  Socializing  a loss is a means to amortize it or spread it out over society in general, so the owners do not absorb it individually. Amortization is similar to the idea behind insurance, in which many people bear a small share in a loss, rather than one or a few people bearing all of it. Therefore, it is accurate to say that society enables corporations to exist, both by passing laws that create them and by limiting the financial risk exposure of their owners. Since our society grants for-profit businesses the right to incorporate and make unlimited profits with limited liability, a reasonable person could conclude that corporations owe a debt to society in return. Corporations\u2019  quid pro quo \u2014a Latin term meaning  this for that \u2014is acceptance of  corporate social responsibility , to benefit the many stakeholders to whom corporations may owe a duty, including customers, the community, the environment, employees, media, and the government ( Figure 4.3 ). \n\n Balancing the Many Responsibilities of a Corporation \n\n A longstanding ethical debate about corporate social responsibility asks whether, in fact, a corporation owes a duty to society or only to its shareholders. The line of important court cases shaping this issue spans almost a century and includes a series of landmark cases involving the  Ford Motor Company , the Wrigley Company, and Hobby Lobby. \n\n In  Dodge v. Ford Motor Company  (1919), the Michigan Supreme Court ruled in favor of  shareholder primacy , saying that founder Henry  Ford  must operate the Ford Motor Company primarily in the profit-maximizing interests of its shareholders. 2  In the traditional corporate model, a corporation earns revenue and, after deducting expenses, distributes the profits to shareholders in the form of dividends. Ford had announced that his company would stop paying big dividends to shareholders and instead would use its profits to achieve several other goals, including improving product quality, expanding company facilities, and perhaps most surprisingly, lowering prices. Shareholders then sued Ford, asking the court to order Ford Motor Company to continue allocating the lion\u2019s share of profits to high dividend payments. (It is ironic that the named shareholders who sued Ford were the Dodge brothers, former Ford suppliers who had recently started their own car company.) \n\n At the trial, Ford ( Figure 4.4 ) testified that he believed his company was sufficiently profitable to consider its broader obligation and engage in activities to benefit the public, including its workers and customers. This was a unique position for the founder and primary owner of a large corporation to take in the early twentieth century. During the rise of capitalism in the United States, most owners sought only to maximize profits, because that was the primary basis of their ability to attract capital and to reinvest in the company. Most investors were interested in a healthy return on their investment, rather than any type of social good. Shareholders contended that the concern Ford expressed for his workers and customers was both improper and illegal. The court agreed, and Ford was forced to abandon his managerial goal of balancing profits and realizing broader social goals. 3 \n\n Ironically, in the same case, the court upheld the validity of a doctrine known as the  business judgment rule , a common-law principle stating that officers, directors, and managers of a corporation are not liable for losses incurred when the evidence demonstrates that decisions were reasonable and made in good faith, which gives corporate management latitude in deciding how to run the company. 4  Essentially, the business judgment rule holds that a court will not second-guess the decisions of a company\u2019s managers or directors. \n\n The legality and appropriateness of social responsibility as a business policy have followed a long and winding road since 1919. In the 1950s and 1960s, for example, some state courts rejected the shareholder primacy doctrine, instead ruling that a broad interpretation of the business judgment rule allowed managers discretion when it came to allocating company assets, including using them for programs demonstrating social awareness. \n\n In 1968, in a highly publicized case, the court ruled that the board of directors of the  Wrigley Company , of baseball and chewing gum fame, had a significant amount of discretion in determining how to balance the interests of stakeholders. 5  The case of  Shlensky v. Wrigley  (1968) revolved around William Wrigley Jr.\u2019s ownership of the Chicago Cubs. The baseball team had steadfastly refused to install the lights necessary for playing night games at Wrigley Field, even though every other stadium in major league baseball had lights. Instead, the Cubs had respected the local community\u2019s belief that night baseball games and their associated lights would negatively affect the surrounding neighborhood, creating more opportunities for crime. In the view of some investors, however, the Cubs\u2019 decision was depressing profits for shareholders. The shareholders brought a challenge against the Wrigley Company, but the Cubs\u2019 owners won the case. \n\n The Wrigley case represented a shift from the idea that corporations should pursue only the maximization of shareholder value, as had been held in the Ford Motor Company case. 6  As a follow-up to this case, lights were finally installed at Wrigley Field in 1988, but only after the owner, William Wrigley III, had sold the team (in 1981) to the Tribune Company, a large media conglomerate that fought for six years to install lights. However, the case stands as precedent for the ability of management to balance various interests and profits when making decisions. \n\n Dodge v. Ford  (1919) and  Shlensky v. Wrigley  (1968) established the dynamic nature of the debate over the shareholder primacy doctrine and indicated a shift in both legal thought and precedent toward allowing management greater latitude in deciding how to best manage a corporation. A more recent decision,  Burwell v. Hobby Lobby  (2014), demonstrated what some may consider the double-edged sword of this latitude. 7  In a 5\u20134 decision in favor of Hobby Lobby, the Supreme Court ruled that some corporations (those that are closely held by a few shareholders) can object on ethical, moral, or religious grounds to the Affordable Care Act\u2019s rule that health insurance policies must cover various forms of contraception; such companies can elect not to offer such coverage. \n\n The majority opinion in the case was written by Justice Samuel Alito, joined by Chief Justice John Roberts and Justices Antonin Scalia, Clarence Thomas, and Anthony Kennedy. In essence, the Court ruled that business owners could place their personal values first and follow their own agenda. The case received a great deal of publicity, some of it quite negative. Essentially, the Court held in this case that \u201ccorporate law does not require for-profit corporations to pursue profit at the expense of everything else,\u201d 8  similar to the ruling in the Chicago Cubs/Wrigley Field case. \n\n The decision was a victory for the family that owns Hobby Lobby and has been praised by some and criticized by others for expanding the rights of corporate owners. Some analysts believe it represents more than just an expansion of management prerogative and enlarges the right of corporations to be treated as a \u201cperson.\u201d The Hobby Lobby case can be interpreted to mean the people who control corporations (owners and/or management) may act on their own values in a way that might well be inconsistent with the interests of employees and other minority shareholders. In the majority decision, Alito wrote, \u201cA corporation is simply a form of organization used by human beings to achieve desired ends. When rights, whether constitutional or statutory, are extended to corporations, the purpose is to protect the rights of these people.\u201d 9  Hobby Lobby is primarily owned by one family, and Alito\u2019s comments seem to suggest that another interpretation would limit the applicability of the case to only closely held corporations, in which the majority of the stock is owned by a small number of shareholders. \n\n Some might think Henry Ford\u2019s attempt to forego profits in order to pay workers higher wages was a good choice but not find Hobby Lobby\u2019s preference for limiting female employees\u2019 health insurance benefits on religious grounds to be so. However, the law must be interpreted logically: If you give management the prerogative to put one social issue ahead of profits, should management not also be able to pursue any social issue of its choosing? An extension of the logic used in the Hobby Lobby case could lead to an expansion of the corporate rights of the personhood doctrine, for example, by allowing the individual right to privacy to become a shield against regulatory scrutiny by government agencies (although a corporation is not a natural person). \n\n Another potential problem with giving management greater rights to pursue social agendas is protecting the interests of minority shareholders who disagree with the majority. Since corporation law is state law, the protections for minority shareholders vary widely, but owners of a small number of shares have little or no power to influence the choices the corporation makes. Some states allow cumulative voting for seats on the board of directors, which increases minority shareholder power. Others permit buyouts or dissolution statutes that apply to closely held corporations. However, in a traditional large corporation, none of these protections for minority interests are likely to apply. Of course, another option is for disgruntled shareholders to sell their shares. \n\n The Two Sides of the Corporate Responsibility Debate \n\n The issue of  corporate social responsibility  is the subject of high-level global discussion and debate among leaders in the public and private sectors, such as the World Economic Forum Annual Meeting in Davos, Switzerland. Numerous respected academic centers also hold forums on CSR, such as the Center on Democracy, Development, and the Rule of Law at Stanford University and the Harvard Law School Forum on Corporate Governance and Financial Regulation. \n\n As we have seen, slow but steady acceptance of CSR as a legitimate business concept has led to the legal and ethical position that corporate directors and managers may exercise business judgment and discretion in running a corporation. This development has come about for multiple reasons: a) the fact that society allows LLCs to exist, b) the sheer magnitude of the economic power corporations possess, and c) the desire of corporations to act responsibly in order to avoid more extensive government regulation. Managers are usually accorded significant latitude as long as they can point to a rational interpretation of their actions as benefiting the corporation as a whole in the long term. The combination of economic and political power in the world\u2019s largest corporations necessitates that executives consider the interests of a broader set of stakeholders, rather than only stockholders. Indeed, social, environmental, and charitable programs often create shareholder value rather than take away from it. And honoring obligations to all stakeholders in a corporation\u2014including those who own no stock shares\u2014is the  moral minimum  a firm must undertake to satisfy the base threshold for acting ethically. \n\n A recent study by researchers at Princeton and the University of Texas indicates that corporations benefit from following CSR policies in multiple ways. 10  These benefits are collectively called a \u201chalo effect\u201d and can add value to the business. As an example, consumers frequently take CSR spending as an indirect indicator that a company\u2019s products are of high quality, and often they are also more willing to buy these products as an indirect way of donating to a good cause. \n\n However, some economists, such as Milton Friedman, Henry Hazlitt, Adam Smith, and others, have argued that CSR initiatives based on environmental or social justice instead  limit  shareholder wealth. 11  The Nobel Prize-winning economist Milton  Friedman  (1912\u20132006) believed shareholders should be able decide for themselves what social initiatives to donate to or to take part in, rather than having a business executive decide for them. He argued that both government regulation and corporate social initiatives allow an outside third party to make these choices for shareholders. \n\n In Friedman\u2019s opinion, too much power assumed by corporate management in pursuing a social agenda might ultimately lead to a form of corporate autocracy. Supporters of the profit maximization principle believe it is a waste of corporate resources to reduce air pollution below the level required by law, to require vendors to participate in a sustainable supply chain initiative, or to pay lower-level employees a salary above the legally mandated minimum wage. Friedman asserted that \u201cdoing good deeds\u201d is not the job of corporations; it is the right of those people who want to do them but should not be imposed on those who do not. His philosophy asserts that socially oriented initiatives are analogous to a form of outside regulation, resulting in higher costs to those corporations that follow socially responsible policies. \n\n When Friedman was laying out this position in the 1970s, it reflected the prevailing opinion of a majority of U.S. shareholders and commentators on corporate law at that time. In the years since then, however, Friedman\u2019s perspective has fallen into disfavor. This does not invalidate his point of view, but it does demonstrate that public opinion about corporations is subject to change over time. The subjectivity or relativity with which we view companies along with their perceived rights and responsibilities is a major theme this text addresses. \n\n Do corporate directors owe a specific fiduciary duty to shareholders? A  fiduciary duty  is a very high level of legal responsibility owed by those who manage someone else\u2019s money, which includes the duties of care and loyalty. Some examples of relationships that include a fiduciary duty are those between a trustee of an estate and its beneficiary, and between a fund manager and a client. According to the American Bar Association, the business judgment rule states \u201cthat as fiduciaries, corporate directors owe the corporation and its shareholders fiduciary duties of diligence and fidelity in performing their corporate duties. These fiduciary obligations include the duty of care and the duty of loyalty . . . the duty of care consists of an obligation to act on an informed basis; the duty of loyalty requires the board and its directors to maintain, in good faith, the corporation\u2019s and its shareholders\u2019 best interests over anyone else\u2019s interests.\u201d 12  So it would seem that the answer is yes, corporate directors do have a specific fiduciary duty to promote the best interests of the corporation. But what exactly does that duty entail? Does that specifically mean returning profits to shareholders in the form of dividends? As we have seen, these questions have frequently spilled over into the courts, in the form of shareholder lawsuits challenging the actions of directors and/or management. \n\n Link to Learning \n\n Fiduciary duty also includes a duty of communication, as you can read in the  oft-cited  Meinhard v. Salmon  case  from 1928, where the New York Court of Appeals held that business partners may have a fiduciary duty to one another regarding business opportunities that arise during the course of the partnership. \n\n UCLA law professor Steven Bainbridge wrote in the  New York Times : \u201cIf directors were allowed to deviate from shareholder wealth maximization, they would inevitably turn to indeterminate balancing standards, which provide no accountability.\u201d 13  As support for his position, Bainbridge pointed to a 2010 case,  eBay Domestic Holdings Inc. v. Newmark , in which a Delaware court ruled that corporate directors are bound by fiduciary duties and standards that include \u201cacting to promote the value of the corporation for the benefit of its stockholders.\u201d 14 \n\n However, Lynn Stout, a professor at Cornell University Law School, wrote a contrasting piece in the  New York Times  in which she said, \u201cThere is a common belief that corporate directors have a legal duty to maximize corporate profits and shareholder value\u2014even if this means skirting ethical rules, damaging the environment or harming employees. But this belief is utterly false. Modern corporate law does not require for-profit corporations to pursue profit at the expense of everything else, and many do not.\u201d 15  Her opinion is based in part on the Hobby Lobby decision referenced above. \n\n Thus, while ethicists may agree that corporations do indeed owe social responsibilities to society, legal experts still differ over this point. The fact that we have seen inconsistent decisions from the courts over the last century confirms the lack of legal consensus. Of course, both legal and ethical opinion are always in flux, so where the debate stands today in no way indicates where it will be in ten years. On this issue, public opinion, as well as that of politicians and even the courts, is like a pendulum swinging back and forth, usually between points of view that are center-right or center-left, rather than at the extremes. However, the pendulum is reset every so often, and the arc within which it swings may differ from era to era. \n\n Cases from the Real World Unilever \u201cEnhancing Livelihoods\u201d through Project Shakti According to management guru Peter Drucker, whose ideas significantly contributed to the foundations of thought about the workings of the modern business corporation, workers \u201cneed to know the organization\u2019s mission and to believe in it.\u201d How do organizations ensure this commitment? By satisfying workers\u2019 values. 16  A program undertaken by Unilever, the Dutch-British multinational company co-headquartered in Rotterdam and London, illustrates the kind of values-oriented corporate endeavor Drucker describes.  Project Shakti  is a Unilever CSR initiative in India that links corporate social responsibility and financial opportunities for local women. 17  It is considered a leading example of micro-entrepreneurship, and it expands the concept of sustainability to include not only environmental issues but also economic opportunity and financial networking in underdeveloped areas. \n\n The goal, according to Unilever, is to give rural Shakti women the ability to earn money for themselves and their families as micro-entrepreneurs. Unilever\u2019s subsidiary in India, Hindustan Lever, has started training programs for thousands of women in small towns and villages across India to help them understand how to run their own small sole proprietorships as distributors of the company\u2019s products. With support from a team of rural sales managers, women who had been unable to support themselves are now becoming empowered by learning how a supply chain works, what products Hindustan Lever produces, and how to distribute them. The sales managers also act in a consulting capacity to help with business basics, money management, negotiations, and related skills that help the women run their businesses effectively. \n\n The program was so successful that Unilever expanded it to include Shakti men, typically the sons, brothers, or husbands of the women already running businesses. The men, who are essentially like delivery drivers, sell Unilever products using bicycles for transportation, enabling them to cover a larger area than women cover on foot. The women spend most of their time running the business. \n\n Project Shakti has enlisted more than 100,000 rural participants, which includes about 75,000 women. The project has changed their lives in ways that are profound, and not only because of the income earned. The women now have increased self-esteem based on a sense of empowerment, and they finally feel they have a place in Indian society. According to the Unilever Sustainable Living Plan, Project Shakti is one of the best and most sustainable ways the company can address women\u2019s social concerns. It allows Unilever to conduct business in a socially responsible manner, helping women to help themselves while extending the reach of its products. \n\n Critical Thinking \n\n Do you believe Unilever sponsors the Shakti program to help women, to boost its own profits, or both? Explain your answer. \n\n If Unilever has mixed motives, does this discredit the company in your eyes? Should it? \n\n How is this program an example of both corporate and personal sustainability? \n\n Could this model program be duplicated elsewhere, in another area and with different products? Why or why not? \n\n It is clear that many different stakeholders value corporate social responsibility, including some investors, shareholders, employees, customers, and suppliers. Indeed, some businesses look at CSR as providing a perfect long-term strategic opportunity to strengthen company fundamentals while contributing to society at the same time. Effective corporate leaders will get try to get investors on board with the idea of CSR, avoiding or minimizing the potential for any litigation related to maximization of profits. And innovative companies are finding ways to create value for both the business and society simultaneously. 18 \n\n Data analysis indicates that following a policy of corporate social responsibility does not have to mean losing money; on the contrary, many corporations that use an ethical approach to doing business are actually quite profitable. Mutual funds, recognizing that investors care about sustainable investing, now offer socially responsible funds, and third-party ratings companies, such as Morningstar, rate the funds so potential investors can evaluate how well the companies in them are meeting environment, social, and governance challenges. An example of such a fund is the Calvert Fund, which describes itself as a \u201cleader in responsible investing with a mission to deliver superior long-term performance to our clients and to enable them to achieve positive impact.\u201d 19 \n\n Link to Learning \n\n This  website for Ellevest  takes you to a digital investment platform run by women for women clients. The idea was launched in 2016 by Sallie Krawcheck, who had worked for large Wall Street firms and experienced first-hand the challenges of using an ethical approach to investing in traditional firms, especially for women. \n\n The chart below analyzes mutual funds and their rate of return over several different time periods; included are examples of both general index funds and \u201csocially responsible\u201d or  social index funds  ( Figure 4.5 ). If we compare the two  general index funds  at the top to the three funds at the bottom that invest in socially responsible companies, we see a competitive return on investment in the social funds. Social responsibility does not mean lower profitability. \n\n Link to Learning \n\n Being socially responsible does not necessarily mean being unprofitable. This  video interview with George Pohle  reveals how ensuring that CSR is at the core of a business\u2019s strategy can yield financial benefits. Pohle is the vice president and global leader of the Business Strategy Consulting Division at IBM Global Business Services. \n 4.2   Sustainability: Business and the Environment \n\n Learning Objectives \n\n By the end of this section, you will be able to: \n\n Explain the concept of earth jurisprudence \n\n Evaluate the claim that sustainability benefits both business and the environment \n\n Identify and describe initiatives that attempt to regulate pollution or encourage businesses to adopt clean energy sources \n\n Public concern for the natural  environment  is a relatively new phenomenon, dating from the 1960s and Rachel Carson\u2019s seminal book  Silent Spring , published in 1962. In 1992, Cormac Cullinan\u2019s  Wild Law  proposed \u201cearth justice\u201d or \u201cearth jurisprudence,\u201d a concept underlying the law\u2019s ability to protect the environment and effectively regulate businesses that pollute. The preoccupation with business success through investment in corporations, in contrast, is a much older concept, dating back at least to the creation of the British East India Company in 1600, and the widespread emergence of the corporation in Europe in the 1700s. If you were a business owner, would you be willing to spend company resources on environmental issues, even if not required to do so by law? If so, would you be able to justify your actions to shareholders and investment analysts as smart business decisions? \n\n Environmental Justice \n\n If a business activity harms the environment, what rights does the environment have to fight back? Corporations, although a form of business entity, are actually considered persons in the eyes of the law. Formally,  corporate personhood , a concept we touched on in the preceding section, is the legal doctrine holding that a corporation, separate and apart from the people who are its owners and managers, has some of the same legal rights and responsibilities enjoyed by natural persons (physical humans), based on an interpretation of the word \u201cperson\u201d in the Fourteenth Amendment. 20 \n\n The generally accepted constitutional basis for allowing corporations to assert that they have rights similar to those of a natural person is that they are organizations of people who should not be deprived of their rights simply because they act collectively. Thus, treating corporations as persons who have legal rights allows them to enter into contracts with other parties and to sue and be sued in a court of law, along with numerous other legal rights. Before and after the Supreme Court\u2019s ruling in  Citizens United v. Federal Election Commission  (2010), which upheld the First Amendment free-speech rights of corporations, there have been numerous challenges to the concept of corporate personhood; however, none have been successful. Thus, U.S. law considers corporations to be persons with rights protected under key constitutional amendments, regulations, and case law, as well as responsibilities under the law, just as human persons have. \n\n A question that logically springs from judicial interpretations of corporate personhood is whether the environment should enjoy similar legal status. Should the environment be considered the legal equivalent of a person, able to sue a business that pollutes it? Should environmental advocates have been able to file a lawsuit against BP (formerly British Petroleum) on behalf of the entire Gulf of Mexico for harm created by the 2010  Deepwater Horizon  oil spill (discussed in more detail in the government regulation section of this chapter), which, at five million barrels, was ten times larger than the famous Exxon Valdez spill and remains the largest and most widespread ocean oil spill in the history of the global petroleum industry? Furthermore, the Deepwater Horizon spill affected not only thousands of businesses and people, but also the entirety of the Gulf of Mexico, which will suffer harm for years to come. Should the Gulf of Mexico have legal standing to sue, just like a person? \n\n While U.S. jurisprudence has not yet officially recognized the concept that Earth has legal rights, there are examples of progress. Ecuador is now the first country to officially recognize the concept. 21  The country rewrote its Constitution in 2008, and it includes a section entitled \u201cRights for Nature.\u201d It recognizes nature\u2019s right to exist, and people have the legal authority to enforce these rights on behalf of the ecosystem, which can itself be named as a litigant in a lawsuit. \n\n Earth jurisprudence is an interpretation of law and governance based on the belief that society will be sustainable only if we recognize the legal rights of Earth as if it were a person. Advocates of earth jurisprudence assert that there is legal precedent for this position. As pointed out earlier in this chapter, it is not only natural persons who have legal rights, but also corporations, which are artificial entities. Our legal system also recognizes the rights of animals and has for several decades. According to earth jurisprudence advocates, officially recognizing the legal status of the environment is necessary to preserving a healthy planet for future generations, in particular because of the problem of \u201cinvisible pollution.\u201d \n\n Businesses that pollute the environment often hide what they are doing in order to avoid getting caught and facing economic, legal, or social consequences. The only witness may be Earth itself, which experiences the harmful impact of their invisible actions. For example, as revealed in a recent report, 22  companies all over the world have for years been secretly burning toxic materials, such as carbon dioxide, at night. A company that needs to dump a toxic substance usually has three choices: dispose of it properly at a safe facility, recycle and reuse it, or secretly dump it. There is no doubt that dumping is the easiest and cheapest option for most businesses. \n\n As another example, approximately twenty-five million people board cruise ships every year, and as a result, cruise ships dump one billion gallons (3.8 billion liters) of sewage into the oceans annually, usually at night so no one sees or smells it. Friends of the Earth, a nongovernmental organization (NGO) concerned with environmental issues, used data from the U.S. Environmental Protection Agency (EPA) to calculate this figure. 23  The sewage dumped into the sea is full of toxins, including heavy metals, pathogens, bacteria, viruses, and pharmaceutical drugs ( Figure 4.6 ). When invisibly released near coasts, this untreated sewage can kill marine animals, contaminate seafood, and sicken swimmers, and no one registers the damage except the ocean itself. Many believe the environment should have the right not to be secretly polluted in the dead of night, and Earth should have rights at least equal to those of corporations. \n\n Cormac Cullinan, an environmental attorney, author, and leading proponent of earth jurisprudence, often collaborates with other environmental advocates such as Thomas Berry, an eco-theologian, scholar, and author. Cullinan, Berry, and others have written extensively about the important legal tenets of earth jurisprudence; however, it is not a legal doctrine officially adopted by the United States or any of its states to date. The concept of earth justice is tied indirectly to the economic theory of the \u201ctragedy of the commons,\u201d a phrase derived from British economist William Forster Lloyd, who, in the mid-nineteenth century, used a hypothetical example of unregulated grazing on common land to explain the human tendency to act independently, putting self-interest first, without regard for the common good of all users. The theory was later popularized by ecologist and philosopher Garrett Hardin, who tied it directly to environmental issues. In other words, when it comes to natural resources, the  tragedy of the commons  holds that people generally use as much of a free resource as they want, without regard for the needs of others or for the long-term environmental effects. As a way of combating the tragedy of the commons, Cullinan and others have written about the concept of earth justice, 24  which includes the following tenets: \n\n \u201cThe Earth and all living things that constitute it have fundamental rights, including the right to exist, to have a habitat or a place to be. \n\n Humans must adapt their legal, political, economic, and social systems to be consistent with the fundamental laws or principles that govern how the universe functions. \n\n Human acts, including acts by businesses that infringe on the fundamental rights of other living things violate fundamental principles and are therefore illegitimate and unlawful.\u201d 25 \n\n Link to Learning \n\n The concept of earth justice relies heavily on  Garrett Hardin\u2019s discussion of the tragedy of the commons  in  Science  in 1968. 26  This classic analysis of the environmental dilemma describes how, from colonial times, Americans regarded the natural environment as something to be used for their own farming and business ends. Overuse, however, results in the inevitable depletion of resources that negatively affects the environment, so that it eventually loses all value. \n\n Today, supporters of the environment assert that government has both a right and an obligation to ensure that businesses do not overuse any resource, and to mandate adequate environmental protection when doing so. In addition, some form of fee may be collected for using up a natural resource, such as severance taxes imposed on the removal of nonrenewable resources like oil and gas, or deposits required for possible cleanup costs after projects have been abandoned. As part of the growing acceptance of the concept of earth justice, several nonprofit educational organizations and NGOs have become active in both lobbying and environmental litigation. One such organization is the Center for Earth Jurisprudence (housed at the Barry School of Law in Orlando), a nonprofit group that conducts research in this area. \n\n Link to Learning \n\n The following  video describing the Center for Earth Jurisprudence  discusses support for laws that legally protect the sustainability of life and health on Earth, focusing upon the springs and other waters of Florida. \n\n Why Sustainability Is Good for Business \n\n The notion that the  environment  should be treated as a person is relatively new. But given the prominence of the environmental movement worldwide, no well-managed business today should be conducted without an awareness of the tenuous balance between the health of the environment and corporate profits. It is quite simply good business practice for executives to be aware that their enterprise\u2019s long-term sustainability, and indeed its profitability, depend greatly on their safeguarding the natural environment. Ignoring this interrelationship between business and the environment not only elicits public condemnation and the attention of lawmakers who listen to their constituents, but it also risks destroying the viability of the companies themselves. Virtually all businesses depend on natural resources in one way or another. \n\n Progressive corporate managers recognize the multifaceted nature of  sustainability \u2014a long-term approach to business activity, environmental responsibility, and societal impact. Sustainability affects not only the environment but also other stakeholders, including employees, the community, politics, law, science, and philosophy. A successful sustainability program thus requires the commitment of every part of the company. For example, engineers are designing manufacturing and production processes to meet the demands of companies dedicated to sustainability, and the idea of company-wide sustainability is now mainstream. Many of the largest companies in the world see sustainability as an important part of their future survivability. \n\n The Global 100 and Sustainability\u2019s Strategic Worth \n\n Corporate Knights is a Canadian research and publishing company that compiles an annual list called the  Global 100 , identifying the world\u2019s most sustainable companies. 27  The 2018 edition of the list, presented at the World Economic Forum in Davos, Switzerland, shows that an increasing number of major multinational companies take sustainability seriously, including many U.S. businesses. The highest-ranking U.S. company is technology giant Cisco, which ranks seventh on the Global 100 list. 28  Other U.S. companies in the top twenty-five include Autodesk, Merck, and McCormick & Co. The countries with the best representation on the list are primarily from North America and Western Europe: the United States (18), France (15), the United Kingdom (10), Germany (7), Brazil (5), Finland (5), and Sweden (5). \n\n You may expect that companies dedicated to sustainability would be less profitable in the long run as they face additional costs. In fact, data from the Global 100\u2019s return on investment shows this is not the case. Let\u2019s examine the evidence. If an investor had put $250 in Global 100 companies in 2005, it would have been worth $580 in 2015, compared to $520 for the same amount invested in a typical index fund. The Global 100\u2019s cumulative return on high-sustainability firms is about 25 percent higher than a traditional investment. 29 \n\n Cisco Systems, number seven on the global list, is a good example of how green procurement and sustainable sourcing have become a regular part of the supply chain. At Cisco, according to a top-level supply chain executive, \u201cwe take seriously the responsibility of delivering products in an ethical and environmentally responsible manner.\u201d 30  Cisco relies on its Supplier Code of Conduct to set standards for suppliers so they follow fair labor practices, ensure safe working conditions, and reduce their  carbon footprint , the amount of carbon dioxide and other carbon compounds released by the consumption of fossil fuels, which can be measured quantitatively (see the link below). Cisco is in the process of embedding sustainability into supply chain management at all levels. \n\n Link to Learning \n\n Do you know what your carbon footprint is? This  personal footprint calculator  allows you to find out where you stand. \n\n Another company dedicated to  sustainability  is Siemens, which was ranked number nine on the 2018 list. Siemens is a multinational industrial conglomerate headquartered in Germany, whose businesses range from power plants to electrical systems and equipment in the medical field and high-tech electronics. Siemens was rated the most energy-efficient firm in its sector, because it produced more dollars in revenue per kilowatt used than any other industrial corporation. This is a standard technique to judge efficiency and demonstrates that Siemens has a low carbon footprint for a company in the industries in which it operates. The commitment of Siemens to sustainability is further demonstrated by its decision to manufacture and sell more environmentally friendly infrastructure products such as green heating and air conditioning systems. \n\n Cisco and Siemens show that businesses across the globe are starting to understand that for a supply chain to be sustainable, companies and their vendors must be partners in a clean and safe environment. Do businesses simply pay lip service to environmental issues while using all available natural resources to make as much money as they can in the present, or are they really committed to sustainability? There is abundant evidence that sustainability has become a policy adopted by businesses for financial reasons, not simply public relations. \n\n McKinsey & Company is one of the world\u2019s largest management consulting firms and a leader in the use of data analytics, both qualitative and quantitative, to evaluate management decisions. McKinsey conducts periodic surveys of companies around the world on matters of importance to corporate leaders. In the 2010 survey, 76 percent of executives agreed that sustainability provides shareholders long-term value, and in the 2014 survey, entitled \u201cSustainability\u2019s Strategic Worth,\u201d the data indicated that many companies consider cost savings to be the number-one reason for adopting such policies. Cost cutting, improved operations, and efficiency were indicated as the primary reasons for adopting sustainability policies by over one-third of all companies (36%). 31 \n\n Other major studies have demonstrated similar results. Grant Thornton is a leading global accounting and consulting firm. Its 2014 report on CSR showed that the top reason companies cite for moving towards more environmentally responsible business practices is financial savings. Grant Thornton conducted more than 2,500 interviews with clients and business executives in approximately thirty-five countries to discover why companies are making a commitment to sustainable practices. The study found that cost management was the key reason for sustainability (67%). 32 \n\n A specific example is Dell Computers, headquartered outside Austin, Texas, and with operations all over the world. The \u201cDell Legacy of Good Plan\u201d has set a goal to reduce greenhouse gas emissions from all facilities and operations by 50 percent by the year 2020, along with several other environmental goals. As part of this overall plan, Dell created the Connected Workplace, a flex-work program allowing alternative arrangements such as variable work hours to avoid rush hour, full- or part-time work at home flexibility, and job sharing. This sustainability initiative helps the company avoid about seven thousand metric tons of greenhouse gas emissions, and, directly related to the financial benefit of sustainability, it saves the company approximately $12 million per year. 33 \n\n However, adopting sustainability policies may require a long-term outlook. A recent article in the  Harvard Business Review  discussed the issue of sustainability and how it can create real cost savings ( Figure 4.7 ). \u201cIt\u2019s hard for companies to recognize that sustainable production can be less expensive. That\u2019s in part because they have to fundamentally change the way they think about lowering costs, taking a leap of faith . . . that initial investments made in more-costly materials and methods will lead to greater savings down the road. It may also require a willingness to buck conventional financial wisdom by focusing not on reducing the cost of each part but on increasing the efficiency of the system as a whole.\u201d 34 \n\n Sustainability Standards \n\n The International Organization for Standardization, or ISO, is an independent NGO and the world\u2019s largest developer of voluntary international business standards. More than twenty thousand ISO standards now cover matters such as sustainability, manufactured products, technology, food, agriculture, and even healthcare. The adoption and use of these standards by companies is voluntary, but they are widely accepted, and following ISO certification guidelines results in the creation of products and services that are clean, safe, reliable, and made by workers who enjoy some degree of protection from workplace hazards. \n\n In the environmental area, the  ISO 14000  series of standards promotes effective environmental management systems in business organizations by providing cost-effective tools that make use of best practices for environmental management. These standards were developed in the 1990s and updated in 2015; they cover everything from the eco-design (ISO 14006) of factories and buildings to environmental labels (ISO 14020) to limits on the release of greenhouse gasses (ISO 14064). While their adoption is still voluntary, a growing number of countries allow only ISO 14000-certified companies to bid on public government contracts, and the same is true of some private-sector companies ( Figure 4.8 ). \n\n Another type of sustainability standard with which businesses may elect to comply is  LEED certification . LEED stands for Leadership in Energy and Environmental Design, and it is a rating system devised by the U.S. Green Building Council to evaluate a structure\u2019s environmental performance. The most famous example is the Empire State Building in New York City, which was awarded LEED Gold status (for existing buildings). The LEED certification was the result of a multimillion-dollar rebuilding program to bring the building up to date, and the building is the tallest in the United States to receive it. There are dozens of other examples of large commercial buildings, such as the Wells Fargo Tower in Los Angeles, as well as thousands of smaller buildings and residential homes. LEED certification is the driver behind the ongoing market transformation towards sustainable design in all types of structures, including buildings, houses, and factories. \n\n The High Cost of Inaction \n\n According to estimates from the EPA, by the year 2050, Earth\u2019s population will be about ten billion people. Dramatic population growth has had a very significant and often negative human impact on the planet. Not only are there more people to feed, house, and care for, but new technologies allow businesses to harness natural resources in unprecedented amounts. NGOs and government agencies alike have taken notice. For years, the Department of State and the Department of Defense have considered climate change to be a potential threat to the long-term security of the United States. If unmanaged, climate change could pose a risk to both U.S. security and Department of Defense facilities and operations. 35  Other respected organizations are also alerting the public to the risks of ignoring climate change. \n\n The  Union of Concerned Scientists  (UCS) has released a detailed report identifying approximately twenty serious risks that will be faced if the problem is not addressed in a substantial way. These risks include rising seas and increased coastal flooding, more intense and frequent heat waves, more destructive hurricanes, wildfires that last longer and produce more damage, and heavier precipitation in some areas and more severe droughts in other areas. In addition to extreme weather events, there would likely be widespread forest death in the Rocky Mountains and other mountain ranges, the destruction of coral reefs, and shifts in the ranges of plants and animals. Both military bases and national landmarks would be at risk, as would the electrical grid and food supply. The UCS, with a membership consisting of the world\u2019s most respected scientists, bases its projections on scientific research studies that have produced empirical evidence of climate change. Its official position is that \u201cglobal warming is already having significant and very costly effects on communities, public health, and our environment.\u201d 36 \n\n Environmental protection and climate change issues receive varying degrees of support at the national level, depending on the commitment different presidents make to them. During periods in which the administration in Washington demonstrates a lower priority for climate change issues, such as the Trump administration\u2019s announced intention to withdraw from the Paris Climate Accord, private companies may take the lead on actions to reduce global warming emissions.  \n\n For example, Microsoft founder Bill Gates recently announced the creation of a private initiative to invest $20 billion on climate-related research and development over the next five years. This is an example of government-funded early experimental research that a business may be able to turn into a commercially viable solution. If government steps back, private-sector companies concerned about long-term sustainability may have to take a leadership role. 37  Ultimately, it requires the cooperation of public and private efforts to address climate change; otherwise, the impacts will continue to intensify, growing more costly and more damaging.\u201d 38 \n\n Link to Learning \n\n This  video produced by the National Oceanic and Atmospheric Administration  in conjunction with the State Department and an Oregon state agency shows the magnitude of ocean pollution. As of 2017, only two states (California and Hawaii) have banned plastic bags, according to the National Conference of State Legislatures. 39 \n\n Sustainability often requires the public and private sectors to cooperate. Inaction contributes to disasters like the 2017 devastation of Houston by Hurricane Harvey and of Puerto Rico by Hurricane Maria. There is often tension between developers who want to build and cities that try to legislate for more green space. Green space not only offers a place for recreation and enjoyment of nature, but also provides essential natural drainage for rain and flood waters, reducing the likelihood that developed areas will end up underwater in a storm. \n\n What Would You Do? Flooding in Houston: Is the Status Quo Sustainable? A symbiotic relationship exists between development and flooding in urban areas such as Houston, Texas. Imagine you are a member of the urban planning commission for the city council of Houston, which recently suffered traumatic flood damage from several major storms, including Hurricanes Harvey and Ike, and Tropical Storm Allison, all of which occurred since 2001 and caused a total of approximately $75 billion in damages. 40  The floods also caused dozens of deaths and changed the lives of millions who lived through them. Future storms may increase in severity, because climate change is warming ocean waters. \n\n The mayor and the city council have asked the planning commission to propose specific solutions to the flooding problem. This solution must not rely exclusively on taxpayer funds and government programs, but rather must include actions by the private sector as well. \n\n One of the most direct solutions is a seemingly simple tradeoff: The greater Houston area must reduce the percentage of land covered by concrete while increasing the percentage of land dedicated to green space, which acts like a sponge to absorb flood waters before they can do severe damage. The planning commission thinks the best way to accomplish this is to issue a municipal ordinance requiring corporate developers and builders to set aside as green space an amount of land at least equal to what will be covered by concrete, (neighborhoods, office buildings, parking lots, shopping centers). However, this will increase the cost of development, because it means more land will be required for each type of project, and as a result, developers will have higher land costs. \n\n Critical Thinking \n\n As a member of the urban planning commission, you will have to convince the stakeholders that a proposal to require more green space is a workable solution. You must get everyone, including developers, investors, neighborhood homeowner associations, politicians, media, and local citizens, on board with the idea that the benefit of sustainable development is worth the price. What will you do? \n\n Is this a matter that should be regulated by the local, state, or federal government? Why? \n\n Who pays for flood damage after a hurricane? Are your answers to this question and the preceding one consistent? \n\n U.S. government agencies, such as the National Aeronautics and Space Administration (NASA) and National Oceanic and Atmospheric Administration, have identified many challenges in which  sustainability  can make a positive contribution. These include climate change, decreasing supplies of clean water, loss of ecological systems, degradation of the oceans, air pollution, an increase in the use and disposal of toxic substances, and the plight of endangered species. 41  Progress toward solving these challenges depends in part on deciding who should help pay for the protection of global environmental resources; this is an issue of both environmental and distributive justice. \n\n One way to address the issue of shared responsibility between corporations and society is the implementation of a \u201ccap and trade\u201d system. According to the Environmental Defense Fund,  cap and trade  is a viable approach to addressing climate change by curbing emissions that pollute the air: The \u201ccap\u201d is a limit on greenhouse gas emissions\u2014if companies exceed their cap, they must pay penalties\u2014whereas the \u201ctrade\u201d allows companies to use the free market to buy and sell pollution allowances that permit them to emit a certain amount of pollution. \n\n At present, there are more questions than answers, including how much of the responsibility lies with governments, how this responsibility can be allocated between developed and developing nations, how much of the cost should the private sector bear, and how should these divisions of cost and responsibility be enforced. Private companies must bear part of the cost, and the business sector recognizes they have some responsibility, but many disagree on whether that should be in the form of after-the-fact fines, or before-the-fact fees and deposits paid to the government. Regulations may very well have to be international in scope, or companies from one country may abuse the environment in another. \n\n Ethics Across Time and Cultures Is It Ethical to Dump Toxic Waste in Countries That Allow It? Should a multinational company take advantage of another country\u2019s lack of regulation or enforcement if it saves money to do so? \n\n A  New York Times  news correspondent reporting from Nigeria found a collection of steel drums stacked behind a village\u2019s family living compound. In this mid-1990s case, ten thousand barrels of toxic waste had been dumped where children live, eat, and drink. 42  As safety and environmental hazard regulations in the United States and Europe have driven toxic waste disposal costs up to $3,000 per ton, toxic waste brokers are looking for the poorest nations with the weakest laws, often in West Africa, where the costs might be closer to $3 per ton. The companies in this incident were looking for cheap waste-dumping sites, and Nigeria agreed to take the toxic chemical waste without notifying local residents. Local people wearing shorts, t-shirts, and sandals unloaded barrels of polychlorinated biphenyls, placing them next to a residential area. Nigeria has often been near the top of the United Nations\u2019 list of most corrupt nations, with government leaders cutting deals to line their own pockets while exposing their citizens to environmental hazards. \n\n A more recent example occurred in C\u00f4te d\u2019Ivoire (Ivory Coast) in 2006, when residents discovered that hundreds of tons of \u201cslops\u201d (chemicals) from a foreign-owned ship had been dumped near Abidjan, the country\u2019s commercial capital. The ship was owned by a multinational energy company named Trafigura. According to a report from Amnesty International, more than 100,000 residents were sickened, leading to fifteen deaths. Trafigura had illegally dumped the toxic waste in C\u00f4te d\u2019Ivoire after searching for a disposal site in several other countries. 43 \n\n Critical Thinking \n\n Should a U.S. or European company take advantage of a country\u2019s weak approach to business and political ethics? \n\n Would your answer change if your decision saved your company $1 million? \n\n Inaction on issues of sustainability can lead to long-term environmental consequences that may not be reversible (the death of ocean coral, the melting of polar ice caps, deforestation). Another hurdle is that it is sometimes difficult to convince companies and their investors that quarterly or annual profits are short-term and transitory, whereas environmental sustainability is long-term and permanent. \n\n Environmental Economics and Policy \n\n Some politicians and business leaders in the United States believe that the U.S. system of capitalism and free enterprise is the main reason for the nation\u2019s prosperity over the past two hundred years and the key to its future success. Free enterprise was very effective in facilitating the economic development of the United States, and many people benefited from it. But it is equally true that this could not have happened without the country\u2019s wealth of natural resources like oil, gas, timber, water, and many others. When we consider the environment and the role of sustainability, the question is not whether our system works well with an abundance of natural resources. Rather, we should ask how well it would work in a nation, indeed in a world, in which such resources were severely limited. \n\n Does business, as the prime user of these resources, owe a debt to society? The  Harvard Business Review  recently conducted a debate on this topic on its opinion/editorial pages. Business owes the world everything and nothing, according to Andrew Winston, author and consultant on environmental and social challenges. \u201cIt\u2019s an important question,\u201d he wrote, \u201cbut one that implies business should do the socially responsible thing out of a sense of duty. This idea is a distraction. Sustainability in business is not about philanthropy, but about profitability, innovation, and growth. It\u2019s just plain good business.\u201d 44  On the other hand, Bart Victor, professor at Vanderbilt University\u2019s Owen Graduate School of Management, wrote, \u201cBusiness is far more powerful and deeply influential than any competing ideological force, political force or environmental force . . . business now has to see itself and its responsibilities and obligations in a new way.\u201d 45 \n\n Using deontological or duty-based reasoning, we might conclude that business does owe a debt to the environment. A basic moral imperative in a normative system of ethics is that someone who uses something must pay for it. In contrast, a more utilitarian philosophy might hold that corporations create jobs, make money for shareholders, pay taxes, and produce things that people want; thus, they have done their part and do not owe any other debt to the environment or society at large. However, utilitarianism is often regarded as a \u201chere and now\u201d philosophy, whereas deontology offers a longer-term approach, taking future generations into account and thus aligning more with  sustainability . \n\n Should businesses have to pay more in fees or taxes than ordinary citizens for public resources or infrastructure they use to make a profit? Consider the example of fracking: West Texas has seen a recent boom in oil and gas drilling due to this relatively new process. Fracking is short for hydraulic fracturing, which creates cracks in rocks beneath Earth\u2019s surface to loosen oil and gas trapped there, thus allowing it to flow more easily to the surface. Fracking has led to a greatly expanded effort to drill horizontally for oil and gas in the United States, especially in formations previously thought to be unprofitable, because there was no feasible way to get the fossil fuels to the surface. However, it comes with a significant downside. \n\n Fracking requires very heavy equipment and an enormous amount of sand, chemicals, and water, most of which must be trucked in. Traffic around Texas\u2019s small towns has increased to ten times the normal amount, buckling the roads under the pressure of a never-ending stream of oil company trucks. The towns do not have the budget to repair them, and residents end up driving on dangerous roads full of potholes. The oil company trucks are using a public resource, the local road system, often built with a combination of state and local taxpayer funds. They are obviously responsible for more of the damage than local residents driving four-door sedans to work. Shouldn\u2019t the businesses have to pay a special levy to repair the roads? Many think it is unfair for small towns to have to burden their taxpayers, most of whom are not receiving any of the profits from oil and gas development, with the cost of road repair. An alternative might be to impose a Pigovian tax, which is a fee assessed against private businesses for engaging in a specific activity (proposed by British economist A. C. Pigou). If set at the proper level, the tax is intended as a deterrent to activities that impose a net cost\u2014what economists call \u201cnegative externalities\u201d\u2014on third parties such as local residents. \n\n This issue highlights one of many environmental debates sparked by the fracking process. Fracking also causes the overuse and pollution of fresh water, spills toxic chemicals into the ground water, and increases the potential for earthquakes due to the injection wells drilled for chemical disposal. Ultimately, as is often the case with issues stemming from natural resource extraction, local residents may receive a few short-term benefits from business activity related to drilling, but they end up suffering a disproportionate share of the long-term harm. \n\n One method of dealing with the long-term harm caused by pollution is a  carbon tax , that is, a \u201cpay-to-pollute\u201d system that charges a fee or tax to those who discharge carbon into the air. A carbon tax serves to motivate users of fossil fuels, which release harmful carbon dioxide into the atmosphere at no cost, to switch to cleaner energy sources or, failing that, to at least pay for the climate damage they cause, based on the amount of greenhouse gas emissions generated from burning fossil fuels. A proposal to implement a carbon tax system in the United States has been recommended by many organizations, including the conservative Climate Leadership Council (CLC). 46  Exxon Mobil, Shell, British Petroleum, and Total, along with other oil companies and a number of large corporations in other industries, recently announced their support for the plan to tax carbon emissions put forth by the CLC. 47 \n\n Link to Learning \n\n Visit the  Carbon Tax Center  to learn about the carbon tax as a monetary disincentive. \n\n Would this \u201cpay-to-pollute\u201d method actually work? Will companies agree to repay the debt they owe to the environment? Michael Gerrard, the director of the Sabin Center for Climate Change Law at Columbia University Law School, said, \u201cIf a sufficiently high carbon tax were imposed, it could accomplish a lot more for fighting climate change than liability lawsuits.\u201d 48  Initial estimates are that if the program were implemented, companies would pay more than $200 billion a year, or $2 trillion in the first decade, an amount deemed sufficient to motivate the expanded use of renewable sources of energy and reduce the use of nonrenewable fossil fuels. \n\n Some environmental organizations, including the Nature Conservancy and the World Resources Institute, are also endorsing the plan, as are some legislators in Washington, DC. \u201cThe basic idea is simple,\u201d Senator Sheldon Whitehouse (D-RI) said. \u201cYou levy a price on a thing you don\u2019t want\u2014carbon pollution\u2014and you use the revenue to help with things you do want.\u201d 49  According to the senator, a U.S. carbon tax or a fee of $45 per metric ton would reduce U.S. carbon emissions by more than 40 percent in the first decade. This is an idea with global support, and it has already been tried. The World Bank has data indicating that forty countries, along with some major cities, have already enacted such programs, including all countries of the EU, as well as New Zealand and Japan. \n\n Cases from the Real World Corporate and Personal Choices Regarding the Environment of the Future The car manufacturer Tesla is developing new technologies to allow people to reduce their carbon footprint. In addition to a line of electric cars, the company makes other renewable energy products, such as roofing tiles that act as solar energy panels, and promotes longer-term projects such as the Hyperloop, a high-speed train project jointly designed by Tesla and SpaceX. \n\n Of course, if businesses are to succeed in selling environmentally friendly products, they must have consumers willing to buy them. A homeowner has to be ready to spend 20 percent more than the cost of a traditional roof to install solar roofing tiles that reduce the consumption of electricity generated by fossil fuels ( Figure 4.9 ). \n\n Another personal decision is whether to buy a $35,000 Tesla Model 3 electric car. While it reduces the driver\u2019s carbon footprint, it requires charging every 250 miles, making long-distance travel a challenge until a national system of charging stations is in place. \n\n Tesla\u2019s founder, Elon Musk, is also the founder of SpaceX, an aerospace manufacturer that produces and launches the only space-capable rockets currently in existence in the United States. Thus, when NASA wants to launch a rocket, it must do so in partnership with SpaceX, a private company. It is often the case that private companies develop important advances in technology, with incentives from government such as tax credits, low-interest loans, or subsidies. This is the reality of capital-intensive, high-tech projects in a free-market economy, in which government spending may be limited for budgetary and political reasons. Not only is SpaceX making the rockets, but it is making them reusable, with long-term sustainability in mind. \n\n Critical Thinking \n\n Should corporations and individual consumers bear joint responsibility for sustaining the environment? Why or why not? \n\n What obligation does each of us have to be aware of our own carbon footprint? \n\n If individual consumers have some obligation to support environmentally friendly technologies, should all consumers bear this responsibility equally? Or just those with the economic means to do so? How should society decide? \n\n Link to Learning \n\n Elon Musk, founder of the electric car manufacturer Tesla and other companies, recently spoke at a global conference held at the Panth\u00e9on-Sorbonne University in Paris. In this  video, Musk explains the effect of carbon dioxide emissions on climate change  in clear and simple terms. \n 4.3   Government and the Private Sector \n\n Learning Objectives \n\n By the end of this section, you will be able to: \n\n Identify three public health issues that might warrant government regulation \n\n Explain what is meant by \u201crevolving door\u201d in a political context \n\n Compare constitutional arguments for and against government regulation of industry \n\n Ideally, all levels of government\u2014local, state, and federal\u2014should work with each other and with private-sector businesses to accomplish a fair and rational balance between their respective roles in maintaining a just society. Rarely does one actor alone solve a problem; more often, it takes either a state-federal or a government-business partnership to make a significant impact on a social or economic challenge. Such partnerships are often quite effective, according to Deloitte, a global consulting and accounting firm. 50 \n\n For example, the federal  Clean Air Act  of 1970 gives the EPA nationwide authority, but controlling air pollution, which does not recognize borders, also necessitates that state governments play a very significant role in enforcing environmental standards. In turn, about half the states also allow major cities to have their own air quality regulatory programs. \u201cThink globally, act locally\u201d seems to capture the essence of government regulation in air quality. For decades, California has had an air-quality program that not only attempts to comply with mandates in the federal program but also goes a step further to create state-specific rules, such as stricter auto emissions guidelines. \n\n In another example, in May 2017, the Environment and Natural Resources Division of the U.S. Department of Justice, together with the EPA and the Texas Commission on Environmental Quality, announced a settlement with Vopak, a Houston energy company, related to air-quality violations by the company. 51  Both federal and state government agencies had filed actions against Vopak, stating that the company failed to comply with Clean Air Act requirements to properly manage equipment at its on-site wastewater treatment facility, resulting in excess emissions of a variety of hazardous air pollutants, as well as volatile organic compounds, in an area classified as not meeting ground-level ozone standards. Per the settlement terms, the company, at considerable cost, \u201cwill install state-of-the art pollution controls at the wastewater treatment system and use infrared cameras\u201d to detect otherwise undetectable air pollution from its chemical storage tanks. Additionally, Vopak will pay a $2.5 million civil penalty. 52 \n\n Sustainability and the Public Interest \n\n For two centuries, businesses have profited from using and selling the nation\u2019s natural resources. The tradeoff in a free but regulated economic system such as that in the United States is to allow the continued extraction of natural resources but to require a commitment to protection of the environment in return. This bargain promotes long-term  sustainability  by balancing the interests of the environment, state and local governments, and users of natural resources. However, this public-private collaboration is not without controversy. \n\n What Would You Do? The Keystone XL Pipeline The case of the  Keystone XL pipeline  is an example of the emotional aspect of many environmental disputes, as our nation tries to come to grips with sustainability issues. Local and national opponents of the Keystone XL pipeline, which would carry crude oil from Canada to the Texas Gulf Coast, have protested for years to stop its construction ( Figure 4.10 ). These efforts accelerated after President Trump approved the pipeline in March 2017, reversing President Obama\u2019s decision to reject it on environmental grounds. It appears that the pipeline is likely to be completed, pending legal action still unresolved in Nebraska. \n\n To fight the pipeline, some opponents have used legal strategies such as court challenges in Nebraska, where regulators have not yet approved its route through the state. Other methods include tactics learned in the fight against the Dakota Access pipeline, in which protestors blocked equipment, occupied construction sites, and fought company employees and law enforcement officers. Protestors have vowed to use the same tactics against the Keystone XL. As Tom Goldtooth, executive director of the Indigenous Environmental Network, told reporters, \u201cOur dedication to stop this pipeline isn\u2019t just for the future determination of our lives as human beings but also for the future of all generations of life, and that we stay true to the understandings of protecting mother earth to the fullest degree and do it in a prayerful way.\u201d 53 \n\n Opponents of projects such as Keystone XL are not always divided along political party lines, geography, age, or other demographics. Bret Clanton is a rancher and a registered Republican who doesn\u2019t fit the standard profile of an environmentalist. The TransCanada Oil Company told him it planned to dig up three miles of his land to lay a section of the Keystone XL pipeline and bulldoze another two and half miles for an access road. \u201cI\u2019ve lived here all my life and this ground is pretty much as God, or whoever, made it, and I just want it to stay that way,\u201d Clanton said. He fought the pipeline from the beginning and lobbied the state government for several years, but he and the others may lose their legal challenges. 54 \n\n Environmentalists now face a conundrum. Should they accept the pipeline and its potential for harm? Or should they advance to more aggressive tactics such as destroying property to forestall it and hope that a candidate friendlier to environmentalists is elected in 2020? Is nonlethal violence justified in the pursuit of environmental justice? \n\n Critical Thinking \n\n How should society and governments react to aggressive environmental protest? \n\n How would you balance a protestor\u2019s First Amendment right of free speech, expression, and assembly with concern for public safety and protection of property? \n\n When discussing the topic of sustainability as a function of responsible and sustainable business conduct, we consider not only environmental health but also  public health . Polluting the environment is bad for public health, but so too are a wide variety of inherently dangerous products from alcohol to tobacco to guns to drugs. The World Health Organization estimates that alcohol is the cause of close to 7 percent of all deaths each year globally, or about 3.5 million people, and total global sales of alcohol are well over $1 trillion per year. 55  The question is whether society should allow businesses to market, sell, and profit from a product that causes so many deaths and creates a significant public health problem. The same question can be asked about tobacco, on which businesses make over half a trillion dollars annually and which the United States has struggled to regulate for years. Some businesses are acting on their own to rein in the sale or use of harmful products. In 2014, CVS, a drugstore and health care giant, chose to stop selling tobacco products, because such sales do not support its corporate mission. 56 \n\n Few issues are the source of as much public debate as guns, but it is clear that gun violence in the United States is a major public health challenge. There are about 35,000 deaths per year in the United States due to firearms, and another 75,000 nonfatal firearm injuries. However, thousands of businesses profit from gun sales. Annual revenue in the gun and ammunition manufacturing industry is close to $14 billion, producing a profit of $1.5 billion, whereas the annual revenue of gun and ammunition stores is an additional $3 billion, resulting in a profit of $500 million. 57  Based on these facts, should the sale of guns remain relatively unregulated, or, in the interest of public health, should the government increase regulatory efforts in this area? On the corporate front, after the most recent fatal mass shooting at a high school in Parkland, Florida, several companies took action without waiting for the law to change. Dick\u2019s Sporting Goods announced it will no longer sell semi-automatic assault rifles, such as the AR-15, as has Kroger, which owns Fred Meyer stores. Walmart has announced it will no longer sell guns to anyone under twenty-one years of age. \n\n Another pressing social issue is opioid abuse. In 2016, there were approximately sixty thousand deaths due to drug overdoses, almost double the number of gun deaths. Profits from the sale of these drugs are in the tens of billions of dollars, and the pharmaceutical industry spends $100 million lobbying Congress not to regulate it more stringently. Some local government entities are suing opioid drug manufacturers, 58  and, in the private sector, CVS recently announced it would now fill opioid prescriptions with supplies for only seven days. While opioids are legal and often legitimately prescribed for pain management, a large part of the problem is that they are also overprescribed. 59  Given these facts, should pharmaceutical corporations be allowed to profit from this product? What ethical or legal responsibilities do those in the medical community have for the problem? \n\n Although sustainability discussions justifiably focus on the protection of human life and public health issues, a related ethical issue close to the hearts of many citizens is  animal rights . Businesses have begun to take notice of public demands in this area, as evidenced by a 2017  Fortune  article about the Yoox Net-a-Porter Group. 60  Net-a-Porter is a large, online retailer (with $2 billion/year in sales) that markets top-line brands such as Prada, Gucci, and Michael Kors. After a survey of its customers showed that a significant majority want the company to forgo fur products, it decided to forbid the use of fur in its entire line. Other big-name brands such as Armani, Hugo Boss, North Face, Nautica, and Timberland have followed Net-a-Porter\u2019s lead and recently announced fur-free policies. \n\n Related developments are taking place in the cosmetics and food industries. Many cosmetics companies have announced cruelty-free product testing policies for products ranging from makeup to hairspray. In the food industry, the U.S. Department of Agriculture recently reported that cage-free eggs account for approximately one-quarter of the wholesale shell egg market. 61  Why? Sales and profits are the answer, along with sustainability. According to research conducted by Walmart, over 75 percent of the retail giant\u2019s customers said they would be more likely to shop at a store that improves its policies related to animal welfare. Thus, not only Walmart but also supermarket chains such as Kroger have announced the gradual implementation of cage-free egg-buying policies, as have fast food giants such as McDonald\u2019s and Burger King. 62  Such changes are often prompted, if not driven, by the influence of informed consumer stakeholders who are demanding the products they want to buy. \n\n The Revolving Door between Government Regulation and the Private Sector \n\n While private companies may take the initiative in response to public demand, and intergovernmental cooperation can accomplish many good things, sometimes the solution is for a private-sector company or industry to work directly with the government, as we saw with the example of Space X. Given the pressure on federal, state, and local agencies to reduce their budgets, many have increasingly turned to public-private partnerships, or P3s, as a means to solve problems. \n\n Sometimes, however, the relationship between business and government can become too close, as when executives from the private sector leave their jobs to work for government agencies, becoming the regulators rather than the regulated, and then return to industry in a kind of \u201crevolving door\u201d effect. For example, Goldman Sachs, one of the world\u2019s largest financial services firms, has seen many of its executives take senior leadership positions in the presidential administrations of both Democrats and Republicans, including the present secretary of the treasury, Steven Mnuchin. The same trend is occurring on a global level; Mario Draghi, the president of the European Central Bank, was previously a vice chair and managing director of Goldman Sachs International, and Mark Carney, the governor of the Bank of England, worked for Goldman Sachs as well. The large number of executives from one of the biggest investment banks in the world moving in and out of government service causes some critics to warn of the \u201cfox guarding the hen house\u201d approach to regulation. Is the relationship between government and the private sector sometimes too cozy? Does this revolving door in fact result in bad policy? \n\n Of course, it would be incorrect to assume, because multiple executives of a firm landed in government positions, that the firm is automatically guilty of wrongdoing. Goldman Sachs has created several programs with ethical goals. The company encourages clients to consider environmental and sustainability issues, and it backs green bonds, which are used to fund projects that have positive environmental and/or climate benefits. In truth, our government would find it difficult to function without the expertise from the private sector supplementing that of the public sector in public service positions. \n\n Research by the Federal Reserve Bank of Kansas City demonstrates how regulation and legislation in this area must strike a balance between encouraging and discouraging executives from the private sector to serve in high-level government positions. Our system of government service does not want to run the risk of undermining \u201cthe ability of regulatory agencies to seek and retain top level talent, but at the same time we do not want to impair the independence of government policy-makers.\u201d 63 \n\n A quick look at some figures indicates the scope of the problem. A 2008 General Accounting Office survey of fifty large defense contractors revealed that almost ninety thousand people who had left the Department of Defense in the preceding eight years were afterwards employed by private-sector companies doing business with the government as contractors. 64  While legal restrictions exist to limit the revolving door effect, most relate only to direct government contracting. Private-sector companies seeking to acquire talent by hiring former employees of the federal government must be aware of the statutory and regulatory restrictions and their associated penalties. \n\n One rule says former senior government employees may not make any communication with or appearance before their former agency, with the intent to influence the agency, for one year after leaving service. The ban is extended to two years for certain \u201cvery senior\u201d officials. 65  Penalties for violations can include fines of up to $50,000 per violation and/or twice the amount of compensation received. On a company level, the penalty can be up to $500,000 per violation and/or twice the amount of the contract. Moreover, individuals who intentionally violate the law may be subject to criminal penalties, which can include up to five years in jail. \n\n In 2009, shortly after he took office, President Obama issued an executive order requiring all executive agency appointees to take an ethics pledge as a prerequisite for accepting appointment. The pledge included a lobbying ban and restrictions on appointees and lobbyists entering and leaving the government. For instance, appointees entering the government had to agree not to participate in any matter both \u201cdirectly and substantially\u201d related to their former employer or clients for two years. 66  However, because these ethical restrictions were implemented by way of executive order, not federal statute, they may vary from president to president. Ethical questions have been raised about traditional conflict of interest concepts in the present administration, because people currently serving in it have retained ownership of private companies rather than selling them or placing them in blind trusts. \n\n Of course, the relationship between government and business is an important one, and expertise in a field can be extremely valuable to both sides in a business-government partnership. However, this collaboration should be transparent and subject to public scrutiny, as noted by the Brookings Institution, one of the oldest nonprofit public policy think tanks. In a report entitled \u201cAmateur Government: When Political Appointees Manage the Federal Bureaucracy,\u201d the Institution warns against the potential for conflicts of interest stemming from allowing too many industry executives to move into government service, set overtly pro-industry policies, and then go back to their higher-paying, private-sector jobs. The key is to seek a balance. 67 \n\n Government Regulation and the Constitution \n\n Over the past decade, many politicians have run for office on a platform of reducing government regulation. There are at least two closely related positions on reducing federal government regulation. The first is essentially a  states\u2019 rights  position that seeks to limit the powers of the federal government to those very specifically enumerated in the Constitution. It is based on principles embodied in the Tenth Amendment and on a narrow interpretation of the Commerce Clause. The Tenth Amendment reserves to the states any right not specifically delegated to the federal government. The  Commerce Clause  is the part of the Constitution that gives the federal government the right to regulate commerce between states. \n\n The second, related view of government regulation holds that \u201cless is better\u201d at all levels, whether state or federal. Its followers simply seek to reduce the size of government and regulation at every level. Some might attribute this position to a libertarian or \u201csmall government\u201d philosophy. \n\n These two philosophies might be characterized as less government regulation vs. no government regulation, other than military defense. The preference for state regulation is often based on a belief in the business community that many states are softer on regulation that the federal government, or that states are closer to the problems businesses face and are more efficient at addressing them. However, there is little clear evidence that one branch of government is more efficient than another. The real challenge is weighing the benefits of regulation against the costs, and finding the right balance between over- and under-regulation. Weak regulation can allow a business to cut corners. For instance, auto emission regulations intended to go into effect by certain dates have been delayed multiple times during the 1980s and the early 2000s. The Obama administration announced plans to enforce tougher rules, but the current administration has said it plans to delay implementation. Auto emission regulations have become politically charged, constantly changing depending on the party in power, and some states have responded with their own legislation instead of waiting for the federal stalemate to end. Regulation that is consistently enforced in the effort to achieve the long-term goal, such as cleaner air, is preferable to a moving target. \n\n A third position is that government is not necessarily a bad thing. Such a \u201cfederalist\u201d philosophy might assert that centralized government provides an array of benefits for citizens. For example, in the  Federalist Papers , Alexander Hamilton emphasized that a well-intentioned central government was not the enemy of liberty but rather the best means of securing the rights achieved through the passage of the Constitution. He and others also pointed out an advantage of federal over state government\u2014a large republic such as the United States would actually benefit from a larger electorate and a larger pool of qualified leaders, and competing state and regional interests would be more balanced under federal regulation. \n\n Acceptance of one or the other of these philosophies may lean an administration towards more or less regulation, as well as calibrating its response to aggressive lobbying by industries seeking to reduce regulation they view as burdensome. The results for the environment and/or public health can sometimes be disastrous. \n\n Cases from the Real World BP Deepwater Horizon Oil Spill and Government Regulation The company that owned and operated the Deepwater Horizon drilling rig, Transocean Ltd., contracted in 2010 with BP to drill a very deep water offshore oil well in the Gulf of Mexico, in a field called the Macondo. The drilling operation failed and ultimately led to an infamous environmental and human disaster called the  Deepwater Horizon  spill that has since been the subject of intense scrutiny and litigation. 68  Eleven workers were killed and seventeen were injured, and at least five million barrels of oil poured into the ocean in the largest such spill in history. The environmental harm was epic in scale ( Figure 4.11 ). Five years later, tar balls still dotted the beach. Oil buried beneath the sand offshore still gets pushed toward the beach whenever the surf is rough. Offshore islands have disappeared because the mangrove roots were coated in oil, killing the trees. Once the mangrove root framework that holds the land together was destroyed, the islands were washed away within a few years. Louisiana was already losing land at a concerning pace, and more has been lost since the spill. Scientists confirm that the disaster has accelerated the pace of the loss. 69 \n\n Many question whether more regulation and a better relationship between regulators and the oil industry might have prevented the Deepwater Horizon disaster. Transocean, the rig owner/operator, did not install a relatively inexpensive safety device, an acoustically triggered shutoff valve, which most experts agree could have stopped the flow of oil from the well into the Gulf. Congress had not mandated such a device, largely as a result of oil industry lobbying, and since it wasn\u2019t required, BP and Transocean were free to act as they pleased. \n\n Other nations with offshore drilling activities, such as Norway and Brazil, mandate that all oil rigs be equipped with backup acoustically triggered shutoff valves as a safety measure. Norway has a stellar reputation for safety related to its North Sea offshore drilling. Two-thirds of Statoil, its largest oil company, is owned by the government, and, as a result, the company does not lobby the government for weakened regulation. The same is true of Petrobras, the Brazilian oil company. 70  Partial government ownership makes public/private-sector cooperation more likely and is therefore likely to improve safety as well. \n\n Critical Thinking \n\n Should the U.S. government pass a law requiring the use of the automatic shutoff valves on oil rigs in its waters? \n\n Should privately owned oil companies be allowed to lobby against safety regulations? \n\n Research whether public attitudes in the United States support stronger offshore drilling safety regulations. What do you think accounts for your findings? \n\n Questions of regulation and political influence have become even more sensitive in recent years, following the decision in  Citizens United v. Federal Election Commission  (2010). 71  In  Citizens United , the U.S. Supreme Court ruled 5\u20134 that laws preventing corporations from using general treasury funds for political advertising violated the First Amendment\u2019s guarantee of freedom of speech. In other words, the government may not prevent corporations from spending money to support or oppose candidates in elections. With this decision, the Court invalidated numerous campaign finance reform laws. Many commentators think the decision opened the floodgates for special-interest groups to spend without limit in U.S. elections. \n\n Link to Learning \n\n Visit the  U.S. Supreme Court case website  named Oyez. Read the  Citizens United  case, both the majority decision and the minority dissents. Judicial language can be a bit difficult to understand, so you may have to read it twice, but it\u2019s worth it, because of the importance of the case. \n\n What does  Citizens United  mean for businesses? Business entities may now seek to persuade the voting public by spending an unlimited amount of money on political ads, whether through social media or traditional print and broadcast media. Businesses opposed to government regulation can spend without limit to help elect candidates whose position on reduced regulation is the same as theirs, thereby increasing the pressure on Congress to deregulate. Many think the profusion of money in U.S. politics is one cause of the partisan divide that often paralyzes the legislative branch and unduly influences the executive branch. \n\n One of the sponsors of the corporate governance law known as the Sarbanes-Oxley Act (SOX), Senator Paul Sarbanes (D-MD), is among those who would like to see financial limits on business lobbying groups and political action committees, several of which are attempting to repeal current regulations such as SOX, which is tough on business fraud.  Sarbanes-Oxley , passed in 2002 in response to several highly publicized corporate fraud cases that took down companies such as Enron and WorldCom, mandates reporting transparency in areas ranging from finance to accounting to supply chain activities. Essentially, it ensures that we now consider it both unethical  and  illegal to deceive shareholders, creditors, and the public at large. \n\n Sarbanes-Oxley applies to publicly traded companies and is enforced by the Securities and Exchange Commission. It covers multiple topics such as the independence of corporate boards and outside certified public accounting firms that audit corporations. The law also makes the CEO and CFO personally responsible for errors in annual audits\u2014thus making it harder to \u201ccook the books.\u201d Finally, it prohibits company loans to executives and grants protection to whistleblowers. \n\n Some critics thought compliance with SOX might be too costly. However, after more than a decade of enforcement, it is now clear to most that Sarbanes-Oxley was, and is, a necessary regulatory step. It has allowed for significant progress to be made in slowing down the kind of unethical conduct that led to the Enron fraud. Although SOX technically applies only to publicly traded companies, many private companies also adopt SOX-style internal controls and transparency, as do not-for-profits such as universities and hospitals. ", "questions": [{"question": {"question_id": "fs-idm207103296", "question_text": "Which of the following is not true?", "question_choices": ["Shareholder primacy is the clear legal precedent in the United States.", "Maximizing shareholder profits is a legitimate goal of management.", "Dividends are paid out of corporate profits.", "Companies that pursue CSR policies can also be profitable."], "cloze_format": "A false statement is that ___ .", "normal_format": "Which of the following is not true?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Dodge v . Ford ( 1919 ) and Shlensky v . Wrigley ( 1968 ) established the dynamic nature of the debate over the shareholder primacy doctrine and indicated a shift in both legal thought and precedent toward allowing management greater latitude in deciding how to best manage a corporation . The Wrigley case represented a shift from the idea that corporations should pursue only the maximization of shareholder value , as had been held in the Ford Motor Company case . In the 1950s and 1960s , for example , some state courts rejected the shareholder primacy doctrine , instead ruling that a broad interpretation of the business judgment rule allowed managers discretion when it came to allocating company assets , including using them for programs demonstrating social awareness . Ford had announced that his company would stop paying big dividends to shareholders and instead would use its profits to achieve several other goals , including improving product quality , expanding company facilities , and perhaps most surprisingly , lowering prices .", "hl_context": "<hl> Dodge v . Ford ( 1919 ) and Shlensky v . Wrigley ( 1968 ) established the dynamic nature of the debate over the shareholder primacy doctrine and indicated a shift in both legal thought and precedent toward allowing management greater latitude in deciding how to best manage a corporation . <hl> A more recent decision , Burwell v . Hobby Lobby ( 2014 ) , demonstrated what some may consider the double-edged sword of this latitude . 7 In a 5 \u2013 4 decision in favor of Hobby Lobby , the Supreme Court ruled that some corporations ( those that are closely held by a few shareholders ) can object on ethical , moral , or religious grounds to the Affordable Care Act \u2019 s rule that health insurance policies must cover various forms of contraception ; such companies can elect not to offer such coverage . <hl> The Wrigley case represented a shift from the idea that corporations should pursue only the maximization of shareholder value , as had been held in the Ford Motor Company case . <hl> 6 As a follow-up to this case , lights were finally installed at Wrigley Field in 1988 , but only after the owner , William Wrigley III , had sold the team ( in 1981 ) to the Tribune Company , a large media conglomerate that fought for six years to install lights . However , the case stands as precedent for the ability of management to balance various interests and profits when making decisions . The legality and appropriateness of social responsibility as a business policy have followed a long and winding road since 1919 . <hl> In the 1950s and 1960s , for example , some state courts rejected the shareholder primacy doctrine , instead ruling that a broad interpretation of the business judgment rule allowed managers discretion when it came to allocating company assets , including using them for programs demonstrating social awareness . <hl> In Dodge v . Ford Motor Company ( 1919 ) , the Michigan Supreme Court ruled in favor of shareholder primacy , saying that founder Henry Ford must operate the Ford Motor Company primarily in the profit-maximizing interests of its shareholders . 2 In the traditional corporate model , a corporation earns revenue and , after deducting expenses , distributes the profits to shareholders in the form of dividends . <hl> Ford had announced that his company would stop paying big dividends to shareholders and instead would use its profits to achieve several other goals , including improving product quality , expanding company facilities , and perhaps most surprisingly , lowering prices . <hl> Shareholders then sued Ford , asking the court to order Ford Motor Company to continue allocating the lion \u2019 s share of profits to high dividend payments . ( It is ironic that the named shareholders who sued Ford were the Dodge brothers , former Ford suppliers who had recently started their own car company . )"}, {"question": {"question_id": "fs-idm212864320", "question_text": "Industries like to be in control of their own destiny and as a result prefer self-regulation to laws imposed by governments. Self-regulation is often ________.", "question_choices": ["based on external codes of conduct", "enforced by the courts", "in conflict with common law", "less costly for firms than government regulation"], "cloze_format": "Industries like to be in control of their own destiny and as a result prefer self-regulation to laws imposed by governments. Self-regulation is often ________.", "normal_format": "Industries like to be in control of their own destiny and as a result prefer self-regulation to laws imposed by governments. Self-regulation is often which of the following?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Weak regulation can allow a business to cut corners .", "hl_context": "These two philosophies might be characterized as less government regulation vs . no government regulation , other than military defense . The preference for state regulation is often based on a belief in the business community that many states are softer on regulation that the federal government , or that states are closer to the problems businesses face and are more efficient at addressing them . However , there is little clear evidence that one branch of government is more efficient than another . The real challenge is weighing the benefits of regulation against the costs , and finding the right balance between over - and under-regulation . <hl> Weak regulation can allow a business to cut corners . <hl> For instance , auto emission regulations intended to go into effect by certain dates have been delayed multiple times during the 1980s and the early 2000s . The Obama administration announced plans to enforce tougher rules , but the current administration has said it plans to delay implementation . Auto emission regulations have become politically charged , constantly changing depending on the party in power , and some states have responded with their own legislation instead of waiting for the federal stalemate to end . Regulation that is consistently enforced in the effort to achieve the long-term goal , such as cleaner air , is preferable to a moving target ."}, {"question": {"question_id": "fs-idm257488320", "question_text": "Which of the following best describes the tragedy of the commons?", "question_choices": ["People are always willing to sacrifice for the good of society.", "People are likely to use all the natural resources they want without regard to others.", "The common good of the people is a popular corporate goal.", "Tragedies occur when there is too much government regulation."], "cloze_format": "The tragedy of the commons is best described as ___ .", "normal_format": "Which of the following best describes the tragedy of the commons?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "The concept of earth justice is tied indirectly to the economic theory of the \u201c tragedy of the commons , \u201d a phrase derived from British economist William Forster Lloyd , who , in the mid-nineteenth century , used a hypothetical example of unregulated grazing on common land to explain the human tendency to act independently , putting self-interest first , without regard for the common good of all users .", "hl_context": "Cormac Cullinan , an environmental attorney , author , and leading proponent of earth jurisprudence , often collaborates with other environmental advocates such as Thomas Berry , an eco-theologian , scholar , and author . Cullinan , Berry , and others have written extensively about the important legal tenets of earth jurisprudence ; however , it is not a legal doctrine officially adopted by the United States or any of its states to date . <hl> The concept of earth justice is tied indirectly to the economic theory of the \u201c tragedy of the commons , \u201d a phrase derived from British economist William Forster Lloyd , who , in the mid-nineteenth century , used a hypothetical example of unregulated grazing on common land to explain the human tendency to act independently , putting self-interest first , without regard for the common good of all users . <hl> The theory was later popularized by ecologist and philosopher Garrett Hardin , who tied it directly to environmental issues . In other words , when it comes to natural resources , the tragedy of the commons holds that people generally use as much of a free resource as they want , without regard for the needs of others or for the long-term environmental effects . As a way of combating the tragedy of the commons , Cullinan and others have written about the concept of earth justice , 24 which includes the following tenets :"}, {"question": {"question_id": "fs-idm261828112", "question_text": "ISOs are sustainability standards for businesses ________.", "question_choices": ["promulgated by the state government", "promulgated by the federal government", "promulgated by the World Trade Organization", "none of the above"], "cloze_format": "ISOs are sustainability standards for businesses ________.", "normal_format": "Which of the following is correct about ISOs that are sustainability standards for businesses?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "bloom": null, "hl_sentences": "The International Organization for Standardization , or ISO , is an independent NGO and the world \u2019 s largest developer of voluntary international business standards .", "hl_context": "<hl> The International Organization for Standardization , or ISO , is an independent NGO and the world \u2019 s largest developer of voluntary international business standards . <hl> More than twenty thousand ISO standards now cover matters such as sustainability , manufactured products , technology , food , agriculture , and even healthcare . The adoption and use of these standards by companies is voluntary , but they are widely accepted , and following ISO certification guidelines results in the creation of products and services that are clean , safe , reliable , and made by workers who enjoy some degree of protection from workplace hazards ."}, {"question": {"question_id": "fs-idm253576464", "question_text": "Which of the following is a potentially effective way to reduce global warming?", "question_choices": ["build more coal-burning power plants", "build more diesel-burning cars", "implement a carbon tax", "implement tax-free gasoline"], "cloze_format": "A potentially effective way to reduce global warming is to ___ .", "normal_format": "Which of the following is a potentially effective way to reduce global warming?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "bloom": null, "hl_sentences": "One method of dealing with the long-term harm caused by pollution is a carbon tax , that is , a \u201c pay-to-pollute \u201d system that charges a fee or tax to those who discharge carbon into the air .", "hl_context": "<hl> One method of dealing with the long-term harm caused by pollution is a carbon tax , that is , a \u201c pay-to-pollute \u201d system that charges a fee or tax to those who discharge carbon into the air . <hl> A carbon tax serves to motivate users of fossil fuels , which release harmful carbon dioxide into the atmosphere at no cost , to switch to cleaner energy sources or , failing that , to at least pay for the climate damage they cause , based on the amount of greenhouse gas emissions generated from burning fossil fuels . A proposal to implement a carbon tax system in the United States has been recommended by many organizations , including the conservative Climate Leadership Council ( CLC ) . 46 Exxon Mobil , Shell , British Petroleum , and Total , along with other oil companies and a number of large corporations in other industries , recently announced their support for the plan to tax carbon emissions put forth by the CLC . 47"}, {"question": {"question_id": "fs-idm398624848", "question_text": "Which of the following is true?", "question_choices": ["Very few business executives have ever left private jobs to go into government service.", "Most government regulatory agencies are funded by donations.", "Numerous executives have left Goldman Sachs to go to work for the government.", "Few people leave government service to go into the private sector."], "cloze_format": "It is true that ___.", "normal_format": "Which of the following is true?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The large number of executives from one of the biggest investment banks in the world moving in and out of government service causes some critics to warn of the \u201c fox guarding the hen house \u201d approach to regulation .", "hl_context": "Sometimes , however , the relationship between business and government can become too close , as when executives from the private sector leave their jobs to work for government agencies , becoming the regulators rather than the regulated , and then return to industry in a kind of \u201c revolving door \u201d effect . For example , Goldman Sachs , one of the world \u2019 s largest financial services firms , has seen many of its executives take senior leadership positions in the presidential administrations of both Democrats and Republicans , including the present secretary of the treasury , Steven Mnuchin . The same trend is occurring on a global level ; Mario Draghi , the president of the European Central Bank , was previously a vice chair and managing director of Goldman Sachs International , and Mark Carney , the governor of the Bank of England , worked for Goldman Sachs as well . <hl> The large number of executives from one of the biggest investment banks in the world moving in and out of government service causes some critics to warn of the \u201c fox guarding the hen house \u201d approach to regulation . <hl> Is the relationship between government and the private sector sometimes too cozy ? Does this revolving door in fact result in bad policy ?"}, {"question": {"question_id": "fs-idm397848528", "question_text": "Which of the following constitutional provisions gives regulatory power to the federal government?", "question_choices": ["First Amendment", "Tenth Amendment", "Commerce Clause", "Supremacy Clause"], "cloze_format": "The constitutional provision that gives regulatory power to the federal government is the ___ .", "normal_format": "Which of the following constitutional provisions gives regulatory power to the federal government?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "bloom": null, "hl_sentences": "The Commerce Clause is the part of the Constitution that gives the federal government the right to regulate commerce between states .", "hl_context": "Over the past decade , many politicians have run for office on a platform of reducing government regulation . There are at least two closely related positions on reducing federal government regulation . The first is essentially a states \u2019 rights position that seeks to limit the powers of the federal government to those very specifically enumerated in the Constitution . It is based on principles embodied in the Tenth Amendment and on a narrow interpretation of the Commerce Clause . The Tenth Amendment reserves to the states any right not specifically delegated to the federal government . <hl> The Commerce Clause is the part of the Constitution that gives the federal government the right to regulate commerce between states . <hl>"}, {"question": {"question_id": "fs-idm398474672", "question_text": "The Citizens United case ________.", "question_choices": ["upheld existing law limiting spending on behalf of political candidates", "overturned existing law", "sent the case back to the lower court to be re-tried", "created more restrictive limits on political spending"], "cloze_format": "The Citizens United case ________.", "normal_format": "Which of the following is correct about the Citizens United case?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "71 In Citizens United , the U . S . Supreme Court ruled 5 \u2013 4 that laws preventing corporations from using general treasury funds for political advertising violated the First Amendment \u2019 s guarantee of freedom of speech . In other words , the government may not prevent corporations from spending money to support or oppose candidates in elections . With this decision , the Court invalidated numerous campaign finance reform laws .", "hl_context": "Questions of regulation and political influence have become even more sensitive in recent years , following the decision in Citizens United v . Federal Election Commission ( 2010 ) . <hl> 71 In Citizens United , the U . S . Supreme Court ruled 5 \u2013 4 that laws preventing corporations from using general treasury funds for political advertising violated the First Amendment \u2019 s guarantee of freedom of speech . <hl> <hl> In other words , the government may not prevent corporations from spending money to support or oppose candidates in elections . <hl> <hl> With this decision , the Court invalidated numerous campaign finance reform laws . <hl> Many commentators think the decision opened the floodgates for special-interest groups to spend without limit in U . S . elections ."}], "summary": " Summary 4.1   Corporate Law and Corporate Responsibility \n\n While some argue that corporations have a primary duty to maximize profits for the benefit of shareholders, others assert that businesses have a duty to the society in which they operate, a duty that serves as the basis of the CSR philosophy. Many court cases have addressed the issue, but it has not been conclusively resolved. \n\n Despite the ongoing ethical debate, being a good corporate citizen is a goal toward which most contemporary corporations strive. An effective CSR policy usually means that companies have to commit to both an internal and external approach to ethics. Corporate social responsibility and good corporate governance are in reality just two sides of the very same coin. Social responsibility does not mean lower profitability. \n\n 4.2   Sustainability: Business and the Environment \n\n Adopting sustainability as a strategy means protecting the environment. Society has an interest in the long-term survival, indeed the flourishing, of ecological habitats and natural resources, and we ask and expect companies to respect this societal goal in their business activities. \n\n When analyzing what a business owes society in return for the freedom to extract our natural resources, we must balance development and preservation. It may be easy to say from afar that a business should cut back on how much it pollutes the air, but what happens when that means cutting back on fossil fuel use and transitioning to electric vehicles, a choice that affects everyone on a personal level? \n\n 4.3   Government and the Private Sector \n\n One challenge in a free enterprise system is balancing the need for government regulation and private-sector corporate managers\u2019 need for independence in running their businesses. The Sarbanes-Oxley Act tries to strike this balance by mandating transparency in corporate governance. This debate also includes the question whether businesses operating in the private sector ought to do public good on their own, regardless of whether the government mandates it. For example, many companies make a commitment to keep the environment clean, and to do so by going above and beyond what the law requires. ", "keyterm": "", "bname": "business_ethics"}, {"chapter": 1, "intro": "Chapter Outline 1.1   What is Government? 1.2   Who Governs? Elitism, Pluralism, and Tradeoffs 1.3   Engagement in a Democracy Introduction \n\n Since its founding, the United States has relied on citizen participation to govern at the local, state, and national levels. This civic engagement ensures that representative democracy will continue to flourish and that people will continue to influence government. The right of citizens to participate in government is an important feature of democracy, and over the centuries many have fought to acquire and defend this right. During the American Revolution (1775\u20131783), British colonists fought for the right to govern themselves. In the early nineteenth century, agitated citizens called for the removal of property requirements for voting so poor white men could participate in government just as wealthy men could. Throughout the late nineteenth and twentieth centuries, women, African Americans, Native Americans, and many other groups fought for the right to vote and hold office.  The poster shown above ( Figure 1.1 ), created during World War II, depicts voting as an important part of the fight to keep the United States free. The purpose of voting and other forms of political engagement is to ensure that government serves the people, and not the other way around. But what does government do to serve the people? What different forms of government exist? How do they differ? How can citizens best engage with and participate in the crucial process of governing the nation? This chapter seeks to answer these questions. ", "chapter_text": "1.1   What is Government? \n\n Learning Objectives \n\n By the end of this section, you will be able to: \n\n Explain what government is and what it does \n\n Identify the type of government in the United States and compare it to other forms of government \n\n Government affects all aspects of people\u2019s lives. What we eat, where we go to school, what kind of education we receive, how our tax money is spent, and what we do in our free time are all affected by government. Americans are often unaware of the pervasiveness of government in their everyday lives, and many are unsure precisely what it does. Here we will look at what government is, what it does, and how the government of the United States differs from other kinds of governments. \n\n DEFINING GOVERNMENT \n\n The term  government  describes the means by which a society organizes itself and allocates authority in order to accomplish collective goals and provide benefits that the society as a whole needs. Among the goals that governments around the world seek to accomplish are economic prosperity for the nation, secure national borders, and the safety and well-being of citizens. Governments also provide benefits for their citizens. The type of benefits provided differ according to the country and their specific type of governmental system, but governments commonly provide such things as education, health care, and an infrastructure for transportation. The term  politics  refers to the process of gaining and exercising control within a government for the purpose of setting and achieving particular goals, especially those related to the division of resources within a nation. \n\n Sometimes governmental systems are confused with economic systems. This is because certain types of political thought or governmental organization are closely related to or develop with certain types of economic systems. For example, the economic system of capitalism in Western Europe and North America developed at roughly the same time as ideas about democratic republics, self-government, and natural rights. At this time, the idea of liberty became an important concept. According to John  Locke , an English political philosopher of the seventeenth century, all people have natural rights to life, liberty, and property. From this came the idea that people should be free to consent to being governed. In the eighteenth century, in Great Britain\u2019s North American colonies, and later in France, this developed into the idea that people should govern themselves through elected representatives and not a king; only those representatives chosen by the people had the right to make laws to govern them. \n\n Similarly, Adam  Smith , a Scottish philosopher who was born nineteen years after Locke\u2019s death, believed that all people should be free to acquire property in any way that they wished. Instead of being controlled by government, business, and industry, Smith argued, people should be allowed to operate as they wish and keep the proceeds of their work. Competition would ensure that prices remained low and faulty goods disappeared from the market. In this way, businesses would reap profits, consumers would have their needs satisfied, and society as a whole would prosper. Smith discussed these ideas, which formed the basis for industrial capitalism, in his book  The Wealth of Nations , which was published in 1776, the same year that the Declaration of Independence was written. \n\n Representative government and capitalism developed together in the United States, and many Americans tend to equate  democracy , a political system in which people govern themselves, with capitalism. In theory, a democratic government promotes individualism and the freedom to act as one chooses instead of being controlled, for good or bad, by government. Capitalism, in turn, relies on individualism. At the same time, successful capitalists prefer political systems over which they can exert at least some influence in order to maintain their liberty. \n\n Democracy and capitalism do not have to go hand in hand, however. Indeed, one might argue that a capitalist economic system might be bad for democracy in some respects. Although Smith theorized that capitalism would lead to prosperity for all, this has not necessarily been the case. Great gaps in wealth between the owners of major businesses, industries, and financial institutions and those who work for others in exchange for wages exist in many capitalist nations. In turn, great wealth may give a very small minority great influence over the government\u2014a greater influence than that held by the majority of the population, which will be discussed later. \n\n Socialism is an alternative economic system. In socialist societies, the means of generating wealth, such as factories, large farms, and banks, are owned by the government and not by private individuals. The government accumulates wealth and then redistributes it to citizens, primarily in the form of social programs that provide such things as free or inexpensive health care, education, and childcare. In socialist countries, the government also usually owns and controls utilities such as electricity, transportation systems like airlines and railroads, and telecommunications systems. In many socialist countries the government is an  oligarchy : only members of a certain political party or ruling elite can participate in government. For example, in China, the government is run by members of the Chinese Communist Party. However, socialist countries can have democratic forms of government as well, such as Sweden. Although many Americans associate socialism with tyranny and a loss of individual liberties, this does not have to be the case, as we see in Sweden. \n\n In the United States, the democratic government works closely together with its capitalist economic system. The interconnectedness of the two affects the way in which goods and services are distributed. The market provides many goods and services needed by Americans. For example, food, clothing, and housing are provided in ample supply by private businesses that earn a profit in return. These goods and services are known as  private goods . 1  People can purchase what they need in the quantity in which they need it. This, of course, is the ideal. In reality, those who live in poverty cannot always afford to buy ample food and clothing to meet their needs, or the food and clothing that they can afford to buy in abundance is of inferior quality. Also, it is often difficult to find adequate housing; housing in the most desirable neighborhoods\u2014those that have low crime rates and good schools\u2014is often too expensive for poor or working-class (and sometimes middle-class) people to buy or rent. \n\n Thus, the market cannot provide everything (in enough quantity or at low enough costs) in order to meet everyone\u2019s needs. Therefore, some goods are provided by the government. Such goods or services that are available to all without charge are called  public goods . Two such public goods are national security and education. It is difficult to see how a private business could protect the United States from attack. How could it build its own armies and create plans for defense and attack? Who would pay the men and women who served? Where would the intelligence come from? Due to its ability to tax, draw upon the resources of an entire nation, and compel citizen compliance, only government is capable of protecting the nation. \n\n Similarly, public schools provide education for all children in the United States. Children of all religions, races and ethnicities, socioeconomic classes, and levels of academic ability can attend public schools free of charge from kindergarten through the twelfth grade. It would be impossible for private schools to provide an education for all of the nation\u2019s children. Private schools do provide some education in the United States; however, they charge tuition, and only those parents who can afford to pay their fees (or whose children gain a scholarship) can attend these institutions. Some schools charge very high tuition, the equivalent to the tuition at a private college. If private schools were the only educational institutions, most poor and working-class children and many middle-class children would be uneducated. Private schooling is a type of good called a  toll good . Toll goods are available to many people, and many people can make use of them, but only if they can pay the price. They occupy a middle ground between public and private goods. All parents may send their children to public schools in the United States. They can choose to send their children to a private school, but the private school will charge them. On the other hand, public schools, which are operated by the government, provide free education so all children can attend school. Therefore, everyone in the nation benefits from the educated voters and workers produced by the public school system. Another distinction between public and private goods is that public goods are available to all, typically without additional charge. \n\n What other public goods does government provide in the United States? At the federal, state, and local level, government provides stability and security, not only in the form of a military but also in the form of police and fire departments. Government provides other valuable goods and services such as public education, public transportation, mail service, and food, housing, and health care for the poor ( Figure 1.2 ). If a house catches on fire, the fire department does not demand payment before they put the fire out. If someone breaks into a house and tries to harm the occupants, the police will try to protect them and arrest the intruder, but the police department will not request payment for services rendered. The provision of these goods and services is funded by citizens paying into the general tax base. \n\n Government also performs the important job of protecting  common goods : goods that all people may use free of charge but that are of limited supply, such as fish in the sea or clean drinking water. Because everyone can use these goods, they must be protected so a few people do not take everything that is available and leave others with nothing. Some examples of common goods, private goods, public goods, and toll goods are listed below ( Figure 1.3 ). \n\n Link to Learning \n\n This  federal website  shares information about the many services the government provides. \n\n Finding a Middle Ground Fishing Regulations One of the many important things government does is regulate public access to  common goods  like natural resources. Unlike public goods, which all people may use without charge, common goods are in limited supply. If more public schools are needed, the government can build more. If more firefighters or mail carriers are needed, the government can hire them. Public lands and wildlife, however, are not goods the government can simply multiply if supply falls due to demand. Indeed, if some people take too freely from the supply of common goods, there will not be enough left for others to use. \n\n Fish are one of the many common goods in which the government currently regulates access. It does so to ensure that certain species are not fished into extinction, thus depriving future generations of an important food source and a means to make a living. This idea is known as sustainability. Environmentalists want to set strict fishing limits on a variety of species. Commercial fishers resist these limits, claiming they are unnecessary and, if enforced, would drive them out of business ( Figure 1.4 ). Currently, fishing limits are set by a combination of scientists, politicians, local resource managers, and groups representing the interests of fishers. 3 \n\n Should the government regulate fishing? Is it right to interfere with people\u2019s ability to earn money today in order to protect the access of future generations to the nation\u2019s common goods? \n\n Besides providing stability and goods and services for all, government also creates a structure by which goods and services can be made available to the people. In the United States, people elect representatives to city councils, state legislatures, and Congress. These bodies make laws to govern their respective jurisdictions. They also pass measures to raise money, through the imposition of taxes on such things as income, property, and sales. Local, state, and national governments also draft budgets to determine how the revenue taken in will be spent for services. On the local level, funds are allotted for education, police and fire departments, and maintenance of public parks. State governments allocate money for state colleges and universities, maintenance of state roads and bridges, and wildlife management, among other priorities. On the national level, money goes to such things as defense, Social Security, pensions for veterans, maintenance of federal courts and prisons, and management of national parks. At each level, representatives elected by the people try to secure funding for things that will benefit those who live in the areas they represent. Once money has been allocated, government agencies at each level then receive funds for the purposes mentioned above and use them to provide services to the public. \n\n Local, state, and national governments also make laws to maintain order and to ensure the efficient functioning of society, including the fair operation of the business marketplace. In the United States, for example, Congress passes laws regulating banking, and government agencies regulate such things as the amount of toxic gases that can be emitted by factories, the purity of food offered for sale, and the safety of toys and automobiles. In this way, government checks the actions of business, something that it would not do if capitalism in the United States functioned strictly in the manner that Adam  Smith  believed it should\u2026almost entirely unregulated. \n\n Besides providing goods to citizens and maintaining public safety, most governments also provide a means for citizens to participate in government and to make their opinions known to those in power. Western democracies like the United States, Britain, France, and others protect citizens\u2019 freedom of speech and the press. These nations, and others in the world, also allow citizens to vote. \n\n As noted earlier, politics is the process by which choices are made regarding how resources will be allocated and which economic and social policies government will pursue. Put more simply, politics is the process of who gets what and how. Politics involves choosing which values government will support and which it will not. If government chooses to support an ideal such as individualism, it may choose to loosen regulations on business and industry or to cut taxes so that people have more money to invest in business. If it chooses to support an ideal such as egalitarianism, which calls for equal treatment for all and the destruction of socioeconomic inequalities, it may raise taxes in order to be able to spend more on public education, public transportation, housing for the poor, and care for the elderly. If, for example, the government is more concerned with national security than with individual liberty, it may authorize the tapping of people\u2019s phones and restrict what newspapers may publish. If liberty is more important, then government will place greater restrictions on the extent that law enforcement agencies can intrude upon citizens\u2019 private communications. The political process and the input of citizens help determine the answer. \n\n Civic engagement, or the participation that connects citizens to government, is a vital ingredient of politics. In the United States, citizens play an important role in influencing what policies are pursued, what values the government chooses to support, what initiatives are granted funding, and who gets to make the final decisions. Political engagement can take many forms: reading about politics, listening to news reports, discussing politics, attending (or watching televised) political debates, donating money to political campaigns, handing out flyers promoting a candidate, voting, joining protest marches, and writing letters to their elected representatives. \n\n DIFFERENT TYPES OF GOVERNMENT \n\n The government of the United States can best be described as a republic, or representative democracy. A democracy is a government in which  political power \u2014influence over institutions, leaders, and policies\u2014rests in the hands of the people. In a  representative democracy , however, the citizens do not govern directly. Instead, they elect representatives to make decisions and pass laws on behalf of all the people. Thus, U.S. citizens vote for members of Congress, the president and vice president, members of state legislatures, governors, mayors, and members of town councils and school boards to act on their behalf. Most representative governments favor  majority rule : the opinions of the majority of the people have more influence with government than those of the minority. If the number of elected representatives who favor a proposed law is greater than those who oppose it, the law will be enacted. \n\n However, in representative governments like the United States,  minority rights  are protected: people cannot be deprived of certain rights even if an overwhelming number of people think that they should be. For example, let\u2019s say American society decided that atheists, people who do not believe that God exists, were evil and should be imprisoned or expelled from the country. Even though atheists only account for about 7 percent of the population, they would be protected due to minority rights. 4  Even though the number of Americans who believe in God far outweighs the number who do not, the minority is still protected. Because decisions are made through majority rule, making your opinions known and voting for those men and women who make decisions that affect all of us are critical and influential forms of civic engagement in a representative democracy such as the United States. \n\n In a  direct democracy , unlike representative democracy, people participate directly in making government decisions. For example, in ancient Athens, the most famous example of a direct democracy, all male citizens were allowed to attend meetings of the Assembly. Here they debated and voted for or against all proposed laws. Although neither the federal government nor any of the state governments function as a direct democracy\u2014the Constitution requires the national and state governments to be representative forms of government\u2014some elements of direct democracy do exist in the United States. While residents of the different states vote for people to represent them and to make laws in their behalf in the state legislatures and in Congress, people may still directly vote on certain issues. For example, a referendum or proposed law might be placed on the ballot for citizens to vote on directly during state or local elections instead of leaving the matter in the hands of the state legislature. At New England town meetings, all residents are allowed to debate decisions affecting the town ( Figure 1.5 ). Such occasions provide additional opportunities for civic engagement. \n\n Most countries now have some form of representative government ( Figure 1.6 ). At the other end of the political spectrum are elite-driven forms of government. In a  monarchy , one ruler, usually a hereditary ruler, holds political power. Although the power of some monarchs is limited by law, and such kings and queens often rule along with an elected legislature that makes laws for the country, this is not always the case. Many southwest Asian kingdoms, such as Saudi Arabia, Qatar, and the United Arab Emirates, have absolute monarchs whose power is unrestricted. As discussed earlier, another nondemocratic form of government is oligarchy, in which a handful of elite members of society, often those who belong to a particular political party, hold all political power. For example, in Cuba, as in China, only members of the Communist Party are allowed to vote or hold public office, and the party\u2019s most important members make all government decisions. Some nondemocratic societies are totalitarian in nature. Under  totalitarianism , the government is more important than the citizens, and it controls all aspects of citizens\u2019 lives. Citizens\u2019 rights are limited, and the government does not allow political criticism or opposition. These forms of government are fairly rare. North Korea is an example of a totalitarian government. \n\n Link to Learning \n\n The  CIA website  provides information about the types of government across the world. \n1.2   Who Governs? Elitism, Pluralism, and Tradeoffs \n\n Learning Objectives \n\n By the end of this section, you will be able to: \n\n Describe the pluralism-elitism debate \n\n Explain the tradeoffs perspective on government \n\n The United States allows its citizens to participate in government in many ways. The United States also has many different levels and branches of government that any citizen or group might approach. Many people take this as evidence that U.S. citizens, especially as represented by competing groups, are able to influence government actions. Some political theorists, however, argue that this is not the case. They claim that only a handful of economic and political elites have any influence over government. \n\n ELITISM VS. PLURALISM \n\n Many Americans fear that a set of elite citizens is really in charge of government in the United States and that others have no influence. This belief is called the  elite theory  of government. In contrast to that perspective is the  pluralist theory  of government, which says that political power rests with competing interest groups who share influence in government. Pluralist theorists assume that citizens who want to get involved in the system do so because of the great number of access points to government. That is, the U.S. system, with several levels and branches, has many places where people and groups can engage the government. \n\n The foremost supporter of elite theory was C. Wright  Mills . In his book,  The Power Elite , Mills argued that government was controlled by a combination of business, military, and political elites. 5  Most are highly educated, often graduating from prestigious universities ( Figure 1.7 ). According to elite theory, the wealthy use their power to control the nation\u2019s economy in such a way that those below them cannot advance economically. Their wealth allows the elite to secure for themselves important positions in politics. They then use this power to make decisions and allocate resources in ways that benefit them. Politicians do the bidding of the wealthy instead of attending to the needs of ordinary people, and order is maintained by force. Indeed, those who favor government by the elite believe the elite are better fit to govern and that average citizens are content to allow them to do so. 6 \n\n In apparent support of the elite perspective, one-third of U.S. presidents have attended Ivy League schools, a much higher percentage than the rest of the U.S. population. 7  All five of the most recent U.S. presidents attended Ivy League schools such as Harvard, Yale, or Columbia. Among members of the House of Representatives, 93 percent have a bachelor\u2019s degree, as do 99 percent of members of the Senate. 8  Fewer than 40 percent of U.S. adults have even an associate\u2019s degree. 9  The majority of the men and women in  Congress  also engaged in either state or local politics, were business people, or practiced law before being elected to Congress. 10  Approximately 80 percent of both the Senate and the House of Representatives are male, and about 21 percent of members of Congress are people of color ( Figure 1.8 ). The nation\u2019s laws are made primarily by well-educated white male professionals and businessmen. The makeup of Congress is important because race, sex, profession, education, and socioeconomic class have an important effect on people\u2019s political interests. For example, changes in the way taxes are levied and spent do not affect all citizens equally. A flat tax, which generally requires that everyone pay the same percentage rate, hurts the poor more than it does the rich. If the income tax rate was flat at 10 percent, all Americans would have to pay 10 percent of their income to the federal government. Someone who made $40,000 a year would have to pay $4,000 and be left with only $36,000 to live on. Someone who made $1,000,000 would have to pay $100,000, a greater sum, but he or she would still be left with $900,000. People who were not wealthy would probably pay more than they could comfortably afford, while the wealthy, who could afford to pay more and still live well, would not see a real impact on their daily lives. Similarly, the allocation of revenue affects the rich and the poor differently. Giving more money to public education does not benefit the wealthy as much as it does the poor, because the wealthy are more likely than the poor to send their children to private schools or to at least have the option of doing so. However, better funded public schools have the potential to greatly improve the upward mobility of members of other socioeconomic classes who have no other option than to send their children to public schools. \n\n Currently, more than half of the members of Congress are millionaires; their median net worth is just over $1 million, and some have much more. 11  As of 2003, more than 40 percent of Congress sent their children to private schools. Overall, only 10 percent of the American population does so. 12  Therefore, a Congress dominated by millionaires who send their children to private schools is more likely to believe that flat taxes are fair and that increased funding for public education is not a necessity. Their experience, however, does not reflect the experience of average Americans. Pluralist theory rejects this approach, arguing that although there are elite members of society they do not control government. Instead, pluralists argue, political power is distributed throughout society. Rather than resting in the hands of individuals, a variety of organized groups hold power, with some groups having more influence on certain issues than others. Thousands of  interest group s exist in the United States. 13  Approximately 70\u201390 percent of Americans report belonging to at least one group. 14 \n\n According to  pluralist theory , people with shared interests will form groups in order to make their desires known to politicians. These groups include such entities as environmental advocates, unions, and organizations that represent the interests of various businesses. Because most people lack the inclination, time, or expertise necessary to decide political issues, these groups will speak for them. As groups compete with one another and find themselves in conflict regarding important issues, government policy begins to take shape. In this way, government policy is shaped from the bottom up and not from the top down, as we see in elitist theory. Robert  Dahl , author of  Who Governs? , was one of the first to advance the pluralist theory, and argued that politicians seeking an \u201celectoral payoff\u201d are attentive to the concerns of politically active citizens and, through them, become acquainted with the needs of ordinary people. They will attempt to give people what they want in exchange for their votes. 15 \n\n Link to Learning \n\n The Center for Responsive Politics is a non-partisan research group that provides data on who gives to whom in elections. Visit  OpenSecrets.org: Center for Responsive Politics  to track campaign contributions, congressional bills and committees, and interest groups and lobbyists. \n\n THE TRADEOFFS PERSPECTIVE \n\n Although elitists and pluralists present political influence as a tug-of-war with people at opposite ends of a rope trying to gain control of government, in reality government action and public policy are influenced by an ongoing series of tradeoffs or compromises. For instance, an action that will meet the needs of large numbers of people may not be favored by the elite members of society. Giving the elite what they want may interfere with plans to help the poor. As pluralists argue, public policy is created as a result of competition among groups. In the end, the interests of both the elite and the people likely influence government action, and compromises will often attempt to please them both. \n\n Since the framing of the U.S. Constitution, tradeoffs have been made between those who favor the supremacy of the central government and those who believe that state governments should be more powerful. Should state governments be able to respond to the desires of citizen groups by legalizing the use of marijuana? Should the national government be able to close businesses that sell marijuana even in states where it is legal? Should those who control the Federal Bureau of Investigation (FBI) and the National Security Agency (NSA) be allowed to eavesdrop on phone conversations of Americans and read their email? Should groups like the American Civil Liberties Union (ACLU), which protect all citizens\u2019 rights to freedom of speech, be able to prevent this? \n\n Many of the tradeoffs made by government are about freedom of speech. The  First Amendment  of the Constitution gives Americans the right to express their opinions on matters of concern to them; the federal government cannot interfere with this right. Because of the  Fourteenth Amendment , state governments must protect this right also. At the same time, neither the federal government nor state governments can allow someone\u2019s right to free expression to interfere with someone else\u2019s ability to exercise his or her own rights. For example, in the United States, it is legal for women to have abortions. Many people oppose this right, primarily for religious reasons, and often protest outside facilities that provide abortions. In 2007, the state of Massachusetts enacted a law that required protestors to stand thirty-five feet away from clinic entrances. The intention was to prevent women seeking abortions from being harassed or threatened with violence. Groups favoring the protection of women\u2019s reproductive rights supported the law. Groups opposed to abortion argued that the buffer zone prevented them from speaking to women to try to persuade them not to have the procedure done. In 2014, in the case of  McCullen v. Coakley , the U.S. Supreme Court struck down the law that created a buffer zone between protestors and clinic entrances. 16  The federal government does not always side with those who oppose abortion, however. Several states have attempted to pass laws requiring women to notify their husbands, and often obtain their consent, before having an abortion. All such laws have been found unconstitutional by the courts. \n\n Tradeoffs also occur as a result of conflict between groups representing the competing interests of citizens. Many Americans believe that the U.S. must become less dependent on foreign sources of energy. Many also would like people to have access to inexpensive sources of energy. Such people are likely to support fracking: the process of hydraulic fracturing that gives drilling companies access to natural gas trapped between layers of shale underground. Fracking produces abundant, inexpensive natural gas, a great benefit to people who live in parts of the country where it is expensive to heat homes during the winter. Fracking also creates jobs. At the same time, many scholars argue that fracking can result in the contamination of drinking water, air pollution, and increased risk of earthquakes. One study has even linked fracking to cancer. Thus, those who want to provide jobs and inexpensive natural gas are in conflict with those who wish to protect the natural environment and human health ( Figure 1.9 ). Both sides are well intentioned, but they disagree over what is best for people. 17 \n\n Tradeoffs are especially common in the United States Congress. Members of the Senate and the House of Representatives usually vote according to the concerns of people who live in their districts. Not only does this often pit the interests of people in different parts of the country against one another, but it also frequently favors the interests of certain groups of people over the interests of others within the same state. For example, allowing oil companies to drill off the state\u2019s coast may please those who need the jobs that will be created, but it will anger those who wish to preserve coastal lands as a refuge for wildlife and, in the event of an accident, may harm the interests of people who depend on fishing and tourism for their living. At times, House members and senators in Congress may ignore the voters in their home states and the groups that represent them in order to follow the dictates of the leaders of the political party to which they belong. For example, a member of Congress from a state with a large elderly population may be inclined to vote in favor of legislation to increase benefits for retired people; however, his or her political party leaders, who disapprove of government spending on social programs, may ask for a vote against it. The opposite can occur as well, especially in the case of a legislator soon facing re-election. With two-year terms of office, we are more likely to see House members buck their party in favor of their constituents. \n\n Finally, the government may attempt to resolve conflicting concerns within the nation as a whole through tradeoffs. After repeated incidents of mass shootings at schools, theaters, churches, and shopping malls, many are concerned with protecting themselves and their families from firearm violence. Some groups would like to ban the sale of automatic weapons completely. Some do not want to ban gun ownership; they merely want greater restrictions to be put in place on who can buy guns or how long people must wait between the time they enter the store to make a purchase and the time when they are actually given possession of the weapon. Others represent the interests of those who oppose any restrictions on the number or type of weapons Americans may own. So far, state governments have attempted to balance the interests of both groups by placing restrictions on such things as who can sell guns, where gun sales may take place, or requirements for background checks, but they have not attempted to ban gun sales altogether. For example, although federal law does not require private gun dealers (people who sell guns but do not derive most of their income from doing so) to conduct background checks before selling firearms to people at gun shows, some states have passed laws requiring this. 18 \n1.3   Engagement in a Democracy \n\n Learning Objectives \n\n By the end of this section, you will be able to: \n\n Explain the importance of citizen engagement in a democracy \n\n Describe the main ways Americans can influence and become engaged in government \n\n Discuss factors that may affect people\u2019s willingness to become engaged in government \n\n Participation in government matters. Although people may not get all that they want, they can achieve many goals and improve their lives through civic engagement. According to the pluralist theory, government cannot function without active participation by at least some citizens. Even if we believe the elite make political decisions, participation in government through the act of voting can change who the members of the elite are. \n\n WHY GET INVOLVED? \n\n Are fewer people today active in politics than in the past? Political scientist Robert  Putnam  has argued that  civic engagement  is declining; although many Americans may report belonging to groups, these groups are usually large, impersonal ones with thousands of members. People who join groups such as Amnesty International or Greenpeace may share certain values and ideals with other members of the group, but they do not actually interact with these other members. These organizations are different from the types of groups Americans used to belong to, like church groups or bowling leagues. Although people are still interested in volunteering and working for the public good, they are more interested in either working individually or joining large organizations where they have little opportunity to interact with others. Putnam considers a number of explanations for this decline in small group membership, including increased participation by women in the workforce, a decrease in the number of marriages and an increase in divorces, and the effect of technological developments, such as the internet, that separate people by allowing them to feel connected to others without having to spend time in their presence. 19 Putnam argues that a decline in  social capital \u2014\u201cthe collective value of all \u2018social networks\u2019 [those whom people know] and the inclinations that arise from these networks to do things for each other\u201d\u2014accompanies this decline in membership in small, interactive groups. 20  Included in social capital are such things as networks of individuals, a sense that one is part of an entity larger than oneself, concern for the collective good and a willingness to help others, and the ability to trust others and to work with them to find solutions to problems. This, in turn, has hurt people\u2019s willingness and ability to engage in representative government. If Putnam is correct, this trend is unfortunate, because becoming active in government and community organizations is important for many reasons. \n\n Link to Learning \n\n To learn more about political engagement in the United States, read  \u201cThe Current State of Civic Engagement in America\u201d  by the Pew Research Center. \n\n Civic engagement can increase the power of ordinary people to influence government actions. Even those without money or connections to important people can influence the policies that affect their lives and change the direction taken by government. U.S. history is filled with examples of people actively challenging the power of elites, gaining rights for themselves, and protecting their interests. For example, slavery was once legal in the United States and large sectors of the U.S. economy were dependent on this forced labor. Slavery was outlawed and blacks were granted citizenship because of the actions of abolitionists. Although some abolitionists were wealthy white men, most were ordinary people, including men and women of both races. White women and blacks were able to actively assist in the campaign to end slavery despite the fact that, with few exceptions, they were unable to vote. Similarly, the right to vote once belonged solely to white men until the Fifteenth Amendment gave the vote to African American men. The Nineteenth Amendment extended the vote to include women, and the Voting Rights Act of 1965 made exercising the right to vote a reality for African American men and women in the South. None of this would have happened, however, without the efforts of people who marched in protest, participated in boycotts, delivered speeches, wrote letters to politicians, and sometimes risked arrest in order to be heard ( Figure 1.10 ). The tactics used to influence the government and effect change by abolitionists and members of the women\u2019s rights and African American civil rights movements are still used by many activists today. \n\n The rights gained by these activists and others have dramatically improved the quality of life for many in the United States. Civil rights legislation did not focus solely on the right to vote or to hold public office; it also integrated schools and public accommodations, prohibited discrimination in housing and employment, and increased access to higher education. Activists for  women\u2019s rights  fought for, and won, greater reproductive freedom for women, better wages, and access to credit. Only a few decades ago, homosexuality was considered a mental disorder, and intercourse between consenting adults of the same sex was illegal in many states. Although legal discrimination against gays and lesbians still remains, consensual intercourse between homosexual adults is no longer illegal anywhere in the United States, and same-sex couples have the right to legally marry. \n\n Activism can improve people\u2019s lives in less dramatic ways as well. Working to make cities clean up vacant lots, destroy or rehabilitate abandoned buildings, build more parks and playgrounds, pass ordinances requiring people to curb their dogs, and ban late-night noise greatly affects people\u2019s quality of life. The actions of individual Americans can make their own lives better and improve their neighbors\u2019 lives as well. \n\n Representative democracy cannot work effectively without the participation of informed citizens, however. Engaged citizens familiarize themselves with the most important issues confronting the country and with the plans different candidates have for dealing with those issues. Then they vote for the candidates they believe will be best suited to the job, and they may join others to raise funds or campaign for those they support. They inform their representatives how they feel about important issues. Through these efforts and others, engaged citizens let their representatives know what they want and thus influence policy. Only then can government actions accurately reflect the interests and concerns of the majority. Even people who believe the elite rule government should recognize that it is easier for them to do so if ordinary people make no effort to participate in public life. \n\n PATHWAYS TO ENGAGEMENT \n\n People can become civically engaged in many ways, either as individuals or as members of groups. Some forms of individual engagement require very little effort. One of the simplest ways is to stay informed about debates and events in the community, in the state, and in the nation. Awareness is the first step toward engagement. News is available from a variety of reputable sources, such as newspapers like the  New York Times ; national news shows, including those offered by the Public Broadcasting Service and National Public Radio; and reputable internet sites. \n\n Link to Learning \n\n Visit  Avaaz  and  Change.org  for more information on current political issues. \n\n Another form of individual engagement is to write or email political representatives. Filing a complaint with the city council is another avenue of engagement. City officials cannot fix problems if they do not know anything is wrong to begin with. Responding to public opinion polls, actively contributing to a political blog, or starting a new blog are all examples of different ways to be involved. \n\n One of the most basic ways to engage with government as an individual is to vote ( Figure 1.11 ). Individual votes do matter. City council members, mayors, state legislators, governors, and members of Congress are all chosen by popular vote. Although the president of the United States is not chosen directly by popular vote but by a group called the Electoral College, the votes of individuals in their home states determine how the Electoral College ultimately votes. Registering to vote beforehand is necessary in most states, but it is usually a simple process, and many states allow registration online. (We discuss voter registration and voter turnout in more depth in a later chapter.) \n\n Voting, however, is not the only form of political engagement in which people may participate. Individuals can engage by attending political rallies, donating money to campaigns, and signing petitions. Starting a petition of one\u2019s own is relatively easy, and some websites that encourage people to become involved in political activism provide petitions that can be circulated through email. Taking part in a poll or survey is another simple way to make your voice heard. \n\n Milestone Votes for Eighteen-Year-Olds Young Americans are often reluctant to become involved in traditional forms of political activity. They may believe politicians are not interested in what they have to say, or they may feel their votes do not matter. However, this attitude has not always prevailed. Indeed, today\u2019s college students can vote because of the activism of college students in the 1960s. Most states at that time required citizens to be twenty-one years of age before they could vote in national elections. This angered many young people, especially young men who could be drafted to fight the war in Vietnam. They argued that it was unfair to deny eighteen-year-olds the right to vote for the people who had the power to send them to war. As a result, the  Twenty-Sixth Amendment , which lowered the voting age in national elections to eighteen, was ratified by the states and went into effect in 1971. \n\n Are you engaged in or at least informed about actions of the federal or local government? Are you registered to vote? How would you feel if you were not allowed to vote until age twenty-one? \n\n Some people prefer to work with groups when participating in political activities or performing service to the community. Group activities can be as simple as hosting a book club or discussion group to talk about politics. Coffee Party USA provides an online forum for people from a variety of political perspectives to discuss issues that are of concern to them. People who wish to be more active often work for political campaigns. Engaging in fundraising efforts, handing out bumper stickers and campaign buttons, helping people register to vote, and driving voters to the polls on Election Day are all important activities that anyone can engage in. Individual citizens can also join interest groups that promote the causes they favor. \n\n Get Connected! Getting Involved In many ways, the pluralists were right. There is plenty of room for average citizens to become active in government, whether it is through a city council subcommittee or another type of local organization. Civic organizations always need volunteers, sometimes for only a short while and sometimes for much longer. \n\n For example,  Common Cause  is a non-partisan organization that seeks to hold government accountable for its actions. It calls for campaign finance reform and paper verification of votes registered on electronic voting machines. Voters would then receive proof that the machine recorded their actual vote. This would help to detect faulty machines that were inaccurately tabulating votes or election fraud. Therefore, one could be sure that election results were reliable and that the winning candidate had in fact received the votes counted in their favor.  Common Cause  has also advocated that the Electoral College be done away with and that presidential elections be decided solely on the basis of the popular vote. \n\n Follow-up activity: Choose one of the following websites to connect with organizations and interest groups in need of help: \n\n Common Cause ; \n\n Friends of the Earth  which mobilizes people to protect the natural environment; \n\n Grassroots International  which works for global justice; \n\n The Family Research Council  which promotes traditional marriage and Judeo-Christian values; or \n\n Eagle Forum  which supports greater restrictions on immigration and fewer restrictions on home schooling. \n\n Political activity is not the only form of engagement, and many people today seek other opportunities to become involved. This is particularly true of young Americans. Although young people today often shy away from participating in traditional political activities, they do express deep concern for their communities and seek out volunteer opportunities. 21  Although they may not realize it, becoming active in the community and engaging in a wide variety of community-based volunteer efforts are important forms of  civic engagement  and help government do its job. The demands on government are great, and funds do not always exist to enable it to undertake all the projects it may deem necessary. Even when there are sufficient funds, politicians have differing ideas regarding how much government should do and what areas it should be active in. Volunteers and community organizations help fill the gaps. Examples of community action include tending a community garden, building a house for Habitat for Humanity, cleaning up trash in a vacant lot, volunteering to deliver meals to the elderly, and tutoring children in after-school programs ( Figure 1.12 ). \n\n Some people prefer even more active and direct forms of engagement such as protest marches and demonstrations, including  civil disobedience . Such tactics were used successfully in the African American civil rights movement of the 1950s and 1960s and remain effective today. Likewise, the sit-ins (and sleep-ins and pray-ins) staged by African American  civil rights  activists, which they employed successfully to desegregate lunch counters, motels, and churches, have been adopted today by movements such as Black Lives Matter and Occupy Wall Street ( Figure 1.13 ). Other tactics, such as boycotting businesses of whose policies the activists disapproved, are also still common. Along with boycotts, there are now \u201cbuycotts,\u201d in which consumers purchase goods and services from companies that give extensively to charity, help the communities in which they are located, or take steps to protect the environment. \n\n Link to Learning \n\n Many ordinary people have become political activists. Read  \u201c19 Young Activists Changing America\u201d  to learn about people who are working to make people\u2019s lives better. \n\n Insider Perspective Ritchie Torres In 2013, at the age of twenty-five, Ritchie  Torres  became the youngest member of the New York City Council and the first gay council member to represent the Bronx ( Figure 1.14 ). Torres became interested in social justice early in his life. He was raised in poverty in the Bronx by his mother and a stepfather who left the family when Torres was twelve. The mold in his family\u2019s public housing apartment caused him to suffer from asthma as a child, and he spent time in the hospital on more than one occasion because of it. His mother\u2019s complaints to the New York City Housing Authority were largely ignored. In high school, Torres decided to become a lawyer, participated in mock trials, and met a young and aspiring local politician named James  Vacca . After graduation, he volunteered to campaign for Vacca in his run for a seat on the City Council. After Vacca was elected, he hired Torres to serve as his housing director to reach out to the community on Vacca\u2019s behalf. While doing so, Torres took pictures of the poor conditions in public housing and collected complaints from residents. In 2013, Torres ran for a seat on the City Council himself and won. He remains committed to improving housing for the poor. 22 \n\n Why don\u2019t more young people run for local office as Torres did? What changes might they effect in their communities if they were elected to a government position? \n\n FACTORS OF ENGAGEMENT \n\n Many Americans engage in political activity on a regular basis. A survey conducted in 2008 revealed that approximately two-thirds of American adults had participated in some type of political action in the past year. These activities included largely non-personal activities that did not require a great deal of interaction with others, such as signing petitions, contacting elected representatives, or contributing money to campaigns. 23 \n\n Americans aged 18\u201329 were less likely to become involved in traditional forms of  political activity  than older Americans. A 2015 poll of more than three thousand young adults by Harvard University\u2019s Institute of Politics revealed that only 22 percent claimed to be politically engaged, and fewer than 10 percent said that they belonged to any type of political organization or had volunteered for a political campaign. Only slightly more said that they had gone to political rallies. 24  However, although Americans under age thirty are less likely than older Americans to engage in traditional types of political participation, many remain engaged in activities on behalf of their communities. One-third reported that they had voluntarily engaged in some form of community service in the past year. 25 \n\n Why are younger Americans less likely to become involved in traditional political organizations? One answer may be that as American politics become more partisan in nature, young people turn away. Committed  partisanship , which is the tendency to identify with and to support (often blindly) a particular political party, alienates some Americans who feel that elected representatives should vote in support of the nation\u2019s best interests instead of voting in the way their party wishes them to. When elected officials ignore all factors other than their party\u2019s position on a particular issue, some voters become disheartened while others may become polarized. However, a recent study reveals that it is a distrust of the opposing party and not an ideological commitment to their own party that is at the heart of most partisanship among voters. 26 \n\n Young Americans are particularly likely to be put off by partisan politics. More Americans under the age of thirty now identify themselves as Independents instead of Democrats or Republicans ( Figure 1.15 ). Instead of identifying with a particular political party, young Americans are increasingly concerned about specific issues, such as same-sex marriage. 27  People whose votes are determined based on single issues are unlikely to vote according to party affiliation.  The other factor involved in low youth voter turnout in the past was that younger Americans did not feel that candidates generally tackle issues relevant to their lives. When younger voters cannot relate to the issues put forth in a campaign, such as entitlements for seniors, they lose interest. This dynamic changed somewhat in 2016 as Democratic candidate Bernie Sanders made college costs an issue, even promising free college tuition for undergraduates at public institutions. Senator Sanders enjoyed intense support on college campuses across the United States. After his nomination campaign failed, this young voter enthusiasm faded. Despite the fact that Democratic nominee Hillary Clinton eventually took up the free tuition issue, young people did not flock to her as well as they had to Sanders. In the general election, won by Republican nominee Donald Trump, turnout was down and Clinton received a smaller proportion of the youth vote than President Obama had in 2012. 28 \n\n While some Americans disapprove of partisanship in general, others are put off by the  ideology \u2014established beliefs and ideals that help shape political policy\u2014of one of the major parties. This is especially true among the young. As some members of the Republican Party have become more ideologically conservative (e.g., opposing same-sex marriage, legalization of certain drugs, immigration reform, gun control, separation of church and state, and access to abortion), those young people who do identify with one of the major parties have in recent years tended to favor the Democratic Party. 29  Of the Americans under age thirty who were surveyed by Harvard in 2015, more tended to hold a favorable opinion of Democrats in Congress than of Republicans, and 56 percent reported that they wanted the Democrats to win the presidency in 2016 ( Figure 1.15 ). Even those young Americans who identify themselves as Republicans are more liberal on certain issues, such as being supportive of same-sex marriage and immigration reform, than are older Republicans. The young Republicans also may be more willing to see similarities between themselves and Democrats. 30  Once again, support for the views of a particular party does not necessarily mean that someone will vote for members of that party. \n\n Other factors may keep even those college students who do wish to vote away from the polls. Because many young Americans attend colleges and universities outside of their home states, they may find it difficult to register to vote. In places where a state-issued ID is required, students may not have one or may be denied one if they cannot prove that they paid in-state tuition rates. 31 \n\n The likelihood that people will become active in politics also depends not only on age but on such factors as wealth and education. In a 2006 poll, the percentage of people who reported that they were regular voters grew as levels of income and education increased. 32  Political involvement also depends on how strongly people feel about current political issues. Unfortunately, public opinion polls, which politicians may rely on when formulating policy or deciding how to vote on issues, capture only people\u2019s  latent preferences  or beliefs. Latent preferences are not deeply held and do not remain the same over time. They may not even represent a person\u2019s true feelings, since they may be formed on the spot when someone is asked a question about which he or she has no real opinion. Indeed, voting itself may reflect merely a latent preference because even people who do not feel strongly about a particular political candidate or issue vote. On the other hand,  intense preferences  are based on strong feelings regarding an issue that someone adheres to over time. People with intense preferences tend to become more engaged in politics; they are more likely to donate time and money to campaigns or to attend political rallies. The more money that one has and the more highly educated one is, the more likely that he or she will form intense preferences and take political action. 33 ", "questions": [{"question": {"question_id": "fs-id1171474484001", "question_text": "What goods are available to all without direct payment?", "question_choices": ["private goods", "public goods", "common goods", "toll goods"], "cloze_format": "The goods that are available to all without direct payment are ___ .", "normal_format": "What goods are available to all without direct payment?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "Such goods or services that are available to all without charge are called public goods .", "hl_context": "Thus , the market cannot provide everything ( in enough quantity or at low enough costs ) in order to meet everyone \u2019 s needs . Therefore , some goods are provided by the government . <hl> Such goods or services that are available to all without charge are called public goods . <hl> Two such public goods are national security and education . It is difficult to see how a private business could protect the United States from attack . How could it build its own armies and create plans for defense and attack ? Who would pay the men and women who served ? Where would the intelligence come from ? Due to its ability to tax , draw upon the resources of an entire nation , and compel citizen compliance , only government is capable of protecting the nation ."}, {"question": {"question_id": "fs-id1171474261414", "question_text": "In which form of government does a small group of elite people hold political power?", "question_choices": ["direct democracy", "monarchy", "oligarchy", "totalitarian"], "cloze_format": "The form of government in which a small group of elite people hold political power is the ___ .", "normal_format": "In which form of government does a small group of elite people hold political power?"}, "answer": {"ans_text": "monarchy", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "At the other end of the political spectrum are elite-driven forms of government . In a monarchy , one ruler , usually a hereditary ruler , holds political power .", "hl_context": "Most countries now have some form of representative government ( Figure 1.6 ) . <hl> At the other end of the political spectrum are elite-driven forms of government . <hl> <hl> In a monarchy , one ruler , usually a hereditary ruler , holds political power . <hl> Although the power of some monarchs is limited by law , and such kings and queens often rule along with an elected legislature that makes laws for the country , this is not always the case . Many southwest Asian kingdoms , such as Saudi Arabia , Qatar , and the United Arab Emirates , have absolute monarchs whose power is unrestricted . As discussed earlier , another nondemocratic form of government is oligarchy , in which a handful of elite members of society , often those who belong to a particular political party , hold all political power . For example , in Cuba , as in China , only members of the Communist Party are allowed to vote or hold public office , and the party \u2019 s most important members make all government decisions . Some nondemocratic societies are totalitarian in nature . Under totalitarianism , the government is more important than the citizens , and it controls all aspects of citizens \u2019 lives . Citizens \u2019 rights are limited , and the government does not allow political criticism or opposition . These forms of government are fairly rare . North Korea is an example of a totalitarian government ."}, {"question": {"question_id": "fs-id1171474296104", "question_text": "The elite theory of government maintains that ________.", "question_choices": ["special interest groups make government policy", "politicians who have held office for a long time are favored by voters", "poor people and people of color should not be allowed to vote", "wealthy, politically powerful people control government, and government has no interest in meeting the needs of ordinary people"], "cloze_format": "The elite theory of government maintains that ________.", "normal_format": "What does the elite theory of government maintain?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "bloom": null, "hl_sentences": "According to elite theory , the wealthy use their power to control the nation \u2019 s economy in such a way that those below them cannot advance economically . Their wealth allows the elite to secure for themselves important positions in politics . They then use this power to make decisions and allocate resources in ways that benefit them . Politicians do the bidding of the wealthy instead of attending to the needs of ordinary people , and order is maintained by force . Many Americans fear that a set of elite citizens is really in charge of government in the United States and that others have no influence . This belief is called the elite theory of government .", "hl_context": "The foremost supporter of elite theory was C . Wright Mills . In his book , The Power Elite , Mills argued that government was controlled by a combination of business , military , and political elites . 5 Most are highly educated , often graduating from prestigious universities ( Figure 1.7 ) . <hl> According to elite theory , the wealthy use their power to control the nation \u2019 s economy in such a way that those below them cannot advance economically . <hl> <hl> Their wealth allows the elite to secure for themselves important positions in politics . <hl> <hl> They then use this power to make decisions and allocate resources in ways that benefit them . <hl> <hl> Politicians do the bidding of the wealthy instead of attending to the needs of ordinary people , and order is maintained by force . <hl> Indeed , those who favor government by the elite believe the elite are better fit to govern and that average citizens are content to allow them to do so . 6 <hl> Many Americans fear that a set of elite citizens is really in charge of government in the United States and that others have no influence . <hl> <hl> This belief is called the elite theory of government . <hl> In contrast to that perspective is the pluralist theory of government , which says that political power rests with competing interest groups who share influence in government . Pluralist theorists assume that citizens who want to get involved in the system do so because of the great number of access points to government . That is , the U . S . system , with several levels and branches , has many places where people and groups can engage the government ."}, {"question": {"question_id": "fs-id1171474403036", "question_text": "According to the pluralist theory of government, ________.", "question_choices": ["government does what the majority of voters want it to do", "government policy is formed as a result of the competition between groups with different goals and interests", "ordinary people acting on their own have a significant influence on government", "wealthy people decide what government policy will be, and politicians have no interest in pleasing anyone else"], "cloze_format": "According to the pluralist theory of government, ________.", "normal_format": "Which of the following is correct according to the pluralist theory of government?"}, "answer": {"ans_text": "government policy is formed as a result of the competition between groups with different goals and interests", "ans_choice": 1}, "bloom": null, "hl_sentences": "According to pluralist theory , people with shared interests will form groups in order to make their desires known to politicians . These groups include such entities as environmental advocates , unions , and organizations that represent the interests of various businesses . As groups compete with one another and find themselves in conflict regarding important issues , government policy begins to take shape . In this way , government policy is shaped from the bottom up and not from the top down , as we see in elitist theory . In contrast to that perspective is the pluralist theory of government , which says that political power rests with competing interest groups who share influence in government .", "hl_context": "<hl> According to pluralist theory , people with shared interests will form groups in order to make their desires known to politicians . <hl> <hl> These groups include such entities as environmental advocates , unions , and organizations that represent the interests of various businesses . <hl> Because most people lack the inclination , time , or expertise necessary to decide political issues , these groups will speak for them . <hl> As groups compete with one another and find themselves in conflict regarding important issues , government policy begins to take shape . <hl> <hl> In this way , government policy is shaped from the bottom up and not from the top down , as we see in elitist theory . <hl> Robert Dahl , author of Who Governs ? , was one of the first to advance the pluralist theory , and argued that politicians seeking an \u201c electoral payoff \u201d are attentive to the concerns of politically active citizens and , through them , become acquainted with the needs of ordinary people . They will attempt to give people what they want in exchange for their votes . 15 Many Americans fear that a set of elite citizens is really in charge of government in the United States and that others have no influence . This belief is called the elite theory of government . <hl> In contrast to that perspective is the pluralist theory of government , which says that political power rests with competing interest groups who share influence in government . <hl> Pluralist theorists assume that citizens who want to get involved in the system do so because of the great number of access points to government . That is , the U . S . system , with several levels and branches , has many places where people and groups can engage the government ."}, {"question": {"question_id": "fs-id1171474441953", "question_text": "Which of the following is a good example of a tradeoff?", "question_choices": ["The government pleases environmental activists by preserving public lands but also pleases ranchers by allowing them to rent public lands for grazing purposes.", "The government pleases environmental activists by reintroducing wolves to Yellowstone National Park but angers ranchers by placing their cattle in danger.", "The government pleases oil companies by allowing them to drill on lands set aside for conservation but allows environmental activist groups to protest the drilling operations.", "Groups that represent a variety of conflicting interests are all allowed to protest outside Congress and the White House."], "cloze_format": "___  is a good example of a tradeoff.", "normal_format": "Which of the following is a good example of a tradeoff?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "Tradeoffs are especially common in the United States Congress . Members of the Senate and the House of Representatives usually vote according to the concerns of people who live in their districts . Not only does this often pit the interests of people in different parts of the country against one another , but it also frequently favors the interests of certain groups of people over the interests of others within the same state .", "hl_context": "<hl> Tradeoffs are especially common in the United States Congress . <hl> <hl> Members of the Senate and the House of Representatives usually vote according to the concerns of people who live in their districts . <hl> <hl> Not only does this often pit the interests of people in different parts of the country against one another , but it also frequently favors the interests of certain groups of people over the interests of others within the same state . <hl> For example , allowing oil companies to drill off the state \u2019 s coast may please those who need the jobs that will be created , but it will anger those who wish to preserve coastal lands as a refuge for wildlife and , in the event of an accident , may harm the interests of people who depend on fishing and tourism for their living . At times , House members and senators in Congress may ignore the voters in their home states and the groups that represent them in order to follow the dictates of the leaders of the political party to which they belong . For example , a member of Congress from a state with a large elderly population may be inclined to vote in favor of legislation to increase benefits for retired people ; however , his or her political party leaders , who disapprove of government spending on social programs , may ask for a vote against it . The opposite can occur as well , especially in the case of a legislator soon facing re-election . With two-year terms of office , we are more likely to see House members buck their party in favor of their constituents ."}, {"question": {"question_id": "fs-id1171474419885", "question_text": "Supporting the actions of the Democratic Party simply because one identifies oneself as a member of that party is an example of ________.", "question_choices": ["partisanship", "ideology", "latent preference", "social capital"], "cloze_format": "Supporting the actions of the Democratic Party simply because one identifies oneself as a member of that party is an example of ________.", "normal_format": "What is supporting the actions of the Democratic Party simply because one identifies oneself as a member of that party an example of?"}, "answer": {"ans_text": "partisanship", "ans_choice": 0}, "bloom": null, "hl_sentences": "Committed partisanship , which is the tendency to identify with and to support ( often blindly ) a particular political party , alienates some Americans who feel that elected representatives should vote in support of the nation \u2019 s best interests instead of voting in the way their party wishes them to .", "hl_context": "Why are younger Americans less likely to become involved in traditional political organizations ? One answer may be that as American politics become more partisan in nature , young people turn away . <hl> Committed partisanship , which is the tendency to identify with and to support ( often blindly ) a particular political party , alienates some Americans who feel that elected representatives should vote in support of the nation \u2019 s best interests instead of voting in the way their party wishes them to . <hl> When elected officials ignore all factors other than their party \u2019 s position on a particular issue , some voters become disheartened while others may become polarized . However , a recent study reveals that it is a distrust of the opposing party and not an ideological commitment to their own party that is at the heart of most partisanship among voters . 26"}, {"question": {"question_id": "fs-id1171474483997", "question_text": "When a person is asked a question about a political issue that he or she has little interest in and has not thought much about, that person\u2019s answer will likely reflect ________.", "question_choices": ["ideology", "partisanship", "intense preferences", "latent preferences"], "cloze_format": "When a person is asked a question about a political issue that he or she has little interest in and has not thought much about, that person\u2019s answer will likely reflect ________.", "normal_format": "When a person is asked a question about a political issue that he or she has little interest in and has not thought much about, what will that person\u2019s answer likely reflect?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Unfortunately , public opinion polls , which politicians may rely on when formulating policy or deciding how to vote on issues , capture only people \u2019 s latent preferences or beliefs . Latent preferences are not deeply held and do not remain the same over time . They may not even represent a person \u2019 s true feelings , since they may be formed on the spot when someone is asked a question about which he or she has no real opinion .", "hl_context": "The likelihood that people will become active in politics also depends not only on age but on such factors as wealth and education . In a 2006 poll , the percentage of people who reported that they were regular voters grew as levels of income and education increased . 32 Political involvement also depends on how strongly people feel about current political issues . <hl> Unfortunately , public opinion polls , which politicians may rely on when formulating policy or deciding how to vote on issues , capture only people \u2019 s latent preferences or beliefs . <hl> <hl> Latent preferences are not deeply held and do not remain the same over time . <hl> <hl> They may not even represent a person \u2019 s true feelings , since they may be formed on the spot when someone is asked a question about which he or she has no real opinion . <hl> Indeed , voting itself may reflect merely a latent preference because even people who do not feel strongly about a particular political candidate or issue vote . On the other hand , intense preferences are based on strong feelings regarding an issue that someone adheres to over time . People with intense preferences tend to become more engaged in politics ; they are more likely to donate time and money to campaigns or to attend political rallies . The more money that one has and the more highly educated one is , the more likely that he or she will form intense preferences and take political action . 33"}], "summary": "Summary 1.1   What is Government? \n\n Government provides stability to society, as well as many crucial services such as free public education, police and fire services, and mail delivery. It also regulates access to common goods, such as public land, for the benefit of all. Government creates a structure whereby people can make their needs and opinions known to public officials. This is one of the key factors that makes the United States a representative democracy. A country where people elect representatives to make political decisions for them depends on the ability and willingness of ordinary people to make their voices known, unlike an oligarchy dominated by only a small group of people. \n\n 1.2   Who Governs? Elitism, Pluralism, and Tradeoffs \n\n Many question whether politicians are actually interested in the needs of average citizens and debate how much influence ordinary people have over what government does. Those who support the elite theory of government argue that a small, wealthy, powerful elite controls government and makes policy to benefit its members and perpetuate their power. Others favor the pluralist theory, which maintains that groups representing the people\u2019s interests do attract the attention of politicians and can influence government policy. In reality, government policy usually is the result of a series of tradeoffs as groups and elites fight with one another for influence and politicians attempt to balance the demands of competing interests, including the interests of the constituents who elected them to office. \n\n 1.3   Engagement in a Democracy \n\n Civic and political engagement allows politicians to know how the people feel. It also improves people\u2019s lives and helps them to build connections with others. Individuals can educate themselves on important issues and events, write to their senator or representative, file a complaint at city hall, attend a political rally, or vote. People can also work in groups to campaign or raise funds for a candidate, volunteer in the community, or protest a social injustice or an unpopular government policy. Although wealthier, older, more highly educated citizens are the most likely to be engaged with their government, especially if they have intense preferences about an issue, younger, less wealthy people can do much to change their communities and their country. ", "keyterm": "", "bname": "american_government"}, {"chapter": 26, "intro": " Chapter Objectives \n\n  After studying this chapter, you will be able to:\n\n Identify the body\u2019s main fluid compartments \n\n Define plasma osmolality and identify two ways in which plasma osmolality is maintained \n\n Identify the six ions most important to the function of the body \n\n Define buffer and discuss the role of buffers in the body \n\n Explain why bicarbonate must be conserved rather than reabsorbed in the kidney \n\n Identify the normal range of blood pH and name the conditions where one has a blood pH that is either too high or too low \n\n Introduction  Homeostasis, or the maintenance of constant conditions in the body, is a fundamental property of all living things. In the human body, the substances that participate in chemical reactions must remain within narrows ranges of concentration. Too much or too little of a single substance can disrupt your bodily functions. Because metabolism relies on reactions that are all interconnected, any disruption might affect multiple organs or even organ systems. Water is the most ubiquitous substance in the chemical reactions of life. The interactions of various aqueous solutions\u2014solutions in which water is the solvent\u2014are continuously monitored and adjusted by a large suite of interconnected feedback systems in your body. Understanding the ways in which the body maintains these critical balances is key to understanding good health. ", "chapter_text": " 26.1   Body Fluids and Fluid Compartments  Learning Objectives By the end of this section, you will be able to: \n\n Explain the importance of water in the body \n\n Contrast the composition of the intracellular fluid with that of the extracellular fluid \n\n Explain the importance of protein channels in the movement of solutes \n\n Identify the causes and symptoms of edema \n\n The chemical reactions of life take place in aqueous solutions. The dissolved substances in a solution are called solutes. In the human body, solutes vary in different parts of the body, but may include proteins\u2014including those that transport lipids, carbohydrates, and, very importantly, electrolytes. Often in medicine, a mineral dissociated from a salt that carries an electrical charge (an ion) is called an electrolyte. For instance, sodium ions (Na + ) and chloride ions (Cl - ) are often referred to as electrolytes. In the body, water moves through semi-permeable membranes of cells and from one compartment of the body to another by a process called osmosis. Osmosis is basically the diffusion of water from regions of higher concentration of water to regions of lower concentration of water, along an osmotic gradient across a semi-permeable membrane. As a result, water will move into and out of cells and tissues, depending on the relative concentrations of the water and solutes found there. An appropriate balance of solutes inside and outside of cells must be maintained to ensure normal function. \n\n Body Water Content \n\n Human beings are mostly water, ranging from about 75 percent of body mass in infants to about 50\u201360 percent in adult men and women, to as low as 45 percent in old age. The percent of body water changes with development, because the proportions of the body given over to each organ and to muscles, fat, bone, and other tissues change from infancy to adulthood ( Figure 26.2 ). Your brain and kidneys have the highest proportions of water, which composes 80\u201385 percent of their masses. In contrast, teeth have the lowest proportion of water, at 8\u201310 percent. \n\n Fluid Compartments \n\n Body fluids can be discussed in terms of their specific  fluid compartment , a location that is largely separate from another compartment by some form of a physical barrier. The  intracellular fluid (ICF)  compartment is the system that includes all fluid enclosed in cells by their  plasma membranes.  Extracellular fluid (ECF)  surrounds all cells in the body. Extracellular fluid has two primary constituents: the fluid component of the blood (called plasma) and the  interstitial fluid (IF)  that surrounds all cells not in the blood ( Figure 26.3 ). \n\n Intracellular Fluid \n\n The ICF lies within cells and is the principal component of the cytosol/cytoplasm. The ICF makes up about 60 percent of the total water in the human body, and in an average-size adult male, the ICF accounts for about 25 liters (seven gallons) of fluid ( Figure 26.4 ). This fluid volume tends to be very stable, because the amount of water in living cells is closely regulated. If the amount of water inside a cell falls to a value that is too low, the cytosol becomes too concentrated with solutes to carry on normal cellular activities; if too much water enters a cell, the cell may burst and be destroyed. \n\n Extracellular Fluid \n\n The ECF accounts for the other one-third of the body\u2019s water content. Approximately 20 percent of the ECF is found in plasma. Plasma travels through the body in blood vessels and transports a range of materials, including blood cells, proteins (including clotting factors and antibodies), electrolytes, nutrients, gases, and wastes. Gases, nutrients, and waste materials travel between capillaries and cells through the IF. Cells are separated from the IF by a selectively permeable cell membrane that helps regulate the passage of materials between the IF and the interior of the cell. \n\n The body has other water-based ECF. These include the cerebrospinal fluid that bathes the brain and spinal cord, lymph, the synovial fluid in joints, the pleural fluid in the pleural cavities, the pericardial fluid in the cardiac sac, the peritoneal fluid in the peritoneal cavity, and the aqueous humor of the eye. Because these fluids are outside of cells, these fluids are also considered components of the ECF compartment. \n\n Composition of Body Fluids \n\n The compositions of the two components of the ECF\u2014plasma and IF\u2014are more similar to each other than either is to the ICF ( Figure 26.5 ). Blood plasma has high concentrations of sodium, chloride, bicarbonate, and protein. The IF has high concentrations of sodium, chloride, and bicarbonate, but a relatively lower concentration of protein. In contrast, the ICF has elevated amounts of potassium, phosphate, magnesium, and protein. Overall, the ICF contains high concentrations of potassium and phosphate ( \n\n HPO \n\n 4 \n\n 2 \u2212 \n\n HPO \n\n 4 \n\n 2 \u2212 \n\n ), whereas both plasma and the ECF contain high concentrations of sodium and chloride. Interactive Link \n\n Watch this  video  to learn more about body fluids, fluid compartments, and electrolytes. When blood volume decreases due to sweating, from what source is water taken in by the blood? \n\n Most body fluids are neutral in charge. Thus, cations, or positively charged ions, and anions, or negatively charged ions, are balanced in fluids. As seen in the previous graph, sodium (Na + ) ions and chloride (Cl - ) ions are concentrated in the ECF of the body, whereas potassium (K + ) ions are concentrated inside cells. Although sodium and potassium can \u201cleak\u201d through \u201cpores\u201d into and out of cells, respectively, the high levels of potassium and low levels of sodium in the ICF are maintained by sodium-potassium pumps in the cell membranes. These pumps use the energy supplied by ATP to pump sodium out of the cell and potassium into the cell ( Figure 26.6 ). \n\n Fluid Movement between Compartments \n\n Hydrostatic pressure , the force exerted by a fluid against a wall, causes movement of fluid between compartments. The hydrostatic pressure of blood is the pressure exerted by blood against the walls of the blood vessels by the pumping action of the heart. In capillaries, hydrostatic pressure (also known as capillary blood pressure) is higher than the opposing \u201ccolloid osmotic pressure\u201d in blood\u2014a \u201cconstant\u201d pressure primarily produced by circulating albumin\u2014at the arteriolar end of the capillary ( Figure 26.7 ). This pressure forces plasma and nutrients out of the capillaries and into surrounding tissues. Fluid and the cellular wastes in the tissues enter the capillaries at the venule end, where the hydrostatic pressure is less than the osmotic pressure in the vessel. Filtration pressure squeezes fluid from the plasma in the blood to the IF surrounding the tissue cells. The surplus fluid in the interstitial space that is not returned directly back to the capillaries is drained from tissues by the lymphatic system, and then re-enters the vascular system at the subclavian veins. Interactive Link \n\n Watch this  video  to see an explanation of the dynamics of fluid in the body\u2019s compartments. What happens in the tissue when capillary blood pressure is less than osmotic pressure? \n\n Hydrostatic pressure is especially important in governing the movement of water in the nephrons of the kidneys to ensure proper filtering of the blood to form urine. As hydrostatic pressure in the kidneys increases, the amount of water leaving the capillaries also increases, and more urine filtrate is formed. If hydrostatic pressure in the kidneys drops too low, as can happen in dehydration, the functions of the kidneys will be impaired, and less nitrogenous wastes will be removed from the bloodstream. Extreme dehydration can result in kidney failure. \n\n Fluid also moves between compartments along an osmotic gradient. Recall that an osmotic gradient is produced by the difference in concentration of all solutes on either side of a semi-permeable membrane. The magnitude of the osmotic gradient is proportional to the difference in the concentration of solutes on one side of the cell membrane to that on the other side. Water will move by osmosis from the side where its concentration is high (and the concentration of solute is low) to the side of the membrane where its concentration is low (and the concentration of solute is high). In the body, water moves by osmosis from plasma to the IF (and the reverse) and from the IF to the ICF (and the reverse). In the body, water moves constantly into and out of fluid compartments as conditions change in different parts of the body. \n\n For example, if you are sweating, you will lose water through your skin. Sweating depletes your tissues of water and increases the solute concentration in those tissues. As this happens, water diffuses from your blood into sweat glands and surrounding skin tissues that have become dehydrated because of the osmotic gradient. Additionally, as water leaves the blood, it is replaced by the water in other tissues throughout your body that are not dehydrated. If this continues, dehydration spreads throughout the body. When a dehydrated person drinks water and rehydrates, the water is redistributed by the same gradient, but in the opposite direction, replenishing water in all of the tissues. \n\n Solute Movement between Compartments \n\n The movement of some solutes between compartments is active, which consumes energy and is an active transport process, whereas the movement of other solutes is passive, which does not require energy. Active transport allows cells to move a specific substance against its concentration gradient through a membrane protein, requiring energy in the form of ATP. For example, the sodium-potassium pump employs active transport to pump sodium out of cells and potassium into cells, with both substances moving against their concentration gradients. \n\n Passive transport of a molecule or ion depends on its ability to pass through the membrane, as well as the existence of a concentration gradient that allows the molecules to diffuse from an area of higher concentration to an area of lower concentration. Some molecules, like gases, lipids, and water itself (which also utilizes water channels in the membrane called aquaporins), slip fairly easily through the cell membrane; others, including polar molecules like glucose, amino acids, and ions do not. Some of these molecules enter and leave cells using facilitated transport, whereby the molecules move down a concentration gradient through specific protein channels in the membrane. This process does not require energy. For example, glucose is transferred into cells by glucose transporters that use facilitated transport ( Figure 26.8 ). \n\n Disorders of the... Fluid Balance: Edema \n\nEdema is the accumulation of excess water in the tissues. It is most common in the soft tissues of the extremities. The physiological causes of edema include water leakage from blood capillaries. Edema is almost always caused by an underlying medical condition, by the use of certain therapeutic drugs, by pregnancy, by localized injury, or by an allergic reaction. In the limbs, the symptoms of edema include swelling of the subcutaneous tissues, an increase in the normal size of the limb, and stretched, tight skin. One quick way to check for subcutaneous edema localized in a limb is to press a finger into the suspected area. Edema is likely if the depression persists for several seconds after the finger is removed (which is called \u201cpitting\u201d). \n\n Pulmonary edema is excess fluid in the air sacs of the lungs, a common symptom of heart and/or kidney failure. People with pulmonary edema likely will experience difficulty breathing, and they may experience chest pain. Pulmonary edema can be life threatening, because it compromises gas exchange in the lungs, and anyone having symptoms should immediately seek medical care. \n\n In pulmonary edema resulting from heart failure, excessive leakage of water occurs because fluids get \u201cbacked up\u201d in the pulmonary capillaries of the lungs, when the left ventricle of the heart is unable to pump sufficient blood into the systemic circulation. Because the left side of the heart is unable to pump out its normal volume of blood, the blood in the pulmonary circulation gets \u201cbacked up,\u201d starting with the left atrium, then into the pulmonary veins, and then into pulmonary capillaries. The resulting increased hydrostatic pressure within pulmonary capillaries, as blood is still coming in from the pulmonary arteries, causes fluid to be pushed out of them and into lung tissues. \n\n Other causes of edema include damage to blood vessels and/or lymphatic vessels, or a decrease in osmotic pressure in chronic and severe liver disease, where the liver is unable to manufacture plasma proteins ( Figure 26.9 ). A decrease in the normal levels of plasma proteins results in a decrease of colloid osmotic pressure (which counterbalances the hydrostatic pressure) in the capillaries. This process causes loss of water from the blood to the surrounding tissues, resulting in edema. \n\n Mild, transient edema of the feet and legs may be caused by sitting or standing in the same position for long periods of time, as in the work of a toll collector or a supermarket cashier. This is because deep veins in the lower limbs rely on skeletal muscle contractions to push on the veins and thus \u201cpump\u201d blood back to the heart. Otherwise, the venous blood pools in the lower limbs and can leak into surrounding tissues. \n\n Medications that can result in edema include vasodilators, calcium channel blockers used to treat hypertension, non-steroidal anti-inflammatory drugs, estrogen therapies, and some diabetes medications. Underlying medical conditions that can contribute to edema include congestive heart failure, kidney damage and kidney disease, disorders that affect the veins of the legs, and cirrhosis and other liver disorders. \n\n Therapy for edema usually focuses on elimination of the cause. Activities that can reduce the effects of the condition include appropriate exercises to keep the blood and lymph flowing through the affected areas. Other therapies include elevation of the affected part to assist drainage, massage and compression of the areas to move the fluid out of the tissues, and decreased salt intake to decrease sodium and water retention. \n 26.2   Water Balance  Learning Objectives By the end of this section, you will be able to: \n\n Explain how water levels in the body influence the thirst cycle \n\n Identify the main route by which water leaves the body \n\n Describe the role of ADH and its effect on body water levels \n\n Define dehydration and identify common causes of dehydration \n\n On a typical day, the average adult will take in about 2500 mL (almost 3 quarts) of aqueous fluids. Although most of the intake comes through the digestive tract, about 230 mL (8 ounces) per day is generated metabolically, in the last steps of aerobic respiration. Additionally, each day about the same volume (2500 mL) of water leaves the body by different routes; most of this lost water is removed as urine. The kidneys also can adjust blood volume though mechanisms that draw water out of the filtrate and urine. The kidneys can regulate water levels in the body; they conserve water if you are dehydrated, and they can make urine more dilute to expel excess water if necessary. Water is lost through the skin through evaporation from the skin surface without overt sweating and from air expelled from the lungs. This type of water loss is called insensible water loss because a person is usually unaware of it. \n\n Regulation of Water Intake \n\n Osmolality is the ratio of solutes in a solution to a volume of solvent in a solution.  Plasma osmolality  is thus the ratio of solutes to water in blood plasma. A person\u2019s plasma osmolality value reflects his or her state of hydration. A healthy body maintains plasma osmolality within a narrow range, by employing several mechanisms that regulate both water intake and output. \n\n Drinking water is considered voluntary. So how is water intake regulated by the body? Consider someone who is experiencing  dehydration , a net loss of water that results in insufficient water in blood and other tissues. The water that leaves the body, as exhaled air, sweat, or urine, is ultimately extracted from blood plasma. As the blood becomes more concentrated, the thirst response\u2014a sequence of physiological processes\u2014is triggered ( Figure 26.10 ). Osmoreceptors are sensory receptors in the thirst center in the hypothalamus that monitor the concentration of solutes (osmolality) of the blood. If blood osmolality increases above its ideal value, the hypothalamus transmits signals that result in a conscious awareness of thirst. The person should (and normally does) respond by drinking water. The hypothalamus of a dehydrated person also releases antidiuretic hormone (ADH) through the posterior pituitary gland. ADH signals the kidneys to recover water from urine, effectively diluting the blood plasma. To conserve water, the hypothalamus of a dehydrated person also sends signals via the sympathetic nervous system to the salivary glands in the mouth. The signals result in a decrease in watery, serous output (and an increase in stickier, thicker mucus output). These changes in secretions result in a \u201cdry mouth\u201d and the sensation of thirst. Decreased blood volume resulting from water loss has two additional effects. First, baroreceptors, blood-pressure receptors in the arch of the aorta and the carotid arteries in the neck, detect a decrease in blood pressure that results from decreased blood volume. The heart is ultimately signaled to increase its rate and/or strength of contractions to compensate for the lowered blood pressure. \n\n Second, the kidneys have a renin-angiotensin hormonal system that increases the production of the active form of the hormone angiotensin II, which helps stimulate thirst, but also stimulates the release of the hormone aldosterone from the adrenal glands. Aldosterone increases the reabsorption of sodium in the distal tubules of the nephrons in the kidneys, and water follows this reabsorbed sodium back into the blood. \n\n If adequate fluids are not consumed, dehydration results and a person\u2019s body contains too little water to function correctly. A person who repeatedly vomits or who has diarrhea may become dehydrated, and infants, because their body mass is so low, can become dangerously dehydrated very quickly. Endurance athletes such as distance runners often become dehydrated during long races. Dehydration can be a medical emergency, and a dehydrated person may lose consciousness, become comatose, or die, if his or her body is not rehydrated quickly. \n\n Regulation of Water Output \n\n Water loss from the body occurs predominantly through the renal system. A person produces an average of 1.5 liters (1.6 quarts) of urine per day. Although the volume of urine varies in response to hydration levels, there is a minimum volume of urine production required for proper bodily functions. The kidney excretes 100 to 1200 milliosmoles of solutes per day to rid the body of a variety of excess salts and other water-soluble chemical wastes, most notably creatinine, urea, and uric acid. Failure to produce the minimum volume of urine means that metabolic wastes cannot be effectively removed from the body, a situation that can impair organ function. The minimum level of urine production necessary to maintain normal function is about 0.47 liters (0.5 quarts) per day. \n\n The kidneys also must make adjustments in the event of ingestion of too much fluid.  Diuresis , which is the production of urine in excess of normal levels, begins about 30 minutes after drinking a large quantity of fluid. Diuresis reaches a peak after about 1 hour, and normal urine production is reestablished after about 3 hours. \n\n Role of ADH \n\n Antidiuretic hormone (ADH) , also known as vasopressin, controls the amount of water reabsorbed from the collecting ducts and tubules in the kidney. This hormone is produced in the hypothalamus and is delivered to the posterior pituitary for storage and release ( Figure 26.11 ). When the osmoreceptors in the hypothalamus detect an increase in the concentration of blood plasma, the hypothalamus signals the release of ADH from the posterior pituitary into the blood. \n\n ADH has two major effects. It constricts the arterioles in the peripheral circulation, which reduces the flow of blood to the extremities and thereby increases the blood supply to the core of the body. ADH also causes the epithelial cells that line the renal collecting tubules to move water channel proteins, called aquaporins, from the interior of the cells to the apical surface, where these proteins are inserted into the cell membrane ( Figure 26.12 ). The result is an increase in the water permeability of these cells and, thus, a large increase in water passage from the urine through the walls of the collecting tubules, leading to more reabsorption of water into the bloodstream. When the blood plasma becomes less concentrated and the level of ADH decreases, aquaporins are removed from collecting tubule cell membranes, and the passage of water out of urine and into the blood decreases. \n\n A diuretic is a compound that increases urine output and therefore decreases water conservation by the body. Diuretics are used to treat hypertension, congestive heart failure, and fluid retention associated with menstruation. Alcohol acts as a diuretic by inhibiting the release of ADH. Additionally, caffeine, when consumed in high concentrations, acts as a diuretic. \n 26.3   Electrolyte Balance  Learning Objectives By the end of this section, you will be able to: \n\n List the role of the six most important electrolytes in the body \n\n Name the disorders associated with abnormally high and low levels of the six electrolytes \n\n Identify the predominant extracellular anion \n\n Describe the role of aldosterone on the level of water in the body \n\n The body contains a large variety of ions, or electrolytes, which perform a variety of functions. Some ions assist in the transmission of electrical impulses along cell membranes in neurons and muscles. Other ions help to stabilize protein structures in enzymes. Still others aid in releasing hormones from endocrine glands. All of the ions in plasma contribute to the osmotic balance that controls the movement of water between cells and their environment. \n\n Electrolytes in living systems include sodium, potassium, chloride, bicarbonate, calcium, phosphate, magnesium, copper, zinc, iron, manganese, molybdenum, copper, and chromium. In terms of body functioning, six electrolytes are most important: sodium, potassium, chloride, bicarbonate, calcium, and phosphate. \n\n Roles of Electrolytes \n\n These six ions aid in nerve excitability, endocrine secretion, membrane permeability, buffering body fluids, and controlling the movement of fluids between compartments. These ions enter the body through the digestive tract. More than 90 percent of the calcium and phosphate that enters the body is incorporated into bones and teeth, with bone serving as a mineral reserve for these ions. In the event that calcium and phosphate are needed for other functions, bone tissue can be broken down to supply the blood and other tissues with these minerals. Phosphate is a normal constituent of nucleic acids; hence, blood levels of phosphate will increase whenever nucleic acids are broken down. Excretion of ions occurs mainly through the kidneys, with lesser amounts lost in sweat and in feces. Excessive sweating may cause a significant loss, especially of sodium and chloride. Severe vomiting or diarrhea will cause a loss of chloride and bicarbonate ions. Adjustments in respiratory and renal functions allow the body to regulate the levels of these ions in the ECF. \n\n Table 26.1  lists the reference values for blood plasma, cerebrospinal fluid (CSF), and urine for the six ions addressed in this section. In a clinical setting, sodium, potassium, and chloride are typically analyzed in a routine urine sample. In contrast, calcium and phosphate analysis requires a collection of urine across a 24-hour period, because the output of these ions can vary considerably over the course of a day. Urine values reflect the rates of excretion of these ions. Bicarbonate is the one ion that is not normally excreted in urine; instead, it is conserved by the kidneys for use in the body\u2019s buffering systems. \n\n Electrolyte and Ion Reference Values \n\n Name \n\n Chemical symbol \n\n Plasma \n\n CSF \n\n Urine \n\n Sodium \n\n Na + \n\n 136.00\u2013146.00 (mM) \n\n 138.00\u2013150.00 (mM) \n\n 40.00\u2013220.00 (mM) \n\n Potassium \n\n K + \n\n 3.50\u20135.00 (mM) \n\n 0.35\u20133.5 (mM) \n\n 25.00\u2013125.00 (mM) \n\n Chloride \n\n Cl - \n\n 98.00\u2013107.00 (mM) \n\n 118.00\u2013132.00 (mM) \n\n 110.00\u2013250.00 (mM) \n\n Bicarbonate \n\n HCO 3 - \n\n 22.00\u201329.00 (mM) \n\n ------ \n\n ------ \n\n Calcium \n\n Ca ++ \n\n 2.15\u20132.55 (mmol/day) \n\n ------ \n\n Up to 7.49 (mmol/day) \n\n Phosphate \n\n HPO \n\n 4 \n\n 2 \u2212 \n\n HPO \n\n 4 \n\n 2 \u2212 \n\n 0.81\u20131.45 (mmol/day) \n\n ------ \n\n 12.90\u201342.00 (mmol/day) \n\n Table  26.1     \n\n Sodium \n\n Sodium is the major cation of the extracellular fluid. It is responsible for one-half of the osmotic pressure gradient that exists between the interior of cells and their surrounding environment. People eating a typical Western diet, which is very high in NaCl, routinely take in 130 to 160 mmol/day of sodium, but humans require only 1 to 2 mmol/day. This excess sodium appears to be a major factor in hypertension (high blood pressure) in some people. Excretion of sodium is accomplished primarily by the kidneys. Sodium is freely filtered through the glomerular capillaries of the kidneys, and although much of the filtered sodium is reabsorbed in the proximal convoluted tubule, some remains in the filtrate and urine, and is normally excreted. \n\n Hyponatremia  is a lower-than-normal concentration of sodium, usually associated with excess water accumulation in the body, which dilutes the sodium. An absolute loss of sodium may be due to a decreased intake of the ion coupled with its continual excretion in the urine. An abnormal loss of sodium from the body can result from several conditions, including excessive sweating, vomiting, or diarrhea; the use of diuretics; excessive production of urine, which can occur in diabetes; and acidosis, either metabolic acidosis or diabetic ketoacidosis. \n\n A relative decrease in blood sodium can occur because of an imbalance of sodium in one of the body\u2019s other fluid compartments, like IF, or from a dilution of sodium due to water retention related to edema or congestive heart failure. At the cellular level, hyponatremia results in increased entry of water into cells by osmosis, because the concentration of solutes within the cell exceeds the concentration of solutes in the now-diluted ECF. The excess water causes swelling of the cells; the swelling of red blood cells\u2014decreasing their oxygen-carrying efficiency and making them potentially too large to fit through capillaries\u2014along with the swelling of neurons in the brain can result in brain damage or even death. \n\n Hypernatremia  is an abnormal increase of blood sodium. It can result from water loss from the blood, resulting in the hemoconcentration of all blood constituents. Hormonal imbalances involving ADH and aldosterone may also result in higher-than-normal sodium values. \n\n Potassium \n\n Potassium is the major intracellular cation. It helps establish the resting membrane potential in neurons and muscle fibers after membrane depolarization and action potentials. In contrast to sodium, potassium has very little effect on osmotic pressure. The low levels of potassium in blood and CSF are due to the sodium-potassium pumps in cell membranes, which maintain the normal potassium concentration gradients between the ICF and ECF. The recommendation for daily intake/consumption of potassium is 4700 mg. Potassium is excreted, both actively and passively, through the renal tubules, especially the distal convoluted tubule and collecting ducts. Potassium participates in the exchange with sodium in the renal tubules under the influence of aldosterone, which also relies on basolateral sodium-potassium pumps. \n\n Hypokalemia  is an abnormally low potassium blood level. Similar to the situation with hyponatremia, hypokalemia can occur because of either an absolute reduction of potassium in the body or a relative reduction of potassium in the blood due to the redistribution of potassium. An absolute loss of potassium can arise from decreased intake, frequently related to starvation. It can also come about from vomiting, diarrhea, or alkalosis. \n\n Some insulin-dependent diabetic patients experience a relative reduction of potassium in the blood from the redistribution of potassium. When insulin is administered and glucose is taken up by cells, potassium passes through the cell membrane along with glucose, decreasing the amount of potassium in the blood and IF, which can cause hyperpolarization of the cell membranes of neurons, reducing their responses to stimuli. \n\n Hyperkalemia , an elevated potassium blood level, also can impair the function of skeletal muscles, the nervous system, and the heart. Hyperkalemia can result from increased dietary intake of potassium. In such a situation, potassium from the blood ends up in the ECF in abnormally high concentrations. This can result in a partial depolarization (excitation) of the plasma membrane of skeletal muscle fibers, neurons, and cardiac cells of the heart, and can also lead to an inability of cells to repolarize. For the heart, this means that it won\u2019t relax after a contraction, and will effectively \u201cseize\u201d and stop pumping blood, which is fatal within minutes. Because of such effects on the nervous system, a person with hyperkalemia may also exhibit mental confusion, numbness, and weakened respiratory muscles. \n\n Chloride \n\n Chloride is the predominant extracellular anion. Chloride is a major contributor to the osmotic pressure gradient between the ICF and ECF, and plays an important role in maintaining proper hydration. Chloride functions to balance cations in the ECF, maintaining the electrical neutrality of this fluid. The paths of secretion and reabsorption of chloride ions in the renal system follow the paths of sodium ions. \n\n Hypochloremia , or lower-than-normal blood chloride levels, can occur because of defective renal tubular absorption. Vomiting, diarrhea, and metabolic acidosis can also lead to hypochloremia.  Hyperchloremia , or higher-than-normal blood chloride levels, can occur due to dehydration, excessive intake of dietary salt (NaCl) or swallowing of sea water, aspirin intoxication, congestive heart failure, and the hereditary, chronic lung disease, cystic fibrosis. In people who have cystic fibrosis, chloride levels in sweat are two to five times those of normal levels, and analysis of sweat is often used in the diagnosis of the disease. \n\n Interactive Link \n\n Read this  article  for an explanation of the effect of seawater on humans. What effect does drinking seawater have on the body? \n\n Bicarbonate \n\n Bicarbonate is the second most abundant anion in the blood. Its principal function is to maintain your body\u2019s acid-base balance by being part of buffer systems. This role will be discussed in a different section. \n\n Bicarbonate ions result from a chemical reaction that starts with carbon dioxide (CO 2 ) and water, two molecules that are produced at the end of aerobic metabolism. Only a small amount of CO 2  can be dissolved in body fluids. Thus, over 90 percent of the CO 2  is converted into bicarbonate ions, HCO 3 \u2013 , through the following reactions: \n\n CO \n\n 2 \n\n \u00a0+\u00a0H \n\n 2 \n\n O \n\n \u2194 \n\n H \n\n 2 \n\n CO \n\n 3 \n\n \u2194 \n\n H \n\n CO \n\n 3 \n\n \u2013 \n\n \u00a0+\u00a0H \n\n + \n\n CO \n\n 2 \n\n \u00a0+\u00a0H \n\n 2 \n\n O \n\n \u2194 \n\n H \n\n 2 \n\n CO \n\n 3 \n\n \u2194 \n\n H \n\n CO \n\n 3 \n\n \u2013 \n\n \u00a0+\u00a0H \n\n + \n\n The bidirectional arrows indicate that the reactions can go in either direction, depending on the concentrations of the reactants and products. Carbon dioxide is produced in large amounts in tissues that have a high metabolic rate. Carbon dioxide is converted into bicarbonate in the cytoplasm of red blood cells through the action of an enzyme called carbonic anhydrase. Bicarbonate is transported in the blood. Once in the lungs, the reactions reverse direction, and CO 2  is regenerated from bicarbonate to be exhaled as metabolic waste. \n\n Calcium \n\n About two pounds of calcium in your body are bound up in bone, which provides hardness to the bone and serves as a mineral reserve for calcium and its salts for the rest of the tissues. Teeth also have a high concentration of calcium within them. A little more than one-half of blood calcium is bound to proteins, leaving the rest in its ionized form. Calcium ions, Ca 2+ , are necessary for muscle contraction, enzyme activity, and blood coagulation. In addition, calcium helps to stabilize cell membranes and is essential for the release of neurotransmitters from neurons and of hormones from endocrine glands. \n\n Calcium is absorbed through the intestines under the influence of activated vitamin D. A deficiency of vitamin D leads to a decrease in absorbed calcium and, eventually, a depletion of calcium stores from the skeletal system, potentially leading to rickets in children and osteomalacia in adults, contributing to osteoporosis. \n\n Hypocalcemia , or abnormally low calcium blood levels, is seen in hypoparathyroidism, which may follow the removal of the thyroid gland, because the four nodules of the parathyroid gland are embedded in it.  Hypercalcemia , or abnormally high calcium blood levels, is seen in primary hyperparathyroidism. Some malignancies may also result in hypercalcemia. \n\n Phosphate \n\n Phosphate is present in the body in three ionic forms:  \n\n H \n\n 2 \n\n PO \n\n 4 \n\n H \n\n 2 \n\n PO \n\n 4 \n\n ,  \n\n HPO \n\n 4 \n\n 2 \u2212 \n\n HPO \n\n 4 \n\n 2 \u2212 \n\n , and  \n\n PO \n\n 4 \n\n 3 \u2212 \n\n PO \n\n 4 \n\n 3 \u2212 \n\n . The most common form is  \n\n HPO \n\n 4 \n\n 2 \u2212 \n\n HPO \n\n 4 \n\n 2 \u2212 \n\n . Bone and teeth bind up 85 percent of the body\u2019s phosphate as part of calcium-phosphate salts. Phosphate is found in phospholipids, such as those that make up the cell membrane, and in ATP, nucleotides, and buffers. Hypophosphatemia , or abnormally low phosphate blood levels, occurs with heavy use of antacids, during alcohol withdrawal, and during malnourishment. In the face of phosphate depletion, the kidneys usually conserve phosphate, but during starvation, this conservation is impaired greatly.  Hyperphosphatemia , or abnormally increased levels of phosphates in the blood, occurs if there is decreased renal function or in cases of acute lymphocytic leukemia. Additionally, because phosphate is a major constituent of the ICF, any significant destruction of cells can result in dumping of phosphate into the ECF. \n\n Regulation of Sodium and Potassium \n\n Sodium is reabsorbed from the renal filtrate, and potassium is excreted into the filtrate in the renal collecting tubule. The control of this exchange is governed principally by two hormones\u2014aldosterone and angiotensin II. Aldosterone \n\n Recall that aldosterone increases the excretion of potassium and the reabsorption of sodium in the distal tubule. Aldosterone is released if blood levels of potassium increase, if blood levels of sodium severely decrease, or if blood pressure decreases. Its net effect is to conserve and increase water levels in the plasma by reducing the excretion of sodium, and thus water, from the kidneys. In a negative feedback loop, increased osmolality of the ECF (which follows aldosterone-stimulated sodium absorption) inhibits the release of the hormone ( Figure 26.13 ). \n\n Angiotensin II \n\n Angiotensin II causes vasoconstriction and an increase in systemic blood pressure. This action increases the glomerular filtration rate, resulting in more material filtered out of the glomerular capillaries and into Bowman\u2019s capsule. Angiotensin II also signals an increase in the release of aldosterone from the adrenal cortex. \n\n In the distal convoluted tubules and collecting ducts of the kidneys, aldosterone stimulates the synthesis and activation of the sodium-potassium pump ( Figure 26.14 ). Sodium passes from the filtrate, into and through the cells of the tubules and ducts, into the ECF and then into capillaries. Water follows the sodium due to osmosis. Thus, aldosterone causes an increase in blood sodium levels and blood volume. Aldosterone\u2019s effect on potassium is the reverse of that of sodium; under its influence, excess potassium is pumped into the renal filtrate for excretion from the body. \n\n Regulation of Calcium and Phosphate \n\n Calcium and phosphate are both regulated through the actions of three hormones: parathyroid hormone (PTH), dihydroxyvitamin D (calcitriol), and calcitonin. All three are released or synthesized in response to the blood levels of calcium. PTH is released from the parathyroid gland in response to a decrease in the concentration of blood calcium. The hormone activates osteoclasts to break down bone matrix and release inorganic calcium-phosphate salts. PTH also increases the gastrointestinal absorption of dietary calcium by converting vitamin D into  dihydroxyvitamin D  (calcitriol), an active form of vitamin D that intestinal epithelial cells require to absorb calcium. PTH raises blood calcium levels by inhibiting the loss of calcium through the kidneys. PTH also increases the loss of phosphate through the kidneys. Calcitonin is released from the thyroid gland in response to elevated blood levels of calcium. The hormone increases the activity of osteoblasts, which remove calcium from the blood and incorporate calcium into the bony matrix. \n 26.4   Acid-Base Balance  Learning Objectives By the end of this section, you will be able to: \n\n Identify the most powerful buffer system in the body \n\n Explain the way in which the respiratory system affects blood pH \n\n Proper physiological functioning depends on a very tight balance between the concentrations of acids and bases in the blood. Acid-balance balance is measured using the pH scale, as shown in  Figure 26.15 . A variety of buffering systems permits blood and other bodily fluids to maintain a narrow pH range, even in the face of perturbations. A buffer is a chemical system that prevents a radical change in fluid pH by dampening the change in hydrogen ion concentrations in the case of excess acid or base. Most commonly, the substance that absorbs the ions is either a weak acid, which takes up hydroxyl ions, or a weak base, which takes up hydrogen ions. \n\n Buffer Systems in the Body \n\n The buffer systems in the human body are extremely efficient, and different systems work at different rates. It takes only seconds for the chemical buffers in the blood to make adjustments to pH. The respiratory tract can adjust the blood pH upward in minutes by exhaling CO 2  from the body. The renal system can also adjust blood pH through the excretion of hydrogen ions (H + ) and the conservation of bicarbonate, but this process takes hours to days to have an effect. \n\n The buffer systems functioning in blood plasma include plasma proteins, phosphate, and bicarbonate and carbonic acid buffers. The kidneys help control acid-base balance by excreting hydrogen ions and generating bicarbonate that helps maintain blood plasma pH within a normal range. Protein buffer systems work predominantly inside cells. \n\n Protein Buffers in Blood Plasma and Cells \n\n Nearly all proteins can function as buffers. Proteins are made up of amino acids, which contain positively charged amino groups and negatively charged carboxyl groups. The charged regions of these molecules can bind hydrogen and hydroxyl ions, and thus function as buffers. Buffering by proteins accounts for two-thirds of the buffering power of the blood and most of the buffering within cells. \n\n Hemoglobin as a Buffer \n\n Hemoglobin is the principal protein inside of red blood cells and accounts for one-third of the mass of the cell. During the conversion of CO 2  into bicarbonate, hydrogen ions liberated in the reaction are buffered by hemoglobin, which is reduced by the dissociation of oxygen. This buffering helps maintain normal pH. The process is reversed in the pulmonary capillaries to re-form CO 2 , which then can diffuse into the air sacs to be exhaled into the atmosphere. This process is discussed in detail in the chapter on the respiratory system. \n\n Phosphate Buffer \n\n Phosphates are found in the blood in two forms: sodium dihydrogen phosphate ( \n\n Na \n\n H \n\n 2 \n\n PO \n\n 4 \n\n \u2212 \n\n Na \n\n H \n\n 2 \n\n PO \n\n 4 \n\n \u2212 \n\n ), which is a weak acid, and sodium monohydrogen phosphate ( \n\n Na \n\n 2 \n\n HPO \n\n 4 \n\n Na \n\n 2 \n\n HPO \n\n 4 \n\n ), which is a weak base. When  \n\n Na \n\n 2 \n\n HPO \n\n 4 \n\n Na \n\n 2 \n\n HPO \n\n 4 \n\n comes into contact with a strong acid, such as HCl, the base picks up a second hydrogen ion to form the weak acid  \n\n Na \n\n H \n\n 2 \n\n PO \n\n 4 \n\n Na \n\n H \n\n 2 \n\n PO \n\n 4 \n\n  and sodium chloride, NaCl. When  \n\n Na \n\n HPO \n\n 4 \n\n Na \n\n HPO \n\n 4 \n\n  (the weak acid) comes into contact with a strong base, such as sodium hydroxide (NaOH), the weak acid reverts back to the weak base and produces water. Acids and bases are still present, but they hold onto the ions. \n\n HCl\u00a0+\u00a0Na \n\n 2 \n\n HPO \n\n 4 \n\n \u2192 \n\n NaH \n\n 2 \n\n PO \n\n 4 \n\n \u00a0+\u00a0NaCl \n\n HCl\u00a0+\u00a0Na \n\n 2 \n\n HPO \n\n 4 \n\n \u2192 \n\n NaH \n\n 2 \n\n PO \n\n 4 \n\n \u00a0+\u00a0NaCl \n\n (strong\u00a0acid)\u00a0+\u00a0(weak\u00a0base)\u00a0 \n\n \u2192 \n\n \u00a0(weak\u00a0acid)\u00a0+\u00a0(salt) \n\n (strong\u00a0acid)\u00a0+\u00a0(weak\u00a0base)\u00a0 \n\n \u2192 \n\n \u00a0(weak\u00a0acid)\u00a0+\u00a0(salt) \n\n NaOH\u00a0+\u00a0NaH \n\n 2 \n\n PO \n\n 4 \n\n \u2192 \n\n Na \n\n 2 \n\n HPO \n\n 4 \n\n \u00a0+\u00a0H \n\n 2 \n\n O \n\n NaOH\u00a0+\u00a0NaH \n\n 2 \n\n PO \n\n 4 \n\n \u2192 \n\n Na \n\n 2 \n\n HPO \n\n 4 \n\n \u00a0+\u00a0H \n\n 2 \n\n O \n\n (strong\u00a0base)\u00a0+\u00a0(weak\u00a0acid)\u00a0 \n\n \u2192 \n\n \u00a0(weak\u00a0base)\u00a0+\u00a0(water) \n\n (strong\u00a0base)\u00a0+\u00a0(weak\u00a0acid)\u00a0 \n\n \u2192 \n\n \u00a0(weak\u00a0base)\u00a0+\u00a0(water) \n\n Bicarbonate-Carbonic Acid Buffer \n\n The bicarbonate-carbonic acid buffer works in a fashion similar to phosphate buffers. The bicarbonate is regulated in the blood by sodium, as are the phosphate ions. When sodium bicarbonate (NaHCO 3 ), comes into contact with a strong acid, such as HCl, carbonic acid (H 2 CO 3 ), which is a weak acid, and NaCl are formed. When carbonic acid comes into contact with a strong base, such as NaOH, bicarbonate and water are formed. \n\n NaHCO \n\n 3 \n\n \u00a0+\u00a0HCl\u00a0 \n\n \u2192 \n\n \u00a0\u00a0H \n\n 2 \n\n CO \n\n 3 \n\n +NaCl \n\n NaHCO \n\n 3 \n\n \u00a0+\u00a0HCl\u00a0 \n\n \u2192 \n\n \u00a0\u00a0H \n\n 2 \n\n CO \n\n 3 \n\n +NaCl \n\n (sodium\u00a0bicarbonate)\u00a0+\u00a0(strong\u00a0acid)\u00a0 \n\n \u2192 \n\n \u00a0(weak\u00a0acid)\u00a0+\u00a0(salt) \n\n (sodium\u00a0bicarbonate)\u00a0+\u00a0(strong\u00a0acid)\u00a0 \n\n \u2192 \n\n \u00a0(weak\u00a0acid)\u00a0+\u00a0(salt) \n\n H \n\n 2 \n\n CO \n\n 3 \n\n \u00a0+\u00a0NaOH \n\n \u2192 \n\n NAHCO \n\n 3- \n\n \u00a0+\u00a0H \n\n 2 \n\n O \n\n H \n\n 2 \n\n CO \n\n 3 \n\n \u00a0+\u00a0NaOH \n\n \u2192 \n\n NAHCO \n\n 3- \n\n \u00a0+\u00a0H \n\n 2 \n\n O \n\n (weak\u00a0acid)\u00a0+\u00a0(strong\u00a0base) \n\n \u2192 \n\n (sodium bicarbonate)\u00a0+\u00a0(water) \n\n (weak\u00a0acid)\u00a0+\u00a0(strong\u00a0base) \n\n \u2192 \n\n (sodium bicarbonate)\u00a0+\u00a0(water) \n\n As with the phosphate buffer, a weak acid or weak base captures the free ions, and a significant change in pH is prevented. Bicarbonate ions and carbonic acid are present in the blood in a 20:1 ratio if the blood pH is within the normal range. With 20 times more bicarbonate than carbonic acid, this capture system is most efficient at buffering changes that would make the blood more acidic. This is useful because most of the body\u2019s metabolic wastes, such as lactic acid and ketone bodies, are acids. Carbonic acid levels in the blood are controlled by the expiration of CO 2  through the lungs. In red blood cells, carbonic anhydrase forces the dissociation of the acid, rendering the blood less acidic. Because of this acid dissociation, CO 2  is exhaled (see equations above). The level of bicarbonate in the blood is controlled through the renal system, where bicarbonate ions in the renal filtrate are conserved and passed back into the blood. However, the bicarbonate buffer is the primary buffering system of the IF surrounding the cells in tissues throughout the body. \n\n Respiratory Regulation of Acid-Base Balance \n\n The respiratory system contributes to the balance of acids and bases in the body by regulating the blood levels of carbonic acid ( Figure 26.16 ). CO 2  in the blood readily reacts with water to form carbonic acid, and the levels of CO 2  and carbonic acid in the blood are in equilibrium. When the CO 2  level in the blood rises (as it does when you hold your breath), the excess CO 2  reacts with water to form additional carbonic acid, lowering blood pH. Increasing the rate and/or depth of respiration (which you might feel the \u201curge\u201d to do after holding your breath) allows you to exhale more CO 2 . The loss of CO 2  from the body reduces blood levels of carbonic acid and thereby adjusts the pH upward, toward normal levels. As you might have surmised, this process also works in the opposite direction. Excessive deep and rapid breathing (as in hyperventilation) rids the blood of CO 2  and reduces the level of carbonic acid, making the blood too alkaline. This brief alkalosis can be remedied by rebreathing air that has been exhaled into a paper bag. Rebreathing exhaled air will rapidly bring blood pH down toward normal. The chemical reactions that regulate the levels of CO 2  and carbonic acid occur in the lungs when blood travels through the lung\u2019s pulmonary capillaries. Minor adjustments in breathing are usually sufficient to adjust the pH of the blood by changing how much CO 2  is exhaled. In fact, doubling the respiratory rate for less than 1 minute, removing \u201cextra\u201d CO 2 , would increase the blood pH by 0.2. This situation is common if you are exercising strenuously over a period of time. To keep up the necessary energy production, you would produce excess CO 2  (and lactic acid if exercising beyond your aerobic threshold). In order to balance the increased acid production, the respiration rate goes up to remove the CO 2 . This helps to keep you from developing acidosis. \n\n The body regulates the respiratory rate by the use of chemoreceptors, which primarily use CO 2  as a signal. Peripheral blood sensors are found in the walls of the aorta and carotid arteries. These sensors signal the brain to provide immediate adjustments to the respiratory rate if CO 2  levels rise or fall. Yet other sensors are found in the brain itself. Changes in the pH of CSF affect the respiratory center in the medulla oblongata, which can directly modulate breathing rate to bring the pH back into the normal range. \n\n Hypercapnia , or abnormally elevated blood levels of CO 2 , occurs in any situation that impairs respiratory functions, including pneumonia and congestive heart failure. Reduced breathing (hypoventilation) due to drugs such as morphine, barbiturates, or ethanol (or even just holding one\u2019s breath) can also result in hypercapnia.  Hypocapnia , or abnormally low blood levels of CO 2 , occurs with any cause of hyperventilation that drives off the CO 2 , such as salicylate toxicity, elevated room temperatures, fever, or hysteria. \n\n Renal Regulation of Acid-Base Balance The renal regulation of the body\u2019s acid-base balance addresses the metabolic component of the buffering system. Whereas the respiratory system (together with breathing centers in the brain) controls the blood levels of carbonic acid by controlling the exhalation of CO 2 , the renal system controls the blood levels of bicarbonate. A decrease of blood bicarbonate can result from the inhibition of carbonic anhydrase by certain diuretics or from excessive bicarbonate loss due to diarrhea. Blood bicarbonate levels are also typically lower in people who have Addison\u2019s disease (chronic adrenal insufficiency), in which aldosterone levels are reduced, and in people who have renal damage, such as chronic nephritis. Finally, low bicarbonate blood levels can result from elevated levels of ketones (common in unmanaged diabetes mellitus), which bind bicarbonate in the filtrate and prevent its conservation. \n\n Bicarbonate ions, HCO 3 - , found in the filtrate, are essential to the bicarbonate buffer system, yet the cells of the tubule are not permeable to bicarbonate ions. The steps involved in supplying bicarbonate ions to the system are seen in  Figure 26.17  and are summarized below: \n\n Step 1: Sodium ions are reabsorbed from the filtrate in exchange for H +  by an antiport mechanism in the apical membranes of cells lining the renal tubule. \n\n Step 2: The cells produce bicarbonate ions that can be shunted to peritubular capillaries. \n\n Step 3: When CO 2  is available, the reaction is driven to the formation of carbonic acid, which dissociates to form a bicarbonate ion and a hydrogen ion. \n\n Step 4: The bicarbonate ion passes into the peritubular capillaries and returns to the blood. The hydrogen ion is secreted into the filtrate, where it can become part of new water molecules and be reabsorbed as such, or removed in the urine. It is also possible that salts in the filtrate, such as sulfates, phosphates, or ammonia, will capture hydrogen ions. If this occurs, the hydrogen ions will not be available to combine with bicarbonate ions and produce CO 2 . In such cases, bicarbonate ions are not conserved from the filtrate to the blood, which will also contribute to a pH imbalance and acidosis. \n\n The hydrogen ions also compete with potassium to exchange with sodium in the renal tubules. If more potassium is present than normal, potassium, rather than the hydrogen ions, will be exchanged, and increased potassium enters the filtrate. When this occurs, fewer hydrogen ions in the filtrate participate in the conversion of bicarbonate into CO 2  and less bicarbonate is conserved. If there is less potassium, more hydrogen ions enter the filtrate to be exchanged with sodium and more bicarbonate is conserved. \n\n Chloride ions are important in neutralizing positive ion charges in the body. If chloride is lost, the body uses bicarbonate ions in place of the lost chloride ions. Thus, lost chloride results in an increased reabsorption of bicarbonate by the renal system. \n\n Disorders of the... Acid-Base Balance: Ketoacidosis \n\n Diabetic acidosis, or ketoacidosis, occurs most frequently in people with poorly controlled diabetes mellitus. When certain tissues in the body cannot get adequate amounts of glucose, they depend on the breakdown of fatty acids for energy. When acetyl groups break off the fatty acid chains, the acetyl groups then non-enzymatically combine to form ketone bodies, acetoacetic acid, beta-hydroxybutyric acid, and acetone, all of which increase the acidity of the blood. In this condition, the brain isn\u2019t supplied with enough of its fuel\u2014glucose\u2014to produce all of the ATP it requires to function. Ketoacidosis can be severe and, if not detected and treated properly, can lead to diabetic coma, which can be fatal. A common early symptom of ketoacidosis is deep, rapid breathing as the body attempts to drive off CO 2  and compensate for the acidosis. Another common symptom is fruity-smelling breath, due to the exhalation of acetone. Other symptoms include dry skin and mouth, a flushed face, nausea, vomiting, and stomach pain. Treatment for diabetic coma is ingestion or injection of sugar; its prevention is the proper daily administration of insulin. \n\n A person who is diabetic and uses insulin can initiate ketoacidosis if a dose of insulin is missed. Among people with type 2 diabetes, those of Hispanic and African-American descent are more likely to go into ketoacidosis than those of other ethnic backgrounds, although the reason for this is unknown. \n 26.5   Disorders of Acid-Base Balance  Learning Objectives By the end of this section, you will be able to: \n\n Identify the three blood variables considered when making a diagnosis of acidosis or alkalosis \n\n Identify the source of compensation for blood pH problems of a respiratory origin \n\n Identify the source of compensation for blood pH problems of a metabolic/renal origin \n\n Normal arterial blood pH is restricted to a very narrow range of 7.35 to 7.45. A person who has a blood pH below 7.35 is considered to be in acidosis (actually, \u201cphysiological acidosis,\u201d because blood is not truly acidic until its pH drops below 7), and a continuous blood pH below 7.0 can be fatal. Acidosis has several symptoms, including headache and confusion, and the individual can become lethargic and easily fatigued ( Figure 26.18 ). A person who has a blood pH above 7.45 is considered to be in alkalosis, and a pH above 7.8 is fatal. Some symptoms of alkalosis include cognitive impairment (which can progress to unconsciousness), tingling or numbness in the extremities, muscle twitching and spasm, and nausea and vomiting. Both acidosis and alkalosis can be caused by either metabolic or respiratory disorders. As discussed earlier in this chapter, the concentration of carbonic acid in the blood is dependent on the level of CO 2  in the body and the amount of CO 2  gas exhaled through the lungs. Thus, the respiratory contribution to acid-base balance is usually discussed in terms of CO 2  (rather than of carbonic acid). Remember that a molecule of carbonic acid is lost for every molecule of CO 2  exhaled, and a molecule of carbonic acid is formed for every molecule of CO 2  retained. \n\n Metabolic Acidosis: Primary Bicarbonate Deficiency \n\n Metabolic acidosis  occurs when the blood is too acidic (pH below 7.35) due to too little bicarbonate, a condition called primary bicarbonate deficiency. At the normal pH of 7.40, the ratio of bicarbonate to carbonic acid buffer is 20:1. If a person\u2019s blood pH drops below 7.35, then he or she is in metabolic acidosis. The most common cause of metabolic acidosis is the presence of organic acids or excessive ketone bodies in the blood.  Table 26.2  lists some other causes of metabolic acidosis. \n\n Common Causes of Metabolic Acidosis and Blood Metabolites \n\n Cause \n\n Metabolite \n\n Diarrhea \n\n Bicarbonate \n\n Uremia \n\n Phosphoric, sulfuric, and lactic acids \n\n Diabetic ketoacidosis \n\n Increased ketone bodies \n\n Strenuous exercise \n\n Lactic acid \n\n Methanol \n\n Formic acid* \n\n Paraldehyde \n\n \u03b2-Hydroxybutyric acid* \n\n Isopropanol \n\n Propionic acid* \n\n Ethylene glycol \n\n Glycolic acid, and some oxalic and formic acids* \n\n Salicylate/aspirin \n\n Sulfasalicylic acid (SSA)* \n\n Table  26.2     *Acid metabolites from ingested chemical. \n\n The first three of the eight causes of metabolic acidosis listed are medical (or unusual physiological) conditions. Strenuous exercise can cause temporary metabolic acidosis due to the production of lactic acid. The last five causes result from the ingestion of specific substances. The active form of aspirin is its metabolite, sulfasalicylic acid. An overdose of aspirin causes acidosis due to the acidity of this metabolite. Metabolic acidosis can also result from uremia, which is the retention of urea and uric acid. Metabolic acidosis can also arise from diabetic ketoacidosis, wherein an excess of ketone bodies are present in the blood. Other causes of metabolic acidosis are a decrease in the excretion of hydrogen ions, which inhibits the conservation of bicarbonate ions, and excessive loss of bicarbonate ions through the gastrointestinal tract due to diarrhea. \n\n Metabolic Alkalosis: Primary Bicarbonate Excess \n\n Metabolic alkalosis  is the opposite of metabolic acidosis. It occurs when the blood is too alkaline (pH above 7.45) due to too much bicarbonate (called primary bicarbonate excess). \n\n A transient excess of bicarbonate in the blood can follow ingestion of excessive amounts of bicarbonate, citrate, or antacids for conditions such as stomach acid reflux\u2014known as heartburn. Cushing\u2019s disease, which is the chronic hypersecretion of adrenocorticotropic hormone (ACTH) by the anterior pituitary gland, can cause chronic metabolic alkalosis. The oversecretion of ACTH results in elevated aldosterone levels and an increased loss of potassium by urinary excretion. Other causes of metabolic alkalosis include the loss of hydrochloric acid from the stomach through vomiting, potassium depletion due to the use of diuretics for hypertension, and the excessive use of laxatives. \n\n Respiratory Acidosis: Primary Carbonic Acid/CO 2  Excess \n\n Respiratory acidosis  occurs when the blood is overly acidic due to an excess of carbonic acid, resulting from too much CO 2  in the blood. Respiratory acidosis can result from anything that interferes with respiration, such as pneumonia, emphysema, or congestive heart failure. \n\n Respiratory Alkalosis: Primary Carbonic Acid/CO 2  Deficiency \n\n Respiratory alkalosis  occurs when the blood is overly alkaline due to a deficiency in carbonic acid and CO 2  levels in the blood. This condition usually occurs when too much CO 2  is exhaled from the lungs, as occurs in hyperventilation, which is breathing that is deeper or more frequent than normal. An elevated respiratory rate leading to hyperventilation can be due to extreme emotional upset or fear, fever, infections, hypoxia, or abnormally high levels of catecholamines, such as epinephrine and norepinephrine. Surprisingly, aspirin overdose\u2014salicylate toxicity\u2014can result in respiratory alkalosis as the body tries to compensate for initial acidosis. \n\n Interactive Link \n\n Watch this  video  to see a demonstration of the effect altitude has on blood pH. What effect does high altitude have on blood pH, and why? \n\n Compensation Mechanisms \n\n Various compensatory mechanisms exist to maintain blood pH within a narrow range, including buffers, respiration, and renal mechanisms. Although compensatory mechanisms usually work very well, when one of these mechanisms is not working properly (like kidney failure or respiratory disease), they have their limits. If the pH and bicarbonate to carbonic acid ratio are changed too drastically, the body may not be able to compensate. Moreover, extreme changes in pH can denature proteins. Extensive damage to proteins in this way can result in disruption of normal metabolic processes, serious tissue damage, and ultimately death. \n\n Respiratory Compensation \n\n Respiratory compensation for metabolic acidosis increases the respiratory rate to drive off CO 2  and readjust the bicarbonate to carbonic acid ratio to the 20:1 level. This adjustment can occur within minutes. Respiratory compensation for metabolic alkalosis is not as adept as its compensation for acidosis. The normal response of the respiratory system to elevated pH is to increase the amount of CO 2  in the blood by decreasing the respiratory rate to conserve CO 2 . There is a limit to the decrease in respiration, however, that the body can tolerate. Hence, the respiratory route is less efficient at compensating for metabolic alkalosis than for acidosis. \n\n Metabolic Compensation \n\n Metabolic and renal compensation for respiratory diseases that can create acidosis revolves around the conservation of bicarbonate ions. In cases of respiratory acidosis, the kidney increases the conservation of bicarbonate and secretion of H +  through the exchange mechanism discussed earlier. These processes increase the concentration of bicarbonate in the blood, reestablishing the proper relative concentrations of bicarbonate and carbonic acid. In cases of respiratory alkalosis, the kidneys decrease the production of bicarbonate and reabsorb H +  from the tubular fluid. These processes can be limited by the exchange of potassium by the renal cells, which use a K + -H +  exchange mechanism (antiporter). \n\n Diagnosing Acidosis and Alkalosis \n\n Lab tests for pH, CO 2  partial pressure (PCO 2 ),   and HCO 3 \u2013  can identify acidosis and alkalosis, indicating whether the imbalance is respiratory or metabolic, and the extent to which compensatory mechanisms are working. The blood pH value, as shown in  Table 26.3 , indicates whether the blood is in acidosis, the normal range, or alkalosis. The PCO 2  and total HCO 3 \u2013  values aid in determining whether the condition is metabolic or respiratory, and whether the patient has been able to compensate for the problem.  Table 26.3  lists the conditions and laboratory results that can be used to classify these conditions. Metabolic acid-base imbalances typically result from kidney disease, and the respiratory system usually responds to compensate. \n\n Types of Acidosis and Alkalosis \n\n pH \n\n PCO 2 \n\n Total HCO 3 \u2013 \n\n Metabolic acidosis \n\n \u2193 \n\n N, then \u2193 \n\n \u2193 \n\n Respiratory acidosis \n\n \u2193 \n\n \u2191 \n\n N, then \u2191 \n\n Metabolic alkalosis \n\n \u2191 \n\n N, then\u2191 \n\n \u2191 \n\n Respiratory alkalosis \n\n \u2191 \n\n \u2193 \n\n N, then \u2193 \n\n Table  26.3     Reference values (arterial): pH: 7.35\u20137.45; pCO 2 : male: 35\u201348 mm Hg, female: 32\u201345 mm Hg; total venous bicarbonate: 22\u201329 mM. N denotes normal; \u2191 denotes a rising or increased value; and \u2193 denotes a falling or decreased value. \n\n Metabolic acidosis is problematic, as lower-than-normal amounts of bicarbonate are present in the blood. The PCO 2  would be normal at first, but if compensation has occurred, it would decrease as the body reestablishes the proper ratio of bicarbonate and carbonic acid/CO 2 . \n\n Respiratory acidosis is problematic, as excess CO 2  is present in the blood. Bicarbonate levels would be normal at first, but if compensation has occurred, they would increase in an attempt to reestablish the proper ratio of bicarbonate and carbonic acid/CO 2 . \n\n Alkalosis is characterized by a higher-than-normal pH. Metabolic alkalosis is problematic, as elevated pH and excess bicarbonate are present. The PCO 2  would again be normal at first, but if compensation has occurred, it would increase as the body attempts to reestablish the proper ratios of bicarbonate and carbonic acid/CO 2 . \n\n Respiratory alkalosis is problematic, as CO 2  deficiency is present in the bloodstream. The bicarbonate concentration would be normal at first. When renal compensation occurs, however, the bicarbonate concentration in blood decreases as the kidneys attempt to reestablish the proper ratios of bicarbonate and carbonic acid/CO 2  by eliminating more bicarbonate to bring the pH into the physiological range. ", "questions": [{"question": {"question_id": "fs-id1855080", "question_text": "Solute contributes to the movement of water between cells and the surrounding medium by ________.", "question_choices": ["osmotic pressure", "hydrostatic pressure", "Brownian movement", "random motion"], "cloze_format": "Solute contributes to the movement of water between cells and the surrounding medium by ________.", "normal_format": "Solute contributes to the movement of water between cells and the surrounding medium by what?"}, "answer": {"ans_text": "osmotic pressure", "ans_choice": 0}, "bloom": "1", "hl_sentences": "Osmosis is basically the diffusion of water from regions of higher concentration of water to regions of lower concentration of water , along an osmotic gradient across a semi-permeable membrane . As a result , water will move into and out of cells and tissues , depending on the relative concentrations of the water and solutes found there .", "hl_context": "The chemical reactions of life take place in aqueous solutions . The dissolved substances in a solution are called solutes . In the human body , solutes vary in different parts of the body , but may include proteins \u2014 including those that transport lipids , carbohydrates , and , very importantly , electrolytes . Often in medicine , a mineral dissociated from a salt that carries an electrical charge ( an ion ) is called an electrolyte . For instance , sodium ions ( Na + ) and chloride ions ( Cl - ) are often referred to as electrolytes . In the body , water moves through semi-permeable membranes of cells and from one compartment of the body to another by a process called osmosis . <hl> Osmosis is basically the diffusion of water from regions of higher concentration of water to regions of lower concentration of water , along an osmotic gradient across a semi-permeable membrane . <hl> <hl> As a result , water will move into and out of cells and tissues , depending on the relative concentrations of the water and solutes found there . <hl> An appropriate balance of solutes inside and outside of cells must be maintained to ensure normal function ."}, {"question": {"question_id": "fs-id1844842", "question_text": "A cation has a(n) ________ charge.", "question_choices": ["neutral", "positive", "alternating", "negative"], "cloze_format": "A cation has a(n) ________ charge.", "normal_format": "Which charge does a cation have?"}, "answer": {"ans_text": "positive", "ans_choice": 1}, "bloom": "1", "hl_sentences": "Thus , cations , or positively charged ions , and anions , or negatively charged ions , are balanced in fluids .", "hl_context": "Most body fluids are neutral in charge . <hl> Thus , cations , or positively charged ions , and anions , or negatively charged ions , are balanced in fluids . <hl> As seen in the previous graph , sodium ( Na + ) ions and chloride ( Cl - ) ions are concentrated in the ECF of the body , whereas potassium ( K + ) ions are concentrated inside cells . Although sodium and potassium can \u201c leak \u201d through \u201c pores \u201d into and out of cells , respectively , the high levels of potassium and low levels of sodium in the ICF are maintained by sodium-potassium pumps in the cell membranes . These pumps use the energy supplied by ATP to pump sodium out of the cell and potassium into the cell ( Figure 26.6 ) ."}, {"question": {"question_id": "fs-id2031157", "question_text": "Interstitial fluid (IF) is ________.", "question_choices": ["the fluid in the cytosol of the cells", "the fluid component of blood", "the fluid that bathes all of the body\u2019s cells except for blood cells", "the intracellular fluids found between membranes"], "cloze_format": "Interstitial fluid (IF) is ________.", "normal_format": "Which of the following is correct about Interstitial fluid (IF)?"}, "answer": {"ans_text": "the fluid that bathes all of the body\u2019s cells except for blood cells", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "Extracellular fluid has two primary constituents : the fluid component of the blood ( called plasma ) and the interstitial fluid ( IF ) that surrounds all cells not in the blood ( Figure 26.3 ) .", "hl_context": "Body fluids can be discussed in terms of their specific fluid compartment , a location that is largely separate from another compartment by some form of a physical barrier . The intracellular fluid ( ICF ) compartment is the system that includes all fluid enclosed in cells by their plasma membranes . Extracellular fluid ( ECF ) surrounds all cells in the body . <hl> Extracellular fluid has two primary constituents : the fluid component of the blood ( called plasma ) and the interstitial fluid ( IF ) that surrounds all cells not in the blood ( Figure 26.3 ) . <hl>"}, {"question": {"question_id": "fs-id1968449", "question_text": "The largest amount of water leaves the body via ________.", "question_choices": ["the GI tract", "the skin as sweat", "expiration", "urine"], "cloze_format": "The largest amount of water leaves the body via ________.", "normal_format": "The largest amount of water leaves the body via what?"}, "answer": {"ans_text": "urine", "ans_choice": 3}, "bloom": "1", "hl_sentences": "Additionally , each day about the same volume ( 2500 mL ) of water leaves the body by different routes ; most of this lost water is removed as urine .", "hl_context": "On a typical day , the average adult will take in about 2500 mL ( almost 3 quarts ) of aqueous fluids . Although most of the intake comes through the digestive tract , about 230 mL (8 ounces ) per day is generated metabolically , in the last steps of aerobic respiration . <hl> Additionally , each day about the same volume ( 2500 mL ) of water leaves the body by different routes ; most of this lost water is removed as urine . <hl> The kidneys also can adjust blood volume though mechanisms that draw water out of the filtrate and urine . The kidneys can regulate water levels in the body ; they conserve water if you are dehydrated , and they can make urine more dilute to expel excess water if necessary . Water is lost through the skin through evaporation from the skin surface without overt sweating and from air expelled from the lungs . This type of water loss is called insensible water loss because a person is usually unaware of it ."}, {"question": {"question_id": "fs-id1378888", "question_text": "Insensible water loss is water lost via ________.", "question_choices": ["skin evaporation and in air from the lungs", "urine", "excessive sweating", "vomiting or diarrhea"], "cloze_format": "Insensible water loss is water lost via ________.", "normal_format": "Insensible water loss is water lost via which of the following?"}, "answer": {"ans_text": "skin evaporation and in air from the lungs", "ans_choice": 0}, "bloom": "1", "hl_sentences": "Water is lost through the skin through evaporation from the skin surface without overt sweating and from air expelled from the lungs . This type of water loss is called insensible water loss because a person is usually unaware of it .", "hl_context": "On a typical day , the average adult will take in about 2500 mL ( almost 3 quarts ) of aqueous fluids . Although most of the intake comes through the digestive tract , about 230 mL (8 ounces ) per day is generated metabolically , in the last steps of aerobic respiration . Additionally , each day about the same volume ( 2500 mL ) of water leaves the body by different routes ; most of this lost water is removed as urine . The kidneys also can adjust blood volume though mechanisms that draw water out of the filtrate and urine . The kidneys can regulate water levels in the body ; they conserve water if you are dehydrated , and they can make urine more dilute to expel excess water if necessary . <hl> Water is lost through the skin through evaporation from the skin surface without overt sweating and from air expelled from the lungs . <hl> <hl> This type of water loss is called insensible water loss because a person is usually unaware of it . <hl>"}, {"question": {"question_id": "fs-id1946886", "question_text": "How soon after drinking a large glass of water will a person start increasing their urine output?", "question_choices": ["5 minutes", "30 minutes", "1 hour", "3 hours"], "cloze_format": "After drinking a large glass of water a person will start increasing their urine output after ___.", "normal_format": "How soon after drinking a large glass of water will a person start increasing their urine output?"}, "answer": {"ans_text": "30 minutes", "ans_choice": 1}, "bloom": null, "hl_sentences": "The kidneys also must make adjustments in the event of ingestion of too much fluid . Diuresis , which is the production of urine in excess of normal levels , begins about 30 minutes after drinking a large quantity of fluid .", "hl_context": "<hl> The kidneys also must make adjustments in the event of ingestion of too much fluid . <hl> <hl> Diuresis , which is the production of urine in excess of normal levels , begins about 30 minutes after drinking a large quantity of fluid . <hl> Diuresis reaches a peak after about 1 hour , and normal urine production is reestablished after about 3 hours ."}, {"question": {"question_id": "fs-id1297197", "question_text": "Bone serves as a mineral reserve for which two ions?", "question_choices": ["sodium and potassium", "calcium and phosphate", "chloride and bicarbonate", "calcium and bicarbonate"], "cloze_format": "The two ions bone serves as a mineral reserve for are ___.", "normal_format": "Bone serves as a mineral reserve for which two ions?"}, "answer": {"ans_text": "calcium and phosphate", "ans_choice": 1}, "bloom": "1", "hl_sentences": "About two pounds of calcium in your body are bound up in bone , which provides hardness to the bone and serves as a mineral reserve for calcium and its salts for the rest of the tissues . More than 90 percent of the calcium and phosphate that enters the body is incorporated into bones and teeth , with bone serving as a mineral reserve for these ions .", "hl_context": "<hl> About two pounds of calcium in your body are bound up in bone , which provides hardness to the bone and serves as a mineral reserve for calcium and its salts for the rest of the tissues . <hl> Teeth also have a high concentration of calcium within them . A little more than one-half of blood calcium is bound to proteins , leaving the rest in its ionized form . Calcium ions , Ca 2 + , are necessary for muscle contraction , enzyme activity , and blood coagulation . In addition , calcium helps to stabilize cell membranes and is essential for the release of neurotransmitters from neurons and of hormones from endocrine glands . These six ions aid in nerve excitability , endocrine secretion , membrane permeability , buffering body fluids , and controlling the movement of fluids between compartments . These ions enter the body through the digestive tract . <hl> More than 90 percent of the calcium and phosphate that enters the body is incorporated into bones and teeth , with bone serving as a mineral reserve for these ions . <hl> In the event that calcium and phosphate are needed for other functions , bone tissue can be broken down to supply the blood and other tissues with these minerals . Phosphate is a normal constituent of nucleic acids ; hence , blood levels of phosphate will increase whenever nucleic acids are broken down . Excretion of ions occurs mainly through the kidneys , with lesser amounts lost in sweat and in feces . Excessive sweating may cause a significant loss , especially of sodium and chloride . Severe vomiting or diarrhea will cause a loss of chloride and bicarbonate ions . Adjustments in respiratory and renal functions allow the body to regulate the levels of these ions in the ECF ."}, {"question": {"question_id": "fs-id1765907", "question_text": "The major cation in extracellular fluid is ________.", "question_choices": ["sodium", "potassium", "chloride", "bicarbonate"], "cloze_format": "The major cation in extracellular fluid is ________.", "normal_format": "What is the major cation in extracellular fluid?"}, "answer": {"ans_text": "sodium", "ans_choice": 0}, "bloom": null, "hl_sentences": "Sodium is the major cation of the extracellular fluid .", "hl_context": "<hl> Sodium is the major cation of the extracellular fluid . <hl> It is responsible for one-half of the osmotic pressure gradient that exists between the interior of cells and their surrounding environment . People eating a typical Western diet , which is very high in NaCl , routinely take in 130 to 160 mmol / day of sodium , but humans require only 1 to 2 mmol / day . This excess sodium appears to be a major factor in hypertension ( high blood pressure ) in some people . Excretion of sodium is accomplished primarily by the kidneys . Sodium is freely filtered through the glomerular capillaries of the kidneys , and although much of the filtered sodium is reabsorbed in the proximal convoluted tubule , some remains in the filtrate and urine , and is normally excreted ."}, {"question": {"question_id": "fs-id1751665", "question_text": "The major cation in intracellular fluid is ________.", "question_choices": ["sodium", "potassium", "chloride", "bicarbonate"], "cloze_format": "The major cation in intracellular fluid is ________.", "normal_format": "What is the major cation in intracellular fluid?"}, "answer": {"ans_text": "potassium", "ans_choice": 1}, "bloom": "1", "hl_sentences": "Potassium is the major intracellular cation .", "hl_context": "<hl> Potassium is the major intracellular cation . <hl> It helps establish the resting membrane potential in neurons and muscle fibers after membrane depolarization and action potentials . In contrast to sodium , potassium has very little effect on osmotic pressure . The low levels of potassium in blood and CSF are due to the sodium-potassium pumps in cell membranes , which maintain the normal potassium concentration gradients between the ICF and ECF . The recommendation for daily intake / consumption of potassium is 4700 mg . Potassium is excreted , both actively and passively , through the renal tubules , especially the distal convoluted tubule and collecting ducts . Potassium participates in the exchange with sodium in the renal tubules under the influence of aldosterone , which also relies on basolateral sodium-potassium pumps ."}, {"question": {"question_id": "fs-id1865704", "question_text": "The major anion in extracellular fluid is ________.", "question_choices": ["sodium", "potassium", "chloride", "bicarbonate"], "cloze_format": "The major anion in extracellular fluid is ________.", "normal_format": "What is the major anion in extracellular fluid?"}, "answer": {"ans_text": "chloride", "ans_choice": 2}, "bloom": "1", "hl_sentences": "Chloride is the predominant extracellular anion .", "hl_context": "<hl> Chloride is the predominant extracellular anion . <hl> Chloride is a major contributor to the osmotic pressure gradient between the ICF and ECF , and plays an important role in maintaining proper hydration . Chloride functions to balance cations in the ECF , maintaining the electrical neutrality of this fluid . The paths of secretion and reabsorption of chloride ions in the renal system follow the paths of sodium ions ."}, {"question": {"question_id": "fs-id1368921", "question_text": "Most of the body\u2019s calcium is found in ________.", "question_choices": ["teeth", "bone", "plasma", "extracellular fluids"], "cloze_format": "Most of the body\u2019s calcium is found in ________.", "normal_format": "Where is most of the body\u2019s calcium found in?"}, "answer": {"ans_text": "bone", "ans_choice": 1}, "bloom": "1", "hl_sentences": "More than 90 percent of the calcium and phosphate that enters the body is incorporated into bones and teeth , with bone serving as a mineral reserve for these ions .", "hl_context": "These six ions aid in nerve excitability , endocrine secretion , membrane permeability , buffering body fluids , and controlling the movement of fluids between compartments . These ions enter the body through the digestive tract . <hl> More than 90 percent of the calcium and phosphate that enters the body is incorporated into bones and teeth , with bone serving as a mineral reserve for these ions . <hl> In the event that calcium and phosphate are needed for other functions , bone tissue can be broken down to supply the blood and other tissues with these minerals . Phosphate is a normal constituent of nucleic acids ; hence , blood levels of phosphate will increase whenever nucleic acids are broken down . Excretion of ions occurs mainly through the kidneys , with lesser amounts lost in sweat and in feces . Excessive sweating may cause a significant loss , especially of sodium and chloride . Severe vomiting or diarrhea will cause a loss of chloride and bicarbonate ions . Adjustments in respiratory and renal functions allow the body to regulate the levels of these ions in the ECF ."}, {"question": {"question_id": "fs-id615370", "question_text": "Abnormally increased blood levels of sodium are termed ________.", "question_choices": ["hyperkalemia", "hyperchloremia", "hypernatremia", "hypercalcemia"], "cloze_format": "Abnormally increased blood levels of sodium are termed ________.", "normal_format": "How are abnormally increased blood levels of sodium termed?"}, "answer": {"ans_text": "hypernatremia", "ans_choice": 2}, "bloom": "1", "hl_sentences": "Hypernatremia is an abnormal increase of blood sodium .", "hl_context": "<hl> Hypernatremia is an abnormal increase of blood sodium . <hl> It can result from water loss from the blood , resulting in the hemoconcentration of all blood constituents . Hormonal imbalances involving ADH and aldosterone may also result in higher-than-normal sodium values ."}, {"question": {"question_id": "fs-id1753178", "question_text": "Which two ions are most affected by aldosterone?", "question_choices": ["sodium and potassium", "chloride and bicarbonate", "calcium and phosphate", "sodium and phosphate"], "cloze_format": "The two ions that are most affected by aldosterone are ___.", "normal_format": "Which two ions are most affected by aldosterone?"}, "answer": {"ans_text": "sodium and potassium", "ans_choice": 0}, "bloom": "1", "hl_sentences": "Thus , aldosterone causes an increase in blood sodium levels and blood volume . Aldosterone \u2019 s effect on potassium is the reverse of that of sodium ; under its influence , excess potassium is pumped into the renal filtrate for excretion from the body . Sodium is reabsorbed from the renal filtrate , and potassium is excreted into the filtrate in the renal collecting tubule . The control of this exchange is governed principally by two hormones \u2014 aldosterone and angiotensin II .", "hl_context": "In the distal convoluted tubules and collecting ducts of the kidneys , aldosterone stimulates the synthesis and activation of the sodium-potassium pump ( Figure 26.14 ) . Sodium passes from the filtrate , into and through the cells of the tubules and ducts , into the ECF and then into capillaries . Water follows the sodium due to osmosis . <hl> Thus , aldosterone causes an increase in blood sodium levels and blood volume . <hl> <hl> Aldosterone \u2019 s effect on potassium is the reverse of that of sodium ; under its influence , excess potassium is pumped into the renal filtrate for excretion from the body . <hl> <hl> Sodium is reabsorbed from the renal filtrate , and potassium is excreted into the filtrate in the renal collecting tubule . <hl> <hl> The control of this exchange is governed principally by two hormones \u2014 aldosterone and angiotensin II . <hl> Aldosterone"}, {"question": {"question_id": "fs-id1372317", "question_text": "Which of the following is the most important buffer inside red blood cells?", "question_choices": ["plasma proteins", "hemoglobin", "phosphate buffers", "bicarbonate: carbonic acid buffer"], "cloze_format": "___ is the most important buffer inside red blood cells.", "normal_format": "Which of the following is the most important buffer inside red blood cells?"}, "answer": {"ans_text": "hemoglobin", "ans_choice": 1}, "bloom": "1", "hl_sentences": "Hemoglobin is the principal protein inside of red blood cells and accounts for one-third of the mass of the cell . During the conversion of CO 2 into bicarbonate , hydrogen ions liberated in the reaction are buffered by hemoglobin , which is reduced by the dissociation of oxygen .", "hl_context": "<hl> Hemoglobin is the principal protein inside of red blood cells and accounts for one-third of the mass of the cell . <hl> <hl> During the conversion of CO 2 into bicarbonate , hydrogen ions liberated in the reaction are buffered by hemoglobin , which is reduced by the dissociation of oxygen . <hl> This buffering helps maintain normal pH . The process is reversed in the pulmonary capillaries to re-form CO 2 , which then can diffuse into the air sacs to be exhaled into the atmosphere . This process is discussed in detail in the chapter on the respiratory system ."}, {"question": {"question_id": "fs-id2033690", "question_text": "Which explanation best describes why plasma proteins can function as buffers?", "question_choices": ["Plasma proteins combine with bicarbonate to make a stronger buffer.", "Plasma proteins are immune to damage from acids.", "Proteins have both positive and negative charges on their surface.", "Proteins are alkaline."], "cloze_format": "The explanation that best describes why plasma proteins can function as buffers is that ___.", "normal_format": "Which explanation best describes why plasma proteins can function as buffers?"}, "answer": {"ans_text": "Proteins have both positive and negative charges on their surface.", "ans_choice": 2}, "bloom": "2", "hl_sentences": "Proteins are made up of amino acids , which contain positively charged amino groups and negatively charged carboxyl groups . The charged regions of these molecules can bind hydrogen and hydroxyl ions , and thus function as buffers .", "hl_context": "Nearly all proteins can function as buffers . <hl> Proteins are made up of amino acids , which contain positively charged amino groups and negatively charged carboxyl groups . <hl> <hl> The charged regions of these molecules can bind hydrogen and hydroxyl ions , and thus function as buffers . <hl> Buffering by proteins accounts for two-thirds of the buffering power of the blood and most of the buffering within cells ."}, {"question": {"question_id": "fs-id2025721", "question_text": "The buffer that is adjusted to control acid-base balance is ________.", "question_choices": ["plasma protein", "hemoglobin", "phosphate buffer", "bicarbonate: carbonic acid buffer"], "cloze_format": "The buffer that is adjusted to control acid-base balance is ________.", "normal_format": "Which is the buffer that is adjusted to control acid-base balance?"}, "answer": {"ans_text": "bicarbonate: carbonic acid buffer", "ans_choice": 3}, "bloom": "1", "hl_sentences": "The kidneys help control acid-base balance by excreting hydrogen ions and generating bicarbonate that helps maintain blood plasma pH within a normal range .", "hl_context": "The buffer systems functioning in blood plasma include plasma proteins , phosphate , and bicarbonate and carbonic acid buffers . <hl> The kidneys help control acid-base balance by excreting hydrogen ions and generating bicarbonate that helps maintain blood plasma pH within a normal range . <hl> Protein buffer systems work predominantly inside cells ."}, {"question": {"question_id": "fs-id1967912", "question_text": "Carbonic acid levels are controlled through the ________.", "question_choices": ["respiratory system", "renal system", "digestive system", "metabolic rate of cells"], "cloze_format": "Carbonic acid levels are controlled through the ________.", "normal_format": "Carbonic acid levels are controlled through which of the following?"}, "answer": {"ans_text": "respiratory system", "ans_choice": 0}, "bloom": null, "hl_sentences": "Whereas the respiratory system ( together with breathing centers in the brain ) controls the blood levels of carbonic acid by controlling the exhalation of CO 2 , the renal system controls the blood levels of bicarbonate .", "hl_context": "Renal Regulation of Acid-Base Balance The renal regulation of the body \u2019 s acid-base balance addresses the metabolic component of the buffering system . <hl> Whereas the respiratory system ( together with breathing centers in the brain ) controls the blood levels of carbonic acid by controlling the exhalation of CO 2 , the renal system controls the blood levels of bicarbonate . <hl> A decrease of blood bicarbonate can result from the inhibition of carbonic anhydrase by certain diuretics or from excessive bicarbonate loss due to diarrhea . Blood bicarbonate levels are also typically lower in people who have Addison \u2019 s disease ( chronic adrenal insufficiency ) , in which aldosterone levels are reduced , and in people who have renal damage , such as chronic nephritis . Finally , low bicarbonate blood levels can result from elevated levels of ketones ( common in unmanaged diabetes mellitus ) , which bind bicarbonate in the filtrate and prevent its conservation ."}, {"question": {"question_id": "fs-id1638887", "question_text": "Bicarbonate ion concentrations in the blood are controlled through the ________.", "question_choices": ["respiratory system", "renal system", "digestive system", "metabolic rate of cells"], "cloze_format": "Bicarbonate ion concentrations in the blood are controlled through the ________.", "normal_format": "Bicarbonate ion concentrations in the blood are controlled through which of the following?"}, "answer": {"ans_text": "renal system", "ans_choice": 1}, "bloom": "1", "hl_sentences": "The level of bicarbonate in the blood is controlled through the renal system , where bicarbonate ions in the renal filtrate are conserved and passed back into the blood .", "hl_context": "As with the phosphate buffer , a weak acid or weak base captures the free ions , and a significant change in pH is prevented . Bicarbonate ions and carbonic acid are present in the blood in a 20:1 ratio if the blood pH is within the normal range . With 20 times more bicarbonate than carbonic acid , this capture system is most efficient at buffering changes that would make the blood more acidic . This is useful because most of the body \u2019 s metabolic wastes , such as lactic acid and ketone bodies , are acids . Carbonic acid levels in the blood are controlled by the expiration of CO 2 through the lungs . In red blood cells , carbonic anhydrase forces the dissociation of the acid , rendering the blood less acidic . Because of this acid dissociation , CO 2 is exhaled ( see equations above ) . <hl> The level of bicarbonate in the blood is controlled through the renal system , where bicarbonate ions in the renal filtrate are conserved and passed back into the blood . <hl> However , the bicarbonate buffer is the primary buffering system of the IF surrounding the cells in tissues throughout the body ."}, {"question": {"question_id": "fs-id1886717", "question_text": "Which of the following is a cause of metabolic acidosis?", "question_choices": ["excessive HCl loss", "increased aldosterone", "diarrhea", "prolonged use of diuretics"], "cloze_format": "___  is a cause of metabolic acidosis.", "normal_format": "Which of the following is a cause of metabolic acidosis?"}, "answer": {"ans_text": "diarrhea", "ans_choice": 2}, "bloom": null, "hl_sentences": "Other causes of metabolic acidosis are a decrease in the excretion of hydrogen ions , which inhibits the conservation of bicarbonate ions , and excessive loss of bicarbonate ions through the gastrointestinal tract due to diarrhea .", "hl_context": "The first three of the eight causes of metabolic acidosis listed are medical ( or unusual physiological ) conditions . Strenuous exercise can cause temporary metabolic acidosis due to the production of lactic acid . The last five causes result from the ingestion of specific substances . The active form of aspirin is its metabolite , sulfasalicylic acid . An overdose of aspirin causes acidosis due to the acidity of this metabolite . Metabolic acidosis can also result from uremia , which is the retention of urea and uric acid . Metabolic acidosis can also arise from diabetic ketoacidosis , wherein an excess of ketone bodies are present in the blood . <hl> Other causes of metabolic acidosis are a decrease in the excretion of hydrogen ions , which inhibits the conservation of bicarbonate ions , and excessive loss of bicarbonate ions through the gastrointestinal tract due to diarrhea . <hl>"}, {"question": {"question_id": "fs-id19679120", "question_text": "Which of the following is a cause of respiratory acidosis?", "question_choices": ["emphysema", "low blood K+", "increased aldosterone", "increased blood ketones"], "cloze_format": "___  is a cause of respiratory acidosis.", "normal_format": "Which of the following is a cause of respiratory acidosis?"}, "answer": {"ans_text": "emphysema", "ans_choice": 0}, "bloom": "3", "hl_sentences": "Respiratory acidosis can result from anything that interferes with respiration , such as pneumonia , emphysema , or congestive heart failure .", "hl_context": "Respiratory acidosis occurs when the blood is overly acidic due to an excess of carbonic acid , resulting from too much CO 2 in the blood . <hl> Respiratory acidosis can result from anything that interferes with respiration , such as pneumonia , emphysema , or congestive heart failure . <hl>"}, {"question": {"question_id": "fs-id2058760", "question_text": "At a pH of 7.40, the carbonic acid ratio is ________.", "question_choices": ["35:1", "4:1", "20:1", "3:1"], "cloze_format": "At a pH of 7.40, the carbonic acid ratio is ________.", "normal_format": "At a pH of 7.40, what is the carbonic acid ratio?"}, "answer": {"ans_text": "20:1", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "At the normal pH of 7.40 , the ratio of bicarbonate to carbonic acid buffer is 20:1 .", "hl_context": "Metabolic acidosis occurs when the blood is too acidic ( pH below 7.35 ) due to too little bicarbonate , a condition called primary bicarbonate deficiency . <hl> At the normal pH of 7.40 , the ratio of bicarbonate to carbonic acid buffer is 20:1 . <hl> If a person \u2019 s blood pH drops below 7.35 , then he or she is in metabolic acidosis . The most common cause of metabolic acidosis is the presence of organic acids or excessive ketone bodies in the blood . Table 26.2 lists some other causes of metabolic acidosis ."}, {"question": {"question_id": "fs-id1355316", "question_text": "Which of the following is characterized as metabolic alkalosis?", "question_choices": ["increased pH, decreased pCO2, decreased HCO3\u2013", "increased pH, increased pCO2, increased HCO3\u2013", "decreased pH, decreased pCO2, decreased HCO3\u2013", "decreased pH, increased pCO2, increased HCO3\u2013"], "cloze_format": "___ is characterized as metabolic alkalosis.", "normal_format": "Which of the following is characterized as metabolic alkalosis?"}, "answer": {"ans_text": "increased pH, increased pCO2, increased HCO3\u2013", "ans_choice": 1}, "bloom": null, "hl_sentences": "Alkalosis is characterized by a higher-than-normal pH . Metabolic alkalosis is problematic , as elevated pH and excess bicarbonate are present . The PCO 2 would again be normal at first , but if compensation has occurred , it would increase as the body attempts to reestablish the proper ratios of bicarbonate and carbonic acid / CO 2 .", "hl_context": "<hl> Alkalosis is characterized by a higher-than-normal pH . <hl> <hl> Metabolic alkalosis is problematic , as elevated pH and excess bicarbonate are present . <hl> <hl> The PCO 2 would again be normal at first , but if compensation has occurred , it would increase as the body attempts to reestablish the proper ratios of bicarbonate and carbonic acid / CO 2 . <hl>"}], "summary": "", "keyterm": "", "bname": "anatomy_and_physiology"}, {"chapter": 16, "intro": " Chapter Outline 16.1   Restoring the Union 16.2   Congress and the Remaking of the South, 1865\u20131866 16.3   Radical Reconstruction, 1867\u20131872 16.4   The Collapse of Reconstruction Introduction \n\n Few times in U.S. history have been as turbulent and transformative as the Civil War and the twelve years that followed. Between 1865 and 1877, one president was murdered and another impeached. The Constitution underwent major revision with the addition of three amendments. The effort to impose Union control and create equality in the defeated South ignited a fierce backlash as various terrorist and vigilante organizations, most notably the Ku Klux Klan, battled to maintain a pre\u2013Civil War society in which Whites held complete power. These groups unleashed a wave of violence, including lynching and arson, aimed at freed Blacks and their White supporters. Historians refer to this era as Reconstruction, when an effort to remake the South faltered and ultimately failed. \n\n The above political cartoon ( Figure 16.1 ) expresses the anguish many Americans felt in the decade after the Civil War. The South, which had experienced catastrophic losses during the conflict, was reduced to political dependence and economic destitution. This humiliating condition led many southern Whites to vigorously contest Union efforts to transform the South\u2019s racial, economic, and social landscape. Supporters of equality grew increasingly dismayed at Reconstruction\u2019s failure to undo the old system, which further compounded the staggering regional and racial inequalities in the United States. ", "chapter_text": " 16.1   Restoring the Union Learning Objectives By the end of this section, you will be able to: \n\n Describe Lincoln\u2019s plan to restore the Union at the end of the Civil War \n\n Discuss the tenets of Radical Republicanism \n\n Analyze the success or failure of the Thirteenth Amendment \n\n The end of the Civil War saw the beginning of the  Reconstruction  era, when former rebel Southern states were integrated back into the Union. President Lincoln moved quickly to achieve the war\u2019s ultimate goal: reunification of the country. He proposed a generous and non-punitive plan to return the former Confederate states speedily to the United States, but some Republicans in Congress protested, considering the president\u2019s plan too lenient to the rebel states that had torn the country apart. The greatest flaw of Lincoln\u2019s plan, according to this view, was that it appeared to forgive traitors instead of guaranteeing civil rights to formerly enslaved people. President Lincoln oversaw the passage of the Thirteenth Amendment abolishing slavery, but he did not live to see its ratification. \n\n THE PRESIDENT\u2019S PLAN \n\n From the outset of the rebellion in 1861, Lincoln\u2019s overriding goal had been to bring the Southern states quickly back into the fold in order to restore the Union ( Figure 16.3 ). In early December 1863, the president began the process of reunification by unveiling a three-part proposal known as the  ten percent plan  that outlined how the states would return. The ten percent plan gave a general pardon to all Southerners except high-ranking Confederate government and military leaders; required 10 percent of the 1860 voting population in the former rebel states to take a binding oath of future allegiance to the United States and the emancipation of the enslaved; and declared that once those voters took those oaths, the restored Confederate states would draft new state constitutions. \n\n Lincoln hoped that the leniency of the plan\u201490 percent of the 1860 voters did not have to swear allegiance to the Union or to emancipation\u2014would bring about a quick and long-anticipated resolution and make emancipation more acceptable everywhere. This approach appealed to some in the moderate wing of the Republican Party, which wanted to put the nation on a speedy course toward reconciliation. However, the proposal instantly drew fire from a larger faction of Republicans in Congress who did not want to deal moderately with the South. These members of Congress, known as  Radical Republicans , wanted to remake the South and punish the rebels. Radical Republicans insisted on harsh terms for the defeated Confederacy and protection for formerly enslaved people, going far beyond what the president proposed. \n\n In February 1864, two of the Radical Republicans, Ohio senator Benjamin Wade and Maryland representative Henry Winter Davis, answered Lincoln with a proposal of their own. Among other stipulations, the Wade-Davis Bill called for a majority of voters and government officials in Confederate states to take an oath, called the  Ironclad Oath , swearing that they had never supported the Confederacy or made war against the United States. Those who could not or would not take the oath would be unable to take part in the future political life of the South. Congress assented to the Wade-Davis Bill, and it went to Lincoln for his signature. The president refused to sign, using the pocket veto (that is, taking no action) to kill the bill. Lincoln understood that no Southern state would have met the criteria of the Wade-Davis Bill, and its passage would simply have delayed the reconstruction of the South. \n\n THE THIRTEENTH AMENDMENT \n\n Despite the 1863 Emancipation Proclamation, the legal status of enslaved people and the institution of slavery remained unresolved. The news of the Proclamation wouldn\u2019t even reach the entire country for another two and a half years. To deal with the remaining uncertainties, the Republican Party made the abolition of slavery a top priority by including the issue in its 1864 party platform. The platform read: \u201cThat as slavery was the cause, and now constitutes the strength of this Rebellion, and as it must be, always and everywhere, hostile to the principles of Republican Government, justice and the National safety demand its utter and complete extirpation from the soil of the Republic; and that, while we uphold and maintain the acts and proclamations by which the Government, in its own defense, has aimed a deathblow at this gigantic evil, we are in favor, furthermore, of such an amendment to the Constitution, to be made by the people in conformity with its provisions, as shall terminate and forever prohibit the existence of Slavery within the limits of the jurisdiction of the United States.\u201d The platform left no doubt about the intention to abolish slavery. The president, along with the Radical Republicans, made good on this campaign promise in 1864 and 1865. A proposed constitutional amendment passed the Senate in April 1864, and the House of Representatives concurred in January 1865. The amendment then made its way to the states, where it swiftly gained the necessary support, including in the South. In December 1865, the Thirteenth Amendment was officially ratified and added to the Constitution. The first amendment added to the Constitution since 1804, it overturned a centuries-old practice by permanently abolishing slavery. \n\n President Lincoln never saw the final ratification of the Thirteenth Amendment. On April 14, 1865, the Confederate supporter and well-known actor John Wilkes Booth shot Lincoln while he was attending a play,  Our American Cousin , at Ford\u2019s Theater in Washington. The president died the next day ( Figure 16.4 ). Booth had steadfastly defended the Confederacy and White supremacy, and his act was part of a larger conspiracy to eliminate the heads of the Union government and keep the Confederate fight going. One of Booth\u2019s associates stabbed and wounded Secretary of State William Seward the night of the assassination. Another associate abandoned the planned assassination of Vice President Andrew Johnson at the last moment. Although Booth initially escaped capture, Union troops shot and killed him on April 26, 1865, in a Maryland barn. Eight other conspirators were convicted by a military tribunal for participating in the conspiracy, and four were hanged. Lincoln\u2019s death earned him immediate martyrdom, and hysteria spread throughout the North. To many Northerners, the assassination suggested an even greater conspiracy than what was revealed, masterminded by the unrepentant leaders of the defeated Confederacy. Militant Republicans would use and exploit this fear relentlessly in the ensuing months. \n\n Despite the Emancipation Proclamation and the ratification progress of the Thirteenth Amendment, slavery endured for some time. The news of the war\u2019s end and the freedom of the slaves traveled slowly, and in some cases was likely deliberately withheld.  When Major General Gordan Granger arrived in Galveston, Texas to assert control, he brought with him a stunning announcement:\n\n \u201cThe people of Texas are informed that, in accordance with a proclamation from the Executive of the United States, all slaves are free. This involves an absolute equality of personal rights and rights of property between former masters and slaves, and the connection heretofore existing between them becomes that between employer and hired labor.\u201d The date, June 19, 1865, would become the most popular annual celebration of the end of slavery, known as Juneteenth. The order was met with resistance and outright opposition. Some slave owners chose to keep the news from the slaves. And when people who learned about their emancipation decided to take advantage of their freedom, many were captured or killed. While the pathway to full freedom remained difficult, and discrimination and segregation would remain in place, newly freed Texans began organizing  celebrations (also referred to as Jubilee Day and Emancipation Day) as early as 1866. Austin held its first Juneteenth celebration in 1867.   \n\n ANDREW JOHNSON AND THE BATTLE OVER RECONSTRUCTION \n\n Lincoln\u2019s assassination elevated Vice President Andrew Johnson, a Democrat, to the presidency. Johnson had come from very humble origins. Born into extreme poverty in North Carolina and having never attended school, Johnson was the picture of a self-made man. His wife had taught him how to read and he had worked as a tailor, a trade he had been apprenticed to as a child. In Tennessee, where he had moved as a young man, he gradually rose up the political ladder, earning a reputation for being a skillful stump speaker and a staunch defender of poor southerners. He was elected to serve in the House of Representatives in the 1840s, became governor of Tennessee the following decade, and then was elected a U.S. senator just a few years before the country descended into war. When Tennessee seceded, Johnson remained loyal to the Union and stayed in the Senate. As Union troops marched on his home state of North Carolina, Lincoln appointed him governor of the then-occupied state of Tennessee, where he served until being nominated by the Republicans to run for vice president on a Lincoln ticket. The nomination of Johnson, a Democrat and a slaveholding southerner, was a pragmatic decision made by concerned Republicans. It was important for them to show that the party supported all loyal men, regardless of their origin or political persuasion. Johnson appeared an ideal choice, because his nomination would bring with it the support of both pro-Southern elements and the War Democrats who rejected the conciliatory stance of the  Copperheads , the northern Democrats who opposed the Civil War. \n\n Unexpectedly elevated to the presidency in 1865, this formerly impoverished tailor\u2019s apprentice and unwavering antagonist of the wealthy southern planter class now found himself tasked with administering the restoration of a destroyed South. Lincoln\u2019s position as president had been that the secession of the Southern states was never legal; that is, they had not succeeded in leaving the Union, therefore they still had certain rights to self-government as states. In keeping with Lincoln\u2019s plan, Johnson desired to quickly reincorporate the South back into the Union on lenient terms and heal the wounds of the nation. This position angered many in his own party. The northern Radical Republican plan for Reconstruction looked to overturn southern society and specifically aimed at ending the plantation system. President Johnson quickly disappointed Radical Republicans when he rejected their idea that the federal government could provide voting rights for freed slaves. The initial disagreements between the president and the Radical Republicans over how best to deal with the defeated South set the stage for further conflict. \n\n In fact, President Johnson\u2019s Proclamation of Amnesty and Reconstruction in May 1865 provided sweeping \u201camnesty and pardon\u201d to rebellious Southerners. It returned to them their property, with the notable exception of the people they had enslaved, and it asked only that they affirm their support for the Constitution of the United States. Those Southerners exempted from this amnesty included the Confederate political leadership, high-ranking military officers, and persons with taxable property worth more than $20,000. The inclusion of this last category was specifically designed to make it clear to the southern planter class that they had a unique responsibility for the outbreak of hostilities. But it also satisfied Johnson\u2019s desire to exact vengeance on a class of people he had fought politically for much of his life. For this class of wealthy Southerners to regain their rights, they would have to swallow their pride and request a personal pardon from Johnson himself. For the Southern states, the requirements for readmission to the Union were also fairly straightforward. States were required to hold individual state conventions where they would repeal the ordinances of secession and ratify the Thirteenth Amendment. By the end of 1865, a number of former Confederate leaders were in the Union capital looking to claim their seats in Congress. Among them was Alexander Stephens, the vice president of the Confederacy, who had spent several months in a Boston jail after the war. Despite the outcries of Republicans in Congress, by early 1866 Johnson announced that all former Confederate states had satisfied the necessary requirements. According to him, nothing more needed to be done; the Union had been restored. \n\n Understandably, Radical Republicans in Congress did not agree with Johnson\u2019s position. They, and their northern constituents, greatly resented his lenient treatment of the former Confederate states, and especially the return of former Confederate leaders like Alexander Stephens to Congress. They refused to acknowledge the southern state governments he allowed. As a result, they would not permit senators and representatives from the former Confederate states to take their places in Congress. \n\n Instead, the Radical Republicans created a joint committee of representatives and senators to oversee Reconstruction. In the 1866 congressional elections, they gained control of the House, and in the ensuing years they pushed for the dismantling of the old southern order and the complete reconstruction of the South. This effort put them squarely at odds with President Johnson, who remained unwilling to compromise with Congress, setting the stage for a series of clashes. \n 16.2   Congress and the Remaking of the South, 1865\u20131866 Learning Objectives By the end of this section, you will be able to: \n\n Describe the efforts made by Congress in 1865 and 1866 to bring to life its vision of Reconstruction \n\n Explain how the Fourteenth Amendment transformed the Constitution \n\n President Johnson and Congress\u2019s views on Reconstruction grew even further apart as Johnson\u2019s presidency progressed. Congress repeatedly pushed for greater rights for freed people and a far more thorough reconstruction of the South, while Johnson pushed for leniency and a swifter reintegration. President Johnson lacked Lincoln\u2019s political skills and instead exhibited a stubbornness and confrontational approach that aggravated an already difficult situation. \n\n THE FREEDMEN\u2019S BUREAU \n\n Freed people everywhere celebrated the end of slavery and immediately began to take steps to improve their own condition by seeking what had long been denied to them: land, financial security, education, and the ability to participate in the political process. They wanted to be reunited with family members, grasp the opportunity to make their own independent living, and exercise their right to have a say in their own government. \n\n However, they faced the wrath of defeated but un-reconciled southerners who were determined to keep Blacks an impoverished and despised underclass. Recognizing the widespread devastation in the South and the dire situation of freed people, Congress created the Bureau of Refugees, Freedmen, and Abandoned Lands in March 1865, popularly known as the  Freedmen\u2019s Bureau . Lincoln had approved of the bureau, giving it a charter for one year. \n\n The Freedmen\u2019s Bureau engaged in many initiatives to ease the transition from slavery to freedom. It delivered food to Blacks and Whites alike in the South. It helped freed people gain labor contracts, a significant step in the creation of wage labor in place of slavery. It helped reunite families of freedmen, and it also devoted much energy to education, establishing scores of public schools where freed people and poor Whites could receive both elementary and higher education. Respected institutions such as Fisk University, Hampton University, and Dillard University are part of the legacy of the Freedmen\u2019s Bureau. \n\n In this endeavor, the Freedmen\u2019s Bureau received support from Christian organizations that had long advocated for abolition, such as the  American Missionary Association  (AMA). The AMA used the knowledge and skill it had acquired while working in missions in Africa and with Native American groups to establish and run schools for those freed from slavery in the postwar South. While men and women, White and Black, taught in these schools, the opportunity was crucially important for participating women ( Figure 16.5 ). At the time, many opportunities, including admission to most institutes of higher learning, remained closed to women. Participating in these schools afforded these women the opportunities they otherwise may have been denied. Additionally, the fact they often risked life and limb to work in these schools in the South demonstrated to the nation that women could play a vital role in American civic life. \n\n The schools that the Freedmen\u2019s Bureau and the AMA established inspired great dismay and resentment among the White populations in the South and were sometimes targets of violence. Indeed, the Freedmen\u2019s Bureau\u2019s programs and its very existence were sources of controversy. Racists and others who resisted this type of federal government activism denounced it as both a waste of federal money and a foolish effort that encouraged laziness among Blacks. Congress renewed the bureau\u2019s charter in 1866, but President Johnson, who steadfastly believed that the work of restoring the Union had been completed, vetoed the re-chartering. Radical Republicans continued to support the bureau, igniting a contest between Congress and the president that intensified during the next several years. Part of this dispute involved conflicting visions of the proper role of the federal government. Radical Republicans believed in the constructive power of the federal government to ensure a better day for freed people. Others, including Johnson, denied that the government had any such role to play. \n\n Americana The Freedmen\u2019s Bureau The image below ( Figure 16.6 ) shows a campaign poster for Hiester Clymer, who ran for governor of Pennsylvania in 1866 on a platform of White supremacy. \n\n The image in the foreground shows an indolent Black man wondering, \u201cWhar is de use for me to work as long as dey make dese appropriations.\u201d White men toil in the background, chopping wood and plowing a field. The text above them reads, \u201cIn the sweat of thy face shall thou eat bread. . . . The White man must work to keep his children and pay his taxes.\u201d In the middle background, the Freedmen\u2019s Bureau looks like the Capitol, and the pillars are inscribed with racist assumptions of things Blacks value, like \u201crum,\u201d \u201cidleness,\u201d and \u201cWhite women.\u201d On the right are estimates of the costs of the Freedmen\u2019s Bureau and the bounties (fees for enlistment) given to both White and Black Union soldiers. \n\n What does this poster indicate about the political climate of the Reconstruction era? How might different people have received this image? \n\n BLACK CODES \n\n In 1865 and 1866, as Johnson announced the end of Reconstruction, southern states began to pass a series of discriminatory state laws collectively known as  Black codes . While the laws varied in both content and severity from state to state, the goal of the laws remained largely consistent. In effect, these codes were designed to maintain the social and economic structure of racial slavery in the absence of slavery itself. The laws codified White supremacy by restricting the civic participation of freed enslaved people\u2014depriving them of the right to vote, the right to serve on juries, the right to own or carry weapons, and, in some cases, even the right to rent or lease land. \n\n A chief component of the Black codes was designed to fulfill an important economic need in the postwar South. Slavery had been a pillar of economic stability in the region before the war. To maintain agricultural production, the South had relied on the enslaved to work the land. Now the region was faced with the daunting prospect of making the transition from a slave economy to one where labor was purchased on the open market. Not surprisingly, planters in the southern states were reluctant to make such a transition. Instead, they drafted Black laws that would re-create the antebellum economic structure with the fa\u00e7ade of a free-labor system. \n\n Black codes used a variety of tactics to tie formerly enslaved people to the land. To work, the formerly enslaved people were forced to sign contracts with their employer. These contracts prevented Black people from working for more than one employer. This meant that, unlike in a free labor market, Black people could not positively influence wages and conditions by choosing to work for the employer who gave them the best terms. The predictable outcome was that formerly enslaved people were forced to work for very low wages. With such low wages, and no ability to supplement income with additional work, workers were reduced to relying on loans from their employers. The debt that these workers incurred ensured that they could never escape from their condition. Those formerly enslaved people who attempt to violate these contracts could be fined or beaten. Those who refused to sign contracts at all could be arrested for vagrancy and then made to work for no wages, essentially being reduced to the very definition of a slave. \n\n The Black codes left no doubt that the former breakaway Confederate states intended to maintain White supremacy at all costs. These draconian state laws helped spur the congressional Joint Committee on Reconstruction into action. Its members felt that ending slavery with the Thirteenth Amendment did not go far enough. Congress extended the life of the Freedmen\u2019s Bureau to combat the Black codes and in April 1866 passed the first Civil Rights Act, which established the citizenship of African Americans. This was a significant step that contradicted the Supreme Court\u2019s 1857 Dred Scott decision, which declared that Black people could never be citizens. The law also gave the federal government the right to intervene in state affairs to protect the rights of citizens, and thus, of African Americans. President Johnson, who continued to insist that restoration of the United States had already been accomplished, vetoed the 1866 Civil Rights Act. However, Congress mustered the necessary votes to override his veto. Despite the Civil Rights Act, the Black codes endured, forming the foundation of the racially discriminatory  Jim Crow  segregation policies that impoverished generations of African Americans. \n\n THE FOURTEENTH AMENDMENT \n\n Questions swirled about the constitutionality of the Civil Rights Act of 1866. The Supreme Court, in its 1857 decision forbidding Black citizenship, had interpreted the Constitution in a certain way; many argued that the 1866 statute, alone, could not alter that interpretation. Seeking to overcome all legal questions, Radical Republicans drafted another constitutional amendment with provisions that followed those of the 1866 Civil Rights Act. In July 1866, the Fourteenth Amendment went to state legislatures for ratification. \n\n The Fourteenth Amendment stated, \u201cAll persons born or naturalized in the United States and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside.\u201d It gave citizens equal protection under both the state and federal law, overturning the Dred Scott decision. It eliminated the three-fifths compromise of the 1787 Constitution, whereby an enslaved person had been counted as three-fifths of a free White person, and it reduced the number of House representatives and Electoral College electors for any state that denied suffrage to any adult male inhabitant, Black or White. As Radical Republicans had proposed in the Wade-Davis bill, individuals who had \u201cengaged in insurrection or rebellion [against] . . . or given aid or comfort to the enemies [of]\u201d the United States were barred from holding political (state or federal) or military office unless pardoned by two-thirds of Congress. \n\n The amendment also answered the question of debts arising from the Civil War by specifying that all debts incurred by fighting to defeat the Confederacy would be honored. Confederate debts, however, would not: \u201c[N]either the United States nor any State shall assume or pay any debt or obligation incurred in aid of insurrection or rebellion against the United States, or any claim for the loss or emancipation of any slave; but all such debts, obligations and claims shall be held illegal and void.\u201d Thus, claims by former slaveholders requesting compensation for slave property had no standing. Any state that ratified the Fourteenth Amendment would automatically be readmitted. Most former Confederate states, except for Tennessee, refused to ratify the amendment in 1866. \n\n President Johnson called openly for the rejection of the Fourteenth Amendment, a move that drove a further wedge between him and congressional Republicans. In late summer of 1866, he gave a series of speeches, known as the \u201cswing around the circle,\u201d designed to gather support for his mild version of Reconstruction. Johnson felt that ending slavery went far enough; extending the rights and protections of citizenship to freed people, he believed, went much too far. He continued to believe that Blacks were inferior to Whites. The president\u2019s \u201cswing around the circle\u201d speeches to gain support for his program and derail the Radical Republicans proved to be a disaster, as hecklers provoked Johnson to make damaging statements. Radical Republicans charged that Johnson had been drunk when he made his speeches. As a result, Johnson\u2019s reputation plummeted. \n 16.3   Radical Reconstruction, 1867\u20131872 Learning Objectives By the end of this section, you will be able to: \n\n Explain the purpose of the second phase of Reconstruction and some of the key legislation put forward by Congress \n\n Describe the impeachment of President Johnson \n\n Discuss the benefits and drawbacks of the Fifteenth Amendment \n\n During the Congressional election in the fall of 1866, Republicans gained even greater victories. This was due in large measure to the northern voter opposition that had developed toward President Johnson because of the inflexible and overbearing attitude he had exhibited in the White House, as well as his missteps during his 1866 speaking tour. Leading Radical Republicans in Congress included Massachusetts senator Charles Sumner (the same senator whom proslavery South Carolina representative Preston Brooks had thrashed with his cane in 1856 during the Bleeding Kansas crisis) and Pennsylvania representative Thaddeus Stevens. These men and their supporters envisioned a much more expansive change in the South. Sumner advocated integrating schools and giving Black men the right to vote while disenfranchising many southern voters. For his part, Stevens considered that the southern states had forfeited their rights as states when they seceded, and were no more than conquered territory that the federal government could organize as it wished. He envisioned the redistribution of plantation lands and U.S. military control over the former Confederacy. \n\n Their goals included the transformation of the South from an area built on slave labor to a free-labor society. They also wanted to ensure that freed people were protected and given the opportunity for a better life. Violent race riots in Memphis, Tennessee, and New Orleans, Louisiana, in 1866 gave greater urgency to the second phase of Reconstruction, begun in 1867. \n\n THE RECONSTRUCTION ACTS \n\n The 1867 Military Reconstruction Act, which encompassed the vision of Radical Republicans, set a new direction for Reconstruction in the South. Republicans saw this law, and three supplementary laws passed by Congress that year, called the  Reconstruction Acts , as a way to deal with the disorder in the South. The 1867 act divided the ten southern states that had yet to ratify the Fourteenth Amendment into five military districts (Tennessee had already been readmitted to the Union by this time and so was excluded from these acts). Martial law was imposed, and a Union general commanded each district. These generals and twenty thousand federal troops stationed in the districts were charged with protecting freed people. When a supplementary act extended the right to vote to all freed men of voting age (21 years old), the military in each district oversaw the elections and the registration of voters. Only after new state constitutions had been written and states had ratified the Fourteenth Amendment could these states rejoin the Union. Predictably, President Johnson vetoed the Reconstruction Acts, viewing them as both unnecessary and unconstitutional. Once again, Congress overrode Johnson\u2019s vetoes, and by the end of 1870, all the southern states under military rule had ratified the Fourteenth Amendment and been restored to the Union ( Figure 16.7 ). \n\n THE IMPEACHMENT OF PRESIDENT JOHNSON \n\n President Johnson\u2019s relentless vetoing of congressional measures created a deep rift in Washington, DC, and neither he nor Congress would back down. Johnson\u2019s prickly personality proved to be a liability, and many people found him grating. Moreover, he firmly believed in White supremacy, declaring in his 1868 State of the Union address, \u201cThe attempt to place the White population under the domination of persons of color in the South has impaired, if not destroyed, the kindly relations that had previously existed between them; and mutual distrust has engendered a feeling of animosity which leading in some instances to collision and bloodshed, has prevented that cooperation between the two races so essential to the success of industrial enterprise in the southern states.\u201d The president\u2019s racism put him even further at odds with those in Congress who wanted to create full equality between Blacks and Whites. \n\n The Republican majority in Congress by now despised the president, and they wanted to prevent him from interfering in congressional Reconstruction. To that end, Radical Republicans passed two laws of dubious constitutionality. The Command of the Army Act prohibited the president from issuing military orders except through the commanding general of the army, who could not be relieved or reassigned without the consent of the Senate. The Tenure of Office Act, which Congress passed in 1867, required the president to gain the approval of the Senate whenever he appointed or removed officials. Congress had passed this act to ensure that Republicans who favored Radical Reconstruction would not be barred or stripped of their jobs. In August 1867, President Johnson removed Secretary of War Edwin M. Stanton, who had aligned himself with the Radical Republicans, without gaining Senate approval. He replaced Stanton with Ulysses S. Grant, but Grant resigned and sided with the Republicans against the president. Many Radical Republicans welcomed this blunder by the president as it allowed them to take action to remove Johnson from office, arguing that Johnson had openly violated the Tenure of Office Act. The House of Representatives quickly drafted a resolution to impeach him, a first in American history. \n\n In impeachment proceedings, the House of Representatives serves as the prosecution and the Senate acts as judge, deciding whether the president should be removed from office ( Figure 16.8 ). The House brought eleven counts against Johnson, all alleging his encroachment on the powers of Congress. In the Senate, Johnson barely survived. Seven Republicans joined the Democrats and independents to support acquittal; the final vote was 35 to 19, one vote short of the required two-thirds majority. The Radicals then dropped the impeachment effort, but the events had effectively silenced President Johnson, and Radical Republicans continued with their plan to reconstruct the South. \n\n THE FIFTEENTH AMENDMENT \n\n In November 1868, Ulysses S. Grant, the Union\u2019s war hero, easily won the presidency in a landslide victory. The Democratic nominee was Horatio Seymour, but the Democrats carried the stigma of disunion. The Republicans, in their campaign, blamed the devastating Civil War and the violence of its aftermath on the rival party, a strategy that southerners called \u201cwaving the bloody shirt.\u201d \n\n Though Grant did not side with the Radical Republicans, his victory allowed the continuance of the Radical Reconstruction program. In the winter of 1869, Republicans introduced another constitutional amendment, the third of the Reconstruction era. When Republicans had passed the Fourteenth Amendment, which addressed citizenship rights and equal protections, they were unable to explicitly ban states from withholding the franchise based on race. With the Fifteenth Amendment, they sought to correct this major weakness by finally extending to Black men the right to vote. The amendment directed that \u201c[t]he right of citizens of the United States to vote shall not be denied or abridged by the United States or by any State on account of race, color, or previous condition of servitude.\u201d Unfortunately, the new amendment had weaknesses of its own. As part of a compromise to ensure the passage of the amendment with the broadest possible support, drafters of the amendment specifically excluded language that addressed literacy tests and poll taxes, the most common ways Blacks were traditionally disenfranchised in both the North and the South. Indeed, Radical Republican leader Charles Sumner of Massachusetts, himself an ardent supporter of legal equality without exception to race, refused to vote for the amendment precisely because it did not address these obvious loopholes. \n\n Despite these weaknesses, the language of the amendment did provide for universal manhood suffrage\u2014the right of all men to vote\u2014and crucially identified Black men, including those who had been enslaved, as deserving the right to vote. This, the third and final of the Reconstruction amendments, was ratified in 1870 ( Figure 16.9 ). With the ratification of the Fifteenth Amendment, many believed that the process of restoring the Union was safely coming to a close and that the rights of the formerly enslaved were finally secure. African American communities expressed great hope as they celebrated what they understood to be a national confirmation of their unqualified citizenship. \n\n WOMEN\u2019S SUFFRAGE \n\n While the Fifteenth Amendment may have been greeted with applause in many corners, leading women\u2019s rights activists, who had been campaigning for decades for the right to vote, saw it as a major disappointment. More dispiriting still was the fact that many women\u2019s rights activists, such as Susan B. Anthony and Elizabeth Cady Stanton, had played a large part in the abolitionist movement leading up to the Civil War. Following the war, women and men, White and Black, formed the  American Equal Rights Association  (AERA) for the expressed purpose of securing \u201cequal Rights to all American citizens, especially the right of suffrage, irrespective of race, color or sex.\u201d Two years later, with the adoption of the Fourteenth Amendment, section 2 of which specifically qualified the liberties it extended to \u201cmale citizens,\u201d it seemed as though the progress made in support of civil rights was not only passing women by but was purposely codifying their exclusion. As Congress debated the language of the Fifteenth Amendment, some held out hope that it would finally extend the franchise to women. Those hopes were dashed when Congress adopted the final language. \n\n The consequence of these frustrated hopes was the effective split of a civil rights movement that had once been united in support of African Americans and women. Seeing this split occur, Frederick Douglass, a great admirer of Stanton, struggled to argue for a piecemeal approach that should prioritize the franchise for Black men if that was the only option. He insisted that his support for women\u2019s right to vote was sincere, but that getting Black men the right to vote was \u201cof the most urgent necessity.\u201d \u201cThe government of this country loves women,\u201d he argued. \u201cThey are the sisters, mothers, wives and daughters of our rulers; but the negro is loathed. . . . The negro needs suffrage to protect his life and property, and to ensure him respect and education.\u201d \n\n These appeals were largely accepted by women\u2019s rights leaders and AERA members like Lucy Stone and Henry Browne Blackwell, who believed that more time was needed to bring about female suffrage. Others demanded immediate action. Among those who pressed forward despite the setback were Stanton and Anthony. They felt greatly aggrieved at the fact that other abolitionists, with whom they had worked closely for years, did not demand that women be included in the language of the amendments. Stanton argued that the women\u2019s vote would be necessary to counter the influence of uneducated freedmen in the South and the waves of poor European immigrants arriving in the East. \n\n In 1869, Stanton and Anthony helped organize the National Woman Suffrage Association (NWSA), an organization dedicated to ensuring that women gained the right to vote immediately, not at some future, undetermined date. Some women, including Virginia Minor, a member of the NWSA, took action by trying to register to vote; Minor attempted this in St. Louis, Missouri, in 1872. When election officials turned her away, Minor brought the issue to the Missouri state courts, arguing that the Fourteenth Amendment ensured that she was a citizen with the right to vote. This legal effort to bring about women\u2019s suffrage eventually made its way to the Supreme Court, which declared in 1874 that \u201cthe constitution of the United States does not confer the right of suffrage upon any one,\u201d effectively dismissing Minor\u2019s claim. \n\n Defining American Constitution of the National Woman Suffrage Association Despite the Fifteenth Amendment\u2019s failure to guarantee female suffrage, women did gain the right to vote in western territories, with the Wyoming Territory leading the way in 1869. One reason for this was a belief that giving women the right to vote would provide a moral compass to the otherwise lawless western frontier. Extending the right to vote in western territories also provided an incentive for White women to emigrate to the West, where they were scarce. However, Susan B. Anthony, Elizabeth Cady Stanton, and others believed that immediate action on the national front was required, leading to the organization of the NWSA and its resulting constitution.\n\n ARTICLE 1.\u2014This organization shall be called the National Woman Suffrage Association. \n\n ARTICLE 2.\u2014The object of this Association shall be to secure STATE and NATIONAL protection for women citizens in the exercise of their right to vote. \n\n ARTICLE 3.\u2014All citizens of the United States subscribing to this Constitution, and contributing not less than one dollar annually, shall be considered members of the Association, with the right to participate in its deliberations. \n\n ARTICLE 4.\u2014The officers of this Association shall be a President, Vice-Presidents from each of the States and Territories, Corresponding and Recording Secretaries, a Treasurer, an Executive Committee of not less than five, and an Advisory Committee consisting of one or more persons from each State and Territory. \n\n ARTICLE 5.\u2014All Woman Suffrage Societies throughout the country shall be welcomed as auxiliaries; and their accredited officers or duly appointed representatives shall be recognized as members of the National Association.\n\n OFFICERS OF THE NATIONAL WOMAN SUFFRAGE ASSOCIATION. \n\n PRESIDENT.\n\n SUSAN B. ANTHONY, Rochester, N. Y. \n\n How was the NWSA organized? How would the fact that it operated at the national level, rather than at the state or local level, help it to achieve its goals? \n\n BLACK POLITICAL ACHIEVEMENTS \n\n Black voter registration in the late 1860s and the ratification of the Fifteenth Amendment finally brought what Lincoln had characterized as \u201ca new birth of freedom.\u201d  Union Leagues , fraternal groups founded in the North that promoted loyalty to the Union and the Republican Party during the Civil War, expanded into the South after the war and were transformed into political clubs that served both political and civic functions. As centers of the Black communities in the South, the leagues became vehicles for the dissemination of information, acted as mediators between members of the Black community and the White establishment, and served other practical functions like helping to build schools and churches for the community they served. As extensions of the Republican Party, these leagues worked to enroll newly enfranchised Black voters, campaign for candidates, and generally help the party win elections ( Figure 16.10 ). \n\n The political activities of the leagues launched a great many African Americans and formerly enslaved people into politics throughout the South. For the first time, Black people began to hold political office, and several were elected to the U.S. Congress. In the 1870s, fifteen members of the House of Representatives and two senators were Black. The two senators, Blanche K. Bruce and Hiram Revels, were both from Mississippi, the home state of former U.S. senator and later Confederate president Jefferson Davis. Hiram Revels ( Figure 16.11 ), was a freeborn man from North Carolina who rose to prominence as a minister in the African Methodist Episcopal Church and then as a Mississippi state senator in 1869. The following year he was elected by the state legislature to fill one of Mississippi\u2019s two U.S. Senate seats, which had been vacant since the war. His arrival in Washington, DC, drew intense interest: as the  New York Times  noted, when \u201cthe colored Senator from Mississippi, was sworn in and admitted to his seat this afternoon . . . there was not an inch of standing or sitting room in the galleries, so densely were they packed. . . . When the Vice-President uttered the words, \u2018The Senator elect will now advance and take the oath,\u2019 a pin might have been heard drop.\u201d \n\n Defining American Senator Revels on Segregated Schools in Washington, DC Hiram R. Revels became the first African American to serve in the U.S. Senate in 1870. In 1871, he gave the following speech about Washington\u2019s segregated schools before Congress. \n\n Will establishing such [desegregated] schools as I am now advocating in this District harm our White friends? . . . By some it is contended that if we establish mixed schools here a great insult will be given to the White citizens, and that the White schools will be seriously damaged. . . . When I was on a lecturing tour in the state of Ohio . . . [o]ne of the leading gentlemen connected with the schools in that town came to see me. . . . He asked me, \u201cHave you been to New England, where they have mixed schools?\u201d I replied, \u201cI have sir.\u201d \u201cWell,\u201d said he, \u201cplease tell me this: does not social equality result from mixed schools?\u201d \u201cNo, sir; very far from it,\u201d I responded. \u201cWhy,\u201d said he, \u201chow can it be otherwise?\u201d I replied, \u201cI will tell you how it can be otherwise, and how it is otherwise. Go to the schools and you see there White children and colored children seated side by side, studying their lessons, standing side by side and reciting their lessons, and perhaps in walking to school they may walk together; but that is the last of it. The White children go to their homes; the colored children go to theirs; and on the Lord\u2019s day you will see those colored children in colored churches, and the White family, you will see the White children there, and the colored children at entertainments given by persons of their color.\u201d I aver, sir, that mixed schools are very far from bringing about social equality.\u201d \n\n According to Senator Revels\u2019s speech, what is \u201csocial equality\u201d and why is it important to the issue of desegregated schools? Does Revels favor social equality or social segregation? Did social equality exist in the United States in 1871? \n\n Though the fact of their presence was dramatic and important, as the  New York Times  description above demonstrates, the few African American representatives and senators who served in Congress during Reconstruction represented only a tiny fraction of the many hundreds, possibly thousands, of Blacks who served in a great number of capacities at the local and state levels. The South during the early 1870s brimmed with formerly enslaved and freeborn Black people serving as school board commissioners, county commissioners, clerks of court, board of education and city council members, justices of the peace, constables, coroners, magistrates, sheriffs, auditors, and registrars. This wave of local African American political activity contributed to and was accompanied by a new concern for the poor and disadvantaged in the South. The southern Republican leadership did away with the hated Black codes, undid the work of White supremacists, and worked to reduce obstacles confronting freed people. \n\n Reconstruction governments invested in infrastructure, paying special attention to the rehabilitation of the southern railroads. They set up public education systems that enrolled both White and Black students. They established or increased funding for hospitals, orphanages, and asylums for the insane. In some states, the state and local governments provided the poor with basic necessities like firewood and even bread. And to pay for these new services and subsidies, the governments levied taxes on land and property, an action that struck at the heart of the foundation of southern economic inequality. Indeed, the land tax compounded the existing problems of White landowners, who were often cash-poor, and contributed to resentment of what southerners viewed as another northern attack on their way of life. \n\n White southerners reacted with outrage at the changes imposed upon them. The sight of once-enslaved Blacks serving in positions of authority as sheriffs, congressmen, and city council members stimulated great resentment at the process of Reconstruction and its undermining of the traditional social and economic foundations of the South. Indignant southerners referred to this period of reform as a time of \u201cnegro misrule.\u201d They complained of profligate corruption on the part of vengeful freed people and greedy northerners looking to fill their pockets with the South\u2019s riches. Unfortunately for the great many honest reformers, southerners did have a handful of real examples of corruption they could point to, such as legislators using state revenues to buy hams and perfumes or giving themselves inflated salaries. Such examples, however, were relatively few and largely comparable to nineteenth-century corruption across the country. Yet these powerful stories, combined with deep-seated racial animosity toward Blacks in the South, led to Democratic campaigns to \u201credeem\u201d state governments. Democrats across the South leveraged planters\u2019 economic power and wielded White vigilante violence to ultimately take back state political power from the Republicans. By the time President Grant\u2019s attentions were being directed away from the South and toward the Indian Wars in the West in 1876, power in the South had largely been returned to Whites and Reconstruction was effectively abandoned. By the end of 1876, only South Carolina, Louisiana, and Florida still had Republican governments. \n\n The sense that the South had been unfairly sacrificed to northern vice and Black vengeance, despite a wealth of evidence to the contrary, persisted for many decades. So powerful and pervasive was this narrative that by the time D. W. Griffith released his 1915 motion picture,  The Birth of a Nation , Whites around the country were primed to accept the fallacy that White southerners were the frequent victims of violence and violation at the hands of unrestrained Blacks. The reality is that the opposite was true. White southerners orchestrated a sometimes violent and generally successful counterrevolution against Reconstruction policies in the South beginning in the 1860s. Those who worked to change and modernize the South typically did so under the stern gaze of exasperated Whites and threats of violence. Black Republican officials in the South were frequently terrorized, assaulted, and even murdered with impunity by organizations like the Ku Klux Klan. When not ignoring the Fourteenth and Fifteenth Amendments altogether, White leaders often used trickery and fraud at the polls to get the results they wanted. As Reconstruction came to a close, these methods came to define southern life for African Americans for nearly a century afterward. \n 16.4   The Collapse of Reconstruction Learning Objectives By the end of this section, you will be able to: \n\n Explain the reasons for the collapse of Reconstruction \n\n Describe the efforts of White southern \u201credeemers\u201d to roll back the gains of Reconstruction \n\n The effort to remake the South generated a brutal reaction among southern Whites, who were committed to keeping Blacks in a subservient position. To prevent Blacks from gaining economic ground and to maintain cheap labor for the agricultural economy, an exploitative system of sharecropping spread throughout the South. Domestic terror organizations, most notably the Ku Klux Klan, employed various methods (arson, whipping, murder) to keep freed people from voting and achieving political, social, or economic equality with Whites. \n\n BUILDING BLACK COMMUNITIES \n\n The degraded status of Black men and women had placed them outside the limits of what antebellum southern Whites considered appropriate gender roles and familial hierarchies. Slave marriages did not enjoy legal recognition. Enslaved men were humiliated and deprived of authority and of the ability to protect enslaved women, who were frequently exposed to the brutality and sexual domination of White enslavers and vigilantes alike. Enslaved parents could not protect their children, who could be bought, sold, put to work, brutally disciplined, and abused without their consent; parents, too, could be sold away from their children ( Figure 16.12 ). Moreover, the division of labor idealized in White southern society, in which men worked the land and women performed the role of domestic caretaker, did not apply to the enslaved. Both enslaved men and women were made to perform hard labor in the fields. \n\n In the Reconstruction era, African Americans embraced the right to enjoy the family bonds and the expression of gender norms they had been systematically denied. Many thousands of freed Black men who had been separated from their families while enslaved took to the road to find their long-lost spouses and children and renew their bonds. In one instance, a journalist reported having interviewed a freed person who traveled over six hundred miles on foot in search of the family that was taken from him while in bondage. Couples that had been spared separation quickly set out to legalize their marriages, often by way of the Freedmen\u2019s Bureau, now that this option was available. Those who had no families would sometimes relocate to southern towns and cities, so as to be part of the larger Black community where churches and other mutual aid societies offered help and camaraderie. \n\n SHARECROPPING \n\n Most freed people stayed in the South on the lands where their families and loved ones had worked for generations while enslaved. They hungered to own and farm their own lands instead of the lands of White plantation owners. In one case, formerly enslaved people on the Sea Islands off the coast of South Carolina initially had hopes of owning the land they had worked for many decades after General Sherman directed that freed people be granted title to plots of forty acres. \n\n The Freedmen\u2019s Bureau provided additional cause for such hopes by directing that leases and titles to lands in the South be made available to formerly enslaved people. However, these efforts ran afoul of President Johnson. In 1865, he ordered the return of land to White landowners, a setback for those freed people, such as those on the South Carolina Sea Islands, who had begun to cultivate the land as their own. Ultimately, there was no redistribution of land in the South. \n\n The end of slavery meant the transition to wage labor. However, this conversion did not entail a new era of economic independence for formerly enslaved people. While they no longer faced relentless toil under the lash, freed people emerged from slavery without any money and needed farm implements, food, and other basic necessities to start their new lives. Under the  crop-lien system , store owners extended credit to farmers under the agreement that the debtors would pay with a portion of their future harvest. However, the creditors charged high interest rates, making it even harder for freed people to gain economic independence. \n\n Throughout the South,  sharecropping  took root, a crop-lien system that worked to the advantage of landowners. Under the system, freed people rented the land they worked, often on the same plantations where they had been enslaved. Some landless Whites also became sharecroppers. Sharecroppers paid their landlords with the crops they grew, often as much as half their harvest. Sharecropping favored the landlords and ensured that freed people could not attain independent livelihoods. The year-to-year leases meant no incentive existed to substantially improve the land, and high interest payments siphoned additional money away from the farmers. Sharecroppers often became trapped in a never-ending cycle of debt, unable to buy their own land and unable to stop working for their creditor because of what they owed. The consequences of sharecropping affected the entire South for many generations, severely limiting economic development and ensuring that the South remained an agricultural backwater. \n\n THE \u201cINVISIBLE EMPIRE OF THE SOUTH\u201d \n\n Paramilitary White-supremacist terror organizations in the South helped bring about the collapse of Reconstruction, using violence as their primary weapon. The \u201cInvisible Empire of the South,\u201d or  Ku Klux Klan , stands as the most notorious. The Klan was founded in 1866 as an oath-bound fraternal order of Confederate veterans in Tennessee, with former Confederate General Nathan Bedford Forrest as its first leader. The organization\u2014its name likely derived from  kuklos , a Greek word meaning circle\u2014devised elaborate rituals and grandiose names for its ranking members: Grand Wizard, Grand Dragon, Grand Titan, and Grand Cyclops. Soon, however, this fraternal organization evolved into a vigilante terrorist group that vented southern Whites\u2019 collective frustration over the loss of the war and the course of Radical Reconstruction through acts of intimidation and violence. \n\n The Klan terrorized newly freed Black people to deter them from exercising their citizenship rights and freedoms. Other anti-Black vigilante groups around the South began to adopt the Klan name and perpetrate acts of unspeakable violence against anyone they considered a tool of Reconstruction. Indeed, as historians have noted, Klan units around the South operated autonomously and with a variety of motives. Some may have sincerely believed they were righting wrongs, others merely satisfying their lurid desires for violence. Nor was the Klan the only racist vigilante organization. Other groups, like the Red Shirts from Mississippi and the Knights of the White Camelia and the White League, both from Louisiana, also sprang up at this time. The Klan and similar organizations also worked as an extension of the Democratic Party to win elections. \n\n Despite the great variety in Klan membership, on the whole, the group tended to direct its attention toward persecuting freed people and people they considered  carpetbaggers , a term of abuse applied to northerners accused of having come to the South to acquire wealth through political power at the expense of southerners. The colorful term captured the disdain of southerners for these people, reflecting the common assumption that these men, sensing great opportunity, packed up all their worldly possessions in carpetbags, a then-popular type of luggage, and made their way to the South. Implied in this definition is the notion that these men came from little and were thus shiftless wanderers motivated only by the desire for quick money. In reality, these northerners tended to be young, idealistic, often well-educated men who responded to northern campaigns urging them to lead the modernization of the South. But the image of them as swindlers taking advantage of the South at its time of need resonated with a White southern population aggrieved by loss and economic decline. Southern Whites who supported Reconstruction, known as  scalawags , also generated great hostility as traitors to the South. They, too, became targets of the Klan and similar groups. \n\n The Klan seized on the pervasive but largely fictional narrative of the northern carpetbagger as a powerful tool for restoring White supremacy and overturning Republican state governments in the South ( Figure 16.13 ). To preserve a White-dominated society, Klan members punished Blacks for attempting to improve their station in life or acting \u201cuppity.\u201d To prevent freed people from attaining an education, the Klan burned public schools. In an effort to stop Blacks from voting, the Klan murdered, whipped, and otherwise intimidated freed people and their White supporters. It wasn\u2019t uncommon for Klan members to intimidate Union League members and Freedmen\u2019s Bureau workers. The Klan even perpetrated acts of political assassination, killing a sitting U.S. congressman from Arkansas and three state congressmen from South Carolina. \n\n Klan tactics included riding out to victims\u2019 houses, masked and armed, and firing into the homes or burning them down ( Figure 16.14 ). Other tactics relied more on the threat of violence, such as happened in Mississippi when fifty masked Klansmen rode out to a local schoolteacher\u2019s house to express their displeasure with the school tax and to suggest that she consider leaving. Still other tactics intimidated through imaginative trickery. One such method was to dress up as ghosts of slain Confederate soldiers and stage stunts designed to convince their victims of their supernatural abilities. \n\n Regardless of the method, the general goal of reinstating White supremacy as a foundational principle and returning the South to a situation that largely resembled antebellum conditions remained a constant. The Klan used its power to eliminate Black economic independence, decimate Blacks\u2019 political rights, reclaim White dominance over Black women\u2019s bodies and Black men\u2019s masculinity, tear apart Black communities, and return Blacks to earlier patterns of economic and political subservience and social deference. In this, they were largely successful. \n\n The president and Congress, however, were not indifferent to the violence, and they worked to bring it to an end. In 1870, at the insistence of the governor of North Carolina, President Grant told Congress to investigate the Klan. In response, Congress in 1871 created the Joint Select Committee to Inquire into the Condition of Affairs in the Late Insurrectionary States. The committee took testimony from freed people in the South, and in 1872, it published a thirteen-volume report on the tactics the Klan used to derail democracy in the South through the use of violence. \n\n My Story Abram Colby on the Methods of the Ku Klux Klan The following statements are from the October 27, 1871, testimony of fifty-two-year-old formerly enslaved Abram Colby, which the joint select committee investigating the Klan took in Atlanta, Georgia. Colby had been elected to the lower house of the Georgia State legislature in 1868.\n\n On the 29th of October, they came to my house and broke my door open, took me out of my bed and took me to the woods and whipped me three hours or more and left me in the woods for dead. They said to me, \u201cDo you think you will ever vote another damned Radical ticket?\u201d I said, \u201cI will not tell you a lie.\u201d They said, \u201cNo; don\u2019t tell a lie.\u201d . . . I said, \u201cIf there was an election to-morrow, I would vote the Radical ticket.\u201d They set in and whipped me a thousand licks more, I suppose. . . . \n\n They said I had influence with the negroes of other counties, and had carried the negroes against them. About two days before they whipped me they offered me $5,000 to turn and go with them, and said they would pay me $2,500 cash if I would turn and let another man go to the legislature in my place. . . . \n\n I would have come before the court here last week, but I knew it was no use for me to try to get Ku-Klux condemned by Ku-Klux, and I did not come. Mr. Saunders, a member of the grand jury here last week, is the father of one of the very men I knew whipped me. . . . \n\n They broke something inside of me, and the doctor has been attending to me for more than a year. Sometimes I cannot get up and down off my bed, and my left hand is not of much use to me.\n\n \u2014Abram Colby testimony, Joint Select Committee Report, 1872 Why did the Klan target Colby? What methods did they use? \n\n Congress also passed a series of three laws designed to stamp out the Klan. Passed in 1870 and 1871, the  Enforcement Acts  or \u201cForce Acts\u201d were designed to outlaw intimidation at the polls and to give the federal government the power to prosecute crimes against freed people in federal rather than state courts. Congress believed that this last step, a provision in the third Enforcement Act, also called the Ku Klux Klan Act, was necessary in order to ensure that trials would not be decided by White juries in southern states friendly to the Klan. The act also allowed the president to impose martial law in areas controlled by the Klan and gave President Grant the power to suspend the writ of habeas corpus, a continuation of the wartime power granted to President Lincoln. The suspension meant individuals suspected of engaging in Klan activity could be jailed indefinitely. \n\n President Grant made frequent use of the powers granted to him by Congress, especially in South Carolina, where federal troops imposed martial law in nine counties in an effort to derail Klan activities. However, the federal government faced entrenched local organizations and a White population firmly opposed to Radical Reconstruction. Changes came slowly or not at all, and disillusionment set in. After 1872, federal government efforts to put down paramilitary terror in the South waned. \n\n  \u201cREDEEMERS\u201d AND THE END OF RECONSTRUCTION \n\n While the president and Congress may have seen the Klan and other clandestine White supremacist, terrorist organizations as a threat to stability and progress in the South, many southern Whites saw them as an instrument of order in a world turned upside down. Many White southerners felt humiliated by the process of Radical Reconstruction and the way Republicans had upended southern society, placing Black people in positions of authority while taxing large landowners to pay for the education of formerly enslaved people. Those committed to rolling back the tide of Radical Reconstruction in the South called themselves  redeemers , a label that expressed their desire to redeem their states from northern control and to restore the antebellum social order whereby Blacks were kept safely under the boot heel of Whites. They represented the Democratic Party in the South and worked tirelessly to end what they saw as an era of \u201cnegro misrule.\u201d By 1877, they had succeeded in bringing about the \u201credemption\u201d of the South, effectively destroying the dream of Radical Reconstruction. \n\n Although Ulysses S. Grant won a second term in the presidential election of 1872, the Republican grip on national political power began to slip in the early 1870s. Three major events undermined Republican control. First, in 1873, the United States experienced the start of a long economic downturn, the result of economic instability in Europe that spread to the United States. In the fall of 1873, the bank of Jay Cooke & Company failed to meet its financial obligations and went bankrupt, setting off a panic in American financial markets. An economic depression ensued, which Democrats blamed on Republicans and which lasted much of the decade. \n\n Second, the Republican Party experienced internal squabbles and divided into two factions. Some Republicans began to question the expansive role of the federal government, arguing for limiting the size and scope of federal initiatives. These advocates, known as Liberal Republicans because they followed classical liberalism in championing small government, formed their own breakaway party. Their ideas changed the nature of the debate over Reconstruction by challenging reliance on federal government help to bring about change in the South. Now some Republicans argued for downsizing Reconstruction efforts. \n\n Third, the Grant administration became mired in scandals, further tarnishing the Republicans while giving Democrats the upper hand. One scandal arose over the siphoning off of money from excise taxes on whiskey. The \u201cWhiskey Ring,\u201d as it was called, involved people at the highest levels of the Grant administration, including the president\u2019s personal secretary, Orville Babcock. Another scandal entangled Cr\u00e9dit Mobilier of America, a construction company and part of the important French Cr\u00e9dit Mobilier banking company. The Union Pacific Railroad company, created by the federal government during the Civil War to construct a transcontinental railroad, paid Cr\u00e9dit Mobilier to build the railroad. However, Cr\u00e9dit Mobilier used the funds it received to buy Union Pacific Railroad bonds and resell them at a huge profit. Some members of Congress, as well as Vice President Schuyler Colfax, had accepted funds from Cr\u00e9dit Mobilier in return for forestalling an inquiry. When the scam became known in 1872, Democratic opponents of Reconstruction pointed to Cr\u00e9dit Mobilier as an example of corruption in the Republican-dominated federal government and evidence that smaller government was better. \n\n The Democratic Party in the South made significant advances in the 1870s in its efforts to wrest political control from the Republican-dominated state governments. The Ku Klux Klan, as well as other paramilitary groups in the South, often operated as military wings of the Democratic Party in former Confederate states. In one notorious episode following a contested 1872 gubernatorial election in Louisiana, as many as 150 freedmen loyal to the Republican Party were killed at the Colfax courthouse by armed members of the Democratic Party, even as many of them tried to surrender ( Figure 16.15 ). \n\n In other areas of the South, the Democratic Party gained control over state politics. Texas came under Democratic control by 1873, and in the following year Alabama and Arkansas followed suit. In national politics, too, the Democrats gained ground\u2014especially during the 1874 elections, when they recaptured control of the House of Representatives for the first time since before the Civil War. Every other southern state, with the exception of Florida, South Carolina, and Louisiana\u2014the states where federal troops remained a force\u2014also fell to the Democratic Party and the restoration of White supremacy. Southerners everywhere celebrated their \u201credemption\u201d from Radical Republican rule. \n\n THE CONTESTED ELECTION OF 1876 \n\n By the time of the 1876 presidential election, Reconstruction had come to an end in most southern states. In Congress, the political power of the Radical Republicans had waned, although some continued their efforts to realize the dream of equality between Blacks and Whites. One of the last attempts to do so was the passage of the 1875 Civil Rights Act, which required equality in public places and on juries. This law was challenged in court, and in 1883 the Supreme Court ruled it unconstitutional, arguing that the Thirteenth and Fourteenth Amendments did not prohibit discrimination by private individuals. By the 1870s, the Supreme Court had also undercut the letter and the spirit of the Fourteenth Amendment by interpreting it as affording freed people only limited federal protection from the Klan and other terror groups. \n\n The country remained bitterly divided, and this was reflected in the contested election of 1876. While Grant wanted to run for a third term, scandals and Democratic successes in the South dashed those hopes. Republicans instead selected Rutherford B. Hayes, the three-time governor of Ohio. Democrats nominated Samuel Tilden, the reform governor of New York, who was instrumental in ending the Tweed Ring and Tammany Hall corruption in New York City. The November election produced an apparent Democratic victory, as Tilden carried the South and large northern states with a 300,000-vote advantage in the popular vote. However, disputed returns from Louisiana, South Carolina, Florida, and Oregon, whose electoral votes totaled twenty, threw the election into doubt. \n\n Hayes could still win if he gained those twenty electoral votes. As the Constitution did not provide a method to determine the validity of disputed votes, the decision fell to Congress, where Republicans controlled the Senate and Democrats controlled the House of Representatives. In late January 1877, Congress tried to break the deadlock by creating a special electoral commission composed of five senators, five representatives, and five justices of the Supreme Court. The congressional delegation represented both parties equally, with five Democrats and five Republicans. The court delegation had two Democrats, two Republicans, and one independent\u2014David Davis, who resigned from the Supreme Court (and from the commission) when the Illinois legislature elected him to the Senate. After Davis\u2019s resignation, President Grant selected a Republican to take his place, tipping the scales in favor of Hayes. The commission then awarded the disputed electoral votes and the presidency to Hayes, voting on party lines, 8 to 7 ( Figure 16.16 ). The Democrats called foul, threatening to hold up the commission\u2019s decision in the courts. \n\n In what became known as the  Compromise of 1877 , Republican Senate leaders worked with the Democratic leadership so they would support Hayes and the commission\u2019s decision. The two sides agreed that one Southern Democrat would be appointed to Hayes\u2019s cabinet, Democrats would control federal patronage (the awarding of government jobs) in their areas in the South, and there would be a commitment to generous internal improvements, including federal aid for the Texas and Pacific Railway. Perhaps most important, all remaining federal troops would be withdrawn from the South, a move that effectively ended Reconstruction. Hayes believed that southern leaders would obey and enforce the Reconstruction-era constitutional amendments that protected the rights of freed people. His trust was soon proved to be misguided, much to his dismay, and he devoted a large part of his life to securing rights for freedmen. For their part, the Democrats took over the remaining southern states, creating what became known as the \u201cSolid South\u201d\u2014a region that consistently voted in a bloc for the Democratic Party. ", "questions": [{"question": {"question_id": "fs-idm253980528", "question_text": "What was Lincoln\u2019s primary goal immediately following the Civil War?", "question_choices": ["punishing the rebel states", "improving the lives of formerly enslaved people", "reunifying the country", "paying off the debts of the war"], "cloze_format": "Lincoln's primary goal immediately following the Civil War was ____.", "normal_format": "What was Lincoln\u2019s primary goal immediately following the Civil War?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "bloom": null, "hl_sentences": "The end of the Civil War saw the beginning of the Reconstruction era , when former rebel Southern states were integrated back into the Union . President Lincoln moved quickly to achieve the war \u2019 s ultimate goal : reunification of the country .", "hl_context": "<hl> The end of the Civil War saw the beginning of the Reconstruction era , when former rebel Southern states were integrated back into the Union . <hl> <hl> President Lincoln moved quickly to achieve the war \u2019 s ultimate goal : reunification of the country . <hl> He proposed a generous and non-punitive plan to return the former Confederate states speedily to the United States , but some Republicans in Congress protested , considering the president \u2019 s plan too lenient to the rebel states that had torn the country apart . The greatest flaw of Lincoln \u2019 s plan , according to this view , was that it appeared to forgive traitors instead of guaranteeing civil rights to formerly enslaved people . President Lincoln oversaw the passage of the Thirteenth Amendment abolishing slavery , but he did not live to see its ratification ."}, {"question": {"question_id": "fs-idm34533248", "question_text": "In 1864 and 1865, Radical Republicans were most concerned with ________.", "question_choices": ["securing civil rights for freed slaves", "barring ex-Confederates from political office", "seeking restitution from Confederate states", "preventing Andrew Johnson\u2019s ascent to the presidency"], "cloze_format": "In 1864 and 1865, Radical Republicans were most concerned with ________.", "normal_format": "In 1864 and 1865, what Radical Republicans were most concerned with?"}, "answer": {"ans_text": "barring ex-Confederates from political office", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "As Radical Republicans had proposed in the Wade-Davis bill , individuals who had \u201c engaged in insurrection or rebellion [ against ] . or given aid or comfort to the enemies [ of ] \u201d the United States were barred from holding political ( state or federal ) or military office unless pardoned by two-thirds of Congress . In February 1864 , two of the Radical Republicans , Ohio senator Benjamin Wade and Maryland representative Henry Winter Davis , answered Lincoln with a proposal of their own . Among other stipulations , the Wade-Davis Bill called for a majority of voters and government officials in Confederate states to take an oath , called the Ironclad Oath , swearing that they had never supported the Confederacy or made war against the United States . Those who could not or would not take the oath would be unable to take part in the future political life of the South . Radical Republicans insisted on harsh terms for the defeated Confederacy and protection for formerly enslaved people , going far beyond what the president proposed .", "hl_context": "The Fourteenth Amendment stated , \u201c All persons born or naturalized in the United States and subject to the jurisdiction thereof , are citizens of the United States and of the State wherein they reside . \u201d It gave citizens equal protection under both the state and federal law , overturning the Dred Scott decision . It eliminated the three-fifths compromise of the 1787 Constitution , whereby an enslaved person had been counted as three-fifths of a free White person , and it reduced the number of House representatives and Electoral College electors for any state that denied suffrage to any adult male inhabitant , Black or White . <hl> As Radical Republicans had proposed in the Wade-Davis bill , individuals who had \u201c engaged in insurrection or rebellion [ against ] . <hl> . . <hl> or given aid or comfort to the enemies [ of ] \u201d the United States were barred from holding political ( state or federal ) or military office unless pardoned by two-thirds of Congress . <hl> <hl> In February 1864 , two of the Radical Republicans , Ohio senator Benjamin Wade and Maryland representative Henry Winter Davis , answered Lincoln with a proposal of their own . <hl> <hl> Among other stipulations , the Wade-Davis Bill called for a majority of voters and government officials in Confederate states to take an oath , called the Ironclad Oath , swearing that they had never supported the Confederacy or made war against the United States . <hl> <hl> Those who could not or would not take the oath would be unable to take part in the future political life of the South . <hl> Congress assented to the Wade-Davis Bill , and it went to Lincoln for his signature . The president refused to sign , using the pocket veto ( that is , taking no action ) to kill the bill . Lincoln understood that no Southern state would have met the criteria of the Wade-Davis Bill , and its passage would simply have delayed the reconstruction of the South . Lincoln hoped that the leniency of the plan \u2014 90 percent of the 1860 voters did not have to swear allegiance to the Union or to emancipation \u2014 would bring about a quick and long-anticipated resolution and make emancipation more acceptable everywhere . This approach appealed to some in the moderate wing of the Republican Party , which wanted to put the nation on a speedy course toward reconciliation . However , the proposal instantly drew fire from a larger faction of Republicans in Congress who did not want to deal moderately with the South . These members of Congress , known as Radical Republicans , wanted to remake the South and punish the rebels . <hl> Radical Republicans insisted on harsh terms for the defeated Confederacy and protection for formerly enslaved people , going far beyond what the president proposed . <hl>"}, {"question": {"question_id": "fs-idm357606272", "question_text": "Which of the following was not one of the functions of the Freedmen\u2019s Bureau?", "question_choices": ["collecting taxes", " reuniting families", " establishing schools", "helping workers secure labor contracts"], "cloze_format": "____ was not one of the functions of the Freedmen's Bureau.", "normal_format": "Which of the following was not one of the functions of the Freedmen\u2019s Bureau?"}, "answer": {"ans_text": "collecting taxes", "ans_choice": 0}, "bloom": null, "hl_sentences": "It helped freed people gain labor contracts , a significant step in the creation of wage labor in place of slavery . It helped reunite families of freedmen , and it also devoted much energy to education , establishing scores of public schools where freed people and poor Whites could receive both elementary and higher education .", "hl_context": "The Freedmen \u2019 s Bureau engaged in many initiatives to ease the transition from slavery to freedom . It delivered food to Blacks and Whites alike in the South . <hl> It helped freed people gain labor contracts , a significant step in the creation of wage labor in place of slavery . <hl> <hl> It helped reunite families of freedmen , and it also devoted much energy to education , establishing scores of public schools where freed people and poor Whites could receive both elementary and higher education . <hl> Respected institutions such as Fisk University , Hampton University , and Dillard University are part of the legacy of the Freedmen \u2019 s Bureau ."}, {"question": {"question_id": "fs-idm343727296", "question_text": "Which person or group was most responsible for the passage of the Fourteenth Amendment?", "question_choices": ["President Johnson", " northern voters", " southern voters", "Radical Republicans in Congress"], "cloze_format": "____ was most responsible for the passage of the Fourteenth Amendment.", "normal_format": "Which person or group was most responsible for the passage of the Fourteenth Amendment?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Seeking to overcome all legal questions , Radical Republicans drafted another constitutional amendment with provisions that followed those of the 1866 Civil Rights Act . In July 1866 , the Fourteenth Amendment went to state legislatures for ratification .", "hl_context": "Questions swirled about the constitutionality of the Civil Rights Act of 1866 . The Supreme Court , in its 1857 decision forbidding Black citizenship , had interpreted the Constitution in a certain way ; many argued that the 1866 statute , alone , could not alter that interpretation . <hl> Seeking to overcome all legal questions , Radical Republicans drafted another constitutional amendment with provisions that followed those of the 1866 Civil Rights Act . <hl> <hl> In July 1866 , the Fourteenth Amendment went to state legislatures for ratification . <hl>"}, {"question": {"question_id": "fs-idp62508496", "question_text": "Under Radical Reconstruction, which of the following did former Confederate states not need to do in order to rejoin the Union?", "question_choices": ["pass the Fourteenth Amendment", " pass the Fifteenth Amendment", " revise their state constitution", "allow all freed men over the age of 21 to vote"], "cloze_format": "Under Radical Reconstruction, former Confederate states did not need to ___ to rejoin the Union.", "normal_format": "Under Radical Reconstruction, which of the following did former Confederate states not need to do in order to rejoin the Union?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "With the Fifteenth Amendment , they sought to correct this major weakness by finally extending to Black men the right to vote . The amendment directed that \u201c [ t ] he right of citizens of the United States to vote shall not be denied or abridged by the United States or by any State on account of race , color , or previous condition of servitude . \u201d Unfortunately , the new amendment had weaknesses of its own . The 1867 act divided the ten southern states that had yet to ratify the Fourteenth Amendment into five military districts ( Tennessee had already been readmitted to the Union by this time and so was excluded from these acts ) . Martial law was imposed , and a Union general commanded each district . These generals and twenty thousand federal troops stationed in the districts were charged with protecting freed people . When a supplementary act extended the right to vote to all freed men of voting age ( 21 years old ) , the military in each district oversaw the elections and the registration of voters . Only after new state constitutions had been written and states had ratified the Fourteenth Amendment could these states rejoin the Union . Once again , Congress overrode Johnson \u2019 s vetoes , and by the end of 1870 , all the southern states under military rule had ratified the Fourteenth Amendment and been restored to the Union ( Figure 16.7 ) .", "hl_context": "Though Grant did not side with the Radical Republicans , his victory allowed the continuance of the Radical Reconstruction program . In the winter of 1869 , Republicans introduced another constitutional amendment , the third of the Reconstruction era . When Republicans had passed the Fourteenth Amendment , which addressed citizenship rights and equal protections , they were unable to explicitly ban states from withholding the franchise based on race . <hl> With the Fifteenth Amendment , they sought to correct this major weakness by finally extending to Black men the right to vote . <hl> <hl> The amendment directed that \u201c [ t ] he right of citizens of the United States to vote shall not be denied or abridged by the United States or by any State on account of race , color , or previous condition of servitude . \u201d Unfortunately , the new amendment had weaknesses of its own . <hl> As part of a compromise to ensure the passage of the amendment with the broadest possible support , drafters of the amendment specifically excluded language that addressed literacy tests and poll taxes , the most common ways Blacks were traditionally disenfranchised in both the North and the South . Indeed , Radical Republican leader Charles Sumner of Massachusetts , himself an ardent supporter of legal equality without exception to race , refused to vote for the amendment precisely because it did not address these obvious loopholes . The 1867 Military Reconstruction Act , which encompassed the vision of Radical Republicans , set a new direction for Reconstruction in the South . Republicans saw this law , and three supplementary laws passed by Congress that year , called the Reconstruction Acts , as a way to deal with the disorder in the South . <hl> The 1867 act divided the ten southern states that had yet to ratify the Fourteenth Amendment into five military districts ( Tennessee had already been readmitted to the Union by this time and so was excluded from these acts ) . <hl> <hl> Martial law was imposed , and a Union general commanded each district . <hl> <hl> These generals and twenty thousand federal troops stationed in the districts were charged with protecting freed people . <hl> <hl> When a supplementary act extended the right to vote to all freed men of voting age ( 21 years old ) , the military in each district oversaw the elections and the registration of voters . <hl> <hl> Only after new state constitutions had been written and states had ratified the Fourteenth Amendment could these states rejoin the Union . <hl> Predictably , President Johnson vetoed the Reconstruction Acts , viewing them as both unnecessary and unconstitutional . <hl> Once again , Congress overrode Johnson \u2019 s vetoes , and by the end of 1870 , all the southern states under military rule had ratified the Fourteenth Amendment and been restored to the Union ( Figure 16.7 ) . <hl>"}, {"question": {"question_id": "fs-idm190186880", "question_text": "The House of Representatives impeached Andrew Johnson over ________.", "question_choices": ["the Civil Rights Act", " the Fourteenth Amendment", " the Military Reconstruction Act", "the Tenure of Office Act"], "cloze_format": "The House of Representatives impeached Andrew Johnson over ________.", "normal_format": "Over which did The House of Representatives impeach Andrew Johnson?"}, "answer": {"ans_text": "the Tenure of Office Act", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Many Radical Republicans welcomed this blunder by the president as it allowed them to take action to remove Johnson from office , arguing that Johnson had openly violated the Tenure of Office Act . The House of Representatives quickly drafted a resolution to impeach him , a first in American history .", "hl_context": "The Republican majority in Congress by now despised the president , and they wanted to prevent him from interfering in congressional Reconstruction . To that end , Radical Republicans passed two laws of dubious constitutionality . The Command of the Army Act prohibited the president from issuing military orders except through the commanding general of the army , who could not be relieved or reassigned without the consent of the Senate . The Tenure of Office Act , which Congress passed in 1867 , required the president to gain the approval of the Senate whenever he appointed or removed officials . Congress had passed this act to ensure that Republicans who favored Radical Reconstruction would not be barred or stripped of their jobs . In August 1867 , President Johnson removed Secretary of War Edwin M . Stanton , who had aligned himself with the Radical Republicans , without gaining Senate approval . He replaced Stanton with Ulysses S . Grant , but Grant resigned and sided with the Republicans against the president . <hl> Many Radical Republicans welcomed this blunder by the president as it allowed them to take action to remove Johnson from office , arguing that Johnson had openly violated the Tenure of Office Act . <hl> <hl> The House of Representatives quickly drafted a resolution to impeach him , a first in American history . <hl>"}, {"question": {"question_id": "fs-idm223934496", "question_text": "Which of the following is not one of the methods the Ku Klux Klan and other terrorist groups used to intimidate Blacks and White sympathizers?", "question_choices": ["burning public schools", " petitioning Congress", " murdering freedmen who tried to vote", "threatening, beating, and killing those who disagreed with them"], "cloze_format": "It was not one of the methods of the Ku Klux Klan and other terrorist groups to ____ to intimidate Black and White sympathizers.", "normal_format": "Which of the following is not one of the methods the Ku Klux Klan and other terrorist groups used to intimidate Blacks and White sympathizers?"}, "answer": {"ans_text": " petitioning Congress", "ans_choice": 1}, "bloom": null, "hl_sentences": "To preserve a White-dominated society , Klan members punished Blacks for attempting to improve their station in life or acting \u201c uppity . \u201d To prevent freed people from attaining an education , the Klan burned public schools . In an effort to stop Blacks from voting , the Klan murdered , whipped , and otherwise intimidated freed people and their White supporters . It wasn \u2019 t uncommon for Klan members to intimidate Union League members and Freedmen \u2019 s Bureau workers . The Klan even perpetrated acts of political assassination , killing a sitting U . S . congressman from Arkansas and three state congressmen from South Carolina .", "hl_context": "The Klan seized on the pervasive but largely fictional narrative of the northern carpetbagger as a powerful tool for restoring White supremacy and overturning Republican state governments in the South ( Figure 16.13 ) . <hl> To preserve a White-dominated society , Klan members punished Blacks for attempting to improve their station in life or acting \u201c uppity . \u201d To prevent freed people from attaining an education , the Klan burned public schools . <hl> <hl> In an effort to stop Blacks from voting , the Klan murdered , whipped , and otherwise intimidated freed people and their White supporters . <hl> <hl> It wasn \u2019 t uncommon for Klan members to intimidate Union League members and Freedmen \u2019 s Bureau workers . <hl> <hl> The Klan even perpetrated acts of political assassination , killing a sitting U . S . congressman from Arkansas and three state congressmen from South Carolina . <hl>"}, {"question": {"question_id": "fs-idm206366752", "question_text": "Which of the following was the term southerners used for a White southerner who tried to overturn the changes of Reconstruction?", "question_choices": ["scalawag", "carpetbagger", "redeemer", "white knight"], "cloze_format": "Southerners used ___ for a White southerner who tried to overturn the changes of Reconstruction.", "normal_format": "Which of the following was the term southerners used for a White southerner who tried to overturn the changes of Reconstruction?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "bloom": null, "hl_sentences": "Those committed to rolling back the tide of Radical Reconstruction in the South called themselves redeemers , a label that expressed their desire to redeem their states from northern control and to restore the antebellum social order whereby Blacks were kept safely under the boot heel of Whites .", "hl_context": "While the president and Congress may have seen the Klan and other clandestine White supremacist , terrorist organizations as a threat to stability and progress in the South , many southern Whites saw them as an instrument of order in a world turned upside down . Many White southerners felt humiliated by the process of Radical Reconstruction and the way Republicans had upended southern society , placing Black people in positions of authority while taxing large landowners to pay for the education of formerly enslaved people . <hl> Those committed to rolling back the tide of Radical Reconstruction in the South called themselves redeemers , a label that expressed their desire to redeem their states from northern control and to restore the antebellum social order whereby Blacks were kept safely under the boot heel of Whites . <hl> They represented the Democratic Party in the South and worked tirelessly to end what they saw as an era of \u201c negro misrule . \u201d By 1877 , they had succeeded in bringing about the \u201c redemption \u201d of the South , effectively destroying the dream of Radical Reconstruction ."}], "summary": " Summary 16.1   Restoring the Union \n\n President Lincoln worked to reach his goal of reunifying the nation quickly and proposed a lenient plan to reintegrate the Confederate states. After his murder in 1865, Lincoln\u2019s vice president, Andrew Johnson, sought to reconstitute the Union quickly, pardoning Southerners en masse and providing Southern states with a clear path back to readmission. By 1866, Johnson announced the end of Reconstruction. Radical Republicans in Congress disagreed, however, and in the years ahead would put forth their own plan of Reconstruction. \n\n 16.2   Congress and the Remaking of the South, 1865\u20131866 \n\n The conflict between President Johnson and the Republican-controlled Congress over the proper steps to be taken with the defeated Confederacy grew in intensity in the years immediately following the Civil War. While the president concluded that all that needed to be done in the South had been done by early 1866, Congress forged ahead to stabilize the defeated Confederacy and extend to freed people citizenship and equality before the law. Congress prevailed over Johnson\u2019s vetoes as the friction between the president and the Republicans increased. \n\n 16.3   Radical Reconstruction, 1867\u20131872 \n\n Though President Johnson declared Reconstruction complete less than a year after the Confederate surrender, members of Congress disagreed. Republicans in Congress began to implement their own plan of bringing law and order to the South through the use of military force and martial law. Radical Republicans who advocated for a more equal society pushed their program forward as well, leading to the ratification of the Fifteenth Amendment, which finally gave Blacks the right to vote. The new amendment empowered Black voters, who made good use of the vote to elect Black politicians. It disappointed female suffragists, however, who had labored for years to gain women\u2019s right to vote. By the end of 1870, all the southern states under Union military control had satisfied the requirements of Congress and been readmitted to the Union. \n\n 16.4   The Collapse of Reconstruction \n\n The efforts launched by Radical Republicans in the late 1860s generated a massive backlash in the South in the 1870s as Whites fought against what they considered \u201cnegro misrule.\u201d Paramilitary terrorist cells emerged, committing countless atrocities in their effort to \u201credeem\u201d the South from Black Republican rule. In many cases, these organizations operated as an extension of the Democratic Party. Scandals hobbled the Republican Party, as did a severe economic depression. By 1875, Reconstruction had largely come to an end. The contested presidential election the following year, which was decided in favor of the Republican candidate, and the removal of federal troops from the South only confirmed the obvious: Reconstruction had failed to achieve its primary objective of creating an interracial democracy that provided equal rights to all citizens. ", "keyterm": "", "bname": "u.s._history"}, {"chapter": 35, "intro": " Chapter Outline 35.1   Neurons and Glial Cells 35.2   How Neurons Communicate 35.3   The Central Nervous System 35.4   The Peripheral Nervous System 35.5   Nervous System Disorders Introduction When you\u2019re reading this book, your nervous system is performing several functions simultaneously. The visual system is processing what is seen on the page; the motor system controls the turn of the pages (or click of the mouse); the prefrontal cortex maintains attention. Even fundamental functions, like breathing and regulation of body temperature, are controlled by the nervous system. A nervous system is an organism\u2019s control center: it processes sensory information from outside (and inside) the body and controls all behaviors\u2014from eating to sleeping to finding a mate. ", "chapter_text": "35.1   Neurons and Glial Cells Learning Objectives By the end of this section, you will be able to:\n\n List and describe the functions of the structural components of a neuron \n\n List and describe the four main types of neurons \n\n Compare the functions of different types of glial cells \n\n Nervous systems throughout the animal kingdom vary in structure and complexity, as illustrated by the variety of animals shown in  Figure 35.2 . Some organisms, like sea sponges, lack a true nervous system. Others, like jellyfish, lack a true brain and instead have a system of separate but connected nerve cells (neurons) called a \u201cnerve net.\u201d Echinoderms such as sea stars have nerve cells that are bundled into fibers called nerves. Flatworms of the phylum Platyhelminthes have both a central nervous system (CNS), made up of a small \u201cbrain\u201d and two nerve cords, and a peripheral nervous system (PNS) containing a system of nerves that extend throughout the body. The insect nervous system is more complex but also fairly decentralized. It contains a brain, ventral nerve cord, and ganglia (clusters of connected neurons). These ganglia can control movements and behaviors without input from the brain. Octopi may have the most complicated of invertebrate nervous systems\u2014they have neurons that are organized in specialized lobes and eyes that are structurally similar to vertebrate species. \n\n Compared to invertebrates, vertebrate nervous systems are more complex, centralized, and specialized. While there is great diversity among different vertebrate nervous systems, they all share a basic structure: a CNS that contains a brain and spinal cord and a PNS made up of peripheral sensory and motor nerves. One interesting difference between the nervous systems of invertebrates and vertebrates is that the nerve cords of many invertebrates are located ventrally whereas the vertebrate spinal cords are located dorsally. There is debate among evolutionary biologists as to whether these different nervous system plans evolved separately or whether the invertebrate body plan arrangement somehow \u201cflipped\u201d during the evolution of vertebrates. \n\n Link to Learning \n\n Watch this video of  biologist Mark Kirschner discussing the \u201cflipping\u201d phenomenon of vertebrate evolution.\n\n Click to view content \n\n The nervous system is made up of  neurons , specialized cells that can receive and transmit chemical or electrical signals, and  glia , cells that provide support functions for the neurons by playing an information processing role that is complementary to neurons. A neuron can be compared to an electrical wire\u2014it transmits a signal from one place to another. Glia can be compared to the workers at the electric company who make sure wires go to the right places, maintain the wires, and take down wires that are broken. Although glia have been compared to workers, recent evidence suggests that also usurp some of the signaling functions of neurons. \n\n There is great diversity in the types of neurons and glia that are present in different parts of the nervous system. There are four major types of neurons, and they share several important cellular components. \n\n Neurons \n\n The nervous system of the common laboratory fly,  Drosophila melanogaster , contains around 100,000 neurons, the same number as a lobster. This number compares to 75 million in the mouse and 300 million in the octopus. A human brain contains around 86 billion neurons. Despite these very different numbers, the nervous systems of these animals control many of the same behaviors\u2014from basic reflexes to more complicated behaviors like finding food and courting mates. The ability of neurons to communicate with each other as well as with other types of cells underlies all of these behaviors. \n\n Most neurons share the same cellular components. But neurons are also highly specialized\u2014different types of neurons have different sizes and shapes that relate to their functional roles. \n\n Parts of a Neuron \n\n Like other cells, each neuron has a cell body (or soma) that contains a nucleus, smooth and rough endoplasmic reticulum, Golgi apparatus, mitochondria, and other cellular components. Neurons also contain unique structures, illustrated in  Figure 35.3  for receiving and sending the electrical signals that make neuronal communication possible.  Dendrites  are tree-like structures that extend away from the cell body to receive messages from other neurons at specialized junctions called  synapses . Although some neurons do not have any dendrites, some types of neurons have multiple dendrites. Dendrites can have small protrusions called dendritic spines, which further increase surface area for possible synaptic connections. \n\n Once a signal is received by the dendrite, it then travels passively to the cell body. The cell body contains a specialized structure, the  axon hillock  that integrates signals from multiple synapses and serves as a junction between the cell body and an  axon . An axon is a tube-like structure that propagates the integrated signal to specialized endings called  axon terminals . These terminals in turn synapse on other neurons, muscle, or target organs. Chemicals released at axon terminals allow signals to be communicated to these other cells. Neurons usually have one or two axons, but some neurons, like amacrine cells in the retina, do not contain any axons. Some axons are covered with  myelin , which acts as an insulator to minimize dissipation of the electrical signal as it travels down the axon, greatly increasing the speed on conduction. This insulation is important as the axon from a human motor neuron can be as long as a meter\u2014from the base of the spine to the toes. The myelin sheath is not actually part of the neuron. Myelin is produced by glial cells. Along the axon there are periodic gaps in the myelin sheath. These gaps are called  nodes of Ranvier  and are sites where the signal is \u201crecharged\u201d as it travels along the axon. \n\n It is important to note that a single neuron does not act alone\u2014neuronal communication depends on the connections that neurons make with one another (as well as with other cells, like muscle cells). Dendrites from a single neuron may receive synaptic contact from many other neurons. For example, dendrites from a Purkinje cell in the cerebellum are thought to receive contact from as many as 200,000 other neurons. \n\n Visual Connection \n\n Which of the following statements is false? \n\n The soma is the cell body of a nerve cell. \n\n Myelin sheath provides an insulating layer to the dendrites. \n\n Axons carry the signal from the soma to the target. \n\n Dendrites carry the signal to the soma. \n\n Types of Neurons There are different types of neurons, and the functional role of a given neuron is intimately dependent on its structure. There is an amazing diversity of neuron shapes and sizes found in different parts of the nervous system (and across species), as illustrated by the neurons shown in  Figure 35.4 . \n\n While there are many defined neuron cell subtypes, neurons are broadly divided into four basic types: unipolar, bipolar, multipolar, and pseudounipolar.  Figure 35.5  illustrates these four basic neuron types. Unipolar neurons have only one structure that extends away from the soma. These neurons are not found in vertebrates but are found in insects where they stimulate muscles or glands. A bipolar neuron has one axon and one dendrite extending from the soma. An example of a bipolar neuron is a retinal bipolar cell, which receives signals from photoreceptor cells that are sensitive to light and transmits these signals to ganglion cells that carry the signal to the brain. Multipolar neurons are the most common type of neuron. Each multipolar neuron contains one axon and multiple dendrites. Multipolar neurons can be found in the central nervous system (brain and spinal cord). An example of a multipolar neuron is a Purkinje cell in the cerebellum, which has many branching dendrites but only one axon. Pseudounipolar cells share characteristics with both unipolar and bipolar cells. A pseudounipolar cell has a single process that extends from the soma, like a unipolar cell, but this process later branches into two distinct structures, like a bipolar cell. Most sensory neurons are pseudounipolar and have an axon that branches into two extensions: one connected to dendrites that receive sensory information and another that transmits this information to the spinal cord. \n\n Everyday Connection Neurogenesis \n\nAt one time, scientists believed that people were born with all the neurons they would ever have. Research performed during the last few decades indicates that neurogenesis, the birth of new neurons, continues into adulthood. Neurogenesis was first discovered in songbirds that produce new neurons while learning songs. For mammals, new neurons also play an important role in learning: about 1000 new neurons develop in the hippocampus (a brain structure involved in learning and memory) each day. While most of the new neurons will die, researchers found that an increase in the number of surviving new neurons in the hippocampus correlated with how well rats learned a new task. Interestingly, both exercise and some antidepressant medications also promote neurogenesis in the hippocampus. Stress has the opposite effect. While neurogenesis is quite limited compared to regeneration in other tissues, research in this area may lead to new treatments for disorders such as Alzheimer\u2019s, stroke, and epilepsy. \n\n How do scientists identify new neurons? A researcher can inject a compound called bromodeoxyuridine (BrdU) into the brain of an animal. While all cells will be exposed to BrdU, BrdU will only be incorporated into the DNA of newly generated cells that are in S phase. A technique called immunohistochemistry can be used to attach a fluorescent label to the incorporated BrdU, and a researcher can use fluorescent microscopy to visualize the presence of BrdU, and thus new neurons, in brain tissue.  Figure 35.6  is a micrograph which shows fluorescently labeled neurons in the hippocampus of a rat. \n\n Link to Learning \n\n This site  contains more information about neurogenesis, including an interactive laboratory simulation and a video that explains how BrdU labels new cells. \n\n Glia \n\n While glia are often thought of as the supporting cast of the nervous system, the number of glial cells in the brain actually outnumbers the number of neurons by a factor of ten. Neurons would be unable to function without the vital roles that are fulfilled by these glial cells. Glia guide developing neurons to their destinations, buffer ions and chemicals that would otherwise harm neurons, and provide myelin sheaths around axons. Scientists have recently discovered that they also play a role in responding to nerve activity and modulating communication between nerve cells. When glia do not function properly, the result can be disastrous\u2014most brain tumors are caused by mutations in glia. \n\n Types of Glia \n\n There are several different types of glia with different functions, two of which are shown in  Figure 35.7 .  Astrocytes , shown in  Figure 35.8 a  make contact with both capillaries and neurons in the CNS. They provide nutrients and other substances to neurons, regulate the concentrations of ions and chemicals in the extracellular fluid, and provide structural support for synapses. Astrocytes also form the blood-brain barrier\u2014a structure that blocks entrance of toxic substances into the brain. Astrocytes, in particular, have been shown through calcium imaging experiments to become active in response to nerve activity, transmit calcium waves between astrocytes, and modulate the activity of surrounding synapses.  Satellite glia  provide nutrients and structural support for neurons in the PNS.  Microglia  scavenge and degrade dead cells and protect the brain from invading microorganisms.  Oligodendrocytes , shown in  Figure 35.8 b  form myelin sheaths around axons in the CNS. One axon can be myelinated by several oligodendrocytes, and one oligodendrocyte can provide myelin for multiple neurons. This is distinctive from the PNS where a single  Schwann cell  provides myelin for only one axon as the entire Schwann cell surrounds the axon.  Radial glia  serve as scaffolds for developing neurons as they migrate to their end destinations.  Ependymal  cells line fluid-filled ventricles of the brain and the central canal of the spinal cord. They are involved in the production of cerebrospinal fluid, which serves as a cushion for the brain, moves the fluid between the spinal cord and the brain, and is a component for the choroid plexus. \n35.2   How Neurons Communicate Learning Objectives By the end of this section, you will be able to:\n\n Describe the basis of the resting membrane potential \n\n Explain the stages of an action potential and how action potentials are propagated \n\n Explain the similarities and differences between chemical and electrical synapses \n\n Describe long-term potentiation and long-term depression \n\n All functions performed by the nervous system\u2014from a simple motor reflex to more advanced functions like making a memory or a decision\u2014require neurons to communicate with one another. While humans use words and body language to communicate, neurons use electrical and chemical signals. Just like a person in a committee, one neuron usually receives and synthesizes messages from multiple other neurons before \u201cmaking the decision\u201d to send the message on to other neurons. \n\n Nerve Impulse Transmission within a Neuron \n\n For the nervous system to function, neurons must be able to send and receive signals. These signals are possible because each neuron has a charged cellular membrane (a voltage difference between the inside and the outside), and the charge of this membrane can change in response to neurotransmitter molecules released from other neurons and environmental stimuli. To understand how neurons communicate, one must first understand the basis of the baseline or \u2018resting\u2019 membrane charge. \n\n Neuronal Charged Membranes The lipid bilayer membrane that surrounds a neuron is impermeable to charged molecules or ions. To enter or exit the neuron, ions must pass through special proteins called ion channels that span the membrane. Ion channels have different configurations: open, closed, and inactive, as illustrated in  Figure 35.9 . Some ion channels need to be activated in order to open and allow ions to pass into or out of the cell. These ion channels are sensitive to the environment and can change their shape accordingly. Ion channels that change their structure in response to voltage changes are called voltage-gated ion channels. Voltage-gated ion channels regulate the relative concentrations of different ions inside and outside the cell. The difference in total charge between the inside and outside of the cell is called the  membrane potential . \n\n Link to Learning \n\n This video discusses the basis of the resting membrane potential.\n\n Click to view content \n\n Resting Membrane Potential A neuron at rest is negatively charged: the inside of a cell is approximately 70 millivolts more negative than the outside (\u221270 mV, note that this number varies by neuron type and by species). This voltage is called the resting membrane potential; it is caused by differences in the concentrations of ions inside and outside the cell. If the membrane were equally permeable to all ions, each type of ion would flow across the membrane and the system would reach equilibrium. Because ions cannot simply cross the membrane at will, there are different concentrations of several ions inside and outside the cell, as shown in  Table 35.1 . The difference in the number of positively charged potassium ions (K + ) inside and outside the cell dominates the resting membrane potential ( Figure 35.10 ). When the membrane is at rest, K +  ions accumulate inside the cell due to a net movement with the concentration gradient. The negative resting membrane potential is created and maintained by increasing the concentration of cations outside the cell (in the extracellular fluid) relative to inside the cell (in the cytoplasm). The negative charge within the cell is created by the cell membrane being more permeable to potassium ion movement than sodium ion movement. In neurons, potassium ions are maintained at high concentrations within the cell while sodium ions are maintained at high concentrations outside of the cell. The cell possesses potassium and sodium leakage channels that allow the two cations to diffuse down their concentration gradient. However, the neurons have far more potassium leakage channels than sodium leakage channels. Therefore, potassium diffuses out of the cell at a much faster rate than sodium leaks in. Because more cations are leaving the cell than are entering, this causes the interior of the cell to be negatively charged relative to the outside of the cell. The actions of the sodium potassium pump help to maintain the resting potential, once established. Recall that  sodium potassium pumps brings two K +  ions into the cell while removing three Na +  ions per ATP consumed. As more cations are expelled from the cell than taken in, the inside of the cell remains negatively charged relative to the extracellular fluid. It should be noted that chloride ions (Cl \u2013 ) tend to accumulate outside of the cell because they are repelled by negatively-charged proteins within the cytoplasm. \n\n Ion Concentration Inside and Outside Neurons \n\n Ion \n\n Extracellular concentration (mM) \n\n Intracellular concentration (mM) \n\n Ratio outside/inside \n\n Na + \n\n 145 \n\n 12 \n\n 12 \n\n K+ \n\n 4 \n\n 155 \n\n 0.026 \n\n Cl \u2212 \n\n 120 \n\n 4 \n\n 30 \n\n Organic anions (A\u2212) \n\n \u2014 \n\n 100 \n\n Table  35.1     The resting membrane potential is a result of different concentrations inside and outside the cell. \n\n Action Potential A neuron can receive input from other neurons and, if this input is strong enough, send the signal to downstream neurons. Transmission of a signal between neurons is generally carried by a chemical called a neurotransmitter. Transmission of a signal within a neuron (from dendrite to axon terminal) is carried by a brief reversal of the resting membrane potential called an  action potential . When neurotransmitter molecules bind to receptors located on a neuron\u2019s dendrites, ion channels open. At excitatory synapses, this opening allows positive ions to enter the neuron and results in  depolarization  of the membrane\u2014a decrease in the difference in voltage between the inside and outside of the neuron. A stimulus from a sensory cell or another neuron depolarizes the target neuron to  its threshold potential (-55 mV). Na +  channels in the axon hillock open, allowing positive ions to enter the cell ( Figure 35.10  and  Figure 35.11 ). Once the sodium channels open, the neuron completely depolarizes to a membrane potential of about +40 mV.  Action potentials are considered an \"all-or nothing\" event, in that, once the threshold potential is reached, the neuron always completely depolarizes. Once depolarization is complete, the cell must now \"reset\" its membrane voltage back to the resting potential. To accomplish this, the Na +  channels close and cannot be opened. This begins the neuron's  refractory period , in which it cannot produce another action potential because its sodium channels will not open. At the same time, voltage-gated K +  channels open, allowing K +  to leave the cell. As K +  ions leave the cell, the membrane potential once again becomes negative. The diffusion of K +  out of the cell actually  hyperpolarizes  the cell, in that the membrane potential becomes more negative than the cell's normal resting potential. At this point, the sodium channels will return to their resting state, meaning they are ready to open again if the membrane potential again  exceeds the threshold potential. Eventually the extra K +  ions diffuse out of the cell through the potassium leakage channels, bringing the cell from its hyperpolarized state, back to its resting membrane potential. \n\n Visual Connection \n\n  Potassium channel blockers, such as amiodarone and procainamide, which are used to treat abnormal electrical activity in the heart, called cardiac dysrhythmia, impede the movement of K +  through voltage-gated K +  channels. Which part of the action potential would you expect potassium channels to affect? \n\n Link to Learning \n\n This  video  presents an overview of action potential. \n\n Myelin and the Propagation of the Action Potential \n\n For an action potential to communicate information to another neuron, it must travel along the axon and reach the axon terminals where it can initiate neurotransmitter release. The speed of conduction of an action potential along an axon is influenced by both the diameter of the axon and the axon\u2019s resistance to current leak. Myelin acts as an insulator that prevents current from leaving the axon; this increases the speed of action potential conduction. In demyelinating diseases like multiple sclerosis, action potential conduction slows because current leaks from previously insulated axon areas. The nodes of Ranvier, illustrated in  Figure 35.13  are gaps in the myelin sheath along the axon. These unmyelinated spaces are about one micrometer long and contain voltage gated Na +  and K +  channels. Flow of ions through these channels, particularly the Na +  channels, regenerates the action potential over and over again along the axon. This \u2018jumping\u2019 of the action potential from one node to the next is called  saltatory conduction . If nodes of Ranvier were not present along an axon, the action potential would propagate very slowly since Na +  and K +  channels would have to continuously regenerate action potentials at every point along the axon instead of at specific points. Nodes of Ranvier also save energy for the neuron since the channels only need to be present at the nodes and not along the entire axon. \n\n Synaptic Transmission \n\n The synapse or \u201cgap\u201d is the place where information is transmitted from one neuron to another. Synapses usually form between axon terminals and dendritic spines, but this is not universally true. There are also axon-to-axon, dendrite-to-dendrite, and axon-to-cell body synapses. The neuron transmitting the signal is called the presynaptic neuron, and the neuron receiving the signal is called the postsynaptic neuron. Note that these designations are relative to a particular synapse\u2014most neurons are both presynaptic and postsynaptic. There are two types of synapses: chemical and electrical. \n\n Chemical Synapse When an action potential reaches the axon terminal it depolarizes the membrane and opens voltage-gated Na +  channels. Na +  ions enter the cell, further depolarizing the presynaptic membrane. This depolarization causes voltage-gated Ca 2+  channels to open. Calcium ions entering the cell initiate a signaling cascade that causes small membrane-bound vesicles, called  synaptic vesicles , containing neurotransmitter molecules to fuse with the presynaptic membrane. Synaptic vesicles are shown in  Figure 35.14 , which is an image from a scanning electron microscope. \n\n Fusion of a vesicle with the presynaptic membrane causes neurotransmitter to be released into the  synaptic cleft , the extracellular space between the presynaptic and postsynaptic membranes, as illustrated in  Figure 35.15 . The neurotransmitter diffuses across the synaptic cleft and binds to receptor proteins on the postsynaptic membrane. \n\n The binding of a specific neurotransmitter causes particular ion channels, in this case ligand-gated channels, on the postsynaptic membrane to open. Neurotransmitters can either have excitatory or inhibitory effects on the postsynaptic membrane, as detailed in  Table 35.1 . For example, when acetylcholine is released at the synapse between a nerve and muscle (called the neuromuscular junction) by a presynaptic neuron, it causes postsynaptic Na +  channels to open. Na +  enters the postsynaptic cell and causes the postsynaptic membrane to depolarize. This depolarization is called an  excitatory postsynaptic potential (EPSP)  and makes the postsynaptic neuron more likely to fire an action potential. Release of neurotransmitter at inhibitory synapses causes  inhibitory postsynaptic potentials (IPSPs) , a hyperpolarization of the presynaptic membrane. For example, when the neurotransmitter GABA (gamma-aminobutyric acid) is released from a presynaptic neuron, it binds to and opens Cl -  channels. Cl -  ions enter the cell and hyperpolarizes the membrane, making the neuron less likely to fire an action potential. \n\n Once neurotransmission has occurred, the neurotransmitter must be removed from the synaptic cleft so the postsynaptic membrane can \u201creset\u201d and be ready to receive another signal. This can be accomplished in three ways: the neurotransmitter can diffuse away from the synaptic cleft, it can be degraded by enzymes in the synaptic cleft, or it can be recycled (sometimes called reuptake) by the presynaptic neuron. Several drugs act at this step of neurotransmission. For example, some drugs that are given to Alzheimer\u2019s patients work by inhibiting acetylcholinesterase, the enzyme that degrades acetylcholine. This inhibition of the enzyme essentially increases neurotransmission at synapses that release acetylcholine. Once released, the acetylcholine stays in the cleft and can continually bind and unbind to postsynaptic receptors. \n\n Neurotransmitter Function and Location \n\n Neurotransmitter \n\n Example \n\n Location \n\n Acetylcholine \n\n \u2014 \n\n CNS and/or PNS \n\n Biogenic amine \n\n Dopamine, serotonin, norepinephrine \n\n CNS and/or PNS \n\n Amino acid \n\n Glycine, glutamate, aspartate, gamma aminobutyric acid \n\n CNS \n\n Neuropeptide \n\n Substance P, endorphins \n\n CNS and/or PNS \n\n Table  35.2     \n\n Electrical Synapse \n\n While electrical synapses are fewer in number than chemical synapses, they are found in all nervous systems and play important and unique roles. The mode of neurotransmission in electrical synapses is quite different from that in chemical synapses. In an electrical synapse, the presynaptic and postsynaptic membranes are very close together and are actually physically connected by channel proteins forming gap junctions. Gap junctions allow current to pass directly from one cell to the next. In addition to the ions that carry this current, other molecules, such as ATP, can diffuse through the large gap junction pores. \n\n There are key differences between chemical and electrical synapses. Because chemical synapses depend on the release of neurotransmitter molecules from synaptic vesicles to pass on their signal, there is an approximately one millisecond delay between when the axon potential reaches the presynaptic terminal and when the neurotransmitter leads to opening of postsynaptic ion channels. Additionally, this signaling is unidirectional. Signaling in electrical synapses, in contrast, is virtually instantaneous (which is important for synapses involved in key reflexes), and some electrical synapses are bidirectional. Electrical synapses are also more reliable as they are less likely to be blocked, and they are important for synchronizing the electrical activity of a group of neurons. For example, electrical synapses in the thalamus are thought to regulate slow-wave sleep, and disruption of these synapses can cause seizures. \n\n Signal Summation Sometimes a single EPSP is strong enough to induce an action potential in the postsynaptic neuron, but often multiple presynaptic inputs must create EPSPs around the same time for the postsynaptic neuron to be sufficiently depolarized to fire an action potential. This process is called  summation  and occurs at the axon hillock, as illustrated in  Figure 35.16 . Additionally, one neuron often has inputs from many presynaptic neurons\u2014some excitatory and some inhibitory\u2014so IPSPs can cancel out EPSPs and vice versa. It is the net change in postsynaptic membrane voltage that determines whether the postsynaptic cell has reached its threshold of excitation needed to fire an action potential. Together, synaptic summation and the threshold for excitation act as a filter so that random \u201cnoise\u201d in the system is not transmitted as important information. \n\n Everyday Connection Brain-computer interface \n\nAmyotrophic lateral sclerosis (ALS, also called Lou Gehrig\u2019s Disease) is a neurological disease characterized by the degeneration of the motor neurons that control voluntary movements. The disease begins with muscle weakening and lack of coordination and eventually destroys the neurons that control speech, breathing, and swallowing; in the end, the disease can lead to paralysis. At that point, patients require assistance from machines to be able to breathe and to communicate. Several special technologies have been developed to allow \u201clocked-in\u201d patients to communicate with the rest of the world. One technology, for example, allows patients to type out sentences by twitching their cheek. These sentences can then be read aloud by a computer. \n\n A relatively new line of research for helping paralyzed patients, including those with ALS, to communicate and retain a degree of self-sufficiency is called brain-computer interface (BCI) technology and is illustrated in  Figure 35.17 . This technology sounds like something out of science fiction: it allows paralyzed patients to control a computer using only their thoughts. There are several forms of BCI. Some forms use EEG recordings from electrodes taped onto the skull. These recordings contain information from large populations of neurons that can be decoded by a computer. Other forms of BCI require the implantation of an array of electrodes smaller than a postage stamp in the arm and hand area of the motor cortex. This form of BCI, while more invasive, is very powerful as each electrode can record actual action potentials from one or more neurons. These signals are then sent to a computer, which has been trained to decode the signal and feed it to a tool\u2014such as a cursor on a computer screen. This means that a patient with ALS can use e-mail, read the Internet, and communicate with others by thinking of moving his or her hand or arm (even though the paralyzed patient cannot make that bodily movement). Recent advances have allowed a paralyzed locked-in patient who suffered a stroke 15 years ago to control a robotic arm and even to feed herself coffee using BCI technology. \n\n Despite the amazing advancements in BCI technology, it also has limitations. The technology can require many hours of training and long periods of intense concentration for the patient; it can also require brain surgery to implant the devices. \n\n Link to Learning \n\n Watch  this video  in which a paralyzed woman use a brain-controlled robotic arm to bring a drink to her mouth, among other images of brain-computer interface technology in action.\n\n Click to view content \n\n Synaptic Plasticity \n\n Synapses are not static structures. They can be weakened or strengthened. They can be broken, and new synapses can be made. Synaptic plasticity allows for these changes, which are all needed for a functioning nervous system. In fact, synaptic plasticity is the basis of learning and memory. Two processes in particular, long-term potentiation (LTP) and long-term depression (LTD) are important forms of synaptic plasticity that occur in synapses in the hippocampus, a brain region that is involved in storing memories. \n\n Long-term Potentiation (LTP) \n\n Long-term potentiation (LTP)  is a persistent strengthening of a synaptic connection. LTP is based on the Hebbian principle: cells that fire together wire together. There are various mechanisms, none fully understood, behind the synaptic strengthening seen with LTP. One known mechanism involves a type of postsynaptic glutamate receptor, called NMDA (N-Methyl-D-aspartate) receptors, shown in  Figure 35.18 . These receptors are normally blocked by magnesium ions; however, when the postsynaptic neuron is depolarized by multiple presynaptic inputs in quick succession (either from one neuron or multiple neurons), the magnesium ions are forced out allowing Ca ions to pass into the postsynaptic cell. Next, Ca 2+  ions entering the cell initiate a signaling cascade that causes a different type of glutamate receptor, called AMPA (\u03b1-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid) receptors, to be inserted into the postsynaptic membrane, since activated AMPA receptors allow positive ions to enter the cell. So, the next time glutamate is released from the presynaptic membrane, it will have a larger excitatory effect (EPSP) on the postsynaptic cell because the binding of glutamate to these AMPA receptors will allow more positive ions into the cell. The insertion of additional AMPA receptors strengthens the synapse and means that the postsynaptic neuron is more likely to fire in response to presynaptic neurotransmitter release. Some drugs of abuse co-opt the LTP pathway, and this synaptic strengthening can lead to addiction. \n\n Long-term Depression (LTD) \n\n Long-term depression (LTD)  is essentially the reverse of LTP: it is a long-term weakening of a synaptic connection. One mechanism known to cause LTD also involves AMPA receptors. In this situation, calcium that enters through NMDA receptors initiates a different signaling cascade, which results in the removal of AMPA receptors from the postsynaptic membrane, as illustrated in  Figure 35.18 . The decrease in AMPA receptors in the membrane makes the postsynaptic neuron less responsive to glutamate released from the presynaptic neuron. While it may seem counterintuitive, LTD may be just as important for learning and memory as LTP. The weakening and pruning of unused synapses allows for unimportant connections to be lost and makes the synapses that have undergone LTP that much stronger by comparison. \n35.3   The Central Nervous System Learning Objectives By the end of this section, you will be able to:\n\n Identify the spinal cord, cerebral lobes, and other brain areas on a diagram of the brain \n\n Describe the basic functions of the spinal cord, cerebral lobes, and other brain areas \n\n The central nervous system (CNS) is made up of the brain, a part of which is shown in  Figure 35.19  and spinal cord and is covered with three layers of protective coverings called  meninges  (from the Greek word for membrane). The outermost layer is the  dura mater  (Latin for \u201chard mother\u201d). As the Latin suggests, the primary function for this thick layer is to protect the brain and spinal cord. The dura mater also contains vein-like structures that carry blood from the brain back to the heart. The middle layer is the web-like  arachnoid mater . The last layer is the  pia mater  (Latin for \u201csoft mother\u201d), which directly contacts and covers the brain and spinal cord like plastic wrap. The space between the arachnoid and pia maters is filled with  cerebrospinal fluid (CSF) . CSF is produced by a tissue called  choroid plexus  in fluid-filled compartments in the CNS called  ventricles . The brain floats in CSF, which acts as a cushion and shock absorber and makes the brain neutrally buoyant. CSF also functions to circulate chemical substances throughout the brain and into the spinal cord. \n\n The entire brain contains only about 8.5 tablespoons of CSF, but CSF is constantly produced in the ventricles. This creates a problem when a ventricle is blocked\u2014the CSF builds up and creates swelling and the brain is pushed against the skull. This swelling condition is called hydrocephalus (\u201cwater head\u201d) and can cause seizures, cognitive problems, and even death if a shunt is not inserted to remove the fluid and pressure. \n\n Brain \n\n The brain is the part of the central nervous system that is contained in the cranial cavity of the skull. It includes the cerebral cortex, limbic system, basal ganglia, thalamus, hypothalamus, and cerebellum. There are three different ways that a brain can be sectioned in order to view internal structures: a sagittal section cuts the brain left to right, as shown in  Figure 35.21 b , a coronal section cuts the brain front to back, as shown in  Figure 35.20 a , and a horizontal section cuts the brain top to bottom. Cerebral Cortex The outermost part of the brain is a thick piece of nervous system tissue called the  cerebral cortex , which is folded into hills called  gyri  (singular: gyrus) and valleys called  sulci  (singular: sulcus). The cortex is made up of two hemispheres\u2014right and left\u2014which are separated by a large sulcus. A thick fiber bundle called the  corpus callosum  (Latin: \u201ctough body\u201d) connects the two hemispheres and allows information to be passed from one side to the other. Although there are some brain functions that are localized more to one hemisphere than the other, the functions of the two hemispheres are largely redundant. In fact, sometimes (very rarely) an entire hemisphere is removed to treat severe epilepsy. While patients do suffer some deficits following the surgery, they can have surprisingly few problems, especially when the surgery is performed on children who have very immature nervous systems. \n\n In other surgeries to treat severe epilepsy, the corpus callosum is cut instead of removing an entire hemisphere. This causes a condition called split-brain, which gives insights into unique functions of the two hemispheres. For example, when an object is presented to patients\u2019 left visual field, they may be unable to verbally name the object (and may claim to not have seen an object at all). This is because the visual input from the left visual field crosses and enters the right hemisphere and cannot then signal to the speech center, which generally is found in the left side of the brain. Remarkably, if a split-brain patient is asked to pick up a specific object out of a group of objects with the left hand, the patient will be able to do so but will still be unable to vocally identify it. \n\n Link to Learning \n\n See  this website  to learn more about split-brain patients and to play a game where you can model the split-brain experiments yourself. \n\n Each cortical hemisphere contains regions called lobes that are involved in different functions. Scientists use various techniques to determine what brain areas are involved in different functions: they examine patients who have had injuries or diseases that affect specific areas and see how those areas are related to functional deficits. They also conduct animal studies where they stimulate brain areas and see if there are any behavioral changes. They use a technique called transmagnetic stimulation (TMS) to temporarily deactivate specific parts of the cortex using strong magnets placed outside the head; and they use functional magnetic resonance imaging (fMRI) to look at changes in oxygenated blood flow in particular brain regions that correlate with specific behavioral tasks. These techniques, and others, have given great insight into the functions of different brain regions but have also showed that any given brain area can be involved in more than one behavior or process, and any given behavior or process generally involves neurons in multiple brain areas. That being said, each hemisphere of the mammalian cerebral cortex can be broken down into four functionally and spatially defined lobes: frontal, parietal, temporal, and occipital.  Figure 35.21  illustrates these four lobes of the human cerebral cortex. \n\n The  frontal lobe  is located at the front of the brain, over the eyes. This lobe contains the olfactory bulb, which processes smells. The frontal lobe also contains the motor cortex, which is important for planning and implementing movement. Areas within the motor cortex map to different muscle groups, and there is some organization to this map, as shown in  Figure 35.22 . For example, the neurons that control movement of the fingers are next to the neurons that control movement of the hand. Neurons in the frontal lobe also control cognitive functions like maintaining attention, speech, and decision-making. Studies of humans who have damaged their frontal lobes show that parts of this area are involved in personality, socialization, and assessing risk. \n\n The  parietal   lobe  is located at the top of the brain. Neurons in the parietal lobe are involved in speech and also reading. Two of the parietal lobe\u2019s main functions are processing  somatosensation \u2014touch sensations like pressure, pain, heat, cold\u2014and processing  proprioception \u2014the sense of how parts of the body are oriented in space. The parietal lobe contains a somatosensory map of the body similar to the motor cortex. \n\n The  occipital   lobe  is located at the back of the brain. It is primarily involved in vision\u2014seeing, recognizing, and identifying the visual world. \n\n The  temporal   lobe  is located at the base of the brain by your ears and is primarily involved in processing and interpreting sounds. It also contains the  hippocampus  (Greek for \u201cseahorse\u201d)\u2014a structure that processes memory formation. The hippocampus is illustrated in  Figure 35.24 . The role of the hippocampus in memory was partially determined by studying one famous epileptic patient, HM, who had both sides of his hippocampus removed in an attempt to cure his epilepsy. His seizures went away, but he could no longer form new memories (although he could remember some facts from before his surgery and could learn new motor tasks). \n\n Evolution Connection Cerebral Cortex \n\nCompared to other vertebrates, mammals have exceptionally large brains for their body size. An entire alligator\u2019s brain, for example, would fill about one and a half teaspoons. This increase in brain to body size ratio is especially pronounced in apes, whales, and dolphins. While this increase in overall brain size doubtlessly played a role in the evolution of complex behaviors unique to mammals, it does not tell the whole story. Scientists have found a relationship between the relatively high surface area of the cortex and the intelligence and complex social behaviors exhibited by some mammals. This increased surface area is due, in part, to increased folding of the cortical sheet (more sulci and gyri). For example, a rat cortex is very smooth with very few sulci and gyri. Cat and sheep cortices have more sulci and gyri. Chimps, humans, and dolphins have even more. \n\n Basal Ganglia \n\n Interconnected brain areas called the  basal ganglia  (or  basal nuclei ), shown in  Figure 35.20 b , play important roles in movement control and posture. Damage to the basal ganglia, as in Parkinson\u2019s disease, leads to motor impairments like a shuffling gait when walking. The basal ganglia also regulate motivation. For example, when a wasp sting led to bilateral basal ganglia damage in a 25-year-old businessman, he began to spend all his days in bed and showed no interest in anything or anybody. But when he was externally stimulated\u2014as when someone asked to play a card game with him\u2014he was able to function normally. Interestingly, he and other similar patients do not report feeling bored or frustrated by their state. \n\n Thalamus \n\n The  thalamus  (Greek for \u201cinner chamber\u201d), illustrated in  Figure 35.24 , acts as a gateway to and from the cortex. It receives sensory and motor inputs from the body and also receives feedback from the cortex. This feedback mechanism can modulate conscious awareness of sensory and motor inputs depending on the attention and arousal state of the animal. The thalamus helps regulate consciousness, arousal, and sleep states. A rare genetic disorder called fatal familial insomnia causes the degeneration of thalamic neurons and glia. This disorder prevents affected patients from being able to sleep, among other symptoms, and is eventually fatal. \n\n Hypothalamus \n\n Below the thalamus is the  hypothalamus , shown in  Figure 35.24 . The hypothalamus controls the endocrine system by sending signals to the pituitary gland, a pea-sized endocrine gland that releases several different hormones that affect other glands as well as other cells. This relationship means that the hypothalamus regulates important behaviors that are controlled by these hormones. The hypothalamus is the body\u2019s thermostat\u2014it makes sure key functions like food and water intake, energy expenditure, and body temperature are kept at appropriate levels. Neurons within the hypothalamus also regulate circadian rhythms, sometimes called sleep cycles. \n\n Limbic System \n\n The  limbic system  is a connected set of structures that regulates emotion, as well as behaviors related to fear and motivation. It plays a role in memory formation and includes parts of the thalamus and hypothalamus as well as the hippocampus. One important structure within the limbic system is a temporal lobe structure called the  amygdala  (Greek for \u201calmond\u201d), illustrated in  Figure 35.24 . The two amygdala are important both for the sensation of fear and for recognizing fearful faces. The  cingulate gyrus  helps regulate emotions and pain. \n\n Cerebellum \n\n The  cerebellum  (Latin for \u201clittle brain\u201d), shown in  Figure 35.21 , sits at the base of the brain on top of the brainstem. The cerebellum controls balance and aids in coordinating movement and learning new motor tasks. \n\n Brainstem \n\n The  brainstem , illustrated in  Figure 35.21 , connects the rest of the brain with the spinal cord. It consists of the midbrain, medulla oblongata, and the pons. Motor and sensory neurons extend through the brainstem allowing for the relay of signals between the brain and spinal cord. Ascending neural pathways cross in this section of the brain allowing the left hemisphere of the cerebrum to control the right side of the body and vice versa. The brainstem coordinates motor control signals sent from the brain to the body. The brainstem controls several important functions of the body including alertness, arousal, breathing, blood pressure, digestion, heart rate, swallowing, walking, and sensory and motor information integration. \n\n Spinal Cord \n\n Connecting to the brainstem and extending down the body through the spinal column is the  spinal cord , shown in  Figure 35.21 . The spinal cord is a thick bundle of nerve tissue that carries information about the body to the brain and from the brain to the body. The spinal cord is contained within the bones of the vertebrate column but is able to communicate signals to and from the body through its connections with spinal nerves (part of the peripheral nervous system). A cross-section of the spinal cord looks like a white oval containing a gray butterfly-shape, as illustrated in  Figure 35.25 . Myelinated axons make up the \u201cwhite matter\u201d and neuron and glial cell bodies make up the \u201cgray matter.\u201d Gray matter is also composed of interneurons, which connect two neurons each located in different parts of the body. Axons and cell bodies in the dorsal (facing the back of the animal) spinal cord convey mostly sensory information from the body to the brain. Axons and cell bodies in the ventral (facing the front of the animal) spinal cord primarily transmit signals controlling movement from the brain to the body. The spinal cord also controls motor reflexes. These reflexes are quick, unconscious movements\u2014like automatically removing a hand from a hot object. Reflexes are so fast because they involve local synaptic connections. For example, the knee reflex that a doctor tests during a routine physical is controlled by a single synapse between a sensory neuron and a motor neuron. While a reflex may only require the involvement of one or two synapses, synapses with interneurons in the spinal column transmit information to the brain to convey what happened (the knee jerked, or the hand was hot). \n\n In the United States, there around 10,000 spinal cord injuries each year. Because the spinal cord is the information superhighway connecting the brain with the body, damage to the spinal cord can lead to paralysis. The extent of the paralysis depends on the location of the injury along the spinal cord and whether the spinal cord was completely severed. For example, if the spinal cord is damaged at the level of the neck, it can cause paralysis from the neck down, whereas damage to the spinal column further down may limit paralysis to the legs. Spinal cord injuries are notoriously difficult to treat because spinal nerves do not regenerate, although ongoing research suggests that stem cell transplants may be able to act as a bridge to reconnect severed nerves. Researchers are also looking at ways to prevent the inflammation that worsens nerve damage after injury. One such treatment is to pump the body with cold saline to induce hypothermia. This cooling can prevent swelling and other processes that are thought to worsen spinal cord injuries. \n35.4   The Peripheral Nervous System Learning Objectives By the end of this section, you will be able to:\n\n Describe the organization and functions of the sympathetic and parasympathetic nervous systems \n\n Describe the organization and function of the sensory-somatic nervous system \n\n The peripheral nervous system (PNS) is the connection between the central nervous system and the rest of the body. The CNS is like the power plant of the nervous system. It creates the signals that control the functions of the body. The PNS is like the wires that go to individual houses. Without those \u201cwires,\u201d the signals produced by the CNS could not control the body (and the CNS would not be able to receive sensory information from the body either). \n\n The PNS can be broken down into the  autonomic nervous system , which controls bodily functions without conscious control, and the  sensory-somatic nervous system , which transmits sensory information from the skin, muscles, and sensory organs to the CNS and sends motor commands from the CNS to the muscles. \n\n Autonomic Nervous System \n\n Visual Connection \n\n  Which of the following statements is false? \n\n The parasympathetic pathway is responsible for resting the body, while the sympathetic pathway is responsible for preparing for an emergency. \n\n Most preganglionic neurons in the sympathetic pathway originate in the spinal cord. \n\n Slowing of the heartbeat is a parasympathetic response. \n\n Parasympathetic neurons are responsible for releasing norepinephrine on the target organ, while sympathetic neurons are responsible for releasing acetylcholine. \n\n The autonomic nervous system serves as the relay between the CNS and the internal organs. It controls the lungs, the heart, smooth muscle, and exocrine and endocrine glands. The autonomic nervous system controls these organs largely without conscious control; it can continuously monitor the conditions of these different systems and implement changes as needed. Signaling to the target tissue usually involves two synapses: a preganglionic neuron (originating in the CNS) synapses to a neuron in a ganglion that, in turn, synapses on the target organ, as illustrated in  Figure 35.26 . There are two divisions of the autonomic nervous system that often have opposing effects: the sympathetic nervous system and the parasympathetic nervous system. \n\n Sympathetic Nervous System \n\n The  sympathetic nervous system  is responsible for the \u201cfight or flight\u201d response that occurs when an animal encounters a dangerous situation. One way to remember this is to think of the surprise a person feels when encountering a snake (\u201csnake\u201d and \u201csympathetic\u201d both begin with \u201cs\u201d). Examples of functions controlled by the sympathetic nervous system include an accelerated heart rate and inhibited digestion. These functions help prepare an organism\u2019s body for the physical strain required to escape a potentially dangerous situation or to fend off a predator. \n\n Most preganglionic neurons in the sympathetic nervous system originate in the spinal cord, as illustrated in  Figure 35.27 . The axons of these neurons release  acetylcholine  on postganglionic neurons within sympathetic ganglia (the sympathetic ganglia form a chain that extends alongside the spinal cord). The acetylcholine activates the postganglionic neurons. Postganglionic neurons then release  norepinephrine  onto target organs. As anyone who has ever felt a rush before a big test, speech, or athletic event can attest, the effects of the sympathetic nervous system are quite pervasive. This is both because one preganglionic neuron synapses on multiple postganglionic neurons, amplifying the effect of the original synapse, and because the adrenal gland also releases norepinephrine (and the closely related hormone epinephrine) into the blood stream. The physiological effects of this norepinephrine release include dilating the trachea and bronchi (making it easier for the animal to breathe), increasing heart rate, and moving blood from the skin to the heart, muscles, and brain (so the animal can think and run). The strength and speed of the sympathetic response helps an organism avoid danger, and scientists have found evidence that it may also increase LTP\u2014allowing the animal to remember the dangerous situation and avoid it in the future. \n\n Parasympathetic Nervous System \n\n While the sympathetic nervous system is activated in stressful situations, the  parasympathetic nervous system  allows an animal to \u201crest and digest.\u201d One way to remember this is to think that during a restful situation like a picnic, the parasympathetic nervous system is in control (\u201cpicnic\u201d and \u201cparasympathetic\u201d both start with \u201cp\u201d). Parasympathetic preganglionic neurons have cell bodies located in the brainstem and in the sacral (toward the bottom) spinal cord, as shown in  Figure 35.27 . The axons of the preganglionic neurons release acetylcholine on the postganglionic neurons, which are generally located very near the target organs. Most postganglionic neurons release acetylcholine onto target organs, although some release nitric oxide. \n\n The parasympathetic nervous system resets organ function after the sympathetic nervous system is activated (the common adrenaline dump you feel after a \u2018fight-or-flight\u2019 event). Effects of acetylcholine release on target organs include slowing of heart rate, lowered blood pressure, and stimulation of digestion. \n\n Sensory-Somatic Nervous System \n\n The sensory-somatic nervous system is made up of cranial and spinal nerves and contains both sensory and motor neurons. Sensory neurons transmit sensory information from the skin, skeletal muscle, and sensory organs to the CNS. Motor neurons transmit messages about desired movement from the CNS to the muscles to make them contract. Without its sensory-somatic nervous system, an animal would be unable to process any information about its environment (what it sees, feels, hears, and so on) and could not control motor movements. Unlike the autonomic nervous system, which has two synapses between the CNS and the target organ, sensory and motor neurons have only one synapse\u2014one ending of the neuron is at the organ and the other directly contacts a CNS neuron. Acetylcholine is the main neurotransmitter released at these synapses. \n\n Humans have 12  cranial nerves , nerves that emerge from or enter the skull (cranium), as opposed to the spinal nerves, which emerge from the vertebral column. Each cranial nerve is accorded a name, which are detailed in  Figure 35.28 . Some cranial nerves transmit only sensory information. For example, the olfactory nerve transmits information about smells from the nose to the brainstem. Other cranial nerves transmit almost solely motor information. For example, the oculomotor nerve controls the opening and closing of the eyelid and some eye movements. Other cranial nerves contain a mix of sensory and motor fibers. For example, the glossopharyngeal nerve has a role in both taste (sensory) and swallowing (motor). \n\n Spinal nerves  transmit sensory and motor information between the spinal cord and the rest of the body. Each of the 31 spinal nerves (in humans) contains both sensory and motor axons. The sensory neuron cell bodies are grouped in structures called dorsal root ganglia and are shown in  Figure 35.29 . Each sensory neuron has one projection\u2014with a sensory receptor ending in skin, muscle, or sensory organs\u2014and another that synapses with a neuron in the dorsal spinal cord. Motor neurons have cell bodies in the ventral gray matter of the spinal cord that project to muscle through the ventral root. These neurons are usually stimulated by interneurons within the spinal cord but are sometimes directly stimulated by sensory neurons. \n35.5   Nervous System Disorders Learning Objectives By the end of this section, you will be able to:\n\n Describe the symptoms, potential causes, and treatment of several examples of nervous system disorders \n\n A nervous system that functions correctly is a fantastically complex, well-oiled machine\u2014synapses fire appropriately, muscles move when needed, memories are formed and stored, and emotions are well regulated. Unfortunately, each year millions of people in the United States deal with some sort of nervous system disorder. While scientists have discovered potential causes of many of these diseases, and viable treatments for some, ongoing research seeks to find ways to better prevent and treat all of these disorders. \n\n Neurodegenerative Disorders \n\n Neurodegenerative disorders  are illnesses characterized by a loss of nervous system functioning that are usually caused by neuronal death. These diseases generally worsen over time as more and more neurons die. The symptoms of a particular neurodegenerative disease are related to where in the nervous system the death of neurons occurs. Spinocerebellar ataxia, for example, leads to neuronal death in the cerebellum. The death of these neurons causes problems in balance and walking. Neurodegenerative disorders include Huntington\u2019s disease, amyotrophic lateral sclerosis, Alzheimer\u2019s disease and other types of dementia disorders, and Parkinson\u2019s disease. Here, Alzheimer\u2019s and Parkinson\u2019s disease will be discussed in more depth. \n\n Alzheimer\u2019s Disease \n\n Alzheimer\u2019s disease  is the most common cause of dementia in the elderly. In 2012, an estimated 5.4 million Americans suffered from Alzheimer\u2019s disease, and payments for their care are estimated at $200 billion. Roughly one in every eight people age 65 or older has the disease. Due to the aging of the baby-boomer generation, there are projected to be as many as 13 million Alzheimer\u2019s patients in the United States in the year 2050. \n\n Symptoms of Alzheimer\u2019s disease include disruptive memory loss, confusion about time or place, difficulty planning or executing tasks, poor judgment, and personality changes. Problems smelling certain scents can also be indicative of Alzheimer\u2019s disease and may serve as an early warning sign. Many of these symptoms are also common in people who are aging normally, so it is the severity and longevity of the symptoms that determine whether a person is suffering from Alzheimer\u2019s. \n\n Alzheimer\u2019s disease was named for Alois Alzheimer, a German psychiatrist who published a report in 1911 about a woman who showed severe dementia symptoms. Along with his colleagues, he examined the woman\u2019s brain following her death and reported the presence of abnormal clumps, which are now called amyloid plaques, along with tangled brain fibers called neurofibrillary tangles. Amyloid plaques, neurofibrillary tangles, and an overall shrinking of brain volume are commonly seen in the brains of Alzheimer\u2019s patients. Loss of neurons in the hippocampus is especially severe in advanced Alzheimer\u2019s patients.  Figure 35.30  compares a normal brain to the brain of an Alzheimer\u2019s patient. Many research groups are examining the causes of these hallmarks of the disease. \n\n One form of the disease is usually caused by mutations in one of three known genes. This rare form of early onset Alzheimer\u2019s disease affects fewer than five percent of patients with the disease and causes dementia beginning between the ages of 30 and 60. The more prevalent, late-onset form of the disease likely also has a genetic component. One particular gene, apolipoprotein E (APOE) has a variant (E4) that increases a carrier\u2019s likelihood of getting the disease. Many other genes have been identified that might be involved in the pathology. \n\n Link to Learning \n\n Visit  this website  for video links discussing genetics and Alzheimer\u2019s disease. \n\n Unfortunately, there is no cure for Alzheimer\u2019s disease. Current treatments focus on managing the symptoms of the disease. Because decrease in the activity of cholinergic neurons (neurons that use the neurotransmitter acetylcholine) is common in Alzheimer\u2019s disease, several drugs used to treat the disease work by increasing acetylcholine neurotransmission, often by inhibiting the enzyme that breaks down acetylcholine in the synaptic cleft. Other clinical interventions focus on behavioral therapies like psychotherapy, sensory therapy, and cognitive exercises. Since Alzheimer\u2019s disease appears to hijack the normal aging process, research into prevention is prevalent. Smoking, obesity, and cardiovascular problems may be risk factors for the disease, so treatments for those may also help to prevent Alzheimer\u2019s disease. Some studies have shown that people who remain intellectually active by playing games, reading, playing musical instruments, and being socially active in later life have a reduced risk of developing the disease. \n\n Parkinson\u2019s Disease \n\n Like Alzheimer\u2019s disease,  Parkinson\u2019s disease  is a neurodegenerative disease. It was first characterized by James Parkinson in 1817. Each year, 50,000-60,000 people in the United States are diagnosed with the disease. Parkinson\u2019s disease causes the loss of dopamine neurons in the substantia nigra, a midbrain structure that regulates movement. Loss of these neurons causes many symptoms including tremor (shaking of fingers or a limb), slowed movement, speech changes, balance and posture problems, and rigid muscles. The combination of these symptoms often causes a characteristic slow hunched shuffling walk, illustrated in  Figure 35.31 . Patients with Parkinson\u2019s disease can also exhibit psychological symptoms, such as dementia or emotional problems. \n\n Although some patients have a form of the disease known to be caused by a single mutation, for most patients the exact causes of Parkinson\u2019s disease remain unknown: the disease likely results from a combination of genetic and environmental factors (similar to Alzheimer\u2019s disease). Post-mortem analysis of brains from Parkinson\u2019s patients shows the presence of Lewy bodies\u2014abnormal protein clumps\u2014in dopaminergic neurons. The prevalence of these Lewy bodies often correlates with the severity of the disease. \n\n There is no cure for Parkinson\u2019s disease, and treatment is focused on easing symptoms. One of the most commonly prescribed drugs for Parkinson\u2019s is L-DOPA, which is a chemical that is converted into dopamine by neurons in the brain. This conversion increases the overall level of dopamine neurotransmission and can help compensate for the loss of dopaminergic neurons in the substantia nigra. Other drugs work by inhibiting the enzyme that breaks down dopamine. \n\n Neurodevelopmental Disorders \n\n Neurodevelopmental disorders occur when the development of the nervous system is disturbed. There are several different classes of neurodevelopmental disorders. Some, like Down Syndrome, cause intellectual deficits. Others specifically affect communication, learning, or the motor system. Some disorders like autism spectrum disorder and attention deficit/hyperactivity disorder have complex symptoms. \n\n Autism \n\n Autism spectrum disorder (ASD)  is a neurodevelopmental disorder. Its severity differs from person to person. Estimates for the prevalence of the disorder have changed rapidly in the past few decades. Current estimates suggest that one in 88 children will develop the disorder. ASD is four times more prevalent in males than females. Link to Learning \n\n This video  discusses possible reasons why there has been a recent increase in the number of people diagnosed with autism. \n\n A characteristic symptom of ASD is impaired social skills. Children with autism may have difficulty making and maintaining eye contact and reading social cues. They also may have problems feeling empathy for others. Other symptoms of ASD include repetitive motor behaviors (such as rocking back and forth), preoccupation with specific subjects, strict adherence to certain rituals, and unusual language use. Up to 30 percent of patients with ASD develop epilepsy, and patients with some forms of the disorder (like Fragile X) also have intellectual disability. Because it is a spectrum disorder, other ASD patients are very functional and have good-to-excellent language skills. Many of these patients do not feel that they suffer from a disorder and instead think that their brains just process information differently. \n\n Except for some well-characterized, clearly genetic forms of autism (like Fragile X and Rett\u2019s Syndrome), the causes of ASD are largely unknown. Variants of several genes correlate with the presence of ASD, but for any given patient, many different mutations in different genes may be required for the disease to develop. At a general level, ASD is thought to be a disease of \u201cincorrect\u201d wiring. Accordingly, brains of some ASD patients lack the same level of synaptic pruning that occurs in non-affected people. In the 1990s, a research paper linked autism to a common vaccine given to children. This paper was retracted when it was discovered that the author falsified data, and follow-up studies showed no connection between vaccines and autism. \n\n Treatment for autism usually combines behavioral therapies and interventions, along with medications to treat other disorders common to people with autism (depression, anxiety, obsessive compulsive disorder). Although early interventions can help mitigate the effects of the disease, there is currently no cure for ASD. \n\n Attention Deficit Hyperactivity Disorder (ADHD) Approximately three to five percent of children and adults are affected by  attention deficit/hyperactivity disorder (ADHD) . Like ASD, ADHD is more prevalent in males than females. Symptoms of the disorder include inattention (lack of focus), executive functioning difficulties, impulsivity, and hyperactivity beyond what is characteristic of the normal developmental stage. Some patients do not have the hyperactive component of symptoms and are diagnosed with a subtype of ADHD: attention deficit disorder (ADD). Many people with ADHD also show comorbitity, in that they develop secondary disorders in addition to ADHD. Examples include depression or obsessive compulsive disorder (OCD).  Figure 35.32  provides some statistics concerning comorbidity with ADHD. The cause of ADHD is unknown, although research points to a delay and dysfunction in the development of the prefrontal cortex and disturbances in neurotransmission. According to studies of twins, the disorder has a strong genetic component. There are several candidate genes that may contribute to the disorder, but no definitive links have been discovered. Environmental factors, including exposure to certain pesticides, may also contribute to the development of ADHD in some patients. Treatment for ADHD often involves behavioral therapies and the prescription of stimulant medications, which paradoxically cause a calming effect in these patients. \n\n Career Connection Neurologist \n\nNeurologists are physicians who specialize in disorders of the nervous system. They diagnose and treat disorders such as epilepsy, stroke, dementia, nervous system injuries, Parkinson\u2019s disease, sleep disorders, and multiple sclerosis. Neurologists are medical doctors who have attended college, medical school, and completed three to four years of neurology residency. \n\n When examining a new patient, a neurologist takes a full medical history and performs a complete physical exam. The physical exam contains specific tasks that are used to determine what areas of the brain, spinal cord, or peripheral nervous system may be damaged. For example, to check whether the hypoglossal nerve is functioning correctly, the neurologist will ask the patient to move his or her tongue in different ways. If the patient does not have full control over tongue movements, then the hypoglossal nerve may be damaged or there may be a lesion in the brainstem where the cell bodies of these neurons reside (or there could be damage to the tongue muscle itself). \n\n Neurologists have other tools besides a physical exam they can use to diagnose particular problems in the nervous system. If the patient has had a seizure, for example, the neurologist can use electroencephalography (EEG), which involves taping electrodes to the scalp to record brain activity, to try to determine which brain regions are involved in the seizure. In suspected stroke patients, a neurologist can use a computerized tomography (CT) scan, which is a type of X-ray, to look for bleeding in the brain or a possible brain tumor. To treat patients with neurological problems, neurologists can prescribe medications or refer the patient to a neurosurgeon for surgery. \n\n Link to Learning \n\n This website  allows you to see the different tests a neurologist might use to see what regions of the nervous system may be damaged in a patient. \n\n Mental Illnesses \n\n Mental illnesses are nervous system disorders that result in problems with thinking, mood, or relating with other people. These disorders are severe enough to affect a person\u2019s quality of life and often make it difficult for people to perform the routine tasks of daily living. Debilitating mental disorders plague approximately 12.5 million Americans (about 1 in 17 people) at an annual cost of more than $300 billion. There are several types of mental disorders including schizophrenia, major depression, bipolar disorder, anxiety disorders and phobias, post-traumatic stress disorders, and obsessive-compulsive disorder (OCD), among others. The American Psychiatric Association publishes the Diagnostic and Statistical Manual of Mental Disorders (or DSM), which describes the symptoms required for a patient to be diagnosed with a particular mental disorder. Each newly released version of the DSM contains different symptoms and classifications as scientists learn more about these disorders, their causes, and how they relate to each other. A more detailed discussion of two mental illnesses\u2014schizophrenia and major depression\u2014is given below. \n\n Schizophrenia \n\n Schizophrenia  is a serious and often debilitating mental illness affecting one percent of people in the United States. Symptoms of the disease include the inability to differentiate between reality and imagination, inappropriate and unregulated emotional responses, difficulty thinking, and problems with social situations. People with schizophrenia can suffer from hallucinations and hear voices; they may also suffer from delusions. Patients also have so-called \u201cnegative\u201d symptoms like a flattened emotional state, loss of pleasure, and loss of basic drives. Many schizophrenic patients are diagnosed in their late adolescence or early 20s. The development of schizophrenia is thought to involve malfunctioning dopaminergic neurons and may also involve problems with glutamate signaling. Treatment for the disease usually requires antipsychotic medications that work by blocking dopamine receptors and decreasing dopamine neurotransmission in the brain. This decrease in dopamine can cause Parkinson\u2019s disease-like symptoms in some patients. While some classes of antipsychotics can be quite effective at treating the disease, they are not a cure, and most patients must remain medicated for the rest of their lives. \n\n Depression \n\n Major depression  affects approximately 6.7 percent of the adults in the United States each year and is one of the most common mental disorders. To be diagnosed with major depressive disorder, a person must have experienced a severely depressed mood lasting longer than two weeks along with other symptoms including a loss of enjoyment in activities that were previously enjoyed, changes in appetite and sleep schedules, difficulty concentrating, feelings of worthlessness, and suicidal thoughts. The exact causes of major depression are unknown and likely include both genetic and environmental risk factors. Some research supports the \u201cclassic monoamine hypothesis,\u201d which suggests that depression is caused by a decrease in norepinephrine and serotonin neurotransmission. One argument against this hypothesis is the fact that some antidepressant medications cause an increase in norepinephrine and serotonin release within a few hours of beginning treatment\u2014but clinical results of these medications are not seen until weeks later. This has led to alternative hypotheses: for example, dopamine may also be decreased in depressed patients, or it may actually be an increase in norepinephrine and serotonin that causes the disease, and antidepressants force a feedback loop that decreases this release. Treatments for depression include psychotherapy, electroconvulsive therapy, deep-brain stimulation, and prescription medications. There are several classes of antidepressant medications that work through different mechanisms. For example, monoamine oxidase inhibitors (MAO inhibitors) block the enzyme that degrades many neurotransmitters (including dopamine, serotonin, norepinephrine), resulting in increased neurotransmitter in the synaptic cleft. Selective serotonin reuptake inhibitors (SSRIs) block the reuptake of serotonin into the presynaptic neuron. This blockage results in an increase in serotonin in the synaptic cleft. Other types of drugs such as norepinephrine-dopamine reuptake inhibitors and norepinephrine-serotonin reuptake inhibitors are also used to treat depression. \n\n Other Neurological Disorders \n\n There are several other neurological disorders that cannot be easily placed in the above categories. These include chronic pain conditions, cancers of the nervous system, epilepsy disorders, and stroke. Epilepsy and stroke are discussed below. \n\n Epilepsy \n\n Estimates suggest that up to three percent of people in the United States will be diagnosed with  epilepsy  in their lifetime. While there are several different types of epilepsy, all are characterized by recurrent seizures. Epilepsy itself can be a symptom of a brain injury, disease, or other illness. For example, people who have intellectual disability or ASD can experience seizures, presumably because the developmental wiring malfunctions that caused their disorders also put them at risk for epilepsy. For many patients, however, the cause of their epilepsy is never identified and is likely to be a combination of genetic and environmental factors. Often, seizures can be controlled with anticonvulsant medications. However, for very severe cases, patients may undergo brain surgery to remove the brain area where seizures originate. \n\n Stroke \n\n A stroke results when blood fails to reach a portion of the brain for a long enough time to cause damage. Without the oxygen supplied by blood flow, neurons in this brain region die. This neuronal death can cause many different symptoms\u2014depending on the brain area affected\u2014 including headache, muscle weakness or paralysis, speech disturbances, sensory problems, memory loss, and confusion. Stroke is often caused by blood clots and can also be caused by the bursting of a weak blood vessel. Strokes are extremely common and are the third most common cause of death in the United States. On average one person experiences a stroke every 40 seconds in the United States. Approximately 75 percent of strokes occur in people older than 65. Risk factors for stroke include high blood pressure, diabetes, high cholesterol, and a family history of stroke. Smoking doubles the risk of stroke. Because a stroke is a medical emergency, patients with symptoms of a stroke should immediately go to the emergency room, where they can receive drugs that will dissolve any clot that may have formed. These drugs will not work if the stroke was caused by a burst blood vessel or if the stroke occurred more than three hours before arriving at the hospital. Treatment following a stroke can include blood pressure medication (to prevent future strokes) and (sometimes intense) physical therapy. ", "questions": [{"question": {"question_id": "fs-idp144948560", "question_text": "Neurons contain ________, which can receive signals from other neurons.", "question_choices": ["axons", "mitochondria", "dendrites", "Golgi bodies"], "cloze_format": "Neurons contain ________, which can receive signals from other neurons.", "normal_format": "What Neurons contain which allow them to receive signals from other neurons?"}, "answer": {"ans_text": "dendrites", "ans_choice": 2}, "bloom": null, "hl_sentences": "Dendrites from a single neuron may receive synaptic contact from many other neurons . Dendrites are tree-like structures that extend away from the cell body to receive messages from other neurons at specialized junctions called synapses .", "hl_context": "It is important to note that a single neuron does not act alone \u2014 neuronal communication depends on the connections that neurons make with one another ( as well as with other cells , like muscle cells ) . <hl> Dendrites from a single neuron may receive synaptic contact from many other neurons . <hl> For example , dendrites from a Purkinje cell in the cerebellum are thought to receive contact from as many as 200,000 other neurons . Like other cells , each neuron has a cell body ( or soma ) that contains a nucleus , smooth and rough endoplasmic reticulum , Golgi apparatus , mitochondria , and other cellular components . Neurons also contain unique structures , illustrated in Figure 35.3 for receiving and sending the electrical signals that make neuronal communication possible . <hl> Dendrites are tree-like structures that extend away from the cell body to receive messages from other neurons at specialized junctions called synapses . <hl> Although some neurons do not have any dendrites , some types of neurons have multiple dendrites . Dendrites can have small protrusions called dendritic spines , which further increase surface area for possible synaptic connections ."}, {"question": {"question_id": "fs-idp105367408", "question_text": "A(n) ________ neuron has one axon and one dendrite extending directly from the cell body.", "question_choices": ["unipolar", "bipolar", "multipolar", "pseudounipolar"], "cloze_format": "A(n) ________ neuron has one axon and one dendrite extending directly from the cell body.", "normal_format": "Which neuron has one axon and one dendrite extending directly from the cell body?"}, "answer": {"ans_text": "bipolar", "ans_choice": 1}, "bloom": null, "hl_sentences": "A bipolar neuron has one axon and one dendrite extending from the soma .", "hl_context": "While there are many defined neuron cell subtypes , neurons are broadly divided into four basic types : unipolar , bipolar , multipolar , and pseudounipolar . Figure 35.5 illustrates these four basic neuron types . Unipolar neurons have only one structure that extends away from the soma . These neurons are not found in vertebrates but are found in insects where they stimulate muscles or glands . <hl> A bipolar neuron has one axon and one dendrite extending from the soma . <hl> An example of a bipolar neuron is a retinal bipolar cell , which receives signals from photoreceptor cells that are sensitive to light and transmits these signals to ganglion cells that carry the signal to the brain . Multipolar neurons are the most common type of neuron . Each multipolar neuron contains one axon and multiple dendrites . Multipolar neurons can be found in the central nervous system ( brain and spinal cord ) . An example of a multipolar neuron is a Purkinje cell in the cerebellum , which has many branching dendrites but only one axon . Pseudounipolar cells share characteristics with both unipolar and bipolar cells . A pseudounipolar cell has a single process that extends from the soma , like a unipolar cell , but this process later branches into two distinct structures , like a bipolar cell . Most sensory neurons are pseudounipolar and have an axon that branches into two extensions : one connected to dendrites that receive sensory information and another that transmits this information to the spinal cord ."}, {"question": {"question_id": "fs-idp81097920", "question_text": "Glia that provide myelin for neurons in the brain are called ________.", "question_choices": ["Schwann cells", "oligodendrocytes", "microglia", "astrocytes"], "cloze_format": "Glia that provide myelin for neurons in the brain are called ________.", "normal_format": "What are glia that provide myelin for neurons in the brain called?"}, "answer": {"ans_text": "oligodendrocytes", "ans_choice": 1}, "bloom": null, "hl_sentences": "Oligodendrocytes , shown in Figure 35.8 b form myelin sheaths around axons in the CNS . One axon can be myelinated by several oligodendrocytes , and one oligodendrocyte can provide myelin for multiple neurons . The nervous system is made up of neurons , specialized cells that can receive and transmit chemical or electrical signals , and glia , cells that provide support functions for the neurons by playing an information processing role that is complementary to neurons . Glia can be compared to the workers at the electric company who make sure wires go to the right places , maintain the wires , and take down wires that are broken .", "hl_context": "There are several different types of glia with different functions , two of which are shown in Figure 35.7 . Astrocytes , shown in Figure 35.8 a make contact with both capillaries and neurons in the CNS . They provide nutrients and other substances to neurons , regulate the concentrations of ions and chemicals in the extracellular fluid , and provide structural support for synapses . Astrocytes also form the blood-brain barrier \u2014 a structure that blocks entrance of toxic substances into the brain . Astrocytes , in particular , have been shown through calcium imaging experiments to become active in response to nerve activity , transmit calcium waves between astrocytes , and modulate the activity of surrounding synapses . Satellite glia provide nutrients and structural support for neurons in the PNS . Microglia scavenge and degrade dead cells and protect the brain from invading microorganisms . <hl> Oligodendrocytes , shown in Figure 35.8 b form myelin sheaths around axons in the CNS . <hl> <hl> One axon can be myelinated by several oligodendrocytes , and one oligodendrocyte can provide myelin for multiple neurons . <hl> This is distinctive from the PNS where a single Schwann cell provides myelin for only one axon as the entire Schwann cell surrounds the axon . Radial glia serve as scaffolds for developing neurons as they migrate to their end destinations . Ependymal cells line fluid-filled ventricles of the brain and the central canal of the spinal cord . They are involved in the production of cerebrospinal fluid , which serves as a cushion for the brain , moves the fluid between the spinal cord and the brain , and is a component for the choroid plexus . 35.2 How Neurons Communicate Learning Objectives By the end of this section , you will be able to : <hl> The nervous system is made up of neurons , specialized cells that can receive and transmit chemical or electrical signals , and glia , cells that provide support functions for the neurons by playing an information processing role that is complementary to neurons . <hl> A neuron can be compared to an electrical wire \u2014 it transmits a signal from one place to another . <hl> Glia can be compared to the workers at the electric company who make sure wires go to the right places , maintain the wires , and take down wires that are broken . <hl> Although glia have been compared to workers , recent evidence suggests that also usurp some of the signaling functions of neurons ."}, {"question": {"question_id": "fs-idm203137248", "question_text": "For a neuron to fire an action potential, its membrane must reach ________.", "question_choices": ["hyperpolarization", "the threshold of excitation", "the refractory period", "inhibitory postsynaptic potential"], "cloze_format": "For a neuron to fire an action potential, its membrane must reach ________.", "normal_format": "For a neuron to fire an action potential, what must its membrane reach?"}, "answer": {"ans_text": "the threshold of excitation", "ans_choice": 1}, "bloom": null, "hl_sentences": "It is the net change in postsynaptic membrane voltage that determines whether the postsynaptic cell has reached its threshold of excitation needed to fire an action potential . Action potentials are considered an \" all-or nothing \" event , in that , once the threshold potential is reached , the neuron always completely depolarizes .", "hl_context": "Signal Summation Sometimes a single EPSP is strong enough to induce an action potential in the postsynaptic neuron , but often multiple presynaptic inputs must create EPSPs around the same time for the postsynaptic neuron to be sufficiently depolarized to fire an action potential . This process is called summation and occurs at the axon hillock , as illustrated in Figure 35.16 . Additionally , one neuron often has inputs from many presynaptic neurons \u2014 some excitatory and some inhibitory \u2014 so IPSPs can cancel out EPSPs and vice versa . <hl> It is the net change in postsynaptic membrane voltage that determines whether the postsynaptic cell has reached its threshold of excitation needed to fire an action potential . <hl> Together , synaptic summation and the threshold for excitation act as a filter so that random \u201c noise \u201d in the system is not transmitted as important information . Action Potential A neuron can receive input from other neurons and , if this input is strong enough , send the signal to downstream neurons . Transmission of a signal between neurons is generally carried by a chemical called a neurotransmitter . Transmission of a signal within a neuron ( from dendrite to axon terminal ) is carried by a brief reversal of the resting membrane potential called an action potential . When neurotransmitter molecules bind to receptors located on a neuron \u2019 s dendrites , ion channels open . At excitatory synapses , this opening allows positive ions to enter the neuron and results in depolarization of the membrane \u2014 a decrease in the difference in voltage between the inside and outside of the neuron . A stimulus from a sensory cell or another neuron depolarizes the target neuron to its threshold potential ( - 55 mV ) . Na + channels in the axon hillock open , allowing positive ions to enter the cell ( Figure 35.10 and Figure 35.11 ) . Once the sodium channels open , the neuron completely depolarizes to a membrane potential of about + 40 mV . <hl> Action potentials are considered an \" all-or nothing \" event , in that , once the threshold potential is reached , the neuron always completely depolarizes . <hl> Once depolarization is complete , the cell must now \" reset \" its membrane voltage back to the resting potential . To accomplish this , the Na + channels close and cannot be opened . This begins the neuron's refractory period , in which it cannot produce another action potential because its sodium channels will not open . At the same time , voltage-gated K + channels open , allowing K + to leave the cell . As K + ions leave the cell , the membrane potential once again becomes negative . The diffusion of K + out of the cell actually hyperpolarizes the cell , in that the membrane potential becomes more negative than the cell's normal resting potential . At this point , the sodium channels will return to their resting state , meaning they are ready to open again if the membrane potential again exceeds the threshold potential . Eventually the extra K + ions diffuse out of the cell through the potassium leakage channels , bringing the cell from its hyperpolarized state , back to its resting membrane potential ."}, {"question": {"question_id": "fs-idm123693728", "question_text": "After an action potential, the opening of additional voltage-gated ________ channels and the inactivation of sodium channels, cause the membrane to return to its resting membrane potential.", "question_choices": ["sodium", "potassium", "calcium", "chloride"], "cloze_format": "After an action potential, the opening of additional voltage-gated ________ channels and the inactivation of sodium channels, cause the membrane to return to its resting membrane potential.", "normal_format": "The opening of which additional voltage-gated channels and the inactivation of sodium channels, after an action potential,  cause the membrane to return to its resting membrane potential? "}, "answer": {"ans_text": "potassium", "ans_choice": 1}, "bloom": null, "hl_sentences": "Transmission of a signal within a neuron ( from dendrite to axon terminal ) is carried by a brief reversal of the resting membrane potential called an action potential . Action potentials are considered an \" all-or nothing \" event , in that , once the threshold potential is reached , the neuron always completely depolarizes . Once depolarization is complete , the cell must now \" reset \" its membrane voltage back to the resting potential . At this point , the sodium channels will return to their resting state , meaning they are ready to open again if the membrane potential again exceeds the threshold potential . Eventually the extra K + ions diffuse out of the cell through the potassium leakage channels , bringing the cell from its hyperpolarized state , back to its resting membrane potential . Resting Membrane Potential A neuron at rest is negatively charged : the inside of a cell is approximately 70 millivolts more negative than the outside ( \u2212 70 mV , note that this number varies by neuron type and by species ) . This voltage is called the resting membrane potential ; it is caused by differences in the concentrations of ions inside and outside the cell . The difference in the number of positively charged potassium ions ( K + ) inside and outside the cell dominates the resting membrane potential ( Figure 35.10 ) . The negative charge within the cell is created by the cell membrane being more permeable to potassium ion movement than sodium ion movement . The cell possesses potassium and sodium leakage channels that allow the two cations to diffuse down their concentration gradient .", "hl_context": "Action Potential A neuron can receive input from other neurons and , if this input is strong enough , send the signal to downstream neurons . Transmission of a signal between neurons is generally carried by a chemical called a neurotransmitter . <hl> Transmission of a signal within a neuron ( from dendrite to axon terminal ) is carried by a brief reversal of the resting membrane potential called an action potential . <hl> When neurotransmitter molecules bind to receptors located on a neuron \u2019 s dendrites , ion channels open . At excitatory synapses , this opening allows positive ions to enter the neuron and results in depolarization of the membrane \u2014 a decrease in the difference in voltage between the inside and outside of the neuron . A stimulus from a sensory cell or another neuron depolarizes the target neuron to its threshold potential ( - 55 mV ) . Na + channels in the axon hillock open , allowing positive ions to enter the cell ( Figure 35.10 and Figure 35.11 ) . Once the sodium channels open , the neuron completely depolarizes to a membrane potential of about + 40 mV . <hl> Action potentials are considered an \" all-or nothing \" event , in that , once the threshold potential is reached , the neuron always completely depolarizes . <hl> <hl> Once depolarization is complete , the cell must now \" reset \" its membrane voltage back to the resting potential . <hl> To accomplish this , the Na + channels close and cannot be opened . This begins the neuron's refractory period , in which it cannot produce another action potential because its sodium channels will not open . At the same time , voltage-gated K + channels open , allowing K + to leave the cell . As K + ions leave the cell , the membrane potential once again becomes negative . The diffusion of K + out of the cell actually hyperpolarizes the cell , in that the membrane potential becomes more negative than the cell's normal resting potential . <hl> At this point , the sodium channels will return to their resting state , meaning they are ready to open again if the membrane potential again exceeds the threshold potential . <hl> <hl> Eventually the extra K + ions diffuse out of the cell through the potassium leakage channels , bringing the cell from its hyperpolarized state , back to its resting membrane potential . <hl> <hl> Resting Membrane Potential A neuron at rest is negatively charged : the inside of a cell is approximately 70 millivolts more negative than the outside ( \u2212 70 mV , note that this number varies by neuron type and by species ) . <hl> <hl> This voltage is called the resting membrane potential ; it is caused by differences in the concentrations of ions inside and outside the cell . <hl> If the membrane were equally permeable to all ions , each type of ion would flow across the membrane and the system would reach equilibrium . Because ions cannot simply cross the membrane at will , there are different concentrations of several ions inside and outside the cell , as shown in Table 35.1 . <hl> The difference in the number of positively charged potassium ions ( K + ) inside and outside the cell dominates the resting membrane potential ( Figure 35.10 ) . <hl> When the membrane is at rest , K + ions accumulate inside the cell due to a net movement with the concentration gradient . The negative resting membrane potential is created and maintained by increasing the concentration of cations outside the cell ( in the extracellular fluid ) relative to inside the cell ( in the cytoplasm ) . <hl> The negative charge within the cell is created by the cell membrane being more permeable to potassium ion movement than sodium ion movement . <hl> In neurons , potassium ions are maintained at high concentrations within the cell while sodium ions are maintained at high concentrations outside of the cell . <hl> The cell possesses potassium and sodium leakage channels that allow the two cations to diffuse down their concentration gradient . <hl> However , the neurons have far more potassium leakage channels than sodium leakage channels . Therefore , potassium diffuses out of the cell at a much faster rate than sodium leaks in . Because more cations are leaving the cell than are entering , this causes the interior of the cell to be negatively charged relative to the outside of the cell . The actions of the sodium potassium pump help to maintain the resting potential , once established . Recall that sodium potassium pumps brings two K + ions into the cell while removing three Na + ions per ATP consumed . As more cations are expelled from the cell than taken in , the inside of the cell remains negatively charged relative to the extracellular fluid . It should be noted that chloride ions ( Cl \u2013 ) tend to accumulate outside of the cell because they are repelled by negatively-charged proteins within the cytoplasm ."}, {"question": {"question_id": "fs-idm74849344", "question_text": "What is the term for protein channels that connect two neurons at an electrical synapse?", "question_choices": ["synaptic vesicles", "voltage-gated ion channels", "gap junction protein", "sodium-potassium exchange pumps"], "cloze_format": "___ is the term for protein channels that connect two neurons at an electrical synapse.", "normal_format": "What is the term for protein channels that connect two neurons at an electrical synapse?"}, "answer": {"ans_text": "gap junction protein", "ans_choice": 2}, "bloom": null, "hl_sentences": "In an electrical synapse , the presynaptic and postsynaptic membranes are very close together and are actually physically connected by channel proteins forming gap junctions .", "hl_context": "While electrical synapses are fewer in number than chemical synapses , they are found in all nervous systems and play important and unique roles . The mode of neurotransmission in electrical synapses is quite different from that in chemical synapses . <hl> In an electrical synapse , the presynaptic and postsynaptic membranes are very close together and are actually physically connected by channel proteins forming gap junctions . <hl> Gap junctions allow current to pass directly from one cell to the next . In addition to the ions that carry this current , other molecules , such as ATP , can diffuse through the large gap junction pores ."}, {"question": {"question_id": "fs-idm137736528", "question_text": "The ________ lobe contains the visual cortex.", "question_choices": ["frontal", "parietal", "temporal", "occipital"], "cloze_format": "The ________ lobe contains the visual cortex.", "normal_format": "Which lobe contains the visual cortex?"}, "answer": {"ans_text": "occipital", "ans_choice": 3}, "bloom": null, "hl_sentences": "The temporal lobe is located at the base of the brain by your ears and is primarily involved in processing and interpreting sounds . The occipital lobe is located at the back of the brain . It is primarily involved in vision \u2014 seeing , recognizing , and identifying the visual world . The parietal lobe is located at the top of the brain . Neurons in the parietal lobe are involved in speech and also reading . The frontal lobe is located at the front of the brain , over the eyes . This lobe contains the olfactory bulb , which processes smells .", "hl_context": "<hl> The temporal lobe is located at the base of the brain by your ears and is primarily involved in processing and interpreting sounds . <hl> It also contains the hippocampus ( Greek for \u201c seahorse \u201d ) \u2014 a structure that processes memory formation . The hippocampus is illustrated in Figure 35.24 . The role of the hippocampus in memory was partially determined by studying one famous epileptic patient , HM , who had both sides of his hippocampus removed in an attempt to cure his epilepsy . His seizures went away , but he could no longer form new memories ( although he could remember some facts from before his surgery and could learn new motor tasks ) . <hl> The occipital lobe is located at the back of the brain . <hl> <hl> It is primarily involved in vision \u2014 seeing , recognizing , and identifying the visual world . <hl> <hl> The parietal lobe is located at the top of the brain . <hl> <hl> Neurons in the parietal lobe are involved in speech and also reading . <hl> Two of the parietal lobe \u2019 s main functions are processing somatosensation \u2014 touch sensations like pressure , pain , heat , cold \u2014 and processing proprioception \u2014 the sense of how parts of the body are oriented in space . The parietal lobe contains a somatosensory map of the body similar to the motor cortex . <hl> The frontal lobe is located at the front of the brain , over the eyes . <hl> <hl> This lobe contains the olfactory bulb , which processes smells . <hl> The frontal lobe also contains the motor cortex , which is important for planning and implementing movement . Areas within the motor cortex map to different muscle groups , and there is some organization to this map , as shown in Figure 35.22 . For example , the neurons that control movement of the fingers are next to the neurons that control movement of the hand . Neurons in the frontal lobe also control cognitive functions like maintaining attention , speech , and decision-making . Studies of humans who have damaged their frontal lobes show that parts of this area are involved in personality , socialization , and assessing risk ."}, {"question": {"question_id": "fs-idm25104496", "question_text": "The ________ connects the two cerebral hemispheres.", "question_choices": ["limbic system", "corpus callosum", "cerebellum", "pituitary"], "cloze_format": "The ________ connects the two cerebral hemispheres.", "normal_format": "What connects the two cerebral hemispheres?"}, "answer": {"ans_text": "corpus callosum", "ans_choice": 1}, "bloom": null, "hl_sentences": "In other surgeries to treat severe epilepsy , the corpus callosum is cut instead of removing an entire hemisphere . This causes a condition called split-brain , which gives insights into unique functions of the two hemispheres . A thick fiber bundle called the corpus callosum ( Latin : \u201c tough body \u201d ) connects the two hemispheres and allows information to be passed from one side to the other .", "hl_context": "<hl> In other surgeries to treat severe epilepsy , the corpus callosum is cut instead of removing an entire hemisphere . <hl> <hl> This causes a condition called split-brain , which gives insights into unique functions of the two hemispheres . <hl> For example , when an object is presented to patients \u2019 left visual field , they may be unable to verbally name the object ( and may claim to not have seen an object at all ) . This is because the visual input from the left visual field crosses and enters the right hemisphere and cannot then signal to the speech center , which generally is found in the left side of the brain . Remarkably , if a split-brain patient is asked to pick up a specific object out of a group of objects with the left hand , the patient will be able to do so but will still be unable to vocally identify it . The brain is the part of the central nervous system that is contained in the cranial cavity of the skull . It includes the cerebral cortex , limbic system , basal ganglia , thalamus , hypothalamus , and cerebellum . There are three different ways that a brain can be sectioned in order to view internal structures : a sagittal section cuts the brain left to right , as shown in Figure 35.21 b , a coronal section cuts the brain front to back , as shown in Figure 35.20 a , and a horizontal section cuts the brain top to bottom . Cerebral Cortex The outermost part of the brain is a thick piece of nervous system tissue called the cerebral cortex , which is folded into hills called gyri ( singular : gyrus ) and valleys called sulci ( singular : sulcus ) . The cortex is made up of two hemispheres \u2014 right and left \u2014 which are separated by a large sulcus . <hl> A thick fiber bundle called the corpus callosum ( Latin : \u201c tough body \u201d ) connects the two hemispheres and allows information to be passed from one side to the other . <hl> Although there are some brain functions that are localized more to one hemisphere than the other , the functions of the two hemispheres are largely redundant . In fact , sometimes ( very rarely ) an entire hemisphere is removed to treat severe epilepsy . While patients do suffer some deficits following the surgery , they can have surprisingly few problems , especially when the surgery is performed on children who have very immature nervous systems ."}, {"question": {"question_id": "fs-idm81517712", "question_text": "Neurons in the ________ control motor reflexes.", "question_choices": ["thalamus", "spinal cord", "parietal lobe", "hippocampus"], "cloze_format": "Neurons in the ________ control motor reflexes.", "normal_format": "Which neutrons control motor reflexes?"}, "answer": {"ans_text": "spinal cord", "ans_choice": 1}, "bloom": null, "hl_sentences": "Spinal nerves transmit sensory and motor information between the spinal cord and the rest of the body . Each of the 31 spinal nerves ( in humans ) contains both sensory and motor axons . Because the spinal cord is the information superhighway connecting the brain with the body , damage to the spinal cord can lead to paralysis . The spinal cord is a thick bundle of nerve tissue that carries information about the body to the brain and from the brain to the body . The spinal cord also controls motor reflexes .", "hl_context": "<hl> Spinal nerves transmit sensory and motor information between the spinal cord and the rest of the body . <hl> <hl> Each of the 31 spinal nerves ( in humans ) contains both sensory and motor axons . <hl> The sensory neuron cell bodies are grouped in structures called dorsal root ganglia and are shown in Figure 35.29 . Each sensory neuron has one projection \u2014 with a sensory receptor ending in skin , muscle , or sensory organs \u2014 and another that synapses with a neuron in the dorsal spinal cord . Motor neurons have cell bodies in the ventral gray matter of the spinal cord that project to muscle through the ventral root . These neurons are usually stimulated by interneurons within the spinal cord but are sometimes directly stimulated by sensory neurons . 35.5 Nervous System Disorders Learning Objectives By the end of this section , you will be able to : In the United States , there around 10,000 spinal cord injuries each year . <hl> Because the spinal cord is the information superhighway connecting the brain with the body , damage to the spinal cord can lead to paralysis . <hl> The extent of the paralysis depends on the location of the injury along the spinal cord and whether the spinal cord was completely severed . For example , if the spinal cord is damaged at the level of the neck , it can cause paralysis from the neck down , whereas damage to the spinal column further down may limit paralysis to the legs . Spinal cord injuries are notoriously difficult to treat because spinal nerves do not regenerate , although ongoing research suggests that stem cell transplants may be able to act as a bridge to reconnect severed nerves . Researchers are also looking at ways to prevent the inflammation that worsens nerve damage after injury . One such treatment is to pump the body with cold saline to induce hypothermia . This cooling can prevent swelling and other processes that are thought to worsen spinal cord injuries . 35.4 The Peripheral Nervous System Learning Objectives By the end of this section , you will be able to : Connecting to the brainstem and extending down the body through the spinal column is the spinal cord , shown in Figure 35.21 . <hl> The spinal cord is a thick bundle of nerve tissue that carries information about the body to the brain and from the brain to the body . <hl> The spinal cord is contained within the bones of the vertebrate column but is able to communicate signals to and from the body through its connections with spinal nerves ( part of the peripheral nervous system ) . A cross-section of the spinal cord looks like a white oval containing a gray butterfly-shape , as illustrated in Figure 35.25 . Myelinated axons make up the \u201c white matter \u201d and neuron and glial cell bodies make up the \u201c gray matter . \u201d Gray matter is also composed of interneurons , which connect two neurons each located in different parts of the body . Axons and cell bodies in the dorsal ( facing the back of the animal ) spinal cord convey mostly sensory information from the body to the brain . Axons and cell bodies in the ventral ( facing the front of the animal ) spinal cord primarily transmit signals controlling movement from the brain to the body . <hl> The spinal cord also controls motor reflexes . <hl> These reflexes are quick , unconscious movements \u2014 like automatically removing a hand from a hot object . Reflexes are so fast because they involve local synaptic connections . For example , the knee reflex that a doctor tests during a routine physical is controlled by a single synapse between a sensory neuron and a motor neuron . While a reflex may only require the involvement of one or two synapses , synapses with interneurons in the spinal column transmit information to the brain to convey what happened ( the knee jerked , or the hand was hot ) ."}, {"question": {"question_id": "fs-idm34543008", "question_text": "Activation of the sympathetic nervous system causes:", "question_choices": ["increased blood flow into the skin", "a decreased heart rate", "an increased heart rate", "increased digestion"], "cloze_format": "Activation of the sympathetic nervous system causes ___ .", "normal_format": "What activation of the sympathetic nervous system cause?"}, "answer": {"ans_text": "an increased heart rate", "ans_choice": 2}, "bloom": null, "hl_sentences": "The parasympathetic nervous system resets organ function after the sympathetic nervous system is activated ( the common adrenaline dump you feel after a \u2018 fight-or-flight \u2019 event ) . Effects of acetylcholine release on target organs include slowing of heart rate , lowered blood pressure , and stimulation of digestion . As anyone who has ever felt a rush before a big test , speech , or athletic event can attest , the effects of the sympathetic nervous system are quite pervasive . The physiological effects of this norepinephrine release include dilating the trachea and bronchi ( making it easier for the animal to breathe ) , increasing heart rate , and moving blood from the skin to the heart , muscles , and brain ( so the animal can think and run ) . Examples of functions controlled by the sympathetic nervous system include an accelerated heart rate and inhibited digestion .", "hl_context": "<hl> The parasympathetic nervous system resets organ function after the sympathetic nervous system is activated ( the common adrenaline dump you feel after a \u2018 fight-or-flight \u2019 event ) . <hl> <hl> Effects of acetylcholine release on target organs include slowing of heart rate , lowered blood pressure , and stimulation of digestion . <hl> Most preganglionic neurons in the sympathetic nervous system originate in the spinal cord , as illustrated in Figure 35.27 . The axons of these neurons release acetylcholine on postganglionic neurons within sympathetic ganglia ( the sympathetic ganglia form a chain that extends alongside the spinal cord ) . The acetylcholine activates the postganglionic neurons . Postganglionic neurons then release norepinephrine onto target organs . <hl> As anyone who has ever felt a rush before a big test , speech , or athletic event can attest , the effects of the sympathetic nervous system are quite pervasive . <hl> This is both because one preganglionic neuron synapses on multiple postganglionic neurons , amplifying the effect of the original synapse , and because the adrenal gland also releases norepinephrine ( and the closely related hormone epinephrine ) into the blood stream . <hl> The physiological effects of this norepinephrine release include dilating the trachea and bronchi ( making it easier for the animal to breathe ) , increasing heart rate , and moving blood from the skin to the heart , muscles , and brain ( so the animal can think and run ) . <hl> The strength and speed of the sympathetic response helps an organism avoid danger , and scientists have found evidence that it may also increase LTP \u2014 allowing the animal to remember the dangerous situation and avoid it in the future . The sympathetic nervous system is responsible for the \u201c fight or flight \u201d response that occurs when an animal encounters a dangerous situation . One way to remember this is to think of the surprise a person feels when encountering a snake ( \u201c snake \u201d and \u201c sympathetic \u201d both begin with \u201c s \u201d ) . <hl> Examples of functions controlled by the sympathetic nervous system include an accelerated heart rate and inhibited digestion . <hl> These functions help prepare an organism \u2019 s body for the physical strain required to escape a potentially dangerous situation or to fend off a predator ."}, {"question": {"question_id": "fs-idp56305456", "question_text": "Where are parasympathetic preganglionic cell bodies located?", "question_choices": ["cerebellum", "brainstem", "dorsal root ganglia", "skin"], "cloze_format": "Parasympathetic preganglionic cell bodies are located in the ___.", "normal_format": "Where are parasympathetic preganglionic cell bodies located?"}, "answer": {"ans_text": "brainstem", "ans_choice": 1}, "bloom": "1", "hl_sentences": "Parasympathetic preganglionic neurons have cell bodies located in the brainstem and in the sacral ( toward the bottom ) spinal cord , as shown in Figure 35.27 .", "hl_context": "While the sympathetic nervous system is activated in stressful situations , the parasympathetic nervous system allows an animal to \u201c rest and digest . \u201d One way to remember this is to think that during a restful situation like a picnic , the parasympathetic nervous system is in control ( \u201c picnic \u201d and \u201c parasympathetic \u201d both start with \u201c p \u201d ) . <hl> Parasympathetic preganglionic neurons have cell bodies located in the brainstem and in the sacral ( toward the bottom ) spinal cord , as shown in Figure 35.27 . <hl> The axons of the preganglionic neurons release acetylcholine on the postganglionic neurons , which are generally located very near the target organs . Most postganglionic neurons release acetylcholine onto target organs , although some release nitric oxide ."}, {"question": {"question_id": "fs-idp23991248", "question_text": "________ is released by motor nerve endings onto muscle.", "question_choices": ["Acetylcholine", "Norepinephrine", "Dopamine", "Serotonin"], "cloze_format": "________ is released by motor nerve endings onto muscle.", "normal_format": "What is released by motor nerve endings onto muscle?"}, "answer": {"ans_text": "Acetylcholine", "ans_choice": 0}, "bloom": null, "hl_sentences": "Unlike the autonomic nervous system , which has two synapses between the CNS and the target organ , sensory and motor neurons have only one synapse \u2014 one ending of the neuron is at the organ and the other directly contacts a CNS neuron . Acetylcholine is the main neurotransmitter released at these synapses . The axons of these neurons release acetylcholine on postganglionic neurons within sympathetic ganglia ( the sympathetic ganglia form a chain that extends alongside the spinal cord ) . An axon is a tube-like structure that propagates the integrated signal to specialized endings called axon terminals . These terminals in turn synapse on other neurons , muscle , or target organs .", "hl_context": "The sensory-somatic nervous system is made up of cranial and spinal nerves and contains both sensory and motor neurons . Sensory neurons transmit sensory information from the skin , skeletal muscle , and sensory organs to the CNS . Motor neurons transmit messages about desired movement from the CNS to the muscles to make them contract . Without its sensory-somatic nervous system , an animal would be unable to process any information about its environment ( what it sees , feels , hears , and so on ) and could not control motor movements . <hl> Unlike the autonomic nervous system , which has two synapses between the CNS and the target organ , sensory and motor neurons have only one synapse \u2014 one ending of the neuron is at the organ and the other directly contacts a CNS neuron . <hl> <hl> Acetylcholine is the main neurotransmitter released at these synapses . <hl> Most preganglionic neurons in the sympathetic nervous system originate in the spinal cord , as illustrated in Figure 35.27 . <hl> The axons of these neurons release acetylcholine on postganglionic neurons within sympathetic ganglia ( the sympathetic ganglia form a chain that extends alongside the spinal cord ) . <hl> The acetylcholine activates the postganglionic neurons . Postganglionic neurons then release norepinephrine onto target organs . As anyone who has ever felt a rush before a big test , speech , or athletic event can attest , the effects of the sympathetic nervous system are quite pervasive . This is both because one preganglionic neuron synapses on multiple postganglionic neurons , amplifying the effect of the original synapse , and because the adrenal gland also releases norepinephrine ( and the closely related hormone epinephrine ) into the blood stream . The physiological effects of this norepinephrine release include dilating the trachea and bronchi ( making it easier for the animal to breathe ) , increasing heart rate , and moving blood from the skin to the heart , muscles , and brain ( so the animal can think and run ) . The strength and speed of the sympathetic response helps an organism avoid danger , and scientists have found evidence that it may also increase LTP \u2014 allowing the animal to remember the dangerous situation and avoid it in the future . Once a signal is received by the dendrite , it then travels passively to the cell body . The cell body contains a specialized structure , the axon hillock that integrates signals from multiple synapses and serves as a junction between the cell body and an axon . <hl> An axon is a tube-like structure that propagates the integrated signal to specialized endings called axon terminals . <hl> <hl> These terminals in turn synapse on other neurons , muscle , or target organs . <hl> Chemicals released at axon terminals allow signals to be communicated to these other cells . Neurons usually have one or two axons , but some neurons , like amacrine cells in the retina , do not contain any axons . Some axons are covered with myelin , which acts as an insulator to minimize dissipation of the electrical signal as it travels down the axon , greatly increasing the speed on conduction . This insulation is important as the axon from a human motor neuron can be as long as a meter \u2014 from the base of the spine to the toes . The myelin sheath is not actually part of the neuron . Myelin is produced by glial cells . Along the axon there are periodic gaps in the myelin sheath . These gaps are called nodes of Ranvier and are sites where the signal is \u201c recharged \u201d as it travels along the axon ."}, {"question": {"question_id": "fs-idm314377216", "question_text": "Parkinson\u2019s disease is a caused by the degeneration of neurons that release ________.", "question_choices": ["serotonin", "dopamine", "glutamate", "norepinephrine"], "cloze_format": "Parkinson\u2019s disease is a caused by the degeneration of neurons that release ________.", "normal_format": "Parkinson\u2019s disease is a caused by the degeneration of neurons that release which of the following?"}, "answer": {"ans_text": "dopamine", "ans_choice": 1}, "bloom": null, "hl_sentences": "One of the most commonly prescribed drugs for Parkinson \u2019 s is L-DOPA , which is a chemical that is converted into dopamine by neurons in the brain . Parkinson \u2019 s disease causes the loss of dopamine neurons in the substantia nigra , a midbrain structure that regulates movement .", "hl_context": "There is no cure for Parkinson \u2019 s disease , and treatment is focused on easing symptoms . <hl> One of the most commonly prescribed drugs for Parkinson \u2019 s is L-DOPA , which is a chemical that is converted into dopamine by neurons in the brain . <hl> This conversion increases the overall level of dopamine neurotransmission and can help compensate for the loss of dopaminergic neurons in the substantia nigra . Other drugs work by inhibiting the enzyme that breaks down dopamine . Like Alzheimer \u2019 s disease , Parkinson \u2019 s disease is a neurodegenerative disease . It was first characterized by James Parkinson in 1817 . Each year , 50,000- 60,000 people in the United States are diagnosed with the disease . <hl> Parkinson \u2019 s disease causes the loss of dopamine neurons in the substantia nigra , a midbrain structure that regulates movement . <hl> Loss of these neurons causes many symptoms including tremor ( shaking of fingers or a limb ) , slowed movement , speech changes , balance and posture problems , and rigid muscles . The combination of these symptoms often causes a characteristic slow hunched shuffling walk , illustrated in Figure 35.31 . Patients with Parkinson \u2019 s disease can also exhibit psychological symptoms , such as dementia or emotional problems ."}, {"question": {"question_id": "fs-idp23122880", "question_text": "________ medications are often used to treat patients with ADHD.", "question_choices": ["Tranquilizer", "Antibiotic", "Stimulant", "Anti-seizure"], "cloze_format": "________ medications are often used to treat patients with ADHD.", "normal_format": "Which medications are often used to treat patients with ADHD?"}, "answer": {"ans_text": "Stimulant", "ans_choice": 2}, "bloom": null, "hl_sentences": "Treatment for ADHD often involves behavioral therapies and the prescription of stimulant medications , which paradoxically cause a calming effect in these patients .", "hl_context": "Attention Deficit Hyperactivity Disorder ( ADHD ) Approximately three to five percent of children and adults are affected by attention deficit / hyperactivity disorder ( ADHD ) . Like ASD , ADHD is more prevalent in males than females . Symptoms of the disorder include inattention ( lack of focus ) , executive functioning difficulties , impulsivity , and hyperactivity beyond what is characteristic of the normal developmental stage . Some patients do not have the hyperactive component of symptoms and are diagnosed with a subtype of ADHD : attention deficit disorder ( ADD ) . Many people with ADHD also show comorbitity , in that they develop secondary disorders in addition to ADHD . Examples include depression or obsessive compulsive disorder ( OCD ) . Figure 35.32 provides some statistics concerning comorbidity with ADHD . The cause of ADHD is unknown , although research points to a delay and dysfunction in the development of the prefrontal cortex and disturbances in neurotransmission . According to studies of twins , the disorder has a strong genetic component . There are several candidate genes that may contribute to the disorder , but no definitive links have been discovered . Environmental factors , including exposure to certain pesticides , may also contribute to the development of ADHD in some patients . <hl> Treatment for ADHD often involves behavioral therapies and the prescription of stimulant medications , which paradoxically cause a calming effect in these patients . <hl>"}, {"question": {"question_id": "fs-idm94176704", "question_text": "Strokes are often caused by ________.", "question_choices": ["neurodegeneration", "blood clots or burst blood vessels", "seizures", "viruses"], "cloze_format": "Strokes are often caused by ________.", "normal_format": "What are strokes often caused by?"}, "answer": {"ans_text": "blood clots or burst blood vessels", "ans_choice": 1}, "bloom": null, "hl_sentences": "Stroke is often caused by blood clots and can also be caused by the bursting of a weak blood vessel .", "hl_context": "A stroke results when blood fails to reach a portion of the brain for a long enough time to cause damage . Without the oxygen supplied by blood flow , neurons in this brain region die . This neuronal death can cause many different symptoms \u2014 depending on the brain area affected \u2014 including headache , muscle weakness or paralysis , speech disturbances , sensory problems , memory loss , and confusion . <hl> Stroke is often caused by blood clots and can also be caused by the bursting of a weak blood vessel . <hl> Strokes are extremely common and are the third most common cause of death in the United States . On average one person experiences a stroke every 40 seconds in the United States . Approximately 75 percent of strokes occur in people older than 65 . Risk factors for stroke include high blood pressure , diabetes , high cholesterol , and a family history of stroke . Smoking doubles the risk of stroke . Because a stroke is a medical emergency , patients with symptoms of a stroke should immediately go to the emergency room , where they can receive drugs that will dissolve any clot that may have formed . These drugs will not work if the stroke was caused by a burst blood vessel or if the stroke occurred more than three hours before arriving at the hospital . Treatment following a stroke can include blood pressure medication ( to prevent future strokes ) and ( sometimes intense ) physical therapy ."}], "summary": "", "keyterm": "", "bname": "biology"}, {"chapter": 13, "intro": " Chapter Outline 13.1   Explain the Pricing of Long-Term Liabilities 13.2   Compute Amortization of Long-Term Liabilities Using the Effective-Interest Method 13.3   Prepare Journal Entries to Reflect the Life Cycle of Bonds 13.4   Appendix: Special Topics Related to Long-Term Liabilities Why It Matters \n\n Olivia is excited to be shopping for her very first car. She has saved up money from birthdays, holidays, and household chores and would like to get a vehicle so she can get a summer job. Her mother mentioned that a coworker is selling one of their vehicles. \n\n Olivia and her family decide to go look at the vehicle and take it for a test drive. After inspecting the vehicle and taking it for a test drive, Olivia decides she would like to purchase the car. Olivia planned on spending up to $6,000 (the amount that she has saved), but the seller is asking $9,000 for this particular vehicle. Because the car has been well-maintained and has many extra features, Olivia decides it is worth spending the extra money in order to get reliable transportation. However, she is not sure how to come up with the additional $3,000. Olivia\u2019s parents tell her she can get a bank loan of $3,000 to cover the difference, but she will have to repay the bank more than the $3,000 she is borrowing. This is because the loan will be repaid over a period of time, say twelve months, and the loan will require that she pay interest in addition to repaying the $3,000 in principal that she is borrowing. After meeting with the bank and signing the necessary paperwork to secure the $3,000 loan, a few days later Olivia returns to the seller with a check for $9,000 and is overjoyed to have purchased her first vehicle. ", "chapter_text": " 13.1   Explain the Pricing of Long-Term Liabilities \n\n Businesses have several ways to secure financing and, in practice, will use a combination of these methods to finance the business. As you\u2019ve learned, net income does not necessarily mean cash. In some cases, in the long-run, profitable operations will provide businesses with sufficient cash to finance current operations and to invest in new opportunities. However, situations might arise where the cash flow generated is insufficient to cover future anticipated expenses or expansion, and the company might need to secure additional funding. \n\n If the extra amount needed is somewhat temporary or small, a short-term source, such as a loan, might be appropriate. Short-term (current) liabilities were covered in  Current Liabilities . When additional long-term funding needs arise, a business can choose to sell stock in the company (equity-based financing) or obtain a  long-term liability  (debt-based financing), such as a loan that is spread over a period longer than a year. \n\n Types of Long-Term Funding \n\n If a company needs additional funding for a major expenditure, such as expansion, the source of funding would typically be repaid over several years, or in the case of equity-based financing, over an indefinite period of time. With equity-based financing, the company sells an interest in the company\u2019s ownership by issuing shares of the company\u2019s common stock. This financing option is equity financing, and it will be addressed in detail in  Corporation Accounting . Here, we will focus on two major long-term debt-based options: long-term loans and bonds. \n\n Debt as an option for financing is an important source of funding for businesses. If a company chooses a debt-based option, the business can borrow money on an intermediate (typically two to four years) or long-term (longer than four years) basis from lenders. In the case of bonds, the funds would be provided by investors. While loans and bonds are similar in that they borrow money on which the borrower will pay interest and eventually repay the lenders, they have some important differences. First, a company can raise funds by borrowing from an individual, bank, or other lender, while a bond is typically sold to numerous investors. When a company chooses a loan, the business signs what is known as a note, and a legal relationship called a  note payable  is created between the borrower and the lender. The document lists the conditions of the financial arrangement, a fixed predetermined interest rate (or, if the agreement allows, a variable interest rate), the amount borrowed, the borrowing costs to be charged, and the timing of the payments. In some cases, companies will secure an  interest-only loan , which means that for the life of the loan the organization pays only the interest expense that has accrued and upon maturity repays the original amount that it borrowed and still owes. For individuals a student loan, car loan, or a mortgage can all be types of notes payable. For Olivia\u2019s car purchase in  Why It Matters , a document such as a  promissory note  is typically created, representing a personal loan agreement between a lender and borrower.  Figure 13.2  shows a sample promissory note that might be used for a simple, relatively intermediate-term loan. If we were considering a loan that would be repaid over a several-year period the document might be a little more complicated, although it would still have many of the same components of Olivia\u2019s loan document. \n\n If debt instruments are created with a variable interest rate that can fluctuate up or down, depending upon predetermined factors, an inflation measurement must also be included in the documentation. The Federal Funds Rate, for example, is a commonly used tool for potential adjustments in interest rates. To keep our discussion simple, we will use a fixed interest rate in our subsequent calculations. \n\n Another difference between loans and bonds is that the note payable creates an obligation for the borrower to repay the lender on a specified date. To demonstrate the mechanics of a loan,with loans, a note payable is created for the borrower when the loan is initiated. This example assumes the loan will be paid in full by the maturity or due date. Typically, over the life of the loan, payments will be composed of both principal and interest components. The principal component paid typically reduces the amount that the borrower owes the lender. For example, assume that a company borrowed $10,000 from a lender under the following terms: a five-year life, an annual interest rate of 10%, and five annual payments at the end of the year. \n\n Under these terms, the annual payment would be $2,637.97. The first year\u2019s payment would be allocated to an interest expense of $1,000, and the remaining amount of the payment would go to reduce the amount borrowed (principal) by $1,637.97. After the first year\u2019s payment, the company would owe a remaining balance of $8,362.03 ($10,000 \u2013 $1637.97.) Additional detail on this type of calculation will be provided in  Compute Amortization of Long-Term Liabilities Using the Effective-Interest Method . \n\n Typical long-term loans have other characteristics. For example, most long-term notes are held by one entity, meaning one party provides all of the financing. If a company bought heavy-duty equipment from Caterpillar, it would be common for the seller of the equipment to also have a division that would provide the financing for the transaction. An additional characteristic of a long-term loan is that in many, if not most, situations, the initial creator of the loan will hold it and receive and process payments until it matures. \n\n Returning to the differences between long-term debt and bonds, another difference is that the process for issuing (selling) bonds can be very complicated, especially for companies that are subject to regulation. The bond issue must be approved by the appropriate regulatory agency, and then outside parties such as investment banks sell the bonds to, typically, a large audience of investors. It is not unusual for several months to pass between the time that the company\u2019s board of directors approves the bond offering, gets regulatory approval, and then markets and issues the bonds. This additional time is often the reason that the market rate for similar bonds in the outside business environment is higher or lower than the stated interest rate that the company committed to pay when the bond process was first begun. This difference can lead to bonds being issued (sold) at a discount or premium. \n\n Finally, while loans can normally be paid off before they are due, in most cases bonds must be held by an owner until they mature. Because of this last characteristic, a bond,such as a thirty-year bond, might have several owners over its lifetime, while most long-term notes payable will only have one owner. \n\n Ethical Considerations Bond Fraud The U.S. Department of the Treasury (DOT) defines historical bonds as \u201cthose bonds that were once valid obligations of American entities but are now worthless as securities and are quickly becoming a favorite tool of scam artists.\u201d 1  The DOT also warns against scams selling non-existent \u201climited edition\u201d U.S. Treasury securities. The scam involves approaching broker-dealers and banks to act as fiduciaries for transactions. Further, the DOT notes: \u201cThe proposal to sell these fictitious securities makes misrepresentations about the way marketable securities are bought and sold, and it also misrepresents the role that we play in the original sale and issuance of our securities.\u201d 2  Many fraudulent attempts are made to sell such bonds. 1 U.S. Department of the Treasury. \u201cHistorical Bond Fraud.\u201d September 21, 2012. https://www.treasury.gov/about/organizational-structure/ig/Pages/Scams/Historical-Bond-Fraud.aspx 2 U.S. Department of the Treasury. \u201cExamples of Known Phony Securities.\u201d April 5, 2013. https://www.treasury.gov/about/organizational-structure/ig/Pages/Scams/Examples-of-Known-Phony-Securities.aspx \n\n According to  Business Insider , in the commonest scam, a fake bearer bond is offered for sale for far less than its stated cover price. The difference in the cost and the cover price entices the victim to buy the bond. Again, from  Business Insider : \u201cAnother variation is a flavor of the \u2018Nigerian prince\u2019 scheme; the fraudster will ask for the victim\u2019s help in depositing a recently obtained \u2018fortune\u2019 in bonds, promising the victim a cut in return.\u201d 3 3 Lawrence Delavigne. \u201cFake Bearer Bonds Were Just the Beginning of Huge Wave of Bond-Fraud.\u201d  Business Insider . October 12, 2009. https://www.businessinsider.com/bond-fraud-is-on-the-rise-2009-10 \n\n A diligent accountant is both educated about the investments of their company or organization and is skeptical about any investment that looks too good to be true. \n\n Your Turn Current versus Long-Term Liabilities Below is a portion of the 2017 Balance Sheet of  Emerson, Inc.  (shown in millions of dollars). 4  There are several observations we can make from this information. 4 Emerson.  2017 Annual Report . Emerson Electric Company. 2017. https://www.emerson.com/documents/corporate/2017emersonannualreport-en-2883292.pdf \n\n Notice the company lists separately the Current Liabilities (listed as \u201cShort-term borrowings and current maturities of long-term debt\u201d) and Long-term Liabilities (listed as \u201cLong-term debt\u201d). Also, under the \u201cCurrent liabilities\u201d heading, notice the \u201cShort-term borrowings and current maturities of long-term debt\u201d decreased significantly from 2016 to 2017. In 2016, Emerson held $2.584 billion in short-term borrowings and current maturities of long-term debt. This amount decreased by $1.722 billion in 2017, which is a 67% decrease. During the same timeframe, long-term debt decreased $257 million, going from $4.051 billion to $3.794 billion, which is a 6.3% decrease. \n\n Thinking about the primary purpose of accounting, why do you think accountants separate liabilities into current liabilities and long-term liabilities? \n\n Solution \n\n The primary purpose of accounting is to provide stakeholders with financial information that is useful for decision making. It is important for stakeholders to understand how much cash will be required to satisfy liabilities within the next year (liquidity) as well as how much will be required to satisfy long-term liabilities (solvency). Stakeholders, especially lenders and owners, are concerned with both liquidity and solvency of the business. \n\n Fundamentals of Bonds \n\n Now let us look at bonds in more depth. A  bond  is a type of financial instrument that a company issues directly to investors, bypassing banks or other lending institutions, with a promise to pay the investor a specified rate of interest over a specified period of time. When a company borrows money by selling bonds, it is said the company is \u201cissuing\u201d bonds. This means the company exchanges cash for a promise to repay the cash, along with interest, over a set period of time. As you\u2019ve learned, bonds are formal legal documents that contain specific information related to the bond. In short, it is a legal contract\u2014called a  bond certificate  (as shown in  Figure 13.3 ) or an indenture\u2014between the issuer (the business borrowing the money) and the lender (the investor lending the money). Bonds are typically issued in relatively small denominations, such as $1,000 so they can be placed in the market and are accessible to a greater market of investors compared to notes. The  bond indenture  is a contract that lists the features of the bond, such as the amount of money that will be repaid in the future, called the  principal  (also called  face value  or maturity value); the  maturity date , the day the bond holder will receive the principal amount; and the  stated interest rate , which is the rate of interest the issuer agrees to pay the bondholder throughout the term of the bond. \n\n For a typical bond, the issuer commits to paying a stated interest rate either once a year (annually) or twice a year (semiannually). It is important to understand that the stated rate will not go up or down over the life of the bond. This means the borrower will pay the same semiannual or annual interest payment on the same dates for the life of the bond. In other words, when an investor buys a typical bond, the investor will receive, in the future, two major cash flows: periodic interest payments paid either annually or semiannually based on the stated rate of the bond, and the maturity value, which is the total amount paid to the owner of the bond on the maturity date. \n\n Link to Learning \n\n The website for the  nonprofit Kiva  allows you to lend money to people around the world. The borrower makes monthly payments to pay the loan back. The companies  Prosper  and  LendingClub  let you borrow or lend money to people in the U.S. who then make monthly payments, with interest, to pay it back. \n\n The process of preparing a bond issuance for sale and then selling on the primary market is lengthy, complex, and is usually performed by underwriters\u2014finance professionals who specialize in issuing bonds and other financial instruments. Here, we will only examine transactions concerning issuance, interest payments, and the sale of existing bonds. \n\n There are two other important characteristics of bonds to discuss. First, for most companies, the total value of bonds issued can often range from hundreds of thousands to several million dollars. The primary reason for this is that bonds are typically used to help finance significant long-term projects or activities, such as the purchase of equipment, land, buildings, or another company. \n\n Concepts In Practice Apple Inc. Issues Bonds On May 11, 2017,  Apple Inc.  issued bonds to get cash.  Apple Inc.  submitted a form to the Securities and Exchange Commission (www.sec.gov) to announce their intentions. \n\n On May 3 of the same year,  Apple Inc.  had issued their 10-Q (quarterly report) that showed the following assets. \n\n Apple Inc.  reported it had $15 billion dollars in cash and a total of $101 billion in Current Assets. Why did it need to issue bonds to raise $7 billion more? \n\n Analysts suggested that  Apple  would use the cash to pay shareholder dividends. Even though  Apple  reported billions of dollars in cash, most of the cash was in foreign countries because that was where the products had been sold. Tax laws vary by country, but if  Apple  transferred the cash to a US bank account, they would have to pay US income tax on it, at a tax rate as high as 39%. So,  Apple  was much better off borrowing and paying 3.2% interest, which is tax deductible, than bringing the cash to the US and paying a 39% income tax. \n\n However, it\u2019s important to remember that in the United States, Congress can change tax laws at any time, so what was then current tax law when this transaction occurred could change in the future. \n\n The second characteristic of bonds is that bonds are often sold to several investors instead of to one individual investor. \n\n When establishing the stated rate of interest the business will pay on a bond, bond underwriters consider many factors, including the interest rates on government treasury bonds (which are assumed to be risk-free), rates on comparable bond offerings, and firm-specific factors related to the business\u2019s risk (including its ability to repay the bond). The more likely the possibility that a company will default on the bond, meaning they either miss an interest payment or do not return the maturity amount to the bond\u2019s owner when it matures, the higher the interest rate is on the bond. It is important to understand that the stated rate will not change over the life of any one bond once it is issued. However, the stated rate on future new bonds may change as economic circumstances and the company\u2019s financial position changes. \n\n Bonds themselves can have different characteristics. For example, a  debenture  is an unsecured bond issued based on the good name and reputation of the company. These companies are not pledging other assets to cover the amount in case they fail to pay the debt, or  default . The opposite of a debenture is a  secured bond , meaning the company is pledging a specific asset as collateral for the bond. With a secured bond, if the company goes under and cannot pay back the bond, the pledged asset would be sold, and the proceeds would be distributed to the bondholders. \n\n There are  term bonds , or single-payment bonds, meaning the entire bond will be repaid all at once, rather than in a series of payments. And there are  serial bonds , or bonds that will mature over a period of time and will be repaid in a series of payments. \n\n A  callable bond  (also known as a  redeemable bond ) is one that can be repurchased or \u201ccalled\u201d by the issuer of the bond. If a company sells callable bonds with an 8% interest rate and the interest rate the bank is offering subsequently drops to 5%, the company can borrow at that new rate of 5%, call the 8% bonds, and pay them off (even if the purchaser does not want to sell them back). In essence, the institution would be lowering its rate of interest to borrow money from 8% to 5% by calling the bond. \n\n Putable bonds  give the bondholder the right to decide whether to sell it back early or keep it until it matures. It is essentially the opposite of a callable bond. \n\n A  convertible bond  can be converted to common stock in a one-way, one-time conversion. Under what conditions would it make sense to convert? Suppose the face-value interest rate of the bond is 8%. If the company is doing well this year, such that there is an expectation that shareholders will receive a significant dividend and the stock price will rise, the stock might appear to be more valuable than the return on the bond. \n\n Think It Through Callable versus Putable Bonds Which type of bond is better for the corporation issuing the bond: callable or putable? \n\n Ethical Considerations Junk Bonds Junk bonds, which are also called speculative or high-yield bonds, are a specific type of bond that can be attractive to certain investors. On one hand, junk bonds are attractive because the bonds pay a rate of interest that is significantly higher than the average market rate. On the other hand, the bonds are riskier because the issuing company is deemed to have a higher risk of defaulting on the bonds. If the economy or the company\u2019s financial condition deteriorates, the company will be unable to repay the money borrowed. In short, junk bonds are deemed to be high risk, high reward investments. \n\n The development of the junk bond market, which occurred during the 1970s and 1980s, is attributed to Michael Milken, the so-called \u201cjunk bond king.\u201d Milken amassed a large fortune by using junk bonds as a means of financing corporate mergers and acquisitions. It is estimated that during the 1980s, Milken earned between $200 million and $550 million per year. 5  In 1990, however, Milken\u2019s winning streak came to an end when, according to the  New York Times , he was indicted on \u201c98 counts of racketeering, securities fraud, mail fraud and other crimes.\u201d 6  He later pleaded guilty to six charges, resulting in a 10-year prison sentence, of which he served two, and was as also forced to pay over $600 million in fines and settlements. 7 5 James Chen. \u201cMicheal Milken.\u201d January 22, 2018. https://www.investopedia.com/terms/m/michaelmilken.asp 6 Kurt Eichenwald. \u201cMilken Set to Pay a $600 Million Fine in Wall St. Fraud.\u201d April 21, 1990. https://www.nytimes.com/1990/04/21/business/milken-set-to-pay-a-600-million-fine-in-wall-st-fraud.html?pagewanted=all 7 Michael Buchanan. \u201cNovember 21, 1990, Michael Milken Sentenced to 10 Years for Security Law Violations.\u201d November 20, 2011. http://reasonabledoubt.org/criminallawblog/entry/november-21-1990-michael-milken-sentenced-to-10-years-for-security-law-violations-today-in-crime-history-1 \n\n Today, Milken remains active in philanthropic activities and, as a cancer survivor, remains committed to medical research. \n\n Pricing Bonds \n\n Imagine a concert-goer who has an extra ticket for a good seat at a popular concert that is sold out. The concert-goer purchased the ticket from the box office at its face value of $100. Because the show is sold out, the ticket could be resold at a premium. But what happens if the concert-goer paid $100 for the ticket and the show is not popular and does not sell out? To convince someone to purchase the ticket from her instead of the box office, the concert-goer will need to sell the ticket at a discount. Bonds behave in the same way as this concert ticket. \n\n Bond quotes can be found in the financial sections of newspapers or on the Internet on many financial websites. Bonds are quoted as a percentage of the bond\u2019s maturity value. The percentage is determined by dividing the current market (selling) price by the maturity value, and then multiplying the value by 100 to convert the decimal into a percentage. In the case of a $30,000 bond discounted to $27,591.94 because of an increase in the market rate of interest, the bond quote would be $27,591.24/$30,000 \u00d7 100, or 91.9708. Using another example, a quote of 88.50 would mean that the bonds in question are selling for 88.50% of the maturity value. If an investor were considering buying a bond with a $10,000 maturity value, the investor would pay 88.50% of the maturity value of $10,000, or $8,850.00. If the investor was considering bonds with a maturity value of $100,000, the price would be $88,500. If the quote were over 100, this would indicate that the market interest rate has decreased from its initial rate. For example, a quote of 123.45 indicates that the investor would pay $123,450 for a $100,000 bond. \n\n Figure 13.4  shows a bond issued on July 1, 2018. It is a promise to pay the holder of the bond $1,000 on June 30, 2023, and 5% of $1,000 every year. We will use this bond to explore how a company addresses interest rate changes when issuing bonds. \n\n On this bond certificate, we see the following: \n\n The $1,000 principal or maturity value. \n\n The interest rate printed on the face of the bond is the stated interest rate, the contract rate, the face rate, or the  coupon rate . This rate is the interest rate used to calculate the interest payment on bonds. \n\n Issuing Bonds When the Contract and Market Rates Are the Same \n\n If the stated rate and the market rate are both 5%, the bond will be issued at  part value , which is the value assigned to stock in the company\u2019s charter, typically set at a very small arbitrary amount, which serves as legal capital; in our example, the part value is $1,000. The purchaser will give the company $1,000 today and will receive $50 at the end of every year for 5 years. In 5 years, the purchaser will receive the maturity value of the $1,000. The bond\u2019s quoted price is 100.00. That is, the bond will sell at 100% of the $1,000 face value, which means the seller of the bond will receive (and the investor will pay) $1,000.00. You will learn the calculations used to determine a bond\u2019s quoted price later; here, we will provide the quoted price for any calculations. Link to Learning \n\n The Securities and Exchange Commission website  Investor.gov provides an explanation of corporate bonds  to learn more. \n\n Issuing Bonds at a Premium \n\n The stated interest rate is not the only rate affecting bonds. There is also the market interest rate, also called the effective interest rate or bond yield. The amount of money that borrowers receive on the date the bonds are issued is influenced by the terms stated on the bond indenture  and  on the market interest rate, which is the rate of interest that investors can earn on similar investments. The market interest rate is influenced by many factors external to the business, such as the overall strength of the economy, the value of the U.S. dollar, and geopolitical factors. \n\n This  market interest rate  is the rate determined by supply and demand, the current overall economic conditions, and the credit worthiness of the borrower, among other factors. Suppose that, while a company has been busy during the long process of getting its bonds approved and issued (it might take several months), the interest rate changed because circumstances in the market changed. At this point, the company cannot change the rate used to market the bond issue. Instead, the company might have to sell the bonds at a price that will be the equivalent of having a different stated rate (one that is equivalent to a market rate based on the company\u2019s financial characteristics at the time of the issuance (sale) of the bonds). \n\n If the company offers 5% (the bond rate used to market the bond issue) and the market rate prior to issuance drops to 4%, the bonds will be in high demand. The company is scheduled to pay a higher interest rate than everyone else, so it can issue them for more than face value, or at a premium. In this example, where the stated interest rate is higher than the market interest rate, let\u2019s say the bond\u2019s quoted price is 104.46. That is, the bond will sell at 104.46% of the $1,000 face value, which means the seller of the bond will receive and the investor will pay $1,044.60. \n\n Issuing Bonds at a Discount \n\n Now let\u2019s consider a situation when the company\u2019s bonds prior to issuance are scheduled to pay 5% and the market rate jumps to 7% at issuance. No one will want to buy the bonds at 5% when they can earn more interest elsewhere. The company will have to sell the $1,000 bond for less than $1,000, or at a discount. In this example, where the stated interest rate is lower than the market interest rate, the bond\u2019s quoted price is 91.80. That is, the bond will sell at 91.80% of the $1,000 face value, which means the seller of the bond will receive (and the investor will pay) $918.00. \n\n Sale of Bonds before Maturity \n\n Let\u2019s look at bonds from the perspective of the issuer and the investor. As we previously discussed, bonds are often classified as long-term liabilities because the money is borrowed for long periods of time, up to 30 years in some cases. This provides the business with the money necessary to fund long-term projects and investments in the business. Due to unanticipated circumstances, the investors, on the other hand, may not want to wait up to 30 years to receive the maturity value of the bond. While the investor will receive periodic interest payments while the bond is held, investors may want to receive the current market value prior to the maturity date. Therefore, from the investor\u2019s perspective, one of the advantages of investing in bonds is that they are typically easy to sell in the secondary market should the investor need the money before the maturity date, which may be many years in the future. The  secondary market  is an organized market where previously issued stocks and bonds can be traded after they are issued. \n\n If a bond sells on the secondary market after it has been issued, the terms of the bond (a particular interest rate, at a determined timeframe, and a given maturity value) do not change. If an investor buys a bond after it is issued or sells it before it matures, there is the possibility that the investor will receive more or less for the bond than the amount the bond was originally sold for. This change in value may occur if the market interest rate differs from the stated interest rate. \n\n Continuing Application Debt Considerations for Grocery Stores Every company faces internal decisions when it comes to borrowing funds for improvements and/or expansions. Consider the improvements your local grocery stores have made over the past couple of years. Just like any large retail business, if grocery stores don\u2019t invest in each property by adding services, upgrading the storefront, or even making more energy efficient changes, the location can fall out of popularity. \n\n Such investments require large amounts of capital infusion. The primary available investment funds for privately-owned grocery chains are bank loans or owners\u2019 capital. This limitation often restricts the expansions or upgrades such a company can do at any one time. Publicly-traded grocery chains can also borrow funds from a bank, but other options, like issuing bonds or more stock can also help fund development. Thus publicly-traded grocery chains have more options to fund improvements and can therefore expand their share of the market more easily, unlike their private smaller counterparts who must decide what improvement is the most critical. \n\n Fundamentals of Interest Calculation \n\n Since interest is paid on long-term liabilities, we now need to examine the process of calculating interest. Interest can be calculated in several ways, some more common than others. For our purposes, we will explore interest calculations using the simple method and the compounded method. Regardless of the method involved, there are three components that we need when calculating interest: \n\n Amount of money borrowed (called the principal). \n\n Interest rate for the time frame of the loan. Note that interest rates are usually stated in annual terms (e.g., 8% per year). If the timeframe is excluded, an annual rate should be assumed. Pay particular attention to how often the interest is to be paid because this will affect the rate used in the calculation: \n\nFor example, if the rate on a bond is 6% per year but the interest is paid semi-annually, the rate used in the interest calculation should be 3% because the interest applies to a 6-month timeframe (6% \u00f7 2). Similarly, if the rate on a bond is 8% per year but the interest is paid quarterly, the rate used in the interest calculation should be 2% (8% \u00f7 4). \n\n Time period for which we are calculating the interest. \n\n Let\u2019s explore simple interest first. We use the following formula to calculate interest in dollars: \n\n Principal  is the amount of money invested or borrowed,  interest rate  is the interest rate paid or earned, and  time  is the length of time the principal is borrowed or invested. Consider a bank deposit of $100 that remains in the account for 3 years, earning 6% per year with the bank paying simple interest. In this calculation, the interest rate is 6% a year, paid once at the end of the year. Using the interest rate formula from above, the interest rate remains 6% (6% \u00f7 1). Using 6% interest per year earned on a $100 principal provides the following results in the first three years ( Figure 13.5 ): \n\n Year 1: The $100 in the bank earns 6% interest, and at the end of the year, the bank pays $6.00 in interest, making the amount in the bank account $106 ($100 principal + $6 interest). \n\n Year 2: Assuming we do not withdraw the interest, the $106 in the bank earns 6% interest on the principal ($100), and at the end of the year, the bank pays $6 in interest, making the total amount $112. \n\n Year 3: Again, assuming we do not withdraw the interest, $112 in the bank earns 6% interest on the principal ($100), and at the end of the year, the bank pays $6 in interest, making the total amount $118. \n\n With simple interest, the amount paid is always based on the principal, not on any interest earned. \n\n Another method commonly used for calculating interest involves compound interest.  Compound interest  means that the interest earned also earns interest.  Figure 13.6  shows the same deposit with compounded interest. \n\n In this case, investing $100 today in a bank that pays 6% per year for 3 years with compound interest will produce $119.10 at the end of the three years, instead of $118.00, which was earned with simple interest. \n\n At this point, we need to provide an assumption we make in this chapter. Since financial institutions typically cannot deal in fractions of a cent, in calculations such as the above, we will round the final answer to the nearest cent, if necessary. For example, the final cash total at the end of the third year in the above example would be $119.1016. However, we rounded the answer to the nearest cent for convenience. In the case of a car or home loan, the rounding can lead to a higher or lower adjustment in your final payment. For example, you might finance a car loan by borrowing $20,000 for 48 months with monthly payments of $469.70 for the first 47 months and $469.74 for the final payment. \n\n Link to Learning \n\n Go to the  Securities and Exchange Commission website for an explanation of US Savings Bonds  to learn more. \n 13.2   Compute Amortization of Long-Term Liabilities Using the Effective-Interest Method \n\n In our discussion of long-term debt amortization, we will examine both notes payable and bonds. While they have some structural differences, they are similar in the creation of their amortization documentation. \n\n Pricing of Long-Term Notes Payable \n\n When a consumer borrows money, she can expect to not only repay the amount borrowed, but also to pay interest on the amount borrowed. When she makes periodic loan payments that pay back the principal and interest over time with payments of equal amounts, these are considered  fully amortized notes . In these timed payments, part of what she pays is interest. The amount borrowed that is still due is often called the principal. After she has made her final payment, she no longer owes anything, and the loan is fully repaid, or amortized.  Amortization  is the process of separating the principal and interest in the loan payments over the life of a loan. A fully amortized loan is fully paid by the end of the maturity period. \n\n In the following example, assume that the borrower acquired a five-year, $10,000 loan from a bank. She will repay the loan with five equal payments at the end of the year for the next five years. The bank\u2019s required interest rate is an annual rate of 12%. \n\n Interest rates are typically quoted in annual terms. Since her interest rate is 12% a year, the borrower must pay 12% interest each year on the principal that she owes. As stated above, these are equal annual payments, and each payment is first applied to any applicable interest expenses, with the remaining funds reducing the principal balance of the loan. \n\n After each payment in a fully amortizing loan, the principal is reduced, which means that since the five payment amounts are equal, the portion allocated to interest is reduced each year, and the amount allocated to principal reduction increases an equal amount. \n\n We can use an amortization table, or schedule, prepared using Microsoft Excel or other financial software, to show the loan balance for the duration of the loan. An amortization table calculates the allocation of interest and principal for each payment and is used by accountants to make journal entries. These journal entrieswill be discussed later in this chapter. \n\n The first step in preparing an amortization table is to determine the annual loan payment. The $10,000 loan amount is the value today and, in financial terms, is called the present value (PV). Since repayment will be in a series of five equal payments, it is an annuity. Look up the PV from an annuity table for 5 periods and 12% interest. The factor is 3.605. Dividing the principal, $10,000, by the factor 3.605 gives us $2,773.93, which is the amount of each yearly payment. For the rest of the chapter, we will provide the necessary data, such as bond prices and payment amounts; you will not need to use the present value tables. \n\n When the first payment is made, part of it is interest and part is principal. To determine the amount of the payment that is interest, multiply the principal by the interest rate ($10,000 \u00d7 0.12), which gives us $1,200. This is the amount of interest charged that year. The payment itself ($2,773.93) is larger than the interest owed for that period of time, so the remainder of the payment is applied against the principal. \n\n Figure 13.7  shows an amortization table for this $10,000 loan, over five years at 12% annual interest. Assume that the final payment will be $2,774.99 in order to eliminate the potential rounding error of $1.06. \n\n Your Turn Creating Your Own Amortization Table You want to borrow $100,000 for five years when the interest rate is 5%. You will make yearly payments of $23,097.48 for 5 years. Fill in the blanks in the amortization table below. Assume that the loan was created on January 1, 2018 and totally repaid by December 31, 2022, after five equal, annual payments. \n\n Solution \n\n Multiply the $100,000 by the 5% interest rate and $5,000 is the amount of interest you owe for year 1. Subtract the interest from the payment of $23,097.48 to find $18,097.48 is applied toward the principal ($100,000), leaving $81,902.52 as the ending balance. In year 2, $81,902.52 is charged 5% interest ($4,095.13), but the rest of the 23,097.48 payment goes toward the loan balance. Follow the same process for years 3 through 5. \n\n Bonds Payable \n\n As you\u2019ve learned, each time a company issues an interest payment to bondholders, amortization of the discount or premium, if one exists, impacts the amount of interest expense that is recorded. Amortization of the discounts increases the amount of interest expense and premiums reduce the amount of interest expense. There are two methods used to amortize bond discounts or premiums: the effective-interest method and the straight-line method. \n\n Our calculations have used what is known as the  effective-interest method , a method that calculates interest expense based on the carrying value of the bond and the market interest rate. Generally accepted accounting principles (GAAP) require the use of the effective-interest method unless there is no significant difference between the effective-interest method and the straight-line method, a method that allocates the same amount of the bond discount or premium for each interest payment. The effective interest amortization method is more accurate than the straight-line method. International Financial Reporting Standards (IFRS) require the use of the effective-interest method, with no exceptions. \n\n The  straight-line method  doesn\u2019t base its calculation of amortization for a period base on a changing carrying value like the effective-interest method does; instead, it allocates the same amount of premium or discount amortation for each of the bond\u2019s payment periods. \n\n For example, assume that $500,000 in bonds were issued at a price of $540,000 on January 1, 2019, with the first annual interest payment to be made on December 31, 2019. Assume that the stated interest rate is 10% and the bond has a four-year life. If the straight-line method is used to amortize the $40,000 premium, you would divide the premium of $40,000 by the number of payments, in this case four, giving a $10,000 per year amortization of the premium.  Figure 13.8  shows the effects of the premium amortization after all of the 2019 transactions are considered. The net effect of creating the $40,000 premium and writing off $10,000 of it gives the company an interest expense of $40,000 instead of $50,000, since the $50,000 expense is reduced by the $10,000 premium write down at the end of the year. \n\n Issued When Market Rate Equals Contract Rate \n\n Assume a company issues a $100,000 bond with a 5% stated rate when the market rate is also 5%. The bond was issued at par, meaning it sold for $100,000. There was no premium or discount to amortize, so there is no application of the effective-interest method in this example. \n\n Issued at a Premium \n\n The same company also issued a 5-year, $100,000 bond with a stated rate of 5% when the market rate was 4%. This bond was issued at a premium, for $104,460. The amount of the premium is $4,460, which will be amortized over the life of the bond using the effective-interest method. This method of amortizing the interest expense associated with a bond is similar to the amortization of the note payable described earlier, in which the principal was separated from the interest payments using the interest rate times the principal. \n\n Begin by assuming the company issued all the bonds on January 1 of year 1 and the first interest payment will be made on December 31 of year 1. The amortization table begins on January 1, year 1, with the carrying value of the bond: the face value of the bond plus the bond premium. \n\n On December 31, year 1, the company will have to pay the bondholders $5,000 (0.05 \u00d7 $100,000). The  cash interest payment  is the amount of interest the company must pay the bondholder. The company promised 5% when the market rate was 4% so it received more money. But the company is only paying interest on $100,000\u2014not on the full amount received. The difference in the sale price was a result of the difference in the interest rates so both rates are used to compute the true interest expense. \n\n The interest on the carrying value is the market rate of interest times the carrying value: 0.04 \u00d7 $104,460 = $4,178. If the company had issued the bonds with a stated rate of 4%, and received $104,460, it would be paying $4,178 in interest. The difference between the cash interest payment and the interest on the carrying value is the amount to be amortized the first year. The complete amortization table for the bond is shown in  Figure 13.9 . The table is necessary to provide the calculations needed for the adjusting journal entries. \n\n Issued at a Discount \n\n The company also issued $100,000 of 5% bonds when the market rate was 7%. It received $91,800 cash and recorded a Discount on Bonds Payable of $8,200. This amount will need to be amortized over the 5-year life of the bonds. Using the same format for an amortization table, but having received $91,800, interest payments are being made on $100,000. \n\n The cash interest payment is still the stated rate times the principal. The interest on carrying value is still the market rate times the carrying value. The difference in the two interest amounts is used to amortize the discount, but now the amortization of discount amount is added to the carrying value. \n\n Figure 13.10  illustrates the relationship between rates whenever a premium or discount is created at bond issuance. \n\n Concepts In Practice Bond Ratings Investors intending to purchase corporate bonds may find it overwhelming to decide which company would be the best to invest in. Investors are concerned with two primary factors: the return  on  the investment (meaning, the periodic interest payments) and the return  of  the investment (meaning, payment of the face value on the maturity date). While there are risks with any investment, attempting to maximize the return  on  the investment and maximizing the likelihood receiving the return  of  the investment would take a significant amount of time for the investor. To become informed and make a wise investment, the investor would have to spend many hours analyzing the financial statements of potential companies to invest in. \n\n One resource investors find useful when screening investment opportunities is through the use of rating agencies. Rating agencies specialize in analyzing financial and other company information in order to assess and rate a company\u2019s riskiness as an investment. A particularly useful website is  Investopedia  which highlights the rating system for three large rating agencies\u2014Moody\u2019s, Standard & Poor\u2019s, and Fitch Ratings. The rating systems, shown below, are somewhat similar to academic grading scales, with rankings ranging from A (highest quality) to D (lowest quality): Rating Agencies 8 8 Michael Schmidt. \u201cWhen to Trust Bond Rating Agencies.\u201d Investopedia. September 29, 2018.  https://www.investopedia.com/articles/bonds/09/bond-rating-agencies.asp \n\n Credit Risk \n\n Moody\u2019s \n\n Standard & Poor\u2019s \n\n Fitch Ratings \n\n Investment Grade \n\n \u2014 \n\n \u2014 \n\n \u2014 \n\n Highest Quality \n\n Aaa \n\n AAA \n\n AAA \n\n High Quality \n\n Aa1, Aa2, Aa3 \n\n AA+, AA, AA\u2013 \n\n AA+, AA, A\u2013 \n\n Upper Medium \n\n A1, A2, A3 \n\n A+, A, A\u2013 \n\n A+, A, A\u2013 \n\n Medium \n\n Baa1, Baa2, Baa3 \n\n BBB+, BBB, BBB\u2013 \n\n BBB+, BBB, BBB\u2013 \n\n Not Investment Grade \n\n Ba1 \n\n BB+ \n\n BB+ \n\n Speculative Medium \n\n Ba2, Ba3 \n\n BB, BB\u2013 \n\n BB, BB\u2013 \n\n Speculative Lower Grade \n\n B1, B2, B3 \n\n B+, B, B\u2013 \n\n B+, B, B\u2013 \n\n Speculative Risky \n\n Caa1 \n\n CCC+ \n\n CCC \n\n Speculative Poor Standing \n\n Caa2, Caa3 \n\n CCC, CCC\u2013 \n\n \u2014 \n\n No Payments / Bankruptcy \n\n Ca / C \n\n \u2014 \n\n \u2014 \n\n In Default \n\n \u2014 \n\n D \n\n DDD, DD, D \n\n Table  13.1   \n 13.3   Prepare Journal Entries to Reflect the Life Cycle of Bonds \n\n Recall from the discussion in  Explain the Pricing of Long-Term Liabilities  that one way businesses can generate long-term financing is by borrowing from lenders. \n\n In this section, we will explore the journal entries related to bonds. Earlier, we found that cash flows related to a bond include the following: \n\n The receipt of cash when the bond is issued \n\n Payment of interest each period \n\n Repayment of the bond at maturity \n\n A journal entry must be made for each of these transactions. As we go through the journal entries, it is important to understand that we are analyzing the accounting transactions from the perspective of the issuer of the bond. These are considered long-term liabilities. The investor would make the opposite journal entries. For example, on the issue date of a bond, the borrower receives cash while the lender pays cash. \n\n A final point to consider relates to accounting for the interest costs on the bond. Recall that the bond indenture specifies how much interest the borrower will pay with each periodic payment based on the stated rate of interest. The periodic interest payments to the buyer (investor) will be the same over the course of the bond. It may help to think of personal loan examples. For example, if you or your family have ever borrowed money from a bank for a car or home, the payments are typically the same each month. The interest payments will be the same because of the rate stipulated in the bond indenture, regardless of what the market rate does. The amount of interest cost that we will recognize in the journal entries, however, will change over the course of the bond term, assuming that we are using the effective interest. \n\n IFRS Connection Defining Long-Term Liabilities Under both IFRS and US GAAP, the general definition of a long-term liability is similar. However, there are many types of long-term liabilities, and various types have specific measurement and reporting criteria that may differ between the two sets of accounting standards. With two exceptions, bonds payable are primarily the same under the two sets of standards. \n\n The first difference pertains to the method of interest amortization. Beyond FASB\u2019s preferred method of interest amortization discussed here, there is another method, the straight-line method. This method is permitted under US GAAP if the results produced by its use would not be materially different than if the effective-interest method were used. IFRS does not permit straight-line amortization and only allows the effective-interest method. \n\n The second difference pertains to how the bonds are reported on the books. Under US GAAP, bonds are recorded at face value and the premium or discount is recorded in a separate account. IFRS does not use \u201cpremium\u201d or \u201cdiscount\u201d accounts. Instead, under IFRS, the carrying value of bonds issued at either a premium or discount is shown on the balance sheet at its net. For example, $100,000 bonds issued at a discount of $4,000 would be recorded under US GAAP as \n\n Under IFRS, these bonds would be reported as \n\n Obviously, the above example implies that, in the subsequent entries to recognize interest expense, under IFRS, the Bonds Payable account is amortized directly for the increase or reduction in bond principal. Suppose in this example that the cash interest was $200 and the interest expense for the first interest period was $250. The entry to record the transaction under the two different standards would be as follows: \n\n Under US GAAP: \n\n Under IFRS: \n\n Note that under either method, the interest expense and the carrying value of the bonds stays the same. \n\n Issuance of Bonds \n\n Since the process of underwriting a bond issuance is lengthy and extensive, there can be several months between the determination of the specific characteristics of a bond issue and the actual issuance of the bond. Before the bonds can be issued, the underwriters perform many time-consuming tasks, including setting the bond interest rate. The bond interest rate is influenced by specific factors relating to the company, such as existing debt balances and the ability of the company to repay the funds, as well as the market rate, which is influenced by many external economic factors. \n\n Because of the time lag caused by underwriting, it is not unusual for the market rate of the bond to be different from the stated interest rate. The difference in the stated rate and the market rate determine the accounting treatment of the transactions involving bonds. When the bond is issued at par, the accounting treatment is simplest. It becomes more complicated when the stated rate and the market rate differ. \n\n Issued When Market Rate Equals Contract Rate \n\n First, we will explore the case when the stated interest rate is equal to the market interest rate when the bonds are issued. \n\n Returning to our example of a $1,000, 5-year bond with a stated interest rate of 5%, at issuance, the market rate was 5% and the sales price was quoted at 100, which means the seller of the bond will receive (and the investor will pay) 100% of the $1,000 face value of the bond. The journal entry to record the sale of 100 of these bonds is: \n\n Since the book value is equal to the amount that will be owed in the future, no other account is included in the journal entry. \n\n Issued at a Premium \n\n If, during the timeframe of establishing the bond stated rate and issuing the bonds, the market rate drops below the stated interest, the bonds would become more valuable. In other words, the investors will earn a higher rate on these bonds than if the investors purchased similar bonds elsewhere in the market. Naturally, investors would want to purchase these bonds and earn a higher interest rate. The increased demand drives up the bond price to a point where investors earn the same interest as similar bonds. Earlier, we found that the sale price of a $1,000, 5-year bond with a stated rate of 5% and a market rate of 4% is 104.46. That is, the bond will sell at 104.46% of the $1,000 face value, which means the seller of the bond will receive (and the investor will pay) $1,044.60. \n\n Selling 100 of these bonds, would yield $104,460. \n\n The financial statement presentation looks like this: \n\n On the date that the bonds were issued, the company received cash of $104,460.00 but agreed to pay $100,000.00 in the future for 100 bonds with a $1,000 face value. The difference in the amount received and the amount owed is called the  premium . Since they promised to pay 5% while similar bonds earn 4%, the company received more cash up front. In other words, they sold the bond at a premium. They did this because the cost of the premium plus the 5% interest on the face value is mathematically the same as receiving the face value but paying 4% interest. The interest rate was effectively the same. \n\n The  premium on bonds payable  account is a contra liability account. It is contra because it increases the amount of the Bonds Payable liability account. It is \u201cmarried\u201d to the Bonds Payable account on the balance sheet. If one of the accounts appears, both must appear. The Premium will disappear over time as it is amortized, but it will decrease the interest expense, which we will see in subsequent journal entries. \n\n Taken together, the Bond Payable liability of $100,000 and the Premium on Bond Payable contra liability of $4,460 show the bond\u2019s carrying value or  book value \u2014the value that assets or liabilities are recorded at in the company\u2019s financial statements. \n\n The effect on the accounting equation looks like this: \n\n It looks like the issuer will have to pay back $104,460, but this is not quite true. If the bonds were to be paid off today, the full $104,460 would have to be paid back. But as time passes, the Premium account is amortized until it is zero. The bondholders have bonds that say the issuer will pay them $100,000, so that is all that is owed at maturity. The premium will disappear over time and will reduce the amount of interest incurred. \n\n Issued at a Discount \n\n Bonds issued at a discount are the exact opposite in concept as bonds issued at a premium. If, during the timeframe of establishing the bond stated rate and issuing the bonds, the market rate rises above the stated interest on the bonds, the bonds become less valuable because investors can earn a higher rate of interest on other similar bonds. In other words, the investors will earn a lower rate on these bonds than if the investors purchased similar bonds elsewhere in the market. Naturally, investors would not want to purchase these bonds and earn a lower interest rate than could be earned elsewhere. The decreased demand drives down the bond price to a point where investors earn the same interest for similar bonds. Earlier, we found the sale price of a $1,000, 5-year bond with a stated interest rate of 5% and a market rate of 7% is 91.80. That is, the bond will sell at 91.80% of the $1,000 face value, which means the seller of the bond will receive (and the investor will pay) $918.00. On selling 100 of the $1,000 bonds today, the journal entry would be: \n\n Today, the company receives cash of $91,800.00, and it agrees to pay $100,000.00 in the future for 100 bonds with a $1,000 face value. The difference in the amount received and the amount owed is called the  discount . Since they promised to pay 5% while similar bonds earn 7%, the company, accepted less cash up front. In other words, they sold the bond at a discount. They did this because giving a discount but still paying only 5% interest on the face value is mathematically the same as receiving the face value but paying 7% interest. The interest rate was effectively the same. \n\n Like the Premium on Bonds Payable account, the  discount on bonds payable  account is a contra liability account and is \u201cmarried\u201d to the Bonds Payable account on the balance sheet. The Discount will disappear over time as it is amortized, but it will increase the interest expense, which we will see in subsequent journal entries. \n\n The effect on the accounting equation looks like this: \n\n First and Second Semiannual Interest Payment \n\n When a company issues bonds, they make a promise to pay interest annually or sometimes more often. If the interest is paid annually, the journal entry is made on the last day of the bond\u2019s year. If interest was promised semiannually, entries are made twice a year. \n\n Concepts In Practice Municipal Bonds Municipal bonds  are a specific type of bonds that are issued by governmental entities such as towns and school districts. These bonds are issued in order to finance specific projects (such as water treatment plants and school building construction) that require a large investment of cash. The primary benefit to the issuing entity (i.e., the town or school district) is that cash can be obtained more quickly than, for example, collecting taxes and fees over a long period of time. This allows the project to be completed sooner, which is a benefit to the community. \n\n Municipal bonds, like other bonds, pay periodic interest based on the stated interest rate and the face value at the end of the bond term. However, corporate bonds often pay a higher rate of interest than municipal bonds. Despite the lower interest rate, one benefit of municipal bonds relates to the tax treatment of the periodic interest payments for investors. With corporate bonds, the periodic interest payments are considered taxable income to the investor. For example, if an investor receives $1,000 of interest and is in the 25% tax bracket, the investor will have to pay $250 of taxes on the interest, leaving the investor with an after-tax payment of $750. With municipal bonds, interest payments are exempt from federal tax. So the same investor receiving $1,000 of interest from a municipal bond would pay no income tax on the interest income. This tax-exempt status of municipal bonds allows the entity to attract investors and fund projects more easily. \n\n Interest Payment: Issued When Market Rate Equals Contract Rate \n\n Recall that the Balance Sheet presentation of the bond when the market rate equals the stated rate is as follows: \n\n In this example, the company issued 100 bonds with a face value of $1,000, a 5-year term, and a stated interest rate of 5% when the market rate was 5% and received $100,000. As previously discussed, since the bonds were sold when the market rate equals the stated rate, the carrying value of the bonds is $100,000. These bonds did not specify when interest was paid, so we can assume that it is an annual payment. If the bonds were issued on January 1, the company would pay interest on December 31 and the journal entry would be: \n\n The interest expense is calculated by taking the Carrying Value ($100,000) multiplied by the market interest rate (5%). The stated rate is used when calculating the interest cash payment. The company is obligated by the bond indenture to pay 5% per year based on the face value of the bond. When the situation changes and the bond is sold at a discount or premium, it is easy to get confused and incorrectly use the market rate here. Since the market rate and the stated rate are the same in this example, we do not have to worry about any differences between the amount of interest expense and the cash paid to bondholders. This journal entry will be made every year for the 5-year life of the bond. \n\n When performing these calculations, the rate is adjusted for more frequent interest payments. If the company had issued 5% bonds that paid interest semiannually, interest payments would be made twice a year, but each interest payment would only be half an annual interest payment. Earning interest for a full year at 5% annually is the equivalent of receiving half of that amount each six months. So, for semiannual payments, we would divide 5% by 2 and pay 2.5% every six months. \n\n Concepts In Practice Mortgage Debt According to  Statista  the amount of mortgage debt\u2014debt incurred to purchase homes\u2014in the United States was $14.9 trillion on 2017. This value does not include the interest cost\u2014the cost of borrowing\u2014related to the debt. \n\n A common loan term for those borrowing money to buy a house is 30 years. Each month, the borrower must make payments on the loan, which would add up to 360 payments for a 30-year loan. Recall from previous discussions on amortization that each payment can be divided into two components: the interest expense and the amount that is applied to reduce the principal. \n\n In order to calculate the amount of interest and principal reduction for each payment, banks and borrowers often use amortization tables. While amortization tables are easily created in Microsoft Excel or other spreadsheet applications, there are many websites that have easy-to-use amortization tables. The popular lending website  Zillow  has a loan calculator to calculate the monthly payments of a loan as well as an amortization table that shows how much interest and principal reduction is applied for each payment. \n\n For example, borrowing $200,000 for 30 years at an interest rate of 5% would require the borrow to repay a total $386,513. The monthly payment on this loan is $1,073.64. This amount represents the $200,000 borrowed and $186,513 of interest cost. If the borrower chose a 15-year loan, the total payments drops significantly to $266,757, but the monthly payments increase to $1,581.59. \n\n Because interest is calculated based on the outstanding loan balance, the amount of interest paid in the first payment is much more than the amount of interest in the final payment. The pie charts below show the amount of the $1,073.64 payment allocated to interest and loan reduction for the first and final payments, respectively, on the 30-year loan. \n\n Interest Payment: Issued at a Premium \n\n Recall that the Balance Sheet presentation of the bond when the market rate at issue is lower than the stated rate is as follows: \n\n In this scenario, the sale price of a $1,000, 5-year bond with a stated rate of 5% and a market rate of 4% was $1,044.60. If the company sold 100 of these bonds, it would receive $104,460 and the journal entry would be: \n\n Again, let\u2019s assume that the bonds pay interest annually. At the end of the bond\u2019s year, we would record the interest expense: \n\n The interest expense determination is calculated using the  effective interest  amortization interest method. Under the effective-interest method, the interest expense is calculated by taking the Carrying (or Book) Value ($104,460) multiplied by the market interest rate (4%). The amount of the cash payment in this example is calculated by taking the face value of the bond ($100,000) multiplied by the stated rate. \n\n Since the market rate and the stated rate are different, we need to account for the difference between the amount of interest expense and the cash paid to bondholders. The amount of the premium amortization is simply the difference between the interest expense and the cash payment. Another way to think about amortization is to understand that, with each cash payment, we need to reduce the amount carried on the books in the Bond Premium account. Since we originally credited Bond Premium when the bonds were issued, we need to debit the account each time the interest is paid to bondholders because the carrying value of the bond has changed. Note that the company received more for the bonds than face value, but it is only paying interest on $100,000. \n\n The partial effect of the first period\u2019s interest payment on the company\u2019s accounting equation in year one is: \n\n And the financial-statement presentation at the end of year 1 is: \n\n The journal entry for year 2 is: \n\n The interest expense is calculated by taking the Carrying (or Book) Value ($103,638) multiplied by the market interest rate (4%). The amount of the cash payment in this example is calculated by taking the face value of the bond ($100,000) multiplied by the stated rate (5%). Since the market rate and the stated rate are different, we again need to account for the difference between the amount of interest expense and the cash paid to bondholders. \n\n The partial effect on the accounting equation in year two is: \n\n And the financial-statement presentation at the end of year 2 is: \n\n By the end of the 5th year, the bond premium will be zero, and the company will only owe the Bonds Payable amount of $100,000. \n\n Link to Learning \n\n A  mortgage calculator  provides monthly payment estimates for a long-term loan like a mortgage. To use the calculator, enter the cost of the house to be purchased, the amount of cash to be borrowed, the number of years over which the mortgage is to be paid back (generally 30 years), and the current interest rate. The calculator returns the amount of the mortgage payment. Mortgages are long-term liabilities that are used to finance real estate purchases. We tend to think of them as home loans, but they can also be used for commercial real estate purchases. \n\n Interest Payment: Issued at a Discount \n\n Recall that the Balance Sheet presentation of the bond when the market rate at issue was higher than the stated rate is as follows: \n\n We found the sale price of a $1,000, 5-year bond with a stated interest rate of 5% and a market rate of 7% was $918.00. We then showed the journal entry to record sale of 100 bonds: \n\n At the end of the bond\u2019s first year, we make this journal entry: \n\n The interest expense is calculated by taking the Carrying Value ($91,800) multiplied by the market interest rate (7%). The amount of the cash payment in this example is calculated by taking the face value of the bond ($100,000) and multiplying it by the stated rate (5%). Since the market rate and the stated rate are different, we need to account for the difference between the amount of interest expense and the cash paid to bondholders. The amount of the discount amortization is simply the difference between the interest expense and the cash payment. Since we originally debited Bond Discount when the bonds were issued, we need to credit the account each time the interest is paid to bondholders because the carrying value of the bond has changed. Note that the company received less for the bonds than face value but is paying interest on the $100,000. \n\n The partial effect on the accounting equation in year one is: \n\n And the financial-statement presentation at the end of year 1 is: \n\n The journal entry for year 2 is: \n\n The interest expense is calculated by taking the Carrying Value ($93,226) multiplied by the market interest rate (7%). The amount of the cash payment in this example is calculated by taking the face value of the bond ($100,000) multiplied by the stated rate (5%). Again, we need to account for the difference between the amount of interest expense and the cash paid to bondholders by crediting the Bond Discount account. \n\n The partial effect on the accounting equation in year two is: \n\n And the financial statement presentation at the end of year 2 is: \n\n By the end of the 5th year, the bond premium will be zero and the company will only owe the Bonds Payable amount of $100,000. \n\n Retirement of Bonds When the Bonds Were Issued at Par \n\n At some point, a company will need to record  bond retirement , when the company pays the obligation. Often, they will retire bonds when they mature. For example, earlier we demonstrated the issuance of a five-year bond, along with its first two interest payments. If we had carried out recording all five interest payments, the next step would have been the maturity and retirement of the bond. At this stage, the bond issuer would pay the maturity value of the bond to the owner of the bond, whether that is the original owner or a secondary investor. \n\n This example demonstrates the least complicated method of a bond issuance and retirement at maturity. There are other possibilities that can be much more complicated and beyond the scope of this course. For example, a bond might be callable by the issuing company, in which the company may pay a call premium paid to the current owner of the bond. Also, a bond might be called while there is still a premium or discount on the bond, and that can complicate the retirement process. Situations like these will be addressed in later accounting courses. \n\n To continue with our example, assume that the company issued 100 bonds with a face value of $1,000, a 5-year term, and a stated interest rate of 5% when the market rate was 5% and received $100,000. It was recorded in this way: \n\n At the end of 5 years, the company will retire the bonds by paying the amount owed. To record this action, the company would debit Bonds Payable and credit Cash. Remember that the bond payable retirement debit entry will always be the face amount of the bonds since, when the bond matures, any discount or premium will have been completely amortized. \n 13.4   Appendix: Special Topics Related to Long-Term Liabilities \n\n Here we will address some special topics related to long-term liabilities. \n\n Brief Comparison between Equity and Debt Financing \n\n Although we briefly addressed equity versus debt financing in  Explain the Pricing of Long-Term Liabilities , we will now review the two options. Let\u2019s consider Maria, who wants to buy a business. The venture is for sale for $1 million, but she only has $200,000. What are her options? In this situation, a business owner can use debt financing by borrowing money or equity financing by selling part of the company, or she can use a combination of both. \n\n Debt financing  means borrowing money that will be repaid on a specific date in the future. Many companies have started by incurring debt. To decide whether this is a viable option, the owners need to determine whether they can afford the monthly payments to repay the debt. One positive to this scenario is that interest paid on the debt is tax deductible and can lower the company\u2019s tax liability. On the other hand, businesses can struggle to make these payments every month, especially as they are starting out. \n\n With  equity financing , a business owner sells part of the business to obtain money to finance business operations. With this type of financing, the original owner gives up some portion of ownership in the company in return for cash. In Maria\u2019s case, partners would supplement her $200,000 and would then own a share of the business. Each partner\u2019s share is based on their financial or other contributions. \n\n If a business owner forms a corporation, each owner will receive shares of stock. Typically, those making the largest financial investment have the largest say in decisions about business operations. The issuance of dividends should also be considered in this set-up. Paying dividends to shareholders is not tax deductible, but dividend payments are also not required. Additionally, a company does not have to buy back any stock it sells. \n\n Ethical Considerations Debt versus Equity Financing Many start-ups and small companies with just one or two owners struggle to obtain the cash to run their operations. Owners may want to use lending, or debt financing, to obtain the money to run operations, but have to turn to investors, or equity financing. Ethical and legal obligations to investors are typically greater than ethical and legal obligations to lenders. This is because a company\u2019s owners have an ethical and legal responsibility to take investors\u2019 interests into account when making business decisions, even if the decision is not in the founding owners\u2019 best interest. The primary obligation to lenders, however, is only to pay back the money borrowed with interest. When determining which type of financing is appropriate for a business operation, the different ethical and legal obligations between having lenders or investors need to be considered. 9 9 Nolo. \u201cFinancing a Small Business: Equity or Debt?\u201d  Forbes . January 5, 2007. https://www.forbes.com/2007/01/05/equity-debt-smallbusiness-ent-fin-cx_nl_0105nolofinancing.html#bd27de55819f \n\n Equity Financing \n\n For a corporation, equity financing involves trading or selling shares of stock in the business to raise funds to run the business. For a sole proprietorship, selling part of the business means it is no longer a sole proprietorship: the subsequent transaction could create either a corporation or partnership. The owners would choose which of the two to create. Equity means ownership. However, business owners can be creative in selling interest in their venture. For example, Maria might sell interest in the building housing her candy store and retain all revenues for herself, or she may decide to share interest in the operations (sales revenues) and retain sole ownership of the building. \n\n The main benefit of financing with equity is that the business owner is not required to pay back the invested funds, so revenue can be re-invested in the company\u2019s growth. Companies funded this way are also more likely to succeed through their initial years. The Small Business Administration suggests a new business should have access to enough cash to operate for six months without having to borrow. The disadvantages of this funding method are that someone else owns part of the business and, depending on the arrangement, may have ideas that conflict with the original owner\u2019s ideas but that cannot be disregarded. \n\n The following characteristics are specific to equity financing: \n\n No required payment to owners or shareholders; dividends or other distributions are optional. Stock owners typically invest in stocks for two reasons: the dividends that many stocks pay or the appreciation in the market value of the stocks. For example, a stock holder might buy Walmart stock for $100 per share with the expectation of selling it for much more than $100 per share at some point in the future. \n\n Ownership interest held by the original or current owners can be diluted by issuing additional new shares of common stock. \n\n Unlike bonds that mature, common stocks do not have a definite life. To convert the stock to cash, some of the shares must be sold. \n\n In the past, common stocks were typically sold in even 100-share lots at a given market price per share. However, with Internet brokerages today, investors can buy any particular quantity they want. \n\n Debt Financing \n\n As you have learned, debt is an obligation to pay back an amount of money at some point in the future. Generally, a term of less than one year is considered short-term, and a term of one year or longer is considered long-term. Borrowing money for college or a car with a promise to pay back the amount to the lender generates debt. Formal debt involves a signed written document with a due date, an interest rate, and the amount of the loan. A student loan is an example of a formal debt. \n\n The following characteristics are specific to debt financing: \n\n The company is required to make timely interest payments to the holders of the bonds or notes payable. \n\n The interest in cash that is to be paid by the company is generally locked in at the agreed-upon rate, and thus the same dollar payments will be made over the life of the bond. Virtually all bonds will have a maturity point. When the bond matures, the maturity value, which was the same as the contract or issuance value, is paid to whoever owns the bond. \n\n The interest paid is deductible on the company\u2019s income tax return. \n\n Bonds or notes payable do not dilute the company\u2019s ownership interest. The holders of the long-term liabilities do not have an ownership interest. \n\n Bonds are typically sold in $1,000 increments. \n\n Concepts In Practice Short-Term Debt Businesses sometimes offer lines of credit (short-term debt) to their customers. For example,  Wilson Sporting Goods  offers open credit to tennis clubs around the country. When the club needs more tennis balls, a club manager calls  Wilson  and says, \u201cI\u2019d like to order some tennis balls.\u201d The person at  Wilson  says, \u201cWhat\u2019s your account number,\u201d and takes the order.  Wilson  does not ask the manager to sign a note but does expect to be paid back. If the club does not pay within 120 days,  Wilson  will not let them order more items until the bill is paid. Ordering on open credit makes transactions simpler for the club and for  Wilson , since there is not a need to formalize every order. But collecting on the amount might be difficult for  Wilson  if the club delays payment. For this reason, typically customers must fill out applications, or have a history with the vendor to go on open credit. \n\n Effect of Interest Points and Loan Term in Years on a Loan \n\n A mortgage loan is typically a long-term loan initiated by a potential home buyer through a mortgage lender. These lenders can be banks and other financial institutions or specialized mortgage lenders.  Figure 13.11  shows some examples of the major categories of loans. The table demonstrates some interesting characteristics of home loans. \n\n The first characteristic is that loans can be classified into several categories. One category is the length of the loan, usually 15 years, 20 years, or 30 years. Some mortgages lock in a fixed interest rate for the life of the loan, while others only lock in the rate for a period of time. An adjustable rate mortgage (ARM), such as a 5-year or 7-year ARM, locks in the interest rate for 5 or 7 years. After that period, the interest rate adjusts to the market rate, which could be higher or lower. Some loans are based on the fair market value (FMV) of the home. For example, above a certain purchase price, the mortgage would be considered a  jumbo loan , with a slightly higher interest rate than a conforming loan with a lower FMV. \n\n The second characteristic demonstrated by the table is the concept of  points . People pay points up front (at the beginning of the loan) to secure a lower interest rate when they take out a home loan. For example, potential borrowers might be informed by their loan officer that they could secure a 30-year loan at 5.0%, with no points or a 30-year loan at 4.75% by paying one point. A point is 1% of the amount of the loan. For example, one point on a $100,000 loan would be $1,000. \n\n Whether or not buying down a lower interest rate by paying points is a smart financial move is beyond the scope of this course. However, when you take a real estate course or decide to buy and finance a home, you will want to conduct your own research on the function of points in a mortgage. \n\n The third and final characteristic is that when you apply for and secure a home loan, there will typically be an assortment of other costs that you will pay, such as loan origination fees and a survey fee, for example. These additional costs are reflected in the loan\u2019s  annual percentage rate  (or APR). These additional costs are considered part of the costs of the loan and explain why the APR rates in the table are higher than the interest rates listed for each loan. \n\n Figure 13.11  shows data from the  Wells Fargo  website. You will notice that there is a column for \u201cInterest Rate\u201d and a column for \u201cAPR.\u201d Why does a 30-year loan have an interest rate of 4.375% with an APR of 4.435%? The difference results from compound interest. \n\n Borrowing $100,000 for one year at 4.0%, with interest compounded yearly, would lead to $4,000 owed in interest. But since mortgages are compounded monthly, a mortgage of $100,000 would generate $4,073.70 in interest in a year. \n\n Summary of Bond Principles \n\n As we conclude our discussion of bonds, there are two principles that are worth noting. The first principle is there is an inverse relationship between the market rate of interest and the price of the bond. That is, when the market interest rate increases, the price of the bond decreases. This is due to the fact that the stated rate of the bond does not change. 10  As we discussed, when the market interest rate is higher than the stated interest rate of the bond, the bond will sell at a discount to attract investors and to compensate for the interest rate earned between similar bonds. When, on the other hand, the market interest rate is lower than the stated interest rate, the bond will sell at a premium, which also compensates for the interest rate earned between similar bonds. It may be helpful to think of the inverse relationship between the market interest rate and the bond price in terms of analogies such as a teeter-totter in a park or a balance scale, as shown in  Figure 13.12 . 10 Another reason for the inverse relationship between the market interest rate and bond prices is due to the time value of money. \n\n In reality, the market interest rate will be above or below the stated interest rate and is rarely equal to the stated rate. The point of this illustration is to help demonstrate the inverse relationship between the market interest rate and the bond selling price. \n\n A second principle relating to bonds involves the relationship of the bond carrying value relative to its face value. By reviewing the amortization tables for bonds sold at a discount and bonds sold at a premium it is clear that the carrying value of bonds will always move toward the face value of the bond. This occurs because interest expense (using the effective-interest method) is calculated using the bond carrying value, which changes each period. \n\n For example, earlier we explored a 5-year, $100,000 bond that sold for $104,460. Return to the amortization table in  Figure 13.9  and notice the ending value on the bond is equal to the bond face value of $100,000 (ignoring the rounding difference). The same is true for bonds sold at a discount. In our example, the $100,000 bond sold at $91,800 and the carrying value in year five was $100,000. Understanding that the carrying value of bonds will always move toward the bond face value is one trick students can use to ensure the amortization table and related accounting are correct. If, on the maturity date, the bond carrying value does not equal the bond face value, something is incorrect. \n\n Let\u2019s summmarize bond characteristics, When businesses borrow money from banks or other investors, the terms of the arrangement, which include the frequency of the periodic interest payments, the interest rate, and the maturity value, are specified in the bond indentures or loan documents. Recall, too, that when the bonds are issued, the bond indenture only specifies how much the borrower will repay the lender on the maturity date. The amount of money received by the business (borrower) during the issue is called the  bond proceeds . The bond proceeds can be impacted by the market interest rate at the time the bonds are sold. Also, because of the lag time between preparing a bond issuance and selling the bonds, the market dynamics may cause the stated interest rate to change. Rarely, the market rate is equal to the stated rate when the bonds are sold, and the bond proceeds will equal the face value of the bonds. More commonly, the market rate is not equal to the stated rate. If the market rate is higher than the stated rate when the bonds are sold, the bonds will be sold at a discount. If the market rate is lower than the stated rate when the bonds are sold, the bonds will be sold at a premium.  Figure 13.10  illustrates this rule: that bond prices are inversely related to the market interest rate. ", "questions": [{"question": {"question_id": "fs-idm394270016", "question_text": "An amortization table ________.", "question_choices": ["breaks each payment into the amount that goes toward interest and the amount that goes toward the principal", "is a special table used in a break room to make people feel equitable", "separates time value of money tables into present value and future value", "separates time value of money tables into single amounts and streams of cash"], "cloze_format": "An amortization table ________.", "normal_format": "Which of the following is correct about an amortization table?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "An amortization table calculates the allocation of interest and principal for each payment and is used by accountants to make journal entries .", "hl_context": "We can use an amortization table , or schedule , prepared using Microsoft Excel or other financial software , to show the loan balance for the duration of the loan . <hl> An amortization table calculates the allocation of interest and principal for each payment and is used by accountants to make journal entries . <hl> These journal entrieswill be discussed later in this chapter ."}, {"question": {"question_id": "fs-idm417557472", "question_text": "A debenture is ________.", "question_choices": ["the interest paid on a bond", "a type of bond that can be sold back to the issuing company whenever the bondholder wishes", "a bond with only the company\u2019s word that they will pay it back", "a bond with assets such as land to back their word that they will pay it back"], "cloze_format": "A debenture is ________.", "normal_format": "What is a debenture?"}, "answer": {"ans_text": "a bond with only the company\u2019s word that they will pay it back", "ans_choice": 2}, "bloom": null, "hl_sentences": "For example , a debenture is an unsecured bond issued based on the good name and reputation of the company .", "hl_context": "Bonds themselves can have different characteristics . <hl> For example , a debenture is an unsecured bond issued based on the good name and reputation of the company . <hl> These companies are not pledging other assets to cover the amount in case they fail to pay the debt , or default . The opposite of a debenture is a secured bond , meaning the company is pledging a specific asset as collateral for the bond . With a secured bond , if the company goes under and cannot pay back the bond , the pledged asset would be sold , and the proceeds would be distributed to the bondholders ."}, {"question": {"question_id": "fs-idm393594832", "question_text": "The principal of a bond is ________.", "question_choices": ["the person who sold the bond for the company", "the person who bought the bond", "the interest rate printed on the front of the bond", "the face amount of the bond that will be paid back at maturity"], "cloze_format": "The principal of a bond is ________.", "normal_format": "What is the principal of a bond?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "bloom": null, "hl_sentences": "The bond indenture is a contract that lists the features of the bond , such as the amount of money that will be repaid in the future , called the principal ( also called face value or maturity value ); the maturity date , the day the bond holder will receive the principal amount ; and the stated interest rate , which is the rate of interest the issuer agrees to pay the bondholder throughout the term of the bond .", "hl_context": "Now let us look at bonds in more depth . A bond is a type of financial instrument that a company issues directly to investors , bypassing banks or other lending institutions , with a promise to pay the investor a specified rate of interest over a specified period of time . When a company borrows money by selling bonds , it is said the company is \u201c issuing \u201d bonds . This means the company exchanges cash for a promise to repay the cash , along with interest , over a set period of time . As you \u2019 ve learned , bonds are formal legal documents that contain specific information related to the bond . In short , it is a legal contract \u2014 called a bond certificate ( as shown in Figure 13.3 ) or an indenture \u2014 between the issuer ( the business borrowing the money ) and the lender ( the investor lending the money ) . Bonds are typically issued in relatively small denominations , such as $ 1,000 so they can be placed in the market and are accessible to a greater market of investors compared to notes . <hl> The bond indenture is a contract that lists the features of the bond , such as the amount of money that will be repaid in the future , called the principal ( also called face value or maturity value ); the maturity date , the day the bond holder will receive the principal amount ; and the stated interest rate , which is the rate of interest the issuer agrees to pay the bondholder throughout the term of the bond . <hl>"}, {"question": {"question_id": "fs-idm397551472", "question_text": "A convertible bond can be converted into ________.", "question_choices": ["preferred stock", "common stock and then converted into preferred stock", "common stock of a different company", "common stock of the company"], "cloze_format": "A convertible bond can be converted into ________.", "normal_format": "What can a convertible bond be converted into?"}, "answer": {"ans_text": "common stock of the company", "ans_choice": 3}, "bloom": null, "hl_sentences": "A convertible bond can be converted to common stock in a one-way , one-time conversion .", "hl_context": "<hl> A convertible bond can be converted to common stock in a one-way , one-time conversion . <hl> Under what conditions would it make sense to convert ? Suppose the face-value interest rate of the bond is 8 % . If the company is doing well this year , such that there is an expectation that shareholders will receive a significant dividend and the stock price will rise , the stock might appear to be more valuable than the return on the bond ."}, {"question": {"question_id": "fs-idm314708096", "question_text": "The International Financial Reporting Standards require the use of ________.", "question_choices": ["any method of amortization of bond premiums", "the straight-line method of amortization of bond discounts", "the effective-interest method of amortization of bond premiums and discounts", "any method approved by US GAAP"], "cloze_format": "The International Financial Reporting Standards require the use of ________.", "normal_format": "The International Financial Reporting Standards require the use of what?"}, "answer": {"ans_text": "the effective-interest method of amortization of bond premiums and discounts", "ans_choice": 2}, "bloom": null, "hl_sentences": "International Financial Reporting Standards ( IFRS ) require the use of the effective-interest method , with no exceptions .", "hl_context": "Our calculations have used what is known as the effective-interest method , a method that calculates interest expense based on the carrying value of the bond and the market interest rate . Generally accepted accounting principles ( GAAP ) require the use of the effective-interest method unless there is no significant difference between the effective-interest method and the straight-line method , a method that allocates the same amount of the bond discount or premium for each interest payment . The effective interest amortization method is more accurate than the straight-line method . <hl> International Financial Reporting Standards ( IFRS ) require the use of the effective-interest method , with no exceptions . <hl>"}, {"question": {"question_id": "fs-idm358003344", "question_text": "The cash interest payment a corporation makes to its bondholders is based on ________.", "question_choices": ["the market rate times the carrying value", "the stated rate times the principal", "the stated rate times the carrying value", "the market rate times the principal"], "cloze_format": "The cash interest payment a corporation makes to its bondholders is based on ________.", "normal_format": "What is the cash interest payment a corporation makes to its bondholders based on?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The cash interest payment is still the stated rate times the principal .", "hl_context": "<hl> The cash interest payment is still the stated rate times the principal . <hl> The interest on carrying value is still the market rate times the carrying value . The difference in the two interest amounts is used to amortize the discount , but now the amortization of discount amount is added to the carrying value ."}, {"question": {"question_id": "fs-idm237689792", "question_text": "The difference between equity financing and debt financing is that", "question_choices": ["equity financing involves borrowing money.", "equity financing involves selling part of the company.", "debt financing involves selling part of the company.", "debt financing means the company has no debt."], "cloze_format": "The difference between equity financing and debt financing is that ___.", "normal_format": "What is the difference between equity financing and debt financing?"}, "answer": {"ans_text": "equity financing involves selling part of the company.", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "For a corporation , equity financing involves trading or selling shares of stock in the business to raise funds to run the business . With equity financing , a business owner sells part of the business to obtain money to finance business operations . In this situation , a business owner can use debt financing by borrowing money or equity financing by selling part of the company , or she can use a combination of both .", "hl_context": "<hl> For a corporation , equity financing involves trading or selling shares of stock in the business to raise funds to run the business . <hl> For a sole proprietorship , selling part of the business means it is no longer a sole proprietorship : the subsequent transaction could create either a corporation or partnership . The owners would choose which of the two to create . Equity means ownership . However , business owners can be creative in selling interest in their venture . For example , Maria might sell interest in the building housing her candy store and retain all revenues for herself , or she may decide to share interest in the operations ( sales revenues ) and retain sole ownership of the building . <hl> With equity financing , a business owner sells part of the business to obtain money to finance business operations . <hl> With this type of financing , the original owner gives up some portion of ownership in the company in return for cash . In Maria \u2019 s case , partners would supplement her $ 200,000 and would then own a share of the business . Each partner \u2019 s share is based on their financial or other contributions . Although we briefly addressed equity versus debt financing in Explain the Pricing of Long-Term Liabilities , we will now review the two options . Let \u2019 s consider Maria , who wants to buy a business . The venture is for sale for $ 1 million , but she only has $ 200,000 . What are her options ? <hl> In this situation , a business owner can use debt financing by borrowing money or equity financing by selling part of the company , or she can use a combination of both . <hl>"}], "summary": " Summary 13.1   Explain the Pricing of Long-Term Liabilities \n\n Businesses can obtain financing (cash) through profitable operations, issuing (selling) debt, and by selling ownership (equity). \n\n Notes payable and bonds payable are specific types of debt that businesses issue in order to generate financial capital. \n\n Liabilities are categorized as either current or noncurrent based on when the liability will be settled relative to the operating period of the business. \n\n A bond indenture is a legal document containing the principal amount, maturity date, stated interest rate and other requirements of the bond issuer. \n\n Bonds can be issued under different structures and include different features. \n\n Periodic interest payments are based on the amount borrowed, the interest rate, and the time period for which interest is calculated. \n\n Bond selling prices are determined by the market interest rate at the time of the sale and the stated interest rate of the bond. \n\n Bonds can be sold at face value, at a premium, or at a discount. \n\n 13.2   Compute Amortization of Long-Term Liabilities Using the Effective-Interest Method \n\n The effective-interest method is a common method used to calculate the interest expense for a given interest payment. \n\n There is an inverse relationship between the price of a bond and the market interest rate. \n\n The carrying value of a bond sold at a discount will increase during the life of a bond until the maturity or face value is reached. \n\n The carrying value of a bond sold at a premium will decrease during the life of a bond until the maturity or face value is reached. \n\n The amount of cash to be paid, the interest expense, and the premium or discount amortization (when applicable) with each periodic payment are calculated based on an amortization table or schedule. \n\n 13.3   Prepare Journal Entries to Reflect the Life Cycle of Bonds \n\n When a company issues a bond, the specific terms of the bond are contained in the bond indenture. \n\n Journal entries are recorded at various stages of a bond, including when the bond is issued, for periodic interest payments, and for payment of the bond at maturity. \n\n The difference between the face value of a bond and the cash proceeds are recorded in the discount (when the proceeds are lower than the face value) and premium (when the proceeds are higher than the face value) accounts. \n\n The carrying or book value of a bond is determined by the balances of the Bond Payable and Discount and/or Premium accounts. \n\n Interest expense associated with a bond interest payment is calculated by the bond\u2019s carrying or book value multiplied by the market interest rate. ", "keyterm": "", "bname": "principles_of_accounting,_volume_1:_financial_accounting"}, {"chapter": 2, "intro": " Chapter Outline 2.1   Atoms, Isotopes, Ions, and Molecules: The Building Blocks 2.2   Water 2.3   Carbon Introduction Elements in various combinations comprise all matter, including living things. Some of the most abundant elements in living organisms include carbon, hydrogen, nitrogen, oxygen, sulfur, and phosphorus. These form the nucleic acids, proteins, carbohydrates, and lipids that are the fundamental components of living matter. Biologists must understand these important building blocks and the unique structures of the atoms that make up molecules, allowing for the formation of cells, tissues, organ systems, and entire organisms. All biological processes follow the laws of physics and chemistry, so in order to understand how biological systems work, it is important to understand the underlying physics and chemistry. For example, the flow of blood within the circulatory system follows the laws of physics that regulate the modes of fluid flow. The breakdown of the large, complex molecules of food into smaller molecules\u2014and the conversion of these to release energy to be stored in adenosine triphosphate (ATP)\u2014is a series of chemical reactions that follow chemical laws. The properties of water and the formation of hydrogen bonds are key to understanding living processes. Recognizing the properties of acids and bases is important, for example, to our understanding of the digestive process. Therefore, the fundamentals of physics and chemistry are important for gaining insight into biological processes. ", "chapter_text": "2.1   Atoms, Isotopes, Ions, and Molecules: The Building Blocks Learning Objectives By the end of this section, you will be able to:\n\n Define matter and elements \n\n Describe the interrelationship between protons, neutrons, and electrons \n\n Compare the ways in which electrons can be donated or shared between atoms \n\n Explain the ways in which naturally occurring elements combine to create molecules, cells, tissues, organ systems, and organisms \n\n At its most fundamental level, life is made up of matter.  Matter  is any substance that occupies space and has mass.  Elements  are unique forms of matter with specific chemical and physical properties that cannot be broken down into smaller substances by ordinary chemical reactions. There are 118 elements, but only 92 occur naturally. The remaining elements are synthesized in laboratories and are unstable. \n\n Each element is designated by its chemical symbol, which is a single capital letter or, when the first letter is already \u201ctaken\u201d by another element, a combination of two letters. Some elements follow the English term for the element, such as C for carbon and Ca for calcium. Other elements\u2019 chemical symbols derive from their Latin names; for example, the symbol for sodium is Na, referring to  natrium , the Latin word for sodium. \n\n The four elements common to all living organisms are oxygen (O), carbon (C), hydrogen (H), and nitrogen (N). In the non-living world, elements are found in different proportions, and some elements common to living organisms are relatively rare on the earth as a whole, as shown in  Table 2.1 . For example, the atmosphere is rich in nitrogen and oxygen but contains little carbon and hydrogen, while the earth\u2019s crust, although it contains oxygen and a small amount of hydrogen, has little nitrogen and carbon. In spite of their differences in abundance, all elements and the chemical reactions between them obey the same chemical and physical laws regardless of whether they are a part of the living or non-living world. \n\n Approximate Percentage of Elements in Living Organisms (Humans) Compared to the Non-living World \n\n Element \n\n Life (Humans) \n\n Atmosphere \n\n Earth\u2019s Crust \n\n Oxygen (O) \n\n 65% \n\n 21% \n\n 46% \n\n Carbon (C) \n\n 18% \n\n trace \n\n trace \n\n Hydrogen (H) \n\n 10% \n\n trace \n\n 0.1% \n\n Nitrogen (N) \n\n 3% \n\n 78% \n\n trace \n\n Table  2.1     \n\n The Structure of the Atom \n\n To understand how elements come together, we must first discuss the smallest component or building block of an element, the atom. An  atom  is the smallest unit of matter that retains all of the chemical properties of an element. For example, one gold atom has all of the properties of gold in that it is a solid metal at room temperature. A gold coin is simply a very large number of gold atoms molded into the shape of a coin and containing small amounts of other elements known as impurities. Gold atoms cannot be broken down into anything smaller while still retaining the properties of gold. \n\n An atom is composed of two regions: the  nucleus , which is in the center of the atom and contains protons and neutrons, and the outermost region of the atom which holds its electrons in orbit around the nucleus, as illustrated in  Figure 2.2 . Atoms contain protons, electrons, and neutrons, among other subatomic particles. The only exception is hydrogen (H), which is made of one proton and one electron with no neutrons. \n\n Protons and neutrons have approximately the same mass, about 1.67 \u00d7 10 -24  grams. Scientists arbitrarily define this amount of mass as one atomic mass unit (amu) or one Dalton, as shown in  Table 2.2 . Although similar in mass, protons and neutrons differ in their electric charge. A  proton  is positively charged whereas a  neutron  is uncharged. Therefore, the number of neutrons in an atom contributes significantly to its mass, but not to its charge.  Electrons  are much smaller in mass than protons, weighing only 9.11 \u00d7 10 -28  grams, or about 1/1800 of an atomic mass unit. Hence, they do not contribute much to an element\u2019s overall atomic mass. Therefore, when considering atomic mass, it is customary to ignore the mass of any electrons and calculate the atom\u2019s mass based on the number of protons and neutrons alone. Although not significant contributors to mass, electrons do contribute greatly to the atom\u2019s charge, as each electron has a negative charge equal to the positive charge of a proton. In uncharged, neutral atoms, the number of electrons orbiting the nucleus is equal to the number of protons inside the nucleus. In these atoms, the positive and negative charges cancel each other out, leading to an atom with no net charge. \n\n Accounting for the sizes of protons, neutrons, and electrons, most of the volume of an atom\u2014greater than 99 percent\u2014is, in fact, empty space. With all this empty space, one might ask why so-called solid objects do not just pass through one another. The reason they do not is that the electrons that surround all atoms are negatively charged and negative charges repel each other. \n\n Protons, Neutrons, and Electrons \n\n Charge \n\n Mass (amu) \n\n Location \n\n Proton \n\n +1 \n\n 1 \n\n nucleus \n\n Neutron \n\n 0 \n\n 1 \n\n nucleus \n\n Electron \n\n \u20131 \n\n 0 \n\n orbitals \n\n Table  2.2     \n\n Atomic Number and Mass \n\n Atoms of each element contain a characteristic number of protons and electrons. The number of protons determines an element\u2019s  atomic number  and is used to distinguish one element from another. The number of neutrons is variable, resulting in isotopes, which are different forms of the same atom that vary only in the number of neutrons they possess. Together, the number of protons and the number of neutrons determine an element\u2019s  mass number , as illustrated in  Figure 2.3 . Note that the small contribution of mass from electrons is disregarded in calculating the mass number. This approximation of mass can be used to easily calculate how many neutrons an element has by simply subtracting the number of protons from the mass number. Since an element\u2019s isotopes will have slightly different mass numbers, scientists also determine the  atomic mass , which is the calculated mean of the mass number for its naturally occurring isotopes. Often, the resulting number contains a fraction. For example, the atomic mass of chlorine (Cl) is 35.45 because chlorine is composed of several isotopes, some (the majority) with atomic mass 35 (17 protons and 18 neutrons) and some with atomic mass 37 (17 protons and 20 neutrons). \n\n Visual Connection \n\n How many neutrons do carbon-12 and carbon-13 have, respectively? \n\n Isotopes Isotopes  are different forms of an element that have the same number of protons but a different number of neutrons. Some elements\u2014such as carbon, potassium, and uranium\u2014have naturally occurring isotopes. Carbon-12 contains six protons, six neutrons, and six electrons; therefore, it has a mass number of 12 (six protons and six neutrons). Carbon-14 contains six protons, eight neutrons, and six electrons; its atomic mass is 14 (six protons and eight neutrons). These two alternate forms of carbon are isotopes. Some isotopes may emit neutrons, protons, and electrons, and attain a more stable atomic configuration (lower level of potential energy); these are radioactive isotopes, or  radioisotopes . Radioactive decay (carbon-14 decaying to eventually become nitrogen-14) describes the energy loss that occurs when an unstable atom\u2019s nucleus releases radiation. Evolution Connection Carbon Dating \n\nCarbon is normally present in the atmosphere in the form of gaseous compounds like carbon dioxide and methane. Carbon-14 ( 14 C) is a naturally occurring radioisotope that is created in the atmosphere from atmospheric  14 N (nitrogen) by the addition of a neutron and the loss of a proton because of cosmic rays. This is a continuous process, so more  14 C is always being created. As a living organism incorporates  14 C initially as carbon dioxide fixed in the process of photosynthesis, the relative amount of  14 C in its body is equal to the concentration of  14 C in the atmosphere. When an organism dies, it is no longer ingesting  14 C, so the ratio between  14 C and  12 C will decline as  14 C decays gradually to  14 N by a process called beta decay\u2014the emission of electrons or positrons. This decay gives off energy in a slow process. \n\n After approximately 5,730 years, half of the starting concentration of  14 C will have been converted back to  14 N. The time it takes for half of the original concentration of an isotope to decay back to its more stable form is called its half-life. Because the half-life of  14 C is long, it is used to date formerly living objects such as old bones or wood. Comparing the ratio of the  14 C concentration found in an object to the amount of  14 C detected in the atmosphere, the amount of the isotope that has not yet decayed can be determined. On the basis of this amount, the age of the material, such as the pygmy mammoth shown in  Figure 2.4 , can be calculated with accuracy if it is not much older than about 50,000 years. Other elements have isotopes with different half lives. For example,  40 K (potassium-40) has a half-life of 1.25 billion years, and  235 U (Uranium 235) has a half-life of about 700 million years. Through the use of radiometric dating, scientists can study the age of fossils or other remains of extinct organisms to understand how organisms have evolved from earlier species. \n\n Link to Learning \n\n To learn more about atoms, isotopes, and how to tell one isotope from another, run the simulation. \n\n Click to view content \n\n The Periodic Table \n\n The different elements are organized and displayed in the  periodic table . Devised by Russian chemist Dmitri Mendeleev (1834\u20131907) in 1869, the table groups elements that, although unique, share certain chemical properties with other elements. The properties of elements are responsible for their physical state at room temperature: they may be gases, solids, or liquids. Elements also have specific  chemical reactivity , the ability to combine and to chemically bond with each other. \n\n In the periodic table, shown in  Figure 2.5 , the elements are organized and displayed according to their atomic number and are arranged in a series of rows and columns based on shared chemical and physical properties. In addition to providing the atomic number for each element, the periodic table also displays the element\u2019s atomic mass. Looking at carbon, for example, its symbol (C) and name appear, as well as its atomic number of six (in the upper left-hand corner) and its atomic mass of 12.11. \n\n The periodic table groups elements according to chemical properties. The differences in chemical reactivity between the elements are based on the number and spatial distribution of an atom\u2019s electrons. Atoms that chemically react and bond to each other form molecules.  Molecules  are simply two or more atoms chemically bonded together. Logically, when two atoms chemically bond to form a molecule, their electrons, which form the outermost region of each atom, come together first as the atoms form a chemical bond. \n\n Electron Shells and the Bohr Model \n\n It should be stressed that there is a connection between the number of protons in an element, the atomic number that distinguishes one element from another, and the number of electrons it has. In all electrically neutral atoms, the number of electrons is the same as the number of protons. Thus, each element, at least when electrically neutral, has a characteristic number of electrons equal to its atomic number. \n\n An early model of the atom was developed in 1913 by Danish scientist Niels Bohr (1885\u20131962). The Bohr model shows the atom as a central nucleus containing protons and neutrons, with the electrons in circular  orbitals  at specific distances from the nucleus, as illustrated in  Figure 2.6 . These orbits form electron shells or energy levels, which are a way of visualizing the number of electrons in the outermost shells. These energy levels are designated by a number and the symbol \u201cn.\u201d For example, 1n represents the first energy level located closest to the nucleus. \n\n Electrons fill orbitals in a consistent order: they first fill the orbitals closest to the nucleus, then they continue to fill orbitals of increasing energy further from the nucleus. If there are multiple orbitals of equal energy, they will be filled with one electron in each energy level before a second electron is added. The electrons of the outermost energy level determine the energetic stability of the atom and its tendency to form chemical bonds with other atoms to form molecules. \n\n Under standard conditions, atoms fill the inner shells first, often resulting in a variable number of electrons in the outermost shell. The innermost shell has a maximum of two electrons but the next two electron shells can each have a maximum of eight electrons. This is known as the  octet rule , which states, with the exception of the innermost shell, that atoms are more stable energetically when they have eight electrons in their  valence shell , the outermost electron shell. Examples of some neutral atoms and their electron configurations are shown in  Figure 2.7 . Notice that in this  Figure 2.7 , helium has a complete outer electron shell, with two electrons filling its first and only shell. Similarly, neon has a complete outer 2n shell containing eight electrons. In contrast, chlorine and sodium have seven and one in their outer shells, respectively, but theoretically they would be more energetically stable if they followed the octet rule and had eight. \n\n Visual Connection \n\n An atom may give, take, or share electrons with another atom to achieve a full valence shell, the most stable electron configuration. Looking at this figure, how many electrons do elements in group 1 need to lose in order to achieve a stable electron configuration? How many electrons do elements in groups 14 and 17 need to gain to achieve a stable configuration? \n\n Understanding that the organization of the periodic table is based on the total number of protons (and electrons) helps us know how electrons are distributed among the outer shell. The periodic table is arranged in columns and rows based on the number of electrons and where these electrons are located. Take a closer look at the some of the elements in the table\u2019s far right column in  Figure 2.5 . The group 18 atoms helium (He), neon (Ne), and argon (Ar) all have filled outer electron shells, making it unnecessary for them to share electrons with other atoms to attain stability; they are highly stable as single atoms. Their non-reactivity has resulted in their being named the  inert gases  (or  noble gases ). Compare this to the group 1 elements in the left-hand column. These elements, including hydrogen (H), lithium (Li), and sodium (Na), all have one electron in their outermost shells. That means that they can achieve a stable configuration and a filled outer shell by donating or sharing one electron with another atom or a molecule such as water. Hydrogen will donate or share its electron to achieve this configuration, while lithium and sodium will donate their electron to become stable. As a result of losing a negatively charged electron, they become positively charged  ions . Group 17 elements, including fluorine and chlorine, have seven electrons in their outmost shells, so they tend to fill this shell with an electron from other atoms or molecules, making them negatively charged ions. Group 14 elements, of which carbon is the most important to living systems, have four electrons in their outer shell allowing them to make several covalent bonds (discussed below) with other atoms. Thus, the columns of the periodic table represent the potential shared state of these elements\u2019 outer electron shells that is responsible for their similar chemical characteristics. \n\n Electron Orbitals Although useful to explain the reactivity and chemical bonding of certain elements, the Bohr model of the atom does not accurately reflect how electrons are spatially distributed surrounding the nucleus. They do not circle the nucleus like the earth orbits the sun, but are found in  electron orbitals . These relatively complex shapes result from the fact that electrons behave not just like particles, but also like waves. Mathematical equations from quantum mechanics known as wave functions can predict within a certain level of probability where an electron might be at any given time. The area where an electron is most likely to be found is called its orbital. \n\n Recall that the Bohr model depicts an atom\u2019s electron shell configuration. Within each electron shell are subshells, and each subshell has a specified number of orbitals containing electrons. While it is impossible to calculate exactly where an electron is located, scientists know that it is most probably located within its orbital path. Subshells are designated by the letter s,  p ,  d , and  f . The  s  subshell is spherical in shape and has one orbital. Principal shell 1n has only a single  s  orbital, which can hold two electrons. Principal shell 2n has one  s  and one  p  subshell, and can hold a total of eight electrons. The  p  subshell has three dumbbell-shaped orbitals, as illustrated in  Figure 2.8 . Subshells  d  and  f  have more complex shapes and contain five and seven orbitals, respectively. These are not shown in the illustration. Principal shell 3n has  s ,  p , and  d  subshells and can hold 18 electrons. Principal shell 4n has  s ,  p ,  d  and  f  orbitals and can hold 32 electrons.  Moving away from the nucleus, the number of electrons and orbitals found in the energy levels increases. Progressing from one atom to the next in the periodic table, the electron structure can be worked out by fitting an extra electron into the next available orbital. The closest orbital to the nucleus, called the 1s orbital, can hold up to two electrons. This orbital is equivalent to the innermost electron shell of the Bohr model of the atom. It is called the 1 s  orbital because it is spherical around the nucleus. The 1 s  orbital is the closest orbital to the nucleus, and it is always filled first, before any other orbital can be filled. Hydrogen has one electron; therefore, it has only one spot within the 1 s  orbital occupied. This is designated as 1 s 1 , where the superscripted 1 refers to the one electron within the 1 s  orbital. Helium has two electrons; therefore, it can completely fill the 1 s  orbital with its two electrons. This is designated as 1 s 2 , referring to the two electrons of helium in the 1 s  orbital. On the periodic table  Figure 2.5 , hydrogen and helium are the only two elements in the first row (period); this is because they only have electrons in their first shell, the 1 s  orbital. Hydrogen and helium are the only two elements that have the 1 s  and no other electron orbitals in the electrically neutral state. \n\n The second electron shell may contain eight electrons. This shell contains another spherical  s  orbital and three \u201cdumbbell\u201d shaped  p  orbitals, each of which can hold two electrons, as shown in  Figure 2.8 . After the 1 s  orbital is filled, the second electron shell is filled, first filling its 2 s  orbital and then its three  p  orbitals. When filling the  p  orbitals, each takes a single electron; once each  p  orbital has an electron, a second may be added. Lithium (Li) contains three electrons that occupy the first and second shells. Two electrons fill the 1 s  orbital, and the third electron then fills the 2 s  orbital. Its  electron configuration  is 1 s 2 2 s 1 . Neon (Ne), on the other hand, has a total of ten electrons: two are in its innermost 1 s  orbital and eight fill its second shell (two each in the 2 s  and three  p  orbitals); thus, it is an inert gas and energetically stable as a single atom that will rarely form a chemical bond with other atoms. Larger elements have additional orbitals, making up the third electron shell. While the concepts of electron shells and orbitals are closely related, orbitals provide a more accurate depiction of the electron configuration of an atom because the orbital model specifies the different shapes and special orientations of all the places that electrons may occupy. \n\n Link to Learning \n\n Watch this visual animation to see the spatial arrangement of the p and s orbitals.\n\n Click to view content \n\n Chemical Reactions and Molecules \n\n All elements are most stable when their outermost shell is filled with electrons according to the octet rule. This is because it is energetically favorable for atoms to be in that configuration and it makes them stable. However, since not all elements have enough electrons to fill their outermost shells, atoms form  chemical bonds  with other atoms thereby obtaining the electrons they need to attain a stable electron configuration. When two or more atoms chemically bond with each other, the resultant chemical structure is a molecule. The familiar water molecule, H 2 O, consists of two hydrogen atoms and one oxygen atom; these bond together to form water, as illustrated in  Figure 2.9 . Atoms can form molecules by donating, accepting, or sharing electrons to fill their outer shells. \n\n Chemical reactions  occur when two or more atoms bond together to form molecules or when bonded atoms are broken apart. The substances used in the beginning of a chemical reaction are called the  reactants  (usually found on the left side of a chemical equation), and the substances found at the end of the reaction are known as the  products  (usually found on the right side of a chemical equation). An arrow is typically drawn between the reactants and products to indicate the direction of the chemical reaction; this direction is not always a \u201cone-way street.\u201d For the creation of the water molecule shown above, the chemical equation would be: \n\n 2 H\u00a0+\u00a0O\u00a0 \u2192 \n\n \u00a0H \n\n 2 \n\n O \n\n 2 H\u00a0+\u00a0O\u00a0 \u2192 \n\n \u00a0H \n\n 2 \n\n O \n\n An example of a simple chemical reaction is the breaking down of hydrogen peroxide molecules, each of which consists of two hydrogen atoms bonded to two oxygen atoms (H 2 O 2 ). The reactant hydrogen peroxide is broken down into water, containing one oxygen atom bound to two hydrogen atoms (H 2 O), and oxygen, which consists of two bonded oxygen atoms (O 2 ). In the equation below, the reaction includes two hydrogen peroxide molecules and two water molecules. This is an example of a  balanced chemical equation , wherein the number of atoms of each element is the same on each side of the equation. According to the law of conservation of matter, the number of atoms before and after a chemical reaction should be equal, such that no atoms are, under normal circumstances, created or destroyed. \n\n 2H \n\n 2 \n\n O \n\n 2 \n\n \u00a0(hydrogen\u00a0peroxide)\u00a0 \u2192 \n\n \u00a02H \n\n 2 \n\n O\u00a0(water)\u00a0+\u00a0O \n\n 2 \n\n \u00a0(oxygen) \n\n 2H \n\n 2 \n\n O \n\n 2 \n\n \u00a0(hydrogen\u00a0peroxide)\u00a0 \u2192 \n\n \u00a02H \n\n 2 \n\n O\u00a0(water)\u00a0+\u00a0O \n\n 2 \n\n \u00a0(oxygen) \n\n Even though all of the reactants and products of this reaction are molecules (each atom remains bonded to at least one other atom), in this reaction only hydrogen peroxide and water are representatives of  compounds : they contain atoms of more than one type of element. Molecular oxygen, on the other hand, as shown in  Figure 2.10 ,consists of two doubly bonded oxygen atoms and is not classified as a compound but as a homonuclear molecule. \n\n Some chemical reactions, such as the one shown above, can proceed in one direction until the reactants are all used up. The equations that describe these reactions contain a unidirectional arrow and are  irreversible .  Reversible reactions  are those that can go in either direction. In reversible reactions, reactants are turned into products, but when the concentration of product goes beyond a certain threshold (characteristic of the particular reaction), some of these products will be converted back into reactants; at this point, the designations of products and reactants are reversed. This back and forth continues until a certain relative balance between reactants and products occurs\u2014a state called  equilibrium . These situations of reversible reactions are often denoted by a chemical equation with a double headed arrow pointing towards both the reactants and products. \n\n For example, in human blood, excess hydrogen ions (H + ) bind to bicarbonate ions (HCO 3 - ) forming an equilibrium state with carbonic acid (H 2 CO 3 ). If carbonic acid were added to this system, some of it would be converted to bicarbonate and hydrogen ions. \n\n HCO \n\n 3 \n\n \u2212 \n\n  + H \n\n + \n\n   \n\n \u2194 \n\n  H \n\n 2 \n\n CO \n\n 3 \n\n HCO \n\n 3 \n\n \u2212 \n\n  + H \n\n + \n\n   \n\n \u2194 \n\n  H \n\n 2 \n\n CO \n\n 3 \n\n In biological reactions, however, equilibrium is rarely obtained because the concentrations of the reactants or products or both are constantly changing, often with a product of one reaction being a reactant for another. To return to the example of excess hydrogen ions in the blood, the formation of carbonic acid will be the major direction of the reaction. However, the carbonic acid can also leave the body as carbon dioxide gas (via exhalation) instead of being converted back to bicarbonate ion, thus driving the reaction to the right by the chemical law known as  law of mass action . These reactions are important for maintaining the homeostasis of our blood. \n\n HCO \n\n 3 \n\n \u2212 \n\n \u00a0+\u00a0H \n\n + \n\n \u00a0 \n\n \u2194 \n\n \u00a0H \n\n 2 \n\n CO \n\n 3 \n\n \u00a0 \u2194 \n\n \u00a0CO \n\n 2 \n\n \u00a0+\u00a0H \n\n 2 \n\n O \n\n HCO \n\n 3 \n\n \u2212 \n\n \u00a0+\u00a0H \n\n + \n\n \u00a0 \n\n \u2194 \n\n \u00a0H \n\n 2 \n\n CO \n\n 3 \n\n \u00a0 \u2194 \n\n \u00a0CO \n\n 2 \n\n \u00a0+\u00a0H \n\n 2 \n\n O \n\n Ions and Ionic Bonds \n\n Some atoms are more stable when they gain or lose an electron (or possibly two) and form ions. This fills their outermost electron shell and makes them energetically more stable. Because the number of electrons does not equal the number of protons, each ion has a net charge.  Cations  are positive ions that are formed by losing electrons. Negative ions are formed by gaining electrons and are called anions.  Anions  are designated by their elemental name being altered to end in \u201c-ide\u201d: the anion of chlorine is called chloride, and the anion of sulfur is called sulfide, for example. \n\n  This movement of electrons from one element to another is referred to as  electron transfer . As  Figure 2.11  illustrates, sodium (Na)  only has one electron in its outer electron shell. It takes less energy for sodium to donate that one electron than it does to accept seven more electrons to fill the outer shell. If sodium loses an electron, it now has 11 protons, 11 neutrons, and only 10 electrons, leaving it with an overall charge of +1. It is now referred to as a sodium ion. Chlorine (Cl) in its lowest energy state (called the ground state) has seven electrons in its outer shell. Again, it is more energy-efficient for chlorine to gain one electron than to lose seven. Therefore, it tends to gain an electron to create an ion with 17 protons, 17 neutrons, and 18 electrons, giving it a net negative (\u20131) charge. It is now referred to as a chloride ion. In this example, sodium will donate its one electron to empty its shell, and chlorine will accept that electron to fill its shell. Both ions now satisfy the octet rule and have complete outermost shells. Because the number of electrons is no longer equal to the number of protons, each is now an ion and has a +1 (sodium cation) or \u20131 (chloride anion) charge. Note that these transactions can normally only take place simultaneously: in order for a sodium atom to lose an electron, it must be in the presence of a suitable recipient like a chlorine atom. \n\n Ionic bonds  are formed between ions with opposite charges. For instance, positively charged sodium ions and negatively charged chloride ions bond together to make crystals of sodium chloride, or table salt, creating a crystalline molecule with zero net charge. \n\n Certain salts are referred to in physiology as  electrolytes  (including sodium, potassium, and calcium), ions necessary for nerve impulse conduction, muscle contractions and water balance. Many sports drinks and dietary supplements provide these ions to replace those lost from the body via sweating during exercise. \n\n Covalent Bonds and Other Bonds and Interactions Another way the octet rule can be satisfied is by the sharing of electrons between atoms to form  covalent bonds . These bonds are stronger and much more common than ionic bonds in the molecules of living organisms. Covalent bonds are commonly found in carbon-based organic molecules, such as our DNA and proteins. Covalent bonds are also found in inorganic molecules like H 2 O, CO 2 , and O 2 . One, two, or three pairs of electrons may be shared, making single, double, and triple bonds, respectively. The more covalent bonds between two atoms, the stronger their connection. Thus, triple bonds are the strongest. The strength of different levels of covalent bonding is one of the main reasons living organisms have a difficult time in acquiring nitrogen for use in constructing their molecules, even though molecular nitrogen, N 2 , is the most abundant gas in the atmosphere. Molecular nitrogen consists of two nitrogen atoms triple bonded to each other and, as with all molecules, the sharing of these three pairs of electrons between the two nitrogen atoms allows for the filling of their outer electron shells, making the molecule more stable than the individual nitrogen atoms. This strong triple bond makes it difficult for living systems to break apart this nitrogen in order to use it as constituents of proteins and DNA. \n\n The formation of water molecules provides an example of covalent bonding. The hydrogen and oxygen atoms that combine to form water molecules are bound together by covalent bonds, as shown in  Figure 2.9 . The electron from the hydrogen splits its time between the incomplete outer shell of the hydrogen atoms and the incomplete outer shell of the oxygen atoms. To completely fill the outer shell of oxygen, which has six electrons in its outer shell but which would be more stable with eight, two electrons (one from each hydrogen atom) are needed: hence the well-known formula H 2 O. The electrons are shared between the two elements to fill the outer shell of each, making both elements more stable. \n\n Link to Learning \n\n View this short video to see an animation of ionic and covalent bonding.\n\n Click to view content \n\n Polar Covalent Bonds \n\n There are two types of covalent bonds: polar and nonpolar. In a  polar covalent bond , shown in  Figure 2.12 , the electrons are unequally shared by the atoms and are attracted more to one nucleus than the other. Because of the unequal distribution of electrons between the atoms of different elements, a slightly positive ( \u03b4 +) or slightly negative ( \u03b4 \u2013) charge develops. This partial charge is an important property of water and accounts for many of its characteristics. Water is a polar molecule, with the hydrogen atoms acquiring a partial positive charge and the oxygen a partial negative charge. This occurs because the nucleus of the oxygen atom is more attractive to the electrons of the hydrogen atoms than the hydrogen nucleus is to the oxygen\u2019s electrons. Thus oxygen has a higher  electronegativity  than hydrogen and the shared electrons spend more time in the vicinity of the oxygen nucleus than they do near the nucleus of the hydrogen atoms, giving the atoms of oxygen and hydrogen slightly negative and positive charges, respectively. Another way of stating this is that the probability of finding a shared electron near an oxygen nucleus is more likely than finding it near a hydrogen nucleus. Either way, the atom\u2019s relative electronegativity contributes to the development of partial charges whenever one element is significantly more electronegative than the other, and the charges generated by these polar bonds may then be used for the formation of hydrogen bonds based on the attraction of opposite partial charges. (Hydrogen bonds, which are discussed in detail below, are weak bonds between slightly positively charged hydrogen atoms to slightly negatively charged atoms in other molecules.) Since macromolecules often have atoms within them that differ in electronegativity, polar bonds are often present in organic molecules. \n\n Nonpolar Covalent Bonds \n\n Nonpolar covalent bonds  form between two atoms of the same element or between different elements that share electrons equally. For example, molecular oxygen (O 2 ) is nonpolar because the electrons will be equally distributed between the two oxygen atoms. \n\n Another example of a nonpolar covalent bond is methane (CH 4 ), also shown in  Figure 2.12 . Carbon has four electrons in its outermost shell and needs four more to fill it. It gets these four from four hydrogen atoms, each atom providing one, making a stable outer shell of eight electrons. Carbon and hydrogen do not have the same electronegativity but are similar; thus, nonpolar bonds form. The hydrogen atoms each need one electron for their outermost shell, which is filled when it contains two electrons. These elements share the electrons equally among the carbons and the hydrogen atoms, creating a nonpolar covalent molecule. \n\n Hydrogen Bonds and Van Der Waals Interactions Ionic and covalent bonds between elements require energy to break.  Ionic bonds are not as strong as covalent, which determines their behavior in biological systems. However, not all bonds are ionic or covalent bonds. Weaker bonds can also form between molecules. Two weak bonds that occur frequently are hydrogen bonds and van der Waals interactions. Without these two types of bonds, life as we know it would not exist. Hydrogen bonds provide many of the critical, life-sustaining properties of water and also stabilize the structures of proteins and DNA, the building block of cells. When polar covalent bonds containing hydrogen form, the hydrogen in that bond has a slightly positive charge because hydrogen\u2019s electron is pulled more strongly toward the other element and away from the hydrogen. Because the hydrogen is slightly positive, it will be attracted to neighboring negative charges. When this happens, a weak interaction occurs between the  \u03b4 + of the hydrogen from one molecule and the  \u03b4 \u2013 charge on the more electronegative atoms of another molecule, usually oxygen or nitrogen, or within the same molecule. This interaction is called a  hydrogen bond . This type of bond is common and occurs regularly between water molecules. Individual hydrogen bonds are weak and easily broken; however, they occur in very large numbers in water and in organic polymers, creating a major force in combination. Hydrogen bonds are also responsible for zipping together the DNA double helix. Like hydrogen bonds,  van der Waals interactions  are weak attractions or interactions between molecules. Van der Waals attractions can occur between any two or more molecules and are dependent on slight fluctuations of the electron densities, which are not always symmetrical around an atom. For these attractions to happen, the molecules need to be very close to one another. These bonds\u2014along with ionic, covalent, and hydrogen bonds\u2014contribute to the three-dimensional structure of the proteins in our cells that is necessary for their proper function. Career Connection Pharmaceutical Chemist \n\nPharmaceutical chemists are responsible for the development of new drugs and trying to determine the mode of action of both old and new drugs. They are involved in every step of the drug development process. Drugs can be found in the natural environment or can be synthesized in the laboratory. In many cases, potential drugs found in nature are changed chemically in the laboratory to make them safer and more effective, and sometimes synthetic versions of drugs substitute for the version found in nature. \n\n After the initial discovery or synthesis of a drug, the chemist then develops the drug, perhaps chemically altering it, testing it to see if the drug is toxic, and then designing methods for efficient large-scale production. Then, the process of getting the drug approved for human use begins. In the United States, drug approval is handled by the Food and Drug Administration (FDA) and involves a series of large-scale experiments using human subjects to make sure the drug is not harmful and effectively treats the condition it aims to treat. This process often takes several years and requires the participation of physicians and scientists, in addition to chemists, to complete testing and gain approval. An example of a drug that was originally discovered in a living organism is Paclitaxel (Taxol), an anti-cancer drug used to treat breast cancer. This drug was discovered in the bark of the pacific yew tree. Another example is aspirin, originally isolated from willow tree bark. Finding drugs often means testing hundreds of samples of plants, fungi, and other forms of life to see if any biologically active compounds are found within them. Sometimes, traditional medicine can give modern medicine clues to where an active compound can be found. For example, the use of willow bark to make medicine has been known for thousands of years, dating back to ancient Egypt. It was not until the late 1800s, however, that the aspirin molecule, known as acetylsalicylic acid, was purified and marketed for human use. \n\n Occasionally, drugs developed for one use are found to have unforeseen effects that allow these drugs to be used in other, unrelated ways. For example, the drug minoxidil (Rogaine) was originally developed to treat high blood pressure. When tested on humans, it was noticed that individuals taking the drug would grow new hair. Eventually the drug was marketed to men and women with baldness to restore lost hair. \n\n The career of the pharmaceutical chemist may involve detective work, experimentation, and drug development, all with the goal of making human beings healthier. \n2.2   Water Learning Objectives By the end of this section, you will be able to:\n\n Describe the properties of water that are critical to maintaining life \n\n Explain why water is an excellent solvent  \n\n Provide examples of water\u2019s cohesive and adhesive properties \n\n Discuss the role of acids, bases, and buffers in homeostasis \n\n Why do scientists spend time looking for water on other planets? Why is water so important? It is because water is essential to life as we know it. Water is one of the more abundant molecules and the one most critical to life on Earth. Approximately 60\u201370 percent of the human body is made up of water. Without it, life as we know it simply would not exist. The polarity of the water molecule and its resulting hydrogen bonding make water a unique substance with special properties that are intimately tied to the processes of life. Life originally evolved in a watery environment, and most of an organism\u2019s cellular chemistry and metabolism occur inside the watery contents of the cell\u2019s cytoplasm. Special properties of water are its high heat capacity and heat of vaporization, its ability to dissolve polar molecules, its cohesive and adhesive properties, and its dissociation into ions that leads to the generation of pH. Understanding these characteristics of water helps to elucidate its importance in maintaining life. \n\n Water\u2019s Polarity \n\n One of water\u2019s important properties is that it is composed of polar molecules: the hydrogen and oxygen within water molecules (H 2 O) form polar covalent bonds. While there is no net charge to a water molecule, the polarity of water creates a slightly positive charge on hydrogen and a slightly negative charge on oxygen, contributing to water\u2019s properties of attraction. Water\u2019s charges are generated because oxygen is more electronegative than hydrogen, making it more likely that a shared electron would be found near the oxygen nucleus than the hydrogen nucleus, thus generating the partial negative charge near the oxygen. \n\n As a result of water\u2019s polarity, each water molecule attracts other water molecules because of the opposite charges between water molecules, forming hydrogen bonds. Water also attracts or is attracted to other polar molecules and ions. A polar substance that interacts readily with or dissolves in water is referred to as  hydrophilic  (hydro- = \u201cwater\u201d; -philic = \u201cloving\u201d). In contrast, non-polar molecules such as oils and fats do not interact well with water, as shown in  Figure 2.13  and separate from it rather than dissolve in it, as we see in salad dressings containing oil and vinegar (an acidic water solution). These nonpolar compounds are called  hydrophobic  (hydro- = \u201cwater\u201d; -phobic = \u201cfearing\u201d). \n\n Water\u2019s States: Gas, Liquid, and Solid \n\n The formation of hydrogen bonds is an important quality of the liquid water that is crucial to life as we know it. As water molecules make hydrogen bonds with each other, water takes on some unique chemical characteristics compared to other liquids and, since living things have a high water content, understanding these chemical features is key to understanding life. In liquid water, hydrogen bonds are constantly formed and broken as the water molecules slide past each other. The breaking of these bonds is caused by the motion (kinetic energy) of the water molecules due to the heat contained in the system. When the heat is raised as water is boiled, the higher kinetic energy of the water molecules causes the hydrogen bonds to break completely and allows water molecules to escape into the air as gas (steam or water vapor). On the other hand, when the temperature of water is reduced and water freezes, the water molecules form a crystalline structure maintained by hydrogen bonding (there is not enough energy to break the hydrogen bonds) that makes ice less dense than liquid water, a phenomenon not seen in the solidification of other liquids. \n\n Water\u2019s lower density in its solid form is due to the way hydrogen bonds are oriented as it freezes: the water molecules are pushed farther apart compared to liquid water. With most other liquids, solidification when the temperature drops includes the lowering of kinetic energy between molecules, allowing them to pack even more tightly than in liquid form and giving the solid a greater density than the liquid. \n\n The lower density of ice, illustrated and pictured in  Figure 2.14 , an anomaly, causes it to float at the surface of liquid water, such as in an iceberg or in the ice cubes in a glass of ice water. In lakes and ponds, ice will form on the surface of the water creating an insulating barrier that protects the animals and plant life in the pond from freezing. Without this layer of insulating ice, plants and animals living in the pond would freeze in the solid block of ice and could not survive. The detrimental effect of freezing on living organisms is caused by the expansion of ice relative to liquid water. The ice crystals that form upon freezing rupture the delicate membranes essential for the function of living cells, irreversibly damaging them. Cells can only survive freezing if the water in them is temporarily replaced by another liquid like glycerol. \n\n Link to Learning \n\n Click  here  to see a 3-D animation of the structure of an ice lattice. (Image credit: Jane Whitney. Image created using Visual Molecular Dynamics VMD software. 2 ) 2 W. Humphrey W., A. Dalke, and K. Schulten, \u201cVMD\u2014Visual Molecular Dynamics,\u201d  Journal of Molecular Graphics  14 (1996): 33-38. \n\n Water\u2019s High Heat Capacity \n\n Water\u2019s high heat capacity is a property caused by hydrogen bonding among water molecules. Water has the highest  specific heat capacity  of any liquids. Specific heat is defined as the amount of heat one gram of a substance must absorb or lose to change its temperature by one degree Celsius. For water, this amount is one  calorie . It therefore takes water a long time to heat and long time to cool. In fact, the specific heat capacity of water is about five times more than that of sand. This explains why the land cools faster than the sea. Due to its high heat capacity, water is used by warm blooded animals to more evenly disperse heat in their bodies: it acts in a similar manner to a car\u2019s cooling system, transporting heat from warm places to cool places, causing the body to maintain a more even temperature. \n\n Water\u2019s Heat of Vaporization \n\n Water also has a high  heat of vaporization , the amount of energy required to change one  gram of a liquid substance to a gas. A considerable amount of heat energy (586 cal) is required to accomplish this change in water. This process occurs on the surface of water. As liquid water heats up, hydrogen bonding makes it difficult to separate the liquid water molecules from each other, which is required for it to enter its gaseous phase (steam). As a result, water acts as a heat sink or heat reservoir and requires much more heat to boil than does a liquid such as ethanol (grain alcohol), whose hydrogen bonding with other ethanol molecules is weaker than water\u2019s hydrogen bonding. Eventually, as water reaches its boiling point of 100\u00b0 Celsius (212\u00b0 Fahrenheit), the heat is able to break the hydrogen bonds between the water molecules, and the kinetic energy (motion) between the water molecules allows them to escape from the liquid as a gas. Even when below its boiling point, water\u2019s individual molecules acquire enough energy from other water molecules such that some surface water molecules can escape and vaporize: this process is known as  evaporation . \n\n The fact that hydrogen bonds need to be broken for water to evaporate means that a substantial amount of energy is used in the process. As the water evaporates, energy is taken up by the process, cooling the environment where the evaporation is taking place. In many living organisms, including in humans, the evaporation of sweat, which is 90 percent water, allows the organism to cool so that homeostasis of body temperature can be maintained. \n\n Water\u2019s Solvent Properties \n\n Since water is a polar molecule with slightly positive and slightly negative charges, ions and polar molecules can readily dissolve in it. Therefore, water is referred to as a  solvent , a substance capable of dissolving other polar molecules and ionic compounds. The charges associated with these molecules will form hydrogen bonds with water, surrounding the particle with water molecules. This is referred to as a  sphere of hydration , or a hydration shell, as illustrated in  Figure 2.15  and serves to keep the particles separated or dispersed in the water. When ionic compounds are added to water, the individual ions react with the polar regions of the water molecules and their ionic bonds are disrupted in the process of  dissociation . Dissociation occurs when atoms or groups of atoms break off from molecules and form ions. Consider table salt (NaCl, or sodium chloride): when NaCl crystals are added to water, the molecules of NaCl dissociate into Na +  and Cl \u2013   ions, and spheres of hydration form around the ions, illustrated in  Figure 2.15 . The positively charged sodium ion is surrounded by the partially negative charge of the water molecule\u2019s oxygen. The negatively charged chloride ion is surrounded by the partially positive charge of the hydrogen on the water molecule. \n\n Water\u2019s Cohesive and Adhesive Properties \n\n Have you ever filled a glass of water to the very top and then slowly added a few more drops? Before it overflows, the water forms a dome-like shape above the rim of the glass. This water can stay above the glass because of the property of  cohesion . In cohesion, water molecules are attracted to each other (because of hydrogen bonding), keeping the molecules together at the liquid-gas (water-air) interface, although there is no more room in the glass. \n\n Cohesion allows for the development of  surface tension , the capacity of a substance to withstand being ruptured when placed under tension or stress. This is also why water forms droplets when placed on a dry surface rather than being flattened out by gravity. When a small scrap of paper is placed onto the droplet of water, the paper floats on top of the water droplet even though paper is denser (heavier) than the water. Cohesion and surface tension keep the hydrogen bonds of water molecules intact and support the item floating on the top. It\u2019s even possible to \u201cfloat\u201d a needle on top of a glass of water if it is placed gently without breaking the surface tension, as shown in  Figure 2.16 . \n\n These cohesive forces are related to water\u2019s property of  adhesion , or the attraction between water molecules and other molecules. This attraction is sometimes stronger than water\u2019s cohesive forces, especially when the water is exposed to charged surfaces such as those found on the inside of thin glass tubes known as capillary tubes. Adhesion is observed when water \u201cclimbs\u201d up the tube placed in a glass of water: notice that the water appears to be higher on the sides of the tube than in the middle. This is because the water molecules are attracted to the charged glass walls of the capillary more than they are to each other and therefore adhere to it. This type of adhesion is called  capillary action , and is illustrated in  Figure 2.17 . \n\n Why are cohesive and adhesive forces important for life? Cohesive and adhesive forces are important for the transport of water from the roots to the leaves in plants. These forces create a \u201cpull\u201d on the water column. This pull results from the tendency of water molecules being evaporated on the surface of the plant to stay connected to water molecules below them, and so they are pulled along. Plants use this natural phenomenon to help transport water from their roots to their leaves. Without these properties of water, plants would be unable to receive the water and the dissolved minerals they require. In another example, insects such as the water strider, shown in  Figure 2.18 , use the surface tension of water to stay afloat on the surface layer of water and even mate there. \n\n pH, Buffers, Acids, and Bases The pH of a solution indicates its acidity or alkalinity. \n\n H \n\n 2 \n\n O \n\n ( \n\n I \n\n ) \n\n   \u2194 \n\n H \n\n + \n\n ( \n\n aq \n\n ) \n\n + \n\n O \n\n H \n\n - \n\n ( \n\n aq \n\n ) \n\n H \n\n 2 \n\n O \n\n ( \n\n I \n\n ) \n\n   \u2194 \n\n H \n\n + \n\n ( \n\n aq \n\n ) \n\n + \n\n O \n\n H \n\n - \n\n ( \n\n aq \n\n ) \n\n litmus  or pH paper, filter paper that has been treated with a natural water-soluble dye so it can be used as a pH indicator, to test how much acid (acidity) or base (alkalinity) exists in a solution. You might have even used some to test whether the water in a swimming pool is properly treated. In both cases, the pH test measures the concentration of hydrogen ions in a given solution. Hydrogen ions are spontaneously generated in pure water by the dissociation (ionization) of a small percentage of water molecules into equal numbers of hydrogen (H + ) ions and hydroxide (OH - ) ions. While the hydroxide ions are kept in solution by their hydrogen bonding with other water molecules, the hydrogen ions, consisting of naked protons, are immediately attracted to un-ionized water molecules, forming hydronium ions (H 3 0 + ). Still, by convention, scientists refer to hydrogen ions and their concentration as if they were free in this state in liquid water. \n\n The concentration of hydrogen ions dissociating from pure water is 1 \u00d7 10 -7  moles H +  ions per liter of water. Moles (mol) are a way to express the amount of a substance (which can be atoms, molecules, ions, etc), with one mole being equal to 6.02 x 10 23  particles of the substance. Therefore, 1 mole of water is equal to 6.02 x 10 23  water molecules. The pH is calculated as the negative of the base 10 logarithm of this concentration. The log10 of 1 \u00d7 10 -7  is -7.0, and the negative of this number (indicated by the \u201cp\u201d of \u201cpH\u201d) yields a pH of 7.0, which is also known as neutral pH. The pH inside of human cells and blood are examples of two areas of the body where near-neutral pH is maintained. Non-neutral pH readings result from dissolving acids or bases in water. Using the negative logarithm to generate positive integers, high concentrations of hydrogen ions yield a low pH number, whereas low levels of hydrogen ions result in a high pH. An  acid  is a substance that increases the concentration of hydrogen ions (H + ) in a solution, usually by having one of its hydrogen atoms dissociate. A  base  provides either hydroxide ions (OH \u2013 ) or other negatively charged ions that combine with hydrogen ions, reducing their concentration in the solution and thereby raising the pH. In cases where the base releases hydroxide ions, these ions bind to free hydrogen ions, generating new water molecules. \n\n The stronger the acid, the more readily it donates H + . For example, hydrochloric acid (HCl) completely dissociates into hydrogen and chloride ions and is highly acidic, whereas the acids in tomato juice or vinegar do not completely dissociate and are considered weak acids. Conversely, strong bases are those substances that readily donate OH \u2013  or take up hydrogen ions. Sodium hydroxide (NaOH) and many household cleaners are highly alkaline and give up OH \u2013  rapidly when placed in water, thereby raising the pH. An example of a weak basic solution is seawater, which has a pH near 8.0, close enough to neutral pH that marine organisms adapted to this saline environment are able to thrive in it. \n\n The  pH scale  is, as previously mentioned, an inverse logarithm and ranges from 0 to 14 ( Figure 2.19 ). Anything below 7.0 (ranging from 0.0 to 6.9) is acidic, and anything above 7.0 (from 7.1 to 14.0) is alkaline. Extremes in pH in either direction from 7.0 are usually considered inhospitable to life. The pH inside cells (6.8) and the pH in the blood (7.4) are both very close to neutral. However, the environment in the stomach is highly acidic, with a pH of 1 to 2. So how do the cells of the stomach survive in such an acidic environment? How do they homeostatically maintain the near neutral pH inside them? The answer is that they cannot do it and are constantly dying. New stomach cells are constantly produced to replace dead ones, which are digested by the stomach acids. It is estimated that the lining of the human stomach is completely replaced every seven to ten days. \n\n Link to Learning \n\n Watch this video for a straightforward explanation of pH and its logarithmic scale.\n\n Click to view content \n\n So how can organisms whose bodies require a near-neutral pH ingest acidic and basic substances (a human drinking orange juice, for example) and survive? Buffers are the key.  Buffers  readily absorb excess H +  or OH \u2013 , keeping the pH of the body carefully maintained in the narrow range required for survival. Maintaining a constant blood pH is critical to a person\u2019s well-being. The buffer maintaining the pH of human blood involves carbonic acid (H 2 CO 3 ), bicarbonate ion (HCO 3 \u2013 ), and carbon dioxide (CO 2 ). When bicarbonate ions combine with free hydrogen ions and become carbonic acid, hydrogen ions are removed, moderating pH changes. Similarly, as shown in  Figure 2.20 , excess carbonic acid can be converted to carbon dioxide gas and exhaled through the lungs. This prevents too many free hydrogen ions from building up in the blood and dangerously reducing the blood\u2019s pH. Likewise, if too much OH \u2013  is introduced into the system, carbonic acid will combine with it to create bicarbonate, lowering the pH. Without this buffer system, the body\u2019s pH would fluctuate enough to put survival in jeopardy. \n\n Other examples of buffers are antacids used to combat excess stomach acid. Many of these over-the-counter medications work in the same way as blood buffers, usually with at least one ion capable of absorbing hydrogen and moderating pH, bringing relief to those that suffer \u201cheartburn\u201d after eating. The unique properties of water that contribute to this capacity to balance pH\u2014as well as water\u2019s other characteristics\u2014are essential to sustaining life on Earth. \n\n Link to Learning \n\n To learn more about water. Visit the  U.S. Geological Survey Water Science for Schools  All About Water! website. \n2.3   Carbon Learning Objectives By the end of this section, you will be able to:\n\n Explain why carbon is important for life \n\n Describe the role of functional groups in biological molecules \n\n Cells are made of many complex molecules called macromolecules, such as proteins, nucleic acids (RNA and DNA), carbohydrates, and lipids. The macromolecules are a subset of  organic molecules  (any carbon-containing liquid, solid, or gas) that are especially important for life. The fundamental component for all of these macromolecules is carbon. The carbon atom has unique properties that allow it to form covalent bonds to as many as four different atoms, making this versatile element ideal to serve as the basic structural component, or \u201cbackbone,\u201d of the macromolecules. \n\n Individual carbon atoms have an incomplete outermost electron shell. With an atomic number of 6 (six electrons and six protons), the first two electrons fill the inner shell, leaving four in the second shell. Therefore, carbon atoms can form up to four covalent bonds with other atoms to satisfy the octet rule. The methane molecule provides an example: it has the chemical formula CH 4 . Each of its four hydrogen atoms forms a single covalent bond with the carbon atom by sharing a pair of electrons. This results in a filled outermost shell. \n\n Hydrocarbons \n\n Hydrocarbons  are organic molecules consisting entirely of carbon and hydrogen, such as methane (CH 4 ) described above. We often use hydrocarbons in our daily lives as fuels\u2014like the propane in a gas grill or the butane in a lighter. The many covalent bonds between the atoms in hydrocarbons store a great amount of energy, which is released when these molecules are burned (oxidized). Methane, an excellent fuel, is the simplest hydrocarbon molecule, with a central carbon atom bonded to four different hydrogen atoms, as illustrated in  Figure 2.21 . The geometry of the methane molecule, where the atoms reside in three dimensions, is determined by the shape of its electron orbitals. The carbons and the four hydrogen atoms form a shape known as a tetrahedron, with four triangular faces; for this reason, methane is described as having tetrahedral geometry. \n\n As the backbone of the large molecules of living things, hydrocarbons may exist as linear carbon chains, carbon rings, or combinations of both. Furthermore, individual carbon-to-carbon bonds may be single, double, or triple covalent bonds, and each type of bond affects the geometry of the molecule in a specific way. This three-dimensional shape or conformation of the large molecules of life (macromolecules) is critical to how they function. \n\n Hydrocarbon Chains \n\n Hydrocarbon chains are formed by successive bonds between carbon atoms and may be branched or unbranched. Furthermore, the overall geometry of the molecule is altered by the different geometries of single, double, and triple covalent bonds, illustrated in  Figure 2.22 . The hydrocarbons ethane, ethene, and ethyne serve as examples of how different carbon-to-carbon bonds affect the geometry of the molecule. The names of all three molecules start with the prefix \u201ceth-,\u201d which is the prefix for two carbon hydrocarbons. The suffixes \u201c-ane,\u201d \u201c-ene,\u201d and \u201c-yne\u201d refer to the presence of single, double, or triple carbon-carbon bonds, respectively. Thus, propane, propene, and propyne follow the same pattern with three carbon molecules, butane, butene, and butyne for four carbon molecules, and so on. Double and triple bonds change the geometry of the molecule: single bonds allow rotation along the axis of the bond, whereas double bonds lead to a planar configuration and triple bonds to a linear one. These geometries have a significant impact on the shape a particular molecule can assume. \n\n Hydrocarbon Rings \n\n So far, the hydrocarbons we have discussed have been  aliphatic hydrocarbons , which consist of linear chains of carbon atoms. Another type of hydrocarbon,  aromatic hydrocarbons , consists of closed rings of carbon atoms. Ring structures are found in hydrocarbons, sometimes with the presence of double bonds, which can be seen by comparing the structure of cyclohexane to benzene in  Figure 2.23 . Examples of biological molecules that incorporate the benzene ring include some amino acids and cholesterol and its derivatives, including the hormones estrogen and testosterone. The benzene ring is also found in the herbicide 2,4-D. Benzene is a natural component of crude oil and has been classified as a carcinogen. Some hydrocarbons have both aliphatic and aromatic portions; beta-carotene is an example of such a hydrocarbon. \n\n Isomers \n\n The three-dimensional placement of atoms and chemical bonds within organic molecules is central to understanding their chemistry. Molecules that share the same chemical formula but differ in the placement (structure) of their atoms and/or chemical bonds are known as  isomers .  Structural isomers  (like butane and isobutene shown in  Figure 2.24  a ) differ in the placement of their covalent bonds: both molecules have four carbons and ten hydrogens (C 4 H 10 ), but the different arrangement of the atoms within the molecules leads to differences in their chemical properties. For example, due to their different chemical properties, butane is suited for use as a fuel for cigarette lighters and torches, whereas isobutene is suited for use as a refrigerant and a propellant in spray cans. Geometric isomers , on the other hand, have similar placements of their covalent bonds but differ in how these bonds are made to the surrounding atoms, especially in carbon-to-carbon double bonds. In the simple molecule butene (C 4 H 8 ), the two methyl groups (CH 3 ) can be on either side of the double covalent bond central to the molecule, as illustrated in  Figure 2.24  b . When the carbons are bound on the same side of the double bond, this is the  cis  configuration; if they are on opposite sides of the double bond, it is a  trans  configuration. In the  trans  configuration, the carbons form a more or less linear structure, whereas the carbons in the  cis  configuration make a bend (change in direction) of the carbon backbone. Visual Connection \n\n Which of the following statements is false? \n\n Molecules with the formulas CH 3 CH 2 COOH and C 3 H 6 O 2  could be structural isomers. \n\n Molecules must have a double bond to be  cis - trans  isomers. \n\n To be enantiomers, a molecule must have at least three different atoms or groups connected to a central carbon. \n\n To be enantiomers, a molecule must have at least four different atoms or groups connected to a central carbon. \n\n In triglycerides (fats and oils), long carbon chains known as fatty acids may contain double bonds, which can be in either the  cis  or  trans  configuration, illustrated in  Figure 2.25 . Fats with at least one double bond between carbon atoms are unsaturated fats. When some of these bonds are in the  cis  configuration, the resulting bend in the carbon backbone of the chain means that triglyceride molecules cannot pack tightly, so they remain liquid (oil) at room temperature. On the other hand, triglycerides with  trans  double bonds (popularly called trans fats), have relatively linear fatty acids that are able to pack tightly together at room temperature and form solid fats. In the human diet, trans fats are linked to an increased risk of cardiovascular disease, so many food manufacturers have reduced or eliminated their use in recent years. In contrast to unsaturated fats, triglycerides without double bonds between carbon atoms are called saturated fats, meaning that they contain all the hydrogen atoms available. Saturated fats are a solid at room temperature and usually of animal origin. \n\n Enantiomers \n\n Enantiomers  are molecules that share the same chemical structure and chemical bonds but differ in the three-dimensional placement of atoms so that they are mirror images. As shown in  Figure 2.26 , an amino acid alanine example, the two structures are non-superimposable. In nature, only the L-forms of amino acids are used to make proteins. Some D forms of amino acids are seen in the cell walls of bacteria, but never in their proteins. Similarly, the D-form of glucose is the main product of photosynthesis and the L-form of the molecule is rarely seen in nature. \n\n Functional Groups \n\n Functional groups  are groups of atoms that occur within molecules and confer specific chemical properties to those molecules. They are found along the \u201ccarbon backbone\u201d of macromolecules. This carbon backbone is formed by chains and/or rings of carbon atoms with the occasional substitution of an element such as nitrogen or oxygen. Molecules with other elements in their carbon backbone are  substituted hydrocarbons . \n\n The functional groups in a macromolecule are usually attached to the carbon backbone at one or several different places along its chain and/or ring structure. Each of the four types of macromolecules\u2014proteins, lipids, carbohydrates, and nucleic acids\u2014has its own characteristic set of functional groups that contributes greatly to its differing chemical properties and its function in living organisms. \n\n A functional group can participate in specific chemical reactions. Some of the important functional groups in biological molecules are shown in  Figure 2.27 ; they include: hydroxyl, methyl, carbonyl, carboxyl, amino, phosphate, and sulfhydryl. These groups play an important role in the formation of molecules like DNA, proteins, carbohydrates, and lipids. Functional groups are usually classified as hydrophobic or hydrophilic depending on their charge or polarity characteristics. An example of a hydrophobic group is the non-polar methane molecule. Among the hydrophilic functional groups is the carboxyl group found in amino acids, some amino acid side chains, and the fatty acids that form triglycerides and phospholipids. This carboxyl group ionizes to release hydrogen ions (H + ) from the COOH group resulting in the negatively charged COO -  group; this contributes to the hydrophilic nature of whatever molecule it is found on. Other functional groups, such as the carbonyl group, have a partially negatively charged oxygen atom that may form hydrogen bonds with water molecules, again making the molecule more hydrophilic. \n\n Hydrogen bonds between functional groups (within the same molecule or between different molecules) are important to the function of many macromolecules and help them to fold properly into and maintain the appropriate shape for functioning. Hydrogen bonds are also involved in various recognition processes, such as DNA complementary base pairing and the binding of an enzyme to its substrate, as illustrated in  Figure 2.28 . ", "questions": [{"question": {"question_id": "fs-idp140338796967024", "question_text": "If xenon has an atomic number of 54 and a mass number of 108, how many neutrons does it have?", "question_choices": ["54", "27", "100", "108"], "cloze_format": "If xenon has an atomic number of 54 and a mass number of 108, it has ___ neutrons.", "normal_format": "If xenon has an atomic number of 54 and a mass number of 108, how many neutrons does it have?"}, "answer": {"ans_text": "54", "ans_choice": 0}, "bloom": "1", "hl_sentences": "The number of protons determines an element \u2019 s atomic number and is used to distinguish one element from another . The number of neutrons is variable , resulting in isotopes , which are different forms of the same atom that vary only in the number of neutrons they possess . Together , the number of protons and the number of neutrons determine an element \u2019 s mass number , as illustrated in Figure 2.3 .", "hl_context": "Atoms of each element contain a characteristic number of protons and electrons . <hl> The number of protons determines an element \u2019 s atomic number and is used to distinguish one element from another . <hl> <hl> The number of neutrons is variable , resulting in isotopes , which are different forms of the same atom that vary only in the number of neutrons they possess . <hl> <hl> Together , the number of protons and the number of neutrons determine an element \u2019 s mass number , as illustrated in Figure 2.3 . <hl> Note that the small contribution of mass from electrons is disregarded in calculating the mass number . This approximation of mass can be used to easily calculate how many neutrons an element has by simply subtracting the number of protons from the mass number . Since an element \u2019 s isotopes will have slightly different mass numbers , scientists also determine the atomic mass , which is the calculated mean of the mass number for its naturally occurring isotopes . Often , the resulting number contains a fraction . For example , the atomic mass of chlorine ( Cl ) is 35.45 because chlorine is composed of several isotopes , some ( the majority ) with atomic mass 35 ( 17 protons and 18 neutrons ) and some with atomic mass 37 ( 17 protons and 20 neutrons ) ."}, {"question": {"question_id": "fs-idp140338796964704", "question_text": "Atoms that vary in the number of neutrons found in their nuclei are called ________.", "question_choices": ["ions", "neutrons", "neutral atoms", "isotopes"], "cloze_format": "Atoms that vary in the number of neutrons found in their nuclei are called ________.", "normal_format": "What are atoms that vary in the number of neutrons found in their nuclei called?"}, "answer": {"ans_text": "isotopes", "ans_choice": 3}, "bloom": null, "hl_sentences": "Isotopes Isotopes are different forms of an element that have the same number of protons but a different number of neutrons . The number of neutrons is variable , resulting in isotopes , which are different forms of the same atom that vary only in the number of neutrons they possess .", "hl_context": "<hl> Isotopes Isotopes are different forms of an element that have the same number of protons but a different number of neutrons . <hl> Some elements \u2014 such as carbon , potassium , and uranium \u2014 have naturally occurring isotopes . Carbon - 12 contains six protons , six neutrons , and six electrons ; therefore , it has a mass number of 12 ( six protons and six neutrons ) . Carbon - 14 contains six protons , eight neutrons , and six electrons ; its atomic mass is 14 ( six protons and eight neutrons ) . These two alternate forms of carbon are isotopes . Some isotopes may emit neutrons , protons , and electrons , and attain a more stable atomic configuration ( lower level of potential energy ); these are radioactive isotopes , or radioisotopes . Radioactive decay ( carbon - 14 decaying to eventually become nitrogen - 14 ) describes the energy loss that occurs when an unstable atom \u2019 s nucleus releases radiation . Evolution Connection Carbon Dating Atoms of each element contain a characteristic number of protons and electrons . The number of protons determines an element \u2019 s atomic number and is used to distinguish one element from another . <hl> The number of neutrons is variable , resulting in isotopes , which are different forms of the same atom that vary only in the number of neutrons they possess . <hl> Together , the number of protons and the number of neutrons determine an element \u2019 s mass number , as illustrated in Figure 2.3 . Note that the small contribution of mass from electrons is disregarded in calculating the mass number . This approximation of mass can be used to easily calculate how many neutrons an element has by simply subtracting the number of protons from the mass number . Since an element \u2019 s isotopes will have slightly different mass numbers , scientists also determine the atomic mass , which is the calculated mean of the mass number for its naturally occurring isotopes . Often , the resulting number contains a fraction . For example , the atomic mass of chlorine ( Cl ) is 35.45 because chlorine is composed of several isotopes , some ( the majority ) with atomic mass 35 ( 17 protons and 18 neutrons ) and some with atomic mass 37 ( 17 protons and 20 neutrons ) ."}, {"question": {"question_id": "fs-idp140338809362704", "question_text": "Potassium has an atomic number of 19. What is its electron configuration?", "question_choices": ["shells 1 and 2 are full, and shell 3 has nine electrons", "shells 1, 2 and 3 are full and shell 4 has three electrons", "shells 1, 2 and 3 are full and shell 4 has one electron", "shells 1, 2 and 3 are full and no other electrons are present"], "cloze_format": "Potassium has an atomic number of 19. Its electron configuration is that ___.", "normal_format": "Potassium has an atomic number of 19. What is its electron configuration?"}, "answer": {"ans_text": "shells 1, 2 and 3 are full and shell 4 has one electron", "ans_choice": 2}, "bloom": "2", "hl_sentences": "Principal shell 1n has only a single s orbital , which can hold two electrons . Principal shell 2n has one s and one p subshell , and can hold a total of eight electrons . Principal shell 3n has s , p , and d subshells and can hold 18 electrons . Principal shell 4n has s , p , d and f orbitals and can hold 32 electrons . Moving away from the nucleus , the number of electrons and orbitals found in the energy levels increases . The 1 s orbital is the closest orbital to the nucleus , and it is always filled first , before any other orbital can be filled .", "hl_context": "Recall that the Bohr model depicts an atom \u2019 s electron shell configuration . Within each electron shell are subshells , and each subshell has a specified number of orbitals containing electrons . While it is impossible to calculate exactly where an electron is located , scientists know that it is most probably located within its orbital path . Subshells are designated by the letter s , p , d , and f . The s subshell is spherical in shape and has one orbital . <hl> Principal shell 1n has only a single s orbital , which can hold two electrons . <hl> <hl> Principal shell 2n has one s and one p subshell , and can hold a total of eight electrons . <hl> The p subshell has three dumbbell-shaped orbitals , as illustrated in Figure 2.8 . Subshells d and f have more complex shapes and contain five and seven orbitals , respectively . These are not shown in the illustration . <hl> Principal shell 3n has s , p , and d subshells and can hold 18 electrons . <hl> <hl> Principal shell 4n has s , p , d and f orbitals and can hold 32 electrons . <hl> <hl> Moving away from the nucleus , the number of electrons and orbitals found in the energy levels increases . <hl> Progressing from one atom to the next in the periodic table , the electron structure can be worked out by fitting an extra electron into the next available orbital . The closest orbital to the nucleus , called the 1s orbital , can hold up to two electrons . This orbital is equivalent to the innermost electron shell of the Bohr model of the atom . It is called the 1 s orbital because it is spherical around the nucleus . <hl> The 1 s orbital is the closest orbital to the nucleus , and it is always filled first , before any other orbital can be filled . <hl> Hydrogen has one electron ; therefore , it has only one spot within the 1 s orbital occupied . This is designated as 1 s 1 , where the superscripted 1 refers to the one electron within the 1 s orbital . Helium has two electrons ; therefore , it can completely fill the 1 s orbital with its two electrons . This is designated as 1 s 2 , referring to the two electrons of helium in the 1 s orbital . On the periodic table Figure 2.5 , hydrogen and helium are the only two elements in the first row ( period ); this is because they only have electrons in their first shell , the 1 s orbital . Hydrogen and helium are the only two elements that have the 1 s and no other electron orbitals in the electrically neutral state ."}, {"question": {"question_id": "fs-idp140338805839136", "question_text": "Which type of bond represents a weak chemical bond?", "question_choices": ["hydrogen bond", "atomic bond", "covalent bond", "nonpolar covalent bond"], "cloze_format": "The type of bond that represents a weak chemical bond is the ___.", "normal_format": "Which type of bond represents a weak chemical bond?"}, "answer": {"ans_text": "hydrogen bond", "ans_choice": 0}, "bloom": null, "hl_sentences": "Two weak bonds that occur frequently are hydrogen bonds and van der Waals interactions .", "hl_context": "Hydrogen Bonds and Van Der Waals Interactions Ionic and covalent bonds between elements require energy to break . Ionic bonds are not as strong as covalent , which determines their behavior in biological systems . However , not all bonds are ionic or covalent bonds . Weaker bonds can also form between molecules . <hl> Two weak bonds that occur frequently are hydrogen bonds and van der Waals interactions . <hl> Without these two types of bonds , life as we know it would not exist . Hydrogen bonds provide many of the critical , life-sustaining properties of water and also stabilize the structures of proteins and DNA , the building block of cells . When polar covalent bonds containing hydrogen form , the hydrogen in that bond has a slightly positive charge because hydrogen \u2019 s electron is pulled more strongly toward the other element and away from the hydrogen . Because the hydrogen is slightly positive , it will be attracted to neighboring negative charges . When this happens , a weak interaction occurs between the \u03b4 + of the hydrogen from one molecule and the \u03b4 \u2013 charge on the more electronegative atoms of another molecule , usually oxygen or nitrogen , or within the same molecule . This interaction is called a hydrogen bond . This type of bond is common and occurs regularly between water molecules . Individual hydrogen bonds are weak and easily broken ; however , they occur in very large numbers in water and in organic polymers , creating a major force in combination . Hydrogen bonds are also responsible for zipping together the DNA double helix . Like hydrogen bonds , van der Waals interactions are weak attractions or interactions between molecules . Van der Waals attractions can occur between any two or more molecules and are dependent on slight fluctuations of the electron densities , which are not always symmetrical around an atom . For these attractions to happen , the molecules need to be very close to one another . These bonds \u2014 along with ionic , covalent , and hydrogen bonds \u2014 contribute to the three-dimensional structure of the proteins in our cells that is necessary for their proper function . Career Connection Pharmaceutical Chemist"}, {"question": {"question_id": "fs-idm114093728", "question_text": "Which of the following statements is not true?", "question_choices": ["Water is polar.", "Water stabilizes temperature.", "Water is essential for life.", "Water is the most abundant molecule in the Earth\u2019s atmosphere."], "cloze_format": "It is a false statement that ___ .", "normal_format": "Which of the following statements is not true?"}, "answer": {"ans_text": "Water is the most abundant molecule in the Earth\u2019s atmosphere.", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "Water is one of the more abundant molecules and the one most critical to life on Earth .", "hl_context": "Why do scientists spend time looking for water on other planets ? Why is water so important ? It is because water is essential to life as we know it . <hl> Water is one of the more abundant molecules and the one most critical to life on Earth . <hl> Approximately 60 \u2013 70 percent of the human body is made up of water . Without it , life as we know it simply would not exist . The polarity of the water molecule and its resulting hydrogen bonding make water a unique substance with special properties that are intimately tied to the processes of life . Life originally evolved in a watery environment , and most of an organism \u2019 s cellular chemistry and metabolism occur inside the watery contents of the cell \u2019 s cytoplasm . Special properties of water are its high heat capacity and heat of vaporization , its ability to dissolve polar molecules , its cohesive and adhesive properties , and its dissociation into ions that leads to the generation of pH . Understanding these characteristics of water helps to elucidate its importance in maintaining life ."}, {"question": {"question_id": "fs-idp3290112", "question_text": "When acids are added to a solution, the pH should ________.", "question_choices": ["decrease", "increase", "stay the same", "cannot tell without testing"], "cloze_format": "When acids are added to a solution, the pH should ________.", "normal_format": "When acids are added to a solution, what should the pH do?"}, "answer": {"ans_text": "decrease", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "Anything below 7.0 ( ranging from 0.0 to 6.9 ) is acidic , and anything above 7.0 ( from 7.1 to 14.0 ) is alkaline . However , the environment in the stomach is highly acidic , with a pH of 1 to 2 .", "hl_context": "The pH scale is , as previously mentioned , an inverse logarithm and ranges from 0 to 14 ( Figure 2.19 ) . <hl> Anything below 7.0 ( ranging from 0.0 to 6.9 ) is acidic , and anything above 7.0 ( from 7.1 to 14.0 ) is alkaline . <hl> Extremes in pH in either direction from 7.0 are usually considered inhospitable to life . The pH inside cells ( 6.8 ) and the pH in the blood ( 7.4 ) are both very close to neutral . <hl> However , the environment in the stomach is highly acidic , with a pH of 1 to 2 . <hl> So how do the cells of the stomach survive in such an acidic environment ? How do they homeostatically maintain the near neutral pH inside them ? The answer is that they cannot do it and are constantly dying . New stomach cells are constantly produced to replace dead ones , which are digested by the stomach acids . It is estimated that the lining of the human stomach is completely replaced every seven to ten days ."}, {"question": {"question_id": "fs-idm171817504", "question_text": "A molecule that binds up excess hydrogen ions in a solution is called a(n) ________.", "question_choices": ["acid", "isotope", "base", "donator"], "cloze_format": "A molecule that binds up excess hydrogen ions in a solution is called a(n) ________.", "normal_format": "What is a molecule that binds up excess hydrogen ions in a solution called?"}, "answer": {"ans_text": "base", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "A base provides either hydroxide ions ( OH \u2013 ) or other negatively charged ions that combine with hydrogen ions , reducing their concentration in the solution and thereby raising the pH . In cases where the base releases hydroxide ions , these ions bind to free hydrogen ions , generating new water molecules .", "hl_context": "The concentration of hydrogen ions dissociating from pure water is 1 \u00d7 10 - 7 moles H + ions per liter of water . Moles ( mol ) are a way to express the amount of a substance ( which can be atoms , molecules , ions , etc ) , with one mole being equal to 6.02 x 10 23 particles of the substance . Therefore , 1 mole of water is equal to 6.02 x 10 23 water molecules . The pH is calculated as the negative of the base 10 logarithm of this concentration . The log 10 of 1 \u00d7 10 - 7 is -7.0 , and the negative of this number ( indicated by the \u201c p \u201d of \u201c pH \u201d ) yields a pH of 7.0 , which is also known as neutral pH . The pH inside of human cells and blood are examples of two areas of the body where near-neutral pH is maintained . Non-neutral pH readings result from dissolving acids or bases in water . Using the negative logarithm to generate positive integers , high concentrations of hydrogen ions yield a low pH number , whereas low levels of hydrogen ions result in a high pH . An acid is a substance that increases the concentration of hydrogen ions ( H + ) in a solution , usually by having one of its hydrogen atoms dissociate . <hl> A base provides either hydroxide ions ( OH \u2013 ) or other negatively charged ions that combine with hydrogen ions , reducing their concentration in the solution and thereby raising the pH . <hl> <hl> In cases where the base releases hydroxide ions , these ions bind to free hydrogen ions , generating new water molecules . <hl>"}, {"question": {"question_id": "fs-idm135464096", "question_text": "Which of the following statements is true?", "question_choices": ["Acids and bases cannot mix together.", "Acids and bases will neutralize each other.", "Acids, but not bases, can change the pH of a solution.", "Acids donate hydroxide ions (OH\u2013); bases donate hydrogen ions (H+)."], "cloze_format": "It is a true statement that ___ .", "normal_format": "Which of the following statements is true?"}, "answer": {"ans_text": "Acids and bases will neutralize each other.", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": "2", "hl_sentences": "Buffers readily absorb excess H + or OH \u2013 , keeping the pH of the body carefully maintained in the narrow range required for survival .", "hl_context": "So how can organisms whose bodies require a near-neutral pH ingest acidic and basic substances ( a human drinking orange juice , for example ) and survive ? Buffers are the key . <hl> Buffers readily absorb excess H + or OH \u2013 , keeping the pH of the body carefully maintained in the narrow range required for survival . <hl> Maintaining a constant blood pH is critical to a person \u2019 s well-being . The buffer maintaining the pH of human blood involves carbonic acid ( H 2 CO 3 ) , bicarbonate ion ( HCO 3 \u2013 ) , and carbon dioxide ( CO 2 ) . When bicarbonate ions combine with free hydrogen ions and become carbonic acid , hydrogen ions are removed , moderating pH changes . Similarly , as shown in Figure 2.20 , excess carbonic acid can be converted to carbon dioxide gas and exhaled through the lungs . This prevents too many free hydrogen ions from building up in the blood and dangerously reducing the blood \u2019 s pH . Likewise , if too much OH \u2013 is introduced into the system , carbonic acid will combine with it to create bicarbonate , lowering the pH . Without this buffer system , the body \u2019 s pH would fluctuate enough to put survival in jeopardy ."}, {"question": {"question_id": "fs-idp44004736", "question_text": "Each carbon molecule can bond with as many as________ other atom(s) or molecule(s).", "question_choices": ["one", "two", "six", "four"], "cloze_format": "Each carbon molecule can bond with as many as________ other atom(s) or molecule(s).", "normal_format": "Each carbon molecule can bond with as many as how many other atom(s) or molecule(s)?"}, "answer": {"ans_text": "four", "ans_choice": 3}, "bloom": null, "hl_sentences": "With an atomic number of 6 ( six electrons and six protons ) , the first two electrons fill the inner shell , leaving four in the second shell . Therefore , carbon atoms can form up to four covalent bonds with other atoms to satisfy the octet rule . The carbon atom has unique properties that allow it to form covalent bonds to as many as four different atoms , making this versatile element ideal to serve as the basic structural component , or \u201c backbone , \u201d of the macromolecules .", "hl_context": "Individual carbon atoms have an incomplete outermost electron shell . <hl> With an atomic number of 6 ( six electrons and six protons ) , the first two electrons fill the inner shell , leaving four in the second shell . <hl> <hl> Therefore , carbon atoms can form up to four covalent bonds with other atoms to satisfy the octet rule . <hl> The methane molecule provides an example : it has the chemical formula CH 4 . Each of its four hydrogen atoms forms a single covalent bond with the carbon atom by sharing a pair of electrons . This results in a filled outermost shell . Cells are made of many complex molecules called macromolecules , such as proteins , nucleic acids ( RNA and DNA ) , carbohydrates , and lipids . The macromolecules are a subset of organic molecules ( any carbon-containing liquid , solid , or gas ) that are especially important for life . The fundamental component for all of these macromolecules is carbon . <hl> The carbon atom has unique properties that allow it to form covalent bonds to as many as four different atoms , making this versatile element ideal to serve as the basic structural component , or \u201c backbone , \u201d of the macromolecules . <hl>"}, {"question": {"question_id": "fs-idm73905536", "question_text": "Which of the following is not a functional group that can bond with carbon?", "question_choices": ["sodium", "hydroxyl", "phosphate", "carbonyl"], "cloze_format": "___ is not a functional group that can bond with carbon.", "normal_format": "Which of the following is not a functional group that can bond with carbon?"}, "answer": {"ans_text": "sodium", "ans_choice": 0}, "bloom": "1", "hl_sentences": "Some of the important functional groups in biological molecules are shown in Figure 2.27 ; they include : hydroxyl , methyl , carbonyl , carboxyl , amino , phosphate , and sulfhydryl .", "hl_context": "A functional group can participate in specific chemical reactions . <hl> Some of the important functional groups in biological molecules are shown in Figure 2.27 ; they include : hydroxyl , methyl , carbonyl , carboxyl , amino , phosphate , and sulfhydryl . <hl> These groups play an important role in the formation of molecules like DNA , proteins , carbohydrates , and lipids . Functional groups are usually classified as hydrophobic or hydrophilic depending on their charge or polarity characteristics . An example of a hydrophobic group is the non-polar methane molecule . Among the hydrophilic functional groups is the carboxyl group found in amino acids , some amino acid side chains , and the fatty acids that form triglycerides and phospholipids . This carboxyl group ionizes to release hydrogen ions ( H + ) from the COOH group resulting in the negatively charged COO - group ; this contributes to the hydrophilic nature of whatever molecule it is found on . Other functional groups , such as the carbonyl group , have a partially negatively charged oxygen atom that may form hydrogen bonds with water molecules , again making the molecule more hydrophilic ."}], "summary": "", "keyterm": "", "bname": "biology"}, {"chapter": 20, "intro": " Chapter Outline 20.1   Political Corruption in Postbellum America 20.2   The Key Political Issues: Patronage, Tariffs, and Gold 20.3   Farmers Revolt in the Populist Era 20.4   Social and Labor Unrest in the 1890s Introduction \n\n L. Frank Baum was a journalist who rose to prominence at the end of the nineteenth century. Baum's most famous story,  The Wizard of Oz  ( Figure 20.1 ), was published in 1900, but \u201cOz\u201d first came into being years earlier, when he told a story to a group of schoolchildren visiting his newspaper office in South Dakota. He made up a tale of a wonderful land, and, searching for a name, he allegedly glanced down at his file cabinet, where the bottom drawer was labeled \u201cO-Z.\u201d Thus was born the world of Oz, where a girl from struggling Kansas hoped to get help from a \u201cwonderful wizard\u201d who proved to be a fraud. Since then, many have speculated that the story reflected Baum's political sympathies for the Populist Party, which galvanized midwestern and southern farmers' demands for federal reform. Whether he intended the story to act as an allegory for the plight of farmers and workers in late nineteenth-century America, or whether he simply wanted to write an \u201cAmerican fairy tale\u201d set in the heartland, Populists looked for answers much like Dorothy did. And the government in Washington proved to be meek rather than magical. ", "chapter_text": " 20.1   Political Corruption in Postbellum America Learning Objectives By the end of this section, you will be able to: \n\n Discuss the national political scene during the Gilded Age \n\n Analyze why many critics considered the Gilded Age a period of ineffective national leadership \n\n The challenges Americans faced in the post-Civil War era extended far beyond the issue of Reconstruction and the challenge of an economy without slavery. Political and social repair of the nation was paramount, as was the correlative question of race relations in the wake of slavery. In addition, farmers faced the task of cultivating arid western soils and selling crops in an increasingly global commodities market, while workers in urban industries suffered long hours and hazardous conditions at stagnant wages. \n\n Farmers, who still composed the largest percentage of the U.S. population, faced mounting debts as agricultural prices spiraled downward. These lower prices were due in large part to the cultivation of more acreage using more productive farming tools and machinery, global market competition, as well as price manipulation by commodity traders, exorbitant railroad freight rates, and costly loans upon which farmers depended. For many, their hard work resulted merely in a continuing decline in prices and even greater debt. These farmers, and others who sought leaders to heal the wounds left from the Civil War, organized in different states, and eventually into a national third-party challenge, only to find that, with the end of Reconstruction, federal political power was stuck in a permanent partisan stalemate, and corruption was widespread at both the state and federal levels. \n\n As the  Gilded Age  unfolded, presidents had very little power, due in large part to highly contested elections in which relative popular majorities were razor-thin. Two presidents won the Electoral College without a popular majority. Further undermining their efficacy was a Congress comprising mostly politicians operating on the principle of political patronage. Eventually, frustrated by the lack of leadership in Washington, some Americans began to develop their own solutions, including the establishment of new political parties and organizations to directly address the problems they faced. Out of the frustration wrought by war and presidential political impotence, as well as an overwhelming pace of industrial change, farmers and workers formed a new grassroots reform movement that, at the end of the century, was eclipsed by an even larger, mostly middle-class, Progressive movement. These reform efforts did bring about change\u2014but not without a fight. \n\n THE GILDED AGE \n\n Mark Twain coined the phrase \u201cGilded Age\u201d in a book he co-authored with Charles Dudley Warner in 1873,  The Gilded Age: A Tale of Today . The book satirized the corruption of post-Civil War society and politics. Indeed, popular excitement over national growth and industrialization only thinly glossed over the stark economic inequalities and various degrees of corruption of the era ( Figure 20.3 ). Politicians of the time largely catered to business interests in exchange for political support and wealth. Many participated in graft and bribery, often justifying their actions with the excuse that corruption was too widespread for a successful politician to resist. The machine politics of the cities, specifically Tammany Hall in New York, illustrate the kind of corrupt, but effective, local and national politics that dominated the era. \n\n Nationally, between 1872 and 1896, the lack of clear popular mandates made presidents reluctant to venture beyond the interests of their traditional supporters. As a result, for nearly a quarter of a century, presidents had a weak hold on power, and legislators were reluctant to tie their political agendas to such weak leaders. On the contrary, weakened presidents were more susceptible to support various legislators\u2019 and lobbyists\u2019 agendas, as they owed tremendous favors to their political parties, as well as to key financial contributors, who helped them garner just enough votes to squeak into office through the Electoral College. As a result of this relationship, the rare pieces of legislation passed were largely responses to the desires of businessmen and industrialists whose support helped build politicians\u2019 careers. \n\n What was the result of this political malaise? Not surprisingly, almost nothing was accomplished on the federal level. However, problems associated with the tremendous economic growth during this time continued to mount. More Americans were moving to urban centers, which were unable to accommodate the massive numbers of working poor. Tenement houses with inadequate sanitation led to widespread illness. In rural parts of the country, people fared no better. Farmers were unable to cope with the challenges of low prices for their crops and exorbitant costs for everyday goods. All around the country, Americans in need of solutions turned further away from the federal government for help, leading to the rise of fractured and corrupt political groups. \n\n Defining American Mark Twain and the Gilded Age Mark Twain ( Figure 20.4 ) wrote  The Gilded Age: A Tale of Today  with his neighbor, Charles Dudley Warner, as a satire about the corrupt politics and lust for power that he felt characterized American society at the time. The book, the only novel Twain ever co-authored, tells of the characters\u2019 desire to sell their land to the federal government and become rich. It takes aim at both the government in Washington and those Americans, in the South and elsewhere, whose lust for money and status among the newly rich in the nation\u2019s capital leads them to corrupt and foolish choices. \n\n In the following conversation from Chapter Fifty-One of the book, Colonel Sellers instructs young Washington Hawkins on the routine practices of Congress: \n\n \u201cNow let\u2019s figure up a little on, the preliminaries. I think Congress always tries to do as near right as it can, according to its lights. A man can\u2019t ask any fairer than that. The first preliminary it always starts out on, is to clean itself, so to speak. It will arraign two or three dozen of its members, or maybe four or five dozen, for taking bribes to vote for this and that and the other bill last winter.\u201d \n\n\u201cIt goes up into the dozens, does it?\u201d \n\n\u201cWell, yes; in a free country likes ours, where any man can run for Congress and anybody can vote for him, you can\u2019t expect immortal purity all the time\u2014it ain\u2019t in nature. Sixty or eighty or a hundred and fifty people are bound to get in who are not angels in disguise, as young Hicks the correspondent says; but still it is a very good average; very good indeed. . . . Well, after they have finished the bribery cases, they will take up cases of members who have bought their seats with money. That will take another four weeks.\u201d \n\n\u201cVery good; go on. You have accounted for two-thirds of the session.\u201d \n\n\u201cNext they will try each other for various smaller irregularities, like the sale of appointments to West Point cadetships, and that sort of thing\u2014 . . . \u201d \n\n\u201cHow long does it take to disinfect itself of these minor impurities?\u201d \n\n\u201cWell, about two weeks, generally.\u201d \n\n\u201cSo Congress always lies helpless in quarantine ten weeks of a session. That\u2019s encouraging.\u201d \n\n The book was a success, in part because it amused people even as it excoriated the politics of the day. For this humor, as well as its astute analysis, Twain and Warner\u2019s book still offers entertainment and insight today. \n\n THE ELECTION OF 1876 SETS THE TONE \n\n In many ways, the presidential election of 1876 foreshadowed the politics of the era, in that it resulted in one of the most controversial results in all of presidential history. The country was in the middle of the economic downturn caused by the Panic of 1873, a downturn that would ultimately last until 1879, all but assuring that Republican incumbent Ulysses S. Grant would not be reelected. Instead, the Republican Party nominated a three-time governor from Ohio, Rutherford B. Hayes. Hayes was a popular candidate who advocated for both \u201chard money\u201d\u2014an economy based upon gold currency transactions\u2014to protect against inflationary pressures and  civil service  reform, that is, recruitment based upon merit and qualifications, which was to replace the practice of handing out government jobs as \u201cspoils.\u201d Most importantly, he had no significant political scandals in his past, unlike his predecessor Grant, who suffered through the  Cr\u00e9dit Mobilier of America scandal . In this most notorious example of Gilded Age corruption, several congressmen accepted cash and stock bribes in return for appropriating inflated federal funds for the construction of the transcontinental railroad. \n\n The Democrats likewise sought a candidate who could champion reform against growing political corruption. They found their man in Samuel J. Tilden, governor of New York and a self-made millionaire, who had made a successful political career fighting corruption in New York City, including spearheading the prosecution against Tammany Hall Boss William Tweed, who was later jailed. Both parties tapped into the popular mood of the day, each claiming to champion reform and promising an end to the corruption that had become rampant in Washington ( Figure 20.5 ). Likewise, both parties promised an end to post-Civil War Reconstruction. \n\n The campaign was a typical one for the era: Democrats shone a spotlight on earlier Republican scandals, such as the Cr\u00e9dit Mobilier affair, and Republicans relied upon the  bloody shirt campaign , reminding the nation of the terrible human toll of the war against southern confederates who now reappeared in national politics under the mantle of the Democratic Party. President Grant previously had great success with the \u201cbloody shirt\u201d strategy in the 1868 election, when Republican supporters attacked Democratic candidate Horatio Seymour for his sympathy with New York City draft rioters during the war. In 1876, true to the campaign style of the day, neither Tilden nor Hayes actively campaigned for office, instead relying upon supporters and other groups to promote their causes. \n\n Fearing a significant African American and White Republican voter turnout in the South, particularly in the wake of the Civil Rights Act of 1875, which further empowered African Americans with protection in terms of public accommodations, Democrats relied upon White supremacist terror organizations to intimidate Blacks and Republicans. Tactics included physically assaulting many while they attempted to vote. The Redshirts, based in Mississippi and the Carolinas, and the White League in Louisiana, relied upon intimidation tactics similar to the Ku Klux Klan but operated in a more open and organized fashion with the sole goal of restoring Democrats to political predominance in the South. In several instances, Redshirts would attack freedmen who attempted to vote, whipping them openly in the streets while simultaneously hosting barbecues to attract Democratic voters to the polls. Women throughout South Carolina began to sew red flannel shirts for the men to wear as a sign of their political views; women themselves began wearing red ribbons in their hair and bows about their waists. The result of the presidential election, ultimately, was close. Tilden won the popular vote by nearly 300,000 votes; however, he had only 184 electoral votes, with 185 needed to proclaim formal victory. Three states, Florida, Louisiana, and South Carolina, were in dispute due to widespread charges of voter fraud and miscounting. Questions regarding the validity of one of the three electors in Oregon cast further doubt on the final vote; however, that state subsequently presented evidence to Congress confirming all three electoral votes for Hayes. \n\n As a result of the disputed election, the House of Representatives established a special electoral commission to determine which candidate won the challenged electoral votes of these three states. In what later became known as the Compromise of 1877, Republican Party leaders offered southern Democrats an enticing deal. The offer was that if the commission found in favor of a Hayes victory, Hayes would order the withdrawal of the remaining U.S. troops from those three southern states, thus allowing the collapse of the radical Reconstruction governments of the immediate post-Civil War era. This move would permit southern Democrats to end federal intervention and control their own states\u2019 fates in the wake of the end of slavery ( Figure 20.6 ). \n\n After weeks of deliberation, the electoral commission voted eight to seven along straight party lines, declaring Hayes the victor in each of the three disputed states. As a result, Hayes defeated Tilden in the electoral vote by a count of 185\u2013184 and became the next president. By April of that year, radical Reconstruction ended as promised, with the removal of federal troops from the final two Reconstruction states, South Carolina and Louisiana. Within a year, Redeemers\u2014largely Southern Democrats\u2014had regained control of the political and social fabric of the South. \n\n Although unpopular among the voting electorate, especially among African Americans who referred to it as \u201cThe Great Betrayal,\u201d the compromise exposed the willingness of the two major political parties to avoid a \u201cstand-off\u201d via a southern Democrat filibuster, which would have greatly prolonged the final decision regarding the election. Democrats were largely satisfied to end Reconstruction and maintain \u201chome rule\u201d in the South in exchange for control over the White House. Likewise, most realized that Hayes would likely be a one-term president at best and prove to be as ineffectual as his pre-Civil War predecessors. \n\n Perhaps most surprising was the lack of even greater public outrage over such a transparent compromise, indicative of the little that Americans expected of their national government. In an era where voter turnout remained relatively high, the two major political parties remained largely indistinguishable in their agendas as well as their propensity for questionable tactics and backroom deals. Likewise, a growing belief in laissez-faire principles as opposed to reforms and government intervention (which many Americans believed contributed to the outbreak of the Civil War) led even more Americans to accept the nature of an inactive federal government ( Figure 20.7 ). \n 20.2   The Key Political Issues: Patronage, Tariffs, and Gold Learning Objectives By the end of this section, you will be able to: \n\n Explain the difference between the spoils system and civil service, and discuss the importance of this issue in the period from 1872 to 1896 \n\n Recognize the ways in which the issue of tariffs impacted different sectors of the economy in late nineteenth-century America \n\n Explain why Americans were split on the issue of a national gold standard versus free coinage of silver \n\n Explain why political patronage was a key issue for political parties in the late nineteenth century \n\n Although Hayes\u2019 questionable ascendancy to the presidency did not create political corruption in the nation\u2019s capital, it did set the stage for politically motivated agendas and widespread inefficiency in the White House for the next twenty-four years. Weak president after weak president took office, and, as mentioned above, not one incumbent was reelected. The populace, it seemed, preferred the devil they  didn\u2019t  know to the one they did. Once elected, presidents had barely enough power to repay the political favors they owed to the individuals who ensured their narrow victories in cities and regions around the country. Their four years in office were spent repaying favors and managing the powerful relationships that put them in the White House. Everyday Americans were largely left on their own. Among the few political issues that presidents routinely addressed during this era were ones of patronage, tariffs, and the nation\u2019s monetary system. \n\n PATRONAGE: THE SPOILS SYSTEM VS CIVIL SERVICE \n\n At the heart of each president\u2019s administration was the protection of the spoils system, that is, the power of the president to practice widespread political patronage. Patronage, in this case, took the form of the president naming his friends and supporters to various political posts. Given the close calls in presidential elections during the era, the maintenance of political machinery and repaying favors with patronage was important to all presidents, regardless of party affiliation. This had been the case since the advent of a two-party political system and universal male suffrage in the Jacksonian era. For example, upon assuming office in March 1829, President Jackson immediately swept employees from over nine hundred political offices, amounting to 10 percent of all federal appointments. Among the hardest-hit was the U.S. Postal Service, which saw Jackson appoint his supporters and closest friends to over four hundred positions in the service ( Figure 20.8 ). \n\n As can be seen in the table below ( Table 20.1 ), every single president elected from 1876 through 1892 won despite receiving less than 50 percent of the popular vote. This established a repetitive cycle of relatively weak presidents who owed many political favors, which could be repaid through one prerogative power: patronage. As a result, the spoils system allowed those with political influence to ascend to powerful positions within the government, regardless of their level of experience or skill, thus compounding both the inefficiency of government as well as enhancing the opportunities for corruption. \n\n Year \n\n Candidates \n\n Popular Vote \n\n Percentage \n\n Electoral Vote \n\n 1876 \n\n Rutherford B. Hayes \n\n 4,034,132 \n\n 47.9% \n\n 185 \n\n Samuel Tilden \n\n 4,286,808 \n\n 50.9% \n\n 184 \n\n Others \n\n 97,709 \n\n 1.2% \n\n 0 \n\n 1880 \n\n James Garfield \n\n 4,453,337 \n\n 48.3% \n\n 214 \n\n Winfield Hancock \n\n 4,444,267 \n\n 48.2% \n\n 155 \n\n Others \n\n 319,806 \n\n 3.5% \n\n 0 \n\n 1884 \n\n Grover Cleveland \n\n 4,914,482 \n\n 48.8% \n\n 219 \n\n James Blaine \n\n 4,856,903 \n\n 48.3% \n\n 182 \n\n Others \n\n 288,660 \n\n 2.9% \n\n 0 \n\n 1888 \n\n Benjamin Harrison \n\n 5,443,663 \n\n 47.8% \n\n 233 \n\n Grover Cleveland \n\n 5,538,163 \n\n 48.6% \n\n 168 \n\n Others \n\n 407,050 \n\n 3.6% \n\n 0 \n\n 1892 \n\n Grover Cleveland \n\n 5,553,898 \n\n 46.0% \n\n 277 \n\n Benjamin Harrison \n\n 5,190,799 \n\n 43.0% \n\n 145 \n\n Others \n\n 1,323,330 \n\n 11.0% \n\n 22 \n\n 1896 \n\n William McKinley \n\n 7,112,138 \n\n 51.0% \n\n 271 \n\n William Jennings Bryan \n\n 6,510,807 \n\n 46.7% \n\n 176 \n\n Others \n\n 315,729 \n\n 2.3% \n\n 0 \n\n Table  20.1   U.S. Presidential Election Results (1876\u20131896)   At the same time, a movement emerged in support of reforming the practice of political appointments. As early as 1872, civil service reformers gathered to create the Liberal Republican Party in an effort to unseat incumbent President Grant. Led by several midwestern Republican leaders and newspaper editors, this party provided the impetus for other reform-minded Republicans to break free from the party and actually join the Democratic Party ranks. With newspaper editor Horace Greeley as their candidate, the party called for a \u201cthorough reform of the civil service as one the most pressing necessities\u201d facing the nation. Although easily defeated in the election that followed, the work of the Liberal Republican Party set the stage for an even stronger push for patronage reform. \n\n Clearly owing favors to his Republican handlers for his surprise compromise victory by the slimmest of margins in 1876, President Hayes was ill-prepared to heed those cries for reform, despite his own stated preference for a new civil service system. In fact, he accomplished little during his four years in office other than granting favors, as dictated by Republican Party handlers. Two powerful Republican leaders attempted to control the president. The first was Roscoe Conkling, Republican senator from New York and leader of the  Stalwarts , a group that strongly supported continuation of the current spoils system ( Figure 20.9 ). Long supporting former President Grant, Conkling had no sympathy for some of Hayes\u2019 early appeals for civil service reform. The other was James G. Blaine, Republican senator from Maine and leader of the  Half-Breeds . The Half-Breeds, who received their derogatory nickname from Stalwart supporters who considered Blaine\u2019s group to be only \u201chalf-Republican,\u201d advocated for some measure of civil service reform. \n\n With his efforts towards ensuring African American civil rights stymied by a Democratic Congress, and his decision to halt the coinage of silver merely adding to the pressures of the economic  Panic of 1873 , Hayes failed to achieve any significant legislation during his presidency. However, he did make a few overtures towards civil service reform. First, he adopted a new patronage rule, which held that a person appointed to an office could be dismissed only in the interest of efficient government operation but not for overtly political reasons. Second, he declared that party leaders could have no official say in political appointments, although Conkling sought to continue his influence. Finally, he decided that government appointees were ineligible to manage campaign elections. Although not sweeping reforms, these were steps in a civil service direction. \n\n Hayes\u2019 first target in his meager reform effort was to remove Chester A. Arthur, a strong Conkling man, from his post as head of the New York City Customs House. Arthur had been notorious for using his post as customs collector to gain political favors for Conkling. When Hayes forcibly removed him from the position, even Half-Breeds questioned the wisdom of the move and began to distance themselves from Hayes. The loss of his meager public support due to the Compromise of 1877 and the declining Congressional faction together sealed Hayes fate and made his reelection impossible. \n\n AN ASSASSIN\u2019S BULLET SETS THE STAGE FOR CIVIL SERVICE REFORM \n\n In the wake of President Hayes\u2019 failure, Republicans began to battle over a successor for the 1880 presidential election. Initially, Stalwarts favored Grant\u2019s return to the White House, while Half-Breeds promoted their leader, James Blaine. Following an expected convention deadlock, both factions agreed to a compromise presidential candidate, Senator James A. Garfield of Ohio, with Chester Arthur as his vice-presidential running mate. The Democratic Party turned to Winfield Scott Hancock, a former Union commander who was a hero of the Battle of Gettysburg, as their candidate. \n\n Garfield won a narrow victory over Hancock by forty thousand votes, although he still did not win a majority of the popular vote. But less than four months into his presidency, events pushed civil service reform on the fast track. On July 2, 1881, Charles Guiteau shot and killed Garfield ( Figure 20.10 ), allegedly uttering at the time, \u201cI am a Stalwart of Stalwarts!\u201d Guiteau himself had wanted to be rewarded for his political support\u2014he had written a speech for the Garfield campaign\u2014with an ambassadorship to France. His actions at the time were largely blamed on the spoils system, prompting more urgent cries for change. \n\n Defining American The Assassination of a President \n\n I executed \n\nthe Divine command. \n\nAnd Garfield did remove, \n\nTo save my party, \n\nand my country \n\nFrom the bitter fate of War. \n\n\u2014Charles Guiteau \n\n Charles Guiteau was a lawyer and supporter of the Republican Party, although not particularly well known in either area. But he gave a few speeches, to modest crowds, in support of the Republican nominee James Garfield, and ultimately deluded himself that his speeches influenced the country enough to cause Garfield\u2019s victory. After the election, Guiteau immediately began pressuring the new president, requesting a post as ambassador. When his queries went unanswered, Guiteau, out of money and angry that his supposed help had been ignored, planned to kill the president. \n\n He spent significant time planning his attack and considered weapons as diverse as dynamite and a stiletto before deciding on a gun, stating, \u201cI wanted it done in an American manner.\u201d He followed the president around the Capitol and let several opportunities pass, unwilling to kill Garfield in front of his wife or son. Frustrated with himself, Guiteau recommitted to the plan and wrote a letter to the White House, explaining how this act would \u201cunite the Republican Party and save the Republic.\u201d \n\n Guiteau shot the president from behind and continued to shoot until police grabbed him and hauled him away. He went to jail, and, the following November after Garfield had died, he stood trial for murder. His poor mental health, which had been evident for some time, led to eccentric courtroom behavior that the newspapers eagerly reported and the public loved. He defended his case with a poem that used religious imagery and suggested that God had ordered him to commit the murder. He defended himself in court by saying, \u201cThe doctors killed Garfield, I just shot him.\u201d While this in fact was true, it did not save him. Guiteau was convicted and hanged in the summer of 1882. \n\n Surprising both his party and the Democrats when he assumed the office of president, Chester Arthur immediately distanced himself from the Stalwarts. Although previously a loyal party man, Arthur understood that he owed his current position to no particular faction or favor. He was in the unique position to usher in a wave a civil service reform unlike any other political candidate, and he chose to do just that. In 1883, he signed into law the Pendleton Civil Service Act, the first significant piece of antipatronage legislation. This law created the Civil Service Commission, which listed all government patronage jobs and then set aside approximately 10 percent of the list as appointments to be determined through a competitive civil service examination process. Furthermore, to prevent future presidents from undoing this reform, the law declared that future presidents could enlarge the list but could never shrink it by moving a civil service job back into the patronage column. \n\n TARIFFS IN THE GILDED AGE \n\n In addition to civil service, President Arthur also carried the reformist spirit into the realm of tariffs, or taxes on international imports to the United States. Tariffs had long been a controversial topic in the United States, especially as the nineteenth century came to a close. Legislators appeared to be bending to the will of big businessmen who desired higher tariffs in order to force Americans to buy their domestically produced goods rather than higher-priced imports. Lower tariffs, on the other hand, would reduce prices and lower the average American\u2019s cost of living, and were therefore favored by many working-class families and farmers, to the extent that any of them fully understood such economic forces beyond the prices they paid at stores. Out of growing concern for the latter group, Arthur created the U.S. Tariff Commission in 1882 to investigate the propriety of increasingly high tariffs. Despite his concern, along with the commission\u2019s recommendation for a 25 percent rollback in most tariffs, the most Arthur could accomplish was the \u201cMongrel Tariff\u201d of 1883, which lowered tariff rates by barely 5 percent. \n\n Such bold attempts at reform further convinced Republican Party leaders, as the 1884 election approached, that Arthur was not their best option to continue in the White House. Arthur quickly found himself a man without a party. As the 1884 election neared, the Republican Party again searched their ranks for a candidate who could restore some semblance of the spoils system while maintaining a reformist image. Unable to find such a man, the predominant Half-Breeds again turned to their own leader, Senator Blaine. However, when news of his many personal corrupt bargains began to surface, a significant portion of the party chose to break from the traditional Stalwarts-versus-Half-Breeds debate and form their own faction, the  Mugwumps , a name taken from the Algonquin phrase for \u201cgreat chief.\u201d \n\n Anxious to capitalize on the disarray within the Republican Party, as well as to return to the White House for the first time in nearly thirty years, the Democratic Party chose to court the Mugwump vote by nominating Grover Cleveland, the reform governor from New York who had built a reputation by attacking machine politics in New York City. Despite several personal charges against him for having fathered a child out of wedlock, Cleveland managed to hold on for a close victory with a margin of less than thirty thousand votes. \n\n Cleveland\u2019s record on civil service reform added little to the initial blows struck by President Arthur. After electing the first Democratic president since 1856, the Democrats could actually make great use of the spoils system. Cleveland was, however, a notable reform president in terms of business regulation and tariffs. When the U.S. Supreme Court ruled in 1886 that individual states could not regulate interstate transportation, Cleveland urged Congress to pass the Interstate Commerce Act of 1887. Among several other powers, this law created the Interstate Commerce Commission (ICC) to oversee railroad prices and ensure that they remained reasonable to all customers. This was an important shift. In the past, railroads had granted special rebates to big businesses, such as John D. Rockefeller\u2019s Standard Oil, while charging small farmers with little economic muscle exorbitant rates. Although the act eventually provided for real regulation of the railroad industry, initial progress was slow due to the lack of enforcement power held by the ICC. Despite its early efforts to regulate railroad rates, the U.S. Supreme Court undermined the commission in  Interstate Commerce Commission v. Cincinnati, New Orleans, and Texas Pacific Railway Cos.  in 1897. Rate regulations were limits on profits that, in the opinion of a majority of the justices, violated the Fourteenth Amendment protection against depriving persons of their property without due process of the law. \n\n As for tariff reform, Cleveland agreed with Arthur\u2019s position that tariffs remained far too high and were clearly designed to protect big domestic industries at the expense of average consumers who could benefit from international competition. While the general public applauded Cleveland\u2019s efforts at both civil service and tariff reform, influential businessmen and industrialists remained adamant that the next president must restore the protective tariffs at all costs. \n\n To counter the Democrats\u2019 re-nomination of Cleveland, the Republican Party turned to Benjamin Harrison, grandson of former president William Henry Harrison. Although Cleveland narrowly won the overall popular vote, Harrison rode the influential coattails of several businessmen and party bosses to win the key electoral states of New York and New Jersey, where party officials stressed Harrison\u2019s support for a higher tariff, and thus secure the White House. Not surprisingly, after Harrison\u2019s victory, the United States witnessed a brief return to higher tariffs and a strengthening of the spoils system. In fact, the McKinley Tariff raised some rates as much as 50 percent, which was the highest tariff in American history to date. \n\n Some of Harrison\u2019s policies were intended to offer relief to average Americans struggling with high costs and low wages, but remained largely ineffective. First, the Sherman Anti-Trust Act of 1890 sought to prohibit business monopolies as \u201cconspiracies in restraint of trade,\u201d but it was seldom enforced during the first decade of its existence. Second, the Sherman Silver Purchase Act of the same year required the U.S. Treasury to mint over four million ounces of silver into coins each month to circulate more cash into the economy, raise prices for farm goods, and help farmers pay their way out of debt. But the measure could not undo the previous \u201chard money\u201d policies that had deflated prices and pulled farmers into well-entrenched cycles of debt. Other measures proposed by Harrison intended to support African Americans, including a Force Bill to protect voters in the South, as well as an Education Bill designed to support public education and improve literacy rates among African Americans, also met with defeat. \n\n MONETARY POLICIES AND THE ISSUE OF GOLD VS SILVER \n\n Although political corruption, the spoils system, and the question of tariff rates were popular discussions of the day, none were more relevant to working-class Americans and farmers than the issue of the nation\u2019s monetary policy and the ongoing debate of gold versus silver ( Figure 20.11 ). There had been frequent attempts to establish a bimetallic standard, which in turn would have created inflationary pressures and placed more money into circulation that could have subsequently benefitted farmers. But the government remained committed to the gold standard, including the official demonetizing of silver altogether in 1873. Such a stance greatly benefitted prominent businessmen engaged in foreign trade while forcing more farmers and working-class Americans into greater debt. \n\n As farmers and working-class Americans sought the means by which to pay their bills and other living expenses, especially in the wake of increased tariffs as the century came to a close, many saw adherence to a strict gold standard as their most pressing problem. With limited gold reserves, the money supply remained constrained. At a minimum, a return to a bimetallic policy that would include the production of silver dollars would provide some relief. However, the aforementioned Sherman Silver Purchase Act was largely ineffective to combat the growing debts that many Americans faced. Under the law, the federal government purchased 4.5 million ounces of silver on a monthly basis in order to mint silver dollars. However, many investors exchanged the bank notes with which the government purchased the silver for gold, thus severely depleting the nation\u2019s gold reserve. Fearing the latter, President Grover Cleveland signed the act\u2019s repeal in 1893. This lack of meaningful monetary measures from the federal government would lead one group in particular who required such assistance\u2014American farmers\u2014to attempt to take control over the political process itself. \n 20.3   Farmers Revolt in the Populist Era Learning Objectives By the end of this section, you will be able to: \n\n Understand how the economic and political climate of the day promoted the formation of the farmers\u2019 protest movement in the latter half of the nineteenth century \n\n Explain how the farmers\u2019 revolt moved from protest to politics \n\n The challenges that many American farmers faced in the last quarter of the nineteenth century were significant. They contended with economic hardships born out of rapidly declining farm prices, prohibitively high tariffs on items they needed to purchase, and foreign competition. One of the largest challenges they faced was overproduction, where the glut of their products in the marketplace drove the price lower and lower. \n\n Overproduction of crops occurred in part due to the westward expansion of homestead farms and in part because industrialization led to new farm tools that dramatically increased crop yields. As farmers fell deeper into debt, whether it be to the local stores where they bought supplies or to the railroads that shipped their produce, their response was to increase crop production each year in the hope of earning more money with which to pay back their debt. The more they produced, the lower prices dropped. To a hard-working farmer, the notion that their own overproduction was the greatest contributing factor to their debt was a completely foreign concept ( Figure 20.12 ). \n\n In addition to the cycle of overproduction, tariffs were a serious problem for farmers. Rising tariffs on industrial products made purchased items more expensive, yet tariffs were  not  being used to keep farm prices artificially high as well. Therefore, farmers were paying inflated prices but not receiving them. Finally, the issue of gold versus silver as the basis of U.S. currency was a very real problem to many farmers. Farmers needed more money in circulation, whether it was paper or silver, in order to create inflationary pressure. Inflationary pressure would allow farm prices to increase, thus allowing them to earn more money that they could then spend on the higher-priced goods in stores. However, in 1878, federal law set the amount of paper money in circulation, and, as mentioned above, Harrison\u2019s Sherman Silver Act, intended to increase the amount of silver coinage, was too modest to do any real good, especially in light of the unintended consequence of depleting the nation\u2019s gold reserve. In short, farmers had a big stack of bills and wanted a big stack of money\u2014be it paper or silver\u2014to pay them. Neither was forthcoming from a government that cared more about issues of patronage and how to stay in the White House for more than four years at a time. \n\n FARMERS BEGIN TO ORGANIZE \n\n The initial response by increasingly frustrated and angry farmers was to organize into groups that were similar to early labor unions. Taking note of how the industrial labor movement had unfolded in the last quarter of the century, farmers began to understand that a collective voice could create significant pressure among political leaders and produce substantive change. While farmers had their own challenges, including that of geography and diverse needs among different types of famers, they believed this model to be useful to their cause. \n\n One of the first efforts to organize farmers came in 1867 with Oliver Hudson Kelly\u2019s creation of the Patrons of Husbandry, more popularly known as the  Grange . In the wake of the Civil War, the Grangers quickly grew to over 1.5 million members in less than a decade ( Figure 20.13 ). Kelly believed that farmers could best help themselves by creating farmers\u2019 cooperatives in which they could pool resources and obtain better shipping rates, as well as prices on seeds, fertilizer, machinery, and other necessary inputs. These cooperatives, he believed, would let them self-regulate production as well as collectively obtain better rates from railroad companies and other businesses. \n\n At the state level, specifically in Wisconsin, Minnesota, Illinois, and Iowa, the Patrons of Husbandry did briefly succeed in urging the passage of Granger Laws, which regulated some railroad rates along with the prices charged by grain elevator operators. The movement also created a political party\u2014the  Greenback Party , so named for its support of print currency (or \u201cgreenbacks\u201d) not based upon a gold standard\u2014which saw brief success with the election of fifteen congressmen. However, such successes were short-lived and had little impact on the lives of everyday farmers. In the Wabash case of 1886, brought by the Wabash, St. Louis, and Pacific Railroad Company, the U.S. Supreme Court ruled against the State of Illinois for passing Granger Laws controlling railroad rates; the court found such laws to be unconstitutional. Their argument held that states did not have the authority to control interstate commerce. As for the Greenback Party, when only seven delegates appeared at an 1888 national convention of the group, the party faded from existence. \n\n The  Farmers\u2019 Alliance , a conglomeration of three regional alliances formed in the mid-1880s, took root in the wake of the Grange movement. In 1890, Dr. Charles Macune, who led the Southern Alliance, which was based in Texas and had over 100,000 members by 1886, urged the creation of a national alliance between his organization, the Northwest Alliance, and the Colored Alliance, the largest African American organization in the United States. Led by Tom Watson, the Colored Alliance, which was founded in Texas but quickly spread throughout the Old South, counted over one million members. Although they originally advocated for self-help, African Americans in the group soon understood the benefits of political organization and a unified voice to improve their plight, regardless of race. While racism kept the alliance splintered among the three component branches, they still managed to craft a national agenda that appealed to their large membership. All told, the Farmers\u2019 Alliance brought together over 2.5 million members, 1.5 million White and 1 million Black ( Figure 20.14 ). \n\n The alliance movement, and the subsequent political party that emerged from it, also featured prominent roles for women. Nearly 250,000 women joined the movement due to their shared interest in the farmers\u2019 worsening situation as well as the promise of being a full partner with political rights within the group, which they saw as an important step towards advocacy for women\u2019s suffrage on a national level. The ability to vote and stand for office within the organization encouraged many women who sought similar rights on the larger American political scene. Prominent alliance spokeswoman, Mary Elizabeth Lease of Kansas, often spoke of membership in the Farmers\u2019 Alliance as an opportunity to \u201craise less corn and more hell!\u201d \n\n The alliance movement had several goals similar to those of the original Grange, including greater regulation of railroad prices and the creation of an inflationary national monetary policy. However, most creative among the solutions promoted by the Farmers\u2019 Alliance was the call for a subtreasury plan. Under this plan, the federal government would store farmers\u2019 crops in government warehouses for a brief period of time, during which the government would provide loans to farmers worth 80 percent of the current crop prices. Thus, farmers would have immediate cash on hand with which to settle debts and purchase goods, while their crops sat in warehouses and farm prices increased due to this control over supply at the market. When market prices rose sufficiently high enough, the farmer could withdraw his crops, sell at the higher price, repay the government loan, and still have profit remaining. \n\n Economists of the day thought the plan had some merit; in fact, a greatly altered version would subsequently be adopted during the Great Depression of the 1930s, in the form of the Agricultural Adjustment Act. However, the federal government never seriously considered the plan, as congressmen questioned the propriety of the government serving as a rural creditor making loans to farmers with no assurance that production controls would result in higher commodity prices. The government\u2019s refusal to act on the proposal left many farmers wondering what it would take to find solutions to their growing indebtedness. \n\n FROM ORGANIZATION TO POLITICAL PARTY \n\n Angry at the federal government\u2019s continued unwillingness to substantively address the plight of the average farmer, Charles Macune and the Farmers\u2019 Alliance chose to create a political party whose representatives\u2014if elected\u2014could enact real change. Put simply, if the government would not address the problem, then it was time to change those elected to power. \n\n In 1891, the alliance formed the  Populist Party , or People\u2019s Party, as it was more widely known. Beginning with nonpresidential-year elections, the Populist Party had modest success, particularly in Kansas, Nebraska, and the Dakotas, where they succeeded in electing several state legislators, one governor, and a handful of congressmen. As the 1892 presidential election approached, the Populists chose to model themselves after the Democratic and Republican Parties in the hope that they could shock the country with a \u201cthird-party\u201d victory. \n\n At their national convention that summer in Omaha, Nebraska, they wrote the Omaha Platform to more fully explain to all Americans the goals of the new party ( Figure 20.15 ). Written by Ignatius Donnelly, the platform statement vilified railroad owners, bankers, and big businessmen as all being part of a widespread conspiracy to control farmers. As for policy changes, the platform called for adoption of the subtreasury plan, government control over railroads, an end to the national bank system, the creation of a federal income tax, the direct election of U.S. senators, and several other measures, all of which aimed at a more proactive federal government that would support the economic and social welfare of all Americans. At the close of the convention, the party nominated James B. Weaver as its presidential candidate. \n\n In a rematch of the 1888 election, the Democrats again nominated Grover Cleveland, while Republicans went with Benjamin Harrison. Despite the presence of a third-party challenger, Cleveland won another close popular vote to become the first U.S. president to be elected to nonconsecutive terms. Although he finished a distant third, Populist candidate Weaver polled a respectable one million votes. Rather than being disappointed, several Populists applauded their showing\u2014especially for a third party with barely two years of national political experience under its belt. They anxiously awaited the 1896 election, believing that if the rest of the country, in particular industrial workers, experienced hardships similar to those that farmers already faced, a powerful alliance among the two groups could carry the Populists to victory. \n 20.4   Social and Labor Unrest in the 1890s Learning Objectives By the end of this section, you will be able to: \n\n Explain how the Depression of 1893 helped the Populist Party to grow in popularity in the 1890s \n\n Understand the forces that contributed to the Populist Party\u2019s decline following the 1896 presidential election \n\n Insofar as farmers wanted the rest of the country to share their plight, they got their wish. Soon after Cleveland\u2019s election, the nation catapulted into the worst economic depression in its history to date. As the government continued to fail in its efforts to address the growing problems, more and more Americans sought relief outside of the traditional two-party system. To many industrial workers, the Populist Party began to seem like a viable solution. \n\n FROM FARMERS\u2019 HARDSHIPS TO A NATIONAL DEPRESSION \n\n The late 1880s and early 1890s saw the American economy slide precipitously. As mentioned above, farmers were already struggling with economic woes, and the rest of the country followed quickly. Following a brief rebound from the speculation-induced Panic of 1873, in which bank investments in railroad bonds spread the nation\u2019s financial resources too thin\u2014a rebound due in large part to the protective tariffs of the 1880s\u2014a greater economic catastrophe hit the nation, as the decade of the 1890s began to unfold. \n\n The causes of the  Depression of 1893  were manifold, but one major element was the speculation in railroads over the previous decades. The rapid proliferation of railroad lines created a false impression of growth for the economy as a whole. Banks and investors fed the growth of the railroads with fast-paced investment in industry and related businesses, not realizing that the growth they were following was built on a bubble. When the railroads began to fail due to expenses outpacing returns on their construction, the supporting businesses, from banks to steel mills, failed also. \n\n Beginning with the closure of the Philadelphia & Reading Railroad Company in 1893, several railroads ceased their operations as a result of investors cashing in their bonds, thus creating a ripple effect throughout the economy. In a single year, from 1893 to 1894, unemployment estimates increased from 3 percent to nearly 19 percent of all working-class Americans. In some states, the unemployment rate soared even higher: over 35 percent in New York State and 43 percent in Michigan. At the height of this depression, over three million American workers were unemployed. By 1895, Americans living in cities grew accustomed to seeing the homeless on the streets or lining up at soup kitchens. \n\n Immediately following the economic downturn, people sought relief through their elected federal government. Just as quickly, they learned what farmers had been taught in the preceding decades: A weak, inefficient government interested solely in patronage and the spoils system in order to maintain its power was in no position to help the American people face this challenge. The federal government had little in place to support those looking for work or to provide direct aid to those in need. Of course, to be fair, the government had seldom faced these questions before. Americans had to look elsewhere. \n\n A notable example of the government\u2019s failure to act was the story of  Coxey\u2019s Army . In the spring of 1894, businessman Jacob Coxey led a march of unemployed Ohioans from Cincinnati to Washington, DC, where leaders of the group urged Congress to pass public works legislation for the federal government to hire unemployed workers to build roads and other public projects. From the original one hundred protesters, the march grew five hundred strong as others joined along the route to the nation\u2019s capital. Upon their arrival, not only were their cries for federal relief ignored, but Coxey and several other marchers were arrested for trespassing on the grass outside the U.S. Capitol. Frustration over the event led many angry workers to consider supporting the Populist Party in subsequent elections. Americana L. Frank Baum: Did Coxey\u2019s Army inspire Dorothy and the Wizard of Oz? Scholars, historians, and economists have long argued inconclusively that L. Frank Baum intended the story of  The Wizard of Oz  as an allegory for the politics of the day. Whether that actually was Baum\u2019s intention is up for debate, but certainly the story could be read as support for the Populist Party\u2019s crusade on behalf of American farmers. In 1894, Baum witnessed Coxey\u2019s Army\u2019s march firsthand, and some feel it may have influenced the story ( Figure 20.16 ). \n\n According to this theory, the Scarecrow represents the American farmer, the Tin Woodman is the industrial worker, and the Cowardly Lion is William Jennings Bryan, a prominent \u201cSilverite\u201d (strong supporters of the Populist Party who advocated for the free coinage of silver) who, in 1900 when the book was published, was largely criticized by the Republicans as being cowardly and indecisive. In the story, the characters march towards Oz, much as Coxey\u2019s Army marched to Washington. Like Dorothy and her companions, Coxey\u2019s Army gets in trouble, before being turned away with no help. \n\n Following this reading, the seemingly powerful but ultimately impotent Wizard of Oz is a representation of the president, and Dorothy only finds happiness by wearing the silver slippers\u2014they only became ruby slippers in the later movie version\u2014along the Yellow Brick Road, a reference to the need for the country to move from the gold standard to a two-metal silver and gold plan. While no literary theorists or historians have proven this connection to be true, it is possible that Coxey\u2019s Army inspired Baum to create Dorothy\u2019s journey on the yellow brick road. \n\n Several strikes also punctuated the growing depression, including a number of violent uprisings in the coal regions of Ohio and Pennsylvania. But the infamous Pullman Strike of 1894 was most notable for its nationwide impact, as it all but shut down the nation\u2019s railroad system in the middle of the depression. The strike began immediately on the heels of the Coxey\u2019s Army march when, in the summer of 1894, company owner George Pullman fired over two thousand employees at Pullman Co.\u2014which made railroad cars, such as Pullman sleeper cars\u2014and reduced the wages of the remaining three thousand workers. Since the factory operated in the company town of Pullman, Illinois, where workers rented homes from George Pullman and shopped at the company store owned by him as well, unemployment also meant eviction. Facing such harsh treatment, all of the Pullman workers went on strike to protest the decisions. Eugene V. Debs, head of the American Railway Union, led the strike. \n\n In order to bring the plight of Pullman, Illinois, to Americans all around the country, Debs adopted the strike strategy of ordering all American Railroad Union members to refuse to handle any train that had Pullman cars on it. Since virtually every train in the United States operated with Pullman cars, the strike truly brought the transportation industry to its knees. Fearful of his ability to end the economic depression with such a vital piece of the economy at a standstill, President Cleveland turned to his attorney general for the answer. The attorney general proposed a solution: use federal troops to operate the trains under the pretense of protecting the delivery of the U.S. mail that was typically found on all trains. When Debs and the American Railway Union refused to obey the court injunction prohibiting interference with the mail, the troops began operating the trains, and the strike quickly ended. Debs himself was arrested, tried, convicted, and sentenced to six months in prison for disobeying the court injunction. The American Railway Union was destroyed, leaving workers even less empowered than before, and Debs was in prison, contemplating alternatives to a capitalist-based national economy. The Depression of 1893 left the country limping towards the next presidential election with few solutions in sight. \n\n THE ELECTION OF 1896 \n\n As the final presidential election of the nineteenth century unfolded, all signs pointed to a possible Populist victory. Not only had the ongoing economic depression convinced many Americans\u2014farmers and factory workers alike\u2014of the inability of either major political party to address the situation, but also the Populist Party, since the last election, benefited from four more years of experience and numerous local victories. As they prepared for their convention in St. Louis that summer, the Populists watched with keen interest as the Republicans and Democrats hosted their own conventions. \n\n The Republicans remained steadfast in their defense of a gold-based standard for the American economy, as well as high protective tariffs. They turned to William McKinley, former congressman and current governor of Ohio, as their candidate. At their convention, the Democrats turned to William Jennings Bryan\u2014a congressman from Nebraska. Bryan defended the importance of a silver-based monetary system and urged the government to coin more silver. Furthermore, being from farm country, he was very familiar with the farmers\u2019 plight and saw some merit in the subtreasury system proposal. In short, Bryan could have been the ideal Populist candidate, but the Democrats got to him first. The Populist Party subsequently endorsed Bryan as well, with their party\u2019s nomination three weeks later ( Figure 20.17 ). \n\n As the Populist convention unfolded, the delegates had an important decision to make: either locate another candidate, even though Bryan would have been an excellent choice, or join the Democrats and support Bryan as the best candidate but risk losing their identity as a third political party as a result. The Populist Party chose the latter and endorsed Bryan\u2019s candidacy. However, they also nominated their own vice-presidential candidate, Georgia Senator Tom Watson, as opposed to the Democratic nominee, Arthur Sewall, presumably in an attempt to maintain some semblance of a separate identity. \n\n The race was a heated one, with McKinley running a typical nineteenth-century style \u201cfront porch\u201d campaign, during which he espoused the long-held Republican Party principles to visitors who would call on him at his Ohio home. Bryan, to the contrary, delivered speeches all throughout the country, bringing his message to the people that Republicans \u201cshall not crucify mankind on a cross of gold.\u201d \n\n Defining American William Jennings Bryan and the \u201cCross of Gold\u201d William Jennings Bryan was a politician and speechmaker in the late nineteenth century, and he was particularly well known for his impassioned argument that the country move to a bimetal or silver standard. He received the Democratic presidential nomination in 1896, and, at the nominating convention, he gave his most famous speech. He sought to argue against Republicans who stated that the gold standard was the only way to ensure stability and prosperity for American businesses. In the speech he said: \n\n We say to you that you have made the definition of a business man too limited in its application. The man who is employed for wages is as much a business man as his employer; the attorney in a country town is as much a business man as the corporation counsel in a great metropolis; the merchant at the cross-roads store is as much a business man as the merchant of New York; the farmer who goes forth in the morning and toils all day, who begins in spring and toils all summer, and who by the application of brain and muscle to the natural resources of the country creates wealth, is as much a business man as the man who goes upon the Board of Trade and bets upon the price of grain; . . . We come to speak of this broader class of business men. \n\n This defense of working Americans as critical to the prosperity of the country resonated with his listeners, as did his passionate ending when he stated, \u201cHaving behind us the producing masses of this nation and the world, supported by the commercial interests, the laboring interests, and the toilers everywhere, we will answer their demand for a gold standard by saying to them: \u2018You shall not press down upon the brow of labor this crown of thorns; you shall not crucify mankind upon a cross of gold.\u2019\u201d \n\n The speech was an enormous success and played a role in convincing the Populist Party that he was the candidate for them. \n\n The result was a close election that finally saw a U.S. president win a majority of the popular vote for the first time in twenty-four years. McKinley defeated Bryan by a popular vote of 7.1 million to 6.5 million. Bryan\u2019s showing was impressive by any standard, as his popular vote total exceeded that of any other presidential candidate in American history to that date\u2014winner or loser. He polled nearly one million more votes than did the previous Democratic victor, Grover Cleveland; however, his campaign also served to split the Democratic vote, as some party members remained convinced of the propriety of the gold standard and supported McKinley in the election. \n\n Amid a growing national depression where Americans truly recognized the importance of a strong leader with sound economic policies, McKinley garnered nearly two million more votes than his Republican predecessor Benjamin Harrison. Put simply, the American electorate was energized to elect a strong candidate who could adequately address the country\u2019s economic woes. Voter turnout was the largest in American history to that date; while both candidates benefitted, McKinley did more so than Bryan ( Figure 20.18 ). \n\n In the aftermath, it is easy to say that it was Bryan\u2019s defeat that all but ended the rise of the Populist Party. Populists had thrown their support to the Democrats who shared similar ideas for the economic rebound of the country and lost. In choosing principle over distinct party identity, the Populists aligned themselves to the growing two-party American political system and would have difficulty maintaining party autonomy afterwards. Future efforts to establish a separate party identity would be met with ridicule by critics who would say that Populists were merely \u201cDemocrats in sheep\u2019s clothing.\u201d \n\n But other factors also contributed to the decline of Populism at the close of the century. First, the discovery of vast gold deposits in Alaska during the Klondike Gold Rush of 1896\u20131899 (also known as the \u201cYukon Gold Rush\u201d) shored up the nation\u2019s weakening economy and made it possible to thrive on a gold standard. Second, the impending Spanish-American War, which began in 1898, further fueled the economy and increased demand for American farm products. Still, the Populist spirit remained, although it lost some momentum at the close of the nineteenth century. As will be seen in a subsequent chapter, the reformist zeal took on new forms as the twentieth century unfolded. ", "questions": [{"question": {"question_id": "fs-idm69568192", "question_text": "Mark Twain\u2019s Gilded Age is a reference to ________.", "question_choices": ["conditions in the South in the pre-Civil War era", "the corrupt politics of the post-Civil War era", "the populist movement", "the Republican Party"], "cloze_format": "Mark Twain\u2019s Gilded Age is a reference to ________.", "normal_format": "What is Mark Twain\u2019s Gilded Age is referred to?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "Defining American Mark Twain and the Gilded Age Mark Twain ( Figure 20.4 ) wrote The Gilded Age : A Tale of Today with his neighbor , Charles Dudley Warner , as a satire about the corrupt politics and lust for power that he felt characterized American society at the time . Mark Twain coined the phrase \u201c Gilded Age \u201d in a book he co-authored with Charles Dudley Warner in 1873 , The Gilded Age : A Tale of Today . The book satirized the corruption of post-Civil War society and politics .", "hl_context": "<hl> Defining American Mark Twain and the Gilded Age Mark Twain ( Figure 20.4 ) wrote The Gilded Age : A Tale of Today with his neighbor , Charles Dudley Warner , as a satire about the corrupt politics and lust for power that he felt characterized American society at the time . <hl> The book , the only novel Twain ever co-authored , tells of the characters \u2019 desire to sell their land to the federal government and become rich . It takes aim at both the government in Washington and those Americans , in the South and elsewhere , whose lust for money and status among the newly rich in the nation \u2019 s capital leads them to corrupt and foolish choices . <hl> Mark Twain coined the phrase \u201c Gilded Age \u201d in a book he co-authored with Charles Dudley Warner in 1873 , The Gilded Age : A Tale of Today . <hl> <hl> The book satirized the corruption of post-Civil War society and politics . <hl> Indeed , popular excitement over national growth and industrialization only thinly glossed over the stark economic inequalities and various degrees of corruption of the era ( Figure 20.3 ) . Politicians of the time largely catered to business interests in exchange for political support and wealth . Many participated in graft and bribery , often justifying their actions with the excuse that corruption was too widespread for a successful politician to resist . The machine politics of the cities , specifically Tammany Hall in New York , illustrate the kind of corrupt , but effective , local and national politics that dominated the era ."}, {"question": {"question_id": "fs-idm34157952", "question_text": "How did the Great Compromise of 1877 influence the election?", "question_choices": ["It allowed a bilateral government agreement.", "It gave new power to northern Republicans.", "It encouraged southern states to support Hayes.", "It gave the federal government new powers."], "cloze_format": "The Great Compromise of 1877 influences the election by ___.", "normal_format": "How did the Great Compromise of 1877 influence the election?"}, "answer": {"ans_text": "It encouraged southern states to support Hayes.", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "In what later became known as the Compromise of 1877 , Republican Party leaders offered southern Democrats an enticing deal . The offer was that if the commission found in favor of a Hayes victory , Hayes would order the withdrawal of the remaining U . S . troops from those three southern states , thus allowing the collapse of the radical Reconstruction governments of the immediate post-Civil War era .", "hl_context": "As a result of the disputed election , the House of Representatives established a special electoral commission to determine which candidate won the challenged electoral votes of these three states . <hl> In what later became known as the Compromise of 1877 , Republican Party leaders offered southern Democrats an enticing deal . <hl> <hl> The offer was that if the commission found in favor of a Hayes victory , Hayes would order the withdrawal of the remaining U . S . troops from those three southern states , thus allowing the collapse of the radical Reconstruction governments of the immediate post-Civil War era . <hl> This move would permit southern Democrats to end federal intervention and control their own states \u2019 fates in the wake of the end of slavery ( Figure 20.6 ) ."}, {"question": {"question_id": "fs-idm77054752", "question_text": "A Mugwump is ________.", "question_choices": ["a supporter of the spoils system", "a liberal Democrat", "a former member of the Republican Party", "a moderate Stalwart"], "cloze_format": "A Mugwump is ________.", "normal_format": "What is a Mugwump?"}, "answer": {"ans_text": "a former member of the Republican Party", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Unable to find such a man , the predominant Half-Breeds again turned to their own leader , Senator Blaine . However , when news of his many personal corrupt bargains began to surface , a significant portion of the party chose to break from the traditional Stalwarts-versus-Half-Breeds debate and form their own faction , the Mugwumps , a name taken from the Algonquin phrase for \u201c great chief . \u201d", "hl_context": "Such bold attempts at reform further convinced Republican Party leaders , as the 1884 election approached , that Arthur was not their best option to continue in the White House . Arthur quickly found himself a man without a party . As the 1884 election neared , the Republican Party again searched their ranks for a candidate who could restore some semblance of the spoils system while maintaining a reformist image . <hl> Unable to find such a man , the predominant Half-Breeds again turned to their own leader , Senator Blaine . <hl> <hl> However , when news of his many personal corrupt bargains began to surface , a significant portion of the party chose to break from the traditional Stalwarts-versus-Half-Breeds debate and form their own faction , the Mugwumps , a name taken from the Algonquin phrase for \u201c great chief . \u201d <hl>"}, {"question": {"question_id": "fs-idm82581616", "question_text": "Which president made significant steps towards civil service reform?", "question_choices": ["Chester A. Arthur", "Benjamin Harrison", "Grover Cleveland", "Roscoe Conkling"], "cloze_format": "___ made significant steps towards civil service reform.", "normal_format": "Which president made significant steps towards civil service reform?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Surprising both his party and the Democrats when he assumed the office of president , Chester Arthur immediately distanced himself from the Stalwarts . He was in the unique position to usher in a wave a civil service reform unlike any other political candidate , and he chose to do just that .", "hl_context": "<hl> Surprising both his party and the Democrats when he assumed the office of president , Chester Arthur immediately distanced himself from the Stalwarts . <hl> Although previously a loyal party man , Arthur understood that he owed his current position to no particular faction or favor . <hl> He was in the unique position to usher in a wave a civil service reform unlike any other political candidate , and he chose to do just that . <hl> In 1883 , he signed into law the Pendleton Civil Service Act , the first significant piece of antipatronage legislation . This law created the Civil Service Commission , which listed all government patronage jobs and then set aside approximately 10 percent of the list as appointments to be determined through a competitive civil service examination process . Furthermore , to prevent future presidents from undoing this reform , the law declared that future presidents could enlarge the list but could never shrink it by moving a civil service job back into the patronage column ."}, {"question": {"question_id": "fs-idp6126544", "question_text": "Which of the following was not a vehicle for the farmers\u2019 protest?", "question_choices": ["the Mugwumps", "the Grange", "the Farmers\u2019 Alliance", "the People\u2019s Party"], "cloze_format": "___ is not a vehicle for the farmers' protest.", "normal_format": "Which of the following was not a vehicle for the farmers\u2019 protest?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "In 1891 , the alliance formed the Populist Party , or People \u2019 s Party , as it was more widely known . Angry at the federal government \u2019 s continued unwillingness to substantively address the plight of the average farmer , Charles Macune and the Farmers \u2019 Alliance chose to create a political party whose representatives \u2014 if elected \u2014 could enact real change . The Farmers \u2019 Alliance , a conglomeration of three regional alliances formed in the mid - 1880s , took root in the wake of the Grange movement . One of the first efforts to organize farmers came in 1867 with Oliver Hudson Kelly \u2019 s creation of the Patrons of Husbandry , more popularly known as the Grange .", "hl_context": "<hl> In 1891 , the alliance formed the Populist Party , or People \u2019 s Party , as it was more widely known . <hl> Beginning with nonpresidential-year elections , the Populist Party had modest success , particularly in Kansas , Nebraska , and the Dakotas , where they succeeded in electing several state legislators , one governor , and a handful of congressmen . As the 1892 presidential election approached , the Populists chose to model themselves after the Democratic and Republican Parties in the hope that they could shock the country with a \u201c third-party \u201d victory . <hl> Angry at the federal government \u2019 s continued unwillingness to substantively address the plight of the average farmer , Charles Macune and the Farmers \u2019 Alliance chose to create a political party whose representatives \u2014 if elected \u2014 could enact real change . <hl> Put simply , if the government would not address the problem , then it was time to change those elected to power . <hl> The Farmers \u2019 Alliance , a conglomeration of three regional alliances formed in the mid - 1880s , took root in the wake of the Grange movement . <hl> In 1890 , Dr . Charles Macune , who led the Southern Alliance , which was based in Texas and had over 100,000 members by 1886 , urged the creation of a national alliance between his organization , the Northwest Alliance , and the Colored Alliance , the largest African American organization in the United States . Led by Tom Watson , the Colored Alliance , which was founded in Texas but quickly spread throughout the Old South , counted over one million members . Although they originally advocated for self-help , African Americans in the group soon understood the benefits of political organization and a unified voice to improve their plight , regardless of race . While racism kept the alliance splintered among the three component branches , they still managed to craft a national agenda that appealed to their large membership . All told , the Farmers \u2019 Alliance brought together over 2.5 million members , 1.5 million White and 1 million Black ( Figure 20.14 ) . <hl> One of the first efforts to organize farmers came in 1867 with Oliver Hudson Kelly \u2019 s creation of the Patrons of Husbandry , more popularly known as the Grange . <hl> In the wake of the Civil War , the Grangers quickly grew to over 1.5 million members in less than a decade ( Figure 20.13 ) . Kelly believed that farmers could best help themselves by creating farmers \u2019 cooperatives in which they could pool resources and obtain better shipping rates , as well as prices on seeds , fertilizer , machinery , and other necessary inputs . These cooperatives , he believed , would let them self-regulate production as well as collectively obtain better rates from railroad companies and other businesses ."}, {"question": {"question_id": "fs-idp44627168", "question_text": "Which of the following contributed directly to the plight of farmers?", "question_choices": ["machine politics", "labor unions", "overproduction", "inadequate supply"], "cloze_format": "___ contributed directly to the plight of farmers.", "normal_format": "Which of the following contributed directly to the plight of farmers?"}, "answer": {"ans_text": "overproduction", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Overproduction of crops occurred in part due to the westward expansion of homestead farms and in part because industrialization led to new farm tools that dramatically increased crop yields . The more they produced , the lower prices dropped . To a hard-working farmer , the notion that their own overproduction was the greatest contributing factor to their debt was a completely foreign concept ( Figure 20.12 ) . One of the largest challenges they faced was overproduction , where the glut of their products in the marketplace drove the price lower and lower .", "hl_context": "<hl> Overproduction of crops occurred in part due to the westward expansion of homestead farms and in part because industrialization led to new farm tools that dramatically increased crop yields . <hl> As farmers fell deeper into debt , whether it be to the local stores where they bought supplies or to the railroads that shipped their produce , their response was to increase crop production each year in the hope of earning more money with which to pay back their debt . <hl> The more they produced , the lower prices dropped . <hl> <hl> To a hard-working farmer , the notion that their own overproduction was the greatest contributing factor to their debt was a completely foreign concept ( Figure 20.12 ) . <hl> The challenges that many American farmers faced in the last quarter of the nineteenth century were significant . They contended with economic hardships born out of rapidly declining farm prices , prohibitively high tariffs on items they needed to purchase , and foreign competition . <hl> One of the largest challenges they faced was overproduction , where the glut of their products in the marketplace drove the price lower and lower . <hl>"}, {"question": {"question_id": "fs-idp72596016", "question_text": "How were members of Coxey\u2019s Army received when they arrived in Washington?", "question_choices": ["They were given an audience with the president.", "They were given an audience with members of Congress.", "They were ignored.", "They were arrested."], "cloze_format": "Members of Coxey's Army received ___ when they arrived in Washington.", "normal_format": "How were members of Coxey\u2019s Army received when they arrived in Washington?"}, "answer": {"ans_text": "They were arrested.", "ans_choice": 3}, "bloom": null, "hl_sentences": "In the spring of 1894 , businessman Jacob Coxey led a march of unemployed Ohioans from Cincinnati to Washington , DC , where leaders of the group urged Congress to pass public works legislation for the federal government to hire unemployed workers to build roads and other public projects . Upon their arrival , not only were their cries for federal relief ignored , but Coxey and several other marchers were arrested for trespassing on the grass outside the U . S . Capitol .", "hl_context": "A notable example of the government \u2019 s failure to act was the story of Coxey \u2019 s Army . <hl> In the spring of 1894 , businessman Jacob Coxey led a march of unemployed Ohioans from Cincinnati to Washington , DC , where leaders of the group urged Congress to pass public works legislation for the federal government to hire unemployed workers to build roads and other public projects . <hl> From the original one hundred protesters , the march grew five hundred strong as others joined along the route to the nation \u2019 s capital . <hl> Upon their arrival , not only were their cries for federal relief ignored , but Coxey and several other marchers were arrested for trespassing on the grass outside the U . S . Capitol . <hl> Frustration over the event led many angry workers to consider supporting the Populist Party in subsequent elections . Americana L . Frank Baum : Did Coxey \u2019 s Army inspire Dorothy and the Wizard of Oz ? Scholars , historians , and economists have long argued inconclusively that L . Frank Baum intended the story of The Wizard of Oz as an allegory for the politics of the day . Whether that actually was Baum \u2019 s intention is up for debate , but certainly the story could be read as support for the Populist Party \u2019 s crusade on behalf of American farmers . In 1894 , Baum witnessed Coxey \u2019 s Army \u2019 s march firsthand , and some feel it may have influenced the story ( Figure 20.16 ) ."}, {"question": {"question_id": "fs-idp6073072", "question_text": "Which of the following does not represent one of the ways in which William Jennings Bryan appealed to Populists?", "question_choices": ["He came from farm country.", "He supported free silver.", "He supported the subtreasury system.", "He advocated for higher tariffs."], "cloze_format": "___ does not represent one of the ways in which William Jennings Bryan appealed to Populists.", "normal_format": "Which of the following does not represent one of the ways in which William Jennings Bryan appealed to Populists?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Bryan defended the importance of a silver-based monetary system and urged the government to coin more silver . Furthermore , being from farm country , he was very familiar with the farmers \u2019 plight and saw some merit in the subtreasury system proposal .", "hl_context": "The Republicans remained steadfast in their defense of a gold-based standard for the American economy , as well as high protective tariffs . They turned to William McKinley , former congressman and current governor of Ohio , as their candidate . At their convention , the Democrats turned to William Jennings Bryan \u2014 a congressman from Nebraska . <hl> Bryan defended the importance of a silver-based monetary system and urged the government to coin more silver . <hl> <hl> Furthermore , being from farm country , he was very familiar with the farmers \u2019 plight and saw some merit in the subtreasury system proposal . <hl> In short , Bryan could have been the ideal Populist candidate , but the Democrats got to him first . The Populist Party subsequently endorsed Bryan as well , with their party \u2019 s nomination three weeks later ( Figure 20.17 ) ."}], "summary": " Summary 20.1   Political Corruption in Postbellum America \n\n In the years following the Civil War, American politics were disjointed, corrupt, and, at the federal level, largely ineffective in terms of addressing the challenges that Americans faced. Local and regional politics, and the bosses who ran the political machines, dominated through systematic graft and bribery. Americans around the country recognized that solutions to the mounting problems they faced would not come from Washington, DC, but from their local political leaders. Thus, the cycle of federal ineffectiveness and machine politics continued through the remainder of the century relatively unabated. \n\n Meanwhile, in the Compromise of 1877, an electoral commission declared Rutherford B. Hayes the winner of the contested presidential election in exchange for the withdrawal of federal troops from South Carolina, Louisiana, and Florida. As a result, Southern Democrats were able to reestablish control over their home governments, which would have a tremendous impact on the direction of southern politics and society in the decades to come. \n\n 20.2   The Key Political Issues: Patronage, Tariffs, and Gold \n\n All told, from 1872 through 1892, Gilded Age politics were little more than political showmanship. The political issues of the day, including the spoils system versus civil service reform, high tariffs versus low, and business regulation, all influenced politicians more than the country at large. Very few measures offered direct assistance to Americans who continued to struggle with the transformation into an industrial society; the inefficiency of a patronage-driven federal government, combined with a growing laissez-faire attitude among the American public, made the passage of effective legislation difficult. Some of Harrison\u2019s policies, such as the Sherman Anti-Trust Act and the Sherman Silver Purchase Act, aimed to provide relief but remained largely ineffective. \n\n 20.3   Farmers Revolt in the Populist Era \n\n Factors such as overproduction and high tariffs left the country\u2019s farmers in increasingly desperate straits, and the federal government\u2019s inability to address their concerns left them disillusioned and worried. Uneven responses from state governments had many farmers seeking an alternative solution to their problems. Taking note of the labor movements growing in industrial cities around the country, farmers began to organize into alliances similar to workers\u2019 unions; these were models of cooperation where larger numbers could offer more bargaining power with major players such as railroads. Ultimately, the alliances were unable to initiate widespread change for their benefit. Still, drawing from the cohesion of purpose, farmers sought to create change from the inside: through politics. They hoped the creation of the Populist Party in 1891 would lead to a president who put the people\u2014and in particular the farmers\u2014first. \n\n 20.4   Social and Labor Unrest in the 1890s \n\n As the economy worsened, more Americans suffered; as the federal government continued to offer few solutions, the Populist movement began to grow. Populist groups approached the 1896 election anticipating that the mass of struggling Americans would support their movement for change. When Democrats chose William Jennings Bryan for their candidate, however, they chose a politician who largely fit the mold of the Populist platform\u2014from his birthplace of Nebraska to his advocacy of the silver standard that most farmers desired. Throwing their support behind Bryan as well, Populists hoped to see a candidate in the White House who would embody the Populist goals, if not the party name. When Bryan lost to Republican William McKinley, the Populist Party lost much of its momentum. As the country climbed out of the depression, the interest in a third party faded away, although the reformist movement remained intact. ", "keyterm": "", "bname": "u.s._history"}, {"chapter": 20, "intro": " Chapter Outline 20.1   Polyclonal and Monoclonal Antibody Production 20.2   Detecting Antigen-Antibody Complexes 20.3   Agglutination Assays 20.4   EIAs and ELISAs 20.5   Fluorescent Antibody Techniques Introduction Many laboratory tests are designed to confirm a presumptive diagnosis by detecting antibodies specific to a suspected pathogen. Unfortunately, many such tests are time-consuming and expensive. That is now changing, however, with the development of new, miniaturized technologies that are fast and inexpensive. For example, researchers at Columbia University are developing a \u201clab-on-a-chip\u201d technology that will test a single drop of blood for 15 different infectious diseases, including HIV and syphilis, in a matter of minutes. 1  The blood is pulled through tiny capillaries into reaction chambers where the patient\u2019s antibodies mix with reagents. A chip reader that attaches to a cell phone analyzes the results and sends them to the patient\u2019s healthcare provider. Currently the device is being field tested in Rwanda to check pregnant women for chronic diseases. Researchers estimate that the chip readers will sell for about $100 and individual chips for $1. 2 1 Chin, Curtis D. et al., \u201cMobile Device for Disease Diagnosis and Data Tracking in Resource-Limited Settings,\u201d  Clinical Chemistry  59, no. 4 (2013): 629-40. 2 Evarts, H., \u201cFast, Low-Cost Device Uses the Cloud to Speed Up Testing for HIV and More,\u201d January 24, 2013. Accessed July 14, 2016. http://engineering.columbia.edu/fast-low-cost-device-uses-cloud-speed-diagnostic-testing-hiv-and-more. ", "chapter_text": " 20.1   Polyclonal and Monoclonal Antibody Production \n\n Learning Objectives \n\n Compare the method of development, use, and characteristics of monoclonal and polyclonal antibodies \n\n Explain the nature of antibody cross-reactivity and why this is less of a problem with monoclonal antibodies \n\n Clinical Focus Part 1 In an unfortunate incident, a healthcare worker struggling with addiction was caught stealing syringes of painkillers and replacing them with syringes filled with unknown substances. The hospital immediately fired the employee and had him arrested; however, two patients that he had worked with later tested positive for HIV. \n\n While there was no proof that the infections originated from the tainted syringes, the hospital\u2019s public health physician took immediate steps to determine whether any other patients had been put at risk. Although the worker had only been employed for a short time, it was determined that he had come into contact with more than 1300 patients. The hospital decided to contact all of these patients and have them tested for HIV. \n\n Why does the hospital feel it is necessary to test every patient for HIV? \n\n What types of tests can be used to determine if a patient has HIV? \n\n Jump to the  next  Clinical Focus box. \n\n In addition to being crucial for our normal immune response,  antibodies  provide powerful tools for research and diagnostic purposes. The high specificity of antibodies makes them an excellent tool for detecting and quantifying a broad array of targets, from drugs to serum proteins to microorganisms. With  in vitro  assays , antibodies can be used to precipitate soluble antigens, agglutinate (clump) cells, opsonize and kill bacteria with the assistance of complement, and neutralize drugs, toxins, and viruses. \n\n An antibody\u2019s  specificity  results from the antigen-binding site formed within the  variable regions \u2014regions of the antibody that have unique patterns of amino acids that can only bind to target antigens with a molecular sequence that provides complementary charges and noncovalent bonds. There are limitations to antibody specificity, however. Some antigens are so chemically similar that  cross-reactivity  occurs; in other words, antibodies raised against one antigen bind to a chemically similar but different antigen. Consider an antigen that consists of a single protein with multiple epitopes ( Figure 20.2 ). This single protein may stimulate the production of many different antibodies, some of which may bind to chemically identical epitopes on other proteins. \n\n Cross-reactivity is more likely to occur between antibodies and antigens that have low  affinity  or  avidity . Affinity, which can be determined experimentally, is a measure of the binding strength between an antibody's binding site and an epitope, whereas avidity is the total strength of all the interactions in an antibody-antigen complex (which may have more than one bonding site). Avidity is influenced by affinity as well as the structural arrangements of the epitope and the variable regions of the antibody.  If an antibody has a high affinity/avidity for a specific antigen, it is less likely to cross-react with an antigen for which it has a lower affinity/avidity. \n\n Check Your Understanding \n\n What property makes antibodies useful for research and clinical diagnosis? \n\n What is cross-reactivity and why does it occur? \n\n Producing Polyclonal Antibodies \n\n Antibodies used for research and diagnostic purposes are often obtained by injecting a lab animal such as a rabbit or a goat with a specific  antigen . Within a few weeks, the animal\u2019s immune system will produce high levels of antibodies specific for the antigen. These antibodies can be harvested in an  antiserum , which is whole serum collected from an animal following exposure to an antigen. Because most antigens are complex structures with multiple epitopes, they result in the production of multiple antibodies in the lab animal. This so-called  polyclonal antibody  response is also typical of the response to infection by the human immune system. Antiserum drawn from an animal will thus contain antibodies from multiple clones of B cells, with each B cell responding to a specific epitope on the antigen ( Figure 20.3 ). \n\n Lab animals are usually injected at least twice with antigen when being used to produce antiserum. The second injection will activate memory cells that make class  IgG  antibodies against the antigen. The memory cells also undergo  affinity maturation , resulting in a pool of antibodies with higher average affinity. Affinity maturation occurs because of mutations in the immunoglobulin gene variable regions, resulting in B cells with slightly altered antigen-binding sites. On re-exposure to the antigen, those B cells capable of producing antibody with higher affinity antigen-binding sites will be stimulated to proliferate and produce more antibody than their lower-affinity peers. An  adjuvant , which is a chemical that provokes a generalized activation of the immune system that stimulates greater antibody production, is often mixed with the antigen prior to injection. \n\n Antiserum obtained from animals will not only contain antibodies against the antigen artificially introduced in the laboratory, but it will also contain antibodies to any other antigens to which the animal has been exposed during its lifetime. For this reason, antisera must first be \u201cpurified\u201d to remove other antibodies before using the antibodies for research or diagnostic assays. \n\n Clinical Uses of Polyclonal Antisera \n\n Polyclonal antisera are used in many clinical tests that are designed to determine whether a patient is producing antibodies in response to a particular pathogen. While these tests are certainly powerful diagnostic tools, they have their limitations, because they are an indirect means of determining whether a particular pathogen is present. Tests based on a polyclonal response can sometimes lead to a  false-positive  result\u2014in other words, a test that confirms the presence of an antigen that is, in fact, not present. Antibody-based tests can also result in a  false-negative  result, which occurs when the test fails to detect an antibody that is, in fact, present. \n\n The accuracy of antibody tests can be described in terms of  test sensitivity  and  test specificity . Test sensitivity is the probability of getting a positive test result when the patient is indeed infected. If a test has high sensitivity, the probability of a false negative is low. Test specificity, on the other hand, is the probability of getting a negative test result when the patient is not infected. If a test has high specificity, the probability of a false positive is low. \n\n False positives often occur due to  cross-reactivity , which can occur when epitopes from a different pathogen are similar to those found on the pathogen being tested for. For this reason, antibody-based tests are often used only as  screening tests ; if the results are positive, other confirmatory tests are used to make sure that the results were not a false positive. \n\n For example, a blood sample from a patient suspected of having hepatitis C can be screened for the virus using antibodies that bind to antigens on  hepatitis C  virus. If the patient is indeed infected with hepatitis C virus, the antibodies will bind to the antigens, yielding a positive test result. If the patient is not infected with hepatitic C virus, the antibodies will generally not bind to anything and the test should be negative; however, a false positive may occur if the patient has been previously infected by any of a variety of pathogens that elicit antibodies that cross-react with the hepatitis C virus antigens. Antibody tests for hepatitis C have high sensitivity (a low probability of a false negative) but low specificity (a high probability of a false positive). Thus, patients who test positive must have a second, confirmatory test to rule out the possibility of a false positive. The  confirmatory test  is a more expensive and time-consuming test that directly tests for the presence of hepatitis C viral RNA in the blood. Only after the confirmatory test comes back positive can the patient be definitively diagnosed with a hepatitis C infection. Antibody-based tests can result in a false negative if, for any reason, the patient\u2019s immune system has not produced detectable levels of antibodies. For some diseases, it may take several weeks following infection before the immune system produces enough antibodies to cross the detection threshold of the assay. In immunocompromised patients, the immune system may not be capable of producing a detectable level of antibodies. \n\n Another limitation of using antibody production as an indicator of disease is that antibodies in the blood will persist long after the infection has been cleared. Depending on the type of infection, antibodies will be present for many months; sometimes, they may be present for the remainder of the patient\u2019s life. Thus, a positive antibody-based test only means that the patient was infected at some point in time; it does not prove that the infection is active. \n\n In addition to their role in diagnosis, polyclonal antisera can activate complement, detect the presence of bacteria in clinical and food industry settings, and perform a wide array of precipitation reactions that can detect and quantify serum proteins, viruses, or other antigens. However, with the many specificities of antibody present in a polyclonal antiserum, there is a significant likelihood that the antiserum will cross-react with antigens to which the individual was never exposed. Therefore, we must always account for the possibility of false-positive results when working with a polyclonal antiserum. \n\n Check Your Understanding \n\n What is a false positive and what are some reasons that false positives occur? \n\n What is a false negative and what are some reasons that false positives occur? \n\n If a patient tests negative on a highly sensitive test, what is the likelihood that the person is infected with the pathogen? \n\n Producing Monoclonal Antibodies \n\n Some types of assays require better antibody specificity and affinity than can be obtained using a polyclonal antiserum. To attain this high specificity, all of the antibodies must bind with high affinity to a single epitope. This high specificity can be provided by  monoclonal antibodies (mAbs) .  Table 20.1  compares some of the important characteristics of monoclonal and polyclonal antibodies. \n\n Unlike polyclonal antibodies, which are produced in live animals, monoclonal antibodies are produced  in vitro  using tissue-culture techniques. mAbs are produced by immunizing an animal, often a mouse, multiple times with a specific antigen. B cells from the spleen of the immunized animal are then removed. Since normal B cells are unable to proliferate forever, they are fused with immortal, cancerous B cells called myeloma cells, to yield  hybridoma  cells. All of the cells are then placed in a selective medium that allows only the hybridomas to grow; unfused myeloma cells cannot grow, and any unfused B cells die off. The hybridomas, which are capable of growing continuously in culture while producing antibodies, are then screened for the desired mAb. Those producing the desired mAb are grown in tissue culture; the culture medium is harvested periodically and mAbs are purified from the medium. This is a very expensive and time-consuming process. It may take weeks of culturing and many liters of media to provide enough mAbs for an experiment or to treat a single patient. mAbs are expensive ( Figure 20.4 ). \n\n Characteristics of Polyclonal and Monoclonal Antibodies \n\n Monoclonal Antibodies \n\n Polyclonal Antibodies \n\n Expensive production \n\n Inexpensive production \n\n Long production time \n\n Rapid production \n\n Large quantities of specific antibodies \n\n Large quantities of nonspecific antibodies \n\n Recognize a single epitope on an antigen \n\n Recognize multiple epitopes on an antigen \n\n Production is continuous and uniform once the hybridoma is made \n\n Different batches vary in composition \n\n Table  20.1     \n\n Clinical Uses of Monoclonal Antibodies \n\n Since the most common methods for producing monoclonal antibodies use mouse cells, it is necessary to create  humanized monoclonal antibodies  for human clinical use. Mouse antibodies cannot be injected repeatedly into humans, because the immune system will recognize them as being foreign and will respond to them with neutralizing antibodies. This problem can be minimized by genetically engineering the antibody in the mouse B cell. The  variable regions  of the mouse light and heavy chain genes are ligated to human constant regions, and the chimeric gene is then transferred into a host cell. This allows production of a mAb that is mostly \u201chuman\u201d with only the antigen-binding site being of mouse origin. \n\n Humanized mAbs have been successfully used to treat cancer with minimal side effects. For example, the humanized monoclonal antibody drug  Herceptin  has been helpful for the treatment of some types of breast cancer. There have also been a few preliminary trials of humanized mAb for the treatment of infectious diseases, but none of these treatments are currently in use. In some cases, mAbs have proven too specific to treat infectious diseases, because they recognize some serovars of a pathogen but not others. Using a cocktail of multiple mAbs that target different strains of the pathogen can address this problem. However, the great cost associated with mAb production is another challenge that has prevented mAbs from becoming practical for use in treating microbial infections. 3 3 Saylor, Carolyn, Ekaterina Dadachova and Arturo Casadevall, \u201cMonoclonal Antibody-Based Therapies for Microbial Diseases,\u201d  Vaccine  27 (2009): G38-G46. \n\n One promising technology for inexpensive mAbs is the use of genetically engineered plants to produce antibodies (or  plantibodies ). This technology transforms plant cells into antibody factories rather than relying on tissue culture cells, which are expensive and technically demanding. In some cases, it may even be possible to deliver these antibodies by having patients eat the plants rather than by extracting and injecting the antibodies. For example, in 2013, a research group cloned antibody genes into plants that had the ability to neutralize an important toxin from bacteria that can cause severe gastrointestinal disease. 4  Eating the plants could potentially deliver the antibodies directly to the toxin. 4 Nakanishi, Katsuhiro et al., \u201cProduction of Hybrid-IgG/IgA Plantibodies with Neutralizing Activity against Shiga Toxin 1,\u201d  PloS One  8, no. 11 (2013): e80712. \n\n Check Your Understanding \n\n How are humanized monoclonal antibodies produced? \n\n What does the \u201cmonoclonal\u201d of monoclonal antibodies mean? \n\n Micro Connections Using Monoclonal Antibodies to Combat Ebola During the 2014\u20132015 Ebola outbreak in West Africa, a few Ebola-infected patients were treated with ZMapp, a drug that had been shown to be effective in trials done in rhesus macaques only a few months before. 5  ZMapp is a combination of three mAbs produced by incorporating the antibody genes into tobacco plants using a viral vector. By using three mAbs, the drug is effective across multiple strains of the virus. Unfortunately, there was only enough ZMapp to treat a tiny number of patients. 5 Qiu, Xiangguo et al., \u201cReversion of Advanced Ebola Virus Disease in Nonhuman Primates with ZMapp,\u201d  Nature  514 (2014): 47\u201353. \n\n While the current technology is not adequate for producing large quantities of ZMapp, it does show that plantibodies\u2014plant-produced mAbs\u2014are feasible for clinical use, potentially cost effective, and worth further development. The last several years have seen an explosion in the number of new mAb-based drugs for the treatment of cancer and infectious diseases; however, the widespread use of such drugs is currently inhibited by their exorbitant cost, especially in underdeveloped parts of the world, where a single dose might cost more than the patient\u2019s lifetime income. Developing methods for cloning antibody genes into plants could reduce costs dramatically. \n 20.2   Detecting Antigen-Antibody Complexes \n\n Learning Objectives \n\n Describe various types of assays used to find antigen-antibody complexes \n\n Describe the circumstances under which antigen-antibody complexes precipitate out of solution \n\n Explain how antibodies in patient serum can be used to diagnose disease \n\n Laboratory tests to detect antibodies and antigens outside of the body (e.g., in a test tube) are called  in vitro  assays. When both antibodies and their corresponding antigens are present in a solution, we can often observe a precipitation reaction in which large complexes (lattices) form and settle out of solution. In the next several sections, we will discuss several common  in vitro  assays. \n\n Precipitin Reactions \n\n A visible antigen-antibody complex is called a  precipitin , and  in vitro  assays that produce a precipitin are called  precipitin reactions . A precipitin reaction typically involves adding soluble antigens to a test tube containing a solution of antibodies. Each antibody has two arms, each of which can bind to an epitope. When an antibody binds to two antigens, the two antigens become bound together by the antibody. A lattice can form as antibodies bind more and more antigens together, resulting in a precipitin ( Figure 20.5 ). Most precipitin tests use a  polyclonal antiserum  rather than  monoclonal antibodies  because polyclonal antibodies can bind to multiple epitopes, making lattice formation more likely. Although mAbs may bind some antigens, the binding will occur less often, making it much less likely that a visible precipitin will form. \n\n The amount of precipitation also depends on several other factors. For example, precipitation is enhanced when the antibodies have a high affinity for the antigen. While most antibodies bind antigen with high affinity, even high-affinity binding uses relatively weak noncovalent bonds, so that individual interactions will often break and new interactions will occur. \n\n In addition, for precipitin formation to be visible, there must be an optimal ratio of antibody to antigen. The optimal ratio is not likely to be a 1:1 antigen-to-antibody ratio; it can vary dramatically, depending on the number of epitopes on the antigen and the class of antibody. Some antigens may have only one or two  epitopes  recognized by the antiserum, whereas other antigens may have many different epitopes and/or multiple instances of the same epitope on a single antigen molecule. \n\n Figure 20.6  illustrates how the ratio of antigen and antibody affects the amount of precipitation. To achieve the optimal ratio, antigen is slowly added to a solution containing antibodies, and the amount of precipitin is determined qualitatively. Initially, there is not enough antigen to produce visible lattice formation; this is called the zone of antibody excess. As more antigen is added, the reaction enters the  equivalence zone  (or zone of equivalence), where both the optimal antigen-antibody interaction and maximal precipitation occur. If even more antigen were added, the amount of antigen would become excessive and actually cause the amount of precipitation to decline. \n\n Check Your Understanding \n\n What is a precipitin? \n\n Why do polyclonal antisera produce a better precipitin reaction? \n\n Precipitin Ring Test \n\n A variety of techniques allow us to use precipitin formation to quantify either antigen concentration or the amount of antibody present in an antiserum. One such technique is the  precipitin ring test  ( Figure 20.7 ), which is used to determine the relative amount of antigen-specific antibody in a sample of serum. To perform this test, a set of test tubes is prepared by adding an antigen solution to the bottom of each tube. Each tube receives the same volume of solution, and the concentration of antigens is constant (e.g., 1 mg/mL). Next, glycerol is added to the antigen solution in each test tube, followed by a  serial dilution  of the antiserum. The glycerol prevents mixing of the antiserum with the antigen solution, allowing antigen-antibody binding to take place only at the interface of the two solutions. The result is a visible ring of precipitin in the tubes that have an antigen-antibody ratio within the equivalence zone. This highest dilution with a visible ring is used to determine the  titer  of the antibodies. The titer is the reciprocal of the highest dilution showing a positive result, expressed as a whole number. In  Figure 20.7 , the titer is 16. \n\n While a measurement of titer does not tell us in absolute terms how much antibody is present, it does give a measure of biological activity, which is often more important than absolute amount. In this example, it would not be useful to know what mass of  IgG  were present in the antiserum, because there are many different specificities of antibody present; but it is important for us to know how much of the antibody activity in a patient\u2019s serum is directed against the antigen of interest (e.g., a particular pathogen or allergen). \n\n Ouchterlony Assay \n\n While the precipitin ring test provides insights into antibody-antigen interactions, it also has some drawbacks. It requires the use of large amounts of serum, and great care must be taken to avoid mixing the solutions and disrupting the ring. Performing a similar test in an agar gel matrix can minimize these problems. This type of assay is variously called  double immunodiffusion  or the  Ouchterlony assay  for Orjan  Ouchterlony , 6  who first described the technique in 1948. 6 Ouchterlony, \u00d6rjan, \u201cIn Vitro Method for Testing the Toxin-Producing Capacity of Diphtheria Bacteria,\u201d  Acta Pathologica Microbiologica Scandinavica  26, no. 4 (1949): 516-24. \n\n When agar is highly purified, it produces a clear, colorless gel. Holes are punched in the gel to form wells, and antigen and antisera are added to neighboring wells. Proteins are able to diffuse through the gel, and precipitin arcs form between the wells at the zone of equivalence. Because the  precipitin  lattice is too large to diffuse through the gel, the arcs are firmly locked in place and easy to see ( Figure 20.8 ). \n\n Although there are now more sensitive and quantitative methods of detecting antibody-antigen interactions, the Ouchterlony test provides a rapid and qualitative way of determining whether an antiserum has antibodies against a particular antigen. The Ouchterlony test is particularly useful when looking for  cross-reactivity . We can check an antiserum against a group of closely related antigens and see which combinations form precipitin arcs. \n\n Radial Immunodiffusion Assay \n\n The  radial immunodiffusion  (RID) assay is similar to the Ouchterlony assay but is used to precisely quantify antigen concentration rather than to compare different antigens. In this assay, the antiserum is added to tempered agar (liquid agar at slightly above 45 \u00b0C), which is poured into a small petri dish or onto a glass slide and allowed to cool. Wells are cut in the cooled agar, and antigen is then added to the wells and allowed to diffuse. As the antigen and antibody interact, they form a zone of precipitation. The square of the diameter of the zone of precipitation is directly proportional to the concentration of antigen. By measuring the zones of precipitation produced by samples of known concentration (see the outer ring of samples in  Figure 20.9 ), we can prepare a standard curve for determining the concentration of an unknown solution. The RID assay is a also useful test for determining the concentration of many serum proteins such as the C3 and C4 complement proteins, among others. \n\n Check Your Understanding \n\n Why does a precipitin ring form in a precipitin ring test, and what are some reasons why a ring might not form? \n\n Compare and contrast the techniques used in an Ouchterlony assay and a radial immunodiffusion assay. \n\n Flocculation Assays \n\n A flocculation assay is similar to a precipitin reaction except that it involves insoluble antigens such as lipids. A  flocculant  is similar to a precipitin in that there is a visible lattice of antigen and antibody, but because lipids are insoluble in aqueous solution, they cannot precipitate. Instead of precipitation, flocculation (foaming) is observed in the test tube fluid. \n\n Micro Connections Using Flocculation to Test for Syphilis Syphilis is a sexually transmitted infection that can cause severe, chronic disease in adults. In addition, it is readily passed from infected mothers to their newborns during pregnancy and childbirth, often resulting in stillbirth or serious long-term health problems for the infant. Unfortunately, syphilis can also be difficult to diagnose in expectant mothers, because it is often asymptomatic, especially in women. In addition, the causative agent, the bacterium  Treponema pallidum , is both difficult to grow on conventional lab media and too small to see using routine microcopy. For these reasons, presumptive diagnoses of syphilis are generally confirmed indirectly in the laboratory using tests that detect antibodies to treponemal antigens. \n\n In 1906, German scientist August von  Wassermann  (1866\u20131925) introduced the first test for syphilis that relied on detecting anti-treponemal antibodies in the patient\u2019s blood. The antibodies detected in the Wassermann test were antiphospholipid antibodies that are nonspecific to  T. pallidum . Their presence can assist in the diagnosis of syphilis, but because they are nonspecific, they can also lead to false-positive results in patients with other diseases and autoimmune conditions. The original  Wasserman test  has been modified over the years to minimize  false-positives  and is now known as the Venereal Disease Research Lab test, better known by its acronym, the  VDRL test . \n\n To perform the VDRL test, patient serum or cerebral spinal fluid is placed on a slide with a mixture of  cardiolipin  (an antigenic phospholipid found in the mitochondrial membrane of various pathogens), lecithin, and cholesterol. The lecithin and cholesterol stabilize the reaction and diminish false positives. Anti-treponemal antibodies from an infected patient\u2019s serum will bind cardiolipin and form a flocculant. Although the VDRL test is more specific than the original Wassermann assay, false positives may still occur in patients with autoimmune diseases that cause extensive cell damage (e.g.,  systemic lupus erythematosus ). \n\n Neutralization Assay \n\n To cause infection, viruses must bind to receptors on host cells. Antiviral antibodies can neutralize viral infections by coating the virions, blocking the binding ( Figure 18.7 ). This activity neutralizes virions and can result in the formation of large antibody-virus complexes (which are readily removed by phagocytosis) or by antibody binding to the virus and blocking its binding to host cell receptors. This neutralization activity is the basis of  neutralization assays , sensitive assays used for diagnoses of viral infections. \n\n When viruses infect cells, they often cause damage ( cytopathic effects ) that may include lysis of the host cells. Cytopathic effects can be visualized by growing host cells in a petri dish, covering the cells with a thin layer of agar, and then adding virus (see  Isolation, Culture, and Identification of Viruses ). The virus will diffuse very slowly through the agar. A virus will enter a host cell, proliferate (causing cell damage), be released from the dead host cell, and then move to neighboring cells. As more and more cells die,  plaques  of dead cells will form ( Figure 20.10 ). \n\n During the course of a viral infection, the patient will mount an antibody response to the virus, and we can quantify those antibodies using a  plaque reduction assay . To perform the assay, a  serial dilution  is carried out on a serum sample. Each dilution is then mixed with a standardized amount of the suspect virus. Any virus-specific antibodies in the serum will neutralize some of the virus. The suspensions are then added to host cells in culture to allow any nonneutralized virus to infect the cells and form plaques after several days. The  titer  is defined as the reciprocal of the highest dilution showing a 50% reduction in plaques. Titer is always expressed as a whole number. For example, if a 1/64 dilution was the highest dilution to show 50% plaque reduction, then the titer is 64. \n\n The presence of antibodies in the patient\u2019s serum does not tell us whether the patient is currently infected or was infected in the past. Current infections can be identified by waiting two weeks and testing another serum sample. A four-fold increase in neutralizing titer in this second sample indicates a new infection. \n\n Check Your Understanding \n\n In a neutralization assay, if a patient\u2019s serum has high numbers of antiviral antibodies, would you expect to see more or fewer plaques? \n\n Immunoelectrophoresis \n\n When a patient has elevated protein levels in the blood or is losing protein in the urine, a clinician will often order a  polyacrylamide gel electrophoresis  ( PAGE ) assay (see  Visualizing and Characterizing DNA, RNA, and Protein ). This assay compares the relative abundance of the various types of serum proteins. Abnormal protein electrophoresis patterns can be further studied using  immunoelectrophoresis (IEP) . The IEP begins by running a PAGE. Antisera against selected serum proteins are added to troughs running parallel to the electrophoresis track, forming  precipitin arcs  similar to those seen in an  Ouchterlony assay  ( Figure 20.11 ). This allows the identification of abnormal immunoglobulin proteins in the sample. \n\n IEP is particularly useful in the diagnosis of  multiple myeloma , a cancer of antibody-secreting cells. Patients with multiple myeloma cannot produce healthy antibodies; instead they produce abnormal antibodies that are monoclonal proteins (M proteins). Thus, patients with multiple myeloma will present with elevated serum protein levels that show a distinct band in the gamma globulin region of a protein electrophoresis gel and a sharp spike (in M protein) on the densitometer scan rather than the normal broad smear ( Figure 20.12 ). When antibodies against the various types of antibody heavy and light chains are used to form precipitin arcs, the  M protein  will cause distinctly skewed arcs against one class of heavy chain and one class of light chain as seen in  Figure 20.11 . \n\n Micro Connections Protein Electrophoresis and the Characterization of Immunoglobulin Structure The advent of electrophoresis ultimately led to researching and understanding the structure of antibodies. When Swedish biochemist Arne Tiselius (1902\u20131971) published the first protein electrophoresis results in 1937, 7  he could identify the protein albumin (the smallest and most abundant serum protein) by the sharp band it produced in the gel. The other serum proteins could not be resolved in a simple protein electrophoresis, so he named the three broad bands, with many proteins in each band, alpha, beta, and gamma globulins. Two years later, American immunologist Elvin Kabat (1914\u20132000) traveled to Sweden to work with Tiselius using this new technique and showed that antibodies migrated as gamma globulins. 8  With this new understanding in hand, researchers soon learned that multiple myeloma, because it is a cancer of antibody-secreting cells, could be tentatively diagnosed by the presence of a large M spike in the gamma-globulin region by protein electrophoresis. Prior to this discovery, studies on immunoglobulin structure had been minimal, because of the difficulty of obtaining pure samples to study. Sera from multiple myeloma patients proved to be an excellent source of highly enriched monoclonal immunoglobulin, providing the raw material for studies over the next 20-plus years that resulted in the elucidation of the structure of immunoglobulin. 7 Tiselius, Arne, \u201cElectrophoresis of Serum Globulin: Electrophoretic Analysis of Normal and Immune Sera,\u201d  Biochemical Journal  31, no. 9 (1937): 1464. 8 Tiselius, Arne and Elvin A. Kabat. \u201cAn Electrophoretic Study of Immune Sera and Purified Antibody Preparations,\u201d  The Journal of Experimental Medicine  69, no. 1 (1939): 119-31. \n\n Check Your Understanding \n\n In general, what does an immunoelectrophoresis assay accomplish? \n\n Immunoblot Assay: The Western Blot \n\n After performing protein gel electrophoresis, specific proteins can be identified in the gel using antibodies. This technique is known as the  western blot . Following separation of proteins by PAGE, the protein antigens in the gel are transferred to and immobilized on a nitrocellulose membrane. This membrane can then be exposed to a  primary antibody  produced to specifically bind to the protein of interest. A second antibody equipped with a molecular beacon will then bind to the first. These secondary antibodies are coupled to another molecule such as an enzyme or a  fluorophore  (a molecule that fluoresces when excited by light). When using antibodies coupled to enzymes, a  chromogenic substrate  for the enzyme is added. This substrate is usually colorless but will develop color in the presence of the antibody. The fluorescence or substrate coloring identifies the location of the specific protein in the membrane to which the antibodies are bound ( Figure 20.13 ). \n\n Typically,  polyclonal antibodies  are used for western blot assays. They are more sensitive than mAbs because of their ability to bind to various epitopes of the primary antigen, and the signal from polyclonal antibodies is typically stronger than that from mAbs. Monoclonal antibodies can also be used; however, they are much more expensive to produce and are less sensitive, since they are only able to recognize one specific epitope. \n\n Several variations of the western blot are useful in research. In a  southwestern blot , proteins are separated by SDS-PAGE, blotted onto a nitrocellulose membrane, allowed to renature, and then probed with a fluorescently or radioactively labeled DNA probe; the purpose of the southwestern is to identify specific DNA-protein interactions.  Far-western blots  are carried out to determine protein-protein interactions between immobilized proteins (separated by SDS-PAGE, blotted onto a nitrocellulose membrane, and allowed to renature) and non-antibody protein probes. The bound non-antibody proteins that interact with the immobilized proteins in a far-western blot may be detected by radiolabeling, fluorescence, or the use of an antibody with an enzymatic molecular beacon. \n\n Check Your Understanding \n\n What is the function of the enzyme in the immunoblot assay? \n\n Complement-Mediated Immunoassay \n\n One of the key functions of antibodies is the activation (fixation) of complement. When antibody binds to bacteria, for example, certain  complement proteins  recognize the bound antibody and activate the  complement cascade . In response, other complement proteins bind to the bacteria where some serve as  opsonins  to increase the efficiency of phagocytosis and others create holes in gram-negative bacterial cell membranes, causing lysis. This lytic activity can be used to detect the presence of antibodies against specific antigens in the serum. \n\n Red blood cells are good indicator cells to use when evaluating complement-mediated cytolysis. Hemolysis of red blood cells releases hemoglobin, which is a brightly colored pigment, and hemolysis of even a small number of red cells will cause the solution to become noticeably pink ( Figure 20.14 ). This characteristic plays a role in the  complement fixation test , which allows the detection of antibodies against specific pathogens. The complement fixation test can be used to check for antibodies against pathogens that are difficult to culture in the lab such as fungi, viruses, or the bacteria  Chlamydia . \n\n To perform the complement fixation test, antigen from a pathogen is added to patient serum. If antibodies to the antigen are present, the antibody will bind the antigen and fix all the available complement. When red blood cells and antibodies against red blood cells are subsequently added to the mix, there will be no complement left to lyse the red cells. Thus, if the solution remains clear, the test is positive. If there are no antipathogen antibodies in the patient\u2019s serum, the added antibodies will activate the complement to lyse the red cells, yielding a negative test ( Figure 20.14 ). \n\n Link to Learning \n\n View this  video  to see an outline of the steps of the complement fixation test. \n\n Check Your Understanding \n\n In a complement fixation test, if the serum turns pink, does the patient have antibodies to the antigen or not? Explain. \n\n Table 20.2  summarizes the various types of antibody-antigen assays discussed in this section. \n\n Mechanisms of Select Antibody-Antigen Assays \n\n Type of Assay \n\n Mechanism \n\n Examples \n\n Precipitation \n\n Antibody binds to soluble antigen, forming a visible precipitin \n\n Precipitin ring test to visualize lattice formation in solution \n\n Immunoelectrophoresis to examine distribution of antigens following electrophoresis \n\n Ouchterlony assay to compare diverse antigens \n\n Radial immunodiffusion assay to quantify antigens \n\n Flocculation \n\n Antibody binds to insoluble molecules in suspension, forming visible aggregates \n\n VDRL test for syphilis \n\n Neutralization \n\n Antibody binds to virus, blocking viral entry into target cells and preventing formation of plaques \n\n Plaque reduction assay for detecting presence of neutralizing antibodies in patient sera \n\n Complement activation \n\n Antibody binds to antigen, inducing complement activation and leaving no complement to lyse red blood cells \n\n Complement fixation test for patient antibodies against hard-to-culture bacteria such as  Chlamydia \n\n Table  20.2     \n 20.3   Agglutination Assays \n\n Learning Objectives \n\n Compare direct and indirect agglutination \n\n Identify various uses of hemagglutination in the diagnosis of disease \n\n Explain how blood types are determined \n\n Explain the steps used to cross-match blood to be used in a transfusion \n\n In addition to causing precipitation of soluble molecules and flocculation of molecules in suspension, antibodies can also clump together cells or particles (e.g., antigen-coated latex beads) in a process called  agglutination  ( Figure 18.9 ). Agglutination can be used as an indicator of the presence of antibodies against bacteria or red blood cells. Agglutination assays are usually quick and easy to perform on a glass slide or  microtiter plate  ( Figure 20.15 ). Microtiter plates have an array of wells to hold small volumes of reagents and to observe reactions (e.g., agglutination) either visually or using a specially designed spectrophotometer. The wells come in many different sizes for assays involving different volumes of reagents. \n\n Agglutination of Bacteria and Viruses \n\n The use of agglutination tests to identify streptococcal bacteria was developed in the 1920s by Rebecca  Lancefield  working with her colleagues A.R.  Dochez  and Oswald  Avery . 9  She used antibodies to identify  M protein , a virulence factor on streptococci that is necessary for the bacteria\u2019s ability to cause strep throat. Production of antibodies against M protein is crucial in mounting a protective response against the bacteria. 9 Lancefield, Rebecca C., \u201cThe Antigenic Complex of  Streptococcus haemoliticus . I. Demonstration of a Type-Specific Substance in Extracts of  Streptococcus haemolyticus ,\u201d  The Journal of Experimental Medicine  47, no. 1 (1928): 91-103. \n\n Lancefield used antisera to show that different strains of the same species of  streptococci  express different versions of M protein, which explains why children can come down with  strep throat  repeatedly. Lancefield classified beta-hemolytic streptococci into many groups based on antigenic differences in group-specific polysaccharides located in the bacterial cell wall. The strains are called  serovars  because they are differentiated using antisera. Identifying the serovars present in a disease outbreak is important because some serovars may cause more severe disease than others. \n\n The method developed by Lancefield is a  direct agglutination assay , since the bacterial cells themselves agglutinate. A similar strategy is more commonly used today when identifying serovars of bacteria and viruses; however, to improve visualization of the agglutination, the antibodies may be attached to inert  latex beads . This technique is called an  indirect agglutination assay  (or  latex fixation assay ), because the agglutination of the beads is a marker for antibody binding to some other antigen ( Figure 20.16 ). Indirect assays can be used to detect the presence of either antibodies or specific antigens. \n\n To identify antibodies in a patient\u2019s serum, the antigen of interest is attached to latex beads. When mixed with patient serum, the antibodies will bind the antigen, cross-linking the latex beads and causing the beads to agglutinate indirectly; this indicates the presence of the antibody ( Figure 20.17 ). This technique is most often used when looking for  IgM  antibodies, because their structure provides maximum cross-linking. One widely used example of this assay is a test for  rheumatoid factor (RF)  to confirm a diagnosis of rheumatoid arthritis. RF is, in fact, the presence of IgM antibodies that bind to the patient\u2019s own  IgG . RF will agglutinate IgG-coated latex beads. \n\n In the reverse test, soluble antigens can be detected in a patient\u2019s serum by attaching specific antibodies (commonly mAbs) to the latex beads and mixing this complex with the serum ( Figure 20.17 ). \n\n Agglutination tests are widely used in underdeveloped countries that may lack appropriate facilities for culturing bacteria. For example, the  Widal test , used for the diagnosis of  typhoid fever , looks for agglutination of  Salmonella enterica  subspecies  typhi  in patient sera. The Widal test is rapid, inexpensive, and useful for monitoring the extent of an outbreak; however, it is not as accurate as tests that involve culturing of the bacteria. The Widal test frequently produces false positives in patients with previous infections with other subspecies of  Salmonella , as well as false negatives in patients with hyperproteinemia or immune deficiencies. \n\n In addition, agglutination tests are limited by the fact that patients generally do not produce detectable levels of antibody during the first week (or longer) of an infection. A patient is said to have undergone  seroconversion  when antibody levels reach the threshold for detection. Typically, seroconversion coincides with the onset of signs and symptoms of disease. However, in an HIV infection, for example, it generally takes 3 weeks for seroconversion to take place, and in some instances, it may take much longer. \n\n Similar to techniques for the precipitin ring test and plaque assays, it is routine to prepare serial two-fold dilutions of the patient\u2019s serum and determine the titer of agglutinating antibody present. Since antibody levels change over time in both primary and secondary immune responses, by checking samples over time, changes in antibody titer can be detected. For example, a comparison of the  titer  during the  acute phase  of an infection versus the titer from the  convalescent phase  will distinguish whether an infection is current or has occurred in the past. It is also possible to monitor how well the patient\u2019s immune system is responding to the pathogen. \n\n Link to Learning \n\n Watch this  video  that demonstrates agglutination reactions with latex beads. \n\n Check Your Understanding \n\n How is agglutination used to distinguish serovars from each other? \n\n In a latex bead assay to test for antibodies in a patient's serum, with what are the beads coated? \n\n What has happened when a patient has undergone seroconversion? \n\n Hemagglutination \n\n Agglutination of red blood cells is called  hemagglutination . One common assay that uses hemagglutination is the  direct Coombs\u2019 test , also called the  direct antihuman globulin test (DAT) , which generally looks for nonagglutinating antibodies. The test can also detect complement attached to red blood cells. \n\n The Coombs\u2019 test is often employed when a newborn has  jaundice , yellowing of the skin caused by high blood concentrations of bilirubin, a product of the breakdown of hemoglobin in the blood. The Coombs\u2019 test is used to determine whether the child\u2019s red blood cells have been bound by the mother\u2019s antibodies. These antibodies would activate complement, leading to red blood cell lysis and the subsequent jaundice. Other conditions that can cause positive direct Coombs\u2019 tests include  hemolytic transfusion reactions ,  autoimmune hemolytic anemia , infectious mononucleosis (caused by  Epstein-Barr virus ),  syphilis , and  Mycoplasma  pneumonia . A positive direct Coombs\u2019 test may also be seen in some cancers and as an allergic reaction to some drugs (e.g., penicillin). \n\n The antibodies bound to red blood cells in these conditions are most often  IgG , and because of the orientation of the antigen-binding sites on IgG and the comparatively large size of a red blood cell, it is unlikely that any visible agglutination will occur. However, the presence of IgG bound to red blood cells can be detected by adding  Coombs\u2019 reagent , an antiserum containing antihuman IgG antibodies (that may be combined with anti-complement) ( Figure 20.18 ). The Coombs\u2019 reagent links the IgG attached to neighboring red blood cells and thus promotes agglutination. \n\n There is also an  indirect Coombs\u2019 test  known as the  indirect antiglobulin test (IAT) . This screens an individual for antibodies against red blood cell antigens (other than the A and B antigens) that are unbound in a patient\u2019s serum ( Figure 20.18 ). IAT can be used to screen pregnant women for antibodies that may cause  hemolytic disease of the newborn . It can also be used prior to giving blood transfusions. More detail on how the IAT is performed is discussed below. \n\n Antibodies that bind to red blood cells are not the only cause of hemagglutination. Some viruses also bind to red blood cells, and this binding can cause agglutination when the viruses cross-link the red blood cells. For example,  influenza viruses  have two different types of viral spikes called  neuraminidase  (N) and  hemagglutinin  (H), the latter named for its ability to agglutinate red blood cells (see  Viruses ). Thus, we can use red blood cells to detect the presence of influenza virus by  direct hemagglutination assays  (HA), in which the virus causes visible agglutination of red blood cells. The  mumps  and  rubella  viruses can also be detected using HA. \n\n Most frequently, a  serial dilution  viral agglutination assay is used to measure the  titer  or estimate the amount of virus produced in cell culture or for vaccine production. A viral titer can be determined using a direct HA by making a serial dilution of the sample containing the virus, starting with a high concentration of sample that is then diluted in a series of wells. The highest dilution producing visible agglutination is the titer. The assay is carried out in a microtiter plate with V- or round-bottomed wells. In the presence of agglutinating viruses, the red blood cells and virus clump together and produce a diffuse mat over the bottom of the well. In the absence of virus, the red blood cells roll or sediment to the bottom of the well and form a dense pellet, which is why flat-bottomed wells cannot be used ( Figure 20.19 ). \n\n A modification of the HA assay can be used to determine the titer of antiviral antibodies. The presence of these antibodies in a patient\u2019s serum or in a lab-produced antiserum will neutralize the virus and block it from agglutinating the red cells, making this a  viral hemagglutination inhibition assay  (HIA). In this assay, patient serum is mixed with a standardized amount of virus. After a short incubation, a standardized amount of red blood cells is added and hemagglutination is observed. The titer of the patient\u2019s serum is the highest dilution that blocks agglutination ( Figure 20.20 ). \n\n Check Your Understanding \n\n What is the mechanism by which viruses are detected in a hemagglutination assay? \n\n Which hemagglutination result tells us the titer of virus in a sample? \n\n Eye on Ethics Animals in the Laboratory Much of what we know today about the human immune system has been learned through research conducted using animals\u2014primarily, mammals\u2014as models. Besides research, mammals are also used for the production of most of the antibodies and other immune system components needed for immunodiagnostics. Vaccines, diagnostics, therapies, and translational medicine in general have all been developed through research with animal models. \n\n Consider some of the common uses of laboratory animals for producing immune system components. Guinea pigs are used as a source of complement, and mice are the primary source of cells for making mAbs. These mAbs can be used in research and for therapeutic purposes. Antisera are raised in a variety of species, including horses, sheep, goats, and rabbits. When producing an antiserum, the animal will usually be injected at least twice, and adjuvants may be used to boost the antibody response. The larger animals used for making antisera will have blood harvested repeatedly over long periods of time, with little harm to the animals, but that is not usually the case for rabbits. Although we can obtain a few milliliters of blood from the ear veins of rabbits, we usually need larger volumes, which results in the deaths of the animals. \n\n We also use animals for the study of disease. The only way to grow  Treponema pallidum  for the study of syphilis is in living animals. Many viruses can be grown in cell culture, but growth in cell culture tells us very little about how the immune system will respond to the virus. When working on a newly discovered disease, we still employ Koch\u2019s postulates, which require causing disease in lab animals using pathogens from pure culture as a crucial step in proving that a particular microorganism is the cause of a disease. Studying the proliferation of bacteria and viruses in animal hosts, and how the host immune system responds, has been central to microbiological research for well over 100 years. \n\n While the practice of using laboratory animals is essential to scientific research and medical diagnostics, many people strongly object to the exploitation of animals for human benefit. This ethical argument is not a new one\u2014indeed, one of Charles Darwin's daughters was an active antivivisectionist (vivisection is the practice of cutting or dissecting a live animal to study it). Most scientists acknowledge that there should be limits on the extent to which animals can be exploited for research purposes. Ethical considerations have led the National Institutes of Health (NIH) to develop strict regulations on the types of research that may be performed. These regulations also include guidelines for the humane treatment of lab animals, setting standards for their housing, care, and euthanization. The NIH document \u201cGuide for the Care and Use of Laboratory Animals\u201d makes it clear that the use of animals in research is a privilege granted by society to researchers. \n\n The NIH guidelines are based on the principle of the three R\u2019s: replace, refine, and reduce. Researchers should strive to  replace  animal models with nonliving models,  replace  vertebrates with invertebrates whenever possible, or use computer-models when applicable. They should  refine  husbandry and experimental procedures to reduce pain and suffering, and use experimental designs and procedures that  reduce  the number of animals needed to obtain the desired information. To obtain funding, researchers must satisfy NIH reviewers that the research justifies the use of animals and that their use is in accordance with the guidelines. \n\n At the local level, any facility that uses animals and receives federal funding must have an Institutional Animal Care and Use Committee (IACUC) that ensures that the NIH guidelines are being followed. The IACUC must include researchers, administrators, a veterinarian, and at least one person with no ties to the institution, that is, a concerned citizen. This committee also performs inspections of laboratories and protocols. For research involving human subjects, an Institutional Review Board (IRB) ensures that proper guidelines are followed. \n\n Link to Learning \n\n Visit this  site  to view the NIH Guide for the Care and Use of Laboratory Animals. \n\n Blood Typing and Cross-Matching \n\n In addition to antibodies against bacteria and viruses to which they have previously been exposed, most individuals also carry antibodies against  blood types  other than their own. There are presently 33 immunologically important blood-type systems, many of which are restricted within various ethnic groups or rarely result in the production of antibodies. The most important and perhaps best known are the  ABO  and  Rh blood groups  (see  Figure 19.4 ). \n\n When units of blood are being considered for  transfusion , pretransfusion blood testing must be performed. For the blood unit, commercially prepared antibodies against the A, B, and Rh antigens are mixed with red blood cells from the units to initially confirm that the blood type on the unit is accurate. Once a unit of blood has been requested for transfusion, it is vitally important to make sure the donor (unit of blood) and recipient (patient) are compatible for these crucial antigens. In addition to confirming the blood type of the unit, the patient\u2019s blood type is also confirmed using the same commercially prepared antibodies to A, B, and Rh. For example, as shown in  Figure 20.21 , if the donor blood is A-positive, it will agglutinate with the anti-A antiserum and with the anti-Rh antiserum. If no agglutination is observed with any of the sera, then the blood type would be O-negative. \n\n Following determination of the blood type, immediately prior to releasing the blood for transfusion, a  cross-match  is performed in which a small aliquot of the donor red blood cells are mixed with serum from the patient awaiting transfusion. If the patient does have antibodies against the donor red blood cells,  hemagglutination  will occur. To confirm any negative test results and check for sensitized red blood cells,  Coombs\u2019 reagent  may be added to the mix to facilitate visualization of the antibody-red blood cell interaction. \n\n Under some circumstances, a minor cross-match may be performed as well. In this assay, a small aliquot of donor serum is mixed with patient red blood cells. This allows the detection of agglutinizing antibodies in the donor serum. This test is rarely necessary because transfusions generally use packed red blood cells with most of the plasma removed by centrifugation. \n\n Red blood cells have many other antigens in addition to ABO and Rh. While most people are unlikely to have antibodies against these antigens, women who have had multiple pregnancies or patients who have had multiple transfusions may have them because of repeated exposure. For this reason, an  antibody screen  test is used to determine if such antibodies are present. Patient serum is checked against commercially prepared, pooled, type O red blood cells that express these antigens. If agglutination occurs, the antigen to which the patient is responding must be identified and determined not to be present in the donor unit. \n\n Check Your Understanding \n\n If a patient's blood agglutinates with anti-B serum, what is the patient\u2019s blood type? \n\n What is a cross-match assay, and why is it performed? \n\n Table 20.3  summarizes the various kinds of agglutination assays discussed in this section. \n\n Mechanisms of Select Antibody-Antigen Assays \n\n Type of Assay \n\n Mechanism \n\n Example \n\n Agglutination \n\n Direct: Antibody is used to clump bacterial cells or other large structures \n\n Serotyping bacteria \n\n Indirect: Latex beads are coupled with antigen or antibody to look for antibody or antigen, respectively, in patient serum \n\n Confirming the presence of rheumatoid factor (IgM-binding Ig) in patient serum \n\n Hemagglutination \n\n Direct: Some bacteria and viruses cross-link red blood cells and clump them together \n\n Diagnosing influenza, mumps, and measles \n\n Direct Coombs\u2019 test (DAT): Detects nonagglutinating antibodies or complement proteins on red blood cells  in vivo \n\n Checking for maternal antibodies binding to neonatal red blood cells \n\n Indirect Coombs\u2019 test (IAT): Screens an individual for antibodies against red blood cell antigens (other than the A and B antigens) that are unbound in a patient\u2019s serum  in vitro \n\n Performing pretransfusion blood testing \n\n Viral hemagglutination inhibition: Uses antibodies from a patient to inhibit viral agglutination \n\n Diagnosing various viral diseases by the presence of patient antibodies against the virus \n\n Blood typing and cross-matching: Detects ABO, Rh, and minor antigens in the blood \n\n Matches donor blood to recipient immune requirements \n\n Table  20.3     \n 20.4   EIAs and ELISAs \n\n Learning Objectives \n\n Explain the differences and similarities between EIA, FEIA, and ELISA \n\n Describe the difference and similarities between immunohistochemistry and immunocytochemistry \n\n Describe the different purposes of direct and indirect ELISA \n\n Similar to the  western blot ,  enzyme immunoassays (EIAs)  use antibodies to detect the presence of antigens. However, EIAs differ from western blots in that the assays are conducted in microtiter plates or  in vivo  rather than on an absorbent membrane. There are many different types of EIAs, but they all involve an antibody molecule whose  constant region  binds an enzyme, leaving the variable region free to bind its specific antigen. The addition of a substrate for the enzyme allows the antigen to be visualized or quantified ( Figure 20.22 ). \n\n In EIAs, the substrate for the enzyme is most often a chromogen, a colorless molecule that is converted into a colored end product. The most widely used enzymes are alkaline phosphatase and horseradish peroxidase for which appropriate substrates are readily available. In some EIAs, the substrate is a  fluorogen , a nonfluorescent molecule that the enzyme converts into a fluorescent form. EIAs that utilize a fluorogen are called  fluorescent enzyme immunoassays (FEIAs) . Fluorescence can be detected by either a  fluorescence microscope  or a  spectrophotometer . \n\n Micro Connections The MMR Titer The MMR vaccine is a combination vaccine that provides protection against measles, mumps, and rubella (German measles). Most people receive the MMR vaccine as children and thus have antibodies against these diseases. However, for various reasons, even vaccinated individuals may become susceptible to these diseases again later in life. For example, some children may receive only one round of the MMR vaccine instead of the recommended two. In addition, the titer of protective antibodies in an individual\u2019s body may begin to decline with age or as the result of some medical conditions. \n\n To determine whether the titer of antibody in an individual\u2019s bloodstream is sufficient to provide protection, an MMR titer test can be performed. The test is a simple immunoassay that can be done quickly with a blood sample. The results of the test will indicate whether the individual still has immunity or needs another dose of the MMR vaccine. \n\n Submitting to an MMR titer is often a pre-employment requirement for healthcare workers, especially those who will frequently be in contact with young children or immunocompromised patients. Were a healthcare worker to become infected with measles, mumps, or rubella, the individual could easily pass these diseases on to susceptible patients, leading to an outbreak. Depending on the results of the MMR titer, healthcare workers might need to be revaccinated prior to beginning work. \n\n Immunostaining \n\n One powerful use of EIA is  immunostaining , in which antibody-enzyme conjugates enhance microscopy.  Immunohistochemistry (IHC)  is used for examining whole tissues. As seen in  Figure 20.23 , a section of tissue can be stained to visualize the various cell types. In this example, a mAb against CD8 was used to stain  CD8  cells in a section of tonsil tissue. It is now possible to count the number of CD8 cells, determine their relative numbers versus the other cell types present, and determine the location of these cells within this tissue. Such data would be useful for studying diseases such as AIDS, in which the normal function of CD8 cells is crucial for slowing disease progression. \n\n Immunocytochemistry (ICC)  is another valuable form of immunostaining. While similar to IHC, in ICC, extracellular matrix material is stripped away, and the cell membrane is etched with alcohol to make it permeable to antibodies. This allows antibodies to pass through the cell membrane and bind to specific targets inside the cell. Organelles, cytoskeletal components, and other intracellular structures can be visualized in this way. While some ICC techniques use EIA, the enzyme can be replaced with a fluorescent molecule, making it a fluorescent immunoassay. \n\n Check Your Understanding \n\n What is the difference between immunohistochemistry and immunocytochemistry? \n\n What must be true of the product of the enzymatic reaction used in immunohistochemistry? \n\n Enzyme-linked Immunosorbent Assays (ELISAs) \n\n The  enzyme-linked immunosorbent assays (ELISAs)  are widely used EIAs. In the  direct ELISA , antigens are immobilized in the well of a microtiter plate. An antibody that is specific for a particular antigen and is conjugated to an enzyme is added to each well. If the antigen is present, then the antibody will bind. After washing to remove any unbound antibodies, a colorless substrate ( chromogen ) is added. The presence of the enzyme converts the substrate into a colored end product ( Figure 20.22 ). While this technique is faster because it only requires the use of one antibody, it has the disadvantage that the signal from a direct ELISA is lower (lower sensitivity). \n\n In a  sandwich ELISA , the goal is to use antibodies to precisely quantify specific antigen present in a solution, such as antigen from a pathogen, a serum protein, or a hormone from the blood or urine to list just a few examples. The first step of a sandwich ELISA is to add the  primary antibody  to all the wells of a microtiter plate ( Figure 20.24 ). The antibody sticks to the plastic by hydrophobic interactions. After an appropriate incubation time, any unbound antibody is washed away. Comparable washes are used between each of the subsequent steps to ensure that only specifically bound molecules remain attached to the plate. A blocking protein is then added (e.g., albumin or the milk protein casein) to bind the remaining nonspecific protein-binding sites in the well. Some of the wells will receive known amounts of antigen to allow the construction of a standard curve, and unknown antigen solutions are added to the other wells. The primary antibody captures the antigen and, following a wash, the  secondary antibody  is added, which is a  polyclonal antibody  that is conjugated to an enzyme. After a final wash, a colorless substrate (chromogen) is added, and the enzyme converts it into a colored end product. The color intensity of the sample caused by the end product is measured with a  spectrophotometer . The amount of color produced (measured as absorbance) is directly proportional to the amount of enzyme, which in turn is directly proportional to the captured antigen. ELISAs are extremely sensitive, allowing antigen to be quantified in the nanogram (10 \u20139  g) per mL range. \n\n In an  indirect ELISA , we quantify antigen-specific antibody rather than antigen. We can use indirect ELISA to detect antibodies against many types of pathogens, including  Borrelia burgdorferi  ( Lyme disease ) and  HIV . There are three important differences between indirect and direct ELISAs as shown in  Figure 20.25 . Rather than using antibody to capture antigen, the indirect ELISA starts with attaching known antigen (e.g., peptides from HIV) to the bottom of the microtiter plate wells. After blocking the unbound sites on the plate, patient serum is added; if antibodies are present ( primary antibody ), they will bind the antigen. After washing away any unbound proteins, the secondary antibody with its conjugated enzyme is directed against the primary antibody (e.g., antihuman immunoglobulin). The  secondary antibody  allows us to quantify how much antigen-specific antibody is present in the patient\u2019s serum by the intensity of the color produced from the conjugated enzyme-chromogen reaction. \n\n As with several other tests for antibodies discussed in this chapter, there is always concern about  cross-reactivity  with antibodies directed against some other antigen, which can lead to false-positive results. Thus, we cannot definitively diagnose an HIV infection (or any other type of infection) based on a single indirect ELISA assay. We must confirm any suspected positive test, which is most often done using either an  immunoblot  that actually identifies the presence of specific peptides from the pathogen or a test to identify the nucleic acids associated with the pathogen, such as  reverse transcriptase PCR (RT-PCR)  or a nucleic acid antigen test. \n\n Check Your Understanding \n\n What is the purpose of the secondary antibody in a direct ELISA? \n\n What do the direct and indirect ELISAs quantify? \n\n Clinical Focus Part 2 Although contacting and testing the 1300 patients for HIV would be time consuming and expensive, administrators hoped to minimize the hospital\u2019s liability by proactively seeking out and treating potential victims of the rogue employee\u2019s crime. Early detection of HIV is important, and prompt treatment can slow the progression of the disease. \n\n There are a variety of screening tests for HIV, but the most widely used is the indirect ELISA. As with other indirect ELISAs, the test works by attaching antigen (in this case, HIV peptides) to a well in a 96-well plate. If the patient is HIV positive, anti-HIV antibodies will bind to the antigen and be identified by the second antibody-enzyme conjugate. \n\n How accurate is an indirect ELISA test for HIV, and what factors could impact the test\u2019s accuracy? \n\n Should the hospital use any other tests to confirm the results of the indirect ELISA? \n\n Jump to the  previous  Clinical Focus box. Jump to the  next  Clinical Focus box. \n\n Immunofiltration and Immunochromatographic Assays \n\n For some situations, it may be necessary to detect or quantify antigens or antibodies that are present at very low concentration in solution. Immunofiltration techniques have been developed to make this possible. In  immunofiltration , a large volume of fluid is passed through a porous membrane into an absorbent pad. An antigen attached to the porous membrane will capture antibody as it passes; alternatively, we can also attach an antibody to the membrane to capture antigen. \n\n The method of immunofiltration has been adapted in the development of  immunochromatographic assays , commonly known as  lateral flow tests  or strip tests. These tests are quick and easy to perform, making them popular for point-of-care use (i.e., in the doctor\u2019s office) or in-home use. One example is the  TORCH test  that allows doctors to screen pregnant women or newborns for infection by an array of viruses and other pathogens ( Toxoplasma , other viruses, rubella, cytomegalovirus, herpes simplex). In-home  pregnancy tests  are another widely used example of a lateral flow test ( Figure 20.26 ). Immunofiltration tests are also popular in developing countries, because they are inexpensive and do not require constant refrigeration of the dried reagents. However, the technology is also built into some sophisticated laboratory equipment. \n\n In lateral flow tests ( Figure 20.27 ), fluids such as urine are applied to an absorbent pad on the test strip. The fluid flows by capillary action and moves through a stripe of beads with antibodies attached to their surfaces. The fluid in the sample actually hydrates the reagents, which are present in a dried state in the stripe. Antibody-coated beads made of latex or tiny gold particles will bind antigens in the test fluid. The antibody-antigen complexes then flow over a second stripe that has immobilized antibody against the antigen; this stripe will retain the beads that have bound antigen. A third control stripe binds any beads. A red color (from gold particles) or blue (from latex beads) developing at the test line indicates a positive test. If the color only develops at the control line, the test is negative. \n\n Like ELISA techniques, lateral flow tests take advantage of antibody sandwiches, providing sensitivity and specificity. While not as quantitative as ELISA, these tests have the advantage of being fast, inexpensive, and not dependent on special equipment. Thus, they can be performed anywhere by anyone. There are some concerns about putting such powerful diagnostic tests into the hands of people who may not understand the tests\u2019 limitations, such as the possibility of false-positive results. While home pregnancy tests have become widely accepted, at-home antibody-detection tests for diseases like HIV have raised some concerns in the medical community. Some have questioned whether self-administration of such tests should be allowed in the absence of medical personnel who can explain the test results and order appropriate confirmatory tests. However, with growing numbers of lateral flow tests becoming available, and the rapid development of lab-on-a-chip technology ( Figure 20.1 ), home medical tests are likely to become even more commonplace in the future. \n\n Check Your Understanding \n\n What physical process does the lateral flow method require to function? \n\n Explain the purpose of the third strip in a lateral flow assay. \n\n Table 20.4  compares some of the key mechanisms and examples of some of the EIAs discussed in this section as well as immunoblots, which were discussed in  Detecting Antigen-Antibody Complexes . \n\n Immunoblots & Enzyme Immunoassays \n\n Type of Assay \n\n Mechanism \n\n Specific Procedures \n\n Examples \n\n Immunoblots \n\n Uses enzyme-antibody conjugates to identify specific proteins that have been transferred to an absorbent membrane \n\n Western blot: Detects the presence of a particular protein \n\n Detecting the presence of HIV peptides (or peptides from other infectious agents) in patient sera \n\n Immunostaining \n\n Uses enzyme-antibody conjugates to stain specific molecules on or in cells \n\n Immunohistochemistry: Used to stain specific cells in a tissue \n\n Stain for presence of CD8 cells in host tissue \n\n Enzyme-linked immunosorbent assay (ELISA) \n\n Uses enzyme-antibody conjugates to quantify target molecules \n\n Direct ELISA: Uses a single antibody to detect the presence of an antigen \n\n Detection of HIV antigen p24 up to one month after being infected \n\n Indirect ELISA: Measures the amount of antibody produced against an antigen \n\n Detection of HIV antibodies in serum \n\n Immunochromatographic (lateral flow) assays \n\n Techniques use the capture of flowing, color-labeled antigen-antibody complexes by fixed antibody for disease diagnosis \n\n Sandwich ELISA: Measures the amount of antigen bound by the antibody \n\n Detection of antibodies for various pathogens in patient sera (e.g., rapid strep, malaria dipstick) \n\n Pregnancy test detecting human chorionic gonadotrophin in urine \n\n Table  20.4     \n\n Clinical Focus Part 3 Although the indirect ELISA for HIV is a sensitive assay, there are several complicating considerations. First, if an infected person is tested too soon after becoming infected, the test can yield false-negative results. The seroconversion window is generally about three weeks, but in some cases, it can be more than two months. \n\n In addition to false negatives, false positives can also occur, usually due to previous infections with other viruses that induce cross-reacting antibodies. The false-positive rate depends on the particular brand of test used, but 0.5% is not unusual. 10  Because of the possibility of a false positive, all positive tests are followed up with a confirmatory test. This confirmatory test is often an immunoblot (western blot) in which HIV peptides from the patient\u2019s blood are identified using an HIV-specific mAb-enzyme conjugate. A positive western blot would confirm an HIV infection and a negative blot would confirm the absence of HIV despite the positive ELISA. 10 Thomas, Justin G., Victor Jaffe, Judith Shaffer, and Jose Abreu, \u201cHIV Testing: US Recommendations 2014,\u201d  Osteopathic Family Physician  6, no. 6 (2014). \n\n Unfortunately, western blots for HIV antigens often yield indeterminant results, in which case, they neither confirm nor invalidate the results of the indirect ELISA. In fact, the rate of indeterminants can be 10\u201349% (which is why, combined with their cost, western blots are not used for screening). Similar to the indirect ELISA, an indeterminant western blot can occur because of cross-reactivity or previous viral infections, vaccinations, or autoimmune diseases. \n\n Of the 1300 patients being tested, how many false-positive ELISA tests would be expected? \n\n Of the false positives, how many indeterminant western blots could be expected? \n\n How would the hospital address any cases in which a patient\u2019s western blot was indeterminant? \n\n Jump to the  previous  Clinical Focus box. Jump to the  next  Clinical Focus box. \n 20.5   Fluorescent Antibody Techniques \n\n Learning Objectives \n\n Describe the benefits of immunofluorescent antibody assays in comparison to nonfluorescent assays \n\n Compare direct and indirect fluorescent antibody assays \n\n Explain how a flow cytometer can be used to quantify specific subsets of cells present in a complex mixture of cell types \n\n Explain how a fluorescence-activated cell sorter can be used to separate unique types of cells \n\n Rapid visualization of bacteria from a clinical sample such as a throat swab or sputum can be achieved through  fluorescent antibody (FA) techniques  that attach a fluorescent marker ( fluorogen ) to the constant region of an antibody, resulting in a reporter molecule that is quick to use, easy to see or measure, and able to bind to target markers with high specificity. We can also label cells, allowing us to precisely quantify particular subsets of cells or even purify these subsets for further research. \n\n As with the enzyme assays, FA methods may be direct, in which a labeled mAb binds an antigen, or indirect, in which secondary polyclonal antibodies bind patient antibodies that react to a prepared antigen. Applications of these two methods were demonstrated in  Figure 2.19 . FA methods are also used in automated cell counting and sorting systems to enumerate or segregate labeled subpopulations of cells in a sample. \n\n Direct Fluorescent Antibody Techniques \n\n Direct fluorescent antibody (DFA) tests  use a fluorescently labeled mAb to bind and illuminate a target antigen. DFA tests are particularly useful for the rapid diagnosis of bacterial diseases. For example, fluorescence-labeled antibodies against  Streptococcus pyogenes  ( group A strep ) can be used to obtain a diagnosis of  strep throat  from a throat swab. The diagnosis is ready in a matter of minutes, and the patient can be started on antibiotics before even leaving the clinic. DFA techniques may also be used to diagnose pneumonia caused by  Mycoplasma pneumoniae  or  Legionella pneumophila  from sputum samples ( Figure 20.28 ). The fluorescent antibodies bind to the bacteria on a microscope slide, allowing ready detection of the bacteria using a  fluorescence microscope . Thus, the DFA technique is valuable for visualizing certain bacteria that are difficult to isolate or culture from patient samples. \n\n Link to Learning \n\n Watch the  animation  on this page to review the procedures of the direct fluorescent antibody test. \n\n Check Your Understanding \n\n In a direct fluorescent antibody test, what does the fluorescent antibody bind to? \n\n Indirect Fluorescent Antibody Techniques \n\n Indirect fluorescent antibody (IFA) tests  ( Figure 20.29 ) are used to look for antibodies in patient serum. For example, an IFA test for the diagnosis of  syphilis  uses  T. pallidum  cells isolated from a lab animal (the bacteria cannot be grown on lab media) and a smear prepared on a glass slide. Patient serum is spread over the smear and anti-treponemal antibodies, if present, are allowed to bind. The serum is washed off and a secondary antibody added. The  secondary antibody  is an antihuman immunoglobulin conjugated to a  fluorogen . On examination, the  T. pallidum  bacteria will only be visible if they have been bound by the antibodies from the patient\u2019s serum. \n\n The IFA test for syphilis provides an important complement to the  VDRL test  discussed in  Detecting Antigen-Antibody Complexes . The VDRL is more likely to generate false-positive reactions than the IFA test; however, the VDRL is a better test for determining whether an infection is currently active. \n\n IFA tests are also useful for the diagnosis of autoimmune diseases. For example,  systemic lupus erythematosus  (SLE) (see  Autoimmune Disorders ) is characterized by elevated expression levels of  antinuclear antibodies  (ANA). These autoantibodies can be expressed against a variety of DNA-binding proteins and even against DNA itself. Because autoimmunity is often difficult to diagnose, especially early in disease progression, testing for ANA can be a valuable clue in making a diagnosis and starting appropriate treatment. \n\n The IFA for ANA begins by fixing cells grown in culture to a glass slide and making them permeable to antibody. The slides are then incubated with serial dilutions of serum from the patient. After incubation, the slide is washed to remove unbound proteins, and the fluorescent antibody (antihuman IgG conjugated to a fluorogen) added. After an incubation and wash, the cells can be examined for fluorescence evident around the nucleus ( Figure 20.30 ). The  titer  of ANA in the serum is determined by the highest dilution showing fluorescence. Because many healthy people express ANA, the American College of Rheumatology recommends that the titer must be at least 1:40 in the presence of symptoms involving two or more organ systems to be considered indicative of SLE. 11 11 Gill, James M., ANNA M. Quisel, PETER V. Rocca, and DENE T. Walters. \u201cDiagnosis of systemic lupus erythematosus.\u201d  American family physician  68, no. 11 (2003): 2179-2186. \n\n Check Your Understanding \n\n In an indirect fluorescent antibody test, what does the fluorescent antibody bind to? \n\n What is the ANA test looking for? \n\n Flow Cytometry \n\n Fluorescently labeled antibodies can be used to quantify cells of a specific type in a complex mixture using  flow cytometry  ( Figure 20.31 ), an  automated, cell-counting  system that detects fluorescing cells as they pass through a narrow tube one cell at a time. For example, in  HIV  infections, it is important to know the level of CD4 T cells in the patient\u2019s blood; if the numbers fall below 500 per \u03bcL of blood, the patient becomes more likely to acquire opportunistic infections; below 200 per \u03bcL, the patient can no longer mount a useful adaptive immune response at all. The analysis begins by incubating a mixed-cell population (e.g., white blood cells from a donor) with a fluorescently labeled mAb specific for a subpopulation of cells (e.g., anti-CD4). Some experiments look at two cell markers simultaneously by adding a different fluorogen to the appropriate mAb. The cells are then introduced to the flow cytometer through a narrow capillary that forces the cells to pass in single file. A laser is used to activate the fluorogen. The fluorescent light radiates out in all directions, so the fluorescence detector can be positioned at an angle from the incident laser light. \n\n Figure 20.31  shows the obscuration bar in front of the forward-scatter detector that prevents laser light from hitting the detector. As a cell passes through the laser bar, the forward-scatter detector detects light scattered around the obscuration bar. The scattered light is transformed into a voltage pulse, and the cytometer counts a cell. The fluorescence from a labeled cell is detected by the side-scatter detectors. The light passes through various dichroic mirrors such that the light emitted from the fluorophore is received by the correct detector. \n\n Data are collected from both the forward- and side-scatter detectors. One way these data can be presented is in the form of a histogram. The forward scatter is placed on the  y -axis (to represent the number of cells), and the side scatter is placed on the  x -axis (to represent the fluoresence of each cell). The scaling for the  x -axis is logarithmic, so fluorescence intensity increases by a factor of 10 with each unit increase along the axis.  Figure 20.32  depicts an example in which a culture of cells is combined with an antibody attached to a fluorophore to detect CD8 cells and then analyzed by flow cytometry. The histogram has two peaks. The peak on the left has lower fluorescence readings, representing the subset of the cell population (approximately 30 cells) that does not fluoresce; hence, they are not bound by antibody and therefore do not express CD8. The peak on the right has higher fluorescence readings, representing the subset of the cell population (approximately 100 cells) that show fluorescence; hence, they are bound by the antibody and therefore do express CD8. \n\n Check Your Understanding \n\n What is the purpose of the laser in a flow cytometer? \n\n In the output from a flow cytometer, the area under the histogram is equivalent to what? \n\n Clinical Focus Resolution After notifying all 1300 patients, the hospital begins scheduling HIV screening. Appointments were scheduled a minimum of 3 weeks after the patient\u2019s last hospital visit to minimize the risk of false negatives. Because some false positives were anticipated, the public health physician set up a counseling protocol for any patient whose indirect ELISA came back positive. \n\n Of the 1300 patients, eight tested positive using the ELISA. Five of these tests were invalidated by negative western blot tests, but one western blot came back positive, confirming that the patient had indeed contracted HIV. The two remaining western blots came back indeterminate. These individuals had to submit to a third test, a PCR, to confirm the presence or absence of HIV sequences. Luckily, both patients tested negative. \n\n As for the lone patient confirmed to have HIV, the tests cannot prove or disprove any connection to the syringes compromised by the former hospital employee. Even so, the hospital\u2019s insurance will fully cover the patient\u2019s treatment, which began immediately. \n\n Although we now have drugs that are typically effective at controlling the progression of HIV and AIDS, there is still no cure. If left untreated, or if the drug regimen fails, the patient will experience a gradual decline in the number of CD4 helper T cells, resulting in severe impairment of all adaptive immune functions. Even moderate declines of helper T cell numbers can result in immunodeficiency, leaving the patient susceptible to opportunistic infections. To monitor the status of the patient\u2019s helper T cells, the hospital will use flow cytometry. This sensitive test allows physicians to precisely determine the number of helper T cells so they can adjust treatment if the number falls below 500 cells/\u00b5L. \n\n Jump to the  previous  Clinical Focus box. \n\n Cell Sorting Using Immunofluorescence \n\n The flow cytometer and immunofluorescence can also be modified to sort cells from a single sample into purified subpopulations of cells for research purposes. This modification of the flow cytometer is called a  fluorescence-activated cell sorter (FACS) . In a FACS, fluorescence by a cell induces the device to put a charge on a droplet of the transporting fluid containing that cell. The charge is specific to the wavelength of the fluorescent light, which allows for differential sorting by those different charges. The sorting is accomplished by an electrostatic deflector that moves the charged droplet containing the cell into one collecting vessel or another. The process results in highly purified subpopulations of cells. \n\n One limitation of a FACS is that it only works on isolated cells. Thus, the method would work in sorting white blood cells, since they exist as isolated cells. But for cells in a tissue, flow cytometry can only be applied if we can excise the tissue and separate it into single cells (using proteases to cleave cell-cell adhesion molecules) without disrupting cell integrity. This method may be used on tumors, but more often, immunohistochemistry and immunocytochemistry are used to study cells in tissues. \n\n Link to Learning \n\n Watch videos to learn more about how  flow cytometry  and a  FACS  work. \n\n Check Your Understanding \n\n In fluorescence activated cell sorting, what characteristic of the target cells allows them to be separated? \n\n Table 20.5  compares the mechanisms of the fluorescent antibody techniques discussed in this section. \n\n Fluorescent Antibody Techniques \n\n Type of Assay \n\n Mechanism \n\n Examples \n\n Direct fluorescent antibody (DFA) \n\n Uses fluorogen-antibody conjugates to label bacteria from patient samples \n\n Visualizing  Legionella pneumophila  from a throat swab \n\n Indirect fluorescent antibody (IFA) \n\n Detects disease-specific antibodies in patent serum \n\n Diagnosing syphilis; detecting antinuclear antibodies (ANA) for lupus and other autoimmune diseases \n\n Flow cytometry \n\n Labels cell membranes with fluorogen-antibody conjugate markers excited by a laser; machine counts the cell and records the relative fluorescence \n\n Counting the number of fluorescently labeled CD4 or CD8 cells in a sample \n\n Fluorescence activated cell sorter (FACS) \n\n Form of flow cytometry that both counts cells and physically separates them into pools of high and low fluorescence cells \n\n Sorting cancer cells \n\n Table  20.5     ", "questions": [{"question": {"question_id": "fs-id1167662675117", "question_text": "For many uses in the laboratory, polyclonal antibodies work well, but for some types of assays, they lack sufficient ________ because they cross-react with inappropriate antigens.", "question_choices": ["specificity", "sensitivity", "accuracy", "reactivity"], "cloze_format": "For many uses in the laboratory, polyclonal antibodies work well, but for some types of assays, they lack sufficient ________ because they cross-react with inappropriate antigens.", "normal_format": "For many uses in the laboratory, polyclonal antibodies work well, but they cross-react with inappropriate antigens for some types of assays due to lack of what?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Some types of assays require better antibody specificity and affinity than can be obtained using a polyclonal antiserum .", "hl_context": "<hl> Some types of assays require better antibody specificity and affinity than can be obtained using a polyclonal antiserum . <hl> To attain this high specificity , all of the antibodies must bind with high affinity to a single epitope . This high specificity can be provided by monoclonal antibodies ( mAbs ) . Table 20.1 compares some of the important characteristics of monoclonal and polyclonal antibodies ."}, {"question": {"question_id": "fs-id1167662601526", "question_text": "How are monoclonal antibodies produced?", "question_choices": ["Antibody-producing B cells from a mouse are fused with myeloma cells and then the cells are grown in tissue culture.", "A mouse is injected with an antigen and then antibodies are harvested from its serum.", "They are produced by the human immune system as a natural response to an infection.", "They are produced by a mouse\u2019s immune system as a natural response to an infection."], "cloze_format": "The way monoclonal antibodies are produced is ___ .", "normal_format": "How are monoclonal antibodies produced?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Unlike polyclonal antibodies , which are produced in live animals , monoclonal antibodies are produced in vitro using tissue-culture techniques . Since normal B cells are unable to proliferate forever , they are fused with immortal , cancerous B cells called myeloma cells , to yield hybridoma cells . All of the cells are then placed in a selective medium that allows only the hybridomas to grow ; unfused myeloma cells cannot grow , and any unfused B cells die off . The hybridomas , which are capable of growing continuously in culture while producing antibodies , are then screened for the desired mAb . Those producing the desired mAb are grown in tissue culture ; the culture medium is harvested periodically and mAbs are purified from the medium .", "hl_context": "<hl> Unlike polyclonal antibodies , which are produced in live animals , monoclonal antibodies are produced in vitro using tissue-culture techniques . <hl> mAbs are produced by immunizing an animal , often a mouse , multiple times with a specific antigen . B cells from the spleen of the immunized animal are then removed . <hl> Since normal B cells are unable to proliferate forever , they are fused with immortal , cancerous B cells called myeloma cells , to yield hybridoma cells . <hl> <hl> All of the cells are then placed in a selective medium that allows only the hybridomas to grow ; unfused myeloma cells cannot grow , and any unfused B cells die off . <hl> <hl> The hybridomas , which are capable of growing continuously in culture while producing antibodies , are then screened for the desired mAb . <hl> <hl> Those producing the desired mAb are grown in tissue culture ; the culture medium is harvested periodically and mAbs are purified from the medium . <hl> This is a very expensive and time-consuming process . It may take weeks of culturing and many liters of media to provide enough mAbs for an experiment or to treat a single patient . mAbs are expensive ( Figure 20.4 ) ."}, {"question": {"question_id": "fs-id1167661533529", "question_text": "The formation of ________ is a positive result in the VDRL test.", "question_choices": ["flocculant", "precipitin", "coagulation", "a bright pink color"], "cloze_format": "The formation of ________ is a positive result in the VDRL test.", "normal_format": "Which formation is a positive result in the VDRL test?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "To perform the VDRL test , patient serum or cerebral spinal fluid is placed on a slide with a mixture of cardiolipin ( an antigenic phospholipid found in the mitochondrial membrane of various pathogens ) , lecithin , and cholesterol . The lecithin and cholesterol stabilize the reaction and diminish false positives . Anti-treponemal antibodies from an infected patient \u2019 s serum will bind cardiolipin and form a flocculant . Although the VDRL test is more specific than the original Wassermann assay , false positives may still occur in patients with autoimmune diseases that cause extensive cell damage ( e . g . , systemic lupus erythematosus ) .", "hl_context": "<hl> To perform the VDRL test , patient serum or cerebral spinal fluid is placed on a slide with a mixture of cardiolipin ( an antigenic phospholipid found in the mitochondrial membrane of various pathogens ) , lecithin , and cholesterol . <hl> <hl> The lecithin and cholesterol stabilize the reaction and diminish false positives . <hl> <hl> Anti-treponemal antibodies from an infected patient \u2019 s serum will bind cardiolipin and form a flocculant . <hl> <hl> Although the VDRL test is more specific than the original Wassermann assay , false positives may still occur in patients with autoimmune diseases that cause extensive cell damage ( e . g . , systemic lupus erythematosus ) . <hl>"}, {"question": {"question_id": "fs-id1167663731676", "question_text": "The titer of a virus neutralization test is the highest dilution of patient serum", "question_choices": ["in which there is no detectable viral DNA.", "in which there is no detectable viral protein.", "that completely blocks plaque formation.", "that reduces plaque formation by at least 50%."], "cloze_format": "The titer of a virus neutralization test is the highest dilution of patient serum ___.", "normal_format": "What is the purpose of a virus neutralization test titer, which is the highest dilution of patient serum?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "bloom": null, "hl_sentences": "The suspensions are then added to host cells in culture to allow any nonneutralized virus to infect the cells and form plaques after several days . The titer is defined as the reciprocal of the highest dilution showing a 50 % reduction in plaques .", "hl_context": "During the course of a viral infection , the patient will mount an antibody response to the virus , and we can quantify those antibodies using a plaque reduction assay . To perform the assay , a serial dilution is carried out on a serum sample . Each dilution is then mixed with a standardized amount of the suspect virus . Any virus-specific antibodies in the serum will neutralize some of the virus . <hl> The suspensions are then added to host cells in culture to allow any nonneutralized virus to infect the cells and form plaques after several days . <hl> <hl> The titer is defined as the reciprocal of the highest dilution showing a 50 % reduction in plaques . <hl> Titer is always expressed as a whole number . For example , if a 1/64 dilution was the highest dilution to show 50 % plaque reduction , then the titer is 64 ."}, {"question": {"question_id": "fs-id1167663980082", "question_text": "In the Ouchterlony assay, we see a sharp precipitin arc form between antigen and antiserum. Why does this arc remain visible for a long time?", "question_choices": ["The antibody molecules are too large to diffuse through the agar.", "The precipitin lattice is too large to diffuse through the agar.", "Methanol, added once the arc forms, denatures the protein and blocks diffusion.", "The antigen molecules are chemically coupled to the gel matrix."], "cloze_format": "The reason that this arc remains visible for a long time is that ___ .", "normal_format": "In the Ouchterlony assay, we see a sharp precipitin arc form between antigen and antiserum. Why does this arc remain visible for a long time?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "When agar is highly purified , it produces a clear , colorless gel . Proteins are able to diffuse through the gel , and precipitin arcs form between the wells at the zone of equivalence . Because the precipitin lattice is too large to diffuse through the gel , the arcs are firmly locked in place and easy to see ( Figure 20.8 ) . Ouchterlony Assay", "hl_context": "<hl> When agar is highly purified , it produces a clear , colorless gel . <hl> Holes are punched in the gel to form wells , and antigen and antisera are added to neighboring wells . <hl> Proteins are able to diffuse through the gel , and precipitin arcs form between the wells at the zone of equivalence . <hl> <hl> Because the precipitin lattice is too large to diffuse through the gel , the arcs are firmly locked in place and easy to see ( Figure 20.8 ) . <hl> <hl> Ouchterlony Assay <hl>"}, {"question": {"question_id": "fs-id1167661553228", "question_text": "We use antisera to distinguish between various ________ within a species of bacteria.", "question_choices": ["isotypes", "serovars", "subspecies", "lines"], "cloze_format": "We use antisera to distinguish between various ________ within a species of bacteria.", "normal_format": "To distinguish between various what we use antisera within a species of bacteria?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "Lancefield used antisera to show that different strains of the same species of streptococci express different versions of M protein , which explains why children can come down with strep throat repeatedly . The strains are called serovars because they are differentiated using antisera .", "hl_context": "<hl> Lancefield used antisera to show that different strains of the same species of streptococci express different versions of M protein , which explains why children can come down with strep throat repeatedly . <hl> Lancefield classified beta-hemolytic streptococci into many groups based on antigenic differences in group-specific polysaccharides located in the bacterial cell wall . <hl> The strains are called serovars because they are differentiated using antisera . <hl> Identifying the serovars present in a disease outbreak is important because some serovars may cause more severe disease than others ."}, {"question": {"question_id": "fs-id1167663929102", "question_text": "When using antisera to characterize bacteria, we will often link the antibodies to ________ to better visualize the agglutination.", "question_choices": ["latex beads", "red blood cells", "other bacteria", "white blood cells"], "cloze_format": "When using antisera to characterize bacteria, we will often link the antibodies to ________ to better visualize the agglutination.", "normal_format": "When using antisera to characterize bacteria, we will often link the antibodies to which of the following to better visualize the agglutination?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "To identify antibodies in a patient \u2019 s serum , the antigen of interest is attached to latex beads . When mixed with patient serum , the antibodies will bind the antigen , cross-linking the latex beads and causing the beads to agglutinate indirectly ; this indicates the presence of the antibody ( Figure 20.17 ) . A similar strategy is more commonly used today when identifying serovars of bacteria and viruses ; however , to improve visualization of the agglutination , the antibodies may be attached to inert latex beads . This technique is called an indirect agglutination assay ( or latex fixation assay ) , because the agglutination of the beads is a marker for antibody binding to some other antigen ( Figure 20.16 ) .", "hl_context": "<hl> To identify antibodies in a patient \u2019 s serum , the antigen of interest is attached to latex beads . <hl> <hl> When mixed with patient serum , the antibodies will bind the antigen , cross-linking the latex beads and causing the beads to agglutinate indirectly ; this indicates the presence of the antibody ( Figure 20.17 ) . <hl> This technique is most often used when looking for IgM antibodies , because their structure provides maximum cross-linking . One widely used example of this assay is a test for rheumatoid factor ( RF ) to confirm a diagnosis of rheumatoid arthritis . RF is , in fact , the presence of IgM antibodies that bind to the patient \u2019 s own IgG . RF will agglutinate IgG-coated latex beads . The method developed by Lancefield is a direct agglutination assay , since the bacterial cells themselves agglutinate . <hl> A similar strategy is more commonly used today when identifying serovars of bacteria and viruses ; however , to improve visualization of the agglutination , the antibodies may be attached to inert latex beads . <hl> <hl> This technique is called an indirect agglutination assay ( or latex fixation assay ) , because the agglutination of the beads is a marker for antibody binding to some other antigen ( Figure 20.16 ) . <hl> Indirect assays can be used to detect the presence of either antibodies or specific antigens ."}, {"question": {"question_id": "fs-id1167663617699", "question_text": "The antibody screening test that is done along with pretransfusion blood typing is used to ensure that the recipient", "question_choices": ["does not have a previously undetected bacterial or viral infection.", "is not immunocompromised.", "actually does have the blood type stated in the online chart.", "is not making antibodies against antigens outside the ABO or Rh systems."], "cloze_format": "The antibody screening test that is done along with pretransfusion blood typing is used to ensure that the recipient ___ .", "normal_format": "To ensure what about the recipient, the antibody screening test is done along with pretransfusion blood typing?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Red blood cells have many other antigens in addition to ABO and Rh . While most people are unlikely to have antibodies against these antigens , women who have had multiple pregnancies or patients who have had multiple transfusions may have them because of repeated exposure . For this reason , an antibody screen test is used to determine if such antibodies are present .", "hl_context": "<hl> Red blood cells have many other antigens in addition to ABO and Rh . <hl> <hl> While most people are unlikely to have antibodies against these antigens , women who have had multiple pregnancies or patients who have had multiple transfusions may have them because of repeated exposure . <hl> <hl> For this reason , an antibody screen test is used to determine if such antibodies are present . <hl> Patient serum is checked against commercially prepared , pooled , type O red blood cells that express these antigens . If agglutination occurs , the antigen to which the patient is responding must be identified and determined not to be present in the donor unit ."}, {"question": {"question_id": "fs-id1167663590104", "question_text": "The direct Coombs\u2019 test is designed to detect when people have a disease that causes them to", "question_choices": ["have an excessively high fever.", "quit making antibodies.", "make too many red blood cells.", "produce antibodies that bind to their own red blood cells."], "cloze_format": "The direct Coombs\u2019 test is designed to detect when people have a disease that causes them to ___ .", "normal_format": "The direct Coombs\u2019 test is designed to detect when people have the disease due to which causes?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The Coombs \u2019 test is often employed when a newborn has jaundice , yellowing of the skin caused by high blood concentrations of bilirubin , a product of the breakdown of hemoglobin in the blood . The Coombs \u2019 test is used to determine whether the child \u2019 s red blood cells have been bound by the mother \u2019 s antibodies . One common assay that uses hemagglutination is the direct Coombs \u2019 test , also called the direct antihuman globulin test ( DAT ) , which generally looks for nonagglutinating antibodies . The test can also detect complement attached to red blood cells .", "hl_context": "<hl> The Coombs \u2019 test is often employed when a newborn has jaundice , yellowing of the skin caused by high blood concentrations of bilirubin , a product of the breakdown of hemoglobin in the blood . <hl> <hl> The Coombs \u2019 test is used to determine whether the child \u2019 s red blood cells have been bound by the mother \u2019 s antibodies . <hl> These antibodies would activate complement , leading to red blood cell lysis and the subsequent jaundice . Other conditions that can cause positive direct Coombs \u2019 tests include hemolytic transfusion reactions , autoimmune hemolytic anemia , infectious mononucleosis ( caused by Epstein-Barr virus ) , syphilis , and Mycoplasma pneumonia . A positive direct Coombs \u2019 test may also be seen in some cancers and as an allergic reaction to some drugs ( e . g . , penicillin ) . Agglutination of red blood cells is called hemagglutination . <hl> One common assay that uses hemagglutination is the direct Coombs \u2019 test , also called the direct antihuman globulin test ( DAT ) , which generally looks for nonagglutinating antibodies . <hl> <hl> The test can also detect complement attached to red blood cells . <hl>"}, {"question": {"question_id": "fs-id1167661643289", "question_text": "Viral hemagglutination assays only work with certain types of viruses because", "question_choices": ["the virus must be able to cross-link red blood cells directly.", "the virus must be able to lyse red blood cells.", "the virus must not be able to lyse red blood cells.", "other viruses are too dangerous to work with in a clinical lab setting."], "cloze_format": "Viral hemagglutination assays only work with certain types of viruses because ___ .", "normal_format": "Why do viral hemagglutination assays only work with certain types of viruses?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "Antibodies that bind to red blood cells are not the only cause of hemagglutination . Some viruses also bind to red blood cells , and this binding can cause agglutination when the viruses cross-link the red blood cells .", "hl_context": "<hl> Antibodies that bind to red blood cells are not the only cause of hemagglutination . <hl> <hl> Some viruses also bind to red blood cells , and this binding can cause agglutination when the viruses cross-link the red blood cells . <hl> For example , influenza viruses have two different types of viral spikes called neuraminidase ( N ) and hemagglutinin ( H ) , the latter named for its ability to agglutinate red blood cells ( see Viruses ) . Thus , we can use red blood cells to detect the presence of influenza virus by direct hemagglutination assays ( HA ) , in which the virus causes visible agglutination of red blood cells . The mumps and rubella viruses can also be detected using HA ."}, {"question": {"question_id": "fs-id1167662784600", "question_text": "In an enzyme immunoassay, the enzyme", "question_choices": ["is bound by the antibody\u2019s antigen-binding site.", "is attached to the well of a microtiter plate.", "is conjugated to the suspect antigen.", "is bound to the constant region of the secondary antibody."], "cloze_format": "In an enzyme immunoassay, the enzyme ___ .", "normal_format": "What is the enzyme in an enzyme immunoassay?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Similar to the western blot , enzyme immunoassays ( EIAs ) use antibodies to detect the presence of antigens . There are many different types of EIAs , but they all involve an antibody molecule whose constant region binds an enzyme , leaving the variable region free to bind its specific antigen .", "hl_context": "<hl> Similar to the western blot , enzyme immunoassays ( EIAs ) use antibodies to detect the presence of antigens . <hl> However , EIAs differ from western blots in that the assays are conducted in microtiter plates or in vivo rather than on an absorbent membrane . <hl> There are many different types of EIAs , but they all involve an antibody molecule whose constant region binds an enzyme , leaving the variable region free to bind its specific antigen . <hl> The addition of a substrate for the enzyme allows the antigen to be visualized or quantified ( Figure 20.22 ) ."}, {"question": {"question_id": "fs-id1167662878234", "question_text": "In a lateral-flow pregnancy test, you see a blue band form on the control line and no band form on the test line. This is probably a ________ test for pregnancy.", "question_choices": ["positive", "false-positive", "false-negative", "negative"], "cloze_format": "In a lateral-flow pregnancy test, you see a blue band form on the control line and no band form on the test line. This is probably a ________ test for pregnancy.", "normal_format": "In a lateral-flow pregnancy test, you see a blue band form on the control line and no band form on the test line. This is probably which test for pregnancy?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "bloom": null, "hl_sentences": "In lateral flow tests ( Figure 20.27 ) , fluids such as urine are applied to an absorbent pad on the test strip . The antibody-antigen complexes then flow over a second stripe that has immobilized antibody against the antigen ; this stripe will retain the beads that have bound antigen . A third control stripe binds any beads . A red color ( from gold particles ) or blue ( from latex beads ) developing at the test line indicates a positive test . If the color only develops at the control line , the test is negative .", "hl_context": "<hl> In lateral flow tests ( Figure 20.27 ) , fluids such as urine are applied to an absorbent pad on the test strip . <hl> The fluid flows by capillary action and moves through a stripe of beads with antibodies attached to their surfaces . The fluid in the sample actually hydrates the reagents , which are present in a dried state in the stripe . Antibody-coated beads made of latex or tiny gold particles will bind antigens in the test fluid . <hl> The antibody-antigen complexes then flow over a second stripe that has immobilized antibody against the antigen ; this stripe will retain the beads that have bound antigen . <hl> <hl> A third control stripe binds any beads . <hl> <hl> A red color ( from gold particles ) or blue ( from latex beads ) developing at the test line indicates a positive test . <hl> <hl> If the color only develops at the control line , the test is negative . <hl>"}, {"question": {"question_id": "fs-id1167660204573", "question_text": "When performing an FEIA, the fluorogen replaces the ________ that is used in an EIA.", "question_choices": ["antigen", "chromogenic substrate", "enzyme", "secondary antibody"], "cloze_format": "When performing an FEIA, the fluorogen replaces the ________ that is used in an EIA.", "normal_format": "When performing an FEIA, what does the fluorogen replace that is used in an EIA?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "In EIAs , the substrate for the enzyme is most often a chromogen , a colorless molecule that is converted into a colored end product . In some EIAs , the substrate is a fluorogen , a nonfluorescent molecule that the enzyme converts into a fluorescent form . EIAs that utilize a fluorogen are called fluorescent enzyme immunoassays ( FEIAs ) .", "hl_context": "<hl> In EIAs , the substrate for the enzyme is most often a chromogen , a colorless molecule that is converted into a colored end product . <hl> The most widely used enzymes are alkaline phosphatase and horseradish peroxidase for which appropriate substrates are readily available . <hl> In some EIAs , the substrate is a fluorogen , a nonfluorescent molecule that the enzyme converts into a fluorescent form . <hl> <hl> EIAs that utilize a fluorogen are called fluorescent enzyme immunoassays ( FEIAs ) . <hl> Fluorescence can be detected by either a fluorescence microscope or a spectrophotometer ."}, {"question": {"question_id": "fs-id1167660303770", "question_text": "In a direct fluorescent antibody test, which of the following would we most likely be looking for using a fluorescently-labeled mAb?", "question_choices": ["bacteria in a patient sample", "bacteria isolated from a patient and grown on agar plates", "antiserum from a patient smeared onto a glass slide", "antiserum from a patient that had bound to antigen-coated beads"], "cloze_format": "In a direct fluorescent antibody test, we would most likely be looking for___ using a fluorescently-labeled mAb.", "normal_format": "In a direct fluorescent antibody test, which of the following would we most likely be looking for using a fluorescently-labeled mAb?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "Direct fluorescent antibody ( DFA ) tests use a fluorescently labeled mAb to bind and illuminate a target antigen . Thus , the DFA technique is valuable for visualizing certain bacteria that are difficult to isolate or culture from patient samples .", "hl_context": "<hl> Direct fluorescent antibody ( DFA ) tests use a fluorescently labeled mAb to bind and illuminate a target antigen . <hl> DFA tests are particularly useful for the rapid diagnosis of bacterial diseases . For example , fluorescence-labeled antibodies against Streptococcus pyogenes ( group A strep ) can be used to obtain a diagnosis of strep throat from a throat swab . The diagnosis is ready in a matter of minutes , and the patient can be started on antibiotics before even leaving the clinic . DFA techniques may also be used to diagnose pneumonia caused by Mycoplasma pneumoniae or Legionella pneumophila from sputum samples ( Figure 20.28 ) . The fluorescent antibodies bind to the bacteria on a microscope slide , allowing ready detection of the bacteria using a fluorescence microscope . <hl> Thus , the DFA technique is valuable for visualizing certain bacteria that are difficult to isolate or culture from patient samples . <hl>"}], "summary": " Summary 20.1   Polyclonal and Monoclonal Antibody Production \n\n Antibodies bind with high  specificity  to antigens used to challenge the immune system, but they may also show  cross-reactivity  by binding to other antigens that share chemical properties with the original antigen. \n\n Injection of an antigen into an animal will result in a  polyclonal antibody  response in which different antibodies are produced that react with the various epitopes on the antigen. \n\n Polyclonal antisera  are useful for some types of laboratory assays, but other assays require more specificity. Diagnostic tests that use polyclonal antisera are typically only used for screening because of the possibility of  false-positive  and  false-negative  results. \n\n Monoclonal antibodies  provide higher specificity than polyclonal antisera because they bind to a single epitope and usually have high  affinity . \n\n Monoclonal antibodies are typically produced by culturing antibody-secreting  hybridomas  derived from mice. mAbs are currently used to treat cancer, but their exorbitant cost has prevented them from being used more widely to treat infectious diseases. Still, their potential for laboratory and clinical use is driving the development of new, cost-effective solutions such as  plantibodies . \n\n 20.2   Detecting Antigen-Antibody Complexes \n\n When present in the correct ratio, antibody and antigen will form a  precipitin , or lattice that precipitates out of solution. \n\n A  precipitin ring test  can be used to visualize lattice formation in solution. The  Ouchterlony assay  demonstrates lattice formation in a gel. The  radial immunodiffusion  assay is used to quantify antigen by measuring the size of a precipitation zone in a gel infused with antibodies. \n\n Insoluble antigens in suspension will form  flocculants  when bound by antibodies. This is the basis of the VDRL test for syphilis in which anti-treponemal antibodies bind to cardiolipin in suspension. \n\n Viral infections can be detected by quantifying virus-neutralizing antibodies in a patient\u2019s serum. \n\n Different antibody classes in plasma or serum are identified by using  immunoelectrophoresis . \n\n The presence of specific antigens (e.g., bacterial or viral proteins) in serum can be demonstrated by  western blot  assays, in which the proteins are transferred to a nitrocellulose membrane and identified using labeled antibodies. \n\n In the complement fixation test, complement is used to detect antibodies against various pathogens. \n\n 20.3   Agglutination Assays \n\n Antibodies can agglutinate cells or large particles into a visible matrix.  Agglutination  tests are often done on cards or in  microtiter plates  that allow multiple reactions to take place side by side using small volumes of reagents. \n\n Using antisera against certain proteins allows identification of  serovars  within species of bacteria. \n\n Detecting antibodies against a pathogen can be a powerful tool for diagnosing disease, but there is a period of time before patients go through  seroconversion  and the level of antibodies becomes detectable. \n\n Agglutination of latex beads in  indirect agglutination assays  can be used to detect the presence of specific antigens or specific antibodies in patient serum. \n\n The presence of some antibacterial and antiviral antibodies can be confirmed by the use of the direct  Coombs\u2019 test , which uses Coombs\u2019 reagent to cross-link antibodies bound to red blood cells and facilitate  hemagglutination . \n\n Some viruses and bacteria will bind and agglutinate red blood cells; this interaction is the basis of the  direct hemagglutination assay , most often used to determine the titer of virus in solution. \n\n Neutralization assays  quantify the level of virus-specific antibody by measuring the decrease in hemagglutination observed after mixing patient serum with a standardized amount of virus. \n\n Hemagglutination assays are also used to screen and  cross-match  donor and recipient blood to ensure that the transfusion recipient does not have antibodies to antigens in the donated blood. \n\n 20.4   EIAs and ELISAs \n\n Enzyme immunoassays (EIA)  are used to visualize and quantify antigens. They use an antibody conjugated to an enzyme to bind the antigen, and the enzyme converts a substrate into an observable end product. The substrate may be either a chromogen or a fluorogen. \n\n Immunostaining  is an EIA technique for visualizing cells in a tissue ( immunohistochemistry ) or examining intracellular structures ( immunocytochemistry ). \n\n Direct ELISA  is used to quantify an antigen in solution. The primary antibody captures the antigen, and the secondary antibody delivers an enzyme. Production of end product from the chromogenic substrate is directly proportional to the amount of captured antigen. \n\n Indirect ELISA  is used to detect antibodies in patient serum by attaching antigen to the well of a microtiter plate, allowing the patient (primary) antibody to bind the antigen and an enzyme-conjugated secondary antibody to detect the primary antibody. \n\n Immunofiltration and immunochromatographic assays  are used in  lateral flow tests , which can be used to diagnose pregnancy and various diseases by detecting color-labeled antigen-antibody complexes in urine or other fluid samples \n\n 20.5   Fluorescent Antibody Techniques \n\n Immunofluorescence  assays use antibody-fluorogen conjugates to illuminate antigens for easy, rapid detection. \n\n Direct immunofluorescence  can be used to detect the presence of bacteria in clinical samples such as sputum. \n\n Indirect immunofluorescence  detects the presence of antigen-specific antibodies in patient sera. The fluorescent antibody binds to the antigen-specific antibody rather than the antigen. \n\n The use of indirect immunofluorescence assays to detect  antinuclear antibodies  is an important tool in the diagnosis of several autoimmune diseases. \n\n Flow cytometry  uses fluorescent mAbs against cell-membrane proteins to quantify specific subsets of cells in complex mixtures. \n\n Fluorescence-activated cell sorters  are an extension of flow cytometry in which fluorescence intensity is used to physically separate cells into high and low fluorescence populations. ", "keyterm": "", "bname": "microbiology"}, {"chapter": 31, "intro": " Chapter Outline 31.1   The Reagan Revolution 31.2   Political and Cultural Fusions 31.3   A New World Order 31.4   Bill Clinton and the New Economy Introduction \n\n \u201cAct up!\u201d might be called the unofficial slogan of the 1980s. Numerous groups were concerned by what they considered disturbing social, cultural, and political trends in the United States and lobbied for their vision of what the nation should be. Conservative politicians cut taxes for the wealthy and shrank programs for the poor, while conservative Christians blamed the legalization of abortion and the increased visibility of gays and lesbians for weakening the American family. When the U.S. Centers for Disease Control first recognized the Acquired Immune Deficiency Syndrome (AIDS) in 1981, the Religious Right regarded it as a plague sent by God to punish homosexual men for their \u201cunnatural\u201d behavior. Politicians, many of whom relied on religious conservatives for their votes, largely ignored the AIDS epidemic. In response, gay men and women formed organizations such as ACT UP to draw attention to their cause ( Figure 31.1 ). \n\n Toward the end of the decade in 1989, protesters from both East and West Berlin began \u201cacting up\u201d and tearing down large chunks of the Berlin Wall, essentially dismantling the Iron Curtain. This symbolic act was the culmination of earlier demonstrations that had swept across Eastern Europe, resulting in the collapse of Communist governments in both Central and Eastern Europe, and marking the beginning of the end of the Cold War. ", "chapter_text": " 31.1   The Reagan Revolution Learning Objectives By the end of this section, you will be able to: \n\n Explain Ronald Reagan\u2019s attitude towards government \n\n Discuss the Reagan administration\u2019s economic policies and their effects on the nation \n\n Ronald Reagan entered the White House in 1981 with strongly conservative values but experience in moderate politics. He appealed to moderates and conservatives anxious about social change and the seeming loss of American power and influence on the world stage. Leading the so-called Reagan Revolution, he appealed to voters with the promise that the principles of conservatism could halt and revert the social and economic changes of the last generation. Reagan won the White House by citing big government and attempts at social reform as the problem, not the solution. He was able to capture the political capital of an unsettled national mood and, in the process, helped set an agenda and policies that would affect his successors and the political landscape of the nation. \n\n REAGAN\u2019S EARLY CAREER \n\n Although many of his movie roles and the persona he created for himself seemed to represent traditional values, Reagan\u2019s rise to the presidency was an unusual transition from pop cultural significance to political success. Born and raised in the Midwest, he moved to California in 1937 to become a Hollywood actor. He also became a reserve officer in the U.S. Army that same year, but when the country entered World War II, he was excluded from active duty overseas because of poor eyesight and spent the war in the army\u2019s First Motion Picture Unit. After the war, he resumed his film career; rose to leadership in the Screen Actors Guild, a Hollywood union; and became a spokesman for General Electric and the host of a television series that the company sponsored. As a young man, he identified politically as a liberal Democrat, but his distaste for communism, along with the influence of the social conservative values of his second wife, actress Nancy Davis, edged him closer to conservative Republicanism ( Figure 31.3 ). By 1962, he had formally switched political parties, and in 1964, he actively campaigned for the Republican presidential nominee Barry Goldwater. \n\n Reagan launched his own political career in 1966 when he successfully ran for governor of California. His opponent was the incumbent Pat Brown, a liberal Democrat who had already served two terms. Reagan, quite undeservedly, blamed Brown for race riots in California and student protests at the University of California at Berkeley. He criticized the Democratic incumbent\u2019s increases in taxes and state government, and denounced \u201cbig government\u201d and the inequities of taxation in favor of free enterprise. As governor, however, he quickly learned that federal and state laws prohibited the elimination of certain programs and that many programs benefited his constituents. He ended up approving the largest budget in the state\u2019s history and approved tax increases on a number of occasions. The contrast between Reagan\u2019s rhetoric and practice made up his political skill: capturing the public mood and catering to it, but compromising when necessary. \n\n REPUBLICANS BACK IN THE WHITE HOUSE \n\n After two unsuccessful Republican primary bids in 1968 and 1976, Reagan won the presidency in 1980. His victory was the result of a combination of dissatisfaction with the presidential leadership of Gerald Ford and Jimmy Carter in the 1970s and the growth of the  New Right . This group of conservative Americans included many very wealthy financial supporters and emerged in the wake of the social reforms and cultural changes of the 1960s and 1970s. Many were evangelical Christians, like those who joined Jerry Falwell\u2019s Moral Majority, and opposed the legalization of abortion, the feminist movement, and sex education in public schools. Reagan also attracted people, often dubbed neoconservatives, who would not previously have voted for the same candidate as conservative Protestants did. Many were middle- and working-class people who resented the growth of federal and state governments, especially benefit programs, and the subsequent increase in taxes during the late 1960s and 1970s. They favored the tax revolts that swept the nation in the late 1970s under the leadership of predominantly older, White, middle-class Americans, which had succeeded in imposing radical reductions in local property and state income taxes. \n\n Voter turnout reflected this new conservative swing, which not only swept Reagan into the White House but created a Republican majority in the Senate. Only 52 percent of eligible voters went to the polls in 1980, the lowest turnout for a presidential election since 1948. Those who did cast a ballot were older, Whiter, and wealthier than those who did not vote ( Figure 31.4 ). Strong support among White voters, those over forty-five years of age, and those with incomes over $50,000 proved crucial for Reagan\u2019s victory. \n\n REAGANOMICS \n\n Reagan\u2019s primary goal upon taking office was to stimulate the sagging economy while simultaneously cutting both government programs and taxes. His economic policies, called  Reaganomics  by the press, were based on a theory called supply-side economics, about which many economists were skeptical. Influenced by economist Arthur Laffer of the University of Southern California, Reagan cut income taxes for those at the top of the economic ladder, which was supposed to motivate the rich to invest in businesses, factories, and the stock market in anticipation of high returns. According to Laffer\u2019s argument, this would eventually translate into more jobs further down the socioeconomic ladder. Economic growth would also increase the total tax revenue\u2014even at a lower tax rate. In other words, proponents of \u201ctrickle-down economics\u201d promised to cut taxes and balance the budget at the same time. Reaganomics also included the deregulation of industry and higher interest rates to control inflation, but these initiatives preceded Reagan and were conceived in the Carter administration. \n\n Many politicians, including Republicans, were wary of Reagan\u2019s economic program; even his eventual vice president, George H. W. Bush, had referred to it as \u201cvoodoo economics\u201d when competing with him for the Republican presidential nomination. When Reagan proposed a 30 percent cut in taxes to be phased in over his first term in office, Congress balked. Opponents argued that the tax cuts would benefit the rich and not the poor, who needed help the most. In response, Reagan presented his plan directly to the people ( Figure 31.5 ). \n\n Reagan was an articulate spokesman for his political perspectives and was able to garner support for his policies. Often called \u201cThe Great Communicator,\u201d he was noted for his ability, honed through years as an actor and spokesperson, to convey a mixture of folksy wisdom, empathy, and concern while taking humorous digs at his opponents. Indeed, listening to Reagan speak often felt like hearing a favorite uncle recall stories about the \u201cgood old days\u201d before big government, expensive social programs, and greedy politicians destroyed the country ( Figure 31.6 ). Americans found this rhetorical style extremely compelling. Public support for the plan, combined with a surge in the president\u2019s popularity after he survived an assassination attempt in March 1981, swayed Congress, including many Democrats. On July 29, 1981, Congress passed the Economic Recovery Tax Act, which phased in a 25 percent overall reduction in taxes over a period of three years. \n\n My Story Richard V. Allen on the Assassination Attempt on Ronald Reagan On March 30, 1981, just months into the Reagan presidency, John Hinckley, Jr. attempted to assassinate the president as he left a speaking engagement at the Washington Hilton Hotel. Hinckley wounded Reagan and three others in the attempt. Here, National Security Adviser Richard V. Allen recalls what happened the day President Reagan was shot: \n\n By 2:52 PM I arrived at the White House and went to [Chief of Staff James] Baker\u2019s office . . . and we placed a call to Vice President George H. W. Bush. . . . \n\n[W]e sent a message with the few facts we knew: the bullets had been fired and press secretary Jim Brady had been hit, as had a Secret Service agent and a DC policeman. At first, the President was thought to be unscathed. \n\nJerry Parr, the Secret Service Detail Chief, shoved the President into the limousine, codenamed \u201cStagecoach,\u201d and slammed the doors shut. The driver sped off. Headed back to the safety of the White House, Parr noticed that the red blood at the President\u2019s mouth was frothy, indicating an internal injury, and suddenly switched the route to the hospital. . . . Parr saved the President\u2019s life. He had lost a serious quantity of blood internally and reached [the emergency room] just in time. . . . \n\nThough the President never lost his sense of humor throughout, and had actually walked into the hospital under his own power before his knees buckled, his condition became grave. \n\n Why do you think Allen mentions the president\u2019s sense of humor and his ability to walk into the hospital on his own? Why might the assassination attempt have helped Reagan achieve some of his political goals, such as getting his tax cuts through Congress? \n\n Reagan was successful at cutting taxes, but he failed to reduce government spending. Although he had long warned about the dangers of big government, he created a new cabinet-level agency, the Department of Veterans Affairs, and the number of federal employees increased during his time in office. He allocated a smaller share of the federal budget to antipoverty programs like Aid to Families with Dependent Children (AFDC), food stamps, rent subsidies, job training programs, and Medicaid, but Social Security and Medicare entitlements, from which his supporters benefited, were left largely untouched except for an increase in payroll taxes to pay for them. Indeed, in 1983, Reagan agreed to a compromise with the Democrats in Congress on a $165 billion injection of funds to save Social Security, which included this payroll tax increase. \n\n But Reagan seemed less flexible when it came to deregulating industry and weakening the power of labor unions. Banks and savings and loan associations were deregulated. Pollution control was enforced less strictly by the Environmental Protection Agency, and restrictions on logging and drilling for oil on public lands were relaxed. Believing the free market was self-regulating, the Reagan administration had little use for labor unions, and in 1981, the president fired twelve thousand federal air traffic controllers who had gone on strike to secure better working conditions (which would also have improved the public\u2019s safety). His action effectively destroyed the Professional Air Traffic Controllers Organization (PATCO) and ushered in a new era of labor relations in which, following his example, employers simply replaced striking workers. The weakening of unions contributed to the leveling off of real wages for the average American family during the 1980s. \n\n Reagan\u2019s economic policymakers succeeded in breaking the cycle of stagflation that had been plaguing the nation, but at significant cost. In its effort to curb high inflation with dramatically increased interest rates, the Federal Reserve also triggered a deep recession. Inflation did drop, but borrowing became expensive and consumers spent less. In Reagan\u2019s first years in office, bankruptcies increased and unemployment reached about 10 percent, its highest level since the Great Depression. Homelessness became a significant problem in cities, a fact the president made light of by suggesting that the press exaggerated the problem and that many homeless people chose to live on the streets. Economic growth resumed in 1983 and gross domestic product grew at an average of 4.5 percent during the rest of his presidency. By the end of Reagan\u2019s second term in office, unemployment had dropped to about 5.3 percent, but the nation was nearly $3 trillion in debt. An increase in defense spending coupled with $3.6 billion in tax relief for the 162,000 American families with incomes of $200,000 or more made a balanced budget, one of the president\u2019s campaign promises in 1980, impossible to achieve. \n\n The Reagan years were a complicated era of social, economic, and political change, with many trends operating simultaneously and sometimes at cross-purposes. While many suffered, others prospered. The 1970s had been the era of the hippie, and  Newsweek  magazine declared 1984 to be the \u201cyear of the  Yuppie .\u201d Yuppies, whose name derived from \u201c(y)oung, (u)rban (p)rofessionals,\u201d were akin to hippies in being young people whose interests, values, and lifestyle influenced American culture, economy, and politics, just as the hippies\u2019 credo had done in the late 1960s and 1970s. Unlike hippies, however, yuppies were materialistic and obsessed with image, comfort, and economic prosperity. Although liberal on some social issues, economically they were conservative. Ironically, some yuppies were former hippies or yippies, like Jerry Rubin, who gave up his crusade against \u201cthe establishment\u201d to become a businessman. \n 31.2   Political and Cultural Fusions Learning Objectives By the end of this section, you will be able to: \n\n Discuss the culture wars and political conflicts of the Reagan era \n\n Describe the Religious Right\u2019s response to the issues of the Reagan era \n\n Ronald Reagan\u2019s victory in 1980 suggested to conservatives that the days of liberalism were over and the liberal establishment might be dismantled. Many looked forward to the discontinuation of policies like affirmative action. Conservative Christians sought to outlaw abortion and stop the movement for gay and lesbian rights. Republicans, and some moderate Democrats, demanded a return to \u201ctraditional\u201d family values, a rhetorical ploy to suggest that male authority over women and children constituted a natural order that women\u2019s rights and the New Left had subverted since the 1960s. As the conservative message regarding the evils of government permeated society, distrust of the federal government grew, inspiring some to form organizations and communities that sought complete freedom from government control. \n\n CREATING CONSERVATIVE POLICY \n\n Ronald Reagan\u2019s popularity and effectiveness as a leader drew from his reputation as a man who fought for what he believed in. He was a very articulate spokesperson for a variety of political ideas based on conservative principles and perspectives. Much of the intellectual meat of the Reagan Revolution came from conservative think tanks (policy or advocacy groups) that specifically sought to shape American political and social dialogues. The  Heritage Foundation , one such group, soon became the intellectual arm of the conservative movement. \n\n Launched in 1973 with a $250,000 contribution from Joseph Coors (of Coors Brewing Company) and support from a variety of corporations and conservative foundations, the Heritage Foundation sought to counteract what conservatives believed to be Richard Nixon\u2019s acceptance of a liberal consensus on too many issues. In producing its policy position papers and political recommendations to conservative candidates and politicians, it helped contribute to a sanitization of U.S. history and a nostalgic glorification of what it deemed to be traditional values, seemingly threatened by the expansion of political and personal freedoms. The foundation had lent considerable support and encouragement to the conservative dialogues that helped carry Ronald Reagan into office in 1980. Just a year later, it produced a document entitled  Mandate for Leadership  that catalogued some two thousand specific recommendations on how to shrink the size and reach of the federal government and implement a more consistent conservative agenda. The newly elected Reagan administration looked favorably on the recommendations and recruited several of the paper\u2019s authors to serve in the White House. \n\n CONSERVATIVE CHRISTIANS AND FAMILY VALUES \n\n Among the strongest supporters of Ronald Reagan\u2019s campaign for president were members of the Religious Right, including Christian groups like the  Moral Majority , 61 percent of whom voted for him. By 1980, evangelical Christians had become an important political and social force in the United States ( Figure 31.7 ). Some thirteen hundred radio stations in the country were owned and operated by evangelicals. Christian television programs, such as Pat Robertson\u2019s  The 700 Club  and Jim Bakker\u2019s  The PTL  (Praise the Lord)  Club , proved enormously popular and raised millions of dollars from viewer contributions. For some, evangelism was a business, but most conservative Christians were true believers who were convinced that premarital and extramarital sex, abortion, drug use, homosexuality, and \u201cirreligious\u201d forms of popular and high culture were responsible for a perceived decline in traditional family values that threatened American society. \n\n Despite the support he received from Christian conservative and family values voters, Reagan was hardly an ideologue when it came to policy. Indeed, he was often quite careful in using hot button, family-value issues to his greatest political advantage. For example, as governor of California, one of the states that ratified the Equal Rights Amendment (ERA) in its first year, he positioned himself as a supporter of the amendment. When he launched his bid for the Republican nomination in 1976, however, he withdrew his support to gain the backing of more conservative members of his party. This move demonstrated both political savvy and foresight. At the time he withdrew his support, the Republican National Convention was still officially backing the amendment. However, in 1980, the party began to qualify its stance, which dovetailed with Reagan\u2019s candidacy for the White House. \n\n Reagan believed the Fourteenth Amendment to the Constitution was sufficient protection for women against discrimination. Once in office, he took a mostly neutral position, neither supporting nor working against the ERA. Nor did this middle position appear to hurt him at the polls; he attracted a significant number of votes from women in 1980, and in 1984, he polled 56 percent of the women\u2019s vote compared to 44 percent for the Democratic ticket of Walter Mondale and Geraldine Ferraro, the first female candidate for vice president from a major party. \n\n Defining American Phyllis Schlafly and the STOP ERA Movement In 1972, after a large number of states jumped to ratify the Equal Rights Amendment, most observers believed its ultimate ratification by all the necessary states was all but certain. But, a decade later, the amendment died without ever getting the necessary votes. There are many reasons it went down in defeat, but a major one was Phyllis Schlafly. \n\n On the surface, Schlafly\u2019s life might suggest that she would naturally support the ERA. After all, she was a well-educated, professional woman who sought advancement in her field and even aspired to high political office. Yet she is a fascinating historical character, precisely because her life and goals don\u2019t conform to expected norms. \n\n Schlafly\u2019s attack on the ERA was ingenious in its method and effectiveness. Rather than attacking the amendment directly as a gateway to unrestrained and immoral behavior as some had, she couched her opposition in language that was sensitive to both privilege and class. Her instrument was the STOP ERA movement, with the acronym STOP, standing for \u201cStop Taking our Privileges.\u201d Schlafly argued that women enjoyed special privileges such as gender-specific restrooms and exemption from the military draft. These, she claimed, would be lost should the ERA be ratified. But she also claimed to stand up for the dignity of being a homemaker and lambasted the feminist movement as elitist. In this, she was keenly aware of the power of class interests. Her organization suggested that privileged women could afford to support the ERA. Working women and poor housewives, however, would ultimately bear the brunt of the loss of protection it would bring. In the end, her tactics were successful in achieving exactly what the movement\u2019s name suggested; she stopped the ERA. \n\n Reagan\u2019s political calculations notwithstanding, his belief that traditional values were threatened by a modern wave of immoral popular culture was genuine. He recognized that nostalgia was a powerful force in politics, and he drew a picture for his audiences of the traditional good old days under attack by immorality and decline. \u201cThose of us who are over thirty-five or so years of age grew up in a different America,\u201d he explained in his farewell address. \u201cWe were taught, very directly, what it means to be an American. And we absorbed, almost in the air, a love of country and an appreciation of its institutions. . . . The movies celebrated democratic values and implicitly reinforced the idea that America was special.\u201d But this America, he insisted, was being washed away. \u201cI\u2019m warning of an eradication of the American memory that could result, ultimately, in an erosion of the American spirit.\u201d \n\n Concern over a decline in the country\u2019s moral values welled up on both sides of the political aisle. In 1985, anxiety over the messages of the music industry led to the founding of the  Parents Music Resource Center  (PMRC), a bipartisan group formed by the wives of prominent Washington politicians including Susan Baker, the wife of Reagan\u2019s treasury secretary, James Baker, and Tipper Gore, the wife of then-senator Al Gore, who later became vice president under Bill Clinton. The goal of the PMRC was to limit the ability of children to listen to music with sexual or violent content. Its strategy was to get the recording industry to adopt a voluntary rating system for music and recordings, similar to the Motion Picture Association of America\u2019s system for movies. \n\n The organization also produced a list of particularly offensive recordings known as the \u201cfilthy fifteen.\u201d By August 1985, nearly twenty record companies had agreed to put labels on their recordings indicating \u201cexplicit lyrics,\u201d but the Senate began hearings on the issue in September ( Figure 31.8 ). While many parents and a number of witnesses advocated the labels, many in the music industry rejected them as censorship.  Twisted Sister \u2019s Dee Snider and folk musician John Denver both advised Congress against the restrictions. In the end, the recording industry suggested a voluntary generic label. Its effect on children\u2019s exposure to raw language is uncertain, but musicians roundly mocked the effort. \n\n THE AIDS CRISIS \n\n In the early 1980s, doctors noticed a disturbing trend: Young gay men in large cities, especially San Francisco and New York, were being diagnosed with, and eventually dying from, a rare cancer called Kaposi\u2019s sarcoma. Because the disease was seen almost exclusively in male homosexuals, it was quickly dubbed \u201cgay cancer.\u201d Doctors soon realized it often coincided with other symptoms, including a rare form of pneumonia, and they renamed it \u201cGay Related Immune Deficiency\u201d (GRID), although people other than gay men, primarily intravenous drug users, were dying from the disease as well. The connection between gay men and GRID\u2014later renamed human immunodeficiency virus/autoimmune deficiency syndrome, or  HIV/AIDS \u2014led heterosexuals largely to ignore the growing health crisis in the gay community, wrongly assuming they were safe from its effects. The federal government also overlooked the disease, and calls for more money to research and find the cure were ignored. \n\n Even after it became apparent that heterosexuals could contract the disease through blood transfusions and heterosexual intercourse, HIV/AIDS continued to be associated primarily with the gay community, especially by political and religious conservatives. Indeed, the Religious Right regarded it as a form of divine retribution meant to punish gay men for their \u201cimmoral\u201d lifestyle. President Reagan, always politically careful, was reluctant to speak openly about the developing crisis even as thousands faced certain death from the disease. \n\n With little help coming from the government, the gay community quickly began to organize its own response. In 1982, New York City men formed the Gay Men\u2019s Health Crisis (GMHC), a volunteer organization that operated an information hotline, provided counseling and legal assistance, and raised money for people with HIV/AIDS. Larry Kramer, one of the original members, left in 1983 and formed his own organization, the AIDS Coalition to Unleash Power (ACT UP), in 1987. ACT UP took a more militant approach, holding demonstrations on Wall Street, outside the U.S. Food and Drug Administration (FDA), and inside the New York Stock Exchange to call attention and shame the government into action. One of the images adopted by the group, a pink triangle paired with the phrase \u201cSilence = Death,\u201d captured media attention and quickly became the symbol of the AIDS crisis ( Figure 31.9 ). \n\n THE WAR ON DRUGS AND THE ROAD TO MASS INCARCERATION \n\n As Ronald Reagan took office in 1981, violent crime in the United States was reaching an all-time high. While there were different reasons for the spike, the most important one was demographics: The primary category of offenders, males between the ages of sixteen and thirty-six, reached an all-time peak as the baby-boomer generation came of age. But the phenomenon that most politicians honed in on as a cause for violent crime was the abuse of a new, cheap drug dealt illegally on city streets. Crack cocaine, a smokable type of cocaine popular with poorer addicts, was hitting the streets in the 1980s, frightening middle-class Americans. Reagan and other conservatives led a campaign to \u201cget tough on crime\u201d and promised the nation a \u201c war on drugs .\u201d Initiatives like the \u201cJust Say No\u201d campaign led by First Lady Nancy Reagan implied that drug addiction and drug-related crime reflected personal morality. \n\n Nixon had first used the term in 1971, but in the 1980s the \u201cwar on drugs\u201d took on an ominous dimension, as politicians scrambled over each other to enact harsher sentences for drug offenses so they could market themselves as tough on crime. State after state switched from variable to mandatory minimum sentences that were exceedingly long and particularly harsh for street drug crimes. The federal government supported the trend with federal sentencing guidelines and additional funds for local law enforcement agencies. This law-and-order movement peaked in the 1990s, when California introduced a \u201cthree strikes\u201d law that mandated life imprisonment without parole for any third felony conviction\u2014even nonviolent ones. As a result, prisons became crowded, and states went deep into debt to build more. By the end of the century, the war began to die down as the public lost interest in the problem, the costs of the punishment binge became politically burdensome, and scholars and politicians began to advocate the decriminalization of drug use. By this time, however, hundreds of thousands of people had been incarcerated for drug offenses and the total number of prisoners in the nation had grown four-fold in the last quarter of the century. Particularly glaring were the racial inequities of the new age of mass incarceration, with African Americans being seven times more likely to be in prison ( Figure 31.10 ). \n 31.3   A New World Order Learning Objectives By the end of this section, you will be able to: \n\n Describe the successes and failures of Ronald Reagan\u2019s foreign policy \n\n Compare the policies of Ronald Reagan with those of George H. W. Bush \n\n Explain the causes and results of the Persian Gulf War \n\n Discuss the events that constituted the end of the Cold War \n\n In addition to reviving the economy and reducing the size of the federal government, Ronald Reagan also wished to restore American stature in the world. He entered the White House a \u201ccold warrior\u201d and referred to the Soviet Union in a 1983 speech as an \u201cevil empire.\u201d Dedicated to upholding even authoritarian governments in foreign countries to keep them safe from Soviet influence, he was also desperate to put to rest  Vietnam Syndrome , the reluctance to use military force in foreign countries for fear of embarrassing defeat, which had influenced U.S. foreign policy since the mid-1970s. \n\n THE MIDDLE EAST AND CENTRAL AMERICA \n\n Reagan\u2019s desire to demonstrate U.S. readiness to use military force abroad sometimes had tragic consequences. In 1983, he sent soldiers to Lebanon as part of a multinational force trying to restore order following an Israeli invasion the year before. On October 23, more than two hundred troops were killed in a barracks bombing in Beirut carried out by Iranian-trained militants known as Hezbollah ( Figure 31.11 ). In February 1984, Reagan announced that, given intensified fighting, U.S. troops were being withdrawn. \n\n Two days after the bombing in Beirut, Reagan and Secretary of State George P. Shultz authorized the invasion of Grenada, a small Caribbean island nation, in an attempt to oust a Communist military junta that had overthrown a moderate regime. Communist Cuba already had troops and technical aid workers stationed on the island and were willing to defend the new regime, but the United States swiftly took command of the situation, and the Cuban soldiers surrendered after two days. \n\n Reagan\u2019s intervention in Grenada was intended to send a message to Marxists in Central America. Meanwhile, however, decades of political repression and economic corruption by certain Latin American governments, sometimes generously supported by U.S. foreign aid, had sown deep seeds of revolutionary discontent. In El Salvador, a 1979 civil-military coup had put a military junta in power that was engaged in a civil war against left-leaning guerillas when Reagan took office. His administration supported the right-wing government, which used death squads to silence dissent. \n\n Neighboring Nicaragua was also governed by a largely Marxist-inspired group, the Sandinistas. This organization, led by Daniel Ortega, had overthrown the brutal, right-wing dictatorship of Anastasio Somoza in 1979. Reagan, however, overlooked the legitimate complaints of the Sandinistas and believed that their rule opened the region to Cuban and Soviet influence. A year into his presidency, convinced it was folly to allow the expansion of Soviet and Communist influence in Latin America, he authorized the Central Intelligence Agency (CIA) to equip and train a group of anti-Sandinista Nicaraguans known as the  Contras  ( contrarevolucion\u00e1rios  or \u201ccounter-revolutionaries\u201d) to oust Ortega. \n\n Reagan\u2019s desire to aid the Contras even after Congress ended its support led him, surprisingly, to Iran. In September 1980, Iraq had invaded neighboring Iran and, by 1982, had begun to gain the upper hand. The Iraqis needed weapons, and the Reagan administration, wishing to assist the enemy of its enemy, had agreed to provide Iraqi president Saddam Hussein with money, arms, and military intelligence. In 1983, however, the capture of Americans by Hezbollah forces in Lebanon changed the president\u2019s plans. In 1985, he authorized the sale of anti-tank and anti-aircraft missiles to Iran in exchange for help retrieving three of the American hostages. \n\n A year later, Reagan\u2019s National Security Council aide, Lieutenant Colonel Oliver North, found a way to sell weapons to Iran and secretly use the proceeds to support the Nicaraguan Contras\u2014in direct violation of a congressional ban on military aid to the anti-Communist guerillas in that Central American nation. Eventually the Senate became aware, and North and others were indicted on various charges, which were all dismissed, overturned on appeal, or granted presidential pardon. Reagan, known for delegating much authority to subordinates and unable to \u201cremember\u201d crucial facts and meetings, escaped the scandal with nothing more than criticism for his lax oversight. The nation was divided over the extent to which the president could go to \u201cprotect national interests,\u201d and the limits of Congress\u2019s constitutional authority to oversee the activities of the executive branch have yet to be resolved. \n\n THE COLD WAR WAXES AND WANES \n\n While trying to shrink the federal budget and the size of government sphere at home, Reagan led an unprecedented military buildup in which money flowed to the Pentagon to pay for expensive new forms of weaponry. The press drew attention to the inefficiency of the nation\u2019s military industrial complex, offering as examples expense bills that included $640 toilet seats and $7,400 coffee machines. One of the most controversial aspects of Reagan\u2019s plan was the Strategic Defense Initiative (SDI), which he proposed in 1983. SDI, or \u201cStar Wars,\u201d called for the development of a defensive shield to protect the United States from a Soviet missile strike. Scientists argued that much of the needed technology had not yet been developed and might never be. Others contended that the plan would violate existing treaties with the Soviet Union and worried about the Soviet response. The system was never built, and the plan, estimated to have cost some $7.5 billion, was finally abandoned. \n\n After his reelection in 1984, Reagan began to moderate his position toward the Soviets.  Mikhail Gorbachev became the General Secretary of the Soviet Communist Party and was willing to meet with the president.  Reagan found he was able to work with the Soviet leader once Gorbachev distanced himself from the traditional communist policies. The new and comparatively young Soviet premier did not want to commit additional funds for another arms race, especially since the war in Afghanistan against mujahedeen\u2014Islamic guerilla fighters\u2014had depleted the Soviet Union\u2019s resources severely since its invasion of the central Asian nation in 1979. Gorbachev recognized that economic despair at home could easily result in larger political upheavals like those in neighboring Poland, where the Solidarity movement had taken hold. He withdrew troops from Afghanistan, introduced political reforms and new civil liberties at home\u2014known as  perestroika  and  glasnost \u2014and proposed arms reduction talks with the United States. In 1985, Gorbachev and Reagan met in Geneva to reduce armaments and shrink their respective military budgets. The following year, meeting in Reykjav\u00edk, Iceland, they surprised the world by announcing that they would try to eliminate nuclear weapons by 1996. In 1987, they agreed to eliminate a whole category of nuclear weapons when they signed the Intermediate-Range Nuclear Forces (INF) Treaty at the White House ( Figure 31.12 ). This laid the foundation for future agreements limiting nuclear weapons. \n\n \u201cNO NEW TAXES\u201d \n\n Confident they could win back the White House, Democrats mounted a campaign focused on more effective and competent government under the leadership of Massachusetts governor Michael Dukakis. When George H. W. Bush, Reagan\u2019s vice president and Republican nominee, found himself down in the polls, political advisor Lee Atwater launched an aggressively negative media campaign, accusing Dukakis of being soft on crime and connecting his liberal policies to a brutal murder in Massachusetts. More importantly, Bush adopted a largely Reaganesque style on matters of economic policy, promising to shrink government and keep taxes low. These tactics were successful, and the Republican Party retained the White House. \n\n Although he promised to carry on Reagan\u2019s economic legacy, the problems Bush inherited made it difficult to do so. Reagan\u2019s policies of cutting taxes and increasing defense spending had exploded the federal budget deficit, making it three times larger in 1989 than when Reagan took office in 1980. Bush was further constrained by the emphatic pledge he had made at the 1988 Republican Convention\u2014\u201cread my lips: no new taxes\u201d\u2014and found himself in the difficult position of trying to balance the budget and reduce the deficit without breaking his promise. However, he also faced a Congress controlled by the Democrats, who wanted to raise taxes on the rich, while Republicans thought the government should drastically cut domestic spending. In October, after a brief government shutdown when Bush vetoed the budget Congress delivered, he and Congress reached a compromise with the Omnibus Budget Reconciliation Act of 1990. The budget included measures to reduce the deficit by both cutting government expenditures and raising taxes, effectively reneging on the \u201cno new taxes\u201d pledge. These economic constraints are one reason why Bush supported a limited domestic agenda of education reform and antidrug efforts, relying on private volunteers and community organizations, which he referred to as \u201ca thousand points of light,\u201d to address most social problems. \n\n When it came to foreign affairs, Bush\u2019s attitude towards the Soviet Union differed little from Reagan\u2019s. Bush sought to ease tensions with America\u2019s rival superpower and stressed the need for peace and cooperation. The desire to avoid angering the Soviets led him to adopt a hands-off approach when, at the beginning of his term, a series of pro-democracy demonstrations broke out across the Communist Eastern Bloc. \n\n In November 1989, the world\u2014including foreign policy experts and espionage agencies from both sides of the Iron Curtain\u2014watched in surprise as peaceful protesters in East Germany marched through checkpoints at the Berlin Wall. Within hours, people from both East and West Berlin flooded the checkpoints and began tearing down large chunks of the wall. Months of earlier demonstrations in East Germany had called on the government to allow citizens to leave the country. These demonstrations were one manifestation of a larger movement sweeping across East Germany, Poland, Hungary, Czechoslovakia, Bulgaria, and Romania, which swiftly led to revolutions, most of them peaceful, resulting in the collapse of Communist governments in Central and Eastern Europe. \n\n In Budapest in 1956 and in Prague in 1968, the Soviet Union had restored order through a large show of force. That this didn\u2019t happen in 1989 was an indication to all that the Soviet Union was itself collapsing. Bush\u2019s refusal to gloat or declare victory helped him maintain the relationship with Gorbachev that Reagan had established. In July 1991, Gorbachev and Bush signed the Strategic Arms Reduction Treaty, or  START , which committed their countries to reducing their nuclear arsenals by 25 percent. A month later, attempting to stop the changes begun by Gorbachev\u2019s reforms, Communist Party hardliners tried to remove him from power. Protests arose throughout the Soviet Union, and by December 1991, the nation had collapsed. In January 1992, twelve former Soviet republics formed the Commonwealth of Independent States to coordinate trade and security measures. The Cold War was over. \n\n AMERICAN GLOBAL POWER IN THE WAKE OF THE COLD WAR \n\n The dust had barely settled on the crumbling Berlin Wall when the Bush administration announced a bold military intervention in Panama in December 1989. Claiming to act on behalf of human rights, U.S. troops deposed the unpopular dictator and drug smuggler Manuel Noriega swiftly, but former CIA connections between President Bush and Noriega, as well as U.S. interests in maintaining control of the Canal Zone, prompted the United Nations and world public opinion to denounce the invasion as a power grab. \n\n As the Soviet Union was ceasing to be a threat, the Middle East became a source of increased concern. In the wake of its eight-year war with Iran from 1980 to 1988, Iraq had accumulated a significant amount of foreign debt. At the same time, other Arab states had increased their oil production, forcing oil prices down and further hurting Iraq\u2019s economy. Iraq\u2019s leader, Saddam Hussein, approached these oil-producing states for assistance, particularly Saudi Arabia and neighboring Kuwait, which Iraq felt directly benefited from its war with Iran. When talks with these countries broke down, and Iraq found itself politically and economically isolated, Hussein ordered the invasion of oil-rich Kuwait in August 1990. Bush faced his first full-scale international crisis. \n\n In response to the invasion, Bush and his foreign policy team forged an unprecedented international coalition of thirty-four countries, including many members of NATO (North Atlantic Treaty Organization) and the Middle Eastern countries of Saudi Arabia, Syria, and Egypt, to oppose Iraqi aggression. Bush hoped that this coalition would herald the beginning of a \u201cnew world order\u201d in which the nations of the world would work together to deter belligerence. A deadline was set for Iraq to withdraw from Kuwait by January 15, or face serious consequences. Wary of not having sufficient domestic support for combat, Bush first deployed troops to the area to build up forces in the region and defend Saudi Arabia via Operation Desert Shield ( Figure 31.13 ). On January 14, Bush succeeded in getting resolutions from Congress authorizing the use of military force against Iraq, and the U.S. then orchestrated an effective air campaign, followed by  Operation Desert Storm , a one-hundred-hour land war involving over 500,000 U.S. troops and another 200,000 from twenty-seven other countries, which expelled Iraqi forces from Kuwait by the end of February. \n\n Some controversy arose among Bush\u2019s advisors regarding whether to end the war without removing Saddam Hussein from power, but General Colin Powell, the head of the Joint Chiefs of Staff, argued that to continue to attack a defeated army would be \u201cun-American.\u201d Bush agreed and troops began moving out of the area in March 1991. Although Hussein was not removed from power, the war nevertheless suggested that the United States no longer suffered from \u201cVietnam Syndrome\u201d and would deploy massive military resources if and when it thought necessary. In April 1991, United Nations (UN) Resolution 687 set the terms of the peace, with long-term implications. Its concluding paragraph authorizing the UN to take such steps as necessary to maintain the peace was later taken as the legal justification for the further use of force, as in 1996 and 1998, when Iraq was again bombed. It was also referenced in the lead-up to the second invasion of Iraq in 2003, when it appeared that Iraq was refusing to comply with other UN resolutions. \n\n A CHANGING DOMESTIC LANDSCAPE \n\n By nearly every measure, Operation Desert Storm was a resounding success. Through deft diplomatic efforts on the international stage, Bush had ensured that many around the world saw the action as legitimate. By making the goals of the military action both clear and limited, he also reassured an American public still skeptical of foreign entanglements. With the Soviet Union vanishing from the world stage, and the United States demonstrating the extent of its diplomatic influence and military potency with President Bush at the helm, his reelection seemed all but inevitable. Indeed, in March 1991, the president had an approval rating of 89 percent. \n\n Despite Bush\u2019s successes internationally, the domestic situation at home was far more complicated. Unlike Reagan, Bush was not a natural culture warrior. Rather, he was a moderate, Connecticut-born Episcopalian, a pragmatic politician, and a life-long civil servant. He was not adept at catering to post-Reagan conservatives as his predecessor had been. By the same token, he appeared incapable of capitalizing on his history of moderation and pragmatism regarding women\u2019s rights and access to abortion. Together with a Democratic Senate, Bush broke new ground in civil rights with his support of the Americans with Disabilities Act, a far-reaching law that prohibited discrimination based on disability in public accommodations and by employers. \n\n President Bush\u2019s weaknesses as a culture warrior were on full display during the controversy that erupted following his nomination of a new Supreme Court judge. In 1991, Justice Thurgood Marshall, the first African American ever to sit on the Supreme Court, opted to retire, thus opening a position on the court. Thinking he was doing the prudent thing by appealing to multiple interests, Bush nominated Clarence Thomas, another African American but also a strong social conservative. The decision to nominate Thomas, however, proved to be anything but prudent. During Thomas\u2019 confirmation hearings before the Senate Judiciary Committee, Anita Hill, a lawyer who had worked for Thomas when he was chairman of the Equal Employment Opportunity Commission (EEOC), came forward with allegations that he had sexually harassed her when he was her supervisor. Thomas denied the accusations and referred to the televised hearings as a \u201chigh tech lynching.\u201d He survived the controversy and was appointed to the Supreme Court by a narrow Senate vote of fifty-two to forty-eight. Hill, also African American, noted later in frustration: \u201cI had a gender, he had a race.\u201d In the aftermath, however, sexual harassment of women in the workplace gained public attention, and harassment complaints made to the EEOC increased 50 percent by the fall of 1992. The controversy also reflected poorly on President Bush and may have hurt him with female voters in 1992. \n 31.4   Bill Clinton and the New Economy Learning Objectives By the end of this section, you will be able to: \n\n Explain political partisanship, antigovernment movements, and economic developments during the Clinton administration \n\n Discuss President Clinton\u2019s foreign policy \n\n Explain how George W. Bush won the election of 2000 \n\n By 1992, many had come to doubt that President George H. W. Bush could solve America\u2019s problems. He had alienated conservative Republicans by breaking his pledge not to raise taxes, and some faulted him for failing to remove Saddam Hussein from power during Operation Desert Storm. Furthermore, despite living much of his adult life in Texas, he could not overcome the stereotypes associated with his privileged New England and Ivy League background, which hurt him among working-class Reagan Democrats. \n\n THE ROAD TO THE WHITE HOUSE \n\n The contrast between George H. W. Bush and William Jefferson Clinton could not have been greater. Bill Clinton was a baby boomer born in 1946 in Hope, Arkansas. His biological father died in a car wreck three months before he was born. When he was a boy, his mother married Roger Clinton, an alcoholic who abused his family. However, despite a troubled home life, Clinton was an excellent student. He took an interest in politics from an early age. On a high school trip to Washington, DC, he met his political idol, President John F. Kennedy. As a student at Georgetown University, he supported both the civil rights and antiwar movements and ran for student council president ( Figure 31.14 ). \n\n In 1968, Clinton received a prestigious Rhodes scholarship to Oxford University. From Oxford he moved on to Yale, where he earned his law degree in 1973. He returned to Arkansas and became a professor at the University of Arkansas\u2019s law school. The following year, he tried his hand at state politics, running for Congress, and was narrowly defeated. In 1977, he became attorney general of Arkansas and was elected governor in 1978. Losing the office to his Republican opponent in 1980, he retook the governor\u2019s mansion in 1982 and remained governor of Arkansas until 1992, when he announced his candidacy for president. \n\n During his campaign, Bill Clinton described himself as a New Democrat, a member of a faction of the Democratic Party that, like the Republicans, favored free trade and deregulation. He tried to appeal to the middle class by promising higher taxes on the rich and reform of the welfare system. Although Clinton garnered only 43 percent of the popular vote, he easily won in the Electoral College with 370 votes to President Bush\u2019s 188. Texas billionaire H. Ross Perot won 19 percent of the popular vote, the best showing by any third-party candidate since 1912. The Democrats took control of both houses of Congress. \n\n \u201cIT\u2019S THE ECONOMY, STUPID\u201d \n\n Clinton took office towards the end of a recession. His administration\u2019s plans for fixing the economy included limiting spending and cutting the budget to reduce the nation\u2019s $60 billion deficit, keeping interest rates low to encourage private investment, and eliminating protectionist tariffs. Clinton also hoped to improve employment opportunities by allocating more money for education. In his first term, he expanded the Earned Income Tax Credit, which lowered the tax obligations of working families who were just above the poverty line. Addressing the budget deficit, the Democrats in Congress passed the Omnibus Budget Reconciliation Act of 1993 without a single Republican vote. The act raised taxes for the top 1.2 percent of the American people, lowered them for fifteen million low-income families, and offered tax breaks to 90 percent of small businesses. \n\n Clinton also strongly supported ratification of the North American Free Trade Agreement (NAFTA), a treaty that eliminated tariffs and trade restrictions among the United States, Canada, and Mexico. The treaty had been negotiated by the Bush administration, and the leaders of all three nations had signed it in December 1992. However, because of strong opposition from American labor unions and some in Congress who feared the loss of jobs to Mexico, the treaty had not been ratified by the time Clinton took office. To allay the concerns of unions, he added an agreement to protect workers and also one to protect the environment. Congress ratified NAFTA late in 1993. The result was the creation of the world\u2019s largest common market in terms of population, including some 425 million people. \n\n During Clinton\u2019s administration, the nation began to experience the longest period of economic expansion in its history, almost ten consecutive years. Year after year, job growth increased and the deficit shrank. Increased tax revenue and budget cuts turned the annual national budget deficit from close to $290 billion in 1992 to a record budget surplus of over $230 billion in 2000. Reduced government borrowing freed up capital for private-sector use, and lower interest rates in turn fueled more growth. During the Clinton years, more people owned homes than ever before in the country\u2019s history (67.7 percent). Inflation dipped to 2.3 percent and the unemployment rate declined, reaching a thirty-year low of 3.9 percent in 2000. \n\n Much of the prosperity of the 1990s was related to technological change and the advent of new information systems. In 1994, the Clinton administration became the first to launch an official White House website and join the revolution of the electronically mediated world. By the 1990s, a new world of instantaneous global exposure was at the fingertips of billions worldwide. \n\n Americana Hope and Anxiety in the Information Age While the roots of innovations like personal computers and the Internet go back to the 1960s and massive Department of Defense spending, it was in the 1980s and 90s that these technologies became part of everyday life. Like most technology-driven periods of transformation, the information age was greeted with a mixture of hope and anxiety upon its arrival. \n\n In the late 1970s and early 1980s, computer manufacturers like Apple, Commodore, and Tandy began offering fully assembled personal computers. (Previously, personal computing had been accessible only to those adventurous enough to buy expensive kits that had to be assembled and programmed.) In short order, computers became a fairly common sight in businesses and upper-middle-class homes ( Figure 31.15 ). Soon, computer owners, even young kids, were launching their own electronic bulletin board systems, small-scale networks that used modems and phone lines, and sharing information in ways not dreamed of just decades before. Computers, it seemed, held out the promise of a bright, new future for those who knew how to use them. \n\n Casting shadows over the bright dreams of a better tomorrow were fears that the development of computer technology would create a dystopian future in which technology became the instrument of society\u2019s undoing. Film audiences watched a teenaged Matthew Broderick hacking into a government computer and starting a nuclear war in  War Games , Angelina Jolie being chased by a computer genius bent on world domination in  Hackers , and Sandra Bullock watching helplessly as her life is turned inside out by conspirators who manipulate her virtual identity in  The Net . Clearly, the idea of digital network connections as the root of our demise resonated in this period of rapid technological change. \n\n DOMESTIC ISSUES \n\n In addition to shifting the Democratic Party to the moderate center on economic issues, Clinton tried to break new ground on a number of domestic issues and make good on traditional Democratic commitments to the disadvantaged, minority groups, and women. At the same time, he faced the challenge of domestic terrorism when a federal building in Oklahoma City was bombed, killing 168 people and injuring hundreds more. \n\n Healthcare Reform \n\n An important and popular part of Clinton\u2019s domestic agenda was healthcare reform that would make universal healthcare a reality. When the plan was announced in September of the president\u2019s first year in office, pollsters and commentators both assumed it would sail through. Many were unhappy with the way the system worked in the United States, where the cost of health insurance seemed increasingly unaffordable for the middle class. Clinton appointed his wife, Hillary Clinton, a Yale Law School graduate and accomplished attorney, to head his Task Force on National Health Care Reform in 1993. The 1,342-page Health Security Act presented to Congress that year sought to offer universal coverage ( Figure 31.16 ). All Americans were to be covered by a healthcare plan that could not reject them based on pre-existing medical conditions. Employers would be required to provide healthcare for their employees. Limits would be placed on the amount that people would have to pay for services; the poor would not have to pay at all. \n\n The outlook for the plan looked good in 1993; it had the support of a number of institutions like the American Medical Association and the Health Insurance Association of America. But in relatively short order, the political winds changed. As budget battles distracted the administration and the midterm elections of 1994 approached, Republicans began to recognize the strategic benefits of opposing reform. Soon they were mounting fierce opposition to the bill. Moderate conservatives dubbed the reform proposals \u201c Hillarycare \u201d and argued that the bill was an unwarranted expansion of the powers of the federal government that would interfere with people\u2019s ability to choose the healthcare provider they wanted. Those further to the right argued that healthcare reform was part of a larger and nefarious plot to control the public. \n\n To rally Republican opposition to Clinton and the Democrats, Newt Gingrich and Richard \u201cDick\u201d Armey, two of the leaders of the Republican minority in the House of Representatives, prepared a document entitled  Contract with America , signed by all but two of the Republican representatives. It listed eight specific legislative reforms or initiatives the Republicans would enact if they gained a majority in Congress in the 1994 midterm elections. \n\n Lacking support on both sides, the healthcare bill was never passed and died in Congress. The reform effort finally ended in September 1994. Dislike of the proposed healthcare plan on the part of conservatives and the bold strategy laid out in the Contract with America enabled the Republican Party to win seven Senate seats and fifty-two House seats in the November elections. The Republicans then used their power to push for conservative reforms. One such piece of legislation was the Personal Responsibility and Work Opportunity Reconciliation Act, signed into law in August 1996. The act set time limits on welfare benefits and required most recipients to begin working within two years of receiving assistance. \n\n Don\u2019t Ask, Don\u2019t Tell \n\n Although Clinton had campaigned as an economically conservative New Democrat, he was thought to be socially liberal and, just days after his victory in the 1992 election, he promised to end the fifty-year ban on gays and lesbians serving in the military. However, in January 1993, after taking the oath of office, Clinton amended his promise in order to appease conservatives. Instead of lifting the longstanding ban, the armed forces would adopt a policy of \u201cdon\u2019t ask, don\u2019t tell.\u201d Those on active duty would not be asked their sexual orientation and, if they were gay, they were not to discuss their sexuality openly or they would be dismissed from military service. This compromise satisfied neither conservatives seeking the exclusion of gays nor the gay community, which argued that homosexuals, like heterosexuals, should be able to live without fear of retribution because of their sexuality. \n\n Clinton again proved himself willing to appease political conservatives when he signed into law the Defense of Marriage Act (DOMA) in September 1996, after both houses of Congress had passed it with such wide margins that a presidential veto could easily be overridden. DOMA defined marriage as a heterosexual union and denied federal benefits to same-sex couples. It also allowed states to refuse to recognize same-sex marriages granted by other states. When Clinton signed the bill, he was personally opposed to same-sex marriage. Nevertheless, he disliked DOMA and later called for its repeal. He also later changed his position on same-sex marriage. On other social issues, however, Clinton was more liberal. He appointed openly gay and lesbian men and women to important positions in government and denounced discrimination against people with AIDS. He supported the idea of the ERA and believed that women should receive pay equal to that of men doing the same work. He opposed the use of racial quotas in employment, but he declared affirmative action programs to be necessary. \n\n As a result of his economic successes and his moderate social policies, Clinton defeated Senator Robert Dole in the 1996 presidential election. With 49 percent of the popular vote and 379 electoral votes, he became the first Democrat to win reelection to the presidency since Franklin Roosevelt. Clinton\u2019s victory was partly due to a significant  gender gap  between the parties, with women tending to favor Democratic candidates. In 1992, Clinton won 45 percent of women\u2019s votes compared to Bush\u2019s 38 percent, and in 1996, he received 54 percent of women\u2019s votes while Dole won 38 percent. \n\n Domestic Terrorism \n\n The fears of those who saw government as little more than a necessary evil appeared to be confirmed in the spring of 1993, when federal and state law enforcement authorities laid siege to the compound of a religious sect called the Branch Davidians near Waco, Texas. The group, which believed the end of world was approaching, was suspected of weapons violations and resisted search-and-arrest warrants with deadly force. A standoff developed that lasted nearly two months and was captured on television each day. A final assault on the compound was made on April 19, and seventy-six men, women, and children died in a fire probably set by members of the sect. Many others committed suicide or were killed by fellow sect members. \n\n During the siege, many antigovernment and militia types came to satisfy their curiosity or show support for those inside. One was Timothy McVeigh, a former U.S. Army infantry soldier. McVeigh had served in Operation Desert Storm in Iraq, earning a bronze star, but he became disillusioned with the military and the government when he was deemed psychologically unfit for the Army Special Forces. He was convinced that the Branch Davidians were victims of government terrorism, and he and his coconspirator, Terry Nichols, determined to avenge them. \n\n Two years later, on the anniversary of the day that the Waco compound burned to the ground, McVeigh parked a rented truck full of explosives in front of the Alfred P. Murrah Federal Building in Oklahoma City and blew it up ( Figure 31.17 ). More than 600 people were injured in the attack and 168 died, including nineteen children at the daycare center inside. McVeigh hoped that his actions would spark a revolution against government control. He and Nichols were both arrested and tried, and McVeigh was executed on June 11, 2001, for the worst act of terrorism committed on American soil. Just a few months later, the terrorist attacks of September 11, 2001 broke that dark record. \n\n CLINTON AND AMERICAN HEGEMONY \n\n For decades, the contours of the Cold War had largely determined U.S. action abroad. Strategists saw each coup, revolution, and civil war as part of the larger struggle between the United States and the Soviet Union. But with the Soviet Union vanquished, the United States was suddenly free of this paradigm, and President Clinton could see international crises in the Middle East, the Balkans, and Africa on their own terms and deal with them accordingly. He envisioned a post-Cold War role in which the United States used its overwhelming military superiority and influence as global policing tools to preserve the peace. This foreign policy strategy had both success and failure. \n\n One notable success was a level of peace in the Middle East. In September 1993, at the White House, Yitzhak Rabin, prime minister of Israel, and Yasser Arafat, chairman of the Palestine Liberation Organization, signed the Oslo Accords, granting some self-rule to Palestinians living in the Israeli-occupied territories of the Gaza Strip and the West Bank ( Figure 31.18 ). A year later, the Clinton administration helped facilitate the second settlement and normalization of relations between Israel and Jordan. \n\n As a small measure of stability was brought to the Middle East, violence erupted in the Balkans. The Communist country of Yugoslavia consisted of six provinces: Serbia, Croatia, Bosnia and Herzegovina, Slovenia, Montenegro, and Macedonia. Each was occupied by a number of ethnic groups, some of which shared a history of hostile relations. In May 1980, the leader of Yugoslavia, Josip Broz Tito, died. Without him to hold the country together, ethnic tensions increased, and this, along with the breakdown of Communism elsewhere in Europe, led to the breakup of Yugoslavia. In 1991, Croatia, Slovenia, and Macedonia declared their independence. In 1992, Bosnia and Herzegovina did as well. Only Serbia and Montenegro remained united as the Serbian-dominated Federal Republic of Yugoslavia. \n\n Almost immediately, ethnic tensions within Bosnia and Herzegovina escalated into war when Yugoslavian Serbs aided Bosnian Serbs who did not wish to live in an independent Bosnia and Herzegovina. These Bosnian Serbs proclaimed the existence of autonomous Serbian regions within the country and attacked Bosnian Muslims and Croats. During the conflict, the Serbs engaged in genocide, described by some as \u201cethnic cleansing.\u201d The brutal conflict also gave rise to the systematic rape of \u201cenemy\u201d women\u2014generally Muslim women exploited by Serbian military or paramilitary forces. The International Criminal Tribunal of Yugoslavia estimated that between twelve thousand and fifty thousand women were raped during the war. \n\n NATO eventually intervened in 1995, and Clinton agreed to U.S. participation in airstrikes against Bosnian Serbs. That year, the Dayton Accords peace settlement was signed in Dayton, Ohio. Four years later, the United States, acting with other NATO members, launched an air campaign against Serbian-dominated Yugoslavia to stop it from attacking ethnic Albanians in Kosovo. Although these attacks were not sanctioned by the UN and were criticized by Russia and China, Yugoslavia withdrew its forces from Kosovo in June 1999. \n\n The use of force did not always bring positive results. For example, back in December 1992, George H. W. Bush had sent a contingent of U.S. soldiers to Somalia, initially to protect and distribute relief supplies to civilians as part of a UN mission. Without an effective Somali government, however, the warlords who controlled different regions often stole food, and their forces endangered the lives of UN workers. In 1993, the Clinton administration sent soldiers to capture one of the warlords, Mohammed Farah Aidid, in the city of Mogadishu. The resulting battle proved disastrous. A Black Hawk helicopter was shot down, and U.S. Army Rangers and members of Delta Force spent hours battling their way through the streets; eighty-four soldiers were wounded and nineteen died. The United States withdrew, leaving Somalia to struggle with its own anarchy. \n\n The sting of the Somalia failure probably contributed to Clinton\u2019s reluctance to send U.S. forces to end the 1994 genocide in Rwanda. In the days of brutal colonial rule, Belgian administrators had given control to Tutsi tribal chiefs, although Hutus constituted a majority of the population. Resentment over ethnic privileges, and the discrimination that began then and continued after independence in 1962, erupted into civil war in 1990. The Hutu majority began to slaughter the Tutsi minority and their Hutu supporters. In 1998, while visiting Rwanda, Clinton apologized for having done nothing to save the lives of the 800,000 massacred in one hundred days of genocidal slaughter. \n\n IMPEACHMENT \n\n Public attention was diverted from Clinton\u2019s foreign policing actions by a series of scandals that marked the last few years of his presidency. From the moment he entered national politics, his opponents had attempted to tie Clinton and his First Lady to a number of loosely defined improprieties, even accusing him of murdering his childhood friend and Deputy White House Counsel Vince Foster. One accusation the Clintons could not shake was of possible improper involvement in a failed real estate venture associated with the Whitewater Development Corporation in Arkansas in the 1970s and 1980s. Kenneth Starr, a former federal appeals court judge, was appointed to investigate the matter in August 1994. \n\n While Starr was never able to prove any wrongdoing, he soon turned up other allegations and his investigative authority was expanded. In May 1994, Paula Jones, a former Arkansas state employee, filed a sexual harassment lawsuit against Bill Clinton. Starr\u2019s office began to investigate this case as well. When a federal court dismissed Jones\u2019s suit in 1998, her lawyers promptly appealed the decision and submitted a list of other alleged victims of Clinton\u2019s harassment. That list included the name of Monica Lewinsky, a young White House intern. Both Lewinsky and Clinton denied under oath that they had had a sexual relationship. The evidence, however, indicated otherwise, and Starr began to investigate the possibility that Clinton had committed perjury. Again, Clinton denied any relationship and even went on national television to assure the American people that he had never had sexual relations with Lewinsky. \n\n However, after receiving a promise of immunity, Lewinsky turned over to Starr evidence of her affair with Clinton, and the president admitted he had indeed had inappropriate relations with her. He nevertheless denied that he had lied under oath. In September, Starr reported to the House of Representatives that he believed Clinton had committed perjury. Voting along partisan lines, the Republican-dominated House of Representatives sent articles of impeachment to the Senate, charging Clinton with lying under oath and obstructing justice. In February 1998, the Senate voted forty-five to fifty-five on the perjury charge and fifty-fifty on obstruction of justice ( Figure 31.19 ). Although acquitted, Clinton did become the first president to be found in contempt of court. Nevertheless, although he lost his law license, he remained a popular president and left office at the end of his second term with an approval rating of 66 percent, the highest of any U.S. president. \n\n THE ELECTION OF 2000 \n\n Despite Clinton\u2019s high approval rating, his vice president and the 2000 Democratic nominee for president, Al Gore, was eager to distance himself from scandal. Unfortunately, he also alienated Clinton loyalists and lost some of the benefit of Clinton\u2019s genuine popularity. Gore\u2019s desire to emphasize his concern for morality led him to select Connecticut senator Joseph I. Lieberman as his running mate. Lieberman had been quick to denounce Clinton\u2019s relationship with Monica Lewinsky. Consumer advocate Ralph Nader ran as the candidate of the  Green Party , a party devoted to environmental issues and grassroots activism, and Democrats feared that he would attract votes that Gore might otherwise win. \n\n On the Republican side, where strategists promised to \u201crestore honor and dignity\u201d to the White House, voters were divided between George W. Bush, governor of Texas and eldest son of former president Bush, and John McCain, an Arizona senator and Vietnam War veteran. Bush had the robust support of both the Christian Right and the Republican leadership. His campaign amassed large donations that it used to defeat McCain, himself an outspoken critic of the influence of money in politics. The nomination secured, Bush selected Dick Cheney, part of the Nixon and Ford administrations and secretary of defense under George H. W. Bush, as his running mate. \n\n One hundred million votes were cast in the 2000 election, and Gore topped Bush in the popular vote by 540,000 ballots, or 0.5 percent. The race was so close that news reports declared each candidate the winner at various times during the evening. It all came down to Florida, where early returns called the election in Bush\u2019s favor by a mere 527 of 5,825,000 votes. Whoever won Florida would get the state\u2019s twenty-five electoral votes and secure the presidency ( Figure 31.20 ). \n\n Because there seemed to be irregularities in four counties traditionally dominated by Democrats, especially in largely African American precincts, Gore called for a recount of the ballots by hand. Florida\u2019s secretary of state, Katherine Harris, set a deadline for the new vote tallies to be submitted, a deadline the counties could not meet. When the Democrats requested an extension, the Florida Supreme Court granted it, but Harris refused to accept the new tallies unless the counties could explain why they had not met the original deadline. When the explanations were submitted, they were rejected. Gore then asked the Florida Supreme Court for an injunction that would prevent Harris from declaring a winner until the recount was finished. On November 26, Harris declared Bush the winner in Florida. Gore protested that not all votes had been recounted by hand. When the Florida Supreme Court ordered the recount to continue, the Republicans appealed to the U.S. Supreme Court, which decided 5\u20134 to stop the recount. Bush received Florida\u2019s electoral votes and, with a total of 271 votes in the Electoral College to Gore\u2019s 266, became the forty-third president of the United States. ", "questions": [{"question": {"question_id": "fs-idm105655472", "question_text": "Before becoming a conservative Republican, Ronald Reagan was ________.", "question_choices": ["a liberal Democrat", "a Socialist", "politically apathetic", "a Herbert Hoover Republican"], "cloze_format": "Before becoming a conservative Republican, Ronald Reagan was ________.", "normal_format": "Before becoming a conservative Republican, what was Ronald Reagan?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "As a young man , he identified politically as a liberal Democrat , but his distaste for communism , along with the influence of the social conservative values of his second wife , actress Nancy Davis , edged him closer to conservative Republicanism ( Figure 31.3 ) .", "hl_context": "Although many of his movie roles and the persona he created for himself seemed to represent traditional values , Reagan \u2019 s rise to the presidency was an unusual transition from pop cultural significance to political success . Born and raised in the Midwest , he moved to California in 1937 to become a Hollywood actor . He also became a reserve officer in the U . S . Army that same year , but when the country entered World War II , he was excluded from active duty overseas because of poor eyesight and spent the war in the army \u2019 s First Motion Picture Unit . After the war , he resumed his film career ; rose to leadership in the Screen Actors Guild , a Hollywood union ; and became a spokesman for General Electric and the host of a television series that the company sponsored . <hl> As a young man , he identified politically as a liberal Democrat , but his distaste for communism , along with the influence of the social conservative values of his second wife , actress Nancy Davis , edged him closer to conservative Republicanism ( Figure 31.3 ) . <hl> By 1962 , he had formally switched political parties , and in 1964 , he actively campaigned for the Republican presidential nominee Barry Goldwater ."}, {"question": {"question_id": "fs-idm102604048", "question_text": "The belief that cutting taxes for the rich will eventually result in economic benefits for the poor is commonly referred to as ________.", "question_choices": ["socialism", "pork barrel politics", "Keynesian economics", "trickle-down economics"], "cloze_format": "The belief that cutting taxes for the rich will eventually result in economic benefits for the poor is commonly referred to as ________.", "normal_format": "What is the belief that cutting taxes for the rich will eventually result in economic benefits for the poor commonly referred to?"}, "answer": {"ans_text": "trickle-down economics", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Influenced by economist Arthur Laffer of the University of Southern California , Reagan cut income taxes for those at the top of the economic ladder , which was supposed to motivate the rich to invest in businesses , factories , and the stock market in anticipation of high returns . According to Laffer \u2019 s argument , this would eventually translate into more jobs further down the socioeconomic ladder . Economic growth would also increase the total tax revenue \u2014 even at a lower tax rate . In other words , proponents of \u201c trickle-down economics \u201d promised to cut taxes and balance the budget at the same time .", "hl_context": "Reagan \u2019 s primary goal upon taking office was to stimulate the sagging economy while simultaneously cutting both government programs and taxes . His economic policies , called Reaganomics by the press , were based on a theory called supply-side economics , about which many economists were skeptical . <hl> Influenced by economist Arthur Laffer of the University of Southern California , Reagan cut income taxes for those at the top of the economic ladder , which was supposed to motivate the rich to invest in businesses , factories , and the stock market in anticipation of high returns . <hl> <hl> According to Laffer \u2019 s argument , this would eventually translate into more jobs further down the socioeconomic ladder . <hl> <hl> Economic growth would also increase the total tax revenue \u2014 even at a lower tax rate . <hl> <hl> In other words , proponents of \u201c trickle-down economics \u201d promised to cut taxes and balance the budget at the same time . <hl> Reaganomics also included the deregulation of industry and higher interest rates to control inflation , but these initiatives preceded Reagan and were conceived in the Carter administration ."}, {"question": {"question_id": "fs-idm23210992", "question_text": "Which statement best describes Reagan\u2019s political style?", "question_choices": ["folksy and likeable", "conservative and inflexible", "liberal and pragmatic", "intelligent and elitist"], "cloze_format": "Reagan's political style is ____.", "normal_format": "Which statement best describes Reagan\u2019s political style?"}, "answer": {"ans_text": "folksy and likeable", "ans_choice": 0}, "bloom": null, "hl_sentences": "Often called \u201c The Great Communicator , \u201d he was noted for his ability , honed through years as an actor and spokesperson , to convey a mixture of folksy wisdom , empathy , and concern while taking humorous digs at his opponents . Indeed , listening to Reagan speak often felt like hearing a favorite uncle recall stories about the \u201c good old days \u201d before big government , expensive social programs , and greedy politicians destroyed the country ( Figure 31.6 ) . Americans found this rhetorical style extremely compelling .", "hl_context": "Reagan was an articulate spokesman for his political perspectives and was able to garner support for his policies . <hl> Often called \u201c The Great Communicator , \u201d he was noted for his ability , honed through years as an actor and spokesperson , to convey a mixture of folksy wisdom , empathy , and concern while taking humorous digs at his opponents . <hl> <hl> Indeed , listening to Reagan speak often felt like hearing a favorite uncle recall stories about the \u201c good old days \u201d before big government , expensive social programs , and greedy politicians destroyed the country ( Figure 31.6 ) . <hl> <hl> Americans found this rhetorical style extremely compelling . <hl> Public support for the plan , combined with a surge in the president \u2019 s popularity after he survived an assassination attempt in March 1981 , swayed Congress , including many Democrats . On July 29 , 1981 , Congress passed the Economic Recovery Tax Act , which phased in a 25 percent overall reduction in taxes over a period of three years ."}, {"question": {"question_id": "fs-idm54892816", "question_text": "What rationale did Phyllis Schlafly and her STOP ERA movement cite when opposing the ratification of the Equal Rights Amendment?", "question_choices": ["the ERA would ultimately lead to the legalization of abortion", "the ERA provided insufficient civil rights protections for women", "mothers could not be feminists", "the ERA would end gender-specific privileges women enjoyed"], "cloze_format": "Phyllis Schlafly and her STOP ERA movement cite ___ when opposing the ratification of the Equal Rights Amendment.", "normal_format": "What rationale did Phyllis Schlafly and her STOP ERA movement cite when opposing the ratification of the Equal Rights Amendment?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Her instrument was the STOP ERA movement , with the acronym STOP , standing for \u201c Stop Taking our Privileges . \u201d Schlafly argued that women enjoyed special privileges such as gender-specific restrooms and exemption from the military draft . Defining American Phyllis Schlafly and the STOP ERA Movement In 1972 , after a large number of states jumped to ratify the Equal Rights Amendment , most observers believed its ultimate ratification by all the necessary states was all but certain .", "hl_context": "Schlafly \u2019 s attack on the ERA was ingenious in its method and effectiveness . Rather than attacking the amendment directly as a gateway to unrestrained and immoral behavior as some had , she couched her opposition in language that was sensitive to both privilege and class . <hl> Her instrument was the STOP ERA movement , with the acronym STOP , standing for \u201c Stop Taking our Privileges . \u201d Schlafly argued that women enjoyed special privileges such as gender-specific restrooms and exemption from the military draft . <hl> These , she claimed , would be lost should the ERA be ratified . But she also claimed to stand up for the dignity of being a homemaker and lambasted the feminist movement as elitist . In this , she was keenly aware of the power of class interests . Her organization suggested that privileged women could afford to support the ERA . Working women and poor housewives , however , would ultimately bear the brunt of the loss of protection it would bring . In the end , her tactics were successful in achieving exactly what the movement \u2019 s name suggested ; she stopped the ERA . <hl> Defining American Phyllis Schlafly and the STOP ERA Movement In 1972 , after a large number of states jumped to ratify the Equal Rights Amendment , most observers believed its ultimate ratification by all the necessary states was all but certain . <hl> But , a decade later , the amendment died without ever getting the necessary votes . There are many reasons it went down in defeat , but a major one was Phyllis Schlafly ."}, {"question": {"question_id": "fs-idp384514368", "question_text": "The group the Reagan administration encouraged and supported in its fight against the Sandinista government in Nicaragua was known as the ________.", "question_choices": ["anti-Somozas", "Shining Path", "Contras", "Red Faction"], "cloze_format": "The group the Reagan administration encouraged and supported in its fight against the Sandinista government in Nicaragua was known as the ________.", "normal_format": "Which group did the Reagan administration encourage and support in its fight against the Sandinista government in Nicaragua?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "bloom": null, "hl_sentences": "A year into his presidency , convinced it was folly to allow the expansion of Soviet and Communist influence in Latin America , he authorized the Central Intelligence Agency ( CIA ) to equip and train a group of anti-Sandinista Nicaraguans known as the Contras ( contrarevolucion\u00e1rios or \u201c counter-revolutionaries \u201d ) to oust Ortega .", "hl_context": "Neighboring Nicaragua was also governed by a largely Marxist-inspired group , the Sandinistas . This organization , led by Daniel Ortega , had overthrown the brutal , right-wing dictatorship of Anastasio Somoza in 1979 . Reagan , however , overlooked the legitimate complaints of the Sandinistas and believed that their rule opened the region to Cuban and Soviet influence . <hl> A year into his presidency , convinced it was folly to allow the expansion of Soviet and Communist influence in Latin America , he authorized the Central Intelligence Agency ( CIA ) to equip and train a group of anti-Sandinista Nicaraguans known as the Contras ( contrarevolucion\u00e1rios or \u201c counter-revolutionaries \u201d ) to oust Ortega . <hl>"}, {"question": {"question_id": "fs-idp258595472", "question_text": "The country that Iraq invaded to trigger the crisis that resulted in the Persian Gulf War was ________.", "question_choices": ["Jordan", "Kuwait", "Saudi Arabia", "Iran"], "cloze_format": "The country that Iraq invaded to trigger the crisis that resulted in the Persian Gulf War was ________.", "normal_format": "Which was the country that Iraq invaded to trigger the crisis that resulted in the Persian Gulf War?"}, "answer": {"ans_text": "Kuwait", "ans_choice": 1}, "bloom": null, "hl_sentences": "On January 14 , Bush succeeded in getting resolutions from Congress authorizing the use of military force against Iraq , and the U . S . then orchestrated an effective air campaign , followed by Operation Desert Storm , a one-hundred-hour land war involving over 500,000 U . S . troops and another 200,000 from twenty-seven other countries , which expelled Iraqi forces from Kuwait by the end of February . When talks with these countries broke down , and Iraq found itself politically and economically isolated , Hussein ordered the invasion of oil-rich Kuwait in August 1990 . Bush faced his first full-scale international crisis .", "hl_context": "In response to the invasion , Bush and his foreign policy team forged an unprecedented international coalition of thirty-four countries , including many members of NATO ( North Atlantic Treaty Organization ) and the Middle Eastern countries of Saudi Arabia , Syria , and Egypt , to oppose Iraqi aggression . Bush hoped that this coalition would herald the beginning of a \u201c new world order \u201d in which the nations of the world would work together to deter belligerence . A deadline was set for Iraq to withdraw from Kuwait by January 15 , or face serious consequences . Wary of not having sufficient domestic support for combat , Bush first deployed troops to the area to build up forces in the region and defend Saudi Arabia via Operation Desert Shield ( Figure 31.13 ) . <hl> On January 14 , Bush succeeded in getting resolutions from Congress authorizing the use of military force against Iraq , and the U . S . then orchestrated an effective air campaign , followed by Operation Desert Storm , a one-hundred-hour land war involving over 500,000 U . S . troops and another 200,000 from twenty-seven other countries , which expelled Iraqi forces from Kuwait by the end of February . <hl> As the Soviet Union was ceasing to be a threat , the Middle East became a source of increased concern . In the wake of its eight-year war with Iran from 1980 to 1988 , Iraq had accumulated a significant amount of foreign debt . At the same time , other Arab states had increased their oil production , forcing oil prices down and further hurting Iraq \u2019 s economy . Iraq \u2019 s leader , Saddam Hussein , approached these oil-producing states for assistance , particularly Saudi Arabia and neighboring Kuwait , which Iraq felt directly benefited from its war with Iran . <hl> When talks with these countries broke down , and Iraq found itself politically and economically isolated , Hussein ordered the invasion of oil-rich Kuwait in August 1990 . <hl> <hl> Bush faced his first full-scale international crisis . <hl>"}, {"question": {"question_id": "fs-idp133368496", "question_text": "Bill Clinton helped create a large free market among Canada, the United States, and Mexico with ratification of the ________ treaty.", "question_choices": ["NAFTA", "NATO", "Organization of American States", "Alliance for Progress"], "cloze_format": "Bill Clinton helped create a large free market among Canada, the United States, and Mexico with ratification of the ________ treaty.", "normal_format": "With the ratification of what treaty, Bill Clinton helped create a large free market among Canada, the United States, and Mexico?"}, "answer": {"ans_text": "NAFTA", "ans_choice": 0}, "bloom": null, "hl_sentences": "Clinton also strongly supported ratification of the North American Free Trade Agreement ( NAFTA ) , a treaty that eliminated tariffs and trade restrictions among the United States , Canada , and Mexico .", "hl_context": "<hl> Clinton also strongly supported ratification of the North American Free Trade Agreement ( NAFTA ) , a treaty that eliminated tariffs and trade restrictions among the United States , Canada , and Mexico . <hl> The treaty had been negotiated by the Bush administration , and the leaders of all three nations had signed it in December 1992 . However , because of strong opposition from American labor unions and some in Congress who feared the loss of jobs to Mexico , the treaty had not been ratified by the time Clinton took office . To allay the concerns of unions , he added an agreement to protect workers and also one to protect the environment . Congress ratified NAFTA late in 1993 . The result was the creation of the world \u2019 s largest common market in terms of population , including some 425 million people ."}, {"question": {"question_id": "fs-idp1460528", "question_text": "The key state in the 2000 election where the U.S. Supreme Court stopped a recount of votes was ________.", "question_choices": ["Florida", "Texas", "Georgia", "Virginia"], "cloze_format": "The key state in the 2000 election where the U.S. Supreme Court stopped a recount of votes was ________.", "normal_format": "Which was the key state in the 2000 election where the U.S. Supreme Court stopped a recount of votes?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "When the Florida Supreme Court ordered the recount to continue , the Republicans appealed to the U . S . Supreme Court , which decided 5 \u2013 4 to stop the recount . One hundred million votes were cast in the 2000 election , and Gore topped Bush in the popular vote by 540,000 ballots , or 0.5 percent .", "hl_context": "Because there seemed to be irregularities in four counties traditionally dominated by Democrats , especially in largely African American precincts , Gore called for a recount of the ballots by hand . Florida \u2019 s secretary of state , Katherine Harris , set a deadline for the new vote tallies to be submitted , a deadline the counties could not meet . When the Democrats requested an extension , the Florida Supreme Court granted it , but Harris refused to accept the new tallies unless the counties could explain why they had not met the original deadline . When the explanations were submitted , they were rejected . Gore then asked the Florida Supreme Court for an injunction that would prevent Harris from declaring a winner until the recount was finished . On November 26 , Harris declared Bush the winner in Florida . Gore protested that not all votes had been recounted by hand . <hl> When the Florida Supreme Court ordered the recount to continue , the Republicans appealed to the U . S . Supreme Court , which decided 5 \u2013 4 to stop the recount . <hl> Bush received Florida \u2019 s electoral votes and , with a total of 271 votes in the Electoral College to Gore \u2019 s 266 , became the forty-third president of the United States . <hl> One hundred million votes were cast in the 2000 election , and Gore topped Bush in the popular vote by 540,000 ballots , or 0.5 percent . <hl> The race was so close that news reports declared each candidate the winner at various times during the evening . It all came down to Florida , where early returns called the election in Bush \u2019 s favor by a mere 527 of 5,825 , 000 votes . Whoever won Florida would get the state \u2019 s twenty-five electoral votes and secure the presidency ( Figure 31.20 ) ."}], "summary": " Summary 31.1   The Reagan Revolution \n\n After decades of liberalism and social reform, Ronald Reagan changed the face of American politics by riding a groundswell of conservatism into the White House. Reagan\u2019s superior rhetorical skills enabled him to gain widespread support for his plans for the nation. Implementing a series of economic policies dubbed \u201cReaganomics,\u201d the president sought to stimulate the economy while shrinking the size of the federal government and providing relief for the nation\u2019s wealthiest taxpayers. During his two terms in office, he cut spending on social programs, while increasing spending on defense. While Reagan was able to break the cycle of stagflation, his policies also triggered a recession, plunged the nation into a brief period of significant unemployment, and made a balanced budget impossible. In the end, Reagan\u2019s policies diminished many Americans\u2019 quality of life while enabling more affluent Americans\u2014the \u201cYuppies\u201d of the 1980s\u2014to prosper. \n\n 31.2   Political and Cultural Fusions \n\n The political conservatism of the 1980s and 1990s was matched by the social conservatism of the period. Conservative politicians wished to limit the size and curb the power of the federal government. Conservative think tanks flourished, the Christian Right defeated the ERA, and bipartisan efforts to add warning labels to explicit music lyrics were the subject of Congressional hearings. HIV/AIDS, which became chiefly and inaccurately associated with the gay community, grew to crisis proportions, as heterosexuals and the federal government failed to act. In response, gay men organized advocacy groups to fight for research on HIV/AIDS. Meanwhile, the so-called war on drugs began a get-tough trend in law enforcement that mandated lengthy sentences for drug-related offenses and hugely increased the American prison population. \n\n 31.3   A New World Order \n\n While Ronald Reagan worked to restrict the influence of the federal government in people\u2019s lives, he simultaneously pursued interventionist policies abroad as part of a global Cold War strategy. Eager to cure the United States of \u201cVietnam Syndrome,\u201d he increased the American stockpile of weapons and aided anti-Communist groups in the Caribbean and Central America. The Reagan administration\u2019s secret sales of arms to Iran proved disastrous, however, and resulted in indictments for administration officials. With the end of the Cold War, attention shifted to escalating tensions in the Middle East, where an international coalition assembled by George H. W. Bush drove invading Iraqi forces from Kuwait. As Bush discovered in the last years of his presidency, even this almost-flawless exercise in international diplomatic and military power was not enough to calm a changing cultural and political climate at home. \n\n 31.4   Bill Clinton and the New Economy \n\n Bill Clinton\u2019s presidency and efforts at remaking the Democratic Party reflect the long-term effects of the Reagan Revolution that preceded him. Reagan benefited from a resurgent conservatism that moved the American political spectrum several degrees to the right. Clinton managed to remake the Democratic Party in ways that effectively institutionalized some of the major tenets of the so-called Reagan Revolution. A \u201cNew Democrat,\u201d he moved the party significantly to the moderate center and supported the Republican call for law and order, and welfare reform\u2014all while maintaining traditional Democratic commitments to minorities, women, and the disadvantaged, and using the government to stimulate economic growth. Nevertheless, Clinton\u2019s legacy was undermined by the shift in the control of Congress to the Republican Party and the loss by his vice president Al Gore in the 2000 presidential election. ", "keyterm": "", "bname": "u.s._history"}, {"chapter": 23, "intro": " Chapter Objectives \n\n After studying this chapter, you will be able to:\n\n List and describe the functional anatomy of the organs and accessory organs of the digestive system \n\n Discuss the processes and control of ingestion, propulsion, mechanical digestion, chemical digestion, absorption, and defecation \n\n Discuss the roles of the liver, pancreas, and gallbladder in digestion \n\n Compare and contrast the digestion of the three macronutrients \n\n Introduction  The digestive system is continually at work, yet people seldom appreciate the complex tasks it performs in a choreographed biologic symphony. Consider what happens when you eat an apple. Of course, you enjoy the apple\u2019s taste as you chew it, but in the hours that follow, unless something goes amiss and you get a stomachache, you don\u2019t notice that your digestive system is working. You may be taking a walk or studying or sleeping, having forgotten all about the apple, but your stomach and intestines are busy digesting it and absorbing its vitamins and other nutrients. By the time any waste material is excreted, the body has appropriated all it can use from the apple. In short, whether you pay attention or not, the organs of the digestive system perform their specific functions, allowing you to use the food you eat to keep you going. This chapter examines the structure and functions of these organs, and explores the mechanics and chemistry of the digestive processes. ", "chapter_text": " 23.1   Overview of the Digestive System  Learning Objectives By the end of this section, you will be able to: \n\n Identify the organs of the alimentary canal from proximal to distal, and briefly state their function \n\n Identify the accessory digestive organs and briefly state their function \n\n Describe the four fundamental tissue layers of the alimentary canal \n\n Contrast the contributions of the enteric and autonomic nervous systems to digestive system functioning \n\n Explain how the peritoneum anchors the digestive organs \n\n The function of the digestive system is to break down the foods you eat, release their nutrients, and absorb those nutrients into the body. Although the small intestine is the workhorse of the system, where the majority of digestion occurs, and where most of the released nutrients are absorbed into the blood or lymph, each of the digestive system organs makes a vital contribution to this process ( Figure 23.2 ). \n\n As is the case with all body systems, the digestive system does not work in isolation; it functions cooperatively with the other systems of the body. Consider for example, the interrelationship between the digestive and cardiovascular systems. Arteries supply the digestive organs with oxygen and processed nutrients, and veins drain the digestive tract. These intestinal veins, constituting the hepatic portal system, are unique; they do not return blood directly to the heart. Rather, this blood is diverted to the liver where its nutrients are off-loaded for processing before blood completes its circuit back to the heart. At the same time, the digestive system provides nutrients to the heart muscle and vascular tissue to support their functioning. The interrelationship of the digestive and endocrine systems is also critical. Hormones secreted by several endocrine glands, as well as endocrine cells of the pancreas, the stomach, and the small intestine, contribute to the control of digestion and nutrient metabolism. In turn, the digestive system provides the nutrients to fuel endocrine function.  Table 23.1  gives a quick glimpse at how these other systems contribute to the functioning of the digestive system. \n\n Contribution of Other Body Systems to the Digestive System \n\n Body system \n\n Benefits received by the digestive system \n\n Cardiovascular \n\n Blood supplies digestive organs with oxygen and processed nutrients \n\n Endocrine \n\n Endocrine hormones help regulate secretion in digestive glands and accessory organs \n\n Integumentary \n\n Skin helps protect digestive organs and synthesizes vitamin D for calcium absorption \n\n Lymphatic \n\n Mucosa-associated lymphoid tissue and other lymphatic tissue defend against entry of pathogens; lacteals absorb lipids; and lymphatic vessels transport lipids to bloodstream \n\n Muscular \n\n Skeletal muscles support and protect abdominal organs \n\n Nervous \n\n Sensory and motor neurons help regulate secretions and muscle contractions in the digestive tract \n\n Respiratory \n\n Respiratory organs provide oxygen and remove carbon dioxide \n\n Skeletal \n\n Bones help protect and support digestive organs \n\n Urinary \n\n Kidneys convert vitamin D into its active form, allowing calcium absorption in the small intestine \n\n Table  23.1     \n\n Digestive System Organs \n\n The easiest way to understand the digestive system is to divide its organs into two main categories. The first group is the organs that make up the alimentary canal. Accessory digestive organs comprise the second group and are critical for orchestrating the breakdown of food and the assimilation of its nutrients into the body. Accessory digestive organs, despite their name, are critical to the function of the digestive system. \n\n Alimentary Canal Organs \n\n Also called the gastrointestinal (GI) tract or gut, the  alimentary canal  (aliment- = \u201cto nourish\u201d) is a one-way tube about 7.62 meters (25 feet) in length during life and closer to 10.67 meters (35 feet) in length when measured after death, once smooth muscle tone is lost. The main function of the organs of the alimentary canal is to nourish the body. This tube begins at the mouth and terminates at the anus. Between those two points, the canal is modified as the pharynx, esophagus, stomach, and small and large intestines to fit the functional needs of the body. Both the mouth and anus are open to the external environment; thus, food and wastes within the alimentary canal are technically considered to be outside the body. Only through the process of absorption do the nutrients in food enter into and nourish the body\u2019s \u201cinner space.\u201d \n\n Accessory Structures \n\n Each  accessory digestive organ  aids in the breakdown of food ( Figure 23.3 ). Within the mouth, the teeth and tongue begin mechanical digestion, whereas the salivary glands begin chemical digestion. Once food products enter the small intestine, the gallbladder, liver, and pancreas release secretions\u2014such as bile and enzymes\u2014essential for digestion to continue. Together, these are called accessory organs because they sprout from the lining cells of the developing gut (mucosa) and augment its function; indeed, you could not live without their vital contributions, and many significant diseases result from their malfunction. Even after development is complete, they maintain a connection to the gut by way of ducts. \n\n Histology of the Alimentary Canal \n\n Throughout its length, the alimentary tract is composed of the same four tissue layers; the details of their structural arrangements vary to fit their specific functions. Starting from the lumen and moving outwards, these layers are the mucosa, submucosa, muscularis, and serosa, which is continuous with the mesentery (see  Figure 23.3 ). \n\n The  mucosa  is referred to as a mucous membrane, because mucus production is a characteristic feature of gut epithelium. The membrane consists of epithelium, which is in direct contact with ingested food, and the lamina propria, a layer of connective tissue analogous to the dermis. In addition, the mucosa has a thin, smooth muscle layer, called the muscularis mucosae (not to be confused with the muscularis layer, described below). \n\n Epithelium \u2014In the mouth, pharynx, esophagus, and anal canal, the epithelium is primarily a non-keratinized, stratified squamous epithelium. In the stomach and intestines, it is a simple columnar epithelium. Notice that the epithelium is in direct contact with the lumen, the space inside the alimentary canal. Interspersed among its epithelial cells are goblet cells, which secrete mucus and fluid into the lumen, and enteroendocrine cells, which secrete hormones into the interstitial spaces between cells. Epithelial cells have a very brief lifespan, averaging from only a couple of days (in the mouth) to about a week (in the gut). This process of rapid renewal helps preserve the health of the alimentary canal, despite the wear and tear resulting from continued contact with foodstuffs. \n\n Lamina propria \u2014In addition to loose connective tissue, the lamina propria contains numerous blood and lymphatic vessels that transport nutrients absorbed through the alimentary canal to other parts of the body. The lamina propria also serves an immune function by housing clusters of lymphocytes, making up the mucosa-associated lymphoid tissue (MALT). These lymphocyte clusters are particularly substantial in the distal ileum where they are known as Peyer\u2019s patches. When you consider that the alimentary canal is exposed to foodborne bacteria and other foreign matter, it is not hard to appreciate why the immune system has evolved a means of defending against the pathogens encountered within it. \n\n Muscularis mucosae \u2014This thin layer of smooth muscle is in a constant state of tension, pulling the mucosa of the stomach and small intestine into undulating folds. These folds dramatically increase the surface area available for digestion and absorption. \n\n As its name implies, the  submucosa  lies immediately beneath the mucosa. A broad layer of dense connective tissue, it connects the overlying mucosa to the underlying muscularis. It includes blood and lymphatic vessels (which transport absorbed nutrients), and a scattering of submucosal glands that release digestive secretions. Additionally, it serves as a conduit for a dense branching network of nerves, the submucosal plexus, which functions as described below. \n\n The third layer of the alimentary canal is the  muscularis  (also called the muscularis externa). The muscularis in the small intestine is made up of a double layer of smooth muscle: an inner circular layer and an outer longitudinal layer. The contractions of these layers promote mechanical digestion, expose more of the food to digestive chemicals, and move the food along the canal. In the most proximal and distal regions of the alimentary canal, including the mouth, pharynx, anterior part of the esophagus, and external anal sphincter, the muscularis is made up of skeletal muscle, which gives you voluntary control over swallowing and defecation. The basic two-layer structure found in the small intestine is modified in the organs proximal and distal to it. The stomach is equipped for its churning function by the addition of a third layer, the oblique muscle. While the colon has two layers like the small intestine, its longitudinal layer is segregated into three narrow parallel bands, the tenia coli, which make it look like a series of pouches rather than a simple tube. The  serosa  is the portion of the alimentary canal superficial to the muscularis. Present only in the region of the alimentary canal within the abdominal cavity, it consists of a layer of visceral peritoneum overlying a layer of loose connective tissue. Instead of serosa, the mouth, pharynx, and esophagus have a dense sheath of collagen fibers called the adventitia. These tissues serve to hold the alimentary canal in place near the ventral surface of the vertebral column. \n\n Nerve Supply \n\n As soon as food enters the mouth, it is detected by receptors that send impulses along the sensory neurons of cranial nerves. Without these nerves, not only would your food be without taste, but you would also be unable to feel either the food or the structures of your mouth, and you would be unable to avoid biting yourself as you chew, an action enabled by the motor branches of cranial nerves. \n\n Intrinsic innervation of much of the alimentary canal is provided by the enteric nervous system, which runs from the esophagus to the anus, and contains approximately 100 million motor, sensory, and interneurons (unique to this system compared to all other parts of the peripheral nervous system). These enteric neurons are grouped into two plexuses. The  myenteric plexus  (plexus of Auerbach) lies in the muscularis layer of the alimentary canal and is responsible for  motility , especially the rhythm and force of the contractions of the muscularis. The  submucosal plexus  (plexus of Meissner) lies in the submucosal layer and is responsible for regulating digestive secretions and reacting to the presence of food (see  Figure 23.3 ). Extrinsic innervations of the alimentary canal are provided by the autonomic nervous system, which includes both sympathetic and parasympathetic nerves. In general, sympathetic activation (the fight-or-flight response) restricts the activity of enteric neurons, thereby decreasing GI secretion and motility. In contrast, parasympathetic activation (the rest-and-digest response) increases GI secretion and motility by stimulating neurons of the enteric nervous system. \n\n Blood Supply \n\n The blood vessels serving the digestive system have two functions. They transport the protein and carbohydrate nutrients absorbed by mucosal cells after food is digested in the lumen. Lipids are absorbed via lacteals, tiny structures of the lymphatic system. The blood vessels\u2019 second function is to supply the organs of the alimentary canal with the nutrients and oxygen needed to drive their cellular processes. \n\n Specifically, the more anterior parts of the alimentary canal are supplied with blood by arteries branching off the aortic arch and thoracic aorta. Below this point, the alimentary canal is supplied with blood by arteries branching from the abdominal aorta. The celiac trunk services the liver, stomach, and duodenum, whereas the superior and inferior mesenteric arteries supply blood to the remaining small and large intestines. \n\n The veins that collect nutrient-rich blood from the small intestine (where most absorption occurs) empty into the hepatic portal system. This venous network takes the blood into the liver where the nutrients are either processed or stored for later use. Only then does the blood drained from the alimentary canal viscera circulate back to the heart. To appreciate just how demanding the digestive process is on the cardiovascular system, consider that while you are \u201cresting and digesting,\u201d about one-fourth of the blood pumped with each heartbeat enters arteries serving the intestines. \n\n The Peritoneum The digestive organs within the abdominal cavity are held in place by the peritoneum, a broad serous membranous sac made up of squamous epithelial tissue surrounded by connective tissue. It is composed of two different regions: the parietal peritoneum, which lines the abdominal wall, and the visceral peritoneum, which envelopes the abdominal organs ( Figure 23.4 ). The peritoneal cavity is the space bounded by the visceral and parietal peritoneal surfaces. A few milliliters of watery fluid act as a lubricant to minimize friction between the serosal surfaces of the peritoneum. \n\n Disorders of the... Digestive System: Peritonitis \n\n Inflammation of the peritoneum is called peritonitis. Chemical peritonitis can develop any time the wall of the alimentary canal is breached, allowing the contents of the lumen entry into the peritoneal cavity. For example, when an ulcer perforates the stomach wall, gastric juices spill into the peritoneal cavity. Hemorrhagic peritonitis occurs after a ruptured tubal pregnancy or traumatic injury to the liver or spleen fills the peritoneal cavity with blood. Even more severe peritonitis is associated with bacterial infections seen with appendicitis, colonic diverticulitis, and pelvic inflammatory disease (infection of uterine tubes, usually by sexually transmitted bacteria). Peritonitis is life threatening and often results in emergency surgery to correct the underlying problem and intensive antibiotic therapy. When your great grandparents and even your parents were young, the mortality from peritonitis was high. Aggressive surgery, improvements in anesthesia safety, the advance of critical care expertise, and antibiotics have greatly improved the mortality rate from this condition. Even so, the mortality rate still ranges from 30 to 40 percent. \n\n The visceral peritoneum includes multiple large folds that envelope various abdominal organs, holding them to the dorsal surface of the body wall. Within these folds are blood vessels, lymphatic vessels, and nerves that innervate the organs with which they are in contact, supplying their adjacent organs. The five major peritoneal folds are described in  Table 23.2 . Note that during fetal development, certain digestive structures, including the first portion of the small intestine (called the duodenum), the pancreas, and portions of the large intestine (the ascending and descending colon, and the rectum) remain completely or partially posterior to the peritoneum. Thus, the location of these organs is described as  retroperitoneal . \n\n The Five Major Peritoneal Folds \n\n Fold \n\n Description \n\n Greater omentum \n\n Apron-like structure that lies superficial to the small intestine and transverse colon; a site of fat deposition in people who are overweight \n\n Falciform ligament \n\n Anchors the liver to the anterior abdominal wall and inferior border of the diaphragm \n\n Lesser omentum \n\n Suspends the stomach from the inferior border of the liver; provides a pathway for structures connecting to the liver \n\n Mesentery \n\n Vertical band of tissue anterior to the lumbar vertebrae and anchoring all of the small intestine except the initial portion (the duodenum) \n\n Mesocolon \n\n Attaches two portions of the large intestine (the transverse and sigmoid colon) to the posterior abdominal wall \n\n Table  23.2     \n\n Interactive Link \n\n By clicking on this  link  you can watch a short video of what happens to the food you eat, as it passes from your mouth to your intestine. Along the way, note how the food changes consistency and form. How does this change in consistency facilitate your gaining nutrients from food? \n 23.2   Digestive System Processes and Regulation  Learning Objectives By the end of this section, you will be able to: \n\n Discuss six fundamental activities of the digestive system, giving an example of each \n\n Compare and contrast the neural and hormonal controls involved in digestion \n\n The digestive system uses mechanical and chemical activities to break food down into absorbable substances during its journey through the digestive system.  Table 23.3  provides an overview of the basic functions of the digestive organs. \n\n Interactive Link \n\n Visit this  site  for an overview of digestion of food in different regions of the digestive tract. Note the route of non-fat nutrients from the small intestine to their release as nutrients to the body. \n\n Functions of the Digestive Organs \n\n Organ \n\n Major functions \n\n Other functions \n\n Mouth \n\n Ingests food \n\n Chews and mixes food \n\n Begins chemical breakdown of carbohydrates \n\n Moves food into the pharynx \n\n Begins breakdown of lipids via lingual lipase \n\n Moistens and dissolves food, allowing you to taste it \n\n Cleans and lubricates the teeth and oral cavity \n\n Has some antimicrobial activity \n\n Pharynx \n\n Propels food from the oral cavity to the esophagus \n\n Lubricates food and passageways \n\n Esophagus \n\n Propels food to the stomach \n\n Lubricates food and passageways \n\n Stomach \n\n Mixes and churns food with gastric juices to form chyme \n\n Begins chemical breakdown of proteins \n\n Releases food into the duodenum as chyme \n\n Absorbs some fat-soluble substances (for example, alcohol, aspirin) \n\n Possesses antimicrobial functions \n\n Stimulates protein-digesting enzymes \n\n Secretes intrinsic factor required for vitamin B 12  absorption in small intestine \n\n Small intestine \n\n Mixes chyme with digestive juices \n\n Propels food at a rate slow enough for digestion and absorption \n\n Absorbs breakdown products of carbohydrates, proteins, lipids, and nucleic acids, along with vitamins, minerals, and water \n\n Performs physical digestion via segmentation \n\n Provides optimal medium for enzymatic activity \n\n Accessory organs \n\n Liver: produces bile salts, which emulsify lipids, aiding their digestion and absorption \n\n Gallbladder: stores, concentrates, and releases bile \n\n Pancreas: produces digestive enzymes and bicarbonate \n\nBicarbonate-rich pancreatic juices help neutralize acidic chyme and provide optimal environment for enzymatic activity\n\n Large intestine \n\n Further breaks down food residues \n\n Absorbs most residual water, electrolytes, and vitamins produced by enteric bacteria \n\n Propels feces toward rectum \n\n Eliminates feces \n\n Food residue is concentrated and temporarily stored prior to defecation \n\n Mucus eases passage of feces through colon \n\n Table  23.3     \n\n Digestive Processes \n\n The processes of digestion include six activities: ingestion, propulsion, mechanical or physical digestion, chemical digestion, absorption, and defecation. \n\n The first of these processes,  ingestion , refers to the entry of food into the alimentary canal through the mouth. There, the food is chewed and mixed with saliva, which contains enzymes that begin breaking down the carbohydrates in the food plus some lipid digestion via lingual lipase. Chewing increases the surface area of the food and allows an appropriately sized bolus to be produced. \n\n Food leaves the mouth when the tongue and pharyngeal muscles propel it into the esophagus. This act of swallowing, the last voluntary act until defecation, is an example of  propulsion , which refers to the movement of food through the digestive tract. It includes both the voluntary process of swallowing and the involuntary process of peristalsis.  Peristalsis  consists of sequential, alternating waves of contraction and relaxation of alimentary wall smooth muscles, which act to propel food along ( Figure 23.5 ). These waves also play a role in mixing food with digestive juices. Peristalsis is so powerful that foods and liquids you swallow enter your stomach even if you are standing on your head. \n\n Digestion includes both mechanical and chemical processes.  Mechanical digestion  is a purely physical process that does not change the chemical nature of the food. Instead, it makes the food smaller to increase both surface area and mobility. It includes  mastication , or chewing, as well as tongue movements that help break food into smaller bits and mix food with saliva. Although there may be a tendency to think that mechanical digestion is limited to the first steps of the digestive process, it occurs after the food leaves the mouth, as well. The mechanical churning of food in the stomach serves to further break it apart and expose more of its surface area to digestive juices, creating an acidic \u201csoup\u201d called  chyme .  Segmentation , which occurs mainly in the small intestine, consists of localized contractions of circular muscle of the muscularis layer of the alimentary canal. These contractions isolate small sections of the intestine, moving their contents back and forth while continuously subdividing, breaking up, and mixing the contents. By moving food back and forth in the intestinal lumen, segmentation mixes food with digestive juices and facilitates absorption. \n\n In  chemical digestion , starting in the mouth, digestive secretions break down complex food molecules into their chemical building blocks (for example, proteins into separate amino acids). These secretions vary in composition, but typically contain water, various enzymes, acids, and salts. The process is completed in the small intestine. \n\n Food that has been broken down is of no value to the body unless it enters the bloodstream and its nutrients are put to work. This occurs through the process of  absorption , which takes place primarily within the small intestine. There, most nutrients are absorbed from the lumen of the alimentary canal into the bloodstream through the epithelial cells that make up the mucosa. Lipids are absorbed into lacteals and are transported via the lymphatic vessels to the bloodstream (the subclavian veins near the heart). The details of these processes will be discussed later. \n\n In  defecation , the final step in digestion, undigested materials are removed from the body as feces. \n\n Aging and the... Digestive System: From Appetite Suppression to Constipation \n\nAge-related changes in the digestive system begin in the mouth and can affect virtually every aspect of the digestive system. Taste buds become less sensitive, so food isn\u2019t as appetizing as it once was. A slice of pizza is a challenge, not a treat, when you have lost teeth, your gums are diseased, and your salivary glands aren\u2019t producing enough saliva. Swallowing can be difficult, and ingested food moves slowly through the alimentary canal because of reduced strength and tone of muscular tissue. Neurosensory feedback is also dampened, slowing the transmission of messages that stimulate the release of enzymes and hormones. \n\n Pathologies that affect the digestive organs\u2014such as hiatal hernia, gastritis, and peptic ulcer disease\u2014can occur at greater frequencies as you age. Problems in the small intestine may include duodenal ulcers, maldigestion, and malabsorption. Problems in the large intestine include hemorrhoids, diverticular disease, and constipation. Conditions that affect the function of accessory organs\u2014and their abilities to deliver pancreatic enzymes and bile to the small intestine\u2014include jaundice, acute pancreatitis, cirrhosis, and gallstones. \n\n In some cases, a single organ is in charge of a digestive process. For example, ingestion occurs only in the mouth and defecation only in the anus. However, most digestive processes involve the interaction of several organs and occur gradually as food moves through the alimentary canal ( Figure 23.6 ). \n\n Some chemical digestion occurs in the mouth. Some absorption can occur in the mouth and stomach, for example, alcohol and aspirin. \n\n Regulatory Mechanisms \n\n Neural and endocrine regulatory mechanisms work to maintain the optimal conditions in the lumen needed for digestion and absorption. These regulatory mechanisms, which stimulate digestive activity through mechanical and chemical activity, are controlled both extrinsically and intrinsically. \n\n Neural Controls \n\n The walls of the alimentary canal contain a variety of sensors that help regulate digestive functions. These include mechanoreceptors, chemoreceptors, and osmoreceptors, which are capable of detecting mechanical, chemical, and osmotic stimuli, respectively. For example, these receptors can sense when the presence of food has caused the stomach to expand, whether food particles have been sufficiently broken down, how much liquid is present, and the type of nutrients in the food (lipids, carbohydrates, and/or proteins). Stimulation of these receptors provokes an appropriate reflex that furthers the process of digestion. This may entail sending a message that activates the glands that secrete digestive juices into the lumen, or it may mean the stimulation of muscles within the alimentary canal, thereby activating peristalsis and segmentation that move food along the intestinal tract. \n\n The walls of the entire alimentary canal are embedded with nerve plexuses that interact with the central nervous system and other nerve plexuses\u2014either within the same digestive organ or in different ones. These interactions prompt several types of reflexes. Extrinsic nerve plexuses orchestrate long reflexes, which involve the central and autonomic nervous systems and work in response to stimuli from outside the digestive system. Short reflexes, on the other hand, are orchestrated by intrinsic nerve plexuses within the alimentary canal wall. These two plexuses and their connections were introduced earlier as the enteric nervous system. Short reflexes regulate activities in one area of the digestive tract and may coordinate local peristaltic movements and stimulate digestive secretions. For example, the sight, smell, and taste of food initiate long reflexes that begin with a sensory neuron delivering a signal to the medulla oblongata. The response to the signal is to stimulate cells in the stomach to begin secreting digestive juices in preparation for incoming food. In contrast, food that distends the stomach initiates short reflexes that cause cells in the stomach wall to increase their secretion of digestive juices. \n\n Hormonal Controls \n\n A variety of hormones are involved in the digestive process. The main digestive hormone of the stomach is gastrin, which is secreted in response to the presence of food. Gastrin stimulates the secretion of gastric acid by the parietal cells of the stomach mucosa. Other GI hormones are produced and act upon the gut and its accessory organs. Hormones produced by the duodenum include secretin, which stimulates a watery secretion of bicarbonate by the pancreas; cholecystokinin (CCK), which stimulates the secretion of pancreatic enzymes and bile from the liver and release of bile from the gallbladder; and gastric inhibitory peptide, which inhibits gastric secretion and slows gastric emptying and motility. These GI hormones are secreted by specialized epithelial cells, called endocrinocytes, located in the mucosal epithelium of the stomach and small intestine. These hormones then enter the bloodstream, through which they can reach their target organs. \n 23.3   The Mouth, Pharynx, and Esophagus  Learning Objectives By the end of this section, you will be able to: \n\n Describe the structures of the mouth, including its three accessory digestive organs \n\n Group the 32 adult teeth according to name, location, and function \n\n Describe the process of swallowing, including the roles of the tongue, upper esophageal sphincter, and epiglottis \n\n Trace the pathway food follows from ingestion into the mouth through release into the stomach \n\n In this section, you will examine the anatomy and functions of the three main organs of the upper alimentary canal\u2014the mouth, pharynx, and esophagus\u2014as well as three associated accessory organs\u2014the tongue, salivary glands, and teeth. \n\n The Mouth \n\n The cheeks, tongue, and palate frame the mouth, which is also called the  oral cavity  (or buccal cavity). The structures of the mouth are illustrated in  Figure 23.7 . \n\n At the entrance to the mouth are the lips, or  labia  (singular = labium). Their outer covering is skin, which transitions to a mucous membrane in the mouth proper. Lips are very vascular with a thin layer of keratin; hence, the reason they are \"red.\" They have a huge representation on the cerebral cortex, which probably explains the human fascination with kissing! The lips cover the orbicularis oris muscle, which regulates what comes in and goes out of the mouth. The  labial frenulum  is a midline fold of mucous membrane that attaches the inner surface of each lip to the gum. The cheeks make up the oral cavity\u2019s sidewalls. While their outer covering is skin, their inner covering is mucous membrane. This membrane is made up of non-keratinized, stratified squamous epithelium. Between the skin and mucous membranes are connective tissue and buccinator muscles. The next time you eat some food, notice how the buccinator muscles in your cheeks and the orbicularis oris muscle in your lips contract, helping you keep the food from falling out of your mouth. Additionally, notice how these muscles work when you are speaking. The pocket-like part of the mouth that is framed on the inside by the gums and teeth, and on the outside by the cheeks and lips is called the  oral vestibule . Moving farther into the mouth, the opening between the oral cavity and throat (oropharynx) is called the  fauces  (like the kitchen \"faucet\"). The main open area of the mouth, or oral cavity proper, runs from the gums and teeth to the fauces. When you are chewing, you do not find it difficult to breathe simultaneously. The next time you have food in your mouth, notice how the arched shape of the roof of your mouth allows you to handle both digestion and respiration at the same time. This arch is called the palate. The anterior region of the palate serves as a wall (or septum) between the oral and nasal cavities as well as a rigid shelf against which the tongue can push food. It is created by the maxillary and palatine bones of the skull and, given its bony structure, is known as the hard palate. If you run your tongue along the roof of your mouth, you\u2019ll notice that the hard palate ends in the posterior oral cavity, and the tissue becomes fleshier. This part of the palate, known as the  soft palate , is composed mainly of skeletal muscle. You can therefore manipulate, subconsciously, the soft palate\u2014for instance, to yawn, swallow, or sing (see  Figure 23.7 ). \n\n A fleshy bead of tissue called the uvula drops down from the center of the posterior edge of the soft palate. Although some have suggested that the uvula is a vestigial organ, it serves an important purpose. When you swallow, the soft palate and uvula move upward, helping to keep foods and liquid from entering the nasal cavity. Unfortunately, it can also contribute to the sound produced by snoring. Two muscular folds extend downward from the soft palate, on either side of the uvula. Toward the front, the  palatoglossal arch  lies next to the base of the tongue; behind it, the  palatopharyngeal arch  forms the superior and lateral margins of the fauces. Between these two arches are the palatine tonsils, clusters of lymphoid tissue that protect the pharynx. The lingual tonsils are located at the base of the tongue. \n\n The Tongue \n\n Perhaps you have heard it said that the  tongue  is the strongest muscle in the body. Those who stake this claim cite its strength proportionate to its size. Although it is difficult to quantify the relative strength of different muscles, it remains indisputable that the tongue is a workhorse, facilitating ingestion, mechanical digestion, chemical digestion (lingual lipase), sensation (of taste, texture, and temperature of food), swallowing, and vocalization. \n\n The tongue is attached to the mandible, the styloid processes of the temporal bones, and the hyoid bone. The hyoid is unique in that it only distantly/indirectly articulates with other bones. The tongue is positioned over the floor of the oral cavity. A medial septum extends the entire length of the tongue, dividing it into symmetrical halves. \n\n Beneath its mucous membrane covering, each half of the tongue is composed of the same number and type of intrinsic and extrinsic skeletal muscles. The intrinsic muscles (those within the tongue) are the longitudinalis inferior, longitudinalis superior, transversus linguae, and verticalis linguae muscles. These allow you to change the size and shape of your tongue, as well as to stick it out, if you wish. Having such a flexible tongue facilitates both swallowing and speech. \n\n As you learned in your study of the muscular system, the extrinsic muscles of the tongue are the palatoglossus, hyoglossus, styloglossus, and genioglossus muscles. These muscles originate outside the tongue and insert into connective tissues within the tongue. The mylohyoid is responsible for raising the tongue, the hyoglossus pulls it down and back, the styloglossus pulls it up and back, and the genioglossus pulls it forward. Working in concert, these muscles perform three important digestive functions in the mouth: (1) position food for optimal chewing, (2) gather food into a  bolus  (rounded mass), and (3) position food so it can be swallowed. \n\n The top and sides of the tongue are studded with papillae, extensions of lamina propria of the mucosa, which are covered in stratified squamous epithelium ( Figure 23.8 ). Fungiform papillae, which are mushroom shaped, cover a large area of the tongue; they tend to be larger toward the rear of the tongue and smaller on the tip and sides. In contrast, filiform papillae are long and thin. Fungiform papillae contain taste buds, and filiform papillae have touch receptors that help the tongue move food around in the mouth. The filiform papillae create an abrasive surface that performs mechanically, much like a cat\u2019s rough tongue that is used for grooming. Lingual glands in the lamina propria of the tongue secrete mucus and a watery serous fluid that contains the enzyme  lingual lipase , which plays a minor role in breaking down triglycerides but does not begin working until it is activated in the stomach. A fold of mucous membrane on the underside of the tongue, the  lingual frenulum , tethers the tongue to the floor of the mouth. People with the congenital anomaly ankyloglossia, also known by the non-medical term \u201ctongue tie,\u201d have a lingual frenulum that is too short or otherwise malformed. Severe ankyloglossia can impair speech and must be corrected with surgery. \n\n The Salivary Glands \n\n Many small  salivary glands  are housed within the mucous membranes of the mouth and tongue. These minor exocrine glands are constantly secreting saliva, either directly into the oral cavity or indirectly through ducts, even while you sleep. In fact, an average of 1 to 1.5 liters of saliva is secreted each day. Usually just enough saliva is present to moisten the mouth and teeth. Secretion increases when you eat, because saliva is essential to moisten food and initiate the chemical breakdown of carbohydrates. Small amounts of saliva are also secreted by the labial glands in the lips. In addition, the buccal glands in the cheeks, palatal glands in the palate, and lingual glands in the tongue help ensure that all areas of the mouth are supplied with adequate saliva. \n\n The Major Salivary Glands \n\n Outside the oral mucosa are three pairs of major salivary glands, which secrete the majority of saliva into ducts that open into the mouth: \n\n The  submandibular glands , which are in the floor of the mouth, secrete saliva into the mouth through the submandibular ducts. \n\n The  sublingual glands , which lie below the tongue, use the lesser sublingual ducts to secrete saliva into the oral cavity. \n\n The  parotid glands  lie between the skin and the masseter muscle, near the ears. They secrete saliva into the mouth through the parotid duct, which is located near the second upper molar tooth ( Figure 23.9 ). \n\n Saliva \n\n Saliva  is essentially (98 to 99.5 percent) water. The remaining 4.5 percent is a complex mixture of ions, glycoproteins, enzymes, growth factors, and waste products. Perhaps the most important ingredient in saliva from the perspective of digestion is the enzyme  salivary amylase , which initiates the breakdown of carbohydrates. Food does not spend enough time in the mouth to allow all the carbohydrates to break down, but salivary amylase continues acting until it is inactivated by stomach acids. Bicarbonate and phosphate ions function as chemical buffers, maintaining saliva at a pH between 6.35 and 6.85. Salivary mucus helps lubricate food, facilitating movement in the mouth, bolus formation, and swallowing. Saliva contains immunoglobulin A, which prevents microbes from penetrating the epithelium, and lysozyme, which makes saliva antimicrobial. Saliva also contains epidermal growth factor, which might have given rise to the adage \u201ca mother\u2019s kiss can heal a wound.\u201d Each of the major salivary glands secretes a unique formulation of saliva according to its cellular makeup. For example, the parotid glands secrete a watery solution that contains salivary amylase. The submandibular glands have cells similar to those of the parotid glands, as well as mucus-secreting cells. Therefore, saliva secreted by the submandibular glands also contains amylase but in a liquid thickened with mucus. The sublingual glands contain mostly mucous cells, and they secrete the thickest saliva with the least amount of salivary amylase. \n\n Homeostatic Imbalances The Parotid Glands: Mumps \n\nInfections of the nasal passages and pharynx can attack any salivary gland. The parotid glands are the usual site of infection with the virus that causes mumps (paramyxovirus). Mumps manifests by enlargement and inflammation of the parotid glands, causing a characteristic swelling between the ears and the jaw. Symptoms include fever and throat pain, which can be severe when swallowing acidic substances such as orange juice. \n\n In about one-third of men who are past puberty, mumps also causes testicular inflammation, typically affecting only one testis and rarely resulting in sterility. With the increasing use and effectiveness of mumps vaccines, the incidence of mumps has decreased dramatically. According to the U.S. Centers for Disease Control and Prevention (CDC), the number of mumps cases dropped from more than 150,000 in 1968 to fewer than 1700 in 1993 to only 11 reported cases in 2011. \n\n Regulation of Salivation \n\n The autonomic nervous system regulates  salivation  (the secretion of saliva). In the absence of food, parasympathetic stimulation keeps saliva flowing at just the right level for comfort as you speak, swallow, sleep, and generally go about life. Over-salivation can occur, for example, if you are stimulated by the smell of food, but that food is not available for you to eat. Drooling is an extreme instance of the overproduction of saliva. During times of stress, such as before speaking in public, sympathetic stimulation takes over, reducing salivation and producing the symptom of dry mouth often associated with anxiety. When you are dehydrated, salivation is reduced, causing the mouth to feel dry and prompting you to take action to quench your thirst. \n\n Salivation can be stimulated by the sight, smell, and taste of food. It can even be stimulated by thinking about food. You might notice whether reading about food and salivation right now has had any effect on your production of saliva. \n\n How does the salivation process work while you are eating? Food contains chemicals that stimulate taste receptors on the tongue, which send impulses to the superior and inferior salivatory nuclei in the brain stem. These two nuclei then send back parasympathetic impulses through fibers in the glossopharyngeal and facial nerves, which stimulate salivation. Even after you swallow food, salivation is increased to cleanse the mouth and to water down and neutralize any irritating chemical remnants, such as that hot sauce in your burrito. Most saliva is swallowed along with food and is reabsorbed, so that fluid is not lost. \n\n The Teeth \n\n The teeth, or  dentes  (singular = dens), are organs similar to bones that you use to tear, grind, and otherwise mechanically break down food. \n\n Types of Teeth \n\n During the course of your lifetime, you have two sets of teeth (one set of teeth is a  dentition ). Your 20  deciduous teeth , or baby teeth, first begin to appear at about 6 months of age. Between approximately age 6 and 12, these teeth are replaced by 32  permanent teeth . Moving from the center of the mouth toward the side, these are as follows ( Figure 23.10 ): \n\n The eight  incisors , four top and four bottom, are the sharp front teeth you use for biting into food. \n\n The four  cuspids  (or canines) flank the incisors and have a pointed edge (cusp) to tear up food. These fang-like teeth are superb for piercing tough or fleshy foods. \n\n Posterior to the cuspids are the eight  premolars  (or bicuspids), which have an overall flatter shape with two rounded cusps useful for mashing foods. \n\n The most posterior and largest are the 12  molars , which have several pointed cusps used to crush food so it is ready for swallowing. The third members of each set of three molars, top and bottom, are commonly referred to as the wisdom teeth, because their eruption is commonly delayed until early adulthood. It is not uncommon for wisdom teeth to fail to erupt; that is, they remain impacted. In these cases, the teeth are typically removed by orthodontic surgery. \n\n Anatomy of a Tooth \n\n The teeth are secured in the alveolar processes (sockets) of the maxilla and the mandible.  Gingivae  (commonly called the gums) are soft tissues that line the alveolar processes and surround the necks of the teeth. Teeth are also held in their sockets by a connective tissue called the periodontal ligament. \n\n The two main parts of a tooth are the  crown , which is the portion projecting above the gum line, and the  root , which is embedded within the maxilla and mandible. Both parts contain an inner  pulp cavity , containing loose connective tissue through which run nerves and blood vessels. The region of the pulp cavity that runs through the root of the tooth is called the root canal. Surrounding the pulp cavity is  dentin , a bone-like tissue. In the root of each tooth, the dentin is covered by an even harder bone-like layer called  cementum . In the crown of each tooth, the dentin is covered by an outer layer of  enamel , the hardest substance in the body ( Figure 23.11 ). \n\n Although enamel protects the underlying dentin and pulp cavity, it is still nonetheless susceptible to mechanical and chemical erosion, or what is known as tooth decay. The most common form, dental caries (cavities) develops when colonies of bacteria feeding on sugars in the mouth release acids that cause soft tissue inflammation and degradation of the calcium crystals of the enamel. The digestive functions of the mouth are summarized in  Table 23.4 . \n\n Digestive Functions of the Mouth \n\n Structure \n\n Action \n\n Outcome \n\n Lips and cheeks \n\n Confine food between teeth \n\n Food is chewed evenly during mastication \n\n Salivary glands \n\n Secrete saliva \n\n Moisten and lubricate the lining of the mouth and pharynx \n\n Moisten, soften, and dissolve food \n\n Clean the mouth and teeth \n\n Salivary amylase breaks down starch \n\n Tongue\u2019s extrinsic muscles \n\n Move tongue sideways, and in and out \n\n Manipulate food for chewing \n\n Shape food into a bolus \n\n Manipulate food for swallowing \n\n Tongue\u2019s intrinsic muscles \n\n Change tongue shape \n\n Manipulate food for swallowing \n\n Taste buds \n\n Sense food in mouth and sense taste \n\n Nerve impulses from taste buds are conducted to salivary nuclei in the brain stem and then to salivary glands, stimulating saliva secretion \n\n Lingual glands \n\n Secrete lingual lipase  \n\n Activated in the stomach \n\n Break down triglycerides into fatty acids and diglycerides \n\n Teeth \n\n Shred and crush food \n\n Break down solid food into smaller particles for deglutition \n\n Table  23.4     \n\n The Pharynx \n\n The  pharynx  (throat) is involved in both digestion and respiration. It receives food and air from the mouth, and air from the nasal cavities. When food enters the pharynx, involuntary muscle contractions close off the air passageways. \n\n A short tube of skeletal muscle lined with a mucous membrane, the pharynx runs from the posterior oral and nasal cavities to the opening of the esophagus and larynx. It has three subdivisions. The most superior, the nasopharynx, is involved only in breathing and speech. The other two subdivisions, the  oropharynx  and the  laryngopharynx , are used for both breathing and digestion. The oropharynx begins inferior to the nasopharynx and is continuous below with the laryngopharynx ( Figure 23.12 ). The inferior border of the laryngopharynx connects to the esophagus, whereas the anterior portion connects to the larynx, allowing air to flow into the bronchial tree. \n\n Histologically, the wall of the oropharynx is similar to that of the oral cavity. The mucosa includes a stratified squamous epithelium that is endowed with mucus-producing glands. During swallowing, the elevator skeletal muscles of the pharynx contract, raising and expanding the pharynx to receive the bolus of food. Once received, these muscles relax and the constrictor muscles of the pharynx contract, forcing the bolus into the esophagus and initiating peristalsis. \n\n Usually during swallowing, the soft palate and uvula rise reflexively to close off the entrance to the nasopharynx. At the same time, the larynx is pulled superiorly and the cartilaginous epiglottis, its most superior structure, folds inferiorly, covering the glottis (the opening to the larynx); this process effectively blocks access to the trachea and bronchi. When the food \u201cgoes down the wrong way,\u201d it goes into the trachea. When food enters the trachea, the reaction is to cough, which usually forces the food up and out of the trachea, and back into the pharynx. \n\n The Esophagus \n\n The  esophagus  is a muscular tube that connects the pharynx to the stomach. It is approximately 25.4 cm (10 in) in length, located posterior to the trachea, and remains in a collapsed form when not engaged in swallowing. As you can see in  Figure 23.13 , the esophagus runs a mainly straight route through the mediastinum of the thorax. To enter the abdomen, the esophagus penetrates the diaphragm through an opening called the esophageal hiatus. \n\n Passage of Food through the Esophagus \n\n The  upper esophageal sphincter , which is continuous with the inferior pharyngeal constrictor, controls the movement of food from the pharynx into the esophagus. The upper two-thirds of the esophagus consists of both smooth and skeletal muscle fibers, with the latter fading out in the bottom third of the esophagus. Rhythmic waves of peristalsis, which begin in the upper esophagus, propel the bolus of food toward the stomach. Meanwhile, secretions from the esophageal mucosa lubricate the esophagus and food. Food passes from the esophagus into the stomach at the  lower esophageal sphincter  (also called the gastroesophageal or cardiac sphincter). Recall that sphincters are muscles that surround tubes and serve as valves, closing the tube when the sphincters contract and opening it when they relax. The lower esophageal sphincter relaxes to let food pass into the stomach, and then contracts to prevent stomach acids from backing up into the esophagus. Surrounding this sphincter is the muscular diaphragm, which helps close off the sphincter when no food is being swallowed. When the lower esophageal sphincter does not completely close, the stomach\u2019s contents can reflux (that is, back up into the esophagus), causing heartburn or gastroesophageal reflux disease (GERD). \n\n Histology of the Esophagus \n\n The mucosa of the esophagus is made up of an epithelial lining that contains non-keratinized, stratified squamous epithelium, with a layer of basal and parabasal cells. This epithelium protects against erosion from food particles. The mucosa\u2019s lamina propria contains mucus-secreting glands. The muscularis layer changes according to location: In the upper third of the esophagus, the muscularis is skeletal muscle. In the middle third, it is both skeletal and smooth muscle. In the lower third, it is smooth muscle. As mentioned previously, the most superficial layer of the esophagus is called the adventitia, not the serosa. In contrast to the stomach and intestines, the loose connective tissue of the adventitia is not covered by a fold of visceral peritoneum. The digestive functions of the esophagus are identified in  Table 23.5 . \n\n Digestive Functions of the Esophagus \n\n Action \n\n Outcome \n\n Upper esophageal sphincter relaxation \n\n Allows the bolus to move from the laryngopharynx to the esophagus \n\n Peristalsis \n\n Propels the bolus through the esophagus \n\n Lower esophageal sphincter relaxation \n\n Allows the bolus to move from the esophagus into the stomach and prevents chyme from entering the esophagus \n\n Mucus secretion \n\n Lubricates the esophagus, allowing easy passage of the bolus \n\n Table  23.5     \n\n Deglutition \n\n Deglutition  is another word for swallowing\u2014the movement of food from the mouth to the stomach. The entire process takes about 4 to 8 seconds for solid or semisolid food, and about 1 second for very soft food and liquids. Although this sounds quick and effortless, deglutition is, in fact, a complex process that involves both the skeletal muscle of the tongue and the muscles of the pharynx and esophagus. It is aided by the presence of mucus and saliva. There are three stages in deglutition: the voluntary phase, the pharyngeal phase, and the esophageal phase ( Figure 23.14 ). The autonomic nervous system controls the latter two phases. \n\n The Voluntary Phase \n\n The  voluntary phase  of deglutition (also known as the oral or buccal phase) is so called because you can control when you swallow food. In this phase, chewing has been completed and swallowing is set in motion. The tongue moves upward and backward against the palate, pushing the bolus to the back of the oral cavity and into the oropharynx. Other muscles keep the mouth closed and prevent food from falling out. At this point, the two involuntary phases of swallowing begin. \n\n The Pharyngeal Phase \n\n In the pharyngeal phase, stimulation of receptors in the oropharynx sends impulses to the deglutition center (a collection of neurons that controls swallowing) in the medulla oblongata. Impulses are then sent back to the uvula and soft palate, causing them to move upward and close off the nasopharynx. The laryngeal muscles also constrict to prevent aspiration of food into the trachea. At this point, deglutition apnea takes place, which means that breathing ceases for a very brief time. Contractions of the pharyngeal constrictor muscles move the bolus through the oropharynx and laryngopharynx. Relaxation of the upper esophageal sphincter then allows food to enter the esophagus. \n\n The Esophageal Phase \n\n The entry of food into the esophagus marks the beginning of the esophageal phase of deglutition and the initiation of peristalsis. As in the previous phase, the complex neuromuscular actions are controlled by the medulla oblongata. Peristalsis propels the bolus through the esophagus and toward the stomach. The circular muscle layer of the muscularis contracts, pinching the esophageal wall and forcing the bolus forward. At the same time, the longitudinal muscle layer of the muscularis also contracts, shortening this area and pushing out its walls to receive the bolus. In this way, a series of contractions keeps moving food toward the stomach. When the bolus nears the stomach, distention of the esophagus initiates a short reflex relaxation of the lower esophageal sphincter that allows the bolus to pass into the stomach. During the esophageal phase, esophageal glands secrete mucus that lubricates the bolus and minimizes friction. \n\n Interactive Link \n\n Watch this  animation  to see how swallowing is a complex process that involves the nervous system to coordinate the actions of upper respiratory and digestive activities. During which stage of swallowing is there a risk of food entering respiratory pathways and how is this risk blocked? \n 23.4   The Stomach  Learning Objectives By the end of this section, you will be able to: \n\n Label on a diagram the four main regions of the stomach, its curvatures, and its sphincter \n\n Identify the four main types of secreting cells in gastric glands, and their important products \n\n Explain why the stomach does not digest itself \n\n Describe the mechanical and chemical digestion of food entering the stomach \n\n Although a minimal amount of carbohydrate digestion occurs in the mouth, chemical digestion really gets underway in the stomach. An expansion of the alimentary canal that lies immediately inferior to the esophagus, the stomach links the esophagus to the first part of the small intestine (the duodenum) and is relatively fixed in place at its esophageal and duodenal ends. In between, however, it can be a highly active structure, contracting and continually changing position and size. These contractions provide mechanical assistance to digestion. The empty stomach is only about the size of your fist, but can stretch to hold as much as 4 liters of food and fluid, or more than 75 times its empty volume, and then return to its resting size when empty. Although you might think that the size of a person\u2019s stomach is related to how much food that individual consumes, body weight does not correlate with stomach size. Rather, when you eat greater quantities of food\u2014such as at holiday dinner\u2014you stretch the stomach more than when you eat less. \n\n Popular culture tends to refer to the stomach as the location where all digestion takes place. Of course, this is not true. An important function of the stomach is to serve as a temporary holding chamber. You can ingest a meal far more quickly than it can be digested and absorbed by the small intestine. Thus, the stomach holds food and parses only small amounts into the small intestine at a time. Foods are not processed in the order they are eaten; rather, they are mixed together with digestive juices in the stomach until they are converted into chyme, which is released into the small intestine. \n\n As you will see in the sections that follow, the stomach plays several important roles in chemical digestion, including the continued digestion of carbohydrates and the initial digestion of proteins and triglycerides. Little if any nutrient absorption occurs in the stomach, with the exception of the negligible amount of nutrients in alcohol. \n\n Structure \n\n There are four main regions in the  stomach : the cardia, fundus, body, and pylorus ( Figure 23.15 ). The  cardia  (or cardiac region) is the point where the esophagus connects to the stomach and through which food passes into the stomach. Located inferior to the diaphragm, above and to the left of the cardia, is the dome-shaped  fundus . Below the fundus is the  body , the main part of the stomach. The funnel-shaped  pylorus  connects the stomach to the duodenum. The wider end of the funnel, the  pyloric antrum , connects to the body of the stomach. The narrower end is called the  pyloric canal , which connects to the duodenum. The smooth muscle  pyloric sphincter  is located at this latter point of connection and controls stomach emptying. In the absence of food, the stomach deflates inward, and its mucosa and submucosa fall into a large fold called a  ruga . The convex lateral surface of the stomach is called the greater curvature; the concave medial border is the lesser curvature. The stomach is held in place by the lesser omentum, which extends from the liver to the lesser curvature, and the greater omentum, which runs from the greater curvature to the posterior abdominal wall. \n\n Histology The wall of the stomach is made of the same four layers as most of the rest of the alimentary canal, but with adaptations to the mucosa and muscularis for the unique functions of this organ. In addition to the typical circular and longitudinal smooth muscle layers, the muscularis has an inner oblique smooth muscle layer ( Figure 23.16 ). As a result, in addition to moving food through the canal, the stomach can vigorously churn food, mechanically breaking it down into smaller particles. \n\n The stomach mucosa\u2019s epithelial lining consists only of surface mucus cells, which secrete a protective coat of alkaline mucus. A vast number of  gastric pits  dot the surface of the epithelium, giving it the appearance of a well-used pincushion, and mark the entry to each  gastric gland , which secretes a complex digestive fluid referred to as gastric juice. \n\n Although the walls of the gastric pits are made up primarily of mucus cells, the gastric glands are made up of different types of cells. The glands of the cardia and pylorus are composed primarily of mucus-secreting cells. Cells that make up the pyloric antrum secrete mucus and a number of hormones, including the majority of the stimulatory hormone,  gastrin . The much larger glands of the fundus and body of the stomach, the site of most chemical digestion, produce most of the gastric secretions. These glands are made up of a variety of secretory cells. These include parietal cells, chief cells, mucous neck cells, and enteroendocrine cells. \n\n Parietal cells \u2014Located primarily in the middle region of the gastric glands are  parietal cells , which are among the most highly differentiated of the body\u2019s epithelial cells. These relatively large cells produce both  hydrochloric acid (HCl)  and  intrinsic factor . HCl is responsible for the high acidity (pH 1.5 to 3.5) of the stomach contents and is needed to activate the protein-digesting enzyme, pepsin. The acidity also kills much of the bacteria you ingest with food and helps to denature proteins, making them more available for enzymatic digestion. Intrinsic factor is a glycoprotein necessary for the absorption of vitamin B 12  in the small intestine. \n\n Chief cells \u2014Located primarily in the basal regions of gastric glands are  chief cells , which secrete  pepsinogen , the inactive proenzyme form of pepsin. HCl is necessary for the conversion of pepsinogen to pepsin. \n\n Mucous neck cells \u2014Gastric glands in the upper part of the stomach contain  mucous neck cells  that secrete thin, acidic mucus that is much different from the mucus secreted by the goblet cells of the surface epithelium. The role of this mucus is not currently known. \n\n Enteroendocrine cells \u2014Finally,  enteroendocrine cells  found in the gastric glands secrete various hormones into the interstitial fluid of the lamina propria. These include gastrin, which is released mainly by enteroendocrine  G cells . \n\n Table 23.6  describes the digestive functions of important hormones secreted by the stomach. \n\n Interactive Link \n\n Watch this  animation  that depicts the structure of the stomach and how this structure functions in the initiation of protein digestion. This view of the stomach shows the characteristic rugae. What is the function of these rugae? \n\n Hormones Secreted by the Stomach \n\n Hormone \n\n Production site \n\n Production stimulus \n\n Target organ \n\n Action \n\n Gastrin \n\n Stomach mucosa, mainly G cells of the pyloric antrum \n\n Presence of peptides and amino acids in stomach \n\n Stomach \n\nIncreases secretion by gastric glands; promotes gastric emptying\n\n Gastrin \n\n Stomach mucosa, mainly G cells of the pyloric antrum \n\n Presence of peptides and amino acids in stomach \n\n Small intestine \n\n Promotes intestinal muscle contraction \n\n Gastrin \n\n Stomach mucosa, mainly G cells of the pyloric antrum \n\n Presence of peptides and amino acids in stomach \n\n Ileocecal valve \n\n Relaxes valve \n\n Gastrin \n\n Stomach mucosa, mainly G cells of the pyloric antrum \n\n Presence of peptides and amino acids in stomach \n\n Large intestine \n\n Triggers mass movements \n\n Ghrelin \n\n Stomach mucosa, mainly fundus \n\n Fasting state (levels increase just prior to meals) \n\n Hypothalamus \n\n Regulates food intake, primarily by stimulating hunger and satiety \n\n Histamine \n\n Stomach mucosa \n\n Presence of food in the stomach \n\n Stomach \n\n Stimulates parietal cells to release HCl \n\n Serotonin \n\n Stomach mucosa \n\n Presence of food in the stomach \n\n Stomach \n\n Contracts stomach muscle \n\n Somatostatin \n\n Mucosa of stomach, especially pyloric antrum; also duodenum \n\n Presence of food in the stomach; sympathetic axon stimulation \n\n Stomach \n\n Restricts all gastric secretions, gastric motility, and emptying \n\n Somatostatin \n\n Mucosa of stomach, especially pyloric antrum; also duodenum \n\n Presence of food in the stomach; sympathetic axon stimulation \n\n Pancreas \n\n Restricts pancreatic secretions \n\n Somatostatin \n\n Mucosa of stomach, especially pyloric antrum; also duodenum \n\n Presence of food in the stomach; sympathetic axon stimulation \n\n Small intestine \n\n Reduces intestinal absorption by reducing blood flow \n\n Table  23.6     \n\n Gastric Secretion \n\n The secretion of gastric juice is controlled by both nerves and hormones. Stimuli in the brain, stomach, and small intestine activate or inhibit gastric juice production. This is why the three phases of gastric secretion are called the cephalic, gastric, and intestinal phases ( Figure 23.17 ). However, once gastric secretion begins, all three phases can occur simultaneously. The  cephalic phase  (reflex phase) of gastric secretion, which is relatively brief, takes place before food enters the stomach. The smell, taste, sight, or thought of food triggers this phase. For example, when you bring a piece of sushi to your lips, impulses from receptors in your taste buds or the nose are relayed to your brain, which returns signals that increase gastric secretion to prepare your stomach for digestion. This enhanced secretion is a conditioned reflex, meaning it occurs only if you like or want a particular food. Depression and loss of appetite can suppress the cephalic reflex. \n\n The  gastric phase  of secretion lasts 3 to 4 hours, and is set in motion by local neural and hormonal mechanisms triggered by the entry of food into the stomach. For example, when your sushi reaches the stomach, it creates distention that activates the stretch receptors. This stimulates parasympathetic neurons to release acetylcholine, which then provokes increased secretion of gastric juice. Partially digested proteins, caffeine, and rising pH stimulate the release of gastrin from enteroendocrine G cells, which in turn induces parietal cells to increase their production of HCl, which is needed to create an acidic environment for the conversion of pepsinogen to pepsin, and protein digestion. Additionally, the release of gastrin activates vigorous smooth muscle contractions. However, it should be noted that the stomach does have a natural means of avoiding excessive acid secretion and potential heartburn. Whenever pH levels drop too low, cells in the stomach react by suspending HCl secretion and increasing mucous secretions. \n\n The  intestinal phase  of gastric secretion has both excitatory and inhibitory elements. The duodenum has a major role in regulating the stomach and its emptying. When partially digested food fills the duodenum, intestinal mucosal cells release a hormone called intestinal (enteric) gastrin, which further excites gastric juice secretion. This stimulatory activity is brief, however, because when the intestine distends with chyme, the enterogastric reflex inhibits secretion. One of the effects of this reflex is to close the pyloric sphincter, which blocks additional chyme from entering the duodenum. \n\n The Mucosal Barrier \n\n The mucosa of the stomach is exposed to the highly corrosive acidity of gastric juice. Gastric enzymes that can digest protein can also digest the stomach itself. The stomach is protected from self-digestion by the  mucosal barrier . This barrier has several components. First, the stomach wall is covered by a thick coating of bicarbonate-rich mucus. This mucus forms a physical barrier, and its bicarbonate ions neutralize acid. Second, the epithelial cells of the stomach's mucosa meet at tight junctions, which block gastric juice from penetrating the underlying tissue layers. Finally, stem cells located where gastric glands join the gastric pits quickly replace damaged epithelial mucosal cells, when the epithelial cells are shed. In fact, the surface epithelium of the stomach is completely replaced every 3 to 6 days. \n\n Homeostatic Imbalances Ulcers: When the Mucosal Barrier Breaks Down \n\nAs effective as the mucosal barrier is, it is not a \u201cfail-safe\u201d mechanism. Sometimes, gastric juice eats away at the superficial lining of the stomach mucosa, creating erosions, which mostly heal on their own. Deeper and larger erosions are called ulcers. \n\n Why does the mucosal barrier break down? A number of factors can interfere with its ability to protect the stomach lining. The majority of all ulcers are caused by either excessive intake of non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin, or  Helicobacter pylori  infection. \n\n Antacids help relieve symptoms of ulcers such as \u201cburning\u201d pain and indigestion. When ulcers are caused by NSAID use, switching to other classes of pain relievers allows healing. When caused by  H. pylori  infection, antibiotics are effective. \n\n A potential complication of ulcers is perforation: Perforated ulcers create a hole in the stomach wall, resulting in peritonitis (inflammation of the peritoneum). These ulcers must be repaired surgically. \n\n Digestive Functions of the Stomach \n\n The stomach participates in virtually all the digestive activities with the exception of ingestion and defecation. Although almost all absorption takes place in the small intestine, the stomach does absorb some drugs, such as alcohol and aspirin. \n\n Mechanical Digestion \n\n Within a few moments after food enters your stomach, mixing waves begin to occur at intervals of approximately 20 seconds. A  mixing wave  is a unique type of peristalsis that mixes and softens the food with gastric juices to create chyme. The initial mixing waves are relatively gentle, but these are followed by more intense waves, starting at the body of the stomach and increasing in force as they reach the pylorus. It is fair to say that long before your sushi exits through the pyloric sphincter, it bears little resemblance to the sushi you ate. The pylorus, which holds around 30 mL (1 fluid ounce) of chyme, acts as a filter, permitting only liquids and small food particles to pass through the mostly, but not fully, closed pyloric sphincter. In a process called  gastric emptying , rhythmic mixing waves force about 3 mL of chyme at a time through the pyloric sphincter and into the duodenum. Release of a greater amount of chyme at one time would overwhelm the capacity of the small intestine to handle it. The rest of the chyme is pushed back into the body of the stomach, where it continues mixing. This process is repeated when the next mixing waves force more chyme into the duodenum. \n\n Gastric emptying is regulated by both the stomach and the duodenum. The presence of chyme in the duodenum activates receptors that inhibit gastric secretion. This prevents additional chyme from being released by the stomach before the duodenum is ready to process it. \n\n Chemical Digestion \n\n The fundus plays an important role, because it stores both undigested food and gases that are released during the process of chemical digestion. Food may sit in the fundus of the stomach for a while before being mixed with the chyme. While the food is in the fundus, the digestive activities of salivary amylase continue until the food begins mixing with the acidic chyme. Ultimately, mixing waves incorporate this food with the chyme, the acidity of which inactivates salivary amylase and activates lingual lipase. Lingual lipase then begins breaking down triglycerides into free fatty acids, and mono- and diglycerides. \n\n The breakdown of protein begins in the stomach through the actions of HCl and the enzyme pepsin. \n\n Its numerous digestive functions notwithstanding, there is only one stomach function necessary to life: the production of intrinsic factor. The intestinal absorption of vitamin B 12 , which is necessary for both the production of mature red blood cells and normal neurological functioning, cannot occur without intrinsic factor. People who undergo total gastrectomy (stomach removal)\u2014for life-threatening stomach cancer, for example\u2014can survive with minimal digestive dysfunction if they receive vitamin B 12  injections. \n\n The contents of the stomach are completely emptied into the duodenum within 2 to 4 hours after you eat a meal. Different types of food take different amounts of time to process. Foods heavy in carbohydrates empty fastest, followed by high-protein foods. Meals with a high triglyceride content remain in the stomach the longest. Since enzymes in the small intestine digest fats slowly, food can stay in the stomach for 6 hours or longer when the duodenum is processing fatty chyme. However, note that this is still a fraction of the 24 to 72 hours that full digestion typically takes from start to finish. \n 23.5   The Small and Large Intestines  Learning Objectives By the end of this section, you will be able to: \n\n Compare and contrast the location and gross anatomy of the small and large intestines \n\n Identify three main adaptations of the small intestine wall that increase its absorptive capacity \n\n Describe the mechanical and chemical digestion of chyme upon its release into the small intestine \n\n List three features unique to the wall of the large intestine and identify their contributions to its function \n\n Identify the beneficial roles of the bacterial flora in digestive system functioning \n\n Trace the pathway of food waste from its point of entry into the large intestine through its exit from the body as feces \n\n The word intestine is derived from a Latin root meaning \u201cinternal,\u201d and indeed, the two organs together nearly fill the interior of the abdominal cavity. In addition, called the small and large bowel, or colloquially the \u201cguts,\u201d they constitute the greatest mass and length of the alimentary canal and, with the exception of ingestion, perform all digestive system functions. \n\n The Small Intestine \n\n Chyme released from the stomach enters the  small intestine , which is the primary digestive organ in the body. Not only is this where most digestion occurs, it is also where practically all absorption occurs. The longest part of the alimentary canal, the small intestine is about 3.05 meters (10 feet) long in a living person (but about twice as long in a cadaver due to the loss of muscle tone). Since this makes it about five times longer than the large intestine, you might wonder why it is called \u201csmall.\u201d In fact, its name derives from its relatively smaller diameter of only about 2.54 cm (1 in), compared with 7.62 cm (3 in) for the large intestine. As we\u2019ll see shortly, in addition to its length, the folds and projections of the lining of the small intestine work to give it an enormous surface area, which is approximately 200 m 2 , more than 100 times the surface area of your skin. This large surface area is necessary for complex processes of digestion and absorption that occur within it. \n\n Structure \n\n The coiled tube of the small intestine is subdivided into three regions. From proximal (at the stomach) to distal, these are the duodenum, jejunum, and ileum ( Figure 23.18 ). \n\n The shortest region is the 25.4-cm (10-in)  duodenum , which begins at the pyloric sphincter. Just past the pyloric sphincter, it bends posteriorly behind the peritoneum, becoming retroperitoneal, and then makes a C-shaped curve around the head of the pancreas before ascending anteriorly again to return to the peritoneal cavity and join the jejunum. The duodenum can therefore be subdivided into four segments: the superior, descending, horizontal, and ascending duodenum. \n\n Of particular interest is the  hepatopancreatic ampulla  (ampulla of Vater). Located in the duodenal wall, the ampulla marks the transition from the anterior portion of the alimentary canal to the mid-region, and is where the bile duct (through which bile passes from the liver) and the  main pancreatic duct  (through which pancreatic juice passes from the pancreas) join. This ampulla opens into the duodenum at a tiny volcano-shaped structure called the  major duodenal papilla . The  hepatopancreatic sphincter  (sphincter of Oddi) regulates the flow of both bile and pancreatic juice from the ampulla into the duodenum. \n\n The  jejunum  is about 0.9 meters (3 feet) long (in life) and runs from the duodenum to the ileum. Jejunum means \u201cempty\u201d in Latin and supposedly was so named by the ancient Greeks who noticed it was always empty at death. No clear demarcation exists between the jejunum and the final segment of the small intestine, the ileum. \n\n The  ileum  is the longest part of the small intestine, measuring about 1.8 meters (6 feet) in length. It is thicker, more vascular, and has more developed mucosal folds than the jejunum. The ileum joins the cecum, the first portion of the large intestine, at the  ileocecal sphincter  (or valve). The jejunum and ileum are tethered to the posterior abdominal wall by the mesentery. The large intestine frames these three parts of the small intestine. \n\n Parasympathetic nerve fibers from the vagus nerve and sympathetic nerve fibers from the thoracic splanchnic nerve provide extrinsic innervation to the small intestine. The superior mesenteric artery is its main arterial supply. Veins run parallel to the arteries and drain into the superior mesenteric vein. Nutrient-rich blood from the small intestine is then carried to the liver via the hepatic portal vein. \n\n Histology \n\n The wall of the small intestine is composed of the same four layers typically present in the alimentary system. However, three features of the mucosa and submucosa are unique. These features, which increase the absorptive surface area of the small intestine more than 600-fold, include circular folds, villi, and microvilli ( Figure 23.19 ). These adaptations are most abundant in the proximal two-thirds of the small intestine, where the majority of absorption occurs. \n\n Circular folds \n\n Also called a plica circulare, a  circular fold  is a deep ridge in the mucosa and submucosa. Beginning near the proximal part of the duodenum and ending near the middle of the ileum, these folds facilitate absorption. Their shape causes the chyme to spiral, rather than move in a straight line, through the small intestine. Spiraling slows the movement of chyme and provides the time needed for nutrients to be fully absorbed. \n\n Villi \n\n Within the circular folds are small (0.5\u20131 mm long) hairlike vascularized projections called  villi  (singular = villus) that give the mucosa a furry texture. There are about 20 to 40 villi per square millimeter, increasing the surface area of the epithelium tremendously. The mucosal epithelium, primarily composed of absorptive cells, covers the villi. In addition to muscle and connective tissue to support its structure, each villus contains a capillary bed composed of one arteriole and one venule, as well as a lymphatic capillary called a  lacteal . The breakdown products of carbohydrates and proteins (sugars and amino acids) can enter the bloodstream directly, but lipid breakdown products are absorbed by the lacteals and transported to the bloodstream via the lymphatic system. \n\n Microvilli \n\n As their name suggests,  microvilli  (singular = microvillus) are much smaller (1  \u00b5 m) than villi. They are cylindrical apical surface extensions of the plasma membrane of the mucosa\u2019s epithelial cells, and are supported by microfilaments within those cells. Although their small size makes it difficult to see each microvillus, their combined microscopic appearance suggests a mass of bristles, which is termed the  brush border . Fixed to the surface of the microvilli membranes are enzymes that finish digesting carbohydrates and proteins. There are an estimated 200 million microvilli per square millimeter of small intestine, greatly expanding the surface area of the plasma membrane and thus greatly enhancing absorption. \n\n Intestinal Glands \n\n In addition to the three specialized absorptive features just discussed, the mucosa between the villi is dotted with deep crevices that each lead into a tubular  intestinal gland  (crypt of Lieberk\u00fchn), which is formed by cells that line the crevices (see  Figure 23.19 ). These produce  intestinal juice , a slightly alkaline (pH 7.4 to 7.8) mixture of water and mucus. Each day, about 0.95 to 1.9 liters (1 to 2 quarts) are secreted in response to the distention of the small intestine or the irritating effects of chyme on the intestinal mucosa. \n\n The submucosa of the duodenum is the only site of the complex mucus-secreting  duodenal glands  (Brunner\u2019s glands), which produce a bicarbonate-rich alkaline mucus that buffers the acidic chyme as it enters from the stomach. The roles of the cells in the small intestinal mucosa are detailed in  Table 23.7 . \n\n Cells of the Small Intestinal Mucosa \n\n Cell type \n\n Location in the mucosa \n\n Function \n\n Absorptive \n\n Epithelium/intestinal glands \n\n Digestion and absorption of nutrients in chyme \n\n Goblet \n\n Epithelium/intestinal glands \n\n Secretion of mucus \n\n Paneth \n\n Intestinal glands \n\n Secretion of the bactericidal enzyme lysozyme; phagocytosis \n\n G cells \n\n Intestinal glands of duodenum  \n\n Secretion of the hormone intestinal gastrin \n\n I cells \n\n Intestinal glands of duodenum \n\n Secretion of the hormone cholecystokinin, which stimulates release of pancreatic juices and bile \n\n K cells \n\n Intestinal glands \n\n Secretion of the hormone glucose-dependent insulinotropic peptide, which stimulates the release of insulin \n\n M cells \n\n Intestinal glands of duodenum and jejunum \n\n Secretion of the hormone motilin, which accelerates gastric emptying, stimulates intestinal peristalsis, and stimulates the production of pepsin \n\n S cells \n\n Intestinal glands \n\n Secretion of the hormone secretin \n\n Table  23.7     \n\n Intestinal MALT \n\n The lamina propria of the small intestine mucosa is studded with quite a bit of MALT. In addition to solitary lymphatic nodules, aggregations of intestinal MALT, which are typically referred to as Peyer\u2019s patches, are concentrated in the distal ileum, and serve to keep bacteria from entering the bloodstream. Peyer\u2019s patches are most prominent in young people and become less distinct as you age, which coincides with the general activity of our immune system. \n\n Interactive Link \n\n Watch this  animation  that depicts the structure of the small intestine, and, in particular, the villi. Epithelial cells continue the digestion and absorption of nutrients and transport these nutrients to the lymphatic and circulatory systems. In the small intestine, the products of food digestion are absorbed by different structures in the villi. Which structure absorbs and transports fats? \n\n Mechanical Digestion in the Small Intestine \n\n The movement of intestinal smooth muscles includes both segmentation and a form of peristalsis called migrating motility complexes. The kind of peristaltic mixing waves seen in the stomach are not observed here. \n\n If you could see into the small intestine when it was going through segmentation, it would look as if the contents were being shoved incrementally back and forth, as the rings of smooth muscle repeatedly contract and then relax. Segmentation in the small intestine does not force chyme through the tract. Instead, it combines the chyme with digestive juices and pushes food particles against the mucosa to be absorbed. The duodenum is where the most rapid segmentation occurs, at a rate of about 12 times per minute. In the ileum, segmentations are only about eight times per minute ( Figure 23.20 ). \n\n When most of the chyme has been absorbed, the small intestinal wall becomes less distended. At this point, the localized segmentation process is replaced by transport movements. The duodenal mucosa secretes the hormone  motilin , which initiates peristalsis in the form of a  migrating motility complex . These complexes, which begin in the duodenum, force chyme through a short section of the small intestine and then stop. The next contraction begins a little bit farther down than the first, forces chyme a bit farther through the small intestine, then stops. These complexes move slowly down the small intestine, forcing chyme on the way, taking around 90 to 120 minutes to finally reach the end of the ileum. At this point, the process is repeated, starting in the duodenum. The ileocecal valve, a sphincter, is usually in a constricted state, but when motility in the ileum increases, this sphincter relaxes, allowing food residue to enter the first portion of the large intestine, the cecum. Relaxation of the ileocecal sphincter is controlled by both nerves and hormones. First, digestive activity in the stomach provokes the  gastroileal reflex , which increases the force of ileal segmentation. Second, the stomach releases the hormone gastrin, which enhances ileal motility, thus relaxing the ileocecal sphincter. After chyme passes through, backward pressure helps close the sphincter, preventing backflow into the ileum. Because of this reflex, your lunch is completely emptied from your stomach and small intestine by the time you eat your dinner. It takes about 3 to 5 hours for all chyme to leave the small intestine. \n\n Chemical Digestion in the Small Intestine \n\n The digestion of proteins and carbohydrates, which partially occurs in the stomach, is completed in the small intestine with the aid of intestinal and pancreatic juices. Lipids arrive in the intestine largely undigested, so much of the focus here is on lipid digestion, which is facilitated by bile and the enzyme pancreatic lipase. Moreover, intestinal juice combines with pancreatic juice to provide a liquid medium that facilitates absorption. The intestine is also where most water is absorbed, via osmosis. The small intestine\u2019s absorptive cells also synthesize digestive enzymes and then place them in the plasma membranes of the microvilli. This distinguishes the small intestine from the stomach; that is, enzymatic digestion occurs not only in the lumen, but also on the luminal surfaces of the mucosal cells. \n\n For optimal chemical digestion, chyme must be delivered from the stomach slowly and in small amounts. This is because chyme from the stomach is typically hypertonic, and if large quantities were forced all at once into the small intestine, the resulting osmotic water loss from the blood into the intestinal lumen would result in potentially life-threatening low blood volume. In addition, continued digestion requires an upward adjustment of the low pH of stomach chyme, along with rigorous mixing of the chyme with bile and pancreatic juices. Both processes take time, so the pumping action of the pylorus must be carefully controlled to prevent the duodenum from being overwhelmed with chyme. \n\n Disorders of the... Small Intestine: Lactose Intolerance \n\nLactose intolerance is a condition characterized by indigestion caused by dairy products. It occurs when the absorptive cells of the small intestine do not produce enough lactase, the enzyme that digests the milk sugar lactose. In most mammals, lactose intolerance increases with age. In contrast, some human populations, most notably Caucasians, are able to maintain the ability to produce lactase as adults. \n\n In people with lactose intolerance, the lactose in chyme is not digested. Bacteria in the large intestine ferment the undigested lactose, a process that produces gas. In addition to gas, symptoms include abdominal cramps, bloating, and diarrhea. Symptom severity ranges from mild discomfort to severe pain; however, symptoms resolve once the lactose is eliminated in feces. \n\n The hydrogen breath test is used to help diagnose lactose intolerance. Lactose-tolerant people have very little hydrogen in their breath. Those with lactose intolerance exhale hydrogen, which is one of the gases produced by the bacterial fermentation of lactose in the colon. After the hydrogen is absorbed from the intestine, it is transported through blood vessels into the lungs. There are a number of lactose-free dairy products available in grocery stores. In addition, dietary supplements are available. Taken with food, they provide lactase to help digest lactose. \n\n The Large Intestine \n\n The  large intestine  is the terminal part of the alimentary canal. The primary function of this organ is to finish absorption of nutrients and water, synthesize certain vitamins, form feces, and eliminate feces from the body. \n\n Structure \n\n The large intestine runs from the appendix to the anus. It frames the small intestine on three sides. Despite its being about one-half as long as the small intestine, it is called large because it is more than twice the diameter of the small intestine, about 3 inches. \n\n Subdivisions \n\n The large intestine is subdivided into four main regions: the cecum, the colon, the rectum, and the anus. The ileocecal valve, located at the opening between the ileum and the large intestine, controls the flow of chyme from the small intestine to the large intestine. \n\n Cecum \n\n The first part of the large intestine is the  cecum , a sac-like structure that is suspended inferior to the ileocecal valve. It is about 6 cm (2.4 in) long, receives the contents of the ileum, and continues the absorption of water and salts. The  appendix  (or vermiform appendix) is a winding tube that attaches to the cecum. Although the 7.6-cm (3-in) long appendix contains lymphoid tissue, suggesting an immunologic function, this organ is generally considered vestigial. However, at least one recent report postulates a survival advantage conferred by the appendix: In diarrheal illness, the appendix may serve as a bacterial reservoir to repopulate the enteric bacteria for those surviving the initial phases of the illness. Moreover, its twisted anatomy provides a haven for the accumulation and multiplication of enteric bacteria. The  mesoappendix , the mesentery of the appendix, tethers it to the mesentery of the ileum. \n\n Colon \n\n The cecum blends seamlessly with the  colon . Upon entering the colon, the food residue first travels up the  ascending colon  on the right side of the abdomen. At the inferior surface of the liver, the colon bends to form the  right colic flexure  (hepatic flexure) and becomes the  transverse colon . The region defined as hindgut begins with the last third of the transverse colon and continues on. Food residue passing through the transverse colon travels across to the left side of the abdomen, where the colon angles sharply immediately inferior to the spleen, at the  left colic flexure  (splenic flexure). From there, food residue passes through the  descending colon , which runs down the left side of the posterior abdominal wall. After entering the pelvis inferiorly, it becomes the s-shaped  sigmoid colon , which extends medially to the midline ( Figure 23.21 ). The ascending and descending colon, and the rectum (discussed next) are located in the retroperitoneum. The transverse and sigmoid colon are tethered to the posterior abdominal wall by the mesocolon. \n\n Homeostatic Imbalances Colorectal Cancer \n\nEach year, approximately 140,000 Americans are diagnosed with colorectal cancer, and another 49,000 die from it, making it one of the most deadly malignancies. People with a family history of colorectal cancer are at increased risk. Smoking, excessive alcohol consumption, and a diet high in animal fat and protein also increase the risk. Despite popular opinion to the contrary, studies support the conclusion that dietary fiber and calcium do not reduce the risk of colorectal cancer. \n\n Colorectal cancer may be signaled by constipation or diarrhea, cramping, abdominal pain, and rectal bleeding. Bleeding from the rectum may be either obvious or occult (hidden in feces). Since most colon cancers arise from benign mucosal growths called polyps, cancer prevention is focused on identifying these polyps. The colonoscopy is both diagnostic and therapeutic. Colonoscopy not only allows identification of precancerous polyps, the procedure also enables them to be removed before they become malignant. Screening for fecal occult blood tests and colonoscopy is recommended for those over 50 years of age. \n\n Rectum \n\n Food residue leaving the sigmoid colon enters the  rectum  in the pelvis, near the third sacral vertebra. The final 20.3 cm (8 in) of the alimentary canal, the rectum extends anterior to the sacrum and coccyx. Even though rectum is Latin for \u201cstraight,\u201d this structure follows the curved contour of the sacrum and has three lateral bends that create a trio of internal transverse folds called the  rectal valves . These valves help separate the feces from gas to prevent the simultaneous passage of feces and gas. \n\n Anal Canal \n\n Finally, food residue reaches the last part of the large intestine, the  anal canal , which is located in the perineum, completely outside of the abdominopelvic cavity. This 3.8\u20135 cm (1.5\u20132 in) long structure opens to the exterior of the body at the anus. The anal canal includes two sphincters. The  internal anal sphincter  is made of smooth muscle, and its contractions are involuntary. The  external anal sphincter  is made of skeletal muscle, which is under voluntary control. Except when defecating, both usually remain closed. \n\n Histology \n\n There are several notable differences between the walls of the large and small intestines ( Figure 23.22 ). For example, few enzyme-secreting cells are found in the wall of the large intestine, and there are no circular folds or villi. Other than in the anal canal, the mucosa of the colon is simple columnar epithelium made mostly of enterocytes (absorptive cells) and goblet cells. In addition, the wall of the large intestine has far more intestinal glands, which contain a vast population of enterocytes and goblet cells. These goblet cells secrete mucus that eases the movement of feces and protects the intestine from the effects of the acids and gases produced by enteric bacteria. The enterocytes absorb water and salts as well as vitamins produced by your intestinal bacteria. \n\n Anatomy \n\n Three features are unique to the large intestine: teniae coli, haustra, and epiploic appendages ( Figure 23.23 ). The  teniae coli  are three bands of smooth muscle that make up the longitudinal muscle layer of the muscularis of the large intestine, except at its terminal end. Tonic contractions of the teniae coli bunch up the colon into a succession of pouches called  haustra  (singular = haustrum), which are responsible for the wrinkled appearance of the colon. Attached to the teniae coli are small, fat-filled sacs of visceral peritoneum called  epiploic appendages . The purpose of these is unknown. Although the rectum and anal canal have neither teniae coli nor haustra, they do have well-developed layers of muscularis that create the strong contractions needed for defecation. The stratified squamous epithelial mucosa of the anal canal connects to the skin on the outside of the anus. This mucosa varies considerably from that of the rest of the colon to accommodate the high level of abrasion as feces pass through. The anal canal\u2019s mucous membrane is organized into longitudinal folds, each called an  anal column , which house a grid of arteries and veins. Two superficial venous plexuses are found in the anal canal: one within the anal columns and one at the anus. \n\n Depressions between the anal columns, each called an  anal sinus , secrete mucus that facilitates defecation. The  pectinate line  (or dentate line) is a horizontal, jagged band that runs circumferentially just below the level of the anal sinuses, and represents the junction between the hindgut and external skin. The mucosa above this line is fairly insensitive, whereas the area below is very sensitive. The resulting difference in pain threshold is due to the fact that the upper region is innervated by visceral sensory fibers, and the lower region is innervated by somatic sensory fibers. \n\n Bacterial Flora \n\n Most bacteria that enter the alimentary canal are killed by lysozyme, defensins, HCl, or protein-digesting enzymes. However, trillions of bacteria live within the large intestine and are referred to as the  bacterial flora . Most of the more than 700 species of these bacteria are nonpathogenic commensal organisms that cause no harm as long as they stay in the gut lumen. In fact, many facilitate chemical digestion and absorption, and some synthesize certain vitamins, mainly biotin, pantothenic acid, and vitamin K. Some are linked to increased immune response. A refined system prevents these bacteria from crossing the mucosal barrier. First, peptidoglycan, a component of bacterial cell walls, activates the release of chemicals by the mucosa\u2019s epithelial cells, which draft immune cells, especially dendritic cells, into the mucosa. Dendritic cells open the tight junctions between epithelial cells and extend probes into the lumen to evaluate the microbial antigens. The dendritic cells with antigens then travel to neighboring lymphoid follicles in the mucosa where T cells inspect for antigens. This process triggers an IgA-mediated response, if warranted, in the lumen that blocks the commensal organisms from infiltrating the mucosa and setting off a far greater, widespread systematic reaction. \n\n Digestive Functions of the Large Intestine \n\n The residue of chyme that enters the large intestine contains few nutrients except water, which is reabsorbed as the residue lingers in the large intestine, typically for 12 to 24 hours. Thus, it may not surprise you that the large intestine can be completely removed without significantly affecting digestive functioning. For example, in severe cases of inflammatory bowel disease, the large intestine can be removed by a procedure known as a colectomy. Often, a new fecal pouch can be crafted from the small intestine and sutured to the anus, but if not, an ileostomy can be created by bringing the distal ileum through the abdominal wall, allowing the watery chyme to be collected in a bag-like adhesive appliance. \n\n Mechanical Digestion \n\n In the large intestine, mechanical digestion begins when chyme moves from the ileum into the cecum, an activity regulated by the ileocecal sphincter. Right after you eat, peristalsis in the ileum forces chyme into the cecum. When the cecum is distended with chyme, contractions of the ileocecal sphincter strengthen. Once chyme enters the cecum, colon movements begin. \n\n Mechanical digestion in the large intestine includes a combination of three types of movements. The presence of food residues in the colon stimulates a slow-moving  haustral contraction . This type of movement involves sluggish segmentation, primarily in the transverse and descending colons. When a haustrum is distended with chyme, its muscle contracts, pushing the residue into the next haustrum. These contractions occur about every 30 minutes, and each last about 1 minute. These movements also mix the food residue, which helps the large intestine absorb water. The second type of movement is peristalsis, which, in the large intestine, is slower than in the more proximal portions of the alimentary canal. The third type is a  mass movement . These strong waves start midway through the transverse colon and quickly force the contents toward the rectum. Mass movements usually occur three or four times per day, either while you eat or immediately afterward. Distension in the stomach and the breakdown products of digestion in the small intestine provoke the  gastrocolic reflex , which increases motility, including mass movements, in the colon. Fiber in the diet both softens the stool and increases the power of colonic contractions, optimizing the activities of the colon. \n\n Chemical Digestion \n\n Although the glands of the large intestine secrete mucus, they do not secrete digestive enzymes. Therefore, chemical digestion in the large intestine occurs exclusively because of bacteria in the lumen of the colon. Through the process of  saccharolytic fermentation , bacteria break down some of the remaining carbohydrates. This results in the discharge of hydrogen, carbon dioxide, and methane gases that create  flatus  (gas) in the colon; flatulence is excessive flatus. Each day, up to 1500 mL of flatus is produced in the colon. More is produced when you eat foods such as beans, which are rich in otherwise indigestible sugars and complex carbohydrates like soluble dietary fiber. \n\n Absorption, Feces Formation, and Defecation \n\n The small intestine absorbs about 90 percent of the water you ingest (either as liquid or within solid food). The large intestine absorbs most of the remaining water, a process that converts the liquid chyme residue into semisolid  feces  (\u201cstool\u201d). Feces is composed of undigested food residues, unabsorbed digested substances, millions of bacteria, old epithelial cells from the GI mucosa, inorganic salts, and enough water to let it pass smoothly out of the body. Of every 500 mL (17 ounces) of food residue that enters the cecum each day, about 150 mL (5 ounces) become feces. \n\n Feces are eliminated through contractions of the rectal muscles. You help this process by a voluntary procedure called  Valsalva\u2019s maneuver , in which you increase intra-abdominal pressure by contracting your diaphragm and abdominal wall muscles, and closing your glottis. \n\n The process of defecation begins when mass movements force feces from the colon into the rectum, stretching the rectal wall and provoking the defecation reflex, which eliminates feces from the rectum. This parasympathetic reflex is mediated by the spinal cord. It contracts the sigmoid colon and rectum, relaxes the internal anal sphincter, and initially contracts the external anal sphincter. The presence of feces in the anal canal sends a signal to the brain, which gives you the choice of voluntarily opening the external anal sphincter (defecating) or keeping it temporarily closed. If you decide to delay defecation, it takes a few seconds for the reflex contractions to stop and the rectal walls to relax. The next mass movement will trigger additional defecation reflexes until you defecate. \n\n If defecation is delayed for an extended time, additional water is absorbed, making the feces firmer and potentially leading to constipation. On the other hand, if the waste matter moves too quickly through the intestines, not enough water is absorbed, and diarrhea can result. This can be caused by the ingestion of foodborne pathogens. In general, diet, health, and stress determine the frequency of bowel movements. The number of bowel movements varies greatly between individuals, ranging from two or three per day to three or four per week. \n\n Interactive Link \n\n By watching this  animation  you will see that for the various food groups\u2014proteins, fats, and carbohydrates\u2014digestion begins in different parts of the digestion system, though all end in the same place. Of the three major food classes (carbohydrates, fats, and proteins), which is digested in the mouth, the stomach, and the small intestine? \n 23.6   Accessory Organs in Digestion: The Liver, Pancreas, and Gallbladder  Learning Objectives By the end of this section, you will be able to: \n\n State the main digestive roles of the liver, pancreas, and gallbladder \n\n Identify three main features of liver histology that are critical to its function \n\n Discuss the composition and function of bile \n\n Identify the major types of enzymes and buffers present in pancreatic juice \n\n Chemical digestion in the small intestine relies on the activities of three accessory digestive organs: the liver, pancreas, and gallbladder ( Figure 23.24 ). The digestive role of the liver is to produce bile and export it to the duodenum. The gallbladder primarily stores, concentrates, and releases bile. The pancreas produces pancreatic juice, which contains digestive enzymes and bicarbonate ions, and delivers it to the duodenum.\n\n The Liver \n\n The  liver  is the largest gland in the body, weighing about three pounds in an adult. It is also one of the most important organs. In addition to being an accessory digestive organ, it plays a number of roles in metabolism and regulation. The liver lies inferior to the diaphragm in the right upper quadrant of the abdominal cavity and receives protection from the surrounding ribs. \n\n The liver is divided into two primary lobes: a large right lobe and a much smaller left lobe. In the right lobe, some anatomists also identify an inferior quadrate lobe and a posterior caudate lobe, which are defined by internal features. The liver is connected to the abdominal wall and diaphragm by five peritoneal folds referred to as ligaments. These are the falciform ligament, the coronary ligament, two lateral ligaments, and the ligamentum teres hepatis. The falciform ligament and ligamentum teres hepatis are actually remnants of the umbilical vein, and separate the right and left lobes anteriorly. The lesser omentum tethers the liver to the lesser curvature of the stomach. \n\n The  porta hepatis  (\u201cgate to the liver\u201d) is where the  hepatic artery  and  hepatic portal vein  enter the liver. These two vessels, along with the common hepatic duct, run behind the lateral border of the lesser omentum on the way to their destinations. As shown in  Figure 23.25 , the hepatic artery delivers oxygenated blood from the heart to the liver. The hepatic portal vein delivers partially deoxygenated blood containing nutrients absorbed from the small intestine and actually supplies more oxygen to the liver than do the much smaller hepatic arteries. In addition to nutrients, drugs and toxins are also absorbed. After processing the bloodborne nutrients and toxins, the liver releases nutrients needed by other cells back into the blood, which drains into the central vein and then through the hepatic vein to the inferior vena cava. With this hepatic portal circulation, all blood from the alimentary canal passes through the liver. This largely explains why the liver is the most common site for the metastasis of cancers that originate in the alimentary canal. \n\n Histology \n\n The liver has three main components: hepatocytes, bile canaliculi, and hepatic sinusoids. A  hepatocyte  is the liver\u2019s main cell type, accounting for around 80 percent of the liver's volume. These cells play a role in a wide variety of secretory, metabolic, and endocrine functions. Plates of hepatocytes called hepatic laminae radiate outward from the portal vein in each  hepatic lobule . \n\n Between adjacent hepatocytes, grooves in the cell membranes provide room for each  bile canaliculus  (plural = canaliculi). These small ducts accumulate the bile produced by hepatocytes. From here, bile flows first into bile ductules and then into bile ducts. The bile ducts unite to form the larger right and left hepatic ducts, which themselves merge and exit the liver as the  common hepatic duct . This duct then joins with the cystic duct from the gallbladder, forming the  common bile duct  through which bile flows into the small intestine. \n\n A  hepatic sinusoid  is an open, porous blood space formed by fenestrated capillaries from nutrient-rich hepatic portal veins and oxygen-rich hepatic arteries. Hepatocytes are tightly packed around the fenestrated endothelium of these spaces, giving them easy access to the blood. From their central position, hepatocytes process the nutrients, toxins, and waste materials carried by the blood. Materials such as bilirubin are processed and excreted into the bile canaliculi. Other materials including proteins, lipids, and carbohydrates are processed and secreted into the sinusoids or just stored in the cells until called upon. The hepatic sinusoids combine and send blood to a  central vein . Blood then flows through a  hepatic vein  into the inferior vena cava. This means that blood and bile flow in opposite directions. The hepatic sinusoids also contain star-shaped  reticuloendothelial cells  (Kupffer cells), phagocytes that remove dead red and white blood cells, bacteria, and other foreign material that enter the sinusoids. The  portal triad  is a distinctive arrangement around the perimeter of hepatic lobules, consisting of three basic structures: a bile duct, a hepatic artery branch, and a hepatic portal vein branch. \n\n Bile \n\n Recall that lipids are hydrophobic, that is, they do not dissolve in water. Thus, before they can be digested in the watery environment of the small intestine, large lipid globules must be broken down into smaller lipid globules, a process called emulsification.  Bile  is a mixture secreted by the liver to accomplish the emulsification of lipids in the small intestine. \n\n Hepatocytes secrete about one liter of bile each day. A yellow-brown or yellow-green alkaline solution (pH 7.6 to 8.6), bile is a mixture of water, bile salts, bile pigments, phospholipids (such as lecithin), electrolytes, cholesterol, and triglycerides. The components most critical to emulsification are bile salts and phospholipids, which have a nonpolar (hydrophobic) region as well as a polar (hydrophilic) region. The hydrophobic region interacts with the large lipid molecules, whereas the hydrophilic region interacts with the watery chyme in the intestine. This results in the large lipid globules being pulled apart into many tiny lipid fragments of about 1  \u00b5 m in diameter. This change dramatically increases the surface area available for lipid-digesting enzyme activity. This is the same way dish soap works on fats mixed with water. Bile salts act as emulsifying agents, so they are also important for the absorption of digested lipids. While most constituents of bile are eliminated in feces, bile salts are reclaimed by the  enterohepatic circulation . Once bile salts reach the ileum, they are absorbed and returned to the liver in the hepatic portal blood. The hepatocytes then excrete the bile salts into newly formed bile. Thus, this precious resource is recycled. \n\n Bilirubin , the main bile pigment, is a waste product produced when the spleen removes old or damaged red blood cells from the circulation. These breakdown products, including proteins, iron, and toxic bilirubin, are transported to the liver via the splenic vein of the hepatic portal system. In the liver, proteins and iron are recycled, whereas bilirubin is excreted in the bile. It accounts for the green color of bile. Bilirubin is eventually transformed by intestinal bacteria into stercobilin, a brown pigment that gives your stool its characteristic color! In some disease states, bile does not enter the intestine, resulting in white (\u2018acholic\u2019) stool with a high fat content, since virtually no fats are broken down or absorbed. \n\n Hepatocytes work non-stop, but bile production increases when fatty chyme enters the duodenum and stimulates the secretion of the gut hormone secretin. Between meals, bile is produced but conserved. The valve-like hepatopancreatic ampulla closes, allowing bile to divert to the gallbladder, where it is concentrated and stored until the next meal. Interactive Link \n\n Watch this  video  to see the structure of the liver and how this structure supports the functions of the liver, including the processing of nutrients, toxins, and wastes. At rest, about 1500 mL of blood per minute flow through the liver. What percentage of this blood flow comes from the hepatic portal system? \n\n The Pancreas \n\n The soft, oblong, glandular  pancreas  lies transversely in the retroperitoneum behind the stomach. Its head is nestled into the \u201cc-shaped\u201d curvature of the duodenum with the body extending to the left about 15.2 cm (6 in) and ending as a tapering tail in the hilum of the spleen. It is a curious mix of exocrine (secreting digestive enzymes) and endocrine (releasing hormones into the blood) functions ( Figure 23.26 ). \n\n The exocrine part of the pancreas arises as little grape-like cell clusters, each called an  acinus  (plural = acini), located at the terminal ends of pancreatic ducts. These acinar cells secrete enzyme-rich  pancreatic juice  into tiny merging ducts that form two dominant ducts. The larger duct fuses with the common bile duct (carrying bile from the liver and gallbladder) just before entering the duodenum via a common opening (the hepatopancreatic ampulla). The smooth muscle sphincter of the hepatopancreatic ampulla controls the release of pancreatic juice and bile into the small intestine. The second and smaller pancreatic duct, the  accessory duct  (duct of Santorini), runs from the pancreas directly into the duodenum, approximately 1 inch above the hepatopancreatic ampulla. When present, it is a persistent remnant of pancreatic development. \n\n Scattered through the sea of exocrine acini are small islands of endocrine cells, the islets of Langerhans. These vital cells produce the hormones pancreatic polypeptide, insulin, glucagon, and somatostatin. \n\n Pancreatic Juice \n\n The pancreas produces over a liter of pancreatic juice each day. Unlike bile, it is clear and composed mostly of water along with some salts, sodium bicarbonate, and several digestive enzymes. Sodium bicarbonate is responsible for the slight alkalinity of pancreatic juice (pH 7.1 to 8.2), which serves to buffer the acidic gastric juice in chyme, inactivate pepsin from the stomach, and create an optimal environment for the activity of pH-sensitive digestive enzymes in the small intestine. Pancreatic enzymes are active in the digestion of sugars, proteins, and fats. The pancreas produces protein-digesting enzymes in their inactive forms. These enzymes are activated in the duodenum. If produced in an active form, they would digest the pancreas (which is exactly what occurs in the disease, pancreatitis). The intestinal brush border enzyme  enteropeptidase  stimulates the activation of trypsin from trypsinogen of the pancreas, which in turn changes the pancreatic enzymes procarboxypeptidase and chymotrypsinogen into their active forms, carboxypeptidase and chymotrypsin. \n\n The enzymes that digest starch (amylase), fat (lipase), and nucleic acids (nuclease) are secreted in their active forms, since they do not attack the pancreas as do the protein-digesting enzymes. \n\n Pancreatic Secretion \n\n Regulation of pancreatic secretion is the job of hormones and the parasympathetic nervous system. The entry of acidic chyme into the duodenum stimulates the release of secretin, which in turn causes the duct cells to release bicarbonate-rich pancreatic juice. The presence of proteins and fats in the duodenum stimulates the secretion of CCK, which then stimulates the acini to secrete enzyme-rich pancreatic juice and enhances the activity of secretin. Parasympathetic regulation occurs mainly during the cephalic and gastric phases of gastric secretion, when vagal stimulation prompts the secretion of pancreatic juice. \n\n Usually, the pancreas secretes just enough bicarbonate to counterbalance the amount of HCl produced in the stomach. Hydrogen ions enter the blood when bicarbonate is secreted by the pancreas. Thus, the acidic blood draining from the pancreas neutralizes the alkaline blood draining from the stomach, maintaining the pH of the venous blood that flows to the liver. \n\n The Gallbladder \n\n The  gallbladder  is 8\u201310 cm (~3\u20134 in) long and is nested in a shallow area on the posterior aspect of the right lobe of the liver. This muscular sac stores, concentrates, and, when stimulated, propels the bile into the duodenum via the common bile duct. It is divided into three regions. The fundus is the widest portion and tapers medially into the body, which in turn narrows to become the neck. The neck angles slightly superiorly as it approaches the hepatic duct. The cystic duct is 1\u20132 cm (less than 1 in) long and turns inferiorly as it bridges the neck and hepatic duct. \n\n The simple columnar epithelium of the gallbladder mucosa is organized in rugae, similar to those of the stomach. There is no submucosa in the gallbladder wall. The wall\u2019s middle, muscular coat is made of smooth muscle fibers. When these fibers contract, the gallbladder\u2019s contents are ejected through the  cystic duct  and into the bile duct ( Figure 23.27 ). Visceral peritoneum reflected from the liver capsule holds the gallbladder against the liver and forms the outer coat of the gallbladder. The gallbladder's mucosa absorbs water and ions from bile, concentrating it by up to 10-fold. \n 23.7   Chemical Digestion and Absorption: A Closer Look  Learning Objectives By the end of this section, you will be able to: \n\n Identify the locations and primary secretions involved in the chemical digestion of carbohydrates, proteins, lipids, and nucleic acids \n\n Compare and contrast absorption of the hydrophilic and hydrophobic nutrients \n\n As you have learned, the process of mechanical digestion is relatively simple. It involves the physical breakdown of food but does not alter its chemical makeup. Chemical digestion, on the other hand, is a complex process that reduces food into its chemical building blocks, which are then absorbed to nourish the cells of the body ( Figure 23.28 ). In this section, you will look more closely at the processes of chemical digestion and absorption. \n\n Chemical Digestion \n\n Large food molecules (for example, proteins, lipids, nucleic acids, and starches) must be broken down into subunits that are small enough to be absorbed by the lining of the alimentary canal. This is accomplished by enzymes through hydrolysis. The many enzymes involved in chemical digestion are summarized in  Table 23.8 . \n\n The Digestive Enzymes \n\n Enzyme Category \n\n Enzyme Name \n\n Source \n\n Substrate \n\n Product \n\n Salivary Enzymes \n\n Lingual lipase \n\n Lingual glands \n\n Triglycerides \n\n Free fatty acids, and mono- and diglycerides \n\n Salivary Enzymes \n\n Salivary amylase \n\n Salivary glands \n\n Polysaccharides \n\n Disaccharides and trisaccharides \n\n Gastric enzymes \n\n Gastric lipase \n\n Chief cells \n\n Triglycerides \n\n Fatty acids and monoacylglycerides \n\n Gastric enzymes \n\n Pepsin* \n\n Chief cells \n\n Proteins \n\n Peptides \n\n Brush border enzymes \n\n \u03b1-Dextrinase \n\n Small intestine \n\n \u03b1-Dextrins \n\n Glucose \n\n Brush border enzymes \n\n Enteropeptidase \n\n Small intestine \n\n Trypsinogen \n\n Trypsin \n\n Brush border enzymes \n\n Lactase \n\n Small intestine \n\n Lactose \n\n Glucose and galactose \n\n Brush border enzymes \n\n Maltase \n\n Small intestine \n\n Maltose \n\n Glucose \n\n Brush border enzymes \n\n Nucleosidases and phosphatases \n\n Small intestine \n\n Nucleotides \n\n Phosphates, nitrogenous bases, and pentoses \n\n Brush border enzymes \n\n Peptidases \n\n Small intestine \n\n Aminopeptidase: amino acids at the amino end of peptides \n\n Dipeptidase: dipeptides \n\n Aminopeptidase: amino acids and peptides \n\n Dipeptidase: amino acids \n\n Brush border enzymes \n\n Sucrase \n\n Small intestine \n\n Sucrose \n\n Glucose and fructose \n\n Pancreatic enzymes \n\n Carboxy-peptidase* \n\n Pancreatic acinar cells \n\n Amino acids at the carboxyl end of peptides \n\n Amino acids and peptides \n\n Pancreatic enzymes \n\n Chymotrypsin* \n\n Pancreatic acinar cells \n\n Proteins \n\n Peptides \n\n Pancreatic enzymes \n\n Elastase* \n\n Pancreatic acinar cells \n\n Proteins \n\n Peptides \n\n Pancreatic enzymes \n\n Nucleases \n\n Pancreatic acinar cells \n\n Ribonuclease: ribonucleic acids \n\n Deoxyribonuclease: deoxyribonucleic acids \n\n Nucleotides \n\n Pancreatic enzymes \n\n Pancreatic amylase \n\n Pancreatic acinar cells \n\n Polysaccharides (starches) \n\n \u03b1-Dextrins, disaccharides (maltose), trisaccharides (maltotriose) \n\n Pancreatic enzymes \n\n Pancreatic lipase \n\n Pancreatic acinar cells \n\n Triglycerides that have been emulsified by bile salts \n\n Fatty acids and monoacylglycerides \n\n Pancreatic enzymes \n\n Trypsin* \n\n Pancreatic acinar cells \n\n Proteins \n\n Peptides \n\n Table  23.8     *These enzymes have been activated by other substances. Carbohydrate Digestion \n\n The average American diet is about 50 percent carbohydrates, which may be classified according to the number of monomers they contain of simple sugars (monosaccharides and disaccharides) and/or complex sugars (polysaccharides). Glucose, galactose, and fructose are the three monosaccharides that are commonly consumed and are readily absorbed. Your digestive system is also able to break down the disaccharide sucrose (regular table sugar: glucose + fructose), lactose (milk sugar: glucose + galactose), and maltose (grain sugar: glucose + glucose), and the polysaccharides glycogen and starch (chains of monosaccharides). Your bodies do not produce enzymes that can break down most fibrous polysaccharides, such as cellulose. While indigestible polysaccharides do not provide any nutritional value, they do provide dietary fiber, which helps propel food through the alimentary canal. \n\n The chemical digestion of starches begins in the mouth and has been reviewed above. \n\n In the small intestine,  pancreatic amylase  does the \u2018heavy lifting\u2019 for starch and carbohydrate digestion ( Figure 23.29 ). After amylases break down starch into smaller fragments, the brush border enzyme  \u03b1-dextrinase  starts working on  \u03b1-dextrin , breaking off one glucose unit at a time. Three brush border enzymes hydrolyze sucrose, lactose, and maltose into monosaccharides.  Sucrase  splits sucrose into one molecule of fructose and one molecule of glucose;  maltase  breaks down maltose and maltotriose into two and three glucose molecules, respectively; and  lactase  breaks down lactose into one molecule of glucose and one molecule of galactose. Insufficient lactase can lead to lactose intolerance. \n\n Protein Digestion \n\n Proteins are polymers composed of amino acids linked by peptide bonds to form long chains. Digestion reduces them to their constituent amino acids. You usually consume about 15 to 20 percent of your total calorie intake as protein. \n\n The digestion of protein starts in the stomach, where HCl and pepsin break proteins into smaller polypeptides, which then travel to the small intestine ( Figure 23.30 ). Chemical digestion in the small intestine is continued by pancreatic enzymes, including chymotrypsin and trypsin, each of which act on specific bonds in amino acid sequences. At the same time, the cells of the brush border secrete enzymes such as  aminopeptidase  and  dipeptidase , which further break down peptide chains. This results in molecules small enough to enter the bloodstream ( Figure 23.31 ). \n\n Lipid Digestion \n\n A healthy diet limits lipid intake to 35 percent of total calorie intake. The most common dietary lipids are triglycerides, which are made up of a glycerol molecule bound to three fatty acid chains. Small amounts of dietary cholesterol and phospholipids are also consumed. \n\n The three lipases responsible for lipid digestion are lingual lipase, gastric lipase, and  pancreatic lipase . However, because the pancreas is the only consequential source of lipase, virtually all lipid digestion occurs in the small intestine. Pancreatic lipase breaks down each triglyceride into two free fatty acids and a monoglyceride. The fatty acids include both short-chain (less than 10 to 12 carbons) and long-chain fatty acids. \n\n Nucleic Acid Digestion \n\n The nucleic acids DNA and RNA are found in most of the foods you eat. Two types of  pancreatic nuclease  are responsible for their digestion:  deoxyribonuclease , which digests DNA, and  ribonuclease , which digests RNA. The nucleotides produced by this digestion are further broken down by two intestinal brush border enzymes ( nucleosidase  and  phosphatase ) into pentoses, phosphates, and nitrogenous bases, which can be absorbed through the alimentary canal wall. The large food molecules that must be broken down into subunits are summarized  Table 23.9 \n\n Absorbable Food Substances \n\n Source \n\n Substance \n\n Carbohydrates \n\n Monosaccharides: glucose, galactose, and fructose \n\n Proteins \n\n Single amino acids, dipeptides, and tripeptides \n\n Triglycerides \n\n Monoacylglycerides, glycerol, and free fatty acids \n\n Nucleic acids \n\n Pentose sugars, phosphates, and nitrogenous bases \n\n Table  23.9     \n\n Absorption The mechanical and digestive processes have one goal: to convert food into molecules small enough to be absorbed by the epithelial cells of the intestinal villi. The absorptive capacity of the alimentary canal is almost endless. Each day, the alimentary canal processes up to 10 liters of food, liquids, and GI secretions, yet less than one liter enters the large intestine. Almost all ingested food, 80 percent of electrolytes, and 90 percent of water are absorbed in the small intestine. Although the entire small intestine is involved in the absorption of water and lipids, most absorption of carbohydrates and proteins occurs in the jejunum. Notably, bile salts and vitamin B 12  are absorbed in the terminal ileum. By the time chyme passes from the ileum into the large intestine, it is essentially indigestible food residue (mainly plant fibers like cellulose), some water, and millions of bacteria ( Figure 23.32 ). \n\n Absorption can occur through five mechanisms: (1) active transport, (2) passive diffusion, (3) facilitated diffusion, (4) co-transport (or secondary active transport), and (5) endocytosis. As you will recall from Chapter 3, active transport refers to the movement of a substance across a cell membrane going from an area of lower concentration to an area of higher concentration (up the concentration gradient). In this type of transport, proteins within the cell membrane act as \u201cpumps,\u201d using cellular energy (ATP) to move the substance. Passive diffusion refers to the movement of substances from an area of higher concentration to an area of lower concentration, while facilitated diffusion refers to the movement of substances from an area of higher to an area of lower concentration using a carrier protein in the cell membrane. Co-transport uses the movement of one molecule through the membrane from higher to lower concentration to power the movement of another from lower to higher. Finally, endocytosis is a transportation process in which the cell membrane engulfs material. It requires energy, generally in the form of ATP. \n\n Because the cell\u2019s plasma membrane is made up of hydrophobic phospholipids, water-soluble nutrients must use transport molecules embedded in the membrane to enter cells. Moreover, substances cannot pass between the epithelial cells of the intestinal mucosa because these cells are bound together by tight junctions. Thus, substances can only enter blood capillaries by passing through the apical surfaces of epithelial cells and into the interstitial fluid. Water-soluble nutrients enter the capillary blood in the villi and travel to the liver via the hepatic portal vein. \n\n In contrast to the water-soluble nutrients, lipid-soluble nutrients can diffuse through the plasma membrane. Once inside the cell, they are packaged for transport via the base of the cell and then enter the lacteals of the villi to be transported by lymphatic vessels to the systemic circulation via the thoracic duct. The absorption of most nutrients through the mucosa of the intestinal villi requires active transport fueled by ATP. The routes of absorption for each food category are summarized in  Table 23.10 . \n\n Absorption in the Alimentary Canal \n\n Food \n\n Breakdown products \n\n Absorption mechanism \n\n Entry to bloodstream \n\n Destination \n\n Carbohydrates \n\n Glucose \n\n Co-transport with sodium ions \n\n Capillary blood in villi \n\n Liver via hepatic portal vein \n\n Carbohydrates \n\n Galactose \n\n Co-transport with sodium ions \n\n Capillary blood in villi \n\n Liver via hepatic portal vein \n\n Carbohydrates \n\n Fructose \n\n Facilitated diffusion \n\n Capillary blood in villi \n\n Liver via hepatic portal vein \n\n Protein \n\n Amino acids \n\n Co-transport with sodium ions \n\n Capillary blood in villi \n\n Liver via hepatic portal vein \n\n Lipids \n\n Long-chain fatty acids \n\n Diffusion into intestinal cells, where they are combined with proteins to create chylomicrons \n\n Lacteals of villi \n\n Systemic circulation via lymph entering thoracic duct \n\n Lipids \n\n Monoacylglycerides \n\n Diffusion into intestinal cells, where they are combined with proteins to create chylomicrons \n\n Lacteals of villi \n\n Systemic circulation via lymph entering thoracic duct \n\n Lipids \n\n Short-chain fatty acids \n\n Simple diffusion \n\n Capillary blood in villi \n\n Liver via hepatic portal vein \n\n Lipids \n\n Glycerol \n\n Simple diffusion \n\n Capillary blood in villi \n\n Liver via hepatic portal vein \n\n Nucleic Acids \n\n Nucleic acid digestion products \n\n Active transport via membrane carriers \n\n Capillary blood in villi \n\n Liver via hepatic portal vein \n\n Table  23.10     Carbohydrate Absorption \n\n All carbohydrates are absorbed in the form of monosaccharides. The small intestine is highly efficient at this, absorbing monosaccharides at an estimated rate of 120 grams per hour. All normally digested dietary carbohydrates are absorbed; indigestible fibers are eliminated in the feces. The monosaccharides glucose and galactose are transported into the epithelial cells by common protein carriers via secondary active transport (that is, co-transport with sodium ions). The monosaccharides leave these cells via facilitated diffusion and enter the capillaries through intercellular clefts. The monosaccharide fructose (which is in fruit) is absorbed and transported by facilitated diffusion alone. The monosaccharides combine with the transport proteins immediately after the disaccharides are broken down. \n\n Protein Absorption \n\n Active transport mechanisms, primarily in the duodenum and jejunum, absorb most proteins as their breakdown products, amino acids. Almost all (95 to 98 percent) protein is digested and absorbed in the small intestine. The type of carrier that transports an amino acid varies. Most carriers are linked to the active transport of sodium. Short chains of two amino acids (dipeptides) or three amino acids (tripeptides) are also transported actively. However, after they enter the absorptive epithelial cells, they are broken down into their amino acids before leaving the cell and entering the capillary blood via diffusion. \n\n Lipid Absorption \n\n About 95 percent of lipids are absorbed in the small intestine. Bile salts not only speed up lipid digestion, they are also essential to the absorption of the end products of lipid digestion. Short-chain fatty acids are relatively water soluble and can enter the absorptive cells (enterocytes) directly. The small size of short-chain fatty acids enables them to be absorbed by enterocytes via simple diffusion, and then take the same path as monosaccharides and amino acids into the blood capillary of a villus. The large and hydrophobic long-chain fatty acids and monoacylglycerides are not so easily suspended in the watery intestinal chyme. However, bile salts and lecithin resolve this issue by enclosing them in a  micelle , which is a tiny sphere with polar (hydrophilic) ends facing the watery environment and hydrophobic tails turned to the interior, creating a receptive environment for the long-chain fatty acids. The core also includes cholesterol and fat-soluble vitamins. Without micelles, lipids would sit on the surface of chyme and never come in contact with the absorptive surfaces of the epithelial cells. Micelles can easily squeeze between microvilli and get very near the luminal cell surface. At this point, lipid substances exit the micelle and are absorbed via simple diffusion. \n\n The free fatty acids and monoacylglycerides that enter the epithelial cells are reincorporated into triglycerides. The triglycerides are mixed with phospholipids and cholesterol, and surrounded with a protein coat. This new complex, called a  chylomicron , is a water-soluble lipoprotein. After being processed by the Golgi apparatus, chylomicrons are released from the cell ( Figure 23.33 ). Too big to pass through the basement membranes of blood capillaries, chylomicrons instead enter the large pores of lacteals. The lacteals come together to form the lymphatic vessels. The chylomicrons are transported in the lymphatic vessels and empty through the thoracic duct into the subclavian vein of the circulatory system. Once in the bloodstream, the enzyme  lipoprotein lipase  breaks down the triglycerides of the chylomicrons into free fatty acids and glycerol. These breakdown products then pass through capillary walls to be used for energy by cells or stored in adipose tissue as fat. Liver cells combine the remaining chylomicron remnants with proteins, forming lipoproteins that transport cholesterol in the blood. \n\n Nucleic Acid Absorption \n\n The products of nucleic acid digestion\u2014pentose sugars, nitrogenous bases, and phosphate ions\u2014are transported by carriers across the villus epithelium via active transport. These products then enter the bloodstream. \n\n Mineral Absorption \n\n The electrolytes absorbed by the small intestine are from both GI secretions and ingested foods. Since electrolytes dissociate into ions in water, most are absorbed via active transport throughout the entire small intestine. During absorption, co-transport mechanisms result in the accumulation of sodium ions inside the cells, whereas anti-port mechanisms reduce the potassium ion concentration inside the cells. To restore the sodium-potassium gradient across the cell membrane, a sodium-potassium pump requiring ATP pumps sodium out and potassium in. \n\n In general, all minerals that enter the intestine are absorbed, whether you need them or not. Iron and calcium are exceptions; they are absorbed in the duodenum in amounts that meet the body\u2019s current requirements, as follows: \n\n Iron \u2014The ionic iron needed for the production of hemoglobin is absorbed into mucosal cells via active transport. Once inside mucosal cells, ionic iron binds to the protein ferritin, creating iron-ferritin complexes that store iron until needed. When the body has enough iron, most of the stored iron is lost when worn-out epithelial cells slough off. When the body needs iron because, for example, it is lost during acute or chronic bleeding, there is increased uptake of iron from the intestine and accelerated release of iron into the bloodstream. Since women experience significant iron loss during menstruation, they have around four times as many iron transport proteins in their intestinal epithelial cells as do men. \n\n Calcium \u2014Blood levels of ionic calcium determine the absorption of dietary calcium. When blood levels of ionic calcium drop, parathyroid hormone (PTH) secreted by the parathyroid glands stimulates the release of calcium ions from bone matrices and increases the reabsorption of calcium by the kidneys. PTH also upregulates the activation of vitamin D in the kidney, which then facilitates intestinal calcium ion absorption. \n\n Vitamin Absorption \n\n The small intestine absorbs the vitamins that occur naturally in food and supplements. Fat-soluble vitamins (A, D, E, and K) are absorbed along with dietary lipids in micelles via simple diffusion. This is why you are advised to eat some fatty foods when you take fat-soluble vitamin supplements. Most water-soluble vitamins (including most B vitamins and vitamin C) also are absorbed by simple diffusion. An exception is vitamin B 12 , which is a very large molecule. Intrinsic factor secreted in the stomach binds to vitamin B 12 , preventing its digestion and creating a complex that binds to mucosal receptors in the terminal ileum, where it is taken up by endocytosis. \n\n Water Absorption \n\n Each day, about nine liters of fluid enter the small intestine. About 2.3 liters are ingested in foods and beverages, and the rest is from GI secretions. About 90 percent of this water is absorbed in the small intestine. Water absorption is driven by the concentration gradient of the water: The concentration of water is higher in chyme than it is in epithelial cells. Thus, water moves down its concentration gradient from the chyme into cells. As noted earlier, much of the remaining water is then absorbed in the colon. ", "questions": [{"question": {"question_id": "fs-id1355942", "question_text": "Which of these organs is not considered an accessory digestive structure?", "question_choices": ["mouth", "salivary glands", "pancreas", "liver"], "cloze_format": "The organ that is not considered an accessory digestive structure is the ___.", "normal_format": "Which of these organs is not considered an accessory digestive structure?"}, "answer": {"ans_text": "mouth", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "In this section , you will examine the anatomy and functions of the three main organs of the upper alimentary canal \u2014 the mouth , pharynx , and esophagus \u2014 as well as three associated accessory organs \u2014 the tongue , salivary glands , and teeth . Each accessory digestive organ aids in the breakdown of food ( Figure 23.3 ) . Within the mouth , the teeth and tongue begin mechanical digestion , whereas the salivary glands begin chemical digestion . Once food products enter the small intestine , the gallbladder , liver , and pancreas release secretions \u2014 such as bile and enzymes \u2014 essential for digestion to continue . Together , these are called accessory organs because they sprout from the lining cells of the developing gut ( mucosa ) and augment its function ; indeed , you could not live without their vital contributions , and many significant diseases result from their malfunction .", "hl_context": "<hl> In this section , you will examine the anatomy and functions of the three main organs of the upper alimentary canal \u2014 the mouth , pharynx , and esophagus \u2014 as well as three associated accessory organs \u2014 the tongue , salivary glands , and teeth . <hl> <hl> Each accessory digestive organ aids in the breakdown of food ( Figure 23.3 ) . <hl> <hl> Within the mouth , the teeth and tongue begin mechanical digestion , whereas the salivary glands begin chemical digestion . <hl> <hl> Once food products enter the small intestine , the gallbladder , liver , and pancreas release secretions \u2014 such as bile and enzymes \u2014 essential for digestion to continue . <hl> <hl> Together , these are called accessory organs because they sprout from the lining cells of the developing gut ( mucosa ) and augment its function ; indeed , you could not live without their vital contributions , and many significant diseases result from their malfunction . <hl> Even after development is complete , they maintain a connection to the gut by way of ducts ."}, {"question": {"question_id": "fs-id1424989", "question_text": "Which of the following organs is supported by a layer of adventitia rather than serosa?", "question_choices": ["esophagus", "stomach", "small intestine", "large intestine"], "cloze_format": "The ___ is an organ that is supported by a layer of adventitia rather than serosa.", "normal_format": "Which of the following organs is supported by a layer of adventitia rather than serosa?"}, "answer": {"ans_text": "esophagus", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "As mentioned previously , the most superficial layer of the esophagus is called the adventitia , not the serosa .", "hl_context": "The mucosa of the esophagus is made up of an epithelial lining that contains non-keratinized , stratified squamous epithelium , with a layer of basal and parabasal cells . This epithelium protects against erosion from food particles . The mucosa \u2019 s lamina propria contains mucus-secreting glands . The muscularis layer changes according to location : In the upper third of the esophagus , the muscularis is skeletal muscle . In the middle third , it is both skeletal and smooth muscle . In the lower third , it is smooth muscle . <hl> As mentioned previously , the most superficial layer of the esophagus is called the adventitia , not the serosa . <hl> In contrast to the stomach and intestines , the loose connective tissue of the adventitia is not covered by a fold of visceral peritoneum . The digestive functions of the esophagus are identified in Table 23.5 ."}, {"question": {"question_id": "fs-id1645617", "question_text": "Which of the following membranes covers the stomach?", "question_choices": ["falciform ligament", "mesocolon", "parietal peritoneum", "visceral peritoneum"], "cloze_format": "The membrane that covers the stomach is called the ___ .", "normal_format": "Which of the following membranes covers the stomach?"}, "answer": {"ans_text": "visceral peritoneum", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "In contrast to the stomach and intestines , the loose connective tissue of the adventitia is not covered by a fold of visceral peritoneum . It is composed of two different regions : the parietal peritoneum , which lines the abdominal wall , and the visceral peritoneum , which envelopes the abdominal organs ( Figure 23.4 ) .", "hl_context": "The mucosa of the esophagus is made up of an epithelial lining that contains non-keratinized , stratified squamous epithelium , with a layer of basal and parabasal cells . This epithelium protects against erosion from food particles . The mucosa \u2019 s lamina propria contains mucus-secreting glands . The muscularis layer changes according to location : In the upper third of the esophagus , the muscularis is skeletal muscle . In the middle third , it is both skeletal and smooth muscle . In the lower third , it is smooth muscle . As mentioned previously , the most superficial layer of the esophagus is called the adventitia , not the serosa . <hl> In contrast to the stomach and intestines , the loose connective tissue of the adventitia is not covered by a fold of visceral peritoneum . <hl> The digestive functions of the esophagus are identified in Table 23.5 . The Peritoneum The digestive organs within the abdominal cavity are held in place by the peritoneum , a broad serous membranous sac made up of squamous epithelial tissue surrounded by connective tissue . <hl> It is composed of two different regions : the parietal peritoneum , which lines the abdominal wall , and the visceral peritoneum , which envelopes the abdominal organs ( Figure 23.4 ) . <hl> The peritoneal cavity is the space bounded by the visceral and parietal peritoneal surfaces . A few milliliters of watery fluid act as a lubricant to minimize friction between the serosal surfaces of the peritoneum ."}, {"question": {"question_id": "fs-id1242453", "question_text": "Which of these processes occurs in the mouth?", "question_choices": ["ingestion", "mechanical digestion", "chemical digestion", "all of the above"], "cloze_format": "The processe that occurs in the mouth is ___.", "normal_format": "Which of these processes occurs in the mouth?"}, "answer": {"ans_text": "all of the above", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "In chemical digestion , starting in the mouth , digestive secretions break down complex food molecules into their chemical building blocks ( for example , proteins into separate amino acids ) . Although there may be a tendency to think that mechanical digestion is limited to the first steps of the digestive process , it occurs after the food leaves the mouth , as well . The first of these processes , ingestion , refers to the entry of food into the alimentary canal through the mouth .", "hl_context": "<hl> In chemical digestion , starting in the mouth , digestive secretions break down complex food molecules into their chemical building blocks ( for example , proteins into separate amino acids ) . <hl> These secretions vary in composition , but typically contain water , various enzymes , acids , and salts . The process is completed in the small intestine . Digestion includes both mechanical and chemical processes . Mechanical digestion is a purely physical process that does not change the chemical nature of the food . Instead , it makes the food smaller to increase both surface area and mobility . It includes mastication , or chewing , as well as tongue movements that help break food into smaller bits and mix food with saliva . <hl> Although there may be a tendency to think that mechanical digestion is limited to the first steps of the digestive process , it occurs after the food leaves the mouth , as well . <hl> The mechanical churning of food in the stomach serves to further break it apart and expose more of its surface area to digestive juices , creating an acidic \u201c soup \u201d called chyme . Segmentation , which occurs mainly in the small intestine , consists of localized contractions of circular muscle of the muscularis layer of the alimentary canal . These contractions isolate small sections of the intestine , moving their contents back and forth while continuously subdividing , breaking up , and mixing the contents . By moving food back and forth in the intestinal lumen , segmentation mixes food with digestive juices and facilitates absorption . <hl> The first of these processes , ingestion , refers to the entry of food into the alimentary canal through the mouth . <hl> There , the food is chewed and mixed with saliva , which contains enzymes that begin breaking down the carbohydrates in the food plus some lipid digestion via lingual lipase . Chewing increases the surface area of the food and allows an appropriately sized bolus to be produced ."}, {"question": {"question_id": "fs-id1890969", "question_text": "Which structure is located where the esophagus penetrates the diaphragm?", "question_choices": ["esophageal hiatus", "cardiac orifice", "upper esophageal sphincter", "lower esophageal sphincter"], "cloze_format": "The ___ is a structure that is located where the esophagus penetrates the diaphragm.", "normal_format": "Which structure is located where the esophagus penetrates the diaphragm?"}, "answer": {"ans_text": "esophageal hiatus", "ans_choice": 0}, "bloom": "1", "hl_sentences": "To enter the abdomen , the esophagus penetrates the diaphragm through an opening called the esophageal hiatus .", "hl_context": "The esophagus is a muscular tube that connects the pharynx to the stomach . It is approximately 25.4 cm ( 10 in ) in length , located posterior to the trachea , and remains in a collapsed form when not engaged in swallowing . As you can see in Figure 23.13 , the esophagus runs a mainly straight route through the mediastinum of the thorax . <hl> To enter the abdomen , the esophagus penetrates the diaphragm through an opening called the esophageal hiatus . <hl>"}, {"question": {"question_id": "fs-id1904959", "question_text": "Which phase of deglutition involves contraction of the longitudinal muscle layer of the muscularis?", "question_choices": ["voluntary phase", "buccal phase", "pharyngeal phase", "esophageal phase"], "cloze_format": "The phase of deglutition that involves contraction of the longitudinal muscle layer of the muscularis is the ___.", "normal_format": "Which phase of deglutition involves contraction of the longitudinal muscle layer of the muscularis?"}, "answer": {"ans_text": "esophageal phase", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "The entry of food into the esophagus marks the beginning of the esophageal phase of deglutition and the initiation of peristalsis . The circular muscle layer of the muscularis contracts , pinching the esophageal wall and forcing the bolus forward . At the same time , the longitudinal muscle layer of the muscularis also contracts , shortening this area and pushing out its walls to receive the bolus .", "hl_context": "<hl> The entry of food into the esophagus marks the beginning of the esophageal phase of deglutition and the initiation of peristalsis . <hl> As in the previous phase , the complex neuromuscular actions are controlled by the medulla oblongata . Peristalsis propels the bolus through the esophagus and toward the stomach . <hl> The circular muscle layer of the muscularis contracts , pinching the esophageal wall and forcing the bolus forward . <hl> <hl> At the same time , the longitudinal muscle layer of the muscularis also contracts , shortening this area and pushing out its walls to receive the bolus . <hl> In this way , a series of contractions keeps moving food toward the stomach . When the bolus nears the stomach , distention of the esophagus initiates a short reflex relaxation of the lower esophageal sphincter that allows the bolus to pass into the stomach . During the esophageal phase , esophageal glands secrete mucus that lubricates the bolus and minimizes friction ."}, {"question": {"question_id": "fs-id1866214", "question_text": "Which of these cells secrete hormones?", "question_choices": ["parietal cells", "mucous neck cells", "enteroendocrine cells", "chief cells"], "cloze_format": "The cells that secrete hormones are ___.", "normal_format": "Which of these cells secrete hormones?"}, "answer": {"ans_text": "enteroendocrine cells", "ans_choice": 2}, "bloom": "1", "hl_sentences": "Enteroendocrine cells \u2014 Finally , enteroendocrine cells found in the gastric glands secrete various hormones into the interstitial fluid of the lamina propria .", "hl_context": "<hl> Enteroendocrine cells \u2014 Finally , enteroendocrine cells found in the gastric glands secrete various hormones into the interstitial fluid of the lamina propria . <hl> These include gastrin , which is released mainly by enteroendocrine G cells ."}, {"question": {"question_id": "fs-id1652176", "question_text": "Where does the majority of chemical digestion in the stomach occur?", "question_choices": ["fundus and body", "cardia and fundus", "body and pylorus", "body"], "cloze_format": "The majority of chemical digestion in the stomach occur in the ___ .", "normal_format": "Where does the majority of chemical digestion in the stomach occur?"}, "answer": {"ans_text": "fundus and body", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "The much larger glands of the fundus and body of the stomach , the site of most chemical digestion , produce most of the gastric secretions .", "hl_context": "Although the walls of the gastric pits are made up primarily of mucus cells , the gastric glands are made up of different types of cells . The glands of the cardia and pylorus are composed primarily of mucus-secreting cells . Cells that make up the pyloric antrum secrete mucus and a number of hormones , including the majority of the stimulatory hormone , gastrin . <hl> The much larger glands of the fundus and body of the stomach , the site of most chemical digestion , produce most of the gastric secretions . <hl> These glands are made up of a variety of secretory cells . These include parietal cells , chief cells , mucous neck cells , and enteroendocrine cells ."}, {"question": {"question_id": "fs-id1865612", "question_text": "During gastric emptying, chyme is released into the duodenum through the ________.", "question_choices": ["esophageal hiatus", "pyloric antrum", "pyloric canal", "pyloric sphincter"], "cloze_format": "During gastric emptying, chyme is released into the duodenum through the ________.", "normal_format": "During gastric emptying, through what is chyme released into the duodenum?"}, "answer": {"ans_text": "pyloric sphincter", "ans_choice": 3}, "bloom": null, "hl_sentences": "In a process called gastric emptying , rhythmic mixing waves force about 3 mL of chyme at a time through the pyloric sphincter and into the duodenum .", "hl_context": "Within a few moments after food enters your stomach , mixing waves begin to occur at intervals of approximately 20 seconds . A mixing wave is a unique type of peristalsis that mixes and softens the food with gastric juices to create chyme . The initial mixing waves are relatively gentle , but these are followed by more intense waves , starting at the body of the stomach and increasing in force as they reach the pylorus . It is fair to say that long before your sushi exits through the pyloric sphincter , it bears little resemblance to the sushi you ate . The pylorus , which holds around 30 mL ( 1 fluid ounce ) of chyme , acts as a filter , permitting only liquids and small food particles to pass through the mostly , but not fully , closed pyloric sphincter . <hl> In a process called gastric emptying , rhythmic mixing waves force about 3 mL of chyme at a time through the pyloric sphincter and into the duodenum . <hl> Release of a greater amount of chyme at one time would overwhelm the capacity of the small intestine to handle it . The rest of the chyme is pushed back into the body of the stomach , where it continues mixing . This process is repeated when the next mixing waves force more chyme into the duodenum ."}, {"question": {"question_id": "fs-id2293827", "question_text": "Parietal cells secrete ________.", "question_choices": ["gastrin", "hydrochloric acid", "pepsin", "pepsinogen"], "cloze_format": "Parietal cells secrete ________.", "normal_format": "What do parietal cells secrete?"}, "answer": {"ans_text": "gastrin", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "Gastrin stimulates the secretion of gastric acid by the parietal cells of the stomach mucosa .", "hl_context": "A variety of hormones are involved in the digestive process . The main digestive hormone of the stomach is gastrin , which is secreted in response to the presence of food . <hl> Gastrin stimulates the secretion of gastric acid by the parietal cells of the stomach mucosa . <hl> Other GI hormones are produced and act upon the gut and its accessory organs . Hormones produced by the duodenum include secretin , which stimulates a watery secretion of bicarbonate by the pancreas ; cholecystokinin ( CCK ) , which stimulates the secretion of pancreatic enzymes and bile from the liver and release of bile from the gallbladder ; and gastric inhibitory peptide , which inhibits gastric secretion and slows gastric emptying and motility . These GI hormones are secreted by specialized epithelial cells , called endocrinocytes , located in the mucosal epithelium of the stomach and small intestine . These hormones then enter the bloodstream , through which they can reach their target organs . 23.3 The Mouth , Pharynx , and Esophagus Learning Objectives By the end of this section , you will be able to :"}, {"question": {"question_id": "fs-id1541092", "question_text": "In which part of the alimentary canal does most digestion occur?", "question_choices": ["stomach", "proximal small intestine", "distal small intestine", "ascending colon"], "cloze_format": "The part of the alimentary canal that most digestion occurs is the ___.", "normal_format": "In which part of the alimentary canal does most digestion occur?"}, "answer": {"ans_text": "proximal small intestine", "ans_choice": 1}, "bloom": "1", "hl_sentences": "Chyme released from the stomach enters the small intestine , which is the primary digestive organ in the body . Not only is this where most digestion occurs , it is also where practically all absorption occurs .", "hl_context": "<hl> Chyme released from the stomach enters the small intestine , which is the primary digestive organ in the body . <hl> <hl> Not only is this where most digestion occurs , it is also where practically all absorption occurs . <hl> The longest part of the alimentary canal , the small intestine is about 3.05 meters ( 10 feet ) long in a living person ( but about twice as long in a cadaver due to the loss of muscle tone ) . Since this makes it about five times longer than the large intestine , you might wonder why it is called \u201c small . \u201d In fact , its name derives from its relatively smaller diameter of only about 2.54 cm ( 1 in ) , compared with 7.62 cm ( 3 in ) for the large intestine . As we \u2019 ll see shortly , in addition to its length , the folds and projections of the lining of the small intestine work to give it an enormous surface area , which is approximately 200 m 2 , more than 100 times the surface area of your skin . This large surface area is necessary for complex processes of digestion and absorption that occur within it ."}, {"question": {"question_id": "fs-id1881662", "question_text": "What is the role of the small intestine\u2019s MALT?", "question_choices": ["secreting mucus", "buffering acidic chyme", "activating pepsin", "preventing bacteria from entering the bloodstream"], "cloze_format": "The role of the small intestine\u2019s MALT is ___ .", "normal_format": "What is the role of the small intestine\u2019s MALT?"}, "answer": {"ans_text": "preventing bacteria from entering the bloodstream", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "In addition to solitary lymphatic nodules , aggregations of intestinal MALT , which are typically referred to as Peyer \u2019 s patches , are concentrated in the distal ileum , and serve to keep bacteria from entering the bloodstream .", "hl_context": "The lamina propria of the small intestine mucosa is studded with quite a bit of MALT . <hl> In addition to solitary lymphatic nodules , aggregations of intestinal MALT , which are typically referred to as Peyer \u2019 s patches , are concentrated in the distal ileum , and serve to keep bacteria from entering the bloodstream . <hl> Peyer \u2019 s patches are most prominent in young people and become less distinct as you age , which coincides with the general activity of our immune system ."}, {"question": {"question_id": "fs-id1481100", "question_text": "Which part of the large intestine attaches to the appendix?", "question_choices": ["cecum", "ascending colon", "transverse colon", "descending colon"], "cloze_format": "The part of the large intestine that attaches to the appendix is the ___ .", "normal_format": "Which part of the large intestine attaches to the appendix?"}, "answer": {"ans_text": "cecum", "ans_choice": 0}, "bloom": "1", "hl_sentences": "The appendix ( or vermiform appendix ) is a winding tube that attaches to the cecum .", "hl_context": "The first part of the large intestine is the cecum , a sac-like structure that is suspended inferior to the ileocecal valve . It is about 6 cm ( 2.4 in ) long , receives the contents of the ileum , and continues the absorption of water and salts . <hl> The appendix ( or vermiform appendix ) is a winding tube that attaches to the cecum . <hl> Although the 7.6- cm ( 3 - in ) long appendix contains lymphoid tissue , suggesting an immunologic function , this organ is generally considered vestigial . However , at least one recent report postulates a survival advantage conferred by the appendix : In diarrheal illness , the appendix may serve as a bacterial reservoir to repopulate the enteric bacteria for those surviving the initial phases of the illness . Moreover , its twisted anatomy provides a haven for the accumulation and multiplication of enteric bacteria . The mesoappendix , the mesentery of the appendix , tethers it to the mesentery of the ileum ."}, {"question": {"question_id": "fs-id2102556", "question_text": "Which of these statements about bile is true?", "question_choices": ["About 500 mL is secreted daily.", "Its main function is the denaturation of proteins.", "It is synthesized in the gallbladder.", "Bile salts are recycled."], "cloze_format": "A true statement about bile is that ___ .", "normal_format": "Which of these statements about bile is true?"}, "answer": {"ans_text": "Bile salts are recycled.", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "While most constituents of bile are eliminated in feces , bile salts are reclaimed by the enterohepatic circulation . Thus , this precious resource is recycled .", "hl_context": "Hepatocytes secrete about one liter of bile each day . A yellow-brown or yellow-green alkaline solution ( pH 7.6 to 8.6 ) , bile is a mixture of water , bile salts , bile pigments , phospholipids ( such as lecithin ) , electrolytes , cholesterol , and triglycerides . The components most critical to emulsification are bile salts and phospholipids , which have a nonpolar ( hydrophobic ) region as well as a polar ( hydrophilic ) region . The hydrophobic region interacts with the large lipid molecules , whereas the hydrophilic region interacts with the watery chyme in the intestine . This results in the large lipid globules being pulled apart into many tiny lipid fragments of about 1 \u00b5 m in diameter . This change dramatically increases the surface area available for lipid-digesting enzyme activity . This is the same way dish soap works on fats mixed with water . Bile salts act as emulsifying agents , so they are also important for the absorption of digested lipids . <hl> While most constituents of bile are eliminated in feces , bile salts are reclaimed by the enterohepatic circulation . <hl> Once bile salts reach the ileum , they are absorbed and returned to the liver in the hepatic portal blood . The hepatocytes then excrete the bile salts into newly formed bile . <hl> Thus , this precious resource is recycled . <hl>"}, {"question": {"question_id": "fs-id1237051", "question_text": "Pancreatic juice ________.", "question_choices": ["deactivates bile.", "is secreted by pancreatic islet cells.", "buffers chyme.", "is released into the cystic duct."], "cloze_format": "Pancreatic juice ________.", "normal_format": "Which of the following is correct about pancreatic juice?"}, "answer": {"ans_text": "buffers chyme.", "ans_choice": 2}, "bloom": "1", "hl_sentences": "Sodium bicarbonate is responsible for the slight alkalinity of pancreatic juice ( pH 7.1 to 8.2 ) , which serves to buffer the acidic gastric juice in chyme , inactivate pepsin from the stomach , and create an optimal environment for the activity of pH-sensitive digestive enzymes in the small intestine .", "hl_context": "The pancreas produces over a liter of pancreatic juice each day . Unlike bile , it is clear and composed mostly of water along with some salts , sodium bicarbonate , and several digestive enzymes . <hl> Sodium bicarbonate is responsible for the slight alkalinity of pancreatic juice ( pH 7.1 to 8.2 ) , which serves to buffer the acidic gastric juice in chyme , inactivate pepsin from the stomach , and create an optimal environment for the activity of pH-sensitive digestive enzymes in the small intestine . <hl> Pancreatic enzymes are active in the digestion of sugars , proteins , and fats . The pancreas produces protein-digesting enzymes in their inactive forms . These enzymes are activated in the duodenum . If produced in an active form , they would digest the pancreas ( which is exactly what occurs in the disease , pancreatitis ) . The intestinal brush border enzyme enteropeptidase stimulates the activation of trypsin from trypsinogen of the pancreas , which in turn changes the pancreatic enzymes procarboxypeptidase and chymotrypsinogen into their active forms , carboxypeptidase and chymotrypsin ."}, {"question": {"question_id": "fs-id1896031", "question_text": "Where does the chemical digestion of starch begin?", "question_choices": ["mouth", "esophagus", "stomach", "small intestine"], "cloze_format": "The location where the chemical digestion of starch begins is the ___ .", "normal_format": "Where does the chemical digestion of starch begin?"}, "answer": {"ans_text": "mouth", "ans_choice": 0}, "bloom": "1", "hl_sentences": "The chemical digestion of starches begins in the mouth and has been reviewed above .", "hl_context": "<hl> The chemical digestion of starches begins in the mouth and has been reviewed above . <hl>"}, {"question": {"question_id": "fs-id1920924", "question_text": "Which of these is involved in the chemical digestion of protein?", "question_choices": ["pancreatic amylase", "trypsin", "sucrase", "pancreatic nuclease"], "cloze_format": "___ is involved in the chemical digestion of protein.", "normal_format": "Which of these is involved in the chemical digestion of protein?"}, "answer": {"ans_text": "trypsin", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "The digestion of protein starts in the stomach , where HCl and pepsin break proteins into smaller polypeptides , which then travel to the small intestine ( Figure 23.30 ) . Chemical digestion in the small intestine is continued by pancreatic enzymes , including chymotrypsin and trypsin , each of which act on specific bonds in amino acid sequences .", "hl_context": "<hl> The digestion of protein starts in the stomach , where HCl and pepsin break proteins into smaller polypeptides , which then travel to the small intestine ( Figure 23.30 ) . <hl> <hl> Chemical digestion in the small intestine is continued by pancreatic enzymes , including chymotrypsin and trypsin , each of which act on specific bonds in amino acid sequences . <hl> At the same time , the cells of the brush border secrete enzymes such as aminopeptidase and dipeptidase , which further break down peptide chains . This results in molecules small enough to enter the bloodstream ( Figure 23.31 ) ."}, {"question": {"question_id": "fs-id1857134", "question_text": "Which of these nutrients is absorbed mainly in the duodenum?", "question_choices": ["glucose", "iron", "sodium", "water"], "cloze_format": "The ___ nutrient is absorbed mainly in the duodenum.", "normal_format": "Which of these nutrients is absorbed mainly in the duodenum?"}, "answer": {"ans_text": "iron", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "Iron and calcium are exceptions ; they are absorbed in the duodenum in amounts that meet the body \u2019 s current requirements , as follows :", "hl_context": "In general , all minerals that enter the intestine are absorbed , whether you need them or not . <hl> Iron and calcium are exceptions ; they are absorbed in the duodenum in amounts that meet the body \u2019 s current requirements , as follows : <hl>"}], "summary": "", "keyterm": "", "bname": "anatomy_and_physiology"}, {"chapter": 10, "intro": " Chapter Objectives After studying this chapter, you will be able to: \n\n Explain the organization of muscle tissue \n\n Describe the function and structure of skeletal, cardiac muscle, and smooth muscle \n\n Explain how muscles work with tendons to move the body \n\n Describe how muscles contract and relax \n\n Define the process of muscle metabolism \n\n Explain how the nervous system controls muscle tension \n\n Relate the connections between exercise and muscle performance \n\n Explain the development and regeneration of muscle tissue \n\n Introduction  When most people think of muscles, they think of the muscles that are visible just under the skin, particularly of the limbs. These are skeletal muscles, so-named because most of them move the skeleton. But there are two other types of muscle in the body, with distinctly different jobs. Cardiac muscle, found in the heart, is concerned with pumping blood through the circulatory system. Smooth muscle is concerned with various involuntary movements, such as having one\u2019s hair stand on end when cold or frightened, or moving food through the digestive system. This chapter will examine the structure and function of these three types of muscles. ", "chapter_text": " 10.1   Overview of Muscle Tissues  Learning Objectives By the end of this section, you will be able to: \n\n Describe the different types of muscle \n\n Explain contractibility and extensibility \n\n Muscle is one of the four primary tissue types of the body, and the body contains three types of muscle tissue: skeletal muscle, cardiac muscle, and smooth muscle ( Figure 10.2 ). All three muscle tissues have some properties in common; they all exhibit a quality called  excitability  as their plasma membranes can change their electrical states (from polarized to depolarized) and send an electrical wave called an action potential along the entire length of the membrane. While the nervous system can influence the excitability of cardiac and smooth muscle to some degree, skeletal muscle completely depends on signaling from the nervous system to work properly. On the other hand, both cardiac muscle and smooth muscle can respond to other stimuli, such as hormones and local stimuli. The muscles all begin the actual process of contracting (shortening) when a protein called actin is pulled by a protein called myosin. This occurs in striated muscle (skeletal and cardiac) after specific binding sites on the actin have been exposed in response to the interaction between calcium ions (Ca ++ ) and proteins (troponin and tropomyosin) that \u201cshield\u201d the actin-binding sites. Ca ++  also is required for the contraction of smooth muscle, although its role is different: here Ca ++  activates enzymes, which in turn activate myosin heads. All muscles require adenosine triphosphate (ATP) to continue the process of contracting, and they all relax when the Ca ++  is removed and the actin-binding sites are re-shielded. \n\n A muscle can return to its original length when relaxed due to a quality of muscle tissue called  elasticity . It can recoil back to its original length due to elastic fibers. Muscle tissue also has the quality of  extensibility ; it can stretch or extend.  Contractility  allows muscle tissue to pull on its attachment points and shorten with force. \n\n Differences among the three muscle types include the microscopic organization of their contractile proteins\u2014actin and myosin. The actin and myosin proteins are arranged very regularly in the cytoplasm of individual muscle cells (referred to as fibers) in both skeletal muscle and cardiac muscle, which creates a pattern, or stripes, called striations. The striations are visible with a light microscope under high magnification (see  Figure 10.2 ).  Skeletal muscle  fibers are multinucleated structures that compose the skeletal muscle.  Cardiac muscle  fibers each have one to two nuclei and are physically and electrically connected to each other so that the entire heart contracts as one unit (called a syncytium). Because the actin and myosin are not arranged in such regular fashion in  smooth muscle , the cytoplasm of a smooth muscle fiber (which has only a single nucleus) has a uniform, nonstriated appearance (resulting in the name smooth muscle). However, the less organized appearance of smooth muscle should not be interpreted as less efficient. Smooth muscle in the walls of arteries is a critical component that regulates blood pressure necessary to push blood through the circulatory system; and smooth muscle in the skin, visceral organs, and internal passageways is essential for moving all materials through the body. \n 10.2   Skeletal Muscle  Learning Objectives By the end of this section, you will be able to: \n\n Describe the layers of connective tissues packaging skeletal muscle \n\n Explain how muscles work with tendons to move the body \n\n Identify areas of the skeletal muscle fibers \n\n Describe excitation-contraction coupling \n\n The best-known feature of skeletal muscle is its ability to contract and cause movement. Skeletal muscles act not only to produce movement but also to stop movement, such as resisting gravity to maintain posture. Small, constant adjustments of the skeletal muscles are needed to hold a body upright or balanced in any position. Muscles also prevent excess movement of the bones and joints, maintaining skeletal stability and preventing skeletal structure damage or deformation. Joints can become misaligned or dislocated entirely by pulling on the associated bones; muscles work to keep joints stable. Skeletal muscles are located throughout the body at the openings of internal tracts to control the movement of various substances. These muscles allow functions, such as swallowing, urination, and defecation, to be under voluntary control. Skeletal muscles also protect internal organs (particularly abdominal and pelvic organs) by acting as an external barrier or shield to external trauma and by supporting the weight of the organs. \n\n Skeletal muscles contribute to the maintenance of homeostasis in the body by generating heat. Muscle contraction requires energy, and when ATP is broken down, heat is produced. This heat is very noticeable during exercise, when sustained muscle movement causes body temperature to rise, and in cases of extreme cold, when shivering produces random skeletal muscle contractions to generate heat. \n\n Each skeletal muscle is an organ that consists of various integrated tissues. These tissues include the skeletal muscle fibers, blood vessels, nerve fibers, and connective tissue. Each skeletal muscle has three layers of connective tissue (called \u201cmysia\u201d) that enclose it and provide structure to the muscle as a whole, and also compartmentalize the muscle fibers within the muscle ( Figure 10.3 ). Each muscle is wrapped in a sheath of dense, irregular connective tissue called the  epimysium , which allows a muscle to contract and move powerfully while maintaining its structural integrity. The epimysium also separates muscle from other tissues and organs in the area, allowing the muscle to move independently. Inside each skeletal muscle, muscle fibers are organized into individual bundles, each called a  fascicle , by a middle layer of connective tissue called the  perimysium . This fascicular organization is common in muscles of the limbs; it allows the nervous system to trigger a specific movement of a muscle by activating a subset of muscle fibers within a bundle, or fascicle of the muscle. Inside each fascicle, each muscle fiber is encased in a thin connective tissue layer of collagen and reticular fibers called the  endomysium . The endomysium contains the extracellular fluid and nutrients to support the muscle fiber. These nutrients are supplied via blood to the muscle tissue. \n\n In skeletal muscles that work with tendons to pull on bones, the collagen in the three tissue layers (the mysia) intertwines with the collagen of a tendon. At the other end of the tendon, it fuses with the periosteum coating the bone. The tension created by contraction of the muscle fibers is then transferred though the mysia, to the tendon, and then to the periosteum to pull on the bone for movement of the skeleton. In other places, the mysia may fuse with a broad, tendon-like sheet called an  aponeurosis , or to fascia, the connective tissue between skin and bones. The broad sheet of connective tissue in the lower back that the latissimus dorsi muscles (the \u201clats\u201d) fuse into is an example of an aponeurosis. \n\n Every skeletal muscle is also richly supplied by blood vessels for nourishment, oxygen delivery, and waste removal. In addition, every muscle fiber in a skeletal muscle is supplied by the axon branch of a somatic motor neuron, which signals the fiber to contract. Unlike cardiac and smooth muscle, the only way to functionally contract a skeletal muscle is through signaling from the nervous system. \n\n Skeletal Muscle Fibers \n\n Because skeletal muscle cells are long and cylindrical, they are commonly referred to as muscle fibers. Skeletal muscle fibers can be quite large for human cells, with diameters up to 100  \u03bc m and lengths up to 30 cm (11.8 in) in the Sartorius of the upper leg. During early development, embryonic myoblasts, each with its own nucleus, fuse with up to hundreds of other myoblasts to form the multinucleated skeletal muscle fibers. Multiple nuclei mean multiple copies of genes, permitting the production of the large amounts of proteins and enzymes needed for muscle contraction. Some other terminology associated with muscle fibers is rooted in the Greek  sarco , which means \u201cflesh.\u201d The plasma membrane of muscle fibers is called the  sarcolemma , the cytoplasm is referred to as  sarcoplasm , and the specialized smooth endoplasmic reticulum, which stores, releases, and retrieves calcium ions (Ca ++ ) is called the  sarcoplasmic reticulum (SR)  ( Figure 10.4 ). As will soon be described, the functional unit of a skeletal muscle fiber is the sarcomere, a highly organized arrangement of the contractile myofilaments  actin  (thin filament) and  myosin  (thick filament), along with other support proteins. \n\n The Sarcomere \n\n The striated appearance of skeletal muscle fibers is due to the arrangement of the myofilaments of actin and myosin in sequential order from one end of the muscle fiber to the other. Each packet of these microfilaments and their regulatory proteins,  troponin  and  tropomyosin  (along with other proteins) is called a  sarcomere . \n\n Interactive Link \n\n Watch this  video  to learn more about macro- and microstructures of skeletal muscles. (a) What are the names of the \u201cjunction points\u201d between sarcomeres? (b) What are the names of the \u201csubunits\u201d within the myofibrils that run the length of skeletal muscle fibers? (c) What is the \u201cdouble strand of pearls\u201d described in the video? (d) What gives a skeletal muscle fiber its striated appearance? \n\n The sarcomere is the functional unit of the muscle fiber. The sarcomere itself is bundled within the myofibril that runs the entire length of the muscle fiber and attaches to the sarcolemma at its end. As myofibrils contract, the entire muscle cell contracts. Because myofibrils are only approximately 1.2  \u03bc m in diameter, hundreds to thousands (each with thousands of sarcomeres) can be found inside one muscle fiber. Each sarcomere is approximately 2  \u03bc m in length with a three-dimensional cylinder-like arrangement and is bordered by structures called Z-discs (also called Z-lines, because pictures are two-dimensional), to which the actin myofilaments are anchored ( Figure 10.5 ). Because the actin and its troponin-tropomyosin complex (projecting from the Z-discs toward the center of the sarcomere) form strands that are thinner than the myosin, it is called the  thin filament  of the sarcomere. Likewise, because the myosin strands and their multiple heads (projecting from the center of the sarcomere, toward but not all to way to, the Z-discs) have more mass and are thicker, they are called the  thick filament  of the sarcomere. \n\n The Neuromuscular Junction \n\n Another specialization of the skeletal muscle is the site where a motor neuron\u2019s terminal meets the muscle fiber\u2014called the  neuromuscular junction (NMJ) . This is where the muscle fiber first responds to signaling by the motor neuron. Every skeletal muscle fiber in every skeletal muscle is innervated by a motor neuron at the NMJ. Excitation signals from the neuron are the only way to functionally activate the fiber to contract. \n\n Interactive Link \n\n Every skeletal muscle fiber is supplied by a motor neuron at the NMJ. Watch this  video  to learn more about what happens at the NMJ. (a) What is the definition of a motor unit? (b) What is the structural and functional difference between a large motor unit and a small motor unit? (c) Can you give an example of each? (d) Why is the neurotransmitter acetylcholine degraded after binding to its receptor? \n\n Excitation-Contraction Coupling \n\n All living cells have membrane potentials, or electrical gradients across their membranes. The inside of the membrane is usually around -60 to -90 mV, relative to the outside.  This is referred to as a cell\u2019s membrane potential. Neurons and muscle cells can use their membrane potentials to generate electrical signals. They do this by controlling the movement of charged particles, called ions, across their membranes to create electrical currents. This is achieved by opening and closing specialized proteins in the membrane called ion channels. Although the currents generated by ions moving through these channel proteins are very small, they form the basis of both neural signaling and muscle contraction. Both neurons and skeletal muscle cells are electrically excitable, meaning that they are able to generate action potentials. An action potential is a special type of electrical signal that can travel along a cell membrane as a wave. This allows a signal to be transmitted quickly and faithfully over long distances. Although the term  excitation-contraction coupling  confuses or scares some students, it comes down to this: for a skeletal muscle fiber to contract, its membrane must first be \u201cexcited\u201d\u2014in other words, it must be stimulated to fire an action potential. The muscle fiber action potential, which sweeps along the sarcolemma as a wave, is \u201ccoupled\u201d to the actual contraction through the release of calcium ions (Ca ++ ) from the SR. Once released, the Ca ++  interacts with the shielding proteins, forcing them to move aside so that the actin-binding sites are available for attachment by myosin heads. The myosin then pulls the actin filaments toward the center, shortening the muscle fiber. In skeletal muscle, this sequence begins with signals from the somatic motor division of the nervous system. In other words, the \u201cexcitation\u201d step in skeletal muscles is always triggered by signaling from the nervous system ( Figure 10.6 ). The motor neurons that tell the skeletal muscle fibers to contract originate in the spinal cord, with a smaller number located in the brainstem for activation of skeletal muscles of the face, head, and neck. These neurons have long processes, called axons, which are specialized to transmit action potentials long distances\u2014 in this case, all the way from the spinal cord to the muscle itself (which may be up to three feet away). The axons of multiple neurons bundle together to form nerves, like wires bundled together in a cable. Signaling begins when a neuronal  action potential  travels along the axon of a motor neuron, and then along the individual branches to terminate at the NMJ. At the NMJ, the axon terminal releases a chemical messenger, or  neurotransmitter , called  acetylcholine (ACh) . The ACh molecules diffuse across a minute space called the  synaptic cleft  and bind to ACh receptors located within the  motor end-plate  of the sarcolemma on the other side of the synapse. Once ACh binds, a channel in the ACh receptor opens and positively charged ions can pass through into the muscle fiber, causing it to  depolarize , meaning that the membrane potential of the muscle fiber becomes less negative (closer to zero.) As the membrane depolarizes, another set of ion channels called  voltage-gated sodium channels  are triggered to open. Sodium ions enter the muscle fiber, and an action potential rapidly spreads (or \u201cfires\u201d) along the entire membrane to initiate excitation-contraction coupling. Things happen very quickly in the world of excitable membranes (just think about how quickly you can snap your fingers as soon as you decide to do it). Immediately following depolarization of the membrane, it repolarizes, re-establishing the negative membrane potential. Meanwhile, the ACh in the synaptic cleft is degraded by the enzyme acetylcholinesterase (AChE) so that the ACh cannot rebind to a receptor and reopen its channel, which would cause unwanted extended muscle excitation and contraction. Propagation of an action potential along the sarcolemma is the excitation portion of excitation-contraction coupling. Recall that this excitation actually triggers the release of calcium ions (Ca ++ ) from its storage in the cell\u2019s SR. For the action potential to reach the membrane of the SR, there are periodic invaginations in the sarcolemma, called  T-tubules  (\u201cT\u201d stands for \u201ctransverse\u201d). You will recall that the diameter of a muscle fiber can be up to 100  \u03bc m, so these T-tubules ensure that the membrane can get close to the SR in the sarcoplasm. The arrangement of a T-tubule with the membranes of SR on either side is called a  triad  ( Figure 10.7 ). The triad surrounds the cylindrical structure called a  myofibril , which contains actin and myosin. The T-tubules carry the action potential into the interior of the cell, which triggers the opening of calcium channels in the membrane of the adjacent SR, causing Ca ++  to diffuse out of the SR and into the sarcoplasm. It is the arrival of Ca ++  in the sarcoplasm that initiates contraction of the muscle fiber by its contractile units, or sarcomeres. \n 10.3   Muscle Fiber Contraction and Relaxation  Learning Objectives By the end of this section, you will be able to: \n\n Describe the components involved in a muscle contraction \n\n Explain how muscles contract and relax \n\n Describe the sliding filament model of muscle contraction \n\n The sequence of events that result in the contraction of an individual muscle fiber begins with a signal\u2014the neurotransmitter, ACh\u2014from the motor neuron innervating that fiber. The local membrane of the fiber will depolarize as positively charged sodium ions (Na + ) enter, triggering an action potential that spreads to the rest of the membrane which will depolarize, including the T-tubules. This triggers the release of calcium ions (Ca ++ ) from storage in the sarcoplasmic reticulum (SR). The Ca ++  then initiates contraction, which is sustained by ATP ( Figure 10.8 ). As long as Ca ++  ions remain in the sarcoplasm to bind to troponin, which keeps the actin-binding sites \u201cunshielded,\u201d and as long as ATP is available to drive the cross-bridge cycling and the pulling of actin strands by myosin, the muscle fiber will continue to shorten to an anatomical limit. \n\n Muscle contraction usually stops when signaling from the motor neuron ends, which repolarizes the sarcolemma and T-tubules, and closes the voltage-gated calcium channels in the SR. Ca ++  ions are then pumped back into the SR, which causes the tropomyosin to reshield (or re-cover) the binding sites on the actin strands. A muscle also can stop contracting when it runs out of ATP and becomes fatigued ( Figure 10.9 ). \n\n Interactive Link \n\n The release of calcium ions initiates muscle contractions. Watch this  video  to learn more about the role of calcium. (a) What are \u201cT-tubules\u201d and what is their role? (b) Please describe how actin-binding sites are made available for cross-bridging with myosin heads during contraction. \n\n The molecular events of muscle fiber shortening occur within the fiber\u2019s sarcomeres (see  Figure 10.10 ). The contraction of a striated muscle fiber occurs as the sarcomeres, linearly arranged within myofibrils, shorten as myosin heads pull on the actin filaments. \n\n The region where thick and thin filaments overlap has a dense appearance, as there is little space between the filaments. This zone where thin and thick filaments overlap is very important to muscle contraction, as it is the site where filament movement starts. Thin filaments, anchored at their ends by the Z-discs, do not extend completely into the central region that only contains thick filaments, anchored at their bases at a spot called the M-line. A myofibril is composed of many sarcomeres running along its length; thus, myofibrils and muscle cells contract as the sarcomeres contract. \n\n The Sliding Filament Model of Contraction \n\n When signaled by a motor neuron, a skeletal muscle fiber contracts as the thin filaments are pulled and then slide past the thick filaments within the fiber\u2019s sarcomeres. This process is known as the sliding filament model of muscle contraction ( Figure 10.10 ). The sliding can only occur when myosin-binding sites on the actin filaments are exposed by a series of steps that begins with Ca ++  entry into the sarcoplasm. \n\n Tropomyosin is a protein that winds around the chains of the actin filament and covers the myosin-binding sites to prevent actin from binding to myosin. Tropomyosin binds to troponin to form a troponin-tropomyosin complex. The troponin-tropomyosin complex prevents the myosin \u201cheads\u201d from binding to the active sites on the actin microfilaments. Troponin also has a binding site for Ca ++  ions. \n\n To initiate muscle contraction, tropomyosin has to expose the myosin-binding site on an actin filament to allow cross-bridge formation between the actin and myosin microfilaments. The first step in the process of contraction is for Ca ++  to bind to troponin so that tropomyosin can slide away from the binding sites on the actin strands. This allows the myosin heads to bind to these exposed binding sites and form cross-bridges. The thin filaments are then pulled by the myosin heads to slide past the thick filaments toward the center of the sarcomere. But each head can only pull a very short distance before it has reached its limit and must be \u201cre-cocked\u201d before it can pull again, a step that requires ATP. \n\n ATP and Muscle Contraction \n\n For thin filaments to continue to slide past thick filaments during muscle contraction, myosin heads must pull the actin at the binding sites, detach, re-cock, attach to more binding sites, pull, detach, re-cock, etc. This repeated movement is known as the cross-bridge cycle. This motion of the myosin heads is similar to the oars when an individual rows a boat: The paddle of the oars (the myosin heads) pull, are lifted from the water (detach), repositioned (re-cocked) and then immersed again to pull ( Figure 10.11 ). Each cycle requires energy, and the action of the myosin heads in the sarcomeres repetitively pulling on the thin filaments also requires energy, which is provided by ATP. Cross-bridge formation occurs when the myosin head attaches to the actin while adenosine diphosphate (ADP) and inorganic phosphate (P i ) are still bound to myosin ( Figure 10.11 a,b ). P i  is then released, causing myosin to form a stronger attachment to the actin, after which the myosin head moves toward the M-line, pulling the actin along with it. As actin is pulled, the filaments move approximately 10 nm toward the M-line. This movement is called the  power stroke , as movement of the thin filament occurs at this step ( Figure 10.11 c ). In the absence of ATP, the myosin head will not detach from actin. \n\n One part of the myosin head attaches to the binding site on the actin, but the head has another binding site for ATP. ATP binding causes the myosin head to detach from the actin ( Figure 10.11 d ). After this occurs, ATP is converted to ADP and P i  by the intrinsic  ATPase  activity of myosin. The energy released during ATP hydrolysis changes the angle of the myosin head into a cocked position ( Figure 10.11 e ). The myosin head is now in position for further movement. \n\n When the myosin head is cocked, myosin is in a high-energy configuration. This energy is expended as the myosin head moves through the power stroke, and at the end of the power stroke, the myosin head is in a low-energy position. After the power stroke, ADP is released; however, the formed cross-bridge is still in place, and actin and myosin are bound together. As long as ATP is available, it readily attaches to myosin, the cross-bridge cycle can recur, and muscle contraction can continue. \n\n Note that each thick filament of roughly 300 myosin molecules has multiple myosin heads, and many cross-bridges form and break continuously during muscle contraction. Multiply this by all of the sarcomeres in one myofibril, all the myofibrils in one muscle fiber, and all of the muscle fibers in one skeletal muscle, and you can understand why so much energy (ATP) is needed to keep skeletal muscles working. In fact, it is the loss of ATP that results in the rigor mortis observed soon after someone dies. With no further ATP production possible, there is no ATP available for myosin heads to detach from the actin-binding sites, so the cross-bridges stay in place, causing the rigidity in the skeletal muscles. \n\n Sources of ATP \n\n ATP supplies the energy for muscle contraction to take place. In addition to its direct role in the cross-bridge cycle, ATP also provides the energy for the active-transport Ca ++  pumps in the SR. Muscle contraction does not occur without sufficient amounts of ATP. The amount of ATP stored in muscle is very low, only sufficient to power a few seconds worth of contractions. As it is broken down, ATP must therefore be regenerated and replaced quickly to allow for sustained contraction. There are three mechanisms by which ATP can be regenerated: creatine phosphate metabolism, anaerobic glycolysis, and fermentation and aerobic respiration. Creatine phosphate  is a molecule that can store energy in its phosphate bonds. In a resting muscle, excess ATP transfers its energy to creatine, producing ADP and creatine phosphate. This acts as an energy reserve that can be used to quickly create more ATP. When the muscle starts to contract and needs energy, creatine phosphate transfers its phosphate back to ADP to form ATP and creatine. This reaction is catalyzed by the enzyme creatine kinase and occurs very quickly; thus, creatine phosphate-derived ATP powers the first few seconds of muscle contraction. However, creatine phosphate can only provide approximately 15 seconds worth of energy, at which point another energy source has to be used ( Figure 10.12 ). \n\n As the ATP produced by creatine phosphate is depleted, muscles turn to glycolysis as an ATP source.  Glycolysis  is an anaerobic (non-oxygen-dependent) process that breaks down glucose (sugar) to produce ATP; however, glycolysis cannot generate ATP as quickly as creatine phosphate. Thus, the switch to glycolysis results in a slower rate of ATP availability to the muscle. The sugar used in glycolysis can be provided by blood glucose or by metabolizing glycogen that is stored in the muscle. The breakdown of one glucose molecule produces two ATP and two molecules of  pyruvic acid , which can be used in aerobic respiration or when oxygen levels are low, converted to lactic acid ( Figure 10.12 b ). If oxygen is available, pyruvic acid is used in aerobic respiration. However, if oxygen is not available, pyruvic acid is converted to  lactic acid , which may contribute to muscle fatigue. This conversion allows the recycling of the enzyme NAD +  from NADH, which is needed for glycolysis to continue. This occurs during strenuous exercise when high amounts of energy are needed but oxygen cannot be sufficiently delivered to muscle. Glycolysis itself cannot be sustained for very long (approximately 1 minute of muscle activity), but it is useful in facilitating short bursts of high-intensity output. This is because glycolysis does not utilize glucose very efficiently, producing a net gain of two ATPs per molecule of glucose, and the end product of lactic acid, which may contribute to muscle fatigue as it accumulates. \n\n Aerobic respiration  is the breakdown of glucose or other nutrients in the presence of oxygen (O 2 ) to produce carbon dioxide, water, and ATP. Approximately 95 percent of the ATP required for resting or moderately active muscles is provided by aerobic respiration, which takes place in mitochondria. The inputs for aerobic respiration include glucose circulating in the bloodstream, pyruvic acid, and fatty acids. Aerobic respiration is much more efficient than anaerobic glycolysis, producing approximately 36 ATPs per molecule of glucose versus four from glycolysis. However, aerobic respiration cannot be sustained without a steady supply of O 2  to the skeletal muscle and is much slower ( Figure 10.12 c ). To compensate, muscles store small amount of excess oxygen in proteins call myoglobin, allowing for more efficient muscle contractions and less fatigue. Aerobic training also increases the efficiency of the circulatory system so that O 2  can be supplied to the muscles for longer periods of time. \n\n Muscle fatigue occurs when a muscle can no longer contract in response to signals from the nervous system. The exact causes of muscle fatigue are not fully known, although certain factors have been correlated with the decreased muscle contraction that occurs during fatigue. ATP is needed for normal muscle contraction, and as ATP reserves are reduced, muscle function may decline. This may be more of a factor in brief, intense muscle output rather than sustained, lower intensity efforts. Lactic acid buildup may lower intracellular pH, affecting enzyme and protein activity. Imbalances in Na +  and K +  levels as a result of membrane depolarization may disrupt Ca ++  flow out of the SR. Long periods of sustained exercise may damage the SR and the sarcolemma, resulting in impaired Ca ++  regulation. \n\n Intense muscle activity results in an  oxygen debt , which is the amount of oxygen needed to compensate for ATP produced without oxygen during muscle contraction. Oxygen is required to restore ATP and creatine phosphate levels, convert lactic acid to pyruvic acid, and, in the liver, to convert lactic acid into glucose or glycogen. Other systems used during exercise also require oxygen, and all of these combined processes result in the increased breathing rate that occurs after exercise. Until the oxygen debt has been met, oxygen intake is elevated, even after exercise has stopped. \n\n Relaxation of a Skeletal Muscle \n\n Relaxing skeletal muscle fibers, and ultimately, the skeletal muscle, begins with the motor neuron, which stops releasing its chemical signal, ACh, into the synapse at the NMJ. The muscle fiber will repolarize, which closes the gates in the SR where Ca ++  was being released. ATP-driven pumps will move Ca ++  out of the sarcoplasm back into the SR. This results in the \u201creshielding\u201d of the actin-binding sites on the thin filaments. Without the ability to form cross-bridges between the thin and thick filaments, the muscle fiber loses its tension and relaxes. \n\n Muscle Strength \n\n The number of skeletal muscle fibers in a given muscle is genetically determined and does not change. Muscle strength is directly related to the amount of myofibrils and sarcomeres within each fiber. Factors, such as hormones and stress (and artificial anabolic steroids), acting on the muscle can increase the production of sarcomeres and myofibrils within the muscle fibers, a change called hypertrophy, which results in the increased mass and bulk in a skeletal muscle. Likewise, decreased use of a skeletal muscle results in atrophy, where the number of sarcomeres and myofibrils disappear (but not the number of muscle fibers). It is common for a limb in a cast to show atrophied muscles when the cast is removed, and certain diseases, such as polio, show atrophied muscles. \n\n Disorders of the... Muscular System \n\n Duchenne muscular dystrophy (DMD) is a progressive weakening of the skeletal muscles. It is one of several diseases collectively referred to as \u201cmuscular dystrophy.\u201d DMD is caused by a lack of the protein dystrophin, which helps the thin filaments of myofibrils bind to the sarcolemma. Without sufficient dystrophin, muscle contractions cause the sarcolemma to tear, causing an influx of Ca ++ , leading to cellular damage and muscle fiber degradation. Over time, as muscle damage accumulates, muscle mass is lost, and greater functional impairments develop. \n\n DMD is an inherited disorder caused by an abnormal X chromosome. It primarily affects males, and it is usually diagnosed in early childhood. DMD usually first appears as difficulty with balance and motion, and then progresses to an inability to walk. It continues progressing upward in the body from the lower extremities to the upper body, where it affects the muscles responsible for breathing and circulation. It ultimately causes death due to respiratory failure, and those afflicted do not usually live past their 20s. \n\n Because DMD is caused by a mutation in the gene that codes for dystrophin, it was thought that introducing healthy myoblasts into patients might be an effective treatment. Myoblasts are the embryonic cells responsible for muscle development, and ideally, they would carry healthy genes that could produce the dystrophin needed for normal muscle contraction. This approach has been largely unsuccessful in humans. A recent approach has involved attempting to boost the muscle\u2019s production of utrophin, a protein similar to dystrophin that may be able to assume the role of dystrophin and prevent cellular damage from occurring. \n 10.4   Nervous System Control of Muscle Tension  Learning Objectives By the end of this section, you will be able to: \n\n Explain concentric, isotonic, and eccentric contractions \n\n Describe the length-tension relationship \n\n Describe the three phases of a muscle twitch \n\n Define wave summation, tetanus, and treppe \n\n To move an object, referred to as load, the sarcomeres in the muscle fibers of the skeletal muscle must shorten. The force generated by the contraction of the muscle (or shortening of the sarcomeres) is called  muscle tension . However, muscle tension also is generated when the muscle is contracting against a load that does not move, resulting in two main types of skeletal muscle contractions: isotonic contractions and isometric contractions. \n\n In  isotonic contractions , where the tension in the muscle stays constant, a load is moved as the length of the muscle changes (shortens). There are two types of isotonic contractions: concentric and eccentric. A  concentric contraction  involves the muscle shortening to move a load. An example of this is the biceps brachii muscle contracting when a hand weight is brought upward with increasing muscle tension. As the biceps brachii contract, the angle of the elbow joint decreases as the forearm is brought toward the body. Here, the biceps brachii contracts as sarcomeres in its muscle fibers are shortening and cross-bridges form; the myosin heads pull the actin. An  eccentric contraction  occurs as the muscle tension diminishes and the muscle lengthens. In this case, the hand weight is lowered in a slow and controlled manner as the amount of cross-bridges being activated by nervous system stimulation decreases. In this case, as tension is released from the biceps brachii, the angle of the elbow joint increases. Eccentric contractions are also used for movement and balance of the body. \n\n An  isometric contraction  occurs as the muscle produces tension without changing the angle of a skeletal joint. Isometric contractions involve sarcomere shortening and increasing muscle tension, but do not move a load, as the force produced cannot overcome the resistance provided by the load. For example, if one attempts to lift a hand weight that is too heavy, there will be sarcomere activation and shortening to a point, and ever-increasing muscle tension, but no change in the angle of the elbow joint. In everyday living, isometric contractions are active in maintaining posture and maintaining bone and joint stability. However, holding your head in an upright position occurs not because the muscles cannot move the head, but because the goal is to remain stationary and not produce movement. Most actions of the body are the result of a combination of isotonic and isometric contractions working together to produce a wide range of outcomes ( Figure 10.13 ). \n\n All of these muscle activities are under the exquisite control of the nervous system. Neural control regulates concentric, eccentric and isometric contractions, muscle fiber recruitment, and muscle tone. A crucial aspect of nervous system control of skeletal muscles is the role of motor units. \n\n Motor Units \n\n As you have learned, every skeletal muscle fiber must be innervated by the axon terminal of a motor neuron in order to contract. Each muscle fiber is innervated by only one motor neuron. The actual group of muscle fibers in a muscle innervated by a single motor neuron is called a  motor unit . The size of a motor unit is variable depending on the nature of the muscle. \n\n A small motor unit is an arrangement where a single motor neuron supplies a small number of muscle fibers in a muscle. Small motor units permit very fine motor control of the muscle. The best example in humans is the small motor units of the extraocular eye muscles that move the eyeballs. There are thousands of muscle fibers in each muscle, but every six or so fibers are supplied by a single motor neuron, as the axons branch to form synaptic connections at their individual NMJs. This allows for exquisite control of eye movements so that both eyes can quickly focus on the same object. Small motor units are also involved in the many fine movements of the fingers and thumb of the hand for grasping, texting, etc. \n\n A large motor unit is an arrangement where a single motor neuron supplies a large number of muscle fibers in a muscle. Large motor units are concerned with simple, or \u201cgross,\u201d movements, such as powerfully extending the knee joint. The best example is the large motor units of the thigh muscles or back muscles, where a single motor neuron will supply thousands of muscle fibers in a muscle, as its axon splits into thousands of branches. \n\n There is a wide range of motor units within many skeletal muscles, which gives the nervous system a wide range of control over the muscle. The small motor units in the muscle will have smaller, lower-threshold motor neurons that are more excitable, firing first to their skeletal muscle fibers, which also tend to be the smallest. Activation of these smaller motor units, results in a relatively small degree of contractile strength (tension) generated in the muscle. As more strength is needed, larger motor units, with bigger, higher-threshold motor neurons are enlisted to activate larger muscle fibers. This increasing activation of motor units produces an increase in muscle contraction known as  recruitment . As more motor units are recruited, the muscle contraction grows progressively stronger. In some muscles, the largest motor units may generate a contractile force of 50 times more than the smallest motor units in the muscle. This allows a feather to be picked up using the biceps brachii arm muscle with minimal force, and a heavy weight to be lifted by the same muscle by recruiting the largest motor units. \n\n When necessary, the maximal number of motor units in a muscle can be recruited simultaneously, producing the maximum force of contraction for that muscle, but this cannot last for very long because of the energy requirements to sustain the contraction. To prevent complete muscle fatigue, motor units are generally not all simultaneously active, but instead some motor units rest while others are active, which allows for longer muscle contractions. The nervous system uses recruitment as a mechanism to efficiently utilize a skeletal muscle. \n\n The Length-Tension Range of a Sarcomere \n\n When a skeletal muscle fiber contracts, myosin heads attach to actin to form cross-bridges followed by the thin filaments sliding over the thick filaments as the heads pull the actin, and this results in sarcomere shortening, creating the tension of the muscle contraction. The cross-bridges can only form where thin and thick filaments already overlap, so that the length of the sarcomere has a direct influence on the force generated when the sarcomere shortens. This is called the length-tension relationship. \n\n The ideal length of a sarcomere to produce maximal tension occurs at 80 percent to 120 percent of its resting length, with 100 percent being the state where the medial edges of the thin filaments are just at the most-medial myosin heads of the thick filaments ( Figure 10.14 ). This length maximizes the overlap of actin-binding sites and myosin heads. If a sarcomere is stretched past this ideal length (beyond 120 percent), thick and thin filaments do not overlap sufficiently, which results in less tension produced. If a sarcomere is shortened beyond 80 percent, the zone of overlap is reduced with the thin filaments jutting beyond the last of the myosin heads and shrinks the H zone, which is normally composed of myosin tails. Eventually, there is nowhere else for the thin filaments to go and the amount of tension is diminished. If the muscle is stretched to the point where thick and thin filaments do not overlap at all, no cross-bridges can be formed, and no tension is produced in that sarcomere. This amount of stretching does not usually occur, as accessory proteins and connective tissue oppose extreme stretching. \n\n The Frequency of Motor Neuron Stimulation \n\n A single action potential from a motor neuron will produce a single contraction in the muscle fibers of its motor unit. This isolated contraction is called a  twitch . A twitch can last for a few milliseconds or 100 milliseconds, depending on the muscle type. The tension produced by a single twitch can be measured by a  myogram , an instrument that measures the amount of tension produced over time ( Figure 10.15 ). Each twitch undergoes three phases. The first phase is the  latent period , during which the action potential is being propagated along the sarcolemma and Ca ++  ions are released from the SR. This is the phase during which excitation and contraction are being coupled but contraction has yet to occur. The  contraction phase  occurs next. The Ca ++  ions in the sarcoplasm have bound to troponin, tropomyosin has shifted away from actin-binding sites, cross-bridges formed, and sarcomeres are actively shortening to the point of peak tension. The last phase is the  relaxation phase , when tension decreases as contraction stops. Ca ++  ions are pumped out of the sarcoplasm into the SR, and cross-bridge cycling stops, returning the muscle fibers to their resting state. \n\n Although a person can experience a muscle \u201ctwitch,\u201d a single twitch does not produce any significant muscle activity in a living body. A series of action potentials to the muscle fibers is necessary to produce a muscle contraction that can produce work. Normal muscle contraction is more sustained, and it can be modified by input from the nervous system to produce varying amounts of force; this is called a  graded muscle response . The frequency of action potentials (nerve impulses) from a motor neuron and the number of motor neurons transmitting action potentials both affect the tension produced in skeletal muscle. \n\n The rate at which a motor neuron fires action potentials affects the tension produced in the skeletal muscle. If the fibers are stimulated while a previous twitch is still occurring, the second twitch will be stronger. This response is called  wave summation , because the excitation-contraction coupling effects of successive motor neuron signaling is summed, or added together ( Figure 10.16 a ). At the molecular level, summation occurs because the second stimulus triggers the release of more Ca ++  ions, which become available to activate additional sarcomeres while the muscle is still contracting from the first stimulus. Summation results in greater contraction of the motor unit. \n\n If the frequency of motor neuron signaling increases, summation and subsequent muscle tension in the motor unit continues to rise until it reaches a peak point. The tension at this point is about three to four times greater than the tension of a single twitch, a state referred to as incomplete tetanus. During incomplete tetanus, the muscle goes through quick cycles of contraction with a short relaxation phase for each. If the stimulus frequency is so high that the relaxation phase disappears completely, contractions become continuous in a process called complete  tetanus  ( Figure 10.16 b ). \n\n During tetanus, the concentration of Ca ++  ions in the sarcoplasm allows virtually all of the sarcomeres to form cross-bridges and shorten, so that a contraction can continue uninterrupted (until the muscle fatigues and can no longer produce tension). \n\n Treppe \n\n When a skeletal muscle has been dormant for an extended period and then activated to contract, with all other things being equal, the initial contractions generate about one-half the force of later contractions. The muscle tension increases in a graded manner that to some looks like a set of stairs. This tension increase is called  treppe , a condition where muscle contractions become more efficient. It\u2019s also known as the \u201cstaircase effect\u201d ( Figure 10.17 ). \n\n It is believed that treppe results from a higher concentration of Ca ++  in the sarcoplasm resulting from the steady stream of signals from the motor neuron. It can only be maintained with adequate ATP. \n\n Muscle Tone \n\n Skeletal muscles are rarely completely relaxed, or flaccid. Even if a muscle is not producing movement, it is contracted a small amount to maintain its contractile proteins and produce  muscle tone . The tension produced by muscle tone allows muscles to continually stabilize joints and maintain posture. \n\n Muscle tone is accomplished by a complex interaction between the nervous system and skeletal muscles that results in the activation of a few motor units at a time, most likely in a cyclical manner. In this manner, muscles never fatigue completely, as some motor units can recover while others are active. \n\n The absence of the low-level contractions that lead to muscle tone is referred to as  hypotonia , and can result from damage to parts of the central nervous system (CNS), such as the cerebellum, or from loss of innervations to a skeletal muscle, as in poliomyelitis. Hypotonic muscles have a flaccid appearance and display functional impairments, such as weak reflexes. Conversely, excessive muscle tone is referred to as  hypertonia , accompanied by hyperreflexia (excessive reflex responses), often the result of damage to upper motor neurons in the CNS. Hypertonia can present with muscle rigidity (as seen in Parkinson\u2019s disease) or spasticity, a phasic change in muscle tone, where a limb will \u201csnap\u201d back from passive stretching (as seen in some strokes). \n 10.5   Types of Muscle Fibers  Learning Objectives By the end of this section, you will be able to: \n\n Describe the types of skeletal muscle fibers \n\n Explain fast and slow muscle fibers \n\n Two criteria to consider when classifying the types of muscle fibers are how fast some fibers contract relative to others, and how fibers produce ATP. Using these criteria, there are three main types of skeletal muscle fibers.  Slow oxidative (SO)  fibers contract relatively slowly and use aerobic respiration (oxygen and glucose) to produce ATP.  Fast oxidative (FO)  fibers have fast contractions and primarily use aerobic respiration, but because they may switch to anaerobic respiration (glycolysis), can fatigue more quickly than SO fibers. Lastly,  fast glycolytic (FG)  fibers have fast contractions and primarily use anaerobic glycolysis. The FG fibers fatigue more quickly than the others. Most skeletal muscles in a human contain(s) all three types, although in varying proportions. \n\n The speed of contraction is dependent on how quickly myosin\u2019s ATPase hydrolyzes ATP to produce cross-bridge action. Fast fibers hydrolyze ATP approximately twice as quickly as slow fibers, resulting in much quicker cross-bridge cycling (which pulls the thin filaments toward the center of the sarcomeres at a faster rate). The primary metabolic pathway used by a muscle fiber determines whether the fiber is classified as oxidative or glycolytic. If a fiber primarily produces ATP through aerobic pathways it is oxidative. More ATP can be produced during each metabolic cycle, making the fiber more resistant to fatigue. Glycolytic fibers primarily create ATP through anaerobic glycolysis, which produces less ATP per cycle. As a result, glycolytic fibers fatigue at a quicker rate. \n\n The oxidative fibers contain many more mitochondria than the glycolytic fibers, because aerobic metabolism, which uses oxygen (O 2 ) in the metabolic pathway, occurs in the mitochondria. The SO fibers possess a large number of mitochondria and are capable of contracting for longer periods because of the large amount of ATP they can produce, but they have a relatively small diameter and do not produce a large amount of tension. SO fibers are extensively supplied with blood capillaries to supply O 2  from the red blood cells in the bloodstream. The SO fibers also possess myoglobin, an O 2 -carrying molecule similar to O 2 -carrying hemoglobin in the red blood cells. The myoglobin stores some of the needed O 2  within the fibers themselves (and gives SO fibers their red color). All of these features allow SO fibers to produce large quantities of ATP, which can sustain muscle activity without fatiguing for long periods of time. \n\n The fact that SO fibers can function for long periods without fatiguing makes them useful in maintaining posture, producing isometric contractions, stabilizing bones and joints, and making small movements that happen often but do not require large amounts of energy. They do not produce high tension, and thus they are not used for powerful, fast movements that require high amounts of energy and rapid cross-bridge cycling. \n\n FO fibers are sometimes called intermediate fibers because they possess characteristics that are intermediate between fast fibers and slow fibers. They produce ATP relatively quickly, more quickly than SO fibers, and thus can produce relatively high amounts of tension. They are oxidative because they produce ATP aerobically, possess high amounts of mitochondria, and do not fatigue quickly. However, FO fibers do not possess significant myoglobin, giving them a lighter color than the red SO fibers. FO fibers are used primarily for movements, such as walking, that require more energy than postural control but less energy than an explosive movement, such as sprinting. FO fibers are useful for this type of movement because they produce more tension than SO fibers but they are more fatigue-resistant than FG fibers. \n\n FG fibers primarily use anaerobic glycolysis as their ATP source. They have a large diameter and possess high amounts of glycogen, which is used in glycolysis to generate ATP quickly to produce high levels of tension. Because they do not primarily use aerobic metabolism, they do not possess substantial numbers of mitochondria or significant amounts of myoglobin and therefore have a white color. FG fibers are used to produce rapid, forceful contractions to make quick, powerful movements. These fibers fatigue quickly, permitting them to only be used for short periods. Most muscles possess a mixture of each fiber type. The predominant fiber type in a muscle is determined by the primary function of the muscle. \n 10.6   Exercise and Muscle Performance  Learning Objectives By the end of this section, you will be able to: \n\n Describe hypertrophy and atrophy \n\n Explain how resistance exercise builds muscle \n\n Explain how performance-enhancing substances affect muscle \n\n Physical training alters the appearance of skeletal muscles and can produce changes in muscle performance. Conversely, a lack of use can result in decreased performance and muscle appearance. Although muscle cells can change in size, new cells are not formed when muscles grow. Instead, structural proteins are added to muscle fibers in a process called  hypertrophy , so cell diameter increases. The reverse, when structural proteins are lost and muscle mass decreases, is called  atrophy . Age-related muscle atrophy is called  sarcopenia . Cellular components of muscles can also undergo changes in response to changes in muscle use. \n\n Endurance Exercise \n\n Slow fibers are predominantly used in endurance exercises that require little force but involve numerous repetitions. The aerobic metabolism used by slow-twitch fibers allows them to maintain contractions over long periods. Endurance training modifies these slow fibers to make them even more efficient by producing more mitochondria to enable more aerobic metabolism and more ATP production. Endurance exercise can also increase the amount of myoglobin in a cell, as increased aerobic respiration increases the need for oxygen. Myoglobin is found in the sarcoplasm and acts as an oxygen storage supply for the mitochondria. \n\n The training can trigger the formation of more extensive capillary networks around the fiber, a process called  angiogenesis , to supply oxygen and remove metabolic waste. To allow these capillary networks to supply the deep portions of the muscle, muscle mass does not greatly increase in order to maintain a smaller area for the diffusion of nutrients and gases. All of these cellular changes result in the ability to sustain low levels of muscle contractions for greater periods without fatiguing. \n\n The proportion of SO muscle fibers in muscle determines the suitability of that muscle for endurance, and may benefit those participating in endurance activities. Postural muscles have a large number of SO fibers and relatively few FO and FG fibers, to keep the back straight ( Figure 10.18 ). Endurance athletes, like marathon-runners also would benefit from a larger proportion of SO fibers, but it is unclear if the most-successful marathoners are those with naturally high numbers of SO fibers, or whether the most successful marathon runners develop high numbers of SO fibers with repetitive training. Endurance training can result in overuse injuries such as stress fractures and joint and tendon inflammation. \n\n Resistance Exercise \n\n Resistance exercises, as opposed to endurance exercise, require large amounts of FG fibers to produce short, powerful movements that are not repeated over long periods. The high rates of ATP hydrolysis and cross-bridge formation in FG fibers result in powerful muscle contractions. Muscles used for power have a higher ratio of FG to SO/FO fibers, and trained athletes possess even higher levels of FG fibers in their muscles. Resistance exercise affects muscles by increasing the formation of myofibrils, thereby increasing the thickness of muscle fibers. This added structure causes hypertrophy, or the enlargement of muscles, exemplified by the large skeletal muscles seen in body builders and other athletes ( Figure 10.19 ). Because this muscular enlargement is achieved by the addition of structural proteins, athletes trying to build muscle mass often ingest large amounts of protein. \n\n Except for the hypertrophy that follows an increase in the number of sarcomeres and myofibrils in a skeletal muscle, the cellular changes observed during endurance training do not usually occur with resistance training. There is usually no significant increase in mitochondria or capillary density. However, resistance training does increase the development of connective tissue, which adds to the overall mass of the muscle and helps to contain muscles as they produce increasingly powerful contractions. Tendons also become stronger to prevent tendon damage, as the force produced by muscles is transferred to tendons that attach the muscle to bone. \n\n For effective strength training, the intensity of the exercise must continually be increased. For instance, continued weight lifting without increasing the weight of the load does not increase muscle size. To produce ever-greater results, the weights lifted must become increasingly heavier, making it more difficult for muscles to move the load. The muscle then adapts to this heavier load, and an even heavier load must be used if even greater muscle mass is desired. \n\n If done improperly, resistance training can lead to overuse injuries of the muscle, tendon, or bone. These injuries can occur if the load is too heavy or if the muscles are not given sufficient time between workouts to recover or if joints are not aligned properly during the exercises. Cellular damage to muscle fibers that occurs after intense exercise includes damage to the sarcolemma and myofibrils. This muscle damage contributes to the feeling of soreness after strenuous exercise, but muscles gain mass as this damage is repaired, and additional structural proteins are added to replace the damaged ones. Overworking skeletal muscles can also lead to tendon damage and even skeletal damage if the load is too great for the muscles to bear. \n\n Performance-Enhancing Substances \n\n Some athletes attempt to boost their performance by using various agents that may enhance muscle performance. Anabolic steroids are one of the more widely known agents used to boost muscle mass and increase power output. Anabolic steroids are a form of testosterone, a male sex hormone that stimulates muscle formation, leading to increased muscle mass. \n\n Endurance athletes may also try to boost the availability of oxygen to muscles to increase aerobic respiration by using substances such as erythropoietin (EPO), a hormone normally produced in the kidneys, which triggers the production of red blood cells. The extra oxygen carried by these blood cells can then be used by muscles for aerobic respiration. Human growth hormone (hGH) is another supplement, and although it can facilitate building muscle mass, its main role is to promote the healing of muscle and other tissues after strenuous exercise. Increased hGH may allow for faster recovery after muscle damage, reducing the rest required after exercise, and allowing for more sustained high-level performance. \n\n Although performance-enhancing substances often do improve performance, most are banned by governing bodies in sports and are illegal for nonmedical purposes. Their use to enhance performance raises ethical issues of cheating because they give users an unfair advantage over nonusers. A greater concern, however, is that their use carries serious health risks. The side effects of these substances are often significant, nonreversible, and in some cases fatal. The physiological strain caused by these substances is often greater than what the body can handle, leading to effects that are unpredictable and dangerous. Anabolic steroid use has been linked to infertility, aggressive behavior, cardiovascular disease, and brain cancer. \n\n Similarly, some athletes have used creatine to increase power output. Creatine phosphate provides quick bursts of ATP to muscles in the initial stages of contraction. Increasing the amount of creatine available to cells is thought to produce more ATP and therefore increase explosive power output, although its effectiveness as a supplement has been questioned. \n\n Everyday Connection Aging and Muscle Tissue \n\nAlthough atrophy due to disuse can often be reversed with exercise, muscle atrophy with age, referred to as sarcopenia, is irreversible. This is a primary reason why even highly trained athletes succumb to declining performance with age. This decline is noticeable in athletes whose sports require strength and powerful movements, such as sprinting, whereas the effects of age are less noticeable in endurance athletes such as marathon runners or long-distance cyclists. As muscles age, muscle fibers die, and they are replaced by connective tissue and adipose tissue ( Figure 10.20 ). Because those tissues cannot contract and generate force as muscle can, muscles lose the ability to produce powerful contractions. The decline in muscle mass causes a loss of strength, including the strength required for posture and mobility. This may be caused by a reduction in FG fibers that hydrolyze ATP quickly to produce short, powerful contractions. Muscles in older people sometimes possess greater numbers of SO fibers, which are responsible for longer contractions and do not produce powerful movements. There may also be a reduction in the size of motor units, resulting in fewer fibers being stimulated and less muscle tension being produced. \n\n Sarcopenia can be delayed to some extent by exercise, as training adds structural proteins and causes cellular changes that can offset the effects of atrophy. Increased exercise can produce greater numbers of cellular mitochondria, increase capillary density, and increase the mass and strength of connective tissue. The effects of age-related atrophy are especially pronounced in people who are sedentary, as the loss of muscle cells is displayed as functional impairments such as trouble with locomotion, balance, and posture. This can lead to a decrease in quality of life and medical problems, such as joint problems because the muscles that stabilize bones and joints are weakened. Problems with locomotion and balance can also cause various injuries due to falls. \n 10.7   Cardiac Muscle Tissue  Learning Objectives By the end of this section, you will be able to: \n\n Describe intercalated discs and gap junctions \n\n Describe a desmosome \n\n Cardiac muscle tissue is only found in the heart. Highly coordinated contractions of cardiac muscle pump blood into the vessels of the circulatory system. Similar to skeletal muscle, cardiac muscle is striated and organized into sarcomeres, possessing the same banding organization as skeletal muscle ( Figure 10.21 ). However, cardiac muscle fibers are shorter than skeletal muscle fibers and usually contain only one nucleus, which is located in the central region of the cell. Cardiac muscle fibers also possess many mitochondria and myoglobin, as ATP is produced primarily through aerobic metabolism. Cardiac muscle fibers cells also are extensively branched and are connected to one another at their ends by intercalated discs. An  intercalated disc  allows the cardiac muscle cells to contract in a wave-like pattern so that the heart can work as a pump. \n\n Interactive Link \n\n View the   University of Michigan WebScope  to explore the tissue sample in greater detail. Intercalated discs are part of the sarcolemma and contain two structures important in cardiac muscle contraction: gap junctions and desmosomes. A gap junction forms channels between adjacent cardiac muscle fibers that allow the depolarizing current produced by cations to flow from one cardiac muscle cell to the next. This joining is called electric coupling, and in cardiac muscle it allows the quick transmission of action potentials and the coordinated contraction of the entire heart. This network of electrically connected cardiac muscle cells creates a functional unit of contraction called a syncytium. The remainder of the intercalated disc is composed of desmosomes. A  desmosome  is a cell structure that anchors the ends of cardiac muscle fibers together so the cells do not pull apart during the stress of individual fibers contracting ( Figure 10.22 ). Contractions of the heart (heartbeats) are controlled by specialized cardiac muscle cells called pacemaker cells that directly control heart rate. Although cardiac muscle cannot be consciously controlled, the pacemaker cells respond to signals from the autonomic nervous system (ANS) to speed up or slow down the heart rate. The pacemaker cells can also respond to various hormones that modulate heart rate to control blood pressure. \n\n The wave of contraction that allows the heart to work as a unit, called a functional syncytium, begins with the pacemaker cells. This group of cells is self-excitable and able to depolarize to threshold and fire action potentials on their own, a feature called  autorhythmicity ; they do this at set intervals which determine heart rate. Because they are connected with gap junctions to surrounding muscle fibers and the specialized fibers of the heart\u2019s conduction system, the pacemaker cells are able to transfer the depolarization to the other cardiac muscle fibers in a manner that allows the heart to contract in a coordinated manner. \n\n Another feature of cardiac muscle is its relatively long action potentials in its fibers, having a sustained depolarization \u201cplateau.\u201d The plateau is produced by Ca ++  entry though voltage-gated calcium channels in the sarcolemma of cardiac muscle fibers. This sustained depolarization (and Ca ++  entry) provides for a longer contraction than is produced by an action potential in skeletal muscle. Unlike skeletal muscle, a large percentage of the Ca ++  that initiates contraction in cardiac muscles comes from outside the cell rather than from the SR. \n 10.8   Smooth Muscle  Learning Objectives By the end of this section, you will be able to: \n\n Describe a dense body \n\n Explain how smooth muscle works with internal organs and passageways through the body \n\n Explain how smooth muscles differ from skeletal and cardiac muscles \n\n Explain the difference between single-unit and multi-unit smooth muscle \n\n Smooth muscle (so-named because the cells do not have striations) is present in the walls of hollow organs like the urinary bladder, uterus, stomach, intestines, and in the walls of passageways, such as the arteries and veins of the circulatory system, and the tracts of the respiratory, urinary, and reproductive systems ( Figure 10.23 ab ). Smooth muscle is also present in the eyes, where it functions to change the size of the iris and alter the shape of the lens; and in the skin where it causes hair to stand erect in response to cold temperature or fear. \n\n Interactive Link \n\n View the   University of Michigan WebScope  to explore the tissue sample in greater detail. \n\n Smooth muscle fibers are spindle-shaped (wide in the middle and tapered at both ends, somewhat like a football) and have a single nucleus; they range from about 30 to 200  \u03bc m (thousands of times shorter than skeletal muscle fibers), and they produce their own connective tissue, endomysium. Although they do not have striations and sarcomeres, smooth muscle fibers do have actin and myosin contractile proteins, and thick and thin filaments. These thin filaments are anchored by dense bodies. A  dense body  is analogous to the Z-discs of skeletal and cardiac muscle fibers and is fastened to the sarcolemma. Calcium ions are supplied by the SR in the fibers and by sequestration from the extracellular fluid through membrane indentations called calveoli. Because smooth muscle cells do not contain troponin, cross-bridge formation is not regulated by the troponin-tropomyosin complex but instead by the regulatory protein  calmodulin . In a smooth muscle fiber, external Ca ++  ions passing through opened calcium channels in the sarcolemma, and additional Ca ++  released from SR, bind to calmodulin. The Ca ++ -calmodulin complex then activates an enzyme called myosin (light chain) kinase, which, in turn, activates the myosin heads by phosphorylating them (converting ATP to ADP and P i , with the P i  attaching to the head). The heads can then attach to actin-binding sites and pull on the thin filaments. The thin filaments also are anchored to the dense bodies; the structures invested in the inner membrane of the sarcolemma (at adherens junctions) that also have cord-like intermediate filaments attached to them. When the thin filaments slide past the thick filaments, they pull on the dense bodies, structures tethered to the sarcolemma, which then pull on the intermediate filaments networks throughout the sarcoplasm. This arrangement causes the entire muscle fiber to contract in a manner whereby the ends are pulled toward the center, causing the midsection to bulge in a corkscrew motion ( Figure 10.24 ). \n\n Although smooth muscle contraction relies on the presence of Ca ++  ions, smooth muscle fibers have a much smaller diameter than skeletal muscle cells. T-tubules are not required to reach the interior of the cell and therefore not necessary to transmit an action potential deep into the fiber. Smooth muscle fibers have a limited calcium-storing SR but have calcium channels in the sarcolemma (similar to cardiac muscle fibers) that open during the action potential along the sarcolemma. The influx of extracellular Ca ++  ions, which diffuse into the sarcoplasm to reach the calmodulin, accounts for most of the Ca ++  that triggers contraction of a smooth muscle cell. \n\n Muscle contraction continues until ATP-dependent calcium pumps actively transport Ca ++  ions back into the SR and out of the cell. However, a low concentration of calcium remains in the sarcoplasm to maintain muscle tone. This remaining calcium keeps the muscle slightly contracted, which is important in certain tracts and around blood vessels. \n\n Because most smooth muscles must function for long periods without rest, their power output is relatively low, but contractions can continue without using large amounts of energy. Some smooth muscle can also maintain contractions even as Ca ++  is removed and myosin kinase is inactivated/dephosphorylated. This can happen as a subset of cross-bridges between myosin heads and actin, called  latch-bridges , keep the thick and thin filaments linked together for a prolonged period, and without the need for ATP. This allows for the maintaining of muscle \u201ctone\u201d in smooth muscle that lines arterioles and other visceral organs with very little energy expenditure. \n\n Smooth muscle is not under voluntary control; thus, it is called involuntary muscle. The triggers for smooth muscle contraction include hormones, neural stimulation by the ANS, and local factors. In certain locations, such as the walls of visceral organs, stretching the muscle can trigger its contraction (the stress-relaxation response). Axons of neurons in the ANS do not form the highly organized NMJs with smooth muscle, as seen between motor neurons and skeletal muscle fibers. Instead, there is a series of neurotransmitter-filled bulges called varicosities as an axon courses through smooth muscle, loosely forming motor units ( Figure 10.25 ). A  varicosity  releases neurotransmitters into the synaptic cleft. Also, visceral muscle in the walls of the hollow organs (except the heart) contains pacesetter cells. A  pacesetter cell  can spontaneously trigger action potentials and contractions in the muscle. \n\n Smooth muscle is organized in two ways: as single-unit smooth muscle, which is much more common; and as multiunit smooth muscle. The two types have different locations in the body and have different characteristics. Single-unit muscle has its muscle fibers joined by gap junctions so that the muscle contracts as a single unit. This type of smooth muscle is found in the walls of all visceral organs except the heart (which has cardiac muscle in its walls), and so it is commonly called  visceral muscle . Because the muscle fibers are not constrained by the organization and stretchability limits of sarcomeres, visceral smooth muscle has a  stress-relaxation response . This means that as the muscle of a hollow organ is stretched when it fills, the mechanical stress of the stretching will trigger contraction, but this is immediately followed by relaxation so that the organ does not empty its contents prematurely. This is important for hollow organs, such as the stomach or urinary bladder, which continuously expand as they fill. The smooth muscle around these organs also can maintain a muscle tone when the organ empties and shrinks, a feature that prevents \u201cflabbiness\u201d in the empty organ. In general, visceral smooth muscle produces slow, steady contractions that allow substances, such as food in the digestive tract, to move through the body. \n\n Multiunit smooth muscle cells rarely possess gap junctions, and thus are not electrically coupled. As a result, contraction does not spread from one cell to the next, but is instead confined to the cell that was originally stimulated. Stimuli for multiunit smooth muscles come from autonomic nerves or hormones but not from stretching. This type of tissue is found around large blood vessels, in the respiratory airways, and in the eyes. \n\n Hyperplasia in Smooth Muscle \n\n Similar to skeletal and cardiac muscle cells, smooth muscle can undergo hypertrophy to increase in size. Unlike other muscle, smooth muscle can also divide to produce more cells, a process called  hyperplasia . This can most evidently be observed in the uterus at puberty, which responds to increased estrogen levels by producing more uterine smooth muscle fibers, and greatly increases the size of the myometrium. \n 10.9   Development and Regeneration of Muscle Tissue  Learning Objectives By the end of this section, you will be able to: \n\n Describe the function of satellite cells \n\n Define fibrosis \n\n Explain which muscle has the greatest regeneration ability \n\n Most muscle tissue of the body arises from embryonic mesoderm. Paraxial mesodermal cells adjacent to the neural tube form blocks of cells called  somites . Skeletal muscles, excluding those of the head and limbs, develop from mesodermal somites, whereas skeletal muscle in the head and limbs develop from general mesoderm. Somites give rise to myoblasts. A  myoblast  is a muscle-forming stem cell that migrates to different regions in the body and then fuse(s) to form a syncytium, or  myotube . As a myotube is formed from many different myoblast cells, it contains many nuclei, but has a continuous cytoplasm. This is why skeletal muscle cells are multinucleate, as the nucleus of each contributing myoblast remains intact in the mature skeletal muscle cell. However, cardiac and smooth muscle cells are not multinucleate because the myoblasts that form their cells do not fuse. \n\n Gap junctions develop in the cardiac and single-unit smooth muscle in the early stages of development. In skeletal muscles, ACh receptors are initially present along most of the surface of the myoblasts, but spinal nerve innervation causes the release of growth factors that stimulate the formation of motor end-plates and NMJs. As neurons become active, electrical signals that are sent through the muscle influence the distribution of slow and fast fibers in the muscle. \n\n Although the number of muscle cells is set during development, satellite cells help to repair skeletal muscle cells. A  satellite cell  is similar to a myoblast because it is a type of stem cell; however, satellite cells are incorporated into muscle cells and facilitate the protein synthesis required for repair and growth. These cells are located outside the sarcolemma and are stimulated to grow and fuse with muscle cells by growth factors that are released by muscle fibers under certain forms of stress. Satellite cells can regenerate muscle fibers to a very limited extent, but they primarily help to repair damage in living cells. If a cell is damaged to a greater extent than can be repaired by satellite cells, the muscle fibers are replaced by scar tissue in a process called  fibrosis . Because scar tissue cannot contract, muscle that has sustained significant damage loses strength and cannot produce the same amount of power or endurance as it could before being damaged. \n\n Smooth muscle tissue can regenerate from a type of stem cell called a  pericyte , which is found in some small blood vessels. Pericytes allow smooth muscle cells to regenerate and repair much more readily than skeletal and cardiac muscle tissue. Similar to skeletal muscle tissue, cardiac muscle does not regenerate to a great extent. Dead cardiac muscle tissue is replaced by scar tissue, which cannot contract. As scar tissue accumulates, the heart loses its ability to pump because of the loss of contractile power. However, some minor regeneration may occur due to stem cells found in the blood that occasionally enter cardiac tissue. \n\n Career Connection Physical Therapist \n\nAs muscle cells die, they are not regenerated but instead are replaced by connective tissue and adipose tissue, which do not possess the contractile abilities of muscle tissue. Muscles atrophy when they are not used, and over time if atrophy is prolonged, muscle cells die. It is therefore important that those who are susceptible to muscle atrophy exercise to maintain muscle function and prevent the complete loss of muscle tissue. In extreme cases, when movement is not possible, electrical stimulation can be introduced to a muscle from an external source. This acts as a substitute for endogenous neural stimulation, stimulating the muscle to contract and preventing the loss of proteins that occurs with a lack of use. \n\n Physiotherapists work with patients to maintain muscles. They are trained to target muscles susceptible to atrophy, and to prescribe and monitor exercises designed to stimulate those muscles. There are various causes of atrophy, including mechanical injury, disease, and age. After breaking a limb or undergoing surgery, muscle use is impaired and can lead to disuse atrophy. If the muscles are not exercised, this atrophy can lead to long-term muscle weakness. A stroke can also cause muscle impairment by interrupting neural stimulation to certain muscles. Without neural inputs, these muscles do not contract and thus begin to lose structural proteins. Exercising these muscles can help to restore muscle function and minimize functional impairments. Age-related muscle loss is also a target of physical therapy, as exercise can reduce the effects of age-related atrophy and improve muscle function. \n\n The goal of a physiotherapist is to improve physical functioning and reduce functional impairments; this is achieved by understanding the cause of muscle impairment and assessing the capabilities of a patient, after which a program to enhance these capabilities is designed. Some factors that are assessed include strength, balance, and endurance, which are continually monitored as exercises are introduced to track improvements in muscle function. Physiotherapists can also instruct patients on the proper use of equipment, such as crutches, and assess whether someone has sufficient strength to use the equipment and when they can function without it. ", "questions": [{"question": {"question_id": "fs-id2025849", "question_text": "Muscle that has a striped appearance is described as being ________.", "question_choices": ["elastic", "nonstriated", "excitable", "striated"], "cloze_format": "Muscle that has a striped appearance is described as being ________.", "normal_format": "A muscle that has a striped appearance is described as being what?"}, "answer": {"ans_text": "striated", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "The actin and myosin proteins are arranged very regularly in the cytoplasm of individual muscle cells ( referred to as fibers ) in both skeletal muscle and cardiac muscle , which creates a pattern , or stripes , called striations .", "hl_context": "Differences among the three muscle types include the microscopic organization of their contractile proteins \u2014 actin and myosin . <hl> The actin and myosin proteins are arranged very regularly in the cytoplasm of individual muscle cells ( referred to as fibers ) in both skeletal muscle and cardiac muscle , which creates a pattern , or stripes , called striations . <hl> The striations are visible with a light microscope under high magnification ( see Figure 10.2 ) . Skeletal muscle fibers are multinucleated structures that compose the skeletal muscle . Cardiac muscle fibers each have one to two nuclei and are physically and electrically connected to each other so that the entire heart contracts as one unit ( called a syncytium ) . Because the actin and myosin are not arranged in such regular fashion in smooth muscle , the cytoplasm of a smooth muscle fiber ( which has only a single nucleus ) has a uniform , nonstriated appearance ( resulting in the name smooth muscle ) . However , the less organized appearance of smooth muscle should not be interpreted as less efficient . Smooth muscle in the walls of arteries is a critical component that regulates blood pressure necessary to push blood through the circulatory system ; and smooth muscle in the skin , visceral organs , and internal passageways is essential for moving all materials through the body . 10.2 Skeletal Muscle Learning Objectives By the end of this section , you will be able to :"}, {"question": {"question_id": "fs-id1604812", "question_text": "Which element is important in directly triggering contraction?", "question_choices": ["sodium (Na+)", "calcium (Ca++)", "potassium (K+)", "chloride (Cl-)"], "cloze_format": "The element that is important in directly triggering contraction is ___.", "normal_format": "Which element is important in directly triggering contraction?"}, "answer": {"ans_text": "calcium (Ca++)", "ans_choice": 1}, "bloom": "1", "hl_sentences": "The release of calcium ions initiates muscle contractions .", "hl_context": "<hl> The release of calcium ions initiates muscle contractions . <hl> Watch this video to learn more about the role of calcium . ( a ) What are \u201c T-tubules \u201d and what is their role ? ( b ) Please describe how actin-binding sites are made available for cross-bridging with myosin heads during contraction ."}, {"question": {"question_id": "fs-id2168542", "question_text": "Which of the following properties is not common to all three muscle tissues?", "question_choices": ["excitability", "the need for ATP", "at rest, uses shielding proteins to cover actin-binding sites", "elasticity"], "cloze_format": "The property that is not common to all three muscle tissues is ___.", "normal_format": "Which of the following properties is not common to all three muscle tissues?"}, "answer": {"ans_text": "at rest, uses shielding proteins to cover actin-binding sites", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": "3", "hl_sentences": "A muscle can return to its original length when relaxed due to a quality of muscle tissue called elasticity . All three muscle tissues have some properties in common ; they all exhibit a quality called excitability as their plasma membranes can change their electrical states ( from polarized to depolarized ) and send an electrical wave called an action potential along the entire length of the membrane . All muscles require adenosine triphosphate ( ATP ) to continue the process of contracting , and they all relax when the Ca + + is removed and the actin-binding sites are re-shielded .", "hl_context": "<hl> A muscle can return to its original length when relaxed due to a quality of muscle tissue called elasticity . <hl> It can recoil back to its original length due to elastic fibers . Muscle tissue also has the quality of extensibility ; it can stretch or extend . Contractility allows muscle tissue to pull on its attachment points and shorten with force . Muscle is one of the four primary tissue types of the body , and the body contains three types of muscle tissue : skeletal muscle , cardiac muscle , and smooth muscle ( Figure 10.2 ) . <hl> All three muscle tissues have some properties in common ; they all exhibit a quality called excitability as their plasma membranes can change their electrical states ( from polarized to depolarized ) and send an electrical wave called an action potential along the entire length of the membrane . <hl> While the nervous system can influence the excitability of cardiac and smooth muscle to some degree , skeletal muscle completely depends on signaling from the nervous system to work properly . On the other hand , both cardiac muscle and smooth muscle can respond to other stimuli , such as hormones and local stimuli . The muscles all begin the actual process of contracting ( shortening ) when a protein called actin is pulled by a protein called myosin . This occurs in striated muscle ( skeletal and cardiac ) after specific binding sites on the actin have been exposed in response to the interaction between calcium ions ( Ca + + ) and proteins ( troponin and tropomyosin ) that \u201c shield \u201d the actin-binding sites . Ca + + also is required for the contraction of smooth muscle , although its role is different : here Ca + + activates enzymes , which in turn activate myosin heads . <hl> All muscles require adenosine triphosphate ( ATP ) to continue the process of contracting , and they all relax when the Ca + + is removed and the actin-binding sites are re-shielded . <hl>"}, {"question": {"question_id": "fs-id1390996", "question_text": "The correct order for the smallest to the largest unit of organization in muscle tissue is ________.", "question_choices": ["fascicle, filament, muscle fiber, myofibril", "filament, myofibril, muscle fiber, fascicle", "muscle fiber, fascicle, filament, myofibril", "myofibril, muscle fiber, filament, fascicle"], "cloze_format": "The correct order for the smallest to the largest unit of organization in muscle tissue is ________.", "normal_format": "What is the correct order for the smallest to the largest unit of organization in muscle tissue?"}, "answer": {"ans_text": "filament, myofibril, muscle fiber, fascicle", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "The sarcomere is the functional unit of the muscle fiber . The sarcomere itself is bundled within the myofibril that runs the entire length of the muscle fiber and attaches to the sarcolemma at its end . As will soon be described , the functional unit of a skeletal muscle fiber is the sarcomere , a highly organized arrangement of the contractile myofilaments actin ( thin filament ) and myosin ( thick filament ) , along with other support proteins . Inside each skeletal muscle , muscle fibers are organized into individual bundles , each called a fascicle , by a middle layer of connective tissue called the perimysium .", "hl_context": "<hl> The sarcomere is the functional unit of the muscle fiber . <hl> <hl> The sarcomere itself is bundled within the myofibril that runs the entire length of the muscle fiber and attaches to the sarcolemma at its end . <hl> As myofibrils contract , the entire muscle cell contracts . Because myofibrils are only approximately 1.2 \u03bc m in diameter , hundreds to thousands ( each with thousands of sarcomeres ) can be found inside one muscle fiber . Each sarcomere is approximately 2 \u03bc m in length with a three-dimensional cylinder-like arrangement and is bordered by structures called Z-discs ( also called Z-lines , because pictures are two-dimensional ) , to which the actin myofilaments are anchored ( Figure 10.5 ) . Because the actin and its troponin-tropomyosin complex ( projecting from the Z-discs toward the center of the sarcomere ) form strands that are thinner than the myosin , it is called the thin filament of the sarcomere . Likewise , because the myosin strands and their multiple heads ( projecting from the center of the sarcomere , toward but not all to way to , the Z-discs ) have more mass and are thicker , they are called the thick filament of the sarcomere . Because skeletal muscle cells are long and cylindrical , they are commonly referred to as muscle fibers . Skeletal muscle fibers can be quite large for human cells , with diameters up to 100 \u03bc m and lengths up to 30 cm ( 11.8 in ) in the Sartorius of the upper leg . During early development , embryonic myoblasts , each with its own nucleus , fuse with up to hundreds of other myoblasts to form the multinucleated skeletal muscle fibers . Multiple nuclei mean multiple copies of genes , permitting the production of the large amounts of proteins and enzymes needed for muscle contraction . Some other terminology associated with muscle fibers is rooted in the Greek sarco , which means \u201c flesh . \u201d The plasma membrane of muscle fibers is called the sarcolemma , the cytoplasm is referred to as sarcoplasm , and the specialized smooth endoplasmic reticulum , which stores , releases , and retrieves calcium ions ( Ca + + ) is called the sarcoplasmic reticulum ( SR ) ( Figure 10.4 ) . <hl> As will soon be described , the functional unit of a skeletal muscle fiber is the sarcomere , a highly organized arrangement of the contractile myofilaments actin ( thin filament ) and myosin ( thick filament ) , along with other support proteins . <hl> Each skeletal muscle is an organ that consists of various integrated tissues . These tissues include the skeletal muscle fibers , blood vessels , nerve fibers , and connective tissue . Each skeletal muscle has three layers of connective tissue ( called \u201c mysia \u201d ) that enclose it and provide structure to the muscle as a whole , and also compartmentalize the muscle fibers within the muscle ( Figure 10.3 ) . Each muscle is wrapped in a sheath of dense , irregular connective tissue called the epimysium , which allows a muscle to contract and move powerfully while maintaining its structural integrity . The epimysium also separates muscle from other tissues and organs in the area , allowing the muscle to move independently . <hl> Inside each skeletal muscle , muscle fibers are organized into individual bundles , each called a fascicle , by a middle layer of connective tissue called the perimysium . <hl> This fascicular organization is common in muscles of the limbs ; it allows the nervous system to trigger a specific movement of a muscle by activating a subset of muscle fibers within a bundle , or fascicle of the muscle . Inside each fascicle , each muscle fiber is encased in a thin connective tissue layer of collagen and reticular fibers called the endomysium . The endomysium contains the extracellular fluid and nutrients to support the muscle fiber . These nutrients are supplied via blood to the muscle tissue ."}, {"question": {"question_id": "fs-id1255244", "question_text": "Depolarization of the sarcolemma means ________.", "question_choices": ["the inside of the membrane has become less negative as sodium ions accumulate", "the outside of the membrane has become less negative as sodium ions accumulate", "the inside of the membrane has become more negative as sodium ions accumulate", "the sarcolemma has completely lost any electrical charge"], "cloze_format": "Depolarization of the sarcolemma means ________.", "normal_format": "What does depolarization of the sarcolemma mean?"}, "answer": {"ans_text": "the inside of the membrane has become less negative as sodium ions accumulate", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The ACh molecules diffuse across a minute space called the synaptic cleft and bind to ACh receptors located within the motor end-plate of the sarcolemma on the other side of the synapse . Once ACh binds , a channel in the ACh receptor opens and positively charged ions can pass through into the muscle fiber , causing it to depolarize , meaning that the membrane potential of the muscle fiber becomes less negative ( closer to zero . ) As the membrane depolarizes , another set of ion channels called voltage-gated sodium channels are triggered to open .", "hl_context": "All living cells have membrane potentials , or electrical gradients across their membranes . The inside of the membrane is usually around - 60 to - 90 mV , relative to the outside . This is referred to as a cell \u2019 s membrane potential . Neurons and muscle cells can use their membrane potentials to generate electrical signals . They do this by controlling the movement of charged particles , called ions , across their membranes to create electrical currents . This is achieved by opening and closing specialized proteins in the membrane called ion channels . Although the currents generated by ions moving through these channel proteins are very small , they form the basis of both neural signaling and muscle contraction . Both neurons and skeletal muscle cells are electrically excitable , meaning that they are able to generate action potentials . An action potential is a special type of electrical signal that can travel along a cell membrane as a wave . This allows a signal to be transmitted quickly and faithfully over long distances . Although the term excitation-contraction coupling confuses or scares some students , it comes down to this : for a skeletal muscle fiber to contract , its membrane must first be \u201c excited \u201d \u2014 in other words , it must be stimulated to fire an action potential . The muscle fiber action potential , which sweeps along the sarcolemma as a wave , is \u201c coupled \u201d to the actual contraction through the release of calcium ions ( Ca + + ) from the SR . Once released , the Ca + + interacts with the shielding proteins , forcing them to move aside so that the actin-binding sites are available for attachment by myosin heads . The myosin then pulls the actin filaments toward the center , shortening the muscle fiber . In skeletal muscle , this sequence begins with signals from the somatic motor division of the nervous system . In other words , the \u201c excitation \u201d step in skeletal muscles is always triggered by signaling from the nervous system ( Figure 10.6 ) . The motor neurons that tell the skeletal muscle fibers to contract originate in the spinal cord , with a smaller number located in the brainstem for activation of skeletal muscles of the face , head , and neck . These neurons have long processes , called axons , which are specialized to transmit action potentials long distances \u2014 in this case , all the way from the spinal cord to the muscle itself ( which may be up to three feet away ) . The axons of multiple neurons bundle together to form nerves , like wires bundled together in a cable . Signaling begins when a neuronal action potential travels along the axon of a motor neuron , and then along the individual branches to terminate at the NMJ . At the NMJ , the axon terminal releases a chemical messenger , or neurotransmitter , called acetylcholine ( ACh ) . <hl> The ACh molecules diffuse across a minute space called the synaptic cleft and bind to ACh receptors located within the motor end-plate of the sarcolemma on the other side of the synapse . <hl> <hl> Once ACh binds , a channel in the ACh receptor opens and positively charged ions can pass through into the muscle fiber , causing it to depolarize , meaning that the membrane potential of the muscle fiber becomes less negative ( closer to zero . ) <hl> <hl> As the membrane depolarizes , another set of ion channels called voltage-gated sodium channels are triggered to open . <hl> Sodium ions enter the muscle fiber , and an action potential rapidly spreads ( or \u201c fires \u201d ) along the entire membrane to initiate excitation-contraction coupling . Things happen very quickly in the world of excitable membranes ( just think about how quickly you can snap your fingers as soon as you decide to do it ) . Immediately following depolarization of the membrane , it repolarizes , re-establishing the negative membrane potential . Meanwhile , the ACh in the synaptic cleft is degraded by the enzyme acetylcholinesterase ( AChE ) so that the ACh cannot rebind to a receptor and reopen its channel , which would cause unwanted extended muscle excitation and contraction . Propagation of an action potential along the sarcolemma is the excitation portion of excitation-contraction coupling . Recall that this excitation actually triggers the release of calcium ions ( Ca + + ) from its storage in the cell \u2019 s SR . For the action potential to reach the membrane of the SR , there are periodic invaginations in the sarcolemma , called T-tubules ( \u201c T \u201d stands for \u201c transverse \u201d ) . You will recall that the diameter of a muscle fiber can be up to 100 \u03bc m , so these T-tubules ensure that the membrane can get close to the SR in the sarcoplasm . The arrangement of a T-tubule with the membranes of SR on either side is called a triad ( Figure 10.7 ) . The triad surrounds the cylindrical structure called a myofibril , which contains actin and myosin . The T-tubules carry the action potential into the interior of the cell , which triggers the opening of calcium channels in the membrane of the adjacent SR , causing Ca + + to diffuse out of the SR and into the sarcoplasm . It is the arrival of Ca + + in the sarcoplasm that initiates contraction of the muscle fiber by its contractile units , or sarcomeres . 10.3 Muscle Fiber Contraction and Relaxation Learning Objectives By the end of this section , you will be able to :"}, {"question": {"question_id": "fs-id1882564", "question_text": "In relaxed muscle, the myosin-binding site on actin is blocked by ________.", "question_choices": ["titin", "troponin", "myoglobin", "tropomyosin"], "cloze_format": "In relaxed muscle, the myosin-binding site on actin is blocked by ________.", "normal_format": "In relaxed muscle, what blocks the myosin-binding site on actin?"}, "answer": {"ans_text": "tropomyosin", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "Tropomyosin is a protein that winds around the chains of the actin filament and covers the myosin-binding sites to prevent actin from binding to myosin .", "hl_context": "<hl> Tropomyosin is a protein that winds around the chains of the actin filament and covers the myosin-binding sites to prevent actin from binding to myosin . <hl> Tropomyosin binds to troponin to form a troponin-tropomyosin complex . The troponin-tropomyosin complex prevents the myosin \u201c heads \u201d from binding to the active sites on the actin microfilaments . Troponin also has a binding site for Ca + + ions ."}, {"question": {"question_id": "fs-id1194380", "question_text": "According to the sliding filament model, binding sites on actin open when ________.", "question_choices": ["creatine phosphate levels rise", "ATP levels rise", "acetylcholine levels rise", "calcium ion levels rise"], "cloze_format": "According to the sliding filament model, binding sites on actin open when ________.", "normal_format": "According to the sliding filament model, when do binding sites on actin open?"}, "answer": {"ans_text": "calcium ion levels rise", "ans_choice": 3}, "bloom": "1", "hl_sentences": "This process is known as the sliding filament model of muscle contraction ( Figure 10.10 ) . The sliding can only occur when myosin-binding sites on the actin filaments are exposed by a series of steps that begins with Ca + + entry into the sarcoplasm .", "hl_context": "When signaled by a motor neuron , a skeletal muscle fiber contracts as the thin filaments are pulled and then slide past the thick filaments within the fiber \u2019 s sarcomeres . <hl> This process is known as the sliding filament model of muscle contraction ( Figure 10.10 ) . <hl> <hl> The sliding can only occur when myosin-binding sites on the actin filaments are exposed by a series of steps that begins with Ca + + entry into the sarcoplasm . <hl>"}, {"question": {"question_id": "fs-id1364700", "question_text": "The cell membrane of a muscle fiber is called ________.", "question_choices": ["myofibril", "sarcolemma", "sarcoplasm", "myofilament"], "cloze_format": "The cell membrane of a muscle fiber is called ________.", "normal_format": "What is the cell membrane of a muscle fiber called?"}, "answer": {"ans_text": "sarcolemma", "ans_choice": 1}, "bloom": "1", "hl_sentences": "Some other terminology associated with muscle fibers is rooted in the Greek sarco , which means \u201c flesh . \u201d The plasma membrane of muscle fibers is called the sarcolemma , the cytoplasm is referred to as sarcoplasm , and the specialized smooth endoplasmic reticulum , which stores , releases , and retrieves calcium ions ( Ca + + ) is called the sarcoplasmic reticulum ( SR ) ( Figure 10.4 ) .", "hl_context": "Because skeletal muscle cells are long and cylindrical , they are commonly referred to as muscle fibers . Skeletal muscle fibers can be quite large for human cells , with diameters up to 100 \u03bc m and lengths up to 30 cm ( 11.8 in ) in the Sartorius of the upper leg . During early development , embryonic myoblasts , each with its own nucleus , fuse with up to hundreds of other myoblasts to form the multinucleated skeletal muscle fibers . Multiple nuclei mean multiple copies of genes , permitting the production of the large amounts of proteins and enzymes needed for muscle contraction . <hl> Some other terminology associated with muscle fibers is rooted in the Greek sarco , which means \u201c flesh . \u201d The plasma membrane of muscle fibers is called the sarcolemma , the cytoplasm is referred to as sarcoplasm , and the specialized smooth endoplasmic reticulum , which stores , releases , and retrieves calcium ions ( Ca + + ) is called the sarcoplasmic reticulum ( SR ) ( Figure 10.4 ) . <hl> As will soon be described , the functional unit of a skeletal muscle fiber is the sarcomere , a highly organized arrangement of the contractile myofilaments actin ( thin filament ) and myosin ( thick filament ) , along with other support proteins ."}, {"question": {"question_id": "fs-id1615887", "question_text": "Muscle relaxation occurs when ________.", "question_choices": ["calcium ions are actively transported out of the sarcoplasmic reticulum", "calcium ions diffuse out of the sarcoplasmic reticulum", "calcium ions are actively transported into the sarcoplasmic reticulum", "calcium ions diffuse into the sarcoplasmic reticulum"], "cloze_format": "Muscle relaxation occurs when ________.", "normal_format": "When does muscle relaxation occur?"}, "answer": {"ans_text": "calcium ions are actively transported into the sarcoplasmic reticulum", "ans_choice": 2}, "bloom": null, "hl_sentences": "The last phase is the relaxation phase , when tension decreases as contraction stops . Ca + + ions are pumped out of the sarcoplasm into the SR , and cross-bridge cycling stops , returning the muscle fibers to their resting state .", "hl_context": "A single action potential from a motor neuron will produce a single contraction in the muscle fibers of its motor unit . This isolated contraction is called a twitch . A twitch can last for a few milliseconds or 100 milliseconds , depending on the muscle type . The tension produced by a single twitch can be measured by a myogram , an instrument that measures the amount of tension produced over time ( Figure 10.15 ) . Each twitch undergoes three phases . The first phase is the latent period , during which the action potential is being propagated along the sarcolemma and Ca + + ions are released from the SR . This is the phase during which excitation and contraction are being coupled but contraction has yet to occur . The contraction phase occurs next . The Ca + + ions in the sarcoplasm have bound to troponin , tropomyosin has shifted away from actin-binding sites , cross-bridges formed , and sarcomeres are actively shortening to the point of peak tension . <hl> The last phase is the relaxation phase , when tension decreases as contraction stops . <hl> <hl> Ca + + ions are pumped out of the sarcoplasm into the SR , and cross-bridge cycling stops , returning the muscle fibers to their resting state . <hl>"}, {"question": {"question_id": "fs-id1220928", "question_text": "During muscle contraction, the cross-bridge detaches when ________.", "question_choices": ["the myosin head binds to an ADP molecule", "the myosin head binds to an ATP molecule", "calcium ions bind to troponin", "calcium ions bind to actin"], "cloze_format": "During muscle contraction, the cross-bridge detaches when ________.", "normal_format": "During muscle contraction, when does the cross-bridge detach?"}, "answer": {"ans_text": "calcium ions bind to troponin", "ans_choice": 2}, "bloom": "1", "hl_sentences": "The first step in the process of contraction is for Ca + + to bind to troponin so that tropomyosin can slide away from the binding sites on the actin strands . This allows the myosin heads to bind to these exposed binding sites and form cross-bridges .", "hl_context": "To initiate muscle contraction , tropomyosin has to expose the myosin-binding site on an actin filament to allow cross-bridge formation between the actin and myosin microfilaments . <hl> The first step in the process of contraction is for Ca + + to bind to troponin so that tropomyosin can slide away from the binding sites on the actin strands . <hl> <hl> This allows the myosin heads to bind to these exposed binding sites and form cross-bridges . <hl> The thin filaments are then pulled by the myosin heads to slide past the thick filaments toward the center of the sarcomere . But each head can only pull a very short distance before it has reached its limit and must be \u201c re-cocked \u201d before it can pull again , a step that requires ATP ."}, {"question": {"question_id": "fs-id1481100", "question_text": "Thin and thick filaments are organized into functional units called ________.", "question_choices": ["myofibrils", "myofilaments", "T-tubules", "sarcomeres"], "cloze_format": "The part of the large intestine that attaches to the appendix is the ___ .", "normal_format": "Which part of the large intestine attaches to the appendix?"}, "answer": {"ans_text": "sarcomeres", "ans_choice": 3}, "bloom": "1", "hl_sentences": "Because the actin and its troponin-tropomyosin complex ( projecting from the Z-discs toward the center of the sarcomere ) form strands that are thinner than the myosin , it is called the thin filament of the sarcomere . Likewise , because the myosin strands and their multiple heads ( projecting from the center of the sarcomere , toward but not all to way to , the Z-discs ) have more mass and are thicker , they are called the thick filament of the sarcomere .", "hl_context": "The sarcomere is the functional unit of the muscle fiber . The sarcomere itself is bundled within the myofibril that runs the entire length of the muscle fiber and attaches to the sarcolemma at its end . As myofibrils contract , the entire muscle cell contracts . Because myofibrils are only approximately 1.2 \u03bc m in diameter , hundreds to thousands ( each with thousands of sarcomeres ) can be found inside one muscle fiber . Each sarcomere is approximately 2 \u03bc m in length with a three-dimensional cylinder-like arrangement and is bordered by structures called Z-discs ( also called Z-lines , because pictures are two-dimensional ) , to which the actin myofilaments are anchored ( Figure 10.5 ) . <hl> Because the actin and its troponin-tropomyosin complex ( projecting from the Z-discs toward the center of the sarcomere ) form strands that are thinner than the myosin , it is called the thin filament of the sarcomere . <hl> <hl> Likewise , because the myosin strands and their multiple heads ( projecting from the center of the sarcomere , toward but not all to way to , the Z-discs ) have more mass and are thicker , they are called the thick filament of the sarcomere . <hl>"}, {"question": {"question_id": "fs-id1220534", "question_text": "During which phase of a twitch in a muscle fiber is tension the greatest?", "question_choices": ["resting phase", "repolarization phase", "contraction phase", "relaxation phase"], "cloze_format": "The phase of a twitch in a muscle fiber during whitch tension is the greatest is the ___.", "normal_format": "During which phase of a twitch in a muscle fiber is tension the greatest?"}, "answer": {"ans_text": "contraction phase", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "Each twitch undergoes three phases . The contraction phase occurs next . The Ca + + ions in the sarcoplasm have bound to troponin , tropomyosin has shifted away from actin-binding sites , cross-bridges formed , and sarcomeres are actively shortening to the point of peak tension .", "hl_context": "A single action potential from a motor neuron will produce a single contraction in the muscle fibers of its motor unit . This isolated contraction is called a twitch . A twitch can last for a few milliseconds or 100 milliseconds , depending on the muscle type . The tension produced by a single twitch can be measured by a myogram , an instrument that measures the amount of tension produced over time ( Figure 10.15 ) . <hl> Each twitch undergoes three phases . <hl> The first phase is the latent period , during which the action potential is being propagated along the sarcolemma and Ca + + ions are released from the SR . This is the phase during which excitation and contraction are being coupled but contraction has yet to occur . <hl> The contraction phase occurs next . <hl> <hl> The Ca + + ions in the sarcoplasm have bound to troponin , tropomyosin has shifted away from actin-binding sites , cross-bridges formed , and sarcomeres are actively shortening to the point of peak tension . <hl> The last phase is the relaxation phase , when tension decreases as contraction stops . Ca + + ions are pumped out of the sarcoplasm into the SR , and cross-bridge cycling stops , returning the muscle fibers to their resting state ."}, {"question": {"question_id": "fs-id1939556", "question_text": "Muscle fatigue is caused by ________.", "question_choices": ["buildup of ATP and lactic acid levels", "exhaustion of energy reserves and buildup of lactic acid levels", "buildup of ATP and pyruvic acid levels", "exhaustion of energy reserves and buildup of pyruvic acid levels"], "cloze_format": "Muscle fatigue is caused by ________.", "normal_format": "What caused muscle fatigue?"}, "answer": {"ans_text": "exhaustion of energy reserves and buildup of pyruvic acid levels", "ans_choice": 3}, "bloom": "1", "hl_sentences": "However , if oxygen is not available , pyruvic acid is converted to lactic acid , which may contribute to muscle fatigue . This occurs during strenuous exercise when high amounts of energy are needed but oxygen cannot be sufficiently delivered to muscle . This is because glycolysis does not utilize glucose very efficiently , producing a net gain of two ATPs per molecule of glucose , and the end product of lactic acid , which may contribute to muscle fatigue as it accumulates .", "hl_context": "As the ATP produced by creatine phosphate is depleted , muscles turn to glycolysis as an ATP source . Glycolysis is an anaerobic ( non-oxygen-dependent ) process that breaks down glucose ( sugar ) to produce ATP ; however , glycolysis cannot generate ATP as quickly as creatine phosphate . Thus , the switch to glycolysis results in a slower rate of ATP availability to the muscle . The sugar used in glycolysis can be provided by blood glucose or by metabolizing glycogen that is stored in the muscle . The breakdown of one glucose molecule produces two ATP and two molecules of pyruvic acid , which can be used in aerobic respiration or when oxygen levels are low , converted to lactic acid ( Figure 10.12 b ) . If oxygen is available , pyruvic acid is used in aerobic respiration . <hl> However , if oxygen is not available , pyruvic acid is converted to lactic acid , which may contribute to muscle fatigue . <hl> This conversion allows the recycling of the enzyme NAD + from NADH , which is needed for glycolysis to continue . <hl> This occurs during strenuous exercise when high amounts of energy are needed but oxygen cannot be sufficiently delivered to muscle . <hl> Glycolysis itself cannot be sustained for very long ( approximately 1 minute of muscle activity ) , but it is useful in facilitating short bursts of high-intensity output . <hl> This is because glycolysis does not utilize glucose very efficiently , producing a net gain of two ATPs per molecule of glucose , and the end product of lactic acid , which may contribute to muscle fatigue as it accumulates . <hl>"}, {"question": {"question_id": "fs-id2068349", "question_text": "A sprinter would experience muscle fatigue sooner than a marathon runner due to ________.", "question_choices": ["anaerobic metabolism in the muscles of the sprinter", "anaerobic metabolism in the muscles of the marathon runner", "aerobic metabolism in the muscles of the sprinter", "glycolysis in the muscles of the marathon runner"], "cloze_format": "A sprinter would experience muscle fatigue sooner than a marathon runner due to ________.", "normal_format": "Why would a sprinter experience muscle fatigue sooner than a marathon runner?"}, "answer": {"ans_text": "anaerobic metabolism in the muscles of the sprinter", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": "3", "hl_sentences": "The proportion of SO muscle fibers in muscle determines the suitability of that muscle for endurance , and may benefit those participating in endurance activities . Endurance athletes , like marathon-runners also would benefit from a larger proportion of SO fibers , but it is unclear if the most-successful marathoners are those with naturally high numbers of SO fibers , or whether the most successful marathon runners develop high numbers of SO fibers with repetitive training . Slow oxidative ( SO ) fibers contract relatively slowly and use aerobic respiration ( oxygen and glucose ) to produce ATP . Fast oxidative ( FO ) fibers have fast contractions and primarily use aerobic respiration , but because they may switch to anaerobic respiration ( glycolysis ) , can fatigue more quickly than SO fibers .", "hl_context": "<hl> The proportion of SO muscle fibers in muscle determines the suitability of that muscle for endurance , and may benefit those participating in endurance activities . <hl> Postural muscles have a large number of SO fibers and relatively few FO and FG fibers , to keep the back straight ( Figure 10.18 ) . <hl> Endurance athletes , like marathon-runners also would benefit from a larger proportion of SO fibers , but it is unclear if the most-successful marathoners are those with naturally high numbers of SO fibers , or whether the most successful marathon runners develop high numbers of SO fibers with repetitive training . <hl> Endurance training can result in overuse injuries such as stress fractures and joint and tendon inflammation . Two criteria to consider when classifying the types of muscle fibers are how fast some fibers contract relative to others , and how fibers produce ATP . Using these criteria , there are three main types of skeletal muscle fibers . <hl> Slow oxidative ( SO ) fibers contract relatively slowly and use aerobic respiration ( oxygen and glucose ) to produce ATP . <hl> <hl> Fast oxidative ( FO ) fibers have fast contractions and primarily use aerobic respiration , but because they may switch to anaerobic respiration ( glycolysis ) , can fatigue more quickly than SO fibers . <hl> Lastly , fast glycolytic ( FG ) fibers have fast contractions and primarily use anaerobic glycolysis . The FG fibers fatigue more quickly than the others . Most skeletal muscles in a human contain ( s ) all three types , although in varying proportions ."}, {"question": {"question_id": "fs-id1349513", "question_text": "What aspect of creatine phosphate allows it to supply energy to muscles?", "question_choices": ["ATPase activity", "phosphate bonds", "carbon bonds", "hydrogen bonds"], "cloze_format": "___ is/are the aspect of creatine phosphate that allows it to supply energy to muscles.", "normal_format": "What aspect of creatine phosphate allows it to supply energy to muscles?"}, "answer": {"ans_text": "phosphate bonds", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Creatine phosphate is a molecule that can store energy in its phosphate bonds .", "hl_context": "ATP supplies the energy for muscle contraction to take place . In addition to its direct role in the cross-bridge cycle , ATP also provides the energy for the active-transport Ca + + pumps in the SR . Muscle contraction does not occur without sufficient amounts of ATP . The amount of ATP stored in muscle is very low , only sufficient to power a few seconds worth of contractions . As it is broken down , ATP must therefore be regenerated and replaced quickly to allow for sustained contraction . There are three mechanisms by which ATP can be regenerated : creatine phosphate metabolism , anaerobic glycolysis , and fermentation and aerobic respiration . <hl> Creatine phosphate is a molecule that can store energy in its phosphate bonds . <hl> In a resting muscle , excess ATP transfers its energy to creatine , producing ADP and creatine phosphate . This acts as an energy reserve that can be used to quickly create more ATP . When the muscle starts to contract and needs energy , creatine phosphate transfers its phosphate back to ADP to form ATP and creatine . This reaction is catalyzed by the enzyme creatine kinase and occurs very quickly ; thus , creatine phosphate-derived ATP powers the first few seconds of muscle contraction . However , creatine phosphate can only provide approximately 15 seconds worth of energy , at which point another energy source has to be used ( Figure 10.12 ) ."}, {"question": {"question_id": "fs-id1285054", "question_text": "Which of the following statements is true?", "question_choices": ["Fast fibers have a small diameter.", "Fast fibers contain loosely packed myofibrils.", "Fast fibers have large glycogen reserves.", "Fast fibers have many mitochondria."], "cloze_format": "The statement that is true is ___.", "normal_format": "Which of the following statements is true?"}, "answer": {"ans_text": "Fast fibers have large glycogen reserves.", "ans_choice": 2}, "bloom": "2", "hl_sentences": "FG fibers primarily use anaerobic glycolysis as their ATP source . They have a large diameter and possess high amounts of glycogen , which is used in glycolysis to generate ATP quickly to produce high levels of tension . Lastly , fast glycolytic ( FG ) fibers have fast contractions and primarily use anaerobic glycolysis .", "hl_context": "<hl> FG fibers primarily use anaerobic glycolysis as their ATP source . <hl> <hl> They have a large diameter and possess high amounts of glycogen , which is used in glycolysis to generate ATP quickly to produce high levels of tension . <hl> Because they do not primarily use aerobic metabolism , they do not possess substantial numbers of mitochondria or significant amounts of myoglobin and therefore have a white color . FG fibers are used to produce rapid , forceful contractions to make quick , powerful movements . These fibers fatigue quickly , permitting them to only be used for short periods . Most muscles possess a mixture of each fiber type . The predominant fiber type in a muscle is determined by the primary function of the muscle . 10.6 Exercise and Muscle Performance Learning Objectives By the end of this section , you will be able to : Two criteria to consider when classifying the types of muscle fibers are how fast some fibers contract relative to others , and how fibers produce ATP . Using these criteria , there are three main types of skeletal muscle fibers . Slow oxidative ( SO ) fibers contract relatively slowly and use aerobic respiration ( oxygen and glucose ) to produce ATP . Fast oxidative ( FO ) fibers have fast contractions and primarily use aerobic respiration , but because they may switch to anaerobic respiration ( glycolysis ) , can fatigue more quickly than SO fibers . <hl> Lastly , fast glycolytic ( FG ) fibers have fast contractions and primarily use anaerobic glycolysis . <hl> The FG fibers fatigue more quickly than the others . Most skeletal muscles in a human contain ( s ) all three types , although in varying proportions ."}, {"question": {"question_id": "fs-id1637254", "question_text": "Which of the following statements is false?", "question_choices": ["Slow fibers have a small network of capillaries.", "Slow fibers contain the pigment myoglobin.", "Slow fibers contain a large number of mitochondria.", "Slow fibers contract for extended periods."], "cloze_format": "The statement that is false is that ___.", "normal_format": "Which of the following statements is false?"}, "answer": {"ans_text": "Slow fibers have a small network of capillaries.", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": "2", "hl_sentences": "The SO fibers possess a large number of mitochondria and are capable of contracting for longer periods because of the large amount of ATP they can produce , but they have a relatively small diameter and do not produce a large amount of tension . The SO fibers also possess myoglobin , an O 2 - carrying molecule similar to O 2 - carrying hemoglobin in the red blood cells . All of these features allow SO fibers to produce large quantities of ATP , which can sustain muscle activity without fatiguing for long periods of time .", "hl_context": "The oxidative fibers contain many more mitochondria than the glycolytic fibers , because aerobic metabolism , which uses oxygen ( O 2 ) in the metabolic pathway , occurs in the mitochondria . <hl> The SO fibers possess a large number of mitochondria and are capable of contracting for longer periods because of the large amount of ATP they can produce , but they have a relatively small diameter and do not produce a large amount of tension . <hl> SO fibers are extensively supplied with blood capillaries to supply O 2 from the red blood cells in the bloodstream . <hl> The SO fibers also possess myoglobin , an O 2 - carrying molecule similar to O 2 - carrying hemoglobin in the red blood cells . <hl> The myoglobin stores some of the needed O 2 within the fibers themselves ( and gives SO fibers their red color ) . <hl> All of these features allow SO fibers to produce large quantities of ATP , which can sustain muscle activity without fatiguing for long periods of time . <hl>"}, {"question": {"question_id": "fs-id2020356", "question_text": "Cardiac muscles differ from skeletal muscles in that they ________.", "question_choices": ["are striated", "utilize aerobic metabolism", "contain myofibrils", "contain intercalated discs"], "cloze_format": "Cardiac muscles differ from skeletal muscles in that they ________.", "normal_format": "How do cardiac muscles differ from skeletal muscles? "}, "answer": {"ans_text": "contain intercalated discs", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "However , cardiac muscle fibers are shorter than skeletal muscle fibers and usually contain only one nucleus , which is located in the central region of the cell . Cardiac muscle fibers also possess many mitochondria and myoglobin , as ATP is produced primarily through aerobic metabolism . Cardiac muscle fibers cells also are extensively branched and are connected to one another at their ends by intercalated discs .", "hl_context": "Cardiac muscle tissue is only found in the heart . Highly coordinated contractions of cardiac muscle pump blood into the vessels of the circulatory system . Similar to skeletal muscle , cardiac muscle is striated and organized into sarcomeres , possessing the same banding organization as skeletal muscle ( Figure 10.21 ) . <hl> However , cardiac muscle fibers are shorter than skeletal muscle fibers and usually contain only one nucleus , which is located in the central region of the cell . <hl> <hl> Cardiac muscle fibers also possess many mitochondria and myoglobin , as ATP is produced primarily through aerobic metabolism . <hl> <hl> Cardiac muscle fibers cells also are extensively branched and are connected to one another at their ends by intercalated discs . <hl> An intercalated disc allows the cardiac muscle cells to contract in a wave-like pattern so that the heart can work as a pump ."}, {"question": {"question_id": "fs-id1432203", "question_text": "If cardiac muscle cells were prevented from undergoing aerobic metabolism, they ultimately would ________.", "question_choices": ["undergo glycolysis", "synthesize ATP", "stop contracting", "start contracting"], "cloze_format": "If cardiac muscle cells were prevented from undergoing aerobic metabolism, they ultimately would ________.", "normal_format": "If cardiac muscle cells were prevented from undergoing aerobic metabolism, what would they ultimately do?"}, "answer": {"ans_text": "stop contracting", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The aerobic metabolism used by slow-twitch fibers allows them to maintain contractions over long periods .", "hl_context": "Slow fibers are predominantly used in endurance exercises that require little force but involve numerous repetitions . <hl> The aerobic metabolism used by slow-twitch fibers allows them to maintain contractions over long periods . <hl> Endurance training modifies these slow fibers to make them even more efficient by producing more mitochondria to enable more aerobic metabolism and more ATP production . Endurance exercise can also increase the amount of myoglobin in a cell , as increased aerobic respiration increases the need for oxygen . Myoglobin is found in the sarcoplasm and acts as an oxygen storage supply for the mitochondria ."}, {"question": {"question_id": "fs-id2131239", "question_text": "Smooth muscles differ from skeletal and cardiac muscles in that they ________.", "question_choices": ["lack myofibrils", "are under voluntary control", "lack myosin", "lack actin"], "cloze_format": "Smooth muscles differ from skeletal and cardiac muscles in that they ________.", "normal_format": "What do smooth muscles differ from skeletal and cardiac muscles in?"}, "answer": {"ans_text": "lack myofibrils", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "The sarcomere is the functional unit of the muscle fiber . The sarcomere itself is bundled within the myofibril that runs the entire length of the muscle fiber and attaches to the sarcolemma at its end . Differences among the three muscle types include the microscopic organization of their contractile proteins \u2014 actin and myosin . The actin and myosin proteins are arranged very regularly in the cytoplasm of individual muscle cells ( referred to as fibers ) in both skeletal muscle and cardiac muscle , which creates a pattern , or stripes , called striations . Because the actin and myosin are not arranged in such regular fashion in smooth muscle , the cytoplasm of a smooth muscle fiber ( which has only a single nucleus ) has a uniform , nonstriated appearance ( resulting in the name smooth muscle ) .", "hl_context": "<hl> The sarcomere is the functional unit of the muscle fiber . <hl> <hl> The sarcomere itself is bundled within the myofibril that runs the entire length of the muscle fiber and attaches to the sarcolemma at its end . <hl> As myofibrils contract , the entire muscle cell contracts . Because myofibrils are only approximately 1.2 \u03bc m in diameter , hundreds to thousands ( each with thousands of sarcomeres ) can be found inside one muscle fiber . Each sarcomere is approximately 2 \u03bc m in length with a three-dimensional cylinder-like arrangement and is bordered by structures called Z-discs ( also called Z-lines , because pictures are two-dimensional ) , to which the actin myofilaments are anchored ( Figure 10.5 ) . Because the actin and its troponin-tropomyosin complex ( projecting from the Z-discs toward the center of the sarcomere ) form strands that are thinner than the myosin , it is called the thin filament of the sarcomere . Likewise , because the myosin strands and their multiple heads ( projecting from the center of the sarcomere , toward but not all to way to , the Z-discs ) have more mass and are thicker , they are called the thick filament of the sarcomere . <hl> Differences among the three muscle types include the microscopic organization of their contractile proteins \u2014 actin and myosin . <hl> <hl> The actin and myosin proteins are arranged very regularly in the cytoplasm of individual muscle cells ( referred to as fibers ) in both skeletal muscle and cardiac muscle , which creates a pattern , or stripes , called striations . <hl> The striations are visible with a light microscope under high magnification ( see Figure 10.2 ) . Skeletal muscle fibers are multinucleated structures that compose the skeletal muscle . Cardiac muscle fibers each have one to two nuclei and are physically and electrically connected to each other so that the entire heart contracts as one unit ( called a syncytium ) . <hl> Because the actin and myosin are not arranged in such regular fashion in smooth muscle , the cytoplasm of a smooth muscle fiber ( which has only a single nucleus ) has a uniform , nonstriated appearance ( resulting in the name smooth muscle ) . <hl> However , the less organized appearance of smooth muscle should not be interpreted as less efficient . Smooth muscle in the walls of arteries is a critical component that regulates blood pressure necessary to push blood through the circulatory system ; and smooth muscle in the skin , visceral organs , and internal passageways is essential for moving all materials through the body . 10.2 Skeletal Muscle Learning Objectives By the end of this section , you will be able to :"}, {"question": {"question_id": "fs-id1898701", "question_text": "From which embryonic cell type does muscle tissue develop?", "question_choices": ["ganglion cells", "myotube cells", "myoblast cells", "satellite cells"], "cloze_format": "The embryonic cell type from which muscle tissue develops is ___.", "normal_format": "From which embryonic cell type does muscle tissue develop?"}, "answer": {"ans_text": "myoblast cells", "ans_choice": 2}, "bloom": null, "hl_sentences": "Myoblasts are the embryonic cells responsible for muscle development , and ideally , they would carry healthy genes that could produce the dystrophin needed for normal muscle contraction .", "hl_context": "Because DMD is caused by a mutation in the gene that codes for dystrophin , it was thought that introducing healthy myoblasts into patients might be an effective treatment . <hl> Myoblasts are the embryonic cells responsible for muscle development , and ideally , they would carry healthy genes that could produce the dystrophin needed for normal muscle contraction . <hl> This approach has been largely unsuccessful in humans . A recent approach has involved attempting to boost the muscle \u2019 s production of utrophin , a protein similar to dystrophin that may be able to assume the role of dystrophin and prevent cellular damage from occurring . 10.4 Nervous System Control of Muscle Tension Learning Objectives By the end of this section , you will be able to :"}, {"question": {"question_id": "fs-id1483312", "question_text": "Which cell type helps to repair injured muscle fibers?", "question_choices": ["ganglion cells", "myotube cells", "myoblast cells", "satellite cells"], "cloze_format": "The ___ are a cell type that helps to repair injured muscle fibers.", "normal_format": "Which cell type helps to repair injured muscle fibers?"}, "answer": {"ans_text": "satellite cells", "ans_choice": 3}, "bloom": "1", "hl_sentences": "Satellite cells can regenerate muscle fibers to a very limited extent , but they primarily help to repair damage in living cells .", "hl_context": "Although the number of muscle cells is set during development , satellite cells help to repair skeletal muscle cells . A satellite cell is similar to a myoblast because it is a type of stem cell ; however , satellite cells are incorporated into muscle cells and facilitate the protein synthesis required for repair and growth . These cells are located outside the sarcolemma and are stimulated to grow and fuse with muscle cells by growth factors that are released by muscle fibers under certain forms of stress . <hl> Satellite cells can regenerate muscle fibers to a very limited extent , but they primarily help to repair damage in living cells . <hl> If a cell is damaged to a greater extent than can be repaired by satellite cells , the muscle fibers are replaced by scar tissue in a process called fibrosis . Because scar tissue cannot contract , muscle that has sustained significant damage loses strength and cannot produce the same amount of power or endurance as it could before being damaged ."}], "summary": "", "keyterm": "", "bname": "anatomy_and_physiology"}, {"chapter": 11, "intro": " Chapter Outline 11.1   Lewis and Clark 11.2   The Missouri Crisis 11.3   Independence for Texas 11.4   The Mexican-American War, 1846\u20131848 11.5   Free Soil or Slave? The Dilemma of the West Introduction \n\n After 1800, the United States militantly expanded westward across North America, confident of its right and duty to gain control of the continent and spread the benefits of its \u201csuperior\u201d culture. In John Gast\u2019s  American Progress  ( Figure 11.1 ), the White, blonde figure of Columbia\u2014a historical personification of the United States\u2014strides triumphantly westward with the Star of Empire on her head. She brings education, symbolized by the schoolbook, and modern technology, represented by the telegraph wire. White settlers follow her lead, driving the helpless natives away and bringing successive waves of technological progress in their wake. In the first half of the nineteenth century, the quest for control of the West led to the Louisiana Purchase, the annexation of Texas, and the Mexican-American War. Efforts to seize western territories from Native peoples and expand the republic by warring with Mexico succeeded beyond expectations. Few nations ever expanded so quickly. Yet, this expansion led to debates about the fate of slavery in the West, creating tensions between North and South that ultimately led to the collapse of American democracy and a brutal civil war. ", "chapter_text": " 11.1   Lewis and Clark Learning Objectives By the end of this section, you will be able to: \n\n Explain the significance of the Louisiana Purchase \n\n Describe the terms of the Adams-On\u00eds Treaty \n\n Describe the role played by the filibuster in American expansion \n\n For centuries Europeans had mistakenly believed an all-water route across the North American continent existed. This \u201c Northwest Passage \u201d would afford the country that controlled it not only access to the interior of North America but also\u2014more importantly\u2014a relatively quick route to the Pacific Ocean and to trade with Asia. The Spanish, French, and British searched for years before American explorers took up the challenge of finding it. Indeed, shortly before Lewis and Clark set out on their expedition for the U.S. government, Alexander Mackenzie, an officer of the British North West Company, a fur trading outfit, had attempted to discover the route. Mackenzie made it to the Pacific and even believed (erroneously) he had discovered the headwaters of the Columbia River, but he could not find an easy water route with a minimum of difficult portages, that is, spots where boats must be carried overland. \n\n Many Americans also dreamed of finding a Northwest Passage and opening the Pacific to American commerce and influence, including President Thomas Jefferson. In April 1803, Jefferson achieved his goal of purchasing the Louisiana Territory from France, effectively doubling the size of the United States. The purchase was made possible due to events outside the nation\u2019s control. With the success of the Haitian Revolution, an uprising of enslaved people against the French, France\u2019s Napoleon abandoned his quest to re-establish an extensive French Empire in America. As a result, he was amenable to selling off the vast Louisiana territory. President Jefferson quickly set out to learn precisely what he had bought and to assess its potential for commercial exploitation. Above all else, Jefferson wanted to exert U.S. control over the territory, an area already well known to French and British explorers. It was therefore vital for the United States to explore and map the land to pave the way for future White settlement. \n\n JEFFERSON\u2019S CORPS OF DISCOVERY HEADS WEST \n\n To head the expedition into the Louisiana territory, Jefferson appointed his friend and personal secretary, twenty-nine-year-old army captain Meriwether Lewis, who was instructed to form a  Corps of Discovery . Lewis in turn selected William Clark, who had once been his commanding officer, to help him lead the group ( Figure 11.3 ). \n\n Jefferson wanted to improve the ability of American merchants to access the ports of China. Establishing a river route from St. Louis to the Pacific Ocean was crucial to capturing a portion of the fur trade that had proven so profitable to Great Britain. He also wanted to legitimize American claims to the land against rivals, such as Great Britain and Spain. Lewis and Clark were thus instructed to map the territory through which they would pass and to explore all tributaries of the Missouri River. This part of the expedition struck fear into Spanish officials, who believed that Lewis and Clark would encroach on New Mexico, the northern part of New Spain. Spain dispatched four unsuccessful expeditions from Santa Fe to intercept the explorers. Lewis and Clark also had directives to establish friendly relationships with the western tribes, introducing them to American trade goods and encouraging warring groups to make peace. Establishing an overland route to the Pacific would bolster U.S. claims to the Pacific Northwest, first established in 1792 when Captain Robert Gray sailed his ship  Columbia  into the mouth of the river that now bears his vessel\u2019s name and forms the present-day border between Oregon and Washington. Finally, Jefferson, who had a keen interest in science and nature, ordered Lewis and Clark to take extensive notes on the geography, plant life, animals, and natural resources of the region into which they would journey. \n\n After spending the winter of 1803\u20131804 encamped at the mouth of the Missouri River while the men prepared for their expedition, the corps set off in May 1804. Although the thirty-three frontiersmen, boatmen, and hunters took with them Alexander Mackenzie\u2019s account of his explorations and the best maps they could find, they did not have any real understanding of the difficulties they would face. Fierce storms left them drenched and freezing. Enormous clouds of gnats and mosquitos swarmed about their heads as they made their way up the Missouri River. Along the way they encountered (and killed) a variety of animals including elk, buffalo, and grizzly bears. One member of the expedition survived a rattlesnake bite. As the men collected minerals and specimens of plants and animals, the overly curious Lewis sampled minerals by tasting them and became seriously ill at one point. What they did not collect, they sketched and documented in the journals they kept. They also noted the customs of the tribes who controlled the land and attempted to establish peaceful relationships with them in order to ensure that future White settlement would not be impeded. \n\n The corps spent their first winter in the wilderness, 1804\u20131805, in a Mandan village in what is now North Dakota. There they encountered a reminder of France\u2019s former vast North American empire when they met a French fur trapper named Toussaint Charbonneau. When the corps left in the spring of 1805, Charbonneau accompanied them as a guide and interpreter, bringing Sacagawea\u2014who had been kidnapped and sold to Charbonneau, who made her his wife\u2014and their newborn son. Charbonneau knew the land better than the Americans, and Sacagawea proved invaluable in many ways, not least of which was that the presence of a young woman and her infant convinced many groups that the men were not a war party and meant no harm ( Figure 11.4 ). \n\n The corps set about making friends with native tribes while simultaneously attempting to assert American power over the territory. Hoping to overawe the people of the land, Lewis would let out a blast of his air rifle, a relatively new piece of technology the Native Americans had never seen. The corps also followed native custom by distributing gifts, including shirts, ribbons, and kettles, as a sign of goodwill. The explorers presented native leaders with medallions, many of which bore Jefferson\u2019s image, and invited them to visit their new \u201cruler\u201d in the East. These medallions or peace medals were meant to allow future explorers to identify friendly native groups. Not all efforts to assert U.S. control went peacefully; some Indians rejected the explorers\u2019 intrusion onto their land. An encounter with the Blackfoot turned hostile, for example, and members of the corps killed two Blackfoot men. \n\n After spending eighteen long months on the trail and nearly starving to death in the Bitterroot Mountains of Montana, the Corps of Discovery finally reached the Pacific Ocean in 1805 and spent the winter of 1805\u20131806 in Oregon. They returned to St. Louis later in 1806 having lost only one man, who had died of appendicitis. Upon their return, Meriwether Lewis was named governor of the Louisiana Territory. Unfortunately, he died only three years later in circumstances that are still disputed, before he could write a complete account of what the expedition had discovered. \n\n Although the Corps of Discovery failed to find an all-water route to the Pacific Ocean (for none existed), it nevertheless accomplished many of the goals Jefferson had set. The men traveled across the North American continent and established relationships with many Native American tribes, paving the way for fur traders like John Jacob Astor who later established trading posts solidifying U.S. claims to Oregon. Delegates of several tribes did go to Washington to meet the president. Hundreds of plant and animal specimens were collected, several of which were named for Lewis and Clark in recognition of their efforts. And the territory was now more accurately mapped and legally claimed by the United States. Nonetheless, most of the vast territory, home to a variety of native peoples, remained unknown to Americans ( Figure 11.5 ). \n\n Americana A Selection of Hats for the Fashionable Gentleman Beaver hats ( Figure 11.6 ) were popular apparel in the eighteenth and nineteenth centuries in both Europe and the United States because they were naturally waterproof and bore a glossy sheen. Demand for beaver pelts (and for the pelts of sea otters, foxes, and martens) by hat makers, dressmakers, and tailors led many fur trappers into the wilderness in pursuit of riches. Beaver hats fell out of fashion in the 1850s when silk hats became the rage and beaver became harder to find. In some parts of the West, the animals had been hunted nearly to extinction. \n\n Are there any contemporary fashions or fads that likewise promise to alter the natural world? \n\n SPANISH FLORIDA AND THE ADAMS-ON\u00cdS TREATY \n\n Despite the Lewis and Clark expedition, the boundaries of the Louisiana Purchase remained contested. Expansionists chose to believe the purchase included vast stretches of land, including all of Spanish Texas. The Spanish government disagreed, however. The first attempt to resolve this issue took place in February 1819 with the signing of the Adams-On\u00eds Treaty, which was actually intended to settle the problem of Florida. \n\n Spanish Florida had presented difficulties for its neighbors since the settlement of the original North American colonies, first for England and then for the United States. By 1819, American settlers no longer feared attack by Spanish troops garrisoned in Florida, but hostile tribes like the Creek and Seminole raided Georgia and then retreated to the relative safety of the Florida wilderness. These tribes also sheltered self-emancipated enslaved people, often intermarrying with them and making them members of their tribes. Sparsely populated by Spanish colonists and far from both Mexico City and Madrid, the frontier in Florida proved next to impossible for the Spanish government to control. \n\n In March 1818, General Andrew Jackson, frustrated by his inability to punish Creek and Seminole raiders, pursued them across the international border into Spanish Florida. Under Jackson\u2019s command, U.S. troops defeated the Creek and Seminole, occupied several Florida settlements, and executed two British citizens accused of acting against the United States. Outraged by the U.S. invasion of its territory, the Spanish government demanded that Jackson and his troops withdraw. In agreeing to the withdrawal, however, U.S. Secretary of State John Quincy Adams also offered to purchase the colony. Realizing that conflict between the United States and the Creeks and Seminoles would continue, Spain opted to cede the Spanish colony to its northern neighbor. The Adams-On\u00eds Treaty, named for Adams and the Spanish ambassador, Lu\u00eds de On\u00eds, made the cession of Florida official while also setting the boundary between the United States and Mexico at the Sabine River ( Figure 11.7 ). In exchange, Adams gave up U.S. claims to lands west of the Sabine and forgave Spain\u2019s $5 million debt to the United States. \n\n The Adams-On\u00eds Treaty upset many American expansionists, who criticized Adams for not laying claim to all of Texas, which they believed had been included in the Louisiana Purchase. In the summer of 1819, James Long, a planter from Natchez, Mississippi, became a  filibuster , or a private, unauthorized military adventurer, when he led three hundred men on an expedition across the Sabine River to take control of Texas. Long\u2019s men succeeded in capturing Nacogdoches, writing a Declaration of Independence (see below), and setting up a republican government. Spanish troops drove them out a month later. Returning in 1820 with a much smaller force, Long was arrested by the Spanish authorities, imprisoned, and killed. Long was but one of many nineteenth-century American filibusters who aimed at seizing territory in the Caribbean and Central America. \n\n Defining American The Long Expedition\u2019s Declaration of Independence The Long Expedition\u2019s short-lived Republic of Texas was announced with the drafting of a Declaration of Independence in 1819. The declaration named settlers\u2019 grievances against the limits put on expansion by the Adams-On\u00eds treaty and expressed their fears of Spain: \n\n The citizens of Texas have long indulged the hope, that in the adjustment of the boundaries of the Spanish possessions in America, and of the territories of the United States, that they should be included within the limits of the latter. The claims of the United States, long and strenuously urged, encouraged the hope. The recent [Adams-On\u00eds] treaty between Spain and the United States of America has dissipated an illusion too long fondly cherished, and has roused the citizens of Texas . . . They have seen themselves . . . literally abandoned to the dominion of the crown of Spain and left a prey . . . to all those exactions which Spanish rapacity is fertile in devising. The citizens of Texas would have proved themselves unworthy of the age . . . unworthy of their ancestry, of the kindred of the republics of the American continent, could they have hesitated in this emergency . . . Spurning the fetters of colonial vassalage, disdaining to submit to the most atrocious despotism that ever disgraced the annals of Europe, they have resolved under the blessing of God to be free.  \n\n How did the filibusters view Spain? What do their actions say about the nature of American society and of U.S. expansion? \n 11.2   The Missouri Crisis Learning Objectives By the end of this section, you will be able to: \n\n Explain why the North and South differed over the admission of Missouri as a state \n\n Explain how the admission of new states to the Union threatened to upset the balance between free and slave states in Congress \n\n Another stage of U.S. expansion took place when inhabitants of Missouri began petitioning for statehood beginning in 1817. The Missouri territory had been part of the Louisiana Purchase and was the first part of that vast acquisition to apply for statehood. By 1818, tens of thousands of settlers had flocked to Missouri, including slaveholders who brought with them some ten thousand enslaved people. When the status of the Missouri territory was taken up in earnest in the U.S. House of Representatives in early 1819, its admission to the Union proved to be no easy matter, since it brought to the surface a violent debate over whether slavery would be allowed in the new state. \n\n Politicians had sought to avoid the issue of slavery ever since the 1787 Constitutional Convention arrived at an uneasy compromise in the form of the \u201cthree-fifths clause.\u201d This provision stated that the entirety of a state\u2019s free population and 60 percent of its enslaved population would be counted in establishing the number of that state\u2019s members in the House of Representatives and the size of its federal tax bill. Although slavery existed in several northern states at the time, the compromise had angered many northern politicians because, they argued, the \u201cextra\u201d population of enslaved people would give southern states more votes than they deserved in both the House and the Electoral College. Admitting Missouri as a slave state also threatened the tenuous balance between free and slave states in the Senate by giving slave states a two-vote advantage. \n\n The debate about representation shifted to the morality of slavery itself when New York representative James Tallmadge, an opponent of slavery, attempted to amend the statehood bill in the House of Representatives. Tallmadge proposed that Missouri be admitted as a free state, that no more enslaved people be allowed to enter Missouri after it achieved statehood, and that all enslaved children born there after its admission be freed at age twenty-five. The amendment shifted the terms of debate by presenting slavery as an evil to be stopped. \n\n Northern representatives supported the  Tallmadge Amendment , denouncing slavery as immoral and opposed to the nation\u2019s founding principles of equality and liberty. Southerners in Congress rejected the amendment as an attempt to gradually abolish slavery\u2014not just in Missouri but throughout the Union\u2014by violating the property rights of slaveholders and their freedom to take their property wherever they wished. Slavery\u2019s apologists, who had long argued that slavery was a necessary evil, now began to perpetuate the idea that slavery was a positive good for the United States. They asserted that it generated wealth and left White men free to exercise their true talents instead of toiling in the soil, as the descendants of Africans were better suited to do. Enslaved people were cared for, supporters argued, and were better off exposed to the teachings of Christianity as enslaved than living as free heathens in uncivilized Africa. Above all, the United States had a destiny, they argued, to create an empire of slavery throughout the Americas. These proslavery arguments were to be made repeatedly and forcefully as expansion to the West proceeded. \n\n Most disturbing for the unity of the young nation, however, was that debaters divided along sectional lines, not party lines. With only a few exceptions, northerners supported the Tallmadge Amendment regardless of party affiliation, and southerners opposed it despite having party differences on other matters. It did not pass, and the crisis over Missouri led to strident calls of disunion and threats of civil war. \n\n Congress finally came to an agreement, called the  Missouri Compromise , in 1820. Missouri and Maine (which had been part of Massachusetts) would enter the Union at the same time, Maine as a free state, Missouri as a slave state. The Tallmadge Amendment was narrowly rejected, the balance between free and slave states was maintained in the Senate, and southerners did not have to fear that Missouri slaveholders would be deprived of their human property. To prevent similar conflicts each time a territory applied for statehood, a line coinciding with the southern border of Missouri (at latitude 36\u00b0 30') was drawn across the remainder of the Louisiana Territory ( Figure 11.8 ). Slavery could exist south of this line but was forbidden north of it, with the obvious exception of Missouri. \n\n My Story Thomas Jefferson on the Missouri Crisis On April 22, 1820, Thomas Jefferson wrote to John Holmes to express his reaction to the Missouri Crisis, especially the open threat of disunion and war: \n\n I thank you, Dear Sir, for the copy you have been so kind as to send me of the letter to your constituents on the Missouri question. it is a perfect justification to them. I had for a long time ceased to read the newspapers or pay any attention to public affairs, confident they were in good hands, and content to be a passenger in our bark to the shore from which I am not distant. but this momentous question [over slavery in Missouri], like a fire bell in the night, awakened and filled me with terror. I considered it at once as the knell of the Union. it is hushed indeed for the moment. but this is a reprieve only, not a final sentence. a geographical line, coinciding with a marked principle, moral and political, once concieved [sic] and held up to the angry passions of men, will never be obliterated; and every new irritation will mark it deeper and deeper. I can say with conscious truth that there is not a man on earth who would sacrifice more than I would, to relieve us from this heavy reproach, in any practicable way. . . . \n\nI regret that I am now to die in the belief that the useless sacrifice of themselves, by the generation of 76. to acquire self government and happiness to their country, is to be thrown away by the unwise and unworthy passions of their sons, and that my only consolation is to be that I live not to weep over it. if they would but dispassionately weigh the blessings they will throw away against an abstract principle more likely to be effected by union than by scission, they would pause before they would perpetuate this act of suicide themselves and of treason against the hopes of the world. to yourself as the faithful advocate of union I tender the offering of my high esteem and respect. \n\nTh. Jefferson  \n\n How would you characterize the former president\u2019s reaction? What do you think he means by writing that the Missouri Compromise line \u201cis a reprieve only, not a final sentence\u201d? \n 11.3   Independence for Texas Learning Objectives By the end of this section, you will be able to: \n\n Explain why American settlers in Texas sought independence from Mexico \n\n Discuss early attempts to make Texas independent of Mexico \n\n Describe the relationship between Anglo-Americans and Tejanos in Texas before and after independence \n\n As the incursions of the earlier filibusters into Texas demonstrated, American expansionists had desired this area of Spain\u2019s empire in America for many years. After the 1819 Adams-On\u00eds treaty established the boundary between Mexico and the United States, more American expansionists began to move into the northern portion of Mexico\u2019s province of Coahuila y Texas. Following Mexico\u2019s independence from Spain in 1821, American settlers immigrated to Texas in even larger numbers, intent on taking the land from the new and vulnerable Mexican nation in order to create a new American slave state. \n\n AMERICAN SETTLERS MOVE TO TEXAS \n\n After the 1819 Adams-On\u00eds Treaty defined the U.S.-Mexico boundary, the Spanish Mexican government began actively encouraging Americans to settle their northern province. Texas was sparsely settled, and the few Mexican farmers and ranchers who lived there were under constant threat of attack by tribes, especially the  Comanche , who supplemented their hunting with raids in pursuit of horses and cattle. To increase the non-Native population in Texas and provide a buffer zone between its tribes and the rest of Mexico, Spain began to recruit  empresarios . An  empresario  was someone who brought settlers to the region in exchange for generous grants of land. Moses Austin, a once-prosperous entrepreneur reduced to poverty by the  Panic of 1819 , requested permission to settle three hundred English-speaking American residents in Texas. Spain agreed on the condition that the resettled people convert to Roman Catholicism. \n\n On his deathbed in 1821, Austin asked his son Stephen to carry out his plans, and Mexico, which had won independence from Spain the same year, allowed Stephen to take control of his father\u2019s grant. Like Spain, Mexico also wished to encourage settlement in the state of Coahuila y Texas and passed colonization laws to encourage immigration. Thousands of Americans, primarily from slave states, flocked to Texas and quickly came to outnumber the  Tejanos , the Mexican residents of the region. The soil and climate offered good opportunities to expand slavery and the cotton kingdom. Land was plentiful and offered at generous terms. Unlike the U.S. government, Mexico allowed buyers to pay for their land in installments and did not require a minimum purchase. Furthermore, to many White people, it seemed not only their God-given right but also their patriotic duty to populate the lands beyond the Mississippi River, bringing with them American slavery, culture, laws, and political traditions ( Figure 11.9 ). \n\n THE TEXAS WAR FOR INDEPENDENCE \n\n Many Americans who migrated to Texas at the invitation of the Mexican government did not completely shed their identity or loyalty to the United States. They brought American traditions and expectations with them (including, for many, the right to enslave individuals). For instance, the majority of these new settlers were Protestant, and though they were not required to attend the Catholic mass, Mexico\u2019s prohibition on the public practice of other religions upset them and they routinely ignored it. \n\n Accustomed to representative democracy, jury trials, and the defendant\u2019s right to appear before a judge, the Anglo-American settlers in Texas also disliked the Mexican legal system, which provided for an initial hearing by an  alcalde , an administrator who often combined the duties of mayor, judge, and law enforcement officer. The  alcalde  sent a written record of the proceeding to a judge in Saltillo, the state capital, who decided the outcome. Settlers also resented that at most two Texas representatives were allowed in the state legislature. \n\n Their greatest source of discontent, though, was the Mexican government\u2019s 1829 abolition of slavery. Most American settlers were from southern states, and many had brought enslaved people with them. Mexico tried to accommodate them by maintaining the fiction that the enslaved workers were indentured servants. But American slaveholders in Texas distrusted the Mexican government and wanted Texas to be a new U.S. slave state. The dislike of most for Roman Catholicism (the prevailing religion of Mexico) and a widely held belief in American racial superiority led them generally to regard Mexicans as dishonest, ignorant, and backward. \n\n Belief in their own superiority inspired some Texans to try to undermine the power of the Mexican government. When  empresario  Haden Edwards attempted to evict people who had settled his land grant before he gained title to it, the Mexican government nullified its agreement with him. Outraged, Edwards and a small party of men took prisoner the  alcalde  of Nacogdoches. The Mexican army marched to the town, and Edwards and his troop then declared the formation of the  Republic of Fredonia  between the Sabine and Rio Grande Rivers. To demonstrate loyalty to their adopted country, a force led by Stephen Austin hastened to Nacogdoches to support the Mexican army. Edwards\u2019s revolt collapsed, and the revolutionaries fled Texas. \n\n The growing presence of American settlers in Texas, their reluctance to abide by Mexican law, and their desire for independence caused the Mexican government to grow wary. In 1830, it forbade future U.S. immigration and increased its military presence in Texas. Settlers continued to stream illegally across the long border; by 1835, after immigration resumed, there were twenty thousand Anglo-Americans in Texas ( Figure 11.10 ). \n\n Fifty-five delegates from the Anglo-American settlements gathered in 1831 to demand the suspension of customs duties, the resumption of immigration from the United States, better protection from Native American tribes, the granting of promised land titles, and the creation of an independent state of Texas separate from Coahuila. Ordered to disband, the delegates reconvened in early April 1833 to write a constitution for an independent Texas. Surprisingly, General Antonio Lopez de Santa Anna, Mexico\u2019s new president, agreed to all demands, except the call for statehood ( Figure 11.11 ). Coahuila y Texas made provisions for jury trials, increased Texas\u2019s representation in the state legislature, and removed restrictions on commerce. \n\n Texans\u2019 hopes for independence were quashed in 1834, however, when Santa Anna dismissed the Mexican Congress and abolished all state governments, including that of Coahuila y Texas. In January 1835, reneging on earlier promises, he dispatched troops to the town of Anahuac to collect customs duties. Lawyer and soldier William B. Travis and a small force marched on Anahuac in June, and the fort surrendered. On October 2, Anglo-American forces met Mexican troops at the town of Gonzales; the Mexican troops fled and the Americans moved on to take San Antonio. Now more cautious, delegates to the Consultation of 1835 at San Felipe de Austin voted against declaring independence, instead drafting a statement, which became known as the Declaration of Causes, promising continued loyalty if Mexico returned to a constitutional form of government. They selected Henry Smith, leader of the Independence Party, as governor of Texas and placed Sam Houston, a former soldier who had been a congressman and governor of Tennessee, in charge of its small military force. \n\n The Consultation delegates met again in March 1836. They declared their independence from Mexico and drafted a constitution calling for an American-style judicial system and an elected president and legislature. Significantly, they also established that slavery would not be prohibited in Texas. Many wealthy Tejanos supported the push for independence, hoping for liberal governmental reforms and economic benefits. \n\n REMEMBER THE ALAMO! \n\n Mexico had no intention of losing its northern province. Santa Anna and his army of four thousand had besieged San Antonio in February 1836. Hopelessly outnumbered, its two hundred defenders, under Travis, fought fiercely from their refuge in an old mission known as the Alamo ( Figure 11.12 ). After ten days, however, the mission was taken and all but a few of the defenders were dead, including Travis and James Bowie, the famed frontiersman who was also a land speculator and slave trader. A few male survivors, possibly including the frontier legend and former Tennessee congressman Davy Crockett, were led outside the walls and executed. The few women and children inside the mission were allowed to leave with the only adult male survivor, a person enslaved by Travis, who was then freed by the Mexican Army. Terrified, they fled. \n\n Although hungry for revenge, the Texas forces under Sam Houston nevertheless withdrew across Texas, gathering recruits as they went. Coming upon Santa Anna\u2019s encampment on the banks of San Jacinto River on April 21, 1836, they waited as the Mexican troops settled for an afternoon nap. Assured by Houston that \u201cVictory is certain!\u201d and told to \u201cTrust in God and fear not!\u201d the seven hundred men descended on a sleeping force nearly twice their number with cries of \u201cRemember the Alamo!\u201d Within fifteen minutes the Battle of San Jacinto was over. Approximately half the Mexican troops were killed, and the survivors, including Santa Anna, taken prisoner. \n\n Santa Anna grudgingly signed a peace treaty and was sent to Washington, where he met with President Andrew Jackson and, under pressure, agreed to recognize an independent Texas with the Rio Grande River as its southwestern border. By the time the agreement had been signed, however, Santa Anna had been removed from power in Mexico. For that reason, the Mexican Congress refused to be bound by Santa Anna\u2019s promises and continued to insist that the renegade territory still belonged to Mexico. \n\n THE LONE STAR REPUBLIC \n\n In September 1836, military hero Sam Houston was elected president of Texas, and, following the relentless logic of U.S. expansion, Texans voted in favor of annexation to the United States. This had been the dream of many settlers in Texas all along. They wanted to expand the United States west and saw Texas as the next logical step. Slaveholders there, such as Sam Houston, William B. Travis and James Bowie (the latter two of whom died at the Alamo), believed too in the destiny of slavery. Mindful of the vicious debates over Missouri that had led to talk of disunion and war, American politicians were reluctant to annex Texas or, indeed, even to recognize it as a sovereign nation. Annexation would almost certainly mean war with Mexico, and the admission of a state with a large enslaved population, though permissible under the Missouri Compromise, would bring the issue of slavery once again to the fore. Texas had no choice but to organize itself as the independent Lone Star Republic. To protect itself from Mexican attempts to reclaim it, Texas sought and received recognition from France, Great Britain, Belgium, and the Netherlands. The United States did not officially recognize Texas as an independent nation until March 1837, nearly a year after the final victory over the Mexican army at San Jacinto. \n\n Uncertainty about its future did not discourage Americans committed to expansion, especially slaveholders, from rushing to settle in the Lone Star Republic, however. Between 1836 and 1846, its population nearly tripled. By 1840, nearly twelve thousand enslaved Africans had been brought to Texas by American slaveholders. Many new settlers had suffered financial losses in the severe financial depression of 1837 and hoped for a new start in the new nation. According to folklore, across the United States, homes and farms were deserted overnight, and curious neighbors found notes reading only \u201cGTT\u201d (\u201cGone to Texas\u201d). Many Europeans, especially Germans, also immigrated to Texas during this period. \n\n In keeping with the program of ethnic cleansing and White racial domination, as illustrated by the image at the beginning of this chapter, Americans in Texas generally treated both Tejano and Native American residents with utter contempt, eager to displace and dispossess them. Anglo-American leaders failed to return the support their Tejano neighbors had extended during the rebellion and repaid them by seizing their lands. In 1839, the republic\u2019s militia attempted to drive out the Cherokee and Comanche. \n\n The impulse to expand did not lay dormant, and Anglo-American settlers and leaders in the newly formed Texas republic soon cast their gaze on the Mexican province of New Mexico as well. Repeating the tactics of earlier filibusters, a Texas force set out in 1841 intent on taking Santa Fe. Its members encountered an army of New Mexicans and were taken prisoner and sent to Mexico City. On Christmas Day, 1842, Texans avenged a Mexican assault on San Antonio by attacking the Mexican town of Mier. In August, another Texas army was sent to attack Santa Fe, but Mexican troops forced them to retreat. Clearly, hostilities between Texas and Mexico had not ended simply because Texas had declared its independence. \n 11.4   The Mexican-American War, 1846\u20131848 Learning Objectives By the end of this section, you will be able to: \n\n Identify the causes of the Mexican-American War \n\n Describe the outcomes of the war in 1848, especially the Mexican Cession \n\n Describe the effect of the California Gold Rush on westward expansion \n\n Tensions between the United States and Mexico rapidly deteriorated in the 1840s as American expansionists eagerly eyed Mexican land to the west, including the lush northern Mexican province of California. Indeed, in 1842, a U.S. naval fleet, incorrectly believing war had broken out, seized Monterey, California, a part of Mexico. Monterey was returned the next day, but the episode only added to the uneasiness with which Mexico viewed its northern neighbor. The forces of expansion, however, could not be contained, and American voters elected James Polk in 1844 because he promised to deliver more lands. President Polk fulfilled his promise by gaining Oregon and, most spectacularly, provoking a war with Mexico that ultimately fulfilled the wildest fantasies of expansionists. By 1848, the United States encompassed much of North America, a republic that stretched from the Atlantic to the Pacific. \n\n JAMES K. POLK AND THE TRIUMPH OF EXPANSION \n\n A fervent belief in expansion gripped the United States in the 1840s. In 1845, a New York newspaper editor, John O\u2019Sullivan, introduced the concept of \u201cmanifest destiny\u201d to describe the very popular idea of the special role of the United States in overspreading the continent\u2014the divine right and duty of White Americans to seize and settle the American West, thus spreading Protestant, democratic values. In this climate of opinion, voters in 1844 elected James K. Polk, a slaveholder from Tennessee, because he vowed to annex Texas as a new slave state and take Oregon. \n\n Annexing Oregon was an important objective for U.S. foreign policy because it appeared to be an area rich in commercial possibilities. Northerners favored U.S. control of Oregon because ports in the Pacific Northwest would be gateways for trade with Asia. Southerners hoped that, in exchange for their support of expansion into the northwest, northerners would not oppose plans for expansion into the southwest. \n\n President Polk\u2014whose campaign slogan in 1844 had been \u201cFifty-four forty or fight!\u201d\u2014asserted the United States\u2019 right to gain full control of what was known as Oregon Country, from its southern border at 42\u00b0 latitude (the current boundary with California) to its northern border at 54\u00b0 40' latitude. According to an 1818 agreement, Great Britain and the United States held joint ownership of this territory, but the 1827 Treaty of Joint Occupation opened the land to settlement by both countries. Realizing that the British were not willing to cede all claims to the territory, Polk proposed the land be divided at 49\u00b0 latitude (the current border between Washington and Canada). The British, however, denied U.S. claims to land north of the Columbia River (Oregon\u2019s current northern border) ( Figure 11.13 ). Indeed, the British foreign secretary refused even to relay Polk\u2019s proposal to London. However, reports of the difficulty Great Britain would face defending Oregon in the event of a U.S. attack, combined with concerns over affairs at home and elsewhere in its empire, quickly changed the minds of the British, and in June 1846, Queen Victoria\u2019s government agreed to a division at the forty-ninth parallel. \n\n In contrast to the diplomatic solution with Great Britain over Oregon, when it came to Mexico, Polk and the American people proved willing to use force to wrest more land for the United States. In keeping with voters\u2019 expectations, President Polk set his sights on the Mexican state of California. After the mistaken capture of Monterey, negotiations about purchasing the port of San Francisco from Mexico broke off until September 1845. Then, following a revolt in California that left it divided in two, Polk attempted to purchase Upper California and New Mexico as well. These efforts went nowhere. The Mexican government, angered by U.S. actions, refused to recognize the independence of Texas. \n\n Finally, after nearly a decade of public clamoring for the annexation of Texas, in December 1845 Polk officially agreed to the annexation of the former Mexican state, making the Lone Star Republic an additional slave state. Incensed that the United States had annexed Texas, however, the Mexican government refused to discuss the matter of selling land to the United States. Indeed, Mexico refused even to acknowledge Polk\u2019s emissary, John Slidell, who had been sent to Mexico City to negotiate. Not to be deterred, Polk encouraged Thomas O. Larkin, the U.S. consul in Monterey, to assist any American settlers and any  Californios , the Mexican residents of the state, who wished to proclaim their independence from Mexico. By the end of 1845, having broken diplomatic ties with the United States over Texas and having grown alarmed by American actions in California, the Mexican government warily anticipated the next move. It did not have long to wait. \n\n WAR WITH MEXICO, 1846\u20131848 \n\n Expansionistic fervor propelled the United States to war against Mexico in 1846. The United States had long argued that the Rio Grande was the border between Mexico and the United States, and at the end of the Texas war for independence Santa Anna had been pressured to agree. Mexico, however, refused to be bound by Santa Anna\u2019s promises and insisted the border lay farther north, at the Nueces River ( Figure 11.14 ). To set it at the Rio Grande would, in effect, allow the United States to control land it had never occupied. In Mexico\u2019s eyes, therefore, President Polk violated its sovereign territory when he ordered U.S. troops into the disputed lands in 1846. From the Mexican perspective, it appeared the United States had invaded their nation. \n\n In January 1846, the U.S. force that was ordered to the banks of the Rio Grande to build a fort on the \u201cAmerican\u201d side encountered a Mexican cavalry unit on patrol. Shots rang out, and sixteen U.S. soldiers were killed or wounded. Angrily declaring that Mexico \u201chas invaded our territory and shed American blood upon American soil,\u201d President Polk demanded the United States declare war on Mexico. On May 12, Congress obliged. \n\n The small but vocal antislavery faction decried the decision to go to war, arguing that Polk had deliberately provoked hostilities so the United States could annex more slave territory. Illinois representative Abraham Lincoln and other members of Congress issued the \u201cSpot Resolutions\u201d in which they demanded to know the precise spot on U.S. soil where American blood had been spilled. Many Whigs also denounced the war. Democrats, however, supported Polk\u2019s decision, and volunteers for the army came forward in droves from every part of the country except New England, the seat of abolitionist activity. Enthusiasm for the war was aided by the widely held belief that Mexico was a weak, impoverished country and that the Mexican people, perceived as ignorant, lazy, and controlled by a corrupt Roman Catholic clergy, would be easy to defeat. ( Figure 11.15 ). \n\n U.S. military strategy had three main objectives: 1) Take control of northern Mexico, including New Mexico; 2) seize California; and 3) capture Mexico City. General Zachary Taylor and his Army of the Center were assigned to accomplish the first goal, and with superior weapons they soon captured the Mexican city of Monterrey. Taylor quickly became a hero in the eyes of the American people, and Polk appointed him commander of all U.S. forces. \n\n General Stephen Watts Kearny, commander of the Army of the West, accepted the surrender of Santa Fe, New Mexico, and moved on to take control of California, leaving Colonel Sterling Price in command.\n\nDespite Kearny\u2019s assurances that New Mexicans need not fear for their lives or their property, the region\u2019s residents rose in revolt in January 1847 in an effort to drive the Americans away. Although Price managed to put an end to the rebellion, tensions remained high. Kearny, meanwhile, arrived in California to find it already in American hands through the joint efforts of California settlers, U.S. naval commander John D. Sloat, and John C. Fremont, a former army captain and son-in-law of Missouri senator Thomas Benton. Sloat, at anchor off the coast of Mazatlan, learned that war had begun and quickly set sail for California. He seized the town of Monterey in July 1846, less than a month after a group of American settlers led by William B. Ide had taken control of Sonoma and declared California a republic. A week after the fall of Monterey, the navy took San Francisco with no resistance. Although some Californios staged a short-lived rebellion in September 1846, many others submitted to the U.S. takeover. Thus Kearny had little to do other than take command of California as its governor. \n\n Leading the Army of the South was General Winfield Scott. Both Taylor and Scott were potential competitors for the presidency, and believing\u2014correctly\u2014that whoever seized Mexico City would become a hero, Polk assigned Scott the campaign to avoid elevating the more popular Taylor, who was affectionately known as \u201cOld Rough and Ready.\u201d \n\n Scott captured Veracruz in March 1847, and moving in a northwesterly direction from there (much as Spanish conquistador Hern\u00e1n Cort\u00e9s had done in 1519), he slowly closed in on the capital. Every step of the way was a hard-fought victory, however, and Mexican soldiers and civilians both fought bravely to save their land from the American invaders. Mexico City\u2019s defenders, including young military cadets, fought to the end. According to legend, cadet Juan Escutia\u2019s last act was to save the Mexican flag, and he leapt from the city\u2019s walls with it wrapped around his body. On September 14, 1847, Scott entered Mexico City\u2019s central plaza; the city had fallen ( Figure 11.16 ). While Polk and other expansionists called for \u201call Mexico,\u201d the Mexican government and the United States negotiated for peace in 1848, resulting in the Treaty of Guadalupe Hidalgo. \n\n The Treaty of Guadalupe Hidalgo, signed in February 1848, was a triumph for American expansionism under which Mexico ceded nearly half its land to the United States. The  Mexican Cession , as the conquest of land west of the Rio Grande was called, included the current states of California, New Mexico, Arizona, Nevada, Utah, and portions of Colorado and Wyoming. Mexico also recognized the Rio Grande as the border with the United States. Mexican citizens in the ceded territory were promised U.S. citizenship in the future when the territories they were living in became states. In exchange, the United States agreed to assume $3.35 million worth of Mexican debts owed to U.S. citizens, paid Mexico $15 million for the loss of its land, and promised to guard the residents of the Mexican Cession from Native American raids. \n\n As extensive as the Mexican Cession was, some argued the United States should not be satisfied until it had taken all of Mexico. Many who were opposed to this idea were southerners who, while desiring the annexation of more slave territory, did not want to make Mexico\u2019s large mestizo (people of mixed Native American and European ancestry) population part of the United States. Others did not want to absorb a large group of Roman Catholics. These expansionists could not accept the idea of new U.S. territory filled with mixed-race, Catholic populations. \n\n CALIFORNIA AND THE GOLD RUSH \n\n The United States had no way of knowing that part of the land about to be ceded by Mexico had just become far more valuable than anyone could have imagined. On January 24, 1848, James Marshall discovered gold in the millrace of the sawmill he had built with his partner John Sutter on the south fork of California\u2019s  American River . Word quickly spread, and within a few weeks all of Sutter\u2019s employees had left to search for gold. When the news reached San Francisco, most of its inhabitants abandoned the town and headed for the American River. By the end of the year, thousands of California\u2019s residents had gone north to the gold fields with visions of wealth dancing in their heads, and in 1849 thousands of people from around the world followed them ( Figure 11.17 ). The Gold Rush had begun. \n\n The fantasy of instant wealth induced a mass exodus to California. Settlers in Oregon and Utah rushed to the American River. Easterners sailed around the southern tip of South America or to Panama\u2019s Atlantic coast, where they crossed the Isthmus of Panama to the Pacific and booked ship\u2019s passage for San Francisco. As California-bound vessels stopped in South American ports to take on food and fresh water, hundreds of Peruvians and Chileans streamed aboard. Easterners who could not afford to sail to California crossed the continent on foot, on horseback, or in wagons. Others journeyed from as far away as Hawaii and Europe. Chinese people came as well, adding to the polyglot population in the California boomtowns ( Figure 11.18 ). \n\n Once in California, gathered in camps with names like Drunkard\u2019s Bar, Angel\u2019s Camp, Gouge Eye, and Whiskeytown, the \u201c forty-niners \u201d did not find wealth so easy to come by as they had first imagined. Although some were able to find gold by panning for it or shoveling soil from river bottoms into sieve-like contraptions called rockers, most did not. The placer gold, the gold that had been washed down the mountains into streams and rivers, was quickly exhausted, and what remained was deep below ground. Independent miners were supplanted by companies that could afford not only to purchase hydraulic mining technology but also to hire laborers to work the hills. The frustration of many a miner was expressed in the words of Sullivan Osborne. In 1857, Osborne wrote that he had arrived in California \u201cfull of high hopes and bright anticipations of the future\u201d only to find his dreams \u201chave long since perished.\u201d Although $550 million worth of gold was found in California between 1849 and 1850, very little of it went to individuals. \n\n Observers in the gold fields also reported abuse of Native Americans by miners. Some miners forced Native Americans to work their claims for them; others drove them off their lands, stole from them, and even murdered them. Foreigners were generally disliked, especially those from South America. The most despised, however, were the thousands of Chinese migrants. Eager to earn money to send to their families in Hong Kong and southern China, they quickly earned a reputation as frugal men and hard workers who routinely took over diggings others had abandoned as worthless and worked them until every scrap of gold had been found. Many American miners, often spendthrifts, resented their presence and discriminated against them, believing the Chinese, who represented about 8 percent of the nearly 300,000 who arrived, were depriving them of the opportunity to make a living. \n\n In 1850, California imposed a tax on foreign miners, and in 1858 it prohibited all immigration from China. Those Chinese who remained in the face of the growing hostility were often beaten and killed, and some Westerners made a sport of cutting off Chinese men\u2019s queues, the long braids of hair worn down their backs ( Figure 11.19 ). In 1882, Congress took up the power to restrict immigration by banning the further immigration of Chinese. \n\n As people flocked to California in 1849, the population of the new territory swelled from a few thousand to about 100,000. The new arrivals quickly organized themselves into communities, and the trappings of \u201ccivilized\u201d life\u2014stores, saloons, libraries, stage lines, and fraternal lodges\u2014began to appear. Newspapers were established, and musicians, singers, and acting companies arrived to entertain the gold seekers. The epitome of these Gold Rush boomtowns was San Francisco, which counted only a few hundred residents in 1846 but by 1850 had reached a population of thirty-four thousand ( Figure 11.20 ). So quickly did the territory grow that by 1850 California was ready to enter the Union as a state. When it sought admission, however, the issue of slavery expansion and sectional tensions emerged once again. \n 11.5   Free Soil or Slave? The Dilemma of the West Learning Objectives By the end of this section, you will be able to: \n\n Describe the terms of the Wilmot Proviso \n\n Discuss why the Free-Soil Party objected to the westward expansion of slavery \n\n Explain why sectional and political divisions in the United States grew \n\n Describe the terms of the Compromise of 1850 \n\n The 1848 treaty with Mexico did not bring the United States domestic peace. Instead, the acquisition of new territory revived and intensified the debate over the future of slavery in the western territories, widening the growing division between North and South and leading to the creation of new single-issue parties. Increasingly, the South came to regard itself as under attack by radical northern abolitionists, and many northerners began to speak ominously of a southern drive to dominate American politics for the purpose of protecting slaveholders\u2019 human property. As tensions mounted and both sides hurled accusations, national unity frayed. Compromise became nearly impossible and antagonistic sectional rivalries replaced the idea of a unified, democratic republic. \n\n THE LIBERTY PARTY, THE WILMOT PROVISO, AND THE ANTISLAVERY MOVEMENT \n\n Committed to protecting White workers by keeping slavery out of the lands taken from Mexico, Pennsylvania congressman David Wilmot attached to an 1846 revenue bill an amendment that would prohibit slavery in the new territory. The  Wilmot Proviso  was not entirely new. Other congressmen had drafted similar legislation, and Wilmot\u2019s language was largely copied from the 1787 Northwest Ordinance that had banned slavery in that territory. His ideas were very controversial in the 1840s, however, because his proposals would prevent American slaveholders from bringing what they viewed as their lawful property, enslaved people, into the western lands. The measure passed the House but was defeated in the Senate. When Polk tried again to raise revenue the following year (to pay for lands taken from Mexico), the Wilmot Proviso was reintroduced, this time calling for the prohibition of slavery not only in the Mexican Cession but in all U.S. territories. The revenue bill passed, but without the proviso. \n\n That Wilmot, a loyal Democrat, should attempt to counter the actions of a Democratic president hinted at the party divisions that were to come. The 1840s were a particularly active time in the creation and reorganization of political parties and constituencies, mainly because of discontent with the positions of the mainstream Whig and Democratic Parties in regard to slavery and its extension into the territories. The first new party, the small and politically weak  Liberty Party  founded in 1840, was a single-issue party, as were many of those that followed it. Its members were abolitionists who fervently believed slavery was evil and should be ended, and that this was best accomplished by political means. \n\n The Wilmot Proviso captured the \u201cantislavery\u201d sentiments during and after the Mexican War. Antislavery advocates differed from the abolitionists. While abolitionists called for the end of slavery everywhere, antislavery advocates, for various reasons, did not challenge the presence of slavery in the states where it already existed. Those who supported antislavery fervently opposed its expansion westward because, they argued, slavery would degrade White labor and reduce its value, cast a stigma upon hard-working Whites, and deprive them of a chance to advance economically. The western lands, they argued, should be open to White men only\u2014small farmers and urban workers for whom the West held the promise of economic advancement. Where slavery was entrenched, according to antislavery advocates, there was little land left for small farmers to purchase, and such men could not compete fairly with slaveholders who held large farms and gangs of enslaved people. Ordinary laborers suffered also; no one would pay a White man a decent wage when an enslaved person worked for nothing. When labor was associated with loss of freedom, antislavery supporters argued, all White workers carried a stigma that marked them as little better than the enslaved. Wilmot opposed the extension of slavery into the Mexican Cession not because of his concern for African Americans, but because of his belief that slavery hurt White workers, and that lands acquired by the government should be used to better the position of White small farmers and laborers. Work was not simply something that people did; it gave them dignity, but in a slave society, labor had no dignity. In response to these arguments, southerners maintained that laborers in northern factories were treated worse than enslaved people. Their work was tedious and low paid. Their meager income was spent on inadequate food, clothing, and shelter. There was no dignity in such a life. In contrast, they argued, southern enslaved people were provided with a home, the necessities of life, and the protection of their slaveholders. Factory owners did not care for or protect their employees in the same way. \n\n THE FREE-SOIL PARTY AND THE ELECTION OF 1848 \n\n The Wilmot Proviso was an issue of great importance to the Democrats. Would they pledge to support it? At the party\u2019s New York State convention in Buffalo, Martin Van Buren\u2019s antislavery supporters\u2014called  Barnburners  because they were likened to farmers who were willing to burn down their own barn to get rid of a rat infestation\u2014spoke in favor of the proviso. Their opponents, known as Hunkers, refused to support it. Angered, the Barnburners organized their own convention, where they chose antislavery, pro\u2013Wilmot Proviso delegates to send to the Democrats\u2019 national convention in Baltimore. In this way, the controversy over the expansion of slavery divided the Democratic Party. \n\n At the national convention, both sets of delegates were seated\u2014the pro-proviso ones chosen by the Barnburners and the anti-proviso ones chosen by the Hunkers. When it came time to vote for the party\u2019s presidential nominee, the majority of votes were for Lewis Cass, an advocate of popular sovereignty. Popular sovereignty was the belief that citizens should be able to decide issues based on the principle of majority rule; in this case, residents of a territory should have the right to decide whether slavery would be allowed in it. Theoretically, this doctrine would allow slavery to become established in any U.S. territory, including those from which it had been banned by earlier laws. \n\n Disgusted by the result, the Barnburners united with antislavery Whigs and former members of the Liberty Party to form a new political party\u2014the  Free-Soil Party , which took as its slogan \u201cFree Soil, Free Speech, Free Labor, and Free Men.\u201d The party had one real goal\u2014to oppose the extension of slavery into the territories ( Figure 11.21 ). In the minds of its members and many other northerners of the time, southern slaveholders had marshaled their wealth and power to control national politics for the purpose of protecting the institution of slavery and extending it into the territories. Many in the Free-Soil Party believed in this far-reaching conspiracy of the slaveholding elite to control both foreign affairs and domestic policies for their own ends, a cabal that came to be known as the  Slave Power . \n\n In the wake of the Mexican War, antislavery sentiment entered mainstream American politics when the new Free-Soil party promptly selected Martin Van Buren as its presidential candidate. For the first time, a national political party committed itself to the goal of stopping the expansion of slavery. The Democrats chose Lewis Cass, and the Whigs nominated General Zachary Taylor, as Polk had assumed they would. On Election Day, Democrats split their votes between Van Buren and Cass. With the strength of the Democratic vote diluted, Taylor won. His popularity with the American people served him well, and his status as a slaveholder helped him win the South. \n\n THE COMPROMISE OF 1850 \n\n The election of 1848 did nothing to quell the controversy over whether slavery would advance into the Mexican Cession. Some slaveholders, like President Taylor, considered the question a moot point because the lands acquired from Mexico were far too dry for growing cotton and therefore, they thought, no slaveholder would want to move there. Other southerners, however, argued that the question was not whether slaveholders  would  want to move to the lands of the Mexican Cession, but whether they  could  and still retain control of their enslaved property. Denying them the right to freely relocate with their lawful property was, they maintained, unfair and unconstitutional. Northerners argued, just as fervidly, that because Mexico had abolished slavery, no enslaved people currently lived in the Mexican Cession, and to introduce slavery there would extend it to a new territory, thus furthering the institution and giving the Slave Power more control over the United States. The strong current of antislavery sentiment\u2014that is, the desire to protect White labor\u2014only increased the opposition to the expansion of slavery into the West. \n\n Most northerners, except members of the Free-Soil Party, favored popular sovereignty for California and the New Mexico territory. Many southerners opposed this position, however, for they feared residents of these regions might choose to outlaw slavery. Some southern politicians spoke ominously of secession from the United States. Free-Soilers rejected popular sovereignty and demanded that slavery be permanently excluded from the territories. \n\n Beginning in January 1850, Congress worked for eight months on a compromise that might quiet the growing sectional conflict. Led by the aged Henry Clay, members finally agreed to the following: \n\n 1. California, which was ready to enter the Union, was admitted as a free state in accordance with its state constitution. \n\n2. Popular sovereignty was to determine the status of slavery in New Mexico and Utah, even though Utah and part of New Mexico were north of the Missouri Compromise line. \n\n3. The slave trade was banned in the nation\u2019s capital. Slavery, however, was allowed to remain. \n\n4. Under a new fugitive slave law, those who helped escaped enslaved individuals or refused to assist in their return would be fined and possibly imprisoned. \n\n5. The border between Texas and New Mexico was established.  \n\n The  Compromise of 1850  brought temporary relief. It resolved the issue of slavery in the territories for the moment and prevented secession. The peace would not last, however. Instead of relieving tensions between North and South, it had actually made them worse. ", "questions": [{"question": {"question_id": "fs-idm228586640", "question_text": "As a result of the Adams-On\u00eds Treaty, the United States gained which territory from Spain?", "question_choices": ["Florida", "New Mexico", "California", "Nevada"], "cloze_format": "The United States gained ___ from Spain as a result of the Adams-Onis Treaty.", "normal_format": "As a result of the Adams-On\u00eds Treaty, the United States gained which territory from Spain?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Realizing that conflict between the United States and the Creeks and Seminoles would continue , Spain opted to cede the Spanish colony to its northern neighbor . The Adams-On\u00eds Treaty , named for Adams and the Spanish ambassador , Lu\u00eds de On\u00eds , made the cession of Florida official while also setting the boundary between the United States and Mexico at the Sabine River ( Figure 11.7 ) .", "hl_context": "In March 1818 , General Andrew Jackson , frustrated by his inability to punish Creek and Seminole raiders , pursued them across the international border into Spanish Florida . Under Jackson \u2019 s command , U . S . troops defeated the Creek and Seminole , occupied several Florida settlements , and executed two British citizens accused of acting against the United States . Outraged by the U . S . invasion of its territory , the Spanish government demanded that Jackson and his troops withdraw . In agreeing to the withdrawal , however , U . S . Secretary of State John Quincy Adams also offered to purchase the colony . <hl> Realizing that conflict between the United States and the Creeks and Seminoles would continue , Spain opted to cede the Spanish colony to its northern neighbor . <hl> <hl> The Adams-On\u00eds Treaty , named for Adams and the Spanish ambassador , Lu\u00eds de On\u00eds , made the cession of Florida official while also setting the boundary between the United States and Mexico at the Sabine River ( Figure 11.7 ) . <hl> In exchange , Adams gave up U . S . claims to lands west of the Sabine and forgave Spain \u2019 s $ 5 million debt to the United States ."}, {"question": {"question_id": "fs-idm127724336", "question_text": "The Long Expedition established a short-lived republic in Texas known as ________.", "question_choices": ["the Lone Star Republic", "the Republic of Texas", "Columbiana", "the Republic of Fredonia"], "cloze_format": "The Long Expedition established a short-lived republic in Texas known as ________.", "normal_format": "What is the Long Expedition established a short-lived republic in Texas known as?"}, "answer": {"ans_text": "the Lone Star Republic", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "In September 1836 , military hero Sam Houston was elected president of Texas , and , following the relentless logic of U . S . expansion , Texans voted in favor of annexation to the United States . This had been the dream of many settlers in Texas all along . They wanted to expand the United States west and saw Texas as the next logical step . Annexation would almost certainly mean war with Mexico , and the admission of a state with a large enslaved population , though permissible under the Missouri Compromise , would bring the issue of slavery once again to the fore . Texas had no choice but to organize itself as the independent Lone Star Republic . The citizens of Texas have long indulged the hope , that in the adjustment of the boundaries of the Spanish possessions in America , and of the territories of the United States , that they should be included within the limits of the latter . Defining American The Long Expedition \u2019 s Declaration of Independence The Long Expedition \u2019 s short-lived Republic of Texas was announced with the drafting of a Declaration of Independence in 1819 .", "hl_context": "<hl> In September 1836 , military hero Sam Houston was elected president of Texas , and , following the relentless logic of U . S . expansion , Texans voted in favor of annexation to the United States . <hl> <hl> This had been the dream of many settlers in Texas all along . <hl> <hl> They wanted to expand the United States west and saw Texas as the next logical step . <hl> Slaveholders there , such as Sam Houston , William B . Travis and James Bowie ( the latter two of whom died at the Alamo ) , believed too in the destiny of slavery . Mindful of the vicious debates over Missouri that had led to talk of disunion and war , American politicians were reluctant to annex Texas or , indeed , even to recognize it as a sovereign nation . <hl> Annexation would almost certainly mean war with Mexico , and the admission of a state with a large enslaved population , though permissible under the Missouri Compromise , would bring the issue of slavery once again to the fore . <hl> <hl> Texas had no choice but to organize itself as the independent Lone Star Republic . <hl> To protect itself from Mexican attempts to reclaim it , Texas sought and received recognition from France , Great Britain , Belgium , and the Netherlands . The United States did not officially recognize Texas as an independent nation until March 1837 , nearly a year after the final victory over the Mexican army at San Jacinto . <hl> The citizens of Texas have long indulged the hope , that in the adjustment of the boundaries of the Spanish possessions in America , and of the territories of the United States , that they should be included within the limits of the latter . <hl> The claims of the United States , long and strenuously urged , encouraged the hope . The recent [ Adams-On\u00eds ] treaty between Spain and the United States of America has dissipated an illusion too long fondly cherished , and has roused the citizens of Texas . . . They have seen themselves . . . literally abandoned to the dominion of the crown of Spain and left a prey . . . to all those exactions which Spanish rapacity is fertile in devising . The citizens of Texas would have proved themselves unworthy of the age . . . unworthy of their ancestry , of the kindred of the republics of the American continent , could they have hesitated in this emergency . . . Spurning the fetters of colonial vassalage , disdaining to submit to the most atrocious despotism that ever disgraced the annals of Europe , they have resolved under the blessing of God to be free . <hl> Defining American The Long Expedition \u2019 s Declaration of Independence The Long Expedition \u2019 s short-lived Republic of Texas was announced with the drafting of a Declaration of Independence in 1819 . <hl> The declaration named settlers \u2019 grievances against the limits put on expansion by the Adams-On\u00eds treaty and expressed their fears of Spain :"}, {"question": {"question_id": "fs-idm96073632", "question_text": "A proposal to prohibit the importation of enslaved people to Missouri following its admission to the United States was made by ________.", "question_choices": ["John C. Calhoun", "Henry Clay", "James Tallmadge", "John Quincy Adams"], "cloze_format": "A proposal to prohibit the importation of enslaved people to Missouri following its admission to the United States was made by ________.", "normal_format": "Who made a proposal to prohibit the importation of enslaved people to Missouri following its admission to the United States?"}, "answer": {"ans_text": "James Tallmadge", "ans_choice": 2}, "bloom": null, "hl_sentences": "Tallmadge proposed that Missouri be admitted as a free state , that no more enslaved people be allowed to enter Missouri after it achieved statehood , and that all enslaved children born there after its admission be freed at age twenty-five .", "hl_context": "The debate about representation shifted to the morality of slavery itself when New York representative James Tallmadge , an opponent of slavery , attempted to amend the statehood bill in the House of Representatives . <hl> Tallmadge proposed that Missouri be admitted as a free state , that no more enslaved people be allowed to enter Missouri after it achieved statehood , and that all enslaved children born there after its admission be freed at age twenty-five . <hl> The amendment shifted the terms of debate by presenting slavery as an evil to be stopped ."}, {"question": {"question_id": "fs-idp287521568", "question_text": "To balance votes in the Senate, ________ was admitted to the Union as a free state at the same time that Missouri was admitted as a slave state.", "question_choices": ["Florida", "Maine", "New York", "Arkansas"], "cloze_format": "To balance votes in the Senate, ________ was admitted to the Union as a free state at the same time that Missouri was admitted as a slave state.", "normal_format": "To balance votes in the Senate, which state was admitted to the Union as a free state at the same time that Missouri was admitted as a slave state?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Congress finally came to an agreement , called the Missouri Compromise , in 1820 . Missouri and Maine ( which had been part of Massachusetts ) would enter the Union at the same time , Maine as a free state , Missouri as a slave state .", "hl_context": "<hl> Congress finally came to an agreement , called the Missouri Compromise , in 1820 . <hl> <hl> Missouri and Maine ( which had been part of Massachusetts ) would enter the Union at the same time , Maine as a free state , Missouri as a slave state . <hl> The Tallmadge Amendment was narrowly rejected , the balance between free and slave states was maintained in the Senate , and southerners did not have to fear that Missouri slaveholders would be deprived of their human property . To prevent similar conflicts each time a territory applied for statehood , a line coinciding with the southern border of Missouri ( at latitude 36 \u00b0 30 ' ) was drawn across the remainder of the Louisiana Territory ( Figure 11.8 ) . Slavery could exist south of this line but was forbidden north of it , with the obvious exception of Missouri ."}, {"question": {"question_id": "fs-idp221147232", "question_text": "Texas won its independence from Mexico in ________.", "question_choices": ["1821", "1830", "1836", "1845"], "cloze_format": "Texas won its independence from Mexico in ________.", "normal_format": "When did Texas win its independence from Mexico?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The Consultation delegates met again in March 1836 . They declared their independence from Mexico and drafted a constitution calling for an American-style judicial system and an elected president and legislature . Texans \u2019 hopes for independence were quashed in 1834 , however , when Santa Anna dismissed the Mexican Congress and abolished all state governments , including that of Coahuila y Texas .", "hl_context": "<hl> The Consultation delegates met again in March 1836 . <hl> <hl> They declared their independence from Mexico and drafted a constitution calling for an American-style judicial system and an elected president and legislature . <hl> Significantly , they also established that slavery would not be prohibited in Texas . Many wealthy Tejanos supported the push for independence , hoping for liberal governmental reforms and economic benefits . <hl> Texans \u2019 hopes for independence were quashed in 1834 , however , when Santa Anna dismissed the Mexican Congress and abolished all state governments , including that of Coahuila y Texas . <hl> In January 1835 , reneging on earlier promises , he dispatched troops to the town of Anahuac to collect customs duties . Lawyer and soldier William B . Travis and a small force marched on Anahuac in June , and the fort surrendered . On October 2 , Anglo-American forces met Mexican troops at the town of Gonzales ; the Mexican troops fled and the Americans moved on to take San Antonio . Now more cautious , delegates to the Consultation of 1835 at San Felipe de Austin voted against declaring independence , instead drafting a statement , which became known as the Declaration of Causes , promising continued loyalty if Mexico returned to a constitutional form of government . They selected Henry Smith , leader of the Independence Party , as governor of Texas and placed Sam Houston , a former soldier who had been a congressman and governor of Tennessee , in charge of its small military force ."}, {"question": {"question_id": "fs-idp6587600", "question_text": "Texans defeated the army of General Antonio Lopez de Santa Anna at the battle of ________.", "question_choices": ["the Alamo", "San Jacinto", "Nacogdoches", "Austin"], "cloze_format": "Texans defeated the army of General Antonio Lopez de Santa Anna at the battle of ________.", "normal_format": "Texans defeated the army of General Antonio Lopez de Santa Anna at which battle?"}, "answer": {"ans_text": "San Jacinto", "ans_choice": 1}, "bloom": null, "hl_sentences": "Coming upon Santa Anna \u2019 s encampment on the banks of San Jacinto River on April 21 , 1836 , they waited as the Mexican troops settled for an afternoon nap . Assured by Houston that \u201c Victory is certain ! \u201d and told to \u201c Trust in God and fear not ! \u201d the seven hundred men descended on a sleeping force nearly twice their number with cries of \u201c Remember the Alamo ! \u201d Within fifteen minutes the Battle of San Jacinto was over . Approximately half the Mexican troops were killed , and the survivors , including Santa Anna , taken prisoner .", "hl_context": "Although hungry for revenge , the Texas forces under Sam Houston nevertheless withdrew across Texas , gathering recruits as they went . <hl> Coming upon Santa Anna \u2019 s encampment on the banks of San Jacinto River on April 21 , 1836 , they waited as the Mexican troops settled for an afternoon nap . <hl> <hl> Assured by Houston that \u201c Victory is certain ! \u201d and told to \u201c Trust in God and fear not ! \u201d the seven hundred men descended on a sleeping force nearly twice their number with cries of \u201c Remember the Alamo ! \u201d Within fifteen minutes the Battle of San Jacinto was over . <hl> <hl> Approximately half the Mexican troops were killed , and the survivors , including Santa Anna , taken prisoner . <hl>"}, {"question": {"question_id": "fs-idm195507456", "question_text": "Which of the following was not a reason the United States was reluctant to annex Texas?", "question_choices": ["The United States did not want to fight a war with Mexico.", "Annexing Texas would add more slave territory to the United States and anger abolitionists.", "Texans considered U.S. citizens inferior and did not want to be part of their country.", "Adding Texas would upset the balance between free and slave states in Congress."], "cloze_format": "The United States did not reluctant to annex Texas because of ___.", "normal_format": "Which of the following was not a reason the United States was reluctant to annex Texas?"}, "answer": {"ans_text": "Texans considered U.S. citizens inferior and did not want to be part of their country.", "ans_choice": 2}, "bloom": null, "hl_sentences": "Mindful of the vicious debates over Missouri that had led to talk of disunion and war , American politicians were reluctant to annex Texas or , indeed , even to recognize it as a sovereign nation . Annexation would almost certainly mean war with Mexico , and the admission of a state with a large enslaved population , though permissible under the Missouri Compromise , would bring the issue of slavery once again to the fore .", "hl_context": "In September 1836 , military hero Sam Houston was elected president of Texas , and , following the relentless logic of U . S . expansion , Texans voted in favor of annexation to the United States . This had been the dream of many settlers in Texas all along . They wanted to expand the United States west and saw Texas as the next logical step . Slaveholders there , such as Sam Houston , William B . Travis and James Bowie ( the latter two of whom died at the Alamo ) , believed too in the destiny of slavery . <hl> Mindful of the vicious debates over Missouri that had led to talk of disunion and war , American politicians were reluctant to annex Texas or , indeed , even to recognize it as a sovereign nation . <hl> <hl> Annexation would almost certainly mean war with Mexico , and the admission of a state with a large enslaved population , though permissible under the Missouri Compromise , would bring the issue of slavery once again to the fore . <hl> Texas had no choice but to organize itself as the independent Lone Star Republic . To protect itself from Mexican attempts to reclaim it , Texas sought and received recognition from France , Great Britain , Belgium , and the Netherlands . The United States did not officially recognize Texas as an independent nation until March 1837 , nearly a year after the final victory over the Mexican army at San Jacinto ."}, {"question": {"question_id": "fs-idp51074592", "question_text": "According to treaties signed in 1818 and 1827, with which country did the United States jointly occupy Oregon?", "question_choices": ["Great Britain", "Spain", "Mexico", "France"], "cloze_format": "The United States jointly occupied Oregan with ___ because of the treaties signed in 1818 and 1827.", "normal_format": "According to treaties signed in 1818 and 1827, with which country did the United States jointly occupy Oregon?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "President Polk \u2014 whose campaign slogan in 1844 had been \u201c Fifty-four forty or fight ! \u201d \u2014 asserted the United States \u2019 right to gain full control of what was known as Oregon Country , from its southern border at 42 \u00b0 latitude ( the current boundary with California ) to its northern border at 54 \u00b0 40 ' latitude . According to an 1818 agreement , Great Britain and the United States held joint ownership of this territory , but the 1827 Treaty of Joint Occupation opened the land to settlement by both countries .", "hl_context": "<hl> President Polk \u2014 whose campaign slogan in 1844 had been \u201c Fifty-four forty or fight ! \u201d \u2014 asserted the United States \u2019 right to gain full control of what was known as Oregon Country , from its southern border at 42 \u00b0 latitude ( the current boundary with California ) to its northern border at 54 \u00b0 40 ' latitude . <hl> <hl> According to an 1818 agreement , Great Britain and the United States held joint ownership of this territory , but the 1827 Treaty of Joint Occupation opened the land to settlement by both countries . <hl> Realizing that the British were not willing to cede all claims to the territory , Polk proposed the land be divided at 49 \u00b0 latitude ( the current border between Washington and Canada ) . The British , however , denied U . S . claims to land north of the Columbia River ( Oregon \u2019 s current northern border ) ( Figure 11.13 ) . Indeed , the British foreign secretary refused even to relay Polk \u2019 s proposal to London . However , reports of the difficulty Great Britain would face defending Oregon in the event of a U . S . attack , combined with concerns over affairs at home and elsewhere in its empire , quickly changed the minds of the British , and in June 1846 , Queen Victoria \u2019 s government agreed to a division at the forty-ninth parallel ."}, {"question": {"question_id": "fs-idm177707360", "question_text": "During the war between the United States and Mexico, revolts against U.S. control broke out in ________.", "question_choices": ["Florida and Texas", "New Mexico and California", "California and Texas", "Florida and California"], "cloze_format": "During the war between the United States and Mexico, revolts against U.S. control broke out in ________.", "normal_format": "During the war between the United States and Mexico, where did revolts against U.S. control break out in?"}, "answer": {"ans_text": "New Mexico and California", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Despite Kearny \u2019 s assurances that New Mexicans need not fear for their lives or their property , the region \u2019 s residents rose in revolt in January 1847 in an effort to drive the Americans away . General Stephen Watts Kearny , commander of the Army of the West , accepted the surrender of Santa Fe , New Mexico , and moved on to take control of California , leaving Colonel Sterling Price in command . U . S . military strategy had three main objectives : 1 ) Take control of northern Mexico , including New Mexico ; 2 ) seize California ; and 3 ) capture Mexico City . Then , following a revolt in California that left it divided in two , Polk attempted to purchase Upper California and New Mexico as well .", "hl_context": "<hl> Despite Kearny \u2019 s assurances that New Mexicans need not fear for their lives or their property , the region \u2019 s residents rose in revolt in January 1847 in an effort to drive the Americans away . <hl> Although Price managed to put an end to the rebellion , tensions remained high . Kearny , meanwhile , arrived in California to find it already in American hands through the joint efforts of California settlers , U . S . naval commander John D . Sloat , and John C . Fremont , a former army captain and son-in-law of Missouri senator Thomas Benton . Sloat , at anchor off the coast of Mazatlan , learned that war had begun and quickly set sail for California . He seized the town of Monterey in July 1846 , less than a month after a group of American settlers led by William B . Ide had taken control of Sonoma and declared California a republic . A week after the fall of Monterey , the navy took San Francisco with no resistance . Although some Californios staged a short-lived rebellion in September 1846 , many others submitted to the U . S . takeover . Thus Kearny had little to do other than take command of California as its governor . <hl> General Stephen Watts Kearny , commander of the Army of the West , accepted the surrender of Santa Fe , New Mexico , and moved on to take control of California , leaving Colonel Sterling Price in command . <hl> <hl> U . S . military strategy had three main objectives : 1 ) Take control of northern Mexico , including New Mexico ; 2 ) seize California ; and 3 ) capture Mexico City . <hl> General Zachary Taylor and his Army of the Center were assigned to accomplish the first goal , and with superior weapons they soon captured the Mexican city of Monterrey . Taylor quickly became a hero in the eyes of the American people , and Polk appointed him commander of all U . S . forces . In contrast to the diplomatic solution with Great Britain over Oregon , when it came to Mexico , Polk and the American people proved willing to use force to wrest more land for the United States . In keeping with voters \u2019 expectations , President Polk set his sights on the Mexican state of California . After the mistaken capture of Monterey , negotiations about purchasing the port of San Francisco from Mexico broke off until September 1845 . <hl> Then , following a revolt in California that left it divided in two , Polk attempted to purchase Upper California and New Mexico as well . <hl> These efforts went nowhere . The Mexican government , angered by U . S . actions , refused to recognize the independence of Texas ."}, {"question": {"question_id": "fs-idp21946928", "question_text": "The practice of allowing residents of territories to decide whether their land should be slave or free was called ________.", "question_choices": ["the democratic process", "the Wilmot Proviso", "popular sovereignty", "the Free Soil solution"], "cloze_format": "The practice of allowing residents of territories to decide whether their land should be slave or free was called ________.", "normal_format": "What was the practice of allowing residents of territories to decide whether their land should be slave or free called?"}, "answer": {"ans_text": "popular sovereignty", "ans_choice": 2}, "bloom": null, "hl_sentences": "Popular sovereignty was the belief that citizens should be able to decide issues based on the principle of majority rule ; in this case , residents of a territory should have the right to decide whether slavery would be allowed in it .", "hl_context": "At the national convention , both sets of delegates were seated \u2014 the pro-proviso ones chosen by the Barnburners and the anti-proviso ones chosen by the Hunkers . When it came time to vote for the party \u2019 s presidential nominee , the majority of votes were for Lewis Cass , an advocate of popular sovereignty . <hl> Popular sovereignty was the belief that citizens should be able to decide issues based on the principle of majority rule ; in this case , residents of a territory should have the right to decide whether slavery would be allowed in it . <hl> Theoretically , this doctrine would allow slavery to become established in any U . S . territory , including those from which it had been banned by earlier laws ."}, {"question": {"question_id": "fs-idm94828576", "question_text": "Which of the following was not a provision of the Compromise of 1850?", "question_choices": ["California was admitted as a free state.", "Slavery was abolished in Washington, DC.", "A stronger fugitive slave law was passed.", "Residents of New Mexico and Utah were to decide for themselves whether their territories would be slave or free."], "cloze_format": "___ was not a provision of the Compromise of 1850.", "normal_format": "Which of the following was not a provision of the Compromise of 1850?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "The border between Texas and New Mexico was established . Under a new fugitive slave law , those who helped escaped enslaved individuals or refused to assist in their return would be fined and possibly imprisoned . The slave trade was banned in the nation \u2019 s capital . Slavery , however , was allowed to remain . Popular sovereignty was to determine the status of slavery in New Mexico and Utah , even though Utah and part of New Mexico were north of the Missouri Compromise line . California , which was ready to enter the Union , was admitted as a free state in accordance with its state constitution . Beginning in January 1850 , Congress worked for eight months on a compromise that might quiet the growing sectional conflict . Led by the aged Henry Clay , members finally agreed to the following :", "hl_context": "5 . <hl> The border between Texas and New Mexico was established . <hl> 4 . <hl> Under a new fugitive slave law , those who helped escaped enslaved individuals or refused to assist in their return would be fined and possibly imprisoned . <hl> 3 . <hl> The slave trade was banned in the nation \u2019 s capital . <hl> <hl> Slavery , however , was allowed to remain . <hl> 2 . <hl> Popular sovereignty was to determine the status of slavery in New Mexico and Utah , even though Utah and part of New Mexico were north of the Missouri Compromise line . <hl> 1 . <hl> California , which was ready to enter the Union , was admitted as a free state in accordance with its state constitution . <hl> <hl> Beginning in January 1850 , Congress worked for eight months on a compromise that might quiet the growing sectional conflict . <hl> <hl> Led by the aged Henry Clay , members finally agreed to the following : <hl>"}], "summary": " Summary 11.1   Lewis and Clark \n\n In 1803, Thomas Jefferson appointed Meriwether Lewis to organize an expedition into the Louisiana Territory to explore and map the area but also to find an all-water route from the Missouri River to the Pacific Coast. The Louisiana Purchase and the journey of Lewis and Clark\u2019s Corps of Discovery captured the imagination of many, who dedicated themselves to the economic exploitation of the western lands and the expansion of American influence and power. In the South, the Adams-On\u00eds treaty legally secured Florida for the United States, though it did nothing to end the resistance of the Seminoles against American expansionists. At the same time, the treaty frustrated those Americans who considered Texas a part of the Louisiana Purchase. Taking matters into their own hands, some American settlers tried to take Texas by force. \n\n 11.2   The Missouri Crisis \n\n The Missouri Crisis created a division over slavery that profoundly and ominously shaped sectional identities and rivalries as never before. Conflict over the uneasy balance between slave and free states in Congress came to a head when Missouri petitioned to join the Union as a slave state in 1819, and the debate broadened from simple issues of representation to a critique of the morality of slavery. The debates also raised the specter of disunion and civil war, leading many, including Thomas Jefferson, to fear for the future of the republic. Under the Missouri Compromise, Missouri and Maine entered the Union at the same time, Maine as a free state, Missouri as a slave state, and a line was drawn across the remainder of the Louisiana territory north of which slavery was forbidden. \n\n 11.3   Independence for Texas \n\n The establishment of the Lone Star Republic formed a new chapter in the history of U.S. westward expansion. In contrast to the addition of the Louisiana Territory through diplomacy with France, Americans in Texas employed violence against Mexico to achieve their goals. Orchestrated largely by slaveholders, the acquisition of Texas appeared the next logical step in creating an American empire that included slavery. Nonetheless, with the Missouri Crisis in mind, the United States refused the Texans\u2019 request to enter the United States as a slave state in 1836. Instead, Texas formed an independent republic where slavery was legal. But American settlers there continued to press for more land. The strained relationship between expansionists in Texas and Mexico in the early 1840s hinted of things to come. \n\n 11.4   The Mexican-American War, 1846\u20131848 \n\n President James K. Polk\u2019s administration was a period of intensive expansion for the United States. After overseeing the final details regarding the annexation of Texas from Mexico, Polk negotiated a peaceful settlement with Great Britain regarding ownership of the Oregon Country, which brought the United States what are now the states of Washington and Oregon. The acquisition of additional lands from Mexico, a country many in the United States perceived as weak and inferior, was not so bloodless. The Mexican Cession added nearly half of Mexico\u2019s territory to the United States, including New Mexico and California, and established the U.S.-Mexico border at the Rio Grande. The California Gold Rush rapidly expanded the population of the new territory, but also prompted concerns over immigration, especially from China. \n\n 11.5   Free Soil or Slave? The Dilemma of the West \n\n The acquisition of lands from Mexico in 1848 reawakened debates regarding slavery. The suggestion that slavery be barred from the Mexican Cession caused rancorous debate between North and South and split the Democratic Party when many northern members left to create the Free-Soil Party. Although the Compromise of 1850 resolved the question of whether slavery would be allowed in the new territories, the solution pleased no one. The peace brought by the compromise was short-lived, and the debate over slavery continued. ", "keyterm": "", "bname": "u.s._history"}, {"chapter": 42, "intro": " Chapter Outline 42.1   Innate Immune Response 42.2   Adaptive Immune Response 42.3   Antibodies 42.4   Disruptions in the Immune System Introduction The environment consists of numerous  pathogens , which are agents, usually microorganisms, that cause diseases in their hosts. A  host  is the organism that is invaded and often harmed by a pathogen. Pathogens include bacteria, protists, fungi and other infectious organisms. We are constantly exposed to pathogens in food and water, on surfaces, and in the air. Mammalian immune systems evolved for protection from such pathogens; they are composed of an extremely diverse array of specialized cells and soluble molecules that coordinate a rapid and flexible defense system capable of providing protection from a majority of these disease agents. Components of the immune system constantly search the body for signs of pathogens. When pathogens are found, immune factors are mobilized to the site of an infection. The immune factors identify the nature of the pathogen, strengthen the corresponding cells and molecules to combat it efficiently, and then halt the immune response after the infection is cleared to avoid unnecessary host cell damage. The immune system can remember pathogens to which it has been exposed to create a more efficient response upon re-exposure. This memory can last several decades. Features of the immune system, such as pathogen identification, specific response, amplification, retreat, and remembrance are essential for survival against pathogens. The immune response can be classified as either innate or active. The innate immune response is always present and attempts to defend against all pathogens rather than focusing on specific ones. Conversely, the adaptive immune response stores information about past infections and mounts pathogen-specific defenses.    ", "chapter_text": "42.1   Innate Immune Response Learning Objectives By the end of this section, you will be able to:\n\n Describe physical and chemical immune barriers \n\n Explain immediate and induced innate immune responses \n\n Discuss natural killer cells \n\n Describe major histocompatibility class I molecules \n\n Summarize how the proteins in a complement system function to destroy extracellular pathogens \n\n The immune system comprises both innate and adaptive immune responses.  Innate immunity  occurs naturally because of genetic factors or physiology; it is not induced by infection or vaccination but works to reduce the workload for the adaptive immune response. Both the innate and adaptive levels of the immune response involve secreted proteins, receptor-mediated signaling, and intricate cell-to-cell communication. The innate immune system developed early in animal evolution, roughly a billion years ago, as an essential response to infection. Innate immunity has a limited number of specific targets: any pathogenic threat triggers a consistent sequence of events that can identify the type of pathogen and either clear the infection independently or mobilize a highly specialized adaptive immune response. For example, tears and mucus secretions contain microbicidal factors. \n\n Physical and Chemical Barriers \n\n Before any immune factors are triggered, the skin functions as a continuous, impassable barrier to potentially infectious pathogens. Pathogens are killed or inactivated on the skin by desiccation (drying out) and by the skin\u2019s acidity. In addition, beneficial microorganisms that coexist on the skin compete with invading pathogens, preventing infection. Regions of the body that are not protected by skin (such as the eyes and mucus membranes) have alternative methods of defense, such as tears and mucus secretions that trap and rinse away pathogens, and cilia in the nasal passages and respiratory tract that push the mucus with the pathogens out of the body. Throughout the body are other defenses, such as the low pH of the stomach (which inhibits the growth of pathogens), blood proteins that bind and disrupt bacterial cell membranes, and the process of urination (which flushes pathogens from the urinary tract). \n\n Despite these barriers, pathogens may enter the body through skin abrasions or punctures, or by collecting on mucosal surfaces in large numbers that overcome the mucus or cilia. Some pathogens have evolved specific mechanisms that allow them to overcome physical and chemical barriers. When pathogens do enter the body, the innate immune system responds with inflammation, pathogen engulfment, and secretion of immune factors and proteins. \n\n Pathogen Recognition \n\n An infection may be intracellular or extracellular, depending on the pathogen. All viruses infect cells and replicate within those cells (intracellularly), whereas bacteria and other parasites may replicate intracellularly or extracellularly, depending on the species. The innate immune system must respond accordingly: by identifying the extracellular pathogen and/or by identifying host cells that have already been infected. When a pathogen enters the body, cells in the blood and lymph detect the specific  pathogen-associated molecular patterns (PAMPs)  on the pathogen\u2019s surface. PAMPs are carbohydrate, polypeptide, and nucleic acid \u201csignatures\u201d that are expressed by viruses, bacteria, and parasites but which differ from molecules on host cells. The immune system has specific cells, described in  Figure 42.2  and shown in  Figure 42.3 , with receptors that recognize these PAMPs. A  macrophage  is a large phagocytic cell that engulfs foreign particles and pathogens. Macrophages recognize PAMPs via complementary  pattern recognition receptors (PRRs) . PRRs are molecules on macrophages and dendritic cells which are in contact with the external environment. A  monocyte  is a type of white blood cell that circulates in the blood and lymph and differentiates into macrophages after it moves into infected tissue. Dendritic cells bind molecular signatures of pathogens and promote pathogen engulfment and destruction. Toll-like receptors (TLRs) are a type of PRR that recognizes molecules that are shared by pathogens but distinguishable from host molecules). TLRs are present in invertebrates as well as vertebrates, and appear to be one of the most ancient components of the immune system. TLRs have also been identified in the mammalian nervous system. Cytokine Release Effect The binding of PRRs with PAMPs triggers the release of cytokines, which signal that a pathogen is present and needs to be destroyed along with any infected cells. A  cytokine  is a chemical messenger that regulates cell differentiation (form and function), proliferation (production), and gene expression to affect immune responses. At least 40 types of cytokines exist in humans that differ in terms of the cell type that produces them, the cell type that responds to them, and the changes they produce. One type cytokine, interferon, is illustrated in  Figure 42.4 . One subclass of cytokines is the interleukin (IL), so named because they mediate interactions between leukocytes (white blood cells). Interleukins are involved in bridging the innate and adaptive immune responses. In addition to being released from cells after PAMP recognition, cytokines are released by the infected cells which bind to nearby uninfected cells and induce those cells to release cytokines, which results in a cytokine burst. \n\n A second class of early-acting cytokines is interferons, which are released by infected cells as a warning to nearby uninfected cells. One of the functions of an  interferon  is to inhibit viral replication. They also have other important functions, such as tumor surveillance. Interferons work by signaling neighboring uninfected cells to destroy RNA and reduce protein synthesis, signaling neighboring infected cells to undergo apoptosis (programmed cell death), and activating immune cells. \n\n In response to interferons, uninfected cells alter their gene expression, which increases the cells\u2019 resistance to infection. One effect of interferon-induced gene expression is a sharply reduced cellular protein synthesis. Virally infected cells produce more viruses by synthesizing large quantities of viral proteins. Thus, by reducing protein synthesis, a cell becomes resistant to viral infection. \n\n Phagocytosis and Inflammation \n\n The first cytokines to be produced are pro-inflammatory; that is, they encourage  inflammation , the localized redness, swelling, heat, and pain that result from the movement of leukocytes and fluid through increasingly permeable capillaries to a site of infection. The population of leukocytes that arrives at an infection site depends on the nature of the infecting pathogen. Both macrophages and dendritic cells engulf pathogens and cellular debris through phagocytosis. A  neutrophil  is also a phagocytic leukocyte that engulfs and digests pathogens. Neutrophils, shown in  Figure 42.3 , are the most abundant leukocytes of the immune system. Neutrophils have a nucleus with two to five lobes, and they contain organelles, called lysosomes, that digest engulfed pathogens. An  eosinophil  is a leukocyte that works with other eosinophils to surround a parasite; it is involved in the allergic response and in protection against helminthes (parasitic worms). \n\n Neutrophils and eosinophils are particularly important leukocytes that engulf large pathogens, such as bacteria and fungi. A  mast cell  is a leukocyte that produces inflammatory molecules, such as histamine, in response to large pathogens. A  basophil  is a leukocyte that, like a neutrophil, releases chemicals to stimulate the inflammatory response as illustrated in  Figure 42.5 . Basophils are also involved in allergy and hypersensitivity responses and induce specific types of inflammatory responses. Eosinophils and basophils produce additional inflammatory mediators to recruit more leukocytes. A hypersensitive immune response to harmless antigens, such as in pollen, often involves the release of histamine by basophils and mast cells. Cytokines also send feedback to cells of the nervous system to bring about the overall symptoms of feeling sick, which include lethargy, muscle pain, and nausea. These effects may have evolved because the symptoms encourage the individual to rest and prevent them from spreading the infection to others. Cytokines also increase the core body temperature, causing a fever, which causes the liver to withhold iron from the blood. Without iron, certain pathogens, such as some bacteria, are unable to replicate; this is called nutritional immunity. \n\n Link to Learning \n\n Watch this 23-second stop-motion  video  showing a neutrophil that searches for and engulfs fungus spores during an elapsed time of about 79 minutes. \n\n Natural Killer Cells \n\n Lymphocytes  are leukocytes that are histologically identifiable by their large, darkly staining nuclei; they are small cells with very little cytoplasm, as shown in  Figure 42.6 . Infected cells are identified and destroyed by  natural killer (NK) cells , lymphocytes that can kill cells infected with viruses or tumor cells (abnormal cells that uncontrollably divide and invade other tissue). T cells and B cells of the adaptive immune system also are classified as lymphocytes.  T cells  are lymphocytes that mature in the thymus gland, and  B cells  are lymphocytes that mature in the bone marrow. NK cells identify intracellular infections, especially from viruses, by the altered expression of  major histocompatibility class (MHC) I molecules  on the surface of infected cells. MHC I molecules are proteins on the surfaces of all nucleated cells, thus they are scarce on red blood cells and platelets which are non-nucleated. The function of MHC I molecules is to display fragments of proteins from the infectious agents within the cell to T-cells; healthy cells will be ignored, while \u201cnon-self\u201d or foreign proteins will be attacked by the immune system. MHC II molecules are found mainly on cells containing antigens (\u201cnon-self proteins\u201d) and on lymphocytes.  MHC II molecules  interact with helper T-cells to trigger the appropriate immune response, which may include the inflammatory response. An infected cell (or a tumor cell) is usually incapable of synthesizing and displaying MHC I molecules appropriately. The metabolic resources of cells infected by some viruses produce proteins that interfere with MHC I processing and/or trafficking to the cell surface. The reduced MHC I on host cells varies from virus to virus and results from active inhibitors being produced by the viruses. This process can deplete host MHC I molecules on the cell surface, which NK cells detect as \u201cunhealthy\u201d or \u201cabnormal\u201d while searching for cellular MHC I molecules. Similarly, the dramatically altered gene expression of tumor cells leads to expression of extremely deformed or absent MHC I molecules that also signal \u201cunhealthy\u201d or \u201cabnormal.\u201d \n\n NK cells are always active; an interaction with normal, intact MHC I molecules on a healthy cell disables the killing sequence, and the NK cell moves on. After the NK cell detects an infected or tumor cell, its cytoplasm secretes granules comprised of  perforin , a destructive protein that creates a pore in the target cell. Granzymes are released along with the perforin in the immunological synapse. A  granzyme  is a protease that digests cellular proteins and induces the target cell to undergo programmed cell death, or apoptosis. Phagocytic cells then digest the cell debris left behind. NK cells are constantly patrolling the body and are an effective mechanism for controlling potential infections and preventing cancer progression. \n\n Complement \n\n An array of approximately 20 types of soluble proteins, called a  complement system , functions to destroy extracellular pathogens. Cells of the liver and macrophages synthesize complement proteins continuously; these proteins are abundant in the blood serum and are capable of responding immediately to infecting microorganisms. The complement system is so named because it is complementary to the antibody response of the adaptive immune system. Complement proteins bind to the surfaces of microorganisms and are particularly attracted to pathogens that are already bound by antibodies. Binding of complement proteins occurs in a specific and highly regulated sequence, with each successive protein being activated by cleavage and/or structural changes induced upon binding of the preceding protein(s). After the first few complement proteins bind, a cascade of sequential binding events follows in which the pathogen rapidly becomes coated in complement proteins. \n\n Complement proteins perform several functions. The proteins serve as a marker to indicate the presence of a pathogen to phagocytic cells, such as macrophages and B cells, and enhance engulfment; this process is called  opsonization . Certain complement proteins can combine to form attack complexes that open pores in microbial cell membranes. These structures destroy pathogens by causing their contents to leak, as illustrated in  Figure 42.7 . \n42.2   Adaptive Immune Response Learning Objectives By the end of this section, you will be able to:\n\n Explain adaptive immunity \n\n Compare and contrast adaptive and innate immunity \n\n Describe cell-mediated immune response and humoral immune response \n\n Describe immune tolerance \n\n The adaptive, or acquired, immune response takes days or even weeks to become established\u2014much longer than the innate response; however, adaptive immunity is more specific to pathogens and has memory.  Adaptive immunity  is an immunity that occurs after exposure to an antigen either from a pathogen or a vaccination. This part of the immune system is activated when the innate immune response is insufficient to control an infection. In fact, without information from the innate immune system, the adaptive response could not be mobilized. There are two types of adaptive responses: the  cell-mediated immune response , which is carried out by T cells, and the  humoral immune response , which is controlled by activated B cells and antibodies. Activated T cells and B cells that are specific to molecular structures on the pathogen proliferate and attack the invading pathogen. Their attack can kill pathogens directly or secrete antibodies that enhance the phagocytosis of pathogens and disrupt the infection. Adaptive immunity also involves a memory to provide the host with long-term protection from reinfection with the same type of pathogen; on re-exposure, this memory will facilitate an efficient and quick response. \n\n Antigen-presenting Cells Unlike NK cells of the innate immune system, B cells (B lymphocytes) are a type of white blood cell that gives rise to antibodies, whereas T cells (T lymphocytes) are a type of white blood cell that plays an important role in the immune response. T cells are a key component in the cell-mediated response\u2014the specific immune response that utilizes T cells to neutralize cells that have been infected with viruses and certain bacteria. There are three types of T cells: cytotoxic, helper, and suppressor T cells. Cytotoxic T cells destroy virus-infected cells in the cell-mediated immune response, and helper T cells play a part in activating both the antibody and the cell-mediated immune responses. Suppressor T cells deactivate T cells and B cells when needed, and thus prevent the immune response from becoming too intense. \n\n An  antigen  is a foreign or \u201cnon-self\u201d macromolecule that reacts with cells of the immune system. Not all antigens will provoke a response. For instance, individuals produce innumerable \u201cself\u201d antigens and are constantly exposed to harmless foreign antigens, such as food proteins, pollen, or dust components. The suppression of immune responses to harmless macromolecules is highly regulated and typically prevents processes that could be damaging to the host, known as tolerance. \n\n The innate immune system contains cells that detect potentially harmful antigens, and then inform the adaptive immune response about the presence of these antigens. An  antigen-presenting cell (APC)  is an immune cell that detects, engulfs, and informs the adaptive immune response about an infection. When a pathogen is detected, these APCs will phagocytose the pathogen and digest it to form many different fragments of the antigen. Antigen fragments will then be transported to the surface of the APC, where they will serve as an indicator to other immune cells.  Dendritic cells  are immune cells that process antigen material; they are present in the skin (Langerhans cells) and the lining of the nose, lungs, stomach, and intestines. Sometimes a dendritic cell presents on the surface of other cells to induce an immune response, thus functioning as an antigen-presenting cell. Macrophages also function as APCs. Before activation and differentiation, B cells can also function as APCs. \n\n After phagocytosis by APCs, the phagocytic vesicle fuses with an intracellular lysosome forming phagolysosome. Within the phagolysosome, the components are broken down into fragments; the fragments are then loaded onto MHC class I or MHC class II molecules and are transported to the cell surface for antigen presentation, as illustrated in  Figure 42.8 . Note that T lymphocytes cannot properly respond to the antigen unless it is processed and embedded in an MHC II molecule. APCs express MHC on their surfaces, and when combined with a foreign antigen, these complexes signal a \u201cnon-self\u201d invader. Once the fragment of antigen is embedded in the MHC II molecule, the immune cell can respond. Helper T- cells are one of the main lymphocytes that respond to antigen-presenting cells. Recall that all other nucleated cells of the body expressed MHC I molecules, which signal \u201chealthy\u201d or \u201cnormal.\u201d Link to Learning \n\n This  animation  from Rockefeller University shows how dendritic cells act as sentinels in the body's immune system. \n\n T and B Lymphocytes \n\n Lymphocytes in human circulating blood are approximately 80 to 90 percent T cells, shown in  Figure 42.9 , and 10 to 20 percent B cells. Recall that the T cells are involved in the cell-mediated immune response, whereas B cells are part of the humoral immune response. \n\n T cells encompass a heterogeneous population of cells with extremely diverse functions. Some T cells respond to APCs of the innate immune system, and indirectly induce immune responses by releasing cytokines. Other T cells stimulate B cells to prepare their own response. Another population of T cells detects APC signals and directly kills the infected cells. Other T cells are involved in suppressing inappropriate immune reactions to harmless or \u201cself\u201d antigens. \n\n T and B cells exhibit a common theme of recognition/binding of specific antigens via a complementary receptor, followed by activation and self-amplification/maturation to specifically bind to the particular antigen of the infecting pathogen. T and B lymphocytes are also similar in that each cell only expresses one type of antigen receptor. Any individual may possess a population of T and B cells that together express a near limitless variety of antigen receptors that are capable of recognizing virtually any infecting pathogen. T and B cells are activated when they recognize small components of antigens, called  epitopes , presented by APCs, illustrated in  Figure 42.10 . Note that recognition occurs at a specific epitope rather than on the entire antigen; for this reason, epitopes are known as \u201cantigenic determinants.\u201d In the absence of information from APCs, T and B cells remain inactive, or na\u00efve, and are unable to prepare an immune response. The requirement for information from the APCs of innate immunity to trigger B cell or T cell activation illustrates the essential nature of the innate immune response to the functioning of the entire immune system. \n\n Na\u00efve T cells can express one of two different molecules, CD4 or CD8, on their surface, as shown in  Figure 42.11 , and are accordingly classified as CD4 +  or CD8 +  cells. These molecules are important because they regulate how a T cell will interact with and respond to an APC. Na\u00efve CD4 +  cells bind APCs via their antigen-embedded MHC II molecules and are stimulated to become  helper T (T H ) lymphocytes , cells that go on to stimulate B cells (or cytotoxic T cells) directly or secrete cytokines to inform more and various target cells about the pathogenic threat. In contrast, CD8 +  cells engage antigen-embedded MHC I molecules on APCs and are stimulated to become  cytotoxic T lymphocytes (CTLs) , which directly kill infected cells by apoptosis and emit cytokines to amplify the immune response. The two populations of T cells have different mechanisms of immune protection, but both bind MHC molecules via their antigen receptors called T cell receptors (TCRs). The CD4 or CD8 surface molecules differentiate whether the TCR will engage an MHC II or an MHC I molecule. Because they assist in binding specificity, the CD4 and CD8 molecules are described as coreceptors. \n\n Visual Connection \n\n Which of the following statements about T cells is false? \n\n Helper T cells release cytokines while cytotoxic T cells kill the infected cell. \n\n Helper T cells are CD4 + , while cytotoxic T cells are CD8 + . \n\n MHC II is a receptor found on most body cells, while MHC I is a receptor found on immune cells only. \n\n The T cell receptor is found on both CD4 +  and CD8 +  T cells. \n\n Consider the innumerable possible antigens that an individual will be exposed to during a lifetime. The mammalian adaptive immune system is adept in responding appropriately to each antigen. Mammals have an enormous diversity of T cell populations, resulting from the diversity of TCRs. Each TCR consists of two polypeptide chains that span the T cell membrane, as illustrated in  Figure 42.12 ; the chains are linked by a disulfide bridge. Each polypeptide chain is comprised of a constant domain and a variable domain: a domain, in this sense, is a specific region of a protein that may be regulatory or structural. The intracellular domain is involved in intracellular signaling. A single T cell will express thousands of identical copies of one specific TCR variant on its cell surface. The specificity of the adaptive immune system occurs because it synthesizes millions of different T cell populations, each expressing a TCR that differs in its variable domain. This TCR diversity is achieved by the mutation and recombination of genes that encode these receptors in stem cell precursors of T cells. The binding between an antigen-displaying MHC molecule and a complementary TCR \u201cmatch\u201d indicates that the adaptive immune system needs to activate and produce that specific T cell because its structure is appropriate to recognize and destroy the invading pathogen. \n\n Helper T Lymphocytes \n\n The T H  lymphocytes function indirectly to identify potential pathogens for other cells of the immune system. These cells are important for extracellular infections, such as those caused by certain bacteria, helminths, and protozoa. T H  lymphocytes recognize specific antigens displayed in the MHC II complexes of APCs. There are two major populations of T H  cells: T H 1 and T H 2. T H 1 cells secrete cytokines to enhance the activities of macrophages and other T cells. T H 1 cells activate the action of cyotoxic T cells, as well as macrophages. T H 2 cells stimulate na\u00efve B cells to destroy foreign invaders via antibody secretion. Whether a T H 1 or a T H 2 immune response develops depends on the specific types of cytokines secreted by cells of the innate immune system, which in turn depends on the nature of the invading pathogen. The T H 1-mediated response involves macrophages and is associated with inflammation. Recall the frontline defenses of macrophages involved in the innate immune response. Some intracellular bacteria, such as  Mycobacterium tuberculosis , have evolved to multiply in macrophages after they have been engulfed. These pathogens evade attempts by macrophages to destroy and digest the pathogen. When  M. tuberculosis  infection occurs, macrophages can stimulate na\u00efve T cells to become T H 1 cells. These stimulated T cells secrete specific cytokines that send feedback to the macrophage to stimulate its digestive capabilities and allow it to destroy the colonizing  M. tuberculosis . In the same manner, T H 1-activated macrophages also become better suited to ingest and kill tumor cells. In summary; T H 1 responses are directed toward intracellular invaders while T H 2 responses are aimed at those that are extracellular. \n\n B Lymphocytes \n\n When stimulated by the T H 2 pathway, na\u00efve B cells differentiate into antibody-secreting plasma cells. A  plasma cell  is an immune cell that secrets antibodies; these cells arise from B cells that were stimulated by antigens. Similar to T cells, na\u00efve B cells initially are coated in thousands of B cell receptors (BCRs), which are membrane-bound forms of Ig (immunoglobulin, or an antibody). The B cell receptor has two heavy chains and two light chains connected by disulfide linkages. Each chain has a constant and a variable region; the latter is involved in antigen binding. Two other membrane proteins, Ig alpha and Ig beta, are involved in signaling. The receptors of any particular B cell, as shown in  Figure 42.13  are all the same, but the hundreds of millions of different B cells in an individual have distinct recognition domains that contribute to extensive diversity in the types of molecular structures to which they can bind. In this state, B cells function as APCs. They bind and engulf foreign antigens via their BCRs and then display processed antigens in the context of MHC II molecules to T H 2 cells. When a T H 2 cell detects that a B cell is bound to a relevant antigen, it secretes specific cytokines that induce the B cell to proliferate rapidly, which makes thousands of identical (clonal) copies of it, and then it synthesizes and secretes antibodies with the same antigen recognition pattern as the BCRs. The activation of B cells corresponding to one specific BCR variant and the dramatic proliferation of that variant is known as  clonal selection . This phenomenon drastically, but briefly, changes the proportions of BCR variants expressed by the immune system, and shifts the balance toward BCRs specific to the infecting pathogen. \n\n T and B cells differ in one fundamental way: whereas T cells bind antigens that have been digested and embedded in MHC molecules by APCs, B cells function as APCs that bind intact antigens that have not been processed. Although T and B cells both react with molecules that are termed \u201cantigens,\u201d these lymphocytes actually respond to very different types of molecules. B cells must be able to bind intact antigens because they secrete antibodies that must recognize the pathogen directly, rather than digested remnants of the pathogen. Bacterial carbohydrate and lipid molecules can activate B cells independently from the T cells. \n\n Cytotoxic T Lymphocytes \n\n CTLs, a subclass of T cells, function to clear infections directly. The cell-mediated part of the adaptive immune system consists of CTLs that attack and destroy infected cells. CTLs are particularly important in protecting against viral infections; this is because viruses replicate within cells where they are shielded from extracellular contact with circulating antibodies. When APCs phagocytize pathogens and present MHC I-embedded antigens to na\u00efve CD8 +  T cells that express complementary TCRs, the CD8 +  T cells become activated to proliferate according to clonal selection. These resulting CTLs then identify non-APCs displaying the same MHC I-embedded antigens (for example, viral proteins)\u2014for example, the CTLs identify infected host cells. \n\n Intracellularly, infected cells typically die after the infecting pathogen replicates to a sufficient concentration and lyses the cell, as many viruses do. CTLs attempt to identify and destroy infected cells before the pathogen can replicate and escape, thereby halting the progression of intracellular infections. CTLs also support NK lymphocytes to destroy early cancers. Cytokines secreted by the T H 1 response that stimulates macrophages also stimulate CTLs and enhance their ability to identify and destroy infected cells and tumors. \n\n CTLs sense MHC I-embedded antigens by directly interacting with infected cells via their TCRs. Binding of TCRs with antigens activates CTLs to release perforin and granzyme, degradative enzymes that will induce apoptosis of the infected cell. Recall that this is a similar destruction mechanism to that used by NK cells. In this process, the CTL does not become infected and is not harmed by the secretion of perforin and granzymes. In fact, the functions of NK cells and CTLs are complementary and maximize the removal of infected cells, as illustrated in  Figure 42.14 . If the NK cell cannot identify the \u201cmissing self\u201d pattern of down-regulated MHC I molecules, then the CTL can identify it by the complex of MHC I with foreign antigens, which signals \u201caltered self.\u201d Similarly, if the CTL cannot detect antigen-embedded MHC I because the receptors are depleted from the cell surface, NK cells will destroy the cell instead. CTLs also emit cytokines, such as interferons, that alter surface protein expression in other infected cells, such that the infected cells can be easily identified and destroyed. Moreover, these interferons can also prevent virally infected cells from releasing virus particles. \n\n Visual Connection \n\n Based on what you know about MHC receptors, why do you think an organ transplanted from an incompatible donor to a recipient will be rejected? \n\n Plasma cells and CTLs are collectively called  effector cells : they represent differentiated versions of their na\u00efve counterparts, and they are involved in bringing about the immune defense of killing pathogens and infected host cells. \n\n Mucosal Surfaces and Immune Tolerance \n\n The innate and adaptive immune responses discussed thus far comprise the systemic immune system (affecting the whole body), which is distinct from the mucosal immune system. Mucosal immunity is formed by mucosa-associated lymphoid tissue, which functions independently of the systemic immune system, and which has its own innate and adaptive components.  Mucosa-associated lymphoid tissue (MALT) , illustrated in  Figure 42.15 , is a collection of lymphatic tissue that combines with epithelial tissue lining the mucosa throughout the body. This tissue functions as the immune barrier and response in areas of the body with direct contact to the external environment. The systemic and mucosal immune systems use many of the same cell types. Foreign particles that make their way to MALT are taken up by absorptive epithelial cells called M cells and delivered to APCs located directly below the mucosal tissue. M cells function in the transport described, and are located in the Peyer\u2019s patch, a lymphoid nodule. APCs of the mucosal immune system are primarily dendritic cells, with B cells and macrophages having minor roles. Processed antigens displayed on APCs are detected by T cells in the MALT and at various mucosal induction sites, such as the tonsils, adenoids, appendix, or the mesenteric lymph nodes of the intestine. Activated T cells then migrate through the lymphatic system and into the circulatory system to mucosal sites of infection. \n\n MALT is a crucial component of a functional immune system because mucosal surfaces, such as the nasal passages, are the first tissues onto which inhaled or ingested pathogens are deposited. The mucosal tissue includes the mouth, pharynx, and esophagus, and the gastrointestinal, respiratory, and urogenital tracts. \n\n The immune system has to be regulated to prevent wasteful, unnecessary responses to harmless substances, and more importantly so that it does not attack \u201cself.\u201d The acquired ability to prevent an unnecessary or harmful immune response to a detected foreign substance known not to cause disease is described as  immune tolerance . Immune tolerance is crucial for maintaining mucosal homeostasis given the tremendous number of foreign substances (such as food proteins) that APCs of the oral cavity, pharynx, and gastrointestinal mucosa encounter. Immune tolerance is brought about by specialized APCs in the liver, lymph nodes, small intestine, and lung that present harmless antigens to an exceptionally diverse population of  regulatory T (T reg ) cells , specialized lymphocytes that suppress local inflammation and inhibit the secretion of stimulatory immune factors. The combined result of T reg  cells is to prevent immunologic activation and inflammation in undesired tissue compartments and to allow the immune system to focus on pathogens instead. In addition to promoting immune tolerance of harmless antigens, other subsets of T reg  cells are involved in the prevention of the  autoimmune response , which is an inappropriate immune response to host cells or self-antigens. Another T reg  class suppresses immune responses to harmful pathogens after the infection has cleared to minimize host cell damage induced by inflammation and cell lysis. \n\n Immunological Memory \n\n The adaptive immune system possesses a memory component that allows for an efficient and dramatic response upon reinvasion of the same pathogen. Memory is handled by the adaptive immune system with little reliance on cues from the innate response. During the adaptive immune response to a pathogen that has not been encountered before, called a primary response, plasma cells secreting antibodies and differentiated T cells increase, then plateau over time. As B and T cells mature into effector cells, a subset of the na\u00efve populations differentiates into B and T memory cells with the same antigen specificities, as illustrated in  Figure 42.16 . \n\n A  memory cell  is an antigen-specific B or T lymphocyte that does not differentiate into effector cells during the primary immune response, but that can immediately become effector cells upon re-exposure to the same pathogen. During the primary immune response, memory cells do not respond to antigens and do not contribute to host defenses. As the infection is cleared and pathogenic stimuli subside, the effectors are no longer needed, and they undergo apoptosis. In contrast, the memory cells persist in the circulation. \n\n Visual Connection \n\n The Rh antigen is found on Rh-positive red blood cells. An Rh-negative female can usually carry an Rh-positive fetus to term without difficulty. However, if she has a second Rh-positive fetus, her body may launch an immune attack that causes hemolytic disease of the newborn. Why do you think hemolytic disease is only a problem during the second or subsequent pregnancies? \n\n If the pathogen is never encountered again during the individual\u2019s lifetime, B and T memory cells will circulate for a few years or even several decades and will gradually die off, having never functioned as effector cells. However, if the host is re-exposed to the same pathogen type, circulating memory cells will immediately differentiate into plasma cells and CTLs without input from APCs or T H  cells. One reason the adaptive immune response is delayed is because it takes time for na\u00efve B and T cells with the appropriate antigen specificities to be identified and activated. Upon reinfection, this step is skipped, and the result is a more rapid production of immune defenses. Memory B cells that differentiate into plasma cells output tens to hundreds-fold greater antibody amounts than were secreted during the primary response, as the graph in  Figure 42.17  illustrates. This rapid and dramatic antibody response may stop the infection before it can even become established, and the individual may not realize they had been exposed. \n\n Vaccination is based on the knowledge that exposure to noninfectious antigens, derived from known pathogens, generates a mild primary immune response. The immune response to vaccination may not be perceived by the host as illness but still confers immune memory. When exposed to the corresponding pathogen to which an individual was vaccinated, the reaction is similar to a secondary exposure. Because each reinfection generates more memory cells and increased resistance to the pathogen, and because some memory cells die, certain vaccine courses involve one or more booster vaccinations to mimic repeat exposures: for instance, tetanus boosters are necessary every ten years because the memory cells only live that long. \n\n Mucosal Immune Memory \n\n A subset of T and B cells of the mucosal immune system differentiates into memory cells just as in the systemic immune system. Upon reinvasion of the same pathogen type, a pronounced immune response occurs at the mucosal site where the original pathogen deposited, but a collective defense is also organized within interconnected or adjacent mucosal tissue. For instance, the immune memory of an infection in the oral cavity would also elicit a response in the pharynx if the oral cavity was exposed to the same pathogen. \n\n Career Connection Vaccinologist \n\n Vaccination (or immunization) involves the delivery, usually by injection as shown in  Figure 42.18 , of noninfectious antigen(s) derived from known pathogens. Other components, called adjuvants, are delivered in parallel to help stimulate the immune response. Immunological memory is the reason vaccines work. Ideally, the effect of vaccination is to elicit immunological memory, and thus resistance to specific pathogens without the individual having to experience an infection. \n\n Vaccinologists are involved in the process of vaccine development from the initial idea to the availability of the completed vaccine. This process can take decades, can cost millions of dollars, and can involve many obstacles along the way. For instance, injected vaccines stimulate the systemic immune system, eliciting humoral and cell-mediated immunity, but have little effect on the mucosal response, which presents a challenge because many pathogens are deposited and replicate in mucosal compartments, and the injection does not provide the most efficient immune memory for these disease agents. For this reason, vaccinologists are actively involved in developing new vaccines that are applied via intranasal, aerosol, oral, or transcutaneous (absorbed through the skin) delivery methods. Importantly, mucosal-administered vaccines elicit both mucosal and systemic immunity and produce the same level of disease resistance as injected vaccines. \n\n Currently, a version of intranasal influenza vaccine is available, and the polio and typhoid vaccines can be administered orally, as shown in  Figure 42.19 . Similarly, the measles and rubella vaccines are being adapted to aerosol delivery using inhalation devices. Eventually, transgenic plants may be engineered to produce vaccine antigens that can be eaten to confer disease resistance. Other vaccines may be adapted to rectal or vaginal application to elicit immune responses in rectal, genitourinary, or reproductive mucosa. Finally, vaccine antigens may be adapted to transdermal application in which the skin is lightly scraped and microneedles are used to pierce the outermost layer. In addition to mobilizing the mucosal immune response, this new generation of vaccines may end the anxiety associated with injections and, in turn, improve patient participation. \n\n Primary Centers of the Immune System \n\n Although the immune system is characterized by circulating cells throughout the body, the regulation, maturation, and intercommunication of immune factors occur at specific sites. The blood circulates immune cells, proteins, and other factors through the body. Approximately 0.1 percent of all cells in the blood are leukocytes, which encompass monocytes (the precursor of macrophages) and lymphocytes. The majority of cells in the blood are erythrocytes (red blood cells).  Lymph  is a watery fluid that bathes tissues and organs with protective white blood cells and does not contain erythrocytes. Cells of the immune system can travel between the distinct lymphatic and blood circulatory systems, which are separated by interstitial space, by a process called extravasation (passing through to surrounding tissue). \n\n The cells of the immune system originate from hematopoietic stem cells in the bone marrow. Cytokines stimulate these stem cells to differentiate into immune cells. B cell maturation occurs in the bone marrow, whereas na\u00efve T cells transit from the bone marrow to the thymus for maturation. In the thymus, immature T cells that express TCRs complementary to self-antigens are destroyed. This process helps prevent autoimmune responses. \n\n On maturation, T and B lymphocytes circulate to various destinations. Lymph nodes scattered throughout the body, as illustrated in  Figure 42.20 , house large populations of T and B cells, dendritic cells, and macrophages. Lymph gathers antigens as it drains from tissues. These antigens then are filtered through lymph nodes before the lymph is returned to circulation. APCs in the lymph nodes capture and process antigens and inform nearby lymphocytes about potential pathogens. The spleen houses B and T cells, macrophages, dendritic cells, and NK cells. The spleen, shown in  Figure 42.21 , is the site where APCs that have trapped foreign particles in the blood can communicate with lymphocytes. Antibodies are synthesized and secreted by activated plasma cells in the spleen, and the spleen filters foreign substances and antibody-complexed pathogens from the blood. Functionally, the spleen is to the blood as lymph nodes are to the lymph. \n42.3   Antibodies Learning Objectives By the end of this section, you will be able to:\n\n Explain cross-reactivity \n\n Describe the structure and function of antibodies  \n\n Discuss antibody production \n\n An  antibody , also known as an immunoglobulin (Ig), is a protein that is produced by plasma cells after stimulation by an antigen. Antibodies are the functional basis of humoral immunity. Antibodies occur in the blood, in gastric and mucus secretions, and in breast milk. Antibodies in these bodily fluids can bind pathogens and mark them for destruction by phagocytes before they can infect cells. \n\n Antibody Structure \n\n An antibody molecule is comprised of four polypeptides: two identical heavy chains (large peptide units) that are partially bound to each other in a \u201cY\u201d formation, which are flanked by two identical light chains (small peptide units), as illustrated in  Figure 42.22 . Bonds between the cysteine amino acids in the antibody molecule attach the polypeptides to each other. The areas where the antigen is recognized on the antibody are variable domains and the antibody base is composed of constant domains. \n\n In germ-line B cells, the variable region of the light chain gene has 40 variable (V) and five joining (J) segments. An enzyme called DNA recombinase randomly excises most of these segments out of the gene, and splices one V segment to one J segment. During RNA processing, all but one V and J segment are spliced out. Recombination and splicing may result in over 10 6  possible VJ combinations. As a result, each differentiated B cell in the human body typically has a unique variable chain. The constant domain, which does not bind antibody, is the same for all antibodies. \n\n Similar to TCRs and BCRs, antibody diversity is produced by the mutation and recombination of approximately 300 different gene segments encoding the light and heavy chain variable domains in precursor cells that are destined to become B cells. The variable domains from the heavy and light chains interact to form the binding site through which an antibody can bind a specific epitope on an antigen. The numbers of repeated constant domains in Ig classes are the same for all antibodies corresponding to a specific class. Antibodies are structurally similar to the extracellular component of the BCRs, and B cell maturation to plasma cells can be visualized in simple terms as the cell acquires the ability to secrete the extracellular portion of its BCR in large quantities. \n\n Antibody Classes \n\n Antibodies can be divided into five classes\u2014IgM, IgG, IgA, IgD, IgE\u2014based on their physiochemical, structural, and immunological properties. IgGs, which make up about 80 percent of all antibodies, have heavy chains that consist of one variable domain and three identical constant domains. IgA and IgD also have three constant domains per heavy chain, whereas IgM and IgE each have four constant domains per heavy chain. The variable domain determines binding specificity and the constant domain of the heavy chain determines the immunological mechanism of action of the corresponding antibody class. It is possible for two antibodies to have the same binding specificities but be in different classes and, therefore, to be involved in different functions. \n\n After an adaptive defense is produced against a pathogen, typically plasma cells first secrete IgM into the blood. BCRs on na\u00efve B cells are of the IgM class and occasionally IgD class. IgM molecules make up approximately ten percent of all antibodies. Prior to antibody secretion, plasma cells assemble IgM molecules into pentamers (five individual antibodies) linked by a joining (J) chain, as shown in  Figure 42.23 . The pentamer arrangement means that these macromolecules can bind ten identical antigens. However, IgM molecules released early in the adaptive immune response do not bind to antigens as stably as IgGs, which are one of the possible types of antibodies secreted in large quantities upon re-exposure to the same pathogen.  Figure 42.23  summarizes the properties of immunoglobulins and illustrates their basic structures. \n\n IgAs populate the saliva, tears, breast milk, and mucus secretions of the gastrointestinal, respiratory, and genitourinary tracts. Collectively, these bodily fluids coat and protect the extensive mucosa (4000 square feet in humans). The total number of IgA molecules in these bodily secretions is greater than the number of IgG molecules in the blood serum. A small amount of IgA is also secreted into the serum in monomeric form. Conversely, some IgM is secreted into bodily fluids of the mucosa. Similar to IgM, IgA molecules are secreted as polymeric structures linked with a J chain. However, IgAs are secreted mostly as dimeric molecules, not pentamers. \n\n IgE is present in the serum in small quantities and is best characterized in its role as an allergy mediator. IgD is also present in small quantities. Similar to IgM, BCRs of the IgD class are found on the surface of na\u00efve B cells. This class supports antigen recognition and maturation of B cells to plasma cells. \n\n Antibody Functions \n\n Differentiated plasma cells are crucial players in the humoral response, and the antibodies they secrete are particularly significant against extracellular pathogens and toxins. Antibodies circulate freely and act independently of plasma cells. Antibodies can be transferred from one individual to another to temporarily protect against infectious disease. For instance, a person who has recently produced a successful immune response against a particular disease agent can donate blood to a nonimmune recipient and confer temporary immunity through antibodies in the donor\u2019s blood serum. This phenomenon is called  passive immunity ; it also occurs naturally during breastfeeding, which makes breastfed infants highly resistant to infections during the first few months of life. \n\n Antibodies coat extracellular pathogens and neutralize them, as illustrated in  Figure 42.24 , by blocking key sites on the pathogen that enhance their infectivity (such as receptors that \u201cdock\u201d pathogens on host cells). Antibody neutralization can prevent pathogens from entering and infecting host cells, as opposed to the CTL-mediated approach of killing cells that are already infected to prevent progression of an established infection. The neutralized antibody-coated pathogens can then be filtered by the spleen and eliminated in urine or feces. \n\n Antibodies also mark pathogens for destruction by phagocytic cells, such as macrophages or neutrophils, because phagocytic cells are highly attracted to macromolecules complexed with antibodies. Phagocytic enhancement by antibodies is called opsonization. In a process called complement fixation, IgM and IgG in serum bind to antigens and provide docking sites onto which sequential complement proteins can bind. The combination of antibodies and complement enhances opsonization even further and promotes rapid clearing of pathogens. \n\n Affinity, Avidity, and Cross Reactivity \n\n Not all antibodies bind with the same strength, specificity, and stability. In fact, antibodies exhibit different  affinities  (attraction) depending on the molecular complementarity between antigen and antibody molecules, as illustrated in  Figure 42.25 . An antibody with a higher affinity for a particular antigen would bind more strongly and stably, and thus would be expected to present a more challenging defense against the pathogen corresponding to the specific antigen. \n\n The term  avidity  describes binding by antibody classes that are secreted as joined, multivalent structures (such as IgM and IgA). Although avidity measures the strength of binding, just as affinity does, the avidity is not simply the sum of the affinities of the antibodies in a multimeric structure. The avidity depends on the number of identical binding sites on the antigen being detected, as well as other physical and chemical factors. Typically, multimeric antibodies, such as pentameric IgM, are classified as having lower affinity than monomeric antibodies, but high avidity. Essentially, the fact that multimeric antibodies can bind many antigens simultaneously balances their slightly lower binding strength for each antibody/antigen interaction. \n\n Antibodies secreted after binding to one epitope on an antigen may exhibit cross reactivity for the same or similar epitopes on different antigens. Because an epitope corresponds to such a small region (the surface area of about four to six amino acids), it is possible for different macromolecules to exhibit the same molecular identities and orientations over short regions.  Cross reactivity  describes when an antibody binds not to the antigen that elicited its synthesis and secretion, but to a different antigen. \n\n Cross reactivity can be beneficial if an individual develops immunity to several related pathogens despite having only been exposed to or vaccinated against one of them. For instance, antibody cross reactivity may occur against the similar surface structures of various Gram-negative bacteria. Conversely, antibodies raised against pathogenic molecular components that resemble self molecules may incorrectly mark host cells for destruction and cause autoimmune damage. Patients who develop systemic lupus erythematosus (SLE) commonly exhibit antibodies that react with their own DNA. These antibodies may have been initially raised against the nucleic acid of microorganisms but later cross-reacted with self-antigens. This phenomenon is also called molecular mimicry. \n\n Antibodies of the Mucosal Immune System \n\n Antibodies synthesized by the mucosal immune system include IgA and IgM. Activated B cells differentiate into mucosal plasma cells that synthesize and secrete dimeric IgA, and to a lesser extent, pentameric IgM. Secreted IgA is abundant in tears, saliva, breast milk, and in secretions of the gastrointestinal and respiratory tracts. Antibody secretion results in a local humoral response at epithelial surfaces and prevents infection of the mucosa by binding and neutralizing pathogens. \n42.4   Disruptions in the Immune System Learning Objectives By the end of this section, you will be able to:\n\n Describe hypersensitivity \n\n Define autoimmunity \n\n A functioning immune system is essential for survival, but even the sophisticated cellular and molecular defenses of the mammalian immune response can be defeated by pathogens at virtually every step. In the competition between immune protection and pathogen evasion, pathogens have the advantage of more rapid evolution because of their shorter generation time and other characteristics. For instance,  Streptococcus pneumoniae  (bacterium that cause pneumonia and meningitis) surrounds itself with a capsule that inhibits phagocytes from engulfing it and displaying antigens to the adaptive immune system.  Staphylococcus aureus  (bacterium that can cause skin infections, abscesses, and meningitis) synthesizes a toxin called leukocidin that kills phagocytes after they engulf the bacterium. Other pathogens can also hinder the adaptive immune system. HIV infects T H  cells via their CD4 surface molecules, gradually depleting the number of T H  cells in the body; this inhibits the adaptive immune system\u2019s capacity to generate sufficient responses to infection or tumors. As a result, HIV-infected individuals often suffer from infections that would not cause illness in people with healthy immune systems but which can cause devastating illness to immune-compromised individuals. Maladaptive responses of immune cells and molecules themselves can also disrupt the proper functioning of the entire system, leading to host cell damage that could become fatal. \n\n Immunodeficiency \n\n Failures, insufficiencies, or delays at any level of the immune response can allow pathogens or tumor cells to gain a foothold and replicate or proliferate to high enough levels that the immune system becomes overwhelmed.  Immunodeficiency  is the failure, insufficiency, or delay in the response of the immune system, which may be acquired or inherited. Immunodeficiency can be acquired as a result of infection with certain pathogens (such as HIV), chemical exposure (including certain medical treatments), malnutrition, or possibly by extreme stress. For instance, radiation exposure can destroy populations of lymphocytes and elevate an individual\u2019s susceptibility to infections and cancer. Dozens of genetic disorders result in immunodeficiencies, including Severe Combined Immunodeficiency (SCID), Bare lymphocyte syndrome, and MHC II deficiencies. Rarely, primary immunodeficiencies that are present from birth may occur. Neutropenia is one form in which the immune system produces a below-average number of neutrophils, the body\u2019s most abundant phagocytes. As a result, bacterial infections may go unrestricted in the blood, causing serious complications. \n\n Hypersensitivities \n\n Maladaptive immune responses toward harmless foreign substances or self antigens that occur after tissue sensitization are termed  hypersensitivities . The types of hypersensitivities include immediate, delayed, and autoimmunity. A large proportion of the population is affected by one or more types of hypersensitivity. \n\n Allergies \n\n The immune reaction that results from immediate hypersensitivities in which an antibody-mediated immune response occurs within minutes of exposure to a harmless antigen is called an  allergy . In the United States, 20 percent of the population exhibits symptoms of allergy or asthma, whereas 55 percent test positive against one or more allergens. Upon initial exposure to a potential allergen, an allergic individual synthesizes antibodies of the IgE class via the typical process of APCs presenting processed antigen to T H  cells that stimulate B cells to produce IgE. This class of antibodies also mediates the immune response to parasitic worms. The constant domain of the IgE molecules interact with mast cells embedded in connective tissues. This process primes, or sensitizes, the tissue. Upon subsequent exposure to the same allergen, IgE molecules on mast cells bind the antigen via their variable domains and stimulate the mast cell to release the modified amino acids histamine and serotonin; these chemical mediators then recruit eosinophils which mediate allergic responses.  Figure 42.26  shows an example of an allergic response to ragweed pollen. The effects of an allergic reaction range from mild symptoms like sneezing and itchy, watery eyes to more severe or even life-threatening reactions involving intensely itchy welts or hives, airway contraction with severe respiratory distress, and plummeting blood pressure. This extreme reaction is known as anaphylactic shock. If not treated with epinephrine to counter the blood pressure and breathing effects, this condition can be fatal. \n\n Delayed hypersensitivity is a cell-mediated immune response that takes approximately one to two days after secondary exposure for a maximal reaction to be observed. This type of hypersensitivity involves the T H 1 cytokine-mediated inflammatory response and may manifest as local tissue lesions or contact dermatitis (rash or skin irritation). Delayed hypersensitivity occurs in some individuals in response to contact with certain types of jewelry or cosmetics. Delayed hypersensitivity facilitates the immune response to poison ivy and is also the reason why the skin test for tuberculosis results in a small region of inflammation on individuals who were previously exposed to  Mycobacterium tuberculosis . That is also why cortisone is used to treat such responses: it will inhibit cytokine production. \n\n Autoimmunity \n\n Autoimmunity  is a type of hypersensitivity to self antigens that affects approximately five percent of the population. Most types of autoimmunity involve the humoral immune response. Antibodies that inappropriately mark self components as foreign are termed  autoantibodies . In patients with the autoimmune disease myasthenia gravis, muscle cell receptors that induce contraction in response to acetylcholine are targeted by antibodies. The result is muscle weakness that may include marked difficultly with fine and/or gross motor functions. In systemic lupus erythematosus, a diffuse autoantibody response to the individual\u2019s own DNA and proteins results in various systemic diseases. As illustrated in  Figure 42.27 , systemic lupus erythematosus may affect the heart, joints, lungs, skin, kidneys, central nervous system, or other tissues, causing tissue damage via antibody binding, complement recruitment, lysis, and inflammation. \n\n Autoimmunity can develop with time, and its causes may be rooted in molecular mimicry. Antibodies and TCRs may bind self antigens that are structurally similar to pathogen antigens, which the immune receptors first raised. As an example, infection with  Streptococcus pyogenes  (bacterium that causes strep throat) may generate antibodies or T cells that react with heart muscle, which has a similar structure to the surface of  S. pyogenes . These antibodies can damage heart muscle with autoimmune attacks, leading to rheumatic fever. Insulin-dependent (Type 1) diabetes mellitus arises from a destructive inflammatory T H 1 response against insulin-producing cells of the pancreas. Patients with this autoimmunity must be injected with insulin that originates from other sources. ", "questions": [{"question": {"question_id": "fs-idm2514368", "question_text": "Which of the following is a barrier against pathogens provided by the skin?", "question_choices": ["high pH", "mucus", "tears", "desiccation"], "cloze_format": "___ is a barrier against pathogens provided by the skin.", "normal_format": "Which of the following is a barrier against pathogens provided by the skin?"}, "answer": {"ans_text": "desiccation", "ans_choice": 3}, "bloom": null, "hl_sentences": "Before any immune factors are triggered , the skin functions as a continuous , impassable barrier to potentially infectious pathogens . Pathogens are killed or inactivated on the skin by desiccation ( drying out ) and by the skin \u2019 s acidity .", "hl_context": "<hl> Before any immune factors are triggered , the skin functions as a continuous , impassable barrier to potentially infectious pathogens . <hl> <hl> Pathogens are killed or inactivated on the skin by desiccation ( drying out ) and by the skin \u2019 s acidity . <hl> In addition , beneficial microorganisms that coexist on the skin compete with invading pathogens , preventing infection . Regions of the body that are not protected by skin ( such as the eyes and mucus membranes ) have alternative methods of defense , such as tears and mucus secretions that trap and rinse away pathogens , and cilia in the nasal passages and respiratory tract that push the mucus with the pathogens out of the body . Throughout the body are other defenses , such as the low pH of the stomach ( which inhibits the growth of pathogens ) , blood proteins that bind and disrupt bacterial cell membranes , and the process of urination ( which flushes pathogens from the urinary tract ) ."}, {"question": {"question_id": "fs-idp30418064", "question_text": "Although interferons have several effects, they are particularly useful against infections with which type of pathogen?", "question_choices": ["bacteria", "viruses", "fungi", "helminths"], "cloze_format": "Although interferons have several effects, the type of pathogen of infections they are particularly useful against is ___.", "normal_format": "Although interferons have several effects, they are particularly useful against infections with which type of pathogen?"}, "answer": {"ans_text": "viruses", "ans_choice": 1}, "bloom": null, "hl_sentences": "One effect of interferon-induced gene expression is a sharply reduced cellular protein synthesis . Virally infected cells produce more viruses by synthesizing large quantities of viral proteins . Thus , by reducing protein synthesis , a cell becomes resistant to viral infection .", "hl_context": "In response to interferons , uninfected cells alter their gene expression , which increases the cells \u2019 resistance to infection . <hl> One effect of interferon-induced gene expression is a sharply reduced cellular protein synthesis . <hl> <hl> Virally infected cells produce more viruses by synthesizing large quantities of viral proteins . <hl> <hl> Thus , by reducing protein synthesis , a cell becomes resistant to viral infection . <hl>"}, {"question": {"question_id": "fs-idp45719456", "question_text": "Which organelle do phagocytes use to digest engulfed particles?", "question_choices": ["lysosome", "nucleus", "endoplasmic reticulum", "mitochondria"], "cloze_format": "The organelle that does phagocytes use to digest engulfed particles is ___.", "normal_format": "Which organelle do phagocytes use to digest engulfed particles?"}, "answer": {"ans_text": "lysosome", "ans_choice": 0}, "bloom": null, "hl_sentences": "Neutrophils have a nucleus with two to five lobes , and they contain organelles , called lysosomes , that digest engulfed pathogens .", "hl_context": "The first cytokines to be produced are pro-inflammatory ; that is , they encourage inflammation , the localized redness , swelling , heat , and pain that result from the movement of leukocytes and fluid through increasingly permeable capillaries to a site of infection . The population of leukocytes that arrives at an infection site depends on the nature of the infecting pathogen . Both macrophages and dendritic cells engulf pathogens and cellular debris through phagocytosis . A neutrophil is also a phagocytic leukocyte that engulfs and digests pathogens . Neutrophils , shown in Figure 42.3 , are the most abundant leukocytes of the immune system . <hl> Neutrophils have a nucleus with two to five lobes , and they contain organelles , called lysosomes , that digest engulfed pathogens . <hl> An eosinophil is a leukocyte that works with other eosinophils to surround a parasite ; it is involved in the allergic response and in protection against helminthes ( parasitic worms ) ."}, {"question": {"question_id": "fs-idp4423040", "question_text": "Which innate immune system component uses MHC I molecules directly in its defense strategy?", "question_choices": [" macrophages", "neutrophils", "NK cells", "interferon"], "cloze_format": "The innate immune system component that uses MHC I molecules directly in its defense strategy is ___.", "normal_format": "Which innate immune system component uses MHC I molecules directly in its defense strategy?"}, "answer": {"ans_text": "NK cells", "ans_choice": 2}, "bloom": null, "hl_sentences": "In fact , the functions of NK cells and CTLs are complementary and maximize the removal of infected cells , as illustrated in Figure 42.14 . If the NK cell cannot identify the \u201c missing self \u201d pattern of down-regulated MHC I molecules , then the CTL can identify it by the complex of MHC I with foreign antigens , which signals \u201c altered self . \u201d Similarly , if the CTL cannot detect antigen-embedded MHC I because the receptors are depleted from the cell surface , NK cells will destroy the cell instead . NK cells are always active ; an interaction with normal , intact MHC I molecules on a healthy cell disables the killing sequence , and the NK cell moves on . Infected cells are identified and destroyed by natural killer ( NK ) cells , lymphocytes that can kill cells infected with viruses or tumor cells ( abnormal cells that uncontrollably divide and invade other tissue ) . NK cells identify intracellular infections , especially from viruses , by the altered expression of major histocompatibility class ( MHC ) I molecules on the surface of infected cells .", "hl_context": "CTLs sense MHC I-embedded antigens by directly interacting with infected cells via their TCRs . Binding of TCRs with antigens activates CTLs to release perforin and granzyme , degradative enzymes that will induce apoptosis of the infected cell . Recall that this is a similar destruction mechanism to that used by NK cells . In this process , the CTL does not become infected and is not harmed by the secretion of perforin and granzymes . <hl> In fact , the functions of NK cells and CTLs are complementary and maximize the removal of infected cells , as illustrated in Figure 42.14 . <hl> <hl> If the NK cell cannot identify the \u201c missing self \u201d pattern of down-regulated MHC I molecules , then the CTL can identify it by the complex of MHC I with foreign antigens , which signals \u201c altered self . \u201d Similarly , if the CTL cannot detect antigen-embedded MHC I because the receptors are depleted from the cell surface , NK cells will destroy the cell instead . <hl> CTLs also emit cytokines , such as interferons , that alter surface protein expression in other infected cells , such that the infected cells can be easily identified and destroyed . Moreover , these interferons can also prevent virally infected cells from releasing virus particles . <hl> NK cells are always active ; an interaction with normal , intact MHC I molecules on a healthy cell disables the killing sequence , and the NK cell moves on . <hl> After the NK cell detects an infected or tumor cell , its cytoplasm secretes granules comprised of perforin , a destructive protein that creates a pore in the target cell . Granzymes are released along with the perforin in the immunological synapse . A granzyme is a protease that digests cellular proteins and induces the target cell to undergo programmed cell death , or apoptosis . Phagocytic cells then digest the cell debris left behind . NK cells are constantly patrolling the body and are an effective mechanism for controlling potential infections and preventing cancer progression . Lymphocytes are leukocytes that are histologically identifiable by their large , darkly staining nuclei ; they are small cells with very little cytoplasm , as shown in Figure 42.6 . <hl> Infected cells are identified and destroyed by natural killer ( NK ) cells , lymphocytes that can kill cells infected with viruses or tumor cells ( abnormal cells that uncontrollably divide and invade other tissue ) . <hl> T cells and B cells of the adaptive immune system also are classified as lymphocytes . T cells are lymphocytes that mature in the thymus gland , and B cells are lymphocytes that mature in the bone marrow . <hl> NK cells identify intracellular infections , especially from viruses , by the altered expression of major histocompatibility class ( MHC ) I molecules on the surface of infected cells . <hl> MHC I molecules are proteins on the surfaces of all nucleated cells , thus they are scarce on red blood cells and platelets which are non-nucleated . The function of MHC I molecules is to display fragments of proteins from the infectious agents within the cell to T-cells ; healthy cells will be ignored , while \u201c non-self \u201d or foreign proteins will be attacked by the immune system . MHC II molecules are found mainly on cells containing antigens ( \u201c non-self proteins \u201d ) and on lymphocytes . MHC II molecules interact with helper T-cells to trigger the appropriate immune response , which may include the inflammatory response . An infected cell ( or a tumor cell ) is usually incapable of synthesizing and displaying MHC I molecules appropriately . The metabolic resources of cells infected by some viruses produce proteins that interfere with MHC I processing and / or trafficking to the cell surface . The reduced MHC I on host cells varies from virus to virus and results from active inhibitors being produced by the viruses . This process can deplete host MHC I molecules on the cell surface , which NK cells detect as \u201c unhealthy \u201d or \u201c abnormal \u201d while searching for cellular MHC I molecules . Similarly , the dramatically altered gene expression of tumor cells leads to expression of extremely deformed or absent MHC I molecules that also signal \u201c unhealthy \u201d or \u201c abnormal . \u201d"}, {"question": {"question_id": "fs-idm148963776", "question_text": "Which of the following is both a phagocyte and an antigen-presenting cell?", "question_choices": ["NK cell", "eosinophil", "neutrophil", "macrophage"], "cloze_format": "The ___ is both a phagocyte and an antigen-presenting cell.", "normal_format": "Which of the following is both a phagocyte and an antigen-presenting cell?"}, "answer": {"ans_text": "macrophage", "ans_choice": 3}, "bloom": null, "hl_sentences": "Antibodies also mark pathogens for destruction by phagocytic cells , such as macrophages or neutrophils , because phagocytic cells are highly attracted to macromolecules complexed with antibodies . An antigen-presenting cell ( APC ) is an immune cell that detects , engulfs , and informs the adaptive immune response about an infection . Macrophages also function as APCs . A macrophage is a large phagocytic cell that engulfs foreign particles and pathogens .", "hl_context": "<hl> Antibodies also mark pathogens for destruction by phagocytic cells , such as macrophages or neutrophils , because phagocytic cells are highly attracted to macromolecules complexed with antibodies . <hl> Phagocytic enhancement by antibodies is called opsonization . In a process called complement fixation , IgM and IgG in serum bind to antigens and provide docking sites onto which sequential complement proteins can bind . The combination of antibodies and complement enhances opsonization even further and promotes rapid clearing of pathogens . The innate immune system contains cells that detect potentially harmful antigens , and then inform the adaptive immune response about the presence of these antigens . <hl> An antigen-presenting cell ( APC ) is an immune cell that detects , engulfs , and informs the adaptive immune response about an infection . <hl> When a pathogen is detected , these APCs will phagocytose the pathogen and digest it to form many different fragments of the antigen . Antigen fragments will then be transported to the surface of the APC , where they will serve as an indicator to other immune cells . Dendritic cells are immune cells that process antigen material ; they are present in the skin ( Langerhans cells ) and the lining of the nose , lungs , stomach , and intestines . Sometimes a dendritic cell presents on the surface of other cells to induce an immune response , thus functioning as an antigen-presenting cell . <hl> Macrophages also function as APCs . <hl> Before activation and differentiation , B cells can also function as APCs . An infection may be intracellular or extracellular , depending on the pathogen . All viruses infect cells and replicate within those cells ( intracellularly ) , whereas bacteria and other parasites may replicate intracellularly or extracellularly , depending on the species . The innate immune system must respond accordingly : by identifying the extracellular pathogen and / or by identifying host cells that have already been infected . When a pathogen enters the body , cells in the blood and lymph detect the specific pathogen-associated molecular patterns ( PAMPs ) on the pathogen \u2019 s surface . PAMPs are carbohydrate , polypeptide , and nucleic acid \u201c signatures \u201d that are expressed by viruses , bacteria , and parasites but which differ from molecules on host cells . The immune system has specific cells , described in Figure 42.2 and shown in Figure 42.3 , with receptors that recognize these PAMPs . <hl> A macrophage is a large phagocytic cell that engulfs foreign particles and pathogens . <hl> Macrophages recognize PAMPs via complementary pattern recognition receptors ( PRRs ) . PRRs are molecules on macrophages and dendritic cells which are in contact with the external environment . A monocyte is a type of white blood cell that circulates in the blood and lymph and differentiates into macrophages after it moves into infected tissue . Dendritic cells bind molecular signatures of pathogens and promote pathogen engulfment and destruction . Toll-like receptors ( TLRs ) are a type of PRR that recognizes molecules that are shared by pathogens but distinguishable from host molecules ) . TLRs are present in invertebrates as well as vertebrates , and appear to be one of the most ancient components of the immune system . TLRs have also been identified in the mammalian nervous system . Cytokine Release Effect The binding of PRRs with PAMPs triggers the release of cytokines , which signal that a pathogen is present and needs to be destroyed along with any infected cells . A cytokine is a chemical messenger that regulates cell differentiation ( form and function ) , proliferation ( production ) , and gene expression to affect immune responses . At least 40 types of cytokines exist in humans that differ in terms of the cell type that produces them , the cell type that responds to them , and the changes they produce . One type cytokine , interferon , is illustrated in Figure 42.4 . One subclass of cytokines is the interleukin ( IL ) , so named because they mediate interactions between leukocytes ( white blood cells ) . Interleukins are involved in bridging the innate and adaptive immune responses . In addition to being released from cells after PAMP recognition , cytokines are released by the infected cells which bind to nearby uninfected cells and induce those cells to release cytokines , which results in a cytokine burst ."}, {"question": {"question_id": "fs-idp86317888", "question_text": "Which immune cells bind MHC molecules on APCs via CD8 coreceptors on their cell surfaces?", "question_choices": ["TH cells", "CTLs", "mast cells", "basophils"], "cloze_format": "The immune cells that bind MHC molecules on APCs via CD8 coreceptors on their cell surfaces are ___.", "normal_format": "Which immune cells bind MHC molecules on APCs via CD8 coreceptors on their cell surfaces?"}, "answer": {"ans_text": "CTLs", "ans_choice": 1}, "bloom": null, "hl_sentences": "In contrast , CD8 + cells engage antigen-embedded MHC I molecules on APCs and are stimulated to become cytotoxic T lymphocytes ( CTLs ) , which directly kill infected cells by apoptosis and emit cytokines to amplify the immune response .", "hl_context": "Na\u00efve T cells can express one of two different molecules , CD4 or CD8 , on their surface , as shown in Figure 42.11 , and are accordingly classified as CD4 + or CD8 + cells . These molecules are important because they regulate how a T cell will interact with and respond to an APC . Na\u00efve CD4 + cells bind APCs via their antigen-embedded MHC II molecules and are stimulated to become helper T ( T H ) lymphocytes , cells that go on to stimulate B cells ( or cytotoxic T cells ) directly or secrete cytokines to inform more and various target cells about the pathogenic threat . <hl> In contrast , CD8 + cells engage antigen-embedded MHC I molecules on APCs and are stimulated to become cytotoxic T lymphocytes ( CTLs ) , which directly kill infected cells by apoptosis and emit cytokines to amplify the immune response . <hl> The two populations of T cells have different mechanisms of immune protection , but both bind MHC molecules via their antigen receptors called T cell receptors ( TCRs ) . The CD4 or CD8 surface molecules differentiate whether the TCR will engage an MHC II or an MHC I molecule . Because they assist in binding specificity , the CD4 and CD8 molecules are described as coreceptors ."}, {"question": {"question_id": "fs-idm64029392", "question_text": "What \u201cself\u201d pattern is identified by NK cells?", "question_choices": ["altered self", "missing self", "normal self", "non-self"], "cloze_format": "The \u201cself\u201d pattern that is identified by NK cells is the ___ .", "normal_format": "What \u201cself\u201d pattern is identified by NK cells?"}, "answer": {"ans_text": "missing self", "ans_choice": 1}, "bloom": null, "hl_sentences": "If the NK cell cannot identify the \u201c missing self \u201d pattern of down-regulated MHC I molecules , then the CTL can identify it by the complex of MHC I with foreign antigens , which signals \u201c altered self . \u201d Similarly , if the CTL cannot detect antigen-embedded MHC I because the receptors are depleted from the cell surface , NK cells will destroy the cell instead .", "hl_context": "CTLs sense MHC I-embedded antigens by directly interacting with infected cells via their TCRs . Binding of TCRs with antigens activates CTLs to release perforin and granzyme , degradative enzymes that will induce apoptosis of the infected cell . Recall that this is a similar destruction mechanism to that used by NK cells . In this process , the CTL does not become infected and is not harmed by the secretion of perforin and granzymes . In fact , the functions of NK cells and CTLs are complementary and maximize the removal of infected cells , as illustrated in Figure 42.14 . <hl> If the NK cell cannot identify the \u201c missing self \u201d pattern of down-regulated MHC I molecules , then the CTL can identify it by the complex of MHC I with foreign antigens , which signals \u201c altered self . \u201d Similarly , if the CTL cannot detect antigen-embedded MHC I because the receptors are depleted from the cell surface , NK cells will destroy the cell instead . <hl> CTLs also emit cytokines , such as interferons , that alter surface protein expression in other infected cells , such that the infected cells can be easily identified and destroyed . Moreover , these interferons can also prevent virally infected cells from releasing virus particles ."}, {"question": {"question_id": "fs-idm169041360", "question_text": "The acquired ability to prevent an unnecessary or destructive immune reaction to a harmless foreign particle, such as a food protein, is called ________.", "question_choices": ["the TH2 response", "allergy", "immune tolerance", "autoimmunity"], "cloze_format": "The acquired ability to prevent an unnecessary or destructive immune reaction to a harmless foreign particle, such as a food protein, is called ________.", "normal_format": "What is the acquired ability to prevent an unnecessary or destructive immune reaction to a harmless foreign particle, such as a food protein, called?"}, "answer": {"ans_text": "immune tolerance", "ans_choice": 2}, "bloom": null, "hl_sentences": "The immune system has to be regulated to prevent wasteful , unnecessary responses to harmless substances , and more importantly so that it does not attack \u201c self . \u201d The acquired ability to prevent an unnecessary or harmful immune response to a detected foreign substance known not to cause disease is described as immune tolerance .", "hl_context": "<hl> The immune system has to be regulated to prevent wasteful , unnecessary responses to harmless substances , and more importantly so that it does not attack \u201c self . \u201d The acquired ability to prevent an unnecessary or harmful immune response to a detected foreign substance known not to cause disease is described as immune tolerance . <hl> Immune tolerance is crucial for maintaining mucosal homeostasis given the tremendous number of foreign substances ( such as food proteins ) that APCs of the oral cavity , pharynx , and gastrointestinal mucosa encounter . Immune tolerance is brought about by specialized APCs in the liver , lymph nodes , small intestine , and lung that present harmless antigens to an exceptionally diverse population of regulatory T ( T reg ) cells , specialized lymphocytes that suppress local inflammation and inhibit the secretion of stimulatory immune factors . The combined result of T reg cells is to prevent immunologic activation and inflammation in undesired tissue compartments and to allow the immune system to focus on pathogens instead . In addition to promoting immune tolerance of harmless antigens , other subsets of T reg cells are involved in the prevention of the autoimmune response , which is an inappropriate immune response to host cells or self-antigens . Another T reg class suppresses immune responses to harmful pathogens after the infection has cleared to minimize host cell damage induced by inflammation and cell lysis ."}, {"question": {"question_id": "fs-idm113318064", "question_text": "A memory B cell can differentiate upon re-exposure to a pathogen of which cell type?", "question_choices": ["CTL", "na\u00efve B cell", "memory T cell", "plasma cell"], "cloze_format": "A memory B cell can differentiate upon re-exposure to a pathogen of the cell type ___ .", "normal_format": "A memory B cell can differentiate upon re-exposure to a pathogen of which cell type?"}, "answer": {"ans_text": "plasma cell", "ans_choice": 3}, "bloom": null, "hl_sentences": "However , if the host is re-exposed to the same pathogen type , circulating memory cells will immediately differentiate into plasma cells and CTLs without input from APCs or T H cells . Memory B cells that differentiate into plasma cells output tens to hundreds-fold greater antibody amounts than were secreted during the primary response , as the graph in Figure 42.17 illustrates .", "hl_context": "If the pathogen is never encountered again during the individual \u2019 s lifetime , B and T memory cells will circulate for a few years or even several decades and will gradually die off , having never functioned as effector cells . <hl> However , if the host is re-exposed to the same pathogen type , circulating memory cells will immediately differentiate into plasma cells and CTLs without input from APCs or T H cells . <hl> One reason the adaptive immune response is delayed is because it takes time for na\u00efve B and T cells with the appropriate antigen specificities to be identified and activated . Upon reinfection , this step is skipped , and the result is a more rapid production of immune defenses . <hl> Memory B cells that differentiate into plasma cells output tens to hundreds-fold greater antibody amounts than were secreted during the primary response , as the graph in Figure 42.17 illustrates . <hl> This rapid and dramatic antibody response may stop the infection before it can even become established , and the individual may not realize they had been exposed ."}, {"question": {"question_id": "fs-idm104907776", "question_text": "Foreign particles circulating in the blood are filtered by the ________.", "question_choices": ["spleen", "lymph nodes", "MALT", "lymph"], "cloze_format": "Foreign particles circulating in the blood are filtered by the ________.", "normal_format": "What are foreign particles circulating in the blood filtered by?"}, "answer": {"ans_text": "spleen", "ans_choice": 0}, "bloom": null, "hl_sentences": "The neutralized antibody-coated pathogens can then be filtered by the spleen and eliminated in urine or feces . The spleen , shown in Figure 42.21 , is the site where APCs that have trapped foreign particles in the blood can communicate with lymphocytes . Antibodies are synthesized and secreted by activated plasma cells in the spleen , and the spleen filters foreign substances and antibody-complexed pathogens from the blood .", "hl_context": "Antibodies coat extracellular pathogens and neutralize them , as illustrated in Figure 42.24 , by blocking key sites on the pathogen that enhance their infectivity ( such as receptors that \u201c dock \u201d pathogens on host cells ) . Antibody neutralization can prevent pathogens from entering and infecting host cells , as opposed to the CTL-mediated approach of killing cells that are already infected to prevent progression of an established infection . <hl> The neutralized antibody-coated pathogens can then be filtered by the spleen and eliminated in urine or feces . <hl> On maturation , T and B lymphocytes circulate to various destinations . Lymph nodes scattered throughout the body , as illustrated in Figure 42.20 , house large populations of T and B cells , dendritic cells , and macrophages . Lymph gathers antigens as it drains from tissues . These antigens then are filtered through lymph nodes before the lymph is returned to circulation . APCs in the lymph nodes capture and process antigens and inform nearby lymphocytes about potential pathogens . The spleen houses B and T cells , macrophages , dendritic cells , and NK cells . <hl> The spleen , shown in Figure 42.21 , is the site where APCs that have trapped foreign particles in the blood can communicate with lymphocytes . <hl> <hl> Antibodies are synthesized and secreted by activated plasma cells in the spleen , and the spleen filters foreign substances and antibody-complexed pathogens from the blood . <hl> Functionally , the spleen is to the blood as lymph nodes are to the lymph . 42.3 Antibodies Learning Objectives By the end of this section , you will be able to :"}, {"question": {"question_id": "fs-idm106393392", "question_text": "The structure of an antibody is similar to the extracellular component of which receptor?", "question_choices": ["MHC I", "MHC II", "BCR", "none of the above"], "cloze_format": "The structure of an antibody is similar to the extracellular component of the ___ receptor.", "normal_format": "The structure of an antibody is similar to the extracellular component of which receptor?"}, "answer": {"ans_text": "BCR", "ans_choice": 2}, "bloom": null, "hl_sentences": "Antibodies are structurally similar to the extracellular component of the BCRs , and B cell maturation to plasma cells can be visualized in simple terms as the cell acquires the ability to secrete the extracellular portion of its BCR in large quantities .", "hl_context": "Similar to TCRs and BCRs , antibody diversity is produced by the mutation and recombination of approximately 300 different gene segments encoding the light and heavy chain variable domains in precursor cells that are destined to become B cells . The variable domains from the heavy and light chains interact to form the binding site through which an antibody can bind a specific epitope on an antigen . The numbers of repeated constant domains in Ig classes are the same for all antibodies corresponding to a specific class . <hl> Antibodies are structurally similar to the extracellular component of the BCRs , and B cell maturation to plasma cells can be visualized in simple terms as the cell acquires the ability to secrete the extracellular portion of its BCR in large quantities . <hl>"}, {"question": {"question_id": "fs-idm78436544", "question_text": "The first antibody class to appear in the serum in response to a newly encountered pathogen is ________.", "question_choices": ["IgM", "IgA", "IgG", "IgE"], "cloze_format": "The first antibody class to appear in the serum in response to a newly encountered pathogen is ________.", "normal_format": "What is the first antibody class to appear in the serum in response to a newly encountered pathogen?"}, "answer": {"ans_text": "IgM", "ans_choice": 0}, "bloom": null, "hl_sentences": "After an adaptive defense is produced against a pathogen , typically plasma cells first secrete IgM into the blood . Antibodies can be divided into five classes \u2014 IgM , IgG , IgA , IgD , IgE \u2014 based on their physiochemical , structural , and immunological properties .", "hl_context": "<hl> After an adaptive defense is produced against a pathogen , typically plasma cells first secrete IgM into the blood . <hl> BCRs on na\u00efve B cells are of the IgM class and occasionally IgD class . IgM molecules make up approximately ten percent of all antibodies . Prior to antibody secretion , plasma cells assemble IgM molecules into pentamers ( five individual antibodies ) linked by a joining ( J ) chain , as shown in Figure 42.23 . The pentamer arrangement means that these macromolecules can bind ten identical antigens . However , IgM molecules released early in the adaptive immune response do not bind to antigens as stably as IgGs , which are one of the possible types of antibodies secreted in large quantities upon re-exposure to the same pathogen . Figure 42.23 summarizes the properties of immunoglobulins and illustrates their basic structures . <hl> Antibodies can be divided into five classes \u2014 IgM , IgG , IgA , IgD , IgE \u2014 based on their physiochemical , structural , and immunological properties . <hl> IgGs , which make up about 80 percent of all antibodies , have heavy chains that consist of one variable domain and three identical constant domains . IgA and IgD also have three constant domains per heavy chain , whereas IgM and IgE each have four constant domains per heavy chain . The variable domain determines binding specificity and the constant domain of the heavy chain determines the immunological mechanism of action of the corresponding antibody class . It is possible for two antibodies to have the same binding specificities but be in different classes and , therefore , to be involved in different functions ."}, {"question": {"question_id": "fs-idm34264256", "question_text": "What is the most abundant antibody class detected in the serum upon reexposure to a pathogen or in reaction to a vaccine?", "question_choices": ["IgM", "IgA", "IgG", "IgE"], "cloze_format": "___ is the most abundant antibody class detected in the serum upon reexposure to a pathogen or in reaction to a vaccine.", "normal_format": "What is the most abundant antibody class detected in the serum upon reexposure to a pathogen or in reaction to a vaccine?"}, "answer": {"ans_text": "IgG", "ans_choice": 2}, "bloom": null, "hl_sentences": "Antibodies can be divided into five classes \u2014 IgM , IgG , IgA , IgD , IgE \u2014 based on their physiochemical , structural , and immunological properties . IgGs , which make up about 80 percent of all antibodies , have heavy chains that consist of one variable domain and three identical constant domains .", "hl_context": "<hl> Antibodies can be divided into five classes \u2014 IgM , IgG , IgA , IgD , IgE \u2014 based on their physiochemical , structural , and immunological properties . <hl> <hl> IgGs , which make up about 80 percent of all antibodies , have heavy chains that consist of one variable domain and three identical constant domains . <hl> IgA and IgD also have three constant domains per heavy chain , whereas IgM and IgE each have four constant domains per heavy chain . The variable domain determines binding specificity and the constant domain of the heavy chain determines the immunological mechanism of action of the corresponding antibody class . It is possible for two antibodies to have the same binding specificities but be in different classes and , therefore , to be involved in different functions ."}, {"question": {"question_id": "fs-idp51217536", "question_text": "Breastfed infants typically are resistant to disease because of ________.", "question_choices": ["active immunity", "passive immunity", "immune tolerance", "immune memory"], "cloze_format": "Breastfed infants typically are resistant to disease because of ________.", "normal_format": "Why are breastfed infants typically resistant to disease?"}, "answer": {"ans_text": "passive immunity", "ans_choice": 1}, "bloom": null, "hl_sentences": "For instance , a person who has recently produced a successful immune response against a particular disease agent can donate blood to a nonimmune recipient and confer temporary immunity through antibodies in the donor \u2019 s blood serum . This phenomenon is called passive immunity ; it also occurs naturally during breastfeeding , which makes breastfed infants highly resistant to infections during the first few months of life .", "hl_context": "Differentiated plasma cells are crucial players in the humoral response , and the antibodies they secrete are particularly significant against extracellular pathogens and toxins . Antibodies circulate freely and act independently of plasma cells . Antibodies can be transferred from one individual to another to temporarily protect against infectious disease . <hl> For instance , a person who has recently produced a successful immune response against a particular disease agent can donate blood to a nonimmune recipient and confer temporary immunity through antibodies in the donor \u2019 s blood serum . <hl> <hl> This phenomenon is called passive immunity ; it also occurs naturally during breastfeeding , which makes breastfed infants highly resistant to infections during the first few months of life . <hl>"}, {"question": {"question_id": "fs-idp17268592", "question_text": "Allergy to pollen is classified as:", "question_choices": ["an autoimmune reaction", "immunodeficiency", "delayed hypersensitivity", "immediate hypersensitivity"], "cloze_format": "Allergy to pollen is classified as ___ .", "normal_format": "What is an allergy to pollen classified as?"}, "answer": {"ans_text": "immediate hypersensitivity", "ans_choice": 3}, "bloom": null, "hl_sentences": "The immune reaction that results from immediate hypersensitivities in which an antibody-mediated immune response occurs within minutes of exposure to a harmless antigen is called an allergy . Figure 42.26 shows an example of an allergic response to ragweed pollen . A hypersensitive immune response to harmless antigens , such as in pollen , often involves the release of histamine by basophils and mast cells .", "hl_context": "<hl> The immune reaction that results from immediate hypersensitivities in which an antibody-mediated immune response occurs within minutes of exposure to a harmless antigen is called an allergy . <hl> In the United States , 20 percent of the population exhibits symptoms of allergy or asthma , whereas 55 percent test positive against one or more allergens . Upon initial exposure to a potential allergen , an allergic individual synthesizes antibodies of the IgE class via the typical process of APCs presenting processed antigen to T H cells that stimulate B cells to produce IgE . This class of antibodies also mediates the immune response to parasitic worms . The constant domain of the IgE molecules interact with mast cells embedded in connective tissues . This process primes , or sensitizes , the tissue . Upon subsequent exposure to the same allergen , IgE molecules on mast cells bind the antigen via their variable domains and stimulate the mast cell to release the modified amino acids histamine and serotonin ; these chemical mediators then recruit eosinophils which mediate allergic responses . <hl> Figure 42.26 shows an example of an allergic response to ragweed pollen . <hl> The effects of an allergic reaction range from mild symptoms like sneezing and itchy , watery eyes to more severe or even life-threatening reactions involving intensely itchy welts or hives , airway contraction with severe respiratory distress , and plummeting blood pressure . This extreme reaction is known as anaphylactic shock . If not treated with epinephrine to counter the blood pressure and breathing effects , this condition can be fatal . Neutrophils and eosinophils are particularly important leukocytes that engulf large pathogens , such as bacteria and fungi . A mast cell is a leukocyte that produces inflammatory molecules , such as histamine , in response to large pathogens . A basophil is a leukocyte that , like a neutrophil , releases chemicals to stimulate the inflammatory response as illustrated in Figure 42.5 . Basophils are also involved in allergy and hypersensitivity responses and induce specific types of inflammatory responses . Eosinophils and basophils produce additional inflammatory mediators to recruit more leukocytes . <hl> A hypersensitive immune response to harmless antigens , such as in pollen , often involves the release of histamine by basophils and mast cells . <hl> Cytokines also send feedback to cells of the nervous system to bring about the overall symptoms of feeling sick , which include lethargy , muscle pain , and nausea . These effects may have evolved because the symptoms encourage the individual to rest and prevent them from spreading the infection to others . Cytokines also increase the core body temperature , causing a fever , which causes the liver to withhold iron from the blood . Without iron , certain pathogens , such as some bacteria , are unable to replicate ; this is called nutritional immunity ."}, {"question": {"question_id": "fs-idm27916016", "question_text": "A potential cause of acquired autoimmunity is ________.", "question_choices": ["tissue hypersensitivity", "molecular mimicry", "histamine release", "radiation exposure"], "cloze_format": "A potential cause of acquired autoimmunity is ________.", "normal_format": "What is a potential cause of acquired autoimmunity?"}, "answer": {"ans_text": "molecular mimicry", "ans_choice": 1}, "bloom": null, "hl_sentences": "Autoimmunity can develop with time , and its causes may be rooted in molecular mimicry .", "hl_context": "<hl> Autoimmunity can develop with time , and its causes may be rooted in molecular mimicry . <hl> Antibodies and TCRs may bind self antigens that are structurally similar to pathogen antigens , which the immune receptors first raised . As an example , infection with Streptococcus pyogenes ( bacterium that causes strep throat ) may generate antibodies or T cells that react with heart muscle , which has a similar structure to the surface of S . pyogenes . These antibodies can damage heart muscle with autoimmune attacks , leading to rheumatic fever . Insulin-dependent ( Type 1 ) diabetes mellitus arises from a destructive inflammatory T H 1 response against insulin-producing cells of the pancreas . Patients with this autoimmunity must be injected with insulin that originates from other sources ."}, {"question": {"question_id": "fs-idp170922736", "question_text": "Autoantibodies are probably involved in:", "question_choices": ["reactions to poison ivy", "pollen allergies", "systemic lupus erythematosus", "HIV/AIDS"], "cloze_format": "Autoantibodies are probably involved in ___.", "normal_format": "What do autoantibodies are probably involved in?"}, "answer": {"ans_text": "systemic lupus erythematosus", "ans_choice": 2}, "bloom": null, "hl_sentences": "In systemic lupus erythematosus , a diffuse autoantibody response to the individual \u2019 s own DNA and proteins results in various systemic diseases .", "hl_context": "Autoimmunity is a type of hypersensitivity to self antigens that affects approximately five percent of the population . Most types of autoimmunity involve the humoral immune response . Antibodies that inappropriately mark self components as foreign are termed autoantibodies . In patients with the autoimmune disease myasthenia gravis , muscle cell receptors that induce contraction in response to acetylcholine are targeted by antibodies . The result is muscle weakness that may include marked difficultly with fine and / or gross motor functions . <hl> In systemic lupus erythematosus , a diffuse autoantibody response to the individual \u2019 s own DNA and proteins results in various systemic diseases . <hl> As illustrated in Figure 42.27 , systemic lupus erythematosus may affect the heart , joints , lungs , skin , kidneys , central nervous system , or other tissues , causing tissue damage via antibody binding , complement recruitment , lysis , and inflammation ."}, {"question": {"question_id": "fs-idp236033616", "question_text": "Which of the following diseases is not due to autoimmunity?", "question_choices": ["rheumatic fever", "systemic lupus erythematosus", "diabetes mellitus", "HIV/AIDS"], "cloze_format": "The ___ disease is not due to autoimmunity.", "normal_format": "Which of the following diseases is not due to autoimmunity?"}, "answer": {"ans_text": "HIV/AIDS", "ans_choice": 3}, "bloom": null, "hl_sentences": "These antibodies can damage heart muscle with autoimmune attacks , leading to rheumatic fever . Insulin-dependent ( Type 1 ) diabetes mellitus arises from a destructive inflammatory T H 1 response against insulin-producing cells of the pancreas . Patients with this autoimmunity must be injected with insulin that originates from other sources . In systemic lupus erythematosus , a diffuse autoantibody response to the individual \u2019 s own DNA and proteins results in various systemic diseases . As illustrated in Figure 42.27 , systemic lupus erythematosus may affect the heart , joints , lungs , skin , kidneys , central nervous system , or other tissues , causing tissue damage via antibody binding , complement recruitment , lysis , and inflammation .", "hl_context": "Autoimmunity can develop with time , and its causes may be rooted in molecular mimicry . Antibodies and TCRs may bind self antigens that are structurally similar to pathogen antigens , which the immune receptors first raised . As an example , infection with Streptococcus pyogenes ( bacterium that causes strep throat ) may generate antibodies or T cells that react with heart muscle , which has a similar structure to the surface of S . pyogenes . <hl> These antibodies can damage heart muscle with autoimmune attacks , leading to rheumatic fever . <hl> <hl> Insulin-dependent ( Type 1 ) diabetes mellitus arises from a destructive inflammatory T H 1 response against insulin-producing cells of the pancreas . <hl> <hl> Patients with this autoimmunity must be injected with insulin that originates from other sources . <hl> Autoimmunity is a type of hypersensitivity to self antigens that affects approximately five percent of the population . Most types of autoimmunity involve the humoral immune response . Antibodies that inappropriately mark self components as foreign are termed autoantibodies . In patients with the autoimmune disease myasthenia gravis , muscle cell receptors that induce contraction in response to acetylcholine are targeted by antibodies . The result is muscle weakness that may include marked difficultly with fine and / or gross motor functions . <hl> In systemic lupus erythematosus , a diffuse autoantibody response to the individual \u2019 s own DNA and proteins results in various systemic diseases . <hl> <hl> As illustrated in Figure 42.27 , systemic lupus erythematosus may affect the heart , joints , lungs , skin , kidneys , central nervous system , or other tissues , causing tissue damage via antibody binding , complement recruitment , lysis , and inflammation . <hl>"}], "summary": "", "keyterm": "", "bname": "biology"}, {"chapter": 5, "intro": " Chapter Outline 5.1   Unicellular Eukaryotic Parasites 5.2   Parasitic Helminths 5.3   Fungi 5.4   Algae 5.5   Lichens Introduction Although bacteria and viruses account for a large number of the infectious diseases that afflict humans, many serious illnesses are caused by eukaryotic organisms. One example is  malaria , which is caused by  Plasmodium , a eukaryotic organism transmitted through mosquito bites. Malaria is a major cause of morbidity (illness) and mortality (death) that threatens 3.4 billion people worldwide. 1  In severe cases, organ failure and blood or metabolic abnormalities contribute to medical emergencies and sometimes death. Even after initial recovery, relapses may occur years later. In countries where malaria is endemic, the disease represents a major public health challenge that can place a tremendous strain on developing economies. 1 Centers for Disease Control and Prevention. \u201cImpact of Malaria.\u201d September 22, 2015. http://www.cdc.gov/malaria/malaria_worldwide/impact.html. Accessed January 18, 2016. Worldwide, major efforts are underway to reduce malaria infections. Efforts include the distribution of insecticide-treated bed nets and the spraying of pesticides. Researchers are also making progress in their efforts to develop effective vaccines. 2  The President\u2019s Malaria Initiative, started in 2005, supports prevention and treatment. The Bill and Melinda Gates Foundation has a large initiative to eliminate malaria. Despite these efforts, malaria continues to cause long-term morbidity (such as intellectual disabilities in children) and mortality (especially in children younger than 5 years), so we still have far to go. 2 RTS, S Clinical Trials Partnership. \u201cEfficacy and safety of RTS,S/AS01 malaria vaccine with or without a booster dose in infants and children in Africa: final results of a phase 3, individually randomised, controlled trial.\u201d The Lancet 23 April 2015. DOI: http://dx.doi.org/10.1016/S0140-6736(15)60721-8. ", "chapter_text": " 5.1   Unicellular Eukaryotic Parasites \n\n Learning Objectives \n\n Summarize the general characteristics of unicellular eukaryotic parasites \n\n Describe the general life cycles and modes of reproduction in unicellular eukaryotic parasites \n\n Identify challenges associated with classifying unicellular eukaryotes \n\n Explain the taxonomic scheme used for unicellular eukaryotes \n\n Give examples of infections caused by unicellular eukaryotes \n\n Clinical Focus Part 1 Upon arriving home from school, 7-year-old Sarah complains that a large spot on her arm will not stop itching. She keeps scratching at it, drawing the attention of her parents. Looking more closely, they see that it is a red circular spot with a raised red edge ( Figure 5.2 ). The next day, Sarah\u2019s parents take her to their doctor, who examines the spot using a  Wood\u2019s lamp . A Wood\u2019s lamp produces ultraviolet light that causes the spot on Sarah\u2019s arm to fluoresce, which confirms what the doctor already suspected: Sarah has a case of  ringworm . \n\n Sarah\u2019s mother is mortified to hear that her daughter has a \u201cworm.\u201d How could this happen? \n\n What are some likely ways that Sarah might have contracted ringworm? \n\n Jump to the  next  Clinical Focus box. \n\n Eukaryotic microbes are an extraordinarily diverse group, including species with a wide range of life cycles, morphological specializations, and nutritional needs. Although more diseases are caused by viruses and bacteria than by microscopic eukaryotes, these eukaryotes are responsible for some diseases of great public health importance. For example, the protozoal disease malaria was responsible for 584,000 deaths worldwide (primarily children in Africa) in 2013, according to the World Health Organization (WHO). The protist parasite  Giardia  causes a diarrheal illness (giardiasis) that is easily transmitted through contaminated water supplies. In the United States,  Giardia  is the most common human intestinal parasite ( Figure 5.3 ). Although it may seem surprising, parasitic worms are included within the study of microbiology because identification depends on observation of microscopic adult worms or eggs. Even in developed countries, these worms are important parasites of humans and of domestic animals. There are fewer fungal pathogens, but these are important causes of illness, as well. On the other hand, fungi have been important in producing antimicrobial substances such as penicillin. In this chapter, we will examine characteristics of protists, worms, and fungi while considering their roles in causing disease. \n\n Characteristics of Protists \n\n The word  protist  is a historical term that is now used informally to refer to a diverse group of microscopic eukaryotic organisms. It is not considered a formal taxonomic term because the organisms it describes do not have a shared evolutionary origin. Historically, the  protists  were informally grouped into the \u201canimal-like\u201d  protozoans , the \u201cplant-like\u201d  algae , and the \u201cfungus-like\u201d protists such as  water molds . These three groups of protists differ greatly in terms of their basic characteristics. For example, algae are photosynthetic organisms that can be unicellular or multicellular. Protozoa, on the other hand, are nonphotosynthetic, motile organisms that are always unicellular. Other informal terms may also be used to describe various groups of protists. For example, microorganisms that drift or float in water, moved by currents, are referred to as  plankton . Types of plankton include  zooplankton , which are motile and nonphotosynthetic, and  phytoplankton , which are photosynthetic. \n\n Protozoans inhabit a wide variety of habitats, both aquatic and terrestrial. Many are free-living, while others are parasitic, carrying out a life cycle within a host or hosts and potentially causing illness. There are also beneficial symbionts that provide metabolic services to their hosts. During the feeding and growth part of their life cycle, they are called  trophozoite s ; these feed on small particulate food sources such as bacteria. While some types of protozoa exist exclusively in the trophozoite form, others can develop from trophozoite to an encapsulated cyst stage when environmental conditions are too harsh for the trophozoite. A  cyst  is a cell with a protective wall, and the process by which a trophozoite becomes a cyst is called  encystment . When conditions become more favorable, these cysts are triggered by environmental cues to become active again through  excystment . \n\n One protozoan genus capable of encystment is  Eimeria , which includes some human and animal pathogens.  Figure 5.4  illustrates the life cycle of  Eimeria . \n\n Protozoans have a variety of reproductive mechanisms. Some protozoans reproduce asexually and others reproduce sexually; still others are capable of both sexual and asexual reproduction. In protozoans, asexual reproduction occurs by binary fission, budding, or schizogony. In  schizogony , the nucleus of a cell divides multiple times before the cell divides into many smaller cells. The products of schizogony are called merozoites and they are stored in structures known as schizonts. Protozoans may also reproduce sexually, which increases genetic diversity and can lead to complex life cycles. Protozoans can produce haploid gametes that fuse through  syngamy . However, they can also exchange genetic material by joining to exchange DNA in a process called  conjugation . This is a different process than the conjugation that occurs in bacteria. The term  protist conjugation  refers to a true form of eukaryotic sexual reproduction between two cells of different mating types. It is found in  ciliate s , a group of protozoans, and is described later in this subsection. \n\n All protozoans have a plasma membrane, or  plasmalemma , and some have bands of protein just inside the membrane that add rigidity, forming a structure called the  pellicle . Some protists, including protozoans, have distinct layers of cytoplasm under the membrane. In these protists, the outer gel layer (with microfilaments of actin) is called the  ectoplasm . Inside this layer is a sol (fluid) region of cytoplasm called the  endoplasm . These structures contribute to complex cell shapes in some protozoans, whereas others (such as amoebas) have more flexible shapes ( Figure 5.5 ). \n\n Different groups of protozoans have specialized feeding structures. They may have a specialized structure for taking in food through phagocytosis, called a  cytostome , and a specialized structure for the exocytosis of wastes called a  cytoproct . Oral grooves leading to cytostomes are lined with hair-like cilia to sweep in food particles. Protozoans are heterotrophic. Protozoans that are  holozoic  ingest whole food particles through phagocytosis. Forms that are  saprozoic  ingest small, soluble food molecules. \n\n Many protists have whip-like  flagella  or hair-like  cilia  made of  microtubules  that can be used for locomotion ( Figure 5.5 ). Other protists use cytoplasmic extensions known as  pseudopodia  (\u201cfalse feet\u201d) to attach the cell to a surface; they then allow cytoplasm to flow into the extension, thus moving themselves forward. \n\n Protozoans have a variety of unique organelles and sometimes lack organelles found in other cells. Some have  contractile vacuole s , organelles that can be used to move water out of the cell for osmotic regulation (salt and water balance) ( Figure 5.5 ). Mitochondria may be absent in parasites or altered to  kinetoplastids  (modified mitochondria) or  hydrogenosomes  (see  Unique Characteristics of Prokaryotic Cells  for more discussion of these structures). \n\n Check Your Understanding \n\n What is the sequence of events in reproduction by schizogony and what are the cells produced called? \n\n Taxonomy of Protists \n\n The protists are a  polyphyletic  group, meaning they lack a shared evolutionary origin. Since the current taxonomy is based on evolutionary history (as determined by biochemistry, morphology, and genetics), protists are scattered across many different taxonomic groups within the domain Eukarya. Eukarya is currently divided into six  supergroups  that are further divided into subgroups, as illustrated in ( Figure 5.6 ). In this section, we will primarily be concerned with the supergroups  Amoebozoa ,  Excavata , and  Chromalveolata ; these supergroups include many protozoans of clinical significance. The supergroups  Opisthokonta  and  Rhizaria  also include some protozoans, but few of clinical significance. In addition to protozoans, Opisthokonta also includes animals and fungi, some of which we will discuss in  Parasitic Helminths  and  Fungi . Some examples of the Archaeplastida will be discussed in  Algae .  Figure 5.7  and  Figure 5.8  summarize the characteristics of each supergroup and subgroup and list representatives of each. \n\n Check Your Understanding \n\n Which supergroups contain the clinically significant protists? \n\n Amoebozoa \n\n The supergroup  Amoebozoa  includes protozoans that use amoeboid movement. Actin microfilaments produce  pseudopodia , into which the remainder of the protoplasm flows, thereby moving the organism. The genus  Entamoeba  includes commensal or parasitic species, including the medically important  E. histolytica , which is transmitted by cysts in feces and is the primary cause of  amoebic dysentery . Another member of this group that is pathogenic to humans is  Acanthamoeba , which can cause  keratitis  (corneal inflammation) and blindness. The notorious \u201cbrain eating amoeba,\u201d  Naegleria fowleri , is a considered a distant relative of the Amoebozoa and is classified in the phylum Percolozoa. \n\n The  Eumycetozoa  are an unusual group of organisms called  slime molds , which have previously been classified as animals, fungi, and plants ( Figure 5.9 ). Slime molds can be divided into two types:  cellular slime molds  and  plasmodial slime molds . The cellular slime molds exist as individual amoeboid cells that periodically aggregate into a mobile slug. The aggregate then forms a fruiting body that produces haploid spores. Plasmodial slime molds exist as large, multinucleate amoeboid cells that form reproductive stalks to produce spores that divide into gametes. One cellular slime mold,  Dictyostelium   discoideum , has been an important study organism for understanding cell differentiation, because it has both single-celled and multicelled life stages, with the cells showing some degree of differentiation in the multicelled form.  Figure 5.10  and  Figure 5.11  illustrate the life cycles of cellular and plasmodial slime molds, respectively. \n\n Chromalveolata \n\n The supergroup  Chromalveolata  is united by similar origins of its members\u2019 plastids and includes the apicomplexans, ciliates,  diatoms , and  dinoflagellates , among other groups (we will cover the diatoms and dinoflagellates in  Algae ). The  apicomplexans  are intra- or extracellular parasites that have an  apical complex  at one end of the cell. The apical complex is a concentration of organelles, vacuoles, and microtubules that allows the parasite to enter host cells ( Figure 5.12 ). Apicomplexans have complex life cycles that include an infective sporozoite that undergoes  schizogony  to make many merozoites (see the example in  Figure 5.4 ). Many are capable of infecting a variety of animal cells, from insects to livestock to humans, and their life cycles often depend on transmission between multiple hosts. The genus  Plasmodium  is an example of this group. \n\n Other apicomplexans are also medically important.  Cryptosporidium parvum  causes intestinal symptoms and can cause epidemic diarrhea when the cysts contaminate drinking water.  Theileria (Babesia) microti , transmitted by the tick  Ixodes scapularis , causes recurring fever that can be fatal and is becoming a common transfusion-transmitted pathogen in the United States ( Theileria  and  Babesia  are closely related genera and there is some debate about the best classification). Finally,  Toxoplasma gondii  causes  toxoplasmosis  and can be transmitted from cat feces, unwashed fruit and vegetables, or from undercooked meat. Because toxoplasmosis can be associated with serious birth defects, pregnant women need to be aware of this risk and use caution if they are exposed to the feces of potentially infected cats. A national survey found the frequency of individuals with antibodies for toxoplasmosis (and thus who presumably have a current latent infection) in the United States to be 11%. Rates are much higher in other countries, including some developed countries. 3  There is also evidence and a good deal of theorizing that the parasite may be responsible for altering infected humans\u2019 behavior and personality traits. 4 3 J. Flegr et al. \u201cToxoplasmosis\u2014A Global Threat. Correlation of Latent Toxoplasmosis With Specific Disease Burden in a Set of 88 Countries.\u201d  PloS ONE  9 no. 3 (2014):e90203. 4 J. Flegr. \u201cEffects of Toxoplasma on Human Behavior.\u201d  Schizophrenia Bull  33, no. 3 (2007):757\u2013760. \n\n The ciliates (Ciliaphora), also within the Chromalveolata, are a large, very diverse group characterized by the presence of  cilia  on their cell surface. Although the cilia may be used for locomotion, they are often used for feeding, as well, and some forms are nonmotile.  Balantidium coli  ( Figure 5.13 ) is the only parasitic ciliate that affects humans by causing intestinal illness, although it rarely causes serious medical issues except in the immunocompromised (those having a weakened immune system). Perhaps the most familiar ciliate is  Paramecium , a motile organism with a clearly visible  cytostome  and  cytoproct  that is often studied in biology laboratories ( Figure 5.14 ). Another ciliate,  Stentor , is sessile and uses its cilia for feeding ( Figure 5.15 ). Generally, these organisms have a  micronucleus  that is diploid, somatic, and used for sexual reproduction by conjugation. They also have a  macronucleus  that is derived from the micronucleus; the macronucleus becomes polyploid (multiple sets of duplicate chromosomes), and has a reduced set of metabolic genes. \n\n Ciliates are able to reproduce through  conjugation , in which two cells attach to each other. In each cell, the diploid micronuclei undergo meiosis, producing eight haploid nuclei each. Then, all but one of the haploid micronuclei and the macronucleus disintegrate; the remaining (haploid) micronucleus undergoes mitosis. The two cells then exchange one micronucleus each, which fuses with the remaining micronucleus present to form a new, genetically different, diploid micronucleus. The diploid micronucleus undergoes two mitotic divisions, so each cell has four micronuclei, and two of the four combine to form a new macronucleus. The chromosomes in the macronucleus then replicate repeatedly, the macronucleus reaches its polyploid state, and the two cells separate. The two cells are now genetically different from each other and from their previous versions. \n\n \u00d6omycetes have similarities to fungi and were once classified with them. They are also called  water molds . However, they differ from fungi in several important ways. \u00d6omycetes have cell walls of cellulose (unlike the chitinous cell walls of fungi) and they are generally diploid, whereas the dominant life forms of fungi are typically haploid.  Phytophthora , the plant pathogen found in the soil that caused the  Irish potato famine , is classified within this group ( Figure 5.16 ). \n\n Link to Learning \n\n Explore the procedures for detecting the presence of an apicomplexan in a public water supply, at  this  website. \n\n This  video  shows the feeding of  Stentor . \n\n Excavata \n\n The third and final supergroup to be considered in this section is the Excavata, which includes primitive eukaryotes and many parasites with limited metabolic abilities. These organisms have complex cell shapes and structures, often including a depression on the surface of the cell called an excavate. The group Excavata includes the subgroups  Fornicata ,  Parabasalia , and  Euglenozoa . The Fornicata lack mitochondria but have flagella. This group includes  Giardia lamblia  (also known as  G. intestinalis  or  G. duodenalis) , a widespread pathogen that causes diarrheal illness and can be spread through cysts from feces that contaminate water supplies ( Figure 5.3 ). Parabasalia are frequent animal endosymbionts; they live in the guts of animals like termites and cockroaches. They have basal bodies and modified mitochondria (kinetoplastids). They also have a large, complex cell structure with an undulating membrane and often have many flagella. The trichomonads (a subgroup of the Parabasalia) include pathogens such as  Trichomonas vaginalis , which causes the human sexually transmitted disease  trichomoniasis . Trichomoniasis often does not cause symptoms in men, but men are able to transmit the infection. In women, it causes vaginal discomfort and discharge and may cause complications in pregnancy if left untreated. \n\n The Euglenozoa are common in the environment and include photosynthetic and nonphotosynthetic species. Members of the genus  Euglena  are typically not pathogenic. Their cells have two flagella, a  pellicle , a  stigma  (eyespot) to sense light, and chloroplasts for photosynthesis ( Figure 5.17 ). The pellicle of  Euglena  is made of a series of protein bands surrounding the cell; it supports the cell membrane and gives the cell shape. \n\n The Euglenozoa also include the trypanosomes, which are parasitic pathogens. The genus  Trypanosoma  includes  T. brucei , which causes  African trypanosomiasis  ( African sleeping sickness  and  T. cruzi , which causes American trypanosomiasis ( Chagas disease ). These tropical diseases are spread by insect bites. In African sleeping sickness,  T. brucei  colonizes the blood and the brain after being transmitted via the bite of a tsetse fly ( Glossina  spp.) ( Figure 5.18 ). The early symptoms include confusion, difficulty sleeping, and lack of coordination. Left untreated, it is fatal. \n\n Chagas\u2019 disease originated and is most common in Latin America. The disease is transmitted by  Triatoma  spp., insects often called \u201ckissing bugs,\u201d and affects either the heart tissue or tissues of the digestive system. Untreated cases can eventually lead to heart failure or significant digestive or neurological disorders. \n\n The genus  Leishmania  includes trypanosomes that cause disfiguring skin disease and sometimes systemic illness as well. \n\n Eye on Ethics Neglected Parasites The Centers for Disease Control and Prevention (CDC) is responsible for identifying public health priorities in the United States and developing strategies to address areas of concern. As part of this mandate, the CDC has officially identified five parasitic diseases it considers to have been neglected (i.e., not adequately studied). These  neglected parasitic infections (NPIs)  include  toxoplasmosis ,  Chagas disease ,  toxocariasis  (a nematode infection transmitted primarily by infected dogs),  cysticercosis  (a disease caused by a tissue infection of the tapeworm  Taenia solium ), and  trichomoniasis  (a sexually transmitted disease caused by the parabasalid  Trichomonas vaginalis ). \n\n The decision to name these specific diseases as NPIs means that the CDC will devote resources toward improving awareness and developing better diagnostic testing and treatment through studies of available data. The CDC may also advise on treatment of these diseases and assist in the distribution of medications that might otherwise be difficult to obtain. 5 5 Centers for Disease Control and Prevention. \u201cNeglected Parasitic Infections (NPIs) in the United States.\u201d http://www.cdc.gov/parasites/npi/. Last updated July 10, 2014. \n\n Of course, the CDC does not have unlimited resources, so by prioritizing these five diseases, it is effectively deprioritizing others. Given that many Americans have never heard of many of these NPIs, it is fair to ask what criteria the CDC used in prioritizing diseases. According to the CDC, the factors considered were the number of people infected, the severity of the illness, and whether the illness can be treated or prevented. Although several of these NPIs may seem to be more common outside the United States, the CDC argues that many cases in the United States likely go undiagnosed and untreated because so little is known about these diseases. 6 6 Centers for Disease Control and Prevention. \u201cFact Sheet: Neglected Parasitic Infections in the United States.\u201d http://www.cdc.gov/parasites/resources/pdf/npi_factsheet.pdf \n\n What criteria should be considered when prioritizing diseases for purposes of funding or research? Are those identified by the CDC reasonable? What other factors could be considered? Should government agencies like the CDC have the same criteria as private pharmaceutical research labs? What are the ethical implications of deprioritizing other potentially neglected parasitic diseases such as leishmaniasis? \n 5.2   Parasitic Helminths \n\n Learning Objectives \n\n Explain why we include the study of parasitic worms within the discipline of microbiology \n\n Compare the basic morphology of the major groups of parasitic helminthes \n\n Describe the characteristics of parasitic nematodes, and give an example of infective eggs and infective larvae \n\n Describe the characteristics of parasitic trematodes and cestodes, and give examples of each \n\n Identify examples of the primary causes of infections due to nematodes, trematodes, and cestodes \n\n Classify parasitic worms according to major groups\n\n Parasitic helminths are animals that are often included within the study of microbiology because many species of these worms are identified by their microscopic eggs and larvae. There are two major groups of  parasitic helminths : the roundworms (Nematoda) and flatworms (Platyhelminthes). Of the many species that exist in these groups, about half are parasitic and some are important human pathogens. As animals, they are multicellular and have organ systems. However, the parasitic species often have limited digestive tracts, nervous systems, and locomotor abilities. Parasitic forms may have complex reproductive cycles with several different life stages and more than one type of host. Some are  monoecious , having both male and female reproductive organs in a single individual, while others are  dioecious , each having either male or female reproductive organs. \n\n Nematoda (Roundworms) \n\n Phylum  Nematoda  (the  roundworms ) is a diverse group containing more than 15,000 species, of which several are important human parasites ( Figure 5.19 ). These unsegmented worms have a full digestive system even when parasitic. Some are common intestinal parasites, and their eggs can sometimes be identified in feces or around the anus of infected individuals.  Ascaris   lumbricoides  is the largest nematode intestinal parasite found in humans; females may reach lengths greater than 1 meter.  A.   lumbricoides  is also very widespread, even in developed nations, although it is now a relatively uncommon problem in the United States. It may cause symptoms ranging from relatively mild (such as a cough and mild abdominal pain) to severe (such as intestinal blockage and impaired growth). \n\n Of all nematode infections in the United States,  pinworm  (caused by  Enterobius vermicularis ) is the most common. Pinworm causes sleeplessness and itching around the anus, where the female worms lay their eggs during the night.  Toxocara   canis  and  T. cati  are nematodes found in dogs and cats, respectively, that can be transmitted to humans, causing  toxocariasis . Antibodies to these parasites have been found in approximately 13.9% of the U.S. population, suggesting that exposure is common. 7  Infection can cause larval migrans, which can result in vision loss and eye inflammation, or fever, fatigue, coughing, and abdominal pain, depending on whether the organism infects the eye or the viscera. Another common nematode infection is  hookworm , which is caused by  Necator americanus  (the New World or North American hookworm) and  Ancylostoma duodenale  (the Old World hookworm). Symptoms of hookworm infection can include abdominal pain, diarrhea, loss of appetite, weight loss, fatigue, and anemia. 7 Won K, Kruszon-Moran D, Schantz P, Jones J. \u201cNational seroprevalence and risk factors for zoonotic Toxocara spp. infection.\u201d In: Abstracts of the 56th American Society of Tropical Medicine and Hygiene; Philadelphia, Pennsylvania; 2007 Nov 4-8. \n\n Trichinellosis, also called  trichinosis , caused by  Trichinella spiralis , is contracted by consuming undercooked meat, which releases the larvae and allows them to encyst in muscles. Infection can cause fever, muscle pains, and digestive system problems; severe infections can lead to lack of coordination, breathing and heart problems, and even death. Finally,  heartworm  in dogs and other animals is caused by the nematode  Dirofilaria immitis ,  which is transmitted by mosquitoes. Symptoms include fatigue and cough; when left untreated, death may result. \n\n Clinical Focus Part 2 The physician explains to Sarah\u2019s mother that ringworm can be transferred between people through touch. \u201cIt\u2019s common in school children, because they often come in close contact with each other, but anyone can become infected,\u201d he adds. \u201cBecause you can transfer it through objects, locker rooms and public pools are also a potential source of infection. It\u2019s very common among wrestlers and athletes in other contact sports.\u201d \n\n Looking very uncomfortable, Sarah says to her mother \u201cI want this worm out of me.\u201d \n\n The doctor laughs and says, \u201cSarah, you\u2019re in luck because ringworm is just a name; it is not an actual worm. You have nothing wriggling around under your skin.\u201d \n\n \u201cThen what is it?\u201d asks Sarah. \n\n What type of pathogen causes ringworm? \n\n Jump to the  next  Clinical Focus box. Go back to the  previous  Clinical Focus box. \n\n Check Your Understanding \n\n What is the most common nematode infection in the United States? \n\n Platyhelminths (Flatworms) \n\n Phylum  Platyhelminthes  (the platyhelminths) are  flatworms . This group includes the flukes, tapeworms, and the turbellarians, which include planarians. The flukes and tapeworms are medically important parasites ( Figure 5.20 ). \n\n The  flukes  ( trematodes ) are nonsegmented flatworms that have an oral sucker ( Figure 5.21 ) (and sometimes a second ventral sucker) and attach to the inner walls of intestines, lungs, large blood vessels, or the liver. Trematodes have complex life cycles, often with multiple hosts. Several important examples are the  liver flukes  ( Clonorchis  and  Opisthorchis ), the  intestinal fluke  ( Fasciolopsis buski ), and the  oriental lung fluke  ( Paragonimus westermani ).  Schistosomiasis  is a serious parasitic disease, considered second in the scale of its impact on human populations only to malaria. The parasites  Schistosoma   mansoni, S. haematobium , and  S. japonicum , which are found in freshwater snails, are responsible for schistosomiasis ( Figure 5.22 ). Immature forms burrow through the skin into the blood. They migrate to the lungs, then to the liver and, later, other organs. Symptoms include anemia, malnutrition, fever, abdominal pain, fluid buildup, and sometimes death. \n\n The other medically important group of platyhelminths are commonly known as  tapeworms  ( cestodes ) and are segmented flatworms that may have suckers or hooks at the  scolex  (head region) ( Figure 5.21 ). Tapeworms use these suckers or hooks to attach to the wall of the small intestine. The body of the worm is made up of segments called  proglottid s  that contain reproductive structures; these detach when the gametes are fertilized, releasing gravid proglottids with eggs. Tapeworms often have an intermediate host that consumes the eggs, which then hatch into a larval form called an oncosphere. The oncosphere migrates to a particular tissue or organ in the intermediate host, where it forms cysticerci. After being eaten by the definitive host, the cysticerci develop into adult tapeworms in the host's digestive system ( Figure 5.23 ).  Taenia saginata  (the beef tapeworm) and  T. solium  (the pork tapeworm) enter humans through ingestion of undercooked, contaminated meat. The adult worms develop and reside in the intestine, but the larval stage may migrate and be found in other body locations such as skeletal and smooth muscle. The beef tapeworm is relatively benign, although it can cause digestive problems and, occasionally, allergic reactions. The pork tapeworm can cause more serious problems when the larvae leave the intestine and colonize other tissues, including those of the central nervous system.  Diphylobothrium latum  is the largest human tapeworm and can be ingested in undercooked fish. It can grow to a length of 15 meters.  Echinococcus granulosus ,  the dog tapeworm, can parasitize humans and uses dogs as an important host. \n\n Check Your Understanding \n\n What group of medically important flatworms is segmented and what group is unsegmented? \n\n Micro Connections Food for Worms? For residents of temperate, developed countries, it may be difficult to imagine just how common helminth infections are in the human population. In fact, they are quite common and even occur frequently in the United States. Worldwide, approximately 807\u20131,221 million people are infected with  Ascaris lumbricoides  (perhaps one-sixth of the human population) and far more are infected if all nematode species are considered. 8  Rates of infection are relatively high even in industrialized nations. Approximately 604\u2013795 million people are infected with whipworm ( Trichuris ) worldwide ( Trichuris  can also infect dogs), and 576\u2013740 million people are infected with  hookworm  ( Necator americanus  and  Ancylostoma duodenale ). 9   Toxocara,  a nematode parasite of dogs and cats, is also able to infect humans. It is widespread in the United States, with about 10,000 symptomatic cases annually. However, one study found 14% of the population (more than 40 million Americans) was seropositive, meaning they had been exposed to the parasite at one time. More than 200 million people have schistosomiasis worldwide. Most of the World Health Organization (WHO) neglected tropical diseases are helminths. In some cases, helminths may cause subclinical illnesses, meaning the symptoms are so mild that that they go unnoticed. In other cases, the effects may be more severe or chronic, leading to fluid accumulation and organ damage. With so many people affected, these parasites constitute a major global public health concern. 8 Fenwick, A. \u201cThe global burden of neglected tropical diseases.\u201d  Public health  126 no.3 (Mar 2012): 233\u20136. 9 de Silva, N., et. al. (2003). \u201cSoil-transmitted helminth infections: updating the global picture\u201d.  Trends in Parasitology  19 (December 2003): 547\u201351. \n\n Micro Connections Eradicating the Guinea Worm Dracunculiasis , or  Guinea worm disease , is caused by a nematode called  Dracunculus medinensis . When people consume contaminated water, water fleas (small crustaceans) containing the nematode larvae may be ingested. These larvae migrate out of the intestine, mate, and move through the body until females eventually emerge (generally through the feet). While Guinea worm disease is rarely fatal, it is extremely painful and can be accompanied by secondary infections and edema ( Figure 5.24 ). \n\n An eradication campaign led by WHO, the CDC, the United Nations Children\u2019s Fund (UNICEF), and the Carter Center (founded by former U.S. president Jimmy Carter) has been extremely successful in reducing cases of dracunculiasis. This has been possible because diagnosis is straightforward, there is an inexpensive method of control, there is no animal reservoir, the water fleas are not airborne (they are restricted to still water), the disease is geographically limited, and there has been a commitment from the governments involved. Additionally, no vaccines or medication are required for treatment and prevention. In 1986, 3.5 million people were estimated to be affected. After the eradication campaign, which included helping people in affected areas learn to filter water with cloth, only four countries continue to report the disease (Chad, Mali, South Sudan, and Ethiopia) with a total of 126 cases reported to WHO in 2014. 10 10 World Health Organization. \u201cSouth Sudan Reports Zero Cases of Guinea-Worm Disease for Seventh Consecutive Month.\u201d 2016. http://www.who.int/dracunculiasis/no_new_case_for_seventh_consecutive_months/en/. Accessed May 2, 2016. \n 5.3   Fungi \n\n Learning Objectives \n\n Explain why the study of fungi such as yeast and molds is within the discipline of microbiology \n\n Describe the unique characteristics of fungi \n\n Describe examples of asexual and sexual reproduction of fungi \n\n Compare the major groups of fungi in this chapter, and give examples of each \n\n Identify examples of the primary causes of infections due to yeasts and molds \n\n Identify examples of toxin-producing fungi \n\n Classify fungal organisms according to major groups \n\n The  fungi  comprise a diverse group of organisms that are heterotrophic and typically saprozoic. In addition to the well-known macroscopic fungi (such as mushrooms and molds), many unicellular yeasts and spores of macroscopic fungi are microscopic. For this reason, fungi are included within the field of microbiology. \n\n Fungi are important to humans in a variety of ways. Both microscopic and macroscopic fungi have medical relevance, with some pathogenic species that can cause  mycoses  (illnesses caused by fungi). Some pathogenic fungi are opportunistic, meaning that they mainly cause infections when the host\u2019s immune defenses are compromised and do not normally cause illness in healthy individuals. Fungi are important in other ways. They act as decomposers in the environment, and they are critical for the production of certain foods such as cheeses. Fungi are also major sources of antibiotics, such as  penicillin  from the fungus  Penicillium . \n\n Characteristics of Fungi \n\n Fungi have well-defined characteristics that set them apart from other organisms. Most multicellular fungal bodies, commonly called  molds , are made up of filaments called  hyphae . Hyphae can form a tangled network called a  mycelium  and form the  thallus  (body) of fleshy fungi. Hyphae that have walls between the cells are called  septate hyphae ; hyphae that lack walls and cell membranes between the cells are called nonseptate or  coenocytic hyphae ). ( Figure 5.25 ). \n\n In contrast to molds,  yeasts  are unicellular fungi. The  budding yeasts  reproduce asexually by budding off a smaller daughter cell; the resulting cells may sometimes stick together as a short chain or  pseudohypha  ( Figure 5.25 ).  Some fungi are dimorphic, having more than one appearance during their life cycle. These  dimorphic fungi  may be able to appear as yeasts or molds, which can be important for infectivity. They are capable of changing their appearance in response to environmental changes such as nutrient availability or fluctuations in temperature, growing as a mold, for example, at 25 \u00b0C (77 \u00b0F), and as yeast cells at 37 \u00b0C (98.6 \u00b0F). This ability helps dimorphic fungi to survive in diverse environments. Two examples of dimorphic yeasts are the human pathogens Histoplasma capsulatum and Candida albicans. H. capsulatum causes the lung disease histoplasmosis, and C. albicans is associated with vaginal yeast infections, oral thrush, and candidiasis of the skin ( Figure 5.26 ). \n\n There are notable unique features in fungal cell walls and membranes. Fungal cell walls contain  chitin , as opposed to the cellulose found in the cell walls of plants and many protists. Additionally, whereas animals have cholesterol in their cell membranes, fungal cell membranes have different sterols called  ergosterols . Ergosterols are often exploited as targets for antifungal drugs. \n\n Fungal life cycles are unique and complex. Fungi reproduce sexually either through cross- or self-fertilization. Haploid fungi form hyphae that have gametes at the tips. Two different mating types (represented as \u201c+ type\u201d and \u201c\u2013 type\u201d) are involved. The cytoplasms of the + and \u2013 type gametes fuse (in an event called plasmogamy), producing a cell with two distinct nuclei (a  dikaryotic  cell). Later, the nuclei fuse (in an event called  karyogamy ) to create a diploid zygote. The zygote undergoes meiosis to form  spores  that germinate to start the haploid stage, which eventually creates more haploid mycelia ( Figure 5.27 ). Depending on the taxonomic group, these sexually produced spores are known as zygospores (in Zygomycota), ascospores (in Ascomycota), or basidiospores (in Basidiomycota) ( Figure 5.28 ). \n\n Fungi may also exhibit asexual reproduction by mitosis, mitosis with budding, fragmentation of hyphae, and formation of asexual spores by mitosis. These spores are specialized cells that, depending on the organism, may have unique characteristics for survival, reproduction, and dispersal. Fungi exhibit several types of asexual spores and these can be important in classification. \n\n Check Your Understanding \n\n Is a dimorphic fungus a yeast or a mold? Explain. \n\n Fungal Diversity \n\n The  fungi  are very diverse, comprising seven major groups. Not all of the seven groups contain pathogens. Some of these groups are generally associated with plants and include plant pathogens. For example, Urediniomycetes and Ustilagomycetes include the plant  rusts  and  smuts , respectively. These form reddish or dark masses, respectively, on plants as rusts (red) or smuts (dark). Some species have substantial economic impact because of their ability to reduce crop yields. Glomeromycota includes the  mycorrhizal fungi , important symbionts with plant roots that can promote plant growth by acting like an extended root system. The Glomeromycota are obligate symbionts, meaning that they can only survive when associated with plant roots; the fungi receive carbohydrates from the plant and the plant benefits from the increased ability to take up nutrients and minerals from the soil. The Chytridiomycetes ( chytrids ) are small fungi, but are extremely ecologically important. Chytrids are generally aquatic and have flagellated, motile gametes; specific types are implicated in amphibian declines around the world. Because of their medical importance, we will focus on Zygomycota, Ascomycota, Basidiomycota, and Microsporidia.  Figure 5.33  summarizes the characteristics of these medically important groups of fungi. \n\n The  Zygomycota  (zygomycetes) are mainly saprophytes with coenocytic hyphae and haploid nuclei. They use sporangiospores for asexual reproduction. The group name comes from the  zygospores  that they use for sexual reproduction ( Figure 5.27 ), which have hard walls formed from the fusion of reproductive cells from two individuals. Zygomycetes are important for food science and as crop pathogens. One example is  Rhizopus stolonifer  ( Figure 5.28 ), an important bread mold that also causes rice seedling blight.  Mucor  is a genus of fungi that can potentially cause necrotizing infections in humans, although most species are intolerant of temperatures found in mammalian bodies ( Figure 5.28 ). \n\n The  Ascomycota  include fungi that are used as food (edible mushrooms, morels, and truffles), others that are common causes of food spoilage (bread molds and plant pathogens), and still others that are human pathogens. Ascomycota may have septate hyphae and cup-shaped fruiting bodies called  ascocarps . Some genera of Ascomycota use sexually produced  ascospores  as well as asexual spores called  conidia , but sexual phases have not been discovered or described for others. Some produce an  ascus  containing ascospores within an ascocarp ( Figure 5.29 ). \n\n Examples of the Ascomycota include several bread molds and minor pathogens, as well as species capable of causing more serious mycoses. Species in the genus  Aspergillus  are important causes of allergy and infection, and are useful in research and in the production of certain fermented alcoholic beverages such as Japanese  sake . The fungus  Aspergillus flavus ,  a contaminant of nuts and stored grains, produces an  aflatoxin  that is both a toxin and the most potent known natural carcinogen.  Neurospora crassa  is of particular use in genetics research because the spores produced by meiosis are kept inside the ascus in a row that reflects the cell divisions that produced them, giving a direct view of segregation and assortment of genes ( Figure 5.30 ).  Penicillium  produces the antibiotic penicillin ( Figure 5.29 ). \n\n Many species of ascomycetes are medically important. A large number of species in the genera  Trichophyton ,  Microsporum , and  Epidermophyton  are  dermatophytes , pathogenic fungi capable of causing skin infections such as athlete\u2019s foot, jock itch, and  ringworm .  Blastomyces dermatitidis  is a dimorphic fungus that can cause  blastomycosis , a respiratory infection that, if left untreated, can become disseminated to other body sites, sometimes leading to death. Another important respiratory pathogen is the dimorphic fungus  Histoplasma capsulatum  ( Figure 5.26 ) ,  which is associated with birds and bats in the Ohio and Mississippi river valleys.  Coccidioides immitis  causes the serious lung disease  Valley fever .  Candida albicans , the most common cause of vaginal and other yeast infections, is also an ascomycete fungus; it is a part of the normal microbiota of the skin, intestine, genital tract, and ear ( Figure 5.29 ). Ascomycetes also cause plant diseases, including ergot infections, Dutch elm disease, and powdery mildews. \n\n Saccharomyces  yeasts, including the baker\u2019s yeast  S. cerevisiae , are unicellular ascomycetes with haploid and diploid stages ( Figure 5.31 ). This and other  Saccharomyces  species are used for brewing beer. \n\n The  Basidiomycota  (basidiomycetes) are fungi that have  basidia  (club-shaped structures) that produce  basidiospores  (spores produced through budding) within fruiting bodies called  basidiocarps  ( Figure 5.32 ). They are important as decomposers and as food. This group includes rusts, stinkhorns, puffballs, and mushrooms. Several species are of particular importance.  Cryptococcus neoformans , a fungus commonly found as a yeast in the environment, can cause serious lung infections when inhaled by individuals with weakened immune systems. The edible meadow mushroom,  Agricus campestris , is a basidiomycete, as is the poisonous mushroom  Amanita   phalloides , known as the death cap. The deadly toxins produced by  A. phalloides  have been used to study transcription. \n\n Finally, the  Microsporidia  are unicellular fungi that are obligate intracellular parasites. They lack mitochondria, peroxisomes, and centrioles, but their spores release a unique  polar tubule  that pierces the host cell membrane to allow the fungus to gain entry into the cell. A number of microsporidia are human pathogens, and infections with microsporidia are called  microsporidiosis . One pathogenic species is  Enterocystozoan bieneusi , which can cause symptoms such as diarrhea, cholecystitis (inflammation of the gall bladder), and in rare cases, respiratory illness. \n\n Check Your Understanding \n\n Which group of fungi appears to be associated with the greatest number of human diseases? \n\n Micro Connections Eukaryotic Pathogens in Eukaryotic Hosts When we think about antimicrobial medications, antibiotics such as penicillin often come to mind. Penicillin and related antibiotics interfere with the synthesis of peptidoglycan cell walls, which effectively targets bacterial cells. These antibiotics are useful because humans (like all eukaryotes) do not have peptidoglycan cell walls. \n\n Developing medications that are effective against eukaryotic cells but not harmful to human cells is more difficult. Despite huge morphological differences, the cells of humans, fungi, and protists are similar in terms of their ribosomes, cytoskeletons, and cell membranes. As a result, it is more challenging to develop medications that target protozoans and fungi in the same way that antibiotics target prokaryotes. \n\n Fungicides have relatively limited modes of action. Because fungi have  ergosterols  (instead of cholesterol) in their cell membranes, the different enzymes involved in sterol production can be a target of some medications. The azole and morpholine  fungicides  interfere with the synthesis of membrane sterols. These are used widely in agriculture (fenpropimorph) and clinically (e.g., miconazole). Some antifungal medications target the  chitin  cell walls of fungi. Despite the success of these compounds in targeting fungi,  antifungal medications  for systemic infections still tend to have more toxic side effects than antibiotics for bacteria. \n\n Clinical Focus Part 3 Sarah is relieved the ringworm is not an actual worm, but wants to know what it really is. The physician explains that ringworm is a fungus. He tells her that she will not see mushrooms popping out of her skin, because this fungus is more like the invisible part of a mushroom that hides in the soil. He reassures her that they are going to get the fungus out of her too. \n\n The doctor cleans and then carefully scrapes the lesion to place a specimen on a slide. By looking at it under a microscope, the physician is able to confirm that a fungal infection is responsible for Sarah\u2019s lesion. In  Figure 5.34 , it is possible to see macro- and microconidia in  Trichophyton rubrum . Cell walls are also visible. Even if the pathogen resembled a helminth under the microscope, the presence of cell walls would rule out the possibility because animal cells lack cell walls. \n\n The doctor prescribes an antifungal cream for Sarah\u2019s mother to apply to the ringworm. Sarah\u2019s mother asks, \u201cWhat should we do if it doesn\u2019t go away?\u201d \n\n Can all forms of ringworm be treated with the same antifungal medication? \n\n Jump to the  next  Clinical Focus box. Go back to the  previous  Clinical Focus box. \n 5.4   Algae \n\n Learning Objectives \n\n Explain why algae are included within the discipline of microbiology \n\n Describe the unique characteristics of algae \n\n Identify examples of toxin-producing algae \n\n Compare the major groups of algae in this chapter, and give examples of each \n\n Classify algal organisms according to major groups \n\n The  algae  are autotrophic protists that can be unicellular or multicellular. These organisms are found in the supergroups  Chromalveolata  (dinoflagellates, diatoms, golden algae, and brown algae) and  Archaeplastida  (red algae and green algae). They are important ecologically and environmentally because they are responsible for the production of approximately 70% of the oxygen and organic matter in aquatic environments. Some types of algae, even those that are microscopic, are regularly eaten by humans and other animals. Additionally, algae are the source for  agar , agarose, and  carrageenan , solidifying agents used in laboratories and in food production. Although algae are typically not pathogenic, some produce toxins. Harmful  algal bloom s , which occur when algae grow quickly and produce dense populations, can produce high concentrations of toxins that impair liver and nervous-system function in aquatic animals and humans. \n\n Like protozoans, algae often have complex cell structures. For instance, algal cells can have one or more chloroplasts that contain structures called  pyrenoids  to synthesize and store starch. The chloroplasts themselves differ in their number of membranes, indicative of secondary or rare tertiary endosymbiotic events. Primary chloroplasts have two membranes\u2014one from the original cyanobacteria that the ancestral eukaryotic cell engulfed, and one from the plasma membrane of the engulfing cell. Chloroplasts in some lineages appear to have resulted from secondary endosymbiosis, in which another cell engulfed a green or red algal cell that already had a primary chloroplast within it. The engulfing cell destroyed everything except the chloroplast and possibly the cell membrane of its original cell, leaving three or four membranes around the chloroplast. Different algal groups have different pigments, which are reflected in common names such as red algae, brown algae, and green algae. \n\n Some algae, the seaweeds, are macroscopic and may be confused with plants. Seaweeds can be red, brown, or green, depending on their photosynthetic pigments. Green algae, in particular, share some important similarities with land plants; however, there are also important distinctions. For example, seaweeds do not have true tissues or organs like plants do. Additionally, seaweeds do not have a waxy cuticle to prevent desiccation. Algae can also be confused with cyanobacteria, photosynthetic bacteria that bear a resemblance to algae; however, cyanobacteria are prokaryotes (see  Nonproteobacteria Gram-negative Bacteria and Phototrophic Bacteria ). \n\n Algae have a variety of life cycles. Reproduction may be asexual by mitosis or sexual using gametes. \n\n Algal Diversity \n\n Although the algae and protozoa were formerly separated taxonomically, they are now mixed into supergroups. The algae are classified within the Chromalveolata and the Archaeplastida. Although the Euglenozoa (within the supergroup Excavata) include photosynthetic organisms, these are not considered algae because they feed and are motile. \n\n The dinoflagellates and stramenopiles fall within the Chromalveolata. The  dinoflagellates  are mostly marine organisms and are an important component of plankton. They have a variety of nutritional types and may be phototrophic, heterotrophic, or mixotrophic. Those that are photosynthetic use chlorophyll  a , chlorophyll  c 2 , and other photosynthetic pigments ( Figure 5.35 ). They generally have two flagella, causing them to whirl (in fact, the name dinoflagellate comes from the Greek word for \u201cwhirl\u201d:  dini ). Some have cellulose plates forming a hard outer covering, or  theca , as armor. Additionally, some dinoflagellates produce neurotoxins that can cause paralysis in humans or fish. Exposure can occur through contact with water containing the dinoflagellate toxins or by feeding on organisms that have eaten dinoflagellates. \n\n When a population of dinoflagellates becomes particularly dense, a  red tide  (a type of harmful algal bloom) can occur. Red tides cause harm to marine life and to humans who consume contaminated marine life. Major toxin producers include  Gonyaulax  and  Alexandrium ,  both of which cause paralytic shellfish poisoning. Another species,  Pfiesteria piscicida , is known as a fish killer because, at certain parts of its life cycle, it can produce toxins harmful to fish and it appears to be responsible for a suite of symptoms, including memory loss and confusion, in humans exposed to water containing the species. \n\n The  stramenopiles  include the  golden algae  ( Chrysophyta ), the  brown algae  ( Phaeophyta ), and the  diatoms  ( Bacillariophyta ). Stramenopiles have chlorophyll  a , chlorophyll  c 1 /c 2 , and fucoxanthin as photosynthetic pigments. Their storage carbohydrate is chrysolaminarin. While some lack cell walls, others have scales. Diatoms have  frustules , which are outer cell walls of crystallized silica; their fossilized remains are used to produce diatomaceous earth, which has a range of uses such as filtration and insulation. Additionally, diatoms can reproduce sexually and asexually, and the male gametes of centric diatoms have flagella providing directed movement to seek female gametes for sexual reproduction. \n\n Brown algae (Phaeophyta) are multicellular marine seaweeds. Some can be extremely large, such as the giant kelp ( Laminaria ). They have leaf-like blades, stalks, and structures called holdfasts that are used to attach to substrate. However, these are not true leaves, stems, or roots ( Figure 5.36 ). Their photosynthetic pigments are chlorophyll  a , chlorophyll  c ,  \u03b2 -carotene, and fucoxanthine. They use laminarin as a storage carbohydrate. \n\n The  Archaeplastids  include the  green algae  ( Chlorophyta ), the  red algae  ( Rhodophyta ), another group of green algae ( Charophyta ), and the land plants. The Charaphyta are the most similar to land plants because they share a mechanism of cell division and an important biochemical pathway, among other traits that the other groups do not have. Like land plants, the Charophyta and Chlorophyta have chlorophyll  a  and chlorophyll  b  as photosynthetic pigments, cellulose cell walls, and starch as a carbohydrate storage molecule.  Chlamydomonas  is a green alga that has a single large chloroplast, two flagella, and a  stigma  (eyespot); it is important in molecular biology research ( Figure 5.37 ). \n\n Chlorella  is a nonmotile, large, unicellular alga, and  Acetabularia  is an even larger unicellular green alga. The size of these organisms challenges the idea that all cells are small, and they have been used in genetics research since Joachim  H\u00e4mmerling  (1901\u20131980) began to work with them in 1943.  Volvox  is a colonial, unicellular alga ( Figure 5.37 ). A larger, multicellular green alga is  Ulva , also known as the sea lettuce because of its large, edible, green blades. The range of life forms within the Chlorophyta\u2014from unicellular to various levels of coloniality to multicellular forms\u2014has been a useful research model for understanding the evolution of multicellularity. The red algae are mainly multicellular but include some unicellular forms. They have rigid cell walls containing  agar  or  carrageenan , which are useful as food solidifying agents and as a solidifier added to growth media for microbes. \n\n Check Your Understanding \n\n Which groups of algae are associated with harmful algal blooms? \n 5.5   Lichens \n\n Learning Objectives \n\n Explain why lichens are included in the study of microbiology \n\n Describe the unique characteristics of a lichen and the role of each partner in the symbiotic relationship of a lichen \n\n Describe ways in which lichens are beneficial to the environment \n\n No one has to worry about getting sick from a lichen infection, but lichens are interesting from a microbiological perspective and they are an important component of most terrestrial ecosystems. Lichens provide opportunities for study of close relationships between unrelated microorganisms. Lichens contribute to soil production by breaking down rock, and they are early colonizers in soilless environments such as lava flows. The  cyanobacteria  in some lichens can fix nitrogen and act as a nitrogen source in some environments. Lichens are also important soil stabilizers in some desert environments and they are an important winter food source for caribou. Finally, lichens produce compounds that have antibacterial effects, and further research may discover compounds that are medically useful to humans. \n\n Characteristics \n\n A  lichen  is a combination of two organisms, a green alga or cyanobacterium and fungus, living in a symbiotic relationship. Whereas algae normally grow only in aquatic or extremely moist environments, lichens can potentially be found on almost any surface (especially rocks) or as  epiphytes  (meaning that they grow on other plants). In some ways, the symbiotic relationship between lichens and algae seems like a  mutualism  (a relationship in which both organisms benefit). The fungus can obtain photosynthates from the algae or cyanobacterium and the algae or cyanobacterium can grow in a drier environment than it could otherwise tolerate. However, most scientists consider this symbiotic relationship to be a controlled  parasitism  (a relationship in which one organism benefits and the other is harmed) because the photosynthetic organism grows less well than it would without the fungus. It is important to note that such symbiotic interactions fall along a continuum between conflict and cooperation. \n\n Lichens are slow growing and can live for centuries. They have been used in foods and to extract chemicals as dyes or antimicrobial substances. Some are very sensitive to pollution and have been used as environmental indicators. \n\n Lichens have a body called a thallus, an outer, tightly packed fungal layer called a  cortex , and an inner, loosely packed fungal layer called a  medulla  ( Figure 5.38 ). Lichens use hyphal bundles called  rhizines  to attach to the substrate. \n\n Lichen Diversity \n\n Lichens are classified as fungi and the fungal partners belong to the Ascomycota and Basidiomycota. Lichens can also be grouped into types based on their morphology. There are three major types of lichens, although other types exist as well. Lichens that are tightly attached to the substrate, giving them a crusty appearance, are called  crustose lichens . Those that have leaf-like lobes are  foliose lichens ; they may only be attached at one point in the growth form, and they also have a second cortex below the medulla. Finally,  fruticose lichens  have rounded structures and an overall branched appearance.  Figure 5.39  shows an example of each of the forms of lichens. \n\n Check Your Understanding \n\n What types of organisms are found in lichens? \n\n What are the three growth forms of lichens? \n\n Clinical Focus Resolution Sarah\u2019s mother asks the doctor what she should do if the cream prescribed for Sarah\u2019s  ringworm  does not work. The doctor explains that ringworm is a general term for a condition caused by multiple species. The first step is to take a scraping for examination under the microscope, which the doctor has already done. He explains that he has identified the infection as a fungus, and that the antifungal cream works against the most common fungi associated with ringworm. However, the cream may not work against some species of fungus. If the cream is not working after a couple of weeks, Sarah should come in for another visit, at which time the doctor will take steps to identify the species of the fungus. \n\n Positive identification of  dermatophytes  requires culturing. For this purpose,  Sabouraud\u2019s agar  may be used. In the case of Sarah\u2019s infection, which cleared up within 2 weeks of treatment, the culture would have a granular texture and would appear pale pink on top and red underneath. These features suggest that the fungus is  Trichophyton rubrum , a common cause of ringworm. \n\n Go back to the  previous  Clinical Focus box. ", "questions": [{"question": {"question_id": "fs-id1172099484030", "question_text": "Which genus includes the causative agent for malaria?", "question_choices": ["Euglena", "Paramecium", "Plasmodium", "Trypanosoma"], "cloze_format": "The genus that includes the causative agent for malaria is the ___.", "normal_format": "Which genus includes the causative agent for malaria?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "bloom": null, "hl_sentences": "One example is malaria , which is caused by Plasmodium , a eukaryotic organism transmitted through mosquito bites .", "hl_context": "Chapter Outline 5.1 Unicellular Eukaryotic Parasites 5.2 Parasitic Helminths 5.3 Fungi 5.4 Algae 5.5 Lichens Introduction Although bacteria and viruses account for a large number of the infectious diseases that afflict humans , many serious illnesses are caused by eukaryotic organisms . <hl> One example is malaria , which is caused by Plasmodium , a eukaryotic organism transmitted through mosquito bites . <hl> Malaria is a major cause of morbidity ( illness ) and mortality ( death ) that threatens 3.4 billion people worldwide . 1 In severe cases , organ failure and blood or metabolic abnormalities contribute to medical emergencies and sometimes death . Even after initial recovery , relapses may occur years later . In countries where malaria is endemic , the disease represents a major public health challenge that can place a tremendous strain on developing economies . 1 Centers for Disease Control and Prevention . \u201c Impact of Malaria . \u201d September 22 , 2015 . http://www.cdc.gov/malaria/malaria_worldwide/impact.html . Accessed January 18 , 2016 . Worldwide , major efforts are underway to reduce malaria infections . Efforts include the distribution of insecticide-treated bed nets and the spraying of pesticides . Researchers are also making progress in their efforts to develop effective vaccines . 2 The President \u2019 s Malaria Initiative , started in 2005 , supports prevention and treatment . The Bill and Melinda Gates Foundation has a large initiative to eliminate malaria . Despite these efforts , malaria continues to cause long-term morbidity ( such as intellectual disabilities in children ) and mortality ( especially in children younger than 5 years ) , so we still have far to go . 2 RTS , S Clinical Trials Partnership . \u201c Efficacy and safety of RTS , S / AS01 malaria vaccine with or without a booster dose in infants and children in Africa : final results of a phase 3 , individually randomised , controlled trial . \u201d The Lancet 23 April 2015 . DOI : http://dx.doi.org/10.1016/S0140-6736(15)60721-8 ."}, {"question": {"question_id": "fs-id1172099454564", "question_text": "Which protist is a concern because of its ability to contaminate water supplies and cause diarrheal illness?", "question_choices": ["Plasmodium vivax", "Toxoplasma gondii", "Giardia lamblia", "Trichomonas vaginalis"], "cloze_format": "The ___ protist is a concern because of its ability to contaminate water supplies and cause diarrheal illness.", "normal_format": "Which protist is a concern because of its ability to contaminate water supplies and cause diarrheal illness?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "bloom": null, "hl_sentences": "This group includes Giardia lamblia ( also known as G . intestinalis or G . duodenalis ) , a widespread pathogen that causes diarrheal illness and can be spread through cysts from feces that contaminate water supplies ( Figure 5.3 ) . The protist parasite Giardia causes a diarrheal illness ( giardiasis ) that is easily transmitted through contaminated water supplies .", "hl_context": "The third and final supergroup to be considered in this section is the Excavata , which includes primitive eukaryotes and many parasites with limited metabolic abilities . These organisms have complex cell shapes and structures , often including a depression on the surface of the cell called an excavate . The group Excavata includes the subgroups Fornicata , Parabasalia , and Euglenozoa . The Fornicata lack mitochondria but have flagella . <hl> This group includes Giardia lamblia ( also known as G . intestinalis or G . duodenalis ) , a widespread pathogen that causes diarrheal illness and can be spread through cysts from feces that contaminate water supplies ( Figure 5.3 ) . <hl> Parabasalia are frequent animal endosymbionts ; they live in the guts of animals like termites and cockroaches . They have basal bodies and modified mitochondria ( kinetoplastids ) . They also have a large , complex cell structure with an undulating membrane and often have many flagella . The trichomonads ( a subgroup of the Parabasalia ) include pathogens such as Trichomonas vaginalis , which causes the human sexually transmitted disease trichomoniasis . Trichomoniasis often does not cause symptoms in men , but men are able to transmit the infection . In women , it causes vaginal discomfort and discharge and may cause complications in pregnancy if left untreated . Eukaryotic microbes are an extraordinarily diverse group , including species with a wide range of life cycles , morphological specializations , and nutritional needs . Although more diseases are caused by viruses and bacteria than by microscopic eukaryotes , these eukaryotes are responsible for some diseases of great public health importance . For example , the protozoal disease malaria was responsible for 584,000 deaths worldwide ( primarily children in Africa ) in 2013 , according to the World Health Organization ( WHO ) . <hl> The protist parasite Giardia causes a diarrheal illness ( giardiasis ) that is easily transmitted through contaminated water supplies . <hl> In the United States , Giardia is the most common human intestinal parasite ( Figure 5.3 ) . Although it may seem surprising , parasitic worms are included within the study of microbiology because identification depends on observation of microscopic adult worms or eggs . Even in developed countries , these worms are important parasites of humans and of domestic animals . There are fewer fungal pathogens , but these are important causes of illness , as well . On the other hand , fungi have been important in producing antimicrobial substances such as penicillin . In this chapter , we will examine characteristics of protists , worms , and fungi while considering their roles in causing disease ."}, {"question": {"question_id": "fs-id1172102040701", "question_text": "A fluke is classified within which of the following?", "question_choices": ["Nematoda", "Rotifera", "Platyhelminthes", "Annelida"], "cloze_format": "A fluke is classified within ___ .", "normal_format": "A fluke is classified within which of the following?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Phylum Platyhelminthes ( the platyhelminths ) are flatworms . This group includes the flukes , tapeworms , and the turbellarians , which include planarians .", "hl_context": "<hl> Phylum Platyhelminthes ( the platyhelminths ) are flatworms . <hl> <hl> This group includes the flukes , tapeworms , and the turbellarians , which include planarians . <hl> The flukes and tapeworms are medically important parasites ( Figure 5.20 ) ."}, {"question": {"question_id": "fs-id1172102097375", "question_text": "A nonsegmented worm is found during a routine colonoscopy of an individual who reported having abdominal cramps, nausea, and vomiting. This worm is likely which of the following?", "question_choices": ["nematode", "fluke", "trematode", "annelid"], "cloze_format": "A nonsegmented worm is found during a routine colonoscopy of an individual who reported having abdominal cramps, nausea, and vomiting. This worm is likely a ___.", "normal_format": "A nonsegmented worm is found during a routine colonoscopy of an individual who reported having abdominal cramps, nausea, and vomiting. This worm is likely which of the following?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Phylum Nematoda ( the roundworms ) is a diverse group containing more than 15,000 species , of which several are important human parasites ( Figure 5.19 ) . These unsegmented worms have a full digestive system even when parasitic . Ascaris lumbricoides is the largest nematode intestinal parasite found in humans ; females may reach lengths greater than 1 meter .", "hl_context": "<hl> Phylum Nematoda ( the roundworms ) is a diverse group containing more than 15,000 species , of which several are important human parasites ( Figure 5.19 ) . <hl> <hl> These unsegmented worms have a full digestive system even when parasitic . <hl> Some are common intestinal parasites , and their eggs can sometimes be identified in feces or around the anus of infected individuals . <hl> Ascaris lumbricoides is the largest nematode intestinal parasite found in humans ; females may reach lengths greater than 1 meter . <hl> A . lumbricoides is also very widespread , even in developed nations , although it is now a relatively uncommon problem in the United States . It may cause symptoms ranging from relatively mild ( such as a cough and mild abdominal pain ) to severe ( such as intestinal blockage and impaired growth ) ."}, {"question": {"question_id": "fs-id1172101784957", "question_text": "A segmented worm has male and female reproductive organs in each segment. Some use hooks to attach to the intestinal wall. Which type of worm is this?", "question_choices": ["fluke", "nematode", "cestode", "annelid"], "cloze_format": "A segmented worm has male and female reproductive organs in each segment. Some use hooks to attach to the intestinal wall. This type of worm is a(n) ___.", "normal_format": "A segmented worm has male and female reproductive organs in each segment. Some use hooks to attach to the intestinal wall. Which type of worm is this?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The other medically important group of platyhelminths are commonly known as tapeworms ( cestodes ) and are segmented flatworms that may have suckers or hooks at the scolex ( head region ) ( Figure 5.21 ) .", "hl_context": "<hl> The other medically important group of platyhelminths are commonly known as tapeworms ( cestodes ) and are segmented flatworms that may have suckers or hooks at the scolex ( head region ) ( Figure 5.21 ) . <hl> Tapeworms use these suckers or hooks to attach to the wall of the small intestine . The body of the worm is made up of segments called proglottid s that contain reproductive structures ; these detach when the gametes are fertilized , releasing gravid proglottids with eggs . Tapeworms often have an intermediate host that consumes the eggs , which then hatch into a larval form called an oncosphere . The oncosphere migrates to a particular tissue or organ in the intermediate host , where it forms cysticerci . After being eaten by the definitive host , the cysticerci develop into adult tapeworms in the host's digestive system ( Figure 5.23 ) . Taenia saginata ( the beef tapeworm ) and T . solium ( the pork tapeworm ) enter humans through ingestion of undercooked , contaminated meat . The adult worms develop and reside in the intestine , but the larval stage may migrate and be found in other body locations such as skeletal and smooth muscle . The beef tapeworm is relatively benign , although it can cause digestive problems and , occasionally , allergic reactions . The pork tapeworm can cause more serious problems when the larvae leave the intestine and colonize other tissues , including those of the central nervous system . Diphylobothrium latum is the largest human tapeworm and can be ingested in undercooked fish . It can grow to a length of 15 meters . Echinococcus granulosus , the dog tapeworm , can parasitize humans and uses dogs as an important host ."}, {"question": {"question_id": "fs-id1172100994182", "question_text": "Mushrooms are a type of which of the following?", "question_choices": ["conidia", "ascus", "polar tubule", "basidiocarp"], "cloze_format": "Mushrooms are a type of ___ .", "normal_format": "Mushrooms are a type of which of the following?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The Basidiomycota ( basidiomycetes ) are fungi that have basidia ( club-shaped structures ) that produce basidiospores ( spores produced through budding ) within fruiting bodies called basidiocarps ( Figure 5.32 ) . This group includes rusts , stinkhorns , puffballs , and mushrooms .", "hl_context": "<hl> The Basidiomycota ( basidiomycetes ) are fungi that have basidia ( club-shaped structures ) that produce basidiospores ( spores produced through budding ) within fruiting bodies called basidiocarps ( Figure 5.32 ) . <hl> They are important as decomposers and as food . <hl> This group includes rusts , stinkhorns , puffballs , and mushrooms . <hl> Several species are of particular importance . Cryptococcus neoformans , a fungus commonly found as a yeast in the environment , can cause serious lung infections when inhaled by individuals with weakened immune systems . The edible meadow mushroom , Agricus campestris , is a basidiomycete , as is the poisonous mushroom Amanita phalloides , known as the death cap . The deadly toxins produced by A . phalloides have been used to study transcription ."}, {"question": {"question_id": "fs-id1172098389537", "question_text": "Which of the following is the most common cause of human yeast infections?", "question_choices": ["Candida albicans", "Blastomyces dermatitidis", "Cryptococcus neoformans", "Aspergillus fumigatus"], "cloze_format": "___ is the most common cause of human yeast infections.", "normal_format": "Which of the following is the most common cause of human yeast infections?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "Candida albicans , the most common cause of vaginal and other yeast infections , is also an ascomycete fungus ; it is a part of the normal microbiota of the skin , intestine , genital tract , and ear ( Figure 5.29 ) . Two examples of dimorphic yeasts are the human pathogens Histoplasma capsulatum and Candida albicans . H . capsulatum causes the lung disease histoplasmosis , and C . albicans is associated with vaginal yeast infections , oral thrush , and candidiasis of the skin ( Figure 5.26 ) .", "hl_context": "Many species of ascomycetes are medically important . A large number of species in the genera Trichophyton , Microsporum , and Epidermophyton are dermatophytes , pathogenic fungi capable of causing skin infections such as athlete \u2019 s foot , jock itch , and ringworm . Blastomyces dermatitidis is a dimorphic fungus that can cause blastomycosis , a respiratory infection that , if left untreated , can become disseminated to other body sites , sometimes leading to death . Another important respiratory pathogen is the dimorphic fungus Histoplasma capsulatum ( Figure 5.26 ) , which is associated with birds and bats in the Ohio and Mississippi river valleys . Coccidioides immitis causes the serious lung disease Valley fever . <hl> Candida albicans , the most common cause of vaginal and other yeast infections , is also an ascomycete fungus ; it is a part of the normal microbiota of the skin , intestine , genital tract , and ear ( Figure 5.29 ) . <hl> Ascomycetes also cause plant diseases , including ergot infections , Dutch elm disease , and powdery mildews . In contrast to molds , yeasts are unicellular fungi . The budding yeasts reproduce asexually by budding off a smaller daughter cell ; the resulting cells may sometimes stick together as a short chain or pseudohypha ( Figure 5.25 ) . Some fungi are dimorphic , having more than one appearance during their life cycle . These dimorphic fungi may be able to appear as yeasts or molds , which can be important for infectivity . They are capable of changing their appearance in response to environmental changes such as nutrient availability or fluctuations in temperature , growing as a mold , for example , at 25 \u00b0 C ( 77 \u00b0 F ) , and as yeast cells at 37 \u00b0 C ( 98.6 \u00b0 F ) . This ability helps dimorphic fungi to survive in diverse environments . <hl> Two examples of dimorphic yeasts are the human pathogens Histoplasma capsulatum and Candida albicans . <hl> <hl> H . capsulatum causes the lung disease histoplasmosis , and C . albicans is associated with vaginal yeast infections , oral thrush , and candidiasis of the skin ( Figure 5.26 ) . <hl>"}, {"question": {"question_id": "fs-id1172100506672", "question_text": "Which of the following is an ascomycete fungus associated with bat droppings that can cause a respiratory infection if inhaled?", "question_choices": ["Candida albicans", "Histoplasma capsulatum", "Rhizopus stolonifera", "Trichophyton rubrum"], "cloze_format": "___ is an ascomycete fungus associated with bat droppings that can cause a respiratory infection if inhaled.", "normal_format": "Which of the following is an ascomycete fungus associated with bat droppings that can cause a respiratory infection if inhaled?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "Another important respiratory pathogen is the dimorphic fungus Histoplasma capsulatum ( Figure 5.26 ) , which is associated with birds and bats in the Ohio and Mississippi river valleys .", "hl_context": "Many species of ascomycetes are medically important . A large number of species in the genera Trichophyton , Microsporum , and Epidermophyton are dermatophytes , pathogenic fungi capable of causing skin infections such as athlete \u2019 s foot , jock itch , and ringworm . Blastomyces dermatitidis is a dimorphic fungus that can cause blastomycosis , a respiratory infection that , if left untreated , can become disseminated to other body sites , sometimes leading to death . <hl> Another important respiratory pathogen is the dimorphic fungus Histoplasma capsulatum ( Figure 5.26 ) , which is associated with birds and bats in the Ohio and Mississippi river valleys . <hl> Coccidioides immitis causes the serious lung disease Valley fever . Candida albicans , the most common cause of vaginal and other yeast infections , is also an ascomycete fungus ; it is a part of the normal microbiota of the skin , intestine , genital tract , and ear ( Figure 5.29 ) . Ascomycetes also cause plant diseases , including ergot infections , Dutch elm disease , and powdery mildews ."}, {"question": {"question_id": "fs-id1172100617698", "question_text": "Which polysaccharide found in red algal cell walls is a useful solidifying agent?", "question_choices": ["chitin", "cellulose", "phycoerythrin", "agar"], "cloze_format": "___ is a polysaccharide found in red algal cell walls that is a useful solidifying agent.", "normal_format": "Which polysaccharide found in red algal cell walls is a useful solidifying agent?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "They have rigid cell walls containing agar or carrageenan , which are useful as food solidifying agents and as a solidifier added to growth media for microbes . These organisms are found in the supergroups Chromalveolata ( dinoflagellates , diatoms , golden algae , and brown algae ) and Archaeplastida ( red algae and green algae ) . Additionally , algae are the source for agar , agarose , and carrageenan , solidifying agents used in laboratories and in food production .", "hl_context": "Chlorella is a nonmotile , large , unicellular alga , and Acetabularia is an even larger unicellular green alga . The size of these organisms challenges the idea that all cells are small , and they have been used in genetics research since Joachim H\u00e4mmerling ( 1901 \u2013 1980 ) began to work with them in 1943 . Volvox is a colonial , unicellular alga ( Figure 5.37 ) . A larger , multicellular green alga is Ulva , also known as the sea lettuce because of its large , edible , green blades . The range of life forms within the Chlorophyta \u2014 from unicellular to various levels of coloniality to multicellular forms \u2014 has been a useful research model for understanding the evolution of multicellularity . The red algae are mainly multicellular but include some unicellular forms . <hl> They have rigid cell walls containing agar or carrageenan , which are useful as food solidifying agents and as a solidifier added to growth media for microbes . <hl> The algae are autotrophic protists that can be unicellular or multicellular . <hl> These organisms are found in the supergroups Chromalveolata ( dinoflagellates , diatoms , golden algae , and brown algae ) and Archaeplastida ( red algae and green algae ) . <hl> They are important ecologically and environmentally because they are responsible for the production of approximately 70 % of the oxygen and organic matter in aquatic environments . Some types of algae , even those that are microscopic , are regularly eaten by humans and other animals . <hl> Additionally , algae are the source for agar , agarose , and carrageenan , solidifying agents used in laboratories and in food production . <hl> Although algae are typically not pathogenic , some produce toxins . Harmful algal bloom s , which occur when algae grow quickly and produce dense populations , can produce high concentrations of toxins that impair liver and nervous-system function in aquatic animals and humans ."}, {"question": {"question_id": "fs-id1172096177531", "question_text": "Which is the term for the hard outer covering of some dinoflagellates?", "question_choices": ["theca", "thallus", "mycelium", "shell"], "cloze_format": "___ is the term for the hard outer covering of some dinoflagellates.", "normal_format": "Which is the term for the hard outer covering of some dinoflagellates?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "Some have cellulose plates forming a hard outer covering , or theca , as armor .", "hl_context": "The dinoflagellates and stramenopiles fall within the Chromalveolata . The dinoflagellates are mostly marine organisms and are an important component of plankton . They have a variety of nutritional types and may be phototrophic , heterotrophic , or mixotrophic . Those that are photosynthetic use chlorophyll a , chlorophyll c 2 , and other photosynthetic pigments ( Figure 5.35 ) . They generally have two flagella , causing them to whirl ( in fact , the name dinoflagellate comes from the Greek word for \u201c whirl \u201d : dini ) . <hl> Some have cellulose plates forming a hard outer covering , or theca , as armor . <hl> Additionally , some dinoflagellates produce neurotoxins that can cause paralysis in humans or fish . Exposure can occur through contact with water containing the dinoflagellate toxins or by feeding on organisms that have eaten dinoflagellates ."}, {"question": {"question_id": "fs-id1172098615682", "question_text": "Which protists are associated with red tides?", "question_choices": ["red algae", "brown algae", "dinoflagellates", "green algae"], "cloze_format": "The protists that are associated with red tides are ___.", "normal_format": "Which protists are associated with red tides?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "When a population of dinoflagellates becomes particularly dense , a red tide ( a type of harmful algal bloom ) can occur .", "hl_context": "<hl> When a population of dinoflagellates becomes particularly dense , a red tide ( a type of harmful algal bloom ) can occur . <hl> Red tides cause harm to marine life and to humans who consume contaminated marine life . Major toxin producers include Gonyaulax and Alexandrium , both of which cause paralytic shellfish poisoning . Another species , Pfiesteria piscicida , is known as a fish killer because , at certain parts of its life cycle , it can produce toxins harmful to fish and it appears to be responsible for a suite of symptoms , including memory loss and confusion , in humans exposed to water containing the species ."}, {"question": {"question_id": "fs-id1172101888699", "question_text": "You encounter a lichen with leafy structures. Which term describes this lichen?", "question_choices": ["crustose", "foliose", "fruticose", "agarose"], "cloze_format": "You encounter a lichen with leafy structures. This lichen is described by the term ___ .", "normal_format": "You encounter a lichen with leafy structures. Which term describes this lichen?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "Lichens are classified as fungi and the fungal partners belong to the Ascomycota and Basidiomycota . Those that have leaf-like lobes are foliose lichens ; they may only be attached at one point in the growth form , and they also have a second cortex below the medulla .", "hl_context": "<hl> Lichens are classified as fungi and the fungal partners belong to the Ascomycota and Basidiomycota . <hl> Lichens can also be grouped into types based on their morphology . There are three major types of lichens , although other types exist as well . Lichens that are tightly attached to the substrate , giving them a crusty appearance , are called crustose lichens . <hl> Those that have leaf-like lobes are foliose lichens ; they may only be attached at one point in the growth form , and they also have a second cortex below the medulla . <hl> Finally , fruticose lichens have rounded structures and an overall branched appearance . Figure 5.39 shows an example of each of the forms of lichens ."}, {"question": {"question_id": "fs-id1172099550350", "question_text": "Which of the following is the term for the outer layer of a lichen?", "question_choices": ["the cortex", "the medulla", "the thallus", "the theca"], "cloze_format": "___ is the term for the outer layer of a lichen.", "normal_format": "Which of the following is the term for the outer layer of a lichen?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "Lichens have a body called a thallus , an outer , tightly packed fungal layer called a cortex , and an inner , loosely packed fungal layer called a medulla ( Figure 5.38 ) .", "hl_context": "<hl> Lichens have a body called a thallus , an outer , tightly packed fungal layer called a cortex , and an inner , loosely packed fungal layer called a medulla ( Figure 5.38 ) . <hl> Lichens use hyphal bundles called rhizines to attach to the substrate ."}, {"question": {"question_id": "fs-id1172099523194", "question_text": "The fungus in a lichen is which of the following?", "question_choices": ["a basidiomycete", "an ascomycete", "a zygomycete", "an apicomplexan"], "cloze_format": "The fungus in a lichen is ___ .", "normal_format": "The fungus in a lichen is which of the following?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "A lichen is a combination of two organisms , a green alga or cyanobacterium and fungus , living in a symbiotic relationship . Candida albicans , the most common cause of vaginal and other yeast infections , is also an ascomycete fungus ; it is a part of the normal microbiota of the skin , intestine , genital tract , and ear ( Figure 5.29 ) .", "hl_context": "<hl> A lichen is a combination of two organisms , a green alga or cyanobacterium and fungus , living in a symbiotic relationship . <hl> Whereas algae normally grow only in aquatic or extremely moist environments , lichens can potentially be found on almost any surface ( especially rocks ) or as epiphytes ( meaning that they grow on other plants ) . In some ways , the symbiotic relationship between lichens and algae seems like a mutualism ( a relationship in which both organisms benefit ) . The fungus can obtain photosynthates from the algae or cyanobacterium and the algae or cyanobacterium can grow in a drier environment than it could otherwise tolerate . However , most scientists consider this symbiotic relationship to be a controlled parasitism ( a relationship in which one organism benefits and the other is harmed ) because the photosynthetic organism grows less well than it would without the fungus . It is important to note that such symbiotic interactions fall along a continuum between conflict and cooperation . Many species of ascomycetes are medically important . A large number of species in the genera Trichophyton , Microsporum , and Epidermophyton are dermatophytes , pathogenic fungi capable of causing skin infections such as athlete \u2019 s foot , jock itch , and ringworm . Blastomyces dermatitidis is a dimorphic fungus that can cause blastomycosis , a respiratory infection that , if left untreated , can become disseminated to other body sites , sometimes leading to death . Another important respiratory pathogen is the dimorphic fungus Histoplasma capsulatum ( Figure 5.26 ) , which is associated with birds and bats in the Ohio and Mississippi river valleys . Coccidioides immitis causes the serious lung disease Valley fever . <hl> Candida albicans , the most common cause of vaginal and other yeast infections , is also an ascomycete fungus ; it is a part of the normal microbiota of the skin , intestine , genital tract , and ear ( Figure 5.29 ) . <hl> Ascomycetes also cause plant diseases , including ergot infections , Dutch elm disease , and powdery mildews ."}], "summary": " Summary 5.1   Unicellular Eukaryotic Parasites \n\n Protists  are a diverse,  polyphyletic  group of eukaryotic organisms. \n\n Protists may be unicellular or multicellular. They vary in how they get their nutrition, morphology, method of locomotion, and mode of reproduction. \n\n Important structures of protists include  contractile vacuoles , cilia, flagella,  pellicles , and pseudopodia; some lack organelles such as mitochondria. \n\n Taxonomy of protists is changing rapidly as relationships are reassessed using newer techniques. \n\n The protists include important pathogens and parasites. \n\n 5.2   Parasitic Helminths \n\n Helminth parasites are included within the study of microbiology because they are often identified by looking for microscopic eggs and larvae. \n\n The two major groups of helminth parasites are the roundworms (Nematoda) and the flatworms (Platyhelminthes). \n\n Nematodes are common intestinal parasites often transmitted through undercooked foods, although they are also found in other environments. \n\n Platyhelminths include  tapeworms  and  flukes , which are often transmitted through undercooked meat. \n\n 5.3   Fungi \n\n The fungi include diverse saprotrophic eukaryotic organisms with chitin cell walls \n\n Fungi can be unicellular or multicellular; some (like yeast) and fungal spores are microscopic, whereas some are large and conspicuous \n\n Reproductive types are important in distinguishing fungal groups \n\n Medically important species exist in the four fungal groups Zygomycota, Ascomycota, Basidiomycota, and Microsporidia \n\n Members of Zygomycota, Ascomycota, and Basidiomycota produce deadly toxins \n\n Important differences in fungal cells, such as ergosterols in fungal membranes, can be targets for antifungal medications, but similarities between human and fungal cells make it difficult to find targets for medications and these medications often have toxic adverse effects \n\n 5.4   Algae \n\n Algae are a diverse group of photosynthetic eukaryotic protists \n\n Algae may be unicellular or multicellular \n\n Large, multicellular algae are called seaweeds but are not plants and lack plant-like tissues and organs \n\n Although algae have little pathogenicity, they may be associated with toxic  algal blooms  that can and aquatic wildlife and contaminate seafood with toxins that cause paralysis \n\n Algae are important for producing  agar , which is used as a solidifying agent in microbiological media, and  carrageenan , which is used as a solidifying agent \n\n 5.5   Lichens \n\n Lichens  are a symbiotic association between a fungus and an algae or a cyanobacterium \n\n The symbiotic association found in lichens is currently considered to be a controlled  parasitism , in which the fungus benefits and the algae or cyanobacterium is harmed \n\n Lichens are slow growing and can live for centuries in a variety of habitats \n\n Lichens are environmentally important, helping to create soil, providing food, and acting as indicators of air pollution ", "keyterm": "", "bname": "microbiology"}, {"chapter": 11, "intro": "Chapter Outline 11.1   The Institutional Design of Congress 11.2   Congressional Elections 11.3   Congressional Representation 11.4   House and Senate Organizations 11.5   The Legislative Process Introduction \n\n When U.S. citizens think of governmental power, they most likely think of the presidency. The framers of the Constitution, however, clearly intended that Congress would be the cornerstone of the new republic. After years of tyranny under a king, they had little interest in creating another system with an overly powerful single individual at the top. Instead, while recognizing the need for centralization in terms of a stronger national government with an elected executive wielding its own authority, those at the Constitutional Convention wanted a strong representative assembly at the national level that would use careful consideration, deliberate action, and constituent representation to carefully draft legislation to meet the needs of the new republic. Thus, Article I of the Constitution grants several key powers to Congress, which include overseeing the budget and all financial matters, introducing legislation, confirming or rejecting judicial and executive nominations, and even declaring war. \n\n Today, however, Congress is the institution most criticized by the public, and the most misunderstood. How exactly does Capitol Hill operate ( Figure 11.1 )? What are the different structures and powers of the House of Representatives and the Senate? How are members of Congress elected? How do they reach their decisions about legislation, budgets, and military action? This chapter addresses these aspects and more as it explores \u201cthe first branch\u201d of government. ", "chapter_text": "11.1   The Institutional Design of Congress \n\n Learning Objectives \n\n By the end of this section, you will be able to: \n\n Describe the role of Congress in the U.S. constitutional system \n\n Define bicameralism \n\n Explain gerrymandering and the apportionment of seats in the House of Representatives \n\n Discuss the three kinds of powers granted to Congress \n\n The origins of the U.S. Constitution and the convention that brought it into existence are rooted in failure\u2014the failure of the Articles of Confederation. After only a handful of years, the states of the union decided that the Articles were simply unworkable. In order to save the young republic, a convention was called, and delegates were sent to assemble and revise the Articles. From the discussions and compromises in this convention emerged Congress in the form we recognize today. In this section, we will explore the debates and compromises that brought about the bicameral (two-chamber) Congress, made up of a House of Representatives and Senate. We will also explore the goals of bicameralism and how it functions. Finally, we will look at the different ways seats are apportioned in the two chambers. \n\n THE GREAT COMPROMISE AND THE BASICS OF BICAMERALISM \n\n Only a few years after the adoption of the Articles of Confederation, the republican experiment seemed on the verge of failure. States deep in debt were printing increasingly worthless paper currency, many were mired in interstate trade battles with each other, and in western Massachusetts, a small group of Revolutionary War veterans angry over the prospect of losing their farms broke into armed open revolt against the state, in what came to be known as Shays\u2019 Rebellion. The conclusion many reached was that the  Articles of Confederation  were simply not strong enough to keep the young republic together. In the spring of 1787, a convention was called, and delegates from all the states (except Rhode Island, which boycotted the convention) were sent to Philadelphia to hammer out a solution to this central problem. \n\n The meeting these delegates convened became known as the  Constitutional Convention of 1787 . Although its prescribed purpose was to revise the Articles of Confederation, a number of delegates charted a path toward disposing of the Articles entirely. Under the Articles, the national legislature had been made up of a single chamber composed of an equal number of delegates from each of the states. Large states, like Virginia, felt it would be unfair to continue with this style of legislative institution. As a result, Virginia\u2019s delegates proposed a plan that called for  bicameralism , or the division of legislators into two separate assemblies. In this proposed two-chamber Congress, states with larger populations would have more representatives in each chamber. Predictably, smaller states like New Jersey were unhappy with this proposal. In response, they issued their own plan, which called for a single-chamber Congress with equal representation and more state authority ( Figure 11.2 ). \n\n The storm of debate over how to allocate power between large and small states was eventually calmed by a third proposal. The Connecticut Compromise, also called the  Great Compromise , proposed a bicameral congress with members apportioned differently in each house. The upper house, the Senate, was to have two members from each state. This soothed the fears of the small states. In the lower house, the House of Representatives, membership would be proportional to the population in each state. This measure protected the interests of the large states. \n\n In the final draft of the U.S. Constitution, the bicameral Congress established by the convention of 1787 was given a number of powers and limitations. These are outlined in  Article I  ( Appendix B ). This article describes the minimum age of congresspersons (Section 2), requires that Congress meet at least once a year (Section 4), guarantees members\u2019 pay (Section 6), and gives Congress the power to levy taxes, borrow money, and regulate commerce (Section 8). These powers and limitations were the Constitutional Convention\u2019s response to the failings of the Articles of Confederation. \n\n Although the basic design of the House and Senate resulted from a political deal between large and small states, the bicameral legislature established by the convention did not emerge from thin air. The concept had existed in Europe as far back as the medieval era. At that time, the two chambers of a legislature were divided based on class and designed to reflect different types of representation. The names of the two houses in the United Kingdom\u2019s bicameral parliament still reflect this older distinction today: the House of Lords and the House of Commons. Likewise, those at the Constitutional Convention purposely structured the U.S. Senate differently from the House of Representatives in the hopes of encouraging different representative memberships in the two houses. Initially, for example, the power to elect senators was given to the state legislatures instead of to the voting public as it is now. The minimum age requirement is also lower for the House of Representatives: A person must be at least twenty-five years old to serve in the House, whereas one must be at least thirty to be a senator. \n\n The bicameral system established at the Constitutional Convention and still followed today requires the two houses to pass identical  bill s , or proposed items of legislation. This ensures that after all amending and modifying has occurred, the two houses ultimately reach an agreement about the legislation they send to the president. Passing the same bill in both houses is no easy feat, and this is by design. The framers intended there to be a complex and difficult process for legislation to become law. This challenge serves a number of important and related functions. First, the difficulty of passing legislation through both houses makes it less likely, though hardly impossible, that the Congress will act on fleeting instincts or without the necessary deliberation. Second, the bicameral system ensures that large-scale dramatic reform is exceptionally difficult to pass and that the status quo is more likely to win the day. This maintains a level of conservatism in government, something the landed elite at the convention preferred. Third, the bicameral system makes it difficult for a single faction or interest group to enact laws and restrictions that would unfairly favor it. \n\n Link to Learning \n\n The  website of the U.S. Congress Visitor Center  contains a number of interesting online exhibits and informational tidbits about the U.S. government\u2019s \u201cfirst branch\u201d (so called because it is described in Article I of the Constitution). \n\n SENATE REPRESENTATION AND HOUSE APPORTIONMENT \n\n The Constitution specifies that every state will have two senators who each serve a six-year term. Therefore, with fifty states in the Union, there are currently one hundred seats in the U.S. Senate. Senators were originally appointed by state legislatures, but in 1913, the Seventeenth Amendment was approved, which allowed for senators to be elected by popular vote in each state. Seats in the House of Representatives are distributed among the states based on each state\u2019s population and each member of the House is elected by voters in a specific congressional district. Each state is guaranteed at least one seat in the House ( Table 11.1 ). \n\n The 114th Congress \n\n House of Representatives \n\n Senate \n\n Total Number of Members \n\n 435 \n\n 100 \n\n Number of Members per State \n\n 1 or more, based on population \n\n 2 \n\n Length of Term of Office \n\n 2 years \n\n 6 years \n\n Minimum Age Requirement \n\n 25 \n\n 30 \n\n Table  11.1     \n\n Congressional  apportionment  today is achieved through the  equal proportions method , which uses a mathematical formula to allocate seats based on U.S. Census Bureau population data, gathered every ten years as required by the Constitution. At the close of the first U.S. Congress in 1791, there were sixty-five representatives, each representing approximately thirty thousand citizens. Then, as the territory of the United States expanded, sometimes by leaps and bounds, the population requirement for each new district increased as well. Adjustments were made, but the roster of the House of Representatives continued to grow until it reached 435 members after the 1910 census. Ten years later, following the 1920 census and with urbanization changing populations across the country, Congress failed to reapportion membership because it became deadlocked on the issue. In 1929, an agreement was reached to permanently cap the number of seats in the House at 435. \n\n Redistricting occurs every ten years, after the U.S. Census has established how many persons live in the United States and where. The boundaries of legislative districts are redrawn as needed to maintain similar numbers of voters in each while still maintaining a total number of 435 districts. Because local areas can see their population grow as well as decline over time, these adjustments in district boundaries are typically needed after ten years have passed. Currently, there are seven states with only one representative (Alaska, Delaware, Montana, North Dakota, South Dakota, Vermont, and Wyoming), whereas the most populous state, California, has a total of fifty-three congressional districts ( Figure 11.3 ). \n\n Two remaining problems in the House are the size of each representative\u2019s  constituency \u2014the body of voters who elect him or her\u2014and the challenge of Washington, DC. First, the average number of citizens in a congressional district now tops 700,000. This is arguably too many for House members to remain very close to the people. George Washington advocated for thirty thousand per elected member to retain effective representation in the House. The second problem is that the approximately 675,000 residents of the federal district of Washington (District of Columbia) do not have voting representation. Like those living in the U.S. territories, they merely have a non-voting delegate. 1 \n\n The stalemate in the 1920s wasn\u2019t the first time reapportionment in the House resulted in controversy (or the last). The first incident took place before any apportionment had even occurred, while the process was being discussed at the Constitutional Convention. Representatives from large slave-owning states believed their slaves should be counted as part of the total population. States with few or no slaves predictably argued against this. The compromise eventually reached allowed for each slave (who could not vote) to count as three-fifths of a person for purposes of congressional representation. Following the abolition of slavery and the end of Reconstruction, the former slave states in the South took a number of steps to prevent former slaves and their children from voting. Yet because these former slaves were now free persons, they were counted fully toward the states\u2019 congressional representation. \n\n Attempts at African American disenfranchisement continued until the civil rights struggle of the 1960s finally brought about the  Voting Rights Act  of 1965. The act cleared several final hurdles to voter registration and voting for African Americans. Following its adoption, many Democrats led the charge to create congressional districts that would enhance the power of African American voters. The idea was to create  majority-minority districts  within states, districts in which African Americans became the majority and thus gained the electoral power to send representatives to Congress. \n\n While the strangely drawn districts succeeded in their stated goals, nearly quintupling the number of African American representatives in Congress in just over two decades, they have frustrated others who claim they are merely a new form of an old practice,  gerrymandering .  Gerrymandering  is the manipulation of legislative district boundaries as a way of favoring a particular candidate. The term combines the word salamander, a reference to the strange shape of these districts, with the name of Massachusetts governor Elbridge Gerry, who in 1812, signed a redistricting plan designed to benefit his party. Despite the questionable ethics behind gerrymandering, the practice is legal, and both major parties have used it to their benefit. It is only when political redistricting appears to dilute the votes of racial minorities that gerrymandering efforts can be challenged under the Voting Rights Act. Other forms of gerrymandering are frequently employed in states where a dominant party seeks to maintain that domination. As we saw in the chapter on political parties, gerrymandering can be a tactic to draw district lines in a way that creates \u201csafe seats\u201d for a particular political party. In states like Maryland, these are safe seats for Democrats. In states like Louisiana, they are safe seats for Republicans ( Figure 11.4 ). \n\n Finding a Middle Ground Racial Gerrymandering and the Paradox of Minority Representation In Ohio, one skirts the shoreline of Lake Erie like a snake. In Louisiana, one meanders across the southern part of the state from the eastern shore of Lake Ponchartrain, through much of New Orleans and north along the Mississippi River to Baton Rouge. And in Illinois, another wraps around the city of Chicago and its suburbs in a wandering line that, when seen on a map, looks like the mouth of a large, bearded alligator attempting to drink from Lake Michigan. \n\n These aren\u2019t geographical features or large infrastructure projects. Rather, they are racially gerrymandered congressional districts. Their strange shapes are the product of careful district restructuring organized around the goal of enhancing the votes of minority groups. The alligator-mouth District 4 in Illinois, for example, was drawn to bring a number of geographically autonomous Latino groups in Illinois together in the same congressional district. \n\n While the strategy of creating majority-minority districts has been a success for minorities\u2019 representation in Congress, its long-term effect has revealed a disturbing paradox: Congress as a whole has become less enthusiastic about minority-specific issues. How is this possible? The problem is that by creating districts with high percentages of minority constituents, strategists have made the other districts less diverse. The representatives in those districts are under very little pressure to consider the interests of minority groups. As a result, they typically do not. 2 \n\n What changes might help correct this problem? Are majority-minority districts no longer an effective strategy for increasing minority representation in Congress? Are there better ways to achieve a higher level of minority representation? \n\n CONGRESSIONAL POWERS \n\n The authority to introduce and pass legislation is a very strong power. But it is only one of the many that Congress possesses. In general, congressional powers can be divided into three types: enumerated, implied, and inherent. An  enumerated power  is a power explicitly stated in the Constitution. An  implied power  is one not specifically detailed in the Constitution but inferred as necessary to achieve the objectives of the national government. And an  inherent power , while not enumerated or implied, must be assumed to exist as a direct result of the country\u2019s existence. In this section, we will learn about each type of power and the foundations of legitimacy they claim. We will also learn about the way the different branches of government have historically appropriated powers not previously granted to them and the way congressional power has recently suffered in this process. \n\n Article I , Section 8, of the U.S. Constitution details the enumerated powers of the legislature. These include the power to levy and collect taxes, declare war, raise an army and navy, coin money, borrow money, regulate commerce among the states and with foreign nations, establish federal courts and bankruptcy rules, establish rules for immigration and naturalization, and issue patents and copyrights. Other powers, such as the ability of Congress to override a presidential veto with a two-thirds vote of both houses, are found elsewhere in the Constitution (Article II, Section 7, in the case of the veto override). The first of these enumerated powers, to levy taxes, is quite possibly the most important power Congress possesses. Without it, most of the others, whether enumerated, implied, or inherent, would be largely theoretical. The power to levy and collect taxes, along with the appropriations power, gives Congress what is typically referred to as \u201cthe power of the purse\u201d ( Figure 11.5 ). This means Congress controls the money. \n\n Some enumerated powers invested in the Congress were included specifically to serve as checks on the other powerful branches of government. These include Congress\u2019s sole power to introduce legislation, the Senate\u2019s final say on many presidential nominations and treaties signed by the president, and the House\u2019s ability to impeach or formally accuse the president or other federal officials of wrongdoing (the first step in removing the person from office; the second step, trial and removal, takes place in the U.S. Senate). Each of these powers also grants Congress  oversight  of the actions of the president and his or her administration\u2014that is, the right to review and monitor other bodies such as the executive branch. The fact that Congress has the sole power to introduce legislation effectively limits the power of the president to develop the same laws he or she is empowered to enforce. The Senate\u2019s exclusive power to give final approval for many of the president\u2019s nominees, including cabinet members and judicial appointments, compels the president to consider the needs and desires of Congress when selecting top government officials. Finally, removing a president from office who has been elected by the entire country should never be done lightly. Giving this responsibility to a large deliberative body of elected officials ensures it will occur only very rarely. \n\n Despite the fact that the Constitution outlines specific enumerated powers, most of the actions Congress takes on a day-to-day basis are not actually included in this list. The reason is that the Constitution not only gives Congress the power to make laws but also gives it some general direction as to what those laws should accomplish. The \u201cnecessary and proper clause\u201d directs Congress \u201cto make all Laws which shall be necessary and proper for carrying into Execution the foregoing Powers, and all other Powers vested by this Constitution in the Government of the United States, or in any Department or Officer thereof.\u201d Laws that regulate banks, establish a minimum wage, and allow for the construction and maintenance of interstate highways are all possible because of the implied powers granted by the necessary and proper clause. Today, the overwhelming portion of Congress\u2019s work is tied to the necessary and proper clause. Finally, Congress\u2019s inherent powers are unlike either the enumerated or the implied powers. Inherent powers are not only not mentioned in the Constitution, but they do not even have a convenient clause in the Constitution to provide for them. Instead, they are powers Congress has determined it must assume if the government is going to work at all. The general assumption is that these powers were deemed so essential to any functioning government that the framers saw no need to spell them out. Such powers include the power to control borders of the state, the power to expand the territory of the state, and the power to defend itself from internal revolution or coups. These powers are not granted to the Congress, or to any other branch of the government for that matter, but they exist because the country exists. \n\n Finding a Middle Ground Understanding the Limits of Congress\u2019s Power to Regulate One of the most important constitutional anchors for Congress\u2019s implicit power to regulate all manner of activities within the states is the short clause in Article I, Section 8, which says Congress is empowered to \u201cto regulate Commerce with foreign Nations, and among the several States, and with Indian Tribes.\u201d The Supreme Court\u2019s broad interpretation of this so-called commerce clause has greatly expanded the power and reach of Congress over the centuries. \n\n From the earliest days of the republic until the end of the nineteenth century, the Supreme Court consistently handed down decisions that effectively broadened the Congress\u2019s power to regulate interstate and intrastate commerce. 3  The growing country, the demands of its expanding economy, and the way changes in technology and transportation contributed to the shrinking of space between the states demanded that Congress be able to function as a regulator. For a short period in the 1930s when federal authority was expanded to combat the Great Depression, the Court began to interpret the commerce clause far more narrowly. But after this interlude, the court\u2019s interpretation swung in an even-broader direction. This change proved particularly important in the 1960s, when Congress rolled back racial segregation throughout much of the South and beyond, and in the 1970s, as federal environmental regulations and programs took root. \n\n But in  United States v. Lopez , a decision issued in 1995, the Court changed course again and, for the first time in half a century, struck down a law as an unconstitutional overstepping of the commerce clause. 4  Five years later, the Court did it again, convincing many that the country may be witnessing the beginning of a rollback in Congress\u2019s power to regulate in the states. When the  Patient Protection and Affordable Care Act  (also known as the ACA, or Obamacare) came before the Supreme Court in 2012, many believed the Court would strike it down. Instead, the justices took the novel approach of upholding the law based on the Congress\u2019s enumerated power to tax, rather than the commerce clause. The decision was a shock to many. 5  And, by not upholding the law on the basis of the commerce clause, the Court left open the possibility that it would continue to pursue a narrower interpretation of the clause. \n\n What are the advantages of the Supreme Court\u2019s broad interpretation of the commerce clause? How do you think this interpretation affects the balance of power between the branches of government? Why are some people concerned that the Court\u2019s view of the clause could change? \n\n In the early days of the republic, Congress\u2019s role was rarely if ever disputed. However, with its decision in  Marbury v. Madison  (1803), the Supreme Court asserted its authority over judicial review and assumed the power to declare laws unconstitutional. 6  Yet, even after that decision, the Court was reluctant to use this power and didn\u2019t do so for over half a century. Initially, the presidency was also a fairly weak branch of government compared with the legislature. But presidents have sought to increase their power almost from the beginning, typically at the expense of the Congress. By the nature of the  enumerated powers  provided to the president, it is during wartime that the chief executive is most powerful and Congress least powerful. For example, President Abraham Lincoln, who oversaw the prosecution of the Civil War, stretched the bounds of his legal authority in a number of ways, such as by issuing the Emancipation Proclamation that freed slaves in the confederate states. 7 \n\n In the twentieth century, the modern tussle over power between the Congress and the president really began. There are two primary reasons this struggle emerged. First, as the country grew larger and more complex, the need for the government to assert its regulatory power grew. The executive branch, because of its hierarchical organization with the president at the top, is naturally seen as a more smoothly run governmental machine than the cumbersome Congress. This gives the president advantages in the struggle for power and indeed gives Congress an incentive to delegate authority to the president on processes, such as trade agreements and national monument designations, that would be difficult for the legislature to carry out. The second reason has to do with the president\u2019s powers as commander-in-chief in the realm of foreign policy. \n\n The twin disasters of the Great Depression in the 1930s and World War II, which lasted until the mid-1940s, provided President Franklin D.  Roosevelt  with a powerful platform from which to expand presidential power. His popularity and his ability to be elected four times allowed him to greatly overshadow Congress. As a result, Congress attempted to restrain the power of the presidency by proposing the  Twenty-Second Amendment  to the Constitution, which limited a president to only two full terms in office. 8  Although this limitation is a significant one, it has not held back the tendency for the presidency to assume increased power. \n\n In the decades following World War II, the United States entered the Cold War, a seemingly endless conflict with the Soviet Union without actual war, and therefore a period that allowed the presidency to assert more authority, especially in foreign affairs. In an exercise of this increased power, in the 1950s, President Harry Truman effectively went around an enumerated power of Congress by sending troops into battle in Korea without a congressional declaration of war ( Figure 11.6 ). By the time of the Kennedy administration in the 1960s, the presidency had assumed nearly all responsibility for creating foreign policy, effectively shutting Congress out. \n\n Following the twin scandals of Vietnam and Watergate in the early 1970s, Congress attempted to assert itself as a coequal branch, even in creating foreign policy, but could not hold back the trend. The  War Powers Resolution  (covered in the foreign policy chapter) was intended to strengthen congressional war powers but ended up clarifying presidential authority in the first sixty days of a military conflict. The war on terrorism after 9/11 has also strengthened the president\u2019s hand. Today, the seemingly endless bickering between the president and the Congress is a reminder of the ongoing struggle for power between the branches, and indeed between the parties, in Washington, DC. \n11.2   Congressional Elections \n\n Learning Objectives \n\n By the end of this section, you will be able to: \n\n Explain how fundamental characteristics of the House and Senate shape their elections \n\n Discuss campaign funding and the effects of incumbency in the House and Senate \n\n Analyze the way congressional elections can sometimes become nationalized \n\n The House and Senate operate very differently, partly because their members differ in the length of their terms, as well as in their age and other characteristics. In this section, we will explore why constitutional rules affect the elections for the two types of representatives and the reason the two bodies function differently by design. We also look at campaign finance to better understand how legislators get elected and stay elected. \n\n UNDERSTANDING THE HOUSE AND SENATE \n\n The U.S. Constitution is very clear about who can be elected as a member of the  House  or  Senate . A House member must be a U.S. citizen of at least seven years\u2019 standing and at least twenty-five years old. Senators are required to have nine years\u2019 standing as citizens and be at least thirty years old when sworn in. Representatives serve two-year terms, whereas senators serve six-year terms. Per the Supreme Court decision in  U.S. Term Limits v. Thornton  (1995), there are currently no term limits for either senators or representatives, despite efforts by many states to impose them in the mid-1990s. 9  House members are elected by the voters in their specific congressional districts. There are currently 435 congressional districts in the United States and thus 435 House members, and each state has a number of House districts roughly proportional to its share of the total U.S. population, with states guaranteed at least one House member. Two senators are elected by each state. \n\n The structural and other differences between the House and Senate have practical consequences for the way the two chambers function. The House of Representatives has developed a stronger and more structured leadership than the Senate. Because its members serve short, two-year terms, they must regularly answer to the demands of their constituency when they run for election or reelection. Even House members of the same party in the same state will occasionally disagree on issues because of the different interests of their specific districts. Thus, the House can be highly partisan at times. \n\n In contrast, members of the Senate are furthest from the demands and scrutiny of their constituents. Because of their longer six-year terms, they will see every member of the House face his or her constituents multiple times before they themselves are forced to seek reelection. Originally, when a state\u2019s two U.S. senators were appointed by the state legislature, the Senate chamber\u2019s distance from the electorate was even greater. Also, unlike members of the House who can seek the narrower interests of their district, senators must maintain a broader appeal in order to earn a majority of the votes across their entire state. In addition, the rules of the Senate allow individual members to slow down or stop legislation they dislike. These structural differences between the two chambers create real differences in the actions of their members. The heat of popular, sometimes fleeting, demands from constituents often glows red hot in the House. The Senate has the flexibility to allow these passions to cool. Dozens of major initiatives were passed by the House and had a willing president, for example, only to be defeated in the Senate. In 2012, the Buffett Rule would have implemented a minimum tax rate of 30 percent on wealthy Americans. Sixty senators had to agree to bring it to a vote, but the bill fell short of that number and died. 10  Similarly, although the ACA became widely known as \u201cObamacare,\u201d the president did not send a piece of legislation to Capitol Hill; he asked Congress to write the bills. Both the House and Senate authored their own versions of the legislation. The House\u2019s version was much bolder and larger in terms of establishing a national health care system. However, it did not stand a chance in the Senate, where a more moderate version of the legislation was introduced. In the end, House leaders saw the Senate version as preferable to doing nothing and ultimately supported it. \n\n CONGRESSIONAL CAMPAIGN FUNDING \n\n Modern political campaigns in the United States are expensive, and they have been growing more so. For example, in 1986, the costs of running a successful House and Senate campaign were $776,687 and $6,625,932, respectively, in 2014 dollars. By 2014, those values had shot to $1,466,533 and $9,655,660 ( Figure 11.7 ). 11  Raising this amount of money takes quite a bit of time and effort. Indeed, a presentation for incoming Democratic representatives suggested a daily Washington schedule of five hours reaching out to donors, while only three or four were to be used for actual congressional work. As this advice reveals, raising money for reelection constitutes a large proportion of the work a congressperson does. This has caused many to wonder whether the amount of money in politics has truly become a corrupting influence. However, overall, the lion\u2019s share of direct campaign contributions in congressional elections comes from individual donors, who are less influential than the political action committees (PACs) that contribute the remainder. 12 \n\n Nevertheless, the complex problem of funding campaigns has a long history in the United States. For nearly the first hundred years of the republic, there were no federal campaign finance laws. Then, between the late nineteenth century and the start of World War I, Congress pushed through a flurry of reforms intended to bring order to the world of campaign finance. These laws made it illegal for politicians to solicit contributions from civil service workers, made corporate contributions illegal, and required candidates to report their fundraising. As politicians and donors soon discovered, however, these laws were full of loopholes and were easily skirted by those who knew the ins and outs of the system. \n\n Another handful of reform attempts were therefore pushed through in the wake of World War II, but then Congress neglected campaign finance reform for a few decades. That lull ended in the early 1970s when the  Federal Election Campaign Act  was passed. Among other things, it created the Federal Election Commission (FEC), required candidates to disclose where their money was coming from and where they were spending it, limited individual contributions, and provided for public financing of presidential campaigns. \n\n Another important reform occurred in 2002, when Senators John McCain (R-AZ) and Russell Feingold (D-WI) drafted, and Congress passed, the  Bipartisan Campaign Reform Act  (BCRA), also referred to as the  McCain-Feingold Act . The purpose of this law was to limit the use of \u201csoft money,\u201d which is raised for purposes like party-building efforts, get-out-the-vote efforts, and issue-advocacy ads. Unlike \u201chard money\u201d contributed directly to a candidate, which is heavily regulated and limited, soft money had almost no regulations or limits. It had never been a problem before the mid-1990s, when a number of very imaginative political operatives developed a great many ways to spend this money. After that, soft-money donations skyrocketed. But the McCain-Feingold bill greatly limited this type of fundraising. \n\n McCain-Feingold placed limits on total contributions to political parties, prohibited coordination between candidates and PAC campaigns, and required candidates to include personal endorsements on their political ads. Until 2010, it also limited advertisements run by unions and corporations thirty days before a primary and sixty days before a general election. 14  The FEC\u2019s enforcement of the law spurred numerous court cases challenging it. The most controversial decision was handed down by the Supreme Court in 2010, whose ruling on  Citizens United v. Federal Election Commission  led to the removal of spending limits on corporations. Justices in the majority argued that the BCRA violated a corporation\u2019s free-speech rights. 15 \n\n The  Citizens United  case began as a lawsuit against the FEC filed by Citizens United, a nonprofit organization that wanted to advertise a documentary critical of former senator and Democratic hopeful Hillary Clinton on the eve of the 2008 Democratic primaries. Advertising or showing the film during this time window was prohibited by the McCain-Feingold Act. But the Court found that this type of restriction violated the organization\u2019s First Amendment right to free speech. As critics of the decision predicted at the time, the Court thus opened the floodgates to private soft money flowing into campaigns again. \n\n In the wake of the  Citizens United  decision, a new type of advocacy group emerged, the  super PAC . A traditional  PAC  is an organization designed to raise hard money to elect or defeat candidates. Such PACs tended to be run by businesses and other groups, like the Teamsters Union and the National Rifle Association, to support their special interests. They are highly regulated in regard to the amount of money they can take in and spend, but super PACs aren\u2019t bound by these regulations. While they cannot give money directly to a candidate or a candidate\u2019s party, they can raise and spend unlimited funds, and they can spend independently of a campaign or party. In the 2012 election cycle, for example, super PACs spent just over $600 million dollars and raised about $200 million more. 16 \n\n At the same time, several limits on campaign contributions have been upheld by the courts and remain in place. Individuals may contribute up to $2700 per candidate per election. Individuals may also give $5000 to PACs and $33,400 to a national party committee. PACs that contribute to more than one candidate are permitted to contribute $5000 per candidate per election, and up to $15,000 to a national party. PACs created to give money to only one candidate are limited to only $2700 per candidate, however ( Figure 11.8 ). 17  The amounts are adjusted every two years, based on inflation. These limits are intended to create a more equal playing field for the candidates, so that candidates must raise their campaign funds from a broad pool of contributors. \n\n Link to Learning \n\n The  Center for Responsive Politics  reports donation amounts that are required by law to be disclosed to the Federal Elections Commission. One finding is that, counter to conventional wisdom, the vast majority of direct campaign contributions come from individual donors, not from PACs and political parties. \n\n INCUMBENCY EFFECTS \n\n Not surprisingly, the jungle of campaign financing regulations and loopholes is more easily navigated by incumbents in Congress than by newcomers. Incumbents are elected officials who currently hold an office. The amount of money they raise against their challengers demonstrates their advantage. In 2014, for example, the average Senate incumbent raised $12,144,933, whereas the average challenger raised only $1,223,566. 18  This is one of the many reasons  incumbent s win a large majority of congressional races each electoral cycle. Incumbents attract more money because people want to give to a winner. In the House, the percentage of incumbents winning reelection has hovered between 85 and 100 percent for the last half century. In the Senate, there is only slightly more variation, given the statewide nature of the race, but it is still a very high majority of incumbents who win reelection ( Figure 11.9 ). As these rates show, even in the worst political environments, incumbents are very difficult to defeat. \n\n The historical difficulty of unseating an incumbent in the House or Senate is often referred to as the  incumbent advantage  or the  incumbency effect . The advantage in financing is a huge part of this effect, but it is not the only important part. Incumbents often have a much higher level of name recognition. All things being equal, voters are far more likely to select the name of the person they recall seeing on television and hearing on the radio for the last few years than the name of a person they hardly know. And donors are more likely to want to give to a proven winner. \n\n But more important is the way the party system itself privileges incumbents. A large percentage of congressional districts across the country are \u201csafe seats\u201d in uncompetitive districts, meaning candidates from a particular party are highly likely to consistently win the seat. This means the functional decision in these elections occurs during the primary, not in the general election. Political parties in general prefer to support incumbents in elections, because the general consensus is that incumbents are better candidates, and their record of success lends support to this conclusion. That said, while the political parties themselves to a degree control and regulate the primaries, popular individual candidates and challengers sometimes rule the day. This has especially been the case in recent years as conservative incumbents have been \u201cprimaried\u201d by challengers more conservative than they. \n\n Insider Perspective The End of Incumbency Advantage? At the start of 2014, House majority whip Eric Cantor, a representative from Virginia, was at the top of his game. He was handsome, popular with talk show hosts and powerful insiders, an impressive campaign fundraiser and speaker, and apparently destined to become Speaker of the House when the current speaker stepped down. Four months later, Cantor lost the opportunity to run for his own congressional seat in a shocking primary election upset that shook the Washington political establishment to its core. \n\n What happened? How did such a powerful incumbent lose a game in which the cards had been stacked so heavily in his favor? Analyses of the stunning defeat quickly showed there were more chinks in Cantor\u2019s polished armor than most wanted to admit. But his weakness wasn\u2019t that he was unable to play the political game. Rather, he may have learned to play it too well. He became seen as too much of a Washington insider. \n\n Cantor\u2019s ambition, political skill, deep connections to political insiders, and ability to come out squeaky clean after even the dirtiest political tussling should have given him a clear advantage over any competitor. But in the political environment of 2014, when conservative voices around the country criticized the party for ignoring the people and catering to political insiders, his strengths became weaknesses. Indeed, Cantor was the only highest-level Republican representative sacrificed to conservative populism. \n\n Were the winds of change blowing for incumbents? Between 1946 and 2012, only 5 percent of incumbent senators and 2 percent of House incumbents lost their party primaries. 19  In 2014, Cantor was one of four House incumbents who did so, while no incumbent senators suffered defeat. All evidence suggests the incumbent advantage, especially in the primary system, is alive and well. The story of Eric Cantor may very well be the classic case of an exception proving the rule. \n\n If you are a challenger running against an incumbent, what are some strategies you could use to make the race competitive? Would Congress operate differently if challengers defeated incumbents more often? \n\n Another reason incumbents wield a great advantage over their challengers is the state power they have at their disposal. 20  One of the many responsibilities of a sitting congressperson is  constituent casework . Constituents routinely reach out to their congressperson for powerful support to solve complex problems, such as applying for and tracking federal benefits or resolving immigration and citizenship challenges. 21  Incumbent members of Congress have paid staff, influence, and access to specialized information that can help their constituents in ways other persons cannot. And congresspersons are hardly reticent about their efforts to support their constituents. Often, they will publicize their casework on their websites or, in some cases, create television advertisements that boast of their helpfulness. Election history has demonstrated that this form of publicity is very effective in garnering the support of voters. \n\n LOCAL AND NATIONAL ELECTIONS \n\n The importance of airing positive constituent casework during campaigns is a testament to the accuracy of saying, \u201cAll politics is local.\u201d This phrase, attributed to former Speaker of the House Tip O\u2019Neill (D-MA), essentially means that the most important motivations directing voters are rooted in local concerns. In general, this is true. People naturally feel more driven by the things that affect them on a daily basis. These are concerns like the quality of the roads, the availability of good jobs, and the cost and quality of public education. Good senators and representatives understand this and will seek to use their influence and power in office to affect these issues for the better. This is an age-old strategy for success in office and elections. \n\n Political scientists have taken note of some voting patterns that appear to challenge this common assumption, however. In 1960, political scientist Angus  Campbell  proposed the  surge-and-decline theory  to explain these patterns. 22  Campbell noticed that since the Civil War, with the exception of 1934, the president\u2019s party has consistently lost seats in Congress during the midterm elections. He proposed that the reason was a surge in political stimulation during presidential elections, which contributes to greater turnout and brings in voters who are ordinarily less interested in politics. These voters, Campbell argued, tend to favor the party holding the presidency. In contrast, midterm elections witness the opposite effect. They are less stimulating and have lower turnout because less-interested voters stay home. This shift, in Campbell\u2019s theory, provides an advantage to the party not currently occupying the presidency. \n\n In the decades since Campbell\u2019s influential theory was published, a number of studies have challenged his conclusions. Nevertheless, the pattern of midterm elections benefiting the president\u2019s opposition has persisted. 23  Only in exceptional years has this pattern been broken: first in 1998 during President Bill Clinton\u2019s second term and the Monica Lewinsky scandal, when exit polls indicated most voters opposed the idea of impeaching the president, and then again in 2002, following the 9/11 terrorist attacks and the ensuing declaration of a \u201cwar on terror.\u201d \n\n The evidence does suggest that national concerns, rather than local ones, can function as powerful motivators at the polls. Consider, for example, the role of the Iraq War in bringing about a Democratic rout of the Republicans in the House in 2006 and in the Senate in 2008. Unlike previous wars in Europe and Vietnam, the war in Iraq was fought by a very small percentage of the population. 24  The vast majority of citizens were not soldiers, few had relatives fighting in the war, and most did not know anyone who directly suffered from the prolonged conflict. Voters in large numbers were motivated by the political and economic disaster of the war to vote for politicians they believed would end it ( Figure 11.10 ). \n\n Congressional elections may be increasingly driven by national issues. Just two decades ago, straight-ticket, party-line voting was still relatively rare across most of the country. 25  In much of the South, which began to vote overwhelmingly Republican in presidential elections during the 1960s and 1970s, Democrats were still commonly elected to the House and Senate. The candidates themselves and the important local issues, apart from party affiliation, were important drivers in congressional elections. This began to change in the 1980s and 1990s, as Democratic representatives across the region began to dwindle. And the South isn\u2019t alone; areas in the Northeast and the Northwest have grown increasingly Democratic. Indeed, the 2014 midterm election was the most nationalized election in many decades. Voters who favor a particular party in a presidential election are now much more likely to also support that same party in House and Senate elections than was the case just a few decades ago. \n11.3   Congressional Representation \n\n Learning Objectives \n\n By the end of this section, you will be able to: \n\n Explain the basics of representation \n\n Describe the extent to which Congress as a body represents the U.S. population \n\n Explain the concept of collective representation \n\n Describe the forces that influence congressional approval ratings \n\n The tension between local and national politics described in the previous section is essentially a struggle between interpretations of representation. Representation is a complex concept. It can mean paying careful attention to the concerns of constituents, understanding that representatives must act as they see fit based on what they feel best for the constituency, or relying on the particular ethnic, racial, or gender diversity of those in office. In this section, we will explore three different models of representation and the concept of descriptive representation. We will look at the way members of Congress navigate the challenging terrain of representation as they serve, and all the many predictable and unpredictable consequences of the decisions they make. \n\n TYPES OF REPRESENTATION: LOOKING OUT FOR CONSTITUENTS \n\n By definition and title, senators and House members are representatives. This means they are intended to be drawn from local populations around the country so they can speak for and make decisions for those local populations, their constituents, while serving in their respective legislative houses. That is,  representation  refers to an elected leader\u2019s looking out for his or her constituents while carrying out the duties of the office. 26 \n\n Theoretically, the process of constituents voting regularly and reaching out to their representatives helps these congresspersons better represent them. It is considered a given by some in representative democracies that representatives will seldom ignore the wishes of constituents, especially on salient issues that directly affect the district or state. In reality, the job of representing in Congress is often quite complicated, and elected leaders do not always know where their constituents stand. Nor do constituents always agree on everything. Navigating their sometimes contradictory demands and balancing them with the demands of the party, powerful interest groups, ideological concerns, the legislative body, their own personal beliefs, and the country as a whole can be a complicated and frustrating process for representatives. \n\n Traditionally, representatives have seen their role as that of a delegate, a trustee, or someone attempting to balance the two. A representative who sees him- or herself as a delegate believes he or she is empowered merely to enact the wishes of constituents. Delegates must employ some means to identify the views of their constituents and then vote accordingly. They are not permitted the liberty of employing their own reason and judgment while acting as representatives in Congress. This is the  delegate model of representation . \n\n In contrast, a representative who understands their role to be that of a trustee believes he or she is entrusted by the constituents with the power to use good judgment to make decisions on the constituents\u2019 behalf. In the words of the eighteenth-century British philosopher Edmund Burke, who championed the  trustee model of representation , \u201cParliament is not a congress of ambassadors from different and hostile interests . . . [it is rather] a deliberative assembly of one nation, with one interest, that of the whole.\u201d 27  In the modern setting, trustee representatives will look to party consensus, party leadership, powerful interests, the member\u2019s own personal views, and national trends to better identify the voting choices they should make. \n\n Understandably, few if any representatives adhere strictly to one model or the other. Instead, most find themselves attempting to balance the important principles embedded in each. Political scientists call this the  politico model of representation . In it, members of Congress act as either trustee or delegate based on rational political calculations about who is best served, the constituency or the nation. \n\n For example, every representative, regardless of party or conservative versus liberal leanings, must remain firm in support of some ideologies and resistant to others. On the political right, an issue that demands support might be gun rights; on the left, it might be a woman\u2019s right to an abortion. For votes related to such issues, representatives will likely pursue a delegate approach. For other issues, especially complex questions the public at large has little patience for, such as subtle economic reforms, representatives will tend to follow a trustee approach. This is not to say their decisions on these issues run contrary to public opinion. Rather, it merely means they are not acutely aware of or cannot adequately measure the extent to which their constituents support or reject the proposals at hand. It could also mean that the issue is not salient to their constituents. Congress works on hundreds of different issues each year, and constituents are likely not aware of the particulars of most of them. \n\n DESCRIPTIVE REPRESENTATION IN CONGRESS \n\n In some cases, representation can seem to have very little to do with the substantive issues representatives in Congress tend to debate. Instead, proper representation for some is rooted in the racial, ethnic, socioeconomic, gender, and sexual identity of the representatives themselves. This form of representation is called  descriptive representation . \n\n At one time, there was relatively little concern about descriptive representation in Congress. A major reason is that until well into the twentieth century, white men of European background constituted an overwhelming majority of the voting population. African Americans were routinely deprived of the opportunity to participate in democracy, and Hispanics and other minority groups were fairly insignificant in number and excluded by the states. While women in many western states could vote sooner, all women were not able to exercise their right to vote nationwide until passage of the  Nineteenth Amendment  in 1920, and they began to make up more than 5 percent of either chamber only in the 1990s. \n\n Many advances in women\u2019s rights have been the result of women\u2019s greater engagement in politics and representation in the halls of government, especially since the founding of the National Organization for Women in 1966 and the National Women\u2019s Political Caucus (NWPC) in 1971. The NWPC was formed by Bella  Abzug  ( Figure 11.11 ), Gloria Steinem, Shirley Chisholm, and other leading feminists to encourage women\u2019s participation in political parties, elect women to office, and raise money for their campaigns. For example, Patsy  Mink  (D-HI) ( Figure 11.11 ), the first Asian American woman elected to Congress, was the coauthor of the  Education Amendments Act  of 1972, Title IX of which prohibits sex discrimination in education. Mink had been interested in fighting discrimination in education since her youth, when she opposed racial segregation in campus housing while a student at the University of Nebraska. She went to law school after being denied admission to medical school because of her gender. Like Mink, many other women sought and won political office, many with the help of the NWPC. Today, EMILY\u2019s List, a PAC founded in 1985 to help elect pro-choice Democratic women to office, plays a major role in fundraising for female candidates. In the 2012 general election, 80 percent of the candidates endorsed by EMILY\u2019s List won a seat. 28 \n\n In the wake of the  Civil Rights Movement , African American representatives also began to enter Congress in increasing numbers. In 1971, to better represent their interests, these representatives founded the  Congressional Black Caucus  (CBC), an organization that grew out of a Democratic select committee formed in 1969. Founding members of the CBC include John Conyers (D-MI), currently the longest-serving member of the House of Representatives, Charles Rangel (D-NY), and Shirley Chisholm, a founder of the NWPC and the first African American woman to be elected to the House of Representatives ( Figure 11.12 ). \n\n In recent decades, Congress has become much more descriptively representative of the United States. The 114th Congress, which began in January 2015, had a historically large percentage of racial and ethnic minorities. African Americans made up the largest percentage, with forty-eight members, while Latinos accounted for thirty-two members, up from nineteen just over a decade before. 29  Yet, demographically speaking, Congress as a whole is still a long way from where the country is and remains largely white, male, and wealthy. For example, although more than half the U.S. population is female, only 20 percent of Congress is. Congress is also overwhelmingly Christian ( Figure 11.13 ). \n\n REPRESENTING CONSTITUENTS \n\n Ethnic, racial, gender, or ideological identity aside, it is a representative\u2019s actions in Congress that ultimately reflect his or her understanding of representation. Congress members\u2019 most important function as lawmakers is writing, supporting, and passing bills. And as representatives of their constituents, they are charged with addressing those constituents\u2019 interests. Historically, this job has included what some have affectionately called \u201cbringing home the bacon\u201d but what many (usually those outside the district in question) call  pork-barrel politics . As a term and a practice, pork-barrel politics\u2014federal spending on projects designed to benefit a particular district or set of constituents\u2014has been around since the nineteenth century, when barrels of salt pork were both a sign of wealth and a system of reward. While pork-barrel politics are often deplored during election campaigns, and earmarks\u2014funds appropriated for specific projects\u2014are no longer permitted in Congress (see feature box below), legislative control of local appropriations nevertheless still exists. In more formal language,  allocation , or the influencing of the national budget in ways that help the district or state, can mean securing funds for a specific district\u2019s project like an airport, or getting tax breaks for certain types of agriculture or manufacturing. Get Connected! Language and Metaphor The language and metaphors of war and violence are common in politics. Candidates routinely \u201csmell blood in the water,\u201d \u201cbattle for delegates,\u201d go \u201chead-to-head,\u201d \u201ccripple\u201d their opponent, and \u201cmake heads roll.\u201d But references to actual violence aren\u2019t the only metaphorical devices commonly used in politics. Another is mentions of food. Powerful speakers frequently \u201cthrow red meat to the crowds;\u201d careful politicians prefer to stick to \u201cmeat-and-potato issues;\u201d and representatives are frequently encouraged by their constituents to \u201cbring home the bacon.\u201d And the way members of Congress typically \u201cbring home the bacon\u201d is often described with another agricultural metaphor, the \u201cearmark.\u201d \n\n In ranching, an  earmark  is a small cut on the ear of a cow or other animal to denote ownership. Similarly, in Congress, an earmark is a mark in a bill that directs some of the bill\u2019s funds to be spent on specific projects or for specific tax exemptions. Since the 1980s, the earmark has become a common vehicle for sending money to various projects around the country. Many a road, hospital, and airport can trace its origins back to a few skillfully drafted earmarks. \n\n Relatively few people outside Congress had ever heard of the term before the 2008 presidential election, when Republican nominee Senator John McCain touted his career-long refusal to use the earmark as a testament to his commitment to reforming spending habits in Washington. 30  McCain\u2019s criticism of the earmark as a form of corruption cast a shadow over a previously common legislative practice. As the country sank into recession and Congress tried to use spending bills to stimulate the economy, the public grew more acutely aware of its earmarking habits. Congresspersons then were eager to distance themselves from the practice. In fact, the use of earmarks to encourage Republicans to help pass health care reform actually made the bill less popular with the public. \n\n In 2011, after Republicans took over the House, they outlawed earmarks. But with deadlocks and stalemates becoming more common, some quiet voices have begun asking for a return to the practice. They argue that Congress works because representatives can satisfy their responsibilities to their constituents by making deals. The earmarks are those deals. By taking them away, Congress has hampered its own ability to \u201cbring home the bacon.\u201d \n\n Are earmarks a vital part of legislating or a corrupt practice that was rightly jettisoned? Pick a cause or industry, and investigate whether any earmarks ever favored it, or research the way earmarks have hurt or helped your state or district, and decide for yourself. \n\n Follow-up activity: Find out where your congressional representative stands on the ban on earmarks and write to support or dissuade him or her. \n\n Such budgetary allocations aren\u2019t always looked upon favorably by constituents. Consider, for example, the passage of the ACA in 2010. The desire for comprehensive universal health care had been a driving position of the Democrats since at least the 1960s. During the 2008 campaign, that desire was so great among both Democrats and Republicans that both parties put forth plans. When the Democrats took control of Congress and the presidency in 2009, they quickly began putting together their plan. Soon, however, the politics grew complex, and the proposed plan became very contentious for the Republican Party. \n\n Nevertheless, the desire to make good on a decades-old political promise compelled Democrats to do everything in their power to pass something. They offered sympathetic members of the Republican Party valuable budgetary concessions; they attempted to include allocations they hoped the opposition might feel compelled to support; and they drafted the bill in a purposely complex manner to avoid future challenges. These efforts, however, had the opposite effect. The Republican Party\u2019s constituency interpreted the allocations as bribery and the bill as inherently flawed, and felt it should be scrapped entirely. The more Democrats dug in, the more frustrated the Republicans became ( Figure 11.14 ). \n\n The Republican opposition, which took control of the House during the 2010 midterm elections, promised constituents they would repeal the law. Their attempts were complicated, however, by the fact that Democrats still held the Senate and the presidency. Yet, the desire to represent the interests of their constituents compelled Republicans to use another tool at their disposal, the symbolic vote. During the 112th and 113th Congresses, Republicans voted more than sixty times to either repeal or severely limit the reach of the law. They understood these efforts had little to no chance of ever making it to the president\u2019s desk. And if they did, he would certainly have vetoed them. But it was important for these representatives to demonstrate to their constituents that they understood their wishes and were willing to act on them. \n\n Historically, representatives have been able to balance their role as members of a national legislative body with their role as representatives of a smaller community. The Obamacare fight, however, gave a boost to the growing concern that the power structure in Washington divides representatives from the needs of their constituency. 31  This has exerted pressure on representatives to the extent that some now pursue a more straightforward delegate approach to representation. Indeed, following the 2010 election, a handful of Republicans began living in their offices in Washington, convinced that by not establishing a residence in Washington, they would appear closer to their constituents at home. 32 \n\n COLLECTIVE REPRESENTATION AND CONGRESSIONAL APPROVAL \n\n The concept of  collective representation  describes the relationship between Congress and the United States as a whole. That is, it considers whether the institution itself represents the American people, not just whether a particular member of Congress represents his or her district. Predictably, it is far more difficult for Congress to maintain a level of collective representation than it is for individual members of Congress to represent their own constituents. Not only is Congress a mixture of different ideologies, interests, and party affiliations, but the collective constituency of the United States has an even-greater level of diversity. Nor is it a solution to attempt to match the diversity of opinions and interests in the United States with those in Congress. Indeed, such an attempt would likely make it more difficult for Congress to maintain collective representation. Its rules and procedures require Congress to use flexibility, bargaining, and concessions. Yet, it is this flexibility and these concessions, which many now interpret as corruption, that tend to engender the high public disapproval ratings experienced by Congress. \n\n After many years of deadlocks and bickering on Capitol Hill, the national perception of Congress is near an all-time low. According to Gallup polls, Congress has a stunningly poor approval rating of about 16 percent. This is unusual even for a body that has rarely enjoyed a high approval rating. For example, for nearly two decades following the Watergate scandal in the early 1970s, the national approval rating of Congress hovered between 30 and 40 percent. 33 \n\n Yet, incumbent reelections have remained largely unaffected. The reason has to do with the remarkable ability of many in the United States to separate their distaste for Congress from their appreciation for their own representative. Paradoxically, this tendency to hate the group but love one\u2019s own representative actually perpetuates the problem of poor congressional approval ratings. The reason is that it blunts voters\u2019 natural desire to replace those in power who are earning such low approval ratings. \n\n As decades of polling indicate, few events push congressional approval ratings above 50 percent. Indeed, when the ratings are graphed, the two noticeable peaks are at 57 percent in 1998 and 84 percent in 2001 ( Figure 11.15 ). In 1998, according to Gallup polling, the rise in approval accompanied a similar rise in other mood measures, including President Bill  Clinton \u2019s approval ratings and general satisfaction with the state of the country and the economy. In 2001, approval spiked after the September 11 terrorist attacks and the  Bush  administration launched the \"War on Terror,\" sending troops first to Afghanistan and later to Iraq. War has the power to bring majorities of voters to view their Congress and president in an overwhelmingly positive way. 34 \n\n Nevertheless, all things being equal, citizens tend to rate Congress more highly when things get done and more poorly when things do not get done. For example, during the first half of President Obama\u2019s first term, Congress\u2019s approval rating reached a relative high of about 40 percent. Both houses were dominated by members of the president\u2019s own party, and many people were eager for Congress to take action to end the deep recession and begin to repair the economy. Millions were suffering economically, out of work, or losing their jobs, and the idea that Congress was busy passing large stimulus packages, working on finance reform, and grilling unpopular bank CEOs and financial titans appealed to many. Approval began to fade as the Republican Party slowed the wheels of Congress during the tumultuous debates over Obamacare and reached a low of 9 percent following the federal government shutdown in October 2013. \n\n One of the events that began the approval rating\u2019s downward trend was Congress\u2019s divisive debate over national deficits. A deficit is what results when Congress spends more than it has available. It then conducts additional deficit spending by increasing the national debt. Many modern economists contend that during periods of economic decline, the nation should run deficits, because additional government spending has a stimulative effect that can help restart a sluggish economy. Despite this benefit, voters rarely appreciate deficits. They see Congress as spending wastefully during a time when they themselves are cutting costs to get by. \n\n The disconnect between the common public perception of running a deficit and its legitimate policy goals is frequently exploited for political advantage. For example, while running for the presidency in 2008, Barack Obama slammed the deficit spending of the George W. Bush presidency, saying it was \u201cunpatriotic.\u201d This sentiment echoed complaints Democrats had been issuing for years as a weapon against President Bush\u2019s policies. Following the election of President Obama and the Democratic takeover of the Senate, the concern over deficit spending shifted parties, with Republicans championing a spendthrift policy as a way of resisting Democratic policies. \n\n Link to Learning \n\n Find your representative at the  U.S. House website  and then explore his or her website and social media accounts to see whether the issues on which your representative spends time are the ones you think are most appropriate. \n11.4   House and Senate Organizations \n\n Learning Objectives \n\n By the end of this section, you will be able to: \n\n Explain the division of labor in the House and in the Senate \n\n Describe the way congressional committees develop and advance legislation \n\n Not all the business of Congress involves bickering, political infighting, government shutdowns, and Machiavellian maneuvering. Congress does actually get work done. Traditionally, it does this work in a very methodical way. In this section, we will explore how Congress functions at the leadership and committee levels. We will learn how the party leadership controls their conferences and how the many committees within Congress create legislation that can then be moved forward or die on the floor. \n\n PARTY LEADERSHIP \n\n The party leadership in Congress controls the actions of Congress. Leaders are elected by the two-party conferences in each chamber. In the House of Representatives, these are the House Democratic Conference and the House Republican Conference. These conferences meet regularly and separately not only to elect their leaders but also to discuss important issues and strategies for moving policy forward. Based on the number of members in each conference, one conference becomes the majority conference and the other becomes the minority conference. Independents like Senator Bernie Sanders will typically join one or the other major party conference, as a matter of practicality and often based on ideological affinity. Without the membership to elect their own leadership, independents would have a very difficult time getting things done in Congress unless they had a relationship with the leaders. \n\n Despite the power of the conferences, however, the most important leadership position in the House is actually elected by the entire body of representatives. This position is called the  Speaker of the House  and is the only House officer mentioned in the Constitution. The Constitution does not require the Speaker to be a member of the House, although to date, all fifty-four Speakers have been. The Speaker is the presiding officer, the administrative head of the House, the partisan leader of the majority party in the House, and an elected representative of a single congressional district ( Figure 11.16 ). As a testament to the importance of the Speaker, since 1947, the holder of this position has been second in line to succeed the president in an emergency, after the vice president. \n\n The Speaker serves until his or her party loses, or until he or she is voted out of the position or chooses to step down. Republican Speaker John Boehner became the latest Speaker to walk away from the position when it appeared his position was in jeopardy. This event shows how the party conference (or caucus) oversees the leadership as much as, if not more than, the leadership oversees the party membership in the chamber. The Speaker is invested with quite a bit of power, such as the ability to assign bills to committees and decide when a bill will be presented to the floor for a vote. The Speaker also rules on House procedures, often delegating authority for certain duties to other members. He or she appoints members and chairs to committees, creates  select committee s  to fulfill a specific purpose and then disband, and can even select a member to be speaker  pro tempore , who acts as Speaker in the Speaker\u2019s absence. Finally, when the Senate joins the House in a joint session, the Speaker presides over these sessions, because they are usually held in the House of Representatives. \n\n Below the Speaker, the majority and minority conferences each elect two leadership positions arranged in hierarchical order. At the top of the hierarchy are the floor leaders of each party. These are generally referred to as the majority and minority leaders. The  minority leader  has a visible if not always a powerful position. As the official leader of the opposition, he or she technically holds the rank closest to that of the Speaker, makes strategy decisions, and attempts to keep order within the minority. However, the majority rules the day in the House, like a cartel. On the majority side, because it holds the speakership, the  majority leader  also has considerable power. Historically, moreover, the majority leader tends to be in the best position to assume the speakership when the current Speaker steps down. \n\n Below these leaders are the two party\u2019s respective  whip s . A whip\u2019s job, as the name suggests, is to whip up votes and otherwise enforce party discipline. Whips make the rounds in Congress, telling members the position of the leadership and the collective voting strategy, and sometimes they wave various carrots and sticks in front of recalcitrant members to bring them in line. The remainder of the leadership positions in the House include a handful of chairs and assistantships. \n\n Like the House, the Senate also has majority and minority leaders and whips, each with duties very similar to those of their counterparts in the House. Unlike the House, however, the Senate doesn\u2019t have a Speaker. The duties and powers held by the Speaker in the House fall to the majority leader in the Senate. Another difference is that, according to the U.S. Constitution, the Senate\u2019s president is actually the elected vice president of the United States, but he or she may vote only in case of a tie. Apart from this and very few other exceptions, the president of the Senate does not actually operate in the Senate. Instead, the Constitution allows for the Senate to choose a  president  pro tempore \u2014usually the most senior senator of the majority party\u2014who presides over the Senate. Despite the title, the job is largely a formal and powerless role. The real power in the Senate is in the hands of the majority leader ( Figure 11.16 ) and the minority leader. Like the Speaker of the House, the majority leader is the chief spokesperson for the majority party, but unlike in the House he or she does not run the floor alone. Because of the traditions of unlimited debate and the filibuster, the majority and minority leaders often occupy the floor together in an attempt to keep things moving along. At times, their interactions are intense and partisan, but for the Senate to get things done, they must cooperate to get the sixty votes needed to run this super-majority legislative institution. \n\n THE COMMITTEE SYSTEM \n\n With 535 members in Congress and a seemingly infinite number of domestic, international, economic, agricultural, regulatory, criminal, and military issues to deal with at any given moment, the two chambers must divide their work based on specialization. Congress does this through the committee system. Specialized committees (or subcommittees) in both the House and the Senate are where bills originate and most of the work that sets the congressional agenda takes place. Committees are roughly approximate to a bureaucratic department in the executive branch. There are well over two hundred committees, subcommittees, select committees, and joint committees in the Congress. The core committees are called  standing committee s . There are twenty standing committees in the House and sixteen in the Senate ( Table 11.2 ). \n\n Congressional Standing and Permanent Select Committees \n\n House of Representatives \n\n Senate \n\n Agriculture \n\n Agriculture, Nutrition, and Forestry \n\n Appropriations \n\n Appropriations \n\n Armed Services \n\n Armed Services \n\n Budget \n\n Banking, Housing, and Urban Affairs \n\n Education and the Workforce \n\n Budget \n\n Energy and Commerce \n\n Commerce, Science, and Transportation \n\n Ethics \n\n Energy and Natural Resources \n\n Financial Services \n\n Environment and Public Works \n\n Foreign Affairs \n\n Ethics (select) \n\n Homeland Security \n\n Finance \n\n House Administration \n\n Foreign Relations \n\n Intelligence (select) \n\n Health, Education, Labor and Pensions \n\n Judiciary \n\n Homeland Security and Governmental Affairs \n\n Natural Resources \n\n Indian Affairs (select) \n\n Oversight and Government Reform \n\n Intelligence (select) \n\n Rules \n\n Judiciary \n\n Science, Space, and Technology \n\n Rules and Administration \n\n Small Business \n\n Small Business and Entrepreneurship \n\n Transportation and Infrastructure \n\n Veterans\u2019 Affairs \n\n Veterans\u2019 Affairs \n\n Ways and Means \n\n Table  11.2     \n\n Members of both parties compete for positions on various committees. These positions are typically filled by majority and minority members to roughly approximate the ratio of majority to minority members in the respective chambers, although committees are chaired by members of the majority party. Committees and their chairs have a lot of power in the legislative process, including the ability to stop a bill from going to the floor (the full chamber) for a vote. Indeed, most bills die in committee. But when a committee is eager to develop legislation, it takes a number of methodical steps. It will reach out to relevant agencies for comment on resolutions to the problem at hand, such as by holding hearings with experts to collect information. In the Senate, committee hearings are also held to confirm presidential appointments ( Figure 11.17 ). After the information has been collected, the committee meets to discuss amendments and legislative language. Finally, the committee will send the bill to the full chamber along with a committee report. The report provides the majority opinion about why the bill should be passed, a minority view to the contrary, and estimates of the proposed law\u2019s cost and impact. \n\n Four types of committees exist in the House and the Senate. The first is the standing, or permanent, committee. This committee is the first call for proposed bills, fewer than 10 percent of which are reported out of committee to the floor. The second type is the  joint committee . Joint committee members are appointed from both the House and the Senate, and are charged with exploring a few key issues, such as the economy and taxation. However, joint committees have no bill-referral authority whatsoever\u2014they are informational only. A  conference committee  is used to reconcile different bills passed in both the House and the Senate. The conference committees are appointed on an ad hoc basis as necessary when a bill passes the House and Senate in different forms. Finally, ad hoc, special, or select committees are temporary committees set up to address specific topics. These types of committees often conduct special investigations, such as on aging or ethics. \n\n Committee hearings can become politically driven public spectacles. Consider the House Select Committee on Benghazi, the committee assembled by Republicans to further investigate the 2011 attacks on the U.S. Consulate in Benghazi, Libya. This prolonged investigation became particularly partisan as Republicans trained their guns on then-secretary of state Hillary Clinton, who was running for the presidency at the time. In two multi-hour hearings in which Secretary Clinton was the only witness, Republicans tended to grandstand in the hopes of gaining political advantage or tripping her up, while Democrats tended to use their time to ridicule Republicans ( Figure 11.18 ). 35  In the end, the long hearings uncovered little more than the elevated state of partisanship in the House, which had scarcely been a secret before. \n\n Members of Congress bring to their roles a variety of specific experiences, interests, and levels of expertise, and try to match these to committee positions. For example, House members from states with large agricultural interests will typically seek positions on the Agriculture Committee. Senate members with a background in banking or finance may seek positions on the Senate Finance Committee. Members can request these positions from their chambers\u2019 respective leadership, and the leadership also selects the committee chairs. \n\n Committee chairs are very powerful. They control the committee\u2019s budget and choose when the committee will meet, when it will hold hearings, and even whether it will consider a bill ( Figure 11.19 ). A chair can convene a meeting when members of the minority are absent or adjourn a meeting when things are not progressing as the majority leadership wishes. Chairs can hear a bill even when the rest of the committee objects. They do not remain in these powerful positions indefinitely, however. In the House, rules prevent committee chairs from serving more than six consecutive years and from serving as the chair of a subcommittee at the same time. A senator may serve only six years as chair of a committee but may, in some instances, also serve as a chair or ranking member of another committee. \n\n Because the Senate is much smaller than the House, senators hold more committee assignments than House members. There are sixteen standing committees in the Senate, and each position must be filled. In contrast, in the House, with 435 members and only twenty standing committees, committee members have time to pursue a more in-depth review of a policy. House members historically defer to the decisions of committees, while senators tend to view committee decisions as recommendations, often seeking additional discussion that could lead to changes. \n\n Link to Learning \n\n Take a look at the  scores of committees  in the  House  and Senate. The late House Speaker Tip O\u2019Neill once quipped that if you didn\u2019t know a new House member\u2019s name, you could just call him Mr. Chairperson. \n11.5   The Legislative Process \n\n Learning Objectives \n\n By the end of this section, you will be able to: \n\n Explain the steps in the classic bill-becomes-law diagram \n\n Describe the modern legislative processes that alter the classic process in some way \n\n A dry description of the function of congressional leadership and the many committees and subcommittees in Congress may suggest that the drafting and amending of legislation is a finely tuned process that has become ever more refined over the course of the last few centuries. In reality, however, committees are more likely to kill legislation than to pass it. And the last few decades have seen a dramatic transformation in the way Congress does business. Creative interpretations of rules and statues have turned small loopholes into the large gateways through which much congressional work now gets done. In this section, we will explore both the traditional legislative route by which a bill becomes a law and the modern incarnation of the process. We will also learn how and why the transformation occurred. \n\n THE CLASSIC LEGISLATIVE PROCESS \n\n The traditional process by which a bill becomes a law is called the  classic legislative process . First, legislation must be drafted. Theoretically, anyone can do this. Much successful legislation has been initially drafted by someone who is not a member of Congress, such as a think tank or advocacy group, or the president. However, Congress is under no obligation to read or introduce this legislation, and only a bill introduced by a member of Congress can hope to become law. Even the president must rely on legislators to introduce his or her legislative agenda. \n\n Technically, bills that raise revenue, like tax bills, must begin in the House. This exception is encoded within the Constitution in  Article I , Section 7, which states, \u201cAll Bills for raising Revenue shall originate in the House of Representatives; but the Senate may propose or concur with amendments as on other Bills.\u201d Yet, despite the seemingly clear language of the Constitution, Congress has found ways to get around this rule. \n\n Once legislation has been proposed, however, the majority leadership consults with the  parliamentarian  about which committee to send it to. Each chamber has a  parliamentarian , an advisor, typically a trained lawyer, who has studied the long and complex rules of the chamber. While Congress typically follows the advice of its parliamentarians, it is not obligated to, and the parliamentarian has no power to enforce his or her interpretation of the rules. Once a committee has been selected, the committee chair is empowered to move the bill through the committee process as he or she sees fit. This occasionally means the chair will refer the bill to one of the committee\u2019s subcommittees. \n\n Whether at the full committee level or in one of the subcommittees, the next step is typically to hold a hearing on the bill. If the chair decides to not hold a hearing, this is tantamount to killing the bill in committee. The hearing provides an opportunity for the committee to hear and evaluate expert opinions on the bill or aspects of it. Experts typically include officials from the agency that would be responsible for executing the bill, the bill\u2019s sponsors from Congress, and industry lobbyists, interest groups, and academic experts from a variety of relevant fields. Typically, the committee will also accept written statements from the public concerning the bill in question. For many bills, the hearing process can be very routine and straightforward. \n\n Once hearings have been completed, the bill enters the  markup  stage. This is essentially an amending and voting process. In the end, with or without amendments, the committee or subcommittee will vote. If the committee decides not to advance the bill at that time, it is tabled.  Tabling a bill  typically means the bill is dead, but there is still an option to bring it back up for a vote again. If the committee decides to advance the bill, however, it is printed and goes to the chamber, either the House or the Senate. For the sake of example, we will assume that a bill goes first to the House (although the reverse could be true, and, in fact, bills can move simultaneously through both chambers). Before it reaches the House floor, it must first go through the House Committee on Rules. This committee establishes the rules of debate, such as time limits and limits on the number and type of amendments. After these rules have been established, the bill moves through the floor, where it is debated and amendments can be added. Once the limits of debate and amendments have been reached, the House holds a vote. If a simple majority, 50 percent plus 1, votes to advance the bill, it moves out of the House and into the Senate. \n\n Once in the Senate, the bill is placed on the calendar so it can be debated. Or, more typically, the Senate will also consider the bill (or a companion version) in its own committees. Since the Senate is much smaller than the House, it can afford to be much more flexible in its rules for debate. Typically, senators allow each other to talk and debate as long as the speaker wants, though they can agree as a body to create time limits. But without these limits, debate continues until a motion to table has been offered and voted on. \n\n This flexibility about speaking in the Senate gave rise to a unique tactic, the  filibuster . The word \u201cfilibuster\u201d comes from the Dutch word  vrijbuiter , which means pirate. And the name is appropriate, since a senator who launches a filibuster virtually hijacks the floor of the chamber by speaking for long periods of time, thus preventing the Senate from closing debate and acting on a bill. The tactic was perfected in the 1850s as Congress wrestled with the complicated issue of slavery. After the Civil War, the use of the filibuster became even more common. Eventually, in 1917, the Senate passed Rule 22, which allowed the chamber to hold a  cloture  vote to end debate. To invoke cloture, the Senate had to get a two-thirds majority. This was difficult to do, but it generally did prevent anyone from hijacking the Senate floor, with the salient exception of Senator Strom Thurmond\u2019s record twenty-four-hour filibuster of the  Civil Rights Act . In 1975, after the heightened partisanship of the civil rights era, the Senate further weakened the filibuster by reducing the number needed for cloture from two-thirds to three-fifths, or sixty votes, where it remains today (except for judicial nominations for which only fifty-five votes are needed to invoke cloture). Moreover, filibusters are not permitted on the annual budget reconciliation act (the  Reconciliation Act  of 2010 was the act under which the implementing legislation for Obamacare was passed). \n\n Milestone The Noble History of the Filibuster? When most people think of the Senate filibuster, they probably picture actor Jimmy Stewart standing exasperated at a podium and demanding the Senate come to its senses and do the right thing. Even for those not familiar with the classic Frank Capra film  Mr. Smith Goes to Washington , the image of a heroic single senator sanding up to the power of the entire chamber while armed only with oratorical skill naturally tends to inspire. Unfortunately, the history of the filibuster is less heartwarming. \n\n This is not to say that noble causes haven\u2019t been championed by filibustering senators; they most certainly have. But they have largely been overshadowed by the outright ridiculous and sometimes racist filibusters of the twentieth century. In the first category, the fifteen-and-a-half-hour marathon of Senator Huey  Long  of Louisiana stands out: Hoping to retain the need for Senate confirmation of some jobs he wanted to keep from his political enemies, Long spent much of his filibuster analyzing the Constitution, talking about his favorite recipes, and telling amusing stories, as was his custom. \n\n In a defining moment for the filibuster, Senator Strom  Thurmond  of South Carolina spoke for twenty-four hours and eighteen minutes against a weak civil rights bill in 1957. A vocal proponent of segregation and white supremacy, Thurmond had made no secret of his views and had earlier run for the presidency on a segregationist platform. Nor was Thurmond the first to use the filibuster to preserve segregation and prevent the expansion of civil rights for African Americans. Groups of dedicated southern senators used the filibuster to prevent the passage of anti-lynching legislation on multiple occasions during the first half of the twentieth century. Later, when faced with the 1964 Civil Rights Act, southern senators staged a fifty-seven-day filibuster to try and kill it. But the momentum of the nation was against them. The bill passed over their obstructionism and helped to reduce segregation. \n\n Is the filibuster the tool of the noble minority attempting to hold back the tide of a powerful minority? Or does its history as a weapon supporting segregation expose it as merely a tactic of obstruction? \n\n Because both the House and the Senate can and often do amend bills, the bills that pass out of each chamber frequently look different. This presents a problem, since the Constitution requires that both chambers pass identical bills. One simple solution is for the first chamber to simply accept the bill that ultimately makes it out of the second chamber. Another solution is for first chamber to further amend the second chamber\u2019s bill and send it back to the second chamber. Congress typically takes one of these two options, but about one in every eight bills cannot be resolved in this way. These bills must be sent to a conference committee that negotiates a reconciliation both chambers can accept without amendment. Only then can the bill progress to the president\u2019s desk for signature or veto. If the president does veto the bill, both chambers must muster a two-thirds vote to overcome the veto and make the bill law without presidential approval ( Figure 11.20 ). \n\n Link to Learning \n\n For one look at the classic legislative process, visit  YouTube  to view \u201cI\u2019m Just a Bill\u201d from the ABC  Schoolhouse Rock!  series. \n\n MODERN LEGISLATION IS DIFFERENT \n\n For much of the nation\u2019s history, the process described above was the standard method by which a bill became a law. Over the course of the last three and a half decades, however, changes in rules and procedure have created a number of alternate routes. Collectively, these different routes constitute what some political scientists have described as a new but unorthodox legislative process. According to political scientist Barbara Sinclair, the primary trigger for the shift away from the classic legislative route was the budget reforms of the 1970s. The 1974  Budget and Impoundment Control Act  gave Congress a mechanism for making large, all-encompassing, budget decisions. In the years that followed, the budget process gradually became the vehicle for creating comprehensive policy changes. One large step in this transformation occurred in 1981 when President Ronald Reagan\u2019s administration suggested using the budget to push through his economic reforms. \n\n The benefit of attaching the reforms to the budget resolution was that Congress could force an up or down (yea or nay) vote on the whole package. Such a packaged bill is called an  omnibus bill . 36  Creating and voting for an  omnibus bill  allows Congress to quickly accomplish policy changes that would have taken many votes and the expending of great political capital over a long period of time. This and successive similar uses of the budget process convinced many in Congress of the utility of this strategy. During the contentious and ideologically divided 1990s, the budget process became the common problem-solving mechanism in the legislature, thus laying the groundwork for the way legislation works today. \n\n An important characteristic feature of modern legislating is the greatly expanded power and influence of the party leadership over the control of bills. One reason for this change was the heightened partisanship that stretches back to the 1980s and is still with us today. With such high political stakes, the party leadership is reluctant to simply allow the committees to work things out on their own. In the House, the leadership uses special rules to guide bills through the legislative process and toward a particular outcome. Uncommon just a few decades ago, these now widely used rules restrict debate and options, and are designed to focus the attention of members. \n\n The practice of multiple referrals, with which entire bills or portions of those bills are referred to more than one committee, greatly weakened the different specialization monopolies committees held primarily in the House but also to an extent in the Senate. With less control over the bills, committees naturally reached out to the leadership for assistance. Indeed, as a testament to its increasing control, the leadership may sometimes avoid committees altogether, preferring to work things out on the floor. And even when bills move through the committees, the leadership often seeks to adjust the legislation before it reaches the floor. \n\n Another feature of the modern legislative process, exclusively in the Senate, is the application of the modern filibuster. Unlike the traditional filibuster, in which a senator took the floor and held it for as long as possible, the modern filibuster is actually a perversion of the cloture rules adopted to control the filibuster. When partisanship is high, as it has been frequently, the senators can request cloture before any bill can get a vote. This has the effect of increasing the number of votes needed for a bill to advance from a simple majority of fifty-one to a super majority of sixty. The effect is to give the Senate minority great power to obstruct if it is inclined to do so. \n\n Link to Learning \n\n The Library of Congress\u2019s  Thomas website  has provided scholars, citizens, and media with a bounty of readily available data on members and bills for more than two decades. ", "questions": [{"question": {"question_id": "fs-id1171471090824", "question_text": "The Great Compromise successfully resolved differences between ________.", "question_choices": ["large and small states", "slave and non-slave states", "the Articles of Confederation and the Constitution", "the House and the Senate"], "cloze_format": "The Great Compromise successfully resolved differences between ________.", "normal_format": "The Great Compromise successfully resolved differences between which of the following?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "The storm of debate over how to allocate power between large and small states was eventually calmed by a third proposal . The Connecticut Compromise , also called the Great Compromise , proposed a bicameral congress with members apportioned differently in each house .", "hl_context": "<hl> The storm of debate over how to allocate power between large and small states was eventually calmed by a third proposal . <hl> <hl> The Connecticut Compromise , also called the Great Compromise , proposed a bicameral congress with members apportioned differently in each house . <hl> The upper house , the Senate , was to have two members from each state . This soothed the fears of the small states . In the lower house , the House of Representatives , membership would be proportional to the population in each state . This measure protected the interests of the large states ."}, {"question": {"question_id": "fs-id1171473268523", "question_text": "While each state has two senators, members of the House are apportioned ________.", "question_choices": ["according to the state\u2019s geographic size", "based on the state\u2019s economic size", "according to the state\u2019s population", "based on each state\u2019s need"], "cloze_format": "While each state has two senators, members of the House are apportioned ________.", "normal_format": "How are members of the House apportioned, while each state has two senators? "}, "answer": {"ans_text": "according to the state\u2019s population", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "There are currently 435 congressional districts in the United States and thus 435 House members , and each state has a number of House districts roughly proportional to its share of the total U . S . population , with states guaranteed at least one House member . Two senators are elected by each state . The Constitution specifies that every state will have two senators who each serve a six-year term . Seats in the House of Representatives are distributed among the states based on each state \u2019 s population and each member of the House is elected by voters in a specific congressional district . The storm of debate over how to allocate power between large and small states was eventually calmed by a third proposal . The Connecticut Compromise , also called the Great Compromise , proposed a bicameral congress with members apportioned differently in each house . The upper house , the Senate , was to have two members from each state .", "hl_context": "The U . S . Constitution is very clear about who can be elected as a member of the House or Senate . A House member must be a U . S . citizen of at least seven years \u2019 standing and at least twenty-five years old . Senators are required to have nine years \u2019 standing as citizens and be at least thirty years old when sworn in . Representatives serve two-year terms , whereas senators serve six-year terms . Per the Supreme Court decision in U . S . Term Limits v . Thornton ( 1995 ) , there are currently no term limits for either senators or representatives , despite efforts by many states to impose them in the mid - 1990s . 9 House members are elected by the voters in their specific congressional districts . <hl> There are currently 435 congressional districts in the United States and thus 435 House members , and each state has a number of House districts roughly proportional to its share of the total U . S . population , with states guaranteed at least one House member . <hl> <hl> Two senators are elected by each state . <hl> <hl> The Constitution specifies that every state will have two senators who each serve a six-year term . <hl> Therefore , with fifty states in the Union , there are currently one hundred seats in the U . S . Senate . Senators were originally appointed by state legislatures , but in 1913 , the Seventeenth Amendment was approved , which allowed for senators to be elected by popular vote in each state . <hl> Seats in the House of Representatives are distributed among the states based on each state \u2019 s population and each member of the House is elected by voters in a specific congressional district . <hl> Each state is guaranteed at least one seat in the House ( Table 11.1 ) . <hl> The storm of debate over how to allocate power between large and small states was eventually calmed by a third proposal . <hl> <hl> The Connecticut Compromise , also called the Great Compromise , proposed a bicameral congress with members apportioned differently in each house . <hl> <hl> The upper house , the Senate , was to have two members from each state . <hl> This soothed the fears of the small states . In the lower house , the House of Representatives , membership would be proportional to the population in each state . This measure protected the interests of the large states ."}, {"question": {"question_id": "fs-id1171473152002", "question_text": "The process of redistricting can present problems for congressional representation because ________.", "question_choices": ["districts must include urban and rural areas", "states can gain but never lose districts", "districts are often drawn to benefit partisan groups", "states have been known to create more districts than they have been apportioned"], "cloze_format": "The process of redistricting can present problems for congressional representation because ________.", "normal_format": "Why can the process of redistricting present problems for congressional representation?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "These aren \u2019 t geographical features or large infrastructure projects . Rather , they are racially gerrymandered congressional districts . Their strange shapes are the product of careful district restructuring organized around the goal of enhancing the votes of minority groups .", "hl_context": "<hl> These aren \u2019 t geographical features or large infrastructure projects . <hl> <hl> Rather , they are racially gerrymandered congressional districts . <hl> <hl> Their strange shapes are the product of careful district restructuring organized around the goal of enhancing the votes of minority groups . <hl> The alligator-mouth District 4 in Illinois , for example , was drawn to bring a number of geographically autonomous Latino groups in Illinois together in the same congressional district ."}, {"question": {"question_id": "fs-id1171470989954", "question_text": "Which of the following is an implied power of Congress?", "question_choices": ["the power to regulate the sale of tobacco in the states", "the power to increase taxes on the wealthiest one percent", "the power to put the president on trial for high crimes", "the power to override a presidential veto"], "cloze_format": "___ is an implied power of Congress.", "normal_format": "Which of the following is an implied power of Congress?"}, "answer": {"ans_text": "the power to regulate the sale of tobacco in the states", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Finding a Middle Ground Understanding the Limits of Congress \u2019 s Power to Regulate One of the most important constitutional anchors for Congress \u2019 s implicit power to regulate all manner of activities within the states is the short clause in Article I , Section 8 , which says Congress is empowered to \u201c to regulate Commerce with foreign Nations , and among the several States , and with Indian Tribes . \u201d The Supreme Court \u2019 s broad interpretation of this so-called commerce clause has greatly expanded the power and reach of Congress over the centuries .", "hl_context": "<hl> Finding a Middle Ground Understanding the Limits of Congress \u2019 s Power to Regulate One of the most important constitutional anchors for Congress \u2019 s implicit power to regulate all manner of activities within the states is the short clause in Article I , Section 8 , which says Congress is empowered to \u201c to regulate Commerce with foreign Nations , and among the several States , and with Indian Tribes . \u201d The Supreme Court \u2019 s broad interpretation of this so-called commerce clause has greatly expanded the power and reach of Congress over the centuries . <hl>"}, {"question": {"question_id": "fs-id1171471260028", "question_text": "Senate races tend to inspire ________.", "question_choices": ["broad discussion of policy issues", "narrow discussion of specific policy issues", "less money than House races", "less media coverage than House races"], "cloze_format": "Senate races tend to inspire ________.", "normal_format": "What do senate races tend to inspire?"}, "answer": {"ans_text": "broad discussion of policy issues", "ans_choice": 0}, "bloom": null, "hl_sentences": "Because the Senate is much smaller than the House , senators hold more committee assignments than House members . House members historically defer to the decisions of committees , while senators tend to view committee decisions as recommendations , often seeking additional discussion that could lead to changes .", "hl_context": "<hl> Because the Senate is much smaller than the House , senators hold more committee assignments than House members . <hl> There are sixteen standing committees in the Senate , and each position must be filled . In contrast , in the House , with 435 members and only twenty standing committees , committee members have time to pursue a more in-depth review of a policy . <hl> House members historically defer to the decisions of committees , while senators tend to view committee decisions as recommendations , often seeking additional discussion that could lead to changes . <hl>"}, {"question": {"question_id": "fs-id1171473125739", "question_text": "The saying \u201cAll politics is local\u201d roughly means ________.", "question_choices": ["the local candidate will always win", "the local constituents want action on national issues", "the local constituents tend to care about things that affect them", "the act of campaigning always occurs at the local level where constituents are"], "cloze_format": "The saying \u201cAll politics is local\u201d roughly means ________.", "normal_format": "What does the saying \u201cAll politics is local\u201d roughly mean?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The importance of airing positive constituent casework during campaigns is a testament to the accuracy of saying , \u201c All politics is local . \u201d This phrase , attributed to former Speaker of the House Tip O \u2019 Neill ( D-MA ) , essentially means that the most important motivations directing voters are rooted in local concerns .", "hl_context": "<hl> The importance of airing positive constituent casework during campaigns is a testament to the accuracy of saying , \u201c All politics is local . \u201d This phrase , attributed to former Speaker of the House Tip O \u2019 Neill ( D-MA ) , essentially means that the most important motivations directing voters are rooted in local concerns . <hl> In general , this is true . People naturally feel more driven by the things that affect them on a daily basis . These are concerns like the quality of the roads , the availability of good jobs , and the cost and quality of public education . Good senators and representatives understand this and will seek to use their influence and power in office to affect these issues for the better . This is an age-old strategy for success in office and elections ."}, {"question": {"question_id": "fs-id1171473101052", "question_text": "A congressperson who pursued a strict delegate model of representation would seek to ________.", "question_choices": ["legislate in the way he or she believed constituents wanted, regardless of the anticipated outcome", "legislate in a way that carefully considered the circumstances and issue so as to reach a solution that is best for everyone", "legislate in a way that is best for the nation regardless of the costs for the constituents", "legislate in the way that he or she thinks is best for the constituents"], "cloze_format": "A congressperson who pursued a strict delegate model of representation would seek to ________.", "normal_format": "What would a congressperson seek to pursue a strict delegate model of representation?"}, "answer": {"ans_text": "legislate in the way that he or she thinks is best for the constituents", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Political scientists call this the politico model of representation . In it , members of Congress act as either trustee or delegate based on rational political calculations about who is best served , the constituency or the nation . A representative who sees him - or herself as a delegate believes he or she is empowered merely to enact the wishes of constituents . Delegates must employ some means to identify the views of their constituents and then vote accordingly . They are not permitted the liberty of employing their own reason and judgment while acting as representatives in Congress . Representation is a complex concept . It can mean paying careful attention to the concerns of constituents , understanding that representatives must act as they see fit based on what they feel best for the constituency , or relying on the particular ethnic , racial , or gender diversity of those in office . We will look at the way members of Congress navigate the challenging terrain of representation as they serve , and all the many predictable and unpredictable consequences of the decisions they make .", "hl_context": "Understandably , few if any representatives adhere strictly to one model or the other . Instead , most find themselves attempting to balance the important principles embedded in each . <hl> Political scientists call this the politico model of representation . <hl> <hl> In it , members of Congress act as either trustee or delegate based on rational political calculations about who is best served , the constituency or the nation . <hl> Traditionally , representatives have seen their role as that of a delegate , a trustee , or someone attempting to balance the two . <hl> A representative who sees him - or herself as a delegate believes he or she is empowered merely to enact the wishes of constituents . <hl> <hl> Delegates must employ some means to identify the views of their constituents and then vote accordingly . <hl> <hl> They are not permitted the liberty of employing their own reason and judgment while acting as representatives in Congress . <hl> This is the delegate model of representation . The tension between local and national politics described in the previous section is essentially a struggle between interpretations of representation . <hl> Representation is a complex concept . <hl> <hl> It can mean paying careful attention to the concerns of constituents , understanding that representatives must act as they see fit based on what they feel best for the constituency , or relying on the particular ethnic , racial , or gender diversity of those in office . <hl> In this section , we will explore three different models of representation and the concept of descriptive representation . <hl> We will look at the way members of Congress navigate the challenging terrain of representation as they serve , and all the many predictable and unpredictable consequences of the decisions they make . <hl>"}, {"question": {"question_id": "fs-id1171470952386", "question_text": "The increasing value constituents have placed on descriptive representation in Congress has had the effect of ________.", "question_choices": ["increasing the sensitivity representatives have to their constituents demands", "decreasing the rate at which incumbents are elected", "increasing the number of minority members in Congress", "decreasing the number of majority minority districts"], "cloze_format": "The increasing value constituents have placed on descriptive representation in Congress has had the effect of ________.", "normal_format": "The increasing value constituents have placed on descriptive representation in Congress has had what effect?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "While the strategy of creating majority-minority districts has been a success for minorities \u2019 representation in Congress , its long-term effect has revealed a disturbing paradox : Congress as a whole has become less enthusiastic about minority-specific issues .", "hl_context": "<hl> While the strategy of creating majority-minority districts has been a success for minorities \u2019 representation in Congress , its long-term effect has revealed a disturbing paradox : Congress as a whole has become less enthusiastic about minority-specific issues . <hl> How is this possible ? The problem is that by creating districts with high percentages of minority constituents , strategists have made the other districts less diverse . The representatives in those districts are under very little pressure to consider the interests of minority groups . As a result , they typically do not . 2"}, {"question": {"question_id": "fs-id1171471032709", "question_text": "House leaders are more powerful than Senate leaders because of ________.", "question_choices": ["the majoritarian nature of the House\u2014a majority can run it like a cartel", "the larger size of the House", "the constitutional position of the House", "the State of the Union address being delivered in the House chamber"], "cloze_format": "House leaders are more powerful than Senate leaders because of ________.", "normal_format": "Why are House leaders more powerful than Senate leaders? "}, "answer": {"ans_text": "the constitutional position of the House", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Instead , the Constitution allows for the Senate to choose a president pro tempore \u2014 usually the most senior senator of the majority party \u2014 who presides over the Senate . Despite the power of the conferences , however , the most important leadership position in the House is actually elected by the entire body of representatives . This position is called the Speaker of the House and is the only House officer mentioned in the Constitution .", "hl_context": "Like the House , the Senate also has majority and minority leaders and whips , each with duties very similar to those of their counterparts in the House . Unlike the House , however , the Senate doesn \u2019 t have a Speaker . The duties and powers held by the Speaker in the House fall to the majority leader in the Senate . Another difference is that , according to the U . S . Constitution , the Senate \u2019 s president is actually the elected vice president of the United States , but he or she may vote only in case of a tie . Apart from this and very few other exceptions , the president of the Senate does not actually operate in the Senate . <hl> Instead , the Constitution allows for the Senate to choose a president pro tempore \u2014 usually the most senior senator of the majority party \u2014 who presides over the Senate . <hl> Despite the title , the job is largely a formal and powerless role . The real power in the Senate is in the hands of the majority leader ( Figure 11.16 ) and the minority leader . Like the Speaker of the House , the majority leader is the chief spokesperson for the majority party , but unlike in the House he or she does not run the floor alone . Because of the traditions of unlimited debate and the filibuster , the majority and minority leaders often occupy the floor together in an attempt to keep things moving along . At times , their interactions are intense and partisan , but for the Senate to get things done , they must cooperate to get the sixty votes needed to run this super-majority legislative institution . <hl> Despite the power of the conferences , however , the most important leadership position in the House is actually elected by the entire body of representatives . <hl> <hl> This position is called the Speaker of the House and is the only House officer mentioned in the Constitution . <hl> The Constitution does not require the Speaker to be a member of the House , although to date , all fifty-four Speakers have been . The Speaker is the presiding officer , the administrative head of the House , the partisan leader of the majority party in the House , and an elected representative of a single congressional district ( Figure 11.16 ) . As a testament to the importance of the Speaker , since 1947 , the holder of this position has been second in line to succeed the president in an emergency , after the vice president ."}, {"question": {"question_id": "fs-id1171473150122", "question_text": "A select committee is different from a standing committee because ________.", "question_choices": ["a select committee includes member of both chambers, while a standing committee includes only members of the House", "a select committee is used for bill reconciliation, while a standing committee is used for prosecutions", "a select committee must stay in session, while a standing committee goes to recess", "a select committee is convened for a specific and temporary purpose, while a standing committee is permanent"], "cloze_format": "A select committee is different from a standing committee because ________.", "normal_format": "A select committee is different from a standing committee because of what?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "bloom": null, "hl_sentences": "The first is the standing , or permanent , committee . Finally , ad hoc , special , or select committees are temporary committees set up to address specific topics .", "hl_context": "Four types of committees exist in the House and the Senate . <hl> The first is the standing , or permanent , committee . <hl> This committee is the first call for proposed bills , fewer than 10 percent of which are reported out of committee to the floor . The second type is the joint committee . Joint committee members are appointed from both the House and the Senate , and are charged with exploring a few key issues , such as the economy and taxation . However , joint committees have no bill-referral authority whatsoever \u2014 they are informational only . A conference committee is used to reconcile different bills passed in both the House and the Senate . The conference committees are appointed on an ad hoc basis as necessary when a bill passes the House and Senate in different forms . <hl> Finally , ad hoc , special , or select committees are temporary committees set up to address specific topics . <hl> These types of committees often conduct special investigations , such as on aging or ethics ."}, {"question": {"question_id": "fs-id1171472284811", "question_text": "Stopping a filibuster requires that ________.", "question_choices": ["a majority of senators agree on the bill", "the speaker steps away from the podium", "the chamber votes for cloture", "the Speaker or majority leader intervenes"], "cloze_format": "Stopping a filibuster requires that ________.", "normal_format": "What does stopping a filibuster require?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "This flexibility about speaking in the Senate gave rise to a unique tactic , the filibuster . In 1975 , after the heightened partisanship of the civil rights era , the Senate further weakened the filibuster by reducing the number needed for cloture from two-thirds to three-fifths , or sixty votes , where it remains today ( except for judicial nominations for which only fifty-five votes are needed to invoke cloture ) .", "hl_context": "<hl> This flexibility about speaking in the Senate gave rise to a unique tactic , the filibuster . <hl> The word \u201c filibuster \u201d comes from the Dutch word vrijbuiter , which means pirate . And the name is appropriate , since a senator who launches a filibuster virtually hijacks the floor of the chamber by speaking for long periods of time , thus preventing the Senate from closing debate and acting on a bill . The tactic was perfected in the 1850s as Congress wrestled with the complicated issue of slavery . After the Civil War , the use of the filibuster became even more common . Eventually , in 1917 , the Senate passed Rule 22 , which allowed the chamber to hold a cloture vote to end debate . To invoke cloture , the Senate had to get a two-thirds majority . This was difficult to do , but it generally did prevent anyone from hijacking the Senate floor , with the salient exception of Senator Strom Thurmond \u2019 s record twenty-four-hour filibuster of the Civil Rights Act . <hl> In 1975 , after the heightened partisanship of the civil rights era , the Senate further weakened the filibuster by reducing the number needed for cloture from two-thirds to three-fifths , or sixty votes , where it remains today ( except for judicial nominations for which only fifty-five votes are needed to invoke cloture ) . <hl> Moreover , filibusters are not permitted on the annual budget reconciliation act ( the Reconciliation Act of 2010 was the act under which the implementing legislation for Obamacare was passed ) ."}, {"question": {"question_id": "fs-id1171474226574", "question_text": "Saying a bill is being marked up is just another way to say it is being ________.", "question_choices": ["tabled", "neglected", "vetoed", "amended"], "cloze_format": "Saying a bill is being marked up is just another way to say it is being ________.", "normal_format": "Saying a bill is being marked up is just another way to say it is being what?"}, "answer": {"ans_text": "amended", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Once hearings have been completed , the bill enters the markup stage . This is essentially an amending and voting process .", "hl_context": "<hl> Once hearings have been completed , the bill enters the markup stage . <hl> <hl> This is essentially an amending and voting process . <hl> In the end , with or without amendments , the committee or subcommittee will vote . If the committee decides not to advance the bill at that time , it is tabled . Tabling a bill typically means the bill is dead , but there is still an option to bring it back up for a vote again . If the committee decides to advance the bill , however , it is printed and goes to the chamber , either the House or the Senate . For the sake of example , we will assume that a bill goes first to the House ( although the reverse could be true , and , in fact , bills can move simultaneously through both chambers ) . Before it reaches the House floor , it must first go through the House Committee on Rules . This committee establishes the rules of debate , such as time limits and limits on the number and type of amendments . After these rules have been established , the bill moves through the floor , where it is debated and amendments can be added . Once the limits of debate and amendments have been reached , the House holds a vote . If a simple majority , 50 percent plus 1 , votes to advance the bill , it moves out of the House and into the Senate ."}, {"question": {"question_id": "fs-id1171472149155", "question_text": "The key means of advancing modern legislation is now ________.", "question_choices": ["committees", "the actions of the leadership", "the budget process", "the filibuster"], "cloze_format": "The key means of advancing modern legislation is now ________.", "normal_format": "What are now the key means of advancing modern legislation?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "This and successive similar uses of the budget process convinced many in Congress of the utility of this strategy . During the contentious and ideologically divided 1990s , the budget process became the common problem-solving mechanism in the legislature , thus laying the groundwork for the way legislation works today .", "hl_context": "The benefit of attaching the reforms to the budget resolution was that Congress could force an up or down ( yea or nay ) vote on the whole package . Such a packaged bill is called an omnibus bill . 36 Creating and voting for an omnibus bill allows Congress to quickly accomplish policy changes that would have taken many votes and the expending of great political capital over a long period of time . <hl> This and successive similar uses of the budget process convinced many in Congress of the utility of this strategy . <hl> <hl> During the contentious and ideologically divided 1990s , the budget process became the common problem-solving mechanism in the legislature , thus laying the groundwork for the way legislation works today . <hl>"}], "summary": "Summary 11.1   The Institutional Design of Congress \n\n The weaknesses of the Articles of Confederation convinced the member states to send delegates to a new convention to revise them. What emerged from the debates and compromises of the convention was instead a new and stronger constitution. The Constitution established a bicameral legislature, with a Senate composed of two members from each state and a House of Representatives composed of members drawn from each state in proportion to its population. Today\u2019s Senate has one hundred members representing fifty states, while membership in the House of Representatives has been capped at 435 since 1929. Apportionment in the House is based on population data collected by the U.S. Census Bureau. \n\n The Constitution empowers Congress with enumerated, implied, and inherent powers. Enumerated powers are specifically addressed in the text of the Constitution. Implied powers are not explicitly called out but are inferred as necessary to achieve the objectives of the national goverment. Inherent powers are assumed to exist by virtue of the fact that the country exists. The power of Congress to regulate interstate and intrastate commerce has generally increased, while its power to control foreign policy has declined over the course of the twentieth century. \n\n 11.2   Congressional Elections \n\n Since the House is closest to its constituents because reelection is so frequent a need, it tends to be more easily led by fleeting public desires. In contrast, the Senate\u2019s distance from its constituents allows it to act more deliberately. Each type of representative, however, must raise considerable sums of money in order to stay in office. Attempts by Congress to rein in campaign spending have largely failed. Nevertheless, incumbents tend to have the easiest time funding campaigns and retaining their seats. They also benefit from the way parties organize primary elections, which are designed to promote incumbency. \n\n 11.3   Congressional Representation \n\n Some representatives follow the delegate model of representation, acting on the expressed wishes of their constituents, whereas others take a trustee model approach, acting on what they believe is in their constituents\u2019 best interests. However, most representatives combine the two approaches and apply each as political circumstances demand. The standard method by which representatives have shown their fidelity to their constituents, namely \u201cbringing home the bacon\u201d of favorable budget allocations, has come to be interpreted as a form of corruption, or pork-barrel politics. \n\n Representation can also be considered in other ways. Descriptive representation is the level at which Congress reflects the nation\u2019s constituents in terms of race, ethnicity, gender, sexuality, and socioeconomic status. Collective representation is the extent to which the institutional body of Congress represents the population as a whole. Despite the incumbency advantage and high opinion many hold of their own legislators, Congress rarely earns an approval rating above 40 percent, and for a number of years the rating has been well below 20 percent. \n\n 11.4   House and Senate Organizations \n\n The leader of the House is the Speaker, who also typically the leader of the majority party. In the Senate, the leader is called the majority leader. The minorities in each chamber also have leaders who help create and act on party strategies. The majority leadership in each chamber controls the important committees where legislature is written, amended, and prepared for the floor. \n\n 11.5   The Legislative Process \n\n In the classic legislative process, bills are introduced and sent to the appropriate committee. Within the committees, hearings are held and the bill is debated and ultimately sent to the floor of the chamber. On the floor, the bill is debated and amended until passed or voted down. If passed, it moves to the second chamber where the debating and amending begins anew. Eventually, if the bill makes it that far, the two chambers meet in a joint committee to reconcile what are now two different bills. Over the last few decades, however, Congress has adopted a very different process whereby large pieces of legislation covering many different items are passed through the budgeting process. This method has had the effect of further empowering the leadership, to the detriment of the committees. The modern legislative process has also been affected by the increasing number of filibuster threats in the Senate and the use of cloture to forestall them. ", "keyterm": "", "bname": "american_government"}, {"chapter": 23, "intro": " Chapter Outline 23.1   Anatomy and Normal Microbiota of the Urogenital Tract 23.2   Bacterial Infections of the Urinary System 23.3   Bacterial Infections of the Reproductive System 23.4   Viral Infections of the Reproductive System 23.5   Fungal Infections of the Reproductive System 23.6   Protozoan Infections of the Urogenital System Introduction The urogenital system is a combination of the urinary tract and reproductive system. Because both systems are open to the external environment, they are prone to infections. Some infections are introduced from outside, whereas others result from imbalances in the microbiota of the urogenital tract. Urinary tract infections  (UTIs) are one the most common bacterial infections worldwide, affecting over 100 million people each year. During 2007 in the United States, doctor office visits for UTIs exceeded 10 million, and an additional 2\u20133 million emergency department visits were attributed to UTIs. Sexually transmitted infections (STIs) also primarily affect the urogenital system and are an important cause of patient morbidity. The Centers for Disease Control and Prevention (CDC) estimates that there are approximately 20 million new cases of reportable STIs annually in the United States, half of which occur in people aged 15\u201324 years old. When STIs spread to the reproductive organs, they can be associated with severe morbidity and loss of fertility. Because males and females have different urogenital anatomy, urogenital infections may affect males and females differently. In this chapter, we will discuss the various microbes that cause urogenital disease and the factors that contribute to their pathogenicity. ", "chapter_text": " 23.1   Anatomy and Normal Microbiota of the Urogenital Tract \n\n Learning Objectives \n\n Compare the anatomy, function, and normal microbiota associated with the male and female urogenital systems \n\n Explain how microorganisms, in general, overcome the defenses of the urogenital system to cause infection \n\n Name, describe, and differentiate between general signs and symptoms associated with infections of the urogenital tract \n\n Clinical Focus Part 1 Nadia is a newly married 26-year-old graduate student in economics. Recently she has been experiencing an unusual vaginal discharge, as well as some itching and discomfort. Since she is due for her annual physical exam, she makes an appointment with her doctor hoping that her symptoms can be quickly treated. However, she worries that she may have some sort of sexually transmitted infection (STI). Although she is now in a monogamous relationship, she is not fully certain of her spouse\u2019s sexual history and she is reluctant to ask him about it. \n\n At her checkup, Nadia describes her symptoms to her primary care physician and, somewhat awkwardly, explains why she thinks she might have an STI. Nadia\u2019s doctor reassures her that she regularly sees patients with similar concerns and encourages her to be fully transparent about her symptoms because some STIs can have serious complications if left untreated. After some further questioning, the doctor takes samples of Nadia\u2019s blood, urine, and vaginal discharge to be sent to the lab for testing. \n\n What are some possible causes of Nadia\u2019s symptoms? \n\n Why does the doctor take so many different samples? \n\n Jump to the  next  Clinical Focus box. \n\n The  urinary system  filters blood, excretes wastes, and maintains an appropriate electrolyte and water balance. The  reproductive system  is responsible for the production of gametes and participates in conception and, in females, development of offspring. Due to their proximity and overlap, these systems are often studied together and referred to as the  urogenital system  (or genitourinary system). \n\n Anatomy of the Urinary Tract \n\n The basic structures of the urinary tract are common in males and females. However, there are unique locations for these structures in females and males, and there is a significant amount of overlap between the urinary and genital structures in males.  Figure 23.2  illustrates the urinary anatomy common to females and males. \n\n The  kidneys  carry out the urinary system\u2019s primary functions of filtering the blood and maintaining water and electrolyte balance. The kidneys are composed of millions of filtration units called nephrons. Each nephron is in intimate contact with blood through a specialized capillary bed called the  glomerulus  (plural  glomeruli ). Fluids, electrolytes, and molecules from the blood pass from the glomerulus into the nephron, creating the filtrate that becomes urine ( Figure 23.3 ). Urine that collects in each kidney empties through a  ureter  and drains to the  urinary bladder , which stores urine. Urine is released from the bladder to the  urethra , which transports it to be excreted from the body through the  urinary meatus , the opening of the urethra. \n\n Anatomy of the Reproductive System \n\n The male reproductive system ( Figure 23.4 ) is located in close proximity to the urinary system, and the urethra is part of both systems. The  testes  are responsible for the production of sperm. The  epididymis  is a coiled tube that collects sperm from the testes and passes it on to the vas deferens. The epididymis is also the site of sperm maturation after they leave the testes. The  seminal vesicles  and  prostate  are accessory glands that produce fluid that supports sperm. During ejaculation, the  vas deferens  releases this mixture of fluid and sperm, called semen, into the urethra, which extends to the end of the  penis . \n\n The female reproductive system is located near the urinary system ( Figure 23.4 ). The external genitalia ( vulva ) in females open to the  vagina , a muscular passageway that connects to the cervix. The  cervix  is the lower part of the  uterus  (the organ where a fertilized egg will implant and develop). The cervix is a common site of infection, especially for viruses that may lead to cervical cancer. The uterus leads to the fallopian tubes and eventually to the ovaries. Ovaries are the site of ova (egg) production, as well as the site of  estrogen  and progesterone production that are involved in maturation and maintenance of reproductive organs, preparation of the uterus for pregnancy, and regulation of the menstrual cycle. \n\n Check Your Understanding \n\n What are the major structures of the urinary system, starting where urine is formed? \n\n What structure in males is shared by the reproductive and the urinary systems? \n\n Normal Microbiota of the Urogenital System \n\n The normal  microbiota  of different body sites provides an important nonspecific defense against infectious diseases (see  Physical Defenses ), and the urogenital tract is no exception. In both men and women, however, the kidneys are sterile. Although urine does contain some antibacterial components, bacteria will grow in urine left out at room temperature. Therefore, it is primarily the flushing action that keeps the ureters and bladder free of microbes. \n\n Below the bladder, the normal microbiota of the male urogenital system is found primarily within the distal urethra and includes bacterial species that are commonly associated with the skin microbiota. In women, the normal microbiota is found within the distal one third of the urethra and the vagina. The normal microbiota of the vagina becomes established shortly after birth and is a complex and dynamic population of bacteria that fluctuates in response to environmental changes. Members of the vaginal microbiota play an important role in the nonspecific defense against vaginal infections and sexually transmitted infections by occupying cellular binding sites and competing for nutrients. In addition, the production of  lactic acid  by members of the microbiota provides an acidic environment within the vagina that also serves as a defense against infections. For the majority of women, the lactic-acid\u2013producing bacteria in the vagina are dominated by a variety of species of  Lactobacillus . For women who lack sufficient lactobacilli in their vagina, lactic acid production comes primarily from other species of bacteria such as  Leptotrichia  spp.,  Megasphaera  spp., and  Atopobium vaginae .  Lactobacillus  spp. use  glycogen  from vaginal epithelial cells for metabolism and production of lactic acid. This process is tightly regulated by the hormone estrogen. Increased levels of estrogen correlate with increased levels of vaginal glycogen, increased production of lactic acid, and a lower  vaginal pH . Therefore, decreases in estrogen during the menstrual cycle and with menopause are associated with decreased levels of vaginal glycogen and lactic acid, and a higher pH. In addition to producing lactic acid,  Lactobacillus  spp. also contribute to the defenses against infectious disease through their production of hydrogen peroxide and  bacteriocins  (antibacterial peptides). \n\n Check Your Understanding \n\n What factors affect the microbiota of the female reproductive tract? \n\n General Signs and Symptoms of Urogenital Infections \n\n Infections of the urinary tract most commonly cause inflammation of the bladder ( cystitis ) or of the urethra ( urethritis ). Urethritis can be associated with cystitis, but can also be caused by sexually transmitted infections. Symptoms of urethritis in men include burning sensation while urinating, discharge from the penis, and blood in the semen or the urine. In women, urethritis is associated with painful and frequent urination, vaginal discharge, fever, chills, and abdominal pain. The symptoms of cystitis are similar to those of urethritis. When urethritis is caused by a sexually transmitted pathogen, additional symptoms involving the genitalia can occur. These can include painful vesicles (blisters), warts, and ulcers. Ureteritis, a rare infection of the ureter, can also occur with cystitis. These infections can be acute or chronic. \n\n Pyelonephritis  and  glomerulonephritis  are infections of the kidney that are potentially serious. Pyelonephritis is an infection of one or both of the kidneys and may develop from a lower urinary tract infection; the upper urinary tract, including the ureters, is often affected. Signs and symptoms of pyelonephritis include fever, chills, nausea, vomiting, lower back pain, and frequent painful urination. Pyelonephritis usually only becomes chronic in individuals who have malformations in or damage to the kidneys. \n\n Glomerulonephritis is an inflammation of the glomeruli of the nephrons. Symptoms include excessive protein and blood in urine, increased blood pressure, and fluid retention leading to edema of face, hands, and feet. Glomerulonephritis may be an acute infection or it can become chronic. \n\n Infections occurring within the reproductive structures of males include epididymitis, orchitis, and prostatitis. Bacterial infections may cause inflammation of the epididymis, called  epididymitis . This inflammation causes pain in the scrotum, testicles, and groin; swelling, redness, and warm skin in these areas may also be observed. Inflammation of the testicle, called  orchitis , is usually caused by a bacterial infection spreading from the epididymis, but it can also be a complication of mumps, a viral disease. The symptoms are similar to those of epididymitis, and it is not uncommon for them both to occur together, in which case the condition is called epididymo-orchitis. Inflammation of the prostate gland, called  prostatitis , can result from a bacterial infection. The signs and symptoms of prostatitis include fever, chills, and pain in the bladder, testicles, and penis. Patients may also experience burning during urination, difficulty emptying the bladder, and painful ejaculation. \n\n Because of its proximity to the exterior, the vagina is a common site for infections in women. The general term for any inflammation of the vagina is  vaginitis . Vaginitis often develops as a result of an overgrowth of bacteria or fungi that normally reside in the vaginal microbiota, although it can also result from infections by transient pathogens. Bacterial infections of the vagina are called bacterial  vaginosis , whereas fungal infections (typically involving  Candida  spp.) are called  yeast infection s . Dynamic changes affecting the normal microbiota, acid production, and pH variations can be involved in the initiation of the microbial overgrowth and the development of vaginitis. Although some individuals may have no symptoms, vaginosis and vaginitis can be associated with discharge, odor, itching, and burning. \n\n Pelvic inflammatory disease (PID)  is an infection of the female reproductive organs including the uterus, cervix, fallopian tubes, and ovaries. The two most common pathogens are the sexually transmitted bacterial pathogens  Neisseria gonorrhoeae  and  Chlamydia trachomatis . Inflammation of the fallopian tubes, called  salpingitis , is the most serious form of PID. Symptoms of PID can vary between women and include pain in the lower abdomen, vaginal discharge, fever, chills, nausea, diarrhea, vomiting, and painful urination. \n\n Check Your Understanding \n\n What conditions can result from infections affecting the urinary system? \n\n What are some common causes of vaginitis in women? \n\n General Causes and Modes of Transmission of Urogenital Infections \n\n Hormonal changes, particularly shifts in  estrogen  in women due to  pregnancy  or  menopause , can increase susceptibility to urogenital infections. As discussed earlier, estrogen plays an important role in regulating the availability of glycogen and subsequent production of lactic acid by  Lactobacillus  species. Low levels of estrogen are associated with an increased vaginal pH and an increased risk of bacterial vaginosis and  yeast infection s. Estrogen also plays a role in maintaining the elasticity, strength, and thickness of the vaginal wall, and keeps the vaginal wall lubricated, reducing dryness. Low levels of estrogen are associated with thinning of the vaginal wall. This thinning increases the risk of tears and abrasions, which compromise the protective barrier and increase susceptibility to pathogens. \n\n Another common cause of urogenital infections in females is fecal contamination that occurs because of the close proximity of the anus and the urethra.  Escherichia coli , an important member of the digestive tract microbiota, is the most common cause of  urinary tract infections  (urethritis and cystitis) in women; it generally causes infection when it is introduced to the urethra in fecal matter. Good hygiene can reduce the risk of urinary tract infections by this route. In men, urinary tract infections are more commonly associated with other conditions, such as an enlarged prostate, kidney stones, or placement of a urinary catheter. All of these conditions impair the normal emptying of the bladder, which serves to flush out microbes capable of causing infection. \n\n Infections that are transmitted between individuals through sexual contact are called  sexually transmitted infections  (STIs) or  sexually transmitted diseases  (STDs). (The CDC prefers the term STD, but WHO prefers STI, 1  which encompasses infections that result in disease as well as those that are subclinical or asymptomatic.) STIs often affect the external genitalia and skin, where microbes are easily transferred through physical contact. Lymph nodes in the genital region may also become swollen as a result of infection. However, many STIs have systemic effects as well, causing symptoms that range from mild (e.g., general malaise) to severe (e.g., liver damage or serious immunosuppression). 1 World Health Organization. \u201cGuidelines for the Management of Sexually Transmitted Infections.\u201d World Health Organization, 2003. http://www.who.int/hiv/pub/sti/en/STIGuidelines2003.pdf. \n\n Check Your Understanding \n\n What role does  Lactobacillus  play in the health of the female reproductive system? \n\n Why do urinary tract infections have different causes in males and females? \n 23.2   Bacterial Infections of the Urinary System \n\n Learning Objectives \n\n Identify the most common bacterial pathogens that can cause urinary tract infections \n\n Compare the major characteristics of specific bacterial diseases affecting the urinary tract \n\n Urinary tract infections  (UTIs) include infections of the urethra, bladder, and kidneys, and are common causes of urethritis, cystitis, pyelonephritis, and glomerulonephritis. Bacteria are the most common causes of UTIs, especially in the urethra and bladder. \n\n Cystitis \n\n Cystitis is most often caused by a bacterial infection of the bladder, but it can also occur as a reaction to certain treatments or irritants such as radiation treatment, hygiene sprays, or spermicides. Common symptoms of cystitis include  dysuria  (urination accompanied by burning, discomfort, or pain),  pyuria  (pus in the urine),  hematuria  (blood in the urine), and bladder pain. \n\n In women,  bladder infections  are more common because the urethra is short and located in close proximity to the anus, which can result in infections of the urinary tract by fecal bacteria. Bladder infections are also more common in the elderly because the bladder may not empty fully, causing urine to pool; the elderly may also have weaker immune systems that make them more vulnerable to infection. Conditions such as prostatitis in men or kidney stones in both men and women can impact proper drainage of urine and increase risk of bladder infections. Catheterization can also increase the risk of bladder infection (see  Case in Point: Cystitis in the Elderly ). \n\n Gram-negative bacteria such as  Escherichia coli  (most commonly),  Proteus vulgaris ,  Pseudomonas aeruginosa , and  Klebsiella pneumoniae  cause most bladder infections. Gram-positive pathogens associated with cystitis include the coagulase-negative  Staphylococcus saprophyticus ,  Enterococcus faecalis , and  Streptococcus agalactiae . Routine manual  urinalysis  using a  urine dipstick  or test strip can be used for rapid screening of infection. These test strips ( Figure 23.5 ) are either held in a urine stream or dipped in a sample of urine to test for the presence of nitrites,  leukocyte esterase , protein, or blood that can indicate an active bacterial infection. The presence of nitrite may indicate the presence of  E. coli  or  K. pneumonia;  these bacteria produce  nitrate reductase , which converts nitrate to nitrite. The leukocyte esterase (LE) test detects the presence of neutrophils as an indication of active infection. \n\n Low specificity, sensitivity, or both, associated with these rapid screening tests require that care be taken in interpretation of results and in their use in diagnosis of urinary tract infections. Therefore, positive LE or nitrite results are followed by a urine culture to confirm a bladder infection. Urine culture is generally accomplished using blood agar and MacConkey agar, and it is important to culture a  clean catch  of urine to minimize contamination with normal microbiota of the penis and vagina. A clean catch of urine is accomplished by first washing the labia and urethral opening of female patients or the penis of male patients. The patient then releases a small amount of urine into the toilet bowl before stopping the flow of urine. Finally, the patient resumes urination, this time filling the container used to collect the specimen. \n\n Bacterial cystitis is commonly treated with  fluoroquinolones ,  nitrofurantoin ,  cephalosporins , or a combination of  trimethoprim  and  sulfamethoxazole . Pain medications may provide relief for patients with dysuria. Treatment is more difficult in elderly patients, who experience a higher rate of complications such as sepsis and kidney infections. \n\n Case in Point Cystitis in the Elderly Robert, an 81-year-old widower with early onset Alzheimer\u2019s, was recently moved to a nursing home because he was having difficulty living on his own. Within a few weeks of his arrival, he developed a fever and began to experience pain associated with urination. He also began having episodes of confusion and delirium. The doctor assigned to examine Robert read his file and noticed that Robert was treated for prostatitis several years earlier. When he asked Robert how often he had been urinating, Robert explained that he had been trying not to drink too much so that he didn\u2019t have to walk to the restroom. \n\n All of this evidence suggests that Robert likely has a urinary tract infection. Robert\u2019s age means that his immune system has probably begun to weaken, and his previous prostate condition may be making it difficult for him to empty his bladder. In addition, Robert\u2019s avoidance of fluids has led to dehydration and infrequent urination, which may have allowed an infection to establish itself in his urinary tract. The fever and dysuria are common signs of a UTI in patients of all ages, and UTIs in elderly patients are often accompanied by a notable decline in mental function. \n\n Physical challenges often discourage elderly individuals from urinating as frequently as they would otherwise. In addition, neurological conditions that disproportionately affect the elderly (e.g., Alzheimer\u2019s and Parkinson\u2019s disease) may also reduce their ability to empty their bladders. Robert\u2019s doctor noted that he was having difficulty navigating his new home and recommended that he be given more assistance and that his fluid intake be monitored. The doctor also took a urine sample and ordered a laboratory culture to confirm the identity of the causative agent. \n\n Why is it important to identify the causative agent in a UTI? \n\n Should the doctor prescribe a broad-spectrum or narrow-spectrum antibiotic to treat Robert\u2019s UTI? Why? \n\n Kidney Infections (Pyelonephritis and Glomerulonephritis) \n\n Pyelonephritis, an inflammation of the kidney, can be caused by bacteria that have spread from other parts of the urinary tract (such as the bladder). In addition,  pyelonephritis  can develop from bacteria that travel through the bloodstream to the kidney. When the infection spreads from the lower urinary tract, the causative agents are typically fecal bacteria such as  E. coli . Common signs and symptoms include back pain (due to the location of the kidneys), fever, and nausea or vomiting. Gross  hematuria  (visible blood in the urine) occurs in 30\u201340% of women but is rare in men. 2  The infection can become serious, potentially leading to  bacteremia  and systemic effects that can become life-threatening. Scarring of the kidney can occur and persist after the infection has cleared, which may lead to dysfunction. 2 Tibor Fulop. \u201cAcute Pyelonephritis\u201d  Medscape , 2015. http://emedicine.medscape.com/article/245559-overview. \n\n Diagnosis of pyelonephritis is made using microscopic examination of urine, culture of urine, testing for leukocyte esterase and nitrite levels, and examination of the urine for blood or protein. It is also important to use blood cultures to evaluate the spread of the pathogen into the bloodstream. Imaging of the kidneys may be performed in high-risk patients with diabetes or immunosuppression, the elderly, patients with previous renal damage, or to rule out an obstruction in the kidney. Pyelonephritis can be treated with either oral or intravenous antibiotics, including  penicillins ,  cephalosporins ,  vancomycin ,  fluoroquinolones ,  carbapenems , and  aminoglycosides . \n\n Glomerulonephritis occurs when the glomeruli of the nephrons are damaged from inflammation. Whereas pyelonephritis is usually acute,  glomerulonephritis  may be acute or chronic. The most well-characterized mechanism of glomerulonephritis is the post-streptococcal sequelae associated with  Streptococcus pyogenes  throat and skin infections. Although  S. pyogenes  does not directly infect the glomeruli of the kidney, immune complexes that form in blood between  S. pyogenes  antigens and antibodies lodge in the capillary endothelial cell junctions of the glomeruli and trigger a damaging inflammatory response. Glomerulonephritis can also occur in patients with  bacterial endocarditis  (infection and inflammation of heart tissue); however, it is currently unknown whether glomerulonephritis associated with endocarditis is also immune-mediated. \n\n Leptospirosis \n\n Leptospira  are generally harmless spirochetes that are commonly found in the soil. However, some pathogenic species can cause an infection called  leptospirosis  in the kidneys and other organs ( Figure 23.6 ). Leptospirosis can produce fever, headache, chills, vomiting, diarrhea, and rash with severe muscular pain. If the disease continues to progress, infection of the kidney, meninges, or liver may occur and may lead to organ failure or meningitis. When the kidney and liver become seriously infected, it is called  Weil\u2019s disease . Pulmonary hemorrhagic syndrome can also develop in the lungs, and  jaundice  may occur. \n\n Leptospira  spp. are found widely in animals such as dogs, horses, cattle, pigs, and rodents, and are excreted in their urine. Humans generally become infected by coming in contact with contaminated soil or water, often while swimming or during flooding; infection can also occur through contact with body fluids containing the bacteria. The bacteria may enter the body through mucous membranes, skin injuries, or by ingestion. The mechanism of pathogenicity is not well understood. \n\n Leptospirosis is extremely rare in the United States, although it is endemic in Hawaii; 50% of all cases in the United States come from Hawaii. 3  It is more common in tropical than in temperate climates, and individuals who work with animals or animal products are most at risk. The bacteria can also be cultivated in specialized media, with growth observed in broth in a few days to four weeks; however, diagnosis of leptospirosis is generally made using faster methods, such as detection of antibodies to  Leptospira  spp. in patient samples using serologic testing. Polymerase chain reaction ( PCR ), enzyme-linked immunosorbent assay ( ELISA ), slide agglutination, and indirect immunofluorescence tests may all be used for diagnosis. Treatment for leptospirosis involves broad-spectrum antibiotics such as  penicillin  and  doxycycline . For more serious cases of leptospirosis, antibiotics may be given intravenously. 3 Centers for Disease Control and Prevention. \u201cLeptospirosis.\u201d 2015. http://www.cdc.gov/leptospirosis/health_care_workers. \n\n Check Your Understanding \n\n What is the most common cause of a kidney infection? \n\n What are the most common symptoms of a kidney infection? \n\n Nongonococcal Urethritis (NGU) \n\n There are two main categories of bacterial urethritis: gonorrheal and nongonococcal. Gonorrheal urethritis is caused by  Neisseria gonorrhoeae  and is associated with gonorrhea, a common STI. This cause of urethritis will be discussed in  Bacterial Infections of the Reproductive System . The term  nongonococcal urethritis (NGU)  refers to inflammation of the urethra that is unrelated to  N. gonorrhoeae . In women, NGU is often asymptomatic. In men, NGU is typically a mild disease, but can lead to purulent discharge and  dysuria . Because the symptoms are often mild or nonexistent, most infected individuals do not know that they are infected, yet they are carriers of the disease. Asymptomatic patients also have no reason to seek treatment, and although not common, untreated NGU can spread to the reproductive organs, causing  pelvic inflammatory disease  and  salpingitis  in women and  epididymitis  and  prostatitis  in men. Important bacterial pathogens that cause nongonococcal urethritis include  Chlamydia trachomatis ,  Mycoplasma genitalium ,  Ureaplasma urealyticum , and  Mycoplasma hominis . \n\n C. trachomatis  is a difficult-to-stain, gram-negative bacterium with an ovoid shape. An intracellular pathogen,  C .  trachomatis  causes the most frequently reported STI in the United States,  chlamydia . Although most persons infected with  C. trachomatis  are asymptomatic, some patients can present with NGU.  C. trachomatis  can also cause non-urogenital infections such as the ocular disease  trachoma  (see  Bacterial Infections of the Skin and Eyes ). The life cycle of  C. trachomatis  is illustrated in  Figure 4.12 . C. trachomatis  has multiple possible virulence factors that are currently being studied to evaluate their roles in causing disease. These include polymorphic outer-membrane  autotransporter proteins ,  stress response proteins , and  type III secretion effectors . The type III secretion effectors have been identified in gram-negative pathogens, including  C. trachomatis.  This virulence factor is an assembly of more than 20 proteins that form what is called an  injectisome  for the transfer of other effector proteins that target the infected host cells. The outer-membrane autotransporter proteins are also an effective mechanism of delivering virulence factors involved in colonization, disease progression, and immune system evasion. \n\n Other species associated with NGU include  Mycoplasma genitalium, Ureaplasma urealyticum , and  Mycoplasma hominis . These bacteria are commonly found in the normal microbiota of healthy individuals, who may acquire them during birth or through sexual contact, but they can sometimes cause infections leading to urethritis (in males and females) or vaginitis and cervicitis (in females). \n\n M. genitalium  is a more common cause of urethritis in most settings than  N. gonorrhoeae , although it is less common than  C. trachomatis . It is responsible for approximately 30% of recurrent or persistent infections, 20\u201325% of nonchlamydial NGU cases, and 15%\u201320% of NGU cases.  M. genitalium  attaches to epithelial cells and has substantial  antigenic variation  that helps it evade host immune responses. It has lipid-associated membrane proteins that are involved in causing inflammation. \n\n Several possible virulence factors have been implicated in the pathogenesis of  U. urealyticum  ( Figure 23.7 ). These include the ureaplasma proteins  phospholipase A ,  phospholipase C ,  multiple banded antigen  (MBA),  urease , and  immunoglobulin \u03b1 protease . The phospholipases are virulence factors that damage the cytoplasmic membrane of target cells. The immunoglobulin \u03b1 protease is an important defense against antibodies. It can generate hydrogen peroxide, which may adversely affect host cell membranes through the production of reactive oxygen species. \n\n Treatments differ for gonorrheal and nongonococcal urethritis. However,  N. gonorrhoeae  and  C. trachomatis  are often simultaneously present, which is an important consideration for treatment. NGU is most commonly treated using  tetracyclines  (such as  doxycycline ) and  azithromycin ;  erythromycin  is an alternative option. Tetracyclines and  fluoroquinolones  are most commonly used to treat  U. urealyticum , but resistance to tetracyclines is becoming an increasing problem. 4  While tetracyclines have been the treatment of choice for  M. hominis , increasing resistance means that other options must be used. Clindamycin and fluoroquinolones are alternatives.  M. genitalium  is generally susceptible to doxycycline, azithromycin, and  moxifloxacin . Like other mycoplasma,  M. genitalium  does not have a cell wall and therefore  \u03b2-lactams  (including penicillins and cephalosporins) are not effective treatments. 4 Ken B Waites. \u201cUreaplasma Infection Medication.\u201d  Medscape , 2015. http://emedicine.medscape.com/article/231470-medication. \n\n Check Your Understanding \n\n What are the three most common causes of urethritis? \n\n What three members of the normal microbiota can cause urethritis? \n\n Disease Profile Bacterial Infections of the Urinary Tract Urinary tract infections can cause inflammation of the urethra (urethritis), bladder (cystitis), and kidneys (pyelonephritis), and can sometimes spread to other body systems through the bloodstream.  Figure 23.8  captures the most important features of various types of UTIs. \n 23.3   Bacterial Infections of the Reproductive System \n\n Learning Objectives \n\n Identify the most common bacterial pathogens that can cause infections of the reproductive system \n\n Compare the major characteristics of specific bacterial diseases affecting the reproductive system \n\n In addition to infections of the urinary tract, bacteria commonly infect the reproductive tract. As with the urinary tract, parts of the reproductive system closest to the external environment are the most likely sites of infection. Often, the same microbes are capable of causing urinary tract and reproductive tract infections. \n\n Bacterial Vaginitis and Vaginosis \n\n Inflammation of the vagina is called  vaginitis , often caused by a bacterial infection. It is also possible to have an imbalance in the normal  vaginal microbiota  without inflammation called  bacterial vaginosis (BV) . Vaginosis may be asymptomatic or may cause mild symptoms such as a thin, white-to-yellow, homogeneous vaginal discharge, burning, odor, and itching. The major causative agent is  Gardnerella vaginalis , a gram-variable to gram-negative pleomorphic bacterium. Other causative agents include anaerobic species such as members of the genera  Bacteroides  and  Fusobacterium . Additionally, ureaplasma and mycoplasma may be involved. The disease is usually self-limiting, although antibiotic treatment is recommended if symptoms develop. \n\n G. vaginalis  appears to be more virulent than other vaginal bacterial species potentially associated with BV. Like  Lactobacillus  spp.,  G. vaginalis  is part of the normal vaginal microbiota, but when the population of  Lactobacillus  spp. decreases and the  vaginal pH  increases,  G. vaginalis  flourishes, causing vaginosis by attaching to vaginal epithelial cells and forming a thick protective  biofilm .  G. vaginalis  also produces a cytotoxin called  vaginolysin  that lyses vaginal epithelial cells and red blood cells. \n\n Since  G. vaginalis  can also be isolated from healthy women, the \u201cgold standard\u201d for the diagnosis of BV is direct examination of vaginal secretions and not the culture of  G. vaginalis . Diagnosis of bacterial vaginosis from vaginal secretions can be accurately made in three ways. The first is to use a  DNA probe . The second method is to assay for  sialidase activity  (sialidase is an enzyme produced by  G. vaginalis  and other bacteria associated with vaginosis, including  Bacteroides  spp.,  Prevotella  spp., and  Mobiluncus  spp.). The third method is to assess gram-stained vaginal smears for microscopic morphology and relative numbers and types of bacteria, squamous epithelial cells, and leukocytes. By examining slides prepared from  vaginal swabs , it is possible to distinguish lactobacilli (long, gram-positive rods) from other gram-negative species responsible for BV. A shift in predominance from gram-positive bacilli to gram-negative coccobacilli can indicate BV. Additionally, the slide may contain so-called  clue cells , which are epithelial cells that appear to have a granular or stippled appearance due to bacterial cells attached to their surface ( Figure 23.9 ). Presumptive diagnosis of bacterial vaginosis can involve an assessment of clinical symptoms and evaluation of vaginal fluids using  Amsel\u2019s diagnostic criteria  which include 3 out of 4 of the following characteristics: \n\n white to yellow discharge; \n\n a fishy odor, most noticeable when 10% KOH is added; \n\n pH greater than 4.5; \n\n the presence of clue cells. \n\n Treatment is often unnecessary because the infection often clears on its own. However, in some cases, antibiotics such as topical or oral  clindamycin  or  metronidazole  may be prescribed. Alternative treatments include oral  tinidazole  or clindamycin ovules (vaginal suppositories). \n\n Check Your Understanding \n\n Explain the difference between vaginosis and vaginitis. \n\n What organisms are responsible for vaginosis and what organisms typically hold it at bay? \n\n Clinical Focus Part 2 There is no catch-all test for STIs, so several tests, in addition to a physical exam, are necessary to diagnose an infection. Nadia tries to relax in the exam room while she waits for the doctor to return, but she is nervous about the results. \n\n When the doctor finally returns, she has some unexpected news: Nadia is pregnant. Surprised and excited, Nadia wants to know if the pregnancy explains her unusual symptoms. The doctor explains that the irritation that Nadia is experiencing is vaginitis, which can be caused by several types of microorganisms. One possibility is bacterial vaginosis, which develops when there is an imbalance in the bacteria in the vagina, as often occurs during pregnancy. Vaginosis can increase the risk of preterm birth and low birth weight, and a few studies have also shown that it can cause second-trimester miscarriage; however, the condition can be treated. To check for it, the doctor has asked the lab to perform a Gram stain on Nadia\u2019s sample. \n\n What result would you expect from the Gram stain if Nadia has bacterial vaginosis? \n\n What is the relationship between pregnancy, estrogen levels, and development of bacterial vaginosis? \n\n Jump to the  next  Clinical Focus box. Go back to the  previous  Clinical Focus box. \n\n Gonorrhea \n\n Also known as the clap,  gonorrhea  is a common sexually transmitted disease of the reproductive system that is especially prevalent in individuals between the ages of 15 and 24. It is caused by  Neisseria gonorrhoeae , often called gonococcus or GC, which have fimbriae that allow the cells to attach to epithelial cells. It also has a type of lipopolysaccharide endotoxin called  lipooligosaccharide  as part of the outer membrane structure that enhances its pathogenicity. In addition to causing  urethritis ,  N. gonorrhoeae  can infect other body tissues such as the skin, meninges, pharynx, and conjunctiva. \n\n Many infected individuals (both men and women) are asymptomatic carriers of gonorrhea. When symptoms do occur, they manifest differently in males and females. Males may develop pain and burning during urination and discharge from the penis that may be yellow, green, or white ( Figure 23.10 ). Less commonly, the testicles may become swollen or tender. Over time, these symptoms can increase and spread. In some cases, chronic infection develops. The disease can also develop in the rectum, causing symptoms such as discharge, soreness, bleeding, itching, and pain (especially in association with bowel movements). \n\n Women may develop pelvic pain, discharge from the vagina, intermenstrual bleeding (i.e., bleeding not associated with normal menstruation), and pain or irritation associated with urination. As with men, the infection can become chronic. In women, however, chronic infection can cause increases in menstrual flow. Rectal infection can also occur, with the symptoms previously described for men. Infections that spread to the endometrium and fallopian tubes can cause  pelvic inflammatory disease (PID) , characterized by pain in the lower abdominal region,  dysuria , vaginal discharge, and fever. PID can also lead to infertility through scarring and blockage of the fallopian tubes ( salpingitis ); it may also increase the risk of a life-threatening  ectopic pregnancy , which occurs when a fertilized egg begins developing somewhere other than the uterus (e.g., in the fallopian tube or ovary). \n\n When a gonorrhea infection disseminates throughout the body, serious complications can develop. The infection may spread through the blood ( bacteremia ) and affect organs throughout the body, including the heart ( gonorrheal endocarditis ), joints ( gonorrheal arthritis ), and meninges encasing the brain ( meningitis ). \n\n Urethritis caused by  N. gonorrhoeae  can be difficult to treat due to  antibiotic resistance  (see  Micro Connections ). Some strains have developed resistance to the  fluoroquinolones , so  cephalosporins  are often a first choice for treatment. Because co-infection with  C. trachomatis  is common, the CDC recommends treating with a combination regimen of  ceftriaxone  and  azithromycin . Treatment of sexual partners is also recommended to avoid reinfection and spread of infection to others. 5 5 Centers for Disease Control and Prevention. \u201c2015 Sexually Transmitted Diseases Treatment Guidelines: Gonococcal Infections,\u201d 2015. http://www.cdc.gov/std/tg2015/gonorrhea.htm. \n\n Check Your Understanding \n\n What are some of the serious consequences of a gonorrhea infection? \n\n What organism commonly coinfects with  N. gonorrhoeae ? \n\n Micro Connections Antibiotic Resistance in  Neisseria Antibiotic resistance in many pathogens is steadily increasing, causing serious concern throughout the public health community. Increased resistance has been especially notable in some species, such as  Neisseria gonorrhoeae . The CDC monitors the spread of antibiotic resistance in  N. gonorrhoeae , which it classifies as an urgent threat, and makes recommendations for treatment. So far,  N. gonorrhoeae  has shown resistance to cefixime (a cephalosporin), ceftriaxone (another cephalosporin), azithromycin, and tetracycline. Resistance to tetracycline is the most common, and was seen in 188,600 cases of gonorrhea in 2011 (out of a total 820,000 cases). In 2011, some 246,000 cases of gonorrhea involved strains of  N. gonorrhoeae  that were resistant to at least one antibiotic. 6  These resistance genes are spread by plasmids, and a single bacterium may be resistant to multiple antibiotics. The CDC currently recommends treatment with two medications, ceftriaxone and azithromycin, to attempt to slow the spread of resistance. If resistance to cephalosporins increases, it will be extremely difficult to control the spread of  N. gonorrhoeae . 6 Centers for Disease Control and Prevention. \u201cAntibiotic Resistance Threats in the United States, 2013,\u201d 2013. http://www.cdc.gov/drugresistance/pdf/ar-threats-2013-508.pdf.  \n\n Chlamydia \n\n Chlamydia trachomatis  is the causative agent of the STI  chlamydia  ( Figure 23.11 ). While many  Chlamydia  infections are asymptomatic, chlamydia is a major cause of nongonococcal urethritis (NGU) and may also cause  epididymitis  and  orchitis  in men. In women, chlamydia infections can cause urethritis,  salpingitis , and PID. In addition, chlamydial infections may be associated with an increased risk of  cervical cancer . \n\n Because chlamydia is widespread, often asymptomatic, and has the potential to cause substantial complications, routine screening is recommended for sexually active women who are under age 25, at high risk (i.e., not in a monogamous relationship), or beginning prenatal care. \n\n Certain serovars of  C. trachomatis  can cause an infection of the lymphatic system in the groin known as  lymphogranuloma venereum . This condition is commonly found in tropical regions and can also co-occur in conjunction with human immunodeficiency virus (HIV) infection. After the microbes invade the lymphatic system, buboes (large lymph nodes, see  Figure 23.11 ) form and can burst, releasing pus through the skin. The male genitals can become greatly enlarged and in women the rectum may become narrow. \n\n Urogenital infections caused by  C. trachomatis  can be treated using  azithromycin  or  doxycycline  (the recommended regimen from the CDC). Erythromycin,  levofloxacin , and  ofloxacin  are alternatives. \n\n Check Your Understanding \n\n Compare the signs and symptoms of chlamydia infection in men and women. \n\n Syphilis \n\n Syphilis  is spread through direct physical (generally sexual) contact, and is caused by the gram-negative spirochete  Treponema pallidum .  T. pallidum  has a relatively simple genome and lacks lipopolysaccharide endotoxin characteristic of gram-negative bacteria. However, it does contain lipoproteins that trigger an immune response in the host, causing tissue damage that may enhance the pathogen\u2019s ability to disseminate while evading the host immune system. \n\n After entering the body,  T. pallidum  moves rapidly into the bloodstream and other tissues. If not treated effectively, syphilis progresses through three distinct stages: primary, secondary, and tertiary. Primary syphilis appears as a single lesion on the cervix, penis, or anus within 10 to 90 days of transmission. Such lesions contain many  T. pallidum  cells and are highly infectious. The lesion, called a  hard chancre , is initially hard and painless, but it soon develops into an ulcerated sore ( Figure 23.12 ). Localized lymph node swelling may occur as well. In some cases, these symptoms may be relatively mild, and the lesion may heal on its own within two to six weeks. Because the lesions are painless and often occur in hidden locations (e.g., the cervix or anus), infected individuals sometimes do not notice them. \n\n The secondary stage generally develops once the primary chancre has healed or begun to heal. Secondary syphilis is characterized by a rash that affects the skin and mucous membranes of the mouth, vagina, or anus. The rash often begins on the palms or the soles of the feet and spreads to the trunk and the limbs ( Figure 23.12 ). The rash may take many forms, such as macular or papular. On mucous membranes, it may manifest as mucus patches or white, wartlike lesions called condylomata lata. The rash may be accompanied by malaise, fever, and swelling of lymph nodes. Individuals are highly contagious in the secondary stage, which lasts two to six weeks and is recurrent in about 25% of cases. \n\n After the secondary phase, syphilis can enter a latent phase, in which there are no symptoms but microbial levels remain high. Blood tests can still detect the disease during latency. The latent phase can persist for years. \n\n Tertiary syphilis, which may occur 10 to 20 years after infection, produces the most severe symptoms and can be fatal. Granulomatous lesions called  gummas  may develop in a variety of locations, including mucous membranes, bones, and internal organs ( Figure 23.12 ). Gummas can be large and destructive, potentially causing massive tissue damage. The most deadly lesions are those of the cardiovascular system (cardiovascular syphilis) and the central nervous system (neurosyphilis). Cardiovascular syphilis can result in a fatal aortic aneurysm (rupture of the aorta) or coronary stenosis (a blockage of the coronary artery). Damage to the central nervous system can cause dementia, personality changes, seizures, general paralysis, speech impairment, loss of vision and hearing, and loss of bowel and bladder control. \n\n The recommended methods for diagnosing early syphilis are darkfield or brightfield (silver stain) microscopy of tissue or exudate from lesions to detect  T. pallidum  ( Figure 23.13 ). If these methods are not available, two types of serologic tests (treponemal and nontreponemal) can be used for a presumptive diagnosis once the spirochete has spread in the body.  Nontreponemal serologic tests  include the  Venereal Disease Research Laboratory  (VDRL) and  rapid plasma reagin  (RPR) tests. These are similar screening tests that detect nonspecific antibodies (those for lipid antigens produced during infection) rather than those produced against the spirochete.  Treponemal serologic tests  measure antibodies directed against  T. pallidum  antigens using particle agglutination ( T. pallidum  passive particle agglutination or TP-PA), immunofluorescence (the fluorescent  T. pallidum  antibody absorption or FTA-ABS), various enzyme reactions (enzyme immunoassays or EIAs) and chemiluminescence immunoassays (CIA). Confirmatory testing, rather than screening, must be done using treponemal rather than nontreponemal tests because only the former tests for antibodies to spirochete antigens. Both treponemal and nontreponemal tests should be used (as opposed to just one) since both tests have limitations than can result in false positives or false negatives. \n\n Neurosyphilis cannot be diagnosed using a single test. With or without clinical signs, it is generally necessary to assess a variety of factors, including reactive serologic test results, cerebrospinal fluid cell count abnormalities, cerebrospinal fluid protein abnormalities, or reactive VDRL-CSF (the VDRL test of cerebrospinal fluid). The VDRL-CSF is highly specific, but not sufficiently sensitive for conclusive diagnosis. \n\n The recommended treatment for syphilis is parenteral  penicillin G  (especially long-acting benzathine penicillin, although the exact choice depends on the stage of disease). Other options include tetracycline and  doxycycline . \n\n Congenital Syphilis \n\n Congenital syphilis is passed by mother to fetus when untreated primary or secondary syphilis is present. In many cases, infection may lead to miscarriage or stillbirth. Children born with  congenital syphilis  show symptoms of secondary syphilis and may develop mucus patches that deform the nose. In infants, gummas can cause significant tissue damage to organs and teeth. Many other complications may develop, such as  osteochondritis ,  anemia , blindness, bone deformations, neurosyphilis, and cardiovascular lesions. Because congenital syphilis poses such a risk to the fetus, expectant mothers are screened for syphilis infection during the first trimester of pregnancy as part of the TORCH panel of prenatal tests. \n\n Check Your Understanding \n\n What aspect of tertiary syphilis can lead to death? \n\n How do treponemal serologic tests detect an infection? \n\n Chancroid \n\n The sexually transmitted infection  chancroid  is caused by the gram-negative rod  Haemophilus ducreyi . It is characterized by  soft chancres   ( Figure 23.14 ) on the genitals or other areas associated with sexual contact, such as the mouth and anus. Unlike the hard chancres associated with syphilis, soft chancres develop into painful, open sores that may bleed or produce fluid that is highly contagious. In addition to causing chancres, the bacteria can invade the lymph nodes, potentially leading to pus discharge through the skin from lymph nodes in the groin. Like other genital lesions, soft chancres are of particular concern because they compromise the protective barriers of the skin or mucous membranes, making individuals more susceptible to HIV and other sexually transmitted diseases. \n\n Several virulence factors have been associated with  H. ducreyi , including  lipooligosaccharide s, protective outer membrane proteins,  antiphagocytic proteins , secretory proteins, and  collagen-specific adhesin NcaA . The collagen-specific adhesion NcaA plays an important role in initial cellular attachment and colonization. Outer membrane proteins DsrA and DltA have been shown to provide protection from serum-mediated killing by antibodies and complement. \n\n H. ducreyi  is difficult to culture; thus, diagnosis is generally based on clinical observation of genital ulcers and tests that rule out other diseases with similar ulcers, such as syphilis and genital herpes. PCR tests for  H. ducreyi  have been developed in some laboratories, but as of 2015 none had been cleared by the US Food and Drug Administration (FDA). 7  Recommended treatments for chancroid include antibiotics such as  azithromycin ,  ciprofloxacin ,  erythromycin  and  ceftriaxone . Resistance to ciprofloxacin and erythromycin has been reported. 8 7 Centers for Disease Control and Prevention. \u201c2015 Sexually Transmitted Diseases Treatment Guidelines: Chancroid,\u201d 2015. http://www.cdc.gov/std/tg2015/chancroid.htm. 8 Ibid. \n\n Check Your Understanding \n\n What is the key difference between chancroid lesions and those associated with syphilis? \n\n Why is it difficult to definitively diagnose chancroid? \n\n Disease Profile Bacterial Reproductive Tract Infections Many bacterial infections affecting the reproductive system are transmitted through sexual contact, but some can be transmitted by other means. In the United States, gonorrhea and chlamydia are common illnesses with incidences of about 350,000 and 1.44 million, respectively, in 2014. Syphilis is a rarer disease with an incidence of 20,000 in 2014. Chancroid is exceedingly rare in the United States with only six cases in 2014 and a median of 10 cases per year for the years 2010\u20132014. 9   Figure 23.15  summarizes bacterial infections of the reproductive tract. 9 Centers for Disease Control and Prevention. \u201c2014 Sexually Transmitted Disease Surveillance,\u201d 2015. http://www.cdc.gov/std/stats14/default.htm. \n 23.4   Viral Infections of the Reproductive System \n\n Learning Objectives \n\n Identify the most common viruses that cause infections of the reproductive system \n\n Compare the major characteristics of specific viral diseases affecting the reproductive system \n\n Several viruses can cause serious problems for the human reproductive system. Most of these viral infections are incurable, increasing the risk of persistent sexual transmission. In addition, such viral infections are very common in the United States. For example, human papillomavirus (HPV) is the most common STI in the country, with an estimated prevalence of 79.1 million infections in 2008; herpes simplex virus 2 (HSV-2) is the next most prevalent STI at 24.1 million infections. 10  In this section, we will examine these and other major viral infections of the reproductive system. 10 Catherine Lindsey Satterwhite, Elizabeth Torrone, Elissa Meites, Eileen F. Dunne, Reena Mahajan, M. Cheryl Ba\u00f1ez Ocfemia, John Su, Fujie Xu, and Hillard Weinstock. \u201cSexually Transmitted Infections Among US Women and Men: Prevalence and Incidence Estimates, 2008.\u201d  Sexually Transmitted Diseases  40, no. 3 (2013): 187\u2013193. \n\n Genital Herpes \n\n Genital herpes  is a common condition caused by the herpes simplex virus ( Figure 23.16 ), an enveloped, double-stranded DNA virus that is classified into two distinct types. Herpes simplex virus has several virulence factors, including infected cell protein (ICP) 34.5, which helps in replication and inhibits the maturation of dendritic cells as a mechanism of avoiding elimination by the immune system. In addition, surface glycoproteins on the viral envelope promote the coating of herpes simplex virus with antibodies and complement factors, allowing the virus to appear as \u201cself\u201d and prevent immune system activation and elimination. \n\n There are two herpes simplex virus types. While herpes simplex virus type 1 (HSV-1) is generally associated with oral lesions like cold sores or fever blisters (see  Viral Infections of the Skin and Eyes ),  herpes simplex virus type 2 (HSV-2)  is usually associated with genital herpes. However, both viruses can infect either location as well as other parts of the body. Oral-genital contact can spread either virus from the mouth to the genital region or vice versa. \n\n Many infected individuals do not develop symptoms, and thus do not realize that they carry the virus. However, in some infected individuals, fever, chills, malaise, swollen lymph nodes, and pain precede the development of fluid-filled vesicles that may be irritating and uncomfortable. When these vesicles burst, they release infectious fluid and allow transmission of HSV. In addition, open herpes lesions can increase the risk of spreading or acquiring HIV. \n\n In men, the herpes lesions typically develop on the penis and may be accompanied by a watery discharge. In women, the vesicles develop most commonly on the vulva, but may also develop on the vagina or cervix ( Figure 23.17 ). The symptoms are typically mild, although the lesions may be irritating or accompanied by urinary discomfort. Use of condoms may not always be an effective means of preventing transmission of genital herpes since the lesions can occur on areas other than the genitals. \n\n Herpes simplex viruses can cause recurrent infections because the virus can become latent and then be reactivated. This occurs more commonly with HSV-2 than with HSV-1. 11  The virus moves down peripheral nerves, typically sensory neurons, to ganglia in the spine (either the trigeminal ganglion or the lumbar-sacral ganglia) and becomes latent. Reactivation can later occur, causing the formation of new vesicles. HSV-2 most effectively reactivates from the lumbar-sacral ganglia. Not everyone infected with HSV-2 experiences reactivations, which are typically associated with stressful conditions, and the frequency of reactivation varies throughout life and among individuals. Between outbreaks or when there are no obvious vesicles, the virus can still be transmitted. 11 Centers for Disease Control and Prevention. \u201c2015 Sexually Transmitted Disease Treatment Guidelines: Genital Herpes,\u201d 2015. http://www.cdc.gov/std/tg2015/herpes.htm. \n\n Virologic and serologic techniques are used for diagnosis. The virus may be cultured from lesions. The immunostaining methods that are used to detect virus from cultures generally require less expertise than methods based on cytopathic effect (CPE), as well as being a less expensive option. However, PCR or other DNA amplification methods may be preferred because they provide the most rapid results without waiting for culture amplification. PCR is also best for detecting systemic infections. Serologic techniques are also useful in some circumstances, such as when symptoms persist but PCR testing is negative. \n\n While there is no cure or vaccine for HSV-2 infections, antiviral medications are available that manage the infection by keeping the virus in its dormant or latent phase, reducing signs and symptoms. If the medication is discontinued, then the condition returns to its original severity. The recommended medications, which may be taken at the start of an outbreak or daily as a method of prophylaxis, are  acyclovir ,  famciclovir , and  valacyclovir . \n\n Neonatal Herpes \n\n Herpes infections in newborns, referred to as  neonatal herpes , are generally transmitted from the mother to the neonate during childbirth, when the child is exposed to pathogens in the birth canal. Infections can occur regardless of whether lesions are present in the birth canal. In most cases, the infection of the newborn is limited to skin, mucous membranes, and eyes, and outcomes are good. However, sometimes the virus becomes disseminated and spreads to the central nervous system, resulting in motor function deficits or death. \n\n In some cases, infections can occur before birth when the virus crosses the placenta. This can cause serious complications in fetal development and may result in spontaneous abortion or severe disabilities if the fetus survives. The condition is most serious when the mother is infected with HSV for the first time during pregnancy. Thus, expectant mothers are screened for HSV infection during the first trimester of pregnancy as part of the  TORCH  panel of prenatal tests (see  How Pathogens Cause Disease ). Systemic acyclovir treatment is recommended to treat newborns with neonatal herpes. \n\n Check Your Understanding \n\n Why are latent herpes virus infections still of clinical concern? \n\n How is neonatal herpes contracted? \n\n Human Papillomas \n\n Warts of all types are caused by a variety of strains of  human papillomavirus (HPV)  (see  Viral Infections of the Skin and Eyes ). Condylomata acuminata, more commonly called  genital warts  or venereal warts ( Figure 23.18 ), are an extremely prevalent STI caused by certain strains of HPV. Condylomata are irregular, soft, pink growths that are found on external genitalia or the anus. \n\n HPV is a small, non-enveloped virus with a circular double-stranded DNA genome. Researchers have identified over 200 different strains (called types) of HPV, with approximately 40 causing STIs. While some types of HPV cause genital warts, HPV infection is often asymptomatic and self-limiting. However, genital HPV infection often co-occurs with other STIs like syphilis or gonorrhea. Additionally, some forms of HPV (not the same ones associated with genital warts) are associated with  cervical cancers . At least 14 oncogenic (cancer-causing) HPV types are known to have a causal association with cervical cancers. Examples of oncogenic HPV are types 16 and 18, which are associated with 70% of cervical cancers. 12  Oncogenic HPV types can also cause oropharyngeal cancer, anal cancer, vaginal cancer, vulvar cancer, and penile cancer. Most of these cancers are caused by HPV type 16. HPV virulence factors include proteins (E6 and E7) that are capable of inactivating tumor suppressor proteins, leading to uncontrolled cell division and the development of cancer. 12 Lauren Thaxton and Alan G. Waxman. \u201cCervical Cancer Prevention: Immunization and Screening 2015.\u201d  Medical Clinics of North America  99, no. 3 (2015): 469\u2013477. \n\n HPV cannot be cultured, so molecular tests are the primary method used to detect HPV. While routine HPV screening is not recommended for men, it is included in guidelines for women. An initial screening for HPV at age 30, conducted at the same time as a  Pap test , is recommended. If the tests are negative, then further HPV testing is recommended every five years. More frequent testing may be needed in some cases. The protocols used to collect, transport, and store samples vary based on both the type of HPV testing and the purpose of the testing. This should be determined in individual cases in consultation with the laboratory that will perform the testing. \n\n Because HPV testing is often conducted concurrently with Pap testing, the most common approach uses a single sample collection within one vial for both. This approach uses liquid-based cytology (LBC). The samples are then used for Pap smear cytology as well as HPV testing and genotyping. HPV can be recognized in Pap smears by the presence of cells called  koilocytes  (called koilocytosis or koilocytotic atypia). Koilocytes have a hyperchromatic atypical nucleus that stains darkly and a high ratio of nuclear material to cytoplasm. There is a distinct clear appearance around the nucleus called a perinuclear halo ( Figure 23.19 ). \n\n Most HPV infections resolve spontaneously; however, various therapies are used to treat and remove warts. Topical medications such as  imiquimod  (which stimulates the production of interferon),  podofilox , or  sinecatechins , may be effective. Warts can also be removed using  cryotherapy  or surgery, but these approaches are less effective for genital warts than for other types of warts. Electrocauterization and carbon dioxide laser therapy are also used for wart removal. \n\n Regular Pap testing can detect abnormal cells that might progress to cervical cancer, followed by biopsy and appropriate treatment. Vaccines for some of the high risk HPV types are now available.  Gardasil vaccine  includes types 6, 11, 16 and 18 (types 6 and 11 are associated with 90% of genital wart infections and types 16 and 18 are associated with 70% of cervical cancers). Gardasil 9 vaccinates against the previous four types and an additional five high-risk types (31, 33, 45, 52, and 58).  Cervarix vaccine  includes just HPV types 16 and 18. Vaccination is the most effective way to prevent infection with oncogenic HPV, but it is important to note that not all oncogenic HPV types are covered by the available vaccines. It is recommended for both boys and girls prior to sexual activity (usually between the ages of nine and fifteen). \n\n Link to Learning \n\n Watch a  video  of how perceptions of HPV affect vaccination rates. \n\n Check Your Understanding \n\n What is diagnostic of an HPV infection in a Pap smear? \n\n What is the motivation for HPV vaccination? \n\n Micro Connections Secret STIs Few people who have an STI (or think they may have one) are eager to share that information publicly. In fact, many patients are even uncomfortable discussing the symptoms privately with their doctors. Unfortunately, the social stigma associated with STIs makes it harder for infected individuals to seek the treatment they need and creates the false perception that STIs are rare. In reality, STIs are quite common, but it is difficult to determine exactly  how  common. \n\n A recent study on the effects of HPV vaccination found a baseline HPV prevalence of 26.8% for women between the ages of 14 and 59. Among women aged 20\u201324, the prevalence was 44.8%; in other words, almost half of the women in this age bracket had a current infection. 13  According to the CDC, HSV-2 infection was estimated to have a prevalence of 15.5% in younger individuals (14\u201349 years of age) in 2007\u20132010, down from 20.3% in the same age group in 1988\u20131994. However, the CDC estimates that 87.4% of infected individuals in this age group have not been diagnosed by a physician. 14 13 Eileen F. Dunne, Elizabeth R. Unger, Maya Sternberg, Geraldine McQuillan, David C. Swan, Sonya S. Patel, and Lauri E. Markowitz. \u201cPrevalence of HPV Infection Among Females in the United States.\u201d  Journal of the American Medical Association  297, no. 8 (2007): 813\u2013819. 14 Centers for Disease Control and Prevention. \u201cGenital Herpes - CDC Fact Sheet,\u201d 2015. http://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm. \n\n Another complicating factor is that many STIs can be asymptomatic or have long periods of latency. For example, the CDC estimates that among women ages 14\u201349 in the United States, about 2.3 million (3.1%) are infected with the sexually transmitted protozoan  Trichomonas  (see  Protozoan Infections of the Urogenital System ); however, in a study of infected women, 85% of those diagnosed with the infection were asymptomatic. 15 15 Centers for Disease Control and Prevention. \u201cTrichomoniasis Statistics,\u201d 2015. http://www.cdc.gov/std/trichomonas/stats.htm. \n\n Even when patients are treated for symptomatic STIs, it can be difficult to obtain accurate data on the number of cases. Whereas STIs like chlamydia, gonorrhea, and syphilis are notifiable diseases\u2014meaning each diagnosis must be reported by healthcare providers to the CDC\u2014other STIs are not notifiable (e.g., genital herpes, genital warts, and trichomoniasis). Between the social taboos, the inconsistency of symptoms, and the lack of mandatory reporting, it can be difficult to estimate the true prevalence of STIs\u2014but it is safe to say they are much more prevalent than most people think. \n\n Disease Profile Viral Reproductive Tract Infections Figure 23.20  summarizes the most important features of viral diseases affecting the human reproductive tract. \n 23.5   Fungal Infections of the Reproductive System \n\n Learning Objectives \n\n Summarize the important characteristics of vaginal candidiasis \n\n Only one major fungal pathogen affects the urogenital system.  Candida  is a genus of fungi capable of existing in a yeast form or as a multicellular fungus.  Candida  spp. are commonly found in the normal, healthy microbiota of the skin, gastrointestinal tract, respiratory system, and female urogenital tract ( Figure 23.21 ). They can be pathogenic due to their ability to adhere to and invade host cells, form biofilms, secrete  hydrolases  (e.g., proteases, phospholipases, and lipases) that assist in their spread through tissues, and change their phenotypes to protect themselves from the immune system. However, they typically only cause disease in the female reproductive tract under conditions that compromise the host\u2019s defenses. While there are at least 20  Candida  species of clinical importance,  C. albicans  is the species most commonly responsible for fungal vaginitis. \n\n As discussed earlier, lactobacilli in the vagina inhibit the growth of other organisms, including bacteria and  Candida , but disruptions can allow  Candida  to increase in numbers. Typical disruptions include antibiotic therapy, illness (especially diabetes),  pregnancy , and the presence of transient microbes. Immunosuppression can also play a role, and the severe immunosuppression associated with HIV infection often allows  Candida  to thrive. This can cause genital or vaginal  candidiasis , a condition characterized by vaginitis and commonly known as a  yeast infection . When a yeast infection develops, inflammation occurs along with symptoms of  pruritus  (itching), a thick white or yellow discharge, and odor. \n\n Other forms of candidiasis include cutaneous candidiasis (see  Mycoses of the Skin ) and oral thrush (see  Microbial Diseases of the Mouth and Oral Cavity ). Although  Candida  spp. are found in the normal microbiota,  Candida  spp. may also be transmitted between individuals. Sexual contact is a common mode of transmission, although candidiasis is not considered an STI. \n\n Diagnosis of vaginal candidiasis can be made using microscopic evaluation of vaginal secretions to determine whether there is an excess of  Candida . Culturing approaches are less useful because  Candida  is part of the normal microbiota and will regularly appear. It is also easy to contaminate samples with  Candida  because it is so common, so care must be taken to handle clinical material appropriately. Samples can be refrigerated if there is a delay in handling.  Candida  is a dimorphic fungus, so it does not only exist in a yeast form; cultivation can be used to identify chlamydospores and pseudohyphae, which develop from germ tubes ( Figure 23.22 ). The presence of the  germ tube  can be used in a diagnostic test in which cultured yeast cells are combined with rabbit serum and observed after a few hours for the presence of germ tubes. Molecular tests are also available if needed. The  Affirm VPII Microbial Identification Test , for instance, tests simultaneously for the vaginal microbes  C. albicans ,  G. vaginalis  (see  Bacterial Infections of the Urinary System ), and  Trichomonas vaginalis  (see  Protozoan Infections of the Urogenital System ). \n\n Topical antifungal medications for vaginal candidiasis include  butoconazole ,  miconazole ,  clotrimazole ,  tioconazole , and  nystatin . Oral treatment with  fluconazole  can be used. There are often no clear precipitating factors for infection, so prevention is difficult. \n\n Check Your Understanding \n\n What factors can lead to candidiasis? \n\n How is candidiasis typically diagnosed? \n\n Clinical Focus Part 3 The Gram stain of Nadia\u2019s vaginal smear showed that the concentration of lactobacilli relative to other species in Nadia\u2019s vaginal sample was abnormally low. However, there were no clue cells visible, which suggests that the infection is not bacterial vaginosis. But a wet-mount slide showed an overgrowth of yeast cells, suggesting that the problem is candidiasis, or a yeast infection ( Figure 23.23 ). This, Nadia\u2019s doctor assures her, is good news. Candidiasis is common during pregnancy and easily treatable. \n\n Knowing that the problem is candidiasis, what treatments might the doctor suggest? \n\n Jump to the  next  Clinical Focus box. Go back to the  previous  Clinical Focus box. \n 23.6   Protozoan Infections of the Urogenital System \n\n Learning Objectives \n\n Identify the most common protozoan pathogen that causes infections of the reproductive system \n\n Summarize the important characteristics of trichomoniasis \n\n Only one major protozoan species causes infections in the urogenital system.  Trichomoniasis , or \u201ctrich,\u201d is the most common nonviral STI and is caused by a flagellated protozoan  Trichomonas vaginalis .  T. vaginalis  has an undulating membrane and, generally, an amoeboid shape when attached to cells in the vagina. In culture, it has an oval shape. \n\n T. vaginalis  is commonly found in the normal  microbiota  of the vagina. As with other vaginal pathogens, it can cause  vaginitis  when there is disruption to the normal microbiota. It is found only as a trophozoite and does not form cysts.  T. vaginalis  can adhere to cells using  adhesins  such as  lipoglycans ; it also has other cell-surface virulence factors, including  tetraspanins  that are involved in cell adhesion, motility, and tissue invasion. In addition,  T. vaginalis  is capable of phagocytosing other microbes of the normal microbiota, contributing to the development of an imbalance that is favorable to infection. \n\n Both men and women can develop trichomoniasis. Men are generally asymptomatic, and although women are more likely to develop symptoms, they are often asymptomatic as well. When symptoms do occur, they are characteristic of urethritis. Men experience itching, irritation, discharge from the penis, and burning after urination or ejaculation. Women experience dysuria; itching, burning, redness, and soreness of the genitalia; and vaginal discharge. The infection may also spread to the cervix. Infection increases the risk of transmitting or acquiring HIV and is associated with pregnancy complications such as preterm birth. \n\n Microscopic evaluation of wet mounts is an inexpensive and convenient method of diagnosis, but the sensitivity of this method is low ( Figure 23.24 ).  Nucleic acid amplification testing  (NAAT) is preferred due to its high sensitivity. Using wet mounts and then NAAT for those who initially test negative is one option to improve sensitivity. Samples may be obtained for NAAT using urine, vaginal, or endocervical specimens for women and with urine and urethral swabs for men. It is also possible to use other methods such as the  OSOM  Trichomonas  Rapid Test  (an immunochromatographic test that detects antigen) and a DNA probe test for multiple species associated with vaginitis (the  Affirm VPII Microbial Identification Test  discussed in section 23.5). 16   T. vaginalis  is sometimes detected on a  Pap test , but this is not considered diagnostic due to high rates of false positives and negatives. The recommended treatment for trichomoniasis is oral  metronidazole  or  tinidazole . Sexual partners should be treated as well. 16 Association of Public Health Laboratories. \u201cAdvances in Laboratory Detection of  Trichomonas vaginalis,\u201d  2013.  http://www.aphl.org/AboutAPHL/publications/Documents/ID_2013August_Advances-in-Laboratory-Detection-of-Trichomonas-vaginalis.pdf. \n\n Check Your Understanding \n\n What are the symptoms of trichomoniasis? \n\n Eye on Ethics STIs and Privacy For many STIs, it is common to contact and treat sexual partners of the patient. This is especially important when a new illness has appeared, as when HIV became more prevalent in the 1980s. But to contact sexual partners, it is necessary to obtain their personal information from the patient. This raises difficult questions. In some cases, providing the information may be embarrassing or difficult for the patient, even though withholding such information could put their sexual partner(s) at risk. \n\n Legal considerations further complicate such situations. The Health Insurance Portability and Accountability Act (HIPPA), passed into law in 1996, sets the standards for the protection of patient information. It requires businesses that use health information, such as insurance companies and healthcare providers, to maintain strict confidentiality of patient records. Contacting a patient\u2019s sexual partners may therefore violate the patient\u2019s privacy rights if the patient\u2019s diagnosis is revealed as a result. \n\n From an ethical standpoint, which is more important: the patient\u2019s privacy rights or the sexual partner\u2019s right to know that they may be at risk of a sexually transmitted disease? Does the answer depend on the severity of the disease or are the rules universal? Suppose the physician knows the identity of the sexual partner but the patient does not want that individual to be contacted. Would it be a violation of HIPPA rules to contact the individual without the patient\u2019s consent? \n\n Questions related to patient privacy become even more complicated when dealing with patients who are minors. Adolescents may be reluctant to discuss their sexual behavior or health with a health professional, especially if they believe that healthcare professionals will tell their parents. This leaves many teens at risk of having an untreated infection or of lacking the information to protect themselves and their partners. On the other hand, parents may feel that they have a right to know what is going on with their child. How should physicians handle this? Should parents always be told even if the adolescent wants confidentiality? Does this affect how the physician should handle notifying a sexual partner? \n\n Clinical Focus Resolution Vaginal candidiasis is generally treated using topical antifungal medications such as butoconazole, miconazole, clotrimazole, ticonozole, nystatin, or oral fluconazole. However, it is important to be careful in selecting a treatment for use during pregnancy. Nadia\u2019s doctor recommended treatment with topical clotrimazole. This drug is classified as a category B drug by the FDA for use in pregnancy, and there appears to be no evidence of harm, at least in the second or third trimesters of pregnancy. Based on Nadia\u2019s particular situation, her doctor thought that it was suitable for very short-term use even though she was still in the first trimester. After a seven-day course of treatment, Nadia\u2019s yeast infection cleared. She continued with a normal pregnancy and delivered a healthy baby eight months later. \n\n Higher levels of hormones during pregnancy can shift the typical microbiota composition and balance in the vagina, leading to high rates of infections such as candidiasis or vaginosis. Topical treatment has an 80\u201390% success rate, with only a small number of cases resulting in recurrent or persistent infections. Longer term or intermittent treatment is usually effective in these cases. \n\n Go back to the  previous  Clinical Focus box. \n\n Disease Profile Fungal and Protozoan Reproductive Tract Infections Figure 23.25  summarizes the most important features of candidiasis and trichomoniasis. \n\n Link to Learning \n\n Take an  online quiz  for a review of sexually transmitted infections. ", "questions": [{"question": {"question_id": "fs-id1167662894791", "question_text": "When it first leaves the kidney, urine flows through", "question_choices": ["the urinary bladder.", "the urethra.", "the ureter.", "the glomeruli."], "cloze_format": "When it first leaves the kidney, urine flows through ___.", "normal_format": "Where does urine flow through when it first leaves the kidney? "}, "answer": {"ans_text": "C", "ans_choice": 2}, "bloom": null, "hl_sentences": "Urine that collects in each kidney empties through a ureter and drains to the urinary bladder , which stores urine .", "hl_context": "The kidneys carry out the urinary system \u2019 s primary functions of filtering the blood and maintaining water and electrolyte balance . The kidneys are composed of millions of filtration units called nephrons . Each nephron is in intimate contact with blood through a specialized capillary bed called the glomerulus ( plural glomeruli ) . Fluids , electrolytes , and molecules from the blood pass from the glomerulus into the nephron , creating the filtrate that becomes urine ( Figure 23.3 ) . <hl> Urine that collects in each kidney empties through a ureter and drains to the urinary bladder , which stores urine . <hl> Urine is released from the bladder to the urethra , which transports it to be excreted from the body through the urinary meatus , the opening of the urethra ."}, {"question": {"question_id": "fs-id1167660187259", "question_text": "What part of the male urogenital tract is shared by the urinary and reproductive systems?", "question_choices": ["the prostate gland", "the seminal vesicles", "the vas deferens", "the urethra"], "cloze_format": "The part of the male urogenital tract that is shared by the urinary and reproductive systems is called ___ .", "normal_format": "What part of the male urogenital tract is shared by the urinary and reproductive systems?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "bloom": null, "hl_sentences": "The male reproductive system ( Figure 23.4 ) is located in close proximity to the urinary system , and the urethra is part of both systems .", "hl_context": "<hl> The male reproductive system ( Figure 23.4 ) is located in close proximity to the urinary system , and the urethra is part of both systems . <hl> The testes are responsible for the production of sperm . The epididymis is a coiled tube that collects sperm from the testes and passes it on to the vas deferens . The epididymis is also the site of sperm maturation after they leave the testes . The seminal vesicles and prostate are accessory glands that produce fluid that supports sperm . During ejaculation , the vas deferens releases this mixture of fluid and sperm , called semen , into the urethra , which extends to the end of the penis ."}, {"question": {"question_id": "fs-id1167662615268", "question_text": "Which species is not associated with NGU?", "question_choices": ["Neisseria gonorrhoeae", "Mycoplasma hominis", "Chlamydia trachomatis", "Mycoplasma genitalium"], "cloze_format": "The ___ specie is not associated with NGU.", "normal_format": "Which species is not associated with NGU?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Chlamydia trachomatis is the causative agent of the STI chlamydia ( Figure 23.11 ) . While many Chlamydia infections are asymptomatic , chlamydia is a major cause of nongonococcal urethritis ( NGU ) and may also cause epididymitis and orchitis in men . Other species associated with NGU include Mycoplasma genitalium , Ureaplasma urealyticum , and Mycoplasma hominis . Gonorrheal urethritis is caused by Neisseria gonorrhoeae and is associated with gonorrhea , a common STI . The term nongonococcal urethritis ( NGU ) refers to inflammation of the urethra that is unrelated to N . gonorrhoeae . Asymptomatic patients also have no reason to seek treatment , and although not common , untreated NGU can spread to the reproductive organs , causing pelvic inflammatory disease and salpingitis in women and epididymitis and prostatitis in men . Important bacterial pathogens that cause nongonococcal urethritis include Chlamydia trachomatis , Mycoplasma genitalium , Ureaplasma urealyticum , and Mycoplasma hominis .", "hl_context": "<hl> Chlamydia trachomatis is the causative agent of the STI chlamydia ( Figure 23.11 ) . <hl> <hl> While many Chlamydia infections are asymptomatic , chlamydia is a major cause of nongonococcal urethritis ( NGU ) and may also cause epididymitis and orchitis in men . <hl> In women , chlamydia infections can cause urethritis , salpingitis , and PID . In addition , chlamydial infections may be associated with an increased risk of cervical cancer . <hl> Other species associated with NGU include Mycoplasma genitalium , Ureaplasma urealyticum , and Mycoplasma hominis . <hl> These bacteria are commonly found in the normal microbiota of healthy individuals , who may acquire them during birth or through sexual contact , but they can sometimes cause infections leading to urethritis ( in males and females ) or vaginitis and cervicitis ( in females ) . There are two main categories of bacterial urethritis : gonorrheal and nongonococcal . <hl> Gonorrheal urethritis is caused by Neisseria gonorrhoeae and is associated with gonorrhea , a common STI . <hl> This cause of urethritis will be discussed in Bacterial Infections of the Reproductive System . <hl> The term nongonococcal urethritis ( NGU ) refers to inflammation of the urethra that is unrelated to N . gonorrhoeae . <hl> In women , NGU is often asymptomatic . In men , NGU is typically a mild disease , but can lead to purulent discharge and dysuria . Because the symptoms are often mild or nonexistent , most infected individuals do not know that they are infected , yet they are carriers of the disease . <hl> Asymptomatic patients also have no reason to seek treatment , and although not common , untreated NGU can spread to the reproductive organs , causing pelvic inflammatory disease and salpingitis in women and epididymitis and prostatitis in men . <hl> <hl> Important bacterial pathogens that cause nongonococcal urethritis include Chlamydia trachomatis , Mycoplasma genitalium , Ureaplasma urealyticum , and Mycoplasma hominis . <hl>"}, {"question": {"question_id": "fs-id1167660284311", "question_text": "A strain of bacteria associated with a bladder infection shows gram-negative rods. What species is most likely to be the causative agent?", "question_choices": ["Mycoplasma hominis", "Escherichia coli", "Neisseria gonorrhoeae", "Chlamydia trachomatis"], "cloze_format": "A strain of bacteria associated with a bladder infection shows gram-negative rods. The specie that is most likely to be the causative agent is the ___ .", "normal_format": "A strain of bacteria associated with a bladder infection shows gram-negative rods. What species is most likely to be the causative agent?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "Gram-negative bacteria such as Escherichia coli ( most commonly ) , Proteus vulgaris , Pseudomonas aeruginosa , and Klebsiella pneumoniae cause most bladder infections . Gram-positive pathogens associated with cystitis include the coagulase-negative Staphylococcus saprophyticus , Enterococcus faecalis , and Streptococcus agalactiae .", "hl_context": "<hl> Gram-negative bacteria such as Escherichia coli ( most commonly ) , Proteus vulgaris , Pseudomonas aeruginosa , and Klebsiella pneumoniae cause most bladder infections . <hl> <hl> Gram-positive pathogens associated with cystitis include the coagulase-negative Staphylococcus saprophyticus , Enterococcus faecalis , and Streptococcus agalactiae . <hl> Routine manual urinalysis using a urine dipstick or test strip can be used for rapid screening of infection . These test strips ( Figure 23.5 ) are either held in a urine stream or dipped in a sample of urine to test for the presence of nitrites , leukocyte esterase , protein , or blood that can indicate an active bacterial infection . The presence of nitrite may indicate the presence of E . coli or K . pneumonia ; these bacteria produce nitrate reductase , which converts nitrate to nitrite . The leukocyte esterase ( LE ) test detects the presence of neutrophils as an indication of active infection ."}, {"question": {"question_id": "fs-id1167662680482", "question_text": "Treponemal and non-treponemal serological testing can be used to test for", "question_choices": ["vaginosis.", "chlamydia.", "syphilis.", "gonorrhea."], "cloze_format": "Treponemal and non-treponemal serological testing can be used to test for ___.", "normal_format": "What can treponemal and non-treponemal serological testing be used for?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "bloom": null, "hl_sentences": "The recommended methods for diagnosing early syphilis are darkfield or brightfield ( silver stain ) microscopy of tissue or exudate from lesions to detect T . pallidum ( Figure 23.13 ) . If these methods are not available , two types of serologic tests ( treponemal and nontreponemal ) can be used for a presumptive diagnosis once the spirochete has spread in the body .", "hl_context": "<hl> The recommended methods for diagnosing early syphilis are darkfield or brightfield ( silver stain ) microscopy of tissue or exudate from lesions to detect T . pallidum ( Figure 23.13 ) . <hl> <hl> If these methods are not available , two types of serologic tests ( treponemal and nontreponemal ) can be used for a presumptive diagnosis once the spirochete has spread in the body . <hl> Nontreponemal serologic tests include the Venereal Disease Research Laboratory ( VDRL ) and rapid plasma reagin ( RPR ) tests . These are similar screening tests that detect nonspecific antibodies ( those for lipid antigens produced during infection ) rather than those produced against the spirochete . Treponemal serologic tests measure antibodies directed against T . pallidum antigens using particle agglutination ( T . pallidum passive particle agglutination or TP-PA ) , immunofluorescence ( the fluorescent T . pallidum antibody absorption or FTA-ABS ) , various enzyme reactions ( enzyme immunoassays or EIAs ) and chemiluminescence immunoassays ( CIA ) . Confirmatory testing , rather than screening , must be done using treponemal rather than nontreponemal tests because only the former tests for antibodies to spirochete antigens . Both treponemal and nontreponemal tests should be used ( as opposed to just one ) since both tests have limitations than can result in false positives or false negatives ."}, {"question": {"question_id": "fs-id1167662475199", "question_text": "Lymphogranuloma venereum is caused by serovars of", "question_choices": ["Neisseria gonorrhoeae.", "Chlamydia trachomatis.", "Treponema pallidum.", "Haemophilis ducreyi."], "cloze_format": "Lymphogranuloma venereum is caused by serovars of ___.", "normal_format": "Which serovars are the cause of Lymphogranuloma venereum?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Certain serovars of C . trachomatis can cause an infection of the lymphatic system in the groin known as lymphogranuloma venereum . Chlamydia trachomatis is the causative agent of the STI chlamydia ( Figure 23.11 ) .", "hl_context": "<hl> Certain serovars of C . trachomatis can cause an infection of the lymphatic system in the groin known as lymphogranuloma venereum . <hl> This condition is commonly found in tropical regions and can also co-occur in conjunction with human immunodeficiency virus ( HIV ) infection . After the microbes invade the lymphatic system , buboes ( large lymph nodes , see Figure 23.11 ) form and can burst , releasing pus through the skin . The male genitals can become greatly enlarged and in women the rectum may become narrow . <hl> Chlamydia trachomatis is the causative agent of the STI chlamydia ( Figure 23.11 ) . <hl> While many Chlamydia infections are asymptomatic , chlamydia is a major cause of nongonococcal urethritis ( NGU ) and may also cause epididymitis and orchitis in men . In women , chlamydia infections can cause urethritis , salpingitis , and PID . In addition , chlamydial infections may be associated with an increased risk of cervical cancer ."}, {"question": {"question_id": "fs-id1167662515220", "question_text": "The latent stage of syphilis, which may last for years, can occur between", "question_choices": ["the secondary and tertiary stages.", "the primary and secondary stages.", "initial infection and the primary stage.", "any of the three stages."], "cloze_format": "The latent stage of syphilis, which may last for years, can occur between ___.", "normal_format": "Koilocytes are characteristic of what?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Tertiary syphilis , which may occur 10 to 20 years after infection , produces the most severe symptoms and can be fatal . After the secondary phase , syphilis can enter a latent phase , in which there are no symptoms but microbial levels remain high . The latent phase can persist for years . If not treated effectively , syphilis progresses through three distinct stages : primary , secondary , and tertiary .", "hl_context": "<hl> Tertiary syphilis , which may occur 10 to 20 years after infection , produces the most severe symptoms and can be fatal . <hl> Granulomatous lesions called gummas may develop in a variety of locations , including mucous membranes , bones , and internal organs ( Figure 23.12 ) . Gummas can be large and destructive , potentially causing massive tissue damage . The most deadly lesions are those of the cardiovascular system ( cardiovascular syphilis ) and the central nervous system ( neurosyphilis ) . Cardiovascular syphilis can result in a fatal aortic aneurysm ( rupture of the aorta ) or coronary stenosis ( a blockage of the coronary artery ) . Damage to the central nervous system can cause dementia , personality changes , seizures , general paralysis , speech impairment , loss of vision and hearing , and loss of bowel and bladder control . <hl> After the secondary phase , syphilis can enter a latent phase , in which there are no symptoms but microbial levels remain high . <hl> Blood tests can still detect the disease during latency . <hl> The latent phase can persist for years . <hl> After entering the body , T . pallidum moves rapidly into the bloodstream and other tissues . <hl> If not treated effectively , syphilis progresses through three distinct stages : primary , secondary , and tertiary . <hl> Primary syphilis appears as a single lesion on the cervix , penis , or anus within 10 to 90 days of transmission . Such lesions contain many T . pallidum cells and are highly infectious . The lesion , called a hard chancre , is initially hard and painless , but it soon develops into an ulcerated sore ( Figure 23.12 ) . Localized lymph node swelling may occur as well . In some cases , these symptoms may be relatively mild , and the lesion may heal on its own within two to six weeks . Because the lesions are painless and often occur in hidden locations ( e . g . , the cervix or anus ) , infected individuals sometimes do not notice them ."}, {"question": {"question_id": "fs-id1167661456097", "question_text": "Genital herpes is most commonly caused by", "question_choices": ["herpes simplex virus 1.", "varicella-zoster virus.", "herpes simplex virus 2.", "cytomegalovirus."], "cloze_format": "Genital herpes is most commonly caused by ___ .", "normal_format": "What is the most commonly caused by Genital herpes?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "bloom": null, "hl_sentences": "While herpes simplex virus type 1 ( HSV - 1 ) is generally associated with oral lesions like cold sores or fever blisters ( see Viral Infections of the Skin and Eyes ) , herpes simplex virus type 2 ( HSV - 2 ) is usually associated with genital herpes .", "hl_context": "There are two herpes simplex virus types . <hl> While herpes simplex virus type 1 ( HSV - 1 ) is generally associated with oral lesions like cold sores or fever blisters ( see Viral Infections of the Skin and Eyes ) , herpes simplex virus type 2 ( HSV - 2 ) is usually associated with genital herpes . <hl> However , both viruses can infect either location as well as other parts of the body . Oral-genital contact can spread either virus from the mouth to the genital region or vice versa ."}, {"question": {"question_id": "fs-id1167663717002", "question_text": "Koilocytes are characteristic of", "question_choices": ["cells infected with human papillomavirus", "cells infected with herpes simplex virus 2", "cells infected with all forms of herpesviruses", "cervical cancer cells"], "cloze_format": "Koilocytes are characteristic of ___ .", "normal_format": "What are Koilocytes characteristic of?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "HPV can be recognized in Pap smears by the presence of cells called koilocytes ( called koilocytosis or koilocytotic atypia ) .", "hl_context": "Because HPV testing is often conducted concurrently with Pap testing , the most common approach uses a single sample collection within one vial for both . This approach uses liquid-based cytology ( LBC ) . The samples are then used for Pap smear cytology as well as HPV testing and genotyping . <hl> HPV can be recognized in Pap smears by the presence of cells called koilocytes ( called koilocytosis or koilocytotic atypia ) . <hl> Koilocytes have a hyperchromatic atypical nucleus that stains darkly and a high ratio of nuclear material to cytoplasm . There is a distinct clear appearance around the nucleus called a perinuclear halo ( Figure 23.19 ) ."}, {"question": {"question_id": "fs-id1167662601844", "question_text": "Which oral medication is recommended as an initial topical treatment for genital yeast infections?", "question_choices": ["penicillin", "acyclovir", "fluconazole", "miconazole"], "cloze_format": "The oral medication ___ is recommended as an initial topical treatment for genital yeast infections.", "normal_format": "Which oral medication is recommended as an initial topical treatment for genital yeast infections?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "bloom": null, "hl_sentences": "Clinical Focus Resolution Vaginal candidiasis is generally treated using topical antifungal medications such as butoconazole , miconazole , clotrimazole , ticonozole , nystatin , or oral fluconazole . Topical antifungal medications for vaginal candidiasis include butoconazole , miconazole , clotrimazole , tioconazole , and nystatin .", "hl_context": "<hl> Clinical Focus Resolution Vaginal candidiasis is generally treated using topical antifungal medications such as butoconazole , miconazole , clotrimazole , ticonozole , nystatin , or oral fluconazole . <hl> However , it is important to be careful in selecting a treatment for use during pregnancy . Nadia \u2019 s doctor recommended treatment with topical clotrimazole . This drug is classified as a category B drug by the FDA for use in pregnancy , and there appears to be no evidence of harm , at least in the second or third trimesters of pregnancy . Based on Nadia \u2019 s particular situation , her doctor thought that it was suitable for very short-term use even though she was still in the first trimester . After a seven-day course of treatment , Nadia \u2019 s yeast infection cleared . She continued with a normal pregnancy and delivered a healthy baby eight months later . <hl> Topical antifungal medications for vaginal candidiasis include butoconazole , miconazole , clotrimazole , tioconazole , and nystatin . <hl> Oral treatment with fluconazole can be used . There are often no clear precipitating factors for infection , so prevention is difficult ."}, {"question": {"question_id": "fs-id1167661368103", "question_text": "What is the only common infection of the reproductive tract caused by a protozoan?", "question_choices": ["gonorrhea", "chlamydia", "trichomoniasis", "candidiasis"], "cloze_format": "___ is the only common infection of the reproductive tract caused by a protozoan.", "normal_format": "What is the only common infection of the reproductive tract caused by a protozoan?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "bloom": null, "hl_sentences": "Only one major protozoan species causes infections in the urogenital system . Trichomoniasis , or \u201c trich , \u201d is the most common nonviral STI and is caused by a flagellated protozoan Trichomonas vaginalis .", "hl_context": "<hl> Only one major protozoan species causes infections in the urogenital system . <hl> <hl> Trichomoniasis , or \u201c trich , \u201d is the most common nonviral STI and is caused by a flagellated protozoan Trichomonas vaginalis . <hl> T . vaginalis has an undulating membrane and , generally , an amoeboid shape when attached to cells in the vagina . In culture , it has an oval shape ."}, {"question": {"question_id": "fs-id1167661438033", "question_text": "Which test is preferred for detecting T. vaginalis because of its high sensitivity?", "question_choices": ["NAAT", "wet mounts", "Pap tests", "all of the above are equally good"], "cloze_format": "The test that is preferred for detecting T. vaginalis because of its high sensitivity is called ___ .", "normal_format": "Which test is preferred for detecting T. vaginalis because of its high sensitivity?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "Nucleic acid amplification testing ( NAAT ) is preferred due to its high sensitivity . Using wet mounts and then NAAT for those who initially test negative is one option to improve sensitivity . 16 T . vaginalis is sometimes detected on a Pap test , but this is not considered diagnostic due to high rates of false positives and negatives . The recommended treatment for trichomoniasis is oral metronidazole or tinidazole .", "hl_context": "Microscopic evaluation of wet mounts is an inexpensive and convenient method of diagnosis , but the sensitivity of this method is low ( Figure 23.24 ) . <hl> Nucleic acid amplification testing ( NAAT ) is preferred due to its high sensitivity . <hl> <hl> Using wet mounts and then NAAT for those who initially test negative is one option to improve sensitivity . <hl> Samples may be obtained for NAAT using urine , vaginal , or endocervical specimens for women and with urine and urethral swabs for men . It is also possible to use other methods such as the OSOM Trichomonas Rapid Test ( an immunochromatographic test that detects antigen ) and a DNA probe test for multiple species associated with vaginitis ( the Affirm VPII Microbial Identification Test discussed in section 23.5 ) . <hl> 16 T . vaginalis is sometimes detected on a Pap test , but this is not considered diagnostic due to high rates of false positives and negatives . <hl> <hl> The recommended treatment for trichomoniasis is oral metronidazole or tinidazole . <hl> Sexual partners should be treated as well . 16 Association of Public Health Laboratories . \u201c Advances in Laboratory Detection of Trichomonas vaginalis , \u201d 2013 . http://www.aphl.org/AboutAPHL/publications/Documents/ID_2013August_Advances-in-Laboratory-Detection-of-Trichomonas-vaginalis.pdf ."}], "summary": " Summary 23.1   Anatomy and Normal Microbiota of the Urogenital Tract \n\n The urinary system is responsible for filtering the blood, excreting wastes, and helping to regulate electrolyte and water balance. \n\n The urinary system includes the  kidneys, ureters ,  urinary bladder , and  urethra ; the bladder and urethra are the most common sites of infection. \n\n Common sites of infection in the male reproductive system include the urethra, as well as the testes,  prostate  and  epididymis . \n\n The most commons sites of infection in the female reproductive system are the  vulva, vagina ,  cervix,  and  fallopian tubes . \n\n Infections of the urogenital tract can occur through colonization from the external environment, alterations in microbiota due to hormonal or other physiological and environmental changes, fecal contamination, and sexual transmission (STIs). \n\n 23.2   Bacterial Infections of the Urinary System \n\n Bacterial  cystitis  is commonly caused by fecal bacteria such as  E. coli. \n\n Pyelonephritis is a serious kidney infection that is often caused by bacteria that travel from infections elsewhere in the urinary tract and may cause systemic complications. \n\n Leptospirosis  is a bacterial infection of the kidney that can be transmitted by exposure to infected animal urine, especially in contaminated water. It is more common in tropical than in temperate climates. \n\n Nongonococcal urethritis (NGU)  is commonly caused by  C. trachomatis, M. genitalium, Ureaplasma urealyticum,  and  M. hominis. \n\n Diagnosis and treatment for bacterial urinary tract infections varies. Urinalysis (e.g., for leukocyte esterase levels, nitrite levels, microscopic evaluation, and culture of urine) is an important component in most cases. Broad-spectrum antibiotics are typically used. \n\n 23.3   Bacterial Infections of the Reproductive System \n\n Bacterial vaginosis  is caused by an imbalance in the vaginal microbiota, with a decrease in lactobacilli and an increase in vaginal pH.  G. vaginalis  is the most common cause of bacterial vaginosis, which is associated with vaginal discharge, odor, burning, and itching. \n\n Gonorrhea  is caused by  N. gonorrhoeae , which can cause infection of the reproductive and urinary tracts and is associated with symptoms of urethritis. If left untreated, it can progress to epididymitis, salpingitis, and pelvic inflammatory disease and enter the bloodstream to infect other sites in the body. \n\n Chlamydia  is the most commonly reported STI and is caused by  C. trachomatis . Most infections are asymptomatic, and infections that are not treated can spread to involve the epididymis of men and cause salpingitis and pelvic inflammatory disease in women. \n\n Syphilis  is caused by  T. pallidum  and has three stages, primary, secondary, and tertiary. Primary syphilis is associated with a painless hard chancre lesion on genitalia. Secondary syphilis is associated with skin and mucous membrane lesions. Tertiary syphilis is the most serious and life-threatening, and can involve serious nervous system damage. \n\n Chancroid  is an infection of the reproductive tract caused by  H. ducreyi  that results in the development of characteristic  soft chancres . \n\n 23.4   Viral Infections of the Reproductive System \n\n Genital herpes  is usually caused by  HSV-2  (although HSV-1 can also be responsible) and may cause the development of infectious, potentially recurrent vesicles \n\n Neonatal herpes  can occur in babies born to infected mothers and can cause symptoms that range from relatively mild (more common) to severe. \n\n Human papillomaviruses  are the most common sexually transmitted viruses and include strains that cause  genital warts  as well as strains that cause  cervical cancer . \n\n 23.5   Fungal Infections of the Reproductive System \n\n Candida  spp. are typically present in the normal microbiota in the body, including the skin, respiratory tract, gastrointestinal tract, and female urogenital system. \n\n Disruptions in the normal vaginal microbiota can lead to an overgrowth of  Candida , causing vaginal  candidiasis . \n\n Vaginal candidiasis can be treated with topical or oral fungicides. Prevention is difficult. \n\n 23.6   Protozoan Infections of the Urogenital System \n\n Trichomoniasis  is a common STI caused by  Trichomonas vaginalis . \n\n T. vaginalis  is common at low levels in the normal microbiota. \n\n Trichomoniasis is often asymptomatic. When symptoms develop, trichomoniasis causes urinary discomfort, irritation, itching, burning, discharge from the penis (in men), and vaginal discharge (in women). \n\n Trichomoniasis is treated with the antiflagellate drugs tinidazole and metronidazole. ", "keyterm": "", "bname": "microbiology"}, {"chapter": 12, "intro": "Learning Objectives 12.1   The Difference Between Sex and Gender \n\n Define and differentiate between sex and gender \n\n Define and discuss what is meant by gender identity \n\n Understand and discuss the role of homophobia and heterosexism in society \n\n Distinguish the meanings of transgender, transsexual, and homosexual identities \n\n 12.2   Gender \n\n Explain the influence of socialization on gender roles in the United States \n\n Understand the stratification of gender in major American institutions \n\n Describe gender from the view of each sociological perspective \n\n 12.3   Sex and Sexuality \n\n Understand different attitudes associated with sex and sexuality \n\n Define sexual inequality in various societies \n\n Discuss theoretical perspectives on sex and sexuality \n\n Introduction to Gender, Sex, and Sexuality \n\n When Harry was born, his parents, Steve and Barb, were delighted to add another boy to their family. But as their baby boy began to grow and develop, they noticed that Harry began to express himself in a manner that they viewed as more feminine than masculine. He gravitated toward dolls and other toys that our culture typically associates with girls. But Harry\u2019s preference was not simply about liking pink more than blue or flowers more than fire trucks. He even began to draw himself as a girl, complete with a dress and high-heeled shoes. In fact, Harry did not just wish to be a girl; he believed he  was  a girl.  \n\n In kindergarten, Harry often got into arguments with male classmates because he insisted that he was a girl, not a boy. He even started calling himself \u201cHailey.\u201d Steve and Barb met with several psychologists, all of whom told them that Hailey was transgendered. But Steve and Barb had a hard time understanding that their five-year-old son could have already developed a gender identity that went against society\u2019s expectations. Concerned with the social ramifications associated with his child being transgendered, Steve hoped this was just a phase. But Barb, and eventually Steve, realized that Harry\u2019s feelings were genuine and unyielding, and they made the decision to let Harry live as Hailey\u2014a girl. They came to this decision after concluding that the criticism he would endure from his peers and other members of society would be less damaging than the confusion he might experience internally if he were forced to live as a boy.  \n\n Many transgendered children grow up hating their bodies, and this population can have high rates of drug abuse and suicide (Weiss 2011). Fearful of these outcomes and eager to make their child happy, Steven and Barb now refer to Harry as Hailey and allow  her  to dress and behave in manners that are considered feminine. To a stranger, Hailey is likely to appear just like any other girl and may even be considered  extra girly  due to her love of all things pink. But to those who once knew Hailey as Harry, Hailey is likely to endure more ridicule and rejection as the result of adopting a feminine gender identity. \n\n Currently, seven-year-old Hailey and her parents are comfortable with her gender status, but Steve and Barb are concerned about what questions and problems might arise as she gets older. \u201cWho\u2019s going to love my child?\u201d asks Steve (Ling 2011). This question isn\u2019t asked because Hailey is unlovable, but because American society has yet to fully listen to or understand the personal narratives of the transgendered population (Hanes and Sanger 2010).  \n\n In this chapter, we will discuss the differences between sex and gender, along with issues like gender identity and sexuality. We will also explore various theoretical perspectives on the subjects of gender and sexuality. ", "chapter_text": "12.1   The Difference Between Sex and Gender \n\n When filling out a document such as a job application or school registration form you are often asked to provide your name, address, phone number, birth date, and sex or gender. But have you ever been asked to provide your sex  and  your gender? As with most people, it may not have occurred to you that sex and gender are not the same. However, sociologists and most other social scientists view sex and gender as conceptually distinct.  Sex  refers to physical or physiological differences between males and females, including both primary sex characteristics (the reproductive system) and secondary characteristics such as height and muscularity.  Gender  is a term that refers to social or cultural distinctions associated with being male or female.  Gender identity  is the extent to which one identifies as being either masculine or feminine (Diamond 2002).  \n\n A person\u2019s sex, as determined by his or her biology, does not always correspond with his or her gender. Therefore, the terms  sex  and  gender  are not interchangeable. A baby boy who is born with male genitalia will be identified as male. As he grows, however, he may identify with the feminine aspects of his culture. Since the term  sex  refers to biological or physical distinctions, characteristics of sex will not vary significantly between different human societies. For example, all persons of the female sex, in general, regardless of culture, will eventually menstruate and develop breasts that can lactate. Characteristics of gender, on the other hand, may vary greatly between different societies. For example, in American culture, it is considered feminine (or a trait of the female gender) to wear a dress or skirt. However, in many Middle Eastern, Asian, and African cultures, dresses or skirts (often referred to as sarongs, robes, or gowns) can be considered masculine. The kilt worn by a Scottish male does not make him appear feminine in his culture. \n\n The dichotomous view of gender (the notion that one is either male or female) is specific to certain cultures and is not universal. In some cultures gender is viewed as fluid. In the past, some anthropologists used the term  berdache  to refer to individuals who occasionally or permanently dressed and lived as the opposite gender. The practice has been noted among certain Native American tribes (Jacobs, Thomas, and Lang 1997). Samoan culture accepts what they refer to as a \u201cthird gender.\u201d  Fa\u2019afafine , which translates as \u201cthe way of the woman,\u201d is a term used to describe individuals who are born biologically male but embody both masculine and feminine traits. Fa\u2019afafines are considered an important part of Samoan culture. Individuals from other cultures may mislabel them as homosexuals because fa\u2019afafines have a varied sexual life that may include men or women (Poasa 1992).  \n\n Social Policy and Debate The Legalese of Sex and Gender The terms  sex  and  gender  have not always been differentiated in the English language. It was not until the 1950s that American and British psychologists and other professionals working with intersex and transsexual patients formally began distinguishing between sex and gender. Since then, psychological and physiological professionals have increasingly used the term gender (Moi 2005). By the end of the 21st century, expanding the proper usage of the term  gender  to everyday language became more challenging\u2014particularly where legal language is concerned. In an effort to clarify usage of the terms  sex  and  gender , U.S. Supreme Court Justice Antonin Scalia wrote in a 1994 briefing, \u201cThe word gender has acquired the new and useful connotation of cultural or attitudinal characteristics (as opposed to physical characteristics) distinctive to the sexes. That is to say, gender is to sex as feminine is to female and masculine is to male\u201d ( J.E.B. v. Alabama , 144 S. Ct. 1436 [1994]). Supreme Court Justice Ruth Bader Ginsburg had a different take, however. Viewing the words as synonymous, she freely swapped them in her briefings so as to avoid having the word \u201csex\u201d pop up too often. It is thought that her secretary supported this practice by suggestions to Ginsberg that \u201cthose nine men\u201d (the other Supreme Court justices), \u201chear that word and their first association is not the way you want them to be thinking\u201d (Case 1995). This anecdote reveals that even human experience that is assumed to be biological and personal (such as our self-perception and behavior) is actually a socially defined variable by culture. \n\n Sexual Orientation A person\u2019s  sexual orientation  is their emotional and sexual attraction to a particular sex (male or female). Sexual orientation is typically divided into four categories:  heterosexuality , the attraction to individuals of the opposite sex;  homosexuality , the attraction to individuals of one\u2019s own sex;  bisexuality , the attraction to individuals of either sex; and  asexuality , no attraction to either sex. Heterosexuals and homosexuals may also be referred to informally as \u201cstraight\u201d and \u201cgay,\u201d respectively. The United States is a heteronormative society, meaning it supports heterosexuality as the norm. Consider that homosexuals are often asked, \u201cWhen did you know you were gay?\u201d but heterosexuals are rarely asked, \u201cWhen did you know that you were straight?\u201d (Ryle 2011).  \n\n According to current scientific understanding, individuals are usually aware of their sexual orientation between middle childhood and early adolescence (American Psychological Association 2008). They do not have to participate in sexual activity to be aware of these emotional, romantic, and physical attractions; people can be celibate and still recognize their sexual orientation. Homosexual women (also referred to as lesbians), homosexual men (also referred to as gays), and bisexuals of both genders may have very different experiences of discovering and accepting their sexual orientation. At the point of puberty, some may be able to claim their sexual orientations while others may be unready or unwilling to make their homosexuality or bisexuality known since it goes against American society\u2019s historical norms (APA 2008).  \n\n Alfred Kinsey was among the first to conceptualize sexuality as a continuum rather than a strict dichotomy of gay or straight. To classify this continuum of heterosexuality and homosexuality, Kinsey created a six-point rating scale that ranges from exclusively heterosexual to exclusively homosexual (see the figure below). In his 1948 work  Sexual Behavior in the Human Male , Kinsey writes, \u201cMales do not represent two discrete populations, heterosexual and homosexual. The world is not to be divided into sheep and goats \u2026 The living world is a continuum in each and every one of its aspects\u201d (Kinsey 1948). \n\n Later scholarship by Eve Kosofsky Sedgwick expanded on Kinsey\u2019s notions. She coined the term \u201chomosocial\u201d to oppose \u201chomosexual,\u201d describing non-sexual same-sex relations. Sedgwick recognized that in American culture, males are subject to a clear divide between the two sides of this continuum, whereas females enjoy more fluidity. This can be illustrated by the way women in America can express homosocial feelings (nonsexual regard for people of the same sex) through hugging, handholding, and physical closeness. In contrast, American males refrain from these expressions since they violate the heteronormative expectation. While women experience a flexible norming of variations of behavior that spans the heterosocial-homosocial spectrum, male behavior is subject to strong social sanction if it veers into homosocial territory because of societal homophobia (Sedgwick 1985).  \n\n There is no scientific consensus regarding the exact reasons why an individual holds a heterosexual, homosexual, or bisexual orientation. There has been research conducted to study the possible genetic, hormonal, developmental, social, and cultural influences on sexual orientation, but there has been no evidence that links sexual orientation to one factor (APA 2008). Research, however, does present evidence showing that homosexuals and bisexuals are treated differently than heterosexuals in schools, the workplace, and the military. It is reported that in the workplace, for example, discrimination based on sexual orientation occurs at a rate of 4 per 10,000, which is higher than the rate of discrimination based on race, which stands at 3.90 (Sears and Mallory 2007.) \n\n Much of this discrimination is based on stereotypes, misinformation, and  homophobia , an extreme or irrational aversion to homosexuals. Major policies to prevent discrimination based on sexual orientation have not come into effect until the last few years. In 2011, President Obama overturned \u201cdon\u2019t ask, don\u2019t tell,\u201d a controversial policy that required homosexuals in the US military to keep their sexuality undisclosed. Between 2004 and 2010, five states and the District of Columbia legalized gay marriage. The Employee Non-Discrimination Act, which ensures workplace equality regardless of sexual orientation, is still pending full government approval. Organizations such as GLAAD (Gay & Lesbian Alliance Against Defamation) advocate for homosexual rights and encourage governments and citizens to recognize the presence of sexual discrimination and work to prevent it. Other advocacy agencies frequently use the acronyms LBGT and LBGTQ, which stands for \u201cLesbian, Gay, Bisexual, Transgender\u201d (and \u201cQueer\u201d or \u201cQuestioning\u201d when the Q is added). \n\n Gender Roles As we grow, we learn how to behave from those around us. In this socialization process, children are introduced to certain roles that are typically linked to their biological sex. The term  gender role  refers to society\u2019s concept of how men and women are expected to act and how they should behave. These roles are based on norms, or standards, created by society. In American culture, masculine roles are usually associated with strength, aggression, and dominance, while feminine roles are usually associated with passivity, nurturing, and subordination. Role learning starts with socialization at birth. Even today, our society is quick to outfit male infants in blue and girls in pink, even applying these color-coded gender labels while a baby is in the womb. \n\n One way children learn gender roles is through play. Parents typically supply boys with trucks, toy guns, and superhero paraphernalia, which are active toys that promote motor skills, aggression, and solitary play. Daughters are often given dolls and dress-up apparel that foster nurturing, social proximity, and role play. Studies have shown that children will most likely choose to play with \u201cgender appropriate\u201d toys (or same-gender toys) even when cross-gender toys are available because parents give children positive feedback (in the form of praise, involvement, and physical closeness) for gender normative behavior (Caldera, Huston, and O\u2019Brien 1998).  \n\n The drive to adhere to masculine and feminine gender roles continues later in life. Men tend to outnumber women in professions such as law enforcement, the military, and politics. Women tend to outnumber men in care-related occupations such as childcare, healthcare, and social work. These occupational roles are examples of typical American male and female behavior, derived from our culture\u2019s traditions. Adherence to them demonstrates fulfillment of social expectations but not necessarily personal preference (Diamond 2002). \n\n Gender Identity American society allows for some level of flexibility when it comes to acting out gender roles. To a certain extent, men can assume some feminine roles and women can assume some masculine roles without interfering with their gender identity.  Gender identity  is an individual\u2019s self-conception of being male or female based on his or her association with masculine or feminine gender roles.  \n\n Individuals who identify with the role that is the opposite of their biological sex are called  transgender . Transgendered males, for example, have such a strong emotional and psychological connection to the feminine aspects of society that they identify their gender as female. The parallel connection to masculinity exists for transgendered females. It is difficult to determine the prevalence of transgenderism in society. However, it is estimated that two to five percent of the US population is transgendered (Transgender Law and Policy Institute 2007).  \n\n Transgendered individuals who wish to alter their bodies through medical interventions such as surgery and hormonal therapy\u2014so that their physical being is better aligned with gender identity\u2014are called  transsexuals . They may also be known as male-to-female (MTF) or female-to-male (FTM). Not all transgendered individuals choose to alter their bodies: many will maintain their original anatomy but may present themselves to society as the opposite gender. This is typically done by adopting the dress, hairstyle, mannerisms, or other characteristic typically assigned to the opposite gender. It is important to note that people who cross-dress, or wear clothing that is traditionally assigned to opposite gender, are not necessarily transgendered. Cross-dressing is typically a form of self-expression, entertainment, or personal style, not necessarily an expression against one\u2019s assigned gender (APA 2008).  \n\n There is no single, conclusive explanation for why people are transgendered. Transgendered expressions and experiences are so diverse that it is difficult to identify their origin. Some hypotheses suggest biological factors such as genetics or prenatal hormone levels as well as social and cultural factors such as childhood and adulthood experiences. Most experts believe that all of these factors contribute to a person\u2019s gender identity (APA 2008).  \n\n It is known, however, that transgendered and transsexual individuals experience discrimination based on their gender identity. People who identify as transgendered are twice as likely to experience assault or discrimination as non-transgendered individuals; they are also one and a half times more likely to experience intimidation (National Coalition of Anti-Violence Programs 2010). Organizations such as the National Coalition of Anti-Violence Programs and Global Action for Trans Equality work to prevent, respond to, and end all types of violence against transgender, transsexual, and homosexual individuals. These organizations hope that by educating the public about gender identity and empowering transgender and transsexual individuals, this violence will end.  \n\n Sociology in the Real World Real-Life  Freaky Friday What if you had to live as the opposite sex? If you are a man, imagine that you were forced to wear frilly dresses, dainty shoes, and makeup to special occasions, and you were expected to enjoy romantic comedies and TLC reality shows. If you are a woman, imagine that you were forced to wear shapeless clothing, put only minimal effort into your personal appearance, not show emotion, and watch countless hours of sporting events and sports-related commentary. It would be pretty uncomfortable, right? Well, maybe not. Many people enjoy participating in activities that are typically associated with the opposite sex and would not mind if some of the cultural expectations for men and women were loosened.  \n\n Now, imagine that when you look at your body in the mirror, you feel disconnected. You feel your genitals are shameful and dirty, and you feel as though you are trapped in someone else\u2019s body with no chance of escape. As you get older, you hate the way your body is changing, and, therefore, you hate yourself. These elements of disconnect and shame are important to understand when discussing transgendered individuals. Fortunately, sociological studies pave the way for a deeper and more empirically grounded understanding of transgendered experience.  \n12.2   Gender \n\n Gender and Socialization The phrase \u201cboys will be boys\u201d is often used to justify behavior such as pushing, shoving, or other forms of aggression from young boys. The phrase implies that such behavior is unchangeable and something that is part of a boy\u2019s nature. Aggressive behavior, when it does not inflict significant harm, is often accepted from boys and men because it is congruent with the cultural script for masculinity. The \u201cscript\u201d written by society is in some ways similar to a script written by a playwright. Just as a playwright expects actors to adhere to a prescribed script, society expects women and men to behave according to the expectations of their respective gender role. Scripts are generally learned through a process known as socialization, which teaches people to behave according to social norms.  \n\n Socialization Children learn at a young age that there are distinct expectations for boys and girls. Cross-cultural studies reveal that children are aware of gender roles by age two or three. At four or five, most children are firmly entrenched in culturally appropriate gender roles (Kane 1996). Children acquire these roles through socialization, a process in which people learn to behave in a particular way as dictated by societal values, beliefs, and attitudes. For example, society often views riding a motorcycle as a masculine activity and, therefore, considers it to be part of the male gender role. Attitudes such as this are typically based on stereotypes, oversimplified notions about members of a group. Gender stereotyping involves overgeneralizing about the attitudes, traits, or behavior patterns of women or men. For example, women may be thought of as too timid or weak to ride a motorcycle.  \n\n Gender stereotypes form the basis of sexism.  Sexism   refers to prejudiced beliefs that value one sex over another. Sexism varies in its level of severity. In parts of the world where women are strongly undervalued, young girls may not be given the same access to nutrition, healthcare, and education as boys. Further, they will grow up believing that they deserve to be treated differently from boys (UNICEF 2011; Thorne 1993). While illegal in the United States when practiced as discrimination, unequal treatment of women continues to pervade social life. It should be noted that discrimination based on sex occurs at both the micro- and macro-levels. Many sociologists focus on discrimination that is built into the social structure; this type of discrimination is known as institutional discrimination (Pincus 2008). Gender socialization occurs through four major agents of socialization: family, education, peer groups, and mass media. Each agent reinforces gender roles by creating and maintaining normative expectations for gender-specific behavior. Exposure also occurs through secondary agents such as religion and the workplace. Repeated exposure to these agents over time leads men and women into a false sense that they are acting naturally rather than following a socially constructed role. \n\n Family is the first agent of socialization. There is considerable evidence that parents socialize sons and daughters differently. Generally speaking, girls are given more latitude to step outside of their prescribed gender role (Coltrane and Adams 2004; Kimmel 2000; Raffaelli and Ontai 2004). However, differential socialization typically results in greater privileges afforded to sons. For instance, boys are allowed more autonomy and independence at an earlier age than daughters. They may be given fewer restrictions on appropriate clothing, dating habits, or curfew. Sons are also often free from performing domestic duties such as cleaning or cooking and other household tasks that are considered feminine. Daughters are limited by their expectation to be passive and nurturing, generally obedient, and to assume many of the domestic responsibilities.  \n\n Even when parents set gender equality as a goal, there may be underlying indications of inequality. For example, when dividing up household chores, boys may be asked to take out the garbage or perform other tasks that require strength or toughness, while girls may be asked to fold laundry or perform duties that require neatness and care. It has been found that fathers are firmer in their expectations for gender conformity than are mothers, and their expectations are stronger for sons than they are for daughters (Kimmel 2000). This is true in many types of activities, including preference of toys, play styles, discipline, chores, and personal achievements. As a result, boys tend to be particularly attuned to their father\u2019s disapproval when engaging in an activity that might be considered feminine, like dancing or singing (Coltraine and Adams 2008). It should be noted that parental socialization and normative expectations vary along lines of social class, race, and ethnicity. African-American families, for instance, are more likely than Caucasians to model an egalitarian role structure for their children (Staples and Boulin Johnson 2004). \n\n The reinforcement of gender roles and stereotypes continues once a child reaches school age. Until very recently, schools were rather explicit in their efforts to stratify boys and girls. The first step toward stratification was segregation. Girls were encouraged to take home economics or humanities courses and boys to take math and science courses.  \n\n Studies suggest that gender socialization still occurs in schools today, perhaps in less obvious forms (Lips 2004). Teachers may not even realize that they are acting in ways that reproduce gender differentiated behavior patterns. Yet, any time they ask students to arrange their seats or line up according to gender, teachers are asserting that boys and girls should be treated differently (Thorne 1993).  \n\n Even in levels as low as kindergarten, schools subtly convey messages to girls indicating that they are less intelligent or less important than boys. For example, in a study involving teacher responses to male and female students, data indicated that teachers praised male students far more than their female counterparts. Additionally, teachers interrupted girls more and gave boys more opportunities to expand on their ideas (Sadker and Sadker 1994). Further, in social as well as academic situations, teachers have traditionally positioned boys and girls oppositionally\u2014reinforcing a sense of competition rather than collaboration (Thorne 1993). Boys are also permitted a greater degree of freedom regarding rule-breaking or minor acts of deviance, whereas girls are expected to follow rules carefully and to adopt an obedient posture (Ready 2001). Schools reinforce the polarization of gender roles and the age-old \u201cbattle of the sexes\u201d by positioning girls and boys in competitive arrangements. \n\n Mimicking the actions of significant others is the first step in the development of a separate sense of self (Mead 1934). Like adults, children become agents who actively facilitate and apply normative gender expectations to those around them. When children do not conform to the appropriate gender role, they may face negative sanctions such as being criticized or marginalized by their peers. Though many of these sanctions are informal, they can be quite severe. For example, a girl who wishes to take karate class instead of dance lessons may be called a \u201ctomboy\u201d and face difficulty gaining acceptance from both male and female peer groups (Ready 2001). Boys, especially, are subject to intense ridicule for gender nonconformity (Coltrane and Adams 2004; Kimmel 2000). \n\n Mass media serves as another significant agent of gender socialization. In television and movies, women tend to have less significant roles and are often portrayed as wives or mothers. When women are given a lead role, they are often one of two extremes: a wholesome, saint-like figure or a malevolent, hypersexual figure (Etaugh and Bridges 2003). This same inequality is pervasive in children\u2019s movies (Smith 2008). Research indicates that of the 101 top-grossing G-rated movies released between 1990 and 2005, three out of four characters were male. Out of those 101 movies, only seven were near being gender balanced, with a character ratio of less than 1.5 males per 1 female (Smith 2008).  \n\n Television commercials and other forms of advertising also reinforce inequality and gender-based stereotypes. Women are almost exclusively present in ads promoting cooking, cleaning, or childcare-related products (Davis 1993). Think about the last time you saw a man star in a dishwasher or laundry detergent commercial. In general, women are underrepresented in roles that involve leadership, intelligence, or a balanced psyche. Of particular concern is the depiction of women in ways that are dehumanizing, especially in music videos. Even in mainstream advertising, however, themes intermingling violence and sexuality are quite common (Kilbourne 2000). \n\n Social Stratification and Inequality Stratification refers to a system in which groups of people experience unequal access to basic, yet highly valuable, social resources. The United States is characterized by gender stratification (as well as stratification of race, income, occupation, and the like). Evidence of gender stratification is especially keen within the economic realm. Despite making up nearly half (49.8 percent) of payroll employment, men vastly outnumber women in authoritative, powerful, and, therefore, high-earning jobs (U.S. Census Bureau 2010). Even when a woman\u2019s employment status is equal to a man\u2019s, she will generally only make 77 cents for every dollar made by her male counterpart (U.S. Census Bureau 2010). Additionally, women who are in the paid labor force still do the majority of the unpaid work at home. On an average day, 84 percent of women (compared to 67 percent of men) spend time doing household management activities (U.S. Census Bureau 2011). This double duty keeps working women in a subordinate role in the family structure (Hochschild and Machung 1989). \n\n Gender stratification through the division of labor is not exclusively American. According to George Murdock\u2019s classic work,  Outline of World Cultures  (1954), all societies classify work by gender. When a pattern appears in all societies, it is called a cultural universal. While the phenomenon of assigning work by gender is universal, its specifics are not. The same task is not assigned to either men or women worldwide. But the way each task\u2019s associated gender is valued is notable. In Murdock\u2019s examination of the division of labor among 324 societies around the world, he found that in nearly all cases the jobs assigned to men were given greater prestige (Murdock and White 1968). Even if the job types were very similar and the differences slight, men\u2019s work was still considered more vital.  \n\n There is a long history of gender stratification in the United States. When looking to the past, it would appear that society has made great strides in terms of abolishing some of the most blatant forms of gender inequality (see timeline below) but underlying effects of male dominance still permeate many aspects of society.  \n\n Before 1809\u2014Women could not execute a will \n\n Before 1840\u2014Women were not allowed to own or control property \n\n Before 1920\u2014Women were not permitted to vote \n\n Before 1963\u2014Employers could legally pay a woman less than a man for the same work \n\n Before 1973\u2014Women did not have the right to a safe and legal abortion (Imbornoni 2009) \n\n Theoretical Perspectives on Gender Sociological theories serve to guide the research process and offer a means for interpreting research data and explaining social phenomena. For example, a sociologist interested in gender stratification in education may study why middle-school girls are more likely than their male counterparts to fall behind grade-level expectations in math and science. Another scholar might investigate why women are underrepresented in political office, while another might examine how congresswomen are treated by their male counterparts in meetings.  \n\n Structural Functionalism Structural functionalism has provided one of the most important perspectives of sociological research in the twentieth century and has been a major influence on research in the social sciences, including gender studies. Viewing the family as the most integral component of society, assumptions about gender roles within marriage assume a prominent place in this perspective.  \n\n Functionalists argue that gender roles were established well before the pre-industrial era when men typically took care of responsibilities outside of the home, such as hunting, and women typically took care of the domestic responsibilities in or around the home. These roles were considered functional because women were often limited by the physical restraints of pregnancy and nursing and unable to leave the home for long periods of time. Once established, these roles were passed on to subsequent generations since they served as an effective means of keeping the family system functioning properly.  \n\n When changes occurred in the social and economic climate of the United States during World War II, changes in the family structure also occurred. Many women had to assume the role of breadwinner (or modern hunter and gatherer) alongside their domestic role in order to stabilize a rapidly changing society. When the men returned from war and wanted to reclaim their jobs, society fell back into a state of imbalance, as many women did not want to forfeit their wage-earning positions (Hawke 2007). \n\n Conflict Theory According to conflict theory, society is a struggle for dominance among social groups (like women versus men) that compete for scarce resources. When sociologists examine gender from this perspective, we can view men as the dominant group and women as the subordinate group. According to conflict theory, social problems are created when dominant groups exploit or oppress subordinate groups. Consider the Women\u2019s Suffrage Movement or the debate over women\u2019s \u201cright to choose\u201d their reproductive futures. It is difficult for women to rise above men, as dominant group members create the rules for success and opportunity in society (Farrington and Chertok 1993).  \n\n Friedrich Engels, a German sociologist, studied family structure and gender roles. Engels suggested that the same owner-worker relationship seen in the labor force is also seen in the household, with women assuming the role of the proletariat. This is due to women\u2019s dependence on men for the attainment of wages, which is even worse for women who are entirely dependent upon their spouses for economic support. Contemporary conflict theorists suggest that when women become wage earners, they can gain power in the family structure and create more democratic arrangements in the home, although they may still carry the majority of the domestic burden, as noted earlier (Rismanand and Johnson-Sumerford 1998). \n\n Feminist Theory Feminist theory is a type of conflict theory that examines inequalities in gender-related issues. It uses the conflict approach to examine the maintenance of gender roles and inequalities. Radical feminism, in particular, considers the role of the family in perpetuating male dominance. In patriarchal societies, men\u2019s contributions are seen as more valuable than those of women. Additionally, women often perceive a disconnect between their personal experiences and the experiences upheld by society as a whole. Patriarchal perspectives and arrangements are widespread and taken for granted. As a result, women\u2019s viewpoints tend to be silenced or marginalized to the point of being discredited or considered invalid.  \n\n Sanday\u2019s study of the Indonesian Minangkabau (2004) revealed that in societies that some consider to be matriarchies (where women comprise the dominant group), women and men tend to work cooperatively rather than competitively regardless of whether a job is considered feminine by American standards. The men, however, do not experience the sense of bifurcated consciousness under this social structure that modern U.S. females encounter (Sanday 2004). \n\n Symbolic Interactionism Symbolic interactionism aims to understand human behavior by analyzing the critical role of symbols in human interaction. This is certainly relevant to the discussion of masculinity and femininity. Imagine that you walk into a bank, hoping to get a small loan for school, a home, or a small business venture. If you meet with a male loan officer, you may state your case logically by listing all of the hard numbers that make you a qualified applicant as a means of appealing to the analytical characteristics associated with masculinity. If you meet with a female loan officer, you may make an emotional appeal by stating your good intentions as a means of appealing to the caring characteristics associated with femininity.  \n\n Because the meanings attached to symbols are socially created and not natural, and fluid, not static, we act and react to symbols based on the current assigned meaning. The word  gay , for example, once meant \u201ccheerful,\u201d but by the 1960s it carried the primary meaning of \u201chomosexual.\u201d In transition, it was even known to mean \u201ccareless\u201d or \u201cbright and showing\u201d (Oxford American Dictionary 2010). Furthermore, the word  gay  (as it refers to a homosexual), carried a somewhat negative and unfavorable meaning 50 years ago, but has since gained more neutral and even positive connotations.  \n\n These shifts in symbolic meaning apply to family structure as well. A half-century ago, when only 20 percent of married women with preschool-aged children were part of the paid workforce, a working mother was considered an anomaly and there was a general view that women who worked were \u201cselfish\u201d and not good mothers. Today, when a majority of women with preschool-aged children are part of the paid workforce (60 percent), a working mother is viewed as more normal (Coltrane and Adams 2008). \n\n Sociologist Charles H. Cooley\u2019s concept of the \u201clooking-glass self\u201d (1902) can also be applied to interactionist gender studies. Cooley suggests that one\u2019s determination of self is based mainly on the view of society (for instance, if society perceives a man as masculine, then that man will perceive himself as masculine). When people perform tasks or possess characteristics based on the gender role assigned to them, they are said to be  doing gender . This notion is based on the work of West & Zimmerman (1987). Whether we are expressing our masculinity or femininity, West and Zimmerman argue, we are  always  \u201cdoing gender.\u201d Thus, gender is something we  do  or perform, not something we  are . \n\n Sociological Research Being Male, Being Female, and Being Healthy In 1971, Broverman and Broverman conducted a groundbreaking study on the traits mental health workers ascribed to males and females. When asked to name the characteristics of a female, the list featured words such as unaggressive, gentle, emotional, tactful, less logical, not ambitious, dependent, passive, and neat. The list of male characteristics featured words such as aggressive, rough, unemotional, blunt, logical, direct, active, and sloppy (Seem and Clark 2006). Later, when asked to describe the characteristics of a healthy person (not gender specific), the list was nearly identical to that of a male.  \n\n This study uncovered the general assumption that being female is associated with being somewhat unhealthy or not of sound mind. This concept seems extremely dated, but in 2006, Seem and Clark replicated the study and found similar results. Again, the characteristics associated with a healthy male were very similar to that of a healthy (genderless) adult. The list of characteristics associated with being female broadened somewhat but did not show significant change from the original study (Seem and Clark 2006). This interpretation of feminine characteristic may help us one day better understand gender disparities in certain illnesses, such as why one in eight women can be expected to develop clinical depression in her lifetime (National Institute of Mental Health 1999). Perhaps these diagnoses are not just a reflection of women\u2019s health, but also a reflection of society\u2019s labeling of female characteristics, or the result of institutionalized sexism. \n12.3   Sex and Sexuality \n\n Sexual Attitudes and Practices In the area of sexuality, sociologists focus their attention on sexual attitudes and practices, not on physiology or anatomy.  Sexuality  is viewed as a person\u2019s capacity for sexual feelings. Studying sexual attitudes and practices is a particularly interesting field of sociology because sexual behavior is a cultural universal. Throughout time and place, the vast majority of human beings have participated in sexual relationships (Broude 2003). Each society, however, interprets sexuality and sexual activity in different ways. Many societies around the world have different attitudes about premarital sex, the age of sexual consent, homosexuality, masturbation, and other sexual behaviors that are not consistent with universally cultural norms (Widmer, Treas and Newcomb 1998). At the same time, sociologists have learned that certain norms (like disapproval of incest) are shared among most societies. Likewise, societies generally have norms that reinforce their accepted social system of sexuality.  \n\n What is considered \u201cnormal\u201d in terms of sexual behavior is based on the mores and values of the society. Societies that value monogamy, for example, would likely oppose extramarital sex. Individuals are socialized to sexual attitudes by their family, education system, peers, media, and religion. Historically, religion has been the greatest influence on sexual behavior in most societies, but in more recent years, peers and the media have emerged as two of the strongest influences, particularly with American teens (Potard, Courtois, and Rusch 2008). Let us take a closer look at sexual attitudes in the United States and around the world. \n\n Sexuality around the World Cross-national research on sexual attitudes in industrialized nations reveals that normative standards differ across the world. For example, several studies have shown that Scandinavian students are more tolerant of premarital sex than are American students (Grose 2007). A study of 37 countries reported that non-Western societies\u2014like China, Iran, and India\u2014valued chastity highly in a potential mate, while Western European countries\u2014such as France, the Netherlands, and Sweden\u2014placed little value on prior sexual experiences (Buss 1989).  \n\n Even among Western cultures, attitudes can differ. For example, according to a 33,590-person survey across 24 countries, 89 percent of Swedes responded that there is nothing wrong with premarital sex, while only 42 percent of Irish responded this way. From the same study, 93 percent of Filipinos responded that sex before age 16 is always wrong or almost always wrong, while only 75 percent of Russians responded this way (Widmer, Treas, and Newcomb 1998). Sexual attitudes can also vary within a country. For instance, 45 percent of Spaniards responded that homosexuality is always wrong, while 42 percent responded that it is never wrong; only 13 percent responded somewhere in the middle (Widmer, Treas, and Newcomb 1998). \n\n Of industrialized nations, Sweden is thought to be the most liberal when it comes to attitudes about sex, including sexual practices and sexual openness. The country has very few regulations on sexual images in the media, and sex education, which starts around age six, is a compulsory part of Swedish school curricula. Sweden\u2019s permissive approach to sex has helped the country avoid some of the major social problems associated with sex. For example, rates of teen pregnancy and sexually transmitted disease are among the world\u2019s lowest (Grose 2007). It would appear that Sweden is a model for the benefits of sexual freedom and frankness. However, implementing Swedish ideals and policies regarding sexuality in other, more politically conservative, nations would likely be met with resistance. \n\n Sexuality in the United States The United States prides itself on being the land of the \u201cfree,\u201d but it is rather restrictive when it comes to its citizens\u2019 general attitudes about sex compared to other industrialized nations. In an international survey, 29 percent of Americans stated that premarital sex is always wrong, while the average among the 24 countries surveyed was 17 percent. Similar discrepancies were found in questions about the condemnation of sex before the age of 16, extramarital sex, and homosexuality, with American total disapproval of these each acts being 12, 13, and 11 percent higher, respectively, than the study\u2019s average (Widmer, Treas and Newcomb 1998).  \n\n American culture is particularly restrictive in its attitudes about sex when it comes to women and sexuality. It is widely believed that men are more sexual than are women. In fact, there is a popular notion that men think about sex every seven seconds. Research, however, suggests that men think about sex an average of 19 times per day, compared to 10 times per day for women (Fisher, Moore, and Pittenger 2011).  \n\n Belief that men have\u2014or have the right to\u2014more sexual urges than women creates a double standard. Ira Reiss, a pioneer researcher in the field of sexual studies, defined the  double standard  as prohibiting premarital sexual intercourse for women but allowing it for men (Reiss 1960). This standard has evolved into allowing women to engage in premarital sex only within committed love relationships, but allowing men to engage in sexual relationships with as many partners as they wish without condition (Milhausen and Herold 1999). Due to this double standard, a woman is likely to have fewer sexual partners in her life time than a man. According to a Centers for Disease Control and Prevention (CDC) survey, the average 35-year-old woman has had three opposite-sex sexual partners while the average 35-year-old man has had twice as many (Centers for Disease Control 2011).  \n\n The future of a society\u2019s sexual attitudes may be somewhat predicted by the values and beliefs that a country\u2019s youth expresses about sex and sexuality. Data from the 2008 National Survey of Family Growth reveals that 64 percent of boys and 71 percent of girls ages 15\u201319 said they \u201cagree\u201d or \u201cstrongly agree\u201d that \u201cit\u2019s okay for an unmarried female to have a child.\u201d In a separate survey, 65 percent of teens stated that they \u201cstrongly agreed\u201d or \u201csomewhat agreed\u201d that although waiting until marriage for sex is a nice idea, it\u2019s not realistic (NBC News 2005). This does not mean that today\u2019s youth have given up traditional sexual values such as monogamy. Nearly all college men (98.9 percent) and women (99.2 percent) who participated in a 2002 study on sexual attitudes stated they wished to settle down with one mutually exclusive sexual partner at some point in their lives, ideally within the next five years (Pedersen et al. 2002). \n\n Sex Education One of the biggest controversies regarding sexual attitudes is sexual education in American classrooms. Unlike in Sweden, sex education is not required in all public school curricula in the United States. The heart of the controversy is not about whether sex education should be taught in school (studies have shown that only seven percent of Americans oppose sex education in schools), it is about the  type  of sex education that should be taught.  \n\n Much of the debate is over the issue of abstinence. In a 2005 survey, 15 percent of Americans believed that schools should teach abstinence exclusively and should not provide contraceptives or information on how to obtain them. Forty-six percent believed that schools should institute an abstinence-plus approach, which teaches children that abstinence is best, but still gives information about protected sex. Thirty-six percent believed that teaching about abstinence is not important and that sex education should focus on sexual safety and responsibility (NPR 2010).  \n\n Research suggests that while government officials may still be debating about the content of sexual education in public schools, the majority of Americans are not. Those who advocated for abstinence-only programs may be the proverbial squeaky wheel when it comes to this controversy, as they represent only 15 percent of parents. Fifty-five percent of Americans feel that giving teens information about sex and how to obtain and use protection will not encourage them to have sexual relations earlier than they would under an abstinence program. Additionally, 77 percent think such a curriculum would make teens more likely to practice safe sex now and in the future (NPR 2004). \n\n Sweden, which has a comprehensive sex education program in its public schools that educates participants about safe sex, can serve as a model for this approach. The teenage birthrate in Sweden is 7 per 1,000 births, compared with 49 per 1,000 births in the United States. Additionally, among 15- to 19-year-olds, reported cases of gonorrhea in Sweden are nearly 600 times lower than in the United States (Grose 2007).  \n\n Sociological Perspectives on Sex and Sexuality  Sociologists representing all three major theoretical perspectives study the role that sexuality plays in social life today. Scholars recognize that sexuality continues to be an important and defining social location and that the manner in which sexuality is constructed has a significant effect on perceptions, interactions, and outcomes. \n\n Structural Functionalism When it comes to sexuality, functionalists stress the importance of regulating sexual behavior to ensure marital cohesion and family stability. Since functionalists identify the family unit as the most integral component in society, they maintain a strict focus on it at all times and argue in favor of social arrangements that promote and ensure family preservation.  \n\n Functionalists such as Talcott Parsons (1955) have long argued that the regulation of sexual activity is an important function of the family. Social norms surrounding family life have, traditionally, encouraged sexual activity within the family unit (marriage) and have discouraged activity outside of it (premarital and extramarital sex). From a functionalist point of view, the purpose of encouraging sexual activity in the confines of marriage is to intensify the bond between spouses and to ensure that procreation occurs within a stable, legally recognized relationship. This structure gives offspring the best possible chance for appropriate socialization and the provision of basic resources.  \n\n From a functionalist standpoint, homosexuality cannot be promoted on a large-scale as an acceptable substitute for heterosexuality. If this occurred, procreation would eventually cease. Thus, homosexuality, if occurring predominantly within the population, is dysfunctional to society. This criticism does not take into account the increasing legal acceptance of same-sex marriage, or the rise in gay and lesbian couples who choose to bear and raise children through a variety of available resources. \n\n Conflict Theory From a conflict theory perspective, sexuality is another area in which power differentials are present and where dominant groups actively work to promote their worldview as well as their economic interests. Recently, we have seen the debate over the legalization of gay marriage intensify nationwide. While five states (Massachusetts, Connecticut, Iowa, New Hampshire, and Vermont) and the District of Columbia have legalized same-sex marriage, 30 states have adopted statutes or constitutional provisions preventing same-sex marriage. One of these provisions, the Defense of Marriage Act, states that marriage between one man and one woman is the only domestic legal union that shall be valid or recognized.  \n\n For conflict theorists, there are two key dimensions to the debate over same-sex marriage\u2014one ideological and the other economic. Dominant groups (in this instance, heterosexuals) wish for their worldview\u2014which embraces traditional marriage and the nuclear family\u2014to win out over what they see as the intrusion of a secular, individually driven worldview. On the other hand, many gay and lesbian activists argue that legal marriage is a fundamental right that cannot be denied based on sexual orientation and that, historically, there already exists a precedent for changes to marriage laws: the 1960s legalization of formerly forbidden interracial marriages is one example.  \n\n From an economic perspective, activists in favor of same-sex marriage point out that legal marriage brings with it certain entitlements, many of which are financial in nature, like Social Security benefits and medical insurance (Solmonese 2008). Denial of these benefits to gay couples is wrong, they argue. Conflict theory suggests that as long as heterosexuals and homosexuals struggle over these social and financial resources, there will be some degree of conflict.  \n\n Symbolic Interactionism Interactionists focus on the meanings associated with sexuality and with sexual orientation. Since femininity is devalued in American society, those who adopt such traits are subject to ridicule; this is especially true for boys or men. Just as masculinity is the symbolic norm, so too has heterosexuality come to signify normalcy. Prior to 1973, the American Psychological Association (APA) defined homosexuality as an abnormal or deviant disorder. Interactionist labeling theory recognizes the impact this has made. Before 1973, the APA was powerful in shaping social attitudes toward homosexuality by defining it as pathological. Today, the APA cites no association between sexual orientation and psychopathology and sees homosexuality as a normal aspect of human sexuality (APA 2008). \n\n Interactionists are also interested in how discussions of homosexuals often focus almost exclusively on the sex lives of gays and lesbians; homosexuals, especially men, may be assumed to be hypersexual and, in some cases, deviant. Interactionism might also focus on the slurs used to describe homosexuals. Labels such as \u201cqueen\u201d and \u201cfag\u201d are often used to demean homosexual men by feminizing them. This subsequently affects how homosexuals perceive themselves. Recall Cooley\u2019s \u201clooking-glass self,\u201d which suggests that self develops as a result of one\u2019s interpretation and evaluation of the responses of others (Cooley 1902). Constant exposure to derogatory labels, jokes, and pervasive homophobia would lead to a negative self-image, or worse, self-hate. The CDC reports that homosexual youths who experience high levels of social rejection are six times more likely to have high levels of depression and eight times more likely to have attempted suicide (CDC 2011). \n\n Queer Theory Queer Theory is a perspective that problematizes the manner in which we have been taught to think about sexual orientation. By calling their discipline \u201cqueer,\u201d these scholars are rejecting the effects of labeling; instead, they embrace the word \u201cqueer\u201d and have reclaimed it for their own purposes. Queer theorists reject the dichotomization of sexual orientations into two mutually exclusive outcomes, homosexual or heterosexual. Rather, the perspective highlights the need for a more flexible and fluid conceptualization of sexuality\u2014one that allows for change, negotiation, and freedom. The current schema used to classify individuals as either \u201cheterosexual\u201d or \u201chomosexual\u201d pits one orientation against the other. This mirrors other oppressive schemas in our culture, especially those surrounding gender and race (black versus white, male versus female).  \n\n Queer theorist Eve Kosofsky Sedgwick argued against American society\u2019s monolithic definition of sexuality\u2014against its reduction to a single factor: the sex of one\u2019s desired partner. Sedgwick identified dozens of other ways in which people\u2019s sexualities were different, such as:  \n\n Even identical genital acts mean very different things to different people. \n\n Sexuality makes up a large share of the self-perceived identity of some people, a small share of others\u2019. \n\n Some people spend a lot of time thinking about sex, others little. \n\n Some people like to have a lot of sex, others little or none. \n\n Many people have their richest mental/emotional involvement with sexual acts that they don\u2019t do, or don\u2019t even want to do. \n\n Some people like spontaneous sexual scenes, others like highly scripted ones, others like spontaneous-sounding ones that are nonetheless totally predictable. \n\n Some people, homo- hetero- and bisexual, experience their sexuality as deeply embedded in a matrix of gender meanings and gender differentials. Others of each sexuality do not (Sedgwick 1990). \n\n In the end, queer theory strives to question the ways society perceives and experiences sex, gender, and sexuality, opening the door to new scholarly understanding. \n\n Throughout this chapter we have examined the complexities of gender, sex, and sexuality. Differentiating between sex, gender, and sexual orientation is an important first step to a deeper understanding and critical analysis of these issues. Understanding the sociology of sex, gender, and sexuality will help to build awareness of the inequalities experienced by subordinate groups such as women, homosexuals, and transgendered individuals.  ", "questions": [{"question": {"question_id": "sq1201_ex1", "question_text": "The terms \u201cmasculine\u201d and \u201cfeminine\u201d refer to a person\u2019s _________.", "question_choices": ["sex", "gender", "both sex and gender", "none of the above"], "cloze_format": "The terms \u201cmasculine\u201d and \u201cfeminine\u201d refer to a person\u2019s _________.", "normal_format": "What do the terms \"masculine\" and \"feminine\" refer to?"}, "answer": {"ans_text": "gender", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Samoan culture accepts what they refer to as a \u201c third gender . \u201d Fa \u2019 afafine , which translates as \u201c the way of the woman , \u201d is a term used to describe individuals who are born biologically male but embody both masculine and feminine traits . A person \u2019 s sex , as determined by his or her biology , does not always correspond with his or her gender . As he grows , however , he may identify with the feminine aspects of his culture . For example , in American culture , it is considered feminine ( or a trait of the female gender ) to wear a dress or skirt . However , in many Middle Eastern , Asian , and African cultures , dresses or skirts ( often referred to as sarongs , robes , or gowns ) can be considered masculine .", "hl_context": "The dichotomous view of gender ( the notion that one is either male or female ) is specific to certain cultures and is not universal . In some cultures gender is viewed as fluid . In the past , some anthropologists used the term berdache to refer to individuals who occasionally or permanently dressed and lived as the opposite gender . The practice has been noted among certain Native American tribes ( Jacobs , Thomas , and Lang 1997 ) . <hl> Samoan culture accepts what they refer to as a \u201c third gender . \u201d Fa \u2019 afafine , which translates as \u201c the way of the woman , \u201d is a term used to describe individuals who are born biologically male but embody both masculine and feminine traits . <hl> Fa \u2019 afafines are considered an important part of Samoan culture . Individuals from other cultures may mislabel them as homosexuals because fa \u2019 afafines have a varied sexual life that may include men or women ( Poasa 1992 ) . <hl> A person \u2019 s sex , as determined by his or her biology , does not always correspond with his or her gender . <hl> Therefore , the terms sex and gender are not interchangeable . A baby boy who is born with male genitalia will be identified as male . <hl> As he grows , however , he may identify with the feminine aspects of his culture . <hl> Since the term sex refers to biological or physical distinctions , characteristics of sex will not vary significantly between different human societies . For example , all persons of the female sex , in general , regardless of culture , will eventually menstruate and develop breasts that can lactate . Characteristics of gender , on the other hand , may vary greatly between different societies . <hl> For example , in American culture , it is considered feminine ( or a trait of the female gender ) to wear a dress or skirt . <hl> <hl> However , in many Middle Eastern , Asian , and African cultures , dresses or skirts ( often referred to as sarongs , robes , or gowns ) can be considered masculine . <hl> The kilt worn by a Scottish male does not make him appear feminine in his culture ."}, {"question": {"question_id": "sq1201_ex2", "question_text": "\u00ad_______ is/are an individual\u2019s self-conception of being male or female based on his or her association with masculine or feminine gender roles.", "question_choices": ["Gender identity", "Gender bias", "Sexual orientation", "Sexual attitudes"], "cloze_format": "\u00ad_______ is/are an individual\u2019s self-conception of being male or female based on his or her association with masculine or feminine gender roles.", "normal_format": "What is/are an individual\u2019s self-conception of being male or female based on his or her association with masculine or feminine gender roles?"}, "answer": {"ans_text": "Gender identity", "ans_choice": 0}, "bloom": null, "hl_sentences": "Gender identity is an individual \u2019 s self-conception of being male or female based on his or her association with masculine or feminine gender roles .", "hl_context": "Gender Identity American society allows for some level of flexibility when it comes to acting out gender roles . To a certain extent , men can assume some feminine roles and women can assume some masculine roles without interfering with their gender identity . <hl> Gender identity is an individual \u2019 s self-conception of being male or female based on his or her association with masculine or feminine gender roles . <hl>"}, {"question": {"question_id": "sq1201_ex3", "question_text": "Research indicates that individuals are aware of their sexual orientation _______.", "question_choices": ["at infancy", "in early adolescence", "in early adulthood", "in late adulthood"], "cloze_format": "Research indicates that individuals are aware of their sexual orientation _______.", "normal_format": "Research indicates when are individuals aware of their sexual orientation?"}, "answer": {"ans_text": "in early adolescence", "ans_choice": 1}, "bloom": "1", "hl_sentences": "According to current scientific understanding , individuals are usually aware of their sexual orientation between middle childhood and early adolescence ( American Psychological Association 2008 ) .", "hl_context": "<hl> According to current scientific understanding , individuals are usually aware of their sexual orientation between middle childhood and early adolescence ( American Psychological Association 2008 ) . <hl> They do not have to participate in sexual activity to be aware of these emotional , romantic , and physical attractions ; people can be celibate and still recognize their sexual orientation . Homosexual women ( also referred to as lesbians ) , homosexual men ( also referred to as gays ) , and bisexuals of both genders may have very different experiences of discovering and accepting their sexual orientation . At the point of puberty , some may be able to claim their sexual orientations while others may be unready or unwilling to make their homosexuality or bisexuality known since it goes against American society \u2019 s historical norms ( APA 2008 ) ."}, {"question": {"question_id": "sq1201_ex4", "question_text": "A person who is biologically female but identifies with the male gender and has undergone surgery to alter her body is considered _______.", "question_choices": ["transgendered", "transsexual", "a cross-dresser", "homosexual"], "cloze_format": "A person who is biologically female but identifies with the male gender and has undergone surgery to alter her body is considered _______.", "normal_format": "How is a person who is biologically female but identifies with the male gender and has undergone surgery to alter her body considered?"}, "answer": {"ans_text": "transsexual", "ans_choice": 1}, "bloom": "1", "hl_sentences": "Transgendered individuals who wish to alter their bodies through medical interventions such as surgery and hormonal therapy \u2014 so that their physical being is better aligned with gender identity \u2014 are called transsexuals .", "hl_context": "<hl> Transgendered individuals who wish to alter their bodies through medical interventions such as surgery and hormonal therapy \u2014 so that their physical being is better aligned with gender identity \u2014 are called transsexuals . <hl> They may also be known as male-to-female ( MTF ) or female-to-male ( FTM ) . Not all transgendered individuals choose to alter their bodies : many will maintain their original anatomy but may present themselves to society as the opposite gender . This is typically done by adopting the dress , hairstyle , mannerisms , or other characteristic typically assigned to the opposite gender . It is important to note that people who cross-dress , or wear clothing that is traditionally assigned to opposite gender , are not necessarily transgendered . Cross-dressing is typically a form of self-expression , entertainment , or personal style , not necessarily an expression against one \u2019 s assigned gender ( APA 2008 ) ."}, {"question": {"question_id": "sq1201_ex5", "question_text": "Which of following is correct regarding the explanation for transgenderism?", "question_choices": ["It is strictly biological and associated with chemical imbalances in the brain.", "It is a behavior that is learned through socializing with other transgendered individuals.", "It is genetic and usually skips one generation.", "Currently, there is no definitive explanation for transgenderism."], "cloze_format": "___ is a correct statement regarding the explanation for transgenderism.", "normal_format": "Which of following is correct regarding the explanation for transgenderism?"}, "answer": {"ans_text": "Currently, there is no definitive explanation for transgenderism.", "ans_choice": 3}, "bloom": "1", "hl_sentences": "There is no single , conclusive explanation for why people are transgendered .", "hl_context": "<hl> There is no single , conclusive explanation for why people are transgendered . <hl> Transgendered expressions and experiences are so diverse that it is difficult to identify their origin . Some hypotheses suggest biological factors such as genetics or prenatal hormone levels as well as social and cultural factors such as childhood and adulthood experiences . Most experts believe that all of these factors contribute to a person \u2019 s gender identity ( APA 2008 ) ."}, {"question": {"question_id": "sq1202_ex1", "question_text": "Which of the following is the best example of a gender stereotype?", "question_choices": ["Women are typically shorter than men.", "Men do not live as long as women.", "Women tend to be overly emotional, while men tend to be levelheaded.", "Men hold more high-earning, leadership jobs than women. "], "cloze_format": "The best example of a gender stereotype is that ___ .", "normal_format": "Which of the following is the best example of a gender stereotype?"}, "answer": {"ans_text": "Women tend to be overly emotional, while men tend to be levelheaded.", "ans_choice": 2}, "bloom": null, "hl_sentences": "When asked to name the characteristics of a female , the list featured words such as unaggressive , gentle , emotional , tactful , less logical , not ambitious , dependent , passive , and neat . The list of male characteristics featured words such as aggressive , rough , unemotional , blunt , logical , direct , active , and sloppy ( Seem and Clark 2006 ) . If you are a woman , imagine that you were forced to wear shapeless clothing , put only minimal effort into your personal appearance , not show emotion , and watch countless hours of sporting events and sports-related commentary . Many people enjoy participating in activities that are typically associated with the opposite sex and would not mind if some of the cultural expectations for men and women were loosened .", "hl_context": "Sociological Research Being Male , Being Female , and Being Healthy In 1971 , Broverman and Broverman conducted a groundbreaking study on the traits mental health workers ascribed to males and females . <hl> When asked to name the characteristics of a female , the list featured words such as unaggressive , gentle , emotional , tactful , less logical , not ambitious , dependent , passive , and neat . <hl> <hl> The list of male characteristics featured words such as aggressive , rough , unemotional , blunt , logical , direct , active , and sloppy ( Seem and Clark 2006 ) . <hl> Later , when asked to describe the characteristics of a healthy person ( not gender specific ) , the list was nearly identical to that of a male . Sociology in the Real World Real-Life Freaky Friday What if you had to live as the opposite sex ? If you are a man , imagine that you were forced to wear frilly dresses , dainty shoes , and makeup to special occasions , and you were expected to enjoy romantic comedies and TLC reality shows . <hl> If you are a woman , imagine that you were forced to wear shapeless clothing , put only minimal effort into your personal appearance , not show emotion , and watch countless hours of sporting events and sports-related commentary . <hl> It would be pretty uncomfortable , right ? Well , maybe not . <hl> Many people enjoy participating in activities that are typically associated with the opposite sex and would not mind if some of the cultural expectations for men and women were loosened . <hl>"}, {"question": {"question_id": "sq1202_ex2", "question_text": "Which of the following is the best example of the role peers play as an agent of socialization for school-aged children?", "question_choices": ["Children can act however they wish around their peers because children are unaware of gender roles.", "Peers serve as a support system for children who wish to act outside of their assigned gender roles.", "Peers tend to reinforce gender roles by criticizing and marginalizing those who behave outside of their assigned roles.", "None of the above"], "cloze_format": "___ is the best example of the role peers play as an agent of socialization for school-aged children.", "normal_format": "Which of the following is the best example of the role peers play as an agent of socialization for school-aged children?"}, "answer": {"ans_text": "Peers tend to reinforce gender roles by criticizing and marginalizing those who behave outside of their assigned roles.", "ans_choice": 2}, "bloom": "3", "hl_sentences": "Like adults , children become agents who actively facilitate and apply normative gender expectations to those around them . When children do not conform to the appropriate gender role , they may face negative sanctions such as being criticized or marginalized by their peers .", "hl_context": "Mimicking the actions of significant others is the first step in the development of a separate sense of self ( Mead 1934 ) . <hl> Like adults , children become agents who actively facilitate and apply normative gender expectations to those around them . <hl> <hl> When children do not conform to the appropriate gender role , they may face negative sanctions such as being criticized or marginalized by their peers . <hl> Though many of these sanctions are informal , they can be quite severe . For example , a girl who wishes to take karate class instead of dance lessons may be called a \u201c tomboy \u201d and face difficulty gaining acceptance from both male and female peer groups ( Ready 2001 ) . Boys , especially , are subject to intense ridicule for gender nonconformity ( Coltrane and Adams 2004 ; Kimmel 2000 ) ."}, {"question": {"question_id": "eip-609", "question_text": "Only women are affected by gender stratification.", "question_choices": ["True", "False"], "cloze_format": "It is ___ that only women are affected by gender stratification.", "normal_format": "Only women are affected by gender stratification."}, "answer": {"ans_text": "False", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "Gender stratification through the division of labor is not exclusively American . According to George Murdock \u2019 s classic work , Outline of World Cultures ( 1954 ) , all societies classify work by gender . When a pattern appears in all societies , it is called a cultural universal . While the phenomenon of assigning work by gender is universal , its specifics are not . The same task is not assigned to either men or women worldwide .", "hl_context": "<hl> Gender stratification through the division of labor is not exclusively American . <hl> <hl> According to George Murdock \u2019 s classic work , Outline of World Cultures ( 1954 ) , all societies classify work by gender . <hl> <hl> When a pattern appears in all societies , it is called a cultural universal . <hl> <hl> While the phenomenon of assigning work by gender is universal , its specifics are not . <hl> <hl> The same task is not assigned to either men or women worldwide . <hl> But the way each task \u2019 s associated gender is valued is notable . In Murdock \u2019 s examination of the division of labor among 324 societies around the world , he found that in nearly all cases the jobs assigned to men were given greater prestige ( Murdock and White 1968 ) . Even if the job types were very similar and the differences slight , men \u2019 s work was still considered more vital ."}, {"question": {"question_id": "sq1202_ex5", "question_text": "According to the symbolic interactionist perspective, we \u201cdo gender\u201d:", "question_choices": ["during half of our activities", "only when they apply to our biological sex", "only if we are actively following gender roles", "all of the time, in everything we do"], "cloze_format": "According to the symbolic interactionist perspective, we \u201cdo gender\u201d ___.", "normal_format": "According to the symbolic interactionist perspective, when do we \u201cdo gender\u201d?"}, "answer": {"ans_text": "all of the time, in everything we do", "ans_choice": 3}, "bloom": null, "hl_sentences": "Sociologist Charles H . Cooley \u2019 s concept of the \u201c looking-glass self \u201d ( 1902 ) can also be applied to interactionist gender studies . Whether we are expressing our masculinity or femininity , West and Zimmerman argue , we are always \u201c doing gender . \u201d Thus , gender is something we do or perform , not something we are .", "hl_context": "<hl> Sociologist Charles H . Cooley \u2019 s concept of the \u201c looking-glass self \u201d ( 1902 ) can also be applied to interactionist gender studies . <hl> Cooley suggests that one \u2019 s determination of self is based mainly on the view of society ( for instance , if society perceives a man as masculine , then that man will perceive himself as masculine ) . When people perform tasks or possess characteristics based on the gender role assigned to them , they are said to be doing gender . This notion is based on the work of West & Zimmerman ( 1987 ) . <hl> Whether we are expressing our masculinity or femininity , West and Zimmerman argue , we are always \u201c doing gender . \u201d Thus , gender is something we do or perform , not something we are . <hl>"}, {"question": {"question_id": "sq1203_ex1", "question_text": "What Western country is thought to be the most liberal in its attitudes toward sex?", "question_choices": ["United States", "Sweden", "Mexico", "Ireland"], "cloze_format": "The Western country that is thought to be the most liberal in its attitudes toward sex is ___.", "normal_format": "What Western country is thought to be the most liberal in its attitudes toward sex?"}, "answer": {"ans_text": "Sweden", "ans_choice": 1}, "bloom": null, "hl_sentences": "Of industrialized nations , Sweden is thought to be the most liberal when it comes to attitudes about sex , including sexual practices and sexual openness .", "hl_context": "<hl> Of industrialized nations , Sweden is thought to be the most liberal when it comes to attitudes about sex , including sexual practices and sexual openness . <hl> The country has very few regulations on sexual images in the media , and sex education , which starts around age six , is a compulsory part of Swedish school curricula . Sweden \u2019 s permissive approach to sex has helped the country avoid some of the major social problems associated with sex . For example , rates of teen pregnancy and sexually transmitted disease are among the world \u2019 s lowest ( Grose 2007 ) . It would appear that Sweden is a model for the benefits of sexual freedom and frankness . However , implementing Swedish ideals and policies regarding sexuality in other , more politically conservative , nations would likely be met with resistance ."}, {"question": {"question_id": "sq1203_ex2", "question_text": "Compared to most Western societies, American sexual attitudes are considered _______.", "question_choices": ["conservative", "liberal", "permissive", "free"], "cloze_format": "Compared to most Western societies, American sexual attitudes are considered _______.", "normal_format": "Compared to most Western societies, what are American sexual attitudes considered?"}, "answer": {"ans_text": "conservative", "ans_choice": 0}, "bloom": null, "hl_sentences": "Sexuality around the World Cross-national research on sexual attitudes in industrialized nations reveals that normative standards differ across the world . For example , several studies have shown that Scandinavian students are more tolerant of premarital sex than are American students ( Grose 2007 ) . A study of 37 countries reported that non-Western societies \u2014 like China , Iran , and India \u2014 valued chastity highly in a potential mate , while Western European countries \u2014 such as France , the Netherlands , and Sweden \u2014 placed little value on prior sexual experiences ( Buss 1989 ) .", "hl_context": "<hl> Sexuality around the World Cross-national research on sexual attitudes in industrialized nations reveals that normative standards differ across the world . <hl> <hl> For example , several studies have shown that Scandinavian students are more tolerant of premarital sex than are American students ( Grose 2007 ) . <hl> <hl> A study of 37 countries reported that non-Western societies \u2014 like China , Iran , and India \u2014 valued chastity highly in a potential mate , while Western European countries \u2014 such as France , the Netherlands , and Sweden \u2014 placed little value on prior sexual experiences ( Buss 1989 ) . <hl>"}, {"question": {"question_id": "sq1203_ex3", "question_text": "Sociologists associate sexuality with _______.", "question_choices": ["heterosexuality", "homosexuality", "biological factors", "a person\u2019s capacity for sexual feelings"], "cloze_format": "Sociologists associate sexuality with _______.", "normal_format": "What do sociologists associate sexuality with?"}, "answer": {"ans_text": "a person\u2019s capacity for sexual feelings", "ans_choice": 3}, "bloom": "4", "hl_sentences": "Sexual Attitudes and Practices In the area of sexuality , sociologists focus their attention on sexual attitudes and practices , not on physiology or anatomy . Sexuality is viewed as a person \u2019 s capacity for sexual feelings .", "hl_context": "<hl> Sexual Attitudes and Practices In the area of sexuality , sociologists focus their attention on sexual attitudes and practices , not on physiology or anatomy . <hl> <hl> Sexuality is viewed as a person \u2019 s capacity for sexual feelings . <hl> Studying sexual attitudes and practices is a particularly interesting field of sociology because sexual behavior is a cultural universal . Throughout time and place , the vast majority of human beings have participated in sexual relationships ( Broude 2003 ) . Each society , however , interprets sexuality and sexual activity in different ways . Many societies around the world have different attitudes about premarital sex , the age of sexual consent , homosexuality , masturbation , and other sexual behaviors that are not consistent with universally cultural norms ( Widmer , Treas and Newcomb 1998 ) . At the same time , sociologists have learned that certain norms ( like disapproval of incest ) are shared among most societies . Likewise , societies generally have norms that reinforce their accepted social system of sexuality ."}, {"question": {"question_id": "sq1203_ex4", "question_text": "According to national surveys, most American parents support which type of sex education program in school?", "question_choices": ["Abstinence only", "Abstinence plus sexual safety", "Sexual safety without promoting abstinence", "No sex education"], "cloze_format": "According to national surveys, most American parents support the ___ type of sex education program in school.", "normal_format": "According to national surveys, most American parents support which type of sex education program in school?"}, "answer": {"ans_text": "Abstinence plus sexual safety", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Forty-six percent believed that schools should institute an abstinence-plus approach , which teaches children that abstinence is best , but still gives information about protected sex .", "hl_context": "Much of the debate is over the issue of abstinence . In a 2005 survey , 15 percent of Americans believed that schools should teach abstinence exclusively and should not provide contraceptives or information on how to obtain them . <hl> Forty-six percent believed that schools should institute an abstinence-plus approach , which teaches children that abstinence is best , but still gives information about protected sex . <hl> Thirty-six percent believed that teaching about abstinence is not important and that sex education should focus on sexual safety and responsibility ( NPR 2010 ) ."}, {"question": {"question_id": "sq1203_ex5", "question_text": "Which theoretical perspective stresses the importance of regulating sexual behavior to ensure marital cohesion and family stability?", "question_choices": ["Functionalism", "Conflict theory", "Symbolic interactionalism", "Queer theory"], "cloze_format": "The theoretical perspective that stresses the importance of regulating sexual behavior to ensure marital cohesion and family stability is the ___.", "normal_format": "Which theoretical perspective stresses the importance of regulating sexual behavior to ensure marital cohesion and family stability?"}, "answer": {"ans_text": "Functionalism", "ans_choice": 0}, "bloom": "3", "hl_sentences": "Structural Functionalism When it comes to sexuality , functionalists stress the importance of regulating sexual behavior to ensure marital cohesion and family stability .", "hl_context": "<hl> Structural Functionalism When it comes to sexuality , functionalists stress the importance of regulating sexual behavior to ensure marital cohesion and family stability . <hl> Since functionalists identify the family unit as the most integral component in society , they maintain a strict focus on it at all times and argue in favor of social arrangements that promote and ensure family preservation ."}], "summary": "", "keyterm": "", "bname": "introduction_to_sociology"}, {"chapter": 26, "intro": " Chapter Outline 26.1   The Rise of Franklin Roosevelt 26.2   The First New Deal 26.3   The Second New Deal Introduction \n\n The election of President  Franklin Delano Roosevelt  signaled both immediate relief for the American public as well as a permanent shift in the role of the federal government in guiding the economy and providing direct assistance to the people, albeit through expensive programs that made extensive budget deficits commonplace. For many, the immediate relief was, at a minimum, psychological: Herbert Hoover was gone, and the situation could not grow worse under Roosevelt. But as his New Deal unfolded, Americans learned more about the fundamental changes their new president brought with him to the Oval Office. In the span of little more than one hundred days, the country witnessed a wave of legislation never seen before or since. \n\n Roosevelt understood the need to \u201csave the patient,\u201d to borrow a medical phrase he often employed, as well as to \u201ccure the ill.\u201d This meant both creating jobs, through such programs as the  Works Progress Administration , which provided employment to over eight million Americans ( Figure 26.1 ), as well as reconfiguring the structure of the American economy. In pursuit of these two goals, Americans re-elected Roosevelt for three additional terms in the White House and became full partners in the reshaping of their country. ", "chapter_text": " 26.1   The Rise of Franklin Roosevelt Learning Objectives By the end of this section, you should be able to:\n\n Describe the events of the 1932 presidential election and identify the characteristics that made Franklin Roosevelt a desirable candidate \n\n Explain why Congress amended the U.S. Constitution to reduce the period of time between presidential elections and inaugurations \n\n Franklin Roosevelt was part of the political establishment and the wealthy elite, but in the 1932 presidential campaign, he did not want to be perceived that way. Roosevelt felt that the country needed sweeping change, and he ran a campaign intended to convince the American people that he could deliver that change. It was not the specifics of his campaign promises that were different; in fact, he gave very few details and likely did not yet have a clear idea of how he would raise the country out of the Great Depression. But he campaigned tirelessly, talking to thousands of people, appearing at his party\u2019s national convention, and striving to show the public that he was a different breed of politician. As Hoover grew more morose and physically unwell in the face of the campaign, Roosevelt thrived. He was elected in a landslide by a country ready for the change he had promised. \n\n THE ELECTION OF FRANKLIN ROOSEVELT \n\n By the 1932 presidential election, Hoover\u2019s popularity was at an all-time low. Despite his efforts to address the hardships that many Americans faced, his ineffectual response to the Great Depression left Americans angry and ready for change. Franklin Roosevelt, though born to wealth and educated at the best schools, offered the change people sought. His experience in politics had previously included a seat in the New York State legislature, a vice-presidential nomination, and a stint as governor of New York. During the latter, he introduced many state-level reforms that later formed the basis of his  New Deal  as well as worked with several advisors who later formed the  Brains Trust  that advised his federal agenda. \n\n Roosevelt exuded confidence, which the American public desperately wished to see in their leader ( Figure 26.3 ). And, despite his affluence, Americans felt that he could relate to their suffering due to his own physical hardships; he had been struck with polio a decade earlier and was essentially paralyzed from the waist down for the remainder of his life. Roosevelt understood that the public sympathized with his ailment; he likewise developed a genuine empathy for public suffering as a result of his illness. However, he never wanted to be photographed in his wheelchair or appear infirm in any way, for fear that the public\u2019s sympathy would transform into concern over his physical ability to discharge the duties of the Oval Office. \n\n Roosevelt also recognized the need to convey to the voting public that he was not simply another member of the political aristocracy. At a time when the country not only faced its most severe economic challenges to date, but Americans began to question some of the fundamental principles of capitalism and democracy, Roosevelt sought to show that he was different\u2014that he could defy expectations\u2014and through his actions could find creative solutions to address the nation\u2019s problems while restoring public confidence in fundamental American values. As a result, he not only was the first presidential candidate to appear in person at a national political convention to accept his party\u2019s nomination but also flew there through terrible weather from New York to Chicago in order to do so\u2014a risky venture in what was still the early stages of flight as public transportation. At the Democratic National Convention in 1932, he coined the famous phrase: \u201cI pledge myself to a new deal for the American people.\u201d The New Deal did not yet exist, but to the American people, any positive and optimistic response to the Great Depression was a welcome one. \n\n Hoover assumed at first that Roosevelt would be easy to defeat, confident that he could never carry the eastern states and the business vote. He was sorely mistaken. Everywhere he went, Hoover was met with antagonism; anti-Hoover signs and protests were the norm. Hoover\u2019s public persona declined rapidly. Many news accounts reported that he seemed physically unwell, with an ashen face and shaking hands. Often, he seemed as though he would faint, and an aide constantly remained nearby with a chair in case he fell. In contrast, Roosevelt thrived on the campaign. He commented, \u201cI have looked into the faces of thousands of Americans, and they have the frightened look of lost children.\u201d \n\n The election results that November were never really in question: With three million more people voting than in 1928, Roosevelt won by a popular count of twenty-three million to fifteen million. He carried all but six states while winning over 57 percent of the popular vote. Whether they voted due to animosity towards Hoover for his relative inactivity, or out of hope for what Roosevelt would accomplish, the American public committed themselves to a new vision. Historians identify this election as the beginning of a new Democratic coalition, bringing together African Americans, other ethnic minorities, and organized labor as a voting bloc upon whom the party would rely for many of its electoral victories over the next fifty years. Unlike some European nations where similar challenges caused democratic constitutions to crumble and give way to radical ideologies and authoritarian governments, the Roosevelt administration changed the nation\u2019s economic fortunes with reforms, preserved the constitution, and expanded rather than limited the reach of democratic principles into the market economy. As a result, radical alternatives, such as the Fascist movement or Communist Party, remained on the margins of the nation\u2019s political culture. \n\n THE INTERREGNUM \n\n After the landslide election, the country\u2014and Hoover\u2014had to endure the  interregnum , the difficult four months between the election and President Roosevelt\u2019s inauguration in March 1933. Congress did not pass a single significant piece of legislation during this period, although Hoover spent much of the time trying to get Roosevelt to commit publicly to a legislative agenda of Hoover\u2019s choosing. Roosevelt remained gracious but refused to begin his administration as the incumbent\u2019s advisor without any legal authority necessary to change policy. Unwilling to tie himself to Hoover\u2019s legacy of failed policies, Roosevelt kept quiet when Hoover supported the passage of a national sales tax. Meanwhile, the country suffered from Hoover\u2019s inability to further drive a legislative agenda through Congress. It was the worst winter since the beginning of the Great Depression, and the banking sector once again suffered another round of panics. While Roosevelt kept his distance from the final tremors of the Hoover administration, the country continued to suffer in wait. In part as a response to the challenges of this time, the U.S. Constitution was subsequently amended to reduce the period from election to inauguration to the now-commonplace two months. \n\n Any ideas that Roosevelt held almost did not come to fruition, thanks to a would-be assassin\u2019s bullet. On February 15, 1933, after delivering a speech from his open car in Miami\u2019s Bayfront Park, local Italian bricklayer  Giuseppe Zangara  emerged from a crowd of well-wishers to fire six shots from his revolver. Although Roosevelt emerged from the assassination attempt unscathed, Zangara wounded five individuals that day, including Chicago Mayor Tony Cermak, who attended the speech in the hopes of resolving any long-standing differences with the president-elect. Roosevelt and his driver immediately rushed Cermak to the hospital where he died 19 days later. Roosevelt\u2019s calm and collected response to the event reassured many Americans of his ability to lead the nation through the challenges they faced. All that awaited was Roosevelt\u2019s inauguration before his ideas would unfold to the expectant public. So what was Roosevelt\u2019s plan? Before he took office, it seems likely that he was not entirely sure. Certain elements were known: He believed in positive government action to solve the Depression; he believed in federal relief, public works, social security, and unemployment insurance; he wanted to restore public confidence in banks; he wanted stronger government regulation of the economy; and he wanted to directly help farmers. But how to take action on these beliefs was more in question. A month before his inauguration, he said to his advisors, \u201cLet\u2019s concentrate upon one thing: Save the people and the nation, and if we have to change our minds twice every day to accomplish that end, we should do it.\u201d \n\n Unlike Hoover, who professed an ideology of \u201cAmerican individualism,\u201d an adherence that rendered him largely incapable of widespread action, Roosevelt remained pragmatic and open-minded to possible solutions. To assist in formulating a variety of relief and recovery programs, Roosevelt turned to a group of men who had previously orchestrated his election campaign and victory. Collectively known as the \u201cBrains Trust\u201d (a phrase coined by a  New York Times  reporter to describe the multiple \u201cbrains\u201d on Roosevelt\u2019s advisory team), the group most notably included Rexford Tugwell, Raymond Moley, and Adolph Berle. Moley, credited with bringing the group into existence, was a government professor who advocated for a new national tax policy to help the nation recover from its economic woes. Tugwell, who eventually focused his energy on the country\u2019s agricultural problems, saw an increased role for the federal government in setting wages and prices across the economy. Berle was a mediating influence, who often advised against a centrally controlled economy, but did see the role that the federal government could play in mediating the stark cycles of prosperity and depression that, if left unchecked, could result in the very situation in which the country presently found itself. Together, these men, along with others, advised Roosevelt through the earliest days of the New Deal and helped to craft significant legislative programs for congressional review and approval. \n\n INAUGURATION DAY: A NEW BEGINNING \n\n March 4, 1933, dawned gray and rainy. Roosevelt rode in an open car along with outgoing president Hoover, facing the public, as he made his way to the U.S. Capitol. Hoover\u2019s mood was somber, still personally angry over his defeat in the general election the previous November; he refused to crack a smile at all during the ride among the crowd, despite Roosevelt\u2019s urging to the contrary. At the ceremony, Roosevelt rose with the aid of leg braces equipped under his specially tailored trousers and placed his hand on a Dutch family Bible as he took his solemn oath. At that very moment, the rain stopped and the sun began to shine directly on the platform, and those present would later claim that it was as though God himself was shining down on Roosevelt and the American people in that moment ( Figure 26.4 ). \n\n Bathed in the sunlight, Roosevelt delivered one of the most famous and oft-quoted inaugural addresses in history. He encouraged Americans to work with him to find solutions to the nation\u2019s problems and not to be paralyzed by fear into inaction. Borrowing a wartime analogy provided by Moley, who served as his speechwriter at the time, Roosevelt called upon all Americans to assemble and fight an essential battle against the forces of economic depression. He famously stated, \u201cThe only thing we have to fear is fear itself.\u201d Upon hearing his inaugural address, one observer in the crowd later commented, \u201cAny man who can talk like that in times like these is worth every ounce of support a true American has.\u201d To borrow the popular song title of the day, \u201chappy days were here again.\u201d Foregoing the traditional inaugural parties, the new president immediately returned to the White House to begin his work to save the nation. \n 26.2   The First New Deal Learning Objectives By the end of this section, you should be able to:\n\n Identify the key pieces of legislation included in Roosevelt\u2019s \u201cFirst New Deal\u201d  \n\n Assess the strengths, weaknesses, and general effectiveness of the First New Deal \n\n Explain Roosevelt\u2019s overall vision for addressing the structural problems in the U.S. economy \n\n Much like a surgeon assessing the condition of an emergency room patient, Roosevelt began his administration with a broad, if not specific, strategy in mind: a combination of relief and recovery programs designed to first save the patient (in this case, the American people), and then to find a long-term cure (reform through federal regulation of the economy). What later became known as the \u201cFirst New Deal\u201d ushered in a wave of legislative activity seldom before seen in the history of the country. By the close of 1933, in an effort to stem the crisis, Congress had passed over fifteen significant pieces of legislation\u2014many of the circulated bills allegedly still wet with ink from the printing presses as members voted upon them. Most bills could be grouped around issues of relief, recovery, and reform. At the outset of the First New Deal, specific goals included 1) bank reform; 2) job creation; 3) economic regulation; and 4) regional planning. \n\n REFORM: THE BANKING CRISIS \n\n When Roosevelt took office, he faced one of the worst moments in the country\u2019s banking history. States were in disarray. New York and Illinois had ordered the closure of their banks in the hopes of avoiding further \u201cbank runs,\u201d which occurred when hundreds (if not thousands) of individuals ran to their banks to withdraw all of their savings. In all, over five thousand banks had been shuttered. Within forty-eight hours of his inauguration, Roosevelt proclaimed an official bank holiday and called Congress into a special session to address the crisis. The resulting  Emergency Banking Act  of 1933 was signed into law on March 9, 1933, a scant eight hours after Congress first saw it. The law officially took the country off the gold standard, a restrictive practice that, although conservative and traditionally viewed as safe, severely limited the circulation of paper money. Those who held gold were told to sell it to the U.S. Treasury for a discounted rate of a little over twenty dollars per ounce. Furthermore, dollar bills were no longer redeemable in gold. The law also gave the comptroller of currency the power to reorganize all national banks faced with insolvency, a level of federal oversight seldom seen prior to the Great Depression. Between March 11 and March 14, auditors from the Reconstruction Finance Corporation, the Treasury Department, and other federal agencies swept through the country, examining each bank. By March 15, 70 percent of the banks were declared solvent and allowed to reopen. \n\n On March 12, the day before the banks were set to reopen, Roosevelt held his first \u201c fireside chat \u201d ( Figure 26.5 ). In this initial radio address to the American people, he explained what the bank examiners had been doing over the previous week. He assured people that any bank open the next day had the federal government\u2019s stamp of approval. The combination of his reassuring manner and the promise that the government was addressing the problems worked wonders in changing the popular mindset. Just as the culture of panic had contributed to the country\u2019s downward spiral after the crash, so did this confidence-inducing move help to build it back up. Consumer confidence returned, and within weeks, close to $1 billion in cash and gold had been brought out from under mattresses and hidden bookshelves, and re-deposited in the nation\u2019s banks. The immediate crisis had been quelled, and the public was ready to believe in their new president. \n\n Defining American The Power of Hearth and Home Fireside chats\u2014Roosevelt\u2019s weekly radio addresses\u2014underscored Roosevelt\u2019s savvy in understanding how best to reach people. Using simple terms and a reassuring tone, he invoked a family patriarch sitting by the fire, explaining to those who trusted him how he was working to help them. It is worth noting how he explained complex financial concepts quite simply, but at the same time, complimented the American people on their \u201cintelligent support.\u201d One of his fireside chats is provided below: \n\n I recognize that the many proclamations from State capitols and from Washington, the legislation, the Treasury regulations, etc., couched for the most part in banking and legal terms, should be explained for the benefit of the average citizen. I owe this in particular because of the fortitude and good temper with which everybody has accepted the inconvenience and hardships of the banking holiday. I know that when you understand what we in Washington have been about I shall continue to have your cooperation as fully as I have had your sympathy and help during the past week. . . .  \n\n The success of our whole great national program depends, of course, upon the cooperation of the public\u2014on its intelligent support and use of a reliable system. . . . After all, there is an element in the readjustment of our financial system more important than currency, more important than gold, and that is the confidence of the people. Confidence and courage are the essentials of success in carrying out our plan. You people must have faith; you must not be stampeded by rumors or guesses. Let us unite in banishing fear. We have provided the machinery to restore our financial system; it is up to you to support and make it work. It is your problem no less than it is mine. Together we cannot fail. \u2014Franklin D. Roosevelt, March 12, 1933 \n\n A huge part of Roosevelt\u2019s success in turning around the country can be seen in his addresses like these: He built support and galvanized the public. Ironically, Roosevelt, the man who famously said we have nothing to fear but fear itself, had a significant fear: fire. Being paralyzed with polio, he was very afraid of being left near a fireplace. But he knew the power of the hearth and home, and drew on this mental image to help the public view him the way that he hoped to be seen. \n\n In June 1933, Roosevelt replaced the Emergency Banking Act with the more permanent  Glass-Steagall Banking Act . This law prohibited commercial banks from engaging in investment banking, therefore stopping the practice of banks speculating in the stock market with deposits. This law also created the Federal Deposit Insurance Corporation, or FDIC, which insured personal bank deposits up to $2,500. Other measures designed to boost confidence in the overall economy beyond the banking system included passage of the Economy Act, which fulfilled Roosevelt\u2019s campaign pledge to reduce government spending by reducing salaries, including his own and those of the Congress. He also signed into law the Securities Act, which required full disclosure to the federal government from all corporations and investment banks that wanted to market stocks and bonds. Roosevelt also sought new revenue through the Beer Tax. As the Twenty-First Amendment, which would repeal the Eighteenth Amendment establishing Prohibition, moved towards ratification, this law authorized the manufacture of 3.2 percent beer and levied a tax on it. \n\n THE FIRST HUNDRED DAYS \n\n In his first hundred days in office, the new president pushed forward an unprecedented number of new bills, all geared towards stabilizing the economy, providing relief to individuals, creating jobs, and helping businesses. A sympathetic Democrat-controlled Congress helped propel his agenda forward. \n\n Relief: Employment for the Masses \n\n Even as he worked to rebuild the economy, Roosevelt recognized that the unemployed millions required jobs more quickly than the economy could provide. In a push to create new jobs, Roosevelt signed the Wagner-Peyser Act, creating the United States Employment Service, which promised states matching funds if they created local employment opportunities. He also authorized $500 million in direct grants through the Federal Emergency Relief Act (FERA). This money went directly to states to infuse relief agencies with the much-needed resources to help the nearly fifteen million unemployed. These two bills illustrate Roosevelt\u2019s dual purposes of providing short-term emergency help and building employment opportunities that would strengthen the economy in the long term. \n\n Roosevelt was aware of the need for immediate help, but he mostly wanted to create more jobs. FERA overseer Harry Hopkins, who later was in charge of the  Civil Works Administration  (CWA), shared this sentiment. With Hopkins at its helm, the CWA, founded in early 1933, went on to put millions of men and women to work. At its peak, there were some four million Americans repairing bridges, building roads and airports, and undertaking other public projects. Another work program was the  Civilian Conservation Corps  Relief Act (CCC). The CCC provided government jobs for young men aged fourteen to twenty-four who came from relief families. They would earn thirty dollars per month planting trees, fighting forest fires, and refurbishing historic sites and parks, building an infrastructure that families would continue to enjoy for generations to come. Within the first two months, the CCC employed its first 250,000 men and eventually established about twenty-five hundred camps ( Figure 26.6 ). \n\n The various programs that made up the First New Deal are listed in the table below ( Table 26.1 ). \n\n New Deal Legislation \n\n Years Enacted \n\n Brief Description \n\n Agricultural Adjustment Administration(AAA) \n\n 1933\u20131935 \n\n Farm program designed to raise process by curtailing production \n\n Civil Works Administration(CWA) \n\n 1933\u20131934 \n\n Temporary job relief program \n\n Civilian Conservation Corps(CCC) \n\n 1933\u20131942 \n\n Employed young men to work in rural areas \n\n Farm Credit Administration(FCA) \n\n 1933-today \n\n Low interest mortgages for farm owners \n\n Federal Deposit Insurance Corporation(FDIC) \n\n 1933\u2013today \n\n Insure private bank deposits \n\n Federal Emergency Relief Act \n\n 1933 \n\n Direct monetary relief to poor unemployed Americans \n\n Glass-Steagall Act \n\n 1933\u20131999 \n\n Separate commercial and investment banking \n\n Homeowners Loan Corporation \n\n 1933\u20131951 \n\n Government mortgages that allowed people to keep their homes \n\n Indian Reorganization Act \n\n 1933 \n\n Abandoned federal policy of assimilation \n\n National Recovery Administration(NRA) \n\n 1933\u20131935 \n\n Industries agree to codes of fair practice to set price, wage, production levels \n\n Public Works Administration(PWA) \n\n 1933\u20131938 \n\n Large public works projects \n\n Resettlement Administration \n\n 1933\u20131935 \n\n Resettles poor tenant farmers \n\n Securities Act of 1933 \n\n 1933\u2013today \n\n Created SEC; regulates stock transactions \n\n Tennessee Valley Authority(TVA) \n\n 1933\u2013today \n\n Regional development program; brought electrification to the valley \n\n Table  26.1   Key Programs from the First New Deal   The final element of Roosevelt\u2019s efforts to provide relief to those in desperate straits was the Home Owners\u2019 Refinancing Act. Created by the Home Owners\u2019 Loan Corporation (HOLC), the program rescued homeowners from foreclosure by refinancing their mortgages. Not only did this save the homes of countless homeowners, but it also saved many of the small banks who owned the original mortgages by relieving them of the refinancing responsibility. Later New Deal legislation created the Federal Housing Authority, which eventually standardized the thirty-year mortgage and promoted the housing boom of the post-World War II era. A similar program, created through the Emergency Farm Mortgage Act and Farm Credit Act, provided the same service for farm mortgages. \n\n Rescuing Farms and Factories \n\n While much of the legislation of the first hundred days focused on immediate relief and job creation through federal programs, Roosevelt was committed to addressing the underlying problems inherent in the American economy. In his efforts to do so, he created two of the most significant pieces of New Deal legislation: the Agricultural Adjustment Act (AAA) and the National Industry Recovery Act (NIRA). \n\n Farms around the country were suffering, but from different causes. In the Great Plains, drought conditions meant that little was growing at all, while in the South, bumper crops and low prices meant that farmers could not sell their goods at prices that could sustain them. The AAA offered some direct relief: Farmers received $4.5 million through relief payments. But the larger part of the program paid southern farmers to reduce their production: Wheat, cotton, corn, hogs, tobacco, rice, and milk farmers were all eligible. Passed into law on May 12, 1933, it was designed to boost prices to a level that would alleviate rural poverty and restore profitability to American agriculture. These price increases would be achieved by encouraging farmers to limit production in order to increase demand while receiving cash payments in return. Corn producers would receive thirty cents per bushel for corn they did not grow. Hog farmers would get five dollars per head for hogs not raised. The program would be financed by a tax on processing plants, passed on to consumers in the form of higher prices. \n\n This was a bold attempt to help farmers address the systemic problems of overproduction and lower commodity prices. Despite previous efforts to regulate farming through subsidies, never before had the federal government intervened on this scale; the notion of paying farmers  not  to produce crops was unheard of. One significant problem, however, was that, in some cases, there was already an excess of crops, in particular, cotton and hogs, which clogged the marketplace. A bumper crop in 1933, combined with the slow implementation of the AAA, led the government to order the plowing under of ten million acres of cotton, and the butchering of six million baby pigs and 200,000 sows. Although it worked to some degree\u2014the price of cotton increased from six to twelve cents per pound\u2014this move was deeply problematic. Critics saw it as the ultimate example of corrupt capitalism: a government destroying food, while its citizens were starving, in order to drive up prices. \n\n Another problem plaguing this relief effort was the disparity between large commercial farms, which received the largest payments and set the quotas, and the small family farms that felt no relief. Large farms often cut production by laying off sharecroppers or evicting tenant farmers, making the program even worse for them than for small farm owners. Their frustration led to the creation of the  Southern Tenant Farmers Union  (STFU), an interracial organization that sought to gain government relief for these most disenfranchised of farmers. The STFU organized, protested, and won its members some wage increases through the mid-1930s, but the overall plight of these workers remained dismal. As a result, many of them followed the thousands of Dust Bowl refugees to California ( Figure 26.7 ). \n\n Americana Labor Songs and the Southern Tenant Farmers Union And if the growers get in the way, we\u2019re gonna roll right over them \n\nWe\u2019re gonna roll right over them, we\u2019re gonna roll right over them \n\nAnd if the growers get in the way, we\u2019re gonna roll right over them \n\nWe\u2019re gonna roll this union on \n\n\u2014John Handcox, \u201cRoll the Union On\u201d \n\n \u201cMean Things Happening in This Land,\u201d \u201cRoll the Union On,\u201d and \u201cStrike in Arkansas\u201d are just a few of the folk songs written by John Handcox. A union organizer and STFU member, Handcox became the voice of the worker\u2019s struggle, writing dozens of songs that have continued to be sung by labor activists and folk singers over the years. Handcox joined the STFU in 1935, and used his songs to rally others, stating, \u201cI found out singing was more inspiring than talking . . . to get the attention of the people.\u201d Racially integrated and with active women members, the STFU was ahead of its time. Although criticized by other union leaders for its relationship with the Communist Party in creating the \u201cPopular Front\u201d for labor activism in 1934, the STFU succeeded in organizing strikes and bringing national attention to the issues that tenant farmers faced. While the programs Roosevelt put in place did not do enough to help these farmers, the STFU\u2014and Handcox\u2019s music\u2014remains a relevant part of the country\u2019s labor movement. \n\n The AAA did succeed on some fronts. By the spring of 1934, farmers had formed over four thousand local committees, with more than three million farmers agreeing to participate. They signed individual contracts agreeing to take land out of production in return for government payments, and checks began to arrive by the end of 1934. For some farmers, especially those with large farms, the program spelled relief. \n\n While Roosevelt hoped the AAA would help farms and farmers, he also sought aid for the beleaguered manufacturing sector. The Emergency Railroad Transportation Act created a national railroad office to encourage cooperation among different railroad companies, hoping to shore up an industry essential to the stability of the manufacturing sector, but one that had been devastated by mismanagement. More importantly, the NIRA suspended antitrust laws and allowed businesses and industries to work together in order to establish codes of fair competition, including issues of price setting and minimum wages. New Deal officials believed that allowing these collaborations would help industries stabilize prices and production levels in the face of competitive overproduction and declining profits; however, at the same time, many felt it important to protect workers from potentially unfair agreements. \n\n A new government agency, the  National Recovery Administration  (NRA), was central to this plan, and mandated that businesses accept a code that included minimum wages and maximum work hours. In order to protect workers from potentially unfair agreements among factory owners, every industry had its own \u201ccode of fair practice\u201d that included workers\u2019 rights to organize and use collective bargaining to ensure that wages rose with prices ( Figure 26.8 ). Headed by General Hugh S. Johnson, the NRA worked to create over five hundred different codes for different industries. The administration of such a complex plan naturally created its own problems. While codes for key industries such as automotive and steel made sense, Johnson pushed to create similar codes for dog food manufacturers, those who made shoulder pads for women\u2019s clothing, and even burlesque shows (regulating the number of strippers in any one show). \n\n The NIRA also created the Public Works Administration (PWA). The PWA set aside $3.3 billion to build public projects such as highways, federal buildings, and military bases. Although this program suffered from political squabbles over appropriations for projects in various congressional districts, as well as significant underfunding of public housing projects, it ultimately offered some of the most lasting benefits of the NIRA. Secretary of the Interior Harold Ickes ran the program, which completed over thirty-four thousand projects, including the Golden Gate Bridge in San Francisco and the Queens-Midtown Tunnel in New York. Between 1933 and 1939, the PWA accounted for the construction of over one-third of all new hospitals and 70 percent of all new public schools in the country. \n\n Another challenge faced by the NRA was that the provision granting workers the right to organize appeared to others as a mandate to do so. In previously unorganized industries, such as oil and gas, rubber, and service occupations, workers now sought groups that would assist in their organization, bolstered by the encouragement they now felt from the government. The Communist Party took advantage of the opportunity to assist in the hope of creating widespread protests against the American industrial structure. The number of strikes nationwide doubled between 1932 and 1934, with over 1.5 million workers going on strike in 1934 alone, often in protests that culminated in bloodshed. A strike at the Auto-Lite plant in Toledo, Ohio, that summer resulted in ten thousand workers from other factories joining in sympathy with their fellow workers to attack potential strike-breakers with stones and bricks. Simultaneously in Minneapolis, a teamsters strike resulted in frequent, bloody confrontations between workers and police, leading the governor to contemplate declaring martial law before the companies agreed to negotiate better wages and conditions for the workers. Finally, a San Francisco strike among 14,000 longshoremen closed the city\u2019s waterfront and eventually led to a city-wide general strike of over 130,000 workers, essentially paralyzing the city. Clashes between workers, and police and National Guardsmen left many strikers bloodied, and at least two dead. \n\n Although Roosevelt\u2019s relief efforts provided jobs to many and benefitted communities with the construction of several essential building projects, the violence that erupted amid clashes between organized labor and factories backed by police and the authorities exposed a fundamental flaw in the president\u2019s approach. Immediate relief did not address long-existing, inherent class inequities that left workers exposed to poor working conditions, low wages, long hours, and little protection. For many workers, life on the job was not much better than life as an unemployed American. Employment programs may have put men back to work and provided much needed relief, but the fundamental flaws in the system required additional attention\u2014attention that Roosevelt was unable to pay in the early days of the New Deal. Critics were plentiful, and the president would be forced to address them in the years ahead. \n\n Regional Planning \n\n Regionally, Roosevelt\u2019s work was most famously seen in the  Tennessee Valley Authority  (TVA) ( Figure 26.9 ), a federal agency tasked with the job of planning and developing the area through flood control, reforestation, and hydroelectric power. Employing several thousand Americans on a project that Roosevelt envisioned as a template for future regional redevelopment, the TVA revitalized a river valley that landowners had badly over-farmed, leaving behind eroded soil that lacked essential nutrients for future farming. Under the direction of David Lilienthal, beginning in 1933, the TVA workers erected a series of dams to harness the Tennessee River in the creation of much-needed  hydroelectric power . The arrival of both electric lighting and machinery to the region eased the lives of the people who lived there, as well as encouraged industrial growth. The TVA also included an educational component, teaching farmers important lessons about crop rotation, soil replenishment, fertilizing, and reforestation. \n\n The TVA was not without its critics, however, most notably among the fifteen thousand families who were displaced due to the massive construction projects. Although eventually the project benefited farmers with the introduction of new farming and fertilizing techniques, as well as the added benefit of electric power, many local citizens were initially mistrustful of the TVA and the federal government\u2019s agenda. Likewise, as with several other New Deal programs, women did not directly benefit from these employment opportunities, as they were explicitly excluded for the benefit of men who most Americans still considered the family\u2019s primary breadwinner. However, with the arrival of electricity came new industrial ventures, including several textile mills up and down the valley, several of which offered employment to women. Throughout his presidency, Roosevelt frequently pointed to the TVA as one of the glowing accomplishments of the New Deal and its ability to bring together the machinery of the federal government along with private interests to revitalize a regional economy. Just months before his death in 1945, he continued to speak of the possibility of creating other regional authorities throughout the country. \n\n ASSESSING THE FIRST NEW DEAL \n\n While many were pleased with the president\u2019s bold plans, there were numerous critics of the New Deal, discussed in the following section. The New Deal was far from perfect, but Roosevelt\u2019s quickly implemented policies reversed the economy\u2019s long slide. It put new capital into ailing banks. It rescued homeowners and farmers from foreclosure and helped people keep their homes. It offered some direct relief to the unemployed poor. It gave new incentives to farmers and industry alike, and put people back to work in an effort to both create jobs and boost consumer spending. The total number of working Americans rose from twenty-four to twenty-seven million between 1933 and 1935, in contrast to the seven-million-worker decline during the Hoover administration. Perhaps most importantly, the First New Deal changed the pervasive pessimism that had held the country in its grip since the end of 1929. For the first time in years, people had hope. \n\n It was the hard work of Roosevelt\u2019s advisors\u2014the \u201cBrains Trust\u201d of scholars and thinkers from leading universities\u2014as well as Congress and the American public who helped the New Deal succeed as well as it did. Ironically, it was the American people\u2019s volunteer spirit, so extolled by Hoover, that Roosevelt was able to harness. The first hundred days of his administration was not a master plan that Roosevelt dreamed up and executed on his own. In fact, it was not a master plan at all, but rather a series of, at times, disjointed efforts made from different assumptions. But after taking office and analyzing the crisis, Roosevelt and his advisors did feel that they had a larger sense of what had caused the Great Depression and thus attempted a variety of solutions to fix it. They believed that it was caused by abuses on the part of a small group of bankers and businessmen, aided by Republican policies that built wealth for a few at the expense of many. The answer, they felt, was to root out these abuses through banking reform, as well as adjust production and consumption of both farm and industrial goods. This adjustment would come about by increasing the purchasing power of everyday people, as well as through regulatory policies like the NRA and AAA. While it may seem counterintuitive to raise crop prices and set prices on industrial goods, Roosevelt\u2019s advisors sought to halt the deflationary spiral and economic uncertainty that had prevented businesses from committing to investments and consumers from parting with their money. \n 26.3   The Second New Deal Learning Objectives By the end of this section, you should be able to:\n\n Identify key pieces of legislation from the Second New Deal \n\n Assess the entire New Deal, especially in terms of its impact on women, African Americans, and Native Americans \n\n Roosevelt won his second term in a landslide, but that did not mean he was immune to criticism. His critics came from both the left and the right, with conservatives deeply concerned over his expansion of government spending and power, and liberals angered that he had not done more to help those still struggling. Adding to Roosevelt\u2019s challenges, the Supreme Court struck down several key elements of the First New Deal, angering Roosevelt and spurring him to try and stack the courts in his second term. Still, he entered his new term with the unequivocal support of the voting public, and he wasted no time beginning the second phase of his economic plan. While the First New Deal focused largely on stemming the immediate suffering of the American people, the Second New Deal put in place legislation that changed America\u2019s social safety net for good. \n\n CHALLENGES FROM CRITICS ON ALL SIDES \n\n While many people supported Roosevelt, especially in the first few years of his presidency, the New Deal did receive significant criticism, both from conservatives who felt that it was a radical agenda to ruin the country\u2019s model of free enterprise, and from liberals who felt that it did not provide enough help to those who needed it most ( Figure 26.10 ). \n\n Industrialists and wealthy Americans led the conservative criticism against the president. Whether attacking his character or simply stating that he was moving away from American values toward fascism and socialism, they sought to undermine his power and popularity. Most notably, the American Liberty League\u2014comprised largely of conservative Democrats who lamented the excesses of several of Roosevelt\u2019s New Deal programs\u2014labeled the AAA as fascist and proclaimed later New Deal programs to be key threats to the very nature of democracy. Additional criticism came from the National Association of Manufacturers, which urged businessmen to outright ignore portions of the NRA that promoted collective bargaining, as well as subsequent labor protection legislation. In 1935, the U.S. Supreme Court dealt the most crushing blow to Roosevelt\u2019s vision, striking down several key pieces of the New Deal as unconstitutional. They found that both the AAA and the NIRA overreached federal authority. The negation of some of his most ambitious economic recovery efforts frustrated Roosevelt greatly, but he was powerless to stop it at this juncture. \n\n Meanwhile, others felt that Roosevelt had not done enough. Dr. Francis E. Townsend of California was one who felt that Roosevelt had failed to adequately address the country\u2019s tremendous problems. Townsend, who was a retired dentist, proposed an expansive pension plan for the elderly. The Townsend Plan, as it was known, gained a great deal of popularity: It recommended paying every citizen over sixty who retired from work the sum of $200 per month, provided they spend it in thirty days. Another figure who gained national attention was Father Charles Coughlin. He was a \u201cradio priest\u201d from Michigan who, although he initially supported the New Deal, subsequently argued that Roosevelt stopped far too short in his defense of labor, monetary reform, and the nationalization of key industries. The president\u2019s plan, he proclaimed, was inadequate. He created the National Union for Social Justice and used his weekly radio show to gain followers. \n\n A more direct political threat to Roosevelt came from muckraker Upton Sinclair, who pursued the California governorship in 1934 through a campaign based upon criticism of the New Deal\u2019s shortcomings. In his \u201cEnd Poverty in California\u201d program, Sinclair called for a progressive income tax, a pension program for the elderly, and state seizure of factories and farms where property taxes remained unpaid. The state would then offer jobs to the unemployed to work those farms and factories in a cooperative mode. Although Sinclair lost the election to his Republican opponent, he did draw local and national attention to several of his ideas. \n\n The biggest threat to the president, however, came from corrupt but beloved Louisiana senator  Huey \u201cKingfish\u201d Long  ( Figure 26.11 ). His disapproval of Roosevelt came in part from his own ambitions for higher office; Long stated that the president was not doing enough to help people and proposed his own Share Our Wealth program. Under this plan, Long recommended the liquidation of all large personal fortunes in order to fund direct payments to less fortunate Americans. He foresaw giving $5,000 to every family, $2,500 to every worker, as well as a series of elderly pensions and education funds. Despite his questionable math, which numerous economists quickly pointed out rendered his program unworkable, by 1935, Long had a significant following of over four million people. If he had not been assassinated by the son-in-law of a local political rival, he may well have been a contender against Roosevelt for the 1936 presidential nomination. \n\n ANSWERING THE CHALLENGE \n\n Roosevelt recognized that some of the criticisms of the New Deal were valid. Although he was still reeling from the Supreme Court\u2019s invalidation of key statutes, he decided to face his re-election bid in 1936 by unveiling another wave of legislation that he dubbed the Second New Deal. In the first week of June 1935, Roosevelt called congressional leaders into the White House and gave them a list of \u201cmust-pass\u201d legislation that he wanted before they adjourned for the summer. Whereas the policies of the first hundred days may have shored up public confidence and stopped the most drastic of the problems, the second hundred days changed the face of America for the next sixty years. \n\n The  Banking Act of 1935  was the most far-reaching revision of banking laws since the creation of the Federal Reserve System in 1914. Previously, regional reserve banks, particularly the New York Reserve Bank\u2014controlled by the powerful Morgan and Rockefeller families\u2014had dominated policy-making at the Federal Reserve. Under the new system, there would be a seven-member board of governors to oversee regional banks. They would have control over reserve requirements, discount rates, board member selection, and more. Not surprisingly, this new board kept initial interest rates quite low, allowing the federal government to borrow billions of dollars of additional cash to fund major relief and recovery programs. \n\n In 1935, Congress also passed the Emergency Relief Appropriation Act, which authorized the single largest expenditure at that time in the country\u2019s history: $4.8 billion. Almost one-third of those funds were invested in a new relief agency, the  Works Progress Administration  (WPA). Harry Hopkins, formerly head of the CWA, took on the WPA and ran it until 1943. In that time, the program provided employment relief to over eight million Americans, or approximately 20 percent of the country\u2019s workforce. The WPA funded the construction of more than 2,500 hospitals, 5,900 schools, 570,000 miles of road, and more. The WPA also created Federal Project Number One, which employed approximately forty thousand artists in theater, art, music, and writing. They produced state murals, guidebooks, concerts, and drama performances all around the country ( Figure 26.12 ). Additionally, the project funded the collection of oral histories, including those of formerly enslaved people, which provided a valuable addition to the nation\u2019s understanding of slave life. Finally, the WPA also included the National Youth Administration (NYA), which provided work-study jobs to over 500,000 college students and four million high school students. \n\n With the implementation of the Second New Deal, Roosevelt also created the country\u2019s present-day social safety net. The  Social Security  Act established programs intended to help the most vulnerable: the elderly, the unemployed, the disabled, and the young. It included a pension fund for all retired people\u2014except domestic workers and farmers, which therefore left many women and African Americans beyond the scope of its benefits\u2014over the age of sixty-five, to be paid through a payroll tax on both employee and employer. Related to this act, Congress also passed a law on unemployment insurance, to be funded by a tax on employers, and programs for unwed mothers, as well as for those who were blind, deaf, or disabled. It is worth noting that some elements of these reforms were pulled from Roosevelt detractors Coughlin and Townsend; the popularity of their movements gave the president more leverage to push forward this type of legislation. \n\n To the benefit of industrial workers, Roosevelt signed into law the Wagner Act, also known as the National Labor Relations Act. The protections previously afforded to workers under the NIRA were inadvertently lost when the Supreme Court struck down the original law due to larger regulatory concerns, leaving workers vulnerable. Roosevelt sought to salvage this important piece of labor legislation, doing so with the Wagner Act. The act created the  National Labor Relations Board  (NLRB) to once again protect American workers\u2019 right to unionize and bargain collectively, as well as to provide a federal vehicle for labor grievances to be heard. Although roundly criticized by the Republican Party and factory owners, the Wagner Act withstood several challenges and eventually received constitutional sanction by the U.S. Supreme Court in 1937. The law received the strong support of John L. Lewis and the Congress of Industrial Organizations who had long sought government protection of industrial unionism, from the time they split from the American Federation of Labor in 1935 over disputes on whether to organize workers along craft or industrial lines. Following passage of the law, Lewis began a widespread publicity campaign urging industrial workers to join \u201cthe president\u2019s union.\u201d The relationship was mutually beneficial to Roosevelt, who subsequently received the endorsement of Lewis\u2019s United Mine Workers union in the 1936 presidential election, along with a sizeable $500,000 campaign contribution. The Wagner Act permanently established government-secured workers\u2019 rights and protections from their employers, and it marked the beginning of labor\u2019s political support for the Democratic Party. \n\n The various programs that made up the Second New Deal are listed in the table below ( Table 26.2 ). \n\n New Deal Legislation \n\n Years Enacted \n\n Brief Description \n\n Fair Labor Standards Act \n\n 1938\u2013today \n\n Established minimum wage and forty-hour workweek \n\n Farm Security Administration \n\n 1935\u2013today \n\n Provides poor farmers with education and economic support programs \n\n Federal Crop Insurance Corporation \n\n 1938\u2013today \n\n Insures crops and livestock against loss of revenue \n\n National Labor Relations Act \n\n 1935\u2013today \n\n Recognized right of workers to unionize & collectively bargain \n\n National Youth Administration \n\n 1935\u20131939 (part of WPA) \n\n Part-time employment for college and high school students \n\n Rural Electrification Administration \n\n 1935\u2013today \n\n Provides public utilities to rural areas \n\n Social Security Act \n\n 1935\u2013today \n\n Aid to retirees, unemployed, disabled \n\n Surplus Commodities Program \n\n 1936\u2013today \n\n Provides food to the poor (still exists in Food Stamps program) \n\n Works Progress Administration \n\n 1935\u20131943 \n\n Jobs program (including artists and youth) \n\n Table  26.2   Key Programs from the Second New Deal   \n\n THE FINAL PIECES \n\n Roosevelt entered the 1936 presidential election on a wave of popularity, and he beat Republican opponent Alf Landon by a nearly unanimous Electoral College vote of 523 to 8. Believing it to be his moment of strongest public support, Roosevelt chose to exact a measure of revenge against the U.S. Supreme Court for challenging his programs and to pressure them against challenging his more recent Second New Deal provisions. To this end, Roosevelt created the informally named \u201c Supreme Court Packing Plan \u201d and tried to pack the court in his favor by expanding the number of justices and adding new ones who supported his views. His plan was to add one justice for every current justice over the age of seventy who refused to step down. This would have allowed him to add six more justices, expanding the bench from nine to fifteen. Opposition was quick and thorough from both the Supreme Court and Congress, as well as from his own party. The subsequent retirement of Justice Van Devanter from the court, as well as the sudden death of Senator Joe T. Robinson, who championed Roosevelt\u2019s plan before the Senate, all but signaled Roosevelt\u2019s defeat. However, although he never received the support to make these changes, Roosevelt appeared to succeed in politically intimidating the current justices into supporting his newer programs, and they upheld both the Wagner Act and the Social Security Act. Never again during his presidency would the Supreme Court strike down any significant elements of his New Deal. \n\n Roosevelt was not as successful in addressing the nation\u2019s growing deficit. When he entered the presidency in 1933, Roosevelt did so with traditionally held fiscal beliefs, including the importance of a balanced budget in order to maintain public confidence in federal government operations. However, the severe economic conditions of the depression quickly convinced the president of the importance of government spending to create jobs and relief for the American people. As he commented to a crowd in Pittsburgh in 1936, \u201cTo balance our budget in 1933 or 1934 or 1935 would have been a crime against the American people. To do so . . . we should have had to set our face against human suffering with callous indifference. When Americans suffered, we refused to pass by on the other side. Humanity came first.\u201d However, after his successful re-election, Roosevelt anticipated that the economy would recover enough by late 1936 that he could curtail spending by 1937. This reduction in spending, he hoped, would curb the deficit. As the early months of 1937 unfolded, Roosevelt\u2019s hopes seemed supported by the most recent economic snapshot of the country. Production, wages, and profits had all returned to pre-1929 levels, while unemployment was at its lowest rate in the decade, down from 25 percent to 14 percent. But no sooner did Roosevelt cut spending when a recession hit. Two million Americans were newly out of work as unemployment quickly rose by 5 percent and industrial production declined by a third. Breadlines began to build again, while banks prepared to close. Historians continue to debate the causes of this recession within a depression. Some believe the fear of increased taxes forced factory owners to curtail planned expansion; others blame the Federal Reserve for tightening the nation\u2019s money supply. Roosevelt, however, blamed the downturn on his decision to significantly curtail federal government spending in job relief programs such as the WPA. Several of his closest advisors, including Harry Hopkins, Henry Wallace, and others, urged him to adopt the new economic theory espoused by British economic John Maynard Keynes, who argued that deficit spending was necessary in advanced capitalist economies in order to maintain employment and stimulate consumer spending. Convinced of the necessity of such an approach, Roosevelt asked Congress in the spring of 1938 for additional emergency relief spending. Congress immediately authorized $33 billion for PWA and WPA work projects. Although World War II would provide the final impetus for lasting economic recovery, Roosevelt\u2019s willingness to adapt in 1938 avoided another disaster. \n\n Roosevelt signed the last substantial piece of New Deal legislation in the summer of 1938. The Fair Labor Standards Act established a federal minimum wage\u2014at the time, forty-five-cents per hour\u2014a maximum workweek of forty hours (with an opportunity for four additional hours of work at overtime wages), and prohibited child labor for those under age sixteen. Roosevelt was unaware that the war would soon dominate his legacy, but this proved to be his last major piece of economic legislation in a presidency that changed the fabric of the country forever. \n\n IN THE FINAL ANALYSIS \n\n The legacy of the New Deal is in part seen in the vast increase in national power: The federal government accepted responsibility for the nation\u2019s economic stability and prosperity. In retrospect, the majority of historians and economists judge it to have been a tremendous success. The New Deal not only established minimum standards for wages, working conditions, and overall welfare, it also allowed millions of Americans to hold onto their homes, farms, and savings. It laid the groundwork for an agenda of expanded federal government influence over the economy that continued through President Harry Truman\u2019s \u201cFair Deal\u201d in the 1950s and President Lyndon Johnson\u2019s call for a \u201cGreat Society\u201d in the 1960s. The New Deal state that embraced its responsibility for the citizens\u2019 welfare and proved willing to use its power and resources to spread the nation\u2019s prosperity lasted well into the 1980s, and many of its tenets persist today. Many would also agree that the postwar economic stability of the 1950s found its roots in the stabilizing influences introduced by social security, the job stability that union contracts provided, and federal housing mortgage programs introduced in the New Deal. The environment of the American West in particular, benefited from New Deal projects such as the Soil Conservation program. \n\n Still, Roosevelt\u2019s programs also had their critics. Following the conservative rise initiated by presidential candidate Barry Goldwater in 1964, and most often associated with the Ronald Reagan era of the 1980s, critics of the welfare state pointed to Roosevelt\u2019s presidency as the start of a slippery slope towards entitlement and the destruction of the individualist spirit upon which the United States had presumably developed in the nineteenth and early twentieth centuries. Although the growth of the GDP between 1934 and 1940 approached an average of 7.5 percent\u2014higher than in any other peacetime period in U.S. history, critics of the New Deal point out that unemployment still hovered around 15 percent in 1940. While the New Deal resulted in some environmental improvements, it also inaugurated a number of massive infrastructural projects, such as the Grand Coulee Dam on the Columbia River, that came with grave environmental consequences. And other shortcomings of the New Deal were obvious and deliberate at the time. \n\n African Americans under the New Deal \n\n Critics point out that not all Americans benefited from the New Deal. African Americans in particular were left out, with overt discrimination in hiring practices within the federal job programs, such as the CCC, CWA, and WPA. The NRA was oftentimes criticized as the \u201cNegro Run Around\u201d or \u201cNegroes Ruined Again\u201d program. As well, the AAA left tenant farmers and sharecroppers, many of whom were Black, with no support. Even Social Security originally excluded domestic workers, a primary source of employment for African American women. Facing such criticism early in his administration, Roosevelt undertook some efforts to ensure a measure of equality in hiring practices for the relief agencies, and opportunities began to present themselves by 1935. The WPA eventually employed 350,000 African Americans annually, accounting for nearly 15 percent of its workforce. By the close of the CCC in 1938, this program had employed over 300,000 African Americans, increasing the Black percentage of its workforce from 3 percent at the outset to nearly 11 percent at its close. Likewise, in 1934, the PWA began to require that all government projects under its purview hire African Americans using a quota that reflected their percentage of the local population being served. Additionally, among several important WPA projects, Federal Project Number One included a literacy program that eventually reached over one million African American children, helping them learn how to read and write. \n\n On the issue of race relations themselves, Roosevelt has a mixed legacy. Within his White House, Roosevelt had a number of African American appointees, although most were in minor positions. Unofficially, Roosevelt relied upon advice from the Federal Council on Negro Affairs, also known as his \u201c Black Cabinet .\u201d This group included a young Harvard economist, Dr. Robert Weaver, who subsequently became the nation\u2019s first Black cabinet secretary in 1966, as President Lyndon Johnson\u2019s Secretary of Housing and Urban Development. Aubrey Williams, the director of the NYA, hired more Black administrators than any other federal agency, and appointed them to oversee projects throughout the country. One key figure in the NYA was  Mary McLeod Bethune  ( Figure 26.13 ), a prominent African American educator tapped by Roosevelt to act as the director of the NYA\u2019s Division of Negro Affairs. Bethune had been a spokesperson and an educator for years; with this role, she became one of the president\u2019s foremost African American advisors. During his presidency, Roosevelt became the first to appoint a Black federal judge, as well as the first commander-in-chief to promote an African American to brigadier general. Most notably, he became the first president to publicly speak against lynching as a \u201cvile form of collective murder.\u201d \n\n My Story Mary McLeod Bethune on Racial Justice Democracy is for me, and for twelve million Black Americans, a goal towards which our nation is marching. It is a dream and an ideal in whose ultimate realization we have a deep and abiding faith. For me, it is based on Christianity, in which we confidently entrust our destiny as a people. Under God\u2019s guidance in this great democracy, we are rising out of the darkness of slavery into the light of freedom. Here my race has been afforded [the] opportunity to advance from a people 80 percent illiterate to a people 80 percent literate; from abject poverty to the ownership and operation of a million farms and 750,000 homes; from total disfranchisement to participation in government; from the status of chattels to recognized contributors to the American culture. \n\n When Mary McLeod Bethune spoke these words, she spoke on behalf of a race of American citizens for whom the Great Depression was much more than economic hardship. For African Americans, the Depression once again exposed the racism and inequality that gripped the nation economically, socially, and politically. Her work as a member of President Franklin Roosevelt\u2019s unofficial \u201cBlack Cabinet\u201d as well as the Director of the Division of Negro Affairs for the NYA, presented her an opportunity to advance African American causes on all fronts\u2014but especially in the area of Black literacy. As part of the larger WPA, she also influenced employment programs in the arts and public work sectors, and routinely had the president\u2019s ear on matters related to racial justice. \n\n However, despite these efforts, Roosevelt also understood the precariousness of his political position. In order to maintain a coalition of Democrats to support his larger relief and recovery efforts, Roosevelt could not afford to alienate Southern Democrats who might easily bolt should he openly advocate for civil rights. While he spoke about the importance of anti-lynching legislation, he never formally pushed Congress to propose such a law. He did publicly support the abolition of the poll tax, which Congress eventually accomplished in 1941. Likewise, although agency directors adopted changes to ensure job opportunities for African Americans at the federal level, at the local level, few advancements were made, and African Americans remained at the back of the employment lines. Despite such failures, however, Roosevelt deserves credit for acknowledging the importance of race relations and civil rights. At the federal level, more than any of his predecessors since the Civil War, Roosevelt remained aware of the role that the federal government can play in initiating important discussions about civil rights, as well as encouraging the development of a new cadre of civil rights leaders. \n\n Although unable to bring about sweeping civil rights reforms for African Americans in the early stages of his administration, Roosevelt was able to work with Congress to significantly improve the lives of Native Americans. In 1934, he signed into law the Indian Reorganization Act (sometimes referred to as the \u201cIndian New Deal\u201d). This law formally abandoned the assimilationist policies set forth in the Dawes Severalty Act of 1887. Rather than forcing Native Americans to adapt to American culture, the new program encouraged them to develop forms of local self-government, as well as to preserve their artifacts and heritage. John Collier, the Commissioner on Indian Bureau Affairs from 1933 to 1945, championed this legislation and saw it as an opportunity to correct past injustices that land allotment and assimilation had wrought upon Native peoples. Although the re-establishment of communal tribal lands would prove to be difficult, Collier used this law to convince federal officials to return nearly two million acres of government-held land to various tribes in order to move the process along. Although subsequent legislation later circumscribed the degree to which tribes were allowed to self-govern on reservations, Collier\u2019s work is still viewed as a significant step in improving race relations with Native Americans and preserving their heritage. \n\n Women and the New Deal \n\n For women, Roosevelt\u2019s policies and practices had a similarly mixed effect. Wage discrimination in federal jobs programs was rampant, and relief policies encouraged women to remain home and leave jobs open for men. This belief was well in line with the gender norms of the day. Several federal relief programs specifically forbade husbands and wives\u2019 both drawing jobs or relief from the same agency. The WPA became the first specific New Deal agency to openly hire women\u2014specifically widows, single women, and the wives of disabled husbands. While they did not take part in construction projects, these women did undertake sewing projects to provide blankets and clothing to hospitals and relief agencies. Likewise, several women took part in the various Federal One art projects. Despite the obvious gender limitations, many women strongly supported Roosevelt\u2019s New Deal, as much for its direct relief handouts for women as for its employment opportunities for men. One such woman was Mary (Molly) Dewson. A longtime activist in the women\u2019s suffrage movement, Dewson worked for women\u2019s rights and ultimately rose to be the Director of the Women\u2019s Division of the Democratic Party. Dewson and Mary McLeod Bethune, the national champion of African American education and literacy who rose to the level of Director of the Division of Negro Affairs for the NYA, understood the limitations of the New Deal, but also the opportunities for advancement it presented during very trying times. Rather than lamenting what Roosevelt could not or would not do, they felt, and perhaps rightly so, that Roosevelt would do more than most to help women and African Americans achieve a piece of the new America he was building. \n\n Among the few, but notable, women who directly impacted Roosevelt\u2019s policies was Frances Perkins, who as Secretary of Labor was the first female member of any presidential cabinet, and First Lady Eleanor Roosevelt, who was a strong and public advocate for social causes. Perkins, one of only two original Cabinet members to stay with Roosevelt for his entire presidency, was directly involved in the administration of the CCC, PWA, NRA, and the Social Security Act. Among several important measures, she took greatest pleasure in championing minimum wage statutes as well as the penultimate piece of New Deal legislation, the Fair Labor Standards Act. Roosevelt came to trust Perkins\u2019 advice with few questions or concerns, and steadfastly supported her work through the end of his life (Figure 26_03_Perkins). \n\n Defining American Molly Dewson and Women Democrats In her effort to get President Roosevelt re-elected in 1936, Dewson commented, \u201cWe don\u2019t make the old-fashioned plea to the women that our nominee is charming, and all that. We appeal to the intelligence of the country\u2019s women. Ours were economic issues and we found the women ready to listen.\u201d \n\n As head of the Women\u2019s Division of the Democratic National Committee (DNC) in 1932, Molly Dewson proved to be an influential supporter of President Franklin Roosevelt and one of his key advisors regarding issues pertaining to women\u2019s rights. Agreeing with First Lady Eleanor Roosevelt that \u201cWomen must learn to play the games as men do,\u201d Dewson worked diligently in her position with the DNC to ensure that women could serve as delegates and alternates to the national conventions. Her approach, and her realization that women were intelligent enough to make rational choices, greatly appealed to Roosevelt. Her methods were perhaps not too different from his own, as he spoke to the public through his fireside chats. Dewson\u2019s impressive organizational skills on behalf of the party earned her the nickname \u201cthe little general\u201d from President Roosevelt. \n\n However, Eleanor Roosevelt, more so than any other individual, came to represent the strongest influence upon the president; and she used her unique position to champion several causes for women, African Americans, and the rural poor ( Figure 26.15 ). She married Franklin Roosevelt, who was her fifth cousin, in 1905 and subsequently had six children, one of whom died at only seven months old. A strong supporter of her husband\u2019s political ambitions, Eleanor campaigned by his side through the failed vice-presidential bid in 1920 and on his behalf after he was diagnosed with polio in 1921. When she discovered letters of her husband\u2019s affair with her social secretary, Lucy Mercer, the marriage became less one of romance and more one of a political partnership that would continue\u2014strained at times\u2014until the president\u2019s death in 1945. \n\n Historians agree that the first lady used her presence in the White House, in addition to the leverage of her failed marriage and knowledge of her husband\u2019s infidelities, to her advantage. She promoted several causes that the president himself would have had difficulty championing at the time. From newspaper and magazine articles she authored, to a busy travel schedule that saw her regularly cross the country, the first lady sought to remind Americans that their plight was foremost on the minds of all working in the White House. Eleanor was so active in her public appearances that, by 1940, she began holding regular press conferences to answer reporters\u2019 questions. Among her first substantial projects was the creation of Arthurdale\u2014a resettlement community for displaced coal miners in West Virginia. Although the planned community became less of an administration priority as the years progressed (eventually folding in 1940), for seven years, Eleanor remained committed to its success as a model of assistance for the rural poor. \n\n Exposed to issues of racial segregation in the Arthurdale experiment, Eleanor subsequently supported many civil rights causes through the remainder of the Roosevelt presidency. When it further became clear that racial discrimination was rampant in the administration of virtually all New Deal job programs\u2014especially in the southern states\u2014she continued to pressure her husband for remedies. In 1934, she openly lobbied for passage of the federal anti-lynching bill that the president privately supported but could not politically endorse. Despite the subsequent failure of the Senate to pass such legislation, Eleanor succeeded in arranging a meeting between her husband and then-NAACP president Walter White to discuss anti-lynching and other pertinent calls for civil rights legislation. \n\n White was only one of Eleanor\u2019s African American guests to the White House. Breaking with precedent, and much to the disdain of many White House officials, the first lady routinely invited prominent African Americans to dine with her and the president. Most notably, when the Daughters of the American Revolution (DAR) refused to permit internationally renowned Black opera contralto Marian Anderson to sing in Constitution Hall, Eleanor resigned her membership in the DAR and arranged for Anderson to sing at a public concert on the steps of the Lincoln Memorial, followed by her appearance at a state dinner at the White House in honor of the king and queen of England. With regard to race relations in particular, Eleanor Roosevelt was able to accomplish what her husband\u2014for delicate political reasons\u2014could not: become the administration\u2019s face for civil rights. ", "questions": [{"question": {"question_id": "fs-idm21008048", "question_text": "Which of the following best describes Roosevelt\u2019s attempts to push his political agenda in the last months of Hoover\u2019s presidency?", "question_choices": ["Roosevelt spoke publicly on the issue of direct relief.", "Roosevelt met privately with Hoover to convince him to institute certain policy shifts before his presidency ended.", "Roosevelt awaited his inauguration before introducing any plans.", "Roosevelt met secretly with members of Congress to attempt to win their favor."], "cloze_format": "___ best described Roosevelt's attempts to push his political agenda in the last months of Hoover's presidency.", "normal_format": "Which of the following best describes Roosevelt\u2019s attempts to push his political agenda in the last months of Hoover\u2019s presidency?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Roosevelt remained gracious but refused to begin his administration as the incumbent \u2019 s advisor without any legal authority necessary to change policy . Unwilling to tie himself to Hoover \u2019 s legacy of failed policies , Roosevelt kept quiet when Hoover supported the passage of a national sales tax .", "hl_context": "After the landslide election , the country \u2014 and Hoover \u2014 had to endure the interregnum , the difficult four months between the election and President Roosevelt \u2019 s inauguration in March 1933 . Congress did not pass a single significant piece of legislation during this period , although Hoover spent much of the time trying to get Roosevelt to commit publicly to a legislative agenda of Hoover \u2019 s choosing . <hl> Roosevelt remained gracious but refused to begin his administration as the incumbent \u2019 s advisor without any legal authority necessary to change policy . <hl> <hl> Unwilling to tie himself to Hoover \u2019 s legacy of failed policies , Roosevelt kept quiet when Hoover supported the passage of a national sales tax . <hl> Meanwhile , the country suffered from Hoover \u2019 s inability to further drive a legislative agenda through Congress . It was the worst winter since the beginning of the Great Depression , and the banking sector once again suffered another round of panics . While Roosevelt kept his distance from the final tremors of the Hoover administration , the country continued to suffer in wait . In part as a response to the challenges of this time , the U . S . Constitution was subsequently amended to reduce the period from election to inauguration to the now-commonplace two months ."}, {"question": {"question_id": "fs-idm41852928", "question_text": "Which of the following was not a policy undertaken by the NIRA?", "question_choices": ["agreement among industries to set prices", "agreement among industries to reinvest profits into their firms", "agreement among industries to set production levels", "recognition of the right of workers to form unions"], "cloze_format": "____ was not a policy undertaken by the NIRA.", "normal_format": "Which of the following was not a policy undertaken by the NIRA?"}, "answer": {"ans_text": "agreement among industries to reinvest profits into their firms", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "A new government agency , the National Recovery Administration ( NRA ) , was central to this plan , and mandated that businesses accept a code that included minimum wages and maximum work hours . In order to protect workers from potentially unfair agreements among factory owners , every industry had its own \u201c code of fair practice \u201d that included workers \u2019 rights to organize and use collective bargaining to ensure that wages rose with prices ( Figure 26.8 ) . More importantly , the NIRA suspended antitrust laws and allowed businesses and industries to work together in order to establish codes of fair competition , including issues of price setting and minimum wages . New Deal officials believed that allowing these collaborations would help industries stabilize prices and production levels in the face of competitive overproduction and declining profits ; however , at the same time , many felt it important to protect workers from potentially unfair agreements .", "hl_context": "<hl> A new government agency , the National Recovery Administration ( NRA ) , was central to this plan , and mandated that businesses accept a code that included minimum wages and maximum work hours . <hl> <hl> In order to protect workers from potentially unfair agreements among factory owners , every industry had its own \u201c code of fair practice \u201d that included workers \u2019 rights to organize and use collective bargaining to ensure that wages rose with prices ( Figure 26.8 ) . <hl> Headed by General Hugh S . Johnson , the NRA worked to create over five hundred different codes for different industries . The administration of such a complex plan naturally created its own problems . While codes for key industries such as automotive and steel made sense , Johnson pushed to create similar codes for dog food manufacturers , those who made shoulder pads for women \u2019 s clothing , and even burlesque shows ( regulating the number of strippers in any one show ) . While Roosevelt hoped the AAA would help farms and farmers , he also sought aid for the beleaguered manufacturing sector . The Emergency Railroad Transportation Act created a national railroad office to encourage cooperation among different railroad companies , hoping to shore up an industry essential to the stability of the manufacturing sector , but one that had been devastated by mismanagement . <hl> More importantly , the NIRA suspended antitrust laws and allowed businesses and industries to work together in order to establish codes of fair competition , including issues of price setting and minimum wages . <hl> <hl> New Deal officials believed that allowing these collaborations would help industries stabilize prices and production levels in the face of competitive overproduction and declining profits ; however , at the same time , many felt it important to protect workers from potentially unfair agreements . <hl>"}, {"question": {"question_id": "fs-idm30680928", "question_text": "What type of help did the CWA provide?", "question_choices": ["direct relief", "farm refinancing", "bank reform", "employment opportunities"], "cloze_format": "The CWA provides ___.", "normal_format": "What type of help did the CWA provide?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "bloom": null, "hl_sentences": "FERA overseer Harry Hopkins , who later was in charge of the Civil Works Administration ( CWA ) , shared this sentiment . With Hopkins at its helm , the CWA , founded in early 1933 , went on to put millions of men and women to work .", "hl_context": "Roosevelt was aware of the need for immediate help , but he mostly wanted to create more jobs . <hl> FERA overseer Harry Hopkins , who later was in charge of the Civil Works Administration ( CWA ) , shared this sentiment . <hl> <hl> With Hopkins at its helm , the CWA , founded in early 1933 , went on to put millions of men and women to work . <hl> At its peak , there were some four million Americans repairing bridges , building roads and airports , and undertaking other public projects . Another work program was the Civilian Conservation Corps Relief Act ( CCC ) . The CCC provided government jobs for young men aged fourteen to twenty-four who came from relief families . They would earn thirty dollars per month planting trees , fighting forest fires , and refurbishing historic sites and parks , building an infrastructure that families would continue to enjoy for generations to come . Within the first two months , the CCC employed its first 250,000 men and eventually established about twenty-five hundred camps ( Figure 26.6 ) ."}, {"question": {"question_id": "fs-idp13151536", "question_text": "Which of the following statements accurately describes Mary McLeod Bethune?", "question_choices": ["She was a prominent supporter of the Townsend Plan.", "She was a key figure in the NYA.", "She was Eleanor Roosevelt\u2019s personal secretary.", "She was a labor organizer."], "cloze_format": "Mary McLeod Bethune is ___.", "normal_format": "Which of the following statements accurately describes Mary McLeod Bethune?"}, "answer": {"ans_text": "She was a key figure in the NYA.", "ans_choice": 1}, "bloom": null, "hl_sentences": "One key figure in the NYA was Mary McLeod Bethune ( Figure 26.13 ) , a prominent African American educator tapped by Roosevelt to act as the director of the NYA \u2019 s Division of Negro Affairs .", "hl_context": "On the issue of race relations themselves , Roosevelt has a mixed legacy . Within his White House , Roosevelt had a number of African American appointees , although most were in minor positions . Unofficially , Roosevelt relied upon advice from the Federal Council on Negro Affairs , also known as his \u201c Black Cabinet . \u201d This group included a young Harvard economist , Dr . Robert Weaver , who subsequently became the nation \u2019 s first Black cabinet secretary in 1966 , as President Lyndon Johnson \u2019 s Secretary of Housing and Urban Development . Aubrey Williams , the director of the NYA , hired more Black administrators than any other federal agency , and appointed them to oversee projects throughout the country . <hl> One key figure in the NYA was Mary McLeod Bethune ( Figure 26.13 ) , a prominent African American educator tapped by Roosevelt to act as the director of the NYA \u2019 s Division of Negro Affairs . <hl> Bethune had been a spokesperson and an educator for years ; with this role , she became one of the president \u2019 s foremost African American advisors . During his presidency , Roosevelt became the first to appoint a Black federal judge , as well as the first commander-in-chief to promote an African American to brigadier general . Most notably , he became the first president to publicly speak against lynching as a \u201c vile form of collective murder . \u201d"}, {"question": {"question_id": "fs-idp25723616", "question_text": "The Social Security Act borrowed some ideas from which of the following?", "question_choices": ["the Townsend Plan", "the Division of Negro Affairs", "the Education Trust", "the NIRA"], "cloze_format": "The Social Security Act borrowed some ideas from ___.", "normal_format": "The Social Security Act borrowed some ideas from which of the following?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The Social Security Act established programs intended to help the most vulnerable : the elderly , the unemployed , the disabled , and the young . It is worth noting that some elements of these reforms were pulled from Roosevelt detractors Coughlin and Townsend ; the popularity of their movements gave the president more leverage to push forward this type of legislation .", "hl_context": "With the implementation of the Second New Deal , Roosevelt also created the country \u2019 s present-day social safety net . <hl> The Social Security Act established programs intended to help the most vulnerable : the elderly , the unemployed , the disabled , and the young . <hl> It included a pension fund for all retired people \u2014 except domestic workers and farmers , which therefore left many women and African Americans beyond the scope of its benefits \u2014 over the age of sixty-five , to be paid through a payroll tax on both employee and employer . Related to this act , Congress also passed a law on unemployment insurance , to be funded by a tax on employers , and programs for unwed mothers , as well as for those who were blind , deaf , or disabled . <hl> It is worth noting that some elements of these reforms were pulled from Roosevelt detractors Coughlin and Townsend ; the popularity of their movements gave the president more leverage to push forward this type of legislation . <hl>"}, {"question": {"question_id": "fs-idp44223808", "question_text": "What was the first New Deal agency to hire women openly?", "question_choices": ["the NRA", "the WPA", "the AAA", "the TVA"], "cloze_format": "___ was the first New Deal agency to hire women openly.", "normal_format": "What was the first New Deal agency to hire women openly?"}, "answer": {"ans_text": "the WPA", "ans_choice": 1}, "bloom": null, "hl_sentences": "The WPA became the first specific New Deal agency to openly hire women \u2014 specifically widows , single women , and the wives of disabled husbands .", "hl_context": "For women , Roosevelt \u2019 s policies and practices had a similarly mixed effect . Wage discrimination in federal jobs programs was rampant , and relief policies encouraged women to remain home and leave jobs open for men . This belief was well in line with the gender norms of the day . Several federal relief programs specifically forbade husbands and wives \u2019 both drawing jobs or relief from the same agency . <hl> The WPA became the first specific New Deal agency to openly hire women \u2014 specifically widows , single women , and the wives of disabled husbands . <hl> While they did not take part in construction projects , these women did undertake sewing projects to provide blankets and clothing to hospitals and relief agencies . Likewise , several women took part in the various Federal One art projects . Despite the obvious gender limitations , many women strongly supported Roosevelt \u2019 s New Deal , as much for its direct relief handouts for women as for its employment opportunities for men . One such woman was Mary ( Molly ) Dewson . A longtime activist in the women \u2019 s suffrage movement , Dewson worked for women \u2019 s rights and ultimately rose to be the Director of the Women \u2019 s Division of the Democratic Party . Dewson and Mary McLeod Bethune , the national champion of African American education and literacy who rose to the level of Director of the Division of Negro Affairs for the NYA , understood the limitations of the New Deal , but also the opportunities for advancement it presented during very trying times . Rather than lamenting what Roosevelt could not or would not do , they felt , and perhaps rightly so , that Roosevelt would do more than most to help women and African Americans achieve a piece of the new America he was building ."}], "summary": " Summary 26.1   The Rise of Franklin Roosevelt \n\n Franklin Roosevelt was a wealthy, well-educated, and popular politician whose history of polio made him a more sympathetic figure to the public. He did not share any specifics of his plan to bring the country out of the Great Depression, but his attitude of optimism and possibility contrasted strongly with Hoover\u2019s defeated misery. The 1932 election was never really in question, and Roosevelt won in a landslide. During the four-month interregnum, however, Americans continued to endure President Hoover\u2019s failed policies, which led the winter of 1932\u20131933 to be the worst of the Depression, with unemployment rising to record levels. \n\n When Roosevelt took office in March 1933, he infused the country with a sense of optimism. He still did not have a formal plan but rather invited the American people to join him in the spirit of experimentation. Roosevelt did bring certain beliefs to office: the belief in an active government that would take direct action on federal relief, public works, social services, and direct aid to farmers. But as much as his policies, Roosevelt\u2019s own personality and engaging manner helped the country feel that they were going to get back on track. \n\n 26.2   The First New Deal \n\n After assuming the presidency, Roosevelt lost no time in taking bold steps to fight back against the poverty and unemployment plaguing the country. He immediately created a bank holiday and used the time to bring before Congress legislation known as the Emergency Banking Act, which allowed federal agencies to examine all banks before they reopened, thus restoring consumer confidence. He then went on, in his historic first hundred days, to sign numerous other significant pieces of legislation that were geared towards creating jobs, shoring up industry and agriculture, and providing relief to individuals through both refinancing options and direct handouts. Not all of his programs were effective, and many generated significant criticism. Overall, however, these programs helped to stabilize the economy, restore confidence, and change the pessimistic mindset that had overrun the country. \n\n 26.3   The Second New Deal \n\n Despite his popularity, Roosevelt had significant critics at the end of the First New Deal. Some on the right felt that he had moved the country in a dangerous direction towards socialism and fascism, whereas others on the left felt that he had not gone far enough to help the still-struggling American people. Reeling after the Supreme Court struck down two key pieces of New Deal legislation, the AAA and NIRA, Roosevelt pushed Congress to pass a new wave of bills to provide jobs, banking reforms, and a social safety net. The laws that emerged\u2014the Banking Act, the Emergency Relief Appropriation Act, and the Social Security Act\u2014still define our country today. \n\n Roosevelt won his second term in a landslide and continued to push for legislation that would help the economy. The jobs programs employed over eight million people and, while systematic discrimination hurt both women and African American workers, these programs were still successful in getting people back to work. The last major piece of New Deal legislation that Roosevelt passed was the Fair Labor Standards Act, which set a minimum wage, established a maximum-hour workweek, and forbade child labor. This law, as well as Social Security, still provides much of the social safety net in the United States today. \n\n While critics and historians continue to debate whether the New Deal ushered in a permanent change to the political culture of the country, from one of individualism to the creation of a welfare state, none deny the fact that Roosevelt\u2019s presidency expanded the role of the federal government in all people\u2019s lives, generally for the better. Even if the most conservative of presidential successors would question this commitment, the notion of some level of government involvement in economic regulation and social welfare had largely been settled by 1941. Future debates would be about the extent and degree of that involvement. ", "keyterm": "", "bname": "u.s._history"}, {"chapter": 29, "intro": " Chapter Outline 29.1   Chordates 29.2   Fishes 29.3   Amphibians 29.4   Reptiles 29.5   Birds 29.6   Mammals 29.7   The Evolution of Primates Introduction Vertebrates are among the most recognizable organisms of the animal kingdom. More than 62,000 vertebrate species have been identified. The vertebrate species now living represent only a small portion of the vertebrates that have existed. The best-known extinct vertebrates are the dinosaurs, a unique group of reptiles, which reached sizes not seen before or after in terrestrial animals. They were the dominant terrestrial animals for 150 million years, until they died out in a mass extinction near the end of the Cretaceous period. Although it is not known with certainty what caused their extinction, a great deal is known about the anatomy of the dinosaurs, given the preservation of skeletal elements in the fossil record. Currently, a number of vertebrate species face extinction primarily due to habitat loss and pollution. According to the International Union for the Conservation of Nature, more than 6,000 vertebrate species are classified as threatened. Amphibians and mammals are the classes with the greatest percentage of threatened species, with 29 percent of all amphibians and 21 percent of all mammals classified as threatened. Attempts are being made around the world to prevent the extinction of threatened species. For example, the Biodiversity Action Plan is an international program, ratified by 188 countries, which is designed to protect species and habitats. ", "chapter_text": "29.1   Chordates Learning Objectives By the end of this section, you will be able to:\n\n Describe the distinguishing characteristics of chordates \n\n Identify the derived character of craniates that sets them apart from other chordates \n\n Describe the developmental fate of the notochord in vertebrates \n\n Vertebrates are members of the kingdom Animalia and the phylum Chordata ( Figure 29.2 ). Recall that animals that possess bilateral symmetry can be divided into two groups\u2014protostomes and deuterostomes\u2014based on their patterns of embryonic development. The deuterostomes, whose name translates as \u201csecond mouth,\u201d consist of two phyla: Chordata and Echinodermata. Echinoderms are invertebrate marine animals that have pentaradial symmetry and a spiny body covering, a group that includes sea stars, sea urchins, and sea cucumbers. The most conspicuous and familiar members of Chordata are vertebrates, but this phylum also includes two groups of invertebrate chordates. \n\n Characteristics of Chordata Animals in the phylum  Chordata  share four key features that appear at some stage during their development: a notochord, a dorsal hollow nerve cord, pharyngeal slits, and a post-anal tail ( Figure 29.3 ). In some groups, some of these are present only during embryonic development. \n\n The chordates are named for the  notochord , which is a flexible, rod-shaped structure that is found in the embryonic stage of all chordates and in the adult stage of some chordate species. It is located between the digestive tube and the nerve cord, and provides skeletal support through the length of the body. In some chordates, the notochord acts as the primary axial support of the body throughout the animal\u2019s lifetime. In vertebrates, the notochord is present during embryonic development, at which time it induces the development of the neural tube and serves as a support for the developing embryonic body. The notochord, however, is not found in the postnatal stage of vertebrates; at this point, it has been replaced by the vertebral column (that is, the spine). \n\n Visual Connection \n\n Which of the following statements about common features of chordates is true? \n\n The dorsal hollow nerve cord is part of the chordate central nervous system. \n\n In vertebrate fishes, the pharyngeal slits become the gills. \n\n Humans are not chordates because humans do not have a tail. \n\n Vertebrates do not have a notochord at any point in their development; instead, they have a vertebral column. \n\n The  dorsal hollow nerve cord  derives from ectoderm that rolls into a hollow tube during development. In chordates, it is located dorsal to the notochord. In contrast, other animal phyla are characterized by solid nerve cords that are located either ventrally or laterally. The nerve cord found in most chordate embryos develops into the brain and spinal cord, which compose the central nervous system. \n\n Pharyngeal slits  are openings in the pharynx (the region just posterior to the mouth) that extend to the outside environment. In organisms that live in aquatic environments, pharyngeal slits allow for the exit of water that enters the mouth during feeding. Some invertebrate chordates use the pharyngeal slits to filter food out of the water that enters the mouth. In vertebrate fishes, the pharyngeal slits are modified into gill supports, and in jawed fishes, into jaw supports. In tetrapods, the slits are modified into components of the ear and tonsils.  Tetrapod  literally means \u201cfour-footed,\u201d which refers to the phylogenetic history of various groups that evolved accordingly, even though some now possess fewer than two pairs of walking appendages. Tetrapods include amphibians, reptiles, birds, and mammals. \n\n The  post-anal tail  is a posterior elongation of the body, extending beyond the anus. The tail contains skeletal elements and muscles, which provide a source of locomotion in aquatic species, such as fishes. In some terrestrial vertebrates, the tail also helps with balance, courting, and signaling when danger is near. In humans, the post-anal tail is vestigial, that is, reduced in size and nonfunctional. \n\n Link to Learning \n\n Click for a video discussing the evolution of chordates and five characteristics that they share.\n\n Click to view content \n\n Chordates and the Evolution of Vertebrates \n\n Chordata also contains two clades of invertebrates: Urochordata and Cephalochordata. Members of these groups also possess the four distinctive features of chordates at some point during their development. \n\n Urochordata \n\n Members of  Urochordata  are also known as  tunicates  ( Figure 29.4 ). The name tunicate derives from the cellulose-like carbohydrate material, called the tunic, which covers the outer body of tunicates. Although adult tunicates are classified as chordates, they do not have a notochord, a dorsal hollow nerve cord, or a post-anal tail, although they do have pharyngeal slits. The larval form, however, possesses all four structures. Most tunicates are hermaphrodites. Tunicate larvae hatch from eggs inside the adult tunicate\u2019s body. After hatching, a tunicate larva swims for a few days until it finds a suitable surface on which it can attach, usually in a dark or shaded location. It then attaches via the head to the surface and undergoes metamorphosis into the adult form, at which point the notochord, nerve cord, and tail disappear. \n\n Most tunicates live a sessile existence on the ocean floor and are suspension feeders. The primary foods of tunicates are plankton and detritus. Seawater enters the tunicate\u2019s body through its incurrent siphon. Suspended material is filtered out of this water by a mucous net (pharyngeal slits) and is passed into the intestine via the action of cilia. The anus empties into the excurrent siphon, which expels wastes and water. Tunicates are found in shallow ocean waters around the world. \n\n Cephalochordata \n\n Members of  Cephalochordata  possess a notochord, dorsal hollow nerve cord, pharyngeal slits, and a post-anal tail in the adult stage ( Figure 29.5 ). The notochord extends into the head, which gives the subphylum its name. Extinct members of this subphylum include  Pikaia , which is the oldest known cephalochordate.  Pikaia  fossils were recovered from the Burgess shales of Canada and dated to the middle of the Cambrian age, making them more than 500 million years old. \n\n Extant members of Cephalochordata are the  lancelets , named for their blade-like shape. Lancelets are only a few centimeters long and are usually found buried in sand at the bottom of warm temperate and tropical seas. Like tunicates, they are suspension feeders. \n\n Craniata and Vertebrata \n\n A  cranium  is a bony, cartilaginous, or fibrous structure surrounding the brain, jaw, and facial bones ( Figure 29.6 ). Most bilaterally symmetrical animals have a head; of these, those that have a cranium compose the clade  Craniata . Craniata includes the hagfishes (Myxini), which have a cranium but lack a backbone, and all of the organisms called \u201cvertebrates.\u201d Vertebrates are members of the clade  Vertebrata . Vertebrates display the four characteristic features of the chordates; however, members of this group also share derived characteristics that distinguish them from invertebrate chordates. Vertebrata is named for the  vertebral column , composed of vertebrae, a series of separate bones joined together as a backbone ( Figure 29.7 ). In adult vertebrates, the vertebral column replaces the notochord, which is only seen in the embryonic stage. \n\n Based on molecular analysis, vertebrates appear to be more closely related to lancelets (cephalochordates) than to tunicates (urochordates) among the invertebrate chordates. This evidence suggests that the cephalochordates diverged from Urochordata and the vertebrates subsequently diverged from the cephalochordates. This hypothesis is further supported by the discovery of a fossil in China from the genus  Haikouella . This organism seems to be an intermediate form between cephalochordates and vertebrates. The  Haikouella  fossils are about 530 million years old and appear similar to modern lancelets. These organisms had a brain and eyes, as do vertebrates, but lack the skull found in craniates. 1  This evidence suggests that vertebrates arose during the Cambrian explosion. Recall that the \u201cCambrian explosion\u201d is the name given to a relatively brief span of time during the Cambrian period during which many animal groups appeared and rapidly diversified. Most modern animal phyla originated during the Cambrian explosion. 1 Chen, J. Y., Huang, D. Y., and Li, C. W., \u201cAn early Cambrian craniate-like chordate,\u201d  Nature  402 (1999): 518\u2013522, doi:10.1038/990080. Vertebrates are the largest group of chordates, with more than 62,000 living species. Vertebrates are grouped based on anatomical and physiological traits. More than one classification and naming scheme is used for these animals. Here we will consider the traditional groups Agnatha, Chondrichthyes, Osteichthyes, Amphibia, Reptilia, Aves, and Mammalia, which constitute classes in the subphylum Vertebrata. Many modern authors classify birds within Reptilia, which correctly reflects their evolutionary heritage. We consider them separately only for convenience. Further, we will consider hagfishes and lampreys together as jawless fishes, the agnathans, although emerging classification schemes separate them into chordate jawless fishes (the hagfishes) and vertebrate jawless fishes (the lampreys). \n\n Animals that possess jaws are known as gnathostomes, which means \u201cjawed mouth.\u201d Gnathostomes include fishes and tetrapods\u2014amphibians, reptiles, birds, and mammals. Tetrapods can be further divided into two groups: amphibians and amniotes. Amniotes are animals whose eggs are adapted for terrestrial living, and this group includes mammals, reptiles, and birds. Amniotic embryos, developing in either an externally shed egg or an egg carried by the female, are provided with a water-retaining environment and are protected by amniotic membranes. \n29.2   Fishes Learning Objectives By the end of this section, you will be able to:\n\n Describe the difference between jawless and jawed fishes \n\n Discuss the distinguishing features of sharks and rays compared to other modern fishes \n\n Modern fishes include an estimated 31,000 species. Fishes were the earliest vertebrates, with jawless species being the earliest and jawed species evolving later. They are active feeders, rather than sessile, suspension feeders. Jawless fishes\u2014the hagfishes and lampreys\u2014have a distinct cranium and complex sense organs including eyes, distinguishing them from the invertebrate chordates. \n\n Jawless Fishes \n\n Jawless fishes are craniates that represent an ancient vertebrate lineage that arose over one half-billion years ago. In the past, the hagfishes and lampreys were classified together as agnathans. Today, hagfishes and lampreys are recognized as separate clades, primarily because lampreys are true vertebrates, whereas hagfishes are not. A defining feature is the lack of paired lateral appendages (fins). Some of the earliest jawless fishes were the  ostracoderms  (which translates to \u201cshell-skin\u201d). Ostracoderms were vertebrate fishes encased in bony armor, unlike present-day jawless fishes, which lack bone in their scales. \n\n Myxini: Hagfishes \n\n The clade  Myxini  includes at least 20 species of hagfishes.  Hagfishes  are eel-like scavengers that live on the ocean floor and feed on dead invertebrates, other fishes, and marine mammals ( Figure 29.8 ). Hagfishes are entirely marine and are found in oceans around the world, except for the polar regions. A unique feature of these animals is the slime glands beneath the skin that release mucus through surface pores. This mucus allows the hagfish to escape from the grip of predators. Hagfish can also twist their bodies in a knot to feed and sometimes eat carcasses from the inside out. \n\n The skeleton of a hagfish is composed of cartilage, which includes a cartilaginous notochord that runs the length of the body. This notochord provides support to the hagfish\u2019s body. Hagfishes do not replace the notochord with a vertebral column during development, as do true vertebrates. \n\n Petromyzontidae: Lampreys \n\n The clade  Petromyzontidae  includes approximately 35\u201340 or more species of lampreys.  Lampreys  are similar to hagfishes in size and shape; however, lampreys possess some vertebral elements. Lampreys lack paired appendages and bone, as do the hagfishes. As adults, lampreys are characterized by a toothed, funnel-like sucking mouth. Many species have a parasitic stage of their life cycle during which they are ectoparasites of fishes ( Figure 29.9 ). \n\n Lampreys live primarily in coastal and fresh waters, and have a worldwide distribution, except for in the tropics and polar regions. Some species are marine, but all species spawn in fresh water. Eggs are fertilized externally, and the larvae distinctly differ from the adult form, spending 3 to 15 years as suspension feeders. Once they attain sexual maturity, the adults reproduce and die within days. \n\n Lampreys possess a notochord as adults; however, this notochord is surrounded by a cartilaginous structure called an arcualia, which may resemble an evolutionarily early form of the vertebral column. \n\n Gnathostomes: Jawed Fishes \n\n Gnathostomes  or \u201cjaw-mouths\u201d are vertebrates that possess jaws. One of the most significant developments in early vertebrate evolution was the development of the jaw, which is a hinged structure attached to the cranium that allows an animal to grasp and tear its food. The evolution of jaws allowed early gnathostomes to exploit food resources that were unavailable to jawless fishes. \n\n Early gnathostomes also possessed two sets of paired fins, allowing the fishes to maneuver accurately. Pectoral fins are typically located on the anterior body, and pelvic fins on the posterior. Evolution of the jaw and paired fins permitted gnathostomes to expand from the sedentary suspension feeding of jawless fishes to become mobile predators. The ability of gnathostomes to exploit new nutrient sources likely is one reason that they replaced most jawless fishes during the Devonian period. Two early groups of gnathostomes were the acanthodians and placoderms ( Figure 29.10 ), which arose in the late Silurian period and are now extinct. Most modern fishes are gnathostomes that belong to the clades Chondrichthyes and Osteichthyes. \n\n Chondrichthyes: Cartilaginous Fishes \n\n The clade  Chondrichthyes  is diverse, consisting of sharks ( Figure 29.11 ), rays, and skates, together with sawfishes and a few dozen species of fishes called  chimaeras , or \u201cghost\u201d sharks.\u201d Chondrichthyes are jawed fishes that possess paired fins and a skeleton made of cartilage. This clade arose approximately 370 million years ago in the early or middle Devonian. They are thought to be descended from the placoderms, which had skeletons made of bone; thus, the cartilaginous skeleton of Chondrichthyes is a later development. Parts of shark skeleton are strengthened by granules of calcium carbonate, but this is not the same as bone. \n\n Most cartilaginous fishes live in marine habitats, with a few species living in fresh water for a part or all of their lives. Most sharks are carnivores that feed on live prey, either swallowing it whole or using their jaws and teeth to tear it into smaller pieces. Shark teeth likely evolved from the jagged scales that cover their skin, called placoid scales. Some species of sharks and rays are suspension feeders that feed on plankton. \n\n Sharks have well-developed sense organs that aid them in locating prey, including a keen sense of smell and electroreception, with the latter perhaps the most sensitive of any animal. Organs called  ampullae of Lorenzini  allow sharks to detect the electromagnetic fields that are produced by all living things, including their prey. Electroreception has only been observed in aquatic or amphibious animals. Sharks, together with most fishes and aquatic and larval amphibians, also have a sense organ called the  lateral line , which is used to detect movement and vibration in the surrounding water, and is often considered homologous to \u201chearing\u201d in terrestrial vertebrates. The lateral line is visible as a darker stripe that runs along the length of a fish\u2019s body. \n\n Sharks reproduce sexually, and eggs are fertilized internally. Most species are ovoviviparous: The fertilized egg is retained in the oviduct of the mother\u2019s body and the embryo is nourished by the egg yolk. The eggs hatch in the uterus, and young are born alive and fully functional. Some species of sharks are oviparous: They lay eggs that hatch outside of the mother\u2019s body. Embryos are protected by a shark egg case or \u201cmermaid\u2019s purse\u201d ( Figure 29.12 ) that has the consistency of leather. The shark egg case has tentacles that snag in seaweed and give the newborn shark cover.  A few species of sharks are viviparous: The young develop within the mother\u2019s body and she gives live birth. \n\n Rays and skates comprise more than 500 species and are closely related to sharks. They can be distinguished from sharks by their flattened bodies, pectoral fins that are enlarged and fused to the head, and gill slits on their ventral surface ( Figure 29.13 ). Like sharks, rays and skates have a cartilaginous skeleton. Most species are marine and live on the sea floor, with nearly a worldwide distribution. \n\n Osteichthyes: Bony Fishes \n\n Members of the clade  Osteichthyes , also called bony fishes, are characterized by a bony skeleton. The vast majority of present-day fishes belong to this group, which consists of approximately 30,000 species, making it the largest class of vertebrates in existence today. \n\n Nearly all bony fishes have an ossified skeleton with specialized bone cells (osteocytes) that produce and maintain a calcium phosphate matrix. This characteristic has only reversed in a few groups of Osteichthyes, such as sturgeons and paddlefish, which have primarily cartilaginous skeletons. The skin of bony fishes is often covered by overlapping scales, and glands in the skin secrete mucus that reduces drag when swimming and aids the fish in osmoregulation. Like sharks, bony fishes have a lateral line system that detects vibrations in water. \n\n All bony fishes use gills to breathe. Water is drawn over gills that are located in chambers covered and ventilated by a protective, muscular flap called the operculum. Many bony fishes also have a  swim bladder , a gas-filled organ that helps to control the buoyancy of the fish. Bony fishes are further divided into two extant clades:  Actinopterygii  (ray-finned fishes) and  Sarcopterygii  (lobe-finned fishes). \n\n Actinopterygii, the ray-finned fishes, include many familiar fishes\u2014tuna, bass, trout, and salmon ( Figure 29.14 a ), among others. Ray-finned fishes are named for their fins that are webs of skin supported by bony spines called rays. In contrast, the fins of Sarcopterygii are fleshy and lobed, supported by bone ( Figure 29.14 b ). Living members of this clade include the less-familiar lungfishes and coelacanths. \n29.3   Amphibians Learning Objectives By the end of this section, you will be able to:\n\n Describe the important difference between the life cycle of amphibians and the life cycles of other vertebrates \n\n Distinguish between the characteristics of Urodela, Anura, and Apoda \n\n Describe the evolutionary history of amphibians \n\n Amphibians are vertebrate tetrapods.  Amphibia  includes frogs, salamanders, and caecilians. The term amphibian loosely translates from the Greek as \u201cdual life,\u201d which is a reference to the metamorphosis that many frogs and salamanders undergo and their mixture of aquatic and terrestrial environments in their life cycle. Amphibians evolved during the Devonian period and were the earliest terrestrial tetrapods. \n\n Link to Learning \n\n Watch this series of five Animal Planet videos on tetrapod evolution:  1: The evolution from fish to earliest tetrapod \n\n Click to view content \n\n 2: Fish to Earliest Tetrapod \n\n Click to view content \n\n 3: The discovery of coelacanth and  Acanthostega  fossils\n\n Click to view content \n\n 4: The number of fingers on \u201clegs\u201d \n\n Click to view content \n\n 5: Reconstructing the environment of early tetrapods \n\n Click to view content \n\n Characteristics of Amphibians \n\n As tetrapods, most amphibians are characterized by four well-developed limbs. Some species of salamanders and all caecilians are functionally limbless; their limbs are vestigial. An important characteristic of extant amphibians is a moist, permeable skin that is achieved via mucus glands that keep the skin moist; thus, exchange of oxygen and carbon dioxide with the environment can take place through it ( cutaneous respiration ). Additional characteristics of amphibians include pedicellate teeth\u2014teeth in which the root and crown are calcified, separated by a zone of noncalcified tissue\u2014and a papilla amphibiorum and papilla basilaris, structures of the inner ear that are sensitive to frequencies below and above 10,00 hertz, respectively. Amphibians also have an auricular operculum, which is an extra bone in the ear that transmits sounds to the inner ear. All extant adult amphibians are carnivorous, and some terrestrial amphibians have a sticky tongue that is used to capture prey. \n\n Evolution of Amphibians \n\n The fossil record provides evidence of the first tetrapods: now-extinct amphibian species dating to nearly 400 million years ago. Evolution of tetrapods from fishes represented a significant change in body plan from one suited to organisms that respired and swam in water, to organisms that breathed air and moved onto land; these changes occurred over a span of 50 million years during the Devonian period. One of the earliest known tetrapods is from the genus  Acanthostega .  Acanthostega  was aquatic; fossils show that it had gills similar to fishes. However, it also had four limbs, with the skeletal structure of limbs found in present-day tetrapods, including amphibians. Therefore, it is thought that  Acanthostega  lived in shallow waters and was an intermediate form between lobe-finned fishes and early, fully terrestrial tetrapods. What preceded  Acanthostega ? In 2006, researchers published news of their discovery of a fossil of a \u201ctetrapod-like fish,\u201d  Tiktaalik roseae , which seems to be an intermediate form between fishes having fins and tetrapods having limbs ( Figure 29.15 ).  Tiktaalik  likely lived in a shallow water environment about 375 million years ago. 2 2 Daeschler, E. B., Shubin, N. H., and Jenkins, F. J. \u201cA Devonian tetrapod-like fish and the evolution of the tetrapod body plan,\u201d  Nature  440 (2006): 757\u2013763, doi:10.1038/nature04639, http://www.nature.com/nature/journal/v440/n7085/abs/nature04639.html.  \n\n The early tetrapods that moved onto land had access to new nutrient sources and relatively few predators. This led to the widespread distribution of tetrapods during the early Carboniferous period, a period sometimes called the \u201cage of the amphibians.\u201d \n\n Modern Amphibians \n\n Amphibia comprises an estimated 6,770 extant species that inhabit tropical and temperate regions around the world. Amphibians can be divided into three clades:  Urodela  (\u201ctailed-ones\u201d), the salamanders;  Anura  (\u201ctail-less ones\u201d), the frogs; and  Apoda  (\u201clegless ones\u201d), the caecilians. \n\n Urodela: Salamanders \n\n Salamanders  are amphibians that belong to the order Urodela. Living salamanders ( Figure 29.16 ) include approximately 620 species, some of which are aquatic, other terrestrial, and some that live on land only as adults. Adult salamanders usually have a generalized tetrapod body plan with four limbs and a tail. They move by bending their bodies from side to side, called lateral undulation, in a fish-like manner while \u201cwalking\u201d their arms and legs fore and aft. It is thought that their gait is similar to that used by early tetrapods. Respiration differs among different species. The majority of salamanders are lungless, and respiration occurs through the skin or through external gills. Some terrestrial salamanders have primitive lungs; a few species have both gills and lungs. \n\n Unlike frogs, virtually all salamanders rely on internal fertilization of the eggs. The only male amphibians that possess copulatory structures are the caecilians, so fertilization among salamanders typically involves an elaborate and often prolonged courtship. Such a courtship allows the successful transfer of sperm from male to female via a spermatophore. Development in many of the most highly evolved salamanders, which are fully terrestrial, occurs during a prolonged egg stage, with the eggs guarded by the mother. During this time, the gilled larval stage is found only within the egg capsule, with the gills being resorbed, and metamorphosis being completed, before hatching. Hatchlings thus resemble tiny adults. \n\n Link to Learning \n\n View  River Monsters: Fish With Arms and Hands?  to see a video about an unusually large salamander species. \n\n Anura: Frogs \n\n Frogs  are amphibians that belong to the order Anura ( Figure 29.17 ). Anurans are among the most diverse groups of vertebrates, with approximately 5,965 species that occur on all of the continents except Antarctica. Anurans have a body plan that is more specialized for movement. Adult frogs use their hind limbs to jump on land. Frogs have a number of modifications that allow them to avoid predators, including skin that acts as camouflage. Many species of frogs and salamanders also release defensive chemicals from glands in the skin that are poisonous to predators. \n\n Frog eggs are fertilized externally, and like other amphibians, frogs generally lay their eggs in moist environments. A moist environment is required as eggs lack a shell and thus dehydrate quickly in dry environments. Frogs demonstrate a great diversity of parental behaviors, with some species laying many eggs and exhibiting little parental care, to species that carry eggs and tadpoles on their hind legs or backs. The life cycle of frogs, as other amphibians, consists of two distinct stages: the larval stage followed by metamorphosis to an adult stage. The larval stage of a frog, the  tadpole , is often a filter-feeding herbivore. Tadpoles usually have gills, a lateral line system, long-finned tails, and lack limbs. At the end of the tadpole stage, frogs undergo metamorphosis into the adult form ( Figure 29.18 ). During this stage, the gills, tail, and lateral line system disappear, and four limbs develop. The jaws become larger and are suited for carnivorous feeding, and the digestive system transforms into the typical short gut of a predator. An eardrum and air-breathing lungs also develop. These changes during metamorphosis allow the larvae to move onto land in the adult stage. \n\n Apoda: Caecilians \n\n An estimated 185 species comprise  caecilians , a group of amphibians that belong to the order Apoda. Although they are vertebrates, a complete lack of limbs leads to their resemblance to earthworms in appearance. They are adapted for a soil-burrowing or aquatic lifestyle, and they are nearly blind. These animals are found in the tropics of South America, Africa, and Southern Asia. They have vestigial limbs, evidence that they evolved from a legged ancestor. \n\n Evolution Connection The Paleozoic Era and the Evolution of Vertebrates \n\nThe climate and geography of Earth was vastly different during the Paleozoic Era, when vertebrates arose, as compared to today. The Paleozoic spanned from approximately 542 to 251 million years ago. The landmasses on Earth were very different from those of today. Laurentia and Gondwana were continents located near the equator that subsumed much of the current day landmasses in a different configuration ( Figure 29.19 ). At this time, sea levels were very high, probably at a level that hasn\u2019t been reached since. As the Paleozoic progressed, glaciations created a cool global climate, but conditions warmed near the end of the first half of the Paleozoic. During the latter half of the Paleozoic, the landmasses began moving together, with the initial formation of a large northern block called Laurasia. This contained parts of what is now North America, along with Greenland, parts of Europe, and Siberia. Eventually, a single supercontinent, called Pangaea, was formed, starting in the latter third of the Paleozoic. Glaciations then began to affect Pangaea\u2019s climate, affecting the distribution of vertebrate life. \n\n During the early Paleozoic, the amount of carbon dioxide in the atmosphere was much greater than it is today. This may have begun to change later, as land plants became more common. As the roots of land plants began to infiltrate rock and soil began to form, carbon dioxide was drawn out of the atmosphere and became trapped in the rock. This reduced the levels of carbon dioxide and increased the levels of oxygen in the atmosphere, so that by the end of the Paleozoic, atmospheric conditions were similar to those of today. \n\n As plants became more common through the latter half of the Paleozoic, microclimates began to emerge and ecosystems began to change. As plants and ecosystems continued to grow and become more complex, vertebrates moved from the water to land. The presence of shoreline vegetation may have contributed to the movement of vertebrates onto land. One hypothesis suggests that the fins of aquatic vertebrates were used to maneuver through this vegetation, providing a precursor to the movement of fins on land and the development of limbs. The late Paleozoic was a time of diversification of vertebrates, as amniotes emerged and became two different lines that gave rise, on one hand, to mammals, and, on the other hand, to reptiles and birds. Many marine vertebrates became extinct near the end of the Devonian period, which ended about 360 million years ago, and both marine and terrestrial vertebrates were decimated by a mass extinction in the early Permian period about 250 million years ago. \n\n Link to Learning \n\n View  Earth\u2019s Paleogeography: Continental Movements Through Time  to see changes in Earth as life evolved. \n29.4   Reptiles Learning Objectives By the end of this section, you will be able to:\n\n Describe the main characteristics of amniotes \n\n Explain the difference between anapsids, synapsids, and diapsids, and give an example of each \n\n Identify the characteristics of reptiles \n\n Discuss the evolution of reptiles \n\n The amniotes \u2014reptiles, birds, and mammals\u2014are distinguished from amphibians by their terrestrially adapted egg, which is protected by amniotic membranes. The evolution of amniotic membranes meant that the embryos of amniotes were provided with their own aquatic environment, which led to less dependence on water for development and thus allowed the amniotes to branch out into drier environments. This was a significant development that distinguished them from amphibians, which were restricted to moist environments due their shell-less eggs. Although the shells of various amniotic species vary significantly, they all allow retention of water. The shells of bird eggs are composed of calcium carbonate and are hard, but fragile. The shells of reptile eggs are leathery and require a moist environment. Most mammals do not lay eggs (except for monotremes). Instead, the embryo grows within the mother\u2019s body; however, even with this internal gestation, amniotic membranes are still present. \n\n Characteristics of Amniotes \n\n The amniotic egg is the key characteristic of amniotes. In amniotes that lay eggs, the shell of the egg provides protection for the developing embryo while being permeable enough to allow for the exchange of carbon dioxide and oxygen. The albumin, or egg white, provides the embryo with water and protein, whereas the fattier egg yolk is the energy supply for the embryo, as is the case with the eggs of many other animals, such as amphibians. However, the eggs of amniotes contain three additional extra-embryonic membranes: the chorion, amnion, and allantois ( Figure 29.20 ). Extra-embryonic membranes are membranes present in amniotic eggs that are not a part of the body of the developing embryo. While the inner amniotic membrane surrounds the embryo itself, the  chorion  surrounds the embryo and yolk sac. The chorion facilitates exchange of oxygen and carbon dioxide between the embryo and the egg\u2019s external environment. The  amnion  protects the embryo from mechanical shock and supports hydration. The  allantois  stores nitrogenous wastes produced by the embryo and also facilitates respiration. In mammals, membranes that are homologous to the extra-embryonic membranes in eggs are present in the placenta. \n\n Visual Connection \n\n Which of the following statements about the parts of an egg are false? \n\n The allantois stores nitrogenous waste and facilitates respiration. \n\n The chorion facilitates gas exchange. \n\n The yolk provides food for the growing embryo. \n\n The amniotic cavity is filled with albumen. \n\n Additional derived characteristics of amniotes include waterproof skin, due to the presence of lipids, and costal (rib) ventilation of the lungs. \n\n Evolution of Amniotes \n\n The first amniotes evolved from amphibian ancestors approximately 340 million years ago during the Carboniferous period. The early amniotes diverged into two main lines soon after the first amniotes arose. The initial split was into synapsids and sauropsids.  Synapsids  include all mammals, including extinct mammalian species. Synapsids also include therapsids, which were mammal-like reptiles from which mammals evolved.  Sauropsids  include reptiles and birds, and can be further divided into anapsids and diapsids. The key differences between the synapsids, anapsids, and diapsids are the structures of the skull and the number of temporal fenestrae behind each eye ( Figure 29.21 ).  Temporal fenestrae  are post-orbital openings in the skull that allow muscles to expand and lengthen.  Anapsids  have no temporal fenestrae, synapsids have one, and  diapsids  have two. Anapsids include extinct organisms and may, based on anatomy, include turtles. However, this is still controversial, and turtles are sometimes classified as diapsids based on molecular evidence. The diapsids include birds and all other living and extinct reptiles. \n\n The diapsids diverged into two groups, the Archosauromorpha (\u201cancient lizard form\u201d) and the Lepidosauromorpha (\u201cscaly lizard form\u201d) during the Mesozoic period ( Figure 29.22 ). The  lepidosaurs  include modern lizards, snakes, and tuataras. The  archosaurs  include modern crocodiles and alligators, and the extinct pterosaurs (\u201cwinged lizard\u201d) and dinosaurs (\u201cterrible lizard\u201d). Clade Dinosauria includes birds, which evolved from a branch of dinosaurs. Visual Connection \n\n Members of the order Testudines have an anapsid-like skull with one opening. However, molecular studies indicate that turtles descended from a diapsid ancestor. Why might this be the case? \n\n In the past, the most common division of amniotes has been into the classes Mammalia, Reptilia, and Aves. Birds are descended, however, from dinosaurs, so this classical scheme results in groups that are not true clades. We will consider birds as a group distinct from reptiles for the purpose of this discussion with the understanding that this does not completely reflect phylogenetic history and relationships. \n\n Characteristics of Reptiles \n\n Reptiles are tetrapods. Limbless reptiles\u2014snakes and other squamates\u2014have vestigial limbs and, like caecilians, are classified as tetrapods because they are descended from four-limbed ancestors. Reptiles lay eggs enclosed in shells on land. Even aquatic reptiles return to the land to lay eggs. They usually reproduce sexually with internal fertilization. Some species display ovoviviparity, with the eggs remaining in the mother\u2019s body until they are ready to hatch. Other species are viviparous, with the offspring born alive. \n\n One of the key adaptations that permitted reptiles to live on land was the development of their scaly skin, containing the protein keratin and waxy lipids, which reduced water loss from the skin. This occlusive skin means that reptiles cannot use their skin for respiration, like amphibians, and thus all breathe with lungs. \n\n Reptiles are ectotherms, animals whose main source of body heat comes from the environment. This is in contrast to endotherms, which use heat produced by metabolism to regulate body temperature. In addition to being ectothermic, reptiles are categorized as poikilotherms, or animals whose body temperatures vary rather than remain stable. Reptiles have behavioral adaptations to help regulate body temperature, such as basking in sunny places to warm up and finding shady spots or going underground to cool down. The advantage of ectothermy is that metabolic energy from food is not required to heat the body; therefore, reptiles can survive on about 10 percent of the calories required by a similarly sized endotherm.  In cold weather, some reptiles such as the garter snake brumate.  Brumation  is similar to hibernation in that the animal becomes less active and can go for long periods without eating, but differs from hibernation in that brumating reptiles are not asleep or living off fat reserves. Rather, their metabolism is slowed in response to cold temperatures, and the animal is very sluggish. \n\n Evolution of Reptiles \n\n Reptiles originated approximately 300 million years ago during the Carboniferous period. One of the oldest known amniotes is  Casineria , which had both amphibian and reptilian characteristics. One of the earliest undisputed reptiles was  Hylonomus . Soon after the first amniotes appeared, they diverged into three groups\u2014synapsids, anapsids, and diapsids\u2014during the Permian period. The Permian period also saw a second major divergence of diapsid reptiles into archosaurs (predecessors of crocodilians and dinosaurs) and lepidosaurs (predecessors of snakes and lizards). These groups remained inconspicuous until the Triassic period, when the archosaurs became the dominant terrestrial group due to the extinction of large-bodied anapsids and synapsids during the Permian-Triassic extinction. About 250 million years ago, archosaurs radiated into the dinosaurs and the pterosaurs. Although they are sometimes mistakenly called dinosaurs, the pterosaurs were distinct from true dinosaurs ( Figure 29.23 ). Pterosaurs had a number of adaptations that allowed for flight, including hollow bones (birds also exhibit hollow bones, a case of convergent evolution). Their wings were formed by membranes of skin that attached to the long, fourth finger of each arm and extended along the body to the legs. \n\n The dinosaurs were a diverse group of terrestrial reptiles with more than 1,000 species identified to date. Paleontologists continue to discover new species of dinosaurs. Some dinosaurs were quadrupeds ( Figure 29.24 ); others were bipeds. Some were carnivorous, whereas others were herbivorous. Dinosaurs laid eggs, and a number of nests containing fossilized eggs have been found. It is not known whether dinosaurs were endotherms or ectotherms. However, given that modern birds are endothermic, the dinosaurs that served as ancestors to birds likely were endothermic as well. Some fossil evidence exists for dinosaurian parental care, and comparative biology supports this hypothesis since the archosaur birds and crocodilians display parental care. \n\n Dinosaurs dominated the Mesozoic Era, which was known as the \u201cage of reptiles.\u201d The dominance of dinosaurs lasted until the end of the Cretaceous, the last period of the Mesozoic Era. The Cretaceous-Tertiary extinction resulted in the loss of most of the large-bodied animals of the Mesozoic Era. Birds are the only living descendants of one of the major clades of dinosaurs. \n\n Link to Learning \n\n Visit this site to see a  video  discussing the hypothesis that an asteroid caused the Cretaceous-Triassic (KT) extinction. \n\n Modern Reptiles \n\n Class Reptilia includes many diverse species that are classified into four living clades. These are the 25 species of Crocodilia, 2 species of Sphenodontia, approximately 9,200 Squamata species, and the Testudines, with about 325 species. \n\n Crocodilia \n\n Crocodilia  (\u201csmall lizard\u201d) arose with a distinct lineage by the middle Triassic; extant species include alligators, crocodiles, and caimans. Crocodilians ( Figure 29.25 ) live throughout the tropics and subtropics of Africa, South America, Southern Florida, Asia, and Australia. They are found in freshwater, saltwater, and brackish habitats, such as rivers and lakes, and spend most of their time in water. Some species are able to move on land due to their semi-erect posture. \n\n Sphenodontia \n\n Sphenodontia  (\u201cwedge tooth\u201d) arose in the Mesozoic era and includes only one living genus,  Tuatara , comprising two species that are found in New Zealand ( Figure 29.26 ). Tuataras measure up to 80 centimeters and weigh about 1 kilogram. Although quite lizard-like in gross appearance, several unique features of the skull and jaws clearly define them and distinguish the group from the squamates. \n\n Squamata \n\n Squamata  (\u201cscaly\u201d) arose in the late Permian, and extant species include lizards and snakes. Both are found on all continents except Antarctica. Lizards and snakes are most closely related to tuataras, both groups having evolved from a lepidosaurian ancestor. Squamata is the largest extant clade of reptiles ( Figure 29.27 ). Most lizards differ from snakes by having four limbs, although these have been variously lost or significantly reduced in at least 60 lineages. Snakes lack eyelids and external ears, which are present in lizards. Lizard species range in size from chameleons and geckos, which are a few centimeters in length, to the Komodo dragon, which is about 3 meters in length. Most lizards are carnivorous, but some large species, such as iguanas, are herbivores. \n\n Snakes are thought to have descended from either burrowing lizards or aquatic lizards over 100 million years ago ( Figure 29.28 ). Snakes comprise about 3,000 species and are found on every continent except Antarctica. They range in size from 10 centimeter-long thread snakes to 10 meter-long pythons and anacondas. All snakes are carnivorous and eat small animals, birds, eggs, fish, and insects. The snake body form is so specialized that, in its general morphology, a \u201csnake is a snake.\u201d Their specializations all point to snakes having evolved to feed on relatively large prey (even though some current species have reversed this trend). Although variations exist, most snakes have a skull that is very flexible, involving eight rotational joints. They also differ from other squamates by having mandibles (lower jaws) without either bony or ligamentous attachment anteriorly. Having this connection via skin and muscle allows for great expansion of the gape and independent motion of the two sides\u2014both advantages in swallowing big items. \n\n Testudines \n\n Turtles are members of the clade  Testudines  (\u201chaving a shell\u201d) ( Figure 29.29 ). Turtles are characterized by a bony or cartilaginous shell. The shell consists of the ventral surface called the plastron and the dorsal surface called the carapace, which develops from the ribs. The plastron is made of scutes or plates; the scutes can be used to differentiate species of turtles. The two clades of turtles are most easily recognized by how they retract their necks. The dominant group, which includes all North American species, retracts its neck in a vertical S-curve. Turtles in the less speciose clade retract the neck with a horizontal curve. \n\n Turtles arose approximately 200 million years ago, predating crocodiles, lizards, and snakes. Similar to other reptiles, turtles are ectotherms. They lay eggs on land, although many species live in or near water. None exhibit parental care. Turtles range in size from the speckled padloper tortoise at 8 centimeters (3.1 inches) to the leatherback sea turtle at 200 centimeters (over 6 feet). The term \u201cturtle\u201d is sometimes used to describe only those species of Testudines that live in the sea, with the terms \u201ctortoise\u201d and \u201cterrapin\u201d used to refer to species that live on land and in fresh water, respectively. \n29.5   Birds Learning Objectives By the end of this section, you will be able to:\n\n Describe the evolutionary history of birds \n\n Describe the derived characteristics in birds that facilitate flight \n\n The most obvious characteristic that sets birds apart from other modern vertebrates is the presence of feathers, which are modified scales. While vertebrates like bats fly without feathers, birds rely on feathers and wings, along with other modifications of body structure and physiology, for flight. \n\n Characteristics of Birds \n\n Birds are endothermic, and because they fly, they require large amounts of energy, necessitating a high metabolic rate. Like mammals, which are also endothermic, birds have an insulating covering that keeps heat in the body: feathers. Specialized feathers called  down feathers  are especially insulating, trapping air in spaces between each feather to decrease the rate of heat loss. Certain parts of a bird\u2019s body are covered in down feathers, and the base of other feathers have a downy portion, whereas newly hatched birds are covered in down. \n\n Feathers not only act as insulation but also allow for flight, enabling the lift and thrust necessary to become airborne. The feathers on a wing are flexible, so the collective feathers move and separate as air moves through them, reducing the drag on the wing.  Flight feathers  are asymmetrical, which affects airflow over them and provides some of the lifting and thrusting force required for flight ( Figure 29.30 ). Two types of flight feathers are found on the wings, primary feathers and secondary feathers.  Primary feathers  are located at the tip of the wing and provide thrust.  Secondary feathers  are located closer to the body, attach to the forearm portion of the wing and provide lift.  Contour feathers  are the feathers found on the body, and they help reduce drag produced by wind resistance during flight. They create a smooth, aerodynamic surface so that air moves smoothly over the bird\u2019s body, allowing for efficient flight. \n\n Flapping of the entire wing occurs primarily through the actions of the chest muscles, the pectoralis and the supracoracoideus. These muscles are highly developed in birds and account for a higher percentage of body mass than in most mammals. These attach to a blade-shaped keel, like that of a boat, located on the sternum. The sternum of birds is larger than that of other vertebrates, which accommodates the large muscles required to generate enough upward force to generate lift with the flapping of the wings. Another skeletal modification found in most birds is the fusion of the two clavicles (collarbones), forming the  furcula  or wishbone. The furcula is flexible enough to bend and provide support to the shoulder girdle during flapping. \n\n An important requirement of flight is a low body weight. As body weight increases, the muscle output required for flying increases. The largest living bird is the ostrich, and while it is much smaller than the largest mammals, it is flightless. For birds that do fly, reduction in body weight makes flight easier. Several modifications are found in birds to reduce body weight, including pneumatization of bones.  Pneumatic bones  are bones that are hollow, rather than filled with tissue ( Figure 29.31 ). They contain air spaces that are sometimes connected to air sacs, and they have struts of bone to provide structural reinforcement. Pneumatic bones are not found in all birds, and they are more extensive in large birds than in small birds. Not all bones of the skeleton are pneumatic, although the skulls of almost all birds are. \n\n Other modifications that reduce weight include the lack of a urinary bladder. Birds possess a cloaca, a structure that allows water to be reabsorbed from waste back into the bloodstream. Uric acid is not expelled as a liquid but is concentrated into urate salts, which are expelled along with fecal matter. In this way, water is not held in the urinary bladder, which would increase body weight. Most bird species only possess one ovary rather than two, further reducing body mass. \n\n The air sacs that extend into bones to form pneumatic bones also join with the lungs and function in respiration. Unlike mammalian lungs in which air flows in two directions, as it is breathed in and out, airflow through bird lungs travels in one direction ( Figure 29.32 ). Air sacs allow for this unidirectional airflow, which also creates a cross-current exchange system with the blood. In a cross-current or counter-current system, the air flows in one direction and the blood flows in the opposite direction, creating a very efficient means of gas exchange. \n\n Evolution of Birds \n\n The evolutionary history of birds is still somewhat unclear. Due to the fragility of bird bones, they do not fossilize as well as other vertebrates. Birds are diapsids, meaning they have two fenestrations or openings in their skulls. Birds belong to a group of diapsids called the archosaurs, which also includes crocodiles and dinosaurs. It is commonly accepted that birds evolved from dinosaurs. \n\n Dinosaurs (including birds) are further subdivided into two groups, the Saurischia (\u201clizard like\u201d) and the Ornithischia (\u201cbird like\u201d). Despite the names of these groups, it was not the bird-like dinosaurs that gave rise to modern birds. Rather, Saurischia diverged into two groups: One included the long-necked herbivorous dinosaurs, such as Apatosaurus. The second group, bipedal predators called  theropods , includes birds. This course of evolution is suggested by similarities between theropod fossils and birds, specifically in the structure of the hip and wrist bones, as well as the presence of the wishbone, formed by the fusing of the clavicles. One important fossil of an animal intermediate to dinosaurs and birds is  Archaeopteryx , which is from the Jurassic period ( Figure 29.33 ).  Archaeopteryx  is important in establishing the relationship between birds and dinosaurs, because it is an intermediate fossil, meaning it has characteristics of both dinosaurs and birds. Some scientists propose classifying it as a bird, but others prefer to classify it as a dinosaur. The fossilized skeleton of  Archaeopteryx  looks like that of a dinosaur, and it had teeth whereas birds do not, but it also had feathers modified for flight, a trait associated only with birds among modern animals. Fossils of older feathered dinosaurs exist, but the feathers do not have the characteristics of flight feathers. It is still unclear exactly how flight evolved in birds. Two main theories exist, the arboreal (\u201ctree\u201d) hypothesis and the terrestrial (\u201cland\u201d) hypothesis. The arboreal hypothesis posits that tree-dwelling precursors to modern birds jumped from branch to branch using their feathers for gliding before becoming fully capable of flapping flight. In contrast to this, the terrestrial hypothesis holds that running was the stimulus for flight, as wings could be used to improve running and then became used for flapping flight. Like the question of how flight evolved, the question of how endothermy evolved in birds still is unanswered. Feathers provide insulation, but this is only beneficial if body heat is being produced internally. Similarly, internal heat production is only viable if insulation is present to retain that heat. It has been suggested that one or the other\u2014feathers or endothermy\u2014evolved in response to some other selective pressure. \n\n During the Cretaceous period, a group known as the  Enantiornithes  was the dominant bird type ( Figure 29.34 ). Enantiornithes means \u201copposite birds,\u201d which refers to the fact that certain bones of the feet are joined differently than the way the bones are joined in modern birds. These birds formed an evolutionary line separate from modern birds, and they did not survive past the Cretaceous. Along with the Enantiornithes, Ornithurae birds (the evolutionary line that includes modern birds) were also present in the Cretaceous. After the extinction of Enantiornithes, modern birds became the dominant bird, with a large radiation occurring during the Cenozoic Era. Referred to as  Neornithes  (\u201cnew birds\u201d), modern birds are now classified into two groups, the  Paleognathae  (\u201cold jaw\u201d) or ratites, a group of flightless birds including ostriches, emus, rheas, and kiwis, and the  Neognathae  (\u201cnew jaw\u201d), which includes all other birds. \n\n Career Connection Veterinarian \n\nVeterinarians treat diseases, disorders, and injuries in animals, primarily vertebrates. They treat pets, livestock, and animals in zoos and laboratories. Veterinarians usually treat dogs and cats, but also treat birds, reptiles, rabbits, and other animals that are kept as pets. Veterinarians that work with farms and ranches treat pigs, goats, cows, sheep, and horses. \n\n Veterinarians are required to complete a degree in veterinary medicine, which includes taking courses in animal physiology, anatomy, microbiology, and pathology, among many other courses. The physiology and biochemistry of different vertebrate species differ greatly. \n\n Veterinarians are also trained to perform surgery on many different vertebrate species, which requires an understanding of the vastly different anatomies of various species. For example, the stomach of ruminants like cows has four compartments versus one compartment for non-ruminants. Birds also have unique anatomical adaptations that allow for flight. \n\n Some veterinarians conduct research in academic settings, broadening our knowledge of animals and medical science. One area of research involves understanding the transmission of animal diseases to humans, called zoonotic diseases. For example, one area of great concern is the transmission of the avian flu virus to humans. One type of avian flu virus, H5N1, is a highly pathogenic strain that has been spreading in birds in Asia, Europe, Africa, and the Middle East. Although the virus does not cross over easily to humans, there have been cases of bird-to-human transmission. More research is needed to understand how this virus can cross the species barrier and how its spread can be prevented. \n29.6   Mammals Learning Objectives By the end of this section, you will be able to:\n\n Name and describe the distinguishing features of the three main groups of mammals \n\n Describe the proposed line of descent that produced mammals \n\n List some derived features that may have arisen in response to mammals\u2019 need for constant, high-level metabolism \n\n Mammals  are vertebrates that possess hair and mammary glands. Several other characteristics are distinctive to mammals, including certain features of the jaw, skeleton, integument, and internal anatomy. Modern mammals belong to three clades: monotremes, marsupials, and eutherians (or placental mammals). \n\n Characteristics of Mammals \n\n The presence of hair is one of the most obvious signs of a mammal. Although it is not very extensive on certain species, such as whales, hair has many important functions for mammals. Mammals are endothermic, and hair provides insulation to retain heat generated by metabolic work. Hair traps a layer of air close to the body, retaining heat. Along with insulation, hair can serve as a sensory mechanism via specialized hairs called vibrissae, better known as whiskers. These attach to nerves that transmit information about sensation, which is particularly useful to nocturnal or burrowing mammals. Hair can also provide protective coloration or be part of social signaling, such as when an animal\u2019s hair stands \u201con end.\u201d \n\n Mammalian integument, or skin, includes secretory glands with various functions.  Sebaceous glands  produce a lipid mixture called sebum that is secreted onto the hair and skin for water resistance and lubrication. Sebaceous glands are located over most of the body.  Eccrine glands  produce sweat, or perspiration, which is mainly composed of water. In most mammals, eccrine glands are limited to certain areas of the body, and some mammals do not possess them at all. However, in primates, especially humans, sweat figures prominently in thermoregulation, regulating the body through evaporative cooling. Sweat glands are located over most of the body surface in primates.  Apocrine glands , or scent glands, secrete substances that are used for chemical communication, such as in skunks.  Mammary glands  produce milk that is used to feed newborns. While male monotremes and eutherians possess mammary glands, male marsupials do not. Mammary glands likely are modified sebaceous or eccrine glands, but their evolutionary origin is not entirely clear. \n\n The skeletal system of mammals possesses many unique features. The lower jaw of mammals consists of only one bone, the  dentary . The jaws of other vertebrates are composed of more than one bone. In mammals, the dentary bone joins the skull at the squamosal bone, while in other vertebrates, the quadrate bone of the jaw joins with the articular bone of the skull. These bones are present in mammals, but they have been modified to function in hearing and form bones in the middle ear ( Figure 29.35 ). Other vertebrates possess only one middle ear bone, the stapes. Mammals have three: the malleus, incus, and stapes. The malleus originated from the articular bone, whereas the incus originated from the quadrate bone. This arrangement of jaw and ear bones aids in distinguishing fossil mammals from fossils of other synapsids. \n\n The adductor muscle that closes the jaw is composed of two muscles in mammals: the temporalis and the masseter. These allow side-to-side movement of the jaw, making chewing possible, which is unique to mammals. Most mammals have  heterodont teeth , meaning that they have different types and shapes of teeth rather than just one type and shape of tooth. Most mammals are  diphyodonts , meaning that they have two sets of teeth in their lifetime: deciduous or \u201cbaby\u201d teeth, and permanent teeth. Other vertebrates are polyphyodonts, that is, their teeth are replaced throughout their entire life. \n\n Mammals, like birds, possess a four-chambered heart. Mammals also have a specialized group of cardiac fibers located in the walls of their right atrium called the sinoatrial node, or pacemaker, which determines the rate at which the heart beats. Mammalian erythrocytes (red blood cells) do not have nuclei, whereas the erythrocytes of other vertebrates are nucleated. \n\n The kidneys of mammals have a portion of the nephron called the loop of Henle or nephritic loop, which allows mammals to produce urine with a high concentration of solutes, higher than that of the blood. Mammals lack a renal portal system, which is a system of veins that moves blood from the hind or lower limbs and region of the tail to the kidneys. Renal portal systems are present in all other vertebrates except jawless fishes. A urinary bladder is present in all mammals. \n\n Mammalian brains have certain characteristics that differ from other vertebrates. In some, but not all mammals, the cerebral cortex, the outermost part of the cerebrum, is highly folded, allowing for a greater surface area than is possible with a smooth cortex. The optic lobes, located in the midbrain, are divided into two parts in mammals, whereas other vertebrates possess a single, undivided lobe. Eutherian mammals also possess a specialized structure that links the two cerebral hemispheres, called the corpus callosum. \n\n Evolution of Mammals \n\n Mammals are synapsids, meaning they have a single opening in the skull. They are the only living synapsids, as earlier forms became extinct by the Jurassic period. The early non-mammalian synapsids can be divided into two groups, the pelycosaurs and the therapsids. Within the therapsids, a group called the cynodonts are thought to be the ancestors of mammals ( Figure 29.36 ). \n\n A key characteristic of synapsids is endothermy, rather than the ectothermy seen in most other vertebrates. The increased metabolic rate required to internally modify body temperature went hand in hand with changes to certain skeletal structures. The later synapsids, which had more evolved characteristics unique to mammals, possess cheeks for holding food and heterodont teeth, which are specialized for chewing, mechanically breaking down food to speed digestion and releasing the energy needed to produce heat. Chewing also requires the ability to chew and breathe at the same time, which is facilitated by the presence of a secondary palate. A secondary palate separates the area of the mouth where chewing occurs from the area above where respiration occurs, allowing breathing to proceed uninterrupted during chewing. A secondary palate is not found in pelycosaurs but is present in cynodonts and mammals. The jawbone also shows changes from early synapsids to later ones. The zygomatic arch, or cheekbone, is present in mammals and advanced therapsids such as cynodonts, but is not present in pelycosaurs. The presence of the zygomatic arch suggests the presence of the masseter muscle, which closes the jaw and functions in chewing. \n\n In the appendicular skeleton, the shoulder girdle of therian mammals is modified from that of other vertebrates in that it does not possess a procoracoid bone or an interclavicle, and the scapula is the dominant bone. \n\n Mammals evolved from therapsids in the late Triassic period, as the earliest known mammal fossils are from the early Jurassic period, some 205 million years ago. Early mammals were small, about the size of a small rodent. Mammals first began to diversify in the Mesozoic Era, from the Jurassic to the Cretaceous periods, although most of these mammals were extinct by the end of the Mesozoic. During the Cretaceous period, another radiation of mammals began and continued through the Cenozoic Era, about 65 million years ago. \n\n Living Mammals\t \n\n The eutherians, or placental mammals, and the marsupials together comprise the clade of therian mammals. Monotremes, or metatherians, form their sister clade. \n\n There are three living species of  monotremes : the platypus and two species of echidnas, or spiny anteaters. The leathery-beaked platypus belongs to the family  Ornithorhynchidae  (\u201cbird beak\u201d), whereas echidnas belong to the family  Tachyglossidae  (\u201csticky tongue\u201d) ( Figure 29.37 ). The platypus and one species of echidna are found in Australia, and the other species of echidna is found in New Guinea. Monotremes are unique among mammals as they lay eggs, rather than giving birth to live young. The shells of their eggs are not like the hard shells of birds, but are a leathery shell, similar to the shells of reptile eggs. Monotremes have no teeth. \n\n Marsupials  are found primarily in Australia, though the opossum is found in North America. Australian marsupials include the kangaroo, koala, bandicoot, Tasmanian devil ( Figure 29.38 ), and several other species. Most species of marsupials possess a pouch in which the very premature young reside after birth, receiving milk and continuing to develop. Marsupials differ from eutherians in that there is a less complex placental connection: The young are born at an extremely early age and latch onto the nipple within the pouch. \n\n Eutherians are the most widespread of the mammals, occurring throughout the world. There are 18 to 20 orders of placental mammals. Some examples are Insectivora, the insect eaters; Edentata, the toothless anteaters; Rodentia, the rodents; Cetacea, the aquatic mammals including whales; Carnivora, carnivorous mammals including dogs, cats, and bears; and Primates, which includes humans.  Eutherian mammals  are sometimes called placental mammals because all species possess a complex placenta that connects a fetus to the mother, allowing for gas, fluid, and nutrient exchange. While other mammals possess a less complex placenta or briefly have a placenta, all eutherians possess a complex placenta during gestation. \n29.7   The Evolution of Primates Learning Objectives By the end of this section, you will be able to:\n\n Describe the derived features that distinguish primates from other animals \n\n Explain why scientists are having difficulty determining the true lines of descent in hominids \n\n Order  Primates  of class Mammalia includes lemurs, tarsiers, monkeys, apes, and humans. Non-human primates live primarily in the tropical or subtropical regions of South America, Africa, and Asia. They range in size from the mouse lemur at 30 grams (1 ounce) to the mountain gorilla at 200 kilograms (441 pounds). The characteristics and evolution of primates is of particular interest to us as it allows us to understand the evolution of our own species. \n\n Characteristics of Primates \n\n All primate species possess adaptations for climbing trees, as they all descended from tree-dwellers. This arboreal heritage of primates has resulted in hands and feet that are adapted for  brachiation , or climbing and swinging through trees. These adaptations include, but are not limited to: 1) a rotating shoulder joint, 2) a big toe that is widely separated from the other toes and thumbs, which are widely separated from fingers (except humans), which allow for gripping branches, 3)  stereoscopic vision , two overlapping fields of vision from the eyes, which allows for the perception of depth and gauging distance. Other characteristics of primates are brains that are larger than those of most other mammals, claws that have been modified into flattened nails, typically only one offspring per pregnancy, and a trend toward holding the body upright. \n\n Order Primates is divided into two groups: prosimians and anthropoids.  Prosimians  include the bush babies of Africa, the lemurs of Madagascar, and the lorises, pottos, and tarsiers of Southeast Asia.  Anthropoids  include monkeys, apes, and humans. In general, prosimians tend to be nocturnal (in contrast to diurnal anthropoids) and exhibit a smaller size and smaller brain than anthropoids. \n\n Evolution of Primates \n\n The first primate-like mammals are referred to as proto-primates. They were roughly similar to squirrels and tree shrews in size and appearance. The existing fossil evidence (mostly from North Africa) is very fragmented. These proto-primates remain largely mysterious creatures until more fossil evidence becomes available. The oldest known primate-like mammals with a relatively robust fossil record is  Plesiadapis  (although some researchers do not agree that  Plesiadapis  was a proto-primate). Fossils of this primate have been dated to approximately 55 million years ago. Plesiadapiforms were proto-primates that had some features of the teeth and skeleton in common with true primates. They were found in North America and Europe in the Cenozoic and went extinct by the end of the Eocene. The first true primates were found in North America, Europe, Asia, and Africa in the Eocene Epoch. These early primates resembled present-day prosimians such as lemurs. Evolutionary changes continued in these early primates, with larger brains and eyes, and smaller muzzles being the trend. By the end of the Eocene Epoch, many of the early prosimian species went extinct due either to cooler temperatures or competition from the first monkeys. \n\n Anthropoid monkeys evolved from prosimians during the Oligocene Epoch. By 40 million years ago, evidence indicates that monkeys were present in the New World (South America) and the Old World (Africa and Asia). New World monkeys are also called  Platyrrhini \u2014a reference to their broad noses ( Figure 29.39 ). Old World monkeys are called  Catarrhini \u2014a reference to their narrow noses. There is still quite a bit of uncertainty about the origins of the New World monkeys. At the time the platyrrhines arose, the continents of South American and Africa had drifted apart. Therefore, it is thought that monkeys arose in the Old World and reached the New World either by drifting on log rafts or by crossing land bridges. Due to this reproductive isolation, New World monkeys and Old World monkeys underwent separate adaptive radiations over millions of years. The New World monkeys are all arboreal, whereas Old World monkeys include arboreal and ground-dwelling species. \n\n Apes evolved from the catarrhines in Africa midway through the Cenozoic, approximately 25 million years ago. Apes are generally larger than monkeys and they do not possess a tail. All apes are capable of moving through trees, although many species spend most their time on the ground. Apes are more intelligent than monkeys, and they have relatively larger brains proportionate to body size. The apes are divided into two groups. The lesser apes comprise the family  Hylobatidae , including gibbons and siamangs. The great apes include the genera  Pan  (chimpanzees and bonobos) ( Figure 29.40 a ),  Gorilla  (gorillas),  Pongo  (orangutans), and  Homo  (humans) ( Figure 29.40 b ). The very arboreal gibbons are smaller than the great apes; they have low sexual dimorphism (that is, the sexes are not markedly different in size); and they have relatively longer arms used for swinging through trees. \n\n Human Evolution \n\n The family Hominidae of order Primates includes the  hominoids : the great apes ( Figure 29.41 ). Evidence from the fossil record and from a comparison of human and chimpanzee DNA suggests that humans and chimpanzees diverged from a common hominoid ancestor approximately 6 million years ago. Several species evolved from the evolutionary branch that includes humans, although our species is the only surviving member. The term  hominin  is used to refer to those species that evolved after this split of the primate line, thereby designating species that are more closely related to humans than to chimpanzees. Hominins were predominantly bipedal and include those groups that likely gave rise to our species\u2014including  Australopithecus ,  Homo habilis , and  Homo erectus \u2014and those non-ancestral groups that can be considered \u201ccousins\u201d of modern humans, such as Neanderthals. Determining the true lines of descent in hominins is difficult. In years past, when relatively few hominin fossils had been recovered, some scientists believed that considering them in order, from oldest to youngest, would demonstrate the course of evolution from early hominins to modern humans. In the past several years, however, many new fossils have been found, and it is clear that there was often more than one species alive at any one time and that many of the fossils found (and species named) represent hominin species that died out and are not ancestral to modern humans. \n\n Very Early Hominins \n\n Three species of very early hominids have made news in the past few years. The oldest of these,  Sahelanthropus tchadensis , has been dated to nearly 7 million years ago. There is a single specimen of this genus, a skull that was a surface find in Chad. The fossil, informally called \u201cToumai,\u201d is a mosaic of primitive and evolved characteristics, and it is unclear how this fossil fits with the picture given by molecular data, namely that the line leading to modern humans and modern chimpanzees apparently bifurcated about 6 million years ago. It is not thought at this time that this species was an ancestor of modern humans. \n\n A second, younger species,  Orrorin tugenensis , is also a relatively recent discovery, found in 2000. There are several specimens of  Orrorin . It is not known whether  Orrorin  was a human ancestor, but this possibility has not been ruled out. Some features of  Orrorin  are more similar to those of modern humans than are the australopiths, although  Orrorin  is much older. \n\n A third genus,  Ardipithecus , was discovered in the 1990s, and the scientists who discovered the first fossil found that some other scientists did not believe the organism to be a biped (thus, it would not be considered a hominid). In the intervening years, several more specimens of  Ardipithecus , classified as two different species, demonstrated that the organism was bipedal. Again, the status of this genus as a human ancestor is uncertain. \n\n Early Hominins: Genus  Australopithecus \n\n Australopithecus  (\u201csouthern ape\u201d) is a genus of hominin that evolved in eastern Africa approximately 4 million years ago and went extinct about 2 million years ago. This genus is of particular interest to us as it is thought that our genus, genus  Homo , evolved from a common ancestor shared with  Australopithecus  about 2 million years ago (after likely passing through some transitional states).  Australopithecus  had a number of characteristics that were more similar to the great apes than to modern humans. For example, sexual dimorphism was more exaggerated than in modern humans. Males were up to 50 percent larger than females, a ratio that is similar to that seen in modern gorillas and orangutans. In contrast, modern human males are approximately 15 to 20 percent larger than females. The brain size of  Australopithecus  relative to its body mass was also smaller than modern humans and more similar to that seen in the great apes. A key feature that  Australopithecus  had in common with modern humans was bipedalism, although it is likely that  Australopithecus  also spent time in trees. Hominin footprints, similar to those of modern humans, were found in Laetoli, Tanzania and dated to 3.6 million years ago. They showed that hominins at the time of  Australopithecus  were walking upright. There were a number of  Australopithecus  species, which are often referred to as  australopiths .  Australopithecus anamensis  lived about 4.2 million years ago. More is known about another early species,  Australopithecus afarensis , which lived between 3.9 and 2.9 million years ago. This species demonstrates a trend in human evolution: the reduction of the dentition and jaw in size.  A .  afarensis  ( Figure 29.42 ) had smaller canines and molars compared to apes, but these were larger than those of modern humans. Its brain size was 380\u2013450 cubic centimeters, approximately the size of a modern chimpanzee brain. It also had  prognathic jaws , which is a relatively longer jaw than that of modern humans. In the mid-1970s, the fossil of an adult female  A .  afarensis  was found in the Afar region of Ethiopia and dated to 3.24 million years ago ( Figure 29.43 ). The fossil, which is informally called \u201cLucy,\u201d is significant because it was the most complete australopith fossil found, with 40 percent of the skeleton recovered. Australopithecus africanus  lived between 2 and 3 million years ago. It had a slender build and was bipedal, but had robust arm bones and, like other early hominids, may have spent significant time in trees. Its brain was larger than that of  A .  afarensis  at 500 cubic centimeters, which is slightly less than one-third the size of modern human brains. Two other species,  Australopithecus bahrelghazali  and  Australopithecus garhi , have been added to the roster of australopiths in recent years. \n\n A Dead End: Genus  Paranthropus \n\n The australopiths had a relatively slender build and teeth that were suited for soft food. In the past several years, fossils of hominids of a different body type have been found and dated to approximately 2.5 million years ago. These hominids, of the genus  Paranthropus , were muscular, stood 1.3-1.4 meters tall, and had large grinding teeth. Their molars showed heavy wear, suggesting that they had a coarse and fibrous vegetarian diet as opposed to the partially carnivorous diet of the australopiths.  Paranthropus  includes  Paranthropus   robustus  of South Africa, and  Paranthropus   aethiopicus  and  Paranthropus   boisei  of East Africa. The hominids in this genus went extinct more than 1 million years ago and are not thought to be ancestral to modern humans, but rather members of an evolutionary branch on the hominin tree that left no descendants. \n\n Early Hominins: Genus  Homo The human genus,  Homo , first appeared between 2.5 and 3 million years ago. For many years, fossils of a species called  H .  habilis  were the oldest examples in the genus  Homo , but in 2010, a new species called  Homo gautengensis  was discovered and may be older. Compared to  A .  africanus ,  H .  habilis  had a number of features more similar to modern humans.  H .  habilis  had a jaw that was less prognathic than the australopiths and a larger brain, at 600\u2013750 cubic centimeters. However,  H .  habilis  retained some features of older hominin species, such as long arms. The name  H .  habilis  means \u201chandy man,\u201d which is a reference to the stone tools that have been found with its remains. \n\n Link to Learning \n\n Watch this video about Smithsonian paleontologist Briana Pobiner explaining the link between hominin eating of meat and evolutionary trends.\n\n Click to view content \n\n H .  erectus  appeared approximately 1.8 million years ago ( Figure 29.44 ). It is believed to have originated in East Africa and was the first hominin species to migrate out of Africa. Fossils of  H .  erectus  have been found in India, China, Java, and Europe, and were known in the past as \u201cJava Man\u201d or \u201cPeking Man.\u201d  H .  erectus  had a number of features that were more similar to modern humans than those of  H .  habilis .  H .  erectus  was larger in size than earlier hominins, reaching heights up to 1.85 meters and weighing up to 65 kilograms, which are sizes similar to those of modern humans. Its degree of sexual dimorphism was less than earlier species, with males being 20 to 30 percent larger than females, which is close to the size difference seen in our species.  H .  erectus  had a larger brain than earlier species at 775\u20131,100 cubic centimeters, which compares to the 1,130\u20131,260 cubic centimeters seen in modern human brains.  H .  erectus  also had a nose with downward-facing nostrils similar to modern humans, rather than the forward facing nostrils found in other primates. Longer, downward-facing nostrils allow for the warming of cold air before it enters the lungs and may have been an adaptation to colder climates. Artifacts found with fossils of  H .  erectus  suggest that it was the first hominin to use fire, hunt, and have a home base.  H .  erectus  is generally thought to have lived until about 50,000 years ago. \n\n Humans:  Homo sapiens \n\n A number of species, sometimes called archaic  Homo sapiens , apparently evolved from  H .  erectus  starting about 500,000 years ago. These species include  Homo heidelbergensis ,  Homo rhodesiensis , and  Homo neanderthalensis . These archaic  H .  sapiens  had a brain size similar to that of modern humans, averaging 1,200\u20131,400 cubic centimeters. They differed from modern humans by having a thick skull, a prominent brow ridge, and a receding chin. Some of these species survived until 30,000\u201310,000 years ago, overlapping with modern humans ( Figure 29.45 ). \n\n There is considerable debate about the origins of anatomically modern humans or  Homo sapiens sapiens . As discussed earlier,  H .  erectus  migrated out of Africa and into Asia and Europe in the first major wave of migration about 1.5 million years ago. It is thought that modern humans arose in Africa from  H .  erectus  and migrated out of Africa about 100,000 years ago in a second major migration wave. Then, modern humans replaced  H .  erectus  species that had migrated into Asia and Europe in the first wave. This evolutionary timeline is supported by molecular evidence. One approach to studying the origins of modern humans is to examine mitochondrial DNA (mtDNA) from populations around the world. Because a fetus develops from an egg containing its mother\u2019s mitochondria (which have their own, non-nuclear DNA), mtDNA is passed entirely through the maternal line. Mutations in mtDNA can now be used to estimate the timeline of genetic divergence. The resulting evidence suggests that all modern humans have mtDNA inherited from a common ancestor that lived in Africa about 160,000 years ago. Another approach to the molecular understanding of human evolution is to examine the Y chromosome, which is passed from father to son. This evidence suggests that all men today inherited a Y chromosome from a male that lived in Africa about 140,000 years ago. ", "questions": [{"question": {"question_id": "fs-idp169399296", "question_text": "Which of the following is not contained in phylum Chordata?", "question_choices": ["Cephalochordata", "Echinodermata", "Urochordata", "Vertebrata"], "cloze_format": "___  is not contained in phylum Chordata.", "normal_format": "Which of the following is not contained in phylum Chordata?"}, "answer": {"ans_text": "Echinodermata", "ans_choice": 1}, "bloom": null, "hl_sentences": "Chordata also contains two clades of invertebrates : Urochordata and Cephalochordata . Vertebrates are members of the kingdom Animalia and the phylum Chordata ( Figure 29.2 ) .", "hl_context": "<hl> Chordata also contains two clades of invertebrates : Urochordata and Cephalochordata . <hl> Members of these groups also possess the four distinctive features of chordates at some point during their development . <hl> Vertebrates are members of the kingdom Animalia and the phylum Chordata ( Figure 29.2 ) . <hl> Recall that animals that possess bilateral symmetry can be divided into two groups \u2014 protostomes and deuterostomes \u2014 based on their patterns of embryonic development . The deuterostomes , whose name translates as \u201c second mouth , \u201d consist of two phyla : Chordata and Echinodermata . Echinoderms are invertebrate marine animals that have pentaradial symmetry and a spiny body covering , a group that includes sea stars , sea urchins , and sea cucumbers . The most conspicuous and familiar members of Chordata are vertebrates , but this phylum also includes two groups of invertebrate chordates ."}, {"question": {"question_id": "fs-idm154235264", "question_text": "Which group of invertebrates is most closely related to vertebrates?", "question_choices": ["cephalochordates", "echinoderms", "arthropods", "urochordates"], "cloze_format": "The group of invertebrates that is most closely related to vertebrates are ___.", "normal_format": "Which group of invertebrates is most closely related to vertebrates?"}, "answer": {"ans_text": "cephalochordates", "ans_choice": 0}, "bloom": "3", "hl_sentences": "Based on molecular analysis , vertebrates appear to be more closely related to lancelets ( cephalochordates ) than to tunicates ( urochordates ) among the invertebrate chordates .", "hl_context": "<hl> Based on molecular analysis , vertebrates appear to be more closely related to lancelets ( cephalochordates ) than to tunicates ( urochordates ) among the invertebrate chordates . <hl> This evidence suggests that the cephalochordates diverged from Urochordata and the vertebrates subsequently diverged from the cephalochordates . This hypothesis is further supported by the discovery of a fossil in China from the genus Haikouella . This organism seems to be an intermediate form between cephalochordates and vertebrates . The Haikouella fossils are about 530 million years old and appear similar to modern lancelets . These organisms had a brain and eyes , as do vertebrates , but lack the skull found in craniates . 1 This evidence suggests that vertebrates arose during the Cambrian explosion . Recall that the \u201c Cambrian explosion \u201d is the name given to a relatively brief span of time during the Cambrian period during which many animal groups appeared and rapidly diversified . Most modern animal phyla originated during the Cambrian explosion . 1 Chen , J . Y . , Huang , D . Y . , and Li , C . W . , \u201c An early Cambrian craniate-like chordate , \u201d Nature 402 ( 1999 ): 518 \u2013 522 , doi : 10.1038 / 990080 . Vertebrates are the largest group of chordates , with more than 62,000 living species . Vertebrates are grouped based on anatomical and physiological traits . More than one classification and naming scheme is used for these animals . Here we will consider the traditional groups Agnatha , Chondrichthyes , Osteichthyes , Amphibia , Reptilia , Aves , and Mammalia , which constitute classes in the subphylum Vertebrata . Many modern authors classify birds within Reptilia , which correctly reflects their evolutionary heritage . We consider them separately only for convenience . Further , we will consider hagfishes and lampreys together as jawless fishes , the agnathans , although emerging classification schemes separate them into chordate jawless fishes ( the hagfishes ) and vertebrate jawless fishes ( the lampreys ) ."}, {"question": {"question_id": "fs-idm71009680", "question_text": "Members of Chondrichthyes differ from members of Osteichthyes by having a ________.", "question_choices": ["jaw", "bony skeleton", "cartilaginous skeleton", "two sets of paired fins"], "cloze_format": "Members of Chondrichthyes differ from members of Osteichthyes by having a ________.", "normal_format": "Members of Chondrichthyes differ from members of Osteichthyes by having which of the following?"}, "answer": {"ans_text": "cartilaginous skeleton", "ans_choice": 2}, "bloom": null, "hl_sentences": "Members of the clade Osteichthyes , also called bony fishes , are characterized by a bony skeleton . They are thought to be descended from the placoderms , which had skeletons made of bone ; thus , the cartilaginous skeleton of Chondrichthyes is a later development .", "hl_context": "<hl> Members of the clade Osteichthyes , also called bony fishes , are characterized by a bony skeleton . <hl> The vast majority of present-day fishes belong to this group , which consists of approximately 30,000 species , making it the largest class of vertebrates in existence today . The clade Chondrichthyes is diverse , consisting of sharks ( Figure 29.11 ) , rays , and skates , together with sawfishes and a few dozen species of fishes called chimaeras , or \u201c ghost \u201d sharks . \u201d Chondrichthyes are jawed fishes that possess paired fins and a skeleton made of cartilage . This clade arose approximately 370 million years ago in the early or middle Devonian . <hl> They are thought to be descended from the placoderms , which had skeletons made of bone ; thus , the cartilaginous skeleton of Chondrichthyes is a later development . <hl> Parts of shark skeleton are strengthened by granules of calcium carbonate , but this is not the same as bone ."}, {"question": {"question_id": "fs-idp74406752", "question_text": "Members of Chondrichthyes are thought to be descended from fishes that had ________.", "question_choices": ["a cartilaginous skeleton", "a bony skeleton", "mucus glands", "slime glands"], "cloze_format": "Members of Chondrichthyes are thought to be descended from fishes that had ________.", "normal_format": "Members of Chondrichthyes are thought to be descended from fishes that had what?"}, "answer": {"ans_text": "a bony skeleton", "ans_choice": 1}, "bloom": null, "hl_sentences": "They are thought to be descended from the placoderms , which had skeletons made of bone ; thus , the cartilaginous skeleton of Chondrichthyes is a later development .", "hl_context": "The clade Chondrichthyes is diverse , consisting of sharks ( Figure 29.11 ) , rays , and skates , together with sawfishes and a few dozen species of fishes called chimaeras , or \u201c ghost \u201d sharks . \u201d Chondrichthyes are jawed fishes that possess paired fins and a skeleton made of cartilage . This clade arose approximately 370 million years ago in the early or middle Devonian . <hl> They are thought to be descended from the placoderms , which had skeletons made of bone ; thus , the cartilaginous skeleton of Chondrichthyes is a later development . <hl> Parts of shark skeleton are strengthened by granules of calcium carbonate , but this is not the same as bone ."}, {"question": {"question_id": "fs-idm215991584", "question_text": "Which of the following is not true of Acanthostega?", "question_choices": ["It was aquatic.", "It had gills.", "It had four limbs.", "It laid shelled eggs."], "cloze_format": "Of Acanthostega, it cannot be said that ___ .", "normal_format": "Which of the following is not true of Acanthostega?"}, "answer": {"ans_text": "It laid shelled eggs.", "ans_choice": 3}, "bloom": null, "hl_sentences": "Acanthostega was aquatic ; fossils show that it had gills similar to fishes . However , it also had four limbs , with the skeletal structure of limbs found in present-day tetrapods , including amphibians .", "hl_context": "The fossil record provides evidence of the first tetrapods : now-extinct amphibian species dating to nearly 400 million years ago . Evolution of tetrapods from fishes represented a significant change in body plan from one suited to organisms that respired and swam in water , to organisms that breathed air and moved onto land ; these changes occurred over a span of 50 million years during the Devonian period . One of the earliest known tetrapods is from the genus Acanthostega . <hl> Acanthostega was aquatic ; fossils show that it had gills similar to fishes . <hl> <hl> However , it also had four limbs , with the skeletal structure of limbs found in present-day tetrapods , including amphibians . <hl> Therefore , it is thought that Acanthostega lived in shallow waters and was an intermediate form between lobe-finned fishes and early , fully terrestrial tetrapods . What preceded Acanthostega ? In 2006 , researchers published news of their discovery of a fossil of a \u201c tetrapod-like fish , \u201d Tiktaalik roseae , which seems to be an intermediate form between fishes having fins and tetrapods having limbs ( Figure 29.15 ) . Tiktaalik likely lived in a shallow water environment about 375 million years ago . 2 2 Daeschler , E . B . , Shubin , N . H . , and Jenkins , F . J . \u201c A Devonian tetrapod-like fish and the evolution of the tetrapod body plan , \u201d Nature 440 ( 2006 ): 757 \u2013 763 , doi : 10.1038 / nature 04639 , http://www.nature.com/nature/journal/v440/n7085/abs/nature04639.html ."}, {"question": {"question_id": "fs-idp31893824", "question_text": "Frogs belong to which order?", "question_choices": ["Anura", "Urodela", "Caudata", "Apoda"], "cloze_format": "Frogs belong to the ___ order.", "normal_format": "Frogs belong to which order?"}, "answer": {"ans_text": "Anura", "ans_choice": 0}, "bloom": "2", "hl_sentences": "Frogs are amphibians that belong to the order Anura ( Figure 29.17 ) .", "hl_context": "<hl> Frogs are amphibians that belong to the order Anura ( Figure 29.17 ) . <hl> Anurans are among the most diverse groups of vertebrates , with approximately 5,965 species that occur on all of the continents except Antarctica . Anurans have a body plan that is more specialized for movement . Adult frogs use their hind limbs to jump on land . Frogs have a number of modifications that allow them to avoid predators , including skin that acts as camouflage . Many species of frogs and salamanders also release defensive chemicals from glands in the skin that are poisonous to predators ."}, {"question": {"question_id": "fs-idp38691344", "question_text": "During the Mesozoic period, diapsids diverged into_______.", "question_choices": ["pterosaurs and dinosaurs", "mammals and reptiles", "lepidosaurs and archosaurs", "Testudines and Sphenodontia"], "cloze_format": "During the Mesozoic period, diapsids diverged into_______.", "normal_format": "During the Mesozoic period, what did diapsids diverge into?"}, "answer": {"ans_text": "lepidosaurs and archosaurs", "ans_choice": 2}, "bloom": null, "hl_sentences": "The diapsids diverged into two groups , the Archosauromorpha ( \u201c ancient lizard form \u201d ) and the Lepidosauromorpha ( \u201c scaly lizard form \u201d ) during the Mesozoic period ( Figure 29.22 ) . The lepidosaurs include modern lizards , snakes , and tuataras . The archosaurs include modern crocodiles and alligators , and the extinct pterosaurs ( \u201c winged lizard \u201d ) and dinosaurs ( \u201c terrible lizard \u201d ) .", "hl_context": "<hl> The diapsids diverged into two groups , the Archosauromorpha ( \u201c ancient lizard form \u201d ) and the Lepidosauromorpha ( \u201c scaly lizard form \u201d ) during the Mesozoic period ( Figure 29.22 ) . <hl> <hl> The lepidosaurs include modern lizards , snakes , and tuataras . <hl> <hl> The archosaurs include modern crocodiles and alligators , and the extinct pterosaurs ( \u201c winged lizard \u201d ) and dinosaurs ( \u201c terrible lizard \u201d ) . <hl> Clade Dinosauria includes birds , which evolved from a branch of dinosaurs . Visual Connection"}, {"question": {"question_id": "fs-idp149751328", "question_text": "Squamata includes_______.", "question_choices": ["crocodiles and alligators", "turtles", "tuataras", "lizards and snakes"], "cloze_format": "Squamata includes_______.", "normal_format": "What does Squamata include?"}, "answer": {"ans_text": "lizards and snakes", "ans_choice": 3}, "bloom": null, "hl_sentences": "Squamata ( \u201c scaly \u201d ) arose in the late Permian , and extant species include lizards and snakes .", "hl_context": "<hl> Squamata ( \u201c scaly \u201d ) arose in the late Permian , and extant species include lizards and snakes . <hl> Both are found on all continents except Antarctica . Lizards and snakes are most closely related to tuataras , both groups having evolved from a lepidosaurian ancestor . Squamata is the largest extant clade of reptiles ( Figure 29.27 ) . Most lizards differ from snakes by having four limbs , although these have been variously lost or significantly reduced in at least 60 lineages . Snakes lack eyelids and external ears , which are present in lizards . Lizard species range in size from chameleons and geckos , which are a few centimeters in length , to the Komodo dragon , which is about 3 meters in length . Most lizards are carnivorous , but some large species , such as iguanas , are herbivores ."}, {"question": {"question_id": "fs-idp165991664", "question_text": "A bird or feathered dinosaur is ________.", "question_choices": ["Neornithes", "Archaeopteryx", "Enantiornithes", "Paleognathae"], "cloze_format": "A bird or feathered dinosaur is ________.", "normal_format": "What is a bird or feathered dinosaur?"}, "answer": {"ans_text": "Archaeopteryx", "ans_choice": 1}, "bloom": null, "hl_sentences": "Archaeopteryx is important in establishing the relationship between birds and dinosaurs , because it is an intermediate fossil , meaning it has characteristics of both dinosaurs and birds . The fossilized skeleton of Archaeopteryx looks like that of a dinosaur , and it had teeth whereas birds do not , but it also had feathers modified for flight , a trait associated only with birds among modern animals .", "hl_context": "Dinosaurs ( including birds ) are further subdivided into two groups , the Saurischia ( \u201c lizard like \u201d ) and the Ornithischia ( \u201c bird like \u201d ) . Despite the names of these groups , it was not the bird-like dinosaurs that gave rise to modern birds . Rather , Saurischia diverged into two groups : One included the long-necked herbivorous dinosaurs , such as Apatosaurus . The second group , bipedal predators called theropods , includes birds . This course of evolution is suggested by similarities between theropod fossils and birds , specifically in the structure of the hip and wrist bones , as well as the presence of the wishbone , formed by the fusing of the clavicles . One important fossil of an animal intermediate to dinosaurs and birds is Archaeopteryx , which is from the Jurassic period ( Figure 29.33 ) . <hl> Archaeopteryx is important in establishing the relationship between birds and dinosaurs , because it is an intermediate fossil , meaning it has characteristics of both dinosaurs and birds . <hl> Some scientists propose classifying it as a bird , but others prefer to classify it as a dinosaur . <hl> The fossilized skeleton of Archaeopteryx looks like that of a dinosaur , and it had teeth whereas birds do not , but it also had feathers modified for flight , a trait associated only with birds among modern animals . <hl> Fossils of older feathered dinosaurs exist , but the feathers do not have the characteristics of flight feathers . It is still unclear exactly how flight evolved in birds . Two main theories exist , the arboreal ( \u201c tree \u201d ) hypothesis and the terrestrial ( \u201c land \u201d ) hypothesis . The arboreal hypothesis posits that tree-dwelling precursors to modern birds jumped from branch to branch using their feathers for gliding before becoming fully capable of flapping flight . In contrast to this , the terrestrial hypothesis holds that running was the stimulus for flight , as wings could be used to improve running and then became used for flapping flight . Like the question of how flight evolved , the question of how endothermy evolved in birds still is unanswered . Feathers provide insulation , but this is only beneficial if body heat is being produced internally . Similarly , internal heat production is only viable if insulation is present to retain that heat . It has been suggested that one or the other \u2014 feathers or endothermy \u2014 evolved in response to some other selective pressure ."}, {"question": {"question_id": "fs-idp219440800", "question_text": "Which of the following feather types helps to reduce drag produced by wind resistance during flight?", "question_choices": ["flight feathers", "primary feathers", "secondary feathers", "contour feathers"], "cloze_format": "The feather type that helps to reduce drag produced by wind resistance during flight is ___.", "normal_format": "Which of the following feather types helps to reduce drag produced by wind resistance during flight?"}, "answer": {"ans_text": "contour feathers", "ans_choice": 3}, "bloom": "3", "hl_sentences": "Contour feathers are the feathers found on the body , and they help reduce drag produced by wind resistance during flight .", "hl_context": "Feathers not only act as insulation but also allow for flight , enabling the lift and thrust necessary to become airborne . The feathers on a wing are flexible , so the collective feathers move and separate as air moves through them , reducing the drag on the wing . Flight feathers are asymmetrical , which affects airflow over them and provides some of the lifting and thrusting force required for flight ( Figure 29.30 ) . Two types of flight feathers are found on the wings , primary feathers and secondary feathers . Primary feathers are located at the tip of the wing and provide thrust . Secondary feathers are located closer to the body , attach to the forearm portion of the wing and provide lift . <hl> Contour feathers are the feathers found on the body , and they help reduce drag produced by wind resistance during flight . <hl> They create a smooth , aerodynamic surface so that air moves smoothly over the bird \u2019 s body , allowing for efficient flight ."}, {"question": {"question_id": "fs-idm7071760", "question_text": "Eccrine glands produce ________.", "question_choices": ["sweat", "lipids", "scents", "milk"], "cloze_format": "Eccrine glands produce ________.", "normal_format": "Which do eccrine glands produce?"}, "answer": {"ans_text": "sweat", "ans_choice": 0}, "bloom": null, "hl_sentences": "Eccrine glands produce sweat , or perspiration , which is mainly composed of water .", "hl_context": "Mammalian integument , or skin , includes secretory glands with various functions . Sebaceous glands produce a lipid mixture called sebum that is secreted onto the hair and skin for water resistance and lubrication . Sebaceous glands are located over most of the body . <hl> Eccrine glands produce sweat , or perspiration , which is mainly composed of water . <hl> In most mammals , eccrine glands are limited to certain areas of the body , and some mammals do not possess them at all . However , in primates , especially humans , sweat figures prominently in thermoregulation , regulating the body through evaporative cooling . Sweat glands are located over most of the body surface in primates . Apocrine glands , or scent glands , secrete substances that are used for chemical communication , such as in skunks . Mammary glands produce milk that is used to feed newborns . While male monotremes and eutherians possess mammary glands , male marsupials do not . Mammary glands likely are modified sebaceous or eccrine glands , but their evolutionary origin is not entirely clear ."}, {"question": {"question_id": "fs-idp21416752", "question_text": "Monotremes include:", "question_choices": ["kangaroos", "koalas", "bandicoots", "platypuses"], "cloze_format": "Monotremes include ___.", "normal_format": "What does monotremes include?"}, "answer": {"ans_text": "platypuses", "ans_choice": 3}, "bloom": null, "hl_sentences": "There are three living species of monotremes : the platypus and two species of echidnas , or spiny anteaters .", "hl_context": "<hl> There are three living species of monotremes : the platypus and two species of echidnas , or spiny anteaters . <hl> The leathery-beaked platypus belongs to the family Ornithorhynchidae ( \u201c bird beak \u201d ) , whereas echidnas belong to the family Tachyglossidae ( \u201c sticky tongue \u201d ) ( Figure 29.37 ) . The platypus and one species of echidna are found in Australia , and the other species of echidna is found in New Guinea . Monotremes are unique among mammals as they lay eggs , rather than giving birth to live young . The shells of their eggs are not like the hard shells of birds , but are a leathery shell , similar to the shells of reptile eggs . Monotremes have no teeth ."}, {"question": {"question_id": "fs-idm19080672", "question_text": "Which of the following is not an anthropoid?", "question_choices": ["lemurs", "monkeys", "apes", "humans"], "cloze_format": "___ is not an anthropoid.", "normal_format": "Which of the following is not an anthropoid?"}, "answer": {"ans_text": "lemurs", "ans_choice": 0}, "bloom": "2", "hl_sentences": "Prosimians include the bush babies of Africa , the lemurs of Madagascar , and the lorises , pottos , and tarsiers of Southeast Asia . Anthropoids include monkeys , apes , and humans .", "hl_context": "Order Primates is divided into two groups : prosimians and anthropoids . <hl> Prosimians include the bush babies of Africa , the lemurs of Madagascar , and the lorises , pottos , and tarsiers of Southeast Asia . <hl> <hl> Anthropoids include monkeys , apes , and humans . <hl> In general , prosimians tend to be nocturnal ( in contrast to diurnal anthropoids ) and exhibit a smaller size and smaller brain than anthropoids ."}, {"question": {"question_id": "fs-idp70511280", "question_text": "Which of the following is part of a clade believed to have died out, leaving no descendants?", "question_choices": ["Paranthropus robustus", "Australopithecus africanus", "Homo erectus", " Homo sapiens sapiens"], "cloze_format": "The ___ is part of a clade believed to have died out, leaving no descendants.", "normal_format": "Which of the following is part of a clade believed to have died out, leaving no descendants?"}, "answer": {"ans_text": "Paranthropus robustus", "ans_choice": 0}, "bloom": "2", "hl_sentences": "Paranthropus includes Paranthropus robustus of South Africa , and Paranthropus aethiopicus and Paranthropus boisei of East Africa . The hominids in this genus went extinct more than 1 million years ago and are not thought to be ancestral to modern humans , but rather members of an evolutionary branch on the hominin tree that left no descendants .", "hl_context": "The australopiths had a relatively slender build and teeth that were suited for soft food . In the past several years , fossils of hominids of a different body type have been found and dated to approximately 2.5 million years ago . These hominids , of the genus Paranthropus , were muscular , stood 1.3- 1.4 meters tall , and had large grinding teeth . Their molars showed heavy wear , suggesting that they had a coarse and fibrous vegetarian diet as opposed to the partially carnivorous diet of the australopiths . <hl> Paranthropus includes Paranthropus robustus of South Africa , and Paranthropus aethiopicus and Paranthropus boisei of East Africa . <hl> <hl> The hominids in this genus went extinct more than 1 million years ago and are not thought to be ancestral to modern humans , but rather members of an evolutionary branch on the hominin tree that left no descendants . <hl>"}], "summary": "", "keyterm": "", "bname": "biology"}, {"chapter": 19, "intro": " Chapter Outline 19.1   Urbanization and Its Challenges 19.2   The African American \u201cGreat Migration\u201d and New European Immigration 19.3   Relief from the Chaos of Urban Life 19.4   Change Reflected in Thought and Writing Introduction \n\n \u201cWe saw the big woman with spikes on her head.\u201d So begins Sadie Frowne\u2019s first memory of arriving in the United States. Many Americans experienced in their new home what the thirteen-year-old Polish girl had seen in the silhouette of the Statue of Liberty ( Figure 19.1 ): a wondrous world of new opportunities fraught with dangers. Sadie and her mother, for instance, had left Poland after her father\u2019s death. Her mother died shortly thereafter, and Sadie had to find her own way in New York, working in factories and slowly assimilating to life in a vast multinational metropolis. Her story is similar to millions of others, as people came to the United States seeking a better future than the one they had at home. \n\n The future they found, however, was often grim. While many believed in the land of opportunity, the reality of urban life in the United States was more chaotic and difficult than people expected. In addition to the challenges of language, class, race, and ethnicity, these new arrivals dealt with low wages, overcrowded buildings, poor sanitation, and widespread disease. The land of opportunity, it seemed, did not always deliver on its promises. ", "chapter_text": " 19.1   Urbanization and Its Challenges Learning Objectives By the end of this section, you will be able to: \n\n Explain the growth of American cities in the late nineteenth century \n\n Identify the key challenges that Americans faced due to urbanization, as well as some of the possible solutions to those challenges \n\n Urbanization  occurred rapidly in the second half of the nineteenth century in the United States for a number of reasons. The new technologies of the time led to a massive leap in industrialization, requiring large numbers of workers. New electric lights and powerful machinery allowed factories to run twenty-four hours a day, seven days a week. Workers were forced into grueling twelve-hour shifts, requiring them to live close to the factories. \n\n While the work was dangerous and difficult, many Americans were willing to leave behind the declining prospects of preindustrial agriculture in the hope of better wages in industrial labor. Furthermore, problems ranging from famine to religious persecution led a new wave of immigrants to arrive from central, eastern, and southern Europe, many of whom settled and found work near the cities where they first arrived. Immigrants sought solace and comfort among others who shared the same language and customs, and the nation\u2019s cities became an invaluable economic and cultural resource. \n\n Although cities such as Philadelphia, Boston, and New York sprang up from the initial days of colonial settlement, the explosion in urban population growth did not occur until the mid-nineteenth century ( Figure 19.3 ). At this time, the attractions of city life, and in particular, employment opportunities, grew exponentially due to rapid changes in industrialization. Before the mid-1800s, factories, such as the early textile mills, had to be located near rivers and seaports, both for the transport of goods and the necessary water power. Production became dependent upon seasonal water flow, with cold, icy winters all but stopping river transportation entirely. The development of the steam engine transformed this need, allowing businesses to locate their factories near urban centers. These factories encouraged more and more people to move to urban areas where jobs were plentiful, but hourly wages were often low and the work was routine and grindingly monotonous. \n\n Eventually, cities developed their own unique characters based on the core industry that spurred their growth. In Pittsburgh, it was steel; in Chicago, it was meat packing; in New York, the garment and financial industries dominated; and Detroit, by the mid-twentieth century, was defined by the automobiles it built. But all cities at this time, regardless of their industry, suffered from the universal problems that rapid expansion brought with it, including concerns over housing and living conditions, transportation, and communication. These issues were almost always rooted in deep class inequalities, shaped by racial divisions, religious differences, and ethnic strife, and distorted by corrupt local politics. \n\n THE KEYS TO SUCCESSFUL URBANIZATION \n\n As the country grew, certain elements led some towns to morph into large urban centers, while others did not. The following four innovations proved critical in shaping urbanization at the turn of the century: electric lighting, communication improvements, intracity transportation, and the rise of skyscrapers. As people migrated for the new jobs, they often struggled with the absence of basic urban infrastructures, such as better transportation, adequate housing, means of communication, and efficient sources of light and energy. Even the basic necessities, such as fresh water and proper sanitation\u2014often taken for granted in the countryside\u2014presented a greater challenge in urban life. \n\n Electric Lighting \n\n Thomas Edison patented the incandescent light bulb in 1879. This development quickly became common in homes as well as factories, transforming how even lower- and middle-class Americans lived. Although slow to arrive in rural areas of the country, electric power became readily available in cities when the first commercial power plants began to open in 1882. When Nikola Tesla subsequently developed the AC (alternating current) system for the Westinghouse Electric & Manufacturing Company, power supplies for lights and other factory equipment could extend for miles from the power source. AC power transformed the use of electricity, allowing urban centers to physically cover greater areas. In the factories, electric lights permitted operations to run twenty-four hours a day, seven days a week. This increase in production required additional workers, and this demand brought more people to cities. \n\n Gradually, cities began to illuminate the streets with electric lamps to allow the city to remain alight throughout the night. No longer did the pace of life and economic activity slow substantially at sunset, the way it had in smaller towns. The cities, following the factories that drew people there, stayed open all the time. \n\n Communications Improvements \n\n The telephone, patented in 1876, greatly transformed communication both regionally and nationally. The telephone rapidly supplanted the telegraph as the preferred form of communication; by 1900, over 1.5 million telephones were in use around the nation, whether as private lines in the homes of some middle- and upper-class Americans, or as jointly used \u201cparty lines\u201d in many rural areas. By allowing instant communication over larger distances at any given time, growing telephone networks made urban sprawl possible.\n\n In the same way that electric lights spurred greater factory production and economic growth, the telephone increased business through the more rapid pace of demand. Now, orders could come constantly via telephone, rather than via mail-order. More orders generated greater production, which in turn required still more workers. This demand for additional labor played a key role in urban growth, as expanding companies sought workers to handle the increasing consumer demand for their products. \n\n Intracity Transportation \n\n As cities grew and sprawled outward, a major challenge was efficient travel within the city\u2014from home to factories or shops, and then back again. Most transportation infrastructure was used to connect cities to each other, typically by rail or canal. Prior to the 1880s, two of the most common forms of transportation within cities were the omnibus and the horse car. An omnibus was a large, horse-drawn carriage. A horse car was similar to an omnibus, but it was placed on iron or steel tracks to provide a smoother ride. While these horse-driven vehicles worked adequately in smaller, less-congested cities, they were not equipped to handle the larger crowds that developed at the close of the century. The horses had to stop and rest, and horse manure became an ongoing problem. In 1887, Frank Sprague invented the electric trolley, which worked along the same concept as the horse car, with a large wagon on tracks, but was powered by electricity rather than horses. The electric trolley could run throughout the day and night, like the factories and the workers who fueled them. But it also modernized less important industrial centers, such as the southern city of Richmond, Virginia. As early as 1873, San Francisco engineers adopted pulley technology from the mining industry to introduce cable cars and turn the city\u2019s steep hills into elegant middle-class communities. However, as crowds continued to grow in the largest cities, such as Chicago and New York, trolleys were unable to move efficiently through the crowds of pedestrians ( Figure 19.4 ). To avoid this challenge, city planners elevated the trolley lines above the streets, creating elevated trains, or L-trains, as early as 1868 in New York City, and quickly spreading to Boston in 1887 and Chicago in 1892. Finally, as skyscrapers began to dominate the air, transportation evolved one step further to move underground as subways. Boston\u2019s subway system began operating in 1897, and was quickly followed by New York and other cities. \n\n The Rise of Skyscrapers \n\n The last limitation that large cities had to overcome was the ever-increasing need for space. Eastern cities, unlike their midwestern counterparts, could not continue to grow outward, as the land surrounding them was already settled. Geographic limitations such as rivers or the coast also hampered sprawl. And in all cities, citizens needed to be close enough to urban centers to conveniently access work, shops, and other core institutions of urban life. The increasing cost of real estate made upward growth attractive, and so did the prestige that towering buildings carried for the businesses that occupied them. Workers completed the first skyscraper in Chicago, the ten-story Home Insurance Building, in 1885 ( Figure 19.5 ). Although engineers had the capability to go higher, thanks to new steel construction techniques, they required another vital invention in order to make taller buildings viable: the elevator. In 1889, the Otis Elevator Company, led by inventor Elisha Otis, installed the first electric elevator. This began the skyscraper craze, allowing developers in eastern cities to build and market prestigious real estate in the hearts of crowded eastern metropoles. Defining American Jacob Riis and the Window into \u201cHow the Other Half Lives\u201d Jacob Riis was a Danish immigrant who moved to New York in the late nineteenth century and, after experiencing poverty and joblessness first-hand, ultimately built a career as a police reporter. In the course of his work, he spent much of his time in the slums and tenements of New York\u2019s working poor. Appalled by what he found there, Riis began documenting these scenes of squalor and sharing them through lectures and ultimately through the publication of his book,  How the Other Half Lives , in 1890 ( Figure 19.6 ). \n\n By most contemporary accounts, Riis was an effective storyteller, using drama and racial stereotypes to tell his stories of the ethnic slums he encountered. But while his racial thinking was very much a product of his time, he was also a reformer; he felt strongly that upper and middle-class Americans could and should care about the living conditions of the poor. In his book and lectures, he argued against the immoral landlords and useless laws that allowed dangerous living conditions and high rents. He also suggested remodeling existing tenements or building new ones. He was not alone in his concern for the plight of the poor; other reporters and activists had already brought the issue into the public eye, and Riis\u2019s photographs added a new element to the story. \n\n To tell his stories, Riis used a series of deeply compelling photographs. Riis and his group of amateur photographers moved through the various slums of New York, laboriously setting up their tripods and explosive chemicals to create enough light to take the photographs. His photos and writings shocked the public, made Riis a well-known figure both in his day and beyond, and eventually led to new state legislation curbing abuses in tenements. \n\n THE IMMEDIATE CHALLENGES OF URBAN LIFE \n\n Congestion, pollution, crime, and disease were prevalent problems in all urban centers; city planners and inhabitants alike sought new solutions to the problems caused by rapid urban growth. Living conditions for most working-class urban dwellers were atrocious. They lived in crowded tenement houses and cramped apartments with terrible ventilation and substandard plumbing and sanitation. As a result, disease ran rampant, with typhoid and cholera common. Memphis, Tennessee, experienced waves of cholera (1873) followed by yellow fever (1878 and 1879) that resulted in the loss of over ten thousand lives. By the late 1880s, New York City, Baltimore, Chicago, and New Orleans had all introduced sewage pumping systems to provide efficient waste management. Many cities were also serious fire hazards. An average working-class family of six, with two adults and four children, had at best a two-bedroom tenement. By one 1900 estimate, in the New York City borough of Manhattan alone, there were nearly fifty thousand tenement houses. The photographs of these tenement houses are seen in Jacob Riis\u2019s book,  How the Other Half Lives , discussed in the feature above. Citing a study by the New York State Assembly at this time, Riis found New York to be the most densely populated city in the world, with as many as eight hundred residents per square acre in the Lower East Side working-class slums, comprising the Eleventh and Thirteenth Wards. \n\n Churches and civic organizations provided some relief to the challenges of working-class city life. Churches were moved to intervene through their belief in the concept of the  social gospel . This philosophy stated that all Christians, whether they were church leaders or social reformers, should be as concerned about the conditions of life in the secular world as the afterlife, and the Reverend Washington Gladden was a major advocate. Rather than preaching sermons on heaven and hell, Gladden talked about social changes of the time, urging other preachers to follow his lead. He advocated for improvements in daily life and encouraged Americans of all classes to work together for the betterment of society. His sermons included the message to \u201clove thy neighbor\u201d and held that all Americans had to work together to help the masses. As a result of his influence, churches began to include gymnasiums and libraries as well as offer evening classes on hygiene and health care. Other religious organizations like the Salvation Army and the Young Men\u2019s Christian Association (YMCA) expanded their reach in American cities at this time as well. Beginning in the 1870s, these organizations began providing community services and other benefits to the urban poor. \n\n In the secular sphere, the  settlement house movement  of the 1890s provided additional relief. Pioneering women such as Jane Addams in Chicago and Lillian Wald in New York led this early progressive reform movement in the United States, building upon ideas originally fashioned by social reformers in England. With no particular religious bent, they worked to create settlement houses in urban centers where they could help the working class, and in particular, working-class women, find aid. Their help included child daycare, evening classes, libraries, gym facilities, and free health care. Addams opened her now-famous Hull House ( Figure 19.7 ) in Chicago in 1889, and Wald\u2019s Henry Street Settlement opened in New York six years later. The movement spread quickly to other cities, where they not only provided relief to working-class women but also offered employment opportunities for women graduating college in the growing field of social work. Oftentimes, living in the settlement houses among the women they helped, these college graduates experienced the equivalent of living social classrooms in which to practice their skills, which also frequently caused friction with immigrant women who had their own ideas of reform and self-improvement. \n\n The success of the settlement house movement later became the basis of a political agenda that included pressure for housing laws, child labor laws, and worker\u2019s compensation laws, among others. Florence Kelley, who originally worked with Addams in Chicago, later joined Wald\u2019s efforts in New York; together, they created the National Child Labor Committee and advocated for the subsequent creation of the Children\u2019s Bureau in the U.S. Department of Labor in 1912. Julia Lathrop\u2014herself a former resident of Hull House\u2014became the first woman to head a federal government agency, when President William Howard Taft appointed her to run the bureau. Settlement house workers also became influential leaders in the women\u2019s suffrage movement as well as the antiwar movement during World War I. \n\n My Story Jane Addams Reflects on the Settlement House Movement Jane Addams was a social activist whose work took many forms. She is perhaps best known as the founder of Hull House in Chicago, which later became a model for settlement houses throughout the country. Here, she reflects on the role that the settlement played. \n\n Life in the Settlement discovers above all what has been called \u2018the extraordinary pliability of human nature,\u2019 and it seems impossible to set any bounds to the moral capabilities which might unfold under ideal civic and educational conditions. But in order to obtain these conditions, the Settlement recognizes the need of cooperation, both with the radical and the conservative, and from the very nature of the case the Settlement cannot limit its friends to any one political party or economic school. \n\n The Settlement casts side none of those things which cultivated men have come to consider reasonable and goodly, but it insists that those belong as well to that great body of people who, because of toilsome and underpaid labor, are unable to procure them for themselves. Added to this is a profound conviction that the common stock of intellectual enjoyment should not be difficult of access because of the economic position of him who would approach it, that those \u2018best results of civilization\u2019 upon which depend the finer and freer aspects of living must be incorporated into our common life and have free mobility through all elements of society if we would have our democracy endure. \n\n The educational activities of a Settlement, as well its philanthropic, civic, and social undertakings, are but differing manifestations of the attempt to socialize democracy, as is the very existence of the Settlement itself.  \n\n In addition to her pioneering work in the settlement house movement, Addams also was active in the women\u2019s suffrage movement as well as an outspoken proponent for international peace efforts. She was instrumental in the relief effort after World War I, a commitment that led to her winning the Nobel Peace Prize in 1931. \n 19.2   The African American \u201cGreat Migration\u201d and New European Immigration Learning Objectives By the end of this section, you will be able to: \n\n Identify the factors that prompted African American and European immigration to American cities in the late nineteenth century \n\n Explain the discrimination and anti-immigration legislation that immigrants faced in the late nineteenth century \n\n New cities were populated with diverse waves of new arrivals, who came to the cities to seek work in the businesses and factories there. While a small percentage of these newcomers were White Americans seeking jobs, most were made up of two groups that had not previously been factors in the urbanization movement: African Americans fleeing the racism of the farms and former plantations in the South, and southern and eastern European immigrants. These new immigrants supplanted the previous waves of northern and western European immigrants, who had tended to move west to purchase land. Unlike their predecessors, the newer immigrants lacked the funds to strike out to the western lands and instead remained in the urban centers where they arrived, seeking any work that would keep them alive. \n\n THE AFRICAN AMERICAN \u201cGREAT MIGRATION\u201d \n\n Between the end of the Civil War and the beginning of the Great Depression, nearly two million African Americans fled the rural South to seek new opportunities elsewhere. While some moved west, the vast majority of this  Great Migration , as the large exodus of African Americans leaving the South in the early twentieth century was called, traveled to the Northeast and Upper Midwest. The following cities were the primary destinations for these African Americans: New York, Chicago, Philadelphia, St. Louis, Detroit, Pittsburgh, Cleveland, and Indianapolis. These eight cities accounted for over two-thirds of the total population of the African American migration. \n\n A combination of both \u201cpush\u201d and \u201cpull\u201d factors played a role in this movement. Despite the end of the Civil War and the passage of the Thirteenth, Fourteenth, and Fifteenth Amendments to the U.S. Constitution (ending slavery, ensuring equal protection under the law, and protecting the right to vote, respectively), African Americans were still subjected to intense racial hatred. The rise of the Ku Klux Klan in the immediate aftermath of the Civil War led to increased death threats, violence, and a wave of lynchings. Even after the formal dismantling of the Klan in the late 1870s, racially motivated violence continued. According to researchers at the Tuskegee Institute, there were thirty-five hundred racially motivated lynchings and other murders committed in the South between 1865 and 1900. For African Americans fleeing this culture of violence, northern and midwestern cities offered an opportunity to escape the dangers of the South. In addition to this \u201cpush\u201d out of the South, African Americans were also \u201cpulled\u201d to the cities by factors that attracted them, including job opportunities, where they could earn a wage rather than be tied to a landlord, and the chance to vote (for men, at least), supposedly free from the threat of violence. Although many lacked the funds to move themselves north, factory owners and other businesses that sought cheap labor assisted the migration. Often, the men moved first then sent for their families once they were ensconced in their new city life. Racism and a lack of formal education relegated these African American workers to many of the lower-paying unskilled or semi-skilled occupations. More than 80 percent of African American men worked menial jobs in steel mills, mines, construction, and meat packing. In the railroad industry, they were often employed as porters or servants ( Figure 19.8 ). In other businesses, they worked as janitors, waiters, or cooks. African American women, who faced discrimination due to both their race and gender, found a few job opportunities in the garment industry or laundries, but were more often employed as maids and domestic servants. Regardless of the status of their jobs, however, African Americans earned higher wages in the North than they did for the same occupations in the South, and typically found housing to be more available. \n\n However, such economic gains were offset by the higher cost of living in the North, especially in terms of rent, food costs, and other essentials. As a result, African Americans often found themselves living in overcrowded, unsanitary conditions, much like the tenement slums in which European immigrants lived in the cities. For newly arrived African Americans, even those who sought out the cities for the opportunities they provided, life in these urban centers was exceedingly difficult. They quickly learned that racial discrimination did not end at the Mason-Dixon Line, but continued to flourish in the North as well as the South. European immigrants, also seeking a better life in the cities of the United States, resented the arrival of the African Americans, whom they feared would compete for the same jobs or offer to work at lower wages. Landlords frequently discriminated against them; their rapid influx into the cities created severe housing shortages and even more overcrowded tenements. Homeowners in traditionally White neighborhoods later entered into covenants in which they agreed not to sell to African American buyers; they also often fled neighborhoods into which African Americans had gained successful entry. In addition, some bankers practiced mortgage discrimination, later known as \u201credlining,\u201d in order to deny home loans to qualified buyers. Such pervasive discrimination led to a concentration of African Americans in some of the worst slum areas of most major metropolitan cities, a problem that remained ongoing throughout most of the twentieth century. \n\n So why move to the North, given that the economic challenges they faced were similar to those that African Americans encountered in the South? The answer lies in noneconomic gains. Greater educational opportunities and more expansive personal freedoms mattered greatly to the African Americans who made the trek northward during the Great Migration. State legislatures and local school districts allocated more funds for the education of both Blacks and Whites in the North, and also enforced compulsory school attendance laws more rigorously. Similarly, unlike the South where a simple gesture (or lack of a deferential one) could result in physical harm to the African American who committed it, life in larger, crowded northern urban centers permitted a degree of anonymity\u2014and with it, personal freedom\u2014that enabled African Americans to move, work, and speak without deferring to every White person with whom they crossed paths. Psychologically, these gains more than offset the continued economic challenges that Black migrants faced. \n\n THE CHANGING NATURE OF EUROPEAN IMMIGRATION \n\n Immigrants also shifted the demographics of the rapidly growing cities. Although immigration had always been a force of change in the United States, it took on a new character in the late nineteenth century. Beginning in the 1880s, the arrival of immigrants from mostly southern and eastern European countries rapidly increased while the flow from northern and western Europe remained relatively constant ( Table 19.1 ). \n\n Region Country \n\n 1870 \n\n 1880 \n\n 1890 \n\n 1900 \n\n 1910 \n\n Northern and Western Europe \n\n 4,845,679 \n\n 5,499,889 \n\n 7,288,917 \n\n 7,204,649 \n\n 7,306,325 \n\n Germany \n\n 1,690,533 \n\n 1,966,742 \n\n 2,784,894 \n\n 2,663,418 \n\n 2,311,237 \n\n Ireland  \n\n 1,855,827 \n\n 1,854,571 \n\n 1,871,509 \n\n 1,615,459 \n\n 1,352,251 \n\n England \n\n 550,924 \n\n 662,676 \n\n 908,141 \n\n 840,513 \n\n 877,719 \n\n Sweden \n\n 97,332 \n\n 194,337 \n\n 478,041 \n\n 582,014 \n\n 665,207 \n\n Austria \n\n 30,508 \n\n 38,663 \n\n 123,271 \n\n 275,907 \n\n 626,341 \n\n Norway \n\n 114,246 \n\n 181,729 \n\n 322,665 \n\n 336,388 \n\n 403,877 \n\n Scotland \n\n 140,835 \n\n 170,136 \n\n 242,231 \n\n 233,524 \n\n 261,076 \n\n Southern and Eastern Europe \n\n 93,824 \n\n 248,620 \n\n 728,851 \n\n 1,674,648 \n\n 4,500,932 \n\n Italy \n\n 17,157 \n\n 44,230 \n\n 182,580 \n\n 484,027 \n\n 1,343,125 \n\n Russia \n\n 4,644 \n\n 35,722 \n\n 182,644 \n\n 423,726 \n\n 1,184,412 \n\n Poland \n\n 14,436 \n\n 48,557 \n\n 147,440 \n\n 383,407 \n\n 937,884 \n\n Hungary \n\n 3,737 \n\n 11,526 \n\n 62,435 \n\n 145,714 \n\n 495,609 \n\n Czechoslovakia \n\n 40,289 \n\n 85,361 \n\n 118,106 \n\n 156,891 \n\n 219,214 \n\n Table  19.1   Cumulative Total of the Foreign-Born Population in the United States, 1870\u20131910 (by major country of birth and European region)   \n\n The previous waves of immigrants from northern and western Europe, particularly Germany, Great Britain, and the Nordic countries, were relatively well off, arriving in the country with some funds and often moving to the newly settled western territories. In contrast, the newer immigrants from southern and eastern European countries, including Italy, Greece, and several Slavic countries including Russia, came over due to \u201cpush\u201d and \u201cpull\u201d factors similar to those that influenced the African Americans arriving from the South. Many were \u201cpushed\u201d from their countries by a series of ongoing famines, by the need to escape religious, political, or racial persecution, or by the desire to avoid compulsory military service. They were also \u201cpulled\u201d by the promise of consistent, wage-earning work. \n\n Whatever the reason, these immigrants arrived without the education and finances of the earlier waves of immigrants, and settled more readily in the port towns where they arrived, rather than setting out to seek their fortunes in the West. By 1890, over 80 percent of the population of New York would be either foreign-born or children of foreign-born parentage. Other cities saw huge spikes in foreign populations as well, though not to the same degree, due in large part to Ellis Island in New York City being the primary port of entry for most European immigrants arriving in the United States. \n\n The number of immigrants peaked between 1900 and 1910, when over nine million people arrived in the United States. To assist in the processing and management of this massive wave of immigrants, the Bureau of Immigration in New York City, which had become the official port of entry, opened Ellis Island in 1892. Today, nearly half of all Americans have ancestors who, at some point in time, entered the country through the portal at Ellis Island. Doctors or nurses inspected the immigrants upon arrival, looking for any signs of infectious diseases ( Figure 19.9 ). Most immigrants were admitted to the country with only a cursory glance at any other paperwork. Roughly 2 percent of the arriving immigrants were denied entry due to a medical condition or criminal history. The rest would enter the country by way of the streets of New York, many unable to speak English and totally reliant on finding those who spoke their native tongue. \n\n Seeking comfort in a strange land, as well as a common language, many immigrants sought out relatives, friends, former neighbors, townspeople, and countrymen who had already settled in American cities. This led to a rise in ethnic enclaves within the larger city. Little Italy, Chinatown, and many other communities developed in which immigrant groups could find everything to remind them of home, from local language newspapers to ethnic food stores. While these enclaves provided a sense of community to their members, they added to the problems of urban congestion, particularly in the poorest slums where immigrants could afford housing. \n\n The demographic shift at the turn of the century was later confirmed by the Dillingham Commission, created by Congress in 1907 to report on the nature of immigration in America; the commission reinforced this ethnic identification of immigrants and their simultaneous discrimination. The report put it simply: These newer immigrants looked and acted differently. They had darker skin tone, spoke languages with which most Americans were unfamiliar, and practiced unfamiliar religions, specifically Judaism and Catholicism. Even the foods they sought out at butchers and grocery stores set immigrants apart. Because of these easily identifiable differences, new immigrants became easy targets for hatred and discrimination. If jobs were hard to find, or if housing was overcrowded, it became easy to blame the immigrants. Like African Americans, immigrants in cities were blamed for the problems of the day. \n\n Growing numbers of Americans resented the waves of new immigrants, resulting in a backlash. The Reverend Josiah Strong fueled the hatred and discrimination in his bestselling book,  Our Country: Its Possible Future and Its Present Crisis , published in 1885. In a revised edition that reflected the 1890 census records, he clearly identified undesirable immigrants\u2014those from southern and eastern European countries\u2014as a key threat to the moral fiber of the country, and urged all good Americans to face the challenge. Several thousand Americans answered his call by forming the American Protective Association, the chief political activist group to promote legislation curbing immigration into the United States. The group successfully lobbied Congress to adopt both an English language literacy test for immigrants, which eventually passed in 1917, and the Chinese Exclusion Act (discussed in a previous chapter). The group\u2019s political lobbying also laid the groundwork for the subsequent Emergency Quota Act of 1921 and the Immigration Act of 1924, as well as the National Origins Act. \n 19.3   Relief from the Chaos of Urban Life Learning Objectives By the end of this section, you will be able to: \n\n Identify how each class of Americans\u2014working class, middle class, and upper class\u2014responded to the challenges associated with urban life \n\n Explain the process of machine politics and how it brought relief to working-class Americans \n\n Settlement houses and religious and civic organizations attempted to provide some support to working-class city dwellers through free health care, education, and leisure opportunities. Still, for urban citizens, life in the city was chaotic and challenging. But how that chaos manifested and how relief was sought differed greatly, depending on where people were in the social caste\u2014the working class, the upper class, or the newly emerging professional middle class\u2014in addition to the aforementioned issues of race and ethnicity. While many communities found life in the largest American cities disorganized and overwhelming, the ways they answered these challenges were as diverse as the people who lived there. Broad solutions emerged that were typically class specific: The rise of machine politics and popular culture provided relief to the working class, higher education opportunities and suburbanization benefitted the professional middle class, and reminders of their elite status gave comfort to the upper class. And everyone, no matter where they fell in the class system, benefited from the efforts to improve the physical landscapes of the fast-growing urban environment. \n\n THE LIFE AND STRUGGLES OF THE URBAN WORKING CLASS \n\n For the working-class residents of America\u2019s cities, one practical way of coping with the challenges of urban life was to take advantage of the system of machine politics, while another was to seek relief in the variety of popular culture and entertainment found in and around cities. Although neither of these forms of relief was restricted to the working class, they were the ones who relied most heavily on them. \n\n Machine Politics \n\n The primary form of relief for working-class urban Americans, and particularly immigrants, came in the form of  machine politics . This phrase referred to the process by which every citizen of the city, no matter their ethnicity or race, was a ward resident with an alderman who spoke on their behalf at city hall. When everyday challenges arose, whether sanitation problems or the need for a sidewalk along a muddy road, citizens would approach their alderman to find a solution. The aldermen knew that, rather than work through the long bureaucratic process associated with city hall, they could work within the \u201cmachine\u201d of local politics to find a speedy, mutually beneficial solution. In machine politics, favors were exchanged for votes, votes were given in exchange for fast solutions, and the price of the solutions included a kickback to the boss. In the short term, everyone got what they needed, but the process was neither transparent nor democratic, and it was an inefficient way of conducting the city\u2019s business. \n\n One example of a machine political system was the Democratic political machine  Tammany Hall  in New York, run by machine boss William Tweed with assistance from George Washington Plunkitt ( Figure 19.10 ). There, citizens knew their immediate problems would be addressed in return for their promise of political support in future elections. In this way, machines provided timely solutions for citizens and votes for the politicians. For example, if in Little Italy there was a desperate need for sidewalks in order to improve traffic to the stores on a particular street, the request would likely get bogged down in the bureaucratic red tape at city hall. Instead, store owners would approach the machine. A district captain would approach the \u201cboss\u201d and make him aware of the problem. The boss would contact city politicians and strongly urge them to appropriate the needed funds for the sidewalk in exchange for the promise that the boss would direct votes in their favor in the upcoming election. The boss then used the funds to pay one of his friends for the sidewalk construction, typically at an exorbitant cost, with a financial kickback to the boss, which was known as  graft . The sidewalk was built more quickly than anyone hoped, in exchange for the citizens\u2019 promises to vote for machine-supported candidates in the next elections. Despite its corrupt nature, Tammany Hall essentially ran New York politics from the 1850s until the 1930s. Other large cities, including Boston, Philadelphia, Cleveland, St. Louis, and Kansas City, made use of political machines as well. \n\n Popular Culture and Entertainment \n\n Working-class residents also found relief in the diverse and omnipresent offerings of popular culture and entertainment in and around cities. These offerings provided an immediate escape from the squalor and difficulties of everyday life. As improved means of internal transportation developed, working-class residents could escape the city and experience one of the popular new forms of entertainment\u2014the amusement park. For example, Coney Island on the Brooklyn shoreline consisted of several different amusement parks, the first of which opened in 1895 ( Figure 19.11 ). At these parks, New Yorkers enjoyed wild rides, animal attractions, and large stage productions designed to help them forget the struggles of their working-day lives. Freak \u201cside\u201d shows fed the public\u2019s curiosity about physical deviance. For a mere ten cents, spectators could watch a high-diving horse, take a ride to the moon to watch moon maidens eat green cheese, or witness the electrocution of an elephant, a spectacle that fascinated the public both with technological marvels and exotic wildlife. The treatment of animals in many acts at Coney Island and other public amusement parks drew the attention of middle-class reformers such as the American Society for the Prevention of Cruelty to Animals. Despite questions regarding the propriety of many of the acts, other cities quickly followed New York\u2019s lead with similar, if smaller, versions of Coney Island\u2019s attractions. \n\n Another common form of popular entertainment was vaudeville\u2014large stage variety shows that included everything from singing, dancing, and comedy acts to live animals and magic. The vaudeville circuit gave rise to several prominent performers, including magician Harry Houdini, who began his career in these variety shows before his fame propelled him to solo acts. In addition to live theater shows, it was primarily working-class citizens who enjoyed the advent of the nickelodeon, a forerunner to the movie theater. The first nickelodeon opened in Pittsburgh in 1905, where nearly one hundred visitors packed into a storefront theater to see a traditional vaudeville show interspersed with one-minute film clips. Several theaters initially used the films as \u201cchasers\u201d to indicate the end of the show to the live audience so they would clear the auditorium. However, a vaudeville performers\u2019 strike generated even greater interest in the films, eventually resulting in the rise of modern movie theaters by 1910. \n\n One other major form of entertainment for the working class was professional baseball ( Figure 19.12 ). Club teams transformed into professional baseball teams with the Cincinnati Red Stockings, now the Cincinnati Reds, in 1869. Soon, professional teams sprang up in several major American cities. Baseball games provided an inexpensive form of entertainment, where for less than a dollar, a person could enjoy a double-header, two hot dogs, and a beer. But more importantly, the teams became a way for newly relocated Americans and immigrants of diverse backgrounds to develop a unified civic identity, all cheering for one team. By 1876, the National League had formed, and soon after, cathedral-style ballparks began to spring up in many cities. Fenway Park in Boston (1912), Forbes Field in Pittsburgh (1909), and the Polo Grounds in New York (1890) all became touch points where working-class Americans came together to support a common cause. \n\n Other popular sports included prize-fighting, which attracted a predominantly male, working- and middle-class audience who lived vicariously through the triumphs of the boxers during a time where opportunities for individual success were rapidly shrinking, and college football, which paralleled a modern corporation in its team hierarchy, divisions of duties, and emphasis on time management. \n\n THE UPPER CLASS IN THE CITIES \n\n The American financial elite did not need to crowd into cities to find work, like their working-class counterparts. But as urban centers were vital business cores, where multi-million-dollar financial deals were made daily, those who worked in that world wished to remain close to the action. The rich chose to be in the midst of the chaos of the cities, but they were also able to provide significant measures of comfort, convenience, and luxury for themselves. \n\n Wealthy citizens seldom attended what they considered the crass entertainment of the working class. Instead of amusement parks and baseball games, urban elites sought out more refined pastimes that underscored their knowledge of art and culture, preferring classical music concerts, fine art collections, and social gatherings with their peers. In New York, Andrew Carnegie built Carnegie Hall in 1891, which quickly became the center of classical music performances in the country. Nearby, the Metropolitan Museum of Art opened its doors in 1872 and still remains one of the largest collections of fine art in the world. Other cities followed suit, and these cultural pursuits became a way for the upper class to remind themselves of their elevated place amid urban squalor. \n\n As new opportunities for the middle class threatened the austerity of upper-class citizens, including the newer forms of transportation that allowed middle-class Americans to travel with greater ease, wealthier Americans sought unique ways to further set themselves apart in society. These included more expensive excursions, such as vacations in Newport, Rhode Island, winter relocation to sunny Florida, and frequent trips aboard steamships to Europe. For those who were not of the highly respected \u201cold money,\u201d but only recently obtained their riches through business ventures, the relief they sought came in the form of one book\u2014the annual  Social Register . First published in 1886 by Louis Keller in New York City, the register became a directory of the wealthy socialites who populated the city. Keller updated it annually, and people would watch with varying degrees of anxiety or complacency to see their names appear in print. Also called the  Blue Book , the register was instrumental in the planning of society dinners, balls, and other social events. For those of newer wealth, there was relief found simply in the notion that they and others witnessed their wealth through the publication of their names in the register. \n\n A NEW MIDDLE CLASS \n\n While the working class were confined to tenement houses in the cities by their need to be close to their work and the lack of funds to find anyplace better, and the wealthy class chose to remain in the cities to stay close to the action of big business transactions, the emerging  middle class  responded to urban challenges with their own solutions. This group included the managers, salesmen, engineers, doctors, accountants, and other salaried professionals who still worked for a living, but were significantly better educated and compensated than the working-class poor. For this new middle class, relief from the trials of the cities came through education and suburbanization. \n\n In large part, the middle class responded to the challenges of the city by physically escaping it. As transportation improved and outlying communities connected to urban centers, the middle class embraced a new type of community\u2014the suburbs. It became possible for those with adequate means to work in the city and escape each evening, by way of a train or trolley, to a house in the suburbs. As the number of people moving to the suburbs grew, there also grew a perception among the middle class that the farther one lived from the city and the more amenities one had, the more affluence one had achieved. \n\n Although a few suburbs existed in the United States prior to the 1880s (such as Llewellyn Park, New Jersey), the introduction of the electric railway generated greater interest and growth during the last decade of the century. The ability to travel from home to work on a relatively quick and cheap mode of transportation encouraged more Americans of modest means to consider living away from the chaos of the city. Eventually, Henry Ford\u2019s popularization of the automobile, specifically in terms of a lower price, permitted more families to own cars and thus consider suburban life. Later in the twentieth century, both the advent of the interstate highway system, along with federal legislation designed to allow families to construct homes with low-interest loans, further sparked the suburban phenomenon. \n\n New Roles for Middle-Class Women \n\n Social norms of the day encouraged middle-class women to take great pride in creating a positive home environment for their working husbands and school-age children, which reinforced the business and educational principles that they practiced on the job or in school. It was at this time that the magazines  Ladies' Home Journal  and  Good Housekeeping  began distribution, to tremendous popularity ( Figure 19.13 ). \n\n While the vast majority of middle-class women took on the expected role of housewife and homemaker, some women were finding paths to college. A small number of men\u2019s colleges began to open their doors to women in the mid-1800s, and co-education became an option. Some of the most elite universities created affiliated women\u2019s colleges, such as Radcliffe College with Harvard, and Pembroke College with Brown University. But more importantly, the first women\u2019s colleges opened at this time. Mount Holyoke, Vassar, Smith, and Wellesley Colleges, still some of the best known women\u2019s schools, opened their doors between 1865 and 1880, and, although enrollment was low (initial class sizes ranged from sixty-one students at Vassar to seventy at Wellesley, seventy-one at Smith, and up to eighty-eight at Mount Holyoke), the opportunity for a higher education, and even a career, began to emerge for young women. These schools offered a unique, all-women environment in which professors and a community of education-seeking young women came together. While most college-educated young women still married, their education offered them new opportunities to work outside the home, most frequently as teachers, professors, or in the aforementioned settlement house environments created by Jane Addams and others. \n\n Education and the Middle Class \n\n Since the children of the professional class did not have to leave school and find work to support their families, they had opportunities for education and advancement that would solidify their position in the middle class. They also benefited from the presence of stay-at-home mothers, unlike working-class children, whose mothers typically worked the same long hours as their fathers. Public school enrollment exploded at this time, with the number of students attending public school tripling from seven million in 1870 to twenty-one million in 1920. Unlike the old-fashioned one-room schoolhouses, larger schools slowly began the practice of employing different teachers for each grade, and some even began hiring discipline-specific instructors. High schools also grew at this time, from one hundred high schools nationally in 1860 to over six thousand by 1900. \n\n The federal government supported the growth of higher education with the Morrill Acts of 1862 and 1890. These laws set aside public land and federal funds to create land-grant colleges that were affordable to middle-class families, offering courses and degrees useful in the professions, but also in trade, commerce, industry, and agriculture ( Figure 19.14 ). Land-grant colleges stood in contrast to the expensive, private Ivy League universities such as Harvard and Yale, which still catered to the elite. Iowa became the first state to accept the provisions of the original Morrill Act, creating what later became Iowa State University. Other states soon followed suit, and the availability of an affordable college education encouraged a boost in enrollment, from 50,000 students nationwide in 1870 to over 600,000 students by 1920. \n\n College curricula also changed at this time. Students grew less likely to take traditional liberal arts classes in rhetoric, philosophy, and foreign language, and instead focused on preparing for the modern work world. Professional schools for the study of medicine, law, and business also developed. In short, education for the children of middle-class parents catered to class-specific interests and helped ensure that parents could establish their children comfortably in the middle class as well. \n\n \u201cCITY BEAUTIFUL\u201d \n\n While the working poor lived in the worst of it and the wealthy elite sought to avoid it, all city dwellers at the time had to deal with the harsh realities of urban sprawl. Skyscrapers rose and filled the air, streets were crowded with pedestrians of all sorts, and, as developers worked to meet the always-increasing demand for space, the few remaining green spaces in the city quickly disappeared. As the U.S. population became increasingly centered in urban areas while the century drew to a close, questions about the quality of city life\u2014particularly with regard to issues of aesthetics, crime, and poverty\u2014quickly consumed many reformers\u2019 minds. Those middle-class and wealthier urbanites who enjoyed the costlier amenities presented by city life\u2014including theaters, restaurants, and shopping\u2014were free to escape to the suburbs, leaving behind the poorer working classes living in squalor and unsanitary conditions. Through the  City Beautiful  movement, leaders such as Frederick Law Olmsted and Daniel Burnham sought to champion middle- and upper-class progressive reforms. They improved the quality of life for city dwellers, but also cultivated middle-class-dominated urban spaces in which Americans of different ethnicities, racial origins, and classes worked and lived. \n\n Olmsted, one of the earliest and most influential designers of urban green space, and the original designer of Central Park in New York, worked with Burnham to introduce the idea of the City Beautiful movement at the Columbian Exposition in 1893. There, they helped to design and construct the \u201cWhite City\u201d\u2014so named for the plaster of Paris construction of several buildings that were subsequently painted a bright white\u2014an example of landscaping and architecture that shone as an example of perfect city planning. From wide-open green spaces to brightly painted white buildings, connected with modern transportation services and appropriate sanitation, the \u201cWhite City\u201d set the stage for American urban city planning for the next generation, beginning in 1901 with the modernization of Washington, DC. This model encouraged city planners to consider three principal tenets: First, create larger park areas inside cities; second, build wider boulevards to decrease traffic congestion and allow for lines of trees and other greenery between lanes; and third, add more suburbs in order to mitigate congested living in the city itself ( Figure 19.15 ). As each city adapted these principles in various ways, the City Beautiful movement became a cornerstone of urban development well into the twentieth century. \n 19.4   Change Reflected in Thought and Writing Learning Objectives By the end of this section, you will be able to: \n\n Explain how American writers, both fiction and nonfiction, helped Americans to better understand the changes they faced in the late nineteenth and early twentieth centuries \n\n Identify some of the influential women and African American writers of the era \n\n In the late nineteenth century, Americans were living in a world characterized by rapid change. Western expansion, dramatic new technologies, and the rise of big business drastically influenced society in a matter of a few decades. For those living in the fast-growing urban areas, the pace of change was even faster and harder to ignore. One result of this time of transformation was the emergence of a series of notable authors, who, whether writing fiction or nonfiction, offered a lens through which to better understand the shifts in American society. \n\n UNDERSTANDING SOCIAL PROGRESS \n\n One key idea of the nineteenth century that moved from the realm of science to the murkier ground of social and economic success was Charles Darwin\u2019s theory of evolution. Darwin was a British naturalist who, in his 1859 work  On the Origin of Species , made the case that species develop and evolve through natural selection, not through divine intervention. The idea quickly drew fire from the Anglican Church (although a liberal branch of Anglicans embraced the notion of natural selection being part of God\u2019s plan) and later from many others, both in England and abroad, who felt that the theory directly contradicted the role of God in the earth\u2019s creation. Although biologists, botanists, and most of the scientific establishment widely accepted the theory of evolution at the time of Darwin\u2019s publication, which they felt synthesized much of the previous work in the field, the theory remained controversial in the public realm for decades. \n\n Political philosopher Herbert Spencer took Darwin\u2019s theory of evolution further, coining the actual phrase \u201csurvival of the fittest,\u201d and later helping to popularize the phrase  social Darwinism  to posit that society evolved much like a natural organism, wherein some individuals will succeed due to racially and ethnically inherent traits, and their ability to adapt. This model allowed that a collection of traits and skills, which could include intelligence, inherited wealth, and so on, mixed with the ability to adapt, would let all Americans rise or fall of their own accord, so long as the road to success was accessible to all. William Graham Sumner, a sociologist at Yale, became the most vocal proponent of social Darwinism. Not surprisingly, this ideology, which Darwin himself would have rejected as a gross misreading of his scientific discoveries, drew great praise from those who made their wealth at this time. They saw their success as proof of biological fitness, although critics of this theory were quick to point out that those who did not succeed often did not have the same opportunities or equal playing field that the ideology of social Darwinism purported. Eventually, the concept fell into disrepute in the 1930s and 1940s, as eugenicists began to utilize it in conjunction with their racial theories of genetic superiority. \n\n Other thinkers of the day took Charles Darwin\u2019s theories in a more nuanced direction, focusing on different theories of  realism  that sought to understand the truth underlying the changes in the United States. These thinkers believed that ideas and social constructs must be proven to work before they could be accepted. Philosopher William James was one of the key proponents of the closely related concept of  pragmatism , which held that Americans needed to experiment with different ideas and perspectives to find the truth about American society, rather than assuming that there was truth in old, previously accepted models. Only by tying ideas, thoughts, and statements to actual objects and occurrences could one begin to identify a coherent truth, according to James. His work strongly influenced the subsequent avant-garde and modernist movements in literature and art, especially in understanding the role of the observer, artist, or writer in shaping the society they attempted to observe. John Dewey built on the idea of pragmatism to create a theory of  instrumentalism , which advocated the use of education in the search for truth. Dewey believed that education, specifically observation and change through the scientific method, was the best tool by which to reform and improve American society as it continued to grow ever more complex. To that end, Dewey strongly encouraged educational reforms designed to create an informed American citizenry that could then form the basis for other, much-needed progressive reforms in society. \n\n In addition to the new medium of photography, popularized by Riis, novelists and other artists also embraced realism in their work. They sought to portray vignettes from real life in their stories, partly in response to the more sentimental works of their predecessors. Visual artists such as George Bellows, Edward Hopper, and Robert Henri, among others, formed the Ashcan School of Art, which was interested primarily in depicting the urban lifestyle that was quickly gripping the United States at the turn of the century. Their works typically focused on working-class city life, including the slums and tenement houses, as well as working-class forms of leisure and entertainment ( Figure 19.16 ). \n\n Novelists and journalists also popularized realism in literary works. Authors such as Stephen Crane, who wrote stark stories about life in the slums or during the Civil War, and Rebecca Harding Davis, who in 1861 published  Life in the Iron Mills , embodied this popular style. Mark Twain also sought realism in his books, whether it was the reality of the pioneer spirit, seen in  The Adventures of Huckleberry Finn , published in 1884, or the issue of corruption in  The Gilded Age , co-authored with Charles Dudley Warner in 1873. The narratives and visual arts of these realists could nonetheless be highly stylized, crafted, and even fabricated, since their goal was the effective portrayal of social realities they thought required reform. Some authors, such as Jack London, who wrote  The Call of the Wild , embraced a school of thought called  naturalism , which concluded that the laws of nature and the natural world were the only truly relevant laws governing humanity ( Figure 19.17 ). Kate Chopin, widely regarded as the foremost woman short story writer and novelist of her day, sought to portray a realistic view of women\u2019s lives in late nineteenth-century America, thus paving the way for more explicit feminist literature in generations to come. Although Chopin never described herself as a feminist per se, her reflective works on her experiences as a southern woman introduced a form of creative nonfiction that captured the struggles of women in the United States through their own individual experiences. She also was among the first authors to openly address the race issue of miscegenation. In her work  Desiree\u2019s Baby , Chopin specifically explores the Creole community of her native Louisiana in depths that exposed the reality of racism in a manner seldom seen in literature of the time. \n\n African American poet, playwright, and novelist of the realist period, Paul Laurence Dunbar dealt with issues of race at a time when most reform-minded Americans preferred to focus on other issues. Through his combination of writing in both standard English and Black dialect, Dunbar delighted readers with his rich portrayals of the successes and struggles associated with African American life. Although he initially struggled to find the patronage and financial support required to develop a full-time literary career, Dunbar\u2019s subsequent professional relationship with literary critic and  Atlantic Monthly  editor William Dean Howells helped to firmly cement his literary credentials as the foremost African American writer of his generation. As with Chopin and Harding, Dunbar\u2019s writing highlighted parts of the American experience that were not well understood by the dominant demographic of the country. In their work, these authors provided readers with insights into a world that was not necessarily familiar to them and also gave hidden communities\u2014be it iron mill workers, southern women, or African American men\u2014a sense of voice. \n\n Defining American Kate Chopin: An Awakening in an Unpopular Time Author Kate Chopin grew up in the American South and later moved to St. Louis, where she began writing stories to make a living after the death of her husband. She published her works throughout the late 1890s, with stories appearing in literary magazines and local papers. It was her second novel,  The Awakening , which gained her notoriety and criticism in her lifetime, and ongoing literary fame after her death ( Figure 19.18 ). \n\n The Awakening , set in the New Orleans society that Chopin knew well, tells the story of a woman struggling with the constraints of marriage who ultimately seeks her own fulfillment over the needs of her family. The book deals far more openly than most novels of the day with questions of women\u2019s sexual desires. It also flouted nineteenth-century conventions by looking at the protagonist\u2019s struggles with the traditional role expected of women. \n\n While a few contemporary reviewers saw merit in the book, most criticized it as immoral and unseemly. It was censored, called \u201cpure poison,\u201d and critics railed against Chopin herself. While Chopin wrote squarely in the tradition of realism that was popular at this time, her work covered ground that was considered \u201ctoo real\u201d for comfort. After the negative reception of the novel, Chopin retreated from public life and discontinued writing. She died five years after its publication. After her death, Chopin\u2019s work was largely ignored, until scholars rediscovered it in the late twentieth century, and her books and stories came back into print.  The Awakening  in particular has been recognized as vital to the earliest edges of the modern feminist movement. \n\n CRITICS OF MODERN AMERICA \n\n While many Americans at this time, both everyday working people and theorists, felt the changes of the era would lead to improvements and opportunities, there were critics of the emerging social shifts as well. Although less popular than Twain and London, authors such as Edward Bellamy, Henry George, and Thorstein Veblen were also influential in spreading critiques of the industrial age. While their critiques were quite distinct from each other, all three believed that the industrial age was a step in the wrong direction for the country. \n\n In the 1888 novel  Looking Backward, 2000-1887 , Edward Bellamy portrays a utopian America in the year 2000, with the country living in peace and harmony after abandoning the capitalist model and moving to a socialist state. In the book, Bellamy predicts the future advent of credit cards, cable entertainment, and \u201csuper-store\u201d cooperatives that resemble a modern day Wal-Mart.  Looking Backward  proved to be a popular bestseller (third only to  Uncle Tom\u2019s Cabin  and  Ben Hur  among late nineteenth-century publications) and appealed to those who felt the industrial age of big business was sending the country in the wrong direction. Eugene Debs, who led the national Pullman Railroad Strike in 1894, later commented on how Bellamy\u2019s work influenced him to adopt socialism as the answer to the exploitative industrial capitalist model. In addition, Bellamy\u2019s work spurred the publication of no fewer than thirty-six additional books or articles by other writers, either supporting Bellamy\u2019s outlook or directly criticizing it. In 1897, Bellamy felt compelled to publish a sequel, entitled  Equality , in which he further explained ideas he had previously introduced concerning educational reform and women\u2019s equality, as well as a world of vegetarians who speak a universal language. Another author whose work illustrated the criticisms of the day was nonfiction writer Henry George, an economist best known for his 1879 work  Progress and Poverty , which criticized the inequality found in an industrial economy. He suggested that, while people should own that which they create, all land and natural resources should belong to all equally, and should be taxed through a \u201csingle land tax\u201d in order to disincentivize private land ownership. His thoughts influenced many economic progressive reformers, as well as led directly to the creation of the now-popular board game, Monopoly. \n\n Another critique of late nineteenth-century American capitalism was Thorstein Veblen, who lamented in  The Theory of the Leisure Class  (1899) that capitalism created a middle class more preoccupied with its own comfort and consumption than with maximizing production. In coining the phrase \u201cconspicuous consumption,\u201d Veblen identified the means by which one class of nonproducers exploited the working class that produced the goods for their consumption. Such practices, including the creation of business trusts, served only to create a greater divide between the haves and have-nots in American society, and resulted in economic inefficiencies that required correction or reform. ", "questions": [{"question": {"question_id": "fs-idm30381024", "question_text": "Which of the following four elements was not essential for creating massive urban growth in late nineteenth-century America?", "question_choices": ["electric lighting", "communication improvements", "skyscrapers", "settlement houses"], "cloze_format": "___ is not an essential for creating massive urban growth in late nineteenth-century America.", "normal_format": "Which of the following four elements was not essential for creating massive urban growth in late nineteenth-century America?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "bloom": null, "hl_sentences": "The following four innovations proved critical in shaping urbanization at the turn of the century : electric lighting , communication improvements , intracity transportation , and the rise of skyscrapers .", "hl_context": "As the country grew , certain elements led some towns to morph into large urban centers , while others did not . <hl> The following four innovations proved critical in shaping urbanization at the turn of the century : electric lighting , communication improvements , intracity transportation , and the rise of skyscrapers . <hl> As people migrated for the new jobs , they often struggled with the absence of basic urban infrastructures , such as better transportation , adequate housing , means of communication , and efficient sources of light and energy . Even the basic necessities , such as fresh water and proper sanitation \u2014 often taken for granted in the countryside \u2014 presented a greater challenge in urban life ."}, {"question": {"question_id": "fs-idm31723008", "question_text": "Which of the following did the settlement house movement offer as a means of relief for working-class women?", "question_choices": ["childcare", "job opportunities", "political advocacy", "relocation services"], "cloze_format": "The settlement house movement offers ___ as a means of relief for working-class women.", "normal_format": "Which of the following did the settlement house movement offer as a means of relief for working-class women?"}, "answer": {"ans_text": "childcare", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "In the secular sphere , the settlement house movement of the 1890s provided additional relief . With no particular religious bent , they worked to create settlement houses in urban centers where they could help the working class , and in particular , working-class women , find aid . Their help included child daycare , evening classes , libraries , gym facilities , and free health care .", "hl_context": "<hl> In the secular sphere , the settlement house movement of the 1890s provided additional relief . <hl> Pioneering women such as Jane Addams in Chicago and Lillian Wald in New York led this early progressive reform movement in the United States , building upon ideas originally fashioned by social reformers in England . <hl> With no particular religious bent , they worked to create settlement houses in urban centers where they could help the working class , and in particular , working-class women , find aid . <hl> <hl> Their help included child daycare , evening classes , libraries , gym facilities , and free health care . <hl> Addams opened her now-famous Hull House ( Figure 19.7 ) in Chicago in 1889 , and Wald \u2019 s Henry Street Settlement opened in New York six years later . The movement spread quickly to other cities , where they not only provided relief to working-class women but also offered employment opportunities for women graduating college in the growing field of social work . Oftentimes , living in the settlement houses among the women they helped , these college graduates experienced the equivalent of living social classrooms in which to practice their skills , which also frequently caused friction with immigrant women who had their own ideas of reform and self-improvement ."}, {"question": {"question_id": "fs-idp12736608", "question_text": "Why did African Americans consider moving from the rural South to the urban North following the Civil War?", "question_choices": ["to be able to buy land", "to avoid slavery", "to find wage-earning work", "to further their education"], "cloze_format": "African Americans consider moving from the rural South to the urban North following the Civil War ___.", "normal_format": "Why did African Americans consider moving from the rural South to the urban North following the Civil War?"}, "answer": {"ans_text": "to find wage-earning work", "ans_choice": 2}, "bloom": null, "hl_sentences": "For African Americans fleeing this culture of violence , northern and midwestern cities offered an opportunity to escape the dangers of the South . In addition to this \u201c push \u201d out of the South , African Americans were also \u201c pulled \u201d to the cities by factors that attracted them , including job opportunities , where they could earn a wage rather than be tied to a landlord , and the chance to vote ( for men , at least ) , supposedly free from the threat of violence .", "hl_context": "A combination of both \u201c push \u201d and \u201c pull \u201d factors played a role in this movement . Despite the end of the Civil War and the passage of the Thirteenth , Fourteenth , and Fifteenth Amendments to the U . S . Constitution ( ending slavery , ensuring equal protection under the law , and protecting the right to vote , respectively ) , African Americans were still subjected to intense racial hatred . The rise of the Ku Klux Klan in the immediate aftermath of the Civil War led to increased death threats , violence , and a wave of lynchings . Even after the formal dismantling of the Klan in the late 1870s , racially motivated violence continued . According to researchers at the Tuskegee Institute , there were thirty-five hundred racially motivated lynchings and other murders committed in the South between 1865 and 1900 . <hl> For African Americans fleeing this culture of violence , northern and midwestern cities offered an opportunity to escape the dangers of the South . <hl> <hl> In addition to this \u201c push \u201d out of the South , African Americans were also \u201c pulled \u201d to the cities by factors that attracted them , including job opportunities , where they could earn a wage rather than be tied to a landlord , and the chance to vote ( for men , at least ) , supposedly free from the threat of violence . <hl> Although many lacked the funds to move themselves north , factory owners and other businesses that sought cheap labor assisted the migration . Often , the men moved first then sent for their families once they were ensconced in their new city life . Racism and a lack of formal education relegated these African American workers to many of the lower-paying unskilled or semi-skilled occupations . More than 80 percent of African American men worked menial jobs in steel mills , mines , construction , and meat packing . In the railroad industry , they were often employed as porters or servants ( Figure 19.8 ) . In other businesses , they worked as janitors , waiters , or cooks . African American women , who faced discrimination due to both their race and gender , found a few job opportunities in the garment industry or laundries , but were more often employed as maids and domestic servants . Regardless of the status of their jobs , however , African Americans earned higher wages in the North than they did for the same occupations in the South , and typically found housing to be more available ."}, {"question": {"question_id": "fs-idp8046144", "question_text": "Which of the following is true of late nineteenth-century southern and eastern European immigrants, as opposed to their western and northern European predecessors?", "question_choices": ["Southern and eastern European immigrants tended to be wealthier.", "Southern and eastern European immigrants were, on the whole, more skilled and able to find better paying employment.", "Many southern and eastern European immigrants acquired land in the West, while western and northern European immigrants tended to remain in urban centers.", "Ellis Island was the first destination for most southern and eastern Europeans."], "cloze_format": "___ of late nineteenth-century southern and eastern European immigrants, as opposed to their western and northern European predecessors.", "normal_format": "Which of the following is true of late nineteenth-century southern and eastern European immigrants, as opposed to their western and northern European predecessors?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "bloom": null, "hl_sentences": "Other cities saw huge spikes in foreign populations as well , though not to the same degree , due in large part to Ellis Island in New York City being the primary port of entry for most European immigrants arriving in the United States . The previous waves of immigrants from northern and western Europe , particularly Germany , Great Britain , and the Nordic countries , were relatively well off , arriving in the country with some funds and often moving to the newly settled western territories . These new immigrants supplanted the previous waves of northern and western European immigrants , who had tended to move west to purchase land .", "hl_context": "Whatever the reason , these immigrants arrived without the education and finances of the earlier waves of immigrants , and settled more readily in the port towns where they arrived , rather than setting out to seek their fortunes in the West . By 1890 , over 80 percent of the population of New York would be either foreign-born or children of foreign-born parentage . <hl> Other cities saw huge spikes in foreign populations as well , though not to the same degree , due in large part to Ellis Island in New York City being the primary port of entry for most European immigrants arriving in the United States . <hl> <hl> The previous waves of immigrants from northern and western Europe , particularly Germany , Great Britain , and the Nordic countries , were relatively well off , arriving in the country with some funds and often moving to the newly settled western territories . <hl> In contrast , the newer immigrants from southern and eastern European countries , including Italy , Greece , and several Slavic countries including Russia , came over due to \u201c push \u201d and \u201c pull \u201d factors similar to those that influenced the African Americans arriving from the South . Many were \u201c pushed \u201d from their countries by a series of ongoing famines , by the need to escape religious , political , or racial persecution , or by the desire to avoid compulsory military service . They were also \u201c pulled \u201d by the promise of consistent , wage-earning work . New cities were populated with diverse waves of new arrivals , who came to the cities to seek work in the businesses and factories there . While a small percentage of these newcomers were White Americans seeking jobs , most were made up of two groups that had not previously been factors in the urbanization movement : African Americans fleeing the racism of the farms and former plantations in the South , and southern and eastern European immigrants . <hl> These new immigrants supplanted the previous waves of northern and western European immigrants , who had tended to move west to purchase land . <hl> Unlike their predecessors , the newer immigrants lacked the funds to strike out to the western lands and instead remained in the urban centers where they arrived , seeking any work that would keep them alive ."}, {"question": {"question_id": "fs-idm76972672", "question_text": "Which of the following was a popular pastime for working-class urban dwellers?", "question_choices": ["football games", "opera", "museums", "amusement parks"], "cloze_format": "___ was a popular pastime for working-class urban dwellers.", "normal_format": "Which of the following was a popular pastime for working-class urban dwellers?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "bloom": null, "hl_sentences": "Working-class residents also found relief in the diverse and omnipresent offerings of popular culture and entertainment in and around cities . As improved means of internal transportation developed , working-class residents could escape the city and experience one of the popular new forms of entertainment \u2014 the amusement park .", "hl_context": "<hl> Working-class residents also found relief in the diverse and omnipresent offerings of popular culture and entertainment in and around cities . <hl> These offerings provided an immediate escape from the squalor and difficulties of everyday life . <hl> As improved means of internal transportation developed , working-class residents could escape the city and experience one of the popular new forms of entertainment \u2014 the amusement park . <hl> For example , Coney Island on the Brooklyn shoreline consisted of several different amusement parks , the first of which opened in 1895 ( Figure 19.11 ) . At these parks , New Yorkers enjoyed wild rides , animal attractions , and large stage productions designed to help them forget the struggles of their working-day lives . Freak \u201c side \u201d shows fed the public \u2019 s curiosity about physical deviance . For a mere ten cents , spectators could watch a high-diving horse , take a ride to the moon to watch moon maidens eat green cheese , or witness the electrocution of an elephant , a spectacle that fascinated the public both with technological marvels and exotic wildlife . The treatment of animals in many acts at Coney Island and other public amusement parks drew the attention of middle-class reformers such as the American Society for the Prevention of Cruelty to Animals . Despite questions regarding the propriety of many of the acts , other cities quickly followed New York \u2019 s lead with similar , if smaller , versions of Coney Island \u2019 s attractions ."}, {"question": {"question_id": "fs-idm44301632", "question_text": "Which of the following was a disadvantage of machine politics?", "question_choices": ["Immigrants did not have a voice.", "Taxpayers ultimately paid higher city taxes due to graft.", "Only wealthy parts of the city received timely responses.", "Citizens who voiced complaints were at risk for their safety."], "cloze_format": "___ was a disadvantage of machine politics.", "normal_format": "Which of the following was a disadvantage of machine politics?"}, "answer": {"ans_text": "Taxpayers ultimately paid higher city taxes due to graft.", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "In machine politics , favors were exchanged for votes , votes were given in exchange for fast solutions , and the price of the solutions included a kickback to the boss . In the short term , everyone got what they needed , but the process was neither transparent nor democratic , and it was an inefficient way of conducting the city \u2019 s business .", "hl_context": "The primary form of relief for working-class urban Americans , and particularly immigrants , came in the form of machine politics . This phrase referred to the process by which every citizen of the city , no matter their ethnicity or race , was a ward resident with an alderman who spoke on their behalf at city hall . When everyday challenges arose , whether sanitation problems or the need for a sidewalk along a muddy road , citizens would approach their alderman to find a solution . The aldermen knew that , rather than work through the long bureaucratic process associated with city hall , they could work within the \u201c machine \u201d of local politics to find a speedy , mutually beneficial solution . <hl> In machine politics , favors were exchanged for votes , votes were given in exchange for fast solutions , and the price of the solutions included a kickback to the boss . <hl> <hl> In the short term , everyone got what they needed , but the process was neither transparent nor democratic , and it was an inefficient way of conducting the city \u2019 s business . <hl>"}, {"question": {"question_id": "fs-idm3525264", "question_text": "Which of the following statements accurately represents Thorstein Veblen\u2019s argument in The Theory of the Leisure Class?", "question_choices": ["All citizens of an industrial society would rise or fall based on their own innate merits.", "The tenets of naturalism were the only laws through which society should be governed.", "The middle class was overly focused on its own comfort and consumption.", "Land and natural resources should belong equally to all citizens."], "cloze_format": "___ represents Thorstein Veblen's argument in The Theory of the Leisure Class.", "normal_format": "Which of the following statements accurately represents Thorstein Veblen\u2019s argument in The Theory of the Leisure Class?"}, "answer": {"ans_text": "The middle class was overly focused on its own comfort and consumption.", "ans_choice": 2}, "bloom": null, "hl_sentences": "Another critique of late nineteenth-century American capitalism was Thorstein Veblen , who lamented in The Theory of the Leisure Class ( 1899 ) that capitalism created a middle class more preoccupied with its own comfort and consumption than with maximizing production .", "hl_context": "<hl> Another critique of late nineteenth-century American capitalism was Thorstein Veblen , who lamented in The Theory of the Leisure Class ( 1899 ) that capitalism created a middle class more preoccupied with its own comfort and consumption than with maximizing production . <hl> In coining the phrase \u201c conspicuous consumption , \u201d Veblen identified the means by which one class of nonproducers exploited the working class that produced the goods for their consumption . Such practices , including the creation of business trusts , served only to create a greater divide between the haves and have-nots in American society , and resulted in economic inefficiencies that required correction or reform ."}, {"question": {"question_id": "fs-idp51006288", "question_text": "Which of the following was not an element of realism?", "question_choices": ["social Darwinism", "instrumentalism", "naturalism", "pragmatism"], "cloze_format": "___ is not an element of realism.", "normal_format": "Which of the following was not an element of realism?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Some authors , such as Jack London , who wrote The Call of the Wild , embraced a school of thought called naturalism , which concluded that the laws of nature and the natural world were the only truly relevant laws governing humanity ( Figure 19.17 ) . Other thinkers of the day took Charles Darwin \u2019 s theories in a more nuanced direction , focusing on different theories of realism that sought to understand the truth underlying the changes in the United States . These thinkers believed that ideas and social constructs must be proven to work before they could be accepted . Philosopher William James was one of the key proponents of the closely related concept of pragmatism , which held that Americans needed to experiment with different ideas and perspectives to find the truth about American society , rather than assuming that there was truth in old , previously accepted models . John Dewey built on the idea of pragmatism to create a theory of instrumentalism , which advocated the use of education in the search for truth . Political philosopher Herbert Spencer took Darwin \u2019 s theory of evolution further , coining the actual phrase \u201c survival of the fittest , \u201d and later helping to popularize the phrase social Darwinism to posit that society evolved much like a natural organism , wherein some individuals will succeed due to racially and ethnically inherent traits , and their ability to adapt .", "hl_context": "Novelists and journalists also popularized realism in literary works . Authors such as Stephen Crane , who wrote stark stories about life in the slums or during the Civil War , and Rebecca Harding Davis , who in 1861 published Life in the Iron Mills , embodied this popular style . Mark Twain also sought realism in his books , whether it was the reality of the pioneer spirit , seen in The Adventures of Huckleberry Finn , published in 1884 , or the issue of corruption in The Gilded Age , co-authored with Charles Dudley Warner in 1873 . The narratives and visual arts of these realists could nonetheless be highly stylized , crafted , and even fabricated , since their goal was the effective portrayal of social realities they thought required reform . <hl> Some authors , such as Jack London , who wrote The Call of the Wild , embraced a school of thought called naturalism , which concluded that the laws of nature and the natural world were the only truly relevant laws governing humanity ( Figure 19.17 ) . <hl> Kate Chopin , widely regarded as the foremost woman short story writer and novelist of her day , sought to portray a realistic view of women \u2019 s lives in late nineteenth-century America , thus paving the way for more explicit feminist literature in generations to come . Although Chopin never described herself as a feminist per se , her reflective works on her experiences as a southern woman introduced a form of creative nonfiction that captured the struggles of women in the United States through their own individual experiences . She also was among the first authors to openly address the race issue of miscegenation . In her work Desiree \u2019 s Baby , Chopin specifically explores the Creole community of her native Louisiana in depths that exposed the reality of racism in a manner seldom seen in literature of the time . <hl> Other thinkers of the day took Charles Darwin \u2019 s theories in a more nuanced direction , focusing on different theories of realism that sought to understand the truth underlying the changes in the United States . <hl> <hl> These thinkers believed that ideas and social constructs must be proven to work before they could be accepted . <hl> <hl> Philosopher William James was one of the key proponents of the closely related concept of pragmatism , which held that Americans needed to experiment with different ideas and perspectives to find the truth about American society , rather than assuming that there was truth in old , previously accepted models . <hl> Only by tying ideas , thoughts , and statements to actual objects and occurrences could one begin to identify a coherent truth , according to James . His work strongly influenced the subsequent avant-garde and modernist movements in literature and art , especially in understanding the role of the observer , artist , or writer in shaping the society they attempted to observe . <hl> John Dewey built on the idea of pragmatism to create a theory of instrumentalism , which advocated the use of education in the search for truth . <hl> Dewey believed that education , specifically observation and change through the scientific method , was the best tool by which to reform and improve American society as it continued to grow ever more complex . To that end , Dewey strongly encouraged educational reforms designed to create an informed American citizenry that could then form the basis for other , much-needed progressive reforms in society . <hl> Political philosopher Herbert Spencer took Darwin \u2019 s theory of evolution further , coining the actual phrase \u201c survival of the fittest , \u201d and later helping to popularize the phrase social Darwinism to posit that society evolved much like a natural organism , wherein some individuals will succeed due to racially and ethnically inherent traits , and their ability to adapt . <hl> This model allowed that a collection of traits and skills , which could include intelligence , inherited wealth , and so on , mixed with the ability to adapt , would let all Americans rise or fall of their own accord , so long as the road to success was accessible to all . William Graham Sumner , a sociologist at Yale , became the most vocal proponent of social Darwinism . Not surprisingly , this ideology , which Darwin himself would have rejected as a gross misreading of his scientific discoveries , drew great praise from those who made their wealth at this time . They saw their success as proof of biological fitness , although critics of this theory were quick to point out that those who did not succeed often did not have the same opportunities or equal playing field that the ideology of social Darwinism purported . Eventually , the concept fell into disrepute in the 1930s and 1940s , as eugenicists began to utilize it in conjunction with their racial theories of genetic superiority ."}], "summary": " Summary 19.1   Urbanization and Its Challenges \n\n Urbanization spread rapidly in the mid-nineteenth century due to a confluence of factors. New technologies, such as electricity and steam engines, transformed factory work, allowing factories to move closer to urban centers and away from the rivers that had previously been vital sources of both water power and transportation. The growth of factories\u2014as well as innovations such as electric lighting, which allowed them to run at all hours of the day and night\u2014created a massive need for workers, who poured in from both rural areas of the United States and from eastern and southern Europe. As cities grew, they were unable to cope with this rapid influx of workers, and the living conditions for the working class were terrible. Tight living quarters, with inadequate plumbing and sanitation, led to widespread illness. Churches, civic organizations, and the secular settlement house movement all sought to provide some relief to the urban working class, but conditions remained brutal for many new city dwellers. \n\n 19.2   The African American \u201cGreat Migration\u201d and New European Immigration \n\n For both African Americans migrating from the postwar South and immigrants arriving from southeastern Europe, a combination of \u201cpush\u201d and \u201cpull\u201d factors influenced their migration to America\u2019s urban centers. African Americans moved away from the racial violence and limited opportunities that existed in the rural South, seeking wages and steady work, as well as the opportunity to vote safely as free men; however, they quickly learned that racial discrimination and violence were not limited to the South. For European immigrants, famine and persecution led them to seek a new life in the United States, where, the stories said, the streets were paved in gold. Of course, in northeastern and midwestern cities, both groups found a more challenging welcome than they had anticipated. City residents blamed recent arrivals for the ills of the cities, from overcrowding to a rise in crime. Activist groups pushed for anti-immigration legislation, seeking to limit the waves of immigrants that sought a better future in the United States. \n\n 19.3   Relief from the Chaos of Urban Life \n\n The burgeoning cities brought together both rich and poor, working class and upper class; however, the realities of urban dwellers\u2019 lives varied dramatically based on where they fell in the social chain. Entertainment and leisure-time activities were heavily dependent on one\u2019s status and wealth. For the working poor, amusement parks and baseball games offered inexpensive entertainment and a brief break from the squalor of the tenements. For the emerging middle class of salaried professionals, an escape to the suburbs kept them removed from the city\u2019s chaos outside of working hours. And for the wealthy, immersion in arts and culture, as well as inclusion in the  Social Register , allowed them to socialize exclusively with those they felt were of the same social status. The City Beautiful movement benefitted all city dwellers, with its emphasis on public green spaces, and more beautiful and practical city boulevards. In all, these different opportunities for leisure and pleasure made city life manageable for the citizens who lived there. \n\n 19.4   Change Reflected in Thought and Writing \n\n Americans were overwhelmed by the rapid pace and scale of change at the close of the nineteenth century. Authors and thinkers tried to assess the meaning of the country\u2019s seismic shifts in culture and society through their work. Fiction writers often used realism in an attempt to paint an accurate portrait of how people were living at the time. Proponents of economic developments and cultural changes cited social Darwinism as an acceptable model to explain why some people succeeded and others failed, whereas other philosophers looked more closely at Darwin\u2019s work and sought to apply a model of proof and pragmatism to all ideas and institutions. Other sociologists and philosophers criticized the changes of the era, citing the inequities found in the new industrial economy and its negative effects on workers. ", "keyterm": "", "bname": "u.s._history"}, {"chapter": 12, "intro": " Chapter Outline 12.1   Identify and Describe Current Liabilities 12.2   Analyze, Journalize, and Report Current Liabilities 12.3   Define and Apply Accounting Treatment for Contingent Liabilities 12.4   Prepare Journal Entries to Record Short-Term Notes Payable 12.5   Record Transactions Incurred in Preparing Payroll Why It Matters \n\n Willow knew from a young age that she had a future in food. She has just transformed her passion into a thriving business venture as the owner of a small restaurant called Summer Eatery. \n\n To grow her business, Willow has decided to provide both restaurant dining and catering services. When Summer Eatery accepts catering orders, it requires a client deposit equal to 50% of the total order. Since Summer Eatery has not yet provided the catering services at the time of deposit, the deposit amount is recognized as unearned revenue. Once the catering services have been provided, this liability to the client is reclassified as revenue for the restaurant. \n\n The catering service is a success, and Summer Eatery\u2019s income increases twofold. The increase in business has allowed Willow to form a strong relationship with her vendors (suppliers). Because of this relationship, some suppliers will deliver the food and equipment she needs and allow the restaurant to defer payment until a later date. This helps Summer Eatery because it does not yet have enough cash on hand to pay for the food and equipment. Rather than incur more debt, or have to delay ordering, this arrangement allows Willow to grow and still meet her current obligations. \n\n It takes more than an idea to make a business grow, and Willow will continue to experience the ebb and flow of running a restaurant and catering service. Her management of short-term obligations will be one of the keys to Summer Eatery\u2019s future success. ", "chapter_text": " 12.1   Identify and Describe Current Liabilities \n\n To assist in understanding current liabilities, assume that you own a landscaping company that provides landscaping maintenance services to clients. As is common for landscaping companies in your area, you require clients to pay an initial deposit of 25% for services before you begin working on their property. Asking a customer to pay for services before you have provided them creates a current liability transaction for your business. As you\u2019ve learned, liabilities require a future disbursement of assets or services resulting from a prior business activity or transaction. For companies to make more informed decisions, liabilities need to be classified into two specific categories: current liabilities and noncurrent (or long-term) liabilities. The differentiating factor between current and long-term is when the liability is due. The focus of this chapter is on current liabilities, while  Long-Term Liabilities  emphasizes long-term liabilities. \n\n Fundamentals of Current Liabilities \n\n A  current liability  is a debt or obligation due within a company\u2019s standard operating period, typically a year, although there are exceptions that are longer or shorter than a year. A company\u2019s typical operating period (sometimes called an operating cycle) is a year, which is used to delineate current and noncurrent liabilities, and current liabilities are considered short term and are typically due within a year or less. \n\n Noncurrent liabilities  are long-term obligations with payment typically due in a subsequent operating period. Current liabilities are reported on the classified balance sheet, listed before noncurrent liabilities. Changes in current liabilities from the beginning of an accounting period to the end are reported on the statement of cash flows as part of the cash flows from operations section. An increase in current liabilities over a period increases cash flow, while a decrease in current liabilities decreases cash flow. \n\n Current vs. Noncurrent Liabilities \n\n Current Liabilities \n\n Noncurrent Liabilities \n\n Due within one year or less for a typical one-year operating period \n\n Due in more than one year or longer than one operating period \n\n Short-term accounts such as: \n\n Accounts Payable \n\n Salaries Payable \n\n Unearned Revenues \n\n Interest Payable \n\n Taxes Payable \n\n Notes Payable within one operating period \n\n Current portion of a longer-term account such as Notes Payable or Bonds Payable \n\n Long-term portion of obligations such as: \n\n Noncurrent portion of a longer-term account such as Notes Payable or Bonds Payable \n\n Table  12.1   A delineator between current and noncurrent liabilities is one year or the company\u2019s operating period, whichever is longer. \n\n Examples of Current Liabilities \n\n Common current liabilities include accounts payable, unearned revenues, the current portion of a note payable, and taxes payable. Each of these liabilities is current because it results from a past business activity, with a disbursement or payment due within a period of less than a year. \n\n Ethical Considerations Proper Current Liabilities Reporting and Calculating Burn Rate When using financial information prepared by accountants, decision-makers rely on ethical accounting practices. For example, investors and creditors look to the current liabilities to assist in calculating a company\u2019s annual  burn rate . The burn rate is the metric defining the monthly and annual cash needs of a company. It is used to help calculate how long the company can maintain operations before becoming insolvent. The proper classification of liabilities as current assists decision-makers in determining the short-term and long-term cash needs of a company. \n\n Another way to think about burn rate is as the amount of cash a company uses that exceeds the amount of cash created by the company\u2019s business operations. The burn rate helps indicate how quickly a company is using its cash. Many start-ups have a high cash burn rate due to spending to start the business, resulting in low cash flow. At first, start-ups typically do not create enough cash flow to sustain operations. \n\n Proper reporting of current liabilities helps decision-makers understand a company\u2019s burn rate and how much cash is needed for the company to meet its short-term and long-term cash obligations. If misrepresented, the cash needs of the company may not be met, and the company can quickly go out of business. Therefore, it is important that the accountant appropriately report current liabilities because a creditor, investor, or other decision-maker\u2019s understanding of a company\u2019s specific cash needs helps them make good financial decisions. \n\n Accounts Payable \n\n Accounts payable  accounts for financial obligations owed to suppliers after purchasing products or services on credit. This account may be an open credit line between the supplier and the company. An open credit line is a borrowing agreement for an amount of money, supplies, or inventory. The option to borrow from the lender can be exercised at any time within the agreed time period. \n\n An account payable is usually a less formal arrangement than a promissory note for a current note payable. Long-term debt is covered in depth in  Long-Term Liabilities . For now, know that for some debt, including short-term or current, a formal contract might be created. This contract provides additional legal protection for the lender in the event of failure by the borrower to make timely payments. Also, the contract often provides an opportunity for the lender to actually sell the rights in the contract to another party. \n\n An invoice from the supplier (such as the one shown in  Figure 12.2 ) detailing the purchase, credit terms, invoice date, and shipping arrangements will suffice for this contractual relationship. In many cases, accounts payable agreements do not include interest payments, unlike notes payable. \n\n For example, assume the owner of a clothing boutique purchases hangers from a manufacturer on credit. The organizations may establish an ongoing purchase agreement, which includes purchase details (such as hanger prices and quantities), credit terms (2/10, n/60), an invoice date, and shipping charges (free on board [FOB] shipping) for each order. The basics of shipping charges and credit terms were addressed in  Merchandising Transactions  if you would like to refresh yourself on the mechanics. Also, to review accounts payable, you can also return to  Merchandising Transactions  for detailed explanations. \n\n Unearned Revenue \n\n Unearned revenue , also known as  deferred revenue , is a customer\u2019s advance payment for a product or service that has yet to be provided by the company. Some common unearned revenue situations include subscription services, gift cards, advance ticket sales, lawyer retainer fees, and deposits for services. As you learned when studying the accounting cycle ( Analyzing and Recording Transactions ,  The Adjustment Process , and  Completing the Accounting Cycle ), we are applying the principles of accrual accounting when revenues and expenses are recognized in different months or years. Under accrual accounting, a company does not record revenue as earned until it has provided a product or service, thus adhering to the revenue recognition principle. Until the customer is provided an obligated product or service, a liability exists, and the amount paid in advance is recognized in the Unearned Revenue account. As soon as the company provides all, or a portion, of the product or service, the value is then recognized as earned revenue. \n\n For example, assume that a landscaping company provides services to clients. The company requires advance payment before rendering service. The customer\u2019s advance payment for landscaping is recognized in the Unearned Service Revenue account, which is a liability. Once the company has finished the client\u2019s landscaping, it may recognize all of the advance payment as earned revenue in the Service Revenue account. If the landscaping company provides part of the landscaping services within the operating period, it may recognize the value of the work completed at that time. \n\n Perhaps at this point a simple example might help clarify the treatment of unearned revenue. Assume that the previous landscaping company has a three-part plan to prepare lawns of new clients for next year. The plan includes a treatment in November 2019, February 2020, and April 2020. The company has a special rate of $120 if the client prepays the entire $120 before the November treatment. In real life, the company would hope to have dozens or more customers. However, to simplify this example, we analyze the journal entries from one customer. Assume that the customer prepaid the service on October 15, 2019, and all three treatments occur on the first day of the month of service. We also assume that $40 in revenue is allocated to each of the three treatments. \n\n Before examining the journal entries, we need some key information. Because part of the service will be provided in 2019 and the rest in 2020, we need to be careful to keep the recognition of revenue in its proper period. If all of the treatments occur, $40 in revenue will be recognized in 2019, with the remaining $80 recognized in 2020. Also, since the customer could request a refund before any of the services have been provided, we need to ensure that we do not recognize revenue until it has been earned. While it is nice to receive funding before you have performed the services, in essence, all you have received when you get the money is a liability (unearned service revenue), with the hope of it eventually becoming revenue. The following journal entries are built upon the client receiving all three treatments. First, for the prepayment of future services and for the revenue earned in 2019, the journal entries are shown. \n\n For the revenue earned in 2020, the journal entries would be. \n\n Concepts In Practice Thinking about Unearned Revenue When thinking about unearned revenue, consider the example of  Amazon.com, Inc .  Amazon  has a large business portfolio that includes a widening presence in the online product and service space.  Amazon  has two services in particular that contribute to their unearned revenue account: Amazon Web Services and Prime membership. \n\n According to  Business Insider ,  Amazon  had $4.8 billion in unearned revenue recognized in their fourth quarter report (December 2016), with most of that contribution coming from Amazon Web Services. 1  This is an increase from prior quarters. The growth is due to larger and longer contracts for web services. The advance payment for web services is transferred to revenue over the term of the contract. The same is true for Prime membership.  Amazon  receives $99 in advance pay from customers, which is amortized over the twelve-month period of the service agreement. This means that each month, Amazon only recognizes $8.25 per Prime membership payment as earned revenue. 1 Eugene Kim. \u201cAn Overlooked Part of Amazon Will Be in the Spotlight When the Company Reports Earnings.\u201d  Business Insider . April 28, 2016. https://www.businessinsider.com/amazon-unearned-revenue-growth-shows-why-it-spent-more-on-shipping-last-quarter-2016-4 \n\n Current Portion of a Note Payable \n\n A  note payable  is a debt to a lender with specific repayment terms, which can include principal and interest. A note payable has written contractual terms that make it available to sell to another party. The  principal  on a note refers to the initial borrowed amount, not including interest. In addition to repayment of principal, interest may accrue.  Interest  is a monetary incentive to the lender, which justifies loan risk. \n\n Let\u2019s review the concept of interest. Interest is an expense that you might pay for the use of someone else\u2019s money. For example, if you have a credit card and you owe a balance at the end of the month it will typically charge you a percentage, such as 1.5% a month (which is the same as 18% annually) on the balance that you owe. Assuming that you owe $400, your interest charge for the month would be $400 \u00d7 1.5%, or $6.00. To pay your balance due on your monthly statement would require $406 (the $400 balance due plus the $6 interest expense). \n\n We make one more observation about interest: interest rates are typically quoted in annual terms. For example, if you borrowed money to buy a car, your interest expense might be quoted as 9%. Note that this is an annual rate. If you are making monthly payments, the monthly charge for interest would be 9% divided by twelve, or 0.75% a month. For example, if you borrowed $20,000, and made sixty equal monthly payments, your monthly payment would be $415.17, and your interest expense component of the $415.17 payment would be $150.00. The formula to calculate interest on either an annual or partial-year basis is: \n\n In our example this would be \n\n $20,000 \u00d7 9% \u00d7 1 12 = $150 $20,000 \u00d7 9% \u00d7 1 12 = $150 \n\n The good news is that for a loan such as our car loan or even a home loan, the loan is typically what is called  fully amortizing . At this point, you just need to know that in our case the amount that you owe would go from a balance due of $20,000 down to $0 after the twentieth payment and the part of your $415.17 monthly payment allocated to interest would be less each month. For example, your last (sixtieth) payment would only incur $3.09 in interest, with the remaining payment covering the last of the principle owed. See  Figure 13.7  for an exhibit that demonstrates this concept. Concepts In Practice Applying Amortization Car loans, mortgages, and education loans have an amortization process to pay down debt. Amortization of a loan requires periodic scheduled payments of principal and interest until the loan is paid in full. Every period, the same payment amount is due, but interest expense is paid first, with the remainder of the payment going toward the principal balance. When a customer first takes out the loan, most of the scheduled payment is made up of interest, and a very small amount goes to reducing the principal balance. Over time, more of the payment goes toward reducing the principal balance rather than interest. \n\n For example, let\u2019s say you take out a car loan in the amount of $10,000. The annual interest rate is 3%, and you are required to make scheduled payments each month in the amount of $400. You first need to determine the monthly interest rate by dividing 3% by twelve months (3%/12), which is 0.25%. The monthly interest rate of 0.25% is multiplied by the outstanding principal balance of $10,000 to get an interest expense of $25. The scheduled payment is $400; therefore, $25 is applied to interest, and the remaining $375 ($400 \u2013 $25) is applied to the outstanding principal balance. This leaves an outstanding principal balance of $9,625. Next month, interest expense is computed using the new principal balance outstanding of $9,625. The new interest expense is $24.06 ($9,625 \u00d7 0.25%). This means $24.06 of the $400 payment applies to interest, and the remaining $375.94 ($400 \u2013 $24.06) is applied to the outstanding principal balance to get a new balance of $9,249.06 ($9,625 \u2013 $375.94). These computations occur until the entire principal balance is paid in full. \n\n A note payable is usually classified as a long-term (noncurrent) liability if the note period is longer than one year or the standard operating period of the company. However, during the company\u2019s current operating period, any portion of the long-term note due that will be paid in the current period is considered a  current portion of a note payable . The outstanding balance note payable during the current period remains a noncurrent note payable. Note that this does not include the interest portion of the payments. On the balance sheet, the current portion of the noncurrent liability is separated from the remaining noncurrent liability. No journal entry is required for this distinction, but some companies choose to show the transfer from a noncurrent liability to a current liability. \n\n For example, a bakery company may need to take out a $100,000 loan to continue business operations. The bakery\u2019s outstanding note principal is $100,000. Terms of the loan require equal annual principal repayments of $10,000 for the next ten years. Payments will be made on July 1 of each of the ten years. Even though the overall $100,000 note payable is considered long term, the $10,000 required repayment during the company\u2019s operating cycle is considered current (short term). This means $10,000 would be classified as the current portion of a noncurrent note payable, and the remaining $90,000 would remain a noncurrent note payable. \n\n The portion of a note payable due in the current period is recognized as current, while the remaining outstanding balance is a noncurrent note payable. For example,  Figure 12.4  shows that $18,000 of a $100,000 note payable is scheduled to be paid within the current period (typically within one year). The remaining $82,000 is considered a long-term liability and will be paid over its remaining life. \n\n In addition to the $18,000 portion of the note payable that will be paid in the current year, any accrued interest on both the current portion and the long-term portion of the note payable that is due will also be paid. Assume, for example, that for the current year $7,000 of interest will be accrued. In the current year the debtor will pay a total of $25,000\u2014that is, $7,000 in interest and $18,000 for the current portion of the note payable. A similar type of payment will be paid each year for as long as any of the note payable remains; however, the annual interest expense would be reduced since the remaining note payable owed will be reduced by the previous payments. \n\n Interest payable can also be a current liability if accrual of interest occurs during the operating period but has yet to be paid. An annual interest rate is established as part of the loan terms. Interest accrued is recorded in Interest Payable (a credit) and Interest Expense (a debit). To calculate interest, the company can use the following equations. This method assumes a twelve-month denominator in the calculation, which means that we are using the calculation method based on a 360-day year. This method was more commonly used prior to the ability to do the calculations using calculators or computers, because the calculation was easier to perform. However, with today\u2019s technology, it is more common to see the interest calculation performed using a 365-day year. We will demonstrate both methods. \n\n For example, we assume the bakery has an annual interest rate on its loan of 7%. The loan interest began accruing on July 1 and it is now December 31. The bakery has accrued six months of interest and would compute the interest liability as \n\n $100,000 \u00d7 7% \u00d7 6 12 = $3,500 $100,000 \u00d7 7% \u00d7 6 12 = $3,500 \n\n The $3,500 is recognized in Interest Payable (a credit) and Interest Expense (a debit). \n\n Taxes Payable \n\n Taxes payable  refers to a liability created when a company collects taxes on behalf of employees and customers or for tax obligations owed by the company, such as sales taxes or income taxes. A future payment to a government agency is required for the amount collected. Some examples of taxes payable include sales tax and income taxes. \n\n Sales taxes  result from sales of products or services to customers. A percentage of the sale is charged to the customer to cover the tax obligation (see  Figure 12.5 ). The sales tax rate varies by state and local municipalities but can range anywhere from 1.76% to almost 10% of the gross sales price. Some states do not have sales tax because they want to encourage consumer spending. Those businesses subject to sales taxation hold the sales tax in the Sales Tax Payable account until payment is due to the governing body. \n\n For example, assume that each time a shoe store sells a $50 pair of shoes, it will charge the customer a sales tax of 8% of the sales price. The shoe store collects a total of $54 from the customer. The $4 sales tax is a current liability until distributed within the company\u2019s operating period to the government authority collecting sales tax. \n\n Income taxes are required to be withheld from an employee\u2019s salary for payment to a federal, state, or local authority (hence they are known as  withholding taxes ). This withholding is a percentage of the employee\u2019s gross pay. Income taxes are discussed in greater detail in  Record Transactions Incurred in Preparing Payroll . \n\n Link to Learning \n\n Businesses can use  the Internal Revenue Service\u2019s Sales Tax Deduction Calculator and associated tips and guidance  to determine their estimated sales tax obligation owed to the state and local government authority. \n 12.2   Analyze, Journalize, and Report Current Liabilities \n\n To illustrate current liability entries, we use transaction information from Sierra Sports (see  Figure 12.6 ). Sierra Sports owns and operates a sporting goods store in the Southwest specializing in sports apparel and equipment. The company engages in regular business activities with suppliers, creditors, customers, and employees. \n\n Accounts Payable \n\n On August 1, Sierra Sports purchases $12,000 of soccer equipment from a manufacturer (supplier) on credit. Assume for the following examples that Sierra Sports uses the  perpetual inventory  method, which uses the Inventory account when the company buys, sells, or adjusts the inventory balance, such as in the following example where they qualified for a discount. In the current transaction, credit terms are 2/10, n/30, the invoice date is August 1, and shipping charges are FOB shipping point (which is included in the purchase cost). \n\n Recall from  Merchandising Transactions , that credit terms of 2/10, n/30 signal the payment terms and discount, and FOB shipping point establishes the point of merchandise ownership, the responsibility during transit, and which entity pays shipping charges. Therefore, 2/10, n/30 means Sierra Sports has ten days to pay its balance due to receive a 2% discount, otherwise Sierra Sports has net thirty days, in this case August 31, to pay in full but not receive a discount. FOB shipping point signals that since Sierra Sports takes ownership of the merchandise when it leaves the manufacturer, it takes responsibility for the merchandise in transit and will pay the shipping charges. \n\n Sierra Sports would make the following journal entry on August 1. \n\n The merchandise is purchased from the supplier on credit. In this case, Accounts Payable would increase (a credit) for the full amount due. Inventory, the asset account, would increase (a debit) for the purchase price of the merchandise. \n\n If Sierra Sports pays the full amount owed on August 10, it qualifies for the discount, and the following entry would occur. \n\n Assume that the payment to the manufacturer occurs within the discount period of ten days (2/10, n/30) and is recognized in the entry. Accounts Payable decreases (debit) for the original amount due, Inventory decreases (credit) for the discount amount of $240 ($12,000 \u00d7 2%), and Cash decreases (credit) for the remaining balance due after discount. \n\n Note that Inventory is decreased in this entry because the value of the merchandise (soccer equipment) is reduced. When applying the perpetual inventory method, this reduction is required by generally accepted accounting principles (GAAP) (under the cost principle) to reflect the actual cost of the merchandise. \n\n A second possibility is that Sierra will return part of the purchase before the ten-day discount window has expired. Assume in this example that $1,000 of the $12,000 purchase was returned to the seller on August 8 and the remaining account payable due was paid by Sierra to the seller on August 10, which means that Sierra qualified for the remaining eligible discount. The following two journal entries represent the return of inventory and the subsequent payment for the remaining account payable owed. The initial journal entry from August 1 will still apply, because we assume that Sierra intended to keep the full $12,000 of inventory when the purchase was made. \n\n When the $1,000 in inventory was returned on August 8, the accounts payable account and the inventory accounts should be reduced by $1,000 as demonstrated in this journal entry. \n\n After this transaction, Sierra still owed $11,000 and still had $11,000 in inventory from the purchase, assuming that Sierra had not sold any of it yet. \n\n When Sierra paid the remaining balance on August 10, the company qualified for the discount. However, since Sierra only owed a remaining balance of $11,000 and not the original $12,000, the discount received was 2% of $11,000, or $220, as demonstrated in this journal entry. Since Sierra owed $11,000 and received a discount of $220, the supplier was paid $10,780. This second journal entry is the same as the one that would have recognized an original purchase of $11,000 that qualified for a discount. \n\n Remember that since we are assuming that Sierra was using the perpetual inventory method, purchases, payments, and adjustments in goods available for sale are reflected in the company\u2019s Inventory account. In our example, one of the potential adjustments is that discounts received are recorded as reductions to the Inventory account. \n\n To demonstrate this concept, after buying $12,000 in inventory, returning $1,000 in inventory, and then paying for the remaining balance and qualifying for the discount, Sierra\u2019s Inventory balance increased by $10,780, as shown. \n\n If Sierra had bought $11,000 of inventory on August 1 and paid cash and taken the discount, after taking the $220 discount, the increase of Inventory on their balance sheet would have been $10,780, as it finally ended up being in our more complicated set of transactions on three different days. The important factor is that the company qualified for a 2% discount on inventory that had a retail price before discounts of $11,000. \n\n In a final possible scenario, assume that Sierra Sports remitted payment outside of the discount window on August 28, but inside of thirty days. In this case, they did not qualify for the discount, and assuming that they made no returns they paid the full, undiscounted balance of $12,000. \n\n If this occurred, both Accounts Payable and Cash decreased by $12,000. Inventory is not affected in this instance because the full cost of the merchandise was paid; so, the increase in value for the inventory was $12,000, and not the $11,760 value determined in our beginning transactions where they qualified for the discount. \n\n Your Turn Accounting for Advance Payments You are the owner of a catering company and require advance payments from clients before providing catering services. You receive an order from the Coopers, who would like you to cater their wedding on June 10. The Coopers pay you $5,500 cash on March 25. Record your journal entries for the initial payment from the Coopers, and when the catering service has been provided on June 10. \n\n Solution \n\n Unearned Revenue \n\n Sierra Sports has contracted with a local youth football league to provide all uniforms for participating teams. The league pays for the uniforms in advance, and Sierra Sports provides the customized uniforms shortly after purchase. The following situation shows the journal entry for the initial purchase with cash. Assume the league pays Sierra Sports for twenty uniforms (cost per uniform is $30, for a total of $600) on April 3. \n\n Sierra Sports would see an increase to Cash (debit) for the payment made from the football league. The revenue from the sale of the uniforms is $600 (20 uniforms \u00d7 $30 per uniform). Unearned Uniform Revenue accounts reflect the prepayment from the league, which cannot be recognized as earned revenue until the uniforms are provided. Unearned Uniform Revenue is a current liability account that increases (credit) with the increase in outstanding product debt. \n\n Sierra provides the uniforms on May 6 and records the following entry. \n\n Now that Sierra has provided all of the uniforms, the unearned revenue can be recognized as earned. This satisfies the revenue recognition principle. Therefore, Unearned Uniform Revenue would decrease (debit), and Uniform Revenue would increase (credit) for the total amount. \n\n Let\u2019s say that Sierra only provides half the uniforms on May 6 and supplies the rest of the order on June 2. The company may not recognize revenue until a product (or a portion of a product) has been provided. This means only half the revenue can be recognized on May 6 ($300) because only half of the uniforms were provided. The rest of the revenue recognition will have to wait until June 2. Since only half of the uniforms were delivered on May 6, only half of the costs of goods sold would be recognized on May 6. The other half of the costs of goods sold would be recognized on June 2 when the other half of the uniforms were delivered. The following entries show the separate entries for partial revenue recognition. \n\n In another scenario using the same cost information, assume that on April 3, the league contracted for the production of the uniforms on credit with terms 5/10, n/30. They signed a contract for the production of the uniforms, so an account receivable was created for Sierra, as shown. \n\n Sierra and the league have worked out credit terms and a discount agreement. As such, the league can delay cash payment for ten days and receive a discount, or for thirty days with no discount assessed. Instead of cash increasing for Sierra, Accounts Receivable increases (debit) for the amount the football league owes. \n\n The league pays for the uniforms on April 15, and Sierra provides all uniforms on May 6. The following entry shows the payment on credit. \n\n The football league made payment outside of the discount period, since April 15 is more than ten days from the invoice date. Thus, they do not receive the 5% discount. Cash increases (debit) for the $600 paid by the football league, and Accounts Receivable decreases (credit). \n\n In the next example, let\u2019s assume that the league made payment within the discount window, on April 13. The following entry occurs. \n\n In this case, Accounts Receivable decreases (credit) for the original amount owed, Sales Discount increases (debit) for the discount amount of $30 ($600 \u00d7 5%), and Cash increases (debit) for the $570 paid by the football league less discount. \n\n When the company provides the uniforms on May 6, Unearned Uniform Revenue decreases (debit) and Uniform Revenue increases (credit) for $600. \n\n Ethical Considerations Stock Options and Unearned Revenue Manipulation The anticipated income of public companies is projected by stock market analysts through  whisper-earnings , or forecasted earnings. It can be advantageous for a company to have its stock beat the stock market\u2019s expectation of earnings. Likewise, falling below the market\u2019s expectation can be a disadvantage. If a company\u2019s whisper-earnings are not going to be met, there could be pressure on the chief financial officer to misrepresent earnings through manipulation of unearned revenue accounts to better match the stock market\u2019s expectation. \n\n Because many executives, other top management, and even employees have stock options, this can also provide incentive to manipulate earnings. A stock option sets a minimum price for the stock on a certain date. This is the date the option vests, at what is commonly called the  strike price . Options are worthless if the stock price on the vesting date is lower than the price at which they were granted. This could result in a loss of income, potentially incentivizing earnings manipulation to meet the stock market\u2019s expectations and exceed the vested stock price in the option. \n\n Researchers have found that when executive options are about to vest, companies are more likely to present financial statements meeting or just slightly beating the earnings forecasts of analysts. The proximity of the actual earnings to earnings forecasts suggests they were manipulated because of the vesting. 2  As Douglas R. Carmichael points out, \u201cpublic companies that fail to report quarterly earnings which meet or exceed analysts\u2019 expectations often experience a drop in their stock prices. This can lead to practices that sometimes include fraudulent overstatement of quarterly revenue.\u201d 3  If earnings meet or exceed expectations, a stock price can hit or surpass the vested stock price in the option. For company members with stock options, this could result in higher income. Thus, financial statements that align closely with analysts\u2019 estimates, rather than showing large projections above or below whisper-earnings, could indicate that accounting information has possibly been adjusted to meet the expected numbers. Such manipulations can be made in unearned revenue accounts. 2 Jena McGregor. \u201cHow Stock Options Lead CEOs to Put Their Own Interests First.\u201d  Washington Post . February 11, 2014. https://www.washingtonpost.com/news/on-leadership/wp/2014/02/11/how-stock-options-lead-ceos-to-put-their-own-interests-first/?utm_term=.24d99a4fb1a5 3 Douglas R. Carmichael. \u201cHocus-Pocus Accounting.\u201d  Journal of Accountancy . October 1, 1999. https://www.journalofaccountancy.com/issues/1999/oct/carmichl.html \n\n In November 1998, the Securities and Exchange Commission (SEC) issued Practice Alert 98-3, Revenue Recognition Issues, SEC Practice Section Professional Issues Task Force, recognizing and discussing the manipulation of earnings used to exceed stock market and analysts\u2019 expectations. Accountants should watch for revenue recognition related issues in preparing the financial statements of their company or client, especially when employees\u2019 or management\u2019s stock options are about to vest. \n\n Current Portion of a Noncurrent Note Payable \n\n Sierra Sports takes out a bank loan on January 1, 2017 to cover expansion costs for a new store. The note amount is $360,000. The note has terms of repayment that include equal principal payments annually over the next twenty years. The annual interest rate on the loan is 9%. Interest accumulates each month based on the standard interest rate formula discussed previously, and on the current outstanding principal balance of the loan. Sierra records interest accumulation every three months, at the end of each third month. The initial loan (note) entry follows. \n\n Notes Payable increases (credit) for the full loan principal amount. Cash increases (debit) as well. On March 31, the end of the first three months, Sierra records their first interest accumulation. \n\n Interest Expense increases (debit) as does Interest Payable (credit) for the amount of interest accumulated but unpaid at the end of the three-month period. The amount $8,100 is found by using the interest formula, where the outstanding principal balance is $360,000, interest rate of 9%, and the part of the year being three out of twelve months: $360,000 \u00d7 9% \u00d7 (3/12). \n\n The same entry for interest will occur every three months until year-end. When accumulated interest is paid on January 1 of the following year, Sierra would record this entry. \n\n Both Interest Payable and Cash decrease for the total interest amount accumulated during 2017. This is calculated by taking each three-month interest accumulation of $8,100 and multiplying by the four recorded interest entries for the periods. You could also compute this by taking the original principal balance and multiplying by 9%. \n\n On December 31, 2017, the first principal payment is due. The following entry occurs to show payment of this principal amount due in the current period. \n\n Notes Payable decreases (debit), as does Cash (credit), for the amount of the noncurrent note payable due in the current period. This amount is calculated by dividing the original principal amount ($360,000) by twenty years to get an annual current principal payment of $18,000 ($360,000/20). \n\n While the accounts used to record a reduction in Notes Payable are the same as the accounts used for a noncurrent note, the reporting on the balance sheet is classified in a different area. The current portion of the noncurrent note payable ($18,000) is reported under Current Liabilities, and the remaining noncurrent balance of $342,000 ($360,000 \u2013 $18,000) is classified and displayed under noncurrent liabilities, as shown in  Figure 12.7 . \n\n Taxes Payable \n\n Let\u2019s consider our previous example where Sierra Sports purchased $12,000 of soccer equipment in August. Sierra now sells the soccer equipment to a local soccer league for $18,000 cash on August 20. The sales tax rate is 6%. The following revenue entry would occur. \n\n Cash increases (debit) for the sales amount plus sales tax. Sales Tax Payable increases (credit) for the 6% tax rate ($18,000 \u00d7 6%). Sierra\u2019s tax liability is owed to the State Tax Board. Sales increases (credit) for the original amount of the sale, not including sales tax. If Sierra\u2019s customer pays on credit, Accounts Receivable would increase (debit) for $19,080 rather than Cash. \n\n When Sierra remits payment to the State Tax Board on October 1, the following entry occurs. \n\n Sales Tax Payable and Cash decrease for the payment amount of $1,080. Sales tax is not an expense to the business because the company is holding it on account for another entity. \n\n Sierra Sports payroll tax journal entries will appear in  Record Transactions Incurred in Preparing Payroll . \n\n Your Turn Accounting for Purchase Discounts You own a shipping and packaging facility and provide shipping services to customers. You have worked out a contract with a local supplier to provide your business with packing materials on an ongoing basis. Terms of your agreement allow for delayed payment of up to thirty days from the invoice date, with an incentive to pay within ten days to receive a 5% discount on the packing materials. On April 3, you purchase 1,000 boxes (Box Inventory) from this supplier at a cost per box of $1.25. You pay the amount due to the supplier on April 11. Record the journal entries to recognize the initial purchase on April 3, and payment of the amount due on April 11. \n\n Solution \n 12.3   Define and Apply Accounting Treatment for Contingent Liabilities \n\n What happens if your business anticipates incurring a loss or debt? Do you need to report this if you are uncertain it will occur? What if you know the loss or debt will occur but it has not happened yet? Do you have to report this event now, or in the future? These are questions businesses must ask themselves when exploring contingencies and their effect on liabilities. \n\n A  contingency  occurs when a current situation has an outcome that is unknown or uncertain and will not be resolved until a future point in time. The outcome could be positive or negative. A  contingent liability  can produce a future debt or negative obligation for the company. Some examples of contingent liabilities include pending litigation (legal action), warranties, customer insurance claims, and bankruptcy. \n\n While a contingency may be positive or negative, we only focus on outcomes that may produce a liability for the company (negative outcome), since these might lead to adjustments in the financial statements in certain cases. Positive contingencies do not require or allow the same types of adjustments to the company\u2019s financial statements as do negative contingencies, since accounting standards do not permit positive contingencies to be recorded. \n\n Pending litigation involves legal claims against the business that may be resolved at a future point in time. The outcome of the lawsuit has yet to be determined but could have negative future impact on the business. \n\n Warranties  arise from products or services sold to customers that cover certain defects (see  Figure 12.8 ). It is unclear if a customer will need to use a warranty, and when, but this is a possibility for each product or service sold that includes a warranty. The same idea applies to insurance claims (car, life, and fire, for example), and bankruptcy. There is an uncertainty that a claim will transpire, or bankruptcy will occur. If the contingencies do occur, it may still be uncertain when they will come to fruition, or the financial implications. \n\n The answer to whether or not uncertainties must be reported comes from Financial Accounting Standards Board (FASB) pronouncements. \n\n Two Financial Accounting Standards Board (FASB) Requirements for Recognition of a Contingent Liability \n\n There are two requirements for contingent liability recognition: \n\n There is a likelihood of occurrence. \n\n Measurement of the occurrence is classified as either estimable or inestimable. \n\n Application of Likelihood of Occurrence Requirement \n\n Let\u2019s explore the likelihood of occurrence requirement in more detail. \n\n According to the FASB, if there is a probable liability determination before the preparation of financial statements has occurred, there is a  likelihood of occurrence , and the liability must be disclosed and recognized. This financial recognition and disclosure are recognized in the current financial statements. The income statement and balance sheet are typically impacted by contingent liabilities. \n\n For example, Sierra Sports has a one-year warranty on part repairs and replacements for a soccer goal they sell. The warranty is good for one year. Sierra Sports notices that some of its soccer goals have rusted screws that require replacement, but they have already sold goals with this problem to customers. There is a probability that someone who purchased the soccer goal may bring it in to have the screws replaced. Not only does the contingent liability meet the probability requirement, it also meets the measurement requirement. \n\n Application of Measurement Requirement \n\n The  measurement requirement  refers to the company\u2019s ability to reasonably estimate the amount of loss. Even though a reasonable estimate is the company\u2019s best guess, it should not be a frivolous number. For a financial figure to be reasonably estimated, it could be based on past experience or industry standards (see  Figure 12.9 ). It could also be determined by the potential future, known financial outcome. \n\n Let\u2019s continue to use Sierra Sports\u2019 soccer goal warranty as our example. If the warranties are honored, the company should know how much each screw costs, labor cost required, time commitment, and any overhead costs incurred. This amount could be a reasonable estimate for the parts repair cost per soccer goal. Since not all warranties may be honored (warranty expired), the company needs to make a reasonable determination for the amount of honored warranties to get a more accurate figure. \n\n Another way to establish the warranty liability could be an estimation of honored warranties as a percentage of sales. In this instance, Sierra could estimate warranty claims at 10% of its soccer goal sales. \n\n When determining if the contingent liability should be recognized, there are four potential treatments to consider. \n\n Let\u2019s expand our discussion and add a brief example of the calculation and application of warranty expenses. To begin, in many ways a warranty expense works similarly to the bad debt expense concept covered in  Accounting for Receivables  in that the anticipated expense is determined by examining past period expense experiences and then basing the current expense on current sales data. Also, as with bad debts, the warranty repairs typically are made in an accounting period sometimes months or even years after the initial sale of the product, which means that we need to estimate future costs to comply with the revenue recognition and matching principles of generally accepted accounting principles (GAAP). \n\n Some industries have such a large number of transactions and a vast data bank of past warranty claims that they have an easier time estimating potential warranty claims, while other companies have a harder time estimating future claims. In our case, we make assumptions about Sierra Sports and build our discussion on the estimated experiences. \n\n For our purposes, assume that Sierra Sports has a line of soccer goals that sell for $800, and the company anticipates selling 500 goals this year (2019). Past experience for the goals that the company has sold is that 5% of them will need to be repaired under their three-year warranty program, and the cost of the average repair is $200. To simplify our example, we concentrate strictly on the journal entries for the warranty expense recognition and the application of the warranty repair pool. If the company sells 500 goals in 2019 and 5% need to be repaired, then 25 goals will be repaired at an average cost of $200. The average cost of $200 \u00d7 25 goals gives an anticipated future repair cost of $5,000 for 2019. Assume for the sake of our example that in 2020 Sierra Sports made repairs that cost $2,800. Following are the necessary journal entries to record the expense in 2019 and the repairs in 2020. The resources used in the warranty repair work could have included several options, such as parts and labor, but to keep it simple we allocated all of the expenses to repair parts inventory. Since the company\u2019s inventory of supply parts (an asset) went down by $2,800, the reduction is reflected with a credit entry to repair parts inventory. First, following is the necessary journal entry to record the expense in 2019. \n\n Next, here is the journal entry to record the repairs in 2020. \n\n Before we finish, we need to address one more issue. Our example only covered the warranty expenses anticipated from the 2019 sales. Since the company has a three-year warranty, and it estimated repair costs of $5,000 for the goals sold in 2019, there is still a balance of $2,200 left from the original $5,000. However, its actual experiences could be more, the same, or less than $2,200. If it is determined that too much is being set aside in the allowance, then future annual warranty expenses can be adjusted downward. If it is determined that not enough is being accumulated, then the warranty expense allowance can be increased. \n\n Since this warranty expense allocation will probably be carried on for many years, adjustments in the estimated warranty expenses can be made to reflect actual experiences. Also, sales for 2020, 2021, 2022, and all subsequent years will need to reflect the same types of journal entries for their sales. In essence, as long as Sierra Sports sells the goals or other equipment and provides a warranty, it will need to account for the warranty expenses in a manner similar to the one we demonstrated. \n\n Think It Through Product Recalls: Contingent Liabilities? Consider the following scenario: A hoverboard is a self-balancing scooter that uses body position and weight transfer to control the device. Hoverboards use a lithium-ion battery pack, which was found to overheat causing an increased risk for the product to catch fire or explode. Several people were badly injured from these fires and explosions. As a result, a recall was issued in mid-2016 on most hoverboard models. Customers were asked to return the product to the original point of sale (the retailer). Retailers were required to accept returns and provide repair when available. In some cases, retailers were held accountable by consumers, and not the manufacturer of the hoverboards. You are the retailer in this situation and must decide if the hoverboard scenario creates any contingent liabilities. If so, what are the contingent liabilities? Do the conditions meet FASB requirements for contingent liability reporting? Which of the four possible treatments are best suited for the potential liabilities identified? Are there any journal entries or note disclosures necessary? \n\n Four Potential Treatments for Contingent Liabilities \n\n If the contingency is  probable and estimable , it is likely to occur and can be reasonably estimated. In this case, the liability and associated expense must be journalized and included in the current period\u2019s financial statements (balance sheet and income statement) along with note disclosures explaining the reason for recognition. The note disclosures are a GAAP requirement pertaining to the full disclosure principle, as detailed in  Analyzing and Recording Transactions . \n\n If the contingent liability is  probable and inestimable , it is likely to occur but cannot be reasonably estimated. In this case, a note disclosure is required in financial statements, but a journal entry and financial recognition should not occur until a reasonable estimate is possible. \n\n If the contingency is  reasonably possible , it could occur but is not probable. The amount may or may not be estimable. Since this condition does not meet the requirement of likelihood, it should not be journalized or financially represented within the financial statements. Rather, it is disclosed in the notes only with any available details, financial or otherwise. \n\n If the contingent liability is considered  remote , it is unlikely to occur and may or may not be estimable. This does not meet the likelihood requirement, and the possibility of actualization is minimal. In this situation, no journal entry or note disclosure in financial statements is necessary. \n\n Financial Statement Treatments \n\n \u00a0 \n\n Journalize \n\n Note Disclosure \n\n Probable and estimable \n\n Yes \n\n Yes \n\n Probable and inestimable \n\n No \n\n Yes \n\n Reasonably possible \n\n No \n\n Yes \n\n Remote \n\n No \n\n No \n\n Table  12.2   Four Treatments of Contingent Liabilities. Proper recognition of the four contingent liability treatments. \n\n Link to Learning \n\n Google , a subsidiary of  Alphabet Inc. , has expanded from a search engine to a global brand with a variety of product and service offerings. Like many other companies, contingent liabilities are carried on  Google \u2019s balance sheet, report expenses related to these contingencies on its income statement, and note disclosures are provided to explain its contingent liability treatments. Check out  Google \u2019s contingent liability considerations in this  press release for Alphabet Inc.\u2019s First Quarter 2017 Results  to see a financial statement package, including note disclosures. \n\n Let\u2019s review some contingent liability treatment examples as they relate to our fictitious company, Sierra Sports. \n\n Probable and Estimable \n\n If Sierra Sports determines the cost of the soccer goal screws are $30, the labor requirement is one hour at a rate of $40 per hour, and there is no extra overhead applied, then the total estimated warranty repair cost would be $70 per goal: $30 + (1 hour \u00d7 $40 per hour). Sierra Sports sold ten goals before it discovered the rusty screw issue. The company believes that only six of those goals will have their warranties honored, based on past experience. This means Sierra will incur a warranty liability of $420 ($70 \u00d7 6 goals). The $420 is considered probable and estimable and is recorded in Warranty Liability and Warranty Expense accounts during the period of discovery (current period). \n\n An example of determining a warranty liability based on a percentage of sales follows. The sales price per soccer goal is $1,200, and Sierra Sports believes 10% of sales will result in honored warranties. The company would record this warranty liability of $120 ($1,200 \u00d7 10%) to Warranty Liability and Warranty Expense accounts. \n\n When the warranty is honored, this would reduce the Warranty Liability account and decrease the asset used for repair (Parts: Screws account) or Cash, if applicable. The recognition would happen as soon as the warranty is honored. This first entry shown is to recognize honored warranties for all six goals. \n\n This second entry recognizes an honored warranty for a soccer goal based on 10% of sales from the period. \n\n As you\u2019ve learned, not only are warranty expense and warranty liability journalized, but they are also recognized on the income statement and balance sheet. The following examples show recognition of Warranty Expense on the income statement  Figure 12.10  and Warranty Liability on the balance sheet  Figure 12.11  for Sierra Sports. \n\n Probable and Not Estimable \n\n Assume that Sierra Sports is sued by one of the customers who purchased the faulty soccer goals. A settlement of responsibility in the case has been reached, but the actual damages have not been determined and cannot be reasonably estimated. This is considered probable but inestimable, because the lawsuit is very likely to occur (given a settlement is agreed upon) but the actual damages are unknown. No journal entry or financial adjustment in the financial statements will occur. Instead, Sierra Sports will include a note describing any details available about the lawsuit. When damages have been determined, or have been reasonably estimated, then journalizing would be appropriate. \n\n Sierra Sports could say the following in its financial statement disclosures: \u201cThere is pending litigation against our company with the likelihood of settlement probable. Detailed terms and damages have not yet reached agreement, and a reasonable assessment of financial impact is currently unknown.\u201d \n\n Reasonably Possible \n\n Sierra Sports may have more litigation in the future surrounding the soccer goals. These lawsuits have not yet been filed or are in the very early stages of the litigation process. Since there is a past precedent for lawsuits of this nature but no establishment of guilt or formal arrangement of damages or timeline, the likelihood of occurrence is reasonably possible. The outcome is not probable but is not remote either. Since the outcome is possible, the contingent liability is disclosed in Sierra Sports\u2019 financial statement notes. \n\n Sierra Sports could say the following in their financial statement disclosures: \u201cWe anticipate more claimants filing legal action against our company with the likelihood of settlement reasonably possible. Assignment of guilt, detailed terms, and potential damages have not been established. A reasonable assessment of financial impact is currently unknown.\u201d \n\n Remote \n\n Sierra Sports worries that as a result of pending litigation and losses associated with the faulty soccer goals, the company might have to file for bankruptcy. After consulting with a financial advisor, the company is pretty certain it can continue operating in the long term without restructuring. The chances are remote that a bankruptcy would occur. Sierra Sports would not recognize this remote occurrence on the financial statements or provide a note disclosure. \n\n IFRS Connection Current Liabilities US GAAP and International Financial Reporting Standards (IFRS) define \u201ccurrent liabilities\u201d similarly and use the same reporting criteria for most all types of current liabilities. However, two primary differences exist between US GAAP and IFRS: the reporting of (1) debt due on demand and (2) contingencies. \n\n Liquidity and solvency are measures of a company\u2019s ability to pay debts as they come due. Liquidity measures evaluate a company\u2019s ability to pay current debts as they come due, while solvency measures evaluate the ability to pay debts long term. One common liquidity measure is the current ratio, and a higher ratio is preferred over a lower one. This ratio\u2014current assets divided by current liabilities\u2014is lowered by an increase in current liabilities (the denominator increases while we assume that the numerator remains the same). When lenders arrange loans with their corporate customers, limits are typically set on how low certain liquidity ratios (such as the current ratio) can go before the bank can demand that the loan be repaid immediately. \n\n In theory, debt that has not been paid and that has become \u201con demand\u201d would be considered a current liability. However, in determining how to report a loan that has become \u201con-demand,\u201d US GAAP and IFRS differ: \n\n Under US GAAP, debts on which payment has been demanded because of violations of the contractual agreement between the lender and creditor are only included in current liabilities if, by the financial statement presentation date, there have been no arrangements made to pay off or restructure the debt. This allows companies time between the end of the fiscal year and the actual publication of the financial statements (typically two months) to make arrangements for repayment of the loan. Most often these loans are refinanced. \n\n Under IFRS, any payment or refinancing arrangements must be made by the fiscal year-end of the debtor. This difference means that companies reporting under IFRS must be proactive in assessing whether their debt agreements will be violated and make appropriate arrangements for refinancing or differing payment options prior to final year-end numbers being reported. \n\n A second set of differences exist regarding reporting contingencies. Where US GAAP uses the term \u201ccontingencies,\u201d IFRS uses \u201cprovisions.\u201d In both cases, gain contingencies are not recorded until they are essentially realized. Both systems want to avoid prematurely recording or overstating gains based on the principles of conservatism. Loss contingencies are recorded (accrued) if certain conditions are met: \n\n Under US GAAP, loss contingencies are accrued if they are probable and can be estimated. Probable means \u201clikely\u201d to occur and is often assessed as an 80% likelihood by practitioners. \n\n Under IFRS, probable is defined as \u201cmore likely than not\u201d and is typically assessed at 50% by practitioners. \n\n The determination of whether a contingency is probable is based on the judgment of auditors and management in both situations. This means a contingent situation such as a lawsuit might be accrued under IFRS but not accrued under US GAAP. Finally, how a loss contingency is measured varies between the two options as well. For example, if a company is told it will be probable that it will lose an active lawsuit, and the legal team gives a range of the dollar value of that loss, under IFRS, the discounted midpoint of that range would be accrued, and the range disclosed. Under US GAAP, the low end of the range would be accrued, and the range disclosed. \n 12.4   Prepare Journal Entries to Record Short-Term Notes Payable \n\n If you have ever taken out a payday loan, you may have experienced a situation where your living expenses temporarily exceeded your assets. You need enough money to cover your expenses until you get your next paycheck. Once you receive that paycheck, you can repay the lender the amount you borrowed, plus a little extra for the lender\u2019s assistance. \n\n There is an ebb and flow to business that can sometimes produce this same situation, where business expenses temporarily exceed revenues. Even if a company finds itself in this situation, bills still need to be paid. The company may consider a short-term note payable to cover the difference. \n\n A  short-term note payable  is a debt created and due within a company\u2019s operating period (less than a year). Some key characteristics of this written promise to pay (see  Figure 12.12 ) include an established date for repayment, a specific payable amount, interest terms, and the possibility of debt resale to another party. A short-term note is classified as a current liability because it is wholly honored within a company\u2019s operating period. This payable account would appear on the balance sheet under Current Liabilities. \n\n Debt sale to a third party is a possibility with any loan, which includes a short-term note payable. The terms of the agreement will state this resale possibility, and the new debt owner honors the agreement terms of the original parties. A lender may choose this option to collect cash quickly and reduce the overall outstanding debt. \n\n We now consider two short-term notes payable situations; one is created by a purchase, and the other is created by a loan. \n\n Think It Through Promissory Notes: Time to Issue More Debt? A common practice for government entities, particularly schools, is to issue short-term ( promissory ) notes to cover daily expenditures until revenues are received from tax collection, lottery funds, and other sources. School boards approve the note issuances, with repayments of principal and interest typically met within a few months. \n\n The goal is to fully cover all expenses until revenues are distributed from the state. However, revenues distributed fluctuate due to changes in collection expectations, and schools may not be able to cover their expenditures in the current period. This leads to a dilemma\u2014whether or not to issue more short-term notes to cover the deficit. \n\n Short-term debt may be preferred over long-term debt when the entity does not want to devote resources to pay interest over an extended period of time. In many cases, the interest rate is lower than long-term debt, because the loan is considered less risky with the shorter payback period. This shorter payback period is also beneficial with amortization expenses; short-term debt typically does not amortize, unlike long-term debt. \n\n What would you do if you found your school in this situation? Would you issue more debt? Are there alternatives? What are some positives and negatives to the promissory note practice? \n\n Recording Short-Term Notes Payable Created by a Purchase \n\n A short-term notes payable created by a purchase typically occurs when a payment to a supplier does not occur within the established time frame. The supplier might require a new agreement that converts the overdue accounts payable into a short-term note payable (see  Figure 12.13 ), with interest added. This gives the company more time to make good on outstanding debt and gives the supplier an incentive for delaying payment. Also, the creation of the note payable creates a stronger legal position for the owner of the note, since the note is a negotiable legal instrument that can be more easily enforced in court actions. \n\n To illustrate, let\u2019s revisit Sierra Sports\u2019 purchase of soccer equipment on August 1. Sierra Sports purchased $12,000 of soccer equipment from a supplier on credit. Credit terms were 2/10, n/30, invoice date August 1. Let\u2019s assume that Sierra Sports was unable to make the payment due within 30 days. On August 31, the supplier renegotiates terms with Sierra and converts the accounts payable into a written note, requiring full payment in two months, beginning September 1. Interest is now included as part of the payment terms at an annual rate of 10%. The conversion entry from an account payable to a Short-Term Note Payable in Sierra\u2019s journal is shown. \n\n Accounts Payable decreases (debit) and Short-Term Notes Payable increases (credit) for the original amount owed of $12,000. When Sierra pays cash for the full amount due, including interest, on October 31, the following entry occurs. \n\n Since Sierra paid the full amount due, Short-Term Notes Payable decreases (debit) for the principal amount of the debt. Interest Expense increases (debit) for two months of interest accumulation. Interest Expense is found from our earlier equation, where Interest = Principal \u00d7 Annual interest rate \u00d7 Part of year ($12,000 \u00d7 10% \u00d7 [2/12]), which is $200. Cash decreases (credit) for $12,200, which is the principal plus the interest due. \n\n The other short-term note scenario is created by a loan. \n\n Recording Short-Term Notes Payable Created by a Loan \n\n A short-term notes payable created by a loan transpires when a business incurs debt with a lender  Figure 12.14 . A business may choose this path when it does not have enough cash on hand to finance a capital expenditure immediately but does not need long-term financing. The business may also require an influx of cash to cover expenses temporarily. There is a written promise to pay the principal balance and interest due on or before a specific date. This payment period is within a company\u2019s operating period (less than a year). Consider a short-term notes payable scenario for Sierra Sports. \n\n Sierra Sports requires a new apparel printing machine after experiencing an increase in custom uniform orders. Sierra does not have enough cash on hand currently to pay for the machine, but the company does not need long-term financing. Sierra borrows $150,000 from the bank on October 1, with payment due within three months (December 31), at a 12% annual interest rate. The following entry occurs when Sierra initially takes out the loan. \n\n Cash increases (debit) as does Short-Term Notes Payable (credit) for the principal amount of the loan, which is $150,000. When Sierra pays in full on December 31, the following entry occurs. \n\n Short-Term Notes Payable decreases (a debit) for the principal amount of the loan ($150,000). Interest Expense increases (a debit) for $4,500 (calculated as $150,000 principal \u00d7 12% annual interest rate \u00d7 [3/12 months]). Cash decreases (a credit) for the principal amount plus interest due. \n\n Link to Learning \n\n Loan calculators can help businesses determine the amount they are able to borrow from a lender given certain factors, such as loan amount, terms, interest rate, and payback categorization (payback periodically or at the end of the loan, for example). A group of information technology professionals provides one such  loan calculator with definitions and additional information and tools  to provide more information. \n 12.5   Record Transactions Incurred in Preparing Payroll \n\n Have you ever looked at your paycheck and wondered where all the money went? Well, it did not disappear; the money was used to contribute required and optional financial payments to various entities. \n\n Payroll can be one of the largest expenses and potential liabilities for a business. Payroll liabilities include employee salaries and wages, and deductions for taxes, benefits, and employer contributions. In this section, we explain these elements of payroll and the required journal entries. \n\n Employee Compensation and Deductions \n\n As an employee working in a business, you receive compensation for your work. This pay could be a monthly salary or hourly wages paid periodically. The amount earned by the employee before any reductions in pay occur is considered  gross income (pay) . These reductions include involuntary and voluntary deductions. The remaining balance after deductions is considered  net income (pay) , or \u201ctake-home-pay.\u201d The take-home-pay is what employees receive and deposit in their bank accounts. \n\n Involuntary Deductions \n\n Involuntary deductions  are withholdings that neither the employer nor the employee have control over and are required by law. \n\n Federal, state, and local income taxes are considered involuntary deductions. Income taxes imposed are different for every employee and are based on their W-4 Form, the Employee\u2019s Withholding Allowance Certificate. An employee will fill in his or her marital status, number of allowances requested, and any additional reduction amounts. The employer will use this information to determine the  federal income tax withholding  amount from each paycheck.  State income tax withholding  may also use W-4 information or the state\u2019s withholdings certificate. The federal income tax withholding and state income tax withholding amounts can be established with tax tables published annually by the  Internal Revenue Service  (IRS) (see  Figure 12.15 ) and state government offices, respectively. Some states though do not require an income tax withholding, since they do not impose a state income tax. Federal and state income liabilities are held in payable accounts until disbursement to the governmental bodies that administer the tax compliance process for their particular governmental entity. \n\n While not a common occurrence,  local income tax withholding  is applied to those living or working within a jurisdiction to cover schooling, social services, park maintenance, and law enforcement. If local income taxes are withheld, these remain current liabilities until paid. \n\n Other involuntary deductions involve  Federal Insurance Contribution Act (FICA) taxes  for Social Security and Medicare. FICA mandates employers to withhold taxes from employee wages \u201cto provide benefits for retirees, the disabled, and children.\u201d The  Social Security tax rate  is 6.2% of employee gross wages. As of 2017, there is a maximum taxable earnings amount of $127,200. Meaning, only the first $127,200 of each employee\u2019s gross wages has the Social Security tax applied. In 2018, the maximum taxable earnings amount increased to $128,400. The  Medicare tax rate  is 1.45% of employee gross income. There is no taxable earnings cap for Medicare tax. The two taxes combined equal 7.65% (6.2% + 1.45%). Both the employer and the employee pay the two taxes on behalf of the employee. \n\n More recent health-care legislation, the Affordable Care Act (ACA), requires an  additional medicare tax  withholding from employee pay of 0.9% for individuals who exceed an income threshold based on their filing status (married, single, or head of household, for example). This Additional Medicare Tax withholding is only applied to employee payroll. \n\n Last, involuntary deductions may also include child support payments, IRS federal tax levies, court-ordered wage garnishments, and bankruptcy judgments. All involuntary deductions are an employer\u2019s liability until they are paid. \n\n Voluntary Deductions \n\n In addition to involuntary deductions, employers may withhold certain  voluntary deductions  from employee wages. Voluntary deductions are not required to be removed from employee pay unless the employee designates reduction of these amounts. Voluntary deductions may include, but are not limited to, health-care coverage, life insurance, retirement contributions, charitable contributions, pension funds, and union dues. Employees can cover the full cost of these benefits or they may cost-share with the employer. \n\n Health-care coverage is a requirement for many businesses to provide as a result of the ACA. Employers may provide partial benefit coverage and request the employee to pay the remainder. For example, the employer would cover 30% of health-care cost, and 70% would be the employee\u2019s responsibility. \n\n Retirement contributions may include those made to an employer-sponsored plan, such as a  defined contribution plan , which \u201cshelters\u201d the income in a 401(k) or a 403(b). In simple terms, a defined contribution plan allows an employee to voluntarily contribute a specified amount or percentage of his or her pretax wages to a special account in order to defer the tax on those earnings. Usually, a portion of the employee\u2019s contribution is matched by his or her employer; employers often use this as an incentive to attract and keep highly skilled and valuable employees. Only when the employee eventually withdraws funds from the plan will he or she be required to pay the tax on those earnings. Because the amount contributed to the plan is not immediately taxed by the IRS, it enables the employee to accumulate funds for his or her retirement. This deferred income may be excluded from the employee\u2019s current federal taxable income but not FICA taxes. All voluntary deductions are considered employer liabilities until remitted. For more in-depth information on retirement planning, and using a  401(k)  or a  403(b) , refer to  Appendix C . \n\n As with involuntary deductions, voluntary deductions are held as a current liability until paid. When payroll is disbursed, journal entries are required. \n\n Concepts In Practice Should You Start Saving for Retirement? Should you save for retirement now or wait? As a student, you may be inclined to put off saving for retirement for many reasons. You may not be in a financial position to do so, you believe Social Security will be enough to cover your needs, or you may not have even thought about it up to this point. \n\n According to a 2012 survey from the Bureau of Labor Statistics, of those who had access to a defined contribution plan, only 68% of employees contributed to their retirement plan. Many employees wait until their mid-thirties or forties to begin saving, and this can delay retirement, or may leave the retiree unable to cover his or her annual expenses. Some pitfalls contributing to this lack of saving are short-term negative spending practices such as high-interest loan debt, credit card purchases, and discretionary spending (optional expenses such as eating out or entertainment). To avoid these hazards, you should \n\n Analyze your spending habits and make changes where possible. \n\n Develop a financial plan with the help of a finance specialist. \n\n Join a defined contribution plan and stick with the plan (do not withdraw funds early). \n\n Try to contribute at least as much as your employer is willing to match. \n\n Consider other short-term savings options like bonds, or high-interest bank accounts. \n\n Have a specific savings goal for your retirement account. For example, many financial advisors recommend saving at least 15% of your monthly income for retirement. However, they usually include both the employee\u2019s contribution and the employer\u2019s. For example, assume that the company matches each dollar invested by the employee with a $0.50 contribution from the employer, up to 8% for the employee. In this case, if the employee contributes 8% and the company provides 4%, that takes the employee to 80% of the recommended goal (12% of the recommended 15%). \n\n Remember, the longer you wait to begin investing, the more you will have to save later on to have enough for retirement. \n\n Journal Entries to Report Employee Compensation and Deductions \n\n We continue to use Sierra Sports as our example company to prepare journal entries. \n\n Sierra Sports employs several people, but our focus is on one specific employee for this example. Billie Sanders works for Sierra Sports and earns a salary each month of $2,000. She claims two withholdings allowances (see  Figure 12.15 ). This amount is paid on the first of the following month. Withholdings for federal and state income taxes are assessed in the amount of $102 and $25, respectively. FICA Social Security is taxed at the 6.2% rate, and FICA Medicare is taxed at the 1.45% rate. Billie has voluntary deductions for health insurance and a 401(k) retirement contribution. She is responsible for 40% of her $500 health-care insurance premium; Sierra Sports pays the remaining 60% (as explained in employer payroll). The 401(k) contributions total $150. The first entry records the salaries liability during the month of August. \n\n Salaries Expense is an equity account used to recognize the accumulated (accrued) expense to the business during August (increase on the debit side). Salaries Expense represents the employee\u2019s gross income (pay) before any deductions. Each deduction liability is listed in its own account; this will help for ease of payment to the different entities. Note that Health Insurance Payable is in the amount of $200, which is 40% of the employee\u2019s responsibility for the premium ($500 \u00d7 0.40 = $200). Salaries Payable represents net income (pay) or the \u201ctake-home pay\u201d for Billie. Salaries Payable is $1,370, which is found by taking gross income and subtracting the sum of the liabilities ($2,000 \u2013 $630 = $1,370). Since salaries are not paid until the first of the following month, this liability will remain during the month of August. All liabilities (payables) increase due to the company\u2019s outstanding debt (increase on the credit side). \n\n The second entry records cash payment of accumulated salaries on September 1. \n\n Payment to Billie Sanders occurs on September 1. The payment is for salaries accumulated from the month of August. The payment decreases Salaries Payable (debit side) since the liability was paid and decreases Cash (credit side), because cash is the asset used for payment. \n\n Link to Learning \n\n The IRS has developed a  simulation database with twenty different taxpayer simulations  to help taxpayers understand their tax returns and withholdings. \n\n Employer Compensation and Deductions \n\n At this point you might be asking yourself, \u201cwhy am I having to pay all of this money and my employer isn\u2019t?\u201d Your employer also has a fiscal and legal responsibility to contribute and match funds to certain payroll liability accounts. \n\n Involuntary Payroll Taxes \n\n Employers must match employee contributions to FICA Social Security (6.2% rate) on the first $127,200 of employee wages for 2017, and FICA Medicare (1.45% rate) on all employee earnings. Withholdings for these taxes are forwarded to the same place as employee contributions; thus, the same accounts are used when recording journal entries. \n\n Employers are required by law to pay into an unemployment insurance system that covers employees in case of job disruption due to factors outside of their control (job elimination from company bankruptcy, for example). The tax recognizing this required payment is the  Federal Unemployment Tax Act (FUTA) . FUTA is at a rate of 6%. This tax applies to the initial $7,000 of each employee\u2019s wages earned during the year. This rate may be reduced by as much as 5.4% as a credit for paying into state unemployment on time, producing a lower rate of 0.6%. The  State Unemployment Tax Act (SUTA)  is similar to the FUTA process, but tax rates and minimum taxable earnings vary by state. \n\n Voluntary Benefits Provided by the Employer \n\n Employers offer competitive advantages (benefits) to employees in an effort to improve job satisfaction and increase employee morale. There is no statute mandating the employer cover these benefits financially. Some possible benefits are health-care coverage, life insurance, contributions to retirement plans, paid sick leave, paid maternity/paternity leave, and  vacation compensation . \n\n Paid sick leave, paid maternity/paternity leave, and vacation compensation help employees take time off when needed or required by providing a stipend while the employee is away. This compensation is often comparable to the wages or salary for the covered period. Some companies have policies that require vacation and paid sick leave to be used within the year or the employee risks losing that benefit in the current period. These benefits are considered estimated liabilities since it is not clear when, if, or how much the employee will use them. Let\u2019s now see the process for journalizing employer compensation and deductions. \n\n Journal Entries to Report Employer Compensation and Deductions \n\n In addition to the employee payroll entries for Billie Sanders, Sierra Sports has an obligation to contribute taxes to federal unemployment, state unemployment, FICA Social Security, and FICA Medicare. They are also responsible for 60% of Billie\u2019s health insurance premium payment. Assume Sierra Sports receives the FUTA credit and is only taxed at the rate of 0.6%, and SUTA taxes are $100. August is Billie Sanders\u2019 first month of pay for the year. The following entry represents the employer payroll liabilities and expense for the month of August. The second entry records the health insurance premium liability. \n\n Employer Payroll Tax Expense is the equity account used to recognize payroll expenses during the period (increases on the debit side). The amount of $265 is the sum of all liabilities from that period. Notice that FICA Social Security Tax Payable and FICA Medicare Tax Payable were used in the employee payroll entry earlier and again here in the employer payroll. You only need to use one account if the payments are for the same recipient and purpose. The amounts of Social Security ($124) and Medicare ($29) taxes withheld match the amounts withheld from employee payroll. Federal Unemployment Tax Payable and State Unemployment Tax Payable recognize the liabilities for federal and state unemployment deductions, respectively. The federal unemployment tax ($12) is computed by multiplying the federal unemployment tax rate of 0.6% by $2,000. These liability accounts increase (credit side) when the amount owed increases. \n\n The second entry recognizes the liability created from providing the voluntary benefit, health insurance coverage. Voluntary and involuntary employer payroll items should be separated. It is also important to separate estimated liabilities from certain voluntary benefits due to their uncertainty. Benefits Expense recognizes the health insurance expense from August. Health Insurance Payable recognizes the outstanding liability for health-care coverage covered by the employer ($500 \u00d7 60% = $300). \n\n The following entries represent payment of the employer payroll and benefit liabilities in the following period. \n\n When payment occurs, all payable accounts decrease (debit) because the company paid all taxes and benefits owed for those liabilities. Cash is the accepted form of payment at the payee organizations (Social Security Administration, and health plan administrator, for example). \n\n Link to Learning \n\n The IRS oversees all tax-related activities on behalf of the US Department of the Treasury. In an effort to assist taxpayers with determining amounts they may owe, the IRS has established a  withholdings calculator  that can let an employee know if he or she needs to submit a new W-4 form to the employer based on the results. ", "questions": [{"question": {"question_id": "fs-idm257332752", "question_text": "Which of the following is not considered a current liability?", "question_choices": ["Accounts Payable", "Unearned Revenue", "the component of a twenty-year note payable due in year 20", "current portion of a noncurrent note payable"], "cloze_format": "(The) ___ is not considered a current liability.", "normal_format": "Which of the following is not considered a current liability?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "A note payable is usually classified as a long-term ( noncurrent ) liability if the note period is longer than one year or the standard operating period of the company . Common current liabilities include accounts payable , unearned revenues , the current portion of a note payable , and taxes payable . Each of these liabilities is current because it results from a past business activity , with a disbursement or payment due within a period of less than a year .", "hl_context": "<hl> A note payable is usually classified as a long-term ( noncurrent ) liability if the note period is longer than one year or the standard operating period of the company . <hl> However , during the company \u2019 s current operating period , any portion of the long-term note due that will be paid in the current period is considered a current portion of a note payable . The outstanding balance note payable during the current period remains a noncurrent note payable . Note that this does not include the interest portion of the payments . On the balance sheet , the current portion of the noncurrent liability is separated from the remaining noncurrent liability . No journal entry is required for this distinction , but some companies choose to show the transfer from a noncurrent liability to a current liability . <hl> Common current liabilities include accounts payable , unearned revenues , the current portion of a note payable , and taxes payable . <hl> <hl> Each of these liabilities is current because it results from a past business activity , with a disbursement or payment due within a period of less than a year . <hl>"}, {"question": {"question_id": "fs-idm330204752", "question_text": "Which of the following best describes a contingent liability that is likely to occur but cannot be reasonably estimated?", "question_choices": ["reasonably possible", "probable and estimable", "probable and inestimable", "remote"], "cloze_format": "___ best describes a contingent liability that is likely to occur but cannot be reasonably estimated.", "normal_format": "Which of the following best describes a contingent liability that is likely to occur but cannot be reasonably estimated?"}, "answer": {"ans_text": "probable and inestimable", "ans_choice": 2}, "bloom": null, "hl_sentences": "If the contingent liability is probable and inestimable , it is likely to occur but cannot be reasonably estimated .", "hl_context": "<hl> If the contingent liability is probable and inestimable , it is likely to occur but cannot be reasonably estimated . <hl> In this case , a note disclosure is required in financial statements , but a journal entry and financial recognition should not occur until a reasonable estimate is possible ."}, {"question": {"question_id": "fs-idm340150112", "question_text": "Which of the following best describes a contingent liability that is unlikely to occur?", "question_choices": ["remote", "probable and estimable", "reasonably possible", "probable and inestimable"], "cloze_format": "A contingent liability that is unlikely to occur is best described as ___.", "normal_format": "Which of the following best describes a contingent liability that is unlikely to occur?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "If the contingent liability is considered remote , it is unlikely to occur and may or may not be estimable .", "hl_context": "<hl> If the contingent liability is considered remote , it is unlikely to occur and may or may not be estimable . <hl> This does not meet the likelihood requirement , and the possibility of actualization is minimal . In this situation , no journal entry or note disclosure in financial statements is necessary ."}, {"question": {"question_id": "fs-idm254941952", "question_text": "Which of the following is not a characteristic of a short-term note payable?", "question_choices": ["Payment is due in less than a year.", "It bears interest.", "It can result from an accounts payable conversion.", "It is reported on the balance sheet under noncurrent liabilities."], "cloze_format": "It  is not a characteristic of a short-term note payable that ___.", "normal_format": "Which of the following is not a characteristic of a short-term note payable?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "A short-term note payable is a debt created and due within a company \u2019 s operating period ( less than a year ) . Some key characteristics of this written promise to pay ( see Figure 12.12 ) include an established date for repayment , a specific payable amount , interest terms , and the possibility of debt resale to another party . A short-term note is classified as a current liability because it is wholly honored within a company \u2019 s operating period . This payable account would appear on the balance sheet under Current Liabilities .", "hl_context": "<hl> A short-term note payable is a debt created and due within a company \u2019 s operating period ( less than a year ) . <hl> <hl> Some key characteristics of this written promise to pay ( see Figure 12.12 ) include an established date for repayment , a specific payable amount , interest terms , and the possibility of debt resale to another party . <hl> <hl> A short-term note is classified as a current liability because it is wholly honored within a company \u2019 s operating period . <hl> <hl> This payable account would appear on the balance sheet under Current Liabilities . <hl>"}], "summary": " Summary 12.1   Identify and Describe Current Liabilities \n\n Current liabilities are debts or obligations that arise from past business activities and are due for payment within a company\u2019s operating period (one year). Common examples of current liabilities include accounts payable, unearned revenue, the current portion of a noncurrent note payable, and taxes payable. \n\n Accounts payable is used to record purchases from suppliers on credit. Accounts payable typically does not include interest payments. \n\n Unearned revenue is recorded when customers pay in advance for products or services before receiving their benefits. The company maintains the liability until services or products are rendered. \n\n Notes payable is a debt to a lender with specific repayment terms, which can include principal and interest. Interest accrued can be computed with the annual interest rate, principal loan amount, and portion of the year accrued. \n\n Employers withhold taxes from employees and customers for payment to government agencies at a later date, but within the business operating period. Common taxes are sales tax and federal, state, and local income taxes. \n\n 12.2   Analyze, Journalize, and Report Current Liabilities \n\n When the merchandiser initially pays the supplier on credit, it increases both Accounts Payable (a credit) and the appropriate merchandise Inventory account (a debit). When the amount due is later paid, it decreases both Accounts Payable (a debit) and Cash (a credit). \n\n When the company collects payment from a customer in advance of providing a product or service, it increases both Unearned Revenue (a credit) and Cash (a debit). When the company provides the product or service, Unearned Revenue decreases (a debit), and Revenue increases (a credit) to realize the amount earned. \n\n To recognize payment of the current portion of a noncurrent note payable, both Notes Payable and Cash would decrease, resulting in a debit and a credit, respectively. To recognize interest accumulation, both Interest Expense and Interest Payable would increase, resulting in a debit and a credit, respectively. \n\n To recognize sales tax in the initial sale to a customer, Cash or Accounts Receivable increases (a debit), and Sales Tax Payable increases (a credit), as does Sales (a credit). When the company remits the sales tax payment to the governing body, Sales Tax Payable decreases (a debit), as does Cash (a credit). \n\n 12.3   Define and Apply Accounting Treatment for Contingent Liabilities \n\n Contingent liabilities arise from a current situation with an uncertain outcome that may occur in the future. Contingent liabilities may include litigation, warranties, insurance claims, and bankruptcy. \n\n Two FASB recognition requirements must be met before declaring a contingent liability. There must be a probable likelihood of occurrence, and the loss amount is reasonably estimated. \n\n The four contingent liability treatments are probable and estimable, probable and inestimable, reasonably possible, and remote. \n\n Recognition in financial statements, as well as a note disclosure, occurs when the outcome is probable and estimable. Probable and not estimable and reasonably possible outcomes require note disclosures only. There is not recognition or note disclosure for a remote outcome. \n\n 12.4   Prepare Journal Entries to Record Short-Term Notes Payable \n\n Short-term notes payable is a debt created and due within a company\u2019s operating period (less than a year). This debt includes a written promise to pay principal and interest. \n\n If a company does not pay for its purchases within a specified time frame, a supplier will convert the accounts payable into a short-term note payable with interest. When the company pays the amount owed, short-term notes payable and Cash will decrease, while interest expense increases. \n\n A company may borrow from a bank because it does not have enough cash on hand to pay for a capital expenditure or cover temporary expenses. The loan will consist of short-term repayment with interest, affecting short-term notes payable, cash, and interest expense. \n\n 12.5   Record Transactions Incurred in Preparing Payroll \n\n An employee\u2019s net income (pay) results from gross income (pay) minus any involuntary and voluntary deductions. Employee payroll deductions may include federal, state, and local income taxes; FICA Social Security; FICA Medicare; and voluntary deductions such as health insurance, retirement plan contributions, and union dues. \n\n When recording employee payroll liabilities, Salaries Expense, Salaries Payable, and all payables for income taxes, Social Security, Medicare, and voluntary deductions, are reported. When the company pays the accrued salaries, Salaries Payable is reduced, as is cash. \n\n Employers are required to match employee withholdings for Social Security and Medicare. They must also remit FUTA and SUTA taxes, as well as voluntary deductions and benefits provided to employees. \n\n When recording employer payroll liabilities, Employer Payroll Taxes Expense and all payables associated with FUTA, SUTA, Social Security, Medicare, and voluntary deductions are required. When the company pays all employer liabilities, each payable and cash account decreases. ", "keyterm": "", "bname": "principles_of_accounting,_volume_1:_financial_accounting"}, {"chapter": 8, "intro": " Chapter Outline 8.1   Energy, Matter, and Enzymes 8.2   Catabolism of Carbohydrates 8.3   Cellular Respiration 8.4   Fermentation 8.5   Catabolism of Lipids and Proteins 8.6   Photosynthesis 8.7   Biogeochemical Cycles Introduction Throughout earth\u2019s history, microbial metabolism has been a driving force behind the development and maintenance of the planet\u2019s biosphere. Eukaryotic organisms such as plants and animals typically depend on organic molecules for energy, growth, and reproduction. Prokaryotes, on the other hand, can metabolize a wide range of organic as well as inorganic matter, from complex organic molecules like cellulose to inorganic molecules and ions such as atmospheric nitrogen (N 2 ), molecular hydrogen (H 2 ), sulfide (S 2\u2212 ), manganese (II) ions (Mn 2+ ), ferrous iron (Fe 2+ ), and ferric iron (Fe 3+ ), to name a few. By metabolizing such substances, microbes chemically convert them to other forms. In some cases, microbial metabolism produces chemicals that can be harmful to other organisms; in others, it produces substances that are essential to the metabolism and survival of other life forms ( Figure 8.1 ). ", "chapter_text": " 8.1   Energy, Matter, and Enzymes \n\n Learning Objectives \n\n Define and describe metabolism \n\n Compare and contrast autotrophs and heterotrophs \n\n Describe the importance of oxidation-reduction reactions in metabolism \n\n Describe why ATP, FAD, NAD + , and NADP +  are important in a cell \n\n Identify the structure and structural components of an enzyme \n\n Describe the differences between competitive and noncompetitive enzyme inhibitors \n\n Clinical Focus Part 1 Hannah is a 15-month-old girl from Washington state. She is spending the summer in Gambia, where her parents are working for a nongovernmental organization. About 3 weeks after her arrival in Gambia, Hannah\u2019s appetite began to diminish and her parents noticed that she seemed unusually sluggish, fatigued, and confused. She also seemed very irritable when she was outdoors, especially during the day. When she began vomiting, her parents figured she had caught a 24-hour virus, but when her symptoms persisted, they took her to a clinic. The local physician noticed that Hannah\u2019s reflexes seemed abnormally slow, and when he examined her eyes with a light, she seemed unusually light sensitive. She also seemed to be experiencing a stiff neck. \n\n What are some possible causes of Hannah\u2019s symptoms? \n\n Jump to the  next  Clinical Focus box. \n\n The term used to describe all of the chemical reactions inside a cell is  metabolism  ( Figure 8.2 ). Cellular processes such as the building or breaking down of complex molecules occur through series of stepwise, interconnected chemical reactions called  metabolic pathway s. Reactions that are spontaneous and release energy are  exergonic reaction s, whereas  endergonic reaction s require energy to proceed. The term  anabolism  refers to those endergonic metabolic pathways involved in  biosynthesis , converting simple molecular building blocks into more complex molecules, and fueled by the use of cellular energy. Conversely, the term  catabolism  refers to exergonic pathways that break down complex molecules into simpler ones. Molecular energy stored in the bonds of complex molecules is released in catabolic pathways and harvested in such a way that it can be used to produce high-energy molecules, which are used to drive anabolic pathways. Thus, in terms of energy and molecules, cells are continually balancing catabolism with anabolism. \n\n Classification by Carbon and Energy Source \n\n Organisms can be identified according to the source of carbon they use for metabolism as well as their energy source. The prefixes auto- (\u201cself\u201d) and hetero- (\u201cother\u201d) refer to the origins of the carbon sources various organisms can use. Organisms that convert inorganic carbon dioxide (CO 2 ) into organic carbon compounds are  autotroph s . Plants and cyanobacteria are well-known examples of autotrophs. Conversely,  heterotroph s  rely on more complex organic carbon compounds as nutrients; these are provided to them initially by autotrophs. Many organisms, ranging from humans to many prokaryotes, including the well-studied  Escherichia coli , are heterotrophic. \n\n Organisms can also be identified by the energy source they use. All energy is derived from the transfer of electrons, but the source of electrons differs between various types of organisms. The prefixes photo- (\u201clight\u201d) and chemo- (\u201cchemical\u201d) refer to the energy sources that various organisms use. Those that get their energy for electron transfer from light are  phototroph s , whereas  chemotroph s  obtain energy for electron transfer by breaking chemical bonds. There are two types of chemotrophs:  organotroph s  and  lithotroph s . Organotrophs, including humans, fungi, and many prokaryotes, are chemotrophs that obtain energy from organic compounds. Lithotrophs (\u201clitho\u201d means \u201crock\u201d) are chemotrophs that get energy from inorganic compounds, including hydrogen sulfide (H 2 S) and reduced iron. Lithotrophy is unique to the microbial world. \n\n The strategies used to obtain both carbon and energy can be combined for the classification of organisms according to nutritional type. Most organisms are  chemoheterotroph s because they use organic molecules as both their electron and carbon sources.  Table 8.1  summarizes this and the other classifications. \n\n Classifications of Organisms by Energy and Carbon Source \n\n Classifications \n\n Energy Source \n\n Carbon Source \n\n Examples \n\n Chemotrophs \n\n Chemoautotrophs \n\n Chemical \n\n Inorganic \n\n Hydrogen-, sulfur-, iron-, nitrogen-, and carbon monoxide-oxidizing bacteria \n\n Chemoheterotrophs \n\n Chemical \n\n Organic compounds \n\n All animals, most fungi, protozoa, and bacteria \n\n Phototrophs \n\n Photoautotrophs \n\n Light \n\n Inorganic \n\n All plants, algae, cyanobacteria, and green and purple sulfur bacteria \n\n Photoheterotrophs \n\n Light \n\n Organic compounds \n\n Green and purple nonsulfur bacteria, heliobacteria \n\n Table  8.1     \n\n Check Your Understanding \n\n Explain the difference between catabolism and anabolism. \n\n Explain the difference between autotrophs and heterotrophs. \n\n Oxidation and Reduction in Metabolism \n\n The transfer of electrons between molecules is important because most of the energy stored in atoms and used to fuel cell functions is in the form of high-energy electrons. The transfer of energy in the form of electrons allows the cell to transfer and use energy incrementally; that is, in small packages rather than a single, destructive burst. Reactions that remove electrons from donor molecules, leaving them oxidized, are  oxidation reaction s ; those that add electrons to acceptor molecules, leaving them reduced, are  reduction reaction s . Because electrons can move from one molecule to another, oxidation and reduction occur in tandem. These pairs of reactions are called oxidation-reduction reactions, or  redox reaction s . \n\n Energy Carriers: NAD + , NADP + , FAD, and ATP \n\n The energy released from the breakdown of the chemical bonds within nutrients can be stored either through the reduction of electron carriers or in the bonds of  adenosine triphosphate (ATP) . In living systems, a small class of compounds functions as mobile  electron carrier s , molecules that bind to and shuttle high-energy electrons between compounds in pathways. The principal electron carriers we will consider originate from the B vitamin group and are derivatives of nucleotides; they are  nicotinamide adenine dinucleotide ,  nicotine adenine dinucleotide phosphate , and  flavin adenine dinucleotide . These compounds can be easily reduced or oxidized. Nicotinamide adenine dinucleotide ( NAD + /NADH ) is the most common mobile electron carrier used in catabolism. NAD +  is the oxidized form of the molecule; NADH is the reduced form of the molecule. Nicotine adenine dinucleotide phosphate ( NADP + ), the oxidized form of an NAD +  variant that contains an extra phosphate group, is another important electron carrier; it forms  NADPH  when reduced. The oxidized form of flavin adenine dinucleotide is  FAD , and its reduced form is  FADH 2 . Both NAD + /NADH and FAD/FADH 2  are extensively used in energy extraction from sugars during  catabolism  in  chemoheterotroph s, whereas NADP + /NADPH plays an important role in anabolic reactions and  photosynthesis . Collectively, FADH 2 , NADH, and NADPH are often referred to as having reducing power due to their ability to donate electrons to various chemical reactions. \n\n A living cell must be able to handle the energy released during catabolism in a way that enables the cell to store energy safely and release it for use only as needed. Living cells accomplish this by using the compound  adenosine triphosphate (ATP) . ATP is often called the \u201cenergy currency\u201d of the cell, and, like currency, this versatile compound can be used to fill any energy need of the cell. At the heart of ATP is a molecule of  adenosine monophosphate (AMP) , which is composed of an adenine molecule bonded to a ribose molecule and a single phosphate group. Ribose is a five-carbon sugar found in RNA, and AMP is one of the nucleotides in RNA. The addition of a second phosphate group to this core molecule results in the formation of  adenosine diphosphate (ADP) ; the addition of a third phosphate group forms ATP ( Figure 8.3 ). Adding a phosphate group to a molecule, a process called  phosphorylation , requires energy. Phosphate groups are negatively charged and thus repel one another when they are arranged in series, as they are in ADP and ATP. This repulsion makes the ADP and ATP molecules inherently unstable. Thus, the bonds between phosphate groups (one in ADP and two in ATP) are called  high-energy phosphate bond s . When these high-energy bonds are broken to release one phosphate (called  inorganic phosphate [P i ] ) or two connected phosphate groups (called  pyrophosphate [PP i ] ) from ATP through a process called  dephosphorylation , energy is released to drive  endergonic reaction s ( Figure 8.4 ). \n\n Check Your Understanding \n\n What is the function of an electron carrier? \n\n Enzyme Structure and Function \n\n A substance that helps speed up a chemical reaction is a  catalyst . Catalysts are not used or changed during chemical reactions and, therefore, are reusable. Whereas inorganic molecules may serve as catalysts for a wide range of chemical reactions, proteins called  enzyme s serve as catalysts for biochemical reactions inside cells. Enzymes thus play an important role in controlling cellular metabolism. \n\n An enzyme functions by lowering the  activation energy  of a chemical reaction inside the cell. Activation energy is the energy needed to form or break chemical bonds and convert reactants to products ( Figure 8.5 ). Enzymes lower the activation energy by binding to the reactant molecules and holding them in such a way as to speed up the reaction. \n\n The chemical reactants to which an enzyme binds are called  substrate s , and the location within the enzyme where the substrate binds is called the enzyme\u2019s  active site . The characteristics of the amino acids near the active site create a very specific chemical environment within the active site that induces suitability to binding, albeit briefly, to a specific substrate (or substrates). Due to this jigsaw puzzle-like match between an enzyme and its substrates,  enzyme s are known for their specificity. In fact, as an enzyme binds to its substrate(s), the enzyme structure changes slightly to find the best fit between the transition state (a structural intermediate between the substrate and product) and the active site, just as a rubber glove molds to a hand inserted into it. This active-site modification in the presence of substrate, along with the simultaneous formation of the transition state, is called  induced fit  ( Figure 8.6 ). Overall, there is a specifically matched enzyme for each substrate and, thus, for each chemical reaction; however, there is some flexibility as well. Some enzymes have the ability to act on several different structurally related substrates. \n\n Enzymes are subject to influences by local environmental conditions such as pH, substrate concentration, and temperature. Although increasing the environmental temperature generally increases reaction rates, enzyme catalyzed or otherwise, increasing or decreasing the temperature outside of an optimal range can affect chemical bonds within the active site, making them less well suited to bind substrates. High temperatures will eventually cause enzymes, like other biological molecules, to denature, losing their three-dimensional structure and function. Enzymes are also suited to function best within a certain pH range, and, as with temperature, extreme environmental pH values (acidic or basic) can cause enzymes to denature. Active-site amino-acid side chains have their own acidic or basic properties that are optimal for catalysis and, therefore, are sensitive to changes in pH. \n\n Another factor that influences enzyme activity is substrate concentration: Enzyme activity is increased at higher concentrations of substrate until it reaches a saturation point at which the enzyme can bind no additional substrate. Overall, enzymes are optimized to work best under the environmental conditions in which the organisms that produce them live. For example, while microbes that inhabit hot springs have enzymes that work best at high temperatures, human pathogens have enzymes that work best at 37\u00b0C. Similarly, while enzymes produced by most organisms work best at a neutral pH, microbes growing in acidic environments make enzymes optimized to low pH conditions, allowing for their growth at those conditions. \n\n Many  enzyme s do not work optimally, or even at all, unless bound to other specific nonprotein helper molecules, either temporarily through ionic or hydrogen bonds or permanently through stronger covalent bonds. Binding to these molecules promotes optimal conformation and function for their respective enzymes. Two types of helper molecules are  cofactor s and  coenzyme s. Cofactors are inorganic ions such as iron (Fe 2+ ) and magnesium (Mg 2+ ) that help stabilize enzyme conformation and function. One example of an enzyme that requires a metal ion as a cofactor is the enzyme that builds DNA molecules, DNA polymerase, which requires a bound zinc ion (Zn 2+ ) to function. \n\n Coenzymes are organic helper molecules that are required for enzyme action. Like enzymes, they are not consumed and, hence, are reusable. The most common sources of coenzymes are dietary vitamins. Some vitamins are precursors to coenzymes and others act directly as coenzymes. \n\n Some cofactors and coenzymes, like  coenzyme A (CoA) , often bind to the enzyme\u2019s  active site , aiding in the chemistry of the transition of a substrate to a product ( Figure 8.7 ). In such cases, an enzyme lacking a necessary cofactor or coenzyme is called an  apoenzyme  and is inactive. Conversely, an enzyme with the necessary associated cofactor or coenzyme is called a  holoenzyme  and is active. NADH and ATP are also both examples of commonly used coenzymes that provide high-energy electrons or  phosphate group s, respectively, which bind to enzymes, thereby activating them. \n\n Check Your Understanding \n\n What role do enzymes play in a chemical reaction? \n\n Enzyme Inhibitors \n\n Enzymes can be regulated in ways that either promote or reduce their activity. There are many different kinds of molecules that inhibit or promote enzyme function, and various mechanisms exist for doing so ( Figure 8.8 ). A  competitive inhibitor  is a molecule similar enough to a substrate that it can compete with the substrate for binding to the active site by simply blocking the substrate from binding. For a competitive inhibitor to be effective, the inhibitor concentration needs to be approximately equal to the substrate concentration. Sulfa drugs provide a good example of competitive competition. They are used to treat bacterial infections because they bind to the active site of an enzyme within the bacterial folic acid synthesis pathway. When present in a sufficient dose, a  sulfa drug  prevents folic acid synthesis, and bacteria are unable to grow because they cannot synthesize DNA, RNA, and proteins. Humans are unaffected because we obtain folic acid from our diets. \n\n On the other hand, a  noncompetitive (allosteric) inhibitor  binds to the enzyme at an  allosteric site , a location other than the active site, and still manages to block substrate binding to the active site by inducing a conformational change that reduces the affinity of the enzyme for its substrate ( Figure 8.9 ). Because only one inhibitor molecule is needed per enzyme for effective inhibition, the concentration of inhibitors needed for noncompetitive inhibition is typically much lower than the substrate concentration. \n\n In addition to allosteric inhibitors, there are  allosteric activator s  that bind to locations on an enzyme away from the active site, inducing a conformational change that increases the affinity of the enzyme\u2019s active site(s) for its substrate(s). \n\n Allosteric control is an important mechanism of regulation of metabolic pathways involved in both catabolism and anabolism. In a most efficient and elegant way, cells have evolved also to use the products of their own metabolic reactions for  feedback inhibition  of enzyme activity. Feedback inhibition involves the use of a pathway product to regulate its own further production. The cell responds to the abundance of specific products by slowing production during anabolic or catabolic reactions ( Figure 8.9 ). \n\n Check Your Understanding \n\n Explain the difference between a competitive inhibitor and a noncompetitive inhibitor. \n 8.2   Catabolism of Carbohydrates \n\n Learning Objectives \n\n Describe why glycolysis is not oxygen dependent \n\n Define and describe the net yield of three-carbon molecules, ATP, and NADH from glycolysis \n\n Explain how three-carbon pyruvate molecules are converted into two-carbon acetyl groups that can be funneled into the Krebs cycle. \n\n Define and describe the net yield of CO 2 , GTP/ATP, FADH 2 , and NADH from the Krebs cycle \n\n Explain how intermediate carbon molecules of the Krebs cycle can be used in a cell \n\n Extensive enzyme pathways exist for breaking down  carbohydrate s to capture energy in  ATP  bonds. In addition, many catabolic pathways produce intermediate molecules that are also used as building blocks for  anabolism . Understanding these processes is important for several reasons. First, because the main metabolic processes involved are common to a wide range of chemoheterotrophic organisms, we can learn a great deal about human metabolism by studying metabolism in more easily manipulated bacteria like  E. coli . Second, because animal and human pathogens are also  chemoheterotroph s, learning about the details of  metabolism  in these bacteria, including possible differences between bacterial and human pathways, is useful for the diagnosis of pathogens as well as for the discovery of antimicrobial therapies targeting specific pathogens. Last, learning specifically about the pathways involved in chemoheterotrophic metabolism also serves as a basis for comparing other more unusual metabolic strategies used by microbes. Although the chemical source of electrons initiating  electron transfer  is different between chemoheterorophs and  chemoautotroph s, many similar processes are used in both types of organisms. \n\n The typical example used to introduce concepts of metabolism to students is carbohydrate catabolism. For chemoheterotrophs, our examples of metabolism start with the catabolism of polysaccharides such as glycogen, starch, or cellulose. Enzymes such as amylase, which breaks down glycogen or starch, and cellulases, which break down cellulose, can cause the hydrolysis of glycosidic bonds between the glucose monomers in these polymers, releasing glucose for further catabolism. \n\n Glycolysis \n\n For bacteria, eukaryotes, and most archaea,  glycolysis  is the most common pathway for the catabolism of glucose; it produces energy, reduced electron carriers, and precursor molecules for cellular metabolism. Every living organism carries out some form of glycolysis, suggesting this mechanism is an ancient universal metabolic process. The process itself does not use oxygen; however, glycolysis can be coupled with additional metabolic processes that are either aerobic or anaerobic. Glycolysis takes place in the cytoplasm of prokaryotic and eukaryotic cells. It begins with a single six-carbon glucose molecule and ends with two molecules of a three-carbon sugar called pyruvate. Pyruvate may be broken down further after glycolysis to harness more energy through aerobic or anaerobic respiration, but many organisms, including many microbes, may be unable to respire; for these organisms, glycolysis may be their only source of generating ATP. \n\n The type of glycolysis found in animals and that is most common in microbes is the  Embden-Meyerhof-Parnas (EMP) pathway , named after Gustav Embden (1874\u20131933), Otto Meyerhof (1884\u20131951), and Jakub Parnas (1884\u20131949). Glycolysis using the EMP pathway consists of two distinct phases ( Figure 8.10 ). The first part of the pathway, called the energy investment phase, uses energy from two ATP molecules to modify a glucose molecule so that the six-carbon sugar molecule can be split evenly into two phosphorylated three-carbon molecules called glyceraldehyde 3-phosphate (G3P). The second part of the pathway, called the energy payoff phase, extracts energy by oxidizing G3P to pyruvate, producing four ATP molecules and reducing two molecules of NAD +  to two molecules of NADH, using electrons that originated from glucose. (A discussion and illustration of the full EMP pathway with chemical structures and enzyme names appear in  Appendix C .) \n\n The ATP molecules produced during the energy payoff phase of glycolysis are formed by  substrate-level phosphorylation  ( Figure 8.11 ), one of two mechanisms for producing ATP. In substrate-level phosphorylation, a phosphate group is removed from an organic molecule and is directly transferred to an available ADP molecule, producing ATP. During glycolysis, high-energy phosphate groups from the intermediate molecules are added to ADP to make ATP. \n\n Overall, in this process of glycolysis, the net gain from the breakdown of a single glucose molecule is: \n\n two ATP molecules \n\n two NADH molecule, and \n\n two pyruvate molecules. \n\n Other Glycolytic Pathways \n\n When we refer to glycolysis, unless otherwise indicated, we are referring to the EMP pathway used by animals and many bacteria. However, some prokaryotes use alternative glycolytic pathways. One important alternative is the  Entner-Doudoroff (ED) pathway , named after its discoverers Nathan Entner and Michael Doudoroff (1911\u20131975). Although some bacteria, including the opportunistic gram-negative pathogen  Pseudomonas aeruginosa , contain only the ED pathway for glycolysis, other bacteria, like  E. coli , have the ability to use either the ED pathway or the EMP pathway. \n\n A third type of glycolytic pathway that occurs in all cells, which is quite different from the previous two pathways, is the  pentose phosphate pathway  ( PPP ) also called the  phosphogluconate pathway  or the  hexose monophosphate shunt . Evidence suggests that the PPP may be the most ancient universal glycolytic pathway. The intermediates from the PPP are used for the  biosynthesis  of nucleotides and amino acids. Therefore, this glycolytic pathway may be favored when the cell has need for nucleic acid and/or protein synthesis, respectively. A discussion and illustration of the complete ED pathway and PPP with chemical structures and enzyme names appear in  Appendix C . \n\n Check Your Understanding \n\n When might an organism use the ED pathway or the PPP for glycolysis? \n\n Transition Reaction, Coenzyme A, and the Krebs Cycle \n\n Glycolysis produces pyruvate, which can be further oxidized to capture more energy. For pyruvate to enter the next oxidative pathway, it must first be decarboxylated by the enzyme complex pyruvate dehydrogenase to a two-carbon acetyl group in the  transition reaction , also called the  bridge reaction  (see  Appendix C  and  Figure 8.12 ). In the transition reaction, electrons are also transferred to NAD +  to form NADH. To proceed to the next phase of this metabolic process, the comparatively tiny two-carbon acetyl must be attached to a very large carrier compound called  coenzyme A (CoA) . The transition reaction occurs in the mitochondrial matrix of eukaryotes; in prokaryotes, it occurs in the cytoplasm because prokaryotes lack membrane-enclosed organelles. \n\n The  Krebs cycle  transfers remaining electrons from the acetyl group produced during the transition reaction to electron carrier molecules, thus reducing them. The Krebs cycle also occurs in the cytoplasm of prokaryotes along with glycolysis and the transition reaction, but it takes place in the mitochondrial matrix of eukaryotic cells where the transition reaction also occurs. The Krebs cycle is named after its discoverer, British scientist Hans Adolf Krebs (1900\u20131981) and is also called the  citric acid cycle , or the  tricarboxylic acid cycle (TCA)  because citric acid has three carboxyl groups in its structure. Unlike glycolysis, the Krebs cycle is a closed loop: The last part of the pathway regenerates the compound used in the first step ( Figure 8.13 ). The eight steps of the cycle are a series of chemical reactions that capture the two-carbon acetyl group (the CoA carrier does not enter the Krebs cycle) from the transition reaction, which is added to a four-carbon intermediate in the Krebs cycle, producing the six-carbon intermediate citric acid (giving the alternate name for this cycle). As one turn of the cycle returns to the starting point of the four-carbon intermediate, the cycle produces two CO 2  molecules, one ATP molecule (or an equivalent, such as guanosine triphosphate [GTP]) produced by substrate-level phosphorylation, and three molecules of NADH and one of FADH 2 . (A discussion and detailed illustration of the full Krebs cycle appear in  Appendix C .) \n\n Although many organisms use the Krebs cycle as described as part of glucose metabolism, several of the intermediate compounds in the Krebs cycle can be used in synthesizing a wide variety of important cellular molecules, including amino acids, chlorophylls, fatty acids, and nucleotides; therefore, the cycle is both anabolic and catabolic ( Figure 8.14 ). \n 8.3   Cellular Respiration \n\n Learning Objectives \n\n Compare and contrast the electron transport system location and function in a prokaryotic cell and a eukaryotic cell \n\n Compare and contrast the differences between substrate-level and oxidative phosphorylation \n\n Explain the relationship between chemiosmosis and proton motive force \n\n Describe the function and location of ATP synthase in a prokaryotic versus eukaryotic cell \n\n Compare and contrast aerobic and anaerobic respiration \n\n We have just discussed two pathways in glucose catabolism\u2014glycolysis and the Krebs cycle\u2014that generate ATP by substrate-level phosphorylation. Most ATP, however, is generated during a separate process called  oxidative phosphorylation , which occurs during cellular respiration. Cellular respiration begins when electrons are transferred from NADH and FADH 2 \u2014made in glycolysis, the transition reaction, and the Krebs cycle\u2014through a series of chemical reactions to a final inorganic electron acceptor (either oxygen in aerobic respiration or non-oxygen inorganic molecules in anaerobic respiration). These electron transfers take place on the inner part of the cell membrane of prokaryotic cells or in specialized protein complexes in the inner membrane of the mitochondria of eukaryotic cells. The energy of the electrons is harvested to generate an electrochemical gradient across the membrane, which is used to make ATP by oxidative phosphorylation. \n\n Electron Transport System \n\n The  electron transport system (ETS)  is the last component involved in the process of cellular respiration; it comprises a series of membrane-associated protein complexes and associated mobile accessory electron carriers ( Figure 8.15 ). Electron transport is a series of chemical reactions that resembles a bucket brigade in that electrons from NADH and FADH 2  are passed rapidly from one ETS electron carrier to the next. These carriers can pass electrons along in the ETS because of their  redox potential . For a protein or chemical to accept electrons, it must have a more positive redox potential than the electron donor. Therefore, electrons move from electron carriers with more negative redox potential to those with more positive redox potential. The four major classes of electron carriers involved in both eukaryotic and prokaryotic electron transport systems are the  cytochrome s,  flavoprotein s,  iron-sulfur protein s, and the  quinone s. In  aerobic respiration , the final electron acceptor (i.e., the one having the most positive redox potential) at the end of the ETS is an oxygen molecule (O 2 ) that becomes reduced to water (H 2 O) by the final ETS carrier. This electron carrier,  cytochrome oxidase , differs between bacterial types and can be used to differentiate closely related bacteria for diagnoses. For example, the gram-negative opportunist  Pseudomonas aeruginosa  and the gram-negative cholera-causing  Vibrio cholerae  use cytochrome c oxidase, which can be detected by the oxidase test, whereas other gram-negative Enterobacteriaceae, like  E. coli , are negative for this test because they produce different cytochrome oxidase types. \n\n There are many circumstances under which aerobic respiration is not possible, including any one or more of the following: \n\n The cell lacks genes encoding an appropriate cytochrome oxidase for transferring electrons to oxygen at the end of the electron transport system. \n\n The cell lacks genes encoding enzymes to minimize the severely damaging effects of dangerous oxygen radicals produced during aerobic respiration, such as hydrogen peroxide (H 2 O 2 ) or superoxide  ( O 2 \u2013 ) . ( O 2 \u2013 ) . \n\n The cell lacks a sufficient amount of oxygen to carry out aerobic respiration. \n\n One possible alternative to aerobic respiration is  anaerobic respiration , using an inorganic molecule other than oxygen as a final electron acceptor. There are many types of anaerobic respiration found in bacteria and archaea. Denitrifiers are important soil bacteria that use nitrate  ( NO 3 \u2013 ) ( NO 3 \u2013 )  and nitrite  ( NO 2 \u2013 ) ( NO 2 \u2013 )  as final electron acceptors, producing nitrogen gas (N 2 ). Many aerobically respiring bacteria, including  E. coli , switch to using nitrate as a final electron acceptor and producing nitrite when oxygen levels have been depleted. \n\n Microbes using anaerobic respiration commonly have an intact Krebs cycle, so these organisms can access the energy of the NADH and FADH 2  molecules formed. However, anaerobic respirers use altered ETS carriers encoded by their genomes, including distinct complexes for electron transfer to their final electron acceptors. Smaller electrochemical gradients are generated from these electron transfer systems, so less ATP is formed through anaerobic respiration. \n\n Check Your Understanding \n\n Do both aerobic respiration and anaerobic respiration use an electron transport chain? \n\n Chemiosmosis, Proton Motive Force, and Oxidative Phosphorylation \n\n In each transfer of an electron through the ETS, the electron loses energy, but with some transfers, the energy is stored as potential energy by using it to pump hydrogen ions (H + ) across a membrane. In prokaryotic cells, H +  is pumped to the outside of the cytoplasmic membrane (called the periplasmic space in gram-negative and gram-positive bacteria), and in eukaryotic cells, they are pumped from the mitochondrial matrix across the inner mitochondrial membrane into the intermembrane space. There is an uneven distribution of H +  across the membrane that establishes an electrochemical gradient because H +  ions are positively charged (electrical) and there is a higher concentration (chemical) on one side of the membrane. This electrochemical gradient formed by the accumulation of H +  (also known as a proton) on one side of the membrane compared with the other is referred to as the  proton motive force  (PMF). Because the ions involved are H + , a pH gradient is also established, with the side of the membrane having the higher concentration of H +  being more acidic. Beyond the use of the PMF to make ATP, as discussed in this chapter, the PMF can also be used to drive other energetically unfavorable processes, including nutrient transport and flagella rotation for motility. \n\n The potential energy of this electrochemical gradient generated by the ETS causes the H +  to diffuse across a membrane (the plasma membrane in prokaryotic cells and the inner membrane in mitochondria in eukaryotic cells). This flow of hydrogen ions across the membrane, called  chemiosmosis , must occur through a channel in the membrane via a membrane-bound enzyme complex called  ATP synthase  ( Figure 8.15 ). The tendency for movement in this way is much like water accumulated on one side of a dam, moving through the dam when opened. ATP synthase (like a combination of the intake and generator of a hydroelectric dam) is a complex protein that acts as a tiny generator, turning by the force of the H +  diffusing through the enzyme, down their electrochemical gradient from where there are many mutually repelling H +  to where there are fewer H + . In prokaryotic cells, H +  flows from the outside of the cytoplasmic membrane into the cytoplasm, whereas in eukaryotic mitochondria, H +  flows from the intermembrane space to the mitochondrial matrix. The turning of the parts of this molecular machine regenerates ATP from ADP and inorganic phosphate (P i ) by  oxidative phosphorylation , a second mechanism for making ATP that harvests the potential energy stored within an electrochemical gradient. \n\n The number of ATP molecules generated from the catabolism of glucose varies. For example, the number of hydrogen ions that the electron transport system complexes can pump through the membrane varies between different species of organisms. In aerobic respiration in mitochondria, the passage of electrons from one molecule of NADH generates enough proton motive force to make three ATP molecules by oxidative phosphorylation, whereas the passage of electrons from one molecule of FADH 2  generates enough proton motive force to make only two ATP molecules. Thus, the 10 NADH molecules made per glucose during glycolysis, the transition reaction, and the Krebs cycle carry enough energy to make 30 ATP molecules, whereas the two FADH 2  molecules made per glucose during these processes provide enough energy to make four ATP molecules. Overall, the theoretical maximum yield of ATP made during the complete aerobic respiration of glucose is 38 molecules, with four being made by substrate-level phosphorylation and 34 being made by oxidative phosphorylation ( Figure 8.16 ). In reality, the total ATP yield is usually less, ranging from one to 34 ATP molecules, depending on whether the cell is using aerobic respiration or anaerobic respiration; in eukaryotic cells, some energy is expended to transport intermediates from the cytoplasm into the mitochondria, affecting ATP yield. \n\n Figure 8.16  summarizes the theoretical maximum yields of ATP from various processes during the complete  aerobic respiration  of one glucose molecule. \n\n Check Your Understanding \n\n What are the functions of the proton motive force? \n 8.4   Fermentation \n\n Learning Objectives \n\n Define fermentation and explain why it does not require oxygen \n\n Describe the fermentation pathways and their end products and give examples of microorganisms that use these pathways \n\n Compare and contrast fermentation and anaerobic respiration \n\n Many cells are unable to carry out respiration because of one or more of the following circumstances: \n\n The cell lacks a sufficient amount of any appropriate, inorganic, final electron acceptor to carry out cellular respiration. \n\n The cell lacks genes to make appropriate complexes and electron carriers in the electron transport system. \n\n The cell lacks genes to make one or more enzymes in the Krebs cycle. \n\n Whereas lack of an appropriate inorganic final electron acceptor is environmentally dependent, the other two conditions are genetically determined. Thus, many prokaryotes, including members of the clinically important genus  Streptococcus , are permanently incapable of respiration, even in the presence of oxygen. Conversely, many prokaryotes are facultative, meaning that, should the environmental conditions change to provide an appropriate inorganic final electron acceptor for respiration, organisms containing all the genes required to do so will switch to cellular respiration for glucose metabolism because respiration allows for much greater ATP production per glucose molecule. \n\n If respiration does not occur, NADH must be reoxidized to NAD +  for reuse as an electron carrier for glycolysis, the cell\u2019s only mechanism for producing any ATP, to continue. Some living systems use an organic molecule (commonly pyruvate) as a final electron acceptor through a process called  fermentation . Fermentation does not involve an electron transport system and does not directly produce any additional ATP beyond that produced during glycolysis by substrate-level phosphorylation. Organisms carrying out fermentation, called fermenters, produce a maximum of two ATP molecules per glucose during glycolysis.  Table 8.2  compares the final electron acceptors and methods of ATP synthesis in aerobic respiration, anaerobic respiration, and fermentation. Note that the number of ATP molecules shown for glycolysis assumes the  Embden-Meyerhof-Parnas pathway . The number of ATP molecules made by  substrate-level phosphorylation  (SLP) versus  oxidative phosphorylation  (OP) are indicated. \n\n Comparison of Respiration Versus Fermentation \n\n Type of Metabolism \n\n Example \n\n Final Electron Acceptor \n\n Pathways Involved in ATP Synthesis (Type of Phosphorylation) \n\n Maximum Yield of ATP Molecules \n\n Aerobic respiration \n\n Staphylococcus aureus \n\n O 2 O 2 \n\n EMP glycolysis (SLP) Krebs cycle (SLP) Electron transport and chemiosmosis (OP): \n\n 2 2 34 \n\n Total \n\n 38 \n\n Anaerobic respiration \n\n Paracoccus denitrificans \n\n NO 3 \u2212 , SO 4 \u22122 , Fe + 3 , CO 2 , NO 3 \u2212 , SO 4 \u22122 , Fe + 3 , CO 2 , other inorganics \n\n EMP glycolysis (SLP) Krebs cycle (SLP) Electron transport and chemiosmosis (OP): \n\n 2 2 1\u201332 \n\n Total \n\n 5 \u2013 36 \n\n Fermentation \n\n Candida albicans \n\n Organics (usually pyruvate) \n\n EMP glycolysis (SLP) Fermentation \n\n 2 0 \n\n Total \n\n 2 \n\n Table  8.2     \n\n Microbial fermentation processes have been manipulated by humans and are used extensively in the production of various foods and other commercial products, including pharmaceuticals. Microbial fermentation can also be useful for identifying microbes for diagnostic purposes. \n\n Fermentation by some bacteria, like those in yogurt and other soured food products, and by animals in muscles during oxygen depletion, is  lactic acid fermentation . The chemical reaction of lactic acid fermentation is as follows: \n\n Pyruvate\u00a0\u00a0+\u00a0\u00a0NADH \u2003 \u2194 \u2003 lactic\u00a0acid\u00a0\u00a0+\u00a0NAD + Pyruvate\u00a0\u00a0+\u00a0\u00a0NADH \u2003 \u2194 \u2003 lactic\u00a0acid\u00a0\u00a0+\u00a0NAD + \n\n Bacteria of several gram-positive genera, including  Lactobacillus ,  Leuconostoc , and  Streptococcus , are collectively known as the  lactic acid bacteria (LAB) , and various strains are important in food production. During  yogurt  and  cheese  production, the highly acidic environment generated by lactic acid fermentation denatures proteins contained in milk, causing it to solidify. When lactic acid is the only fermentation product, the process is said to be  homolactic fermentation ; such is the case for  Lactobacillus delbrueckii  and  S. thermophiles  used in yogurt production. However, many bacteria perform  heterolactic fermentation , producing a mixture of lactic acid, ethanol and/or acetic acid, and CO 2  as a result, because of their use of the branched pentose phosphate pathway instead of the EMP pathway for glycolysis. One important heterolactic fermenter is  Leuconostoc mesenteroides , which is used for souring vegetables like cucumbers and cabbage, producing pickles and sauerkraut, respectively. \n\n Lactic acid bacteria are also important medically. The production of low pH environments within the body inhibits the establishment and growth of pathogens in these areas. For example, the vaginal microbiota is composed largely of lactic acid bacteria, but when these bacteria are reduced, yeast can proliferate, causing a yeast infection. Additionally, lactic acid bacteria are important in maintaining the health of the gastrointestinal tract and, as such, are the primary component of probiotics. \n\n Another familiar fermentation process is  alcohol fermentation , which produces ethanol. The ethanol fermentation reaction is shown in  Figure 8.17 . In the first reaction, the enzyme  pyruvate decarboxylase  removes a carboxyl group from pyruvate, releasing CO 2  gas while producing the two-carbon molecule acetaldehyde. The second reaction, catalyzed by the enzyme alcohol dehydrogenase, transfers an electron from NADH to acetaldehyde, producing ethanol and NAD + . The ethanol fermentation of pyruvate by the yeast  Saccharomyces cerevisiae  is used in the production of alcoholic beverages and also makes bread products rise due to CO 2  production. Outside of the food industry, ethanol fermentation of plant products is important in  biofuel  production. \n\n Beyond lactic acid fermentation and alcohol fermentation, many other fermentation methods occur in prokaryotes, all for the purpose of ensuring an adequate supply of NAD +  for glycolysis ( Table 8.3 ). Without these pathways, glycolysis would not occur and no ATP would be harvested from the breakdown of glucose. It should be noted that most forms of fermentation besides  homolactic fermentation  produce gas, commonly CO 2  and/or hydrogen gas. Many of these different types of fermentation pathways are also used in food production and each results in the production of different organic acids, contributing to the unique flavor of a particular fermented food product. The propionic acid produced during  propionic acid fermentation  contributes to the distinctive flavor of Swiss cheese, for example. \n\n Several fermentation products are important commercially outside of the food industry. For example, chemical solvents such as  acetone  and  butanol  are produced during  acetone-butanol-ethanol fermentation . Complex organic pharmaceutical compounds used in antibiotics (e.g., penicillin), vaccines, and vitamins are produced through  mixed acid fermentation . Fermentation products are used in the laboratory to differentiate various bacteria for diagnostic purposes. For example, enteric bacteria are known for their ability to perform mixed acid fermentation, reducing the pH, which can be detected using a pH indicator. Similarly, the bacterial production of acetoin during butanediol fermentation can also be detected. Gas production from fermentation can also be seen in an inverted Durham tube that traps produced gas in a broth culture. \n\n Microbes can also be differentiated according to the substrates they can ferment. For example,  E. coli  can ferment lactose, forming gas, whereas some of its close gram-negative relatives cannot. The ability to ferment the sugar alcohol sorbitol is used to identify the pathogenic enterohemorrhagic O157:H7 strain of  E. coli  because, unlike other  E. coli  strains, it is unable to ferment sorbitol. Last, mannitol fermentation differentiates the mannitol-fermenting  Staphylococcus aureus  from other non\u2013mannitol-fermenting staphylococci. \n\n Common Fermentation Pathways \n\n Pathway \n\n End Products \n\n Example Microbes \n\n Commercial Products \n\n Acetone-butanol-ethanol \n\n Acetone, butanol, ethanol, CO 2 \n\n Clostridium acetobutylicum \n\n Commercial solvents, gasoline alternative \n\n Alcohol \n\n Ethanol, CO 2 \n\n Candida, Saccharomyces \n\n Beer, bread \n\n Butanediol \n\n Formic and lactic acid; ethanol; acetoin; 2,3 butanediol; CO 2 ; hydrogen gas \n\n Klebsiella, Enterobacter \n\n Chardonnay wine \n\n Butyric acid \n\n Butyric acid, CO 2 , hydrogen gas \n\n Clostridium butyricum \n\n Butter \n\n Lactic acid \n\n Lactic acid \n\n Streptococcus, Lactobacillus \n\n Sauerkraut, yogurt, cheese \n\n Mixed acid \n\n Acetic, formic, lactic, and succinic acids; ethanol, CO 2 , hydrogen gas \n\n Escherichia, Shigella \n\n Vinegar, cosmetics, pharmaceuticals \n\n Propionic acid \n\n Acetic acid, propionic acid, CO 2 \n\n Propionibacterium, Bifidobacterium \n\n Swiss cheese \n\n Table  8.3     \n\n Check Your Understanding \n\n When would a metabolically versatile microbe perform fermentation rather than cellular respiration? \n\n Micro Connections Identifying Bacteria by Using API Test Panels Identification of a microbial isolate is essential for the proper diagnosis and appropriate treatment of patients. Scientists have developed techniques that identify bacteria according to their biochemical characteristics. Typically, they either examine the use of specific carbon sources as substrates for fermentation or other metabolic reactions, or they identify fermentation products or specific enzymes present in reactions. In the past, microbiologists have used individual test tubes and plates to conduct biochemical testing. However, scientists, especially those in clinical laboratories, now more frequently use plastic, disposable, multitest panels that contain a number of miniature reaction tubes, each typically including a specific substrate and pH indicator. After inoculation of the test panel with a small sample of the microbe in question and incubation, scientists can compare the results to a database that includes the expected results for specific biochemical reactions for known microbes, thus enabling rapid identification of a sample microbe. These test panels have allowed scientists to reduce costs while improving efficiency and reproducibility by performing a larger number of tests simultaneously. \n\n Many commercial, miniaturized biochemical test panels cover a number of clinically important groups of bacteria and yeasts. One of the earliest and most popular test panels is the Analytical Profile Index (API) panel invented in the 1970s. Once some basic laboratory characterization of a given strain has been performed, such as determining the strain\u2019s Gram morphology, an appropriate test strip that contains 10 to 20 different biochemical tests for differentiating strains within that microbial group can be used. Currently, the various  API strips  can be used to quickly and easily identify more than 600 species of bacteria, both aerobic and anaerobic, and approximately 100 different types of yeasts. Based on the colors of the reactions when metabolic end products are present, due to the presence of pH indicators, a metabolic profile is created from the results ( Figure 8.18 ). Microbiologists can then compare the sample\u2019s profile to the database to identify the specific microbe. \n\n Clinical Focus Part 2 Many of Hannah\u2019s symptoms are consistent with several different infections, including influenza and pneumonia. However, her sluggish reflexes along with her light sensitivity and stiff neck suggest some possible involvement of the central nervous system, perhaps indicating  meningitis . Meningitis is an infection of the cerebrospinal fluid (CSF) around the brain and spinal cord that causes inflammation of the meninges, the protective layers covering the brain. Meningitis can be caused by viruses, bacteria, or fungi. Although all forms of meningitis are serious, bacterial meningitis is particularly serious. Bacterial meningitis may be caused by several different bacteria, but the bacterium  Neisseria meningitidis , a gram-negative, bean-shaped diplococcus, is a common cause and leads to death within 1 to 2 days in 5% to 10% of patients. \n\n Given the potential seriousness of Hannah\u2019s conditions, her physician advised her parents to take her to the hospital in the Gambian capital of Banjul and there have her tested and treated for possible meningitis. After a 3-hour drive to the hospital, Hannah was immediately admitted. Physicians took a blood sample and performed a lumbar puncture to test her CSF. They also immediately started her on a course of the antibiotic ceftriaxone, the drug of choice for treatment of meningitis caused by  N. meningitidis , without waiting for laboratory test results. \n\n How might biochemical testing be used to confirm the identity of  N. meningitidis ? \n\n Why did Hannah\u2019s doctors decide to administer antibiotics without waiting for the test results? \n\n Jump to the  next  Clinical Focus box. Go back to the  previous  Clinical Focus box. \n 8.5   Catabolism of Lipids and Proteins \n\n Learning Objectives \n\n Describe how lipids are catabolized \n\n Describe how lipid catabolism can be used to identify microbes \n\n Describe how proteins are catabolized \n\n Describe how protein catabolism can be used to identify bacteria \n\n Previous sections have discussed the catabolism of glucose, which provides energy to living cells, as well as how polysaccharides like glycogen, starch, and cellulose are degraded to glucose monomers. But microbes consume more than just carbohydrates for food. In fact, the microbial world is known for its ability to degrade a wide range of molecules, both naturally occurring and those made by human processes, for use as carbon sources. In this section, we will see that the pathways for both lipid and protein catabolism connect to those used for carbohydrate catabolism, eventually leading into glycolysis, the transition reaction, and the Krebs cycle pathways. Metabolic pathways should be considered to be porous\u2014that is, substances enter from other pathways, and intermediates leave for other pathways. These pathways are not closed systems. Many of the substrates, intermediates, and products in a particular pathway are reactants in other pathways. \n\n Lipid Catabolism \n\n Triglycerides are a form of long-term energy storage in animals. They are made of  glycerol  and three  fatty acids  (see  Figure 7.12 ). Phospholipids compose the cell and organelle membranes of all organisms except the archaea. Phospholipid structure is similar to  triglycerides  except that one of the fatty acids is replaced by a phosphorylated head group (see  Figure 7.13 ). Triglycerides and  phospholipids  are broken down first by releasing fatty acid chains (and/or the phosphorylated head group, in the case of phospholipids) from the three-carbon glycerol backbone. The reactions breaking down triglycerides are catalyzed by  lipases  and those involving phospholipids are catalyzed by  phospholipases . These enzymes contribute to the virulence of certain microbes, such as the bacterium  Staphylococcus aureus  and the fungus  Cryptococcus neoformans . These microbes use phospholipases to destroy lipids and phospholipids in host cells and then use the catabolic products for energy (see  Virulence Factors of Bacterial and Viral Pathogens ). \n\n The resulting products of lipid catabolism, glycerol and fatty acids, can be further degraded. Glycerol can be phosphorylated to glycerol-3-phosphate and easily converted to glyceraldehyde 3-phosphate, which continues through glycolysis. The released fatty acids are catabolized in a process called  \u03b2-oxidation , which sequentially removes two-carbon acetyl groups from the ends of fatty acid chains, reducing NAD +  and FAD to produce NADH and FADH 2 , respectively, whose electrons can be used to make ATP by oxidative phosphorylation. The acetyl groups produced during \u03b2-oxidation are carried by coenzyme A to the Krebs cycle, and their movement through this cycle results in their degradation to CO 2 , producing ATP by substrate-level phosphorylation and additional NADH and FADH 2  molecules (see  Appendix C  for a detailed illustration of \u03b2-oxidation). \n\n Other types of lipids can also be degraded by certain microbes. For example, the ability of certain pathogens, like  Mycobacterium tuberculosis , to degrade cholesterol contributes to their virulence. The side chains of cholesterol can be easily removed enzymatically, but degradation of the remaining fused rings is more problematic. The four fused rings are sequentially broken in a multistep process facilitated by specific enzymes, and the resulting products, including pyruvate, can be further catabolized in the Krebs cycle. \n\n Check Your Understanding \n\n How can lipases and phospholipases contribute to virulence in microbes? \n\n Protein Catabolism \n\n Proteins are degraded through the concerted action of a variety of microbial  protease  enzymes. Extracellular proteases cut proteins internally at specific amino acid sequences, breaking them down into smaller peptides that can then be taken up by cells. Some clinically important pathogens can be identified by their ability to produce a specific type of extracellular protease. For example, the production of the extracellular protease  gelatinase  by members of the genera  Proteus  and  Serratia  can be used to distinguish them from other gram-negative enteric bacteria. Following inoculation and growth of microbes in gelatin broth, degradation of the gelatin protein due to gelatinase production prevents solidification of gelatin when refrigerated. Other pathogens can be distinguished by their ability to degrade casein, the main protein found in milk. When grown on skim milk agar, production of the extracellular protease  caseinase  causes degradation of casein, which appears as a zone of clearing around the microbial growth. Caseinase production by the opportunist pathogen  Pseudomonas aeruginosa  can be used to distinguish it from other related gram-negative bacteria. \n\n After extracellular protease degradation and uptake of peptides in the cell, the peptides can then be broken down further into individual amino acids by additional intracellular proteases, and each amino acid can be enzymatically deaminated to remove the amino group. The remaining molecules can then enter the transition reaction or the Krebs cycle. \n\n Check Your Understanding \n\n How can protein catabolism help identify microbes? \n\n Clinical Focus Part 3 Because bacterial meningitis progresses so rapidly, Hannah\u2019s doctors had decided to treat her aggressively with antibiotics, based on empirical observation of her symptoms. However, laboratory testing to confirm the cause of Hannah\u2019s meningitis was still important for several reasons.  N. meningitidis  is an infectious pathogen that can be spread from person to person through close contact; therefore, if tests confirm  N. meningitidis  as the cause of Hannah\u2019s symptoms, Hannah\u2019s parents and others who came into close contact with her might need to be vaccinated or receive prophylactic antibiotics to lower their risk of contracting the disease. On the other hand, if it turns out that  N. meningitidis  is not the cause, Hannah\u2019s doctors might need to change her treatment. \n\n The clinical laboratory performed a Gram stain on Hannah\u2019s blood and CSF samples. The Gram stain showed the presence of a bean-shaped gram-negative diplococcus. The technician in the hospital lab cultured Hannah\u2019s blood sample on both blood agar and chocolate agar, and the bacterium that grew on both media formed gray, nonhemolytic colonies. Next, he performed an oxidase test on this bacterium and determined that it was oxidase positive. Last, he examined the repertoire of sugars that the bacterium could use as a carbon source and found that the bacterium was positive for glucose and maltose use but negative for lactose and sucrose use. All of these test results are consistent with characteristics of  N. meningitidis . \n\n What do these test results tell us about the metabolic pathways of  N. meningitidis ? \n\n Why do you think that the hospital used these biochemical tests for identification in lieu of molecular analysis by DNA testing? \n\n Jump to the  next  Clinical Focus box. Go back to the  previous  Clinical Focus box. \n 8.6   Photosynthesis \n\n Learning Objectives \n\n Describe the function and locations of photosynthetic pigments in eukaryotes and prokaryotes \n\n Describe the major products of the light-dependent and light-independent reactions \n\n Describe the reactions that produce glucose in a photosynthetic cell \n\n Compare and contrast cyclic and noncyclic photophosphorylation \n\n Heterotrophic organisms ranging from  E. coli  to humans rely on the chemical energy found mainly in carbohydrate molecules. Many of these carbohydrates are produced by  photosynthesis , the biochemical process by which phototrophic organisms convert solar energy (sunlight) into chemical energy. Although photosynthesis is most commonly associated with plants, microbial photosynthesis is also a significant supplier of chemical energy, fueling many diverse ecosystems. In this section, we will focus on microbial photosynthesis. \n\n Photosynthesis takes place in two sequential stages: the light-dependent reactions and the light-independent reactions ( Figure 8.19 ). In the  light-dependent reaction s , energy from sunlight is absorbed by pigment molecules in photosynthetic membranes and converted into stored chemical energy. In the  light-independent reaction s , the chemical energy produced by the light-dependent reactions is used to drive the assembly of sugar molecules using CO 2 ; however, these reactions are still light dependent because the products of the light-dependent reactions necessary for driving them are short-lived. The light-dependent reactions produce ATP and either NADPH or NADH to temporarily store energy. These energy carriers are used in the light-independent reactions to drive the energetically unfavorable process of \u201cfixing\u201d inorganic CO 2  in an organic form, sugar. \n\n Photosynthetic Structures in Eukaryotes and Prokaryotes \n\n In all  phototrophic eukaryotes , photosynthesis takes place inside a  chloroplast , an organelle that arose in eukaryotes by endosymbiosis of a photosynthetic bacterium (see  Unique Characteristics of Eukaryotic Cells ). These chloroplasts are enclosed by a double membrane with inner and outer layers. Within the chloroplast is a third membrane that forms stacked, disc-shaped photosynthetic structures called  thylakoid s ( Figure 8.20 ). A stack of thylakoids is called a  granum , and the space surrounding the granum within the chloroplast is called  stroma . \n\n Photosynthetic membranes in prokaryotes, by contrast, are not organized into distinct membrane-enclosed organelles; rather, they are infolded regions of the plasma membrane. In cyanobacteria, for example, these infolded regions are also referred to as thylakoids. In either case, embedded within the thylakoid membranes or other photosynthetic bacterial membranes are  photosynthetic pigment  molecules organized into one or more photosystems, where light energy is actually converted into chemical energy. \n\n Photosynthetic pigments within the photosynthetic membranes are organized into  photosystem s , each of which is composed of a light-harvesting (antennae) complex and a reaction center. The  light-harvesting complex  consists of multiple proteins and associated pigments that each may absorb light energy and, thus, become excited. This energy is transferred from one pigment molecule to another until eventually (after about a millionth of a second) it is delivered to the reaction center. Up to this point, only energy\u2014not electrons\u2014has been transferred between molecules. The  reaction center  contains a pigment molecule that can undergo oxidation upon excitation, actually giving up an electron. It is at this step in  photosynthesis  that light energy is converted into an excited electron. \n\n Different kinds of light-harvesting pigments absorb unique patterns of wavelengths (colors) of visible light. Pigments reflect or transmit the wavelengths they cannot absorb, making them appear the corresponding color. Examples of photosynthetic pigments (molecules used to absorb solar energy) are  bacteriochlorophyll s (green, purple, or red),  carotenoid s (orange, red, or yellow),  chlorophyll s (green),  phycocyanins  (blue), and  phycoerythrins  (red). By having mixtures of pigments, an organism can absorb energy from more wavelengths. Because photosynthetic bacteria commonly grow in competition for sunlight, each type of photosynthetic bacteria is optimized for harvesting the wavelengths of light to which it is commonly exposed, leading to stratification of microbial communities in aquatic and soil ecosystems by light quality and penetration. \n\n Once the light harvesting complex transfers the energy to the reaction center, the reaction center delivers its high-energy electrons, one by one, to an electron carrier in an  electron transport system , and electron transfer through the  ETS  is initiated. The ETS is similar to that used in  cellular respiration  and is embedded within the photosynthetic membrane. Ultimately, the electron is used to produce  NADH  or  NADPH . The  electrochemical gradient  that forms across the photosynthetic membrane is used to generate  ATP  by chemiosmosis through the process of  photophosphorylation , another example of  oxidative phosphorylation  ( Figure 8.21 ). \n\n Check Your Understanding \n\n In a phototrophic eukaryote, where does photosynthesis take place? \n\n Oxygenic and Anoxygenic Photosynthesis \n\n For photosynthesis to continue, the electron lost from the reaction center pigment must be replaced. The source of this electron (H 2 A) differentiates the  oxygenic photosynthesis  of plants and cyanobacteria from  anoxygenic photosynthesis  carried out by other types of bacterial phototrophs ( Figure 8.22 ). In oxygenic photosynthesis, H 2 O is split and supplies the electron to the reaction center. Because oxygen is generated as a byproduct and is released, this type of photosynthesis is referred to as oxygenic photosynthesis. However, when other reduced compounds serve as the electron donor, oxygen is not generated; these types of photosynthesis are called anoxygenic photosynthesis. Hydrogen sulfide (H 2 S) or thiosulfate  ( S 2 O 3 2\u2212 ) ( S 2 O 3 2\u2212 )  can serve as the electron donor, generating elemental sulfur and sulfate  ( SO 4 2\u2212 ) ( SO 4 2\u2212 )  ions, respectively, as a result. \n\n Photosystems have been classified into two types:  photosystem I (PSI)  and  photosystem II (PSII)  ( Figure 8.23 ). Cyanobacteria and plant chloroplasts have both photosystems, whereas anoxygenic photosynthetic bacteria use only one of the photosystems. Both photosystems are excited by light energy simultaneously. If the cell requires both ATP and NADPH for biosynthesis, then it will carry out  noncyclic photophosphorylation . Upon passing of the PSII reaction center electron to the ETS that connects PSII and PSI, the lost electron from the PSII reaction center is replaced by the splitting of water. The excited PSI reaction center electron is used to reduce NADP +  to NADPH and is replaced by the electron exiting the ETS. The flow of electrons in this way is called the  Z-scheme . \n\n If a cell\u2019s need for ATP is significantly greater than its need for NADPH, it may bypass the production of reducing power through  cyclic photophosphorylation . Only PSI is used during cyclic photophosphorylation; the high-energy electron of the PSI reaction center is passed to an ETS carrier and then ultimately returns to the oxidized PSI reaction center pigment, thereby reducing it. \n\n Check Your Understanding \n\n Why would a photosynthetic bacterium have different pigments? \n\n Light-Independent Reactions \n\n After the energy from the sun is converted into chemical energy and temporarily stored in ATP and NADPH molecules (having lifespans of millionths of a second), photoautotrophs have the fuel needed to build multicarbon carbohydrate molecules, which can survive for hundreds of millions of years, for long-term energy storage. The carbon comes from CO 2 , the gas that is a waste product of cellular respiration. \n\n The  Calvin-Benson cycle  (named for Melvin Calvin [1911\u20131997] and Andrew Benson [1917\u20132015]), the biochemical pathway used for fixation of CO 2 , is located within the cytoplasm of photosynthetic bacteria and in the stroma of eukaryotic chloroplasts. The  light-independent reaction s of the Calvin cycle can be organized into three basic stages: fixation, reduction, and regeneration (see  Appendix C  for a detailed illustration of the Calvin cycle). \n\n Fixation : The enzyme  ribulose bisphosphate carboxylase (RuBisCO)  catalyzes the addition of a CO 2  to  ribulose bisphosphate (RuBP) . This results in the production of  3-phosphoglycerate  ( 3-PGA ). \n\n Reduction : Six molecules of both ATP and NADPH (from the light-dependent reactions) are used to convert 3-PGA into glyceraldehyde 3-phosphate (G3P). Some G3P is then used to build glucose. \n\n Regeneration : The remaining G3P not used to synthesize glucose is used to regenerate RuBP, enabling the system to continue CO 2  fixation. Three more molecules of ATP are used in these regeneration reactions. \n\n The Calvin cycle is used extensively by plants and photoautotrophic bacteria, and the enzyme RuBisCO is said to be the most plentiful enzyme on earth, composing 30%\u201350% of the total soluble protein in plant chloroplasts. 1  However, besides its prevalent use in photoautotrophs, the Calvin cycle is also used by many nonphotosynthetic chemoautotrophs to fix CO 2 . Additionally, other bacteria and archaea use alternative systems for CO 2  fixation. Although most bacteria using Calvin cycle alternatives are chemoautotrophic, certain green sulfur photoautotrophic bacteria have been also shown to use an alternative CO 2  fixation pathway. 1 A. Dhingra et al. \u201cEnhanced Translation of a Chloroplast-Expressed  Rbc S Gene Restores Small Subunit Levels and Photosynthesis in Nuclear  Rbc S Antisense Plants.\u201d  Proceedings of the National Academy of Sciences of the United States of America  101 no. 16 (2004):6315\u20136320. \n\n Check Your Understanding \n\n Describe the three stages of the Calvin cycle. \n 8.7   Biogeochemical Cycles \n\n Learning Objectives \n\n Define and describe the importance of microorganisms in the biogeochemical cycles of carbon, nitrogen, and sulfur \n\n Define and give an example of bioremediation \n\n Energy flows directionally through ecosystems, entering as sunlight for  phototroph s or as inorganic molecules for  chemoautotroph s. The six most common elements associated with organic molecules\u2014carbon, hydrogen, nitrogen, oxygen, phosphorus, and sulfur\u2014take a variety of chemical forms and may exist for long periods in the atmosphere, on land, in water, or beneath earth\u2019s surface. Geologic processes, such as erosion, water drainage, the movement of the continental plates, and weathering, all are involved in the cycling of elements on earth. Because geology and chemistry have major roles in the study of this process, the recycling of inorganic matter between living organisms and their nonliving environment is called a  biogeochemical cycle . Here, we will focus on the function of microorganisms in these cycles, which play roles at each step, most frequently interconverting oxidized versions of molecules with reduced ones. \n\n Carbon Cycle \n\n Carbon is one of the most important elements to living organisms, as shown by its abundance and presence in all organic molecules. The  carbon cycle  exemplifies the connection between organisms in various ecosystems. Carbon is exchanged between  heterotroph s and  autotroph s within and between ecosystems primarily by way of atmospheric CO 2 , a fully oxidized version of carbon that serves as the basic building block that autotrophs use to build multicarbon, high-energy organic molecules such as glucose. Photoautotrophs and chemoautotrophs harness energy from the sun and from inorganic chemical compounds, respectively, to covalently bond carbon atoms together into reduced organic compounds whose energy can be later accessed through the processes of  respiration  and  fermentation  ( Figure 8.24 ). \n\n Overall, there is a constant exchange of CO 2  between the heterotrophs (which produce CO 2  as a result of respiration or fermentation) and the autotrophs (which use the CO 2  for fixation). Autotrophs also respire or ferment, consuming the organic molecules they form; they do not fix carbon for heterotrophs, but rather use it for their own metabolic needs. \n\n Bacteria and archaea that use methane as their carbon source are called  methanotroph s. Reduced one-carbon compounds like methane accumulate in certain anaerobic environments when CO 2  is used as a terminal electron acceptor in anaerobic respiration by archaea called  methanogen s. Some methanogens also ferment acetate (two carbons) to produce methane and CO 2 . Methane accumulation due to  methanogenesis  occurs in both natural anaerobic soil and aquatic environments; methane accumulation also occurs as a result of animal husbandry because methanogens are members of the normal microbiota of ruminants. Environmental methane accumulation due to methanogenesis is of consequence because it is a strong greenhouse gas, and methanotrophs help to reduce atmospheric methane levels. \n\n Check Your Understanding \n\n Describe the interaction between heterotrophs and autotrophs in the carbon cycle. \n\n Nitrogen Cycle \n\n Many biological macromolecules, including proteins and nucleic acids, contain nitrogen; however, getting nitrogen into living organisms is difficult. Prokaryotes play essential roles in the  nitrogen cycle  ( Figure 8.25 ), transforming nitrogen between various forms for their own needs, benefiting other organisms indirectly. Plants and  phytoplankton  cannot incorporate nitrogen from the atmosphere (where it exists as tightly bonded, triple covalent N 2 ), even though this molecule composes approximately 78% of the atmosphere. Nitrogen enters the living world through free-living and symbiotic bacteria, which incorporate nitrogen into their macromolecules through specialized biochemical pathways called  nitrogen fixation . Cyanobacteria in aquatic ecosystems fix inorganic nitrogen (from nitrogen gas) into ammonia (NH 3 ) that can be easily incorporated into biological macromolecules.  Rhizobium  bacteria ( Figure 8.1 ) also fix nitrogen and live symbiotically in the root nodules of legumes (such as beans, peanuts, and peas), providing them with needed organic nitrogen while receiving fixed carbon as sugar in exchange. Free-living bacteria, such as members of the genus  Azotobacter , are also able to fix nitrogen. \n\n The nitrogen that enters living systems by nitrogen fixation is eventually converted from organic nitrogen back into nitrogen gas by microbes through three steps: ammonification,  nitrification , and  denitrification . In terrestrial systems, the first step is the  ammonification  process, in which certain bacteria and fungi convert nitrogenous waste from living animals or from the remains of dead organisms into ammonia (NH 3 ). This ammonia is then oxidized to nitrite  ( NO 2 \u2212 ) , ( NO 2 \u2212 ) ,  then to nitrate  ( NO 3 \u2212 ) , ( NO 3 \u2212 ) ,  by nitrifying soil bacteria such as members of the genus  Nitrosomonas , through the process of nitrification. Last, the process of denitrification occurs, whereby soil bacteria, such as members of the genera  Pseudomonas  and  Clostridium , use nitrate as a terminal electron acceptor in  anaerobic respiration , converting it into nitrogen gas that reenters the atmosphere. A similar process occurs in the marine nitrogen cycle, where these three processes are performed by marine bacteria and archaea. \n\n Human activity releases nitrogen into the environment by the use of artificial fertilizers that contain nitrogen and phosphorus compounds, which are then washed into lakes, rivers, and streams by surface runoff. A major effect from fertilizer runoff is saltwater and freshwater  eutrophication , in which nutrient runoff causes the overgrowth and subsequent death of aquatic algae, making water sources anaerobic and inhospitable for the survival of aquatic organisms. \n\n Check Your Understanding \n\n What are the four steps of the nitrogen cycle? \n\n Link to Learning \n\n To learn more about the nitrogen cycle, visit the  PBS  website. \n\n Sulfur Cycle \n\n Sulfur is an essential element for the macromolecules of living organisms. As part of the amino acids cysteine and methionine, it is involved in the formation of proteins. It is also found in several vitamins necessary for the synthesis of important biological molecules like  coenzyme A . Several groups of microbes are responsible for carrying out processes involved in the  sulfur cycle  ( Figure 8.26 ). Anoxygenic photosynthetic bacteria as well as chemoautotrophic archaea and bacteria use hydrogen sulfide as an  electron donor , oxidizing it first to elemental sulfur (S 0 ), then to sulfate  ( SO 4 2 \u2212 ) . ( SO 4 2 \u2212 ) .  This leads to stratification of hydrogen sulfide in soil, with levels increasing at deeper, more anaerobic depths. \n\n Many bacteria and plants can use sulfate as a sulfur source. Decomposition dead organisms by fungi and bacteria remove sulfur groups from amino acids, producing hydrogen sulfide, returning inorganic sulfur to the environment. \n\n Check Your Understanding \n\n Which groups of microbes carry out the sulfur cycle? \n\n Other Biogeochemical Cycles \n\n Beyond their involvement in the carbon, nitrogen, and sulfur cycles, prokaryotes are involved in other biogeochemical cycles as well. Like the carbon, nitrogen, and sulfur cycles, several of these additional biogeochemical cycles, such as the iron (Fe), manganese (Mn), and chromium (Cr) cycles, also involve redox chemistry, with prokaryotes playing roles in both oxidation and reduction. Several other elements undergo chemical cycles that do not involve redox chemistry. Examples of these are phosphorus (P), calcium (Ca), and silica (Si) cycles. The cycling of these elements is particularly important in oceans because large quantities of these elements are incorporated into the exoskeletons of marine organisms. These  biogeochemical cycle s do not involve redox chemistry but instead involve fluctuations in the solubility of compounds containing calcium, phosphorous, and silica. The overgrowth of naturally occurring microbial communities is typically limited by the availability of nitrogen (as previously mentioned), phosphorus, and iron. Human activities introducing excessive amounts of iron, nitrogen, or phosphorus (typically from detergents) may lead to  eutrophication . \n\n Bioremediation \n\n Microbial  bioremediation  leverages microbial metabolism to remove  xenobiotic s  or other pollutants. Xenobiotics are compounds synthesized by humans and introduced into the environment in much higher concentrations than would naturally occur. Such environmental contamination may involve adhesives, dyes, flame retardants, lubricants, oil and petroleum products, organic solvents, pesticides, and products of the combustion of gasoline and oil. Many xenobiotics resist breakdown, and some accumulate in the food chain after being consumed or absorbed by fish and wildlife, which, in turn, may be eaten by humans. Of particular concern are contaminants like  polycyclic aromatic hydrocarbon (PAH) , a carcinogenic xenobiotic found in crude oil, and  trichloroethylene (TCE) , a common groundwater contaminant. \n\n Bioremediation processes can be categorized as in situ or ex situ. Bioremediation conducted at the site of contamination is called  in situ bioremediation  and does not involve movement of contaminated material. In contrast,  ex situ bioremediation  involves the removal of contaminated material from the original site so that it can be treated elsewhere, typically in a large, lined pit where conditions are optimized for degradation of the contaminant. \n\n Some bioremediation processes rely on microorganisms that are indigenous to the contaminated site or material. Enhanced bioremediation techniques, which may be applied to either in situ or ex situ processing, involve the addition of nutrients and/or air to encourage the growth of pollution-degrading microbes; they may also involve the addition of non-native microbes known for their ability to degrade contaminants. For example, certain bacteria of the genera  Rhodococcus  and  Pseudomonas  are known for their ability to degrade many environmental contaminants, including aromatic compounds like those found in oil, down to CO 2 . The genes encoding their degradatory enzymes are commonly found on plasmids. Others, like  Alcanivorax borkumensis , produce surfactants that are useful in the solubilization of the hydrophobic molecules found in oil, making them more accessible to other microbes for degradation. \n\n Check Your Understanding \n\n Compare and contrast the benefits of in situ and ex situ bioremediation. \n\n Clinical Focus Resolution Although there is a DNA test specific for  Neisseria meningitidis , it is not practical for use in some developing countries because it requires expensive equipment and a high level of expertise to perform. The hospital in Banjul was not equipped to perform DNA testing. Biochemical testing, however, is much less expensive and is still effective for microbial identification. \n\n Fortunately for Hannah, her symptoms began to resolve with antibiotic therapy. Patients who survive  bacterial meningitis  often suffer from long-term complications such as brain damage, hearing loss, and seizures, but after several weeks of recovery, Hannah did not seem to be exhibiting any long-term effects and her behavior returned to normal. Because of her age, her parents were advised to monitor her closely for any signs of developmental issues and have her regularly evaluated by her pediatrician. \n\n N. meningitidis  is found in the normal respiratory microbiota in 10%\u201320% of the human population. 2  In most cases, it does not cause disease, but for reasons not fully understood, the bacterium can sometimes invade the bloodstream and cause infections in other areas of the body, including the brain. The disease is more common in infants and children, like Hannah. 2 Centers for Disease Control and Prevention. \u201cMeningococcal Disease: Causes and Transmission.\u201d http://www.cdc.gov/meningococcal/about/causes-transmission.html. Accessed September 12, 2016. \n\n The prevalence of meningitis caused by  N. meningitidis  is particularly high in the so-called  meningitis belt , a region of sub-Saharan African that includes 26 countries stretching from Senegal to Ethiopia ( Figure 8.27 ). The reasons for this high prevalence are not clear, but several factors may contribute to higher rates of transmission, such as the dry, dusty climate; overcrowding and low standards of living; and the relatively low immunocompetence and nutritional status of the population. 3  A vaccine against four bacterial strains of  N. meningitidis  is available. Vaccination is recommended for 11- and 12-year-old children, with a booster at age 16 years. Vaccination is also recommended for young people who live in close quarters with others (e.g., college dormitories, military barracks), where the disease is more easily transmitted. Travelers visiting the \u201cmeningitis belt\u201d should also be vaccinated, especially during the dry season (December through June) when the prevalence is highest. 4 5 3 Centers for Disease Control and Prevention. \u201cMeningococcal Disease in Other Countries.\u201d http://www.cdc.gov/meningococcal/global.html. Accessed September 12, 2016. 4 Centers for Disease Control and Prevention. \u201cHealth Information for Travelers to the Gambia: Traveler View.\u201d http://wwwnc.cdc.gov/travel/destinations/traveler/none/the-gambia. Accessed September 12, 2016.  5 Centers for Disease Control and Prevention. \u201cMeningococcal: Who Needs to Be Vaccinated?\u201d http://www.cdc.gov/vaccines/vpd-vac/mening/who-vaccinate.htm. Accessed September 12, 2016. \n\n Go back to the  previous  Clinical Focus box. ", "questions": [{"question": {"question_id": "fs-id1167660133127", "question_text": "Which of the following is an organism that obtains its energy from the transfer of electrons originating from chemical compounds and its carbon from an inorganic source?", "question_choices": ["chemoautotroph", "chemoheterotroph", "photoheterotroph", "photoautotroph"], "cloze_format": "___ is an organism that obtains its energy from the transfer of electrons originating from chemical compounds and its carbon from an inorganic source.", "normal_format": "Which of the following is an organism that obtains its energy from the transfer of electrons originating from chemical compounds and its carbon from an inorganic source?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Photoautotrophs and chemoautotrophs harness energy from the sun and from inorganic chemical compounds , respectively , to covalently bond carbon atoms together into reduced organic compounds whose energy can be later accessed through the processes of respiration and fermentation ( Figure 8.24 ) . All energy is derived from the transfer of electrons , but the source of electrons differs between various types of organisms . The prefixes photo - ( \u201c light \u201d ) and chemo - ( \u201c chemical \u201d ) refer to the energy sources that various organisms use . Those that get their energy for electron transfer from light are phototroph s , whereas chemotroph s obtain energy for electron transfer by breaking chemical bonds . There are two types of chemotrophs : organotroph s and lithotroph s . Organotrophs , including humans , fungi , and many prokaryotes , are chemotrophs that obtain energy from organic compounds . Lithotrophs ( \u201c litho \u201d means \u201c rock \u201d ) are chemotrophs that get energy from inorganic compounds , including hydrogen sulfide ( H 2 S ) and reduced iron .", "hl_context": "Carbon is one of the most important elements to living organisms , as shown by its abundance and presence in all organic molecules . The carbon cycle exemplifies the connection between organisms in various ecosystems . Carbon is exchanged between heterotroph s and autotroph s within and between ecosystems primarily by way of atmospheric CO 2 , a fully oxidized version of carbon that serves as the basic building block that autotrophs use to build multicarbon , high-energy organic molecules such as glucose . <hl> Photoautotrophs and chemoautotrophs harness energy from the sun and from inorganic chemical compounds , respectively , to covalently bond carbon atoms together into reduced organic compounds whose energy can be later accessed through the processes of respiration and fermentation ( Figure 8.24 ) . <hl> Organisms can also be identified by the energy source they use . <hl> All energy is derived from the transfer of electrons , but the source of electrons differs between various types of organisms . <hl> <hl> The prefixes photo - ( \u201c light \u201d ) and chemo - ( \u201c chemical \u201d ) refer to the energy sources that various organisms use . <hl> <hl> Those that get their energy for electron transfer from light are phototroph s , whereas chemotroph s obtain energy for electron transfer by breaking chemical bonds . <hl> <hl> There are two types of chemotrophs : organotroph s and lithotroph s . <hl> <hl> Organotrophs , including humans , fungi , and many prokaryotes , are chemotrophs that obtain energy from organic compounds . <hl> <hl> Lithotrophs ( \u201c litho \u201d means \u201c rock \u201d ) are chemotrophs that get energy from inorganic compounds , including hydrogen sulfide ( H 2 S ) and reduced iron . <hl> Lithotrophy is unique to the microbial world ."}, {"question": {"question_id": "fs-id1167662772078", "question_text": "Which of the following molecules is reduced?", "question_choices": ["NAD+", "FAD", "O2", "NADPH"], "cloze_format": "The ___ molecule is reduced.", "normal_format": "Which of the following molecules is reduced?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "bloom": null, "hl_sentences": "Nicotine adenine dinucleotide phosphate ( NADP + ) , the oxidized form of an NAD + variant that contains an extra phosphate group , is another important electron carrier ; it forms NADPH when reduced .", "hl_context": "The energy released from the breakdown of the chemical bonds within nutrients can be stored either through the reduction of electron carriers or in the bonds of adenosine triphosphate ( ATP ) . In living systems , a small class of compounds functions as mobile electron carrier s , molecules that bind to and shuttle high-energy electrons between compounds in pathways . The principal electron carriers we will consider originate from the B vitamin group and are derivatives of nucleotides ; they are nicotinamide adenine dinucleotide , nicotine adenine dinucleotide phosphate , and flavin adenine dinucleotide . These compounds can be easily reduced or oxidized . Nicotinamide adenine dinucleotide ( NAD + / NADH ) is the most common mobile electron carrier used in catabolism . NAD + is the oxidized form of the molecule ; NADH is the reduced form of the molecule . <hl> Nicotine adenine dinucleotide phosphate ( NADP + ) , the oxidized form of an NAD + variant that contains an extra phosphate group , is another important electron carrier ; it forms NADPH when reduced . <hl> The oxidized form of flavin adenine dinucleotide is FAD , and its reduced form is FADH 2 . Both NAD + / NADH and FAD / FADH 2 are extensively used in energy extraction from sugars during catabolism in chemoheterotroph s , whereas NADP + / NADPH plays an important role in anabolic reactions and photosynthesis . Collectively , FADH 2 , NADH , and NADPH are often referred to as having reducing power due to their ability to donate electrons to various chemical reactions ."}, {"question": {"question_id": "fs-id1167660173340", "question_text": "Enzymes work by which of the following?", "question_choices": ["increasing the activation energy", "reducing the activation energy", "making exergonic reactions endergonic", "making endergonic reactions exergonic"], "cloze_format": "Enzymes work by ___ .", "normal_format": "Enzymes work by which of the following?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "An enzyme functions by lowering the activation energy of a chemical reaction inside the cell .", "hl_context": "<hl> An enzyme functions by lowering the activation energy of a chemical reaction inside the cell . <hl> Activation energy is the energy needed to form or break chemical bonds and convert reactants to products ( Figure 8.5 ) . Enzymes lower the activation energy by binding to the reactant molecules and holding them in such a way as to speed up the reaction ."}, {"question": {"question_id": "fs-id1167657983076", "question_text": "To which of the following does a competitive inhibitor most structurally resemble?", "question_choices": ["the active site", "the allosteric site", "the substrate", "a coenzyme"], "cloze_format": "A competitive inhibitor does most structurally resemble to ___.", "normal_format": "To which of the following does a competitive inhibitor most structurally resemble?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "A competitive inhibitor is a molecule similar enough to a substrate that it can compete with the substrate for binding to the active site by simply blocking the substrate from binding . For a competitive inhibitor to be effective , the inhibitor concentration needs to be approximately equal to the substrate concentration .", "hl_context": "Enzymes can be regulated in ways that either promote or reduce their activity . There are many different kinds of molecules that inhibit or promote enzyme function , and various mechanisms exist for doing so ( Figure 8.8 ) . <hl> A competitive inhibitor is a molecule similar enough to a substrate that it can compete with the substrate for binding to the active site by simply blocking the substrate from binding . <hl> <hl> For a competitive inhibitor to be effective , the inhibitor concentration needs to be approximately equal to the substrate concentration . <hl> Sulfa drugs provide a good example of competitive competition . They are used to treat bacterial infections because they bind to the active site of an enzyme within the bacterial folic acid synthesis pathway . When present in a sufficient dose , a sulfa drug prevents folic acid synthesis , and bacteria are unable to grow because they cannot synthesize DNA , RNA , and proteins . Humans are unaffected because we obtain folic acid from our diets ."}, {"question": {"question_id": "fs-id1167660666747", "question_text": "Which of the following are organic molecules that help enzymes work correctly?", "question_choices": ["cofactors", "coenzymes", "holoenzymes", "apoenzymes"], "cloze_format": "___  are organic molecules that help enzymes work correctly.", "normal_format": "Which of the following are organic molecules that help enzymes work correctly?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "Coenzymes are organic helper molecules that are required for enzyme action . Binding to these molecules promotes optimal conformation and function for their respective enzymes . Two types of helper molecules are cofactor s and coenzyme s . Cofactors are inorganic ions such as iron ( Fe 2 + ) and magnesium ( Mg 2 + ) that help stabilize enzyme conformation and function .", "hl_context": "<hl> Coenzymes are organic helper molecules that are required for enzyme action . <hl> Like enzymes , they are not consumed and , hence , are reusable . The most common sources of coenzymes are dietary vitamins . Some vitamins are precursors to coenzymes and others act directly as coenzymes . Many enzyme s do not work optimally , or even at all , unless bound to other specific nonprotein helper molecules , either temporarily through ionic or hydrogen bonds or permanently through stronger covalent bonds . <hl> Binding to these molecules promotes optimal conformation and function for their respective enzymes . <hl> <hl> Two types of helper molecules are cofactor s and coenzyme s . Cofactors are inorganic ions such as iron ( Fe 2 + ) and magnesium ( Mg 2 + ) that help stabilize enzyme conformation and function . <hl> One example of an enzyme that requires a metal ion as a cofactor is the enzyme that builds DNA molecules , DNA polymerase , which requires a bound zinc ion ( Zn 2 + ) to function ."}, {"question": {"question_id": "fs-id1167661617141", "question_text": "During which of the following is ATP not made by substrate-level phosphorylation?", "question_choices": ["Embden-Meyerhof pathway", "Transition reaction", "Krebs cycle", "Entner-Doudoroff pathway"], "cloze_format": "ATP is not made by substrate-level phosphorylation during the ___.", "normal_format": "During which of the following is ATP not made by substrate-level phosphorylation?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The Krebs cycle also occurs in the cytoplasm of prokaryotes along with glycolysis and the transition reaction , but it takes place in the mitochondrial matrix of eukaryotic cells where the transition reaction also occurs . The eight steps of the cycle are a series of chemical reactions that capture the two-carbon acetyl group ( the CoA carrier does not enter the Krebs cycle ) from the transition reaction , which is added to a four-carbon intermediate in the Krebs cycle , producing the six-carbon intermediate citric acid ( giving the alternate name for this cycle ) .", "hl_context": "The Krebs cycle transfers remaining electrons from the acetyl group produced during the transition reaction to electron carrier molecules , thus reducing them . <hl> The Krebs cycle also occurs in the cytoplasm of prokaryotes along with glycolysis and the transition reaction , but it takes place in the mitochondrial matrix of eukaryotic cells where the transition reaction also occurs . <hl> The Krebs cycle is named after its discoverer , British scientist Hans Adolf Krebs ( 1900 \u2013 1981 ) and is also called the citric acid cycle , or the tricarboxylic acid cycle ( TCA ) because citric acid has three carboxyl groups in its structure . Unlike glycolysis , the Krebs cycle is a closed loop : The last part of the pathway regenerates the compound used in the first step ( Figure 8.13 ) . <hl> The eight steps of the cycle are a series of chemical reactions that capture the two-carbon acetyl group ( the CoA carrier does not enter the Krebs cycle ) from the transition reaction , which is added to a four-carbon intermediate in the Krebs cycle , producing the six-carbon intermediate citric acid ( giving the alternate name for this cycle ) . <hl> As one turn of the cycle returns to the starting point of the four-carbon intermediate , the cycle produces two CO 2 molecules , one ATP molecule ( or an equivalent , such as guanosine triphosphate [ GTP ] ) produced by substrate-level phosphorylation , and three molecules of NADH and one of FADH 2 . ( A discussion and detailed illustration of the full Krebs cycle appear in Appendix C . )"}, {"question": {"question_id": "fs-id1167663697644", "question_text": "During the catabolism of glucose, which of the following is produced only in the Krebs cycle?", "question_choices": ["ATP", "NADH", "NADPH", "FADH2"], "cloze_format": "During the catabolism of glucose, ___ is produced only in the Krebs cycle.", "normal_format": "During the catabolism of glucose, which of the following is produced only in the Krebs cycle?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "bloom": null, "hl_sentences": "The Krebs cycle transfers remaining electrons from the acetyl group produced during the transition reaction to electron carrier molecules , thus reducing them . The eight steps of the cycle are a series of chemical reactions that capture the two-carbon acetyl group ( the CoA carrier does not enter the Krebs cycle ) from the transition reaction , which is added to a four-carbon intermediate in the Krebs cycle , producing the six-carbon intermediate citric acid ( giving the alternate name for this cycle ) . As one turn of the cycle returns to the starting point of the four-carbon intermediate , the cycle produces two CO 2 molecules , one ATP molecule ( or an equivalent , such as guanosine triphosphate [ GTP ] ) produced by substrate-level phosphorylation , and three molecules of NADH and one of FADH 2 .", "hl_context": "<hl> The Krebs cycle transfers remaining electrons from the acetyl group produced during the transition reaction to electron carrier molecules , thus reducing them . <hl> The Krebs cycle also occurs in the cytoplasm of prokaryotes along with glycolysis and the transition reaction , but it takes place in the mitochondrial matrix of eukaryotic cells where the transition reaction also occurs . The Krebs cycle is named after its discoverer , British scientist Hans Adolf Krebs ( 1900 \u2013 1981 ) and is also called the citric acid cycle , or the tricarboxylic acid cycle ( TCA ) because citric acid has three carboxyl groups in its structure . Unlike glycolysis , the Krebs cycle is a closed loop : The last part of the pathway regenerates the compound used in the first step ( Figure 8.13 ) . <hl> The eight steps of the cycle are a series of chemical reactions that capture the two-carbon acetyl group ( the CoA carrier does not enter the Krebs cycle ) from the transition reaction , which is added to a four-carbon intermediate in the Krebs cycle , producing the six-carbon intermediate citric acid ( giving the alternate name for this cycle ) . <hl> <hl> As one turn of the cycle returns to the starting point of the four-carbon intermediate , the cycle produces two CO 2 molecules , one ATP molecule ( or an equivalent , such as guanosine triphosphate [ GTP ] ) produced by substrate-level phosphorylation , and three molecules of NADH and one of FADH 2 . <hl> ( A discussion and detailed illustration of the full Krebs cycle appear in Appendix C . )"}, {"question": {"question_id": "fs-id1167663616674", "question_text": "Which of the following is not a name for the cycle resulting in the conversion of a two-carbon acetyl to one ATP, two CO2, one FADH2, and three NADH molecules?", "question_choices": ["Krebs cycle", "tricarboxylic acid cycle", "Calvin cycle", "citric acid cycle"], "cloze_format": "The ___ is not a name for the cycle resulting in the conversion of a two-carbon acetyl to one ATP, two CO2, one FADH2, and three NADH molecules.", "normal_format": "Which of the following is not a name for the cycle resulting in the conversion of a two-carbon acetyl to one ATP, two CO2, one FADH2, and three NADH molecules?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The Krebs cycle is named after its discoverer , British scientist Hans Adolf Krebs ( 1900 \u2013 1981 ) and is also called the citric acid cycle , or the tricarboxylic acid cycle ( TCA ) because citric acid has three carboxyl groups in its structure . As one turn of the cycle returns to the starting point of the four-carbon intermediate , the cycle produces two CO 2 molecules , one ATP molecule ( or an equivalent , such as guanosine triphosphate [ GTP ] ) produced by substrate-level phosphorylation , and three molecules of NADH and one of FADH 2 .", "hl_context": "The Krebs cycle transfers remaining electrons from the acetyl group produced during the transition reaction to electron carrier molecules , thus reducing them . The Krebs cycle also occurs in the cytoplasm of prokaryotes along with glycolysis and the transition reaction , but it takes place in the mitochondrial matrix of eukaryotic cells where the transition reaction also occurs . <hl> The Krebs cycle is named after its discoverer , British scientist Hans Adolf Krebs ( 1900 \u2013 1981 ) and is also called the citric acid cycle , or the tricarboxylic acid cycle ( TCA ) because citric acid has three carboxyl groups in its structure . <hl> Unlike glycolysis , the Krebs cycle is a closed loop : The last part of the pathway regenerates the compound used in the first step ( Figure 8.13 ) . The eight steps of the cycle are a series of chemical reactions that capture the two-carbon acetyl group ( the CoA carrier does not enter the Krebs cycle ) from the transition reaction , which is added to a four-carbon intermediate in the Krebs cycle , producing the six-carbon intermediate citric acid ( giving the alternate name for this cycle ) . <hl> As one turn of the cycle returns to the starting point of the four-carbon intermediate , the cycle produces two CO 2 molecules , one ATP molecule ( or an equivalent , such as guanosine triphosphate [ GTP ] ) produced by substrate-level phosphorylation , and three molecules of NADH and one of FADH 2 . <hl> ( A discussion and detailed illustration of the full Krebs cycle appear in Appendix C . )"}, {"question": {"question_id": "fs-id1167660269926", "question_text": "Which is the location of electron transports systems in prokaryotes?", "question_choices": ["the outer mitochondrial membrane", "the cytoplasm", "the inner mitochondrial membrane", "the cytoplasmic membrane"], "cloze_format": "___ is the location of electron transports systems in prokaryotes.", "normal_format": "Which is the location of electron transports systems in prokaryotes?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "In prokaryotic cells , H + is pumped to the outside of the cytoplasmic membrane ( called the periplasmic space in gram-negative and gram-positive bacteria ) , and in eukaryotic cells , they are pumped from the mitochondrial matrix across the inner mitochondrial membrane into the intermembrane space .", "hl_context": "In each transfer of an electron through the ETS , the electron loses energy , but with some transfers , the energy is stored as potential energy by using it to pump hydrogen ions ( H + ) across a membrane . <hl> In prokaryotic cells , H + is pumped to the outside of the cytoplasmic membrane ( called the periplasmic space in gram-negative and gram-positive bacteria ) , and in eukaryotic cells , they are pumped from the mitochondrial matrix across the inner mitochondrial membrane into the intermembrane space . <hl> There is an uneven distribution of H + across the membrane that establishes an electrochemical gradient because H + ions are positively charged ( electrical ) and there is a higher concentration ( chemical ) on one side of the membrane . This electrochemical gradient formed by the accumulation of H + ( also known as a proton ) on one side of the membrane compared with the other is referred to as the proton motive force ( PMF ) . Because the ions involved are H + , a pH gradient is also established , with the side of the membrane having the higher concentration of H + being more acidic . Beyond the use of the PMF to make ATP , as discussed in this chapter , the PMF can also be used to drive other energetically unfavorable processes , including nutrient transport and flagella rotation for motility ."}, {"question": {"question_id": "fs-id1167660408030", "question_text": "Which is the source of the energy used to make ATP by oxidative phosphorylation?", "question_choices": ["oxygen", "high-energy phosphate bonds", "the proton motive force", "Pi"], "cloze_format": "___ is the source of the energy used to make ATP by oxidative phosphorylation.", "normal_format": "Which is the source of the energy used to make ATP by oxidative phosphorylation?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "bloom": null, "hl_sentences": "In aerobic respiration in mitochondria , the passage of electrons from one molecule of NADH generates enough proton motive force to make three ATP molecules by oxidative phosphorylation , whereas the passage of electrons from one molecule of FADH 2 generates enough proton motive force to make only two ATP molecules .", "hl_context": "The number of ATP molecules generated from the catabolism of glucose varies . For example , the number of hydrogen ions that the electron transport system complexes can pump through the membrane varies between different species of organisms . <hl> In aerobic respiration in mitochondria , the passage of electrons from one molecule of NADH generates enough proton motive force to make three ATP molecules by oxidative phosphorylation , whereas the passage of electrons from one molecule of FADH 2 generates enough proton motive force to make only two ATP molecules . <hl> Thus , the 10 NADH molecules made per glucose during glycolysis , the transition reaction , and the Krebs cycle carry enough energy to make 30 ATP molecules , whereas the two FADH 2 molecules made per glucose during these processes provide enough energy to make four ATP molecules . Overall , the theoretical maximum yield of ATP made during the complete aerobic respiration of glucose is 38 molecules , with four being made by substrate-level phosphorylation and 34 being made by oxidative phosphorylation ( Figure 8.16 ) . In reality , the total ATP yield is usually less , ranging from one to 34 ATP molecules , depending on whether the cell is using aerobic respiration or anaerobic respiration ; in eukaryotic cells , some energy is expended to transport intermediates from the cytoplasm into the mitochondria , affecting ATP yield ."}, {"question": {"question_id": "fs-id1167660256138", "question_text": "A cell might perform anaerobic respiration for which of the following reasons?", "question_choices": ["It lacks glucose for degradation.", "It lacks the transition reaction to convert pyruvate to acetyl-CoA.", "It lacks Krebs cycle enzymes for processing acetyl-CoA to CO2.", "It lacks a cytochrome oxidase for passing electrons to oxygen."], "cloze_format": "A cell might perform anaerobic respiration because ___.", "normal_format": "A cell might perform anaerobic respiration for which of the following reasons?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The cell lacks genes encoding an appropriate cytochrome oxidase for transferring electrons to oxygen at the end of the electron transport system . There are many circumstances under which aerobic respiration is not possible , including any one or more of the following :", "hl_context": "<hl> The cell lacks genes encoding an appropriate cytochrome oxidase for transferring electrons to oxygen at the end of the electron transport system . <hl> <hl> There are many circumstances under which aerobic respiration is not possible , including any one or more of the following : <hl>"}, {"question": {"question_id": "fs-id1167660383885", "question_text": "In prokaryotes, which of the following is true?", "question_choices": ["As electrons are transferred through an ETS, H+ is pumped out of the cell.", "As electrons are transferred through an ETS, H+ is pumped into the cell.", "As protons are transferred through an ETS, electrons are pumped out of the cell.", "As protons are transferred through an ETS, electrons are pumped into the cell."], "cloze_format": "In prokaryotes, it is true that ___.", "normal_format": "In prokaryotes, which of the following is true?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "In each transfer of an electron through the ETS , the electron loses energy , but with some transfers , the energy is stored as potential energy by using it to pump hydrogen ions ( H + ) across a membrane . In prokaryotic cells , H + is pumped to the outside of the cytoplasmic membrane ( called the periplasmic space in gram-negative and gram-positive bacteria ) , and in eukaryotic cells , they are pumped from the mitochondrial matrix across the inner mitochondrial membrane into the intermembrane space .", "hl_context": "<hl> In each transfer of an electron through the ETS , the electron loses energy , but with some transfers , the energy is stored as potential energy by using it to pump hydrogen ions ( H + ) across a membrane . <hl> <hl> In prokaryotic cells , H + is pumped to the outside of the cytoplasmic membrane ( called the periplasmic space in gram-negative and gram-positive bacteria ) , and in eukaryotic cells , they are pumped from the mitochondrial matrix across the inner mitochondrial membrane into the intermembrane space . <hl> There is an uneven distribution of H + across the membrane that establishes an electrochemical gradient because H + ions are positively charged ( electrical ) and there is a higher concentration ( chemical ) on one side of the membrane . This electrochemical gradient formed by the accumulation of H + ( also known as a proton ) on one side of the membrane compared with the other is referred to as the proton motive force ( PMF ) . Because the ions involved are H + , a pH gradient is also established , with the side of the membrane having the higher concentration of H + being more acidic . Beyond the use of the PMF to make ATP , as discussed in this chapter , the PMF can also be used to drive other energetically unfavorable processes , including nutrient transport and flagella rotation for motility ."}, {"question": {"question_id": "fs-id1167662744777", "question_text": "Which of the following is not an electron carrier within an electron transport system?", "question_choices": ["flavoprotein", "ATP synthase", "ubiquinone", "cytochrome oxidase"], "cloze_format": "___ is not an electron carrier within an electron transport system.", "normal_format": "Which of the following is not an electron carrier within an electron transport system?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "The electrochemical gradient that forms across the photosynthetic membrane is used to generate ATP by chemiosmosis through the process of photophosphorylation , another example of oxidative phosphorylation ( Figure 8.21 ) . The electron transport system ( ETS ) is the last component involved in the process of cellular respiration ; it comprises a series of membrane-associated protein complexes and associated mobile accessory electron carriers ( Figure 8.15 ) . The four major classes of electron carriers involved in both eukaryotic and prokaryotic electron transport systems are the cytochrome s , flavoprotein s , iron-sulfur protein s , and the quinone s . In aerobic respiration , the final electron acceptor ( i . e . , the one having the most positive redox potential ) at the end of the ETS is an oxygen molecule ( O 2 ) that becomes reduced to water ( H 2 O ) by the final ETS carrier . This electron carrier , cytochrome oxidase , differs between bacterial types and can be used to differentiate closely related bacteria for diagnoses .", "hl_context": "Once the light harvesting complex transfers the energy to the reaction center , the reaction center delivers its high-energy electrons , one by one , to an electron carrier in an electron transport system , and electron transfer through the ETS is initiated . The ETS is similar to that used in cellular respiration and is embedded within the photosynthetic membrane . Ultimately , the electron is used to produce NADH or NADPH . <hl> The electrochemical gradient that forms across the photosynthetic membrane is used to generate ATP by chemiosmosis through the process of photophosphorylation , another example of oxidative phosphorylation ( Figure 8.21 ) . <hl> <hl> The electron transport system ( ETS ) is the last component involved in the process of cellular respiration ; it comprises a series of membrane-associated protein complexes and associated mobile accessory electron carriers ( Figure 8.15 ) . <hl> Electron transport is a series of chemical reactions that resembles a bucket brigade in that electrons from NADH and FADH 2 are passed rapidly from one ETS electron carrier to the next . These carriers can pass electrons along in the ETS because of their redox potential . For a protein or chemical to accept electrons , it must have a more positive redox potential than the electron donor . Therefore , electrons move from electron carriers with more negative redox potential to those with more positive redox potential . <hl> The four major classes of electron carriers involved in both eukaryotic and prokaryotic electron transport systems are the cytochrome s , flavoprotein s , iron-sulfur protein s , and the quinone s . In aerobic respiration , the final electron acceptor ( i . e . , the one having the most positive redox potential ) at the end of the ETS is an oxygen molecule ( O 2 ) that becomes reduced to water ( H 2 O ) by the final ETS carrier . <hl> <hl> This electron carrier , cytochrome oxidase , differs between bacterial types and can be used to differentiate closely related bacteria for diagnoses . <hl> For example , the gram-negative opportunist Pseudomonas aeruginosa and the gram-negative cholera-causing Vibrio cholerae use cytochrome c oxidase , which can be detected by the oxidase test , whereas other gram-negative Enterobacteriaceae , like E . coli , are negative for this test because they produce different cytochrome oxidase types ."}, {"question": {"question_id": "fs-id1167662622034", "question_text": "Which of the following is the purpose of fermentation?", "question_choices": ["to make ATP", "to make carbon molecule intermediates for anabolism", "to make NADH", "to make NAD+"], "cloze_format": "The purpose of fermentation is ___ .", "normal_format": "Which of the following is the purpose of fermentation?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Beyond lactic acid fermentation and alcohol fermentation , many other fermentation methods occur in prokaryotes , all for the purpose of ensuring an adequate supply of NAD + for glycolysis ( Table 8.3 ) .", "hl_context": "<hl> Beyond lactic acid fermentation and alcohol fermentation , many other fermentation methods occur in prokaryotes , all for the purpose of ensuring an adequate supply of NAD + for glycolysis ( Table 8.3 ) . <hl> Without these pathways , glycolysis would not occur and no ATP would be harvested from the breakdown of glucose . It should be noted that most forms of fermentation besides homolactic fermentation produce gas , commonly CO 2 and / or hydrogen gas . Many of these different types of fermentation pathways are also used in food production and each results in the production of different organic acids , contributing to the unique flavor of a particular fermented food product . The propionic acid produced during propionic acid fermentation contributes to the distinctive flavor of Swiss cheese , for example ."}, {"question": {"question_id": "fs-id1167660275815", "question_text": "Which molecule typically serves as the final electron acceptor during fermentation?", "question_choices": ["oxygen", "NAD+", "pyruvate", "CO2"], "cloze_format": "The ___ molecule typically serves as the final electron acceptor during fermentation.", "normal_format": "Which molecule typically serves as the final electron acceptor during fermentation?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "bloom": null, "hl_sentences": "Some living systems use an organic molecule ( commonly pyruvate ) as a final electron acceptor through a process called fermentation .", "hl_context": "If respiration does not occur , NADH must be reoxidized to NAD + for reuse as an electron carrier for glycolysis , the cell \u2019 s only mechanism for producing any ATP , to continue . <hl> Some living systems use an organic molecule ( commonly pyruvate ) as a final electron acceptor through a process called fermentation . <hl> Fermentation does not involve an electron transport system and does not directly produce any additional ATP beyond that produced during glycolysis by substrate-level phosphorylation . Organisms carrying out fermentation , called fermenters , produce a maximum of two ATP molecules per glucose during glycolysis . Table 8.2 compares the final electron acceptors and methods of ATP synthesis in aerobic respiration , anaerobic respiration , and fermentation . Note that the number of ATP molecules shown for glycolysis assumes the Embden-Meyerhof-Parnas pathway . The number of ATP molecules made by substrate-level phosphorylation ( SLP ) versus oxidative phosphorylation ( OP ) are indicated ."}, {"question": {"question_id": "fs-id1167662550707", "question_text": "Which fermentation product is important for making bread rise?", "question_choices": ["ethanol", "CO2", "lactic acid", "hydrogen gas"], "cloze_format": "___ is a fermentation product that is important for making bread rise.", "normal_format": "Which fermentation product is important for making bread rise?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The ethanol fermentation of pyruvate by the yeast Saccharomyces cerevisiae is used in the production of alcoholic beverages and also makes bread products rise due to CO 2 production .", "hl_context": "Another familiar fermentation process is alcohol fermentation , which produces ethanol . The ethanol fermentation reaction is shown in Figure 8.17 . In the first reaction , the enzyme pyruvate decarboxylase removes a carboxyl group from pyruvate , releasing CO 2 gas while producing the two-carbon molecule acetaldehyde . The second reaction , catalyzed by the enzyme alcohol dehydrogenase , transfers an electron from NADH to acetaldehyde , producing ethanol and NAD + . <hl> The ethanol fermentation of pyruvate by the yeast Saccharomyces cerevisiae is used in the production of alcoholic beverages and also makes bread products rise due to CO 2 production . <hl> Outside of the food industry , ethanol fermentation of plant products is important in biofuel production ."}, {"question": {"question_id": "fs-id1167662473146", "question_text": "Which of the following is not a commercially important fermentation product?", "question_choices": ["ethanol", "pyruvate", "butanol", "penicillin"], "cloze_format": "___ is not a commercially important fermentation product.", "normal_format": "Which of the following is not a commercially important fermentation product?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "For example , chemical solvents such as acetone and butanol are produced during acetone-butanol-ethanol fermentation . Complex organic pharmaceutical compounds used in antibiotics ( e . g . , penicillin ) , vaccines , and vitamins are produced through mixed acid fermentation . Another familiar fermentation process is alcohol fermentation , which produces ethanol .", "hl_context": "Several fermentation products are important commercially outside of the food industry . <hl> For example , chemical solvents such as acetone and butanol are produced during acetone-butanol-ethanol fermentation . <hl> <hl> Complex organic pharmaceutical compounds used in antibiotics ( e . g . , penicillin ) , vaccines , and vitamins are produced through mixed acid fermentation . <hl> Fermentation products are used in the laboratory to differentiate various bacteria for diagnostic purposes . For example , enteric bacteria are known for their ability to perform mixed acid fermentation , reducing the pH , which can be detected using a pH indicator . Similarly , the bacterial production of acetoin during butanediol fermentation can also be detected . Gas production from fermentation can also be seen in an inverted Durham tube that traps produced gas in a broth culture . <hl> Another familiar fermentation process is alcohol fermentation , which produces ethanol . <hl> The ethanol fermentation reaction is shown in Figure 8.17 . In the first reaction , the enzyme pyruvate decarboxylase removes a carboxyl group from pyruvate , releasing CO 2 gas while producing the two-carbon molecule acetaldehyde . The second reaction , catalyzed by the enzyme alcohol dehydrogenase , transfers an electron from NADH to acetaldehyde , producing ethanol and NAD + . The ethanol fermentation of pyruvate by the yeast Saccharomyces cerevisiae is used in the production of alcoholic beverages and also makes bread products rise due to CO 2 production . Outside of the food industry , ethanol fermentation of plant products is important in biofuel production ."}, {"question": {"question_id": "fs-id1167662753292", "question_text": "Which of the following molecules is not produced during the breakdown of phospholipids?", "question_choices": ["glucose", "glycerol", "acetyl groups", "fatty acids"], "cloze_format": "The ___ molecule is not produced during the breakdown of phospholipids.", "normal_format": "Which of the following molecules is not produced during the breakdown of phospholipids?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The resulting products of lipid catabolism , glycerol and fatty acids , can be further degraded . Glycerol can be phosphorylated to glycerol - 3 - phosphate and easily converted to glyceraldehyde 3 - phosphate , which continues through glycolysis . The released fatty acids are catabolized in a process called \u03b2-oxidation , which sequentially removes two-carbon acetyl groups from the ends of fatty acid chains , reducing NAD + and FAD to produce NADH and FADH 2 , respectively , whose electrons can be used to make ATP by oxidative phosphorylation . The acetyl groups produced during \u03b2-oxidation are carried by coenzyme A to the Krebs cycle , and their movement through this cycle results in their degradation to CO 2 , producing ATP by substrate-level phosphorylation and additional NADH and FADH 2 molecules ( see Appendix C for a detailed illustration of \u03b2-oxidation ) .", "hl_context": "<hl> The resulting products of lipid catabolism , glycerol and fatty acids , can be further degraded . <hl> <hl> Glycerol can be phosphorylated to glycerol - 3 - phosphate and easily converted to glyceraldehyde 3 - phosphate , which continues through glycolysis . <hl> <hl> The released fatty acids are catabolized in a process called \u03b2-oxidation , which sequentially removes two-carbon acetyl groups from the ends of fatty acid chains , reducing NAD + and FAD to produce NADH and FADH 2 , respectively , whose electrons can be used to make ATP by oxidative phosphorylation . <hl> <hl> The acetyl groups produced during \u03b2-oxidation are carried by coenzyme A to the Krebs cycle , and their movement through this cycle results in their degradation to CO 2 , producing ATP by substrate-level phosphorylation and additional NADH and FADH 2 molecules ( see Appendix C for a detailed illustration of \u03b2-oxidation ) . <hl>"}, {"question": {"question_id": "fs-id1167662484738", "question_text": "Caseinase is which type of enzyme?", "question_choices": ["phospholipase", "lipase", "extracellular protease", "intracellular protease"], "cloze_format": "Caseinase is a ___type of enzyme.", "normal_format": "Caseinase is which type of enzyme?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Extracellular proteases cut proteins internally at specific amino acid sequences , breaking them down into smaller peptides that can then be taken up by cells . When grown on skim milk agar , production of the extracellular protease caseinase causes degradation of casein , which appears as a zone of clearing around the microbial growth .", "hl_context": "Proteins are degraded through the concerted action of a variety of microbial protease enzymes . <hl> Extracellular proteases cut proteins internally at specific amino acid sequences , breaking them down into smaller peptides that can then be taken up by cells . <hl> Some clinically important pathogens can be identified by their ability to produce a specific type of extracellular protease . For example , the production of the extracellular protease gelatinase by members of the genera Proteus and Serratia can be used to distinguish them from other gram-negative enteric bacteria . Following inoculation and growth of microbes in gelatin broth , degradation of the gelatin protein due to gelatinase production prevents solidification of gelatin when refrigerated . Other pathogens can be distinguished by their ability to degrade casein , the main protein found in milk . <hl> When grown on skim milk agar , production of the extracellular protease caseinase causes degradation of casein , which appears as a zone of clearing around the microbial growth . <hl> Caseinase production by the opportunist pathogen Pseudomonas aeruginosa can be used to distinguish it from other related gram-negative bacteria ."}, {"question": {"question_id": "fs-id1167662504408", "question_text": "Which of the following is the first step in triglyceride degradation?", "question_choices": ["removal of fatty acids", "\u03b2-oxidation", "breakage of fused rings", "formation of smaller peptides"], "cloze_format": "___  is the first step in triglyceride degradation.", "normal_format": "Which of the following is the first step in triglyceride degradation?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "Triglycerides are a form of long-term energy storage in animals . Triglycerides and phospholipids are broken down first by releasing fatty acid chains ( and / or the phosphorylated head group , in the case of phospholipids ) from the three-carbon glycerol backbone .", "hl_context": "<hl> Triglycerides are a form of long-term energy storage in animals . <hl> They are made of glycerol and three fatty acids ( see Figure 7.12 ) . Phospholipids compose the cell and organelle membranes of all organisms except the archaea . Phospholipid structure is similar to triglycerides except that one of the fatty acids is replaced by a phosphorylated head group ( see Figure 7.13 ) . <hl> Triglycerides and phospholipids are broken down first by releasing fatty acid chains ( and / or the phosphorylated head group , in the case of phospholipids ) from the three-carbon glycerol backbone . <hl> The reactions breaking down triglycerides are catalyzed by lipases and those involving phospholipids are catalyzed by phospholipases . These enzymes contribute to the virulence of certain microbes , such as the bacterium Staphylococcus aureus and the fungus Cryptococcus neoformans . These microbes use phospholipases to destroy lipids and phospholipids in host cells and then use the catabolic products for energy ( see Virulence Factors of Bacterial and Viral Pathogens ) ."}, {"question": {"question_id": "fs-id1167659071010", "question_text": "During the light-dependent reactions, which molecule loses an electron?", "question_choices": ["a light-harvesting pigment molecule", "a reaction center pigment molecule", "NADPH", "3-phosphoglycerate"], "cloze_format": "During the light-dependent reactions, the molecule that loses an electron is called ___ .", "normal_format": "During the light-dependent reactions, which molecule loses an electron?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Photosynthetic pigments within the photosynthetic membranes are organized into photosystem s , each of which is composed of a light-harvesting ( antennae ) complex and a reaction center . The reaction center contains a pigment molecule that can undergo oxidation upon excitation , actually giving up an electron . It is at this step in photosynthesis that light energy is converted into an excited electron . Photosynthesis takes place in two sequential stages : the light-dependent reactions and the light-independent reactions ( Figure 8.19 ) . In the light-dependent reaction s , energy from sunlight is absorbed by pigment molecules in photosynthetic membranes and converted into stored chemical energy .", "hl_context": "<hl> Photosynthetic pigments within the photosynthetic membranes are organized into photosystem s , each of which is composed of a light-harvesting ( antennae ) complex and a reaction center . <hl> The light-harvesting complex consists of multiple proteins and associated pigments that each may absorb light energy and , thus , become excited . This energy is transferred from one pigment molecule to another until eventually ( after about a millionth of a second ) it is delivered to the reaction center . Up to this point , only energy \u2014 not electrons \u2014 has been transferred between molecules . <hl> The reaction center contains a pigment molecule that can undergo oxidation upon excitation , actually giving up an electron . <hl> <hl> It is at this step in photosynthesis that light energy is converted into an excited electron . <hl> <hl> Photosynthesis takes place in two sequential stages : the light-dependent reactions and the light-independent reactions ( Figure 8.19 ) . <hl> <hl> In the light-dependent reaction s , energy from sunlight is absorbed by pigment molecules in photosynthetic membranes and converted into stored chemical energy . <hl> In the light-independent reaction s , the chemical energy produced by the light-dependent reactions is used to drive the assembly of sugar molecules using CO 2 ; however , these reactions are still light dependent because the products of the light-dependent reactions necessary for driving them are short-lived . The light-dependent reactions produce ATP and either NADPH or NADH to temporarily store energy . These energy carriers are used in the light-independent reactions to drive the energetically unfavorable process of \u201c fixing \u201d inorganic CO 2 in an organic form , sugar ."}, {"question": {"question_id": "fs-id1167663620588", "question_text": "In prokaryotes, in which direction are hydrogen ions pumped by the electron transport system of photosynthetic membranes?", "question_choices": ["to the outside of the plasma membrane", "to the inside (cytoplasm) of the cell", "to the stroma", "to the intermembrane space of the chloroplast"], "cloze_format": "In prokaryotes, the direction in which hydrogen ions are pumped by the electron transport system of photosynthetic membranes is ___ .", "normal_format": "In prokaryotes, in which direction are hydrogen ions pumped by the electron transport system of photosynthetic membranes?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "In each transfer of an electron through the ETS , the electron loses energy , but with some transfers , the energy is stored as potential energy by using it to pump hydrogen ions ( H + ) across a membrane . In prokaryotic cells , H + is pumped to the outside of the cytoplasmic membrane ( called the periplasmic space in gram-negative and gram-positive bacteria ) , and in eukaryotic cells , they are pumped from the mitochondrial matrix across the inner mitochondrial membrane into the intermembrane space .", "hl_context": "<hl> In each transfer of an electron through the ETS , the electron loses energy , but with some transfers , the energy is stored as potential energy by using it to pump hydrogen ions ( H + ) across a membrane . <hl> <hl> In prokaryotic cells , H + is pumped to the outside of the cytoplasmic membrane ( called the periplasmic space in gram-negative and gram-positive bacteria ) , and in eukaryotic cells , they are pumped from the mitochondrial matrix across the inner mitochondrial membrane into the intermembrane space . <hl> There is an uneven distribution of H + across the membrane that establishes an electrochemical gradient because H + ions are positively charged ( electrical ) and there is a higher concentration ( chemical ) on one side of the membrane . This electrochemical gradient formed by the accumulation of H + ( also known as a proton ) on one side of the membrane compared with the other is referred to as the proton motive force ( PMF ) . Because the ions involved are H + , a pH gradient is also established , with the side of the membrane having the higher concentration of H + being more acidic . Beyond the use of the PMF to make ATP , as discussed in this chapter , the PMF can also be used to drive other energetically unfavorable processes , including nutrient transport and flagella rotation for motility ."}, {"question": {"question_id": "fs-id1167663968436", "question_text": "Which of the following does not occur during cyclic photophosphorylation in cyanobacteria?", "question_choices": ["electron transport through an ETS", "photosystem I use", "ATP synthesis", "NADPH formation"], "cloze_format": "___ does not occur during cyclic photophosphorylation in cyanobacteria.", "normal_format": "Which of the following does not occur during cyclic photophosphorylation in cyanobacteria?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "If the cell requires both ATP and NADPH for biosynthesis , then it will carry out noncyclic photophosphorylation .", "hl_context": "Photosystems have been classified into two types : photosystem I ( PSI ) and photosystem II ( PSII ) ( Figure 8.23 ) . Cyanobacteria and plant chloroplasts have both photosystems , whereas anoxygenic photosynthetic bacteria use only one of the photosystems . Both photosystems are excited by light energy simultaneously . <hl> If the cell requires both ATP and NADPH for biosynthesis , then it will carry out noncyclic photophosphorylation . <hl> Upon passing of the PSII reaction center electron to the ETS that connects PSII and PSI , the lost electron from the PSII reaction center is replaced by the splitting of water . The excited PSI reaction center electron is used to reduce NADP + to NADPH and is replaced by the electron exiting the ETS . The flow of electrons in this way is called the Z-scheme ."}, {"question": {"question_id": "fs-id1167661765640", "question_text": "Which of the following are two products of the light-dependent reactions?", "question_choices": ["glucose and NADPH", "NADPH and ATP", "glyceraldehyde 3-phosphate and CO2", "glucose and oxygen"], "cloze_format": "___ are two products of the light-dependent reactions.", "normal_format": "Which of the following are two products of the light-dependent reactions?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "In the light-independent reaction s , the chemical energy produced by the light-dependent reactions is used to drive the assembly of sugar molecules using CO 2 ; however , these reactions are still light dependent because the products of the light-dependent reactions necessary for driving them are short-lived . The light-dependent reactions produce ATP and either NADPH or NADH to temporarily store energy .", "hl_context": "Photosynthesis takes place in two sequential stages : the light-dependent reactions and the light-independent reactions ( Figure 8.19 ) . In the light-dependent reaction s , energy from sunlight is absorbed by pigment molecules in photosynthetic membranes and converted into stored chemical energy . <hl> In the light-independent reaction s , the chemical energy produced by the light-dependent reactions is used to drive the assembly of sugar molecules using CO 2 ; however , these reactions are still light dependent because the products of the light-dependent reactions necessary for driving them are short-lived . <hl> <hl> The light-dependent reactions produce ATP and either NADPH or NADH to temporarily store energy . <hl> These energy carriers are used in the light-independent reactions to drive the energetically unfavorable process of \u201c fixing \u201d inorganic CO 2 in an organic form , sugar ."}, {"question": {"question_id": "fs-id1167662444785", "question_text": "Which of the following is the group of archaea that can use CO2 as their final electron acceptor during anaerobic respiration, producing CH4?", "question_choices": ["methylotrophs", "methanotrophs", "methanogens", "anoxygenic photosynthesizers"], "cloze_format": "___  is the group of archaea that can use CO2 as their final electron acceptor during anaerobic respiration, producing CH4.", "normal_format": "Which of the following is the group of archaea that can use CO2 as their final electron acceptor during anaerobic respiration, producing CH4?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Bacteria and archaea that use methane as their carbon source are called methanotroph s . Reduced one-carbon compounds like methane accumulate in certain anaerobic environments when CO 2 is used as a terminal electron acceptor in anaerobic respiration by archaea called methanogen s . Some methanogens also ferment acetate ( two carbons ) to produce methane and CO 2 .", "hl_context": "<hl> Bacteria and archaea that use methane as their carbon source are called methanotroph s . Reduced one-carbon compounds like methane accumulate in certain anaerobic environments when CO 2 is used as a terminal electron acceptor in anaerobic respiration by archaea called methanogen s . Some methanogens also ferment acetate ( two carbons ) to produce methane and CO 2 . <hl> Methane accumulation due to methanogenesis occurs in both natural anaerobic soil and aquatic environments ; methane accumulation also occurs as a result of animal husbandry because methanogens are members of the normal microbiota of ruminants . Environmental methane accumulation due to methanogenesis is of consequence because it is a strong greenhouse gas , and methanotrophs help to reduce atmospheric methane levels ."}, {"question": {"question_id": "fs-id1167660573218", "question_text": "Which of the following processes is not involved in the conversion of organic nitrogen to nitrogen gas?", "question_choices": ["nitrogen fixation", "ammonification", "nitrification", "denitrification"], "cloze_format": "The ___ process is not involved in the conversion of organic nitrogen to nitrogen gas.", "normal_format": "Which of the following processes is not involved in the conversion of organic nitrogen to nitrogen gas?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "The nitrogen that enters living systems by nitrogen fixation is eventually converted from organic nitrogen back into nitrogen gas by microbes through three steps : ammonification , nitrification , and denitrification .", "hl_context": "<hl> The nitrogen that enters living systems by nitrogen fixation is eventually converted from organic nitrogen back into nitrogen gas by microbes through three steps : ammonification , nitrification , and denitrification . <hl> In terrestrial systems , the first step is the ammonification process , in which certain bacteria and fungi convert nitrogenous waste from living animals or from the remains of dead organisms into ammonia ( NH 3 ) . This ammonia is then oxidized to nitrite ( NO 2 \u2212 ) , ( NO 2 \u2212 ) , then to nitrate ( NO 3 \u2212 ) , ( NO 3 \u2212 ) , by nitrifying soil bacteria such as members of the genus Nitrosomonas , through the process of nitrification . Last , the process of denitrification occurs , whereby soil bacteria , such as members of the genera Pseudomonas and Clostridium , use nitrate as a terminal electron acceptor in anaerobic respiration , converting it into nitrogen gas that reenters the atmosphere . A similar process occurs in the marine nitrogen cycle , where these three processes are performed by marine bacteria and archaea ."}, {"question": {"question_id": "fs-id1167662519291", "question_text": "Which of the following processes produces hydrogen sulfide?", "question_choices": ["anoxygenic photosynthesis", "oxygenic photosynthesis", "anaerobic respiration", "chemoautrophy"], "cloze_format": "The proces that produces hydrogen sulfide is ___.", "normal_format": "Which of the following processes produces hydrogen sulfide?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "This leads to stratification of hydrogen sulfide in soil , with levels increasing at deeper , more anaerobic depths .", "hl_context": "Sulfur is an essential element for the macromolecules of living organisms . As part of the amino acids cysteine and methionine , it is involved in the formation of proteins . It is also found in several vitamins necessary for the synthesis of important biological molecules like coenzyme A . Several groups of microbes are responsible for carrying out processes involved in the sulfur cycle ( Figure 8.26 ) . Anoxygenic photosynthetic bacteria as well as chemoautotrophic archaea and bacteria use hydrogen sulfide as an electron donor , oxidizing it first to elemental sulfur ( S 0 ) , then to sulfate ( SO 4 2 \u2212 ) . ( SO 4 2 \u2212 ) . <hl> This leads to stratification of hydrogen sulfide in soil , with levels increasing at deeper , more anaerobic depths . <hl>"}, {"question": {"question_id": "fs-id1167662914922", "question_text": "The biogeochemical cycle of which of the following elements is based on changes in solubility rather than redox chemistry?", "question_choices": ["carbon", "sulfur", "nitrogen", "phosphorus"], "cloze_format": "The biogeochemical cycle of the ___ element is based on changes in solubility rather than redox chemistry.", "normal_format": "The biogeochemical cycle of which of the following elements is based on changes in solubility rather than redox chemistry?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Beyond their involvement in the carbon , nitrogen , and sulfur cycles , prokaryotes are involved in other biogeochemical cycles as well . Several other elements undergo chemical cycles that do not involve redox chemistry . Examples of these are phosphorus ( P ) , calcium ( Ca ) , and silica ( Si ) cycles . These biogeochemical cycle s do not involve redox chemistry but instead involve fluctuations in the solubility of compounds containing calcium , phosphorous , and silica .", "hl_context": "<hl> Beyond their involvement in the carbon , nitrogen , and sulfur cycles , prokaryotes are involved in other biogeochemical cycles as well . <hl> Like the carbon , nitrogen , and sulfur cycles , several of these additional biogeochemical cycles , such as the iron ( Fe ) , manganese ( Mn ) , and chromium ( Cr ) cycles , also involve redox chemistry , with prokaryotes playing roles in both oxidation and reduction . <hl> Several other elements undergo chemical cycles that do not involve redox chemistry . <hl> <hl> Examples of these are phosphorus ( P ) , calcium ( Ca ) , and silica ( Si ) cycles . <hl> The cycling of these elements is particularly important in oceans because large quantities of these elements are incorporated into the exoskeletons of marine organisms . <hl> These biogeochemical cycle s do not involve redox chemistry but instead involve fluctuations in the solubility of compounds containing calcium , phosphorous , and silica . <hl> The overgrowth of naturally occurring microbial communities is typically limited by the availability of nitrogen ( as previously mentioned ) , phosphorus , and iron . Human activities introducing excessive amounts of iron , nitrogen , or phosphorus ( typically from detergents ) may lead to eutrophication ."}], "summary": " Summary 8.1   Energy, Matter, and Enzymes \n\n Metabolism  includes chemical reactions that break down complex molecules ( catabolism ) and those that build complex molecules ( anabolism ). \n\n Organisms may be classified according to their source of carbon.  Autotrophs  convert inorganic carbon dioxide into organic carbon;  heterotrophs  use fixed organic carbon compounds. \n\n Organisms may also be classified according to their energy source.  Phototrophs  obtain their energy from light.  Chemotrophs  get their energy from chemical compounds.  Organotrophs  use organic molecules, and  lithotrophs  use inorganic chemicals. \n\n Cellular  electron carriers  accept high-energy electrons from foods and later serve as electron donors in subsequent  redox reactions .  FAD/FADH 2 , NAD + /NADH ,  and NADP + /NADPH  are important electron carriers. \n\n Adenosine triphosphate (ATP)  serves as the energy currency of the cell, safely storing chemical energy in its two  high-energy phosphate bonds  for later use to drive processes requiring energy. \n\n Enzymes  are biological  catalysts  that increase the rate of chemical reactions inside cells by lowering the activation energy required for the reaction to proceed. \n\n In nature,  exergonic reactions  do not require energy beyond activation energy to proceed, and they release energy. They may proceed without enzymes, but at a slow rate. Conversely,  endergonic reactions  require energy beyond activation energy to occur. In cells, endergonic reactions are coupled to exergonic reactions, making the combination energetically favorable. \n\n Substrates  bind to the enzyme\u2019s  active site . This process typically alters the structures of both the active site and the substrate, favoring transition-state formation; this is known as  induced fit . \n\n Cofactors  are inorganic ions that stabilize enzyme conformation and function.  Coenzymes  are organic molecules required for proper enzyme function and are often derived from vitamins. An enzyme lacking a cofactor or coenzyme is an  apoenzyme;  an enzyme with a bound cofactor or coenzyme is a  holoenzyme . \n\n Competitive inhibitors  regulate enzymes by binding to an enzyme\u2019s active site, preventing substrate binding.  Noncompetitive (allosteric) inhibitors  bind to  allosteric sites , inducing a conformational change in the enzyme that prevents it from functioning.  Feedback inhibition  occurs when the product of a metabolic pathway noncompetitively binds to an enzyme early on in the pathway, ultimately preventing the synthesis of the product. \n\n 8.2   Catabolism of Carbohydrates \n\n Glycolysis  is the first step in the breakdown of glucose, resulting in the formation of ATP, which is produced by  substrate-level phosphorylation ; NADH; and two pyruvate molecules. Glycolysis does not use oxygen and is not oxygen dependent. \n\n After glycolysis, a three-carbon pyruvate is decarboxylated to form a two-carbon acetyl group, coupled with the formation of NADH. The acetyl group is attached to a large carrier compound called coenzyme A. \n\n After the transition step, coenzyme A transports the two-carbon acetyl to the  Krebs cycle , where the two carbons enter the cycle. Per turn of the cycle, one acetyl group derived from glycolysis is further oxidized, producing three NADH molecules, one FADH 2 , and one ATP by  substrate-level phosphorylation , and releasing two CO 2  molecules. \n\n The Krebs cycle may be used for other purposes. Many of the intermediates are used to synthesize important cellular molecules, including amino acids, chlorophylls, fatty acids, and nucleotides. \n\n 8.3   Cellular Respiration \n\n Most ATP generated during the cellular respiration of glucose is made by  oxidative phosphorylation . \n\n An  electron transport system (ETS)  is composed of a series of membrane-associated protein complexes and associated mobile accessory electron carriers. The ETS is embedded in the cytoplasmic membrane of prokaryotes and the inner mitochondrial membrane of eukaryotes. \n\n Each ETS complex has a different redox potential, and electrons move from electron carriers with more negative redox potential to those with more positive redox potential. \n\n To carry out  aerobic respiration , a cell requires oxygen as the final electron acceptor. A cell also needs a complete Krebs cycle, an appropriate cytochrome oxidase, and oxygen detoxification enzymes to prevent the harmful effects of oxygen radicals produced during aerobic respiration. \n\n Organisms performing  anaerobic respiration  use alternative electron transport system carriers for the ultimate transfer of electrons to the final non-oxygen electron acceptors. \n\n Microbes show great variation in the composition of their electron transport systems, which can be used for diagnostic purposes to help identify certain pathogens. \n\n As electrons are passed from NADH and FADH 2  through an ETS, the electron loses energy. This energy is stored through the pumping of H +  across the membrane, generating a  proton motive force . \n\n The energy of this proton motive force can be harnessed by allowing hydrogen ions to diffuse back through the membrane by  chemiosmosis  using  ATP synthase . As hydrogen ions diffuse through down their electrochemical gradient, components of ATP synthase spin, making ATP from ADP and P i  by oxidative phosphorylation. \n\n Aerobic respiration forms more ATP (a maximum of 34 ATP molecules) during oxidative phosphorylation than does anaerobic respiration (between one and 32 ATP molecules). \n\n 8.4   Fermentation \n\n Fermentation uses an organic molecule as a final electron acceptor to regenerate NAD +  from NADH so that glycolysis can continue. \n\n Fermentation does not involve an electron transport system, and no ATP is made by the fermentation process directly. Fermenters make very little ATP\u2014only two ATP molecules per glucose molecule during glycolysis. \n\n Microbial fermentation processes have been used for the production of foods and pharmaceuticals, and for the identification of microbes. \n\n During lactic acid fermentation, pyruvate accepts electrons from NADH and is reduced to lactic acid. Microbes performing  homolactic fermentation  produce only lactic acid as the fermentation product; microbes performing  heterolactic fermentation  produce a mixture of lactic acid, ethanol and/or acetic acid, and CO 2 . \n\n Lactic acid production by the normal microbiota prevents growth of pathogens in certain body regions and is important for the health of the gastrointestinal tract. \n\n During ethanol fermentation, pyruvate is first decarboxylated (releasing CO 2 ) to acetaldehyde, which then accepts electrons from NADH, reducing acetaldehyde to ethanol. Ethanol fermentation is used for the production of alcoholic beverages, for making bread products rise, and for biofuel production. \n\n Fermentation products of pathways (e.g., propionic acid fermentation) provide distinctive flavors to food products. Fermentation is used to produce chemical solvents (acetone-butanol-ethanol fermentation) and pharmaceuticals (mixed acid fermentation). \n\n Specific types of microbes may be distinguished by their fermentation pathways and products. Microbes may also be differentiated according to the substrates they are able to ferment. \n\n 8.5   Catabolism of Lipids and Proteins \n\n Collectively, microbes have the ability to degrade a wide variety of carbon sources besides carbohydrates, including lipids and proteins. The catabolic pathways for all of these molecules eventually connect into glycolysis and the Krebs cycle. \n\n Several types of lipids can be microbially degraded. Triglycerides are degraded by extracellular  lipases , releasing fatty acids from the glycerol backbone. Phospholipids are degraded by  phospholipases , releasing fatty acids and the phosphorylated head group from the glycerol backbone. Lipases and phospholipases act as virulence factors for certain pathogenic microbes. \n\n Fatty acids can be further degraded inside the cell through  \u03b2-oxidation , which sequentially removes two-carbon acetyl groups from the ends of fatty acid chains. \n\n Protein degradation involves extracellular  proteases  that degrade large proteins into smaller peptides. Detection of the extracellular proteases gelatinase and caseinase can be used to differentiate clinically relevant bacteria. \n\n 8.6   Photosynthesis \n\n Heterotrophs depend on the carbohydrates produced by autotrophs, many of which are photosynthetic, converting solar energy into chemical energy. \n\n Different photosynthetic organisms use different mixtures of  photosynthetic pigments , which increase the range of the wavelengths of light an organism can absorb. \n\n Photosystems  (PSI and PSII) each contain a  light-harvesting complex , composed of multiple proteins and associated pigments that absorb light energy. The  light-dependent reactions  of photosynthesis convert solar energy into chemical energy, producing ATP and NADPH or NADH to temporarily store this energy. \n\n In  oxygenic photosynthesis , H 2 O serves as the electron donor to replace the reaction center electron, and oxygen is formed as a byproduct. In  anoxygenic photosynthesis , other reduced molecules like H 2 S or thiosulfate may be used as the electron donor; as such, oxygen is not formed as a byproduct. \n\n Noncyclic photophosphorylation  is used in oxygenic photosynthesis when there is a need for both ATP and NADPH production. If a cell\u2019s needs for ATP outweigh its needs for NADPH, then it may carry out  cyclic photophosphorylation  instead, producing only ATP. \n\n The  light-independent reactions  of photosynthesis use the ATP and NADPH from the light-dependent reactions to fix CO 2  into organic sugar molecules. \n\n 8.7   Biogeochemical Cycles \n\n The recycling of inorganic matter between living organisms and their nonliving environment is called a  biogeochemical cycle . Microbes play significant roles in these cycles. \n\n In the  carbon cycle , heterotrophs degrade reduced organic molecule to produce carbon dioxide, whereas autotrophs fix carbon dioxide to produce organics.  Methanogens  typically form methane by using CO 2  as a final electron acceptor during anaerobic respiration; methanotrophs oxidize the methane, using it as their carbon source. \n\n In the  nitrogen cycle , nitrogen-fixing bacteria convert atmospheric nitrogen into ammonia (ammonification). The ammonia can then be oxidized to nitrite and nitrate (nitrification). Nitrates can then be assimilated by plants. Soil bacteria convert nitrate back to nitrogen gas (denitrification). \n\n In  sulfur cycling , many anoxygenic photosynthesizers and chemoautotrophs use hydrogen sulfide as an electron donor, producing elemental sulfur and then sulfate; sulfate-reducing bacteria and archaea then use sulfate as a final electron acceptor in anaerobic respiration, converting it back to hydrogen sulfide. \n\n Human activities that introduce excessive amounts of naturally limited nutrients (like iron, nitrogen, or phosphorus) to aquatic systems may lead to eutrophication. \n\n Microbial  bioremediation  is the use of microbial metabolism to remove or degrade  xenobiotics  and other environmental contaminants and pollutants. Enhanced bioremediation techniques may involve the introduction of non-native microbes specifically chosen or engineered for their ability to degrade contaminants. ", "keyterm": "", "bname": "microbiology"}, {"chapter": 6, "intro": " Chapter Outline 6.1   Intentional Torts and Negligence 6.2   Product and Strict Liability Introduction \n\n Learning Outcome \n\n Explain torts system application to business. ", "chapter_text": " 6.1   Intentional Torts and Negligence \n\n Civil suits arise from damages suffered by one or more persons or entities at the hands of another person or entity. The damage can happen in a variety of circumstances, and may be intentional or unintentional. Unlike criminal cases, civil suits seek to provide some form of remedy for the loss suffered by an injured party. Civil suits are decided by judges and juries based on the specific situation, especially when violation of  statutes , or laws, is not in question. \n\n Torts \n\n Civil suits involve different causes of action, and they are included in one general classification:  torts . The word \u201ctort\u201d means \u201cwrong\u201d in French. Thus, torts are wrongs committed against others who suffer some form of damage as a result. While these damages could also be the result of criminal action, the criminal element of the matter is not tried in a civil lawsuit. The standard of proof is lower for civil suits, and a finding of liability in a tort case does not necessarily translate to guilt in a criminal case. \n\n The actor of the wrongs has historically been called a  tortfeasor . When a wrong is committed by a tortfeasor, damage is done to another.  Tort law  seeks to address this damage based on the circumstances of the issue, which is based on  fault . Civil lawsuits are used by the injured parties to seek redress for the loss associated with the tort. Unlike criminal proceedings, redress is often provided in the form of money as opposed to incarceration. As such, the burden of proof of fault is lower. The\u00a0 offender , or tortfeasor, who commits the act is the accused in a civil suit. The  plaintiff , who is the injured party, files the lawsuit on which the civil court will make a decision. The offender ultimately becomes the  defendant , who must respond to the accusations of the plaintiff in a civil suit. \n\n During tort litigation, the judge and jury have certain separate functions (Kionka, 2013): \n\n\t\t\t\t\t\t\tFunctions During a Tort Litigation\n\n\t\t\t\t\t\t \n\n\t\t\t\t\t\t\tThe Judge Decides Issues of Law\n\n\t\t\t\t\t\t \n\n\t\t\t\t\t\t\tThe Jury Decides Questions of Fact\n\n\t\t\t\t\t\t \n\n\t\t\t\t\t\t\tThe duty of the defendant to the plaintiff, if any\n\n\t\t\t\t\t\t \n\n\t\t\t\t\t\t\tWhat happened\n\n\t\t\t\t\t\t \n\n\t\t\t\t\t\t\tThe elements of the defense\n\n\t\t\t\t\t\t \n\n\t\t\t\t\t\t\tLegal consequences of what happened\n\n\t\t\t\t\t\t \n\n\t\t\t\t\t\t\tApplication of legal rules\n\n\t\t\t\t\t\t \n\n\t\t\t\t\t\t\tThe damages suffered by the plaintiff\n\n\t\t\t\t\t\t \n\n Table  6.1     \n\n Harm \n\n Two types of torts are intentional torts and negligence.  Intentional torts  occur as the result of a conscious and purposeful act.  Negligence  occurs when an individual does not exercise duty of care. Torts are acts or omissions that result in injury or  harm  to an individual in such a way that it leads to a civil wrong that occurs as liability (WEX, n.d.). In tort law, harm can be defined as a loss or disadvantage suffered as a result of the actions or omissions of another (WEX, n.d.). This loss can be physical harm, such as slipping and falling on a wet floor, or personal property harm, such as allowing water to ruin furniture. The damage is the result of what someone else did, or did not do, either intentionally or based on a lack of reasonable care. \n\n There are two basic elements to torts: damages and compensation (Laws, tort.laws.com). Tort law acts to compensate persons who have suffered damages at the hands of another (Baime, 2018). Tort law determines the legal responsibility of the defendant and the value of the harm. Different types of torts look at different types of circumstances. \n\n Intentional Torts \n\n Intentional torts are committed by an offender who understands that he or she is committing a tort. Intent does not always equate to directly causing an end result. In some cases, the intent may be something else, such as the possession of knowledge that some harm may occur. The harm may result from intentional action, or due to some circumstance that the offender feels will be excusable (Kionka, 2013). \n\n Some circumstances that could allow the defendant to argue that the action is excusable would include: permission by the injured party, or defense of property, self, or another person (Kionka, 2013). If the injured party agrees to allow the defendant to juggle knives and one slips and causes harm, the action might be excusable to some extent. If a defendant caused harm to the plaintiff\u2019s car while trying to avoid being hit by the car, it would likely be excusable. \n\n Different types of intentional torts are based on different circumstances and face different  remedies , or means of recovering losses (Baime, 2018): \n\n Assault  is an intentional tort that occurs when an individual has a reasonable apprehension of an intentional act that is designed to cause harm to himself or herself, or to another person. \n\n Malicious prosecution  occurs when an individual files groundless complaints to initiate a criminal matter against another. \n\n Defamation  occurs when an individual intentionally creates and promotes malicious falsehoods about another. Defamation can occur in two ways: slander and libel.  Slander  is, in effect, when falsehoods are spoken.  Libel  occurs when falsehoods are expressed in written or other recorded forums. \n\n Invasion of privacy  involves unwanted production of negative public information. Different standards apply to invasion of privacy based on the status of the individual as a public figure. \n\n Negligence \n\n Negligence is another type of tort that has two meanings. It is the name of a  cause of action  in a tort, and it is a form of conduct that does not meet the  reasonable standard of care  (Kionka, 2013). The cause of action is the reason for the damage, and the standard of care is based on the care that a reasonable person would need in a given situation. Negligence is decided by determining the duty of the defendant, whether or not the defendant committed a breach of that duty, the cause of the injury, and the injury itself. \n\n For an action to be deemed negligent, there must be a legal  duty of care , or responsibility to act, based on the reasonable standard in a situation (Baime, 2018). An individual can be considered negligent if he agreed to watch a child, but did not do so, and then harm came to the child. An individual would not be considered negligent if he did not know that he was supposed to watch the child, or did not agree to watch the child. \n\n A  reasonable person  is defined as someone who must exercise reasonable care based on what he or she knows about the situation, how much experience he or she has with the situation, and how he or she perceives the situation (Kionka, 2013). In some cases, this knowledge could be based on common knowledge of community matters, such as knowing that a bridge is closed for repairs. \n\n In some cases, the duty of care is based on a  special relationship , which is a relationship based on an implied duty of care. This implied duty of care often comes about as a  duty to aid , or a duty to protect another, e.g., a nurse caring for patients in a hospital, or a lifeguard being responsible for swimmers in the guarded area (Baime, 2018). A passerby does not have a duty to aid, but if the individual tries to help, then he or she is responsible for acting responsibly. \n\n The elements of a negligence cause of action are (Kionka, 2013): \n\n A duty by the defendant to either act or refrain from acting \n\n A breach of that duty, based on a failure to conform to the standard of care by the defendant \n\n A causal connection between the defendant\u2019s action or inaction, and the injury to the plaintiff \n\n Measurable harm that can be remedied in monetary damages \n\n Foreseeability \n\n Negligence case decisions are influenced by whether or not a defendant could have predicted that an action or inaction could have resulted in the tort, or  foreseeability  (Baime, 2018). Responsibility is often based on whether or not the harm caused by an action or inaction was  reasonably foreseeable , which means that the result was fairly obvious before it occurred (Baime, 2018). A person assisting an inebriated individual into her car could be considered negligent due to the likelihood that harm would come to her while she is driving in an intoxicated state. This situation is an example of the  foreseeable probability of harm . \n\n Conclusion \n\n Intentional torts and negligence arise based on intentional and unintentional acts committed by individuals. Damages are decided in civil courts by first determining fault and harm, and then by assigning a remedy. Sometimes, the damage can be excused if the circumstances indicate that the defendant acted with permission, or in his or her own defense. The main standard used to make a decision is the reasonable standard of care: what would a reasonable person do? \n 6.2   Product and Strict Liability \n\n Determination of fault and damages for intentional torts and negligence are based on the reasonable standard of care. Another form of torts looks at liability without fault, or  strict liability . Strict liability determines liability, or harm, based on reasons other than fault (CCBC Legal Studies, n.d.). The mistakes leading to harm can be completely unintentional, and in some cases, unavoidable. Yet, damage is done, and a civil suit arises. \n\n Strict Liability \n\n Strict liability provides a remedy when harm is suffered through no intentional fault. The courts needed to create a standard that would cover this form of tort, or one without fault. The courts came up with the  abnormally dangerous activity standard , which assigns responsibility when an individual engages in some form of dangerous activity, even if care is taken to avoid mishap (CCBC Legal Studies, n.d.). If a homeowner has horses in a pasture that is bounded by electric fencing, it can be determined that the homeowner exercised reasonable care. However, suppose that the electricity goes down, the horses get out onto the road, and an accident occurs as a result. In this case, the owner is responsible, even though he took reasonable care and the event was unforeseen. \n\n For a court to assign strict liability based on abnormally dangerous activities, the activity must meet certain criteria. The court must establish that at least four of the following six factors are present (CCBC Legal Studies, n.d.): \n\n The activity poses a high degree of risk of harm to a person, the land of another, or the property owned by another. \n\n The harm resulting from this activity would likely be substantial. \n\n The use of reasonable care would not eliminate this risk. \n\n The activity is not something that would be considered a matter of common usage. \n\n The activity is not appropriate for the place where it occurs. \n\n The danger of the activity overshadows the benefit it poses to a given community. \n\n In essence, the basis for determining strict liability is the extent of the risk involved in the activity. This basis could also apply to the ownership of dangerous pets. A dog that is known to be aggressive would qualify the owner for strict liability should it get out and bite someone. The courts would find that the owner knew, or should have known, that the dog was dangerous and had a propensity to cause harm (Kionka, 2013). \n\n Trespass \n\n In some situations, the owner of the dangerous activity might not be held liable. One such situation is trespassing. Trespassing occurs as an individual enters or remains upon property owned by another without permission (Kionka, 2013). In the case of trespassing, the owner of the property does not have a duty to make the premises safe based on reasonable care for the trespasser (Kionka, 2013). Also, the owner does not have a responsibility to cancel or alter activities on the premises to avoid endangering the trespasser (Kionka, 2013). \n\n In some cases, however, the property owner could be held liable (Kionka, 2013): \n\n When the area in question is a common place for trespassing \n\n When the owner knows a trespasser is present \n\n When the trespasser needs aid, then the owner has a duty to rescue him or her \n\n When the trespasser is a child, and the dangerous activity is deemed as an  attractive nuisance , or an attraction that a reasonable child would wish to view \n\n Even though trespassing can present an exception to liability in the presence of a dangerous activity, it is not a given. There are numerous exceptions that allow for liability. In effect, strict liability can occur in a given situation even when the property owner has provided care that goes above and beyond what is reasonable. The court does not need to establish proof of lack of due care when applying strict liability to a case (Baime, 2018). \n\n Product Liability \n\n Individuals are not always the defendants involved in civil suits. Manufacturers, wholesalers, distributors, and retailers can also be named in torts that pertain to products and qualify as strict liability (CCBC Legal Studies, n.d.). Some products contain flaws that were not intentionally created; such flaws may not be discovered until an individual suffers harm as a result of using them. \n\n It is not always possible to conclusively prove that an act or omission was responsible for the harm (Baime, 2018). As a result, the courts developed the doctrine of  res ipsa loquitor , which means that whatever it is speaks for itself. The burden of proof shifts from the plaintiff to the defendant, who must disprove negligence. However, the plaintiff must first establish three factors (Baime, 2018): \n\n The defendant had control over the product in question while it was being manufactured. \n\n Under normal use and circumstances, the product would not cause damage or harm, but damage or harm has occurred in the case in question. \n\n The behavior of the plaintiff did not significantly contribute to the harm caused. \n\n The doctrine of res ipsa loquitor does not establish proof of negligence, but it does allow the jury to infer what is not explicitly available pertaining to negligent acts or omissions on the part of the defendant (Baime, 2018). \n\n Negligence can occur when products are created because defects can harm consumers. Think about the potential harm that would occur if brake manufacturers were negligent. This negligence would cause brakes to have flaws, which would prevent them from doing their job of stopping cars. If a car does not stop, people will likely be injured. The manufacturing defect would result in a product liability lawsuit, based on legal responsibility for the harmful consequences proximately caused by the product defect (Baime, 2018). Since the courts would not be able to see the negligence occurring, the courts would base their decision on res ipsa loquitor and the fact that the brakes would not normally fail under normal use by the driver. \n\n The Unreasonably Dangerous Product Standard \n\n In the case of product liability, the court uses an unreasonably dangerous product standard to determine liability. The unreasonably dangerous product would be so dangerous that the danger would be beyond the expectation of the user, and a less dangerous option could have been produced instead (Kionka, 2013). This type of unreasonably dangerous product often falls into one of three categories (Kionka, 2013): \n\n A flaw in the manufacturing process that occurred because the manufacturer failed to exercise proper care during manufacturing \n\n A defect in the design of the product, which makes it dangerous, and safer alternatives are available and economically feasible \n\n The product includes insufficient warnings or instructions for the proper use of the product and its potential dangers \n\n Defenses \n\n There are defenses to product liability claims. In some cases, the plaintiff\u2019s own behaviors contribute to his or her injuries, based on his or her own negligence. This situation is known as  contributory negligence . Contributory negligence, when determined by the court, prevents any recovery of damages by the plaintiff (Baime, 2018). So, if the court finds contributory negligence, the plaintiff is unable to recover any damages for the injury. Two forms of contributory negligence are assumption of risk and misuse. \n\n Assumption of risk  is one defense. In some cases, the defendant can argue that the user assumed the risk of using the product if he or she used the product while knowing that the defect in the product created a risk (CCBC Legal Studies, n.d.). An individual who purchases a saw and sees that the guard is too small to cover the teeth, but decides to use it anyway, is assuming the risk of using the product. If the saw cuts the individual, then the manufacturer could argue that the person assumed the risk because he saw the defect, understood the risk, and used the saw anyway. \n\n Another defense is product  misuse . In some cases, an individual will use a product in ways that it is not meant to be used (CCBC Legal Studies, n.d.). The user might not be aware of a defect, and he or she proceeds to use the product incorrectly. Misuse by the individual would be to blame for any resulting harm. \n\n Plaintiffs might also be responsible for  comparative negligence . With comparative negligence, the plaintiff\u2019s own actions in the use of the product contributed to the harm caused by the product, but the plaintiff might still receive damages (CCBC Legal Studies, n.d.). The amount of negligence on behalf of each part (plaintiff and defendant) is compared to determine the damages to which the plaintiff is entitled (Baime, 2018). If a plaintiff is found to be 30% responsible, and the defendant 70% responsible, then the plaintiff would be entitled to 70% of the damages suffered. \n\n Conclusion \n\n In some cases, a plaintiff suffers harm, but fault is not easily determined, or fault is not the issue. A defendant can exercise reasonable care while the nature of the activity lends itself to risk of harm. Products could have obvious or hidden defects that cause harm to another. When defects occur, the plaintiff has the ability to file a civil suit against the entity that is responsible for the harm-causing defect. The plaintiff might also share some responsibility in the harm, and based on product liability, the court decision will be adjusted accordingly. ", "questions": [{"question": {"question_id": "fs-212323156", "question_text": "When an individual creates and promotes malicious falsehoods about another that individual may be liable for:", "question_choices": ["Libel.", "Slander.", "Defamation.", "All of the above."], "cloze_format": "The elements of a contract do not include ___ ", "normal_format": "Which of the following element is NOT an element of a contract?"}, "answer": {"ans_text": "d", "ans_choice": 3}, "bloom": null, "hl_sentences": "Defamation occurs when an individual intentionally creates and promotes malicious falsehoods about another . Defamation can occur in two ways : slander and libel .", "hl_context": "<hl> Defamation occurs when an individual intentionally creates and promotes malicious falsehoods about another . <hl> <hl> Defamation can occur in two ways : slander and libel . <hl> Slander is , in effect , when falsehoods are spoken . Libel occurs when falsehoods are expressed in written or other recorded forums ."}, {"question": {"question_id": "fs-21232315", "question_text": "All of the following are elements of negligence except:", "question_choices": ["A reasonable person.", "A duty by the defendant to either act or refrain from acting.", "A breach of a duty owed by defendant.", "Measurable harm."], "cloze_format": "The burden of proof in a criminal case is ___ .", "normal_format": "What is a criminal case that is the burden of proof?"}, "answer": {"ans_text": "a", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Intentional torts and negligence arise based on intentional and unintentional acts committed by individuals . The main standard used to make a decision is the reasonable standard of care : what would a reasonable person do ?", "hl_context": "<hl> Intentional torts and negligence arise based on intentional and unintentional acts committed by individuals . <hl> Damages are decided in civil courts by first determining fault and harm , and then by assigning a remedy . Sometimes , the damage can be excused if the circumstances indicate that the defendant acted with permission , or in his or her own defense . <hl> The main standard used to make a decision is the reasonable standard of care : what would a reasonable person do ? <hl> 6.2 Product and Strict Liability"}, {"question": {"question_id": "fs-2123231", "question_text": "Which of the following is a special relationship giving rise to a duty to act to aid or protect one in peril?", "question_choices": ["Hotel and guest.", "Cousin to cousin.", "School principal and student.", "Hotel and guest, and school principal and student."], "cloze_format": "It is ___ that businesses can be charged with crimes", "normal_format": "Businesses can be charged with crimes."}, "answer": {"ans_text": "Hotel and guest, and school principal and student.", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "In some cases , the duty of care is based on a special relationship , which is a relationship based on an implied duty of care . This implied duty of care often comes about as a duty to aid , or a duty to protect another , e . g . , a nurse caring for patients in a hospital , or a lifeguard being responsible for swimmers in the guarded area ( Baime , 2018 ) .", "hl_context": "<hl> In some cases , the duty of care is based on a special relationship , which is a relationship based on an implied duty of care . <hl> <hl> This implied duty of care often comes about as a duty to aid , or a duty to protect another , e . g . , a nurse caring for patients in a hospital , or a lifeguard being responsible for swimmers in the guarded area ( Baime , 2018 ) . <hl> A passerby does not have a duty to aid , but if the individual tries to help , then he or she is responsible for acting responsibly ."}, {"question": {"question_id": "fs-212323150", "question_text": "The elements of res ipsa loquitor that a plaintiff must establish in a product liability lawsuit include all of the following except:", "question_choices": ["The defendant breached his or her duty of care.", "The defendant had control over the product in question while it was being manufactured.", "Under normal circumstances, the product would not cause damage or harm, but damage or harm has occurred in the case in question.", "The behavior of the plaintiff did not significantly contribute to the harm caused."], "cloze_format": "The elements of res ipsa loquitor that a plaintiff must establish in a product liability lawsuit does not include ___ .", "normal_format": "The elements of res ipsa loquitor that a plaintiff must establish in a product liability lawsuit do NOT include which of the following?"}, "answer": {"ans_text": "a", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The behavior of the plaintiff did not significantly contribute to the harm caused . Under normal use and circumstances , the product would not cause damage or harm , but damage or harm has occurred in the case in question . The defendant had control over the product in question while it was being manufactured . As a result , the courts developed the doctrine of res ipsa loquitor , which means that whatever it is speaks for itself . The burden of proof shifts from the plaintiff to the defendant , who must disprove negligence . However , the plaintiff must first establish three factors ( Baime , 2018 ):", "hl_context": "<hl> The behavior of the plaintiff did not significantly contribute to the harm caused . <hl> <hl> Under normal use and circumstances , the product would not cause damage or harm , but damage or harm has occurred in the case in question . <hl> <hl> The defendant had control over the product in question while it was being manufactured . <hl> It is not always possible to conclusively prove that an act or omission was responsible for the harm ( Baime , 2018 ) . <hl> As a result , the courts developed the doctrine of res ipsa loquitor , which means that whatever it is speaks for itself . <hl> <hl> The burden of proof shifts from the plaintiff to the defendant , who must disprove negligence . <hl> <hl> However , the plaintiff must first establish three factors ( Baime , 2018 ): <hl>"}], "summary": "", "keyterm": "", "bname": "business_law_i_essentials"}, {"chapter": 7, "intro": " Chapter Outline 7.1   Describe How and Why Managers Use Budgets 7.2   Prepare Operating Budgets 7.3   Prepare Financial Budgets 7.4   Prepare Flexible Budgets 7.5   Explain How Budgets Are Used to Evaluate Goals Why It Matters \n\n Chris and Nikki are studying abroad next semester. Chris wants to spend her weekends sightseeing, but she does not have a lot of extra money. She creates a budget so she can save money to sightsee. She can reliably predict costs such as tuition, books, travel, and much of the sightseeing costs. She can also predict the amount of resources she will have to meet those costs, including scholarships, some savings, and earnings from her job. \n\n Chris developed a budget from this information and planned for emergencies by including extra working hours and listing expenses that could be eliminated. On her trip, Chris was very careful with expenses and visited all the places she budgeted to visit. \n\n Chris\u2019s roommate, Nikki, on the other hand, did not plan ahead before going abroad. She did not have any travel funds for the last several weeks and lamented that she should not have purchased so many souvenirs. \n\n Chris and Nikki are clear illustrations of why people and companies prepare budgets. Preparing a budget for future anticipated activities requires a company to look critically at its revenue and expenses. A good budget gives management the ability to evaluate results at the end of the budget cycle. Even well-planned budgets can have emergencies or unplanned financial disruptions, but having a budget provides a company with the information to develop an alternative budget. A good budget can be adjusted to work with changes in income and still produce similar results. \n\n In this chapter, you will learn the basic process companies use to create budgets and the general composition of basic budgets that are summed up in a master budget. You will also learn the importance of the flexible budget and be introduced to the idea of how budgets are used to evaluate company and management performance. ", "chapter_text": " 7.1   Describe How and Why Managers Use Budgets \n\n Implementation of a company\u2019s strategic plan often begins by determining management\u2019s basic expectations about future economic, competitive, and technological conditions, and their effects on anticipated goals, both long-term and short-term. Many firms at this stage conduct a situational analysis that involves examining their  strengths  and  weaknesses  and the external  opportunities  available and the  threats  that they might face from competitors. This common analysis is often labeled as SWOT. \n\n After performing the situational analysis, the organization identifies potential strategies that could enable achievement of its goals. Finally, the company will create, initiate, and monitor both long-term and short-term plans. \n\n An important step in the initiation of the company\u2019s strategic plan is the creation of a budget. A good budgeting system will help a company reach its strategic goals by allowing management to plan and to control major categories of activity, such as revenue, expenses, and financing options. As detailed in  Accounting as a Tool for Managers , planning involves developing future objectives, whereas controlling involves monitoring the planning objectives that have been put into place. \n\n There are many advantages to budgeting, including: \n\n Communication\n\n Budgeting is a formal method to communicate a company\u2019s plans to its internal stakeholders, such as executives, department managers, and others who have an interest in\u2014or responsibility for\u2014monitoring the company\u2019s performance. \n\n Budgeting requires managers to plan for both revenues and expenses. \n\n Planning\n\n Preparing a budget requires managers to consider and evaluate\n\n The assumptions used to prepare the budget. \n\n Long-term financial goals. \n\n Short-term financial goals. \n\n The company\u2019s position in the market. \n\n How each department supports the strategic plan. \n\n Preparing a budget requires departments to work together to\n\n Determine realizable sales goals. \n\n Compute the manufacturing or other requirements necessary to meet the sales goals. \n\n Solve bottlenecks that are predicted by the budget. \n\n Allocate resources so they can be used effectively to meet the sales and manufacturing goals. \n\n Compare forecasted or flexible budgets with actual results. \n\n Evaluation\n\n When compared to actual results, budgets are early alerts and they forecast:\n\n Cash flows for various levels of production. \n\n When loans may be required or when loans may be reduced. \n\n Budgets show which areas, departments, units, and so forth, are profitable or meet their appropriate goals. Similarly, they also show which components are unprofitable or do not reach their anticipated goals. \n\n Budgets set defined benchmarks that may be used for evaluating company and management performance, including raises and bonuses, as well as negative consequences, such as firing. \n\n To understand the benefits of budgeting, consider Big Bad Bikes, a company that manufactures high-end mountain bikes. The company will begin producing and selling trainers this year. Trainers are stands that allow a rider to ride their bike indoors similar to the way bikes are used in spinning classes. Big Bad Bikes has a 5-year plan and has always been successful in managing its budget. Managers participate in developing the budget and are aware that all expenses must be related to the company\u2019s strategic plan. They know that managing their departments is much easier when the budget is developed to support the strategic plan. \n\n The plan for Big Bad Bikes is to introduce itself to the trainer market with a sales price of $70 for the first two quarters of the year and then raise the price to $75 per unit. The marketing department estimates that sales will be 1,000 units for the first two quarters, 1,500 for the third quarter, and 2,500 per quarter through the second year. Management will work with each department to communicate goals and build a budget based on the sales plan. The resulting budget can be evaluated by all departments involved. \n\n Ethical Considerations Break-Even Analysis and Profitability In the long run, proper budget reporting assists management in making good decisions. Management uses budgets to evaluate the performance of employees and their department. They can also use budgets to evaluate and benchmark the performance of a business unit in a large business organization or of the entire performance of a small company. They can also use budgets to evaluate separate projects. In budgeting situations, employees may feel a tension between reporting actual results and reporting results that reach the predetermined goals created by the budget. This creates a situation where managers may choose to act unethically and pressure accountants to report favorable financial results not supported by the operations. \n\n Accountants need to be aware of this circumstance and use ethical standards when assisting the development and creation of budgets. After a proper budget has been created, the reporting of the actual results will assist in creating a realistic and honest picture of the actual operations for the managers reviewing the budget. The budget accountant needs to take steps to ensure that employees are not trying to misreport the budget results; for example, managers might be tempted to set artificially low standards to ensure that targets are hit and significantly exceeded. Such results could lead to what might be considered as excessive bonuses paid to managers. \n\n The Basics of Budgeting \n\n All companies\u2014large and small\u2014have limits on the amount of money or resources they can receive and pay out. How these resources are used to reach their goals and objectives must be planned. The quantitative plan estimating when and how much cash or other resources will be received and when and how the cash or other resources will be used is the  budget . As you\u2019ve learned, some of the benefits of budgeting include improved communication, planning, coordination, and evaluation. \n\n All budgets are quantitative plans for the future and will be constructed based on the needs of the organization for which the budget is being created. Depending on the complexity, some budgets can take months or even years to develop. The most common time period covered by a budget is one year, although the time period may vary from strategic, long-term budgets to very detailed, short-term budgets. Generally, the closer the company is to the start of the budget\u2019s time period, the more detailed the budget becomes. \n\n Management begins with a vision of the future. The long-term vision sets the direction of the company. The vision develops into goals and strategies that are built into the budget and are directly or indirectly reflected on the master budget. \n\n The master budget has two major categories: the financial budget and the operating budget. The financial budget plans the use of assets and liabilities and results in a projected balance sheet. The operating budget helps plan future revenue and expenses and results in a projected income statement. The operating budget has several subsidiary budgets that all begin with projected sales. For example, management estimates sales for the upcoming few years. It then breaks down estimated sales into quarters, months, and weeks and prepares the sales budget. The sales budget is the foundation for other operating budgets. Management uses the number of units from the sales budget and the company\u2019s inventory policy to determine how many units need to be produced. This information in units and in dollars becomes the production budget. \n\n The production budget is then broken up into budgets for materials, labor, and overhead, which use the standard quantity and standard price for raw materials that need to be purchased, the standard direct labor rate and the standard direct labor hours that need to be scheduled, and the standard costs for all other direct and indirect operating expenses. Companies use the historic quantities of the amount of material per unit and the hours of direct labor per unit to compute a standard used to estimate the quantity of materials and labor hours needed for the expected level of production. Current costs are used to develop standard costs for the price of materials, the direct labor rate, as well as an estimate of overhead costs. \n\n The budget development process results in various budgets for various purposes, such as revenue, expenses, or units produced, but they all begin with a plan. To save time and eliminate unnecessary repetition, management often starts with the current year\u2019s budget and adjusts it to meet future needs. \n\n There are various strategies companies use in adjusting the budget amounts and planning for the future. For example, budgets can be derived from a top-down approach or from a bottom-up approach.  Figure 7.2  shows the general difference between the top-down approach and the bottom-up approach. The top-down approach typically begins with senior management. The goals, assumptions, and predicted revenue and expenses information are passed from the senior manager to middle managers, who further pass the information downward. Each department must then determine how it can allocate its expenses efficiently while still meeting the company goals. The benefit of this approach is that it ties in to the strategic plan and company goals. Another benefit of passing the amount of allowed expenses downward is that the final anticipated costs are reduced by the  vetting  (fact checking and information gathering) process. \n\n In the top-down approach, management must devote attention to efficiently allocating resources to ensure that expenses are not padded to create budgetary slack. The drawback to this approach to budgeting is that the budget is prepared by individuals who are not familiar with specific operations and expenses to understand each department\u2019s nuances. \n\n The bottom-up approach (sometimes also named a self-imposed or participative budget) begins at the lowest level of the company. After senior management has communicated the expected departmental goals, the departments then plans and predicts their sales and estimates the amount of resources needed to reach these goals. This information is communicated to the supervisor, who then passes it on to upper levels of management. The advantages of this approach are that managers feel their work is valued and that knowledgeable individuals develop the budget with realistic numbers. Therefore, the budget is more likely to be attainable. The drawback is that managers may not fully understand or may misunderstand the strategic plan. \n\n Other approaches in addition to the top-down and bottom-up approaches are a combination approach and the zero-based budgeting approach. In the combination approach, guidelines and targets are set at the top while the managers work to develop a budget within the targeted parameters. \n\n Zero-based budgeting  begins with zero dollars and then adds to the budget only revenues and expenses that can be supported or justified.  Figure 7.3  illustrates the difference between traditional budget preparation and zero-based budgeting in a bottom-up budgeting scenario. The advantage to zero-based budgeting is that unnecessary expenses are eliminated because managers cannot justify them. The drawback is that every expense needs to be justified, including obvious ones, so it takes a lot of time to complete. A compromise tactic is to use a zero-based budgeting approach for certain expenses, like travel, that can be easily justified and linked to the company goals. \n\n Often budgets are developed so they can adjust for changes in the volume or activity and help management make decisions. Changes and challenges can affect the budget and have an impact on a company\u2019s plans. A flexible budget adjusts the cost of goods produced for varying levels of production and is more useful than a static budget, which remains at one amount regardless of the production level. A flexible budget is created at the end of the accounting period, whereas the static budget is created before the fiscal year begins. \n\n Additionally  Figure 7.4  shows a comparison of a static budget and a flexible budget for Bingo\u2019s Bags, a company that produces purses and backpacks. In the flexible budget, the budgeted costs are calculated with actual sales, whereas in the static budget, budgeted costs are calculated with budgeted sales. The flexible budget allows management to see what they would expect the budget to look like based on the actual sales and budgeted costs. Flexible budgets are addressed in greater detail in  Prepare Flexible Budgets . \n\n In order to handle changes that occur in the future, companies can also use a  rolling budget , which is one that is continuously updated. While the company\u2019s goals may be multi-year, the rolling budget is adjusted monthly, and a new month is added as each month passes. Rolling budgets allow management to respond to changes in estimates or actual occurrences, but it also takes management away from other duties as it requires continual updating.  Figure 7.5  shows an example of how a rolling quarterly budget would work. Notice that as one month rolls off (is completed) another month is added to the budget so that four quarters of a year are always presented. \n\n Because budgets are used to evaluate a manager\u2019s performance as well as the company\u2019s, managers are responsible for specific expenses within their own budget. Each manager\u2019s performance is evaluated by how well he or she manages the revenues and expenses under his or her control. Each individual who exercises control over spending should have a budget specifying limits on that spending. \n\n The Role of the Master Budget \n\n Most organizations will create a master budget\u2014whether that organization is large or small, public or private, or a merchandising, manufacturing, or service company. A  master budget  is one that includes two areas, operational and financial, each of which has its own sub-budgets. The  operating budget  spans several areas that help plan and manage day-to-day business. The  financial budget  depicts the expectations for cash inflows and outflows, including cash payments for planned operations, the purchase or sale of assets, the payment or financing of loans, and changes in equity. Each of the sub-budgets is made up of separate but interrelated budgets, and the number and type of separate budgets will differ depending on the type and size of the organization. For example, the sales budget predicts the sales expected for each quarter. The direct materials budget uses information from the sales budget to compute the number of units necessary for production. This information is used in other budgets, such as the direct materials budget, which plans when materials will be purchased, how much will be purchased, and how much that material should cost. You will review some specific examples of budgeting for direct materials in  Prepare Operating Budgets . \n\n Figure 7.6  shows how operating budgets and financial budgets are related within a master budget. \n\n The Role of Operating Budgets \n\n An operating budget consists of the sales budget, production budget, direct material budget, direct labor budget, and overhead budget. These budgets serve to assist in planning and monitoring the day-to-day activities of the organization by informing management of how many units need to be produced, how much material needs to be ordered, how many labor hours need to be scheduled, and the amount of overhead expected to be incurred. The individual pieces of the operating budget collectively lead to the creation of the budgeted income statement. For example, Big Bad Bikes estimates it will sell 1,000 trainers for $70 each in the first quarter and prepares a sales budget to show the sales by quarter. Management understands that it needs to have on hand the 1,000 trainers that it estimates will be sold. It also understands that additional inventory needs to be on hand in the event there are additional sales and to prepare for sales in the second quarter. This information is used to develop a production budget. Each trainer requires 3.2 pounds of material that usually costs $1.25 per pound. Knowing how many units are to be produced and how much inventory needs to be on hand is used to develop a direct materials budget. \n\n The direct materials budget lets managers know when and how much raw materials need to be ordered. The same is true for direct labor, as management knows how many units will be manufactured and how many hours of direct labor are needed. The necessary hours of direct labor and the estimated labor rate are used to develop the direct labor budget. While the materials and labor are determined from the production budget, only the variable overhead can be determined from the production budget. Existing information regarding fixed manufacturing costs are combined with variable manufacturing costs to determine the manufacturing overhead budget. The information from the sales budget is used to determine the sales and administrative budget. Finally, the sales, direct materials, direct labor, fixed manufacturing overhead budget, and sales and administrative budgets are used to develop a pro-forma income statement. \n\n The Role of Financial Budgets \n\n A financial budget consists of the cash budget, the budgeted balance sheet, and the budget for capital expenses. Similar to the individual budgets that make up the operating budgets, the financial budgets serve to assist with planning and monitoring the financing requirements of the organization. Management plans its capital asset needs and states them in the capital expense budget. Management addresses its collection and payment policies to determine when it will receive cash from sales and when it will pay the material, labor, and overhead expenses. The capital expense budget and the estimated payment and collection of cash allow management to build a cash budget and determine when it will need financing or have additional funds to pay back loans. These budgets taken together will be part of the budgeted balance sheet.  Figure 7.6  shows how these budgets relate. \n\n Your Turn Maintaining a Cash Balance DaQuan recently began work as a senior accountant at Mad Coffee Company. He learned he would be responsible for monitoring the cash balance because there is a bank loan requirement that a minimum balance of $10,000 be maintained with the bank at all times. DaQuan asked to see the cash budget so he could anticipate when the balance was most likely to go below $10,000. How can DaQuan determine potential cash balance issues by looking at the budget? \n\n Solution \n\n Budgeting helps plan for those times when cash is in short supply and bills need to be paid. Proper budgeting shows when and for how long a cash shortage may exist. DaQuan can see the months when the cash payments exceed the cash receipts and when the company is in danger of having a cash balance below the minimum requirement of $10,000. Knowing the inflow and outflow of cash will help him plan and manage the shortage through a line of credit, delay in purchasing, delay in hiring, or delay in payment of non-essential items. \n\n Link to Learning \n\n Budgeting is a task that should be completed by all organizations, not only those limited to manufacturing. Unfortunately, there are many individuals who want to operate a business and know nothing about budgeting. Often, professional organizations or industry trade groups offer information to help their members succeed in business. For example, the real estate profession provides information and suggestions such as this  article on preparing a marketing budget  to help professionals. \n 7.2   Prepare Operating Budgets \n\n Operating budgets  are a primary component of the master budget and involve examining the expectations for the primary operations of the business. Assumptions such as sales in units, sales price, manufacturing costs per unit, and direct material needed per unit involve a significant amount of time and input from various parts of the organization. It is important to obtain all of the information, however, because the more accurate the information, the more accurate the resulting budget, and the more likely management is to effectively monitor and achieve its budget goals. \n\n Individual Operating Budgets \n\n In order for an organization to align the budget with the strategic plan, it must budget for the day-to-day operations of the business. This means the company must understand when and how many sales will occur, as well as what expenses are required to generate those sales. In short, each component\u2014sales, production, and other expenses\u2014must be properly budgeted to generate the operating budget components and the resulting pro-forma budgeted income statement. \n\n The budgeting process begins with the estimate of sales. When management has a solid estimate of sales for each quarter, month, week, or other relevant time period, they can determine how many units must be produced. From there, they determine the expenditures, such as direct materials necessary to produce the units. It is critical for the sales estimate to be accurate so that management knows how many units to produce. If the estimate is understated, the company will not have enough inventory to satisfy customers, and they will not have ordered enough material or scheduled enough direct labor to manufacture more units. Customers may then shop somewhere else to meet their needs. Likewise, if sales are overestimated, management will have purchased more material than necessary and have a larger labor force than needed. This overestimate will cause management to have spent more cash than was necessary. \n\n Sales Budget \n\n The  sales budget  details the expected sales in units and the sales price for the budget period. The information from the sales budget is carried to several places in the master budget. It is used to determine how many units must be produced as well as when and how much cash will be collected from those sales. \n\n For example, Big Bad Bikes used information from competitor sales, its marketing department, and industry trends to estimate the number of units that will be sold in each quarter of the coming year. The number of units is multiplied by the sales price to determine the sales by quarter as shown in  Figure 7.7 . \n\n The sales budget leads into the production budget to determine how many units must be produced each week, month, quarter, or year. It also leads into the cash receipts budget, which will be discussed in  Prepare Financial Budgets . \n\n Production Budget \n\n Estimating sales leads to identifying the desired quantity of inventory to meet the demand. Management wants to have enough inventory to meet production, but they do not want too much in the ending inventory to avoid paying for unnecessary storage. Management often uses a formula to estimate how much should remain in ending inventory. Management wants to be flexible with its budgeting, wants to create budgets that can grow or shrink as needed, and needs to have inventory on hand. So the amount of ending inventory often is a percentage of the next week\u2019s, month\u2019s, or quarter\u2019s sales. \n\n In creating the production budget, a major issue is how much inventory should be on hand. Having inventory on hand helps the company avoid losing a customer because the product isn\u2019t available. However, there are storage costs associated with holding inventory as well as having a lag time between paying to manufacture a product and receiving cash from selling that product. Management must balance the two issues and determine the amount of inventory that should be available. \n\n When determining the number of units needed to be produced, start with the estimated sales plus the desired ending inventory to derive the maximum number of units that must be available during the period. Since the number of units in beginning inventory are already produced, subtracting the beginning inventory from the goods available results in the number of units that need to be produced. \n\n After management has estimated how many units will sell and how many units need to be in ending inventory, it develops the  production budget  to compute the number of units that need to be produced during each quarter. The formula is the reverse of the formula for the cost of goods sold. \n\n The number of units expected to be sold plus the desired ending inventory equals the number of units that are available. When the beginning inventory is subtracted from the number of units available, management knows how many units must be produced during that quarter to meet sales. \n\n In a merchandising firm, retailers do not produce their inventory but purchase it. Therefore, stores such as  Walmart  do not have raw materials and instead substitute the number of units to be purchased in place of the number of units to be produced; the result is the merchandise inventory to be purchased. \n\n To illustrate the steps in developing a production budget, recall that Big Bad Bikes is introducing a new product that the marketing department thinks will have strong sales. For new products, Big Bad Bikes requires a target ending inventory of 30% of the next quarter\u2019s sales. Unfortunately, they were unable to manufacture any units before the end of the current year, so the first quarter\u2019s beginning inventory is 0 units. As shown in  Figure 7.7 , sales in quarter 2 are estimated at 1,000 units; since 30% is required to be in ending inventory, the ending inventory for quarter 1 needs to be 300 units. With expected sales of 1,000 units for quarter 2 and a required ending inventory of 30%, or 300 units, Big Bad Bikes needs to have 1,300 units available during the quarter. Since 1,300 units needed to be available and there are zero units in beginning inventory, Big Bad Bikes needs to manufacture 1,300 units, as shown in  Figure 7.8 \n\n The ending inventory from one quarter is the beginning inventory for the next quarter and the calculations are all the same. In order to determine the ending inventory in quarter 4, Big Bad Bikes must estimate the sales for the first quarter of the next year. Big Bad Bikes\u2019s marketing department believes sales will increase in each of the next several quarters, and they estimate sales as 3,500 for the first quarter of the next year and 4,500 for the second quarter of the next year. Thirty percent of 3,500 is 1,050, so the number of units required in the ending inventory for quarter 4 is 1,050. \n\n The number of units needed in production for the first quarter of the next year provides information needed for other budgets such as the direct materials budget, so Big Bad Bikes must also determine the number of units needed in production for that first quarter. The estimated sales of 3,500 and the desired ending inventory of 1,350 (30% of the next quarter\u2019s estimated sales of 4,500) determines that 4,850 units are required during the quarter. The beginning inventory is estimated to be 1,050, which means the number of units that need to be produced during the first quarter of year 2 is 3,800. \n\n The number of units needed to be produced each quarter was computed from the estimated sales and is used to determine the quantity of direct or raw material to purchase, to schedule enough direct labor to manufacture the units, and to approximate the overhead required for production. It is also necessary to estimate the sales for the first quarter of the next year. The ending inventory for the current year is based on the sales estimates for the first quarter of the following year. From this amount, the production budget and direct materials budget are calculated and flow to the operating and cash budget. \n\n Direct Materials Budget \n\n From the production budget, management knows how many units need to be produced in each budget period. Management is already aware of how much material it needs to produce each unit and can combine the direct material per unit with the production budget to compute the  direct materials budget . This information is used to ensure the correct quantity of materials is ordered and the correct amount is budgeted for those materials. \n\n Similar to the production budget, management wants to have an ending inventory available to ensure there are enough materials on hand. The direct materials budget illustrates how much material needs to be ordered and how much that material costs. The calculation is similar to that used in the production budget, with the addition of the cost per unit. \n\n If Big Bad Bikes uses 3.2 pounds of material for each trainer it manufactures and each pound of material costs $1.25, we can create a direct materials budget. Management\u2019s goal is to have 20% of the next quarter\u2019s material needs on hand as the desired ending materials inventory. Therefore, the determination of each quarter\u2019s material needs is partially dependent on the following quarter\u2019s production requirements. The desired ending inventory of material is readily determined for quarters 1 through 3 as those needs are based on the production requirements for quarters 2 through 4. To compute the desired ending materials inventory for quarter 4, we need the production requirements for quarter 1 of year 2. Recall that the number of units to be produced during the first quarter of year 2 is 3,800. Thus, quarter 4 materials ending inventory requirement is 20% of 3,800. That information is used to compute the direct materials budget shown in  Figure 7.9 . \n\n Management knows how much the materials will cost and integrates this information into the schedule of expected cash disbursements, which will be shown in  Prepare Financial Budgets . This information will also be used in the budgeted income statement and on the budgeted balance sheet. With 6,000 units estimated for sale, 3.2 pounds of material per unit, and $1.25 per pound, the direct materials used represent $24,000 of the cost of goods sold. The remaining $7,240 is included in ending inventory as units completed and raw material. \n\n Direct Labor Budget \n\n Management uses the same information in the production budget to develop the  direct labor budget . This information is used to ensure that the proper amount of staff is available for production and that there is money available to pay for the labor, including potential overtime. Typically, the number of hours is computed and then multiplied by an hourly rate, so the total direct labor cost is known. \n\n If Big Bad Bikes knows that they need 45 minutes or 0.75 hours of direct labor for each unit produced, and the labor rate for this type of manufacturing is $20 per hour, the computation for direct labor simply begins with the number of units in the production budget. As shown in  Figure 7.10 , the number of units produced each quarter multiplied by the number of hours per unit equals the required direct labor hours needed to be scheduled in order to meet production needs. The total number of hours is next multiplied by the direct labor rate per hour, and the labor cost can be budgeted and used in the cash disbursement budget and operating budget illustrated in  Prepare Financial Budgets . \n\n The direct labor of $105,750 will be apportioned to the budgeted income statement and budgeted balance sheet. With 0.75 hours of direct labor per unit and $20 per direct labor hour, each unit will cost $15 in direct labor. Of the 7,050 units produced, 6,000 units will be sold, so $90,000 represents the labor portion of the cost of goods sold and will be shown on the income statement, while the remaining $15,750 will be the labor portion of ending inventory and will be shown on the balance sheet. \n\n Manufacturing Overhead Budget \n\n The  manufacturing overhead budget  includes the remainder of the production costs not covered by the direct materials and direct labor budgets. In the manufacturing overhead budgeting process, producers will typically allocate overhead costs depending upon their cost behavior production characteristics, which are generally classified as either variable or fixed. Based on this allocation process, the variable component will be treated as occurring proportionately in relation to budgeted activity, while the fixed component will be treated as remaining constant. This process is similar to the overhead allocation process you learned in studying product, process, or activity-based costing. \n\n For Big Bad Bikes to create their manufacturing overhead budget, they first determine that the appropriate driver for assigning overhead costs to products is direct labor hours. The overhead allocation rates for the variable overhead costs are: indirect material of $1.00 per hour, indirect labor of $1.25 per hour, maintenance of $0.25 per hour, and utilities of $0.50 per hour. The fixed overhead costs per quarter are: supervisor salaries of $15,000, fixed maintenance salaries of $4,000, insurance of $7,000, and depreciation expenses of $3,000. \n\n Given the direct labor hours for each quarter from the direct labor budget, the variable costs are the number of hours multiplied by the variable overhead application rate. The fixed costs are the same for each quarter, as shown in the manufacturing overhead budget in  Figure 7.11 . \n\n The total manufacturing overhead cost was $131,863 for 7,050 units, or $18.70 per unit (rounded). Since 6,000 units are sold, $112,200 (6,000 units \u00d7 $18.70 /unit) will be expensed as cost of goods sold, while the remaining $19,663 will be part of finished goods ending inventory. \n\n Sales and Administrative Expenses Budget \n\n The direct materials budget, the direct labor budget, and the manufacturing overhead budget plan for all costs related to production, while the  selling and administrative expense budget  contains a listing of variable and fixed expenses estimated to be incurred in all areas other than production costs. While this one budget contains all nonmanufacturing expenses, in practice, it actually comprises several small budgets created by managers in sales and administrative positions. All managers must follow the budget, but setting an appropriate budget for selling and administrative functions is complicated and is not always thoroughly understood by managers without a background in managerial accounting. \n\n If Big Bad Bikes pays a sales commission of $2 per unit sold and a transportation cost of $0.50 per unit, they can use these costs to put together their sales and administrative budget. All other costs are fixed costs per quarter: sales salaries of $5,000; administrative salaries of $5,000; marketing expenses of $5,000; insurance of $1,000; and depreciation of $2,000. The sales and administrative budget is shown in  Figure 7.12 , along with the budgeted sales used in the computation of variable sales and administrative expenses. \n\n Only manufacturing costs are treated as a product cost and included in ending inventory, so all of the expenses in the sales and administrative budget are period expenses and included in the budgeted income statement. \n\n Budgeted Income Statement \n\n A  budgeted income statement  is formatted similarly to a traditional income statement except that it contains budgeted data. Once all of the operating budgets have been created, these costs are used to prepare a budgeted income statement and budgeted balance sheet. The manufacturing costs are allocated to the cost of goods sold and the ending inventory. \n\n Big Bad Bikes uses the information on direct materials ( Figure 7.9 ), direct labor ( Figure 7.10 ), and manufacturing overhead ( Figure 7.11 ) to allocate the manufacturing costs between the cost of goods sold and the ending work in process inventory, as shown in ( Figure 7.13 ). \n\n Once they perform this allocation, the budgeted income statement can be prepared. Big Bad Bikes estimates an interest of $954. It also estimates that $22,000 of its income will not be collected and will be reported as uncollectible expense. The budgeted income statement is shown in  Figure 7.14 . \n\n Think It Through Errors in a Budgeted Balance Sheet Which error has the potential to cause more problems with the budgeted balance sheet: overstating sales or understating the cash collected? \n 7.3   Prepare Financial Budgets \n\n Now that you have developed an understanding of operating budgets, let\u2019s turn to the other primary component of the master budget: financial budgets. Preparing financial budgets involves examining the expectations for financing the operations of the business and planning for the cash needs of the organization. The budget helps estimate the source, amount, and timing of cash collection and cash payments as well as determine if and when additional financing is needed or debt can be paid. \n\n Individual Financial Budgets \n\n Preparing a financial budget first requires preparing the capital asset budget, the cash budgets, and the budgeted balance sheet. The capital asset budget represents a significant investment in cash, and the amount is carried to the cash budget. Therefore, it needs to be prepared before the cash budget. If the cash will not be available, the capital asset budget can be adjusted and, again, carried to the cash budget. \n\n When the budgets are complete, the beginning and ending balance from the cash budget, changes in financing, and changes in equity are shown on the budgeted balance sheet. \n\n Capital Asset Budget \n\n The  capital asset budget , also called the  capital expenditure budget , shows the company\u2019s plans to invest in long-term assets. Some assets, such as computers, must be replaced every few years, while other assets, such as manufacturing equipment, are purchased very infrequently. Some assets can be purchased with cash, whereas others may require a loan. Budgeting for these types of expenditures requires long-range planning because the purchases affect cash flows in current and future periods and affect the income statement due to depreciation and interest expenses. \n\n Cash Budget \n\n The  cash budget  is the combined budget of all inflows and outflows of cash. It should be divided into the shortest time period possible, so management can be quickly made aware of potential problems resulting from fluctuations in cash flow. One goal of this budget is to anticipate the timing of cash inflows and outflows, which allows a company to try to avoid a decrease in the cash balance due to paying out more cash than it receives. In order to provide timely feedback and alert management to short-term cash needs, the cash flow budget is commonly geared toward monthly or quarterly figures.  Figure 7.15  shows how the other budgets tie into the cash budget. \n\n Cash is so important to the operations of a company that, often, companies will arrange to have an emergency cash source, such as a  line of credit , to avoid defaulting on current payables due and also to protect against other unanticipated expenses, such as major repair costs on equipment. This line of credit would be similar in function to the  overdraft protection  offered on many checking accounts. \n\n Because the cash budget accounts for every inflow and outflow of cash, it is broken down into smaller components. The  cash collections schedule  includes all of the cash inflow expected to be received from customer sales, whether those customers pay at the same rate or even if they pay at all. The cash collections schedule includes all the cash expected to be received and does not include the amount of the receivables estimated as uncollectible. The  cash payments schedule  plans the outflow or payments of all accounts payable, showing when cash will be used to pay for direct material purchases. Both the cash collections schedule and the cash payments schedule are included along with other cash transactions in a cash budget. The cash budget, then, combines the cash collection schedule, the cash payment schedule, and all other budgets that plan for the inflow or outflow of cash. When everything is combined into one budget, that budget shows if financing arrangements are needed to maintain balances or if excess cash is available to pay for additional liabilities or assets. \n\n The operating budgets all begin with the sales budget. The cash collections schedule does as well. Since purchases are made at varying times during the period and cash is received from customers at varying rates, data are needed to estimate how much will be collected in the month of sale, the month after the sale, two months after the sale, and so forth. Bad debts also need to be estimated, since that is cash that will not be collected. \n\n To illustrate, let\u2019s return to Big Bad Bikes. They believe cash collections for the trainer sales will be similar to the collections from their bicycle sales, so they will use that pattern to budget cash collections for the trainers. In the quarter of sales, 65% of that quarter\u2019s sales will be collected. In the quarter after the sale, 30% will be collected. This leaves 5% of the sales considered uncollectible.  Figure 7.16  illustrates when each quarter\u2019s sales will be collected. An estimate of the net realizable balance of Accounts Receivable can be reconciled by using information from the cash collections schedule: \n\n For example, in quarter 1 of year 2, 65% of the quarter 1 sales will be collected in cash, as well as 30% of the sales from quarter 4 of the prior year. There were no sales in quarter 4 of the prior year so 30% of zero sales shows the collections are $0. Using information from Big Bad Bikes sales budget, the cash collections from the sales are shown in  Figure 7.17 . \n\n When the cash collections schedule is made for sales, management must account for other potential cash collections such as cash received from the sale of equipment or the issuance of stock. These are listed individually in the cash inflows portion of the cash budget. \n\n The cash payments schedule, on the other hand, shows when cash will be used to pay for Accounts Payable. One such example are direct material purchases, which originates from the direct materials budget. When the production budget is determined from the sales, management prepares the direct materials budget to determine when and how much material needs to be ordered. Orders for materials take place throughout the quarter, and payments for the purchases are made at different intervals from the orders. A schedule of cash payments is similar to the cash collections schedule, except that it accounts for the company\u2019s purchases instead of the company\u2019s sales. The information from the cash payments schedule feeds into the cash budget. \n\n Big Bad Bikes typically pays half of its purchases in the quarter of purchase. The remaining half is paid in the following quarter, so payments in the first quarter include payments for purchases made during the first quarter as well as half of the purchases for the preceding quarter.  Figure 7.18  shows when each quarter\u2019s purchases will be paid. Additionally, the balance of purchases in Accounts Payable can be reconciled by using information from the cash payment schedule as follows: \n\n The first quarter of the year plans cash payments from the prior quarter as well as the current quarter. Again, since the trainers are a new product, in this example, there are no purchases in the preceding quarter, and the payments are $0.  Figure 7.19 . \n\n While the cash payments schedule is made for purchases of material on account, there are other outflows of cash for the company, and management must estimate all other cash payments for the year. Typically, this includes the manufacturing overhead budget, the sales and administrative budget, the capital asset budget, and any other potential payments of cash. Since depreciation is an expense not requiring cash, the cash budget includes the amount from the budgets less depreciation. Cash payments are listed on the cash budget following cash receipts.  Figure 7.20  shows the major components of the cash budget. \n\n The cash budget totals the cash receipts and adds it to the beginning cash balance to determine the available cash. From the available cash, the cash payments are subtracted to compute the net cash excess or deficiency of cash for the quarter. This amount is the potential ending cash balance. Organizations typically require a minimum cash balance. If the potential ending cash balance does not meet the minimum amount, management must plan to acquire financing to reach that amount. If the potential ending cash balance exceeds the minimum cash balance, the excess amount may be used to pay any financing loans and interest. \n\n Big Bad Bikes has a minimum cash balance requirement of $10,000 and has a line of credit available for an interest rate of 19%. They also plan to issue additional capital stock for $5,000 in the first quarter, to pay taxes of $1,000 during each quarter, and to purchase a copier for $8,500 cash in the third quarter. The beginning cash balance for Big Bad Bikes is $13,000, which can be used to create the cash budget shown in  Figure 7.21 . \n\n Budgeted Balance Sheet \n\n The cash budget shows how cash changes from the beginning of the year to the end of the year, and the ending cash balance is the amount shown on the budgeted balance sheet. The  budgeted balance sheet  is the estimated assets, liabilities, and equities that the company would have at the end of the year if their performance were to meet its expectations.  Table 7.1  shows a list of the most common changes to the balance sheet and where the information is derived. \n\n Common Changes in the Budgeted Balance Sheet \n\n Information Source \n\n Balance Sheet Change \n\n Cash balance \n\n  ending cash balance from the cash budget \n\n Accounts Receivable balance \n\n  uncollected receivables from the cash collections schedule \n\n Inventory \n\n  ending balance in inventory as shown from calculations to create the income statement \n\n Machinery & Equipment \n\n  ending balance in the capital asset budget \n\n Accounts Payable \n\n  unpaid purchases from the cash payments schedule \n\n Table  7.1   \n\n Other balance sheet changes throughout the year are reflected in the income statement and statement of cash flows. For example, the beginning cash balance of Accounts Receivable plus the sales, less the cash collected results in the ending balance of Accounts Receivable. A similar formula is used to compute the ending balance in Accounts Payable. Other budgets and information such as the capital asset budget, depreciation, and financing loans are used as well. \n\n To explain how to use a budgeted balance sheet, let\u2019s return to Big Bad Bikes. For simplicity, assume that they did not have accounts receivable or payable at the beginning of the year. They also incurred and paid back their financing during the year, so there is no ending debt. However, the cash budget shows cash inflows and outflows not related to sales or the purchase of materials. The company\u2019s capital assets increased by $8,500 from the copier purchase, and their common stock increased by $5,000 from the additional issue as shown in  Figure 7.22 . \n\n Though there seem to be many budgets, they all fit together like a puzzle to create an overall picture of how a company expects the upcoming business year to look.  Figure 7.15  detailed the components of the master budget, and can be used to summarize the budget process. All budgets begin with the sales budget. This budget estimates the number of units that need to be manufactured and precedes the production budget. The production budget (refer to  Figure 7.6 ) provides the necessary information for the budgets needed to plan how many units will be produced. Knowing how many units need to be produced from the production budget, the direct materials budget, direct labor budget, and the manufacturing overhead budget are all prepared. The sales and administrative budget is a nonmanufacturing budget that relies on the sales estimates to pay commissions and other variable expenses. The sales and expenses estimated in all of these budgets are used to develop a budgeted income statement. \n\n The estimated sales information is used to prepare the cash collections schedule, and the direct materials budget is used to prepare the cash payment schedule. The cash receipts and cash payments budget are combined with the direct labor budget, the manufacturing overhead budget, the sales and administrative budget, and the capital assets budget to develop the cash budget. Finally, all the information is used to flow to the budgeted balance sheet. \n\n Your Turn Creating a Master Budget Molly Malone is starting her own company in which she will produce and sell Molly\u2019s Macaroons. Molly is trying to learn about the budget process as she puts her business plan together. Help Molly by explaining the optimal order for preparing the following budgets and schedules and why this is the optimal order. \n\n budgeted balance sheet \n\n budgeted income statement \n\n capital asset budget \n\n cash budget \n\n cash collections schedule \n\n cash payments schedule \n\n direct materials budget \n\n direct labor budget \n\n master budget \n\n manufacturing overhead \n\n production budget \n\n sales budget \n\n selling and administrative budget \n\n Solution \n\n A master budget always begins with the sales budget must be prepared first as this determines the number of units that will need to be produced. The next step would be to create the production budget, which helps determine the number of units that will need to be produced each period to meet sales goals. Once Molly knows how many units she will need to produce, she will need to budget the costs associated with those units, which will require her to create the direct materials budget, the direct labor budget and the manufacturing overhead budget. But Molly will have costs other than manufacturing costs so she will need to create a selling and administrative expenses budget. Molly will need to determine what are her capital asset needs and budget for those. Now that Molly has all her revenues budgeted and her costs budgeted, she can determine her budgeted cash inflows and outflows by putting together the cash schedules that lead to the cash budget. Molly will then need to create a cash collections schedule and a cash payments schedule and that information, along with the cash inflow and outflow information from her other budgets, will allow her to create her cash budget. Once Molly has completed her cash budget she will be able to put together her budgeted income statement and budgeted balance sheet. \n 7.4   Prepare Flexible Budgets \n\n A company makes a budget for the smallest time period possible so that management can find and adjust problems to minimize their impact on the business. Everything starts with the estimated sales, but what happens if the sales are more or less than expected? How does this affect the budget? What adjustments does a company have to make in order to compare the actual numbers to budgeted numbers when evaluating results? If production is higher than planned and has been increased to meet the increased sales, expenses will be over budget. But is this bad? To account for actual sales and expenses differing from budgeted sales and expenses, companies will often create flexible budgets to allow budgets to fluctuate with future demand. \n\n Flexible Budgets \n\n A  flexible budget  is one based on different volumes of sales. A flexible budget flexes the static budget for each anticipated level of production. This flexibility allows management to estimate what the budgeted numbers would look like at various levels of sales. Flexible budgets are prepared at each analysis period (usually monthly), rather than in advance, since the idea is to compare the operating income to the expenses deemed appropriate at the actual production level. \n\n Big Bad Bikes is planning to use a flexible budget when they begin making trainers. The company knows its variable costs per unit and knows it is introducing its new product to the marketplace. Its estimations of sales and sales price will likely change as the product takes hold and customers purchase it. Big Bad Bikes developed a flexible budget that shows the change in income and expenses as the number of units changes. It also looked at the effect a change in price would have if the number of units remained the same. The expenses that do not change are the fixed expenses, as shown in  Figure 7.23 . \n\n Static versus Flexible Budgets \n\n A  static budget  is one that is prepared based on a single level of output for a given period. The master budget, and all the budgets included in the master budget, are examples of static budgets. Actual results are compared to the static budget numbers as one means to evaluate company performance. However, this comparison may be like comparing apples to oranges because variable costs should follow production, which should follow sales. Thus, if sales differ from what is budgeted, then comparing actual costs to budgeted costs may not provide a clear indicator of how well the company is meeting its targets. A flexible budget created each period allows for a comparison of apples to apples because it will calculate budgeted costs based on the actual sales activity. \n\n For example,  Figure 7.24  shows a static quarterly budget for 1,500 trainers sold by Big Bad Bikes. The budget will change if there are more or fewer units sold. \n\n Budget with Varying Levels of Production \n\n Companies develop a budget based on their expectations for their most likely level of sales and expenses. Often, a company can expect that their production and sales volume will vary from budget period to budget period. They can use their various expected levels of production to create a flexible budget that includes these different levels of production. Then, they can modify the flexible budget when they have their actual production volume and compare it to the flexible budget for the same production volume. A flexible budget is more complicated, requires a solid understanding of a company\u2019s fixed and variable expenses, and allows for greater control over changes that occur throughout the year. For example, suppose a proposed sale of items does not occur because the expected client opted to go with another supplier. In a static budget situation, this would result in large variances in many accounts due to the static budget being set based on sales that included the potential large client. A flexible budget on the other hand would allow management to adjust their expectations in the budget for both changes in costs and revenue that would occur from the loss of the potential client. The changes made in the flexible budget would then be compared to what actually occurs to result in more realistic and representative variance. This ability to change the budget also makes it easier to pinpoint who is responsible if a revenue or cost target is missed. \n\n Big Bad Bikes used the flexible budget concept to develop a budget based on its expectation that production levels will vary by quarter. By the fourth quarter, sales are expected to be strong enough to pay back the financing from earlier in the year. The budget shown in  Figure 7.25  illustrates the payment of interest and contains information helpful to management when determining which items should be produced if production capacity is limited. \n\n Concepts In Practice Flexible Budgets and Sustainability The ability to provide flexible budgets can be critical in new or changing businesses where the accuracy of estimating sales or usage my not be strong. For example, organizations are often reporting their sustainability efforts and may have some products that require more electricity than other products. The reporting of the energy per unit of output has sometimes been in error and can mislead management into making changes that may or may not help the company. For example, based on the energy per unit reported, management may decide to change the product mix, the amount that is outsourced, and/or the amount that is produced. 1  If the energy output isn\u2019t correct, the decisions may be wrong and create an adverse impact on the budget. 1 Jon Bartley, et al. \u201cUsing Flexible Budgeting to Improve Sustainability Measures.:  American Institute of CPAs . Jan. 23, 2017. https://www.aicpa.org/interestareas/businessindustryandgovernment/resources/sustainability/improvesustainabilitymeasures.html \n\n Link to Learning \n\n In theory, a flexible budget is not difficult to develop since the variable costs change with production and the fixed costs remain the same. However, planning to meet an organization\u2019s goals can be very difficult if there are not many variable costs, if the cash inflows are relatively fixed, and if the fixed costs are high. For example, this  article shows some large U.S. cities are faced with complicated budgets  because of high fixed costs. \n 7.5   Explain How Budgets Are Used to Evaluate Goals \n\n As you\u2019ve learned, an advantage of budgeting is evaluating performance. Having a strong understanding of their budgets helps managers keep track of expenses and work toward the company\u2019s goals. Companies need to understand their revenue and expense details to develop budgets as a tool for planning operations and cash flow. Part of understanding revenue and expenses is evaluating the prior year. Did the company earn the expected profit? Could it have earned a higher profit? What expenses or revenues were not on the budget? Critically evaluating the actual results versus the estimated budgetary results can help management plan for the future.  Variance analysis  helps the manager analyze its results. It does not necessarily find a problem, but it does indicate where a problem may exist. The same is true for favorable variances as well as unfavorable variances. A favorable variance occurs when revenue is higher than budgeted or expenses are lower than budgeted. An unfavorable variance is when revenue is lower than budgeted or expenses are higher than budgeted. \n\n Comparing Favorable to Unfavorable Variances \n\n Favorable \n\n Unfavorable \n\n Actual Sales > Budgeted Sales \n\n Actual Sales < Budgeted Sales \n\n Actual Expenses < Budgeted Expenses \n\n Actual Expenses > Budgeted expenses \n\n Table  7.2   \n\n It is easy to understand that an unfavorable variance may be a problem. But that is not always true, as a higher labor rate may mean the company has a higher quality employee who is able to waste less material. Likewise, having a favorable variance indicates that more revenue was earned or less expenses were incurred but further analysis can indicate if costs were cut too far and better materials should have been purchased. \n\n If a company has only a static budget, meaningful comparisons are difficult. Analyzing the sales for Bid Bad Bikes will illustrate whether there was a profit and how net income impacts the company. In the third quarter, Big Bad Bikes sold 1,400 trainers and had third quarter net income of $15,915 as shown in  Figure 7.26 . \n\n The company earned a profit during the third quarter, but what does that mean to the company? Simply having net income instead of a net loss does not help plan for the future. The third quarter static budget was for the sale of 1,500 units. Comparing that budget to the actual results shows whether there is a favorable variance or an unfavorable variance. A comparison of the actual costs with the budget for the third quarter, as shown in  Figure 7.27 , has a favorable variance for all of the expenses and an unfavorable variance for everything associated with revenues. \n\n How do those results advise management when evaluating the company\u2019s performance? It is difficult to look at one variance and make a conclusion about the company or its management. However, the variances can help narrow down the areas that need addressing because they differ from the budgeted amount. For example, looking at the variance when using a static budget does not indicate the amount of the variance results because they sold 100 fewer units than budgeted. The variance for the cost of goods sold is favorable, but it should be if production was less than the budget. A static budget does not evaluate whether costs for 1,400 were appropriate for production of those 1,400 units. \n\n Using a static budget to evaluate performance affects the bottom line as well as the individual expenses. The net income for the sale of 1,400 units is less than the budgeted net income for 1,500 units, but it does not indicate whether expenses were appropriate for 1,400 units. If there had been 1,600 units sold, the expenses would be more than the budgeted amount, but sales would be higher. Would it be fair to evaluate a manager\u2019s control over their expenses using a static budget? \n\n Ethical Considerations Budget Manipulation and Ethics Training Why is ethics training important? An organization that bases a manager\u2019s evaluation and pay on how close to the budget the division performs may inadvertently encourage that manager to act unethically in order to get a pay raise. Many employees manipulate the budget process to enhance their earnings by garnering bonuses based upon questionably ethical behavior and improper financial reporting. Generally, this unethical behavior involves either manipulating the numbers in the budget or modifying the timing of reports to apply income to a different budget period. Kenton Walker and Gary Fleischman studied ethics in budgeting and determined that certain ethics-related structures in a business created a better operational environment. \n\n The study found that the existence of formal ethical codes, ethics training, good management role models, and social pressure to be disclosing within an organization can be a deterrent to budget manipulation by employees. The authors recommended: \u201cTherefore, organizations should carefully cultivate an ethical atmosphere that is sensitive to the pressures employees may feel to game the budget through actions that involve cheating and/or manipulating earnings targets to maximize bonuses.\u201d  2  The study concluded that requiring organizational ethics training that includes role playing helps teach ethical behavior in budgeting and other areas of business. Ethics training never goes out so style. 2 Kenton B. Walker, et al. \u201cToeing the Line: The Ethics of Manipulating Budgets and Earnings.\u201d  Management Accounting Quarterly  14, no. 3 (Spring 2013). https://www.imanet.org/-/media/f4869589d9d444de8c211d245a0192ff.ashx \n\n Evaluating the expenses on a flexible budget computed for the number of units sold would provide an indication of management\u2019s ability to control expenses. As shown in  Figure 7.28 , some expenses have a favorable variance, while others have an unfavorable variance. This type of variance analysis provides more information to evaluate management and help prepare the next year\u2019s budget. For example, the direct labor in the flexible budget comparison shows an unfavorable variance, meaning the direct labor expense was more than budgeted for the production of 1,400 units. When comparing direct labor expense, the direct labor in the static budget mentioned earlier was even larger because it computed direct labor required to manufacture 1,500 units. It is not surprising that the static budget variance is favorable because 100 fewer units were actually produced. However, that information is not as useful as the unfavorable variance when comparing 1,400 units produced versus the budgeted direct labor for 1,400 units used. \n\n Think It Through A Budget for a New Business You are beginning your own business and developed a budget based on modest sales and expense assumptions. The actual results are very close to the budget at the end of the first and second months. During the third month, both cash collected and paid differ significantly from the budget. What could be the cause and what should you do? \n\n Link to Learning \n\n Budgeting is only the beginning of the process. Evaluating the results to determine if the financial goals are being met can make the difference in whether an organization or individual meets its goals or not.  Forbes  recognizes that budgeting is an important personal task that should start early in one\u2019s professional career. This  article provides some custom budgeting guidelines for young adults  to help. ", "questions": [{"question": {"question_id": "fs-idm214666480", "question_text": "Which of the following is not a part of budgeting?", "question_choices": ["planning", "finding bottlenecks", "providing performance evaluations", "preventing net operating losses"], "cloze_format": "___  is not a part of budgeting.", "normal_format": "Which of the following is not a part of budgeting?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "bloom": null, "hl_sentences": "As you \u2019 ve learned , an advantage of budgeting is evaluating performance . Companies need to understand their revenue and expense details to develop budgets as a tool for planning operations and cash flow . Part of understanding revenue and expenses is evaluating the prior year . Critically evaluating the actual results versus the estimated budgetary results can help management plan for the future . Variance analysis helps the manager analyze its results . It does not necessarily find a problem , but it does indicate where a problem may exist .", "hl_context": "<hl> As you \u2019 ve learned , an advantage of budgeting is evaluating performance . <hl> Having a strong understanding of their budgets helps managers keep track of expenses and work toward the company \u2019 s goals . <hl> Companies need to understand their revenue and expense details to develop budgets as a tool for planning operations and cash flow . <hl> <hl> Part of understanding revenue and expenses is evaluating the prior year . <hl> Did the company earn the expected profit ? Could it have earned a higher profit ? What expenses or revenues were not on the budget ? <hl> Critically evaluating the actual results versus the estimated budgetary results can help management plan for the future . <hl> <hl> Variance analysis helps the manager analyze its results . <hl> <hl> It does not necessarily find a problem , but it does indicate where a problem may exist . <hl> The same is true for favorable variances as well as unfavorable variances . A favorable variance occurs when revenue is higher than budgeted or expenses are lower than budgeted . An unfavorable variance is when revenue is lower than budgeted or expenses are higher than budgeted ."}, {"question": {"question_id": "fs-idm206820480", "question_text": "Which of the following is an operating budget?", "question_choices": ["cash budget", "production budget", "tax budget", "capital budget"], "cloze_format": "___ is an operating budget.", "normal_format": "Which of the following is an operating budget?"}, "answer": {"ans_text": "production budget", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The operating budget helps plan future revenue and expenses and results in a projected income statement . The operating budget has several subsidiary budgets that all begin with projected sales . For example , management estimates sales for the upcoming few years . It then breaks down estimated sales into quarters , months , and weeks and prepares the sales budget . This information in units and in dollars becomes the production budget .", "hl_context": "The master budget has two major categories : the financial budget and the operating budget . The financial budget plans the use of assets and liabilities and results in a projected balance sheet . <hl> The operating budget helps plan future revenue and expenses and results in a projected income statement . <hl> <hl> The operating budget has several subsidiary budgets that all begin with projected sales . <hl> <hl> For example , management estimates sales for the upcoming few years . <hl> <hl> It then breaks down estimated sales into quarters , months , and weeks and prepares the sales budget . <hl> The sales budget is the foundation for other operating budgets . Management uses the number of units from the sales budget and the company \u2019 s inventory policy to determine how many units need to be produced . <hl> This information in units and in dollars becomes the production budget . <hl>"}, {"question": {"question_id": "fs-idm214249552", "question_text": "Which of the following is a finance budget?", "question_choices": ["cash budget", "production budget", "direct materials purchasing budget", "tax budget"], "cloze_format": "The ___  is a finance budget.", "normal_format": "Which of the following is a finance budget?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "A financial budget consists of the cash budget , the budgeted balance sheet , and the budget for capital expenses .", "hl_context": "<hl> A financial budget consists of the cash budget , the budgeted balance sheet , and the budget for capital expenses . <hl> Similar to the individual budgets that make up the operating budgets , the financial budgets serve to assist with planning and monitoring the financing requirements of the organization . Management plans its capital asset needs and states them in the capital expense budget . Management addresses its collection and payment policies to determine when it will receive cash from sales and when it will pay the material , labor , and overhead expenses . The capital expense budget and the estimated payment and collection of cash allow management to build a cash budget and determine when it will need financing or have additional funds to pay back loans . These budgets taken together will be part of the budgeted balance sheet . Figure 7.6 shows how these budgets relate ."}, {"question": {"question_id": "fs-idm200713264", "question_text": "Which approach requires management to justify all its expenditures?", "question_choices": ["bottom-up approach", "zero-based budgeting", "master budgeting", "capital allocation budgeting"], "cloze_format": "The approach that requires management to justify all its expenditures is the ___ .", "normal_format": "Which approach requires management to justify all its expenditures?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Zero-based budgeting begins with zero dollars and then adds to the budget only revenues and expenses that can be supported or justified . The advantage to zero-based budgeting is that unnecessary expenses are eliminated because managers cannot justify them .", "hl_context": "<hl> Zero-based budgeting begins with zero dollars and then adds to the budget only revenues and expenses that can be supported or justified . <hl> Figure 7.3 illustrates the difference between traditional budget preparation and zero-based budgeting in a bottom-up budgeting scenario . <hl> The advantage to zero-based budgeting is that unnecessary expenses are eliminated because managers cannot justify them . <hl> The drawback is that every expense needs to be justified , including obvious ones , so it takes a lot of time to complete . A compromise tactic is to use a zero-based budgeting approach for certain expenses , like travel , that can be easily justified and linked to the company goals ."}, {"question": {"question_id": "fs-idm218800864", "question_text": "Which of the following is true in a bottom-up budgeting approach?", "question_choices": ["Every expense needs to be justified.", "Supervisors tell departments their budget amount and the departments are free to work within those amounts.", "Departments budget their needs however they see fit.", "Departments determine their needs and relate them to the overall goals."], "cloze_format": "In a bottom-up budgeting approach it is true that ___.", "normal_format": "Which of the following is true in a bottom-up budgeting approach?"}, "answer": {"ans_text": "Supervisors tell departments their budget amount and the departments are free to work within those amounts.", "ans_choice": 1}, "bloom": null, "hl_sentences": "The bottom-up approach ( sometimes also named a self-imposed or participative budget ) begins at the lowest level of the company . After senior management has communicated the expected departmental goals , the departments then plans and predicts their sales and estimates the amount of resources needed to reach these goals . This information is communicated to the supervisor , who then passes it on to upper levels of management .", "hl_context": "<hl> The bottom-up approach ( sometimes also named a self-imposed or participative budget ) begins at the lowest level of the company . <hl> <hl> After senior management has communicated the expected departmental goals , the departments then plans and predicts their sales and estimates the amount of resources needed to reach these goals . <hl> <hl> This information is communicated to the supervisor , who then passes it on to upper levels of management . <hl> The advantages of this approach are that managers feel their work is valued and that knowledgeable individuals develop the budget with realistic numbers . Therefore , the budget is more likely to be attainable . The drawback is that managers may not fully understand or may misunderstand the strategic plan ."}, {"question": {"question_id": "fs-idm482017472", "question_text": "The most common budget is prepared for a ________.", "question_choices": ["week", "month", "quarter", "year"], "cloze_format": "The most common budget is prepared for a ________.", "normal_format": "For how long is the most common budget prepared?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "bloom": null, "hl_sentences": "The most common time period covered by a budget is one year , although the time period may vary from strategic , long-term budgets to very detailed , short-term budgets .", "hl_context": "All budgets are quantitative plans for the future and will be constructed based on the needs of the organization for which the budget is being created . Depending on the complexity , some budgets can take months or even years to develop . <hl> The most common time period covered by a budget is one year , although the time period may vary from strategic , long-term budgets to very detailed , short-term budgets . <hl> Generally , the closer the company is to the start of the budget \u2019 s time period , the more detailed the budget becomes ."}, {"question": {"question_id": "fs-idm213422192", "question_text": "Which of the operating budgets is prepared first?", "question_choices": ["production budget", "sales budget", "cash received budget", "cash payments budget"], "cloze_format": "The operating budget that is prepared first is the ___.", "normal_format": "Which of the operating budgets is prepared first?"}, "answer": {"ans_text": "sales budget", "ans_choice": 1}, "bloom": null, "hl_sentences": "The operating budget has several subsidiary budgets that all begin with projected sales . For example , management estimates sales for the upcoming few years . It then breaks down estimated sales into quarters , months , and weeks and prepares the sales budget . The sales budget is the foundation for other operating budgets .", "hl_context": "The master budget has two major categories : the financial budget and the operating budget . The financial budget plans the use of assets and liabilities and results in a projected balance sheet . The operating budget helps plan future revenue and expenses and results in a projected income statement . <hl> The operating budget has several subsidiary budgets that all begin with projected sales . <hl> <hl> For example , management estimates sales for the upcoming few years . <hl> <hl> It then breaks down estimated sales into quarters , months , and weeks and prepares the sales budget . <hl> <hl> The sales budget is the foundation for other operating budgets . <hl> Management uses the number of units from the sales budget and the company \u2019 s inventory policy to determine how many units need to be produced . This information in units and in dollars becomes the production budget ."}, {"question": {"question_id": "fs-idm223830944", "question_text": "The direct materials budget is prepared using which budget\u2019s information?", "question_choices": ["cash payments budget", "cash receipts budget", "production budget", "raw materials budget"], "cloze_format": "The budget\u2019s information that the direct materials budget is prepared using is the ___.", "normal_format": "The direct materials budget is prepared using which budget\u2019s information?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "bloom": null, "hl_sentences": "When the production budget is determined from the sales , management prepares the direct materials budget to determine when and how much material needs to be ordered . The direct materials budget illustrates how much material needs to be ordered and how much that material costs . Management is already aware of how much material it needs to produce each unit and can combine the direct material per unit with the production budget to compute the direct materials budget . This information is used to ensure the correct quantity of materials is ordered and the correct amount is budgeted for those materials .", "hl_context": "The cash payments schedule , on the other hand , shows when cash will be used to pay for Accounts Payable . One such example are direct material purchases , which originates from the direct materials budget . <hl> When the production budget is determined from the sales , management prepares the direct materials budget to determine when and how much material needs to be ordered . <hl> Orders for materials take place throughout the quarter , and payments for the purchases are made at different intervals from the orders . A schedule of cash payments is similar to the cash collections schedule , except that it accounts for the company \u2019 s purchases instead of the company \u2019 s sales . The information from the cash payments schedule feeds into the cash budget . Similar to the production budget , management wants to have an ending inventory available to ensure there are enough materials on hand . <hl> The direct materials budget illustrates how much material needs to be ordered and how much that material costs . <hl> The calculation is similar to that used in the production budget , with the addition of the cost per unit . From the production budget , management knows how many units need to be produced in each budget period . <hl> Management is already aware of how much material it needs to produce each unit and can combine the direct material per unit with the production budget to compute the direct materials budget . <hl> <hl> This information is used to ensure the correct quantity of materials is ordered and the correct amount is budgeted for those materials . <hl>"}, {"question": {"question_id": "fs-idm214782720", "question_text": "Which of the following is not an operating budget?", "question_choices": ["sales budget", "production budget", "direct labor budget", "cash budget"], "cloze_format": "___ is not an operating budget.", "normal_format": "Which of the following is not an operating budget?"}, "answer": {"ans_text": "cash budget", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The production budget is then broken up into budgets for materials , labor , and overhead , which use the standard quantity and standard price for raw materials that need to be purchased , the standard direct labor rate and the standard direct labor hours that need to be scheduled , and the standard costs for all other direct and indirect operating expenses . The operating budget has several subsidiary budgets that all begin with projected sales . For example , management estimates sales for the upcoming few years . The sales budget is the foundation for other operating budgets . This information in units and in dollars becomes the production budget .", "hl_context": "<hl> The production budget is then broken up into budgets for materials , labor , and overhead , which use the standard quantity and standard price for raw materials that need to be purchased , the standard direct labor rate and the standard direct labor hours that need to be scheduled , and the standard costs for all other direct and indirect operating expenses . <hl> Companies use the historic quantities of the amount of material per unit and the hours of direct labor per unit to compute a standard used to estimate the quantity of materials and labor hours needed for the expected level of production . Current costs are used to develop standard costs for the price of materials , the direct labor rate , as well as an estimate of overhead costs . The master budget has two major categories : the financial budget and the operating budget . The financial budget plans the use of assets and liabilities and results in a projected balance sheet . The operating budget helps plan future revenue and expenses and results in a projected income statement . <hl> The operating budget has several subsidiary budgets that all begin with projected sales . <hl> <hl> For example , management estimates sales for the upcoming few years . <hl> It then breaks down estimated sales into quarters , months , and weeks and prepares the sales budget . <hl> The sales budget is the foundation for other operating budgets . <hl> Management uses the number of units from the sales budget and the company \u2019 s inventory policy to determine how many units need to be produced . <hl> This information in units and in dollars becomes the production budget . <hl>"}, {"question": {"question_id": "fs-idm481549280", "question_text": "Which of the following statements is not correct?", "question_choices": ["The sales budget is computed by multiplying estimated sales by the sales price.", "The production budget begins with the sales estimated for each period.", "The direct materials budget begins with the sales estimated for each period.", "The sales budget is typically the first budget prepared."], "cloze_format": "The false statement is that ___ .", "normal_format": "Which of the following statements is not correct?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "From the production budget , management knows how many units need to be produced in each budget period . Management is already aware of how much material it needs to produce each unit and can combine the direct material per unit with the production budget to compute the direct materials budget .", "hl_context": "<hl> From the production budget , management knows how many units need to be produced in each budget period . <hl> <hl> Management is already aware of how much material it needs to produce each unit and can combine the direct material per unit with the production budget to compute the direct materials budget . <hl> This information is used to ensure the correct quantity of materials is ordered and the correct amount is budgeted for those materials ."}, {"question": {"question_id": "fs-idm219964864", "question_text": "The units required in production each period are computed by which of the following methods?", "question_choices": ["adding budgeted sales to the desired ending inventory and subtracting beginning inventory", "adding beginning inventory, budgeted sales, and desired ending inventory", "adding beginning inventory to budgeted sales and subtracting desired ending inventory", "adding budgeted sales to the beginning inventory and subtracting the desired ending inventory."], "cloze_format": "The units required in production each period are computed by the method of ___ .", "normal_format": "The units required in production each period are computed by which of the following methods?"}, "answer": {"ans_text": "adding budgeted sales to the desired ending inventory and subtracting beginning inventory", "ans_choice": 0}, "bloom": null, "hl_sentences": "When determining the number of units needed to be produced , start with the estimated sales plus the desired ending inventory to derive the maximum number of units that must be available during the period . Since the number of units in beginning inventory are already produced , subtracting the beginning inventory from the goods available results in the number of units that need to be produced .", "hl_context": "<hl> When determining the number of units needed to be produced , start with the estimated sales plus the desired ending inventory to derive the maximum number of units that must be available during the period . <hl> <hl> Since the number of units in beginning inventory are already produced , subtracting the beginning inventory from the goods available results in the number of units that need to be produced . <hl>"}, {"question": {"question_id": "fs-idm354528256", "question_text": "The cash budget is part of which category of budgets?", "question_choices": ["sales budget", "cash payments budget", "financial budget", "operating budget"], "cloze_format": "The category of budgets that the cash budget is part of is the ___.", "normal_format": "The cash budget is part of which category of budgets?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "bloom": null, "hl_sentences": "Preparing a financial budget first requires preparing the capital asset budget , the cash budgets , and the budgeted balance sheet . A financial budget consists of the cash budget , the budgeted balance sheet , and the budget for capital expenses .", "hl_context": "<hl> Preparing a financial budget first requires preparing the capital asset budget , the cash budgets , and the budgeted balance sheet . <hl> The capital asset budget represents a significant investment in cash , and the amount is carried to the cash budget . Therefore , it needs to be prepared before the cash budget . If the cash will not be available , the capital asset budget can be adjusted and , again , carried to the cash budget . <hl> A financial budget consists of the cash budget , the budgeted balance sheet , and the budget for capital expenses . <hl> Similar to the individual budgets that make up the operating budgets , the financial budgets serve to assist with planning and monitoring the financing requirements of the organization . Management plans its capital asset needs and states them in the capital expense budget . Management addresses its collection and payment policies to determine when it will receive cash from sales and when it will pay the material , labor , and overhead expenses . The capital expense budget and the estimated payment and collection of cash allow management to build a cash budget and determine when it will need financing or have additional funds to pay back loans . These budgets taken together will be part of the budgeted balance sheet . Figure 7.6 shows how these budgets relate ."}, {"question": {"question_id": "fs-idm348117824", "question_text": "Which is not a section of the cash budget?", "question_choices": ["cash receipts", "cash disbursements", "allowance for uncollectible accounts", "financing needs"], "cloze_format": "___ is not a section of the cash budget.", "normal_format": "Which is not a section of the cash budget?"}, "answer": {"ans_text": "allowance for uncollectible accounts", "ans_choice": 2}, "bloom": null, "hl_sentences": "The cash receipts and cash payments budget are combined with the direct labor budget , the manufacturing overhead budget , the sales and administrative budget , and the capital assets budget to develop the cash budget . The cash collections schedule includes all the cash expected to be received and does not include the amount of the receivables estimated as uncollectible .", "hl_context": "The estimated sales information is used to prepare the cash collections schedule , and the direct materials budget is used to prepare the cash payment schedule . <hl> The cash receipts and cash payments budget are combined with the direct labor budget , the manufacturing overhead budget , the sales and administrative budget , and the capital assets budget to develop the cash budget . <hl> Finally , all the information is used to flow to the budgeted balance sheet . Because the cash budget accounts for every inflow and outflow of cash , it is broken down into smaller components . The cash collections schedule includes all of the cash inflow expected to be received from customer sales , whether those customers pay at the same rate or even if they pay at all . <hl> The cash collections schedule includes all the cash expected to be received and does not include the amount of the receivables estimated as uncollectible . <hl> The cash payments schedule plans the outflow or payments of all accounts payable , showing when cash will be used to pay for direct material purchases . Both the cash collections schedule and the cash payments schedule are included along with other cash transactions in a cash budget . The cash budget , then , combines the cash collection schedule , the cash payment schedule , and all other budgets that plan for the inflow or outflow of cash . When everything is combined into one budget , that budget shows if financing arrangements are needed to maintain balances or if excess cash is available to pay for additional liabilities or assets ."}, {"question": {"question_id": "fs-idm617181376", "question_text": "Which budget is the starting point in preparing financial budgets?", "question_choices": ["the budgeted income statement", "the budgeted balance sheet", "the capital expense budget", "the cash receipts budget"], "cloze_format": "The budget that is the starting point in preparing financial budgets is ___.", "normal_format": "Which budget is the starting point in preparing financial budgets?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "A budgeted income statement is formatted similarly to a traditional income statement except that it contains budgeted data . Once all of the operating budgets have been created , these costs are used to prepare a budgeted income statement and budgeted balance sheet .", "hl_context": "<hl> A budgeted income statement is formatted similarly to a traditional income statement except that it contains budgeted data . <hl> <hl> Once all of the operating budgets have been created , these costs are used to prepare a budgeted income statement and budgeted balance sheet . <hl> The manufacturing costs are allocated to the cost of goods sold and the ending inventory ."}, {"question": {"question_id": "fs-idm348508704", "question_text": "Which of the following includes only financial budgets?", "question_choices": ["capital asset budget, budgeted income statement, sales budget", "production budget, capital asset budget, budgeted balance sheet", "cash budget, budgeted balance sheet, capital asset budget", "budgeted income statement, direct material purchases budget, cash budget"], "cloze_format": "___  include only financial budgets.", "normal_format": "Which of the following includes only financial budgets?"}, "answer": {"ans_text": "cash budget, budgeted balance sheet, capital asset budget", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Preparing a financial budget first requires preparing the capital asset budget , the cash budgets , and the budgeted balance sheet . The capital asset budget represents a significant investment in cash , and the amount is carried to the cash budget . Therefore , it needs to be prepared before the cash budget . A financial budget consists of the cash budget , the budgeted balance sheet , and the budget for capital expenses .", "hl_context": "<hl> Preparing a financial budget first requires preparing the capital asset budget , the cash budgets , and the budgeted balance sheet . <hl> <hl> The capital asset budget represents a significant investment in cash , and the amount is carried to the cash budget . <hl> <hl> Therefore , it needs to be prepared before the cash budget . <hl> If the cash will not be available , the capital asset budget can be adjusted and , again , carried to the cash budget . <hl> A financial budget consists of the cash budget , the budgeted balance sheet , and the budget for capital expenses . <hl> Similar to the individual budgets that make up the operating budgets , the financial budgets serve to assist with planning and monitoring the financing requirements of the organization . Management plans its capital asset needs and states them in the capital expense budget . Management addresses its collection and payment policies to determine when it will receive cash from sales and when it will pay the material , labor , and overhead expenses . The capital expense budget and the estimated payment and collection of cash allow management to build a cash budget and determine when it will need financing or have additional funds to pay back loans . These budgets taken together will be part of the budgeted balance sheet . Figure 7.6 shows how these budgets relate ."}, {"question": {"question_id": "fs-idm222609568", "question_text": "Which budget evaluates the results of operations at the actual level of activity?", "question_choices": ["capital budget", "cash budget", "flexible budget", "static budget"], "cloze_format": "The budget that evaluates the results of operations at the actual level of activity is the ___.", "normal_format": "Which budget evaluates the results of operations at the actual level of activity?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "A flexible budget is one based on different volumes of sales . A flexible budget flexes the static budget for each anticipated level of production . This flexibility allows management to estimate what the budgeted numbers would look like at various levels of sales . Flexible budgets are prepared at each analysis period ( usually monthly ) , rather than in advance , since the idea is to compare the operating income to the expenses deemed appropriate at the actual production level .", "hl_context": "<hl> A flexible budget is one based on different volumes of sales . <hl> <hl> A flexible budget flexes the static budget for each anticipated level of production . <hl> <hl> This flexibility allows management to estimate what the budgeted numbers would look like at various levels of sales . <hl> <hl> Flexible budgets are prepared at each analysis period ( usually monthly ) , rather than in advance , since the idea is to compare the operating income to the expenses deemed appropriate at the actual production level . <hl>"}, {"question": {"question_id": "fs-idm194894144", "question_text": "What is the main difference between static and flexible budgets?", "question_choices": ["The fixed manufacturing overhead is adjusted for units sold in the flexible budget.", "The variable manufacturing overhead is adjusted in the static budget.", "There is no difference between the budgets.", "The variable costs are adjusted in a flexible budget."], "cloze_format": "The main difference between static and flexible budgets is that ___ .", "normal_format": "What is the main difference between static and flexible budgets?"}, "answer": {"ans_text": "The variable costs are adjusted in a flexible budget.", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "A static budget is one that is prepared based on a single level of output for a given period . The master budget , and all the budgets included in the master budget , are examples of static budgets . Actual results are compared to the static budget numbers as one means to evaluate company performance . However , this comparison may be like comparing apples to oranges because variable costs should follow production , which should follow sales .", "hl_context": "<hl> A static budget is one that is prepared based on a single level of output for a given period . <hl> <hl> The master budget , and all the budgets included in the master budget , are examples of static budgets . <hl> <hl> Actual results are compared to the static budget numbers as one means to evaluate company performance . <hl> <hl> However , this comparison may be like comparing apples to oranges because variable costs should follow production , which should follow sales . <hl> Thus , if sales differ from what is budgeted , then comparing actual costs to budgeted costs may not provide a clear indicator of how well the company is meeting its targets . A flexible budget created each period allows for a comparison of apples to apples because it will calculate budgeted costs based on the actual sales activity ."}], "summary": " Summary 7.1   Describe How and Why Managers Use Budgets \n\n A good budgeting system assists management in reaching their goals through the planning and control of cash inflows through revenue and financing and outflows through payment and expenses. \n\n There are various budgeting strategies including bottom-up, top-down, and zero-based budgeting. \n\n A static budget is prepared at one level of activity, while a flexible budget allows the variable expenses to be adjusted for various levels of activity. \n\n A master budget includes the subcategories of operating budgets and financial budgets. \n\n A master budget is developed at the estimated level of activity. \n\n 7.2   Prepare Operating Budgets \n\n The sales budget is the first budget developed, and the estimated sales in turn guide the production budget. \n\n The production budget shows the quantity of goods produced for each time period and leads to computing when and how much direct material needs to be ordered, when and how much labor needs to be scheduled, and when and how much manufacturing overhead needs to be planned. \n\n The sales and administrative budget plans for the nonmanufacturing expenses. \n\n All operating budgets combine to develop the budgeted income statement. \n\n 7.3   Prepare Financial Budgets \n\n The financial budgets include the capital asset budget and the cash budget. The cash collections schedule and cash payments schedule are computed and combined with the other budgets to develop the cash budget. \n\n Information from the other budgets and the budgeted income statement are used to develop the budgeted balance sheet. \n\n 7.4   Prepare Flexible Budgets \n\n A master budget and related budgets are prepared as static budgets for the estimated level of activity. \n\n A flexible budget adjusts the budgets for various levels of activity and allows for the actual results to be evaluated at the actual volume of activity. \n\n 7.5   Explain How Budgets Are Used to Evaluate Goals \n\n Management\u2019s evaluations of the actual results versus the estimated budgetary results help plan for the future. \n\n Favorable variances occur when sales are higher or expenses are lower than budgeted. \n\n Unfavorable variances occur when sales are lower or expenses are higher than budgeted. ", "keyterm": "", "bname": "principles_of_accounting,_volume_2:_managerial_accounting"}, {"chapter": 14, "intro": " Chapter Outline 14.1   What Is Stress? 14.2   Stressors 14.3   Stress and Illness 14.4   Regulation of Stress 14.5   The Pursuit of Happiness Introduction \n\n Few would deny that today\u2019s college students are under a lot of pressure. In addition to many usual stresses and strains incidental to the college experience (e.g., exams, term papers, and the dreaded freshman 15), students today are faced with increased college tuitions, burdensome debt, and difficulty finding employment after graduation. A significant population of non-traditional college students may face additional stressors, such as raising children or holding down a full-time job while working toward a degree. \n\n Of course, life is filled with many additional challenges beyond those incurred in college or the workplace. We might have concerns with financial security, difficulties with friends or neighbors, family responsibilities, and we may not have enough time to do the things we want to do. Even minor hassles\u2014losing things, traffic jams, and loss of internet service\u2014all involve pressure and demands that can make life seem like a struggle and that can compromise our sense of well-being. That is, all can be stressful in some way. \n\n Scientific interest in stress, including how we adapt and cope, has been longstanding in psychology; indeed, after nearly a century of research on the topic, much has been learned and many insights have been developed. This chapter examines stress and highlights our current understanding of the phenomenon, including its psychological and physiological natures, its causes and consequences, and the steps we can take to master stress rather than become its victim. ", "chapter_text": " 14.1   What Is Stress? Learning Objectives By the end of this section, you will be able to:\n\n Differentiate between stimulus-based and response-based definitions of stress \n\n Define stress as a process \n\n Differentiate between good stress and bad stress \n\n Describe the early contributions of Walter Cannon and Hans Selye to the stress research field \n\n Understand the physiological basis of stress and describe the general adaptation syndrome \n\n The term  stress  as it relates to the human condition first emerged in scientific literature in the 1930s, but it did not enter the popular vernacular until the 1970s (Lyon, 2012). Today, we often use the term loosely in describing a variety of unpleasant feeling states; for example, we often say we are stressed out when we feel frustrated, angry, conflicted, overwhelmed, or fatigued. Despite the widespread use of the term, stress is a fairly vague concept that is difficult to define with precision. \n\n Researchers have had a difficult time agreeing on an acceptable definition of stress. Some have conceptualized stress as a demanding or threatening event or situation (e.g., a high-stress job, overcrowding, and long commutes to work). Such conceptualizations are known as stimulus-based definitions because they characterize stress as a stimulus that causes certain reactions. Stimulus-based definitions of stress are problematic, however, because they fail to recognize that people differ in how they view and react to challenging life events and situations. For example, a conscientious student who has studied diligently all semester would likely experience less stress during final exams week than would a less responsible, unprepared student. \n\n Others have conceptualized stress in ways that emphasize the physiological responses that occur when faced with demanding or threatening situations (e.g., increased arousal). These conceptualizations are referred to as response-based definitions because they describe stress as a response to environmental conditions. For example, the endocrinologist Hans  Selye , a famous stress researcher, once defined stress as the \u201cresponse of the body to any demand, whether it is caused by, or results in, pleasant or unpleasant conditions\u201d (Selye, 1976, p. 74). Selye\u2019s definition of stress is response-based in that it conceptualizes stress chiefly in terms of the body\u2019s physiological reaction to any demand that is placed on it. Neither stimulus-based nor response-based definitions provide a complete definition of stress. Many of the physiological reactions that occur when faced with demanding situations (e.g., accelerated heart rate) can also occur in response to things that most people would not consider to be genuinely stressful, such as receiving unanticipated good news: an unexpected promotion or raise. \n\n A useful way to conceptualize  stress  is to view it as a process whereby an individual perceives and responds to events that he appraises as overwhelming or threatening to his well-being (Lazarus & Folkman, 1984). A critical element of this definition is that it emphasizes the importance of how we appraise\u2014that is, judge\u2014demanding or threatening events (often referred to as  stressors ); these appraisals, in turn, influence our reactions to such events. Two kinds of appraisals of a stressor are especially important in this regard: primary and secondary appraisals. A  primary appraisal  involves judgment about the degree of potential harm or threat to well-being that a stressor might entail. A stressor would likely be appraised as a threat if one anticipates that it could lead to some kind of harm, loss, or other negative consequence; conversely, a stressor would likely be appraised as a challenge if one believes that it carries the potential for gain or personal growth. For example, an employee who is promoted to a leadership position would likely perceive the promotion as a much greater threat if she believed the promotion would lead to excessive work demands than if she viewed it as an opportunity to gain new skills and grow professionally. Similarly, a college student on the cusp of graduation may face the change as a threat or a challenge ( Figure 14.2 ). \n\n The perception of a threat triggers a  secondary appraisal : judgment of the options available to cope with a stressor, as well as perceptions of how effective such options will be (Lyon, 2012) ( Figure 14.3 ). As you may recall from what you learned about self-efficacy, an individual\u2019s belief in his ability to complete a task is important (Bandura, 1994). A threat tends to be viewed as less catastrophic if one believes something can be done about it (Lazarus & Folkman, 1984). Imagine that two middle-aged women, Robin and Maria, perform breast self-examinations one morning and each woman notices a lump on the lower region of her left breast. Although both women view the breast lump as a potential threat (primary appraisal), their secondary appraisals differ considerably. In considering the breast lump, some of the thoughts racing through Robin\u2019s mind are, \u201cOh my God, I could have breast cancer! What if the cancer has spread to the rest of my body and I cannot recover? What if I have to go through chemotherapy? I\u2019ve heard that experience is awful! What if I have to quit my job? My husband and I won\u2019t have enough money to pay the mortgage. Oh, this is just horrible\u2026I can\u2019t deal with it!\u201d On the other hand, Maria thinks, \u201cHmm, this may not be good. Although most times these things turn out to be benign, I need to have it checked out. If it turns out to be breast cancer, there are doctors who can take care of it because the medical technology today is quite advanced. I\u2019ll have a lot of different options, and I\u2019ll be just fine.\u201d Clearly, Robin and Maria have different outlooks on what might turn out to be a very serious situation: Robin seems to think that little could be done about it, whereas Maria believes that, worst case scenario, a number of options that are likely to be effective would be available. As such, Robin would clearly experience greater stress than would Maria. \n\n To be sure, some stressors are inherently more stressful than others in that they are more threatening and leave less potential for variation in cognitive appraisals (e.g., objective threats to one\u2019s health or safety). Nevertheless, appraisal will still play a role in augmenting or diminishing our reactions to such events (Everly & Lating, 2002). \n\n If a person appraises an event as harmful and believes that the demands imposed by the event exceed the available resources to manage or adapt to it, the person will subjectively experience a state of stress. In contrast, if one does not appraise the same event as harmful or threatening, she is unlikely to experience stress. According to this definition, environmental events trigger stress reactions by the way they are interpreted and the meanings they are assigned. In short, stress is largely in the eye of the beholder: it\u2019s not so much what happens to you as it is how you respond (Selye, 1976). \n\n Good Stress? Although stress carries a negative connotation, at times it may be of some benefit. Stress can motivate us to do things in our best interests, such as study for exams, visit the doctor regularly, exercise, and perform to the best of our ability at work. Indeed, Selye (1974) pointed out that not all stress is harmful. He argued that stress can sometimes be a positive, motivating force that can improve the quality of our lives. This kind of stress, which Selye called  eustress  (from the Greek  eu  = \u201cgood\u201d), is a good kind of stress associated with positive feelings, optimal health, and performance. A moderate amount of stress can be beneficial in challenging situations. For example, athletes may be motivated and energized by pregame stress, and students may experience similar beneficial stress before a major exam. Indeed, research shows that moderate stress can enhance both immediate and delayed recall of educational material. Male participants in one study who memorized a scientific text passage showed improved memory of the passage immediately after exposure to a mild stressor as well as one day following exposure to the stressor (Hupbach & Fieman, 2012). \n\n Increasing one\u2019s level of stress will cause performance to change in a predictable way. As shown in  Figure 14.4 , as stress increases, so do performance and general well-being (eustress); when stress levels reach an optimal level (the highest point of the curve), performance reaches its peak. A person at this stress level is colloquially at the top of his game, meaning he feels fully energized, focused, and can work with minimal effort and maximum efficiency. But when stress exceeds this optimal level, it is no longer a positive force\u2014it becomes excessive and debilitating, or what Selye termed  distress  (from the Latin  dis  = \u201cbad\u201d). People who reach this level of stress feel burned out; they are fatigued, exhausted, and their performance begins to decline. If the stress remains excessive, health may begin to erode as well (Everly & Lating, 2002). \n\n The Prevalence of Stress \n\n Stress is everywhere and, as shown in  Figure 14.5 , it has been on the rise over the last several years. Each of us is acquainted with stress\u2014some are more familiar than others. In many ways, stress feels like a load you just can\u2019t carry\u2014a feeling you experience when, for example, you have to drive somewhere in a crippling blizzard, when you wake up late the morning of an important job interview, when you run out of money before the next pay period, and before taking an important exam for which you realize you are not fully prepared. \n\n Stress is an experience that evokes a variety of responses, including those that are physiological (e.g., accelerated heart rate, headaches, or gastrointestinal problems), cognitive (e.g., difficulty concentrating or making decisions), and behavioral (e.g., drinking alcohol, smoking, or taking actions directed at eliminating the cause of the stress). Although stress can be positive at times, it can have deleterious health implications, contributing to the onset and progression of a variety of physical illnesses and diseases (Cohen & Herbert, 1996). \n\n The scientific study of how stress and other psychological factors impact health falls within the realm of  health psychology , a subfield of psychology devoted to understanding the importance of psychological influences on health, illness, and how people respond when they become ill (Taylor, 1999). Health psychology emerged as a discipline in the 1970s, a time during which there was increasing awareness of the role behavioral and lifestyle factors play in the development of illnesses and diseases (Straub, 2007). In addition to studying the connection between stress and illness, health psychologists investigate issues such as why people make certain lifestyle choices (e.g., smoking or eating unhealthy food despite knowing the potential adverse health implications of such behaviors). Health psychologists also design and investigate the effectiveness of interventions aimed at changing unhealthy behaviors. Perhaps one of the more fundamental tasks of health psychologists is to identify which groups of people are especially at risk for negative health outcomes, based on psychological or behavioral factors. For example, measuring differences in stress levels among demographic groups and how these levels change over time can help identify populations who may have an increased risk for illness or disease. \n\n Figure 14.6  depicts the results of three national surveys in which several thousand individuals from different demographic groups completed a brief stress questionnaire; the surveys were administered in 1983, 2006, and 2009 (Cohen & Janicki-Deverts, 2012). All three surveys demonstrated higher stress in women than in men. Unemployed individuals reported high levels of stress in all three surveys, as did those with less education and income; retired persons reported the lowest stress levels. However, from 2006 to 2009 the greatest increase in stress levels occurred among men, Whites, people aged 45\u201364, college graduates, and those with full-time employment. One interpretation of these findings is that concerns surrounding the 2008\u20132009 economic downturn (e.g., threat of or actual job loss and substantial loss of retirement savings) may have been especially stressful to White, college-educated, employed men with limited time remaining in their working careers. \n\n Early Contributions to the Study of Stress \n\n As previously stated, scientific interest in stress goes back nearly a century. One of the early pioneers in the study of stress was Walter  Cannon , an eminent American physiologist at Harvard Medical School ( Figure 14.7 ). In the early part of the 20th century, Cannon was the first to identify the body\u2019s physiological reactions to stress. \n\n Cannon and the Fight-or-Flight Response \n\n Imagine that you are hiking in the beautiful mountains of Colorado on a warm and sunny spring day. At one point during your hike, a large, frightening-looking black bear appears from behind a stand of trees and sits about 50 yards from you. The bear notices you, sits up, and begins to lumber in your direction. In addition to thinking, \u201cThis is definitely not good,\u201d a constellation of physiological reactions begins to take place inside you. Prompted by a deluge of epinephrine (adrenaline) and norepinephrine (noradrenaline) from your adrenal glands, your pupils begin to dilate. Your heart starts to pound and speeds up, you begin to breathe heavily and perspire, you get butterflies in your stomach, and your muscles become tense, preparing you to take some kind of direct action. Cannon proposed that this reaction, which he called the  fight-or-flight response , occurs when a person experiences very strong emotions\u2014especially those associated with a perceived threat (Cannon, 1932). During the fight-or-flight response, the body is rapidly aroused by activation of both the sympathetic nervous system and the endocrine system ( Figure 14.8 ). This arousal helps prepare the person to either fight or flee from a perceived threat. \n\n According to Cannon, the fight-or-flight response is a built-in mechanism that assists in maintaining homeostasis\u2014an internal environment in which physiological variables such as blood pressure, respiration, digestion, and temperature are stabilized at levels optimal for survival. Thus, Cannon viewed the fight-or-flight response as adaptive because it enables us to adjust internally and externally to changes in our surroundings, which is helpful in species survival. \n\n Selye and the General Adaptation Syndrome Another important early contributor to the stress field was Hans  Selye , mentioned earlier. He would eventually become one of the world\u2019s foremost experts in the study of stress ( Figure 14.9 ). As a young assistant in the biochemistry department at McGill University in the 1930s, Selye was engaged in research involving sex hormones in rats. Although he was unable to find an answer for what he was initially researching, he incidentally discovered that when exposed to prolonged negative stimulation (stressors)\u2014such as extreme cold, surgical injury, excessive muscular exercise, and shock\u2014the rats showed signs of adrenal enlargement, thymus and lymph node shrinkage, and stomach ulceration. Selye realized that these responses were triggered by a coordinated series of physiological reactions that unfold over time during continued exposure to a stressor. These physiological reactions were nonspecific, which means that regardless of the type of stressor, the same pattern of reactions would occur. What Selye discovered was the  general adaptation syndrome , the body\u2019s nonspecific physiological response to stress. \n\n The general adaptation syndrome, shown in  Figure 14.10 , consists of three stages: (1) alarm reaction, (2) stage of resistance, and (3) stage of exhaustion (Selye, 1936; 1976).  Alarm reaction  describes the body\u2019s immediate reaction upon facing a threatening situation or emergency, and it is roughly analogous to the fight-or-flight response described by Cannon. During an alarm reaction, you are alerted to a stressor, and your body alarms you with a cascade of physiological reactions that provide you with the energy to manage the situation. A person who wakes up in the middle of the night to discover her house is on fire, for example, is experiencing an alarm reaction. \n\n If exposure to a stressor is prolonged, the organism will enter the  stage of resistance . During this stage, the initial shock of alarm reaction has worn off and the body has adapted to the stressor. Nevertheless, the body also remains on alert and is prepared to respond as it did during the alarm reaction, although with less intensity. For example, suppose a child who went missing is still missing 72 hours later. Although the parents would obviously remain extremely disturbed, the magnitude of physiological reactions would likely have diminished over the 72 intervening hours due to some adaptation to this event. \n\n If exposure to a stressor continues over a longer period of time, the  stage of exhaustion  ensues. At this stage, the person is no longer able to adapt to the stressor: the body\u2019s ability to resist becomes depleted as physical wear takes its toll on the body\u2019s tissues and organs. As a result, illness, disease, and other permanent damage to the body\u2014even death\u2014may occur. If a missing child still remained missing after three months, the long-term stress associated with this situation may cause a parent to literally faint with exhaustion at some point or even to develop a serious and irreversible illness. \n\n In short, Selye\u2019s general adaptation syndrome suggests that stressors tax the body via a three-phase process\u2014an initial jolt, subsequent readjustment, and a later depletion of all physical resources\u2014that ultimately lays the groundwork for serious health problems and even death. It should be pointed out, however, that this model is a response-based conceptualization of stress, focusing exclusively on the body\u2019s physical responses while largely ignoring psychological factors such as appraisal and interpretation of threats. Nevertheless, Selye\u2019s model has had an enormous impact on the field of stress because it offers a general explanation for how stress can lead to physical damage and, thus, disease. As we shall discuss later, prolonged or repeated stress has been implicated in development of a number of disorders such as hypertension and coronary artery disease. \n\n The Physiological Basis of Stress \n\n What goes on inside our bodies when we experience stress? The physiological mechanisms of stress are extremely complex, but they generally involve the work of two systems\u2014the  sympathetic nervous system  and the  hypothalamic-pituitary-adrenal (HPA) axis . When a person first perceives something as stressful (Selye\u2019s alarm reaction), the sympathetic nervous system triggers arousal via the release of adrenaline from the adrenal glands. Release of these hormones activates the fight-or-flight responses to stress, such as accelerated heart rate and respiration. At the same time, the HPA axis, which is primarily endocrine in nature, becomes especially active, although it works much more slowly than the sympathetic nervous system. In response to stress, the hypothalamus (one of the limbic structures in the brain) releases corticotrophin-releasing factor, a hormone that causes the pituitary gland to release adrenocorticotropic hormone (ACTH) ( Figure 14.11 ). The ACTH then activates the adrenal glands to secrete a number of hormones into the bloodstream; an important one is cortisol, which can affect virtually every organ within the body.  Cortisol  is commonly known as a stress hormone and helps provide that boost of energy when we first encounter a stressor, preparing us to run away or fight. However, sustained elevated levels of cortisol weaken the immune system. \n\n In short bursts, this process can have some favorable effects, such as providing extra energy, improving  immune system  functioning temporarily, and decreasing pain sensitivity. However, extended release of cortisol\u2014as would happen with prolonged or chronic stress\u2014often comes at a high price. High levels of cortisol have been shown to produce a number of harmful effects. For example, increases in cortisol can significantly weaken our immune system (Glaser & Kiecolt-Glaser, 2005), and high levels are frequently observed among depressed individuals (Geoffroy, Hertzman, Li, & Power, 2013). In summary, a stressful event causes a variety of physiological reactions that activate the adrenal glands, which in turn release epinephrine, norepinephrine, and cortisol. These hormones affect a number of bodily processes in ways that prepare the stressed person to take direct action, but also in ways that may heighten the potential for illness. \n\n When stress is extreme or chronic, it can have profoundly negative consequences. For example, stress often contributes to the development of certain psychological disorders, including post-traumatic stress disorder, major depressive disorder, and other serious psychiatric conditions. Additionally, we noted earlier that stress is linked to the development and progression of a variety of physical illnesses and diseases. For example, researchers in one study found that people injured during the September 11, 2001, World Trade Center disaster or who developed post-traumatic stress symptoms afterward later suffered significantly elevated rates of heart disease (Jordan, Miller-Archie, Cone, Morabia, & Stellman, 2011). Another investigation yielded that self-reported stress symptoms among aging and retired Finnish food industry workers were associated with morbidity 11 years later. This study also predicted the onset of musculoskeletal, nervous system, and endocrine and metabolic disorders (Salonen, Arola, Nyg\u00e5rd, & Huhtala, 2008). Another study reported that male South Korean manufacturing employees who reported high levels of work-related stress were more likely to catch the common cold over the next several months than were those employees who reported lower work-related stress levels (Park et al., 2011). Later, you will explore the mechanisms through which stress can produce physical illness and disease. \n 14.2   Stressors Learning Objectives By the end of this section, you will be able to:\n\n Describe different types of possible stressors \n\n Explain the importance of life changes as potential stressors \n\n Describe the Social Readjustment Rating Scale \n\n Understand the concepts of job strain and job burnout \n\n For an individual to experience  stress , he must first encounter a potential  stressor . In general, stressors can be placed into one of two broad categories: chronic and acute. Chronic stressors include events that persist over an extended period of time, such as caring for a parent with dementia, long-term unemployment, or imprisonment. Acute stressors involve brief focal events that sometimes continue to be experienced as overwhelming well after the event has ended, such as falling on an icy sidewalk and breaking your leg (Cohen, Janicki-Deverts, & Miller, 2007). Whether chronic or acute, potential stressors come in many shapes and sizes. They can include major traumatic events, significant life changes, daily hassles, as well as other situations in which a person is regularly exposed to threat, challenge, or danger. \n\n Traumatic Events \n\n Some stressors involve traumatic events or situations in which a person is exposed to actual or threatened death or serious injury. Stressors in this category include exposure to military combat, threatened or actual physical assaults (e.g., physical attacks, sexual assault, robbery, childhood abuse), terrorist attacks, natural disasters (e.g., earthquakes, floods, hurricanes), and automobile accidents. Men, non-Whites, and individuals in lower socioeconomic status (SES) groups report experiencing a greater number of traumatic events than do women, Whites, and individuals in higher SES groups (Hatch & Dohrenwend, 2007). Some individuals who are exposed to stressors of extreme magnitude develop post-traumatic stress disorder (PTSD): a chronic stress reaction characterized by experiences and behaviors that may include intrusive and painful memories of the stressor event, jumpiness, persistent negative emotional states, detachment from others, angry outbursts, and avoidance of reminders of the event (American Psychiatric Association [APA], 2013). \n\n Life Changes \n\n Most stressors that we encounter are not nearly as intense as the ones described above. Many potential stressors we face involve events or situations that require us to make changes in our ongoing lives and require time as we adjust to those changes. Examples include death of a close family member, marriage, divorce, and moving ( Figure 14.12 ). \n\n In the 1960s, psychiatrists Thomas  Holmes  and Richard  Rahe  wanted to examine the link between life stressors and physical illness, based on the hypothesis that life events requiring significant changes in a person\u2019s normal life routines are stressful, whether these events are desirable or undesirable. They developed the  Social Readjustment Rating Scale (SRRS) , consisting of 43 life events that require varying degrees of personal readjustment (Holmes & Rahe, 1967). Many life events that most people would consider pleasant (e.g., holidays, retirement, marriage) are among those listed on the SRRS; these are examples of eustress. Holmes and Rahe also proposed that life events can add up over time, and that experiencing a cluster of stressful events increases one\u2019s risk of developing physical illnesses. \n\n In developing their scale, Holmes and Rahe asked 394 participants to provide a numerical estimate for each of the 43 items; each estimate corresponded to how much readjustment participants felt each event would require. These estimates resulted in mean value scores for each event\u2014often called life change units (LCUs) (Rahe, McKeen, & Arthur, 1967). The numerical scores ranged from 11 to 100, representing the perceived magnitude of life change each event entails. Death of a spouse ranked highest on the scale with 100 LCUs, and divorce ranked second highest with 73 LCUs. In addition, personal injury or illness, marriage, and job termination also ranked highly on the scale with 53, 50, and 47 LCUs, respectively. Conversely, change in residence (20 LCUs), change in eating habits (15 LCUs), and vacation (13 LCUs) ranked low on the scale ( Table 14.1 ). Minor violations of the law ranked the lowest with 11 LCUs. To complete the scale, participants checked yes for events experienced within the last 12 months. LCUs for each checked item are totaled for a score quantifying the amount of life change. Agreement on the amount of adjustment required by the various life events on the SRRS is highly consistent, even cross-culturally (Holmes & Masuda, 1974). \n\n Life event \n\n Life change units \n\n Death of a close family member \n\n 63 \n\n Personal injury or illness \n\n 53 \n\n Dismissal from work \n\n 47 \n\n Change in financial state \n\n 38 \n\n Change to different line of work \n\n 36 \n\n Outstanding personal achievement \n\n 28 \n\n Beginning or ending school \n\n 26 \n\n Change in living conditions \n\n 25 \n\n Change in working hours or conditions \n\n 20 \n\n Change in residence \n\n 20 \n\n Change in schools \n\n 20 \n\n Change in social activities \n\n 18 \n\n Change in sleeping habits \n\n 16 \n\n Change in eating habits \n\n 15 \n\n Minor violation of the law \n\n 11 \n\n Table  14.1   Some Stressors on the Social Readjustment Rating Scale (Holmes & Rahe, 1967) Extensive research has demonstrated that accumulating a high number of life change units within a brief period of time (one or two years) is related to a wide range of physical illnesses (even accidents and athletic injuries) and mental health problems (Monat & Lazarus, 1991; Scully, Tosi, & Banning, 2000). In an early demonstration, researchers obtained LCU scores for U.S. and Norwegian Navy personnel who were about to embark on a six-month voyage. A later examination of medical records revealed positive (but small) correlations between LCU scores prior to the voyage and subsequent illness symptoms during the ensuing six-month journey (Rahe, 1974). In addition, people tend to experience more physical symptoms, such as backache, upset stomach, diarrhea, and acne, on specific days in which self-reported LCU values are considerably higher than normal, such as the day of a family member\u2019s wedding (Holmes & Holmes, 1970). \n\n The Social Readjustment Rating Scale (SRRS) provides researchers a simple, easy-to-administer way of assessing the amount of stress in people\u2019s lives, and it has been used in hundreds of studies (Thoits, 2010). Despite its widespread use, the scale has been subject to criticism. First, many of the items on the SRRS are vague; for example, death of a close friend could involve the death of a long-absent childhood friend that requires little social readjustment (Dohrenwend, 2006). In addition, some have challenged its assumption that undesirable life events are no more stressful than desirable ones (Derogatis & Coons, 1993). However, most of the available evidence suggests that, at least as far as mental health is concerned, undesirable or negative events are more strongly associated with poor outcomes (such as depression) than are desirable, positive events (Hatch & Dohrenwend, 2007). Perhaps the most serious criticism is that the scale does not take into consideration respondents\u2019 appraisals of the life events it contains. As you recall, appraisal of a stressor is a key element in the conceptualization and overall experience of stress. Being fired from work may be devastating to some but a welcome opportunity to obtain a better job for others. The SRRS remains one of the most well-known instruments in the study of stress, and it is a useful tool for identifying potential stress-related health outcomes (Scully et al., 2000). \n\n Link to Learning \n\n Go to this  site  to complete the SRRS scale and determine the total number of LCUs you have experienced over the last year. \n\n Connect the Concepts Correlational Research The Holmes and Rahe Social Readjustment Rating Scale (SRRS) uses the  correlational research  method to identify the connection between stress and health. That is, respondents\u2019 LCU scores are correlated with the number or frequency of self-reported symptoms indicating health problems. These correlations are typically positive\u2014as LCU scores increase, the number of symptoms increase. Consider all the thousands of studies that have used this scale to correlate stress and illness symptoms: If you were to assign an average correlation coefficient to this body of research, what would be your best guess? How strong do you think the correlation coefficient would be? Why can\u2019t the SRRS show a causal relationship between stress and illness? If it were possible to show causation, do you think stress causes illness or illness causes stress? \n\n Hassles \n\n Potential stressors do not always involve major life events.  Daily hassles \u2014the minor irritations and annoyances that are part of our everyday lives (e.g., rush hour traffic, lost keys, obnoxious coworkers, inclement weather, arguments with friends or family)\u2014can build on one another and leave us just as stressed as life change events ( Figure 14.13 ) (Kanner, Coyne, Schaefer, & Lazarus, 1981). \n\n Researchers have demonstrated that the frequency of daily hassles is actually a better predictor of both physical and psychological health than are life change units. In a well-known study of San Francisco residents, the frequency of daily hassles was found to be more strongly associated with physical health problems than were life change events (DeLongis, Coyne, Dakof, Folkman, & Lazarus, 1982). In addition, daily minor hassles, especially interpersonal conflicts, often lead to negative and distressed mood states (Bolger, DeLongis, Kessler, & Schilling, 1989). Cyber hassles that occur on social media may represent a new source of stress. In one investigation, undergraduates who, over a 10-week period, reported greater Facebook-induced stress (e.g., guilt or discomfort over rejecting friend requests and anger or sadness over being unfriended by another) experienced increased rates of upper respiratory infections, especially if they had larger social networks (Campisi et al., 2012). Clearly, daily hassles can add up and take a toll on us both emotionally and physically. \n\n Other Stressors \n\n Stressors can include situations in which one is frequently exposed to challenging and unpleasant events, such as difficult, demanding, or unsafe working conditions. Although most jobs and occupations can at times be demanding, some are clearly more stressful than others ( Figure 14.14 ). For example, most people would likely agree that a firefighter\u2019s work is inherently more stressful than that of a florist. Equally likely, most would agree that jobs containing various unpleasant elements, such as those requiring exposure to loud noise (heavy equipment operator), constant harassment and threats of physical violence (prison guard), perpetual frustration (bus driver in a major city), or those mandating that an employee work alternating day and night shifts (hotel desk clerk), are much more demanding\u2014and thus, more stressful\u2014than those that do not contain such elements.  Table 14.2  lists several occupations and some of the specific stressors associated with those occupations (Sulsky & Smith, 2005). \n\n Occupation \n\n Stressors Specific to Occupation (Sulsky & Smith, 2005) \n\n Police officer \n\n physical dangers, excessive paperwork, red tape, dealing with court system, coworker and supervisor conflict, lack of support from the public \n\n Firefighter \n\n uncertainty over whether a serious fire or hazard awaits after an alarm \n\n Social worker \n\n little positive feedback from jobs or from the public, unsafe work environments, frustration in dealing with bureaucracy, excessive paperwork, sense of personal responsibility for clients, work overload \n\n Teacher \n\n Excessive paperwork, lack of adequate supplies or facilities, work overload, lack of positive feedback, vandalism, threat of physical violence \n\n Nurse \n\n Work overload, heavy physical work, patient concerns (dealing with death and medical concerns), interpersonal problems with other medical staff (especially physicians) \n\n Emergency medical worker \n\n Unpredictable and extreme nature of the job, inexperience  \n\n Air traffic controller \n\n Little control over potential crisis situations and workload, fear of causing an accident, peak traffic situations, general work environment \n\n Clerical and secretarial work \n\n Little control over job mobility, unsupportive supervisors, work overload, lack of perceived control  \n\n Managerial work \n\n Work overload, conflict and ambiguity in defining the managerial role, difficult work relationships \n\n Table  14.2   Occupations and Their Related Stressors \n\n Although the specific stressors for these occupations are diverse, they seem to share two common denominators: heavy workload and uncertainty about and lack of control over certain aspects of a job. Both of these factors contribute to  job strain , a work situation that combines excessive job demands and workload with little discretion in decision making or job control (Karasek & Theorell, 1990). Clearly, many occupations other than the ones listed in  Table 14.2  involve at least a moderate amount of job strain in that they often involve heavy workloads and little job control (e.g., inability to decide when to take breaks). Such jobs are often low-status and include those of factory workers, postal clerks, supermarket cashiers, taxi drivers, and short-order cooks. Job strain can have adverse consequences on both physical and mental health; it has been shown to be associated with increased risk of hypertension (Schnall & Landsbergis, 1994), heart attacks (Theorell et al., 1998), recurrence of heart disease after a first heart attack (Aboa-\u00c9boul\u00e9 et al., 2007), significant weight loss or gain (Kivim\u00e4ki et al., 2006), and major depressive disorder (Stansfeld, Shipley, Head, & Fuhrer, 2012). A longitudinal study of over 10,000 British civil servants reported that workers under 50 years old who earlier had reported high job strain were 68% more likely to later develop heart disease than were those workers under 50 years old who reported little job strain (Chandola et al., 2008). \n\n Some people who are exposed to chronically stressful work conditions can experience  job burnout , which is a general sense of emotional exhaustion and cynicism in relation to one\u2019s job (Maslach & Jackson, 1981). Job burnout occurs frequently among those in human service jobs (e.g., social workers, teachers, therapists, and police officers). Job burnout consists of three dimensions. The first dimension is exhaustion\u2014a sense that one\u2019s emotional resources are drained or that one is at the end of her rope and has nothing more to give at a psychological level. Second, job burnout is characterized by depersonalization: a sense of emotional detachment between the worker and the recipients of his services, often resulting in callous, cynical, or indifferent attitudes toward these individuals. Third, job burnout is characterized by diminished personal accomplishment, which is the tendency to evaluate one\u2019s work negatively by, for example, experiencing dissatisfaction with one\u2019s job-related accomplishments or feeling as though one has categorically failed to influence others\u2019 lives through one\u2019s work. \n\n Job strain appears to be one of the greatest risk factors leading to job burnout, which is most commonly observed in workers who are older (ages 55\u201364), unmarried, and whose jobs involve manual labor. Heavy alcohol consumption, physical inactivity, being overweight, and having a physical or lifetime mental disorder are also associated with job burnout (Ahola, et al., 2006). In addition, depression often co-occurs with job burnout. One large-scale study of over 3,000 Finnish employees reported that half of the participants with severe job burnout had some form of depressive disorder (Ahola et al., 2005). Job burnout is often precipitated by feelings of having invested considerable energy, effort, and time into one\u2019s work while receiving little in return (e.g., little respect or support from others or low pay) (Tatris, Peeters, Le Blanc, Schreurs, & Schaufeli, 2001). \n\n As an illustration, consider CharlieAnn, a nursing assistant who worked in a nursing home. CharlieAnn worked long hours for little pay in a difficult facility. Her supervisor was domineering, unpleasant, and unsupportive; he was disrespectful of CharlieAnn\u2019s personal time, frequently informing her at the last minute she must work several additional hours after her shift ended or that she must report to work on weekends. CharlieAnn had very little autonomy at her job. She had little say in her day-to-day duties and how to perform them, and she was not permitted to take breaks unless her supervisor explicitly told her that she could. CharlieAnn did not feel as though her hard work was appreciated, either by supervisory staff or by the residents of the home. She was very unhappy over her low pay, and she felt that many of the residents treated her disrespectfully. \n\n After several years, CharlieAnn began to hate her job. She dreaded going to work in the morning, and she gradually developed a callous, hostile attitude toward many of the residents. Eventually, she began to feel as though she could no longer help the nursing home residents. CharlieAnn\u2019s absenteeism from work increased, and one day she decided that she had had enough and quit. She now has a job in sales, vowing never to work in nursing again. \n\n Link to Learning \n\n A humorous example illustrating lack of supervisory support can be found in the 1999 comedy  Office Space . Follow  this link  to view a brief excerpt in which a sympathetic character\u2019s insufferable boss makes a last-minute demand that he \u201cgo ahead and come in\u201d to the office on both Saturday and Sunday. \n\n Finally, our close relationships with friends and family\u2014particularly the negative aspects of these relationships\u2014can be a potent source of stress. Negative aspects of close relationships can include adverse exchanges and conflicts, lack of emotional support or confiding, and lack of reciprocity. All of these can be overwhelming, threatening to the relationship, and thus stressful. Such stressors can take a toll both emotionally and physically. A longitudinal investigation of over 9,000 British civil servants found that those who at one point had reported the highest levels of negative interactions in their closest relationship were 34% more likely to experience serious heart problems (fatal or nonfatal heart attacks) over a 13\u201315 year period, compared to those who experienced the lowest levels of negative interaction (De Vogli, Chandola & Marmot, 2007). \n 14.3   Stress and Illness Learning Objectives By the end of this section, you will be able to:\n\n Explain the nature of psychophysiological disorders \n\n Describe the immune system and how stress impacts its functioning \n\n Describe how stress and emotional factors can lead to the development and exacerbation of cardiovascular disorders, asthma, and tension headaches \n\n In this section, we will discuss  stress  and illness. As stress researcher Robert Sapolsky (1998) describes,\n\n stress-related disease emerges, predominantly, out of the fact that we so often activate a physiological system that has evolved for responding to acute physical emergencies, but we turn it on for months on end, worrying about mortgages, relationships, and promotions. (p. 6) \n\n The stress response, as noted earlier, consists of a coordinated but complex system of physiological reactions that are called upon as needed. These reactions are beneficial at times because they prepare us to deal with potentially dangerous or threatening situations (for example, recall our old friend, the fearsome bear on the trail). However, health is affected when physiological reactions are sustained, as can happen in response to ongoing stress. \n\n Psychophysiological Disorders \n\n If the reactions that compose the stress response are chronic or if they frequently exceed normal ranges, they can lead to cumulative wear and tear on the body, in much the same way that running your air conditioner on full blast all summer will eventually cause wear and tear on it. For example, the high blood pressure that a person under considerable job strain experiences might eventually take a toll on his heart and set the stage for a heart attack or heart failure. Also, someone exposed to high levels of the stress hormone cortisol might become vulnerable to infection or disease because of weakened immune system functioning (McEwen, 1998). \n\n Link to Learning \n\n Robert Sapolsky, a noted Stanford University neurobiologist and professor, has for over 30 years conducted extensive research on stress, its impact on our bodies, and how psychological tumult can escalate stress\u2014even in baboons. Here are two videos featuring Dr. Sapolsky: one is regarding  killer stress  and the other is an excellent  in-depth documentary  from  National Geographic . \n\n Physical disorders or diseases whose symptoms are brought about or worsened by stress and emotional factors are called  psychophysiological disorders . The physical symptoms of psychophysiological disorders are real and they can be produced or exacerbated by psychological factors (hence the  psycho  and  physiological  in psychophysiological). A list of frequently encountered psychophysiological disorders is provided in  Table 14.3 . \n\n Type of Psychophysiological Disorder \n\n Examples \n\n Cardiovascular  \n\n hypertension, coronary heart disease \n\n Gastrointestinal  \n\n irritable bowel syndrome \n\n Respiratory  \n\n asthma, allergy \n\n Musculoskeletal  \n\n low back pain, tension headaches \n\n Skin  \n\n acne, eczema, psoriasis \n\n Table  14.3   Types of Psychophysiological Disorders (adapted from Everly & Lating, 2002) In addition to stress itself, emotional upset and certain stressful personality traits have been proposed as potential contributors to ill health. Franz Alexander (1950), an early-20th-century psychoanalyst and physician, once postulated that various diseases are caused by specific unconscious conflicts. For example, he linked hypertension to repressed anger, asthma to separation anxiety, and ulcers to an unconscious desire to \u201cremain in the dependent infantile situation\u2014to be loved and cared for\u201d (Alexander, 1950, p. 102). Although hypertension does appear to be linked to anger (as you will learn below), Alexander\u2019s assertions have not been supported by research. Years later, Friedman and Booth-Kewley (1987), after statistically reviewing 101 studies examining the link between personality and illness, proposed the existence of disease-prone personality characteristics, including depression, anger/hostility, and anxiety. Indeed, a study of over 61,000 Norwegians identified depression as a risk factor for all major disease-related causes of death (Mykletun et al., 2007). In addition, neuroticism\u2014a personality trait that reflects how anxious, moody, and sad one is\u2014has been identified as a risk factor for chronic health problems and mortality (Ploubidis & Grundy, 2009). \n\n Below, we discuss two kinds of psychophysiological disorders about which a great deal is known: cardiovascular disorders and asthma. First, however, it is necessary to turn our attention to a discussion of the immune system\u2014one of the major pathways through which stress and emotional factors can lead to illness and disease. \n\n Stress and the Immune System \n\n In a sense, the  immune system  is the body\u2019s surveillance system. It consists of a variety of structures, cells, and mechanisms that serve to protect the body from invading toxins and microorganisms that can harm or damage the body\u2019s tissues and organs. When the immune system is working as it should, it keeps us healthy and disease free by eliminating bacteria, viruses, and other foreign substances that have entered the body (Everly & Lating, 2002). \n\n Immune System Errors \n\n Sometimes, the immune system will function erroneously. For example, sometimes it can go awry by mistaking your body\u2019s own healthy cells for invaders and repeatedly attacking them. When this happens, the person is said to have an autoimmune disease, which can affect almost any part of the body. How an autoimmune disease affects a person depends on what part of the body is targeted. For instance, rheumatoid arthritis, an autoimmune disease that affects the joints, results in joint pain, stiffness, and loss of function. Systemic lupus erythematosus, an autoimmune disease that affects the skin, can result in rashes and swelling of the skin. Grave\u2019s disease, an autoimmune disease that affects the thyroid gland, can result in fatigue, weight gain, and muscle aches (National Institute of Arthritis and Musculoskeletal and Skin Diseases [NIAMS], 2012). \n\n In addition, the immune system may sometimes break down and be unable to do its job. This situation is referred to as  immunosuppression , the decreased effectiveness of the immune system. When people experience immunosuppression, they become susceptible to any number of infections, illness, and diseases. For example, acquired immune deficiency syndrome (AIDS) is a serious and lethal disease that is caused by human immunodeficiency virus (HIV), which greatly weakens the immune system by infecting and destroying antibody-producing cells, thus rendering a person vulnerable to any of a number of opportunistic infections (Powell, 1996). \n\n Stressors and Immune Function \n\n The question of whether stress and negative emotional states can influence immune function has captivated researchers for over three decades, and discoveries made over that time have dramatically changed the face of health psychology (Kiecolt-Glaser, 2009).  Psychoneuroimmunology  is the field that studies how psychological factors such as stress influence the immune system and immune functioning. The term psychoneuroimmunology was first coined in 1981, when it appeared as the title of a book that reviewed available evidence for associations between the brain, endocrine system, and immune system (Zacharie, 2009). To a large extent, this field evolved from the discovery that there is a connection between the central nervous system and the immune system. \n\n Some of the most compelling evidence for a connection between the brain and the immune system comes from studies in which researchers demonstrated that immune responses in animals could be classically conditioned (Everly & Lating, 2002). For example, Ader and Cohen (1975) paired flavored water (the conditioned stimulus) with the presentation of an immunosuppressive drug (the unconditioned stimulus), causing sickness (an unconditioned response). Not surprisingly, rats exposed to this pairing developed a conditioned aversion to the flavored water. However, the taste of the water itself later produced immunosuppression (a conditioned response), indicating that the immune system itself had been conditioned. Many subsequent studies over the years have further demonstrated that immune responses can be classically conditioned in both animals and humans (Ader & Cohen, 2001). Thus, if classical conditioning can alter immunity, other psychological factors should be capable of altering it as well. \n\n Hundreds of studies involving tens of thousands of participants have tested many kinds of brief and chronic stressors and their effect on the immune system (e.g., public speaking, medical school examinations, unemployment, marital discord, divorce, death of spouse, burnout and job strain, caring for a relative with Alzheimer\u2019s disease, and exposure to the harsh climate of Antarctica). It has been repeatedly demonstrated that many kinds of stressors are associated with poor or weakened immune functioning (Glaser & Kiecolt-Glaser, 2005; Kiecolt-Glaser, McGuire, Robles, & Glaser, 2002; Segerstrom & Miller, 2004). \n\n When evaluating these findings, it is important to remember that there is a tangible physiological connection between the brain and the immune system. For example, the sympathetic nervous system innervates immune organs such as the thymus, bone marrow, spleen, and even lymph nodes (Maier, Watkins, & Fleshner, 1994). Also, we noted earlier that stress hormones released during hypothalamic-pituitary-adrenal (HPA) axis activation can adversely impact immune function. One way they do this is by inhibiting the production of  lymphocytes , white blood cells that circulate in the body\u2019s fluids that are important in the immune response (Everly & Lating, 2002). \n\n Some of the more dramatic examples demonstrating the link between stress and impaired immune function involve studies in which volunteers were exposed to viruses. The rationale behind this research is that because stress weakens the immune system, people with high stress levels should be more likely to develop an illness compared to those under little stress. In one memorable experiment using this method, researchers interviewed 276 healthy volunteers about recent stressful experiences (Cohen et al., 1998). Following the interview, these participants were given nasal drops containing the cold virus (in case you are wondering why anybody would ever want to participate in a study in which they are subjected to such treatment, the participants were paid $800 for their trouble). When examined later, participants who reported experiencing chronic stressors for more than one month\u2014especially enduring difficulties involving work or relationships\u2014were considerably more likely to have developed colds than were participants who reported no chronic stressors ( Figure 14.15 ). \n\n In another study, older volunteers were given an influenza virus vaccination. Compared to controls, those who were caring for a spouse with Alzheimer\u2019s disease (and thus were under chronic stress) showed poorer antibody response following the vaccination (Kiecolt-Glaser, Glaser, Gravenstein, Malarkey, & Sheridan, 1996). \n\n Other studies have demonstrated that stress slows down wound healing by impairing immune responses important to wound repair (Glaser & Kiecolt-Glaser, 2005). In one study, for example, skin blisters were induced on the forearm. Subjects who reported higher levels of stress produced lower levels of immune proteins necessary for wound healing (Glaser et al., 1999). Stress, then, is not so much the sword that kills the knight, so to speak; rather, it\u2019s the sword that breaks the knight\u2019s shield, and your immune system is that shield. \n\n Dig Deeper Stress and Aging: A Tale of Telomeres Have you ever wondered why people who are stressed often seem to have a haggard look about them? A pioneering study from 2004 suggests that the reason is because stress can actually accelerate the cell biology of aging. \n\n Stress, it seems, can shorten telomeres, which are segments of DNA that protect the ends of chromosomes. Shortened telomeres can inhibit or block cell division, which includes growth and proliferation of new cells, thereby leading to more rapid aging (Sapolsky, 2004). In the study, researchers compared  telomere  lengths in the white blood cells in mothers of chronically ill children to those of mothers of healthy children (Epel et al., 2004). Mothers of chronically ill children would be expected to experience more stress than would mothers of healthy children. The longer a mother had spent caring for her ill child, the shorter her telomeres (the correlation between years of caregiving and telomere length was  r  = -.40). In addition, higher levels of perceived stress were negatively correlated with telomere size ( r  = -.31). These researchers also found that the average telomere length of the most stressed mothers, compared to the least stressed, was similar to what you would find in people who were 9\u201317 years older than they were on average. \n\n Numerous other studies since have continued to find associations between stress and eroded telomeres (Blackburn & Epel, 2012). Some studies have even demonstrated that stress can begin to erode telomeres in childhood and perhaps even before children are born. For example, childhood exposure to violence (e.g., maternal domestic violence, bullying victimization, and physical maltreatment) was found in one study to accelerate telomere erosion from ages 5 to 10 (Shalev et al., 2013). Another study reported that young adults whose mothers had experienced severe stress during their pregnancy had shorter telomeres than did those whose mothers had stress-free and uneventful pregnancies (Entringer et al., 2011). Further, the corrosive effects of childhood stress on telomeres can extend into young adulthood. In an investigation of over 4,000 U.K. women ages 41\u201380, adverse experiences during childhood (e.g., physical abuse, being sent away from home, and parent divorce) were associated with shortened telomere length (Surtees et al., 2010), and telomere size decreased as the amount of experienced adversity increased ( Figure 14.16 ). \n\n Efforts to dissect the precise cellular and physiological mechanisms linking short telomeres to stress and disease are currently underway. For the time being, telomeres provide us with yet another reminder that stress, especially during early life, can be just as harmful to our health as smoking or fast food (Blackburn & Epel, 2012). \n\n Cardiovascular Disorders  \n\n The cardiovascular system is composed of the heart and blood circulation system. For many years, disorders that involve the cardiovascular system\u2014known as  cardiovascular disorders \u2014have been a major focal point in the study of psychophysiological disorders because of the cardiovascular system\u2019s centrality in the stress response (Everly & Lating, 2002).  Heart disease  is one such condition. Each year, heart disease causes approximately one in three deaths in the United States, and it is the leading cause of death in the developed world (Centers for Disease Control and Prevention [CDC], 2011; Shapiro, 2005). \n\n The symptoms of heart disease vary somewhat depending on the specific kind of heart disease one has, but they generally involve angina\u2014chest pains or discomfort that occur when the heart does not receive enough blood (Office on Women\u2019s Health, 2009). The pain often feels like the chest is being pressed or squeezed; burning sensations in the chest and shortness of breath are also commonly reported. Such pain and discomfort can spread to the arms, neck, jaws, stomach (as nausea), and back (American Heart Association [AHA], 2012a) ( Figure 14.17 ). \n\n A major risk factor for heart disease is  hypertension , which is high blood pressure. Hypertension forces a person\u2019s heart to pump harder, thus putting more physical strain on the heart. If left unchecked, hypertension can lead to a heart attack, stroke, or heart failure; it can also lead to kidney failure and blindness. Hypertension is a serious cardiovascular disorder, and it is sometimes called the silent killer because it has no symptoms\u2014one who has high blood pressure may not even be aware of it (AHA, 2012b). \n\n Many risk factors contributing to cardiovascular disorders have been identified. These risk factors include social determinants such as aging, income, education, and employment status, as well as behavioral risk factors that include unhealthy diet, tobacco use, physical inactivity, and excessive alcohol consumption; obesity and diabetes are additional risk factors (World Health Organization [WHO], 2013).   Over the past few decades, there has been much greater recognition and awareness of the importance of stress and other psychological factors in cardiovascular health (Nusair, Al-dadah, & Kumar, 2012). Indeed, exposure to stressors of many kinds has also been linked to cardiovascular problems; in the case of hypertension, some of these stressors include job strain (Trudel, Brisson, & Milot, 2010), natural disasters (Saito, Kim, Maekawa, Ikeda, & Yokoyama, 1997), marital conflict (Nealey-Moore, Smith, Uchino, Hawkins, & Olson-Cerny, 2007), and exposure to high traffic noise levels at one\u2019s home (de Kluizenaar, Gansevoort, Miedema, & de Jong, 2007). Perceived discrimination appears to be associated with hypertension among African Americans (Sims et al., 2012). In addition, laboratory-based stress tasks, such as performing mental arithmetic under time pressure, immersing one\u2019s hand into ice water (known as the cold pressor test), mirror tracing, and public speaking have all been shown to elevate blood pressure (Phillips, 2011). \n\n Are You Type A or Type B? \n\n Sometimes research ideas and theories emerge from seemingly trivial observations. In the 1950s, cardiologist Meyer Friedman was looking over his waiting room furniture, which consisted of upholstered chairs with armrests. Friedman decided to have these chairs reupholstered. When the man doing the reupholstering came to the office to do the work, he commented on how the chairs were worn in a unique manner\u2014the front edges of the cushions were worn down, as were the front tips of the arm rests. It seemed like the cardiology patients were tapping or squeezing the front of the armrests, as well as literally sitting on the edge of their seats (Friedman & Rosenman, 1974). Were cardiology patients somehow different than other types of patients? If so, how? \n\n After researching this matter, Friedman and his colleague, Ray Rosenman, came to understand that people who are prone to heart disease tend to think, feel, and act differently than those who are not. These individuals tend to be intensively driven workaholics who are preoccupied with deadlines and always seem to be in a rush. According to Friedman and Rosenman, these individuals exhibit  Type A  behavior pattern; those who are more relaxed and laid-back were characterized as  Type B  ( Figure 14.18 ). In a sample of Type As and Type Bs, Friedman and Rosenman were startled to discover that heart disease was over seven times more frequent among the Type As than the Type Bs (Friedman & Rosenman, 1959). \n\n The major components of the Type A pattern include an aggressive and chronic struggle to achieve more and more in less and less time (Friedman & Rosenman, 1974). Specific characteristics of the Type A pattern include an excessive competitive drive, chronic sense of time urgency, impatience, and hostility toward others (particularly those who get in the person\u2019s way). \n\n An example of a person who exhibits Type A behavior pattern is Jeffrey. Even as a child, Jeffrey was intense and driven. He excelled at school, was captain of the swim team, and graduated with honors from an Ivy League college. Jeffrey never seems able to relax; he is always working on something, even on the weekends. However, Jeffrey always seems to feel as though there are not enough hours in the day to accomplish all he feels he should. He volunteers to take on extra tasks at work and often brings his work home with him; he often goes to bed angry late at night because he feels that he has not done enough. Jeffrey is quick tempered with his coworkers; he often becomes noticeably agitated when dealing with those coworkers he feels work too slowly or whose work does not meet his standards. He typically reacts with hostility when interrupted at work. He has experienced problems in his marriage over his lack of time spent with family. When caught in traffic during his commute to and from work, Jeffrey incessantly pounds on his horn and swears loudly at other drivers. When Jeffrey was 52, he suffered his first heart attack. \n\n By the 1970s, a majority of practicing cardiologists believed that Type A behavior pattern was a significant risk factor for heart disease (Friedman, 1977). Indeed, a number of early longitudinal investigations demonstrated a link between Type A behavior pattern and later development of heart disease (Rosenman et al., 1975; Haynes, Feinleib, & Kannel, 1980). \n\n Subsequent research examining the association between Type A and heart disease, however, failed to replicate these earlier findings (Glassman, 2007; Myrtek, 2001). Because Type A theory did not pan out as well as they had hoped, researchers shifted their attention toward determining if any of the specific elements of Type A predict heart disease. \n\n Extensive research clearly suggests that the anger/hostility dimension of Type A behavior pattern may be one of the most important factors in the development of heart disease. This relationship was initially described in the Haynes et al. (1980) study mentioned above: Suppressed hostility was found to substantially elevate the risk of heart disease for both men and women. Also, one investigation followed over 1,000 male medical students from 32 to 48 years. At the beginning of the study, these men completed a questionnaire assessing how they react to pressure; some indicated that they respond with high levels of  anger , whereas others indicated that they respond with less anger. Decades later, researchers found that those who earlier had indicated the highest levels of anger were over 6 times more likely than those who indicated less anger to have had a heart attack by age 55, and they were 3.5 times more likely to have experienced heart disease by the same age (Chang, Ford, Meoni, Wang, & Klag, 2002). From a health standpoint, it clearly does not pay to be an angry young person. \n\n After reviewing and statistically summarizing 35 studies from 1983 to 2006, Chida and Steptoe (2009) concluded that the bulk of the evidence suggests that anger and hostility constitute serious long-term risk factors for adverse cardiovascular outcomes among both healthy individuals and those already suffering from heart disease. One reason angry and hostile moods might contribute to cardiovascular diseases is that such moods can create social strain, mainly in the form of antagonistic social encounters with others. This strain could then lay the foundation for disease-promoting cardiovascular responses among hostile individuals (Vella, Kamarck, Flory, & Manuck, 2012). In this transactional model, hostility and social strain form a cycle ( Figure 14.19 ). For example, suppose Kaitlin has a hostile disposition; she has a cynical, distrustful attitude toward others and often thinks that other people are out to get her. She is very defensive around people, even those she has known for years, and she is always looking for signs that others are either disrespecting or belittling her. In the shower each morning before work, she often mentally rehearses what she would say to someone who said or did something that angered her, such as making a political statement that was counter to her own ideology. As Kaitlin goes through these mental rehearsals, she often grins and thinks about the retaliation on anyone who will irk her that day. \n\n Socially, she is confrontational and tends to use a harsh tone with people, which often leads to very disagreeable and sometimes argumentative social interactions. As you might imagine, Kaitlin is not especially popular with others, including coworkers, neighbors, and even members of her own family. They either avoid her at all costs or snap back at her, which causes Kaitlin to become even more cynical and distrustful of others, making her disposition even more hostile. Kaitlin\u2019s hostility\u2014through her own doing\u2014has created an antagonistic environment that cyclically causes her to become even more hostile and angry, thereby potentially setting the stage for cardiovascular problems. \n\n In addition to anger and hostility, a number of other negative emotional states have been linked with heart disease, including negative affectivity and depression (Suls & Bunde, 2005).  Negative affectivity  is a tendency to experience distressed emotional states involving anger, contempt, disgust, guilt, fear, and nervousness (Watson, Clark, & Tellegen, 1988). It has been linked with the development of both hypertension and heart disease. For example, over 3,000 initially healthy participants in one study were tracked longitudinally, up to 22 years. Those with higher levels of negative affectivity at the time the study began were substantially more likely to develop and be treated for hypertension during the ensuing years than were those with lower levels of negative affectivity (Jonas & Lando, 2000). In addition, a study of over 10,000 middle-aged London-based civil servants who were followed an average of 12.5 years revealed that those who earlier had scored in the upper third on a test of negative affectivity were 32% more likely to have experienced heart disease, heart attack, or angina over a period of years than were those who scored in the lowest third (Nabi, Kivimaki, De Vogli, Marmot, & Singh-Manoux, 2008). Hence, negative affectivity appears to be a potentially vital risk factor for the development of cardiovascular disorders. \n\n Depression and the Heart \n\n For centuries, poets and folklore have asserted that there is a connection between moods and the heart (Glassman & Shapiro, 1998). You are no doubt familiar with the notion of a broken heart following a disappointing or depressing event and have encountered that notion in songs, films, and literature. \n\n Perhaps the first to recognize the link between  depression  and  heart disease  was Benjamin Malzberg (1937), who found that the death rate among institutionalized patients with melancholia (an archaic term for depression) was six times higher than that of the population. A classic study in the late 1970s looked at over 8,000 manic-depressive persons in Denmark, finding a nearly 50% increase in deaths from heart disease among these patients compared with the general Danish population (Weeke, 1979). By the early 1990s, evidence began to accumulate showing that depressed individuals who were followed for long periods of time were at increased risk for heart disease and cardiac death (Glassman, 2007). In one investigation of over 700 Denmark residents, those with the highest depression scores were 71% more likely to have experienced a heart attack than were those with lower depression scores (Barefoot & Schroll, 1996).  Figure 14.20  illustrates the gradation in risk of heart attacks for both men and women. \n\n After more than two decades of research, it is now clear that a relationship exists: Patients with heart disease have more depression than the general population, and people with depression are more likely to eventually develop heart disease and experience higher mortality than those who do not have depression (Hare, Toukhsati, Johansson, & Jaarsma, 2013); the more severe the depression, the higher the risk (Glassman, 2007). Consider the following:\n\n In one study, death rates from cardiovascular problems was substantially higher in depressed people; depressed men were 50% more likely to have died from cardiovascular problems, and depressed women were 70% more likely (\u00d6sby, Brandt, Correia, Ekbom, & Spar\u00e9n, 2001). \n\n A statistical review of 10 longitudinal studies involving initially healthy individuals revealed that those with elevated depressive symptoms have, on average, a 64% greater risk of developing heart disease than do those with fewer symptoms (Wulsin & Singal, 2003). \n\n A study of over 63,000 registered nurses found that those with more depressed symptoms when the study began were 49% more likely to experience fatal heart disease over a 12-year period (Whang et al., 2009). \n\n The American Heart Association, fully aware of the established importance of depression in cardiovascular diseases, several years ago recommended routine depression screening for all heart disease patients (Lichtman et al., 2008). Recently, they have recommended including depression as a risk factor for heart disease patients (AHA, 2014). \n\n Although the exact mechanisms through which depression might produce heart problems have not been fully clarified, a recent investigation examining this connection in early life has shed some light. In an ongoing study of childhood depression, adolescents who had been diagnosed with depression as children were more likely to be obese, smoke, and be physically inactive than were those who had not received this diagnosis (Rottenberg et al., 2014). One implication of this study is that depression, especially if it occurs early in life, may increase the likelihood of living an unhealthy lifestyle, thereby predisposing people to an unfavorable cardiovascular disease risk profile. \n\n It is important to point out that depression may be just one piece of the emotional puzzle in elevating the risk for heart disease, and that chronically experiencing several negative emotional states may be especially important. A longitudinal investigation of Vietnam War veterans found that depression, anxiety, hostility, and trait anger each independently predicted the onset of heart disease (Boyle, Michalek, & Suarez, 2006). However, when each of these negative psychological attributes was combined into a single variable, this new variable (which researchers called psychological risk factor) predicted heart disease more strongly than any of the individual variables. Thus, rather than examining the predictive power of isolated psychological risk factors, it seems crucial for future researchers to examine the effects of combined and more general negative emotional and psychological traits in the development of cardiovascular illnesses. \n\n Asthma \n\n Asthma  is a chronic and serious disease in which the airways of the respiratory system become obstructed, leading to great difficulty expelling air from the lungs. The airway obstruction is caused by inflammation of the airways (leading to thickening of the airway walls) and a tightening of the muscles around them, resulting in a narrowing of the airways ( Figure 14.21 ) (American Lung Association, 2010). Because airways become obstructed, a person with asthma will sometimes have great difficulty breathing and will experience repeated episodes of wheezing, chest tightness, shortness of breath, and coughing, the latter occurring mostly during the morning and night (CDC, 2006). \n\n According to the Centers for Disease Control and Prevention (CDC), around 4,000 people die each year from asthma-related causes, and asthma is a contributing factor to another 7,000 deaths each year (CDC, 2013a). The CDC has revealed that asthma affects 18.7 million U.S. adults and is more common among people with lower education and income levels (CDC, 2013b). Especially concerning is that asthma is on the rise, with rates of asthma increasing 157% between 2000 and 2010 (CDC, 2013b). \n\n Asthma attacks are acute episodes in which an asthma sufferer experiences the full range of symptoms. Asthma exacerbation is often triggered by environmental factors, such as air pollution, allergens (e.g., pollen, mold, and pet hairs), cigarette smoke, airway infections, cold air or a sudden change in temperature, and exercise (CDC, 2013b). \n\n Psychological factors appear to play an important role in asthma (Wright, Rodriguez, & Cohen, 1998), although some believe that psychological factors serve as potential triggers in only a subset of asthma patients (Ritz, Steptoe, Bobb, Harris, & Edwards, 2006). Many studies over the years have demonstrated that some people with asthma will experience asthma-like symptoms if they expect to experience such symptoms, such as when breathing an inert substance that they (falsely) believe will lead to airway obstruction (Sodergren & Hyland, 1999). As stress and emotions directly affect immune and respiratory functions, psychological factors likely serve as one of the most common triggers of asthma exacerbation (Trueba & Ritz, 2013). \n\n People with asthma tend to report and display a high level of negative emotions such as anxiety, and asthma attacks have been linked to periods of high emotionality (Lehrer, Isenberg, & Hochron, 1993). In addition, high levels of emotional distress during both laboratory tasks and daily life have been found to negatively affect airway function and can produce asthma-like symptoms in people with asthma (von Leupoldt, Ehnes, & Dahme, 2006). In one investigation, 20 adults with asthma wore preprogrammed wristwatches that signaled them to breathe into a portable device that measures airway function. Results showed that higher levels of negative emotions and stress were associated with increased airway obstruction and self-reported asthma symptoms (Smyth, Soefer, Hurewitz, Kliment, & Stone, 1999). In addition, D\u2019Amato, Liccardi, Cecchi, Pellegrino, & D\u2019Amato (2010) described a case study of an 18-year-old man with asthma whose girlfriend had broken up with him, leaving him in a depressed state. She had also unfriended him on Facebook , while friending other young males. Eventually, the young man was able to \u201cfriend\u201d her once again and could monitor her activity through Facebook. Subsequently, he would experience asthma symptoms whenever he logged on and accessed her profile. When he later resigned not to use Facebook any longer, the asthma attacks stopped. This case suggests that the use of Facebook and other forms of social media may represent a new source of stress\u2014it may be a triggering factor for asthma attacks, especially in depressed asthmatic individuals. \n\n Exposure to stressful experiences, particularly those that involve parental or interpersonal conflicts, has been linked to the development of asthma throughout the lifespan. A longitudinal study of 145 children found that parenting difficulties during the first year of life increased the chances that the child developed asthma by 107% (Klinnert et al., 2001). In addition, a cross-sectional study of over 10,000 Finnish college students found that high rates of parent or personal conflicts (e.g., parental divorce, separation from spouse, or severe conflicts in other long-term relationships) increased the risk of asthma onset (Kilpel\u00e4inen, Koskenvuo, Helenius, & Terho, 2002). Further, a study of over 4,000 middle-aged men who were interviewed in the early 1990s and again a decade later found that breaking off an important life partnership (e.g., divorce or breaking off relationship from parents) increased the risk of developing asthma by 124% over the time of the study (Loerbroks, Apfelbacher, Thayer, Debling, & St\u00fcrmer, 2009). \n\n Tension Headaches \n\n A headache is a continuous pain anywhere in the head and neck region. Migraine headaches are a type of headache thought to be caused by blood vessel swelling and increased blood flow (McIntosh, 2013). Migraines are characterized by severe pain on one or both sides of the head, an upset stomach, and disturbed vision. They are more frequently experienced by women than by men (American Academy of Neurology, 2014). Tension headaches are triggered by tightening/tensing of facial and neck muscles; they are the most commonly experienced kind of headache, accounting for about 42% of all headaches worldwide (Stovner et al., 2007). In the United States, well over one-third of the population experiences tension headaches each year, and 2\u20133% of the population suffers from chronic tension headaches (Schwartz, Stewart, Simon, & Lipton, 1998). \n\n A number of factors can contribute to tension headaches, including sleep deprivation, skipping meals, eye strain, overexertion, muscular tension caused by poor posture, and stress (MedicineNet, 2013). Although there is uncertainty regarding the exact mechanisms through which stress can produce tension headaches, stress has been demonstrated to increase sensitivity to pain (Caceres & Burns, 1997; Logan et al., 2001). In general, tension headache sufferers, compared to non-sufferers, have a lower threshold for and greater sensitivity to pain (Ukestad & Wittrock, 1996), and they report greater levels of subjective stress when faced with a stressor (Myers, Wittrock, & Foreman, 1998). Thus, stress may contribute to tension headaches by increasing pain sensitivity in already-sensitive pain pathways in tension headache sufferers (Cathcart, Petkov, & Pritchard, 2008). \n 14.4   Regulation of Stress Learning Objectives By the end of this section, you will be able to:\n\n Define coping and differentiate between problem-focused and emotion-focused coping \n\n Describe the importance of perceived control in our reactions to stress \n\n Explain how social support is vital in health and longevity \n\n As we learned in the previous section,  stress \u2014especially if it is chronic\u2014takes a toll on our bodies and can have enormously negative health implications. When we experience events in our lives that we appraise as stressful, it is essential that we use effective coping strategies to manage our stress.  Coping  refers to mental and behavioral efforts that we use to deal with problems relating to stress, including its presumed cause and the unpleasant feelings and emotions it produces. \n\n Coping Styles \n\n Lazarus and Folkman (1984) distinguished two fundamental kinds of coping: problem-focused coping and emotion-focused coping. In problem-focused coping, one attempts to manage or alter the problem that is causing one to experience stress (i.e., the stressor). Problem-focused coping strategies are similar to strategies used in everyday problem-solving: they typically involve identifying the problem, considering possible solutions, weighing the costs and benefits of these solutions, and then selecting an alternative (Lazarus & Folkman, 1984). As an example, suppose Bradford receives a midterm notice that he is failing statistics class. If Bradford adopts a  problem-focused coping  approach to managing his stress, he would be proactive in trying to alleviate the source of the stress. He might contact his professor to discuss what must be done to raise his grade, he might also decide to set aside two hours daily to study statistics assignments, and he may seek tutoring assistance. A problem-focused approach to managing stress means we actively try to do things to address the problem. \n\n Emotion-focused coping, in contrast, consists of efforts to change or reduce the negative emotions associated with stress. These efforts may include avoiding, minimizing, or distancing oneself from the problem, or positive comparisons with others (\u201cI\u2019m not as bad off as she is\u201d), or seeking something positive in a negative event (\u201cNow that I\u2019ve been fired, I can sleep in for a few days\u201d). In some cases,  emotion-focused coping  strategies involve reappraisal, whereby the stressor is construed differently (and somewhat self-deceptively) without changing its objective level of threat (Lazarus & Folkman, 1984). For example, a person sentenced to federal prison who thinks, \u201cThis will give me a great chance to network with others,\u201d is using reappraisal. If Bradford adopted an emotion-focused approach to managing his midterm deficiency stress, he might watch a comedy movie, play video games, or spend hours on Twitter to take his mind off the situation. In a certain sense, emotion-focused coping can be thought of as treating the symptoms rather than the actual cause. \n\n While many stressors elicit both kinds of coping strategies, problem-focused coping is more likely to occur when encountering stressors we perceive as controllable, while emotion-focused coping is more likely to predominate when faced with stressors that we believe we are powerless to change (Folkman &  Lazarus, 1980). Clearly, emotion-focused coping is more effective in dealing with uncontrollable stressors. For example, if at midnight you are stressing over a 40-page paper due in the morning that you have not yet started, you are probably better off recognizing the hopelessness of the situation and doing something to take your mind off it; taking a problem-focused approach by trying to accomplish this task would only lead to frustration, anxiety, and even more stress. \n\n Fortunately, most stressors we encounter can be modified and are, to varying degrees, controllable. A person who cannot stand her job can quit and look for work elsewhere; a middle-aged divorcee can find another potential partner; the freshman who fails an exam can study harder next time, and a breast lump does not necessarily mean that one is fated to die of breast cancer. \n\n Control and Stress \n\n The desire and ability to predict events, make decisions, and affect outcomes\u2014that is, to enact control in our lives\u2014is a basic tenet of human behavior (Everly & Lating, 2002). Albert Bandura (1997) stated that \u201cthe intensity and chronicity of human stress is governed largely by perceived control over the demands of one\u2019s life\u201d (p. 262). As cogently described in his statement, our reaction to potential stressors depends to a large extent on how much control we feel we have over such things.  Perceived control  is our beliefs about our personal capacity to exert influence over and shape outcomes, and it has major implications for our health and happiness (Infurna & Gerstorf, 2014). Extensive research has demonstrated that perceptions of personal control are associated with a variety of favorable outcomes, such as better physical and mental health and greater psychological well-being (Diehl & Hay, 2010). Greater personal control is also associated with lower reactivity to stressors in daily life. For example, researchers in one investigation found that higher levels of perceived control at one point in time were later associated with lower emotional and physical reactivity to interpersonal stressors (Neupert, Almeida, & Charles, 2007). Further, a daily diary study with 34 older widows found that their stress and anxiety levels were significantly reduced on days during which the widows felt greater perceived control (Ong, Bergeman, & Bisconti, 2005). \n\n Dig Deeper Learned Helplessness When we lack a sense of control over the events in our lives, particularly when those events are threatening, harmful, or noxious, the psychological consequences can be profound. In one of the better illustrations of this concept, psychologist Martin Seligman conducted a series of classic experiments in the 1960s (Seligman & Maier, 1967) in which dogs were placed in a chamber where they received electric shocks from which they could not escape. Later, when these dogs were given the opportunity to escape the shocks by jumping across a partition, most failed to even try; they seemed to just give up and passively accept any shocks the experimenters chose to administer. In comparison, dogs who were previously allowed to escape the shocks tended to jump the partition and escape the pain ( Figure 14.22 ). \n\n Seligman believed that the dogs who failed to try to escape the later shocks were demonstrating  learned helplessness : They had acquired a belief that they were powerless to do anything about the noxious stimulation they were receiving. Seligman also believed that the passivity and lack of initiative these dogs demonstrated was similar to that observed in human depression. Therefore, Seligman speculated that acquiring a sense of learned helplessness might be an important cause of depression in humans: Humans who experience negative life events that they believe they are unable to control may become helpless. As a result, they give up trying to control or change the situation and some may become depressed and show lack of initiative in future situations in which they can control the outcomes (Seligman, Maier, & Geer, 1968). \n\n Seligman and colleagues later reformulated the original learned helplessness model of depression (Abramson, Seligman, & Teasdale, 1978). In their reformulation, they emphasized attributions (i.e., a mental explanation for why something occurred) that lead to the perception that one lacks control over negative outcomes are important in fostering a sense of learned helplessness. For example, suppose a coworker shows up late to work; your belief as to what caused the coworker\u2019s tardiness would be an attribution (e.g., too much traffic, slept too late, or just doesn\u2019t care about being on time). \n\n The reformulated version of Seligman\u2019s study holds that the attributions made for negative life events contribute to depression. Consider the example of a student who performs poorly on a midterm exam. This model suggests that the student will make three kinds of attributions for this outcome: internal vs. external (believing the outcome was caused by his own personal inadequacies or by environmental factors), stable vs. unstable (believing the cause can be changed or is permanent), and global vs. specific (believing the outcome is a sign of inadequacy in most everything versus just this area). Assume that the student makes an internal (\u201cI\u2019m just not smart\u201d), stable (\u201cNothing can be done to change the fact that I\u2019m not smart\u201d) and global (\u201cThis is another example of how lousy I am at everything\u201d) attribution for the poor performance. The reformulated theory predicts that the student would perceive a lack of control over this stressful event and thus be especially prone to developing depression. Indeed, research has demonstrated that people who have a tendency to make internal, global, and stable attributions for bad outcomes tend to develop symptoms of depression when faced with negative life experiences (Peterson & Seligman, 1984). \n\n Seligman\u2019s learned helplessness model has emerged over the years as a leading theoretical explanation for the onset of major depressive disorder. When you study psychological disorders, you will learn more about the latest reformulation of this model\u2014now called hopelessness theory. \n\n People who report higher levels of perceived control view their health as controllable, thereby making it more likely that they will better manage their health and engage in behaviors conducive to good health (Bandura, 2004). Not surprisingly, greater perceived control has been linked to lower risk of physical health problems, including declines in physical functioning (Infurna, Gerstorf, Ram, Schupp, & Wagner, 2011), heart attacks (Rosengren et al., 2004), and both cardiovascular disease incidence (St\u00fcrmer, Hasselbach, & Amelang, 2006) and mortality from cardiac disease (Surtees et al., 2010). In addition, longitudinal studies of British civil servants have found that those in low-status jobs (e.g., clerical and office support staff) in which the degree of control over the job is minimal are considerably more likely to develop heart disease than those with high-status jobs or considerable control over their jobs (Marmot, Bosma, Hemingway, & Stansfeld, 1997). \n\n The link between perceived control and health may provide an explanation for the frequently observed relationship between social class and health outcomes (Kraus, Piff, Mendoza-Denton, Rheinschmidt, & Keltner, 2012). In general, research has found that more affluent individuals experience better health mainly because they tend to believe that they can personally control and manage their reactions to life\u2019s stressors (Johnson & Krueger, 2006). Perhaps buoyed by the perceived level of control, individuals of higher social class may be prone to overestimating the degree of influence they have over particular outcomes. For example, those of higher social class tend to believe that their votes have greater sway on election outcomes than do those of lower social class, which may explain higher rates of voting in more affluent communities (Krosnick, 1990). Other research has found that a sense of perceived control can protect less affluent individuals from poorer health, depression, and reduced life-satisfaction\u2014all of which tend to accompany lower social standing (Lachman & Weaver, 1998). \n\n Taken together, findings from these and many other studies clearly suggest that perceptions of control and coping abilities are important in managing and coping with the stressors we encounter throughout life. \n\n Social Support \n\n The need to form and maintain strong, stable relationships with others is a powerful, pervasive, and fundamental human motive (Baumeister & Leary, 1995). Building strong interpersonal relationships with others helps us establish a network of close, caring individuals who can provide social support in times of distress, sorrow, and fear.  Social support  can be thought of as the soothing impact of friends, family, and acquaintances (Baron & Kerr, 2003). Social support can take many forms, including advice, guidance, encouragement, acceptance, emotional comfort, and tangible assistance (such as financial help). Thus, other people can be very comforting to us when we are faced with a wide range of life stressors, and they can be extremely helpful in our efforts to manage these challenges. Even in nonhuman animals, species mates can offer social support during times of stress. For example, elephants seem to be able to sense when other elephants are stressed and will often comfort them with physical contact\u2014such as a trunk touch\u2014or an empathetic vocal response (Krumboltz, 2014). \n\n Scientific interest in the importance of social support first emerged in the 1970s when health researchers developed an interest in the health consequences of being socially integrated (Stroebe & Stroebe, 1996). Interest was further fueled by longitudinal studies showing that social connectedness reduced mortality. In one classic study, nearly 7,000 Alameda County, California, residents were followed over 9 years. Those who had previously indicated that they lacked social and community ties were more likely to die during the follow-up period than those with more extensive social networks. Compared to those with the most social contacts, isolated men and women were, respectively, 2.3 and 2.8 times more likely to die. These trends persisted even after controlling for a variety of health-related variables, such as smoking, alcohol consumption, self-reported health at the beginning of the study, and physical activity (Berkman & Syme, 1979). \n\n Since the time of that study, social support has emerged as one of the well-documented psychosocial factors affecting health outcomes (Uchino, 2009). A statistical review of 148 studies conducted between 1982 and 2007 involving over 300,000 participants concluded that individuals with stronger social relationships have a 50% greater likelihood of survival compared to those with weak or insufficient social relationships (Holt-Lunstad, Smith, & Layton, 2010). According to the researchers, the magnitude of the effect of social support observed in this study is comparable with quitting smoking and exceeded many well-known risk factors for mortality, such as obesity and physical inactivity ( Figure 14.23 ). A number of large-scale studies have found that individuals with low levels of social support are at greater risk of mortality, especially from cardiovascular disorders (Brummett et al., 2001). Further, higher levels of social supported have been linked to better survival rates following breast cancer (Falagas et al., 2007) and infectious diseases, especially HIV infection (Lee & Rotheram-Borus, 2001). In fact, a person with high levels of social support is less likely to contract a common cold. In one study, 334 participants completed questionnaires assessing their sociability; these individuals were subsequently exposed to a virus that causes a common cold and monitored for several weeks to see who became ill. Results showed that increased sociability was linearly associated with a decreased probability of developing a cold (Cohen, Doyle, Turner, Alper, & Skoner, 2003). \n\n For many of us, friends are a vital source of social support. But what if you found yourself in a situation in which you lacked friends or companions? For example, suppose a popular high school student attends a far-away college, does not know anyone, and has trouble making friends and meaningful connections with others during the first semester. What can be done? If real life social support is lacking, access to distant friends via social media may help compensate. In a study of college freshmen, those with few face-to-face friends on campus but who communicated electronically with distant friends were less distressed that those who did not (Raney & Troop-Gordon, 2012). Also, for some people, our families\u2014especially our parents\u2014are a major source of social support. \n\n Social support appears to work by boosting the immune system, especially among people who are experiencing stress (Uchino, Vaughn, Carlisle, & Birmingham, 2012). In a pioneering study, spouses of cancer patients who reported high levels of social support showed indications of better immune functioning on two out of three immune functioning measures, compared to spouses who were below the median on reported social support (Baron, Cutrona, Hicklin, Russell, & Lubaroff, 1990). Studies of other populations have produced similar results, including those of spousal caregivers of dementia sufferers, medical students, elderly adults, and cancer patients (Cohen & Herbert, 1996; Kiecolt-Glaser, McGuire, Robles, & Glaser, 2002). \n\n In addition, social support has been shown to reduce blood pressure for people performing stressful tasks, such as giving a speech or performing mental arithmetic (Lepore, 1998). In these kinds of studies, participants are usually asked to perform a stressful task either alone, with a stranger present (who may be either supportive or unsupportive), or with a friend present. Those tested with a friend present generally exhibit lower blood pressure than those tested alone or with a stranger (Fontana, Diegnan, Villeneuve, & Lepore, 1999). In one study, 112 female participants who performed stressful mental arithmetic exhibited lower blood pressure when they received support from a friend rather than a stranger, but only if the friend was a male (Phillips, Gallagher, & Carroll, 2009). Although these findings are somewhat difficult to interpret, the authors mention that it is possible that females feel less supported and more evaluated by other females, particularly females whose opinions they value. \n\n Taken together, the findings above suggest one of the reasons social support is connected to favorable health outcomes is because it has several beneficial physiological effects in stressful situations. However, it is also important to consider the possibility that social support may lead to better health behaviors, such as a healthy diet, exercising, smoking cessation, and cooperation with medical regimens (Uchino, 2009). \n\n Dig Deeper Coping with Prejudice and Discrimination While having social support is quite beneficial, being the recipient of prejudicial attitudes and discriminatory behaviors is associated with a number of negative outcomes. In their literature review, Brondolo, Brady, Pencille, Beatty, and Contrada (2009) describe how racial  prejudice  and  discrimination  serve as unique, significant stressors for those who are the targets of such attitudes and behavior. Being the target of racism is associated with increased rates of depression, lowered self-esteem, hypertension, and cardiovascular disease. \n\n Given the complex and pervasive nature of racism as a stressor, Brondolo et al. (2009) point out the importance of coping with this specific stressor. Their review is aimed at determining which coping strategies are most effective at offsetting negative health outcomes associated with racism-related stress. The authors examine the effectiveness of three coping strategies: focusing on racial identity to handle race-related stress,  anger  expression/suppression, and seeking social support. You\u2019ve learned a bit about social support, so we\u2019ll focus the remainder of this discussion on the potential coping strategies of focusing on racial identity and anger expression/suppression. Focusing on racial identity refers to the process by which a person comes to feel as if he belongs to a given racial group; this may increase a sense of pride associated with group membership. Brondolo et al. (2009) suggest that a strong sense of racial identity might help an individual who is the target of racism differentiate between prejudicial attitudes/behaviors that are directed toward his group as a whole rather than at him as a person. Furthermore, the sense of belonging to his group might alleviate the distress of being ostracized by others. However, the research literature on the effectiveness of this technique has produced mixed results. Anger expression/suppression refers to the options available as a function of the anger evoked by racial prejudice and discrimination. Put simply, a target of racist attitudes and behaviors can act upon her anger or suppress her anger. As discussed by Brondolo et al. (2009), there has been very little research on the effectiveness of either approach; the results are quite mixed with some showing anger expression and others showing anger suppression as the healthier option. \n\n In the end, racism-related stress is a complex issue and each of the coping strategies discussed here has strengths and weaknesses. Brondolo et al. (2009) argue that it is imperative that additional research be conducted to ascertain the most effective strategies for coping with the negative outcomes that are experienced by the targets of racism. \n\n Stress Reduction Techniques \n\n Beyond having a sense of control and establishing social support networks, there are numerous other means by which we can manage stress ( Figure 14.24 ). A common technique people use to combat stress is  exercise  (Salmon, 2001). It is well-established that exercise, both of long (aerobic) and short (anaerobic) duration, is beneficial for both physical and mental health (Everly & Lating, 2002). There is considerable evidence that physically fit individuals are more resistant to the adverse effects of stress and recover more quickly from stress than less physically fit individuals (Cotton, 1990). In a study of more than 500 Swiss police officers and emergency service personnel, increased physical fitness was associated with reduced stress, and regular exercise was reported to protect against stress-related health problems (Gerber, Kellman, Hartman, & P\u00fchse, 2010). \n\n One reason exercise may be beneficial is because it might buffer some of the deleterious physiological mechanisms of stress. One study found rats that exercised for six weeks showed a decrease in hypothalamic-pituitary-adrenal responsiveness to mild stressors (Campeau et al., 2010). In high-stress humans, exercise has been shown to prevent telomere shortening, which may explain the common observation of a youthful appearance among those who exercise regularly (Puterman et al., 2010). Further, exercise in later adulthood appears to minimize the detrimental effects of stress on the hippocampus and memory (Head, Singh, & Bugg, 2012). Among cancer survivors, exercise has been shown to reduce anxiety (Speck, Courneya, Masse, Duval, & Schmitz, 2010) and depressive symptoms (Craft, VanIterson, Helenowski, Rademaker, & Courneya, 2012). Clearly, exercise is a highly effective tool for regulating stress. \n\n In the 1970s, Herbert Benson, a cardiologist, developed a stress reduction method called the  relaxation response technique  (Greenberg, 2006). The relaxation response technique combines relaxation with transcendental  meditation , and consists of four components (Stein, 2001):\n\n sitting upright on a comfortable chair with feet on the ground and body in a relaxed position, \n\n a quiet environment with eyes closed, \n\n repeating a word or a phrase\u2014a mantra\u2014to oneself, such as \u201calert mind, calm body,\u201d \n\n passively allowing the mind to focus on pleasant thoughts, such as nature or the warmth of your blood nourishing your body. \n\n The relaxation response approach is conceptualized as a general approach to stress reduction that reduces sympathetic arousal, and it has been used effectively to treat people with high blood pressure (Benson & Proctor, 1994).   Another technique to combat stress,  biofeedback , was developed by Gary Schwartz at Harvard University in the early 1970s. Biofeedback is a technique that uses electronic equipment to accurately measure a person\u2019s neuromuscular and autonomic activity\u2014feedback is provided in the form of visual or auditory signals. The main assumption of this approach is that providing somebody biofeedback will enable the individual to develop strategies that help gain some level of voluntary control over what are normally involuntary bodily processes (Schwartz & Schwartz, 1995). A number of different bodily measures have been used in biofeedback research, including facial muscle movement, brain activity, and skin temperature, and it has been applied successfully with individuals experiencing tension headaches, high blood pressure, asthma, and phobias (Stein, 2001). \n 14.5   The Pursuit of Happiness Learning Objectives By the end of this section, you will be able to:\n\n Define and discuss happiness, including its determinants \n\n Describe the field of positive psychology and identify the kinds of problems it addresses \n\n Explain the meaning of positive affect and discuss its importance in health outcomes \n\n Describe the concept of flow and its relationship to happiness and fulfillment \n\n Although the study of  stress  and how it affects us physically and psychologically is fascinating, it is\u2014admittedly\u2014somewhat of a grim topic. Psychology is also interested in the study of a more upbeat and encouraging approach to human affairs\u2014the quest for happiness. \n\n Happiness \n\n America\u2019s founders declared that its citizens have an unalienable right to pursue happiness. But what is happiness? When asked to define the term, people emphasize different aspects of this elusive state. Indeed, happiness is somewhat ambiguous and can be defined from different perspectives (Martin, 2012). Some people, especially those who are highly committed to their religious faith, view happiness in ways that emphasize virtuosity, reverence, and enlightened spirituality. Others see happiness as primarily contentment\u2014the inner peace and joy that come from deep satisfaction with one\u2019s surroundings, relationships with others, accomplishments, and oneself. Still others view happiness mainly as pleasurable engagement with their personal environment\u2014having a career and hobbies that are engaging, meaningful, rewarding, and exciting. These differences, of course, are merely differences in emphasis. Most people would probably agree that each of these views, in some respects, captures the essence of happiness. \n\n Elements of Happiness \n\n Some psychologists have suggested that happiness consists of three distinct elements: the pleasant life, the good life, and the meaningful life, as shown in  Figure 14.25  (Seligman, 2002; Seligman, Steen, Park, & Peterson, 2005). The pleasant life is realized through the attainment of day-to-day pleasures that add fun, joy, and excitement to our lives. For example, evening walks along the beach and a fulfilling sex life can enhance our daily pleasure and contribute to the pleasant life. The good life is achieved through identifying our unique skills and abilities and engaging these talents to enrich our lives; those who achieve the good life often find themselves absorbed in their work or their recreational pursuits. The meaningful life involves a deep sense of fulfillment that comes from using our talents in the service of the greater good: in ways that benefit the lives of others or that make the world a better place. In general, the happiest people tend to be those who pursue the full life\u2014they orient their pursuits toward all three elements (Seligman et al., 2005). \n\n For practical purposes, a precise definition of  happiness  might incorporate each of these elements: an enduring state of mind consisting of joy, contentment, and other positive emotions, plus the sense that one\u2019s life has meaning and value (Lyubomirsky, 2001). The definition implies that happiness is a long-term state\u2014what is often characterized as subjective well-being\u2014rather than merely a transient positive mood we all experience from time to time. It is this enduring happiness that has captured the interests of psychologists and other social scientists. \n\n The study of happiness has grown dramatically in the last three decades (Diener, 2013). One of the most basic questions that happiness investigators routinely examine is this: How happy are people in general? The average person in the world tends to be relatively happy and tends to indicate experiencing more positive feelings than negative feelings (Diener, Ng, Harter, & Arora, 2010). When asked to evaluate their current lives on a scale ranging from 0 to 10 (with 0 representing \u201cworst possible life\u201d and 10 representing \u201cbest possible life\u201d), people in more than 150 countries surveyed from 2010\u20132012 reported an average score of 5.2. People who live in North America, Australia, and New Zealand reported the highest average score at 7.1, whereas those living Sub-Saharan Africa reported the lowest average score at 4.6 (Helliwell, Layard, & Sachs, 2013). Worldwide, the five happiest countries are Denmark, Norway, Switzerland, the Netherlands, and Sweden; the United States is ranked 17th happiest ( Figure 14.26 ) (Helliwell et al., 2013). \n\n Several years ago, a Gallup survey of more than 1,000 U.S. adults found that 52% reported that they were \u201cvery happy.\u201d In addition, more than 8 in 10 indicated that they were \u201cvery satisfied\u201d with their lives (Carroll, 2007). However, a recent poll of 2,345 U.S. adults surprisingly revealed that only one-third reported they are \u201cvery happy.\u201d The poll also revealed that the happiness levels of certain groups, including minorities, recent college graduates, and the disabled, have trended downward in recent years (Gregoire, 2013). Although it is difficult to explain this apparent decline in happiness, it may be connected to the challenging economic conditions the United States has endured over the last several years. Of course, this presumption would imply that happiness is closely tied to one\u2019s finances. But, is it? This question brings us to the next important issue: What factors influence happiness? \n\n Factors Connected to Happiness \n\n What really makes people happy? What factors contribute to sustained joy and contentment? Is it money, attractiveness, material possessions, a rewarding occupation, a satisfying relationship? Extensive research over the years has examined this question. One finding is that age is related to happiness: Life satisfaction usually increases the older people get, but there do not appear to be gender differences in happiness (Diener, Suh, Lucas, & Smith, 1999). Although it is important to point out that much of this work has been correlational, many of the key findings (some of which may surprise you) are summarized below. \n\n Family and other social relationships appear to be key factors correlated with happiness. Studies show that married people report being happier than those who are single, divorced, or widowed (Diener et al., 1999). Happy individuals also report that their marriages are fulfilling (Lyubomirsky, King, & Diener, 2005). In fact, some have suggested that satisfaction with marriage and family life is the strongest predictor of happiness (Myers, 2000). Happy people tend to have more friends, more high-quality social relationships, and stronger social support networks than less happy people (Lyubomirsky et al., 2005). Happy people also have a high frequency of contact with friends (Pinquart & S\u00f6rensen, 2000). \n\n Can money buy happiness? In general, extensive research suggests that the answer is yes, but with several caveats. While a nation\u2019s per capita gross domestic product (GDP) is associated with happiness levels (Helliwell et al., 2013), changes in GDP (which is a less certain index of household income) bear little relationship to changes in happiness (Diener, Tay, & Oishi, 2013). On the whole, residents of affluent countries tend to be happier than residents of poor countries; within countries, wealthy individuals are happier than poor individuals, but the association is much weaker (Diener & Biswas-Diener, 2002). To the extent that it leads to increases in purchasing power, increases in income are associated with increases in happiness (Diener, Oishi, & Ryan, 2013). However, income within societies appears to correlate with happiness only up to a point. In a study of over 450,000 U.S. residents surveyed by the Gallup Organization, Kahneman and Deaton (2010) found that well-being rises with annual income, but only up to $75,000. The average increase in reported well-being for people with incomes greater than $75,000 was null. As implausible as these findings might seem\u2014after all, higher incomes would enable people to indulge in Hawaiian vacations, prime seats as sporting events, expensive automobiles, and expansive new homes\u2014higher incomes may impair people\u2019s ability to savor and enjoy the small pleasures of life (Kahneman, 2011). Indeed, researchers in one study found that participants exposed to a subliminal reminder of wealth spent less time savoring a chocolate candy bar and exhibited less enjoyment of this experience than did participants who were not reminded of wealth (Quoidbach, Dunn, Petrides, & Mikolajczak, 2010). \n\n What about education and employment? Happy people, compared to those who are less happy, are more likely to graduate from college and secure more meaningful and engaging jobs. Once they obtain a job, they are also more likely to succeed (Lyubomirsky et al., 2005). While education shows a positive (but weak) correlation with happiness, intelligence is not appreciably related to happiness (Diener et al., 1999). \n\n Does religiosity correlate with happiness? In general, the answer is yes (Hackney & Sanders, 2003). However, the relationship between religiosity and happiness depends on societal circumstances. Nations and states with more difficult living conditions (e.g., widespread hunger and low life expectancy) tend to be more highly religious than societies with more favorable living conditions. Among those who live in nations with difficult living conditions, religiosity is associated with greater well-being; in nations with more favorable living conditions, religious and nonreligious individuals report similar levels of well-being (Diener, Tay, & Myers, 2011). \n\n Clearly the living conditions of one\u2019s nation can influence factors related to happiness. What about the influence of one\u2019s culture? To the extent that people possess characteristics that are highly valued by their culture, they tend to be happier (Diener, 2012). For example, self-esteem is a stronger predictor of life satisfaction in individualistic cultures than in collectivistic cultures (Diener, Diener, & Diener, 1995), and extraverted people tend to be happier in extraverted cultures than in introverted cultures (Fulmer et al., 2010). \n\n So we\u2019ve identified many factors that exhibit some correlation to happiness. What factors don\u2019t show a correlation? Researchers have studied both parenthood and physical attractiveness as potential contributors to happiness, but no link has been identified. Although people tend to believe that parenthood is central to a meaningful and ful\ufb01lling life, aggregate findings from a range of countries indicate that people who do not have children are generally happier than those who do (Hansen, 2012). And although one\u2019s perceived level of attractiveness seems to predict happiness, a person\u2019s objective physical attractiveness is only weakly correlated with her happiness (Diener, Wolsic, & Fujita, 1995). \n\n Life Events and Happiness \n\n An important point should be considered regarding happiness. People are often poor at affective forecasting: predicting the intensity and duration of their future emotions (Wilson & Gilbert, 2003). In one study, nearly all newlywed spouses predicted their marital satisfaction would remain stable or improve over the following four years; despite this high level of initial optimism, their marital satisfaction actually declined during this period (Lavner, Karner, & Bradbury, 2013). In addition, we are often incorrect when estimating how our long-term happiness would change for the better or worse in response to certain life events. For example, it is easy for many of us to imagine how euphoric we would feel if we won the lottery, were asked on a date by an attractive celebrity, or were offered our dream job. It is also easy to understand how long-suffering fans of the Chicago Cubs baseball team, which has not won a World Series championship since 1908, think they would feel permanently elated if their team would finally win another World Series. Likewise, it easy to predict that we would feel permanently miserable if we suffered a crippling accident or if a romantic relationship ended. \n\n However, something similar to sensory adaptation often occurs when people experience emotional reactions to life events. In much the same way our senses adapt to changes in stimulation (e.g., our eyes adapting to bright light after walking out of the darkness of a movie theater into the bright afternoon sun), we eventually adapt to changing emotional circumstances in our lives (Brickman & Campbell, 1971; Helson, 1964). When an event that provokes positive or negative emotions occurs, at first we tend to experience its emotional impact at full intensity. We feel a burst of pleasure following such things as a marriage proposal, birth of a child, acceptance to law school, an inheritance, and the like; as you might imagine, lottery winners experience a surge of happiness after hitting the jackpot (Lutter, 2007). Likewise, we experience a surge of misery following widowhood, a divorce, or a layoff from work. In the long run, however, we eventually adjust to the emotional new normal; the emotional impact of the event tends to erode, and we eventually revert to our original baseline happiness levels. Thus, what was at first a thrilling lottery windfall or World Series championship eventually loses its luster and becomes the status quo ( Figure 14.27 ). Indeed, dramatic life events have much less long-lasting impact on happiness than might be expected (Brickman, Coats, & Janoff-Bulman, 1978). \n\n Recently, some have raised questions concerning the extent to which important life events can permanently alter people\u2019s happiness set points (Diener, Lucas, & Scollon, 2006). Evidence from a number of investigations suggests that, in some circumstances, happiness levels do not revert to their original positions. For example, although people generally tend to adapt to marriage so that it no longer makes them happier or unhappier than before, they often do not fully adapt to unemployment or severe disabilities (Diener, 2012).  Figure 14.28 , which is based on longitudinal data from a sample of over 3,000 German respondents, shows life satisfaction scores several years before, during, and after various life events, and it illustrates how people adapt (or fail to adapt) to these events. German respondents did not get lasting emotional boosts from marriage; instead, they reported brief increases in happiness, followed by quick adaptation. In contrast, widows and those who had been laid off experienced sizeable decreases in happiness that appeared to result in long-term changes in life satisfaction (Diener et al., 2006). Further, longitudinal data from the same sample showed that happiness levels changed significantly over time for nearly a quarter of respondents, with 9% showing major changes (Fujita & Diener, 2005). Thus, long-term happiness levels can and do change for some people. \n\n Increasing Happiness \n\n Some recent findings about happiness provide an optimistic picture, suggesting that real changes in happiness are possible. For example, thoughtfully developed well-being interventions designed to augment people\u2019s baseline levels of happiness may increase happiness in ways that are permanent and long-lasting, not just temporary. These changes in happiness may be targeted at individual, organizational, and societal levels (Diener et al., 2006). Researchers in one study found that a series of happiness interventions involving such exercises as writing down three good things that occurred each day led to increases in happiness that lasted over six months (Seligman et al., 2005). \n\n Measuring  happiness  and well-being at the societal level over time may assist policy makers in determining if people are generally happy or miserable, as well as when and why they might feel the way they do. Studies show that average national happiness scores (over time and across countries) relate strongly to six key variables: per capita gross domestic product (GDP, which reflects a nation\u2019s economic standard of living), social support, freedom to make important life choices, healthy life expectancy, freedom from perceived corruption in government and business, and generosity (Helliwell et al., 2013). Investigating why people are happy or unhappy might help policymakers develop programs that increase happiness and well-being within a society (Diener et al., 2006). Resolutions about contemporary political and social issues that are frequent topics of debate\u2014such as poverty, taxation, affordable health care and housing, clean air and water, and income inequality\u2014might be best considered with people\u2019s happiness in mind. \n\n Positive Psychology \n\n In 1998,  Seligman  (the same person who conducted the learned helplessness experiments mentioned earlier), who was then president of the American Psychological Association, urged psychologists to focus more on understanding how to build human strength and psychological well-being. In deliberately setting out to create a new direction and new orientation for psychology, Seligman helped establish a growing movement and field of research called positive psychology (Compton, 2005). In a very general sense,  positive psychology  can be thought of as the science of happiness; it is an area of study that seeks to identify and promote those qualities that lead to greater fulfillment in our lives. This field looks at people\u2019s strengths and what helps individuals to lead happy, contented lives, and it moves away from focusing on people\u2019s pathology, faults, and problems. According to Seligman and Csikszentmihalyi (2000), positive psychology, \n\n at the subjective level is about valued subjective experiences: well-being, contentment, and satisfaction (in the past); hope and optimism (for the future); and\u2026 happiness (in the present). At the individual level, it is about positive individual traits: the capacity for love and vocation, courage, interpersonal skill, aesthetic sensibility, perseverance, forgiveness, originality, future mindedness, spirituality, high talent, and wisdom. (p. 5) \n\n Some of the topics studied by positive psychologists include altruism and empathy, creativity, forgiveness and compassion, the importance of positive emotions, enhancement of immune system functioning, savoring the fleeting moments of life, and strengthening virtues as a way to increase authentic happiness (Compton, 2005). Recent efforts in the field of positive psychology have focused on extending its principles toward peace and well-being at the level of the global community. In a war-torn world in which conflict, hatred, and distrust are common, such an extended \u201cpositive peace psychology\u201d could have important implications for understanding how to overcome oppression and work toward global peace (Cohrs, Christie, White, & Das, 2013). \n\n Dig Deeper The Center for Investigating Healthy Minds On the campus of the University of Wisconsin\u2013Madison, the Center for Investigating Healthy Minds at the Waisman Center conducts rigorous scientific research on healthy aspects of the mind, such as kindness, forgiveness, compassion, and mindfulness. Established in 2008 and led by renowned neuroscientist Dr. Richard J. Davidson, the Center examines a wide range of ideas, including such things as a kindness curriculum in schools, neural correlates of prosocial behavior, psychological effects of Tai Chi training, digital games to foster prosocial behavior in children, and the effectiveness of yoga and breathing exercises in reducing symptoms of post-traumatic stress disorder. \n\n According to its website, the Center was founded after Dr. Davidson was challenged by His Holiness, the 14th Dalai Lama, \u201cto apply the rigors of science to study positive qualities of mind\u201d (Center for Investigating Health Minds, 2013). The Center continues to conduct scientific research with the aim of developing mental health training approaches that help people to live happier, healthier lives). \n\n Positive Affect and Optimism \n\n Taking a cue from positive psychology, extensive research over the last 10-15 years has examined the importance of positive psychological attributes in physical well-being. Qualities that help promote psychological well-being (e.g., having meaning and purpose in life, a sense of autonomy, positive emotions, and satisfaction with life) are linked with a range of favorable health outcomes (especially improved cardiovascular health) mainly through their relationships with biological functions and health behaviors (such as diet, physical activity, and sleep quality) (Boehm & Kubzansky, 2012). The quality that has received attention is  positive affect , which refers to pleasurable engagement with the environment, such as happiness, joy, enthusiasm, alertness, and excitement (Watson, Clark, & Tellegen, 1988). The characteristics of positive affect, as with negative affect (discussed earlier), can be brief, long-lasting, or trait-like (Pressman & Cohen, 2005). Independent of age, gender, and income, positive affect is associated with greater social connectedness, emotional and practical support, adaptive coping efforts, and lower depression; it is also associated with longevity and favorable physiological functioning (Steptoe, O\u2019Donnell, Marmot, & Wardle, 2008). \n\n Positive affect also serves as a protective factor against heart disease. In a 10-year study of Nova Scotians, the rate of heart disease was 22% lower for each one-point increase on the measure of positive affect, from 1 (no positive affect expressed) to 5 (extreme positive affect) (Davidson, Mostofsky, & Whang, 2010). In terms of our health, the expression, \u201cdon\u2019t worry, be happy\u201d is helpful advice indeed. There has also been much work suggesting that  optimism \u2014the general tendency to look on the bright side of things\u2014is also a significant predictor of positive health outcomes. \n\n Although positive affect and optimism are related in some ways, they are not the same (Pressman & Cohen, 2005). Whereas positive affect is mostly concerned with positive feeling states, optimism has been regarded as a generalized tendency to expect that good things will happen (Chang, 2001). It has also been conceptualized as a tendency to view life\u2019s stressors and difficulties as temporary and external to oneself (Peterson & Steen, 2002). Numerous studies over the years have consistently shown that optimism is linked to longevity, healthier behaviors, fewer postsurgical complications, better immune functioning among men with prostate cancer, and better treatment adherence (Rasmussen & Wallio, 2008). Further, optimistic people report fewer physical symptoms, less pain, better physical functioning, and are less likely to be rehospitalized following heart surgery (Rasmussen, Scheier, & Greenhouse, 2009). \n\n Flow \n\n Another factor that seems to be important in fostering a deep sense of well-being is the ability to derive flow from the things we do in life.  Flow  is described as a particular experience that is so engaging and engrossing that it becomes worth doing for its own sake (Csikszentmihalyi, 1997). It is usually related to creative endeavors and leisure activities, but it can also be experienced by workers who like their jobs or students who love studying (Csikszentmihalyi, 1999). Many of us instantly recognize the notion of flow. In fact, the term derived from respondents\u2019 spontaneous use of the term when asked to describe how it felt when what they were doing was going well. When people experience flow, they become involved in an activity to the point where they feel they lose themselves in the activity. They effortlessly maintain their concentration and focus, they feel as though they have complete control of their actions, and time seems to pass more quickly than usual (Csikszentmihalyi, 1997). Flow is considered a pleasurable experience, and it typically occurs when people are engaged in challenging activities that require skills and knowledge they know they possess. For example, people would be more likely report flow experiences in relation to their work or hobbies than in relation to eating. When asked the question, \u201cDo you ever get involved in something so deeply that nothing else seems to matter, and you lose track of time?\u201d about 20% of Americans and Europeans report having these flow-like experiences regularly (Csikszentmihalyi, 1997). \n\n Although wealth and material possessions are nice to have, the notion of flow suggests that neither are prerequisites for a happy and fulfilling life. Finding an activity that you are truly enthusiastic about, something so absorbing that doing it is reward itself (whether it be playing tennis, studying Arabic, writing children\u2019s novels, or cooking lavish meals) is perhaps the real key. According to Csikszentmihalyi (1999), creating conditions that make flow experiences possible should be a top social and political priority. How might this goal be achieved? How might flow be promoted in school systems? In the workplace? What potential benefits might be accrued from such efforts? \n\n In an ideal world, scientific research endeavors should inform us on how to bring about a better world for all people. The field of positive psychology promises to be instrumental in helping us understand what truly builds hope, optimism, happiness, healthy relationships, flow, and genuine personal fulfillment. ", "questions": [{"question": {"question_id": "fs-idm145714288", "question_text": "Negative effects of stress are most likely to be experienced when an event is perceived as ________.", "question_choices": ["negative, but it is likely to affect one\u2019s friends rather than oneself", "challenging", "confusing", "threatening, and no clear options for dealing with it are apparent"], "cloze_format": "Negative effects of stress are most likely to be experienced when an event is perceived as ________.", "normal_format": "Negative effects of stress are most likely to be experienced when an event is perceived as which of the following?"}, "answer": {"ans_text": "threatening, and no clear options for dealing with it are apparent", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "In contrast , if one does not appraise the same event as harmful or threatening , she is unlikely to experience stress .", "hl_context": "If a person appraises an event as harmful and believes that the demands imposed by the event exceed the available resources to manage or adapt to it , the person will subjectively experience a state of stress . <hl> In contrast , if one does not appraise the same event as harmful or threatening , she is unlikely to experience stress . <hl> According to this definition , environmental events trigger stress reactions by the way they are interpreted and the meanings they are assigned . In short , stress is largely in the eye of the beholder : it \u2019 s not so much what happens to you as it is how you respond ( Selye , 1976 ) ."}, {"question": {"question_id": "fs-idm164262560", "question_text": "Between 2006 and 2009, the greatest increases in stress levels were found to occur among ________.", "question_choices": ["Blacks", "those aged 45\u201364", "the unemployed", "those without college degrees"], "cloze_format": "Between 2006 and 2009, the greatest increases in stress levels were found to occur among ________.", "normal_format": "Between 2006 and 2009, the greatest increases in stress levels were found to occur among which of the following?"}, "answer": {"ans_text": "those aged 45\u201364", "ans_choice": 1}, "bloom": null, "hl_sentences": "However , from 2006 to 2009 the greatest increase in stress levels occurred among men , Whites , people aged 45 \u2013 64 , college graduates , and those with full-time employment .", "hl_context": "Figure 14.6 depicts the results of three national surveys in which several thousand individuals from different demographic groups completed a brief stress questionnaire ; the surveys were administered in 1983 , 2006 , and 2009 ( Cohen & Janicki-Deverts , 2012 ) . All three surveys demonstrated higher stress in women than in men . Unemployed individuals reported high levels of stress in all three surveys , as did those with less education and income ; retired persons reported the lowest stress levels . <hl> However , from 2006 to 2009 the greatest increase in stress levels occurred among men , Whites , people aged 45 \u2013 64 , college graduates , and those with full-time employment . <hl> One interpretation of these findings is that concerns surrounding the 2008 \u2013 2009 economic downturn ( e . g . , threat of or actual job loss and substantial loss of retirement savings ) may have been especially stressful to White , college-educated , employed men with limited time remaining in their working careers ."}, {"question": {"question_id": "fs-idm147843024", "question_text": "At which stage of Selye\u2019s general adaptation syndrome is a person especially vulnerable to illness?", "question_choices": ["exhaustion", "alarm reaction", "fight-or-flight", "resistance"], "cloze_format": "___ is the stage of Selye's general adaption syndrome is a person especially vulnerable to illness.", "normal_format": "At which stage of Selye\u2019s general adaptation syndrome is a person especially vulnerable to illness?"}, "answer": {"ans_text": "exhaustion", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "If exposure to a stressor continues over a longer period of time , the stage of exhaustion ensues . As a result , illness , disease , and other permanent damage to the body \u2014 even death \u2014 may occur .", "hl_context": "<hl> If exposure to a stressor continues over a longer period of time , the stage of exhaustion ensues . <hl> At this stage , the person is no longer able to adapt to the stressor : the body \u2019 s ability to resist becomes depleted as physical wear takes its toll on the body \u2019 s tissues and organs . <hl> As a result , illness , disease , and other permanent damage to the body \u2014 even death \u2014 may occur . <hl> If a missing child still remained missing after three months , the long-term stress associated with this situation may cause a parent to literally faint with exhaustion at some point or even to develop a serious and irreversible illness ."}, {"question": {"question_id": "fs-idm29183856", "question_text": "During an encounter judged as stressful, cortisol is released by the ________.", "question_choices": ["sympathetic nervous system", "hypothalamus", "pituitary gland", "adrenal glands"], "cloze_format": "During an encounter judged as stressful, cortisol is released by the ________.", "normal_format": "During an encounter judged as stressful, cortisol is released by what?"}, "answer": {"ans_text": "adrenal glands", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "In summary , a stressful event causes a variety of physiological reactions that activate the adrenal glands , which in turn release epinephrine , norepinephrine , and cortisol . When a person first perceives something as stressful ( Selye \u2019 s alarm reaction ) , the sympathetic nervous system triggers arousal via the release of adrenaline from the adrenal glands . Cortisol is commonly known as a stress hormone and helps provide that boost of energy when we first encounter a stressor , preparing us to run away or fight .", "hl_context": "In short bursts , this process can have some favorable effects , such as providing extra energy , improving immune system functioning temporarily , and decreasing pain sensitivity . However , extended release of cortisol \u2014 as would happen with prolonged or chronic stress \u2014 often comes at a high price . High levels of cortisol have been shown to produce a number of harmful effects . For example , increases in cortisol can significantly weaken our immune system ( Glaser & Kiecolt-Glaser , 2005 ) , and high levels are frequently observed among depressed individuals ( Geoffroy , Hertzman , Li , & Power , 2013 ) . <hl> In summary , a stressful event causes a variety of physiological reactions that activate the adrenal glands , which in turn release epinephrine , norepinephrine , and cortisol . <hl> These hormones affect a number of bodily processes in ways that prepare the stressed person to take direct action , but also in ways that may heighten the potential for illness . What goes on inside our bodies when we experience stress ? The physiological mechanisms of stress are extremely complex , but they generally involve the work of two systems \u2014 the sympathetic nervous system and the hypothalamic-pituitary-adrenal ( HPA ) axis . <hl> When a person first perceives something as stressful ( Selye \u2019 s alarm reaction ) , the sympathetic nervous system triggers arousal via the release of adrenaline from the adrenal glands . <hl> Release of these hormones activates the fight-or-flight responses to stress , such as accelerated heart rate and respiration . At the same time , the HPA axis , which is primarily endocrine in nature , becomes especially active , although it works much more slowly than the sympathetic nervous system . In response to stress , the hypothalamus ( one of the limbic structures in the brain ) releases corticotrophin-releasing factor , a hormone that causes the pituitary gland to release adrenocorticotropic hormone ( ACTH ) ( Figure 14.11 ) . The ACTH then activates the adrenal glands to secrete a number of hormones into the bloodstream ; an important one is cortisol , which can affect virtually every organ within the body . <hl> Cortisol is commonly known as a stress hormone and helps provide that boost of energy when we first encounter a stressor , preparing us to run away or fight . <hl> However , sustained elevated levels of cortisol weaken the immune system ."}, {"question": {"question_id": "fs-idp3876848", "question_text": "According to the Holmes and Rahe scale, which life event requires the greatest amount of readjustment?", "question_choices": ["marriage", "personal illness", "divorce", "death of spouse"], "cloze_format": "According to the Holmes and Rahe scale, ___ requires the greatest amount of readjustment.", "normal_format": "According to the Holmes and Rahe scale, which life event requires the greatest amount of readjustment?"}, "answer": {"ans_text": "death of spouse", "ans_choice": 3}, "bloom": null, "hl_sentences": "In developing their scale , Holmes and Rahe asked 394 participants to provide a numerical estimate for each of the 43 items ; each estimate corresponded to how much readjustment participants felt each event would require . Death of a spouse ranked highest on the scale with 100 LCUs , and divorce ranked second highest with 73 LCUs .", "hl_context": "<hl> In developing their scale , Holmes and Rahe asked 394 participants to provide a numerical estimate for each of the 43 items ; each estimate corresponded to how much readjustment participants felt each event would require . <hl> These estimates resulted in mean value scores for each event \u2014 often called life change units ( LCUs ) ( Rahe , McKeen , & Arthur , 1967 ) . The numerical scores ranged from 11 to 100 , representing the perceived magnitude of life change each event entails . <hl> Death of a spouse ranked highest on the scale with 100 LCUs , and divorce ranked second highest with 73 LCUs . <hl> In addition , personal injury or illness , marriage , and job termination also ranked highly on the scale with 53 , 50 , and 47 LCUs , respectively . Conversely , change in residence ( 20 LCUs ) , change in eating habits ( 15 LCUs ) , and vacation ( 13 LCUs ) ranked low on the scale ( Table 14.1 ) . Minor violations of the law ranked the lowest with 11 LCUs . To complete the scale , participants checked yes for events experienced within the last 12 months . LCUs for each checked item are totaled for a score quantifying the amount of life change . Agreement on the amount of adjustment required by the various life events on the SRRS is highly consistent , even cross-culturally ( Holmes & Masuda , 1974 ) ."}, {"question": {"question_id": "fs-idm870384", "question_text": "What is one of the major criticisms of the Social Readjustment Rating Scale?", "question_choices": ["It has too few items.", "It was developed using only people from the New England region of the United States.", "It does not take into consideration how a person appraises an event.", "None of the items included are positive."], "cloze_format": "____ is one of the major criticms of the Social Readjustment Rating Scale.", "normal_format": "What is one of the major criticisms of the Social Readjustment Rating Scale?"}, "answer": {"ans_text": "It does not take into consideration how a person appraises an event.", "ans_choice": 2}, "bloom": null, "hl_sentences": "The Social Readjustment Rating Scale ( SRRS ) provides researchers a simple , easy-to-administer way of assessing the amount of stress in people \u2019 s lives , and it has been used in hundreds of studies ( Thoits , 2010 ) . Perhaps the most serious criticism is that the scale does not take into consideration respondents \u2019 appraisals of the life events it contains .", "hl_context": "<hl> The Social Readjustment Rating Scale ( SRRS ) provides researchers a simple , easy-to-administer way of assessing the amount of stress in people \u2019 s lives , and it has been used in hundreds of studies ( Thoits , 2010 ) . <hl> Despite its widespread use , the scale has been subject to criticism . First , many of the items on the SRRS are vague ; for example , death of a close friend could involve the death of a long-absent childhood friend that requires little social readjustment ( Dohrenwend , 2006 ) . In addition , some have challenged its assumption that undesirable life events are no more stressful than desirable ones ( Derogatis & Coons , 1993 ) . However , most of the available evidence suggests that , at least as far as mental health is concerned , undesirable or negative events are more strongly associated with poor outcomes ( such as depression ) than are desirable , positive events ( Hatch & Dohrenwend , 2007 ) . <hl> Perhaps the most serious criticism is that the scale does not take into consideration respondents \u2019 appraisals of the life events it contains . <hl> As you recall , appraisal of a stressor is a key element in the conceptualization and overall experience of stress . Being fired from work may be devastating to some but a welcome opportunity to obtain a better job for others . The SRRS remains one of the most well-known instruments in the study of stress , and it is a useful tool for identifying potential stress-related health outcomes ( Scully et al . , 2000 ) ."}, {"question": {"question_id": "fs-idm3394944", "question_text": "Which of the following is not a dimension of job burnout?", "question_choices": ["depersonalization", "hostility", "exhaustion", "diminished personal accomplishment"], "cloze_format": "___ is not a dimension of job burnout.", "normal_format": "Which of the following is not a dimension of job burnout?"}, "answer": {"ans_text": "hostility", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The first dimension is exhaustion \u2014 a sense that one \u2019 s emotional resources are drained or that one is at the end of her rope and has nothing more to give at a psychological level . Second , job burnout is characterized by depersonalization : a sense of emotional detachment between the worker and the recipients of his services , often resulting in callous , cynical , or indifferent attitudes toward these individuals . Third , job burnout is characterized by diminished personal accomplishment , which is the tendency to evaluate one \u2019 s work negatively by , for example , experiencing dissatisfaction with one \u2019 s job-related accomplishments or feeling as though one has categorically failed to influence others \u2019 lives through one \u2019 s work .", "hl_context": "Some people who are exposed to chronically stressful work conditions can experience job burnout , which is a general sense of emotional exhaustion and cynicism in relation to one \u2019 s job ( Maslach & Jackson , 1981 ) . Job burnout occurs frequently among those in human service jobs ( e . g . , social workers , teachers , therapists , and police officers ) . Job burnout consists of three dimensions . <hl> The first dimension is exhaustion \u2014 a sense that one \u2019 s emotional resources are drained or that one is at the end of her rope and has nothing more to give at a psychological level . <hl> <hl> Second , job burnout is characterized by depersonalization : a sense of emotional detachment between the worker and the recipients of his services , often resulting in callous , cynical , or indifferent attitudes toward these individuals . <hl> <hl> Third , job burnout is characterized by diminished personal accomplishment , which is the tendency to evaluate one \u2019 s work negatively by , for example , experiencing dissatisfaction with one \u2019 s job-related accomplishments or feeling as though one has categorically failed to influence others \u2019 lives through one \u2019 s work . <hl>"}, {"question": {"question_id": "fs-idp18973616", "question_text": "The white blood cells that attack foreign invaders to the body are called ________.", "question_choices": ["antibodies", "telomeres", "lymphocytes", "immune cells"], "cloze_format": "The white blood cells that attack foreign invaders to the body are called ________.", "normal_format": "What are the white blood cells that attack foreign invaders to the body called?"}, "answer": {"ans_text": "lymphocytes", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "One way they do this is by inhibiting the production of lymphocytes , white blood cells that circulate in the body \u2019 s fluids that are important in the immune response ( Everly & Lating , 2002 ) .", "hl_context": "When evaluating these findings , it is important to remember that there is a tangible physiological connection between the brain and the immune system . For example , the sympathetic nervous system innervates immune organs such as the thymus , bone marrow , spleen , and even lymph nodes ( Maier , Watkins , & Fleshner , 1994 ) . Also , we noted earlier that stress hormones released during hypothalamic-pituitary-adrenal ( HPA ) axis activation can adversely impact immune function . <hl> One way they do this is by inhibiting the production of lymphocytes , white blood cells that circulate in the body \u2019 s fluids that are important in the immune response ( Everly & Lating , 2002 ) . <hl>"}, {"question": {"question_id": "fs-idm45589568", "question_text": "The risk of heart disease is especially high among individuals with ________.", "question_choices": ["depression", "asthma", "telomeres", "lymphocytes"], "cloze_format": "The risk of heart disease is especially high among individuals with ________.", "normal_format": "The risk of heart disease is especially high among individuals with what?"}, "answer": {"ans_text": "depression", "ans_choice": 0}, "bloom": null, "hl_sentences": "It is important to point out that depression may be just one piece of the emotional puzzle in elevating the risk for heart disease , and that chronically experiencing several negative emotional states may be especially important . The American Heart Association , fully aware of the established importance of depression in cardiovascular diseases , several years ago recommended routine depression screening for all heart disease patients ( Lichtman et al . , 2008 ) . Perhaps the first to recognize the link between depression and heart disease was Benjamin Malzberg ( 1937 ) , who found that the death rate among institutionalized patients with melancholia ( an archaic term for depression ) was six times higher than that of the population . By the early 1990s , evidence began to accumulate showing that depressed individuals who were followed for long periods of time were at increased risk for heart disease and cardiac death ( Glassman , 2007 ) .", "hl_context": "<hl> It is important to point out that depression may be just one piece of the emotional puzzle in elevating the risk for heart disease , and that chronically experiencing several negative emotional states may be especially important . <hl> A longitudinal investigation of Vietnam War veterans found that depression , anxiety , hostility , and trait anger each independently predicted the onset of heart disease ( Boyle , Michalek , & Suarez , 2006 ) . However , when each of these negative psychological attributes was combined into a single variable , this new variable ( which researchers called psychological risk factor ) predicted heart disease more strongly than any of the individual variables . Thus , rather than examining the predictive power of isolated psychological risk factors , it seems crucial for future researchers to examine the effects of combined and more general negative emotional and psychological traits in the development of cardiovascular illnesses . <hl> The American Heart Association , fully aware of the established importance of depression in cardiovascular diseases , several years ago recommended routine depression screening for all heart disease patients ( Lichtman et al . , 2008 ) . <hl> Recently , they have recommended including depression as a risk factor for heart disease patients ( AHA , 2014 ) . <hl> Perhaps the first to recognize the link between depression and heart disease was Benjamin Malzberg ( 1937 ) , who found that the death rate among institutionalized patients with melancholia ( an archaic term for depression ) was six times higher than that of the population . <hl> A classic study in the late 1970s looked at over 8,000 manic-depressive persons in Denmark , finding a nearly 50 % increase in deaths from heart disease among these patients compared with the general Danish population ( Weeke , 1979 ) . <hl> By the early 1990s , evidence began to accumulate showing that depressed individuals who were followed for long periods of time were at increased risk for heart disease and cardiac death ( Glassman , 2007 ) . <hl> In one investigation of over 700 Denmark residents , those with the highest depression scores were 71 % more likely to have experienced a heart attack than were those with lower depression scores ( Barefoot & Schroll , 1996 ) . Figure 14.20 illustrates the gradation in risk of heart attacks for both men and women ."}, {"question": {"question_id": "fs-idp440032", "question_text": "The most lethal dimension of Type A behavior pattern seems to be ________.", "question_choices": ["hostility", "impatience", "time urgency", "competitive drive"], "cloze_format": "The most lethal dimension of Type A behavior pattern seems to be ________.", "normal_format": "What seems to be the most lethal dimension of Type A behavior pattern?"}, "answer": {"ans_text": "hostility", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Extensive research clearly suggests that the anger / hostility dimension of Type A behavior pattern may be one of the most important factors in the development of heart disease . This relationship was initially described in the Haynes et al . ( 1980 ) study mentioned above : Suppressed hostility was found to substantially elevate the risk of heart disease for both men and women .", "hl_context": "<hl> Extensive research clearly suggests that the anger / hostility dimension of Type A behavior pattern may be one of the most important factors in the development of heart disease . <hl> <hl> This relationship was initially described in the Haynes et al . <hl> <hl> ( 1980 ) study mentioned above : Suppressed hostility was found to substantially elevate the risk of heart disease for both men and women . <hl> Also , one investigation followed over 1,000 male medical students from 32 to 48 years . At the beginning of the study , these men completed a questionnaire assessing how they react to pressure ; some indicated that they respond with high levels of anger , whereas others indicated that they respond with less anger . Decades later , researchers found that those who earlier had indicated the highest levels of anger were over 6 times more likely than those who indicated less anger to have had a heart attack by age 55 , and they were 3.5 times more likely to have experienced heart disease by the same age ( Chang , Ford , Meoni , Wang , & Klag , 2002 ) . From a health standpoint , it clearly does not pay to be an angry young person ."}, {"question": {"question_id": "fs-idm90451024", "question_text": "Which of the following statements pertaining to asthma is false?", "question_choices": ["Parental and interpersonal conflicts have been tied to the development of asthma.", "Asthma sufferers can experience asthma-like symptoms simply by believing that an inert substance they breathe will lead to airway obstruction.", "Asthma has been shown to be linked to periods of depression.", "Rates of asthma have decreased considerably since 2000."], "cloze_format": "___ is a false statement pertaining to asthma.", "normal_format": "Which of the following statements pertaining to asthma is false?"}, "answer": {"ans_text": "Rates of asthma have decreased considerably since 2000.", "ans_choice": 3}, "bloom": null, "hl_sentences": "Especially concerning is that asthma is on the rise , with rates of asthma increasing 157 % between 2000 and 2010 ( CDC , 2013b ) .", "hl_context": "According to the Centers for Disease Control and Prevention ( CDC ) , around 4,000 people die each year from asthma-related causes , and asthma is a contributing factor to another 7,000 deaths each year ( CDC , 2013a ) . The CDC has revealed that asthma affects 18.7 million U . S . adults and is more common among people with lower education and income levels ( CDC , 2013b ) . <hl> Especially concerning is that asthma is on the rise , with rates of asthma increasing 157 % between 2000 and 2010 ( CDC , 2013b ) . <hl>"}, {"question": {"question_id": "fs-idm5313072", "question_text": "Emotion-focused coping would likely be a better method than problem-focused coping for dealing with which of the following stressors?", "question_choices": ["terminal cancer", "poor grades in school", "unemployment", "divorce"], "cloze_format": "Emotion-focused coping would likely be a better method than problem-focused coping for dealing with ___.", "normal_format": "Emotion-focused coping would likely be a better method than problem-focused coping for dealing with which of the following stressors?"}, "answer": {"ans_text": "terminal cancer", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "While many stressors elicit both kinds of coping strategies , problem-focused coping is more likely to occur when encountering stressors we perceive as controllable , while emotion-focused coping is more likely to predominate when faced with stressors that we believe we are powerless to change ( Folkman & Lazarus , 1980 ) .", "hl_context": "<hl> While many stressors elicit both kinds of coping strategies , problem-focused coping is more likely to occur when encountering stressors we perceive as controllable , while emotion-focused coping is more likely to predominate when faced with stressors that we believe we are powerless to change ( Folkman & Lazarus , 1980 ) . <hl> Clearly , emotion-focused coping is more effective in dealing with uncontrollable stressors . For example , if at midnight you are stressing over a 40 - page paper due in the morning that you have not yet started , you are probably better off recognizing the hopelessness of the situation and doing something to take your mind off it ; taking a problem-focused approach by trying to accomplish this task would only lead to frustration , anxiety , and even more stress ."}, {"question": {"question_id": "fs-idm2731856", "question_text": "The concept of learned helplessness was formulated by Seligman to explain the ________.", "question_choices": ["inability of dogs to attempt to escape avoidable shocks after having received inescapable shocks", "failure of dogs to learn to from prior mistakes", "ability of dogs to learn to help other dogs escape situations in which they are receiving uncontrollable shocks", "inability of dogs to learn to help other dogs escape situations in which they are receiving uncontrollable electric shocks"], "cloze_format": "The concept of learned helplessness was formulated by Seligman to explain the ________.", "normal_format": "The concept of learned helplessness was formulated by Seligman to explain what?"}, "answer": {"ans_text": "inability of dogs to attempt to escape avoidable shocks after having received inescapable shocks", "ans_choice": 0}, "bloom": null, "hl_sentences": "In one of the better illustrations of this concept , psychologist Martin Seligman conducted a series of classic experiments in the 1960s ( Seligman & Maier , 1967 ) in which dogs were placed in a chamber where they received electric shocks from which they could not escape . Later , when these dogs were given the opportunity to escape the shocks by jumping across a partition , most failed to even try ; they seemed to just give up and passively accept any shocks the experimenters chose to administer . In comparison , dogs who were previously allowed to escape the shocks tended to jump the partition and escape the pain ( Figure 14.22 ) .", "hl_context": "Dig Deeper Learned Helplessness When we lack a sense of control over the events in our lives , particularly when those events are threatening , harmful , or noxious , the psychological consequences can be profound . <hl> In one of the better illustrations of this concept , psychologist Martin Seligman conducted a series of classic experiments in the 1960s ( Seligman & Maier , 1967 ) in which dogs were placed in a chamber where they received electric shocks from which they could not escape . <hl> <hl> Later , when these dogs were given the opportunity to escape the shocks by jumping across a partition , most failed to even try ; they seemed to just give up and passively accept any shocks the experimenters chose to administer . <hl> <hl> In comparison , dogs who were previously allowed to escape the shocks tended to jump the partition and escape the pain ( Figure 14.22 ) . <hl>"}, {"question": {"question_id": "fs-idm19382000", "question_text": "Which of the following is not one of the presumed components of happiness?", "question_choices": ["using our talents to help improve the lives of others", "learning new skills", "regular pleasurable experiences", "identifying and using our talents to enrich our lives"], "cloze_format": "___ is not one of the presumed components of happiness.", "normal_format": "Which of the following is not one of the presumed components of happiness?"}, "answer": {"ans_text": "learning new skills", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Some psychologists have suggested that happiness consists of three distinct elements : the pleasant life , the good life , and the meaningful life , as shown in Figure 14.25 ( Seligman , 2002 ; Seligman , Steen , Park , & Peterson , 2005 ) . The pleasant life is realized through the attainment of day-to-day pleasures that add fun , joy , and excitement to our lives . The good life is achieved through identifying our unique skills and abilities and engaging these talents to enrich our lives ; those who achieve the good life often find themselves absorbed in their work or their recreational pursuits .", "hl_context": "<hl> Some psychologists have suggested that happiness consists of three distinct elements : the pleasant life , the good life , and the meaningful life , as shown in Figure 14.25 ( Seligman , 2002 ; Seligman , Steen , Park , & Peterson , 2005 ) . <hl> <hl> The pleasant life is realized through the attainment of day-to-day pleasures that add fun , joy , and excitement to our lives . <hl> For example , evening walks along the beach and a fulfilling sex life can enhance our daily pleasure and contribute to the pleasant life . <hl> The good life is achieved through identifying our unique skills and abilities and engaging these talents to enrich our lives ; those who achieve the good life often find themselves absorbed in their work or their recreational pursuits . <hl> The meaningful life involves a deep sense of fulfillment that comes from using our talents in the service of the greater good : in ways that benefit the lives of others or that make the world a better place . In general , the happiest people tend to be those who pursue the full life \u2014 they orient their pursuits toward all three elements ( Seligman et al . , 2005 ) ."}, {"question": {"question_id": "fs-idp69296064", "question_text": "Researchers have identified a number of factors that are related to happiness. Which of the following is not one of them?", "question_choices": ["age", "annual income up to $75,000", "physical attractiveness", "marriage"], "cloze_format": "____ is not a factor related to happiness.", "normal_format": "Researchers have identified a number of factors that are related to happiness. Which of the following is not one of them?"}, "answer": {"ans_text": "physical attractiveness", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Researchers have studied both parenthood and physical attractiveness as potential contributors to happiness , but no link has been identified .", "hl_context": "So we \u2019 ve identified many factors that exhibit some correlation to happiness . What factors don \u2019 t show a correlation ? <hl> Researchers have studied both parenthood and physical attractiveness as potential contributors to happiness , but no link has been identified . <hl> Although people tend to believe that parenthood is central to a meaningful and ful\ufb01lling life , aggregate findings from a range of countries indicate that people who do not have children are generally happier than those who do ( Hansen , 2012 ) . And although one \u2019 s perceived level of attractiveness seems to predict happiness , a person \u2019 s objective physical attractiveness is only weakly correlated with her happiness ( Diener , Wolsic , & Fujita , 1995 ) ."}, {"question": {"question_id": "fs-idm95668896", "question_text": "How does positive affect differ from optimism?", "question_choices": ["Optimism is more scientific than positive affect.", "Positive affect is more scientific than optimism.", "Positive affect involves feeling states, whereas optimism involves expectations.", "Optimism involves feeling states, whereas positive affect involves expectations."], "cloze_format": "Positive affect differs from optimism because ____.", "normal_format": "How does positive affect differ from optimism?"}, "answer": {"ans_text": "Positive affect involves feeling states, whereas optimism involves expectations.", "ans_choice": 2}, "bloom": null, "hl_sentences": "Whereas positive affect is mostly concerned with positive feeling states , optimism has been regarded as a generalized tendency to expect that good things will happen ( Chang , 2001 ) .", "hl_context": "Although positive affect and optimism are related in some ways , they are not the same ( Pressman & Cohen , 2005 ) . <hl> Whereas positive affect is mostly concerned with positive feeling states , optimism has been regarded as a generalized tendency to expect that good things will happen ( Chang , 2001 ) . <hl> It has also been conceptualized as a tendency to view life \u2019 s stressors and difficulties as temporary and external to oneself ( Peterson & Steen , 2002 ) . Numerous studies over the years have consistently shown that optimism is linked to longevity , healthier behaviors , fewer postsurgical complications , better immune functioning among men with prostate cancer , and better treatment adherence ( Rasmussen & Wallio , 2008 ) . Further , optimistic people report fewer physical symptoms , less pain , better physical functioning , and are less likely to be rehospitalized following heart surgery ( Rasmussen , Scheier , & Greenhouse , 2009 ) ."}], "summary": " Summary 14.1   What Is Stress? \n\n Stress is a process whereby an individual perceives and responds to events appraised as overwhelming or threatening to one\u2019s well-being. The scientific study of how stress and emotional factors impact health and well-being is called health psychology, a field devoted to studying the general impact of psychological factors on health. The body\u2019s primary physiological response during stress, the fight-or-flight response, was first identified in the early 20th century by Walter Cannon. The fight-or-flight response involves the coordinated activity of both the sympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis. Hans Selye, a noted endocrinologist, referred to these physiological reactions to stress as part of general adaptation syndrome, which occurs in three stages: alarm reaction (fight-or-flight reactions begin), resistance (the body begins to adapt to continuing stress), and exhaustion (adaptive energy is depleted, and stress begins to take a physical toll). \n\n 14.2   Stressors \n\n Stressors can be chronic (long term) or acute (short term), and can include traumatic events, significant life changes, daily hassles, and situations in which people are frequently exposed to challenging and unpleasant events. Many potential stressors include events or situations that require us to make changes in our lives, such as a divorce or moving to a new residence. Thomas Holmes and Richard Rahe developed the Social Readjustment Rating Scale (SRRS) to measure stress by assigning a number of life change units to life events that typically require some adjustment, including positive events. Although the SRRS has been criticized on a number of grounds, extensive research has shown that the accumulation of many LCUs is associated with increased risk of illness. Many potential stressors also include daily hassles, which are minor irritations and annoyances that can build up over time. In addition, jobs that are especially demanding, offer little control over one\u2019s working environment, or involve unfavorable working conditions can lead to job strain, thereby setting the stage for job burnout. \n\n 14.3   Stress and Illness \n\n Psychophysiological disorders are physical diseases that are either brought about or worsened by stress and other emotional factors. One of the mechanisms through which stress and emotional factors can influence the development of these diseases is by adversely affecting the body\u2019s immune system. A number of studies have demonstrated that stress weakens the functioning of the immune system. Cardiovascular disorders are serious medical conditions that have been consistently shown to be influenced by stress and negative emotions, such as anger, negative affectivity, and depression. Other psychophysiological disorders that are known to be influenced by stress and emotional factors include asthma and tension headaches. \n\n 14.4   Regulation of Stress \n\n When faced with stress, people must attempt to manage or cope with it. In general, there are two basic forms of coping: problem-focused coping and emotion-focused coping. Those who use problem-focused coping strategies tend to cope better with stress because these strategies address the source of stress rather than the resulting symptoms. To a large extent, perceived control greatly impacts reaction to stressors and is associated with greater physical and mental well-being. Social support has been demonstrated to be a highly effective buffer against the adverse effects of stress. Extensive research has shown that social support has beneficial physiological effects for people, and it seems to influence immune functioning. However, the beneficial effects of social support may be related to its influence on promoting healthy behaviors. \n\n 14.5   The Pursuit of Happiness \n\n Happiness is conceptualized as an enduring state of mind that consists of the capacity to experience pleasure in daily life, as well as the ability to engage one\u2019s skills and talents to enrich one\u2019s life and the lives of others. Although people around the world generally report that they are happy, there are differences in average happiness levels across nations. Although people have a tendency to overestimate the extent to which their happiness set points would change for the better or for the worse following certain life events, researchers have identified a number of factors that are consistently related to happiness. In recent years, positive psychology has emerged as an area of study seeking to identify and promote qualities that lead to greater happiness and fulfillment in our lives. These components include positive affect, optimism, and flow. ", "keyterm": "", "bname": "psychology"}, {"chapter": 44, "intro": " Chapter Outline 44.1   The Scope of Ecology 44.2   Biogeography 44.3   Terrestrial Biomes 44.4   Aquatic Biomes 44.5   Climate and the Effects of Global Climate Change Introduction Why study ecology? Perhaps you are interested in learning about the natural world and how living things have adapted to the physical conditions of their environment. Or, perhaps you\u2019re a future physician seeking to understand the connection between human health and ecology. Humans are a part of the ecological landscape, and human health is one important part of human interaction with our physical and living environment. Lyme disease, for instance, serves as one modern-day example of the connection between our health and the natural world ( Figure 44.1 ). More formally known as Lyme borreliosis, Lyme disease is a bacterial infection that can be transmitted to humans when they are bitten by the deer tick ( Ixodes scapularis ), which is the primary vector for this disease. However, not all deer ticks carry the bacteria that will cause Lyme disease in humans, and  I. scapularis  can have other hosts besides deer. In fact, it turns out that the probability of infection depends on the type of host upon which the tick develops: a higher proportion of ticks that live on white-footed mice carry the bacterium than do ticks that live on deer. Knowledge about the environments and population densities in which the host species is abundant would help a physician or an epidemiologist better understand how Lyme disease is transmitted and how its incidence could be reduced. ", "chapter_text": "44.1   The Scope of Ecology Learning Objectives By the end of this section, you will be able to:\n\n Define ecology and the four levels of ecological research \n\n Describe examples of the ways in which ecology requires the integration of different scientific disciplines \n\n Distinguish between abiotic and biotic components of the environment \n\n Recognize the relationship between abiotic and biotic components of the environment \n\n Ecology  is the study of the interactions of living organisms with their environment. One core goal of ecology is to understand the distribution and abundance of living things in the physical environment. Attainment of this goal requires the integration of scientific disciplines inside and outside of biology, such as biochemistry, physiology, evolution, biodiversity, molecular biology, geology, and climatology. Some ecological research also applies aspects of chemistry and physics, and it frequently uses mathematical models. \n\n Link to Learning \n\n Climate change can alter where organisms live, which can sometimes directly affect human health. Watch the PBS video  \u201cFeeling the Effects of Climate Change\u201d  in which researchers discover a pathogenic organism living far outside of its normal range. Levels of Ecological Study \n\n When a discipline such as biology is studied, it is often helpful to subdivide it into smaller, related areas. For instance, cell biologists interested in cell signaling need to understand the chemistry of the signal molecules (which are usually proteins) as well as the result of cell signaling. Ecologists interested in the factors that influence the survival of an endangered species might use mathematical models to predict how current conservation efforts affect endangered organisms. To produce a sound set of management options, a conservation biologist needs to collect accurate data, including current population size, factors affecting reproduction (like physiology and behavior), habitat requirements (such as plants and soils), and potential human influences on the endangered population and its habitat (which might be derived through studies in sociology and urban ecology). Within the discipline of ecology, researchers work at four specific levels, sometimes discretely and sometimes with overlap: organism, population, community, and ecosystem ( Figure 44.2 ). \n\n Organismal Ecology Researchers studying ecology at the organismal level are interested in the adaptations that enable individuals to live in specific habitats. These adaptations can be morphological, physiological, and behavioral. For instance, the Karner blue butterfly ( Lycaeides melissa samuelis ) ( Figure 44.3 ) is considered a specialist because the females preferentially oviposit (that is, lay eggs) on wild lupine. This preferential adaptation means that the Karner blue butterfly is highly dependent on the presence of wild lupine plants for its continued survival. After hatching, the larval caterpillars emerge and spend four to six weeks feeding solely on wild lupine ( Figure 44.4 ). The caterpillars pupate (undergo metamorphosis) and emerge as butterflies after about four weeks. The adult butterflies feed on the nectar of flowers of wild lupine and other plant species. A researcher interested in studying Karner blue butterflies at the organismal level might, in addition to asking questions about egg laying, ask questions about the butterflies\u2019 preferred temperature (a physiological question) or the behavior of the caterpillars when they are at different larval stages (a behavioral question). \n\n Population Ecology \n\n A population is a group of interbreeding organisms that are members of the same species living in the same area at the same time. (Organisms that are all members of the same species are called  conspecifics .) A population is identified, in part, by where it lives, and its area of population may have natural or artificial boundaries: natural boundaries might be rivers, mountains, or deserts, while examples of artificial boundaries include mowed grass, manmade structures, or roads. The study of population ecology focuses on the number of individuals in an area and how and why population size changes over time. Population ecologists are particularly interested in counting the Karner blue butterfly, for example, because it is classified as federally endangered. However, the distribution and density of this species is highly influenced by the distribution and abundance of wild lupine. Researchers might ask questions about the factors leading to the decline of wild lupine and how these affect Karner blue butterflies. For example, ecologists know that wild lupine thrives in open areas where trees and shrubs are largely absent. In natural settings, intermittent wildfires regularly remove trees and shrubs, helping to maintain the open areas that wild lupine requires. Mathematical models can be used to understand how wildfire suppression by humans has led to the decline of this important plant for the Karner blue butterfly. \n\n Community Ecology \n\n A biological community consists of the different species within an area, typically a three-dimensional space, and the interactions within and among these species. Community ecologists are interested in the processes driving these interactions and their consequences. Questions about conspecific interactions often focus on competition among members of the same species for a limited resource. Ecologists also study interactions among various species; members of different species are called  heterospecifics . Examples of heterospecific interactions include predation, parasitism, herbivory, competition, and pollination. These interactions can have regulating effects on population sizes and can impact ecological and evolutionary processes affecting diversity. \n\n For example, Karner blue butterfly larvae form mutualistic relationships with ants. Mutualism is a form of a long-term relationship that has coevolved between two species and from which each species benefits. For mutualism to exist between individual organisms, each species must receive some benefit from the other as a consequence of the relationship. Researchers have shown that there is an increase in the probability of survival when Karner blue butterfly larvae (caterpillars) are tended by ants. This might be because the larvae spend less time in each life stage when tended by ants, which provides an advantage for the larvae. Meanwhile, the Karner blue butterfly larvae secrete a carbohydrate-rich substance that is an important energy source for the ants. Both the Karner blue larvae and the ants benefit from their interaction. \n\n Ecosystem Ecology \n\n Ecosystem ecology is an extension of organismal, population, and community ecology. The ecosystem is composed of all the  biotic  components (living things) in an area along with the  abiotic  components (non-living things) of that area. Some of the abiotic components include air, water, and soil. Ecosystem biologists ask questions about how nutrients and energy are stored and how they move among organisms and the surrounding atmosphere, soil, and water. \n\n The Karner blue butterflies and the wild lupine live in an oak-pine barren habitat. This habitat is characterized by natural disturbance and nutrient-poor soils that are low in nitrogen. The availability of nutrients is an important factor in the distribution of the plants that live in this habitat. Researchers interested in ecosystem ecology could ask questions about the importance of limited resources and the movement of resources, such as nutrients, though the biotic and abiotic portions of the ecosystem. \n\n Career Connection Ecologist \n\nA career in ecology contributes to many facets of human society. Understanding ecological issues can help society meet the basic human needs of food, shelter, and health care. Ecologists can conduct their research in the laboratory and outside in natural environments ( Figure 44.5 ). These natural environments can be as close to home as the stream running through your campus or as far away as the hydrothermal vents at the bottom of the Pacific Ocean. Ecologists manage natural resources such as white-tailed deer populations ( Odocoileus virginianus ) for hunting or aspen ( Populus  spp.) timber stands for paper production. Ecologists also work as educators who teach children and adults at various institutions including universities, high schools, museums, and nature centers. Ecologists may also work in advisory positions assisting local, state, and federal policymakers to develop laws that are ecologically sound, or they may develop those policies and legislation themselves. To become an ecologist requires an undergraduate degree, usually in a natural science. The undergraduate degree is often followed by specialized training or an advanced degree, depending on the area of ecology selected. Ecologists should also have a broad background in the physical sciences, as well as a sound foundation in mathematics and statistics. \n\n Link to Learning \n\n Visit this  site  to see Stephen Wing, a marine ecologist from the University of Otago, discuss the role of an ecologist and the types of issues ecologists explore. \n44.2   Biogeography Learning Objectives By the end of this section, you will be able to:\n\n Define biogeography \n\n List and describe abiotic factors that affect the global distribution of plant and animal species \n\n Compare the impact of abiotic forces on aquatic and terrestrial environments \n\n Summarize the affect of abiotic factors on net primary productivity \n\n Many forces influence the communities of living organisms present in different parts of the biosphere (all of the parts of Earth inhabited by life). The biosphere extends into the atmosphere (several kilometers above Earth) and into the depths of the oceans. Despite its apparent vastness to an individual human, the biosphere occupies only a minute space when compared to the known universe. Many abiotic forces influence where life can exist and the types of organisms found in different parts of the biosphere. The abiotic factors influence the distribution of  biomes : large areas of land with similar climate, flora, and fauna. \n\n Biogeography \n\n Biogeography  is the study of the geographic distribution of living things and the abiotic factors that affect their distribution. Abiotic factors such as temperature and rainfall vary based mainly on latitude and elevation. As these abiotic factors change, the composition of plant and animal communities also changes. For example, if you were to begin a journey at the equator and walk north, you would notice gradual changes in plant communities. At the beginning of your journey, you would see tropical wet forests with broad-leaved evergreen trees, which are characteristic of plant communities found near the equator. As you continued to travel north, you would see these broad-leaved evergreen plants eventually give rise to seasonally dry forests with scattered trees. You would also begin to notice changes in temperature and moisture. At about 30 degrees north, these forests would give way to deserts, which are characterized by low precipitation. Moving farther north, you would see that deserts are replaced by grasslands or prairies. Eventually, grasslands are replaced by deciduous temperate forests. These deciduous forests give way to the boreal forests found in the subarctic, the area south of the Arctic Circle. Finally, you would reach the Arctic tundra, which is found at the most northern latitudes. This trek north reveals gradual changes in both climate and the types of organisms that have adapted to environmental factors associated with ecosystems found at different latitudes. However, different ecosystems exist at the same latitude due in part to abiotic factors such as jet streams, the Gulf Stream, and ocean currents. If you were to hike up a mountain, the changes you would see in the vegetation would parallel those as you move to higher latitudes. \n\n Ecologists who study biogeography examine patterns of species distribution. No species exists everywhere; for example, the Venus flytrap is endemic to a small area in North and South Carolina. An  endemic  species is one which is naturally found only in a specific geographic area that is usually restricted in size. Other species are generalists: species which live in a wide variety of geographic areas; the raccoon, for example, is native to most of North and Central America. \n\n Species distribution patterns are based on biotic and abiotic factors and their influences during the very long periods of time required for species evolution; therefore, early studies of biogeography were closely linked to the emergence of evolutionary thinking in the eighteenth century. Some of the most distinctive assemblages of plants and animals occur in regions that have been physically separated for millions of years by geographic barriers. Biologists estimate that Australia, for example, has between 600,000 and 700,000 species of plants and animals. Approximately 3/4 of living plant and mammal species are endemic species found solely in Australia ( Figure 44.6 ab ). \n\n Sometimes ecologists discover unique patterns of species distribution by determining where species are  not  found. Hawaii, for example, has no native land species of reptiles or amphibians, and has only one native terrestrial mammal, the hoary bat. Most of New Guinea, as another example, lacks placental mammals. \n\n Link to Learning \n\n Check out this  video  to observe a platypus swimming in its natural habitat in New South Wales, Australia. \n\n Plants can be endemic or generalists: endemic plants are found only on specific regions of the Earth, while generalists are found on many regions. Isolated land masses\u2014such as Australia, Hawaii, and Madagascar\u2014often have large numbers of endemic plant species. Some of these plants are endangered due to human activity. The forest gardenia ( Gardenia brighamii ), for instance, is endemic to Hawaii; only an estimated 15\u201320 trees are thought to exist ( Figure 44.7 ). \n\n Energy Sources \n\n Energy from the sun is captured by green plants, algae, cyanobacteria, and photosynthetic protists. These organisms convert solar energy into the chemical energy needed by all living things. Light availability can be an important force directly affecting the evolution of adaptations in photosynthesizers. For instance, plants in the understory of a temperate forest are shaded when the trees above them in the canopy completely leaf out in the late spring. Not surprisingly, understory plants have adaptations to successfully capture available light. One such adaptation is the rapid growth of spring ephemeral plants such as the spring beauty ( Figure 44.8 ). These spring flowers achieve much of their growth and finish their life cycle (reproduce) early in the season before the trees in the canopy develop leaves. \n\n In aquatic ecosystems, the availability of light may be limited because sunlight is absorbed by water, plants, suspended particles, and resident microorganisms. Toward the bottom of a lake, pond, or ocean, there is a zone that light cannot reach. Photosynthesis cannot take place there and, as a result, a number of adaptations have evolved that enable living things to survive without light. For instance, aquatic plants have photosynthetic tissue near the surface of the water; for example, think of the broad, floating leaves of a water lily\u2014water lilies cannot survive without light. In environments such as hydrothermal vents, some bacteria extract energy from inorganic chemicals because there is no light for photosynthesis. \n\n The availability of nutrients in aquatic systems is also an important aspect of energy or photosynthesis. Many organisms sink to the bottom of the ocean when they die in the open water; when this occurs, the energy found in that living organism is sequestered for some time unless ocean upwelling occurs.  Ocean upwelling  is the rising of deep ocean waters that occurs when prevailing winds blow along surface waters near a coastline ( Figure 44.9 ). As the wind pushes ocean waters offshore, water from the bottom of the ocean moves up to replace this water. As a result, the nutrients once contained in dead organisms become available for reuse by other living organisms. \n\n In freshwater systems, the recycling of nutrients occurs in response to air temperature changes. The nutrients at the bottom of lakes are recycled twice each year: in the spring and fall turnover. The  spring and fall turnover  is a seasonal process that recycles nutrients and oxygen from the bottom of a freshwater ecosystem to the top of a body of water ( Figure 44.10 ). These turnovers are caused by the formation of a  thermocline : a layer of water with a temperature that is significantly different from that of the surrounding layers. In wintertime, the surface of lakes found in many northern regions is frozen. However, the water under the ice is slightly warmer, and the water at the bottom of the lake is warmer yet at 4 \u00b0C to 5 \u00b0C (39.2 \u00b0F to 41 \u00b0F). Water is densest at 4 \u00b0C; therefore, the deepest water is also the densest. The deepest water is oxygen poor because the decomposition of organic material at the bottom of the lake uses up available oxygen that cannot be replaced by means of oxygen diffusion into the water due to the surface ice layer. Visual Connection \n\n How might turnover in tropical lakes differ from turnover in lakes that exist in temperate regions? \n\n In springtime, air temperatures increase and surface ice melts. When the temperature of the surface water begins to reach 4 \u00b0C, the water becomes heavier and sinks to the bottom. The water at the bottom of the lake is then displaced by the heavier surface water and, thus, rises to the top. As that water rises to the top, the sediments and nutrients from the lake bottom are brought along with it. During the summer months, the lake water stratifies, or forms layers, with the warmest water at the lake surface. As air temperatures drop in the fall, the temperature of the lake water cools to 4 \u00b0C; therefore, this causes fall turnover as the heavy cold water sinks and displaces the water at the bottom. The oxygen-rich water at the surface of the lake then moves to the bottom of the lake, while the nutrients at the bottom of the lake rise to the surface ( Figure 44.10 ). During the winter, the oxygen at the bottom of the lake is used by decomposers and other organisms requiring oxygen, such as fish. \n\n Temperature \n\n Temperature affects the physiology of living things as well as the density and state of water. Temperature exerts an important influence on living things because few living things can survive at temperatures below 0 \u00b0C (32 \u00b0F) due to metabolic constraints. It is also rare for living things to survive at temperatures exceeding 45 \u00b0C (113 \u00b0F); this is a reflection of evolutionary response to typical temperatures. Enzymes are most efficient within a narrow and specific range of temperatures; enzyme degradation can occur at higher temperatures. Therefore, organisms either must maintain an internal temperature or they must inhabit an environment that will keep the body within a temperature range that supports metabolism. Some animals have adapted to enable their bodies to survive significant temperature fluctuations, such as seen in hibernation or reptilian torpor. Similarly, some bacteria are adapted to surviving in extremely hot temperatures such as geysers. Such bacteria are examples of extremophiles: organisms that thrive in extreme environments. Temperature can limit the distribution of living things. Animals faced with temperature fluctuations may respond with adaptations, such as migration, in order to survive. Migration, the movement from one place to another, is an adaptation found in many animals, including many that inhabit seasonally cold climates. Migration solves problems related to temperature, locating food, and finding a mate. In migration, for instance, the Arctic Tern ( Sterna paradisaea ) makes a 40,000 km (24,000 mi) round trip flight each year between its feeding grounds in the southern hemisphere and its breeding grounds in the Arctic Ocean. Monarch butterflies ( Danaus plexippus ) live in the eastern United States in the warmer months and migrate to Mexico and the southern United States in the wintertime. Some species of mammals also make migratory forays. Reindeer ( Rangifer tarandus ) travel about 5,000 km (3,100 mi) each year to find food. Amphibians and reptiles are more limited in their distribution because they lack migratory ability. Not all animals that can migrate do so: migration carries risk and comes at a high energy cost. \n\n Some animals hibernate or estivate to survive hostile temperatures. Hibernation enables animals to survive cold conditions, and estivation allows animals to survive the hostile conditions of a hot, dry climate. Animals that hibernate or estivate enter a state known as torpor: a condition in which their metabolic rate is significantly lowered. This enables the animal to wait until its environment better supports its survival. Some amphibians, such as the wood frog ( Rana sylvatica ), have an antifreeze-like chemical in their cells, which retains the cells\u2019 integrity and prevents them from bursting. \n\n Water \n\n Water is required by all living things because it is critical for cellular processes. Since terrestrial organisms lose water to the environment by simple diffusion, they have evolved many adaptations to retain water. \n\n Plants have a number of interesting features on their leaves, such as leaf hairs and a waxy cuticle, that serve to decrease the rate of water loss via transpiration. \n\n Freshwater organisms are surrounded by water and are constantly in danger of having water rush into their cells because of osmosis. Many adaptations of organisms living in freshwater environments have evolved to ensure that solute concentrations in their bodies remain within appropriate levels. One such adaptation is the excretion of dilute urine. \n\n Marine organisms are surrounded by water with a higher solute concentration than the organism and, thus, are in danger of losing water to the environment because of osmosis. These organisms have morphological and physiological adaptations to retain water and release solutes into the environment. For example, Marine iguanas ( Amblyrhynchus cristatus ), sneeze out water vapor that is high in salt in order to maintain solute concentrations within an acceptable range while swimming in the ocean and eating marine plants. \n\n Inorganic Nutrients and Soil \n\n Inorganic nutrients, such as nitrogen and phosphorus, are important in the distribution and the abundance of living things. Plants obtain these inorganic nutrients from the soil when water moves into the plant through the roots. Therefore, soil structure (particle size of soil components), soil pH, and soil nutrient content play an important role in the distribution of plants. Animals obtain inorganic nutrients from the food they consume. Therefore, animal distributions are related to the distribution of what they eat. In some cases, animals will follow their food resource as it moves through the environment. \n\n Other Aquatic Factors \n\n Some abiotic factors, such as oxygen, are important in aquatic ecosystems as well as terrestrial environments. Terrestrial animals obtain oxygen from the air they breathe. Oxygen availability can be an issue for organisms living at very high elevations, however, where there are fewer molecules of oxygen in the air. In aquatic systems, the concentration of dissolved oxygen is related to water temperature and the speed at which the water moves. Cold water has more dissolved oxygen than warmer water. In addition, salinity, current, and tide can be important abiotic factors in aquatic ecosystems. \n\n Other Terrestrial Factors \n\n Wind can be an important abiotic factor because it influences the rate of evaporation and transpiration. The physical force of wind is also important because it can move soil, water, or other abiotic factors, as well as an ecosystem\u2019s organisms. \n\n Fire is another terrestrial factor that can be an important agent of disturbance in terrestrial ecosystems. Some organisms are adapted to fire and, thus, require the high heat associated with fire to complete a part of their life cycle. For example, the jack pine\u2014a coniferous tree\u2014requires heat from fire for its seed cones to open ( Figure 44.11 ). Through the burning of pine needles, fire adds nitrogen to the soil and limits competition by destroying undergrowth. \n\n Abiotic Factors Influencing Plant Growth \n\n Temperature and moisture are important influences on plant production (primary productivity) and the amount of organic matter available as food (net primary productivity).  Net primary productivity  is an estimation of all of the organic matter available as food; it is calculated as the total amount of carbon fixed per year minus the amount that is oxidized during cellular respiration. In terrestrial environments, net primary productivity is estimated by measuring the  aboveground biomass  per unit area, which is the total mass of living plants, excluding roots. This means that a large percentage of plant biomass which exists underground is not included in this measurement. Net primary productivity is an important variable when considering differences in biomes. Very productive biomes have a high level of aboveground biomass. \n\n Annual biomass production is directly related to the abiotic components of the environment. Environments with the greatest amount of biomass have conditions in which photosynthesis, plant growth, and the resulting net primary productivity are optimized. The climate of these areas is warm and wet. Photosynthesis can proceed at a high rate, enzymes can work most efficiently, and stomata can remain open without the risk of excessive transpiration; together, these factors lead to the maximal amount of carbon dioxide (CO 2 ) moving into the plant, resulting in high biomass production. The aboveground biomass produces several important resources for other living things, including habitat and food. Conversely, dry and cold environments have lower photosynthetic rates and therefore less biomass. The animal communities living there will also be affected by the decrease in available food. \n44.3   Terrestrial Biomes Learning Objectives By the end of this section, you will be able to:\n\n Identify the two major abiotic factors that determine terrestrial biomes \n\n Recognize distinguishing characteristics of each of the eight major terrestrial biomes \n\n The Earth\u2019s biomes are categorized into two major groups: terrestrial and aquatic. Terrestrial biomes are based on land, while aquatic biomes include both ocean and freshwater biomes. The eight major terrestrial biomes on Earth are each distinguished by characteristic temperatures and amount of precipitation. Comparing the annual totals of precipitation and fluctuations in precipitation from one biome to another provides clues as to the importance of abiotic factors in the distribution of biomes. Temperature variation on a daily and seasonal basis is also important for predicting the geographic distribution of the biome and the vegetation type in the biome. The distribution of these biomes shows that the same biome can occur in geographically distinct areas with similar climates ( Figure 44.12 ). \n\n Visual Connection \n\n Which of the following statements about biomes is false? \n\n Chaparral is dominated by shrubs. \n\n Savannas and temperate grasslands are dominated by grasses. \n\n Boreal forests are dominated by deciduous trees. \n\n Lichens are common in the arctic tundra. \n\n Tropical Wet Forest \n\n Tropical wet forests are also referred to as tropical rainforests. This biome is found in equatorial regions ( Figure 44.12 ). The vegetation is characterized by plants with broad leaves that fall off throughout the year. Unlike the trees of deciduous forests, the trees in this biome do not have a seasonal loss of leaves associated with variations in temperature and sunlight; these forests are \u201cevergreen\u201d year-round. \n\n The temperature and sunlight profiles of tropical wet forests are very stable in comparison to that of other terrestrial biomes, with the temperatures ranging from 20 \u00b0C to 34 \u00b0C (68 \u00b0F to 93 \u00b0F). When one compares the annual temperature variation of tropical wet forests with that of other forest biomes, the lack of seasonal temperature variation in the tropical wet forest becomes apparent. This lack of seasonality leads to year-round plant growth, rather than the seasonal (spring, summer, and fall) growth seen in other biomes. In contrast to other ecosystems, tropical ecosystems do not have long days and short days during the yearly cycle. Instead, a constant daily amount of sunlight (11\u201312 hrs per day) provides more solar radiation, thereby, a longer period of time for plant growth. The annual rainfall in tropical wet forests ranges from 125 to 660 cm (50\u2013200 in) with some monthly variation. While sunlight and temperature remain fairly consistent, annual rainfall is highly variable. Tropical wet forests have wet months in which there can be more than 30 cm (11\u201312 in) of precipitation, as well as dry months in which there are fewer than 10 cm (3.5 in) of rainfall. However, the driest month of a tropical wet forest still exceeds the  annual  rainfall of some other biomes, such as deserts. \n\n Tropical wet forests have high net primary productivity because the annual temperatures and precipitation values in these areas are ideal for plant growth. Therefore, the extensive biomass present in the tropical wet forest leads to plant communities with very high species diversities ( Figure 44.13 ). Tropical wet forests have more species of trees than any other biome; on average between 100 and 300 species of trees are present in a single hectare (2.5 acres) of South America. One way to visualize this is to compare the distinctive horizontal layers within the tropical wet forest biome. On the forest floor is a sparse layer of plants and decaying plant matter. Above that is an understory of short shrubby foliage. A layer of trees rises above this understory and is topped by a closed upper  canopy \u2014the uppermost overhead layer of branches and leaves. Some additional trees emerge through this closed upper canopy. These layers provide diverse and complex habitats for the variety of plants, fungi, animals, and other organisms within the tropical wet forests. For instance, epiphytes are plants that grow on other plants, which typically are not harmed. Epiphytes are found throughout tropical wet forest biomes. Many species of animals use the variety of plants and the complex structure of the tropical wet forests for food and shelter. Some organisms live several meters above ground and have adapted to this arboreal lifestyle. \n\n Savannas \n\n Savannas are grasslands with scattered trees, and they are located in Africa, South America, and northern Australia ( Figure 44.12 ). Savannas are hot, tropical areas with temperatures averaging from 24 \u00b0C to 29 \u00b0C (75 \u00b0F to 84 \u00b0F) and an annual rainfall of 10\u201340 cm (3.9\u201315.7 in). Savannas have an extensive dry season; for this reason, forest trees do not grow as well as they do in the tropical wet forest (or other forest biomes). As a result, within the grasses and forbs (herbaceous flowering plants) that dominate the savanna, there are relatively few trees ( Figure 44.14 ). Since fire is an important source of disturbance in this biome, plants have evolved well-developed root systems that allow them to quickly re-sprout after a fire. \n\n Subtropical Deserts \n\n Subtropical deserts exist between 15 \u00b0 and 30 \u00b0 north and south latitude and are centered on the Tropics of Cancer and Capricorn ( Figure 44.12 ). This biome is very dry; in some years, evaporation exceeds precipitation. Subtropical hot deserts can have daytime soil surface temperatures above 60 \u00b0C (140 \u00b0F) and nighttime temperatures approaching 0 \u00b0C (32 \u00b0F). In cold deserts, temperatures can be as high as 25 \u00b0C and can drop below -30 \u00b0C (-22 \u00b0F). Subtropical deserts are characterized by low annual precipitation of fewer than 30 cm (12 in) with little monthly variation and lack of predictability in rainfall. In some cases, the annual rainfall can be as low as 2 cm (0.8 in) in subtropical deserts located in central Australia (\u201cthe Outback\u201d) and northern Africa. The vegetation and low animal diversity of this biome is closely related to this low and unpredictable precipitation. Very dry deserts lack perennial vegetation that lives from one year to the next; instead, many plants are annuals that grow quickly and reproduce when rainfall does occur, then they die. Many other plants in these areas are characterized by having a number of adaptations that conserve water, such as deep roots, reduced foliage, and water-storing stems ( Figure 44.15 ). Seed plants in the desert produce seeds that can be in dormancy for extended periods between rains. Adaptations in desert animals include nocturnal behavior and burrowing. \n\n Chaparral \n\n The chaparral is also called the scrub forest and is found in California, along the Mediterranean Sea, and along the southern coast of Australia ( Figure 44.12 ). The annual rainfall in this biome ranges from 65 cm to 75 cm (25.6\u201329.5 in), and the majority of the rain falls in the winter. Summers are very dry and many chaparral plants are dormant during the summertime. The chaparral vegetation, shown in  Figure 44.16 , is dominated by shrubs and is adapted to periodic fires, with some plants producing seeds that only germinate after a hot fire. The ashes left behind after a fire are rich in nutrients like nitrogen that fertilize the soil and promote plant regrowth. \n\n Temperate Grasslands \n\n Temperate grasslands are found throughout central North America, where they are also known as prairies; they are also in Eurasia, where they are known as steppes ( Figure 44.12 ). Temperate grasslands have pronounced annual fluctuations in temperature with hot summers and cold winters. The annual temperature variation produces specific growing seasons for plants. Plant growth is possible when temperatures are warm enough to sustain plant growth and when ample water is available, which occurs in the spring, summer, and fall. During much of the winter, temperatures are low, and water, which is stored in the form of ice, is not available for plant growth. \n\n Annual precipitation ranges from 25 cm to 75 cm (9.8\u201329.5 in). Because of relatively lower annual precipitation in temperate grasslands, there are few trees except for those found growing along rivers or streams. The dominant vegetation tends to consist of grasses and some prairies sustain populations of grazing animals  Figure 44.17 . The vegetation is very dense and the soils are fertile because the subsurface of the soil is packed with the roots and rhizomes (underground stems) of these grasses. The roots and rhizomes act to anchor plants into the ground and replenish the organic material (humus) in the soil when they die and decay. \n\n Fires, mainly caused by lightning, are a natural disturbance in temperate grasslands. When fire is suppressed in temperate grasslands, the vegetation eventually converts to scrub and dense forests. Often, the restoration or management of temperate grasslands requires the use of controlled burns to suppress the growth of trees and maintain the grasses. \n\n Temperate Forests \n\n Temperate forests are the most common biome in eastern North America, Western Europe, Eastern Asia, Chile, and New Zealand ( Figure 44.12 ). This biome is found throughout mid-latitude regions. Temperatures range between -30 \u00b0C and 30 \u00b0C (-22 \u00b0F to 86 \u00b0F) and drop to below freezing on an annual basis. These temperatures mean that temperate forests have defined growing seasons during the spring, summer, and early fall. Precipitation is relatively constant throughout the year and ranges between 75 cm and 150 cm (29.5\u201359 in). Because of the moderate annual rainfall and temperatures, deciduous trees are the dominant plant in this biome ( Figure 44.18 ). Deciduous trees lose their leaves each fall and remain leafless in the winter. Thus, no photosynthesis occurs in the deciduous trees during the dormant winter period. Each spring, new leaves appear as the temperature increases. Because of the dormant period, the net primary productivity of temperate forests is less than that of tropical wet forests. In addition, temperate forests show less diversity of tree species than tropical wet forest biomes. \n\n The trees of the temperate forests leaf out and shade much of the ground; however, this biome is more open than tropical wet forests because trees in the temperate forests do not grow as tall as the trees in tropical wet forests. The soils of the temperate forests are rich in inorganic and organic nutrients. This is due to the thick layer of leaf litter on forest floors. As this leaf litter decays, nutrients are returned to the soil. The leaf litter also protects soil from erosion, insulates the ground, and provides habitats for invertebrates (such as the pill bug or roly-poly,  Armadillidium  vulgare ) and their predators, such as the red-backed salamander ( Plethodon cinereus ). \n\n Boreal Forests \n\n The boreal forest, also known as taiga or coniferous forest, is found south of the Arctic Circle and across most of Canada, Alaska, Russia, and northern Europe ( Figure 44.12 ). This biome has cold, dry winters and short, cool, wet summers. The annual precipitation is from 40 cm to 100 cm (15.7\u201339 in) and usually takes the form of snow. Little evaporation occurs because of the cold temperatures. \n\n The long and cold winters in the boreal forest have led to the predominance of cold-tolerant cone-bearing plants. These are evergreen coniferous trees like pines, spruce, and fir, which retain their needle-shaped leaves year-round. Evergreen trees can photosynthesize earlier in the spring than deciduous trees because less energy from the sun is required to warm a needle-like leaf than a broad leaf. This benefits evergreen trees, which grow faster than deciduous trees in the boreal forest. In addition, soils in boreal forest regions tend to be acidic with little available nitrogen. Leaves are a nitrogen-rich structure and deciduous trees must produce a new set of these nitrogen-rich structures each year. Therefore, coniferous trees that retain nitrogen-rich needles may have a competitive advantage over the broad-leafed deciduous trees. \n\n The net primary productivity of boreal forests is lower than that of temperate forests and tropical wet forests. The aboveground biomass of boreal forests is high because these slow-growing tree species are long lived and accumulate standing biomass over time. Plant species diversity is less than that seen in temperate forests and tropical wet forests. Boreal forests lack the pronounced elements of the layered forest structure seen in tropical wet forests. The structure of a boreal forest is often only a tree layer and a ground layer ( Figure 44.19 ). When conifer needles are dropped, they decompose more slowly than broad leaves; therefore, fewer nutrients are returned to the soil to fuel plant growth. \n\n Arctic Tundra \n\n The Arctic tundra lies north of the subarctic boreal forest and is located throughout the Arctic regions of the northern hemisphere ( Figure 44.12 ). The average winter temperature is -34 \u00b0C (-34 \u00b0F) and the average summer temperature is from 3 \u00b0C to 12 \u00b0C (37 \u00b0F\u201352 \u00b0F). Plants in the arctic tundra have a very short growing season of approximately 10\u201312 weeks. However, during this time, there are almost 24 hours of daylight and plant growth is rapid. The annual precipitation of the Arctic tundra is very low with little annual variation in precipitation. And, as in the boreal forests, there is little evaporation due to the cold temperatures. Plants in the Arctic tundra are generally low to the ground ( Figure 44.20 ). There is little species diversity, low net primary productivity, and low aboveground biomass. The soils of the Arctic tundra may remain in a perennially frozen state referred to as  permafrost . The permafrost makes it impossible for roots to penetrate deep into the soil and slows the decay of organic matter, which inhibits the release of nutrients from organic matter. During the growing season, the ground of the Arctic tundra can be completely covered with plants or lichens. \n\n Link to Learning \n\n Watch this  Assignment Discovery: Biomes  video  for an overview of biomes. To explore further, select one of the biomes on the extended playlist: desert, savanna, temperate forest, temperate grassland, tropic, tundra. \n44.4   Aquatic Biomes Learning Objectives By the end of this section, you will be able to:\n\n Describe the effects of abiotic factors on the composition of plant and animal communities in aquatic biomes  \n\n Compare and contrast the characteristics of the ocean zones \n\n Summarize the characteristics of standing water and flowing water freshwater biomes \n\n Abiotic Factors Influencing Aquatic Biomes \n\n Like terrestrial biomes, aquatic biomes are influenced by a series of abiotic factors. The aquatic medium\u2014water\u2014 has different physical and chemical properties than air, however. Even if the water in a pond or other body of water is perfectly clear (there are no suspended particles), water, on its own, absorbs light. As one descends into a deep body of water, there will eventually be a depth which the sunlight cannot reach. While there are some abiotic and biotic factors in a terrestrial ecosystem that might obscure light (like fog, dust, or insect swarms), usually these are not permanent features of the environment. The importance of light in aquatic biomes is central to the communities of organisms found in both freshwater and marine ecosystems. In freshwater systems, stratification due to differences in density is perhaps the most critical abiotic factor and is related to the energy aspects of light. The thermal properties of water (rates of heating and cooling) are significant to the function of marine systems and have major impacts on global climate and weather patterns. Marine systems are also influenced by large-scale physical water movements, such as currents; these are less important in most freshwater lakes. \n\n The ocean is categorized by several areas or zones ( Figure 44.21 ). All of the ocean\u2019s open water is referred to as the  pelagic realm  (or zone). The  benthic realm  (or zone) extends along the ocean bottom from the shoreline to the deepest parts of the ocean floor. Within the pelagic realm is the  photic zone , which is the portion of the ocean that light can penetrate (approximately 200 m or 650 ft). At depths greater than 200 m, light cannot penetrate; thus, this is referred to as the  aphotic zone . The majority of the ocean is aphotic and lacks sufficient light for photosynthesis. The deepest part of the ocean, the Challenger Deep (in the Mariana Trench, located in the western Pacific Ocean), is about 11,000 m (about 6.8 mi) deep. To give some perspective on the depth of this trench, the ocean is, on average, 4267 m or 14,000 ft deep. These realms and zones are relevant to freshwater lakes as well. \n\n Visual Connection \n\n In which of the following regions would you expect to find photosynthetic organisms? \n\n the aphotic zone, the neritic zone, the oceanic zone, and the benthic realm \n\n the photic zone, the intertidal zone, the neritic zone, and the oceanic zone \n\n the photic zone, the abyssal zone, the neritic zone, and the oceanic zone \n\n the pelagic realm, the aphotic zone, the neritic zone, and the oceanic zone \n\n Marine Biomes \n\n The ocean is the largest marine biome. It is a continuous body of salt water that is relatively uniform in chemical composition; it is a weak solution of mineral salts and decayed biological matter. Within the ocean, coral reefs are a second kind of marine biome. Estuaries, coastal areas where salt water and fresh water mix, form a third unique marine biome. \n\n Ocean \n\n The physical diversity of the ocean is a significant influence on plants, animals, and other organisms. The ocean is categorized into different zones based on how far light reaches into the water. Each zone has a distinct group of species adapted to the biotic and abiotic conditions particular to that zone. \n\n The  intertidal zone , which is the zone between high and low tide, is the oceanic region that is closest to land ( Figure 44.21 ). Generally, most people think of this portion of the ocean as a sandy beach. In some cases, the intertidal zone is indeed a sandy beach, but it can also be rocky or muddy. The intertidal zone is an extremely variable environment because of tides. Organisms are exposed to air and sunlight at low tide and are underwater most of the time, especially during high tide. Therefore, living things that thrive in the intertidal zone are adapted to being dry for long periods of time. The shore of the intertidal zone is also repeatedly struck by waves, and the organisms found there are adapted to withstand damage from the pounding action of the waves ( Figure 44.22 ). The exoskeletons of shoreline crustaceans (such as the shore crab,  Carcinus maenas ) are tough and protect them from desiccation (drying out) and wave damage. Another consequence of the pounding waves is that few algae and plants establish themselves in the constantly moving rocks, sand, or mud. \n\n The  neritic zone  ( Figure 44.21 ) extends from the intertidal zone to depths of about 200 m (or 650 ft) at the edge of the continental shelf. Since light can penetrate this depth, photosynthesis can occur in the neritic zone. The water here contains silt and is well-oxygenated, low in pressure, and stable in temperature. Phytoplankton and floating  Sargassum  (a type of free-floating marine seaweed) provide a habitat for some sea life found in the neritic zone. Zooplankton, protists, small fishes, and shrimp are found in the neritic zone and are the base of the food chain for most of the world\u2019s fisheries. Beyond the neritic zone is the open ocean area known as the  oceanic zone  ( Figure 44.21 ). Within the oceanic zone there is thermal stratification where warm and cold waters mix because of ocean currents. Abundant plankton serve as the base of the food chain for larger animals such as whales and dolphins. Nutrients are scarce and this is a relatively less productive part of the marine biome. When photosynthetic organisms and the protists and animals that feed on them die, their bodies fall to the bottom of the ocean where they remain; unlike freshwater lakes, the open ocean lacks a process for bringing the organic nutrients back up to the surface. The majority of organisms in the aphotic zone include sea cucumbers (phylum Echinodermata) and other organisms that survive on the nutrients contained in the dead bodies of organisms in the photic zone. \n\n Beneath the pelagic zone is the benthic realm, the deepwater region beyond the continental shelf ( Figure 44.21 ). The bottom of the benthic realm is comprised of sand, silt, and dead organisms. Temperature decreases, remaining above freezing, as water depth increases. This is a nutrient-rich portion of the ocean because of the dead organisms that fall from the upper layers of the ocean. Because of this high level of nutrients, a diversity of fungi, sponges, sea anemones, marine worms, sea stars, fishes, and bacteria exist. \n\n The deepest part of the ocean is the  abyssal zone , which is at depths of 4000 m or greater. The abyssal zone ( Figure 44.21 ) is very cold and has very high pressure, high oxygen content, and low nutrient content. There are a variety of invertebrates and fishes found in this zone, but the abyssal zone does not have plants because of the lack of light. Hydrothermal vents are found primarily in the abyssal zone; chemosynthetic bacteria utilize the hydrogen sulfide and other minerals emitted from the vents. These chemosynthetic bacteria use the hydrogen sulfide as an energy source and serve as the base of the food chain found in the abyssal zone. \n\n Coral Reefs \n\n Coral reefs  are ocean ridges formed by marine invertebrates living in warm shallow waters within the photic zone of the ocean. They are found within 30\u02da north and south of the equator. The Great Barrier Reef is a well-known reef system located several miles off the northeastern coast of Australia. Other coral reef systems are fringing islands, which are directly adjacent to land, or atolls, which are circular reef systems surrounding a former landmass that is now underwater. The coral organisms (members of phylum Cnidaria) are colonies of saltwater polyps that secrete a calcium carbonate skeleton. These calcium-rich skeletons slowly accumulate, forming the underwater reef ( Figure 44.23 ). Corals found in shallower waters (at a depth of approximately 60 m or about 200 ft) have a mutualistic relationship with photosynthetic unicellular algae. The relationship provides corals with the majority of the nutrition and the energy they require. The waters in which these corals live are nutritionally poor and, without this mutualism, it would not be possible for large corals to grow. Some corals living in deeper and colder water do not have a mutualistic relationship with algae; these corals attain energy and nutrients using stinging cells on their tentacles to capture prey. \n\n Link to Learning \n\n Watch this  National Oceanic and Atmospheric Administration (NOAA) video  to see marine ecologist Dr. Peter Etnoyer discusses his research on coral organisms. It is estimated that more than 4,000 fish species inhabit coral reefs. These fishes can feed on coral, the  cryptofauna  (invertebrates found within the calcium carbonate substrate of the coral reefs), or the seaweed and algae that are associated with the coral. In addition, some fish species inhabit the boundaries of a coral reef; these species include  predators , herbivores, or  planktivores . Predators are animal species that hunt and are carnivores or \u201cflesh eaters.\u201d Herbivores eat plant material, and planktivores eat plankton. \n\n Evolution Connection Global Decline of Coral Reefs \n\nIt takes a long time to build a coral reef. The animals that create coral reefs have evolved over millions of years, continuing to slowly deposit the calcium carbonate that forms their characteristic ocean homes. Bathed in warm tropical waters, the coral animals and their symbiotic algal partners evolved to survive at the upper limit of ocean water temperature. \n\n Together, climate change and human activity pose dual threats to the long-term survival of the world\u2019s coral reefs. As global warming due to fossil fuel emissions raises ocean temperatures, coral reefs are suffering. The excessive warmth causes the reefs to expel their symbiotic, food-producing algae, resulting in a phenomenon known as bleaching. When bleaching occurs, the reefs lose much of their characteristic color as the algae and the coral animals die if loss of the symbiotic zooxanthellae is prolonged. \n\n Rising levels of atmospheric carbon dioxide further threaten the corals in other ways; as CO 2  dissolves in ocean waters, it lowers the pH and increases ocean acidity. As acidity increases, it interferes with the calcification that normally occurs as coral animals build their calcium carbonate homes. \n\n When a coral reef begins to die, species diversity plummets as animals lose food and shelter. Coral reefs are also economically important tourist destinations, so the decline of coral reefs poses a serious threat to coastal economies. \n\n Human population growth has damaged corals in other ways, too. As human coastal populations increase, the runoff of sediment and agricultural chemicals has increased, too, causing some of the once-clear tropical waters to become cloudy. At the same time, overfishing of popular fish species has allowed the predator species that eat corals to go unchecked. \n\n Although a rise in global temperatures of 1\u20132\u02daC (a conservative scientific projection) in the coming decades may not seem large, it is very significant to this biome. When change occurs rapidly, species can become extinct before evolution leads to new adaptations. Many scientists believe that global warming, with its rapid (in terms of evolutionary time) and inexorable increases in temperature, is tipping the balance beyond the point at which many of the world\u2019s coral reefs can recover. \n\n Estuaries: Where the Ocean Meets Fresh Water \n\n Estuaries  are biomes that occur where a source of fresh water, such as a river, meets the ocean. Therefore, both fresh water and salt water are found in the same vicinity; mixing results in a diluted (brackish) saltwater. Estuaries form protected areas where many of the young offspring of crustaceans, mollusks, and fish begin their lives. Salinity is a very important factor that influences the organisms and the adaptations of the organisms found in estuaries. The salinity of estuaries varies and is based on the rate of flow of its freshwater sources. Once or twice a day, high tides bring salt water into the estuary. Low tides occurring at the same frequency reverse the current of salt water. \n\n The short-term and rapid variation in salinity due to the mixing of fresh water and salt water is a difficult physiological challenge for the plants and animals that inhabit estuaries. Many estuarine plant species are halophytes: plants that can tolerate salty conditions. Halophytic plants are adapted to deal with the salinity resulting from saltwater on their roots or from sea spray. In some halophytes, filters in the roots remove the salt from the water that the plant absorbs. Other plants are able to pump oxygen into their roots. Animals, such as mussels and clams (phylum Mollusca), have developed behavioral adaptations that expend a lot of energy to function in this rapidly changing environment. When these animals are exposed to low salinity, they stop feeding, close their shells, and switch from aerobic respiration (in which they use gills) to anaerobic respiration (a process that does not require oxygen). When high tide returns to the estuary, the salinity and oxygen content of the water increases, and these animals open their shells, begin feeding, and return to aerobic respiration. \n\n Freshwater Biomes \n\n Freshwater biomes include lakes and ponds (standing water) as well as rivers and streams (flowing water). They also include wetlands, which will be discussed later. Humans rely on freshwater biomes to provide aquatic resources for drinking water, crop irrigation, sanitation, and industry. These various roles and human benefits are referred to as  ecosystem services . Lakes and ponds are found in terrestrial landscapes and are, therefore, connected with abiotic and biotic factors influencing these terrestrial biomes. \n\n Lakes and Ponds \n\n Lakes and ponds can range in area from a few square meters to thousands of square kilometers. Temperature is an important abiotic factor affecting living things found in lakes and ponds. In the summer, thermal stratification of lakes and ponds occurs when the upper layer of water is warmed by the sun and does not mix with deeper, cooler water. Light can penetrate within the photic zone of the lake or pond. Phytoplankton (algae and cyanobacteria) are found here and carry out photosynthesis, providing the base of the food web of lakes and ponds. Zooplankton, such as rotifers and small crustaceans, consume these phytoplankton. At the bottom of lakes and ponds, bacteria in the aphotic zone break down dead organisms that sink to the bottom. \n\n Nitrogen and phosphorus are important limiting nutrients in lakes and ponds. Because of this, they are determining factors in the amount of phytoplankton growth in lakes and ponds. When there is a large input of nitrogen and phosphorus (from sewage and runoff from fertilized lawns and farms, for example), the growth of algae skyrockets, resulting in a large accumulation of algae called an  algal bloom . Algal blooms ( Figure 44.24 ) can become so extensive that they reduce light penetration in water. As a result, the lake or pond becomes aphotic and photosynthetic plants cannot survive. When the algae die and decompose, severe oxygen depletion of the water occurs. Fishes and other organisms that require oxygen are then more likely to die, and resulting dead zones are found across the globe. Lake Erie and the Gulf of Mexico represent freshwater and marine habitats where phosphorus control and storm water runoff pose significant environmental challenges. \n\n Rivers and Streams \n\n Rivers and streams are continuously moving bodies of water that carry large amounts of water from the source, or headwater, to a lake or ocean. The largest rivers include the Nile River in Africa, the Amazon River in South America, and the Mississippi River in North America. \n\n Abiotic features of rivers and streams vary along the length of the river or stream. Streams begin at a point of origin referred to as  source water . The source water is usually cold, low in nutrients, and clear. The  channel  (the width of the river or stream) is narrower than at any other place along the length of the river or stream. Because of this, the current is often faster here than at any other point of the river or stream. \n\n The fast-moving water results in minimal silt accumulation at the bottom of the river or stream; therefore, the water is clear. Photosynthesis here is mostly attributed to algae that are growing on rocks; the swift current inhibits the growth of phytoplankton. An additional input of energy can come from leaves or other organic material that falls into the river or stream from trees and other plants that border the water. When the leaves decompose, the organic material and nutrients in the leaves are returned to the water. Plants and animals have adapted to this fast-moving water. For instance, leeches (phylum Annelida) have elongated bodies and suckers on both ends. These suckers attach to the substrate, keeping the leech anchored in place. Freshwater trout species (phylum Chordata) are an important predator in these fast-moving rivers and streams. \n\n As the river or stream flows away from the source, the width of the channel gradually widens and the current slows. This slow-moving water, caused by the gradient decrease and the volume increase as tributaries unite, has more sedimentation. Phytoplankton can also be suspended in slow-moving water. Therefore, the water will not be as clear as it is near the source. The water is also warmer. Worms (phylum Annelida) and insects (phylum Arthropoda) can be found burrowing into the mud. The higher order predator vertebrates (phylum Chordata) include waterfowl, frogs, and fishes. These predators must find food in these slow moving, sometimes murky, waters and, unlike the trout in the waters at the source, these vertebrates may not be able to use vision as their primary sense to find food. Instead, they are more likely to use taste or chemical cues to find prey. \n\n Wetlands \n\n Wetlands are environments in which the soil is either permanently or periodically saturated with water. Wetlands are different from lakes because wetlands are shallow bodies of water whereas lakes vary in depth.  Emergent vegetation  consists of wetland plants that are rooted in the soil but have portions of leaves, stems, and flowers extending above the water\u2019s surface. There are several types of wetlands including marshes, swamps, bogs, mudflats, and salt marshes ( Figure 44.25 ). The three shared characteristics among these types\u2014what makes them wetlands\u2014are their hydrology, hydrophytic vegetation, and hydric soils. \n\n Freshwater marshes and swamps are characterized by slow and steady water flow. Bogs develop in depressions where water flow is low or nonexistent. Bogs usually occur in areas where there is a clay bottom with poor percolation. Percolation is the movement of water through the pores in the soil or rocks. The water found in a bog is stagnant and oxygen depleted because the oxygen that is used during the decomposition of organic matter is not replaced. As the oxygen in the water is depleted, decomposition slows. This leads to organic acids and other acids building up and lowering the pH of the water. At a lower pH, nitrogen becomes unavailable to plants. This creates a challenge for plants because nitrogen is an important limiting resource. Some types of bog plants (such as sundews, pitcher plants, and Venus flytraps) capture insects and extract the nitrogen from their bodies. Bogs have low net primary productivity because the water found in bogs has low levels of nitrogen and oxygen. \n44.5   Climate and the Effects of Global Climate Change Learning Objectives By the end of this section, you will be able to:\n\n Define global climate change \n\n Summarize the effects of the Industrial Revolution on global atmospheric carbon dioxide concentration \n\n Describe three natural factors affecting long-term global climate \n\n List two or more greenhouse gases and describe their role in the greenhouse effect \n\n All biomes are universally affected by global conditions, such as climate, that ultimately shape each biome\u2019s environment. Scientists who study climate have noted a series of marked changes that have gradually become increasingly evident during the last sixty years.  Global climate change  is the term used to describe altered global weather patterns, including a worldwide increase in temperature, due largely to rising levels of atmospheric carbon dioxide. \n\n Climate and Weather \n\n A common misconception about global climate change is that a specific weather event occurring in a particular region (for example, a very cool week in June in central Indiana) is evidence of global climate change. However, a cold week in June is a weather-related event and not a climate-related one. These misconceptions often arise because of confusion over the terms climate and weather. \n\n Climate  refers to the long-term, predictable atmospheric conditions of a specific area. The climate of a biome is characterized by having consistent temperature and annual rainfall ranges. Climate does not address the amount of rain that fell on one particular day in a biome or the colder-than-average temperatures that occurred on one day. In contrast,  weather  refers to the conditions of the atmosphere during a short period of time. Weather forecasts are usually made for 48-hour cycles. Long-range weather forecasts are available but can be unreliable. \n\n To better understand the difference between climate and weather, imagine that you are planning an outdoor event in northern Wisconsin. You would be thinking about  climate  when you plan the event in the summer rather than the winter because you have long-term knowledge that any given Saturday in the months of May to August would be a better choice for an outdoor event in Wisconsin than any given Saturday in January. However, you cannot determine the specific day that the event should be held on because it is difficult to accurately predict the weather on a specific day. Climate can be considered \u201caverage\u201d weather. \n\n Global Climate Change \n\n Climate change can be understood by approaching three areas of study: \n\n current and past global climate change \n\n causes of past and present-day global climate change \n\n ancient and current results of climate change \n\n It is helpful to keep these three different aspects of climate change clearly separated when consuming media reports about global climate change. It is common for reports and discussions about global climate change to confuse the data showing that Earth\u2019s climate is changing with the factors that drive this climate change. \n\n Evidence for Global Climate Change \n\n Since scientists cannot go back in time to directly measure climatic variables, such as average temperature and precipitation, they must instead indirectly measure temperature. To do this, scientists rely on historical evidence of Earth\u2019s past climate. \n\n Antarctic ice cores are a key example of such evidence. These ice cores are samples of polar ice obtained by means of drills that reach thousands of meters into ice sheets or high mountain glaciers. Viewing the ice cores is like traveling backwards through time; the deeper the sample, the earlier the time period. Trapped within the ice are bubbles of air and other biological evidence that can reveal temperature and carbon dioxide data. Antarctic ice cores have been collected and analyzed to indirectly estimate the temperature of the Earth over the past 400,000 years ( Figure 44.26 a ). The 0 \u00b0C on this graph refers to the long-term average. Temperatures that are greater than 0 \u00b0C exceed Earth\u2019s long-term average temperature. Conversely, temperatures that are less than 0 \u00b0C are less than Earth\u2019s average temperature. This figure shows that there have been periodic cycles of increasing and decreasing temperature. Before the late 1800s, the Earth has been as much as 9 \u00b0C cooler and about 3 \u00b0C warmer. Note that the graph in  Figure 44.26 b  shows that the atmospheric concentration of carbon dioxide has also risen and fallen in periodic cycles; note the relationship between carbon dioxide concentration and temperature.  Figure 44.26 b  shows that carbon dioxide levels in the atmosphere have historically cycled between 180 and 300 parts per million (ppm) by volume. Figure 44.26 a  does not show the last 2,000 years with enough detail to compare the changes of Earth\u2019s temperature during the last 400,000 years with the temperature change that has occurred in the more recent past. Two significant temperature anomalies, or irregularities, have occurred in the last 2000 years. These are the Medieval Climate Anomaly (or the Medieval Warm Period) and the Little Ice Age. A third temperature anomaly aligns with the Industrial Era. The Medieval Climate Anomaly occurred between 900 and 1300 AD. During this time period, many climate scientists think that slightly warmer weather conditions prevailed in many parts of the world; the higher-than-average temperature changes varied between 0.10 \u00b0C and 0.20 \u00b0C above the norm. Although 0.10 \u00b0C does not seem large enough to produce any noticeable change, it did free seas of ice. Because of this warming, the Vikings were able to colonize Greenland. The Little Ice Age was a cold period that occurred between 1550 AD and 1850 AD. During this time, a slight cooling of a little less than 1 \u00b0C was observed in North America, Europe, and possibly other areas of the Earth. This 1 \u00b0C change in global temperature is a seemingly small deviation in temperature (as was observed during the Medieval Climate Anomaly); however, it also resulted in noticeable changes. Historical accounts reveal a time of exceptionally harsh winters with much snow and frost. The Industrial Revolution, which began around 1750, was characterized by changes in much of human society. Advances in agriculture increased the food supply, which improved the standard of living for people in Europe and the United States. New technologies were invented and provided jobs and cheaper goods. These new technologies were powered using fossil fuels, especially coal. The Industrial Revolution starting in the early nineteenth century ushered in the beginning of the Industrial Era. When a fossil fuel is burned, carbon dioxide is released. With the beginning of the Industrial Era, atmospheric carbon dioxide began to rise ( Figure 44.27 ). \n\n Current and Past Drivers of Global Climate Change \n\n Since it is not possible to go back in time to directly observe and measure climate, scientists use indirect evidence to determine the drivers, or factors, that may be responsible for climate change. The indirect evidence includes data collected using ice cores, boreholes (a narrow shaft bored into the ground), tree rings, glacier lengths, pollen remains, and ocean sediments. The data shows a correlation between the timing of temperature changes and drivers of climate change: before the Industrial Era (pre-1780), there were three drivers of climate change that were not related to human activity or atmospheric gases. The first of these is the Milankovitch cycles. The  Milankovitch cycles  describe the effects of slight changes in the Earth\u2019s orbit on Earth\u2019s climate. The length of the Milankovitch cycles ranges between 19,000 and 100,000 years. In other words, one could expect to see some predictable changes in the Earth\u2019s climate associated with changes in the Earth\u2019s orbit at a minimum of every 19,000 years. \n\n The variation in the sun\u2019s intensity is the second natural factor responsible for climate change.  Solar intensity  is the amount of solar power or energy the sun emits in a given amount of time. There is a direct relationship between solar intensity and temperature. As solar intensity increases (or decreases), the Earth\u2019s temperature correspondingly increases (or decreases). Changes in solar intensity have been proposed as one of several possible explanations for the Little Ice Age. \n\n Finally, volcanic eruptions are a third natural driver of climate change. Volcanic eruptions can last a few days, but the solids and gases released during an eruption can influence the climate over a period of a few years, causing short-term climate changes. The gases and solids released by volcanic eruptions can include carbon dioxide, water vapor, sulfur dioxide, hydrogen sulfide, hydrogen, and carbon monoxide. Generally, volcanic eruptions cool the climate. This occurred in 1783 when volcanos in Iceland erupted and caused the release of large volumes of sulfuric oxide. This led to  haze-effect cooling , a global phenomenon that occurs when dust, ash, or other suspended particles block out sunlight and trigger lower global temperatures as a result; haze-effect cooling usually extends for one or more years. In Europe and North America, haze-effect cooling produced some of the lowest average winter temperatures on record in 1783 and 1784. \n\n Greenhouse gases are probably the most significant drivers of the climate. When heat energy from the sun strikes the Earth, gases known as  greenhouse gases  trap the heat in the atmosphere, as do the glass panes of a greenhouse keep heat from escaping. The greenhouse gases that affect Earth include carbon dioxide, methane, water vapor, nitrous oxide, and ozone. Approximately half of the radiation from the sun passes through these gases in the atmosphere and strikes the Earth. This radiation is converted into thermal radiation on the Earth\u2019s surface, and then a portion of that energy is re-radiated back into the atmosphere. Greenhouse gases, however, reflect much of the thermal energy back to the Earth\u2019s surface. The more greenhouse gases there are in the atmosphere, the more thermal energy is reflected back to the Earth\u2019s surface. Greenhouse gases absorb and emit radiation and are an important factor in the  greenhouse effect : the warming of Earth due to carbon dioxide and other greenhouse gases in the atmosphere. Evidence supports the relationship between atmospheric concentrations of carbon dioxide and temperature: as carbon dioxide rises, global temperature rises. Since 1950, the concentration of atmospheric carbon dioxide has increased from about 280 ppm to 382 ppm in 2006. In 2011, the atmospheric carbon dioxide concentration was 392 ppm. However, the planet would not be inhabitable by current life forms if water vapor did not produce its drastic greenhouse warming effect. \n\n Scientists look at patterns in data and try to explain differences or deviations from these patterns. The atmospheric carbon dioxide data reveal a historical pattern of carbon dioxide increasing and decreasing, cycling between a low of 180 ppm and a high of 300 ppm. Scientists have concluded that it took around 50,000 years for the atmospheric carbon dioxide level to increase from its low minimum concentration to its higher maximum concentration. However, starting recently, atmospheric carbon dioxide concentrations have increased beyond the historical maximum of 300 ppm. The current increases in atmospheric carbon dioxide have happened very quickly\u2014in a matter of hundreds of years rather than thousands of years. What is the reason for this difference in the rate of change and the amount of increase in carbon dioxide? A key factor that must be recognized when comparing the historical data and the current data is the presence of modern human society; no other driver of climate change has yielded changes in atmospheric carbon dioxide levels at this rate or to this magnitude. \n\n Human activity releases carbon dioxide and methane, two of the most important greenhouse gases, into the atmosphere in several ways. The primary mechanism that releases carbon dioxide is the burning of fossil fuels, such as gasoline, coal, and natural gas ( Figure 44.28 ). Deforestation, cement manufacture, animal agriculture, the clearing of land, and the burning of forests are other human activities that release carbon dioxide. Methane (CH 4 ) is produced when bacteria break down organic matter under anaerobic conditions. Anaerobic conditions can happen when organic matter is trapped underwater (such as in rice paddies) or in the intestines of herbivores. Methane can also be released from natural gas fields and the decomposition that occurs in landfills. Another source of methane is the melting of clathrates.  Clathrates  are frozen chunks of ice and methane found at the bottom of the ocean. When water warms, these chunks of ice melt and methane is released. As the ocean\u2019s water temperature increases, the rate at which clathrates melt is increasing, releasing even more methane. This leads to increased levels of methane in the atmosphere, which further accelerates the rate of global warming. This is an example of the positive feedback loop that is leading to the rapid rate of increase of global temperatures. \n\n Documented Results of Climate Change: Past and Present \n\n Scientists have geological evidence of the consequences of long-ago climate change. Modern-day phenomena such as retreating glaciers and melting polar ice cause a continual rise in sea level. Meanwhile, changes in climate can negatively affect organisms. \n\n Geological Climate Change \n\n Global warming has been associated with at least one planet-wide extinction event during the geological past. The Permian extinction event occurred about 251 million years ago toward the end of the roughly 50-million-year-long geological time span known as the Permian period. This geologic time period was one of the three warmest periods in Earth\u2019s geologic history. Scientists estimate that approximately 70 percent of the terrestrial plant and animal species and 84 percent of marine species became extinct, vanishing forever near the end of the Permian period. Organisms that had adapted to wet and warm climatic conditions, such as annual rainfall of 300\u2013400 cm (118\u2013157 in) and 20 \u00b0C\u201330 \u00b0C (68 \u00b0F\u201386 \u00b0F) in the tropical wet forest, may not have been able to survive the Permian climate change. Link to Learning \n\n Watch this  NASA video  to discover the mixed effects of global warming on plant growth. While scientists found that warmer temperatures in the 1980s and 1990s caused an increase in plant productivity, this advantage has since been counteracted by more frequent droughts. \n\n Present Climate Change \n\n A number of global events have occurred that may be attributed to climate change during our lifetimes. Glacier National Park in Montana is undergoing the retreat of many of its glaciers, a phenomenon known as glacier recession. In 1850, the area contained approximately 150 glaciers. By 2010, however, the park contained only about 24 glaciers greater than 25 acres in size. One of these glaciers is the Grinnell Glacier ( Figure 44.29 ) at Mount Gould. Between 1966 and 2005, the size of Grinnell Glacier shrank by 40 percent. Similarly, the mass of the ice sheets in Greenland and the Antarctic is decreasing: Greenland lost 150\u2013250 km 3  of ice per year between 2002 and 2006. In addition, the size and thickness of the Arctic sea ice is decreasing. \n\n This loss of ice is leading to increases in the global sea level. On average, the sea is rising at a rate of 1.8 mm per year. However, between 1993 and 2010 the rate of sea level increase ranged between 2.9 and 3.4 mm per year. A variety of factors affect the volume of water in the ocean, including the temperature of the water (the density of water is related to its temperature) and the amount of water found in rivers, lakes, glaciers, polar ice caps, and sea ice. As glaciers and polar ice caps melt, there is a significant contribution of liquid water that was previously frozen. \n\n In addition to some abiotic conditions changing in response to climate change, many organisms are also being affected by the changes in temperature. Temperature and precipitation play key roles in determining the geographic distribution and phenology of plants and animals. (Phenology is the study of the effects of climatic conditions on the timing of periodic lifecycle events, such as flowering in plants or migration in birds.) Researchers have shown that 385 plant species in Great Britain are flowering 4.5 days sooner than was recorded earlier during the previous 40 years. In addition, insect-pollinated species were more likely to flower earlier than wind-pollinated species. The impact of changes in flowering date would be mitigated if the insect pollinators emerged earlier. This mismatched timing of plants and pollinators could result in injurious ecosystem effects because, for continued survival, insect-pollinated plants must flower when their pollinators are present. ", "questions": [{"question": {"question_id": "fs-idp212979968", "question_text": "The study of nutrient cycling though the environment is an example of which of the following?", "question_choices": ["organismal ecology", "population ecology", "community ecology", "ecosystem ecology"], "cloze_format": "The study of nutrient cycling though the environment is an example of ___.", "normal_format": "The study of nutrient cycling though the environment is an example of which of the following?"}, "answer": {"ans_text": "ecosystem ecology", "ans_choice": 3}, "bloom": null, "hl_sentences": "Researchers interested in ecosystem ecology could ask questions about the importance of limited resources and the movement of resources , such as nutrients , though the biotic and abiotic portions of the ecosystem . Ecosystem ecology is an extension of organismal , population , and community ecology . Ecosystem biologists ask questions about how nutrients and energy are stored and how they move among organisms and the surrounding atmosphere , soil , and water .", "hl_context": "The Karner blue butterflies and the wild lupine live in an oak-pine barren habitat . This habitat is characterized by natural disturbance and nutrient-poor soils that are low in nitrogen . The availability of nutrients is an important factor in the distribution of the plants that live in this habitat . <hl> Researchers interested in ecosystem ecology could ask questions about the importance of limited resources and the movement of resources , such as nutrients , though the biotic and abiotic portions of the ecosystem . <hl> <hl> Ecosystem ecology is an extension of organismal , population , and community ecology . <hl> The ecosystem is composed of all the biotic components ( living things ) in an area along with the abiotic components ( non-living things ) of that area . Some of the abiotic components include air , water , and soil . <hl> Ecosystem biologists ask questions about how nutrients and energy are stored and how they move among organisms and the surrounding atmosphere , soil , and water . <hl>"}, {"question": {"question_id": "fs-idm245558256", "question_text": "Understory plants in a temperate forest have adaptations to capture limited ________.", "question_choices": ["water", "nutrients", "heat", "sunlight"], "cloze_format": "Understory plants in a temperate forest have adaptations to capture limited ________.", "normal_format": "Understory plants in a temperate forest have adaptations to capture limited which of the following?"}, "answer": {"ans_text": "sunlight", "ans_choice": 3}, "bloom": null, "hl_sentences": "For instance , plants in the understory of a temperate forest are shaded when the trees above them in the canopy completely leaf out in the late spring . Not surprisingly , understory plants have adaptations to successfully capture available light .", "hl_context": "Energy from the sun is captured by green plants , algae , cyanobacteria , and photosynthetic protists . These organisms convert solar energy into the chemical energy needed by all living things . Light availability can be an important force directly affecting the evolution of adaptations in photosynthesizers . <hl> For instance , plants in the understory of a temperate forest are shaded when the trees above them in the canopy completely leaf out in the late spring . <hl> <hl> Not surprisingly , understory plants have adaptations to successfully capture available light . <hl> One such adaptation is the rapid growth of spring ephemeral plants such as the spring beauty ( Figure 44.8 ) . These spring flowers achieve much of their growth and finish their life cycle ( reproduce ) early in the season before the trees in the canopy develop leaves ."}, {"question": {"question_id": "fs-idp82347056", "question_text": "Which of the following biomes is characterized by abundant water resources?", "question_choices": ["deserts", "boreal forests", "savannas", "tropical wet forests"], "cloze_format": "The biome that is characterized by abundant water resources is ___.", "normal_format": "Which of the following biomes is characterized by abundant water resources?"}, "answer": {"ans_text": "tropical wet forests", "ans_choice": 3}, "bloom": null, "hl_sentences": "Tropical wet forests have high net primary productivity because the annual temperatures and precipitation values in these areas are ideal for plant growth . Tropical wet forests have wet months in which there can be more than 30 cm ( 11 \u2013 12 in ) of precipitation , as well as dry months in which there are fewer than 10 cm ( 3.5 in ) of rainfall . However , the driest month of a tropical wet forest still exceeds the annual rainfall of some other biomes , such as deserts .", "hl_context": "<hl> Tropical wet forests have high net primary productivity because the annual temperatures and precipitation values in these areas are ideal for plant growth . <hl> Therefore , the extensive biomass present in the tropical wet forest leads to plant communities with very high species diversities ( Figure 44.13 ) . Tropical wet forests have more species of trees than any other biome ; on average between 100 and 300 species of trees are present in a single hectare ( 2.5 acres ) of South America . One way to visualize this is to compare the distinctive horizontal layers within the tropical wet forest biome . On the forest floor is a sparse layer of plants and decaying plant matter . Above that is an understory of short shrubby foliage . A layer of trees rises above this understory and is topped by a closed upper canopy \u2014 the uppermost overhead layer of branches and leaves . Some additional trees emerge through this closed upper canopy . These layers provide diverse and complex habitats for the variety of plants , fungi , animals , and other organisms within the tropical wet forests . For instance , epiphytes are plants that grow on other plants , which typically are not harmed . Epiphytes are found throughout tropical wet forest biomes . Many species of animals use the variety of plants and the complex structure of the tropical wet forests for food and shelter . Some organisms live several meters above ground and have adapted to this arboreal lifestyle . The temperature and sunlight profiles of tropical wet forests are very stable in comparison to that of other terrestrial biomes , with the temperatures ranging from 20 \u00b0 C to 34 \u00b0 C ( 68 \u00b0 F to 93 \u00b0 F ) . When one compares the annual temperature variation of tropical wet forests with that of other forest biomes , the lack of seasonal temperature variation in the tropical wet forest becomes apparent . This lack of seasonality leads to year-round plant growth , rather than the seasonal ( spring , summer , and fall ) growth seen in other biomes . In contrast to other ecosystems , tropical ecosystems do not have long days and short days during the yearly cycle . Instead , a constant daily amount of sunlight ( 11 \u2013 12 hrs per day ) provides more solar radiation , thereby , a longer period of time for plant growth . The annual rainfall in tropical wet forests ranges from 125 to 660 cm ( 50 \u2013 200 in ) with some monthly variation . While sunlight and temperature remain fairly consistent , annual rainfall is highly variable . <hl> Tropical wet forests have wet months in which there can be more than 30 cm ( 11 \u2013 12 in ) of precipitation , as well as dry months in which there are fewer than 10 cm ( 3.5 in ) of rainfall . <hl> <hl> However , the driest month of a tropical wet forest still exceeds the annual rainfall of some other biomes , such as deserts . <hl>"}, {"question": {"question_id": "fs-idp59080928", "question_text": "Which of the following biomes is characterized by short growing seasons?", "question_choices": ["deserts", "tropical wet forests", "Arctic tundras", "savannas"], "cloze_format": "The biome that is characterized by short growing seasons is ___.", "normal_format": "Which of the following biomes is characterized by short growing seasons?"}, "answer": {"ans_text": "Arctic tundras", "ans_choice": 2}, "bloom": null, "hl_sentences": "Plants in the arctic tundra have a very short growing season of approximately 10 \u2013 12 weeks .", "hl_context": "The Arctic tundra lies north of the subarctic boreal forest and is located throughout the Arctic regions of the northern hemisphere ( Figure 44.12 ) . The average winter temperature is - 34 \u00b0 C ( - 34 \u00b0 F ) and the average summer temperature is from 3 \u00b0 C to 12 \u00b0 C ( 37 \u00b0 F \u2013 52 \u00b0 F ) . <hl> Plants in the arctic tundra have a very short growing season of approximately 10 \u2013 12 weeks . <hl> However , during this time , there are almost 24 hours of daylight and plant growth is rapid . The annual precipitation of the Arctic tundra is very low with little annual variation in precipitation . And , as in the boreal forests , there is little evaporation due to the cold temperatures . Plants in the Arctic tundra are generally low to the ground ( Figure 44.20 ) . There is little species diversity , low net primary productivity , and low aboveground biomass . The soils of the Arctic tundra may remain in a perennially frozen state referred to as permafrost . The permafrost makes it impossible for roots to penetrate deep into the soil and slows the decay of organic matter , which inhibits the release of nutrients from organic matter . During the growing season , the ground of the Arctic tundra can be completely covered with plants or lichens ."}, {"question": {"question_id": "fs-idm162787312", "question_text": "A key feature of estuaries is:", "question_choices": ["low light conditions and high productivity", "salt water and fresh water", "frequent algal blooms", "little or no vegetation"], "cloze_format": "A key feature of estuaries is ___ .", "normal_format": "What is a key feature of estuaries?"}, "answer": {"ans_text": "salt water and fresh water", "ans_choice": 1}, "bloom": null, "hl_sentences": "Estuaries are biomes that occur where a source of fresh water , such as a river , meets the ocean . Therefore , both fresh water and salt water are found in the same vicinity ; mixing results in a diluted ( brackish ) saltwater . Estuaries , coastal areas where salt water and fresh water mix , form a third unique marine biome .", "hl_context": "<hl> Estuaries are biomes that occur where a source of fresh water , such as a river , meets the ocean . <hl> <hl> Therefore , both fresh water and salt water are found in the same vicinity ; mixing results in a diluted ( brackish ) saltwater . <hl> Estuaries form protected areas where many of the young offspring of crustaceans , mollusks , and fish begin their lives . Salinity is a very important factor that influences the organisms and the adaptations of the organisms found in estuaries . The salinity of estuaries varies and is based on the rate of flow of its freshwater sources . Once or twice a day , high tides bring salt water into the estuary . Low tides occurring at the same frequency reverse the current of salt water . The ocean is the largest marine biome . It is a continuous body of salt water that is relatively uniform in chemical composition ; it is a weak solution of mineral salts and decayed biological matter . Within the ocean , coral reefs are a second kind of marine biome . <hl> Estuaries , coastal areas where salt water and fresh water mix , form a third unique marine biome . <hl>"}, {"question": {"question_id": "fs-idp206966240", "question_text": "Which of the following natural forces is responsible for the release of carbon dioxide and other atmospheric gases?", "question_choices": ["the Milankovitch cycles", "volcanoes", "solar intensity", "burning of fossil fuels"], "cloze_format": "The  natural force that is responsible for the release of carbon dioxide and other atmospheric gases is (the) ___.", "normal_format": "Which of the following natural forces is responsible for the release of carbon dioxide and other atmospheric gases?"}, "answer": {"ans_text": "volcanoes", "ans_choice": 1}, "bloom": null, "hl_sentences": "Volcanic eruptions can last a few days , but the solids and gases released during an eruption can influence the climate over a period of a few years , causing short-term climate changes . The gases and solids released by volcanic eruptions can include carbon dioxide , water vapor , sulfur dioxide , hydrogen sulfide , hydrogen , and carbon monoxide .", "hl_context": "Finally , volcanic eruptions are a third natural driver of climate change . <hl> Volcanic eruptions can last a few days , but the solids and gases released during an eruption can influence the climate over a period of a few years , causing short-term climate changes . <hl> <hl> The gases and solids released by volcanic eruptions can include carbon dioxide , water vapor , sulfur dioxide , hydrogen sulfide , hydrogen , and carbon monoxide . <hl> Generally , volcanic eruptions cool the climate . This occurred in 1783 when volcanos in Iceland erupted and caused the release of large volumes of sulfuric oxide . This led to haze-effect cooling , a global phenomenon that occurs when dust , ash , or other suspended particles block out sunlight and trigger lower global temperatures as a result ; haze-effect cooling usually extends for one or more years . In Europe and North America , haze-effect cooling produced some of the lowest average winter temperatures on record in 1783 and 1784 ."}], "summary": "", "keyterm": "", "bname": "biology"}, {"chapter": 3, "intro": " Chapter Outline 3.1   Describe Principles, Assumptions, and Concepts of Accounting and Their Relationship to Financial Statements 3.2   Define and Describe the Expanded Accounting Equation and Its Relationship to Analyzing Transactions 3.3   Define and Describe the Initial Steps in the Accounting Cycle 3.4   Analyze Business Transactions Using the Accounting Equation and Show the Impact of Business Transactions on Financial Statements 3.5   Use Journal Entries to Record Transactions and Post to T-Accounts 3.6   Prepare a Trial Balance Why It Matters \n\n Mark Summers wants to start his own dry-cleaning business upon finishing college. He has chosen to name his business Supreme Cleaners. Before he embarks on this journey, Mark must establish what the new business will require. He needs to determine if he wants to have anyone invest in his company. He also needs to consider any loans that he might need to take out from his bank to fund the initial start-up. There are daily business activities that Mark will need to keep track of, such as sales, purchasing equipment, paying bills, collecting money from customers, and paying back investors, among other things. This process utilizes a standard accounting framework so that the financial operations are comparable to other company\u2019s financial operations. \n\n He knows it is important for him to keep thorough documentation of these business activities to give his investors and creditors, and himself, a clear and accurate picture of operations. Without this, he may find it difficult to stay in business. He will maintain an organized record of all of Supreme Cleaners\u2019 financial activities from their inception, using an accounting process meant to result in accurate financial statement preparation. ", "chapter_text": " 3.1   Describe Principles, Assumptions, and Concepts of Accounting and Their Relationship to Financial Statements \n\n If you want to start your own business, you need to maintain detailed and accurate records of business performance in order for you, your investors, and your lenders, to make informed decisions about the future of your company. Financial statements are created with this purpose in mind. A set of financial statements includes the income statement, statement of owner\u2019s equity, balance sheet, and statement of cash flows. These statements are discussed in detail in  Introduction to Financial Statements . This chapter explains the relationship between financial statements and several steps in the accounting process. We go into much more detail in  The Adjustment Process  and  Completing the Accounting Cycle . \n\n Accounting Principles, Assumptions, and Concepts \n\n In  Introduction to Financial Statements , you learned that the  Financial Accounting Standards Board (FASB)  is an independent, nonprofit organization that sets the standards for financial accounting and reporting, including  generally accepted accounting principles (GAAP) , for both public- and private-sector businesses in the United States. \n\n As you may also recall,  GAAP  are the concepts, standards, and rules that guide the preparation and presentation of financial statements. If US accounting rules are followed, the accounting rules are called US GAAP. International accounting rules are called  International Financial Reporting Standards (IFRS) . Publicly traded companies (those that offer their shares for sale on exchanges in the United States) have the reporting of their financial operations regulated by the  Securities and Exchange Commission (SEC) . \n\n You also learned that the SEC is an independent federal agency that is charged with protecting the interests of investors, regulating stock markets, and ensuring companies adhere to GAAP requirements. By having proper accounting standards such as US GAAP or IFRS, information presented publicly is considered comparable and reliable. As a result, financial statement users are more informed when making decisions. The SEC not only enforces the accounting rules but also delegates the process of setting standards for US GAAP to the FASB. \n\n Some companies that operate on a global scale may be able to report their financial statements using IFRS. The SEC regulates the financial reporting of companies selling their shares in the United States, whether US GAAP or IFRS are used. The basics of accounting discussed in this chapter are the same under either set of guidelines. \n\n Ethical Considerations Auditing of Publicly Traded Companies When a publicly traded company in the United States issues its financial statements, the financial statements have been audited by a  Public Company Accounting Oversight Board (PCAOB)  approved auditor. The PCAOB is the organization that sets the auditing standards, after approval by the SEC. It is important to remember that auditing is not the same as accounting. The role of the Auditor is to examine and provide assurance that financial statements are reasonably stated under the rules of appropriate accounting principles. The auditor conducts the audit under a set of standards known as Generally Accepted Auditing Standards. The accounting department of a company and its auditors are employees of two different companies. The auditors of a company are required to be employed by a different company so that there is independence. \n\n The nonprofit Center for Audit Quality explains auditor independence: \u201cAuditors\u2019 independence from company management is essential for a successful audit because it enables them to approach the audit with the necessary professional skepticism.\u201d 1  The center goes on to identify a key practice to protect independence by which an external auditor reports not to a company\u2019s management, which could make it more difficult to maintain independence, but to a company\u2019s audit committee. The audit committee oversees the auditors\u2019 work and monitors disagreements between management and the auditor about financial reporting. Internal auditors of a company are not the auditors that provide an opinion on the financial statements of a company. According to the Center for Audit Quality, \u201cBy law, public companies\u2019 annual financial statements are audited each year by independent auditors\u2014accountants who examine the data for conformity with U.S. Generally Accepted Accounting Principles (GAAP).\u201d 2  The opinion from the independent auditors regarding a publicly traded company is filed for public inspection, along with the financial statements of the publicly traded company. 1 Center for Audit Quality.  Guide to Public Company Auditing . https://www.iasplus.com/en/binary/usa/aicpa/0905caqauditguide.pdf 2 Center for Audit Quality.  Guide to Public Company Auditing . https://www.iasplus.com/en/binary/usa/aicpa/0905caqauditguide.pdf \n\n The Conceptual Framework \n\n The FASB uses a  conceptual framework , which is a set of concepts that guide financial reporting. These concepts can help ensure information is comparable and reliable to stakeholders. Guidance may be given on how to report transactions, measurement requirements, and application on financial statements, among other things. 3 3 Financial Accounting Standards Board. \u201cThe Conceptual Framework.\u201d http://www.fasb.org/jsp/FASB/Page/BridgePage&cid=1176168367774 \n\n IFRS Connection GAAP, IFRS, and the Conceptual Framework The procedural part of accounting\u2014recording transactions right through to creating financial statements\u2014is a universal process. Businesses all around the world carry out this process as part of their normal operations. In carrying out these steps, the timing and rate at which transactions are recorded and subsequently reported in the financial statements are determined by the accepted accounting principles used by the company. \n\n As you learned in  Role of Accounting in Society , US-based companies will apply US GAAP as created by the FASB, and most international companies will apply IFRS as created by the International Accounting Standards Board (IASB). As illustrated in this chapter, the starting point for either FASB or IASB in creating accounting standards, or principles, is the conceptual framework. Both FASB and IASB cover the same topics in their frameworks, and the two frameworks are similar. The conceptual framework helps in the standard-setting process by creating the foundation on which those standards should be based. It can also help companies figure out how to record transactions for which there may not currently be an applicable standard. Though there are many similarities between the conceptual framework under US GAAP and IFRS, these similar foundations result in different standards and/or different interpretations. \n\n Once an accounting standard has been written for US GAAP, the FASB often offers clarification on how the standard should be applied. Businesses frequently ask for guidance for their particular industry. When the FASB creates accounting standards and any subsequent clarifications or guidance, it only has to consider the effects of those standards, clarifications, or guidance on US-based companies. This means that FASB has only one major legal system and government to consider. When offering interpretations or other guidance on application of standards, the FASB can utilize knowledge of the US-based legal and taxation systems to help guide their points of clarification and can even create interpretations for specific industries. This means that interpretation and guidance on US GAAP standards can often contain specific details and guidelines in order to help align the accounting process with legal matters and tax laws. \n\n In applying their conceptual framework to create standards, the IASB must consider that their standards are being used in 120 or more different countries, each with its own legal and judicial systems. Therefore, it is much more difficult for the IASB to provide as much detailed guidance once the standard has been written, because what might work in one country from a taxation or legal standpoint might not be appropriate in a different country. This means that IFRS interpretations and guidance have fewer detailed components for specific industries as compared to US GAAP guidance. \n\n The conceptual framework sets the basis for accounting standards set by rule-making bodies that govern how the financial statements are prepared. Here are a few of the principles, assumptions, and concepts that provide guidance in developing GAAP. \n\n Revenue Recognition Principle \n\n The  revenue recognition principle  directs a company to recognize revenue in the period in which it is earned; revenue is not considered earned until a product or service has been provided. This means the period of time in which you performed the service or gave the customer the product is the period in which revenue is recognized. \n\n There also does not have to be a correlation between when cash is collected and when revenue is recognized. A customer may not pay for the service on the day it was provided. Even though the customer has not yet paid cash, there is a reasonable expectation that the customer will pay in the future. Since the company has provided the service, it would recognize the revenue as earned, even though cash has yet to be collected. \n\n For example, Lynn Sanders owns a small printing company, Printing Plus. She completed a print job for a customer on August 10. The customer did not pay cash for the service at that time and was billed for the service, paying at a later date. When should Lynn recognize the revenue, on August 10 or at the later payment date? Lynn should record revenue as earned on August 10. She provided the service to the customer, and there is a reasonable expectation that the customer will pay at the later date. \n\n Expense Recognition (Matching) Principle \n\n The  expense recognition principle  (also referred to as the  matching principle ) states that we must match expenses with associated revenues in the period in which the revenues were earned. A mismatch in expenses and revenues could be an understated net income in one period with an overstated net income in another period. There would be no reliability in statements if expenses were recorded separately from the revenues generated. \n\n For example, if Lynn earned printing revenue in April, then any associated expenses to the revenue generation (such as paying an employee) should be recorded on the same income statement. The employee worked for Lynn in April, helping her earn revenue in April, so Lynn must match the expense with the revenue by showing both on the April income statement. \n\n Cost Principle \n\n The  cost principle , also known as the  historical cost principle , states that virtually everything the company owns or controls ( assets ) must be recorded at its value at the date of acquisition. For most assets, this value is easy to determine as it is the price agreed to when buying the asset from the vendor. There are some exceptions to this rule, but always apply the cost principle unless FASB has specifically stated that a different valuation method should be used in a given circumstance. \n\n The primary exceptions to this historical cost treatment, at this time, are financial instruments, such as stocks and bonds, which might be recorded at their fair market value. This is called mark-to-market accounting or fair value accounting and is more advanced than the general basic concepts underlying the introduction to basic accounting concepts; therefore, it is addressed in more advanced accounting courses. \n\n Once an asset is recorded on the books, the value of that asset must remain at its historical cost, even if its value in the market changes. For example, Lynn Sanders purchases a piece of equipment for $40,000. She believes this is a bargain and perceives the value to be more at $60,000 in the current market. Even though Lynn feels the equipment is worth $60,000, she may only record the cost she paid for the equipment of $40,000. \n\n Full Disclosure Principle \n\n The  full disclosure principle  states that a business must report any business activities that could affect what is reported on the financial statements. These activities could be nonfinancial in nature or be supplemental details not readily available on the main financial statement. Some examples of this include any pending litigation, acquisition information, methods used to calculate certain figures, or stock options. These disclosures are usually recorded in footnotes on the statements, or in addenda to the statements. \n\n Separate Entity Concept \n\n The  separate entity concept  prescribes that a business may only report activities on financial statements that are specifically related to company operations, not those activities that affect the owner personally. This concept is called the separate entity concept because the business is considered an entity separate and apart from its owner(s). \n\n For example, Lynn Sanders purchases two cars; one is used for personal use only, and the other is used for business use only. According to the separate entity concept, Lynn may record the purchase of the car used by the company in the company\u2019s accounting records, but not the car for personal use. \n\n Conservatism \n\n This concept is important when valuing a transaction for which the dollar value cannot be as clearly determined, as when using the cost principle.  Conservatism  states that if there is uncertainty in a potential financial estimate, a company should err on the side of caution and report the most conservative amount. This would mean that any uncertain or estimated expenses/losses should be recorded, but uncertain or estimated revenues/gains should not. This understates net income, therefore reducing profit. This gives stakeholders a more reliable view of the company\u2019s financial position and does not overstate income. \n\n Monetary Measurement Concept \n\n In order to record a transaction, we need a system of  monetary measurement , or a  monetary unit  by which to value the transaction. In the United States, this monetary unit is the US dollar. Without a dollar amount, it would be impossible to record information in the financial records. It also would leave stakeholders unable to make financial decisions, because there is no comparability measurement between companies. This concept ignores any change in the purchasing power of the dollar due to inflation. \n\n Going Concern Assumption \n\n The  going concern assumption  assumes a business will continue to operate in the foreseeable future. A common time frame might be twelve months. However, one should presume the business is doing well enough to continue operations unless there is evidence to the contrary. For example, a business might have certain expenses that are paid off (or reduced) over several time periods. If the business will stay operational in the foreseeable future, the company can continue to recognize these long-term expenses over several time periods. Some red flags that a business may no longer be a going concern are defaults on loans or a sequence of losses. \n\n Time Period Assumption \n\n The  time period assumption  states that a company can present useful information in shorter time periods, such as years, quarters, or months. The information is broken into time frames to make comparisons and evaluations easier. The information will be timely and current and will give a meaningful picture of how the company is operating. \n\n For example, a school year is broken down into semesters or quarters. After each semester or quarter, your grade point average (GPA) is updated with new information on your performance in classes you completed. This gives you timely grading information with which to make decisions about your schooling. \n\n A potential or existing investor wants timely  i nformation by which to measure the performance of the company, and to help decide whether to invest. Because of the time period assumption, we need to be sure to recognize revenues and expenses in the proper period. This might mean allocating costs over more than one accounting or reporting period. \n\n The use of the principles, assumptions, and concepts in relation to the preparation of financial statements is better understood when looking at the full accounting cycle and its relation to the detailed process required to record business activities ( Figure 3.2 ). \n\n Concepts In Practice Tax Cuts and Jobs Act In 2017, the US government enacted the Tax Cuts and Jobs Act. As a result, financial stakeholders needed to resolve several issues surrounding the standards from GAAP principles and the FASB. The issues were as follows: \u201cCurrent Generally Accepted Accounting Principles (GAAP) requires that deferred tax liabilities and assets be adjusted for the effect of a change in tax laws or rates,\u201d and \u201cimplementation issues related to the Tax Cuts and Jobs Act and income tax reporting.\u201d 4 4 Financial Accounting Standards Board (FASB). \u201cAccounting for the Tax Cuts and Jobs Act.\u201d https://www.fasb.org/taxcutsjobsact#section_1 \n\n In response, the FASB issued updated guidance on both issues. You can explore these revised guidelines at the FASB website (https://www.fasb.org/taxcutsjobsact#section_1). \n\n The Accounting Equation \n\n Introduction to Financial Statements  briefly discussed the accounting equation, which is important to the study of accounting because it shows what the organization owns and the sources of (or claims against) those resources. The  accounting equation  is expressed as follows: \n\n Recall that the accounting equation can be thought of from a \u201csources and claims\u201d perspective; that is, the assets (items owned by the organization) were obtained by incurring liabilities or were provided by owners. Stated differently, everything a company owns must equal everything the company owes to creditors (lenders) and owners (individuals for sole proprietors or stockholders for companies or corporations). \n\n In our example in  Why It Matters , we used an individual owner, Mark Summers, for the Supreme Cleaners discussion to simplify our example. Individual owners are sole proprietors in legal terms. This distinction becomes significant in such areas as legal liability and tax compliance. For sole proprietors, the owner\u2019s interest is labeled \u201cowner\u2019s equity.\u201d \n\n In  Introduction to Financial Statements , we addressed the owner\u2019s value in the firm as  capital  or  owner\u2019s equity . This assumed that the business is a sole proprietorship. However, for the rest of the text we switch the structure of the business to a corporation, and instead of owner\u2019s equity, we begin using  stockholder\u2019s equity , which includes account titles such as  common stock  and  retained earnings  to represent the owners\u2019 interests. The primary reason for this distinction is that the typical company can have several to thousands of owners, and the financial statements for corporations require a greater amount of complexity. \n\n As you also learned in  Introduction to Financial Statements , the accounting equation represents the balance sheet and shows the relationship between assets, liabilities, and owners\u2019 equity (for sole proprietorships/individuals) or common stock (for companies). \n\n You may recall from mathematics courses that an equation must always be in balance. Therefore, we must ensure that the two sides of the accounting equation are always equal. We explore the components of the accounting equation in more detail shortly. First, we need to examine several underlying concepts that form the foundation for the accounting equation: the double-entry accounting system, debits and credits, and the \u201cnormal\u201d balance for each account that is part of a formal accounting system. \n\n Double-Entry Bookkeeping \n\n The basic components of even the simplest accounting system are  accounts  and a  general ledger . An  account  is a record showing increases and decreases to assets, liabilities, and equity\u2014the basic components found in the accounting equation. As you know from  Introduction to Financial Statements , each of these categories, in turn, includes many individual accounts, all of which a company maintains in its general ledger. A  general ledger  is a comprehensive listing of all of a company\u2019s accounts with their individual balances. \n\n Accounting is based on what we call a  double-entry accounting system , which requires the following: \n\n Each time we record a transaction, we must record a change in at least two different accounts. Having two or more accounts change will allow us to keep the accounting equation in balance. \n\n Not only will at least two accounts change, but there must also be at least one debit and one credit side impacted. \n\n The sum of the debits must equal the sum of the credits for each transaction. \n\n In order for companies to record the myriad of transactions they have each year, there is a need for a simple but detailed system. Journals are useful tools to meet this need. \n\n Debits and Credits \n\n Each account can be represented visually by splitting the account into left and right sides as shown. This graphic representation of a general ledger account is known as a  T-account . The concept of the T-account was briefly mentioned in  Introduction to Financial Statements  and will be used later in this chapter to analyze transactions. A T-account is called a \u201cT-account\u201d because it looks like a \u201cT,\u201d as you can see with the T-account shown here. \n\n A  debit  records financial information on the left side of each account. A  credit  records financial information on the right side of an account. One side of each account will increase and the other side will decrease. The  ending account balance  is found by calculating the difference between debits and credits for each account. You will often see the terms  debit  and  credit  represented in shorthand, written as  DR  or  dr  and  CR  or  cr , respectively. Depending on the account type, the sides that increase and decrease may vary. We can illustrate each account type and its corresponding debit and credit effects in the form of an  expanded accounting equation . You will learn more about the expanded accounting equation and use it to analyze transactions in  Define and Describe the Expanded Accounting Equation and Its Relationship to Analyzing Transactions . \n\n As we can see from this expanded accounting equation, Assets accounts increase on the debit side and decrease on the credit side. This is also true of Dividends and Expenses accounts. Liabilities increase on the credit side and decrease on the debit side. This is also true of Common Stock and Revenues accounts. This becomes easier to understand as you become familiar with the  normal balance  of an account. \n\n Normal Balance of an Account \n\n The  normal balance  is the expected balance each account type maintains, which is the side that increases. As assets and expenses increase on the debit side, their normal balance is a debit. Dividends paid to shareholders also have a normal balance that is a debit entry. Since liabilities, equity (such as common stock), and revenues increase with a credit, their \u201cnormal\u201d balance is a credit.  Table 3.1  shows the normal balances and increases for each account type. \n\n Account Normal Balances and Increases \n\n Type of account \n\n Increases with \n\n Normal balance \n\n Asset \n\n Debit \n\n Debit \n\n Liability \n\n Credit \n\n Credit \n\n Common Stock \n\n Credit \n\n Credit \n\n Dividends \n\n Debit \n\n Debit \n\n Revenue \n\n Credit \n\n Credit \n\n Expense \n\n Debit \n\n Debit \n\n Table  3.1   \n\n When an account produces a balance that is contrary to what the expected normal balance of that account is, this account has an  abnormal balance . Let\u2019s consider the following example to better understand abnormal balances. \n\n Let\u2019s say there were a credit of $4,000 and a debit of $6,000 in the Accounts Payable account. Since Accounts Payable increases on the credit side, one would expect a normal balance on the credit side. However, the difference between the two figures in this case would be a debit balance of $2,000, which is an abnormal balance. This situation could possibly occur with an overpayment to a supplier or an error in recording. \n\n Concepts In Practice Assets We define an asset to be a resource that a company owns that has an economic value. We also know that the employment activities performed by an employee of a company are considered an expense, in this case a salary expense. In baseball, and other sports around the world, players\u2019 contracts are consistently categorized as assets that lose value over time (they are amortized). \n\n For example, the  Texas Rangers  list \u201cPlayer rights contracts and signing bonuses-net\u201d as an asset on its balance sheet. They decrease this asset\u2019s value over time through a process called  amortization . For tax purposes, players\u2019 contracts are treated akin to office equipment even though expenses for player salaries and bonuses have already been recorded. This can be a point of contention for some who argue that an owner does not assume the lost value of a player\u2019s contract, the player does. 5 5 Tommy Craggs. \u201cMLB Confidential, Part 3: Texas Rangers.\u201d Deadspin. August 24, 2010. https://deadspin.com/5619951/mlb-confidential-part-3-texas-rangers \n 3.2   Define and Describe the Expanded Accounting Equation and Its Relationship to Analyzing Transactions \n\n Before we explore how to analyze transactions, we first need to understand what governs the way transactions are recorded. \n\n As you have learned, the accounting equation represents the idea that a company needs assets to operate, and there are two major sources that contribute to operations: liabilities and equity. The company borrows the funds, creating liabilities, or the company can take the funds provided by the profits generated in the current or past periods, creating retained earnings or some other form of stockholder\u2019s equity. Recall the accounting equation\u2019s basic form. \n\n Expanded Accounting Equation \n\n The  expanded accounting equation  breaks down the equity portion of the accounting equation into more detail. This expansion of the equity section allows a company to see the impact to equity from changes to revenues and expenses, and to owner investments and payouts. It is important to have more detail in this equity category to understand the effect on financial statements from period to period. For example, an increase to revenue can increase net income on the income statement, increase retained earnings on the statement of retained earnings, and change the distribution of stockholder\u2019s equity on the balance sheet. This may be difficult to understand where these changes have occurred without revenue recognized individually in this expanded equation. \n\n The expanded accounting equation is shown here. \n\n Note that this expanded accounting equation breaks down Equity into four categories: common stock, dividends, revenues, and expenses. This considers each element of contributed capital and retained earnings individually to better illustrate each one\u2019s impact on changes in equity. \n\n A business can now use this equation to analyze transactions in more detail. But first, it may help to examine the many accounts that can fall under each of the main categories of Assets, Liabilities, and Equity, in terms of their relationship to the expanded accounting equation. We can begin this discussion by looking at the  chart of accounts . \n\n Chart of Accounts \n\n Recall that the basic components of even the simplest accounting system are accounts and a general ledger. Accounts shows all the changes made to assets, liabilities, and equity\u2014the three main categories in the accounting equation. Each of these categories, in turn, includes many individual accounts, all of which a company maintains in its general ledger. \n\n When a company first starts the analysis process, it will make a list of all the accounts used in day-to-day transactions. For example, a company may have accounts such as cash, accounts receivable, supplies, accounts payable, unearned revenues, common stock, dividends, revenues, and expenses. Each company will make a list that works for its business type, and the transactions it expects to engage in. The accounts may receive numbers using the system presented in  Table 3.2 . \n\n Account Numbering System \n\n Account category \n\n Assigned account number will start with \n\n Account numbers for a small company \n\n Account numbers for a large company \n\n Assets \n\n 1 \n\n 100\u2013199 \n\n 1000\u20131999 \n\n Liabilities \n\n 2 \n\n 200\u2013299 \n\n 2000\u20132999 \n\n Stockholders\u2019 equity \n\n 3 \n\n 300\u2013399 \n\n 3000\u20133999 \n\n Revenues \n\n 4 \n\n 400\u2013499 \n\n 4000\u20134999 \n\n Expenses \n\n 5 \n\n 500\u2013599 \n\n 5000\u20135999 \n\n Table  3.2   \n\n We call this account numbering system a  chart of accounts . The accounts are presented in the chart of accounts in the order in which they appear on the financial statements, beginning with the balance sheet accounts and then the income statement accounts. Additional numbers starting with six and continuing might be used in large merchandising and manufacturing companies. The information in the chart of accounts is the foundation of a well-organized accounting system. \n\n Breaking Down the Expanded Accounting Equation \n\n Refer to the expanded accounting equation ( Figure 3.3 ). We begin with the left side of the equation, the assets, and work toward the right side of the equation to liabilities and equity. \n\n Assets and the Expanded Accounting Equation \n\n On the left side of the equation are assets.  Assets  are resources a company owns that have an economic value. Assets are represented on the balance sheet financial statement. Some common examples of assets are cash, accounts receivable, inventory, supplies, prepaid expenses, notes receivable, equipment, buildings, machinery, and land. \n\n Cash includes paper currency as well as coins, checks, bank accounts, and money orders. Anything that can be quickly liquidated into cash is considered cash. Cash activities are a large part of any business, and the flow of cash in and out of the company is reported on the statement of cash flows. \n\n Accounts receivable is money that is owed to the company, usually from a customer. The customer has not yet paid with cash for the provided good or service but will do so in the future. Common phrasing to describe this situation is that a customer purchased something \u201con account,\u201d meaning that the customer has asked to be billed and will pay at a later date: \u201cAccount\u201d because a customer has not paid us yet but instead has asked to be billed; \u201cReceivable\u201d because we will receive the money in the future. \n\n Inventory refers to the goods available for sale. Service companies do not have goods for sale and would thus not have inventory. Merchandising and manufacturing businesses do have inventory. You learn more about this topic in  Inventory . \n\n Examples of supplies (office supplies) include pens, paper, and pencils. Supplies are considered assets until an employee uses them. At the point they are used, they no longer have an economic value to the organization, and their cost is now an expense to the business. \n\n Prepaid expenses  are items paid for in advance of their use. They are considered assets until used. Some examples can include insurance and rent. Insurance, for example, is usually purchased for more than one month at a time (six months typically). The company does not use all six months of the insurance at once, it uses it one month at a time. However, the company prepays for all of it up front. As each month passes, the company will adjust its records to reflect the cost of one month of insurance usage. \n\n Notes receivable is similar to accounts receivable in that it is money owed to the company by a customer or other entity. The difference here is that a note typically includes interest and specific contract terms, and the amount may be due in more than one accounting period. \n\n Equipment examples include desks, chairs, and computers; anything that has a long-term value to the company that is used in the office. Equipment is considered a long-term asset, meaning you can use it for more than one accounting period (a year for example). Equipment will lose value over time, in a process called  depreciation . You will learn more about this topic in  The Adjustment Process . \n\n Buildings, machinery, and land are all considered long-term assets. Machinery is usually specific to a manufacturing company that has a factory producing goods. Machinery and buildings also depreciate. Unlike other long-term assets such as machinery, buildings, and equipment, land is not depreciated. The process to calculate the loss on land value could be very cumbersome, speculative, and unreliable; therefore, the treatment in accounting is for land to  not  be depreciated over time. \n\n Liabilities and the Expanded Accounting Equation \n\n The accounting equation emphasizes a basic idea in business; that is, businesses need assets in order to operate. There are two ways a business can finance the purchase of assets. First, it can sell shares of its stock to the public to raise money to purchase the assets, or it can use profits earned by the business to finance its activities. Second, it can borrow the money from a lender such as a financial institution. You will learn about other assets as you progress through the book. Let\u2019s now take a look at the right side of the accounting equation. \n\n Liabilities  are obligations to pay an amount owed to a lender (creditor) based on a past transaction. Liabilities are reported on the balance sheet. It is important to understand that when we talk about liabilities, we are not just talking about loans. Money collected for gift cards, subscriptions, or as advance deposits from customers could also be liabilities. Essentially, anything a company owes and has yet to pay within a period is considered a liability, such as salaries, utilities, and taxes. \n\n For example, a company uses $400 worth of utilities in May but is not billed for the usage, or asked to pay for the usage, until June. Even though the company does not have to pay the bill until June, the company owed money for the usage that occurred in May. Therefore, the company must record the usage of electricity, as well as the liability to pay the utility bill, in May. \n\n Eventually that debt must be repaid by performing the service, fulfilling the subscription, or providing an asset such as merchandise or cash. Some common examples of liabilities include accounts payable, notes payable, and unearned revenue. \n\n Accounts payable recognizes that the company owes money and has not paid. Remember, when a customer purchases something \u201con account\u201d it means the customer has asked to be billed and will pay at a later date. In this case the purchasing company is the \u201ccustomer.\u201d The company will have to pay the money due in the future, so we use the word \u201cpayable.\u201d The debt owed is usually paid off in less than one accounting period (less than a year typically) if it is classified as an account payable. \n\n A notes payable is similar to accounts payable in that the company owes money and has not yet paid. Some key differences are that the contract terms are usually longer than one accounting period, interest is included, and there is typically a more formalized contract that dictates the terms of the transaction. \n\n Unearned revenue  represents a customer\u2019s advanced payment for a product or service that has yet to be provided by the company. Since the company has not yet provided the product or service, it cannot recognize the customer\u2019s payment as revenue, according to the revenue recognition principle. Thus, the account is called unearned revenue. The company owing the product or service creates the liability to the customer. \n\n Equity and the Expanded Accounting Equation \n\n Stockholder\u2019s equity  refers to the owner\u2019s (stockholders) investments in the business and earnings. These two components are contributed capital and retained earnings. \n\n The owner\u2019s investments in the business typically come in the form of common stock and are called  contributed capital . There is a hybrid owner\u2019s investment labeled as preferred stock that is a combination of debt and equity (a concept covered in more advanced accounting courses). The company will issue shares of common stock to represent stockholder ownership. You will learn more about common stock in  Corporation Accounting . \n\n Another component of stockholder\u2019s equity is company earnings. These retained earnings are what the company holds onto at the end of a period to reinvest in the business, after any distributions to ownership occur. Stated more technically, retained earnings are a company\u2019s cumulative earnings since the creation of the company minus any dividends that it has declared or paid since its creation. One tricky point to remember is that retained earnings are not classified as assets. Instead, they are a component of the stockholder\u2019s equity account, placing it on the right side of the accounting equation. \n\n Distribution of earnings to ownership is called a dividend. The dividend could be paid with cash or be a distribution of more company stock to current shareholders. Either way, dividends will decrease retained earnings. Dividends are considered a contra equity account. An account is a  contra account  if its normal balance is opposite of the normal balance of the category to which it belongs. The normal balance for the equity category is a credit balance whereas the normal balance for dividends is a debit balance resulting in dividends reducing total equity.  Also affecting retained earnings are revenues and expenses, by way of net income or net loss. Revenues are earnings from the sale of goods and services. An increase in revenues will also contribute toward an increase in retained earnings. Expenses are the cost of resources associated with earning revenues. An increase to expenses will contribute toward a decrease in retained earnings. Recall that this concept of recognizing expenses associated with revenues is the expense recognition principle. Some examples of expenses include bill payments for utilities, employee salaries, and loan interest expense. A business does not have an expense until it is \u201cincurred.\u201d Incurred means the resource is used or consumed. For example, you will not recognize utilities as an expense until you have used the utilities. The difference between revenues earned and expenses incurred is called net income (loss) and can be found on the income statement. \n\n Net income reported on the income statement flows into the statement of retained earnings. If a business has net income (earnings) for the period, then this will increase its retained earnings for the period. This means that revenues exceeded expenses for the period, thus increasing retained earnings. If a business has net loss for the period, this decreases retained earnings for the period. This means that the expenses exceeded the revenues for the period, thus decreasing retained earnings. \n\n You will notice that stockholder\u2019s equity increases with common stock issuance and revenues, and decreases from dividend payouts and expenses. Stockholder\u2019s equity is reported on the balance sheet in the form of contributed capital (common stock) and retained earnings. The statement of retained earnings computes the retained earnings balance at the beginning of the period, adds net income or subtracts net loss from the income statement, and subtracts dividends declared, to result in an ending retained earnings balance reported on the balance sheet. \n\n Now that you have a basic understanding of the accounting equation, and examples of assets, liabilities, and stockholder\u2019s equity, you will be able to analyze the many transactions a business may encounter and determine how each transaction affects the accounting equation and corresponding financial statements. First, however, in  Define and Examine the Initial Steps in the Accounting Cycle  we look at how the role of identifying and analyzing transactions fits into the continuous process known as the  accounting cycle . \n\n Link to Learning \n\n The Financial Accounting Standards Board had a policy that allowed companies to reduce their tax liability from share-based compensation deductions. This led companies to create what some call the \u201ccontentious debit,\u201d to defer tax liability and increase tax expense in a current period. See the  article \u201cThe contentious debit\u2014seriously\u201d on continuous debt  for further discussion of this practice. \n 3.3   Define and Describe the Initial Steps in the Accounting Cycle \n\n This chapter on analyzing and recording transactions is the first of three consecutive chapters (including  The Adjustment Process  and  Completing the Accounting Cycle ) covering the steps in one continuous process known as the accounting cycle. The  accounting cycle  is a step-by-step process to record business activities and events to keep financial records up to date. The process occurs over one accounting period and will begin the cycle again in the following period. A  period  is one operating cycle of a business, which could be a month, quarter, or year. Review the accounting cycle in  Figure 3.5 . \n\n As you can see, the cycle begins with identifying and analyzing transactions, and culminates in reversing entries (which we do not cover in this textbook). The entire cycle is meant to keep financial data organized and easily accessible to both internal and external users of information. In this chapter, we focus on the first four steps in the accounting cycle: identify and analyze transactions, record transactions to a journal, post journal information to a ledger, and prepare an unadjusted trial balance. \n\n In  The Adjustment Process  we review steps 5, 6, and 7 in the accounting cycle: record adjusting entries, prepare an adjusted trial balance, and prepare financial statements. In  Completing the Accounting Cycle , we review steps 8 and 9: closing entries and prepare a post-closing trial balance. As stated previously, we do not cover reversing entries. \n\n Ethical Considerations Turning Hacked Gift Card Accounts into Cash Gift cards are a great way for a company to presell its products and to create cash flow. One of the problems with gift cards is that fraudsters are using the retailer\u2019s weak internal controls to defraud the retailer\u2019s customers. A fraudster can hack into autoloading gift cards and drain a customer\u2019s bank account by buying new, physical gift cards through the autoloading gift card account. This is a real problem, and an internal control to reduce this type of fraud is to use a double verification system for the transfer of money from a bank account to reloadable gift card account. Accountants can help their organization limit gift card fraud by reviewing their company\u2019s internal controls over the gift card process. \n\n A simple explanation of this fraud is that a fraudster will gain access to an individual\u2019s email account through phishing or by other means, such as a fraudster putting a key logger on a public computer or in a corrupted public Wi-Fi. The individual uses the same password for the reloadable gift card as his or her email account, and the fraudster will see emails about the gift card. The fraudster contacts the retailor posing as the individual, and the retailor creates an in-store gift card redemption code, and the fraudster or his or her accomplice will go to the store posing as the individual and buy physical gift cards with the redemption code. The customer\u2019s bank account will be drained, and the customer will be upset. In another gift card fraud, the individual\u2019s credit card is stolen and used to buy physical gift cards from a retailor. This type of fraud causes problems for the retailer, for the retailer\u2019s reputation is damaged through the implementation of poor internal controls. \n\n Does the fraudster use the fraudulently acquired gift cards? No, there is an entire market for selling gift cards on  Craigslist , just go look and see how easy it is to buy discounted gift cards on  Craigslist . Also, there are companies such as  cardcash.com  and  cardhub.com  that buy and resell gift cards. The fraudster just sells the gift cards, and the retailer has no idea it is redeeming fraudulently acquired gift cards. Through the implementation of proper internal controls, the accountant can help limit this fraud and protect his or her employer\u2019s reputation. \n\n First Four Steps in the Accounting Cycle \n\n The first four steps in the accounting cycle are (1) identify and analyze transactions, (2) record transactions to a journal, (3) post journal information to a ledger, and (4) prepare an unadjusted trial balance. We begin by introducing the steps and their related documentation. \n\n These first four steps set the foundation for the recording process. \n\n Step 1 . Identifying and analyzing transactions is the first step in the process. This takes information from original sources or activities and translates that information into usable financial data. An  original source  is a traceable record of information that contributes to the creation of a business transaction. For example, a sales invoice is considered an original source. Activities would include paying an employee, selling products, providing a service, collecting cash, borrowing money, and issuing stock to company owners. Once the original source has been identified, the company will analyze the information to see how it influences financial records. \n\n Let\u2019s say that Mark Summers of Supreme Cleaners (from  Why It Matters ) provides cleaning services to a customer. He generates an invoice for $200, the amount the customer owes, so he can be paid for the service. This sales receipt contains information such as how much the customer owes, payment terms, and dates. This sales receipt is an original source containing financial information that creates a business transaction for the company. \n\n Step 2 . The second step in the process is recording transactions to a journal. This takes analyzed data from step 1 and organizes it into a comprehensive record of every company transaction. A  transaction  is a business activity or event that has an effect on financial information presented on financial statements. The information to record a transaction comes from an original source. A  journal  (also known as the  book of original entry  or  general journal ) is a record of all transactions. \n\n For example, in the previous transaction, Supreme Cleaners had the invoice for $200. Mark Summers needs to record this $200 in his financial records. He needs to choose what accounts represent this transaction, whether or not this transaction will increase or decreases the accounts, and how that impacts the accounting equation before he can record the transaction in his journal. He needs to do this process for every transaction occurring during the period. \n\n Figure 3.7  includes information such as the date of the transaction, the accounts required in the journal entry, and columns for debits and credits. \n\n Step 3 . The third step in the process is posting journal information to a ledger.  Posting  takes all transactions from the journal during a period and moves the information to a general ledger, or ledger. As you\u2019ve learned, account balances can be represented visually in the form of T-accounts. \n\n Returning to Supreme Cleaners, Mark identified the accounts needed to represent the $200 sale and recorded them in his journal. He will then take the account information and move it to his general ledger. All of the accounts he used during the period will be shown on the general ledger, not only those accounts impacted by the $200 sale. \n\n Step 4 . The fourth step in the process is to prepare an unadjusted trial balance. This step takes information from the general ledger and transfers it onto a document showing all account balances, and ensuring that debits and credits for the period balance (debit and credit totals are equal). \n\n Mark Summers from Supreme Cleaners needs to organize all of his accounts and their balances, including the $200 sale, onto a trial balance. He also needs to ensure his debits and credits are balanced at the culmination of this step. \n\n It is important to note that recording the entire process requires a strong attention to detail. Any mistakes early on in the process can lead to incorrect reporting information on financial statements. If this occurs, accountants may have to go all the way back to the beginning of the process to find their error. Make sure that as you complete each step, you are careful and really take the time to understand how to record information and why you are recording it. In the next section, you will learn how the accounting equation is used to analyze transactions. \n\n Concepts In Practice Forensic Accounting Ever dream about working for the Federal Bureau of Investigation (FBI)? As a forensic accountant, that dream might just be possible. A forensic accountant investigates financial crimes, such as tax evasion, insider trading, and embezzlement, among other things. Forensic accountants review financial records looking for clues to bring about charges against potential criminals. They consider every part of the accounting cycle, including original source documents, looking through journal entries, general ledgers, and financial statements. They may even be asked to testify to their findings in a court of law. \n\n To be a successful forensic accountant, one must be detailed, organized, and naturally inquisitive. This position will need to retrace the steps a suspect may have taken to cover up fraudulent financial activities. Understanding how a company operates can help identify fraudulent activities that veer from the company\u2019s position. Some of the best forensic accountants have put away major criminals such as Al Capone, Bernie Madoff, Ken Lay, and Ivan Boesky. \n\n Link to Learning \n\n A tool that can be helpful to businesses looking for an easier way to view their accounting processes is to have drillable financial statements. This feature can be found in several software systems, allowing companies to go through the accounting cycle from transaction entry to financial statement construction. Read this  Journal of Accountancy  column on drillable financial statements  to learn more. \n 3.4   Analyze Business Transactions Using the Accounting Equation and Show the Impact of Business Transactions on Financial Statements \n\n You gained a basic understanding of both the basic and expanded accounting equations, and looked at examples of assets, liabilities, and stockholder\u2019s equity in  Define and Examine the Expanded Accounting Equation and Its Relationship to Analyzing Transactions . Now, we can consider some of the transactions a business may encounter. We can review how each transaction would affect the basic accounting equation and the corresponding financial statements. \n\n As discussed in  Define and Examine the Initial Steps in the Accounting Cycle , the first step in the accounting cycle is to identify and analyze transactions. Each original source must be evaluated for financial implications. Meaning, will the information contained on this original source affect the financial statements? If the answer is yes, the company will then analyze the information for  how  it affects the financial statements. For example, if a company receives a cash payment from a customer, the company needs to know how to record the cash payment in a meaningful way to keep its financial statements up to date. \n\n Your Turn Monetary Value of Transactions You are the accountant for a small computer programming company. You must record the following transactions. What values do you think you will use for each transaction? \n\n The company purchased a secondhand van to be used to travel to customers. The sellers told you they believe it is worth $12,500 but agreed to sell it to your company for $11,000. You believe the company got a really good deal because the van has a $13,000 Blue Book value. \n\n Your company purchased its office building five years ago for $175,000. Values of real estate have been rising quickly over the last five years, and a realtor told you the company could easily sell it for $250,000 today. Since the building is now worth $250,000, you are contemplating whether you should increase its value on the books to reflect this estimated current market value. \n\n Your company has performed a task for a customer. The customer agreed to a minimum price of $2,350 for the work, but if the customer has absolutely no issues with the programming for the first month, the customer will pay you $2,500 (which includes a bonus for work well done). The owner of the company is almost 100% sure she will receive $2,500 for the job done. You have to record the revenue earned and need to decide how much should be recorded. \n\n The owner of the company believes the most valuable asset for his company is the employees. The service the company provides depends on having intelligent, hardworking, dependable employees who believe they need to deliver exactly what the customer wants in a reasonable amount of time. Without the employees, the company would not be so successful. The owner wants to know if she can include the value of her employees on the balance sheet as an asset. \n\n Solution \n\n The van must be recorded on the books at $11,000 per the cost principle. That is the price that was agreed to between a willing buyer and seller. \n\n The cost principle states that you must record an asset on the books for the price you bought it for and then leave it on the books at that value unless there is a specific rule to the contrary. The company purchased the building for $175,000. It must stay on the books at $175,000. Companies are not allowed to increase the value of an asset on their books just because they believe it is worth more. \n\n You must record the revenue at $2,350 per the rules of conservatism. We do not want to record revenue at $2,500 when we are not absolutely 100% sure that is what we will earn. Recording it at $2,500 might mislead our statement users to think we have earned more revenue than we really have. \n\n Even though the employees are a wonderful asset for the company, they cannot be included on the balance sheet as an asset. There is no way to assign a monetary value in US dollars to our employees. Therefore, we cannot include them in our assets. \n\n Reviewing and Analyzing Transactions \n\n Let us assume our business is a service-based company. We use Lynn Sanders\u2019 small printing company, Printing Plus, as our example. Please notice that since Printing Plus is a corporation, we are using the Common Stock account, instead of Owner\u2019s Equity. The following are several transactions from this business\u2019s current month: \n\n Issues $20,000 shares of common stock for cash. \n\n Purchases equipment on account for $3,500, payment due within the month. \n\n Receives $4,000 cash in advance from a customer for services not yet rendered. \n\n Provides $5,500 in services to a customer who asks to be billed for the services. \n\n Pays a $300 utility bill with cash. \n\n Distributed $100 cash in dividends to stockholders. \n\n We now analyze each of these transactions, paying attention to how they impact the accounting equation and corresponding financial statements. \n\n Transaction 1:  Issues $20,000 shares of common stock for cash. \n\n Analysis:  Looking at the accounting equation, we know cash is an asset and common stock is stockholder\u2019s equity. When a company collects cash, this will increase assets because cash is coming into the business. When a company issues common stock, this will increase a stockholder\u2019s equity because he or she is receiving investments from owners. \n\n Remember that the accounting equation must remain balanced, and assets need to equal liabilities plus equity. On the asset side of the equation, we show an increase of $20,000. On the liabilities and equity side of the equation, there is also an increase of $20,000, keeping the equation balanced. Changes to assets, specifically cash, will increase assets on the balance sheet and increase cash on the statement of cash flows. Changes to stockholder\u2019s equity, specifically common stock, will increase stockholder\u2019s equity on the balance sheet. \n\n Transaction 2:  Purchases equipment on account for $3,500, payment due within the month. \n\n Analysis : We know that the company purchased equipment, which is an asset. We also know that the company purchased the equipment on account, meaning it did not pay for the equipment immediately and asked for payment to be billed instead and paid later. Since the company owes money and has not yet paid, this is a liability, specifically labeled as  accounts payable . There is an increase to assets because the company has equipment it did not have before. There is also an increase to liabilities because the company now owes money. The more money the company owes, the more that liability will increase. \n\n The accounting equation remains balanced because there is a $3,500 increase on the asset side, and a $3,500 increase on the liability and equity side. This change to assets will increase assets on the balance sheet. The change to liabilities will increase liabilities on the balance sheet. \n\n Transaction 3:  Receives $4,000 cash in advance from a customer for services not yet rendered. \n\n Analysis:  We know that the company collected cash, which is an asset. This collection of $4,000 increases assets because money is coming into the business. \n\n The company has yet to provide the service. According to the revenue recognition principle, the company cannot recognize that revenue until it provides the service. Therefore, the company has a liability to the customer to provide the service and must record the liability as unearned revenue. The liability of $4,000 worth of services increases because the company has more unearned revenue than previously. \n\n The equation remains balanced, as assets and liabilities increase. The balance sheet would experience an increase in assets and an increase in liabilities. \n\n Transaction 4:  Provides $5,500 in services to a customer who asks to be billed for the services. \n\n Analysis:  The customer asked to be billed for the service, meaning the customer did not pay with cash immediately. The customer owes money and has not yet paid, signaling an accounts receivable. Accounts receivable is an asset that is increasing in this case. This customer obligation of $5,500 adds to the balance in accounts receivable. \n\n The company did provide the services. As a result, the revenue recognition principle requires recognition as revenue, which increases equity for $5,500. The increase to assets would be reflected on the balance sheet. The increase to equity would affect three statements. The income statement would see an increase to revenues, changing net income (loss). Net income (loss) is computed into retained earnings on the statement of retained earnings. This change to retained earnings is shown on the balance sheet under stockholder\u2019s equity. \n\n Transaction 5:  Pays a $300 utility bill with cash. \n\n Analysis:  The company paid with cash, an asset. Assets are decreasing by $300 since cash was used to pay for this utility bill. The company no longer has that money. \n\n Utility payments are generated from bills for services that were used and paid for within the accounting period, thus recognized as an expense. The expense decreases equity by $300. The decrease to assets, specifically cash, affects the balance sheet and statement of cash flows. The decrease to equity as a result of the expense affects three statements. The income statement would see a change to expenses, changing net income (loss). Net income (loss) is computed into retained earnings on the statement of retained earnings. This change to retained earnings is shown on the balance sheet under stockholder\u2019s equity. \n\n Transaction 6:  Distributed $100 cash in dividends to stockholders. \n\n Analysis:  The company paid the distribution with cash, an asset. Assets decrease by $100 as a result. Dividends affect equity and, in this case, decrease equity by $100. The decrease to assets, specifically cash, affects the balance sheet and statement of cash flows. The decrease to equity because of the dividend payout affects the statement of retained earnings by reducing ending retained earnings, and the balance sheet by reducing stockholder\u2019s equity. \n\n Let\u2019s summarize the transactions and make sure the accounting equation has remained balanced. Shown are each of the transactions. \n\n As you can see, assets total $32,600, while liabilities added to equity also equal $32,600. Our accounting equation remains balanced. In  Use Journal Entries to Record Transactions and Post to T-Accounts , we add other elements to the accounting equation and expand the equation to include individual revenue and expense accounts. \n\n Your Turn Debbie\u2019s Dairy Farm Debbie\u2019s Dairy Farm had the following transactions: \n\n Debbie ordered shelving worth $750. \n\n Debbie\u2019s selling price on a gallon of milk is $3.00. She finds out that most local stores are charging $3.50. Based on this information, she decides to increase her price to $3.25. She has an employee put a new price sticker on each gallon. \n\n A customer buys a gallon of milk paying cash. \n\n The shelving is delivered with an invoice for $750. \n\n Which events will be recorded in the accounting system? \n\n Solution \n\n Debbie did not yet receive the shelving\u2014it has only been ordered. As of now there is no new asset owned by the company. Since the shelving has not yet been delivered, Debbie does not owe any money to the other company. Debbie will not record the transaction. \n\n Changing prices does not have an impact on the company at the time the price is changed. All that happened was that a new price sticker was placed on the milk. Debbie still has all the milk and has not received any money. Debbie will not record the transaction. \n\n Debbie now has a transaction to record. She has received cash and the customer has taken some of her inventory of milk. She has an increase in one asset (cash) and a decrease in another asset (inventory.) She also has earned revenue. \n\n Debbie has taken possession of the shelving and is the legal owner. She also has an increase in her liabilities as she accepted delivery of the shelving but has not paid for it. Debbie will record this transaction. \n 3.5   Use Journal Entries to Record Transactions and Post to T-Accounts \n\n When we introduced debits and credits, you learned about the usefulness of T-accounts as a graphic representation of any account in the general ledger. But before transactions are posted to the T-accounts, they are first recorded using special forms known as  journals . \n\n Journals \n\n Accountants use special forms called  journals  to keep track of their business transactions. A journal is the first place information is entered into the accounting system. A journal is often referred to as the  book of original entry  because it is the place the information originally enters into the system. A journal keeps a historical account of all recordable transactions with which the company has engaged. In other words, a journal is similar to a diary for a business. When you enter information into a journal, we say you are  journalizing  the entry. Journaling the entry is the second step in the accounting cycle. Here is a picture of a journal. \n\n You can see that a journal has columns labeled debit and credit. The debit is on the left side, and the credit is on the right. Let\u2019s look at how we use a journal. \n\n When filling in a journal, there are some rules you need to follow to improve journal entry organization. \n\n Formatting When Recording Journal Entries \n\n Include a date of when the transaction occurred. \n\n The debit account title(s) always come first and on the left. \n\n The credit account title(s) always come after all debit titles are entered, and on the right. \n\n The titles of the credit accounts will be indented below the debit accounts. \n\n You will have at least one debit (possibly more). \n\n You will always have at least one credit (possibly more). \n\n The dollar value of the debits must equal the dollar value of the credits or else the equation will go out of balance. \n\n You will write a short description after each journal entry. \n\n Skip a space after the description before starting the next journal entry. \n\n An example journal entry format is as follows. It is not taken from previous examples but is intended to stand alone. \n\n Note that this example has only one debit account and one credit account, which is considered a  simple entry . A  compound entry  is when there is more than one account listed under the debit and/or credit column of a journal entry (as seen in the following). \n\n Notice that for this entry, the rules for recording journal entries have been followed. There is a date of April 1, 2018, the debit account titles are listed first with Cash and Supplies, the credit account title of Common Stock is indented after the debit account titles, there are at least one debit and one credit, the debit amounts equal the credit amount, and there is a short description of the transaction. \n\n Let\u2019s now look at a few transactions from Printing Plus and record their journal entries. \n\n Recording Transactions \n\n We now return to our company example of Printing Plus, Lynn Sanders\u2019 printing service company. We will analyze and record each of the transactions for her business and discuss how this impacts the financial statements. Some of the listed transactions have been ones we have seen throughout this chapter. More detail for each of these transactions is provided, along with a few new transactions. \n\n On January 3, 2019, issues $20,000 shares of common stock for cash. \n\n On January 5, 2019, purchases equipment on account for $3,500, payment due within the month. \n\n On January 9, 2019, receives $4,000 cash in advance from a customer for services not yet rendered. \n\n On January 10, 2019, provides $5,500 in services to a customer who asks to be billed for the services. \n\n On January 12, 2019, pays a $300 utility bill with cash. \n\n On January 14, 2019, distributed $100 cash in dividends to stockholders. \n\n On January 17, 2019, receives $2,800 cash from a customer for services rendered. \n\n On January 18, 2019, paid in full, with cash, for the equipment purchase on January 5. \n\n On January 20, 2019, paid $3,600 cash in salaries expense to employees. \n\n On January 23, 2019, received cash payment in full from the customer on the January 10 transaction. \n\n On January 27, 2019, provides $1,200 in services to a customer who asks to be billed for the services. \n\n On January 30, 2019, purchases supplies on account for $500, payment due within three months. \n\n Transaction 1:  On January 3, 2019, issues $20,000 shares of common stock for cash. \n\n Analysis: \n\n This is a transaction that needs to be recorded, as Printing Plus has received money, and the stockholders have invested in the firm. \n\n Printing Plus now has more cash. Cash is an asset, which in this case is increasing. Cash increases on the debit side. \n\n When the company issues stock, stockholders purchase common stock, yielding a higher common stock figure than before issuance. The common stock account is increasing and affects equity. Looking at the expanded accounting equation, we see that Common Stock increases on the credit side. \n\n Impact on the financial statements:  Both of these accounts are balance sheet accounts. You will see total assets increase and total stockholders\u2019 equity will also increase, both by $20,000. With both totals increasing by $20,000, the accounting equation, and therefore our balance sheet, will be in balance. There is no effect on the income statement from this transaction as there were no revenues or expenses recorded. \n\n Transaction 2:  On January 5, 2019, purchases equipment on account for $3,500, payment due within the month. \n\n Analysis: \n\n In this case, equipment is an asset that is increasing. It increases because Printing Plus now has more equipment than it did before. Assets increase on the debit side; therefore, the Equipment account would show a $3,500 debit. \n\n The company did not pay for the equipment immediately. Lynn asked to be sent a bill for payment at a future date. This creates a liability for Printing Plus, who owes the supplier money for the equipment. Accounts Payable is used to recognize this liability. This liability is increasing, as the company now owes money to the supplier. A liability account increases on the credit side; therefore, Accounts Payable will increase on the credit side in the amount of $3,500. \n\n Impact on the financial statements:  Since both accounts in the entry are balance sheet accounts, you will see no effect on the income statement. \n\n Transaction 3:  On January 9, 2019, receives $4,000 cash in advance from a customer for services not yet rendered. \n\n Analysis: \n\n Cash was received, thus increasing the Cash account. Cash is an asset that increases on the debit side. \n\n Printing Plus has not yet provided the service, meaning it cannot recognize the revenue as earned. The company has a liability to the customer until it provides the service. The Unearned Revenue account would be used to recognize this liability. This is a liability the company did not have before, thus increasing this account. Liabilities increase on the credit side; thus, Unearned Revenue will recognize the $4,000 on the credit side. \n\n Impact on the financial statements:  Since both accounts in the entry are balance sheet accounts, you will see no effect on the income statement. \n\n Transaction 4:  On January 10, 2019, provides $5,500 in services to a customer who asks to be billed for the services. \n\n Analysis: \n\n The company provided service to the client; therefore, the company may recognize the revenue as earned (revenue recognition principle), which increases revenue. Service Revenue is a revenue account affecting equity. Revenue accounts increase on the credit side; thus, Service Revenue will show an increase of $5,500 on the credit side. \n\n The customer did not immediately pay for the services and owes Printing Plus payment. This money will be received in the future, increasing Accounts Receivable. Accounts Receivable is an asset account. Asset accounts increase on the debit side. Therefore, Accounts Receivable will increase for $5,500 on the debit side. \n\n Impact on the financial statements:  You have revenue of $5,500. Revenue is reported on your income statement. The more revenue you have, the more net income (earnings) you will have. The more earnings you have, the more retained earnings you will keep. Retained earnings is a stockholders\u2019 equity account, so total equity will increase $5,500. Accounts receivable is going up so total assets will increase by $5,500. The accounting equation, and therefore the balance sheet, remain in balance. \n\n Transaction 5:  On January 12, 2019, pays a $300 utility bill with cash. \n\n Analysis: \n\n Cash was used to pay the utility bill, which means cash is decreasing. Cash is an asset that decreases on the credit side. \n\n Paying a utility bill creates an expense for the company. Utility Expense increases, and does so on the debit side of the accounting equation. \n\n Impact on the financial statements:  You have an expense of $300. Expenses are reported on your income statement. More expenses lead to a decrease in net income (earnings). The fewer earnings you have, the fewer retained earnings you will end up with. Retained earnings is a stockholders\u2019 equity account, so total equity will decrease by $300. Cash is decreasing, so total assets will decrease by $300, impacting the balance sheet. \n\n Transaction 6:  On January 14, 2019, distributed $100 cash in dividends to stockholders. \n\n Analysis: \n\n Cash was used to pay the dividends, which means cash is decreasing. Cash is an asset that decreases on the credit side. \n\n Dividends distribution occurred, which increases the Dividends account. Dividends is a part of stockholder\u2019s equity and is recorded on the debit side. This debit entry has the effect of reducing stockholder\u2019s equity. \n\n Impact on the financial statements:  You have dividends of $100. An increase in dividends leads to a decrease in stockholders\u2019 equity (retained earnings). Cash is decreasing, so total assets will decrease by $100, impacting the balance sheet. \n\n Transaction 7:  On January 17, 2019, receives $2,800 cash from a customer for services rendered. \n\n Analysis: \n\n The customer used cash as the payment method, thus increasing the amount in the Cash account. Cash is an asset that is increasing, and it does so on the debit side. \n\n Printing Plus provided the services, which means the company can recognize revenue as earned in the Service Revenue account. Service Revenue increases equity; therefore, Service Revenue increases on the credit side. \n\n Impact on the financial statements:  Revenue is reported on the income statement. More revenue will increase net income (earnings), thus increasing retained earnings. Retained earnings is a stockholders\u2019 equity account, so total equity will increase $2,800. Cash is increasing, which increases total assets on the balance sheet. \n\n Transaction 8:  On January 18, 2019, paid in full, with cash, for the equipment purchase on January 5. \n\n Analysis: \n\n Cash is decreasing because it was used to pay for the outstanding liability created on January 5. Cash is an asset and will decrease on the credit side. \n\n Accounts Payable recognized the liability the company had to the supplier to pay for the equipment. Since the company is now paying off the debt it owes, this will decrease Accounts Payable. Liabilities decrease on the debit side; therefore, Accounts Payable will decrease on the debit side by $3,500. \n\n Impact on the financial statements:  Since both accounts in the entry are balance sheet accounts, you will see no effect on the income statement. \n\n Transaction 9:  On January 20, 2019, paid $3,600 cash in salaries expense to employees. \n\n Analysis: \n\n Cash was used to pay for salaries, which decreases the Cash account. Cash is an asset that decreases on the credit side. \n\n Salaries are an expense to the business for employee work. This will increase Salaries Expense, affecting equity. Expenses increase on the debit side; thus, Salaries Expense will increase on the debit side. \n\n Impact on the financial statements:  You have an expense of $3,600. Expenses are reported on the income statement. More expenses lead to a decrease in net income (earnings). The fewer earnings you have, the fewer retained earnings you will end up with. Retained earnings is a stockholders\u2019 equity account, so total equity will decrease by $3,600. Cash is decreasing, so total assets will decrease by $3,600, impacting the balance sheet. \n\n Transaction 10:  On January 23, 2019, received cash payment in full from the customer on the January 10 transaction. \n\n Analysis: \n\n Cash was received, thus increasing the Cash account. Cash is an asset, and assets increase on the debit side. \n\n Accounts Receivable was originally used to recognize the future customer payment; now that the customer has paid in full, Accounts Receivable will decrease. Accounts Receivable is an asset, and assets decrease on the credit side. \n\n Impact on the financial statements:  In this transaction, there was an increase to one asset (Cash) and a decrease to another asset (Accounts Receivable). This means total assets change by $0, because the increase and decrease to assets in the same amount cancel each other out. There are no changes to liabilities or stockholders\u2019 equity, so the equation is still in balance. Since there are no revenues or expenses affected, there is no effect on the income statement. \n\n Transaction 11:  On January 27, 2019, provides $1,200 in services to a customer who asks to be billed for the services. \n\n Analysis: \n\n The customer does not pay immediately for the services but is expected to pay at a future date. This creates an Accounts Receivable for Printing Plus. The customer owes the money, which increases Accounts Receivable. Accounts Receivable is an asset, and assets increase on the debit side. \n\n Printing Plus provided the service, thus earning revenue. Service Revenue would increase on the credit side. \n\n Impact on the financial statements:  Revenue is reported on the income statement. More revenue will increase net income (earnings), thus increasing retained earnings. Retained earnings is a stockholders\u2019 equity account, so total equity will increase $1,200. Cash is increasing, which increases total assets on the balance sheet. \n\n Transaction 12:  On January 30, 2019, purchases supplies on account for $500, payment due within three months. \n\n Analysis: \n\n The company purchased supplies, which are assets to the business until used. Supplies is increasing, because the company has more supplies than it did before. Supplies is an asset that is increasing on the debit side. \n\n Printing Plus did not pay immediately for the supplies and asked to be billed for the supplies, payable at a later date. This creates a liability for the company, Accounts Payable. This liability increases Accounts Payable; thus, Accounts Payable increases on the credit side. \n\n Impact on the financial statements:  There is an increase to a liability and an increase to assets. These accounts both impact the balance sheet but not the income statement. \n\n The complete journal for these transactions is as follows: \n\n We now look at the next step in the accounting cycle, step 3: post journal information to the ledger. \n\n Continuing Application Colfax Market Colfax Market  is a small corner grocery store that carries a variety of staple items such as meat, milk, eggs, bread, and so on. As a smaller grocery store,  Colfax  does not offer the variety of products found in a larger supermarket or chain. However, it records journal entries in a similar way. \n\n Grocery stores of all sizes must purchase product and track inventory. While the number of entries might differ, the recording process does not. For example,  Colfax  might purchase food items in one large quantity at the beginning of each month, payable by the end of the month. Therefore, it might only have a few accounts payable and inventory journal entries each month. Larger grocery chains might have multiple deliveries a week, and multiple entries for purchases from a variety of vendors on their accounts payable weekly. \n\n This similarity extends to other retailers, from clothing stores to sporting goods to hardware. No matter the size of a company and no matter the product a company sells, the fundamental accounting entries remain the same. \n\n Posting to the General Ledger \n\n Recall that the general ledger is a record of each account and its balance. Reviewing journal entries individually can be tedious and time consuming. The general ledger is helpful in that a company can easily extract account and balance information. Here is a small section of a general ledger. \n\n You can see at the top is the name of the account \u201cCash,\u201d as well as the assigned account number \u201c101.\u201d Remember, all asset accounts will start with the number 1. The date of each transaction related to this account is included, a possible description of the transaction, and a reference number if available. There are debit and credit columns, storing the financial figures for each transaction, and a balance column that keeps a running total of the balance in the account after every transaction. \n\n Let\u2019s look at one of the journal entries from Printing Plus and fill in the corresponding ledgers. \n\n As you can see, there is one ledger account for Cash and another for Common Stock. Cash is labeled account number 101 because it is an asset account type. The date of January 3, 2019, is in the far left column, and a description of the transaction follows in the next column. Cash had a debit of $20,000 in the journal entry, so $20,000 is transferred to the general ledger in the debit column. The balance in this account is currently $20,000, because no other transactions have affected this account yet. \n\n Common Stock has the same date and description. Common Stock had a credit of $20,000 in the journal entry, and that information is transferred to the general ledger account in the credit column. The balance at that time in the Common Stock ledger account is $20,000. \n\n Another key element to understanding the general ledger, and the third step in the accounting cycle, is how to calculate balances in ledger accounts. \n\n Link to Learning \n\n It is a good idea to familiarize yourself with the type of information companies report each year. Peruse  Best Buy \u2019s 2017 annual report  to learn more about  Best Buy . Take note of the company\u2019s balance sheet on page 53 of the report and the income statement on page 54. These reports have much more information than the financial statements we have shown you; however, if you read through them you may notice some familiar items. \n\n Calculating Account Balances \n\n When calculating balances in ledger accounts, one must take into consideration which side of the account increases and which side decreases. To find the account balance, you must find the difference between the sum of all figures on the side that increases and the sum of all figures on the side that decreases. \n\n For example, the Cash account is an asset. We know from the accounting equation that assets increase on the debit side and decrease on the credit side. If there was a debit of $5,000 and a credit of $3,000 in the Cash account, we would find the difference between the two, which is $2,000 (5,000 \u2013 3,000). The debit is the larger of the two sides ($5,000 on the debit side as opposed to $3,000 on the credit side), so the Cash account has a debit balance of $2,000. \n\n Another example is a liability account, such as Accounts Payable, which increases on the credit side and decreases on the debit side. If there were a $4,000 credit and a $2,500 debit, the difference between the two is $1,500. The credit is the larger of the two sides ($4,000 on the credit side as opposed to $2,500 on the debit side), so the Accounts Payable account has a credit balance of $1,500. \n\n The following are selected journal entries from Printing Plus that affect the Cash account. We will use the Cash ledger account to calculate account balances. \n\n The general ledger account for Cash would look like the following: \n\n In the last column of the Cash ledger account is the running balance. This shows where the account stands after each transaction, as well as the final balance in the account. How do we know on which side, debit or credit, to input each of these balances? Let\u2019s consider the general ledger for Cash. \n\n On January 3, there was a debit balance of $20,000 in the Cash account. On January 9, a debit of $4,000 was included. Since both are on the debit side, they will be added together to get a balance on $24,000 (as is seen in the balance column on the January 9 row). On January 12, there was a credit of $300 included in the Cash ledger account. Since this figure is on the credit side, this $300 is subtracted from the previous balance of $24,000 to get a new balance of $23,700. The same process occurs for the rest of the entries in the ledger and their balances. The final balance in the account is $24,800. \n\n Checking to make sure the final balance figure is correct; one can review the figures in the debit and credit columns. In the debit column for this cash account, we see that the total is $32,300 (20,000 + 4,000 + 2,800 + 5,500). The credit column totals $7,500 (300 + 100 + 3,500 + 3,600). The difference between the debit and credit totals is $24,800 (32,300 \u2013 7,500). The balance in this Cash account is a debit of $24,800. Having a debit balance in the Cash account is the normal balance for that account. \n\n Posting to the T-Accounts \n\n The third step in the accounting cycle is to post journal information to the ledger. To do this we can use a T-account format. A company will take information from its journal and post to this general ledger. Posting refers to the process of transferring data from the journal to the general ledger. It is important to understand that T-accounts are only used for illustrative purposes in a textbook, classroom, or business discussion. They are not official accounting forms. Companies will use ledgers for their official books, not T-accounts. \n\n Let\u2019s look at the journal entries for Printing Plus and post each of those entries to their respective T-accounts. \n\n The following are the journal entries recorded earlier for Printing Plus. \n\n Transaction 1:  On January 3, 2019, issues $20,000 shares of common stock for cash. \n\n In the journal entry, Cash has a debit of $20,000. This is posted to the Cash T-account on the debit side (left side). Common Stock has a credit balance of $20,000. This is posted to the Common Stock T-account on the credit side (right side). \n\n Transaction 2:  On January 5, 2019, purchases equipment on account for $3,500, payment due within the month. \n\n In the journal entry, Equipment has a debit of $3,500. This is posted to the Equipment T-account on the debit side. Accounts Payable has a credit balance of $3,500. This is posted to the Accounts Payable T-account on the credit side. \n\n Transaction 3:  On January 9, 2019, receives $4,000 cash in advance from a customer for services not yet rendered. \n\n In the journal entry, Cash has a debit of $4,000. This is posted to the Cash T-account on the debit side. You will notice that the transaction from January 3 is listed already in this T-account. The next transaction figure of $4,000 is added directly below the $20,000 on the debit side. Unearned Revenue has a credit balance of $4,000. This is posted to the Unearned Revenue T-account on the credit side. \n\n Transaction 4:  On January 10, 2019, provides $5,500 in services to a customer who asks to be billed for the services. \n\n In the journal entry, Accounts Receivable has a debit of $5,500. This is posted to the Accounts Receivable T-account on the debit side. Service Revenue has a credit balance of $5,500. This is posted to the Service Revenue T-account on the credit side. \n\n Transaction 5:  On January 12, 2019, pays a $300 utility bill with cash. \n\n In the journal entry, Utility Expense has a debit balance of $300. This is posted to the Utility Expense T-account on the debit side. Cash has a credit of $300. This is posted to the Cash T-account on the credit side. You will notice that the transactions from January 3 and January 9 are listed already in this T-account. The next transaction figure of $300 is added on the credit side. \n\n Transaction 6:  On January 14, 2019, distributed $100 cash in dividends to stockholders. \n\n In the journal entry, Dividends has a debit balance of $100. This is posted to the Dividends T-account on the debit side. Cash has a credit of $100. This is posted to the Cash T-account on the credit side. You will notice that the transactions from January 3, January 9, and January 12 are listed already in this T-account. The next transaction figure of $100 is added directly below the January 12 record on the credit side. \n\n Transaction 7:  On January 17, 2019, receives $2,800 cash from a customer for services rendered. \n\n In the journal entry, Cash has a debit of $2,800. This is posted to the Cash T-account on the debit side. You will notice that the transactions from January 3, January 9, January 12, and January 14 are listed already in this T-account. The next transaction figure of $2,800 is added directly below the January 9 record on the debit side. Service Revenue has a credit balance of $2,800. This too has a balance already from January 10. The new entry is recorded under the Jan 10 record, posted to the Service Revenue T-account on the credit side. \n\n Transaction 8:  On January 18, 2019, paid in full, with cash, for the equipment purchase on January 5. \n\n On this transaction, Cash has a credit of $3,500. This is posted to the Cash T-account on the credit side beneath the January 14 transaction. Accounts Payable has a debit of $3,500 (payment in full for the Jan. 5 purchase). You notice there is already a credit in Accounts Payable, and the new record is placed directly across from the January 5 record. \n\n Transaction 9:  On January 20, 2019, paid $3,600 cash in salaries expense to employees. \n\n On this transaction, Cash has a credit of $3,600. This is posted to the Cash T-account on the credit side beneath the January 18 transaction. Salaries Expense has a debit of $3,600. This is placed on the debit side of the Salaries Expense T-account. \n\n Transaction 10:  On January 23, 2019, received cash payment in full from the customer on the January 10 transaction. \n\n On this transaction, Cash has a debit of $5,500. This is posted to the Cash T-account on the debit side beneath the January 17 transaction. Accounts Receivable has a credit of $5,500 (from the Jan. 10 transaction). The record is placed on the credit side of the Accounts Receivable T-account across from the January 10 record. \n\n Transaction 11:  On January 27, 2019, provides $1,200 in services to a customer who asks to be billed for the services. \n\n On this transaction, Accounts Receivable has a debit of $1,200. The record is placed on the debit side of the Accounts Receivable T-account underneath the January 10 record. Service Revenue has a credit of $1,200. The record is placed on the credit side of the Service Revenue T-account underneath the January 17 record. \n\n Transaction 12:  On January 30, 2019, purchases supplies on account for $500, payment due within three months. \n\n On this transaction, Supplies has a debit of $500. This will go on the debit side of the Supplies T-account. Accounts Payable has a credit of $500. You notice there are already figures in Accounts Payable, and the new record is placed directly underneath the January 5 record. \n\n T-Accounts Summary \n\n Once all journal entries have been posted to T-accounts, we can check to make sure the accounting equation remains balanced. A summary showing the T-accounts for Printing Plus is presented in  Figure 3.10 . \n\n The sum on the assets side of the accounting equation equals $30,000, found by adding together the final balances in each asset account (24,800 + 1,200 + 500 + 3,500). To find the total on the liabilities and equity side of the equation, we need to find the difference between debits and credits. Credits on the liabilities and equity side of the equation total $34,000 (500 + 4,000 + 20,000 + 9,500). Debits on the liabilities and equity side of the equation total $4,000 (100 + 3,600 + 300). The difference $34,000 \u2013 $4,000 = $30,000. Thus, the equation remains balanced with $30,000 on the asset side and $30,000 on the liabilities and equity side. Now that we have the T-account information, and have confirmed the accounting equation remains balanced, we can create the unadjusted trial balance. \n\n Your Turn Journalizing Transactions You have the following transactions the last few days of April. \n\n Apr.\u00a025 \n\n You stop by your uncle\u2019s gas station to refill both gas cans for your company, Watson\u2019s Landscaping. Your uncle adds the total of $28 to your account. \n\n Apr.\u00a026 \n\n You record another week\u2019s revenue for the lawns mowed over the past week. You earned $1,200. You received cash equal to 75% of your revenue. \n\n Apr.\u00a027 \n\n You pay your local newspaper $35 to run an advertisement in this week\u2019s paper. \n\n Apr.\u00a029 \n\n You make a $25 payment on account. \n\n Table  3.3   \n\n Prepare the necessary journal entries for these four transactions. \n\n Explain why you debited and credited the accounts you did. \n\n What will be the new balance in each account used in these entries? \n\n Solution \n\n April 25 \n\n You have incurred more gas expense. This means you have an increase in the total amount of gas expense for April. Expenses go up with debit entries. Therefore, you will debit gas expense. \n\n You purchased the gas on account. This will increase your liabilities. Liabilities increase with credit entries. Credit accounts payable to increase the total in the account. \n\n April 26 \n\n You have received more cash from customers, so you want the total cash to increase. Cash is an asset, and assets increase with debit entries, so debit cash. \n\n You also have more money owed to you by your customers. You have performed the services, your customers owe you the money, and you will receive the money in the future. Debit accounts receivable as asset accounts increase with debits. \n\n You have mowed lawns and earned more revenue. You want the total of your revenue account to increase to reflect this additional revenue. Revenue accounts increase with credit entries, so credit lawn-mowing revenue. \n\n April 27 \n\n Advertising is an expense of doing business. You have incurred more expenses, so you want to increase an expense account. Expense accounts increase with debit entries. Debit advertising expense. \n\n You paid cash for the advertising. You have less cash, so credit the cash account. Cash is an asset, and asset account totals decrease with credits. \n\n April 29 \n\n You paid \u201con account.\u201d Remember that \u201con account\u201d means a service was performed or an item was received without being paid for. The customer asked to be billed. You were the customer in this case. You made a purchase of gas on account earlier in the month, and at that time you increased accounts payable to show you had a liability to pay this amount sometime in the future. You are now paying down some of the money you owe on that account. Since you paid this money, you now have less of a liability so you want to see the liability account, accounts payable, decrease by the amount paid. Liability accounts decrease with debit entries. \n\n You paid, which means you gave cash (or wrote a check or electronically transferred) so you have less cash. To decrease the total cash, credit the account because asset accounts are reduced by recording credit entries. \n\n Your Turn Normal Account Balances Calculate the balances in each of the following accounts. Do they all have the normal balance they should have? If not, which one? How do you know this? \n\n Solution \n\n Think It Through Gift Cards Gift cards have become an important topic for managers of any company. Understanding who buys gift cards, why, and when can be important in business planning. Also, knowing when and how to determine that a gift card will not likely be redeemed will affect both the company\u2019s balance sheet (in the liabilities section) and the income statement (in the revenues section). \n\n According to a 2017 holiday shopping report from the National Retail Federation, gift cards are the most-requested presents for the eleventh year in a row, with 61% of people surveyed saying they are at the top of their wish lists. 6   CEB TowerGroup  projects that total gift card volume will reach $160 billion by 2018. 7 6 National Retail Federation (NRF). \u201cNRF Consumer Survey Points to Busy Holiday Season, Backs Up Economic Forecast and Import Numbers.\u201d October 27, 2017. https://nrf.com/media-center/press-releases/nrf-consumer-survey-points-busy-holiday-season-backs-economic-forecast 7 CEB Tower Group. \u201c2015 Gift Card Sales to Reach New Peak of $130 Billion.\u201d PR Newswire. December 8, 2015. https://www.prnewswire.com/news-releases/2015-gift-card-sales-to-reach-new-peak-of-130-billion-300189615.html How are all of these gift card sales affecting one of America\u2019s favorite specialty coffee companies,  Starbucks ? \n\n In 2014 one in seven adults received a  Starbucks  gift card. On Christmas Eve alone $2.5 million gift cards were sold. This is a rate of 1,700 cards per minute. 8 8 Sara Haralson. \u201cLast-Minute Shoppers Rejoice! Starbucks Has You Covered.\u201d  Fortune . December 22, 2015. http://fortune.com/video/2015/12/22/starbucks-gift-cards/ \n\n The following discussion about gift cards is taken from  Starbucks \u2019s 2016 annual report: \n\n When an amount is loaded onto a stored value card we recognize a corresponding liability for the full amount loaded onto the card, which is recorded within stored value card liability on our consolidated balance sheets. When a stored value card is redeemed at a company-operated store or online, we recognize revenue by reducing the stored value card liability. When a stored value card is redeemed at a licensed store location, we reduce the corresponding stored value card liability and cash, which is reimbursed to the licensee. There are no expiration dates on our stored value cards, and in most markets, we do not charge service fees that cause a decrement to customer balances. While we will continue to honor all stored value cards presented for payment, management may determine the likelihood of redemption, based on historical experience, is deemed to be remote for certain cards due to long periods of inactivity. In these circumstances, unredeemed card balances may be recognized as breakage income. In fiscal 2016, 2015, and 2014, we recognized breakage income of $60.5 million, $39.3 million, and $38.3 million, respectively. 9 9 U.S. Securities and Exchange Commission. Communication from Starbucks Corporation regarding 2014 10-K Filing. November 14, 2014. https://www.sec.gov/Archives/edgar/data/829224/000082922415000020/filename1.htm \n\n As of October 1, 2017,  Starbucks  had a total of $1,288,500,000 in stored value card liability. \n 3.6   Prepare a Trial Balance \n\n Once all the monthly transactions have been analyzed, journalized, and posted on a continuous day-to-day basis over the accounting period (a month in our example), we are ready to start working on preparing a trial balance (unadjusted). Preparing an unadjusted trial balance is the fourth step in the accounting cycle. A  trial balance  is a list of all accounts in the general ledger that have nonzero balances. A trial balance is an important step in the accounting process, because it helps identify any computational errors throughout the first three steps in the cycle. \n\n Note that for this step, we are considering our trial balance to be unadjusted. The  unadjusted trial balance  in this section includes accounts before they have been adjusted. As you see in step 6 of the accounting cycle, we create another trial balance that is adjusted (see  The Adjustment Process ). \n\n When constructing a trial balance, we must consider a few formatting rules, akin to those requirements for financial statements: \n\n The header must contain the name of the company, the label of a Trial Balance (Unadjusted), and the date. \n\n Accounts are listed in the accounting equation order with assets listed first followed by liabilities and finally equity. \n\n Amounts at the top of each debit and credit column should have a dollar sign. \n\n When amounts are added, the final figure in each column should be underscored. \n\n The totals at the end of the trial balance need to have dollar signs and be double-underscored. \n\n Transferring information from T-accounts to the trial balance requires consideration of the final balance in each account. If the final balance in the ledger account (T-account) is a debit balance, you will record the total in the left column of the trial balance. If the final balance in the ledger account (T-account) is a credit balance, you will record the total in the right column. \n\n Once all ledger accounts and their balances are recorded, the debit and credit columns on the trial balance are totaled to see if the figures in each column match each other. The final total in the debit column must be the same dollar amount that is determined in the final credit column. For example, if you determine that the final debit balance is $24,000 then the final credit balance in the trial balance must also be $24,000. If the two balances are not equal, there is a mistake in at least one of the columns. \n\n Let\u2019s now take a look at the T-accounts and unadjusted trial balance for Printing Plus to see how the information is transferred from the T-accounts to the unadjusted trial balance. \n\n For example, Cash has a final balance of $24,800 on the debit side. This balance is transferred to the Cash account in the debit column on the unadjusted trial balance. Accounts Receivable ($1,200), Supplies ($500), Equipment ($3,500), Dividends ($100), Salaries Expense ($3,600), and Utility Expense ($300) also have debit final balances in their T-accounts, so this information will be transferred to the debit column on the unadjusted trial balance. Accounts Payable ($500), Unearned Revenue ($4,000), Common Stock ($20,000) and Service Revenue ($9,500) all have credit final balances in their T-accounts. These credit balances would transfer to the credit column on the unadjusted trial balance. \n\n Once all balances are transferred to the unadjusted trial balance, we will sum each of the debit and credit columns. The debit and credit columns both total $34,000, which means they are equal and in balance. However, just because the column totals are equal and in balance, we are still not guaranteed that a mistake is not present. \n\n What happens if the columns are not equal? \n\n Concepts In Practice Enron and Arthur Andersen One of the most well-known financial schemes is that involving the companies  Enron Corporation  and  Arthur Andersen .  Enron  defrauded thousands by intentionally inflating revenues that did not exist.  Arthur Andersen  was the auditing firm in charge of independently verifying the accuracy of  Enron \u2019s financial statements and disclosures. This meant they would review statements to make sure they aligned with GAAP principles, assumptions, and concepts, among other things. \n\n It has been alleged that  Arthur Andersen  was negligent in its dealings with  Enron  and contributed to the collapse of the company.  Arthur Andersen  was brought up on a charge of obstruction of justice for shredding important documents related to criminal actions by  Enron . They were found guilty but had that conviction overturned. However, the damage was done, and the company\u2019s reputation prevented it from operating as it had. 10 10 James Titcomb. \u201cArthur Andersen Returns 12 Years after Enron Scandal.\u201d  The Telegraph.  September 2, 2014. https://www.telegraph.co.uk/finance/newsbysector/banksandfinance/11069713/Arthur-Andersen-returns-12-years-after-Enron-scandal.html \n\n Locating Errors \n\n Sometimes errors may occur in the accounting process, and the trial balance can make those errors apparent when it does not balance. \n\n One way to find the error is to take the difference between the two totals and divide the difference by two. For example, let\u2019s assume the following is the trial balance for Printing Plus. \n\n You notice that the balances are not the same. Find the difference between the two totals: $34,100 \u2013 $33,900 = $200 difference. Now divide the difference by two: $200/2 = $100. Since the credit side has a higher total, look carefully at the numbers on the credit side to see if any of them are $100. The Dividends account has a $100 figure listed in the credit column. Dividends normally have a debit balance, but here it is a credit. Look back at the Dividends T-account to see if it was copied onto the trial balance incorrectly. If the answer is the same as the T-account, then trace it back to the journal entry to check for mistakes. You may discover in your investigation that you copied the number from the T-account incorrectly. Fix your error, and the debit total will go up $100 and the credit total down $100 so that they will both now be $34,000. \n\n Another way to find an error is to take the difference between the two totals and divide by nine. If the outcome of the difference is a whole number, then you may have transposed a figure. For example, let\u2019s assume the following is the trial balance for Printing Plus. \n\n Find the difference between the two totals: $35,800 \u2013 34,000 = $1,800 difference. This difference divided by nine is $200 ($1,800/9 = $200). Looking at the debit column, which has the higher total, we determine that the Equipment account had transposed figures. The account should be $3,500 and not $5,300. We transposed the three and the five. \n\n What do you do if you have tried both methods and neither has worked? Unfortunately, you will have to go back through one step at a time until you find the error. \n\n If a trial balance is in balance, does this mean that all of the numbers are correct? Not necessarily. We can have errors and still be mathematically in balance. It is important to go through each step very carefully and recheck your work often to avoid mistakes early on in the process. \n\n After the unadjusted trial balance is prepared and it appears error-free, a company might look at its financial statements to get an idea of the company\u2019s position before adjustments are made to certain accounts. A more complete picture of company position develops after adjustments occur, and an adjusted trial balance has been prepared. These next steps in the accounting cycle are covered in  The Adjustment Process . \n\n Your Turn Completing a Trial Balance Complete the trial balance for Magnificent Landscaping Service using the following T-account final balance information for April 30, 2018. \n\n Solution \n\n Think It Through Correcting Errors in the Trial Balance You own a small consulting business. Each month, you prepare a trial balance showing your company\u2019s position. After preparing your trial balance this month, you discover that it does not balance. The debit column shows $2,000 more dollars than the credit column. You decide to investigate this error. \n\n What methods could you use to find the error? What are the ramifications if you do not find and fix this error? How can you minimize these types of errors in the future? ", "questions": [{"question": {"question_id": "fs-idm390991968", "question_text": "That a business may only report activities on financial statements that are specifically related to company operations, not those activities that affect the owner personally, is known as which of the following?", "question_choices": ["separate entity concept", "monetary measurement concept", "going concern assumption", "time period assumption"], "cloze_format": "That a business may only report activities on financial statements that are specifically related to company operations, not those activities that affect the owner personally, is known as the ___ .", "normal_format": "That a business may only report activities on financial statements that are specifically related to company operations, not those activities that affect the owner personally, is known as which of the following?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "The separate entity concept prescribes that a business may only report activities on financial statements that are specifically related to company operations , not those activities that affect the owner personally .", "hl_context": "<hl> The separate entity concept prescribes that a business may only report activities on financial statements that are specifically related to company operations , not those activities that affect the owner personally . <hl> This concept is called the separate entity concept because the business is considered an entity separate and apart from its owner ( s ) ."}, {"question": {"question_id": "fs-idm401248816", "question_text": "That companies can present useful information in shorter time periods such as years, quarters, or months is known as which of the following?", "question_choices": ["separate entity concept", "monetary measurement concept", "going concern assumption", "time period assumption"], "cloze_format": "That companies can present useful information in shorter time periods such as years, quarters, or months is known as the ___ .", "normal_format": "That companies can present useful information in shorter time periods such as years, quarters, or months is known as which of the following?"}, "answer": {"ans_text": "time period assumption", "ans_choice": 3}, "bloom": null, "hl_sentences": "Because of the time period assumption , we need to be sure to recognize revenues and expenses in the proper period . The time period assumption states that a company can present useful information in shorter time periods , such as years , quarters , or months .", "hl_context": "A potential or existing investor wants timely i nformation by which to measure the performance of the company , and to help decide whether to invest . <hl> Because of the time period assumption , we need to be sure to recognize revenues and expenses in the proper period . <hl> This might mean allocating costs over more than one accounting or reporting period . <hl> The time period assumption states that a company can present useful information in shorter time periods , such as years , quarters , or months . <hl> The information is broken into time frames to make comparisons and evaluations easier . The information will be timely and current and will give a meaningful picture of how the company is operating ."}, {"question": {"question_id": "fs-idm389746928", "question_text": "The system of using a monetary unit, such as the US dollar, to value the transaction is known as which of the following?", "question_choices": ["separate entity concept", "monetary measurement concept", "going concern assumption", "time period assumption"], "cloze_format": "The system of using a monetary unit, such as the US dollar, to value the transaction is known as the ___.", "normal_format": "The system of using a monetary unit, such as the US dollar, to value the transaction is known as which of the following?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "In order to record a transaction , we need a system of monetary measurement , or a monetary unit by which to value the transaction .", "hl_context": "<hl> In order to record a transaction , we need a system of monetary measurement , or a monetary unit by which to value the transaction . <hl> In the United States , this monetary unit is the US dollar . Without a dollar amount , it would be impossible to record information in the financial records . It also would leave stakeholders unable to make financial decisions , because there is no comparability measurement between companies . This concept ignores any change in the purchasing power of the dollar due to inflation ."}, {"question": {"question_id": "fs-idm395528320", "question_text": "Which of the following terms is used when assuming a business will continue to operate in the foreseeable future?", "question_choices": ["separate entity concept", "monetary measurement concept", "going concern assumption", "time period assumption"], "cloze_format": "The term that is used when assuming a business will continue to operate in the foreseeable future is ___.", "normal_format": "Which of the following terms is used when assuming a business will continue to operate in the foreseeable future?"}, "answer": {"ans_text": "going concern assumption", "ans_choice": 2}, "bloom": null, "hl_sentences": "The going concern assumption assumes a business will continue to operate in the foreseeable future .", "hl_context": "<hl> The going concern assumption assumes a business will continue to operate in the foreseeable future . <hl> A common time frame might be twelve months . However , one should presume the business is doing well enough to continue operations unless there is evidence to the contrary . For example , a business might have certain expenses that are paid off ( or reduced ) over several time periods . If the business will stay operational in the foreseeable future , the company can continue to recognize these long-term expenses over several time periods . Some red flags that a business may no longer be a going concern are defaults on loans or a sequence of losses ."}, {"question": {"question_id": "fs-idm394109440", "question_text": "The standards, procedures, and principles companies must follow when preparing their financial statements are known as which of the following?", "question_choices": ["Financial Accounting Standards Board (FASB)", "generally accepted accounting principles (GAAP)", "Securities and Exchange Commission (SEC)", "conceptual framework"], "cloze_format": "The standards, procedures, and principles companies must follow when preparing their financial statements are known as the ___ .", "normal_format": "The standards, procedures, and principles companies must follow when preparing their financial statements are known as which of the following?"}, "answer": {"ans_text": "generally accepted accounting principles (GAAP)", "ans_choice": 1}, "bloom": null, "hl_sentences": "In Introduction to Financial Statements , you learned that the Financial Accounting Standards Board ( FASB ) is an independent , nonprofit organization that sets the standards for financial accounting and reporting , including generally accepted accounting principles ( GAAP ) , for both public - and private-sector businesses in the United States .", "hl_context": "<hl> In Introduction to Financial Statements , you learned that the Financial Accounting Standards Board ( FASB ) is an independent , nonprofit organization that sets the standards for financial accounting and reporting , including generally accepted accounting principles ( GAAP ) , for both public - and private-sector businesses in the United States . <hl>"}, {"question": {"question_id": "fs-idm397434832", "question_text": "These are used by the FASB, and it is a set of concepts that guide financial reporting.", "question_choices": ["Financial Accounting Standards Board (FASB)", "generally accepted accounting principles (GAAP)", "Securities and Exchange Commission (SEC)", "conceptual framework"], "cloze_format": "___ is used by the FASB, and it is a set of concepts that guide financial reporting.", "normal_format": "What is used by the FASB as a set of concepts that guide financial reporting?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "bloom": null, "hl_sentences": "As illustrated in this chapter , the starting point for either FASB or IASB in creating accounting standards , or principles , is the conceptual framework . The FASB uses a conceptual framework , which is a set of concepts that guide financial reporting .", "hl_context": "As you learned in Role of Accounting in Society , US-based companies will apply US GAAP as created by the FASB , and most international companies will apply IFRS as created by the International Accounting Standards Board ( IASB ) . <hl> As illustrated in this chapter , the starting point for either FASB or IASB in creating accounting standards , or principles , is the conceptual framework . <hl> Both FASB and IASB cover the same topics in their frameworks , and the two frameworks are similar . The conceptual framework helps in the standard-setting process by creating the foundation on which those standards should be based . It can also help companies figure out how to record transactions for which there may not currently be an applicable standard . Though there are many similarities between the conceptual framework under US GAAP and IFRS , these similar foundations result in different standards and / or different interpretations . <hl> The FASB uses a conceptual framework , which is a set of concepts that guide financial reporting . <hl> These concepts can help ensure information is comparable and reliable to stakeholders . Guidance may be given on how to report transactions , measurement requirements , and application on financial statements , among other things . 3 3 Financial Accounting Standards Board . \u201c The Conceptual Framework . \u201d http://www.fasb.org/jsp/FASB/Page/BridgePage&cid=1176168367774"}, {"question": {"question_id": "fs-idm418290544", "question_text": "This is the independent federal agency protecting the interests of investors, regulating stock markets, and ensuring companies adhere to GAAP requirements.", "question_choices": ["Financial Accounting Standards Board (FASB)", "generally accepted accounting principles (GAAP)", "Securities and Exchange Commission (SEC)", "conceptual framework"], "cloze_format": "The ___ is the independent federal agency protecting the interests of investors, regulating stock markets, and ensuring companies adhere to GAAP requirements.", "normal_format": "What is the independent federal agency protecting the interests of investors, regulating stock markets, and ensuring companies adhere to GAAP requirements?"}, "answer": {"ans_text": "Securities and Exchange Commission (SEC)", "ans_choice": 2}, "bloom": null, "hl_sentences": "You also learned that the SEC is an independent federal agency that is charged with protecting the interests of investors , regulating stock markets , and ensuring companies adhere to GAAP requirements .", "hl_context": "<hl> You also learned that the SEC is an independent federal agency that is charged with protecting the interests of investors , regulating stock markets , and ensuring companies adhere to GAAP requirements . <hl> By having proper accounting standards such as US GAAP or IFRS , information presented publicly is considered comparable and reliable . As a result , financial statement users are more informed when making decisions . The SEC not only enforces the accounting rules but also delegates the process of setting standards for US GAAP to the FASB ."}, {"question": {"question_id": "fs-idm416453040", "question_text": "Which of the following is the principle that a business must report any business activities that could affect what is reported on the financial statements?", "question_choices": ["revenue recognition principle", "expense recognition (matching) principle", "cost principle", "full disclosure principle"], "cloze_format": "The ___ is the principle that a business must report any business activities that could affect what is reported on the financial statements.", "normal_format": "Which of the following is the principle that a business must report any business activities that could affect what is reported on the financial statements?"}, "answer": {"ans_text": "full disclosure principle", "ans_choice": 3}, "bloom": null, "hl_sentences": "The full disclosure principle states that a business must report any business activities that could affect what is reported on the financial statements .", "hl_context": "<hl> The full disclosure principle states that a business must report any business activities that could affect what is reported on the financial statements . <hl> These activities could be nonfinancial in nature or be supplemental details not readily available on the main financial statement . Some examples of this include any pending litigation , acquisition information , methods used to calculate certain figures , or stock options . These disclosures are usually recorded in footnotes on the statements , or in addenda to the statements ."}, {"question": {"question_id": "fs-idm406742592", "question_text": "Also known as the historical cost principle, ________ states that everything the company owns or controls (assets) must be recorded at their value at the date of acquisition.", "question_choices": ["revenue recognition principle", "expense recognition (matching) principle", "cost principle", "full disclosure principle"], "cloze_format": "Also known as the historical cost principle, ________ states that everything the company owns or controls (assets) must be recorded at their value at the date of acquisition.", "normal_format": "Also known as the historical cost principle, which of the following states that everything the company owns or controls (assets) must be recorded at their value at the date of acquisition?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "bloom": null, "hl_sentences": "The cost principle states that you must record an asset on the books for the price you bought it for and then leave it on the books at that value unless there is a specific rule to the contrary . The cost principle , also known as the historical cost principle , states that virtually everything the company owns or controls ( assets ) must be recorded at its value at the date of acquisition .", "hl_context": "<hl> The cost principle states that you must record an asset on the books for the price you bought it for and then leave it on the books at that value unless there is a specific rule to the contrary . <hl> The company purchased the building for $ 175,000 . It must stay on the books at $ 175,000 . Companies are not allowed to increase the value of an asset on their books just because they believe it is worth more . <hl> The cost principle , also known as the historical cost principle , states that virtually everything the company owns or controls ( assets ) must be recorded at its value at the date of acquisition . <hl> For most assets , this value is easy to determine as it is the price agreed to when buying the asset from the vendor . There are some exceptions to this rule , but always apply the cost principle unless FASB has specifically stated that a different valuation method should be used in a given circumstance ."}, {"question": {"question_id": "fs-idm385482560", "question_text": "Which of the following principles matches expenses with associated revenues in the period in which the revenues were generated?", "question_choices": ["revenue recognition principle", "expense recognition (matching) principle", "cost principle", "full disclosure principle"], "cloze_format": "The ___ is a principle that matches expenses with associated revenues in the period in which the revenues were generated.", "normal_format": "Which of the following principles matches expenses with associated revenues in the period in which the revenues were generated?"}, "answer": {"ans_text": "expense recognition (matching) principle", "ans_choice": 1}, "bloom": null, "hl_sentences": "The expense recognition principle ( also referred to as the matching principle ) states that we must match expenses with associated revenues in the period in which the revenues were earned .", "hl_context": "<hl> The expense recognition principle ( also referred to as the matching principle ) states that we must match expenses with associated revenues in the period in which the revenues were earned . <hl> A mismatch in expenses and revenues could be an understated net income in one period with an overstated net income in another period . There would be no reliability in statements if expenses were recorded separately from the revenues generated ."}, {"question": {"question_id": "fs-idm383502752", "question_text": "Which of the following does not accurately represent the accounting equation?", "question_choices": ["Assets \u2013 Liabilities = Stockholders\u2019 Equity", "Assets \u2013 Stockholders\u2019 Equity = Liabilities", "Assets = Liabilities + Stockholders\u2019 Equity", "Assets + Liabilities = Stockholders\u2019 Equity"], "cloze_format": "___ does not accurately represent the accounting equation.", "normal_format": "Which of the following does not accurately represent the accounting equation?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "As you have learned , the accounting equation represents the idea that a company needs assets to operate , and there are two major sources that contribute to operations : liabilities and equity . The company borrows the funds , creating liabilities , or the company can take the funds provided by the profits generated in the current or past periods , creating retained earnings or some other form of stockholder \u2019 s equity .", "hl_context": "<hl> As you have learned , the accounting equation represents the idea that a company needs assets to operate , and there are two major sources that contribute to operations : liabilities and equity . <hl> <hl> The company borrows the funds , creating liabilities , or the company can take the funds provided by the profits generated in the current or past periods , creating retained earnings or some other form of stockholder \u2019 s equity . <hl> Recall the accounting equation \u2019 s basic form ."}, {"question": {"question_id": "fs-idm400833200", "question_text": "Which of these statements is false ?", "question_choices": ["Assets = Liabilities + Equity", "Assets \u2013 Liabilities = Equity", "Liabilities \u2013 Equity = Assets", "Liabilities = Assets \u2013 Equity"], "cloze_format": "The statement that is false is that ___.", "normal_format": "Which of these statements is false ?"}, "answer": {"ans_text": "Liabilities \u2013 Equity = Assets", "ans_choice": 2}, "bloom": null, "hl_sentences": "Remember that the accounting equation must remain balanced , and assets need to equal liabilities plus equity .", "hl_context": "<hl> Remember that the accounting equation must remain balanced , and assets need to equal liabilities plus equity . <hl> On the asset side of the equation , we show an increase of $ 20,000 . On the liabilities and equity side of the equation , there is also an increase of $ 20,000 , keeping the equation balanced . Changes to assets , specifically cash , will increase assets on the balance sheet and increase cash on the statement of cash flows . Changes to stockholder \u2019 s equity , specifically common stock , will increase stockholder \u2019 s equity on the balance sheet ."}, {"question": {"question_id": "fs-idm394831664", "question_text": "Which of these accounts is an asset?", "question_choices": ["Common Stock", "Supplies", "Accounts Payable", "Fees Earned"], "cloze_format": "The ___ account is an asset.", "normal_format": "Which of these accounts is an asset?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "The company purchased supplies , which are assets to the business until used .", "hl_context": "<hl> The company purchased supplies , which are assets to the business until used . <hl> Supplies is increasing , because the company has more supplies than it did before . Supplies is an asset that is increasing on the debit side ."}, {"question": {"question_id": "fs-idm418486352", "question_text": "Which of these accounts is a liability?", "question_choices": ["Accounts Receivable", "Supplies", "Salaries Expense", "Accounts Payable"], "cloze_format": "The account that is a liability is ___.", "normal_format": "Which of these accounts is a liability?"}, "answer": {"ans_text": "Accounts Payable", "ans_choice": 3}, "bloom": null, "hl_sentences": "This creates a liability for the company , Accounts Payable . Accounts Payable recognized the liability the company had to the supplier to pay for the equipment .", "hl_context": "Printing Plus did not pay immediately for the supplies and asked to be billed for the supplies , payable at a later date . <hl> This creates a liability for the company , Accounts Payable . <hl> This liability increases Accounts Payable ; thus , Accounts Payable increases on the credit side . <hl> Accounts Payable recognized the liability the company had to the supplier to pay for the equipment . <hl> Since the company is now paying off the debt it owes , this will decrease Accounts Payable . Liabilities decrease on the debit side ; therefore , Accounts Payable will decrease on the debit side by $ 3,500 ."}, {"question": {"question_id": "fs-idm409252656", "question_text": "Which process of the accounting cycle often requires the most analytical thought?", "question_choices": ["making a journal entry", "posting transactions to accounts", "summarizing the trial balance", "preparing the financial statements"], "cloze_format": "The process of the accounting cycle that often requires the most analytical thought is ___.", "normal_format": "Which process of the accounting cycle often requires the most analytical thought?"}, "answer": {"ans_text": "summarizing the trial balance", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "If a trial balance is in balance , does this mean that all of the numbers are correct ? Not necessarily . We can have errors and still be mathematically in balance . It is important to go through each step very carefully and recheck your work often to avoid mistakes early on in the process . Preparing an unadjusted trial balance is the fourth step in the accounting cycle . A trial balance is an important step in the accounting process , because it helps identify any computational errors throughout the first three steps in the cycle .", "hl_context": "<hl> If a trial balance is in balance , does this mean that all of the numbers are correct ? <hl> <hl> Not necessarily . <hl> <hl> We can have errors and still be mathematically in balance . <hl> <hl> It is important to go through each step very carefully and recheck your work often to avoid mistakes early on in the process . <hl> Once all the monthly transactions have been analyzed , journalized , and posted on a continuous day-to-day basis over the accounting period ( a month in our example ) , we are ready to start working on preparing a trial balance ( unadjusted ) . <hl> Preparing an unadjusted trial balance is the fourth step in the accounting cycle . <hl> A trial balance is a list of all accounts in the general ledger that have nonzero balances . <hl> A trial balance is an important step in the accounting process , because it helps identify any computational errors throughout the first three steps in the cycle . <hl>"}, {"question": {"question_id": "fs-idm408883248", "question_text": "The step-by-step process to record business activities and events to keep financial records up to date is ________.", "question_choices": ["day-to-day cycle", "accounting cycle", "general ledger", "journal"], "cloze_format": "The step-by-step process to record business activities and events to keep financial records up to date is ________.", "normal_format": "What is the step-by-step process called to record business activities and events to keep financial records up to date?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "The accounting cycle is a step-by-step process to record business activities and events to keep financial records up to date .", "hl_context": "This chapter on analyzing and recording transactions is the first of three consecutive chapters ( including The Adjustment Process and Completing the Accounting Cycle ) covering the steps in one continuous process known as the accounting cycle . <hl> The accounting cycle is a step-by-step process to record business activities and events to keep financial records up to date . <hl> The process occurs over one accounting period and will begin the cycle again in the following period . A period is one operating cycle of a business , which could be a month , quarter , or year . Review the accounting cycle in Figure 3.5 ."}, {"question": {"question_id": "fs-idm402068528", "question_text": "One operating cycle of a business, which could be a month, quarter, or year, is commonly referred to as which of the following?", "question_choices": ["period", "round", "tally", "mark"], "cloze_format": "One operating cycle of a business, which could be a month, quarter, or year, is commonly referred to as a ___.", "normal_format": "One operating cycle of a business, which could be a month, quarter, or year, is commonly referred to as which of the following?"}, "answer": {"ans_text": "period", "ans_choice": 0}, "bloom": null, "hl_sentences": "A period is one operating cycle of a business , which could be a month , quarter , or year .", "hl_context": "This chapter on analyzing and recording transactions is the first of three consecutive chapters ( including The Adjustment Process and Completing the Accounting Cycle ) covering the steps in one continuous process known as the accounting cycle . The accounting cycle is a step-by-step process to record business activities and events to keep financial records up to date . The process occurs over one accounting period and will begin the cycle again in the following period . <hl> A period is one operating cycle of a business , which could be a month , quarter , or year . <hl> Review the accounting cycle in Figure 3.5 ."}, {"question": {"question_id": "fs-idm400679904", "question_text": "________ takes all transactions from the journal during a period and moves the information to a general ledger (ledger).", "question_choices": ["Hitching", "Posting", "Vetting", "Laxing"], "cloze_format": "________ takes all transactions from the journal during a period and moves the information to a general ledger (ledger).", "normal_format": "What takes all transactions from the journal during a period and moves the information to a general ledger (ledger)?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "Posting takes all transactions from the journal during a period and moves the information to a general ledger , or ledger .", "hl_context": "Step 3 . The third step in the process is posting journal information to a ledger . <hl> Posting takes all transactions from the journal during a period and moves the information to a general ledger , or ledger . <hl> As you \u2019 ve learned , account balances can be represented visually in the form of T-accounts ."}, {"question": {"question_id": "fs-idm627266720", "question_text": "Which of these events will not be recognized?", "question_choices": ["A service is performed, but the payment is not collected on the same day.", "Supplies are purchased. They are not paid for; the company will be billed.", "A copy machine is ordered. It will be delivered in two weeks.", "Electricity has been used but has not been paid for."], "cloze_format": " ___ is the event that will not be recognized.", "normal_format": "Which of these events will not be recognized?"}, "answer": {"ans_text": "A copy machine is ordered. It will be delivered in two weeks.", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "There also does not have to be a correlation between when cash is collected and when revenue is recognized . A customer may not pay for the service on the day it was provided . Since the company has provided the service , it would recognize the revenue as earned , even though cash has yet to be collected .", "hl_context": "<hl> There also does not have to be a correlation between when cash is collected and when revenue is recognized . <hl> <hl> A customer may not pay for the service on the day it was provided . <hl> Even though the customer has not yet paid cash , there is a reasonable expectation that the customer will pay in the future . <hl> Since the company has provided the service , it would recognize the revenue as earned , even though cash has yet to be collected . <hl>"}, {"question": {"question_id": "fs-idm623443312", "question_text": "What is the impact on the accounting equation when a current month\u2019s utility expense is paid?", "question_choices": ["both sides increase", "both sides decrease", "only the Asset side changes", "neither side changes"], "cloze_format": "When a current month\u2019s utility expense is paid, the impact on the accounting equation is that ___ .", "normal_format": "What is the impact on the accounting equation when a current month\u2019s utility expense is paid?"}, "answer": {"ans_text": "both sides decrease", "ans_choice": 1}, "bloom": null, "hl_sentences": "Utility Expense increases , and does so on the debit side of the accounting equation .", "hl_context": "Paying a utility bill creates an expense for the company . <hl> Utility Expense increases , and does so on the debit side of the accounting equation . <hl>"}, {"question": {"question_id": "fs-idm314743552", "question_text": "What is the impact on the accounting equation when a payment of account payable is made?", "question_choices": ["both sides increase", "both sides decrease", "only the Asset side changes", "neither side changes"], "cloze_format": "The impact on the accounting equation when a payment of account payable is made is that ___.", "normal_format": "What is the impact on the accounting equation when a payment of account payable is made?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "Accounts Payable recognized the liability the company had to the supplier to pay for the equipment . Since the company is now paying off the debt it owes , this will decrease Accounts Payable . Liabilities decrease on the debit side ; therefore , Accounts Payable will decrease on the debit side by $ 3,500 .", "hl_context": "<hl> Accounts Payable recognized the liability the company had to the supplier to pay for the equipment . <hl> <hl> Since the company is now paying off the debt it owes , this will decrease Accounts Payable . <hl> <hl> Liabilities decrease on the debit side ; therefore , Accounts Payable will decrease on the debit side by $ 3,500 . <hl>"}, {"question": {"question_id": "fs-idm359950400", "question_text": "What is the impact on the accounting equation when an accounts receivable is collected?", "question_choices": ["both sides increase", "both sides decrease", "only the Asset side changes", "the total of neither side changes"], "cloze_format": "The impact on the accounting equation when an accounts receivable is collected is that ___ .", "normal_format": "What is the impact on the accounting equation when an accounts receivable is collected?"}, "answer": {"ans_text": "both sides increase", "ans_choice": 0}, "bloom": null, "hl_sentences": "Accounts Receivable is an asset account . Asset accounts increase on the debit side .", "hl_context": "The customer did not immediately pay for the services and owes Printing Plus payment . This money will be received in the future , increasing Accounts Receivable . <hl> Accounts Receivable is an asset account . <hl> <hl> Asset accounts increase on the debit side . <hl> Therefore , Accounts Receivable will increase for $ 5,500 on the debit side ."}, {"question": {"question_id": "fs-idm367280656", "question_text": "What is the impact on the accounting equation when a sale occurs?", "question_choices": ["both sides increase", "both sides decrease", "only the Asset side changes", "neither side changes"], "cloze_format": "The impact on the accounting equation when a sale occurs is that ___ .", "normal_format": "What is the impact on the accounting equation when a sale occurs?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "Revenues are earnings from the sale of goods and services . An increase in revenues will also contribute toward an increase in retained earnings .", "hl_context": "Distribution of earnings to ownership is called a dividend . The dividend could be paid with cash or be a distribution of more company stock to current shareholders . Either way , dividends will decrease retained earnings . Dividends are considered a contra equity account . An account is a contra account if its normal balance is opposite of the normal balance of the category to which it belongs . The normal balance for the equity category is a credit balance whereas the normal balance for dividends is a debit balance resulting in dividends reducing total equity . Also affecting retained earnings are revenues and expenses , by way of net income or net loss . <hl> Revenues are earnings from the sale of goods and services . <hl> <hl> An increase in revenues will also contribute toward an increase in retained earnings . <hl> Expenses are the cost of resources associated with earning revenues . An increase to expenses will contribute toward a decrease in retained earnings . Recall that this concept of recognizing expenses associated with revenues is the expense recognition principle . Some examples of expenses include bill payments for utilities , employee salaries , and loan interest expense . A business does not have an expense until it is \u201c incurred . \u201d Incurred means the resource is used or consumed . For example , you will not recognize utilities as an expense until you have used the utilities . The difference between revenues earned and expenses incurred is called net income ( loss ) and can be found on the income statement ."}, {"question": {"question_id": "fs-idm366287040", "question_text": "What is the impact on the accounting equation when stock is issued, in exchange for assets?", "question_choices": ["both sides increase", "both sides decrease", "only the Asset side changes", "neither side changes"], "cloze_format": "When stock is issued, in exchange for assets, the impact on the accounting equation is that ___ .", "normal_format": "What is the impact on the accounting equation when stock is issued, in exchange for assets?"}, "answer": {"ans_text": "both sides increase", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The common stock account is increasing and affects equity . Looking at the expanded accounting equation , we see that Common Stock increases on the credit side . When a company issues common stock , this will increase a stockholder \u2019 s equity because he or she is receiving investments from owners .", "hl_context": "When the company issues stock , stockholders purchase common stock , yielding a higher common stock figure than before issuance . <hl> The common stock account is increasing and affects equity . <hl> <hl> Looking at the expanded accounting equation , we see that Common Stock increases on the credit side . <hl> Analysis : Looking at the accounting equation , we know cash is an asset and common stock is stockholder \u2019 s equity . When a company collects cash , this will increase assets because cash is coming into the business . <hl> When a company issues common stock , this will increase a stockholder \u2019 s equity because he or she is receiving investments from owners . <hl>"}, {"question": {"question_id": "fs-idm391680368", "question_text": "Which of the following accounts is increased by a debit?", "question_choices": ["Common Stock", "Accounts Payable", "Supplies", "Service Revenue"], "cloze_format": "The account that is increased by a debit is the ___.", "normal_format": "Which of the following accounts is increased by a debit?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Supplies is an asset that is increasing on the debit side .", "hl_context": "The company purchased supplies , which are assets to the business until used . Supplies is increasing , because the company has more supplies than it did before . <hl> Supplies is an asset that is increasing on the debit side . <hl>"}, {"question": {"question_id": "fs-idm403029744", "question_text": "Which of the following accounts does not increase with a debit entry?", "question_choices": ["Retained Earnings", "Buildings", "Prepaid Rent", "Electricity Expense"], "cloze_format": "The account that does not increase with a debit entry is ___.", "normal_format": "Which of the following accounts does not increase with a debit entry?"}, "answer": {"ans_text": "Retained Earnings", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Expense accounts increase with debit entries . If a business has net income ( earnings ) for the period , then this will increase its retained earnings for the period .", "hl_context": "Advertising is an expense of doing business . You have incurred more expenses , so you want to increase an expense account . <hl> Expense accounts increase with debit entries . <hl> Debit advertising expense . Net income reported on the income statement flows into the statement of retained earnings . <hl> If a business has net income ( earnings ) for the period , then this will increase its retained earnings for the period . <hl> This means that revenues exceeded expenses for the period , thus increasing retained earnings . If a business has net loss for the period , this decreases retained earnings for the period . This means that the expenses exceeded the revenues for the period , thus decreasing retained earnings ."}, {"question": {"question_id": "fs-idm397977424", "question_text": "Which of the following pairs increase with credit entries?", "question_choices": ["supplies and retained earnings", "rent expense and unearned revenue", "prepaid rent and common stock", "unearned service revenue and accounts payable"], "cloze_format": "The pair that increases with credit entries is ___.", "normal_format": "Which of the following pairs increase with credit entries?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Revenue accounts increase with credit entries , so credit lawn-mowing revenue .", "hl_context": "You have mowed lawns and earned more revenue . You want the total of your revenue account to increase to reflect this additional revenue . <hl> Revenue accounts increase with credit entries , so credit lawn-mowing revenue . <hl>"}, {"question": {"question_id": "fs-idm397220320", "question_text": "Which of the following accounts will normally have a debit balance?", "question_choices": ["Common Stock", "Fees Earned", "Supplies", "Accounts Payable"], "cloze_format": "The account that will normally have a debit balance is the ___.", "normal_format": "Which of the following accounts will normally have a debit balance?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Supplies is an asset that is increasing on the debit side .", "hl_context": "The company purchased supplies , which are assets to the business until used . Supplies is increasing , because the company has more supplies than it did before . <hl> Supplies is an asset that is increasing on the debit side . <hl>"}, {"question": {"question_id": "fs-idm392113840", "question_text": "What type of account is prepaid insurance?", "question_choices": ["Stockholders\u2019 Equity", "Expense", "Liability", "Asset"], "cloze_format": "The type of account that is prepaid insurance is ___.", "normal_format": "What type of account is prepaid insurance?"}, "answer": {"ans_text": "Asset", "ans_choice": 3}, "bloom": null, "hl_sentences": "Prepaid expenses are items paid for in advance of their use . They are considered assets until used .", "hl_context": "<hl> Prepaid expenses are items paid for in advance of their use . <hl> <hl> They are considered assets until used . <hl> Some examples can include insurance and rent . Insurance , for example , is usually purchased for more than one month at a time ( six months typically ) . The company does not use all six months of the insurance at once , it uses it one month at a time . However , the company prepays for all of it up front . As each month passes , the company will adjust its records to reflect the cost of one month of insurance usage ."}, {"question": {"question_id": "fs-idm391861056", "question_text": "Unearned service revenue occurs when which of the following occurs?", "question_choices": ["company receives cash from a customer before performing the service", "company pays cash before receiving a service from a supplier", "company pays cash after receiving a service from a supplier", "company receives cash from a customer after performing a service"], "cloze_format": "Unearned service revenue occurs when a ___.", "normal_format": "Unearned service revenue occurs when which of the following occurs?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The revenue recognition principle directs a company to recognize revenue in the period in which it is earned ; revenue is not considered earned until a product or service has been provided .", "hl_context": "<hl> The revenue recognition principle directs a company to recognize revenue in the period in which it is earned ; revenue is not considered earned until a product or service has been provided . <hl> This means the period of time in which you performed the service or gave the customer the product is the period in which revenue is recognized ."}, {"question": {"question_id": "fs-idm414545120", "question_text": "Which of these transactions requires a debit entry to Cash?", "question_choices": ["paid balance due to suppliers", "sold merchandise on account", "collected balance due from customers", "purchased supplies for cash"], "cloze_format": "The transaction that requires a debit entry to Cash is ___.", "normal_format": "Which of these transactions requires a debit entry to Cash?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "You have received more cash from customers , so you want the total cash to increase . Cash is an asset , and assets increase with debit entries , so debit cash .", "hl_context": "<hl> You have received more cash from customers , so you want the total cash to increase . <hl> <hl> Cash is an asset , and assets increase with debit entries , so debit cash . <hl>"}, {"question": {"question_id": "fs-idm639056224", "question_text": "Which of these transactions requires a credit entry to Revenue?", "question_choices": ["received cash from services performed this month", "collected balance due from customers", "received cash from bank loan", "refunded a customer for a defective product"], "cloze_format": "The transaction that requires a credit entry to Revenue is ___.", "normal_format": "Which of these transactions requires a credit entry to Revenue?"}, "answer": {"ans_text": "received cash from services performed this month", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Service Revenue increases equity ; therefore , Service Revenue increases on the credit side .", "hl_context": "Printing Plus provided the services , which means the company can recognize revenue as earned in the Service Revenue account . <hl> Service Revenue increases equity ; therefore , Service Revenue increases on the credit side . <hl>"}, {"question": {"question_id": "fs-idm382099328", "question_text": "Which of the following accounting records is the main source of information used to prepare the financial statements?", "question_choices": ["journal entries", "T-accounts", "trial balance", "chart of accounts"], "cloze_format": "___ is the accounting record that is the main source of information used to prepare the financial statements.", "normal_format": "Which of the following accounting records is the main source of information used to prepare the financial statements?"}, "answer": {"ans_text": "trial balance", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "In The Adjustment Process we review steps 5 , 6 , and 7 in the accounting cycle : record adjusting entries , prepare an adjusted trial balance , and prepare financial statements .", "hl_context": "<hl> In The Adjustment Process we review steps 5 , 6 , and 7 in the accounting cycle : record adjusting entries , prepare an adjusted trial balance , and prepare financial statements . <hl> In Completing the Accounting Cycle , we review steps 8 and 9 : closing entries and prepare a post-closing trial balance . As stated previously , we do not cover reversing entries ."}], "summary": " Summary 3.1   Describe Principles, Assumptions, and Concepts of Accounting and Their Relationship to Financial Statements \n\n The Financial Accounting Standards Board (FASB) is an independent, nonprofit organization that sets the standards for financial accounting and reporting standards for both public- and private-sector businesses in the United States, including generally accepted accounting principles (GAAP). \n\n GAAP are the concepts, standards, and rules that guide the preparation and presentation of financial statements. \n\n The Securities and Exchange Commission (SEC) is an independent federal agency that is charged with protecting the interests of investors, regulating stock markets, and ensuring companies adhere to GAAP requirements. \n\n The FASB uses a conceptual framework, which is a set of concepts that guide financial reporting. \n\n The revenue recognition principle requires companies to record revenue when it is earned. Revenue is earned when a product or service has been provided. \n\n The expense recognition principle requires that expenses incurred match with revenues earned in the same period. The expenses are associated with revenue generation. \n\n The cost principle records assets at their value at the date of acquisition. A company may not record what it estimates or thinks the value of the asset is, only what is verifiable. This verification is typically represented by an actual transaction. \n\n The full disclosure principle requires companies to relay any information to the public that may affect financials that are not readily available on the financial statements. This helps users of information make decisions that are more informed. \n\n The separate entity concept maintains that only business activities, and not the owner\u2019s personal financials, may be reported on company financial statements. \n\n Conservatism prescribes that a company should record expenses or losses when there is an expectation of their existence but only recognize gains or revenue when there is assurance that they will be realized. \n\n Monetary measurement requires a monetary unit be used to report financial information, such as the US dollar. This makes information comparable. \n\n The going concern assumption assumes that a business will continue to operate in the foreseeable future. If there is a concern the business will not continue operating, this needs to be disclosed to management and other users of information. \n\n Time period assumption presents financial information in equal and short time frames, such as a month, quarter, or year. \n\n The accounting equation shows that assets must equal the sum of liabilities and equity. Transactions are analyzed with this equation to prepare for the next step in the accounting cycle. \n\n 3.2   Define and Describe the Expanded Accounting Equation and Its Relationship to Analyzing Transactions \n\n The expanded accounting equation breaks down the equity portion of the accounting equation into more detail to show common stock, dividends, revenue, and expenses individually. \n\n The chart of accounts is a numbering system that lists all of a company\u2019s accounts in the order in which they appear on the financial statements, beginning with the balance sheet accounts and then the income statement accounts. \n\n 3.3   Define and Describe the Initial Steps in the Accounting Cycle \n\n Step 1 in the accounting cycle: Identifying and analyzing transactions requires a company to take information from an original source, identify its purpose as a financial transaction, and connect that information to an accounting equation. \n\n Step 2 in the accounting cycle: Recording transactions to a journal takes financial information identified in the transaction and copies that information, using the accounting equation, into a journal. The journal is a record of all transactions. \n\n Step 3 in the accounting cycle: Posting journal information to a ledger takes all information transferred to the journal and posts it to a general ledger. The general ledger in an accumulation of all accounts a company maintains and their balances. \n\n Step 4 in the accounting cycle: Preparing an unadjusted trial balance requires transfer of information from the general ledger (T-accounts) to an unadjusted trial balance showing all account balances. \n\n 3.4   Analyze Business Transactions Using the Accounting Equation and Show the Impact of Business Transactions on Financial Statements \n\n Both the basic and the expanded accounting equations are useful in analyzing how any transaction affects a company\u2019s financial statements. \n\n 3.5   Use Journal Entries to Record Transactions and Post to T-Accounts \n\n Journals are the first place where information is entered into the accounting system, which is why they are often referred to as books of original entry. \n\n Journalizing transactions transfers information from accounting equation analysis to a record of each transaction. \n\n There are several formatting rules for journalizing transactions that include where to put debits and credits, which account titles come first, the need for a date and inclusion of a brief description. \n\n Step 3 in the accounting cycle posts journal information to the general ledger (T-accounts). Final balances in each account must be calculated before transfer to the trial balance occurs. \n\n 3.6   Prepare a Trial Balance \n\n The trial balance contains a listing of all accounts in the general ledger with nonzero balances. Information is transferred from the T-accounts to the trial balance. \n\n Sometimes errors occur on the trial balance, and there are ways to find these errors. One may have to go through each step of the accounting process to locate an error on the trial balance. ", "keyterm": "", "bname": "principles_of_accounting,_volume_1:_financial_accounting"}, {"chapter": 24, "intro": " Chapter Outline 24.1   Anatomy and Normal Microbiota of the Digestive System 24.2   Microbial Diseases of the Mouth and Oral Cavity 24.3   Bacterial Infections of the Gastrointestinal Tract 24.4   Viral Infections of the Gastrointestinal Tract 24.5   Protozoan Infections of the Gastrointestinal Tract 24.6   Helminthic Infections of the Gastrointestinal Tract Introduction Gastrointestinal (GI) diseases are so common that, unfortunately, most people have had first-hand experience with the unpleasant symptoms, such as diarrhea, vomiting, and abdominal discomfort. The causes of gastrointestinal illness can vary widely, but such diseases can be grouped into two categories: those caused by  infection  (the growth of a pathogen in the GI tract) or  intoxication  (the presence of a microbial toxin in the GI tract). Foodborne pathogens like  Escherichia coli   O157:H7  are among the most common sources of gastrointestinal disease. Contaminated food and water have always posed a health risk for humans, but in today\u2019s global economy, outbreaks can occur on a much larger scale.  E. coli  O157:H7 is a potentially deadly strain of  E. coli  with a history of contaminating meat and produce that are not properly processed. The source of an  E. coli  O157:H7 outbreak can be difficult to trace, especially if the contaminated food is processed in a foreign country. Once the source is identified, authorities may issue recalls of the contaminated food products, but by then there are typically numerous cases of food poisoning, some of them fatal. ", "chapter_text": " 24.1   Anatomy and Normal Microbiota of the Digestive System \n\n Learning Objectives \n\n Describe the major anatomical features of the human digestive system \n\n Describe the normal microbiota of various regions in the human digestive system \n\n Explain how microorganisms overcome the defenses of the digestive tract to cause infection or intoxication \n\n Describe general signs and symptoms associated with infections of the digestive system \n\n Clinical Focus Part 1 After a morning of playing outside, four-year-old Carli ran inside for lunch. After taking a bite of her fried egg, she pushed it away and whined, \u201cIt\u2019s too slimy, Mommy. I don\u2019t want any more.\u201d But her mother, in no mood for games, curtly replied that if she wanted to go back outside she had better finish her lunch. Reluctantly, Carli complied, trying hard not to gag as she choked down the runny egg. \n\n That night, Carli woke up feeling nauseated. She cried for her parents and then began to vomit. Her parents tried to comfort her, but she continued to vomit all night and began to have diarrhea and run a fever. By the morning, her parents were very worried. They rushed her to the emergency room. \n\n What could have caused Carli\u2019s signs and symptoms? \n\n Jump to the  next  Clinical Focus box. \n\n The human  digestive system , or the gastrointestinal (GI) tract, begins with the mouth and ends with the anus. The parts of the mouth include the teeth, the gums, the tongue, the oral vestibule (the space between the gums, lips, and teeth), and the oral cavity proper (the space behind the teeth and gums). Other parts of the  GI tract  are the pharynx, esophagus, stomach, small intestine, large intestine, rectum, and anus ( Figure 24.2 ). Accessory digestive organs include the salivary glands, liver, gallbladder, spleen, and pancreas. \n\n The digestive system contains normal microbiota, including archaea, bacteria, fungi, protists, and even viruses. Because this microbiota is important for normal functioning of the digestive system, alterations to the microbiota by antibiotics or diet can be harmful. Additionally, the introduction of pathogens to the GI tract can cause infections and diseases. In this section, we will review the microbiota found in a healthy digestive tract and the general signs and symptoms associated with oral and GI infections. \n\n Anatomy and Normal Microbiota of the Oral Cavity \n\n Food enters the digestive tract through the mouth, where mechanical digestion (by chewing) and chemical digestion (by enzymes in  saliva ) begin. Within the  mouth  are the  tongue ,  teeth , and  salivary glands , including the parotid, sublingual, and submandibular glands ( Figure 24.3 ). The salivary glands produce saliva, which lubricates food and contains digestive enzymes. \n\n The structure of a  tooth  ( Figure 24.4 ) begins with the visible outer surface, called the  crown , which has to be extremely hard to withstand the force of biting and chewing. The crown is covered with  enamel , which is the hardest material in the body. Underneath the crown, a layer of relatively hard  dentin  extends into the root of the tooth around the innermost  pulp  cavity, which includes the pulp chamber at the top of the tooth and pulp canal, or  root canal , located in the root. The pulp that fills the pulp cavity is rich in blood vessels, lymphatic vessels, connective tissue, and nerves. The root of the tooth and some of the crown are covered with  cementum , which works with the periodontal ligament to anchor the tooth in place in the jaw bone. The soft tissues surrounding the teeth and bones are called  gums , or  gingiva . The  gingival space  or  gingival crevice  is located between the gums and teeth. \n\n Microbes such as bacteria and archaea are abundant in the mouth and coat all of the surfaces of the oral cavity. However, different structures, such as the teeth or cheeks, host unique communities of both aerobic and anaerobic microbes. Some factors appear to work against making the mouth hospitable to certain microbes. For example, chewing allows microbes to mix better with saliva so they can be swallowed or spit out more easily. Saliva also contains enzymes, including  lysozyme , which can damage microbial cells. Recall that lysozyme is part of the first line of defense in the innate immune system and cleaves the \u03b2-(1,4) glycosidic linkages between N-acetylglucosamine (NAG) and N-acetylmuramic acid (NAM) in bacterial peptidoglycan (see  Chemical Defenses ). Additionally, fluids containing immunoglobulins and phagocytic cells are produced in the gingival spaces. Despite all of these chemical and mechanical activities, the mouth supports a large microbial community. \n\n Check Your Understanding \n\n What factors make the mouth inhospitable for certain microbes? \n\n Anatomy and Normal Microbiota of the GI Tract \n\n As food leaves the oral cavity, it travels through the pharynx, or the back of the throat, and moves into the  esophagus , which carries the food from the  pharynx  to the  stomach  without adding any additional digestive enzymes. The stomach produces  mucus  to protect its lining, as well as digestive enzymes and acid to break down food. Partially digested food then leaves the stomach through the  pyloric sphincter , reaching the first part of the small intestine called the  duodenum . Pancreatic juice, which includes enzymes and bicarbonate ions, is released into the small intestine to neutralize the acidic material from the stomach and to assist in digestion. Bile, produced by the  liver  but stored in the  gallbladder , is also released into the  small intestine  to emulsify fats so that they can travel in the watery environment of the small intestine. Digestion continues in the small intestine, where the majority of nutrients contained in the food are absorbed. Simple columnar epithelial cells called  enterocytes  line the lumen surface of the small intestinal folds called  villi . Each enterocyte has smaller  microvilli  (cytoplasmic membrane extensions) on the cellular apical surface that increase the surface area to allow more absorption of nutrients to occur ( Figure 24.5 ). \n\n Digested food leaves the small intestine and moves into the  large intestine , or  colon , where there is a more diverse microbiota. Near this junction, there is a small pouch in the large intestine called the  cecum , which attaches to the  appendix . Further digestion occurs throughout the colon and water is reabsorbed, then waste is excreted through the  rectum , the last section of the colon, and out of the body through the  anus  ( Figure 24.2 ). \n\n The environment of most of the GI tract is harsh, which serves two purposes: digestion and immunity. The stomach is an extremely acidic environment (pH 1.5\u20133.5) due to the gastric juices that break down food and kill many ingested microbes; this helps prevent infection from pathogens. The environment in the small intestine is less harsh and is able to support microbial communities. Microorganisms present in the small intestine can include  lactobacilli ,  diptherioids  and the fungus  Candida . On the other hand, the large intestine (colon) contains a diverse and abundant microbiota that is important for normal function. These microbes include  Bacteriodetes  (especially the genera  Bacteroides  and  Prevotella ) and  Firmicutes  (especially members of the genus  Clostridium ). Methanogenic archaea and some fungi are also present, among many other species of bacteria. These microbes all aid in digestion and contribute to the production of feces, the waste excreted from the digestive tract, and flatus, the gas produced from microbial fermentation of undigested food. They can also produce valuable nutrients. For example,  lactic acid bacteria  such as  bifidobacteria  can synthesize vitamins, such as vitamin B12, folate, and riboflavin, that humans cannot synthesize themselves.  E. coli  found in the intestine can also break down food and help the body produce vitamin K, which is important for blood coagulation. \n\n The GI tract has several other methods of reducing the risk of infection by pathogens. Small aggregates of underlying lymphoid tissue in the ileum, called  Peyer\u2019s patches  ( Figure 24.5 ), detect pathogens in the intestines via microfold (M) cells, which transfer antigens from the lumen of the intestine to the lymphocytes on Peyer\u2019s patches to induce an immune response. The Peyer\u2019s patches then secrete  IgA  and other pathogen-specific antibodies into the intestinal lumen to help keep intestinal microbes at safe levels. Goblet cells, which are modified simple columnar epithelial cells, also line the  GI tract  ( Figure 24.6 ). Goblet cells secrete a gel-forming  mucin , which is the major component of  mucus . The production of a protective layer of mucus helps reduce the risk of pathogens reaching deeper tissues. \n\n The constant movement of materials through the gastrointestinal tract also helps to move transient pathogens out of the body. In fact, feces are composed of approximately 25% microbes, 25% sloughed epithelial cells, 25% mucus, and 25% digested or undigested food. Finally, the normal microbiota provides an additional barrier to infection via a variety of mechanisms. For example, these organisms outcompete potential pathogens for space and nutrients within the intestine. This is known as  competitive exclusion . Members of the microbiota may also secrete protein toxins known as  bacteriocins  that are able to bind to specific receptors on the surface of susceptible bacteria. \n\n Check Your Understanding \n\n Compare and contrast the microbiota of the small and large intestines. \n\n General Signs and Symptoms of Oral and GI Disease \n\n Despite numerous defense mechanisms that protect against infection, all parts of the digestive tract can become sites of infection or intoxication. The term  food poisoning  is sometimes used as a catch-all for GI infections and intoxications, but not all forms of GI disease originate with foodborne pathogens or toxins. \n\n In the mouth,  fermentation  by anaerobic microbes produces acids that damage the teeth and gums. This can lead to tooth decay, cavities, and  periodontal disease , a condition characterized by chronic inflammation and erosion of the  gums . Additionally, some pathogens can cause infections of the mucosa, glands, and other structures in the mouth, resulting in inflammation, sores, cankers, and other lesions. An open sore in the mouth or GI tract is typically called an  ulcer . \n\n Infections and intoxications of the lower GI tract often produce symptoms such as nausea, vomiting, diarrhea, aches, and fever. In some cases, vomiting and diarrhea may cause severe dehydration and other complications that can become serious or fatal. Various clinical terms are used to describe gastrointestinal symptoms. For example,  gastritis  is an inflammation of the stomach lining that results in swelling and  enteritis  refers to inflammation of the intestinal mucosa. When the inflammation involves both the stomach lining and the intestinal lining, the condition is called  gastroenteritis . Inflammation of the liver is called  hepatitis . Inflammation of the colon, called  colitis , commonly occurs in cases of food intoxication. Because an inflamed colon does not reabsorb water as effectively as it normally does, stools become watery, causing diarrhea. Damage to the epithelial cells of the colon can also cause bleeding and excess  mucus  to appear in watery stools, a condition called  dysentery . \n\n Check Your Understanding \n\n List possible causes and signs and symptoms of food poisoning. \n 24.2   Microbial Diseases of the Mouth and Oral Cavity \n\n Learning Objectives \n\n Explain the role of microbial activity in diseases of the mouth and oral cavity \n\n Compare the major characteristics of specific oral diseases and infections \n\n Despite the presence of  saliva  and the mechanical forces of chewing and eating, some microbes thrive in the mouth. These microbes can cause damage to the teeth and can cause infections that have the potential to spread beyond the mouth and sometimes throughout the body. \n\n Dental Caries \n\n Cavities of the teeth, known clinically as  dental caries , are microbial lesions that cause damage to the teeth. Over time, the lesion can grow through the outer  enamel  layer to infect the underlying  dentin  or even the innermost  pulp . If dental caries are not treated, the infection can become an  abscess  that spreads to the deeper tissues of the  teeth , near the roots, or to the bloodstream. \n\n Tooth decay results from the metabolic activity of microbes that live on the teeth. A layer of proteins and carbohydrates forms when clean teeth come into contact with saliva. Microbes are attracted to this food source and form a  biofilm  called  plaque . The most important cariogenic species in these biofilms is  Streptococcus mutans . When  sucrose , a disaccharide sugar from food, is broken down by bacteria in the mouth,  glucose  and  fructose  are produced. The glucose is used to make  dextran , which is part of the extracellular matrix of the biofilm. Fructose is fermented, producing organic acids such as  lactic acid . These acids dissolve the minerals of the tooth, including  enamel , even though it is the hardest material in the body. The acids work even more quickly on exposed  dentin  ( Figure 24.7 ). Over time, the  plaque   biofilm  can become thick and eventually calcify. When a heavy plaque deposit becomes hardened in this way, it is called  tartar  or  dental calculus  ( Figure 24.8 ). These substantial plaque biofilms can include a variety of bacterial species, including  Streptococcus  and  Actinomyces  species. \n\n Some tooth decay is visible from the outside, but it is not always possible to see all decay or the extent of the decay. X-ray imaging is used to produce radiographs that can be studied to look for deeper decay and damage to the root or bone ( Figure 24.8 ). If not detected, the decay can reach the pulp or even spread to the bloodstream. Painful abscesses can develop. \n\n To prevent tooth decay, prophylactic treatment and good hygiene are important. Regular tooth brushing and flossing physically removes microbes and combats microbial growth and  biofilm  formation. Toothpaste contains  fluoride , which becomes incorporated into the hydroxyapatite of tooth  enamel , protecting it against acidity caused by fermentation of mouth microbiota. Fluoride is also bacteriostatic, thus slowing enamel degradation. Antiseptic mouthwashes commonly contain plant-derived  phenolics  like  thymol  and  eucalyptol  and/or heavy metals like  zinc chloride  (see  Using Chemicals to Control Microorganisms ). Phenolics tend to be stable and persistent on surfaces, and they act through denaturing proteins and disrupting membranes. \n\n Regular dental cleanings allow for the detection of decay at early stages and the removal of  tartar . They may also help to draw attention to other concerns, such as damage to the enamel from acidic drinks. Reducing sugar consumption may help prevent damage that results from the microbial fermentation of sugars. Additionally, sugarless candies or gum with sugar alcohols (such as  xylitol ) can reduce the production of acids because these are fermented to nonacidic compounds (although excess consumption may lead to gastrointestinal distress). Fluoride treatment or ingesting fluoridated water strengthens the minerals in teeth and reduces the incidence of  dental caries . \n\n If  caries  develop, prompt treatment prevents worsening. Smaller areas of decay can be drilled to remove affected tissue and then filled. If the  pulp  is affected, then a  root canal  may be needed to completely remove the infected tissues to avoid continued spread of the infection, which could lead to painful  abscesses . \n\n Check Your Understanding \n\n Name some ways that microbes contribute to tooth decay. \n\n What is the most important cariogenic species of bacteria? \n\n Periodontal Disease \n\n In addition to damage to the  teeth  themselves, the surrounding structures can be affected by microbes. Periodontal disease is the result of infections that lead to inflammation and tissue damage in the structures surrounding the teeth. The progression from mild to severe  periodontal disease  is generally reversible and preventable with good oral hygiene. \n\n Inflammation of the gums that can lead to irritation and bleeding is called  gingivitis . When  plaque  accumulates on the teeth, bacteria colonize the  gingival space . As this space becomes increasingly blocked, the environment becomes anaerobic. This allows a wide variety of microbes to colonize, including  Porphyromonas ,  Streptococcus , and  Actinomyces . The bacterial products, which include  lipopolysaccharide  (LPS),  proteases ,  lipoteichoic acids , and others, cause inflammation and gum damage ( Figure 24.9 ). It is possible that methanogenic archaeans (including  Methanobrevibacter oralis  and other  Methanobrevibacter  species) also contribute to disease progression as some species have been identified in patients with  periodontal disease , but this has proven difficult to study. 1 2 3  Gingivitis is diagnosed by visual inspection, including measuring pockets in the gums, and X-rays, and is usually treated using good dental hygiene and professional dental cleaning, with antibiotics reserved for severe cases. 1 Hans-Peter Horz and Georg Conrads. \u201cMethanogenic  Archaea  and Oral Infections\u2014Ways to Unravel the Black Box.\u201d  Journal of Oral Microbiology  3(2011). doi: 10.3402/jom.v3i0.5940. 2 Hiroshi Maeda, Kimito Hirai, Junji Mineshiba, Tadashi Yamamoto, Susumu Kokeguchi, and Shogo Takashiba. \u201cMedical Microbiological Approach to Archaea in Oral Infectious Diseases.\u201d  Japanese Dental Science Review  49: 2, p. 72\u201378. 3 Paul W. Lepp, Mary M. Brinig, Cleber C. Ouverney, Katherine Palm, Gary C. Armitage, and David A. Relman. \u201cMethanogenic  Archaea  and Human Periodontal Disease.\u201d  Proceedings of the National Academy of Sciences of the United States of America  101 (2003): 16, pp. 6176\u20136181. doi: 10.1073/pnas.0308766101. \n\n Over time, chronic gingivitis can develop into the more serious condition of  periodontitis  ( Figure 24.10 ). When this happens, the gums recede and expose parts of the tooth below the  crown . This newly exposed area is relatively unprotected, so bacteria can grow on it and spread underneath the  enamel  of the crown and cause  cavities . Bacteria in the  gingival space  can also erode the  cementum , which helps to hold the  teeth  in place. If not treated, erosion of cementum can lead to the movement or loss of teeth. The bones of the jaw can even erode if the infection spreads. This condition can be associated with bleeding and halitosis (bad breath). Cleaning and appropriate dental hygiene may be sufficient to treat periodontitis. However, in cases of severe periodontitis, an antibiotic may be given. Antibiotics may be given in pill form or applied directly to the gum (local treatment). Antibiotics given can include  tetracycline ,  doxycycline ,  macrolides  or  \u03b2-lactams . Because periodontitis can be caused by a mix of microbes, a combination of antibiotics may be given. \n\n Trench Mouth \n\n When certain bacteria, such as  Prevotella intermedia ,  Fusobacterium  species, and  Treponema vicentii , are involved and periodontal disease progresses,  acute necrotizing ulcerative gingivitis  or  trench mouth , also called Vincent's disease, can develop. This is severe periodontitis characterized by erosion of the gums, ulcers, substantial pain with chewing, and halitosis ( Figure 24.11 ) that can be diagnosed by visual examination and X-rays. In countries with good medical and dental care, it is most common in individuals with weakened immune systems, such as patients with AIDS. In addition to cleaning and pain medication, patients may be prescribed antibiotics such as  amoxicillin ,  amoxicillin clavulanate ,  clindamycin , or  doxycycline . \n\n Check Your Understanding \n\n How does gingivitis progress to periodontitis? \n\n Micro Connections Healthy Mouth, Healthy Body Good oral health promotes good overall health, and the reverse is also true. Poor oral health can lead to difficulty eating, which can cause malnutrition. Painful or loose teeth can also cause a person to avoid certain foods or eat less. Malnutrition due to dental problems is of greatest concern for the elderly, for whom it can worsen other health conditions and contribute to mortality. Individuals who have serious illnesses, especially AIDS, are also at increased risk of malnutrition from dental problems. \n\n Additionally, poor oral health can contribute to the development of disease. Increased bacterial growth in the mouth can cause inflammation and infection in other parts of the body. For example,  Streptococcus  in the mouth, the main contributor to biofilms on teeth, tartar, and dental caries, can spread throughout the body when there is damage to the tissues inside the mouth, as can happen during dental work.  S. mutans  produces a surface adhesin known as P1, which binds to salivary agglutinin on the surface of the tooth. P1 can also bind to extracellular matrix proteins including fibronectin and collagen. When  Streptococcus  enters the bloodstream as a result of tooth brushing or dental cleaning, it causes inflammation that can lead to the accumulation of plaque in the arteries and contribute to the development of  atherosclerosis , a condition associated with cardiovascular disease, heart attack, and stroke. In some cases, bacteria that spread through the blood vessels can lodge in the heart and cause  endocarditis  (an example of a focal infection). \n\n Oral Infections \n\n As noted earlier, normal oral microbiota can cause dental and periodontal infections. However, there are number of other infections that can manifest in the oral cavity when other microbes are present. \n\n Herpetic Gingivostomatitis \n\n As described in  Viral Infections of the Skin and Eyes , infections by  herpes simplex virus type 1 (HSV-1)  frequently manifest as  oral herpes , also called  acute herpes labialis  and characterized by  cold sores  on the lips, mouth, or gums. HSV-1 can also cause acute  herpetic gingivostomatitis , a condition that results in ulcers of the mucous membranes inside the mouth ( Figure 24.12 ). Herpetic gingivostomatitis is normally self-limiting except in immunocompromised patients. Like oral herpes, the infection is generally diagnosed through clinical examination, but cultures or biopsies may be obtained if other signs or symptoms suggest the possibility of a different causative agent. If treatment is needed, mouthwashes or antiviral medications such as  acyclovir ,  famciclovir , or  valacyclovir  may be used. \n\n Oral Thrush \n\n The yeast  Candida  is part of the normal human microbiota, but overgrowths, especially of  Candida albicans , can lead to infections in several parts of the body. When  Candida  infection develops in the oral cavity, it is called  oral thrush . Oral thrush is most common in infants because they do not yet have well developed immune systems and have not acquired the robust normal microbiota that keeps  Candida  in check in adults. Oral thrush is also common in immunodeficient patients and is a common infection in patients with AIDS. \n\n Oral thrush is characterized by the appearance of white patches and pseudomembranes in the mouth ( Figure 24.13 ) and can be associated with bleeding. The infection may be treated topically with  nystatin  or  clotrimazole  oral suspensions, although systemic treatment is sometimes needed. In serious cases, systemic azoles such as  fluconazole  or  itraconazole  (for strains resistant to fluconazole), may be used. Amphotericin B can also be used if the infection is severe or if the  Candida  species is azole-resistant. \n\n Mumps \n\n The viral disease  mumps  is an infection of the parotid glands, the largest of the three pairs of  salivary glands  ( Figure 24.3 ). The causative agent is mumps virus (MuV), a  paramyxovirus  with an envelope that has hemagglutinin and neuraminidase spikes. A fusion protein located on the surface of the envelope helps to fuse the viral envelope to the host cell plasma membrane. \n\n Mumps virus is transmitted through respiratory droplets or through contact with contaminated saliva, making it quite contagious so that it can lead easily to epidemics. It causes fever, muscle pain, headache, pain with chewing, loss of appetite, fatigue, and weakness. There is swelling of the salivary glands and associated pain ( Figure 24.14 ). The virus can enter the bloodstream ( viremia ), allowing it to spread to the organs and the central nervous system. The infection ranges from subclinical cases to cases with serious complications, such as  encephalitis ,  meningitis , and deafness. Inflammation of the pancreas, testes, ovaries, and breasts may also occur and cause permanent damage to those organs; despite these complications, a mumps infection rarely cause sterility. \n\n Mumps can be recognized based on clinical signs and symptoms, and a diagnosis can be confirmed with laboratory testing. The virus can be identified using culture or molecular techniques such as RT-PCR. Serologic tests are also available, especially enzyme immunoassays that detect antibodies. There is no specific treatment for mumps, so supportive therapies are used. The most effective way to avoid infection is through vaccination. Although mumps used to be a common childhood disease, it is now rare in the United States due to vaccination with the measles, mumps, and rubella (MMR) vaccine. \n\n Check Your Understanding \n\n Compare and contrast the signs and symptoms of herpetic gingivostomatitis, oral thrush, and mumps. \n\n Disease Profile Oral Infections Infections of the mouth and oral cavity can be caused by a variety of pathogens, including bacteria, viruses, and fungi. Many of these infections only affect the mouth, but some can spread and become systemic infections.  Figure 24.15  summarizes the main characteristics of common oral infections. \n 24.3   Bacterial Infections of the Gastrointestinal Tract \n\n Learning Objectives \n\n Identify the most common bacteria that can cause infections of the GI tract \n\n Compare the major characteristics of specific bacterial diseases affecting the GI tract \n\n A wide range of gastrointestinal diseases are caused by bacterial contamination of food. Recall that  foodborne disease  can arise from either  infection  or  intoxication . In both cases, bacterial toxins are typically responsible for producing disease signs and symptoms. The distinction lies in where the toxins are produced. In an infection, the microbial agent is ingested, colonizes the gut, and then produces toxins that damage host cells. In an intoxication, bacteria produce toxins in the food before it is ingested. In either case, the toxins cause damage to the cells lining the gastrointestinal tract, typically the colon. This leads to the common signs and symptoms of diarrhea or watery stool and abdominal cramps, or the more severe  dysentery . Symptoms of foodborne diseases also often include nausea and vomiting, which are mechanisms the body uses to expel the toxic materials. \n\n Most bacterial gastrointestinal illness is short-lived and self-limiting; however, loss of fluids due to severe diarrheal illness can lead to dehydration that can, in some cases, be fatal without proper treatment. Oral rehydration therapy with electrolyte solutions is an essential aspect of treatment for most patients with GI disease, especially in children and infants. \n\n Staphylococcal Food Poisoning \n\n Staphylococcal food poisoning  is one form of food intoxication. When  Staphylococcus aureus  grows in food, it may produce  enterotoxins  that, when ingested, can cause symptoms such as nausea, diarrhea, cramping, and vomiting within one to six hours. In some severe cases, it may cause headache, dehydration, and changes in blood pressure and heart rate. Signs and symptoms resolve within 24 to 48 hours.  S. aureus  is often associated with a variety of raw or undercooked and cooked foods including meat (e.g., canned meat, ham, and sausages) and dairy products (e.g., cheeses, milk, and butter). It is also commonly found on hands and can be transmitted to prepared foods through poor hygiene, including poor handwashing and the use of contaminated food preparation surfaces, such as cutting boards. The greatest risk is for food left at a temperature below 60 \u00b0C (140 \u00b0F), which allows the bacteria to grow. Cooked foods should generally be reheated to at least 60 \u00b0C (140 \u00b0F) for safety and most raw meats should be cooked to even higher internal temperatures ( Figure 24.16 ). \n\n There are at least 21  Staphylococcal  enterotoxins and  Staphylococcal  enterotoxin-like toxins that can cause food intoxication. The enterotoxins are proteins that are resistant to low pH, allowing them to pass through the stomach. They are heat stable and are not destroyed by boiling at 100 \u00b0C. Even though the bacterium itself may be killed, the enterotoxins alone can cause vomiting and diarrhea, although the mechanisms are not fully understood. At least some of the symptoms may be caused by the enterotoxin functioning as a  superantigen  and provoking a strong immune response by activating T cell proliferation. \n\n The rapid onset of signs and symptoms helps to diagnose this  foodborne illness . Because the bacterium does not need to be present for the toxin to cause symptoms, diagnosis is confirmed by identifying the  toxin  in a food sample or in biological specimens (feces or vomitus) from the patient. Serological techniques, including ELISA, can also be used to identify the toxin in food samples. \n\n The condition generally resolves relatively quickly, within 24 hours, without treatment. In some cases, supportive treatment in a hospital may be needed. \n\n Check Your Understanding \n\n How can  S. aureus  cause food intoxication? \n\n Shigellosis (Bacillary Dysentery) \n\n When gastrointestinal illness is associated with the rod-shaped, gram-negative bacterium  Shigella , it is called  bacillary dysentery , or  shigellosis . Infections can be caused by  S. dysenteriae ,  S. flexneri ,  S. boydii , and/or  S. sonnei  that colonize the GI tract. Shigellosis can be spread from hand to mouth or through contaminated food and water. Most commonly, it is transmitted through the fecal-oral route. \n\n Shigella  bacteria invade intestinal epithelial cells. When taken into a phagosome, they can escape and then live within the cytoplasm of the cell or move to adjacent cells. As the organisms multiply, the epithelium and structures with M cells of the  Peyer\u2019s patches  in the intestine may become ulcerated and cause loss of fluid. Stomach cramps, fever, and watery diarrhea that may also contain pus,  mucus , and/or blood often develop. More severe cases may result in ulceration of the mucosa, dehydration, and rectal bleeding. Additionally, patients may later develop  hemolytic uremic syndrome (HUS) , a serious condition in which damaged blood cells build up in the kidneys and may cause kidney failure, or  reactive arthritis , a condition in which arthritis develops in multiple joints following infection. Patients may also develop chronic post-infection irritable bowel syndrome (IBS). \n\n S. dysenteriae  type 1 is able to produce  Shiga toxin , which targets the endothelial cells of small blood vessels in the small and large intestine by binding to a glycosphingolipid. Once inside the endothelial cells, the toxin targets the large ribosomal subunit, thus affecting protein synthesis of these cells. Hemorrhaging and lesions in the colon can result. The toxin can target the kidney\u2019s glomerulus, the blood vessels where filtration of blood in the kidney begins, thus resulting in HUS. \n\n Stool samples, which should be processed promptly, are analyzed using serological or molecular techniques. One common method is to perform immunoassays for  S. dysenteriae.  (Other methods that can be used to identify  Shigella  include API test strips, Enterotube systems, or PCR testing. The presence of white blood cells and blood in fecal samples occurs in about 70% of patients 4  ( Figure 24.17 ). Severe cases may require antibiotics such as  ciprofloxacin  and  azithromycin , but these must be carefully prescribed because resistance is increasingly common. 4 Jaya Sureshbabu. \u201cShigella Infection Workup.\u201d  Medscape . Updated Jun 28, 2016. http://emedicine.medscape.com/article/968773-workup. \n\n Check Your Understanding \n\n Compare and contrast  Shigella  infections and intoxications. \n\n Salmonellosis \n\n Salmonella  gastroenteritis, also called  salmonellosis , is caused by the rod-shaped, gram-negative bacterium  Salmonella . Two species,  S. enterica  and  S. bongori , cause disease in humans, but  S. enterica  is the most common. The most common serotypes of  S. enterica  are Enteritidis and  Typhi . We will discuss typhoid fever caused by serotypes Typhi and Paratyphi A separately. Here, we will focus on salmonellosis caused by other serotypes. \n\n Salmonella  is a part of the normal intestinal microbiota of many individuals. However, salmonellosis is caused by exogenous agents, and infection can occur depending on the serotype, size of the inoculum, and overall health of the host. Infection is caused by ingestion of contaminated food, handling of eggshells, or exposure to certain animals.  Salmonella  is part of poultry\u2019s microbiota, so exposure to raw eggs and raw poultry can increase the risk of infection. Handwashing and cooking foods thoroughly greatly reduce the risk of transmission.  Salmonella  bacteria can survive freezing for extended periods but cannot survive high temperatures. \n\n Once the bacteria are ingested, they multiply within the intestines and penetrate the epithelial mucosal cells via M cells where they continue to grow ( Figure 24.18 ). They trigger inflammatory processes and the hypersecretion of fluids. Once inside the body, they can persist inside the phagosomes of macrophages.  Salmonella  can cross the epithelial cell membrane and enter the bloodstream and lymphatic system. Some strains of  Salmonella  also produce an  enterotoxin  that can cause an  intoxication . \n\n Infected individuals develop fever, nausea, abdominal cramps, vomiting, headache, and diarrhea. These signs and symptoms generally last a few days to a week. According to the Centers for Disease Control and Prevention (CDC), there are 1,000,000 cases annually, with 380 deaths each year. 5  However, because the disease is usually self-limiting, many cases are not reported to doctors and the overall incidence may be underreported. Diagnosis involves culture followed by serotyping and DNA fingerprinting if needed. Positive results are reported to the CDC. When an unusual serotype is detected, samples are sent to the CDC for further analysis. Serotyping is important for determining treatment. Oral rehydration therapy is commonly used. Antibiotics are only recommended for serious cases. When antibiotics are needed, as in immunocompromised patients,  fluoroquinolones , third-generation  cephalosporins , and  ampicillin  are recommended. Antibiotic resistance is a serious concern. 5 Centers for Disease Control and Prevention.  Salmonella . Updated August 25, 2016. https://www.cdc.gov/salmonella.  \n\n Typhoid Fever \n\n Certain serotypes of  S. enterica , primarily serotype  Typhi  ( S. typhi ) but also  Paratyphi , cause a more severe type of salmonellosis called  typhoid fever . This serious illness, which has an untreated mortality rate of 10%, causes high fever, body aches, headache, nausea, lethargy, and a possible rash. \n\n Some individuals carry  S. typhi  without presenting signs or symptoms (known as asymptomatic carriers) and continually shed them through their feces. These carriers often have the bacteria in the gallbladder or intestinal epithelium. Individuals consuming food or water contaminated with these feces can become infected. \n\n S. typhi  penetrate the intestinal mucosa, grow within the macrophages, and are transported through the body, most notably to the liver and gallbladder. Eventually, the macrophages lyse, releasing  S. typhi  into the bloodstream and lymphatic system. Mortality can result from ulceration and perforation of the intestine. A wide range of complications, such as pneumonia and jaundice, can occur with disseminated disease. \n\n S. typhi  have  Salmonella  pathogenicity islands  (SPIs) that contain the genes for many of their virulence factors. Two examples of important typhoid  toxins  are the  Vi antigen , which encodes for capsule production, and chimeric  A2B5 toxin , which causes many of the signs and symptoms of the acute phase of typhoid fever. \n\n Clinical examination and culture are used to make the diagnosis. The bacteria can be cultured from feces, urine, blood, or bone marrow. Serology, including ELISA, is used to identify the most pathogenic strains, but confirmation with DNA testing or culture is needed. A PCR test can also be used, but is not widely available. \n\n The recommended antibiotic treatment involves  fluoroquinolones ,  ceftriaxone , and  azithromycin . Individuals must be extremely careful to avoid infecting others during treatment. Typhoid fever can be prevented through vaccination for individuals traveling to parts of the world where it is common. \n\n Check Your Understanding \n\n Why is serotyping particularly important in  Salmonella  infections and typhoid fever? \n\n Eye on Ethics Typhoid Mary Mary  Mallon  was an Irish immigrant who worked as a cook in New York in the early 20 th  century. Over seven years, from 1900 to 1907, Mallon worked for a number of different households, unknowingly spreading illness to the people who lived in each one. In 1906, one family hired George Soper, an expert in typhoid fever epidemics, to determine the cause of the illnesses in their household. Eventually, Soper tracked Mallon down and directly linked 22 cases of typhoid fever to her. He discovered that Mallon was a carrier for typhoid but was immune to it herself. Although active carriers had been recognized before, this was the first time that an asymptomatic carrier of infection had been identified. \n\n Because she herself had never been ill, Mallon found it difficult to believe she could be the source of the illness. She fled from Soper and the authorities because she did not want to be quarantined or forced to give up her profession, which was relatively well paid for someone with her background. However, Mallon was eventually caught and kept in an isolation facility in the Bronx, where she remained until 1910, when the New York health department released her under the condition that she never again work with food. Unfortunately, Mallon did not comply, and she soon began working as a cook again. After new cases began to appear that resulted in the death of two individuals, the authorities tracked her down again and returned her to isolation, where she remained for 23 more years until her death in 1938. Epidemiologists were able to trace 51 cases of typhoid fever and three deaths directly to Mallon, who is unflatteringly remembered as \u201c Typhoid Mary .\u201d \n\n The Typhoid Mary case has direct correlations in the health-care industry. Consider Kaci Hickox, an American nurse who treated Ebola patients in West Africa during the 2014 epidemic. After returning to the United States, Hickox was quarantined against her will for three days and later found not to have Ebola. Hickox vehemently opposed the quarantine. In an editorial published in the British newspaper  The Guardian , 6  Hickox argued that quarantining asymptomatic health-care workers who had not tested positive for a disease would not only prevent such individuals from practicing their profession, but discourage others from volunteering to work in disease-ridden areas where health-care workers are desperately needed. 6 Kaci Hickox. \u201cStop Calling Me the \u2018Ebola Nurse.\u2019\u201d  The Guardian.  November 17, 2014. http://www.theguardian.com/commentisfree/2014/nov/17/stop-calling-me-ebola-nurse-kaci-hickox. \n\n What is the responsibility of an individual like Mary Mallon to change her behavior to protect others? What happens when an individual believes that she is not a risk, but others believe that she is? How would you react if you were in Mallon\u2019s shoes and were placed in a quarantine you did not believe was necessary, at the expense of your own freedom and possibly your career? Would it matter if you were definitely infected or not? \n\n E. coli  Infections \n\n The gram-negative rod  Escherichia coli  is a common member of the normal microbiota of the colon. Although the vast majority of  E. coli  strains are helpful commensal bacteria, some can be pathogenic and may cause dangerous diarrheal disease. The pathogenic strains have additional virulence factors such as type 1  fimbriae  that promote colonization of the colon or may produce toxins (see  Virulence Factors of Bacterial and Viral Pathogens ). These virulence factors are acquired through  horizontal gene transfer . \n\n Extraintestinal disease can result if the bacteria spread from the gastrointestinal tract. Although these bacteria can be spread from person to person, they are often acquired through contaminated food or water. There are six recognized pathogenic groups of  E. coli , but we will focus here on the four that are most commonly transmitted through food and water. \n\n Enterotoxigenic  E. coli  (ETEC) , also known as  traveler\u2019s diarrhea , causes diarrheal illness and is common in less developed countries. In Mexico, ETEC infection is called Montezuma\u2019s Revenge. Following ingestion of contaminated food or water, infected individuals develop a watery diarrhea, abdominal cramps,  malaise  (a feeling of being unwell), and a low fever. ETEC produces a heat-stable  enterotoxin  similar to  cholera toxin , and  adhesins  called  colonization factors  that help the bacteria to attach to the intestinal wall. Some strains of ETEC also produce heat-labile toxins. The disease is usually relatively mild and self-limiting. Diagnosis involves culturing and PCR. If needed, antibiotic treatment with  fluoroquinolones ,  doxycycline ,  rifaximin , and  trimethoprim-sulfamethoxazole  ( TMP/SMZ ) may shorten infection duration. However, antibiotic resistance is a problem. \n\n Enteroinvasive  E. coli  (EIEC)  is very similar to  shigellosis , including its pathogenesis of intracellular invasion into intestinal epithelial tissue. This bacterium carries a large plasmid that is involved in epithelial cell penetration. The illness is usually self-limiting, with symptoms including watery diarrhea, chills, cramps, malaise, fever, and dysentery. Culturing and PCR testing can be used for diagnosis. Antibiotic treatment is not recommended, so supportive therapy is used if needed. \n\n Enteropathogenic  E. coli  (EPEC)  can cause a potentially fatal diarrhea, especially in infants and those in less developed countries. Fever, vomiting, and diarrhea can lead to severe dehydration. These  E. coli  inject a protein (Tir) that attaches to the surface of the intestinal epithelial cells and triggers rearrangement of host cell actin from  microvilli  to pedestals. Tir also happens to be the receptor for  Intimin , a surface protein produced by EPEC, thereby allowing  E. coli  to \u201csit\u201d on the pedestal. The genes necessary for this pedestal formation are encoded on the locus for  enterocyte effacement  (LEE)  pathogenicity island . As with ETEC, diagnosis involves culturing and PCR. Treatment is similar to that for ETEC. \n\n The most dangerous strains are  enterohemorrhagic  E. coli  (EHEC) , which are the strains capable of causing epidemics. In particular, the strain  O157:H7  has been responsible for several recent outbreaks. Recall that the O and H refer to surface antigens that contribute to pathogenicity and trigger a host immune response (\u201cO\u201d refers to the O-side chain of the  lipopolysaccharide  and the \u201cH\u201d refers to the  flagella ). Similar to EPEC, EHEC also forms pedestals. EHEC also produces a Shiga-like toxin. Because the genome of this bacterium has been sequenced, it is known that the  Shiga toxin  genes were most likely acquired through transduction (horizontal gene transfer). The Shiga toxin genes originated from  Shigella   dysenteriae . Prophage from a bacteriophage that previously infected  Shigella  integrated into the chromosome of  E. coli . The Shiga-like toxin is often called verotoxin. \n\n EHEC can cause disease ranging from relatively mild to life-threatening. Symptoms include bloody diarrhea with severe cramping, but no fever. Although it is often self-limiting, it can lead to hemorrhagic colitis and profuse bleeding. One possible complication is HUS. Diagnosis involves culture, often using MacConkey with sorbitol agar to differentiate between  E. coli  O157:H7, which does not ferment sorbitol, and other less virulent strains of  E. coli  that can ferment sorbitol. \n\n Serological typing or PCR testing also can be used, as well as genetic testing for Shiga toxin. To distinguish EPEC from EHEC, because they both form pedestals on intestinal epithelial cells, it is necessary to test for genes encoding for both the Shiga-like toxin and for the LEE. Both EPEC and EHEC have LEE, but EPEC lacks the gene for Shiga toxin. Antibiotic therapy is not recommended and may worsen HUS because of the toxins released when the bacteria are killed, so supportive therapies must be used.  Table 24.1  summarizes the characteristics of the four most common pathogenic groups. \n\n Some Pathogenic Groups of  E. col i \n\n Group \n\n Virulence Factors and Genes \n\n Signs and Symptoms \n\n Diagnostic Tests \n\n Treatment \n\n Enterotoxigenic  E. coli  (ETEC) \n\n Heat stable enterotoxin similar to cholera toxin \n\n Relatively mild, watery diarrhea \n\n Culturing, PCR \n\n Self-limiting; if needed, fluoroquinolones, doxycycline, rifaximin, TMP/SMZ; antibiotic resistance is a problem \n\n Enteroinvasive  E. coli  (EIEC) \n\n Inv  (invasive plasmid) genes \n\n Relatively mild, watery diarrhea; dysentery or inflammatory colitis may occur \n\n Culturing, PCR; testing for  inv  gene; additional assays to distinguish from  Shigella \n\n Supportive therapy only; antibiotics not recommended \n\n Enteropathogenic  E. coli  (EPEC) \n\n Locus of enterocyte effacement (LEE) pathogenicity island \n\n Severe fever, vomiting, nonbloody diarrhea, dehydration; potentially fatal \n\n Culturing, PCR; detection of LEE lacking Shiga-like toxin genes \n\n Self-limiting; if needed, fluoroquinolones, doxycycline, rifaximin (TMP/SMZ); antibiotic resistance is a problem \n\n Enterohemorrhagic  E. coli  (EHEC) \n\n Verotoxin \n\n May be mild or very severe; bloody diarrhea; may result in HUS \n\n Culturing; plate on MacConkey agar with sorbitol agar as it does not ferment sorbitol; PCR detection of LEE containing Shiga-like toxin genes \n\n Antibiotics are not recommended due to the risk of HUS \n\n Table  24.1     \n\n Check Your Understanding \n\n Compare and contrast the virulence factors and signs and symptoms of infections with the four main  E. coli  groups. \n\n Cholera and Other Vibrios \n\n The gastrointestinal disease  cholera  is a serious infection often associated with poor sanitation, especially following natural disasters, because it is spread through contaminated water and food that has not been heated to temperatures high enough to kill the bacteria. It is caused by  Vibrio cholerae  serotype O1, a gram-negative, flagellated bacterium in the shape of a curved rod (vibrio). According to the CDC, cholera causes an estimated 3 to 5 million cases and 100,000 deaths each year. 7 7 Centers for Disease Control and Prevention.  Cholera\u2014Vibrio cholerae Infection . Updated November 6, 2014. http://www.cdc.gov/cholera/general. Accessed Sept 14, 2016. \n\n Because  V. cholerae  is killed by stomach acid, relatively large doses are needed for a few microbial cells to survive to reach the intestines and cause infection. The motile cells travel through the mucous layer of the intestines, where they attach to epithelial cells and release  cholera enterotoxin . The toxin is an A-B toxin with activity through adenylate cyclase (see  Virulence Factors of Bacterial and Viral Pathogens ). Within the intestinal cell, cyclic AMP (cAMP) levels increase, which activates a chloride channel and results in the release of ions into the intestinal lumen. This increase in osmotic pressure in the lumen leads to water also entering the lumen. As the water and electrolytes leave the body, it causes rapid dehydration and electrolyte imbalance. Diarrhea is so profuse that it is often called \u201crice water stool,\u201d and patients are placed on cots with a hole in them to monitor the fluid loss ( Figure 24.19 ). \n\n Cholera is diagnosed by taking a stool sample and culturing for  Vibrio . The bacteria are oxidase positive and show non-lactose fermentation on MacConkey agar. Gram-negative lactose fermenters will produce red colonies while non-fermenters will produce white/colorless colonies. Gram-positive bacteria will not grow on MacConkey. Lactose fermentation is commonly used for pathogen identification because the normal microbiota generally ferments lactose while pathogens do not.  V. cholerae  may also be cultured on thiosulfate citrate bile salts sucrose (TCBS) agar, a selective and differential media for  Vibrio  spp., which produce a distinct yellow colony. \n\n Cholera may be self-limiting and treatment involves rehydration and electrolyte replenishment. Although antibiotics are not typically needed, they can be used for severe or disseminated disease. Tetracyclines are recommended, but  doxycycline ,  erythromycin ,  orfloxacin ,  ciprofloxacin , and  TMP/SMZ  may be used. Recent evidence suggests that  azithromycin  is also a good first-line antibiotic. Good sanitation\u2014including appropriate sewage treatment, clean supplies for cooking, and purified drinking water\u2014is important to prevent infection ( Figure 24.19 ) \n\n V. cholera  is not the only  Vibrio  species that can cause disease.  V. parahemolyticus  is associated with consumption of contaminated seafood and causes gastrointestinal illness with signs and symptoms such as watery diarrhea, nausea, fever, chills, and abdominal cramps. The bacteria produce a heat-stable  hemolysin , leading to dysentery and possible disseminated disease. It also sometimes causes wound infections.  V. parahemolyticus  is diagnosed using cultures from blood, stool, or a wound. As with  V. cholera , selective medium (especially TCBS agar) works well. Tetracycline and  ciprofloxacin  can be used to treat severe cases, but antibiotics generally are not needed. \n\n Vibrio vulnificus  is found in warm seawater and, unlike  V. cholerae , is not associated with poor sanitary conditions. The bacteria can be found in raw seafood, and ingestion causes gastrointestinal illness. It can also be acquired by individuals with open skin wounds who are exposed to water with high concentrations of the pathogen. In some cases, the infection spreads to the bloodstream and causes septicemia. Skin infection can lead to edema, ecchymosis (discoloration of skin due to bleeding), and abscesses. Patients with underlying disease have a high fatality rate of about 50%. It is of particular concern for individuals with chronic liver disease or who are otherwise immunodeficient because a healthy immune system can often prevent infection from developing.  V. vulnificus  is diagnosed by culturing for the pathogen from stool samples, blood samples, or skin abscesses. Adult patients are treated with  doxycycline  combined with a third generation  cephalosporin  or with  fluoroquinolones , and children are treated with  TMP/SMZ . \n\n Two other vibrios,  Aeromonas hydrophila  and  Plesiomonas shigelloides , are also associated with marine environments and raw seafood; they can also cause gastroenteritis. Like  V. vulnificus ,  A. hydrophila  is more often associated with infections in wounds, generally those acquired in water. In some cases, it can also cause septicemia. Other species of  Aeromonas  can cause illness.  P. shigelloides  is sometimes associated with more serious systemic infections if ingested in contaminated food or water. Culture can be used to diagnose  A. hydrophila  and  P. shigelloides  infections, for which antibiotic therapy is generally not needed. When necessary,  tetracycline  and  ciprofloxacin , among other antibiotics, may be used for treatment of  A. hydrophila , and  fluoroquinolones  and  trimethoprim  are the effective treatments for  P. shigelloides . \n\n Check Your Understanding \n\n How does  V. cholera  infection cause rapid dehydration? \n\n Campylobacter jejuni  Gastroenteritis \n\n Campylobacter  is a genus of gram-negative, spiral or curved bacteria. They may have one or two flagella.  Campylobacter jejuni  gastroenteritis , a form of  campylobacteriosis , is a widespread illness that is caused by  Campylobacter jejuni . The primary route of transmission is through poultry that becomes contaminated during slaughter. Handling of the raw chicken in turn contaminates cooking surfaces, utensils, and other foods. Unpasteurized milk or contaminated water are also potential vehicles of transmission. In most cases, the illness is self-limiting and includes fever, diarrhea, cramps, vomiting, and sometimes  dysentery . More serious signs and symptoms, such as bacteremia, meningitis, pancreatitis, cholecystitis, and hepatitis, sometimes occur. It has also been associated with autoimmune conditions such as  Guillain-Barr\u00e9 syndrome , a neurological disease that occurs after some infections and results in temporary paralysis.  HUS  following infection can also occur. The virulence in many strains is the result of hemolysin production and the presence of  Campylobacter   cytolethal distending toxin  (CDT), a powerful deoxyribonuclease (DNase) that irreversibly damages host cell DNA. \n\n Diagnosis involves culture under special conditions, such as elevated temperature, low oxygen tension, and often medium supplemented with antimicrobial agents. These bacteria should be cultured on selective medium (such as Campy CV, charcoal selective medium, or cefaperazone charcoal deoxycholate agar) and incubated under microaerophilic conditions for at least 72 hours at 42 \u00b0C. Antibiotic treatment is not usually needed, but  erythromycin  or  ciprofloxacin  may be used. \n\n Peptic Ulcers \n\n The gram-negative bacterium  Helicobacter pylori  is able to tolerate the acidic environment of the human stomach and has been shown to be a major cause of  peptic ulcers , which are ulcers of the stomach or duodenum. The bacterium is also associated with increased risk of stomach cancer ( Figure 24.20 ). According to the CDC, approximately two-thirds of the population is infected with  H. pylori,  but less than 20% have a risk of developing ulcers or stomach cancer.  H. pylori  is found in approximately 80% of stomach ulcers and in over 90% of duodenal ulcers. 8 8 Centers for Disease Control and Prevention. \u201c Helicobacter pylori : Fact Sheet for Health Care Providers.\u201d Updated July 1998. http://www.cdc.gov/ulcer/files/hpfacts.pdf. \n\n H. pylori  colonizes epithelial cells in the stomach using pili for adhesion. These bacteria produce  urease , which stimulates an immune response and creates ammonia that neutralizes stomach acids to provide a more hospitable microenvironment. The infection damages the cells of the stomach lining, including those that normally produce the protective mucus that serves as a barrier between the tissue and stomach acid. As a result, inflammation ( gastritis ) occurs and ulcers may slowly develop. Ulcer formation can also be caused by toxin activity. It has been reported that 50% of clinical isolates of  H. pylori  have detectable levels of exotoxin activity  in vitro . 9  This  toxin , VacA, induces vacuole formation in host cells. VacA has no primary sequence homology with other bacterial toxins, and in a mouse model, there is a correlation between the presence of the toxin gene, the activity of the toxin, and gastric epithelial tissue damage. 9 T. L. Cover. \u201cThe Vacuolating Cytotoxin of  Helicobacter pylori .\u201d  Molecular Microbiology  20 (1996) 2: pp. 241\u2013246. http://www.ncbi.nlm.nih.gov/pubmed/8733223. \n\n Signs and symptoms include nausea, lack of appetite, bloating, burping, and weight loss. Bleeding ulcers may produce dark stools. If no treatment is provided, the ulcers can become deeper, more tissues can be involved, and stomach perforation can occur. Because perforation allows digestive enzymes and acid to leak into the body, it is a very serious condition. \n\n To diagnose  H. pylori  infection, multiple methods are available. In a breath test, the patient swallows radiolabeled urea. If  H. pylori  is present, the bacteria will produce  urease  to break down the urea. This reaction produces radiolabeled carbon dioxide that can be detected in the patient\u2019s breath. Blood testing can also be used to detect antibodies to  H. pylori . The bacteria themselves can be detected using either a stool test or a stomach wall biopsy. \n\n Antibiotics can be used to treat the infection. However, unique to  H. pylori,  the recommendation from the US Food and Drug Administration is to use a triple therapy. The current protocols are 10 days of treatment with  omeprazole ,  amoxicillin , and  clarithromycin  (OAC); 14 days of treatment with  bismuth subsalicylate ,  metronidazole , and  tetracycline  (BMT); or 10 or 14 days of treatment with  lansoprazole ,  amoxicillin , and  clarithromycin  (LAC). Omeprazole, bismuth subsalicylate, and lansoprazole are not antibiotics but are instead used to decrease acid levels because  H. pylori  prefers acidic environments. \n\n Although treatment is often valuable, there are also risks to  H. pylori  eradication. Infection with  H. pylori  may actually protect against some cancers, such as esophageal adenocarcinoma and gastroesophageal reflux disease. 10 11 10 Martin J. Blaser. \u201cDisappearing Microbiota:  Helicobacter pylori  Protection against Esophageal Adenocarcinoma.\u201d  Cancer Prevention Research  1 (2008) 5: pp. 308\u2013311. http://cancerpreventionresearch.aacrjournals.org/content/1/5/308.full.pdf+html. 11 Ivan F. N. Hung and Benjamin C. Y. Wong. \u201cAssessing the Risks and Benefits of Treating  Helicobacter pylori  Infection.\u201d  Therapeutic Advances in Gastroenterology  2 (2009) 3: pp, 141\u2013147. doi: 10.1177/1756283X08100279. \n\n Check Your Understanding \n\n How does  H. pylori  cause peptic ulcers? \n\n Clostridium perfringens  Gastroenteritis \n\n Clostridium perfringens  gastroenteritis  is a generally mild foodborne disease that is associated with undercooked meats and other foods.  C. perfringens  is a gram-positive, rod-shaped, endospore-forming anaerobic bacterium that is tolerant of high and low temperatures. At high temperatures, the bacteria can form endospores that will germinate rapidly in foods or within the intestine. Food poisoning by type A strains is common. This strain always produces an  enterotoxin , sometimes also present in other strains, that causes the clinical symptoms of cramps and diarrhea. A more severe form of the illness, called  pig-bel  or  enteritis necroticans , causes hemorrhaging, pain, vomiting, and bloating. Gangrene of the intestines may result. This form has a high mortality rate but is rare in the United States. \n\n Diagnosis involves detecting the  C. perfringens  toxin in stool samples using either molecular biology techniques (PCR detection of the toxin gene) or immunology techniques (ELISA). The bacteria itself may also be detected in foods or in fecal samples. Treatment includes rehydration therapy, electrolyte replacement, and intravenous fluids. Antibiotics are not recommended because they can damage the balance of the microbiota in the gut, and there are concerns about antibiotic resistance. The illness can be prevented through proper handling and cooking of foods, including prompt refrigeration at sufficiently low temperatures and cooking food to a sufficiently high temperature. \n\n Clostridium difficile \n\n Clostridium difficile  is a gram-positive rod that can be a commensal bacterium as part of the normal microbiota of healthy individuals. When the normal microbiota is disrupted by long-term antibiotic use, it can allow the overgrowth of this bacterium, resulting in  antibiotic-associated diarrhea  caused by  C. difficile . Antibiotic-associated diarrhea can also be considered a  nosocomial disease . Patients at the greatest risk of  C. difficile  infection are those who are immunocompromised, have been in health-care settings for extended periods, are older, have recently taken antibiotics, have had gastrointestinal procedures done, or use proton pump inhibitors, which reduce stomach acidity and allow proliferation of  C. difficile . Because this species can form  endospores , it can survive for extended periods of time in the environment under harsh conditions and is a considerable concern in health-care settings. \n\n This bacterium produces two toxins,  Clostridium difficile  toxin A  (TcdA) and  Clostridium difficile  toxin B  (TcdB). These toxins inactivate small GTP-binding proteins, resulting in actin condensation and cell rounding, followed by cell death. Infections begin with focal necrosis, then ulceration with exudate, and can progress to  pseudomembranous colitis , which involves inflammation of the colon and the development of a pseudomembrane of fibrin containing dead epithelial cells and leukocytes ( Figure 24.21 ). Watery diarrhea, dehydration, fever, loss of appetite, and abdominal pain can result. Perforation of the colon can occur, leading to septicemia, shock, and death.  C. difficile  is also associated with  necrotizing enterocolitis  in premature babies and  neutropenic enterocolitis  associated with cancer therapies. \n\n Diagnosis is made by considering the patient history (such as exposure to antibiotics), clinical presentation, imaging, endoscopy, lab tests, and other available data. Detecting the  toxin  in stool samples is used to confirm diagnosis. Although culture is preferred, it is rarely practical in clinical practice because the bacterium is an obligate anaerobe. Nucleic acid amplification tests, including PCR, are considered preferable to ELISA testing for molecular analysis. \n\n The first step of conventional treatment is to stop antibiotic use, and then to provide supportive therapy with electrolyte replacement and fluids. Metronidazole is the preferred treatment if the  C. difficile  diagnosis has been confirmed.  Vancomycin  can also be used, but it should be reserved for patients for whom metronidazole was ineffective or who meet other criteria (e.g., under 10 years of age, pregnant, or allergic to metronidazole). \n\n A newer approach to treatment, known as a  fecal transplant , focuses on restoring the microbiota of the gut in order to combat the infection. In this procedure, a healthy individual donates a stool sample, which is mixed with saline and transplanted to the recipient via colonoscopy, endoscopy, sigmoidoscopy, or enema. It has been reported that this procedure has greater than 90% success in resolving  C. difficile  infections. 12 12 Faith Rohlke and Neil Stollman. \u201cFecal Microbiota Transplantation in Relapsing  Clostridium difficile  Infection,\u201d  Therapeutic Advances in Gastroenterology  5 (2012) 6: 403\u2013420. doi: 10.1177/1756283X12453637. \n\n Check Your Understanding \n\n How does antibiotic use lead to  C. difficile  infections? \n\n Foodborne Illness Due to  Bacillus cereus \n\n Bacillus cereus , commonly found in soil, is a gram-positive endospore-forming bacterium that can sometimes cause foodborne illness.  B. cereus  endospores can survive cooking and produce  enterotoxins  in food after it has been heated; illnesses often occur after eating rice and other prepared foods left at room temperature for too long. The signs and symptoms appear within a few hours of ingestion and include nausea, pain, and abdominal cramps.  B. cereus  produces two toxins: one causing diarrhea, and the other causing vomiting. More severe signs and symptoms can sometimes develop. \n\n Diagnosis can be accomplished by isolating bacteria from stool samples or vomitus and uneaten infected food. Treatment involves rehydration and supportive therapy. Antibiotics are not typically needed, as the illness is usually relatively mild and is due to toxin activity. \n\n Foodborne Illness Due to  Yersinia \n\n The genus  Yersinia  is best known for  Yersinia pestis , a gram-negative rod that causes the plague. However,  Y. enterocolitica  and  Y. pseudotuberculosis  can cause  gastroenteritis . The infection is generally transmitted through the fecal-oral route, with ingestion of food or water that has been contaminated by feces. Intoxication can also result because of the activity of its  endotoxin  and  exotoxins  ( enterotoxin  and  cytotoxin necrotizing factor ). The illness is normally relatively mild and self-limiting. However, severe diarrhea and dysentery can develop in infants. In adults, the infection can spread and cause complications such as reactive arthritis, thyroid disorders, endocarditis, glomerulonephritis, eye inflammation, and/or erythema nodosum. Bacteremia may develop in rare cases. \n\n Diagnosis is generally made by detecting the bacteria in stool samples. Samples may also be obtained from other tissues or body fluids. Treatment is usually supportive, including rehydration, without antibiotics. If bacteremia or other systemic disease is present, then antibiotics such as  fluoroquinolones ,  aminoglycosides ,  doxycycline , and  trimethoprim-sulfamethoxazole  may be used. Recovery can take up to two weeks. \n\n Check Your Understanding \n\n Compare and contrast foodborne illnesses due to  B. cereus  and  Yersinia . \n\n Disease Profile Bacterial Infections of the Gastrointestinal Tract Bacterial infections of the gastrointestinal tract generally occur when bacteria or bacterial  toxins  are ingested in contaminated food or water. Toxins and other virulence factors can produce gastrointestinal inflammation and general symptoms such as diarrhea and vomiting. Bacterial GI infections can vary widely in terms of severity and treatment. Some can be treated with antibiotics, but in other cases antibiotics may be ineffective in combating toxins or even counterproductive if they compromise the GI microbiota.  Figure 24.22  and  Figure 24.23  the key features of common bacterial GI infections. \n\n Clinical Focus Part 2 At the hospital, Carli\u2019s doctor began to think about possible causes of her severe gastrointestinal distress. One possibility was food poisoning, but no one else in her family was sick. The doctor asked about what Carli had eaten the previous day; her mother mentioned that she\u2019d had eggs for lunch, and that they may have been a little undercooked. The doctor took a sample of Carli\u2019s stool and sent it for laboratory testing as part of her workup. She suspected that Carli could have a case of bacterial or viral gastroenteritis, but she needed to know the cause in order to prescribe an appropriate treatment. \n\n In the laboratory, technicians microscopically identified gram-negative bacilli in Carli\u2019s stool sample. They also established a pure culture of the bacteria and analyzed it for antigens. This testing showed that the causative agent was  Salmonella . \n\n What should the doctor do now to treat Carli? \n\n Jump to the  next  Clinical Focus box. Go back to the  previous  Clinical Focus box. \n 24.4   Viral Infections of the Gastrointestinal Tract \n\n Learning Objectives \n\n Identify the most common viruses that can cause infections of the GI tract \n\n Compare the major characteristics of specific viral diseases affecting the GI tract and liver \n\n In the developing world, acute viral  gastroenteritis  is devastating and a leading cause of death for children. 13  Worldwide, diarrhea is the second leading cause of mortality for children under age five, and 70% of childhood gastroenteritis is viral. 14  As discussed, there are a number of bacteria responsible for diarrhea, but viruses can also cause diarrhea.  E. coli  and  rotavirus  are the most common causative agents in the developing world. In this section, we will discuss rotaviruses and other, less common viruses that can also cause gastrointestinal illnesses. 13 Caleb K. King, Roger Glass, Joseph S. Bresee, Christopher Duggan. \u201cManaging Acute Gastroenteritis Among Children: Oral Rehydration, Maintenance, and Nutritional Therapy.\u201d  MMWR  52 (2003) RR16: pp. 1\u201316. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5216a1.htm. 14 Elizabeth Jane Elliott. \u201cAcute Gastroenteritis in Children.\u201d  British Medical Journal  334 (2007) 7583: 35\u201340, doi: 10.1136/bmj.39036.406169.80; S. Ramani and G. Kang. \u201cViruses Causing Diarrhoea in the Developing World.\u201d  Current Opinions in Infectious Diseases  22 (2009) 5: pp. 477\u2013482. doi: 10.1097/QCO.0b013e328330662f; Michael Vincent F Tablang. \u201cViral Gastroenteritis.\u201d  Medscape . http://emedicine.medscape.com/article/176515-overview. \n\n Gastroenteritis Caused by Rotaviruses \n\n Rotaviruses are double-stranded RNA viruses in the family  Reoviridae . They are responsible for common diarrheal illness, although prevention through vaccination is becoming more common. The virus is primarily spread by the fecal-oral route ( Figure 24.24 ). \n\n These viruses are widespread in children, especially in day-care centers. The CDC estimates that 95% of children in the United States have had at least one rotavirus infection by the time they reach age five. 15  Due to the memory of the body\u2019s immune system, adults who come into contact with rotavirus will not contract the infection or, if they do, are asymptomatic. The elderly, however, are vulnerable to rotavirus infection due to weakening of the immune system with age, so infections can spread through nursing homes and similar facilities. In these cases, the infection may be transmitted from a family member who may have subclinical or clinical disease. The virus can also be transmitted from contaminated surfaces, on which it can survive for some time. 15 Centers for Disease Control and Prevention. \u201cRotavirus,\u201d  The Pink Book.  Updated September 8, 2015. http://www.cdc.gov/vaccines/pubs/pinkbook/rota.html.  \n\n Infected individuals exhibit fever, vomiting, and diarrhea. The virus can survive in the stomach following a meal, but is normally found in the small intestines, particularly the epithelial cells on the  villi . Infection can cause food intolerance, especially with respect to lactose. The illness generally appears after an incubation period of about two days and lasts for approximately one week (three to eight days). Without supportive treatment, the illness can cause severe fluid loss, dehydration, and even death. Even with milder illness, repeated infections can potentially lead to malnutrition, especially in developing countries, where rotavirus infection is common due to poor sanitation and lack of access to clean drinking water. Patients (especially children) who are malnourished after an episode of diarrhea are more susceptible to future diarrheal illness, increasing their risk of death from rotavirus infection. \n\n The most common clinical tool for diagnosis is enzyme immunoassay, which detects the virus from fecal samples. Latex agglutination assays are also used. Additionally, the virus can be detected using electron microscopy and RT-PCR. \n\n Treatment is supportive with oral rehydration therapy. Preventive vaccination is also available. In the United States, rotavirus vaccines are part of the standard vaccine schedule and administration follows the guidelines of the World Health Organization (WHO). The WHO recommends that all infants worldwide receive the rotavirus vaccine, the first dose between six and 15 weeks of age and the second before 32 weeks. 16 16 World Health Organization. \u201cRotavirus.\u201d  Immunization, Vaccines, and Biologicals.  Updated April 21, 2010. http://www.who.int/immunization/topics/rotavirus/en/. \n\n Gastroenteritis Caused by Noroviruses \n\n Noroviruses , commonly identified as  Norwalk viruses , are  caliciviruses . Several strains can cause  gastroenteritis . There are millions of cases a year, predominately in infants, young children, and the elderly. These viruses are easily transmitted and highly contagious. They are known for causing widespread infections in groups of people in confined spaces, such as on cruise ships. The viruses can be transmitted through direct contact, through touching contaminated surfaces, and through contaminated food. Because the virus is not killed by disinfectants used at standard concentrations for killing bacteria, the risk of transmission remains high, even after cleaning. \n\n The signs and symptoms of norovirus infection are similar to those for  rotavirus , with watery diarrhea, mild cramps, and fever. Additionally, these viruses sometimes cause projectile vomiting. The illness is usually relatively mild, develops 12 to 48 hours after exposure, and clears within a couple of days without treatment. However, dehydration may occur. \n\n Norovirus can be detected using PCR or enzyme immunoassay (EIA) testing. RT-qPCR is the preferred approach as EIA is insufficiently sensitive. If EIA is used for rapid testing, diagnosis should be confirmed using PCR. No medications are available, but the illness is usually self-limiting. Rehydration therapy and electrolyte replacement may be used. Good hygiene, hand washing, and careful food preparation reduce the risk of infection. \n\n Gastroenteritis Caused by Astroviruses \n\n Astroviruses  are single-stranded RNA viruses (family  Astroviridae ) that can cause severe gastroenteritis, especially in infants and children. Signs and symptoms include diarrhea, nausea, vomiting, fever, abdominal pain, headache, and malaise. The viruses are transmitted through the fecal-oral route (contaminated food or water). For diagnosis, stool samples are analyzed. Testing may involve enzyme immunoassays and immune electron microscopy. Treatment involves supportive rehydration and electrolyte replacement if needed. \n\n Check Your Understanding \n\n Why are rotaviruses, noroviruses, and astroviruses more common in children? \n\n Disease Profile Viral Infections of the Gastrointestinal Tract A number of viruses can cause  gastroenteritis , characterized by inflammation of the GI tract and other signs and symptoms with a range of severities. As with bacterial GI infections, some cases can be relatively mild and self-limiting, while others can become serious and require intensive treatment. Antimicrobial drugs are generally not used to treat viral gastroenteritis; generally, these illnesses can be treated effectively with rehydration therapy to replace fluids lost in bouts of diarrhea and vomiting. Because most viral causes of gastroenteritis are quite contagious, the best preventive measures involve avoiding and/or isolating infected individuals and limiting transmission through good hygiene and sanitation. \n\n Hepatitis \n\n Hepatitis is a general term meaning inflammation of the liver, which can have a variety of causes. In some cases, the cause is viral infection. There are five main hepatitis viruses that are clinically significant:  hepatitisviruses  A ( HAV ), B ( HBV ), C ( HCV ), D, ( HDV ) and E ( HEV ) ( Figure 24.26 ). Note that other viruses, such as  Epstein-Barr virus  (EBV),  yellow fever , and  cytomegalovirus  (CMV) can also cause  hepatitis  and are discussed in  Viral Infections of the Circulatory and Lymphatic Systems . \n\n Although the five hepatitis viruses differ, they can cause some similar signs and symptoms because they all have an affinity for  hepatocytes  (liver cells). HAV and HEV can be contracted through ingestion while HBV, HCV, and HDV are transmitted by parenteral contact. It is possible for individuals to become long term or chronic carriers of hepatitis viruses. \n\n The virus enters the blood ( viremia ), spreading to the spleen, the kidneys, and the liver. During viral replication, the virus infects hepatocytes. The inflammation is caused by the hepatocytes replicating and releasing more hepatitis virus. Signs and symptoms include malaise, anorexia, loss of appetite, dark urine, pain in the upper right quadrant of the abdomen, vomiting, nausea, diarrhea, joint pain, and gray stool. Additionally, when the liver is diseased or injured, it is unable to break down hemoglobin effectively, and bilirubin can build up in the body, giving the skin and mucous membranes a yellowish color, a condition called  jaundice  ( Figure 24.27 ). In severe cases, death from liver  necrosis  may occur. \n\n Despite having many similarities, each of the hepatitis viruses has its own unique characteristics.  HAV  is generally transmitted through the fecal-oral route, close personal contact, or exposure to contaminated water or food. Hepatitis A can develop after an incubation period of 15 to 50 days (the mean is 30). It is normally mild or even asymptomatic and is usually self-limiting within weeks to months. A more severe form,  fulminant hepatitis , rarely occurs but has a high fatality rate of 70\u201380%. Vaccination is available and is recommended especially for children (between ages one and two), those traveling to countries with higher risk, those with liver disease and certain other conditions, and drug users. \n\n Although  HBV  is associated with similar signs and symptoms, transmission and outcomes differ. This virus has a mean incubation period of 120 days and is generally associated with exposure to infectious blood or body fluids such as semen or saliva. Exposure can occur through skin puncture, across the placenta, or through mucosal contact, but it is not spread through casual contact such as hugging, hand holding, sneezing, or coughing, or even through breastfeeding or kissing. Risk of infection is greatest for those who use intravenous drugs or who have sexual contact with an infected individual. Health-care workers are also at risk from needle sticks and other injuries when treating infected patients. The infection can become chronic and may progress to cirrhosis or liver failure. It is also associated with liver cancer. Chronic infections are associated with the highest mortality rates and are more common in infants. Approximately 90% of infected infants become chronic carriers, compared with only 6\u201310% of infected adults. 17  Vaccination is available and is recommended for children as part of the standard vaccination schedule (one dose at birth and the second by 18 months of age) and for adults at greater risk (e.g., those with certain diseases, intravenous drug users, and those who have sex with multiple partners). Health-care agencies are required to offer the HBV vaccine to all workers who have occupational exposure to blood and/or other infectious materials. 17 Centers for Disease Control and Prevention. \u201cThe ABCs of Hepatitis.\u201d Updated 2016. http://www.cdc.gov/hepatitis/resources/professionals/pdfs/abctable.pdf. \n\n HCV  is often undiagnosed and therefore may be more widespread than is documented. It has a mean incubation period of 45 days and is transmitted through contact with infected blood. Although some cases are asymptomatic and/or resolve spontaneously, 75%\u201385% of infected individuals become chronic carriers. Nearly all cases result from parenteral transmission often associated with IV drug use or transfusions. The risk is greatest for individuals with past or current history of intravenous drug use or who have had sexual contact with infected individuals. It has also been spread through contaminated blood products and can even be transmitted through contaminated personal products such as toothbrushes and razors. New medications have recently been developed that show great effectiveness in treating HCV and that are tailored to the specific genotype causing the infection. \n\n HDV  is uncommon in the United States and only occurs in individuals who are already infected with HBV, which it requires for replication. Therefore, vaccination against HBV is also protective against HDV infection. HDV is transmitted through contact with infected blood. \n\n HEV  infections are also rare in the United States but many individuals have a positive antibody titer for HEV. The virus is most commonly spread by the fecal-oral route through food and/or water contamination, or person-to-person contact, depending on the genotype of the virus, which varies by location. There are four genotypes that differ somewhat in their mode of transmission, distribution, and other factors (for example, two are zoonotic and two are not, and only one causes chronic infection). Genotypes three and four are only transmitted through food, while genotypes one and two are also transmitted through water and fecal-oral routes. Genotype one is the only type transmitted person-to-person and is the most common cause of HEV outbreaks. Consumption of undercooked meat, especially deer or pork, and shellfish can lead to infection. Genotypes three and four are zoonoses, so they can be transmitted from infected animals that are consumed. Pregnant women are at particular risk. This disease is usually self-limiting within two weeks and does not appear to cause chronic infection. \n\n General laboratory testing for hepatitis begins with blood testing to examine liver function ( Figure 24.28 ). When the liver is not functioning normally, the blood will contain elevated levels of  alkaline phosphatase ,  alanine aminotransferase  (ALT),  aspartate aminotransferase  (AST), direct  bilirubin , total bilirubin, serum albumin, serum total protein, and calculated globulin, albumin/globulin (A/G) ratio. Some of these are included in a complete metabolic panel (CMP), which may first suggest a possible liver problem and indicate the need for more comprehensive testing. A hepatitis virus serological test panel can be used to detect antibodies for hepatitis viruses A, B, C, and sometimes D. Additionally, other immunological and genomic tests are available. \n\n Specific treatments other than supportive therapy, rest, and fluids are often not available for hepatitis virus infection, except for HCV, which is often self-limited. Immunoglobulins can be used prophylactically following possible exposure. Medications are also used, including  interferon alpha 2b  and antivirals (e.g.,  lamivudine ,  entecavir ,  adefovir , and  telbivudine ) for chronic infections. Hepatitis C can be treated with interferon (as monotherapy or combined with other treatments), protease inhibitors, and other antivirals (e.g., the polymerase inhibitor  sofosbuvir ). Combination treatments are commonly used. Antiviral and immunosuppressive medications may be used for chronic cases of HEV. In severe cases, liver transplants may be necessary. Additionally, vaccines are available to prevent infection with HAV and HBV. The HAV vaccine is also protective against HEV. The HBV vaccine is also protective against HDV. There is no vaccine against HCV. \n\n Link to Learning \n\n Learn more information about  hepatitis virus  infections. \n\n Check Your Understanding \n\n Why do the five different hepatitis viruses all cause similar signs and symptoms? \n\n Micro Connections Preventing HBV Transmission in Health-Care Settings Hepatitis B was once a leading on-the-job hazard for health-care workers. Many health-care workers over the years have become infected, some developing cirrhosis and liver cancer. In 1982, the CDC recommended that health-care workers be vaccinated against HBV, and rates of infection have declined since then. Even though vaccination is now common, it is not always effective and not all individuals are vaccinated. Therefore, there is still a small risk for infection, especially for health-care workers working with individuals who have chronic infections, such as drug addicts, and for those with higher risk of needle sticks, such as phlebotomists. Dentists are also at risk. \n\n Health-care workers need to take appropriate precautions to prevent infection by HBV and other illnesses. Blood is the greatest risk, but other body fluids can also transmit infection. Damaged skin, as occurs with eczema or psoriasis, can also allow transmission. Avoiding contact with body fluids, especially blood, by wearing gloves and face protection and using disposable syringes and needles reduce the risk of infection. Washing exposed skin with soap and water is recommended. Antiseptics may also be used, but may not help. Post-exposure treatment, including treatment with hepatitis B immunoglobulin (HBIG) and vaccination, may be used in the event of exposure to the virus from an infected patient. Detailed protocols are available for managing these situations. The virus can remain infective for up to seven days when on surfaces, even if no blood or other fluids are visible, so it is important to consider the best choices for disinfecting and sterilizing equipment that could potentially transmit the virus. The CDC recommends a solution of 10% bleach to disinfect surfaces. 18  Finally, testing blood products is important to reduce the risk of transmission during transfusions and similar procedures. 18 Centers for Disease Control and Prevention. \u201cHepatitis B FAQs for Health Professionals.\u201d Updated August 4, 2016. http://www.cdc.gov/hepatitis/HBV/HBVfaq.htm. \n\n Disease Profile Viral Hepatitis Hepatitis  involves inflammation of the liver that typically manifests with signs and symptoms such as jaundice, nausea, vomiting, joint pain, gray stool, and loss of appetite. However, the severity and duration of the disease can vary greatly depending on the causative agent. Some infections may be completely asymptomatic, whereas others may be life threatening. The five different viruses capable of causing hepatitis are compared in  Figure 24.28 . For the sake of comparison, this table presents only the unique aspects of each form of viral hepatitis, not the commonalities. \n 24.5   Protozoan Infections of the Gastrointestinal Tract \n\n Learning Objectives \n\n Identify the most common protozoans that can cause infections of the GI tract \n\n Compare the major characteristics of specific protozoan diseases affecting the GI tract \n\n Like other microbes,  protozoa  are abundant in natural microbiota but can also be associated with significant illness. Gastrointestinal diseases caused by protozoa are generally associated with exposure to contaminated food and water, meaning that those without access to good sanitation are at greatest risk. Even in developed countries, infections can occur and these microbes have sometimes caused significant outbreaks from contamination of public water supplies. \n\n Giardiasis \n\n Also called backpacker\u2019s diarrhea or beaver fever,  giardiasis  is a common disease in the United States caused by the flagellated protist  Giardia lamblia , also known as  Giardia intestinalis  or  Giardia duodenalis  ( Figure 1.16 ). To establish infection,  G. lamblia  uses a large adhesive disk to attach to the intestinal mucosa. The disk is comprised of microtubules. During adhesion, the  flagella  of  G. lamblia  move in a manner that draws fluid out from under the disk, resulting in an area of lower pressure that promotes its adhesion to the intestinal epithelial cells. Due to its attachment,  Giardia  also blocks absorption of nutrients, including fats. \n\n Transmission occurs through contaminated food or water or directly from person to person. Children in day-care centers are at risk due to their tendency to put items into their mouths that may be contaminated. Large outbreaks may occur if a public water supply becomes contaminated.  Giardia  have a resistant cyst stage in their life cycle that is able to survive cold temperatures and the chlorination treatment typically used for drinking water in municipal reservoirs. As a result, municipal water must be filtered to trap and remove these cysts. Once consumed by the host,  Giardia  develops into the active tropozoite. \n\n Infected individuals may be asymptomatic or have gastrointestinal signs and symptoms, sometimes accompanied by weight loss. Common symptoms, which appear one to three weeks after exposure, include diarrhea, nausea, stomach cramps, gas, greasy stool (because fat absorption is being blocked), and possible dehydration. The parasite remains in the colon and does not cause systemic infection. Signs and symptoms generally clear within two to six weeks. Chronic infections may develop and are often resistant to treatment. These are associated with weight loss, episodic diarrhea, and malabsorption syndrome due to the blocked nutrient absorption. \n\n Diagnosis may be made using observation under the microscope. A stool  ova and parasite  ( O&P ) exam involves direct examination of a stool sample for the presence of cysts and trophozoites; it can be used to distinguish common parasitic intestinal infections. ELISA and other immunoassay tests, including commercial direct fluorescence antibody kits, are also used. The most common treatments use  metronidazole  as the first-line choice, followed by  tinidazole . If the infection becomes chronic, the parasites may become resistant to medications. \n\n Cryptosporidiosis \n\n Another protozoan intestinal illness is  cryptosporidiosis , which is usually caused by  Cryptosporidium   parvum  or  C. hominis . ( Figure 24.29 ) These pathogens are commonly found in animals and can be spread in feces from mice, birds, and farm animals. Contaminated water and food are most commonly responsible for transmission. The protozoan can also be transmitted through human contact with infected animals or their feces. \n\n In the United States, outbreaks of cryptosporidiosis generally occur through contamination of the public water supply or contaminated water at water parks, swimming pools, and day-care centers. The risk is greatest in areas with poor sanitation, making the disease more common in developing countries. \n\n Signs and symptoms include watery diarrhea, nausea, vomiting, cramps, fever, dehydration, and weight loss. The illness is generally self-limiting within a month. However, immunocompromised patients, such as those with HIV/AIDS, are at particular risk of severe illness or death. \n\n Diagnosis involves direct examination of stool samples, often over multiple days. As with giardiasis, a stool  O&P  exam may be helpful. Acid fast staining is often used. Enzyme immunoassays and molecular analysis (PCR) are available. \n\n The first line of treatment is typically oral rehydration therapy. Medications are sometimes used to treat the diarrhea. The broad-range anti-parasitic drug  nitazoxanide  can be used to treat cryptosporidiosis. Other anti-parasitic drugs that can be used include  azithromycin  and  paromomycin . \n\n Amoebiasis (Amebiasis) \n\n The protozoan parasite  Entamoeba histolytica  causes  amoebiasis , which is known as  amoebic dysentery  in severe cases.  E. histolytica  is generally transmitted through water or food that has fecal contamination. The disease is most widespread in the developing world and is one of the leading causes of mortality from parasitic disease worldwide.  Disease can be caused by as few as 10 cysts being transmitted. \n\n Signs and symptoms range from nonexistent to mild diarrhea to severe amoebic dysentery. Severe infection causes the abdomen to become distended and may be associated with fever. The parasite may live in the colon without causing signs or symptoms or may invade the mucosa to cause colitis. In some cases, the disease spreads to the spleen, brain, genitourinary tract, or lungs. In particular, it may spread to the liver and cause an abscess. When a liver abscess develops, fever, nausea, liver tenderness, weight loss, and pain in the right abdominal quadrant may occur. Chronic infection may occur and is associated with intermittent diarrhea, mucus, pain, flatulence, and weight loss. \n\n Direct examination of fecal specimens may be used for diagnosis. As with cryptosporidiosis, samples are often examined on multiple days. A stool  O&P  exam of fecal or biopsy specimens may be helpful. Immunoassay, serology, biopsy, molecular, and antibody detection tests are available. Enzyme immunoassay may not distinguish current from past illness. Magnetic resonance imaging (MRI) can be used to detect any liver abscesses. The first line of treatment is  metronidazole  or  tinidazole , followed by  diloxanide furoate ,  iodoquinol , or  paromomycin  to eliminate the cysts that remain. \n\n Cyclosporiasis \n\n The intestinal disease  cyclosporiasis  is caused by the protozoan  Cyclospora cayetanensis . It is endemic to tropical and subtropical regions and therefore uncommon in the United States, although there have been outbreaks associated with contaminated produce imported from regions where the protozoan is more common. \n\n This  protist  is transmitted through contaminated food and water and reaches the lining of the small intestine, where it causes infection. Signs and symptoms begin within seven to ten days after ingestion. Based on limited data, it appears to be seasonal in ways that differ regionally and that are poorly understood. 19 19 Centers for Disease Control and Prevention. \u201cCyclosporiasis FAQs for Health Professionals.\u201d Updated June 13, 2014. http://www.cdc.gov/parasites/cyclosporiasis/health_professionals/hp-faqs.html. \n\n Some individuals do not develop signs or symptoms. Those who do may exhibit explosive and watery diarrhea, fever, nausea, vomiting, cramps, loss of appetite, fatigue, and bloating. These symptoms may last for months without treatment. Trimethoprim-sulfamethoxazole is the recommended treatment. \n\n Microscopic examination is used for diagnosis. A stool  O&P  examination may be helpful. The oocysts have a distinctive blue halo when viewed using ultraviolet fluorescence microscopy ( Figure 24.30 ). \n\n Check Your Understanding \n\n Which protozoan GI infections are common in the United States? \n\n Disease Profile Protozoan Gastrointestinal Infections Protozoan GI infections are generally transmitted through contaminated food or water, triggering diarrhea and vomiting that can lead to dehydration. Rehydration therapy is an important aspect of treatment, but most protozoan GI infections can also be treated with drugs that target protozoans. \n 24.6   Helminthic Infections of the Gastrointestinal Tract \n\n Learning Objectives \n\n Identify the most common helminths that cause infections of the GI tract \n\n Compare the major characteristics of specific helminthic diseases affecting GI tract \n\n Helminths are widespread intestinal parasites. These parasites can be divided into three common groups: round-bodied worms also described as  nematodes , flat-bodied worms that are segmented (also described as  cestodes ), and flat-bodied worms that are non-segmented (also described as  trematodes ). The nematodes include  roundworms ,  pinworms ,  hookworms , and  whipworms . Cestodes include beef, pork, and fish  tapeworms . Trematodes are collectively called  flukes  and more uniquely identified with the body site where the adult flukes are located. Although infection can have serious consequences, many of these parasites are so well adapted to the human host that there is little obvious disease. \n\n Ascariasis \n\n Infections caused by the large nematode roundworm  Ascaris lumbricoides , a soil-transmitted helminth, are called  ascariasis . Over 800 million to 1 billion people are estimated to be infected worldwide. 20  Infections are most common in warmer climates and at warmer times of year. At present, infections are uncommon in the United States. The eggs of the worms are transmitted through contaminated food and water. This may happen if food is grown in contaminated soil, including when manure is used as fertilizer. 20 Centers for Disease Control and Prevention. \u201cParasites\u2013Ascariasis.\u201d Updated May 24, 2016. http://www.cdc.gov/parasites/ascariasis/index.html. \n\n When an individual consumes embryonated eggs (those with a developing embryo), the eggs travel to the intestine and the larvae are able to hatch.  Ascaris  is able to produce proteases that allow for penetration and degradation of host tissue. The juvenile worms can then enter the circulatory system and migrate to the lungs where they enter the alveoli (air sacs). From here they crawl to the pharynx and then follow the gut lumen to return to the small intestine, where they mature into adult  roundworms . Females in the host will produce and release eggs that leave the host via feces. In some cases, the worms can block ducts such as those of the  pancreas  or  gallbladder . \n\n The infection is commonly asymptomatic. When signs and symptoms are present, they include shortness of breath, cough, nausea, diarrhea, blood in the stool, abdominal pain, weight loss, and fatigue. The roundworms may be visible in the stool. In severe cases, children with substantial infections may experience intestinal blockage. \n\n The eggs can be identified by microscopic examination of the stool ( Figure 24.32 ). In some cases, the worms themselves may be identified if coughed up or excreted in stool. They can also sometimes be identified by X-rays, ultrasounds, or MRIs. \n\n Ascariasis is self-limiting, but can last one to two years because the worms can inhibit the body\u2019s inflammatory response through glycan gimmickry (see  Virulence Factors of Eukaryotic Pathogens ). The first line of treatment is  mebendazole  or  albendazole . In some severe cases, surgery may be required. \n\n Check Your Understanding \n\n Describe the route by which  A. lumbricoides  reaches the host\u2019s intestines as an adult worm. \n\n Hookworm \n\n Two species of nematode worms are associated with  hookworm infection . Both species are found in the Americas, Africa, and Asia.  Necator americanus  is found predominantly in the United States and Australia. Another species,  Ancylostoma doudenale , is found in southern Europe, North Africa, the Middle East, and Asia. \n\n The eggs of these species develop into larvae in soil contaminated by dog or cat feces. These larvae can penetrate the skin. After traveling through the venous circulation, they reach the lungs. When they are coughed up, they are then swallowed and can enter the intestine and develop into mature adults. At this stage, they attach to the wall of the intestine, where they feed on blood and can potentially cause anemia. Signs and symptoms include cough, an itchy rash, loss of appetite, abdominal pain, and diarrhea. In children, hookworms can affect physical and cognitive growth. \n\n Some hookworm species, such as  Ancylostoma braziliense  that is commonly found in animals such as cats and dogs, can penetrate human skin and migrate, causing  cutaneous larva migrans , a skin disease caused by the larvae of hookworms. As they move across the skin, in the subcutaneous tissue, pruritic tracks appear ( Figure 24.33 ). \n\n The infection is diagnosed using microscopic examination of the stool, allowing for observation of eggs in the feces. Medications such as  albendazole ,  mebendazole , and  pyrantel pamoate  are used as needed to treat systemic infection. In addition to systemic medication for symptoms associated with cutaneous larva migrans, topical  thiabendazole  is applied to the affected areas. \n\n Strongyloidiasis \n\n Strongyloidiasis  is generally caused by  Strongyloides stercoralis , a soil-transmitted  helminth  with both free-living and parasitic forms. In the parasitic form, the larvae of these  nematodes  generally penetrate the body through the skin, especially through bare feet, although transmission through organ transplantation or at facilities like day-care centers can also occur. When excreted in the stool, larvae can become free-living adults rather than developing into the parasitic form. These free-living worms reproduce, laying eggs that hatch into larvae that can develop into the parasitic form. In the parasitic life cycle, infective larvae enter the skin, generally through the feet. The larvae reach the circulatory system, which allows them to travel to the alveolar spaces of the lungs. They are transported to the  pharynx  where, like many other helminths, the infected patient coughs them up and swallows them again so that they return to the  intestine . Once they reach the intestine, females live in the epithelium and produce eggs that develop asexually, unlike the free-living forms, which use sexual reproduction. The larvae may be excreted in the stool or can reinfect the host by entering the tissue of the intestines and skin around the anus, which can lead to chronic infections. \n\n The condition is generally asymptomatic, although severe symptoms can develop after treatment with corticosteroids for asthma or chronic obstructive pulmonary disease, or following other forms of immunosuppression. When the immune system is suppressed, the rate of autoinfection increases, and huge amounts of larvae migrate to organs throughout the body. \n\n Signs and symptoms are generally nonspecific. The condition can cause a rash at the site of skin entry, cough (dry or with blood), fever, nausea, difficulty breathing, bloating, pain, heartburn, and, rarely, arthritis, or cardiac or kidney complications. Disseminated strongyloidiasis or hyperinfection is a life-threatening form of the disease that can occur, usually following immunosuppression such as that caused by glucocorticoid treatment (most commonly), with other immunosuppressive medications, with HIV infection, or with malnutrition. \n\n As with other helminths, direct examination of the stool is important in diagnosis. Ideally, this should be continued over seven days. Serological testing, including antigen testing, is also available. These can be limited by cross-reactions with other similar parasites and by the inability to distinguish current from resolved infection. Ivermectin is the preferred treatment, with  albendazole  as a secondary option. \n\n Check Your Understanding \n\n How does an acute infection of  S. stercoralis  become chronic? \n\n Pinworms (Enterobiasis) \n\n Enterobius vermicularis , commonly called  pinworms , are tiny (2\u201313 mm) nematodes that cause  enterobiasis . Of all helminthic infections, enterobiasis is the most common in the United States, affecting as many as one-third of American children. 21  Although the signs and symptoms are generally mild, patients may experience abdominal pain and insomnia from itching of the perianal region, which frequently occurs at night when worms leave the anus to lay eggs. The itching contributes to transmission, as the disease is transmitted through the fecal-oral route. When an infected individual scratches the anal area, eggs may get under the fingernails and later be deposited near the individual\u2019s mouth, causing reinfection, or on fomites, where they can be transferred to new hosts. After being ingested, the larvae hatch within the small intestine and then take up residence in the colon and develop into adults. From the colon, the female adult exits the body at night to lay eggs ( Figure 24.34 ). 21 \u201cRoundworms.\u201d  University of Maryland Medical Center Medical Reference Guide . Last reviewed December 9, 2014. https://umm.edu/health/medical/altmed/condition/roundworms. \n\n Infection is diagnosed in any of three ways. First, because the worms emerge at night to lay eggs, it is possible to inspect the perianal region for worms while an individual is asleep. An alternative is to use transparent tape to remove eggs from the area around the anus first thing in the morning for three days to yield eggs for microscopic examination. Finally, it may be possible to detect eggs through examination of samples from under the fingernails, where eggs may lodge due to scratching. Once diagnosis has been made,  mebendazole ,  albendazole , and  pyrantel pamoate  are effective for treatment. \n\n Trichuriasis \n\n The nematode whipworm  Trichuris trichiura  is a parasite that is transmitted by ingestion from soil-contaminated hands or food and causes  trichuriasis . Infection is most common in warm environments, especially when there is poor sanitation and greater risk of fecal contamination of soil, or when food is grown in soil using manure as a fertilizer. The signs and symptoms may be minimal or nonexistent. When a substantial infection develops, signs and symptoms include painful, frequent diarrhea that may contain mucus and blood. It is possible for the infection to cause rectal prolapse, a condition in which a portion of the rectum becomes detached from the inside of the body and protrudes from the anus ( Figure 24.35 ). Severely infected children may experience reduced growth and their cognitive development may be affected. \n\n When fertilized eggs are ingested, they travel to the intestine and the larvae emerge, taking up residence in the walls of the colon and cecum. They attach themselves with part of their bodies embedded in the mucosa. The larvae mature and live in the cecum and ascending colon. After 60 to 70 days, females begin to lay 3000 to 20,000 eggs per day. \n\n Diagnosis involves examination of the feces for the presence of eggs. It may be necessary to use concentration techniques and to collect specimens on multiple days. Following diagnosis, the infection may be treated with  mebendazole ,  albendazole , or  ivermectin . \n\n Trichinosis \n\n Trichinosis  ( trichenellosis ) develops following consumption of food that contains  Trichinella   spiralis  (most commonly) or other  Trichinella  species. These microscopic nematode worms are most commonly transmitted in meat, especially pork, that has not been cooked thoroughly.  T. spiralis  larvae in meat emerge from cysts when exposed to acid and pepsin in the stomach. They develop into mature adults within the large intestine. The larvae produced in the large intestine are able to migrate into the muscles mechanically via the stylet of the parasite, forming cysts. Muscle proteins are reduced in abundance or undetectable in cells that contain  Trichinella  (nurse cells). Animals that ingest the cysts from other animals can later develop infection ( Figure 24.36 ). \n\n Although infection may be asymptomatic, symptomatic infections begin within a day or two of consuming the nematodes. Abdominal symptoms arise first and can include diarrhea, constipation, and abdominal pain. Other possible symptoms include headache, light sensitivity, muscle pain, fever, cough, chills, and conjunctivitis. More severe symptoms affecting motor coordination, breathing, and the heart sometimes occur. It may take months for the symptoms to resolve, and the condition is occasionally fatal. Mild cases may be mistaken for influenza or similar conditions. \n\n Infection is diagnosed using clinical history, muscle biopsy to look for larvae, and serological testing, including immunoassays. Enzyme immunoassay is the most common test. It is difficult to effectively treat larvae that have formed cysts in the muscle, although medications may help. It is best to begin treatment as soon as possible because medications such as  mebendazole  and  albendazole  are effective in killing only the adult worms in the intestine. Steroids may be used to reduce inflammation if larvae are in the muscles. \n\n Check Your Understanding \n\n Compare and contrast the transmissions of pinworms and whipworms. \n\n Tapeworms (Taeniasis) \n\n Taeniasis  is a  tapeworm  infection, generally caused by pork ( Taenia   solium ), beef ( Taenia saginata ), and Asian ( Taenia asiatica ) tapeworms found in undercooked meat. Consumption of raw or undercooked fish, including contaminated sushi, can also result in infection from the fish tapeworm ( Diphyllobothrium   latum ). Tapeworms are flatworms ( cestodes ) with multiple body segments and a head called a  scolex  that attaches to the intestinal wall. Tapeworms can become quite large, reaching 4 to 8 meters long ( Figure 24.37 ).  Figure 5.23  illustrates the life cycle of a tapeworm. \n\n Tapeworms attached to the intestinal wall produce eggs that are excreted in feces. After ingestion by animals, the eggs hatch and the larvae emerge. They may take up residence in the intestine, but can sometimes move to other tissues, especially muscle or brain tissue. When  T. solium  larvae form cysts in tissue, the condition is called  cysticercosis . This occurs through ingestion of eggs via the fecal-oral route, not through consumption of undercooked meat. It can develop in the muscles, eye (ophthalmic cysticercosis), or brain (neurocysticercosis). \n\n Infections may be asymptomatic or they may cause mild gastrointestinal symptoms such as epigastric discomfort, nausea, diarrhea, flatulence, or hunger pains. It is also common to find visible tapeworm segments passed in the stool. In cases of cysticercosis, symptoms differ depending upon where the cysts become established. Neurocysticercosis can have severe, life-threatening consequences and is associated with headaches and seizures because of the presence of the tapeworm larvae encysted in the brain. Cysts in muscles may be asymptomatic, or they may be painful. \n\n To diagnose these conditions, microscopic analysis of stool samples from three separate days is generally recommended. Eggs or body segments, called proglottids, may be visible in these samples. Molecular methods have been developed but are not yet widely available. Imaging, such as CT and MRI, may be used to detect cysts. Praziquantel or  niclosamide  are used for treatment. \n\n Micro Connections What\u2019s in Your Sushi Roll? As foods that contain raw fish, such as sushi and sashimi, continue to increase in popularity throughout the world, so does the risk of parasitic infections carried by raw or undercooked fish.  Diphyllobothrium  species, known as fish tapeworms, is one of the main culprits. Evidence suggests that undercooked salmon caused an increase in  Diphyllobothrium  infections in British Columbia in the 1970s and early 1980s. In the years since, the number of reported cases in the United States and Canada has been low, but it is likely that cases are underreported because the causative agent is not easily recognized. 22 22 Nancy Craig. \u201cFish Tapeworm and Sushi.\u201d  Canadian Family Physician  58 (2012) 6: pp. 654\u2013658. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3374688/. \n\n Another illness transmitted in undercooked fish is herring worm disease, or anisakiasis, in which nematodes attach to the epithelium of the esophagus, stomach, or small intestine. Cases have increased around the world as raw fish consumption has increased. 23 23 Centers for Disease Control and Prevention. \u201cAnisakiasis FAQs.\u201d Updated November 12, 2012. http://www.cdc.gov/parasites/anisakiasis/faqs.html. \n\n Although the message may be unpopular with sushi lovers, fish should be frozen or cooked before eating. The extremely low and high temperatures associated with freezing and cooking kill worms and larvae contained in the meat, thereby preventing infection. Ingesting fresh, raw sushi may make for a delightful meal, but it also entails some risk. \n\n Hydatid Disease \n\n Another cestode,  Echinococcus granulosus , causes a serious infection known as  hydatid disease  ( cystic echinococcosis ).  E. granulosus  is found in dogs (the definitive host), as well as several intermediate hosts (sheep, pigs, goats, cattle). The cestodes are transmitted through eggs in the feces from infected animals, which can be an occupational hazard for individuals who work in agriculture. \n\n Once ingested,  E. granulosus  eggs hatch in the small intestine and release the larvae. The larvae invade the intestinal wall to gain access to the circulatory system. They form hydatid cysts in internal organs, especially in the lungs and liver, that grow slowly and are often undetected until they become large. If the cysts burst, a severe allergic reaction (anaphylaxis) may occur. \n\n Cysts present in the liver can cause enlargement of the liver, nausea, vomiting, right epigastric pain, pain in the right upper quadrant, and possible allergic signs and symptoms. Cysts in the lungs can lead to alveolar disease. Abdominal pain, weight loss, pain, and malaise may occur, and inflammatory processes develop. \n\n E. granulosus  can be detected through imaging (ultrasonography, CT, MRI) that shows the cysts. Serologic tests, including ELISA and indirect hemagglutinin tests, are used. Cystic disease is most effectively treated with surgery to remove cysts, but other treatments are also available, including chemotherapy with anti-helminthic drugs ( albendazole  or  mebendazole ). \n\n Check Your Understanding \n\n Describe the risks of the cysts associated with taeniasis and hydatid disease. \n\n Flukes \n\n Flukes are flatworms that have a leaflike appearance. They are a type of trematode worm, and multiple species are associated with disease in humans. The most common are liver flukes and intestinal flukes ( Figure 24.38 ). \n\n Liver Flukes \n\n The  liver flukes  are several species of trematodes that cause disease by interfering with the bile duct.  Fascioliasis  is caused by  Fasciola   hepatica  and  Fasciola gigantica  in contaminated raw or undercooked aquatic plants (e.g., watercress). In  Fasciola  infection, adult flukes develop in the bile duct and release eggs into the feces. Clonochiasis is caused by  Clonorchis sinensis  in contaminated freshwater fish. Other flukes, such as  Opisthorchis viverrini  (found in fish) and  Opisthorchis felineus  (found in freshwater snails), also cause infections. Liver flukes spend part of their life cycle in freshwater snails, which serve as an intermediate host. Humans are typically infected after eating aquatic plants contaminated by the infective larvae after they have left the snail. Once they reach the human intestine, they migrate back to the bile duct, where they mature. The life cycle is similar for the other infectious liver flukes, (see  Figure 5.22 ). \n\n When  Fasciola  flukes cause acute infection, signs and symptoms include nausea, vomiting, abdominal pain, rash, fever, malaise, and breathing difficulties. If the infection becomes chronic, with adult flukes living in the bile duct, then cholangitis, cirrhosis, pancreatitis, cholecystitis, and gallstones may develop. Symptoms are similar for infections by other liver flukes. Cholangiocarcinoma can occur from  C. sinensis  infection. The  Opisthorchis  species can also be associated with cancer development. \n\n Diagnosis is accomplished using patient history and examination of samples from feces or other samples (such as vomitus). Because the eggs may appear similar, immunoassay techniques are available that can help distinguish species. The preferred treatment for fascioliasis is  triclabendazole .  C. sinensis  and  Opisthorchis  spp. infections are treated with  praziquantel  or  albendazole . \n\n Intestinal Flukes \n\n The  intestinal flukes  are trematodes that develop in the intestines. Many, such as  Fasciolopsis buski , which causes  fasciolopsiasis , are closely related to liver flukes. Intestinal flukes are ingested from contaminated aquatic plants that have not been properly cooked. When the cysts are consumed, the larvae emerge in the duodenum and develop into adults while attached to the intestinal epithelium. The eggs are released in stool. \n\n Intestinal fluke infection is often asymptomatic, but some cases may involve mild diarrhea and abdominal pain. More severe symptoms such as vomiting, nausea, allergic reactions, and anemia can sometimes occur, and high parasite loads may sometimes lead to intestinal obstructions. \n\n Diagnosis is the same as with liver flukes: examination of feces or other samples and immunoassay. Praziquantel is used to treat infections caused by intestinal flukes. \n\n Check Your Understanding \n\n How are flukes transmitted? \n\n Disease Profile Helminthic Gastrointestinal Infections Numerous helminths are capable of colonizing the GI tract. Many such infections are asymptomatic, but others may cause signs and symptoms ranging from mild GI stress to severe systemic infection. Helminths have complex and unique life cycles that dictate their specific modes of transmission. Most helminthic infections can be treated with medications. \n\n Clinical Focus Resolution Carli\u2019s doctor explained that she had bacterial gastroenteritis caused by  Salmonella  bacteria. The source of these bacteria was likely the undercooked egg. Had the egg been fully cooked, the high temperature would have been sufficient to kill any  Salmonella  in or on the egg. In this case, enough bacteria survived to cause an infection once the egg was eaten. \n\n Carli\u2019s signs and symptoms continued to worsen. Her fever became higher, her vomiting and diarrhea continued, and she began to become dehydrated. She felt thirsty all the time and had continual abdominal cramps. Carli\u2019s doctor treated her with intravenous fluids to help with her dehydration, but did not prescribe antibiotics. Carli\u2019s parents were confused because they thought a bacterial infection should always be treated with antibiotics. \n\n The doctor explained that the worst medical problem for Carli was dehydration. Except in the most vulnerable and sick patients, such as those with HIV/AIDS, antibiotics do not reduce recovery time or improve outcomes in  Salmonella  infections. In fact, antibiotics can actually delay the natural excretion of bacteria from the body. Rehydration therapy replenishes lost fluids, diminishing the effects of dehydration and improving the patient\u2019s condition while the infection resolves. \n\n After two days of rehydration therapy, Carli\u2019s signs and symptoms began to fade. She was still somewhat thirsty, but the amount of urine she passed became larger and the color lighter. She stopped vomiting. Her fever was gone, and so was the diarrhea. At that point, stool analysis found very few  Salmonella  bacteria. In one week, Carli was discharged as fully recovered. \n\n Go back to the  previous  Clinical Focus box. ", "questions": [{"question": {"question_id": "fs-id1167663737442", "question_text": "Which of the following is NOT a way the normal microbiota of the intestine helps to prevent infection?", "question_choices": ["It produces acids that lower the pH of the stomach.", "It speeds up the process by which microbes are flushed from the digestive tract.", "It consumes food and occupies space, outcompeting potential pathogens.", "It generates large quantities of oxygen that kill anaerobic pathogens."], "cloze_format": "A false statement about the way the normal microbiota of the intestine helps to prevent infection is that ___ .", "normal_format": "Which of the following is NOT a way the normal microbiota of the intestine helps to prevent infection?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The constant movement of materials through the gastrointestinal tract also helps to move transient pathogens out of the body . Finally , the normal microbiota provides an additional barrier to infection via a variety of mechanisms . For example , these organisms outcompete potential pathogens for space and nutrients within the intestine . The stomach is an extremely acidic environment ( pH 1.5 \u2013 3.5 ) due to the gastric juices that break down food and kill many ingested microbes ; this helps prevent infection from pathogens . These microbes all aid in digestion and contribute to the production of feces , the waste excreted from the digestive tract , and flatus , the gas produced from microbial fermentation of undigested food .", "hl_context": "<hl> The constant movement of materials through the gastrointestinal tract also helps to move transient pathogens out of the body . <hl> In fact , feces are composed of approximately 25 % microbes , 25 % sloughed epithelial cells , 25 % mucus , and 25 % digested or undigested food . <hl> Finally , the normal microbiota provides an additional barrier to infection via a variety of mechanisms . <hl> <hl> For example , these organisms outcompete potential pathogens for space and nutrients within the intestine . <hl> This is known as competitive exclusion . Members of the microbiota may also secrete protein toxins known as bacteriocins that are able to bind to specific receptors on the surface of susceptible bacteria . The environment of most of the GI tract is harsh , which serves two purposes : digestion and immunity . <hl> The stomach is an extremely acidic environment ( pH 1.5 \u2013 3.5 ) due to the gastric juices that break down food and kill many ingested microbes ; this helps prevent infection from pathogens . <hl> The environment in the small intestine is less harsh and is able to support microbial communities . Microorganisms present in the small intestine can include lactobacilli , diptherioids and the fungus Candida . On the other hand , the large intestine ( colon ) contains a diverse and abundant microbiota that is important for normal function . These microbes include Bacteriodetes ( especially the genera Bacteroides and Prevotella ) and Firmicutes ( especially members of the genus Clostridium ) . Methanogenic archaea and some fungi are also present , among many other species of bacteria . <hl> These microbes all aid in digestion and contribute to the production of feces , the waste excreted from the digestive tract , and flatus , the gas produced from microbial fermentation of undigested food . <hl> They can also produce valuable nutrients . For example , lactic acid bacteria such as bifidobacteria can synthesize vitamins , such as vitamin B12 , folate , and riboflavin , that humans cannot synthesize themselves . E . coli found in the intestine can also break down food and help the body produce vitamin K , which is important for blood coagulation ."}, {"question": {"question_id": "fs-id1167663629180", "question_text": "What types of microbes live in the intestines?", "question_choices": ["Diverse species of bacteria, archaea, and fungi, especially Bacteroides and Firmicutes bacteria", "A narrow range of bacteria, especially Firmicutes", "A narrow range of bacteria and fungi, especially Bacteroides", "Archaea and fungi only"], "cloze_format": "The microbes that live in the intestines are ___ .", "normal_format": "What types of microbes live in the intestines?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "Microorganisms present in the small intestine can include lactobacilli , diptherioids and the fungus Candida . On the other hand , the large intestine ( colon ) contains a diverse and abundant microbiota that is important for normal function . These microbes include Bacteriodetes ( especially the genera Bacteroides and Prevotella ) and Firmicutes ( especially members of the genus Clostridium ) . Methanogenic archaea and some fungi are also present , among many other species of bacteria . The digestive system contains normal microbiota , including archaea , bacteria , fungi , protists , and even viruses .", "hl_context": "The environment of most of the GI tract is harsh , which serves two purposes : digestion and immunity . The stomach is an extremely acidic environment ( pH 1.5 \u2013 3.5 ) due to the gastric juices that break down food and kill many ingested microbes ; this helps prevent infection from pathogens . The environment in the small intestine is less harsh and is able to support microbial communities . <hl> Microorganisms present in the small intestine can include lactobacilli , diptherioids and the fungus Candida . <hl> <hl> On the other hand , the large intestine ( colon ) contains a diverse and abundant microbiota that is important for normal function . <hl> <hl> These microbes include Bacteriodetes ( especially the genera Bacteroides and Prevotella ) and Firmicutes ( especially members of the genus Clostridium ) . <hl> <hl> Methanogenic archaea and some fungi are also present , among many other species of bacteria . <hl> These microbes all aid in digestion and contribute to the production of feces , the waste excreted from the digestive tract , and flatus , the gas produced from microbial fermentation of undigested food . They can also produce valuable nutrients . For example , lactic acid bacteria such as bifidobacteria can synthesize vitamins , such as vitamin B12 , folate , and riboflavin , that humans cannot synthesize themselves . E . coli found in the intestine can also break down food and help the body produce vitamin K , which is important for blood coagulation . <hl> The digestive system contains normal microbiota , including archaea , bacteria , fungi , protists , and even viruses . <hl> Because this microbiota is important for normal functioning of the digestive system , alterations to the microbiota by antibiotics or diet can be harmful . Additionally , the introduction of pathogens to the GI tract can cause infections and diseases . In this section , we will review the microbiota found in a healthy digestive tract and the general signs and symptoms associated with oral and GI infections ."}, {"question": {"question_id": "fs-id1167661507142", "question_text": "What pathogen is the most important contributor to biofilms in plaque?", "question_choices": ["Staphylococcus aureus", "Streptococcus mutans", "Escherichia coli", "Clostridium difficile"], "cloze_format": "The ___ pathogen is the most important contributor to biofilms in plaque.", "normal_format": "What pathogen is the most important contributor to biofilms in plaque?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "For example , Streptococcus in the mouth , the main contributor to biofilms on teeth , tartar , and dental caries , can spread throughout the body when there is damage to the tissues inside the mouth , as can happen during dental work . The most important cariogenic species in these biofilms is Streptococcus mutans .", "hl_context": "Additionally , poor oral health can contribute to the development of disease . Increased bacterial growth in the mouth can cause inflammation and infection in other parts of the body . <hl> For example , Streptococcus in the mouth , the main contributor to biofilms on teeth , tartar , and dental caries , can spread throughout the body when there is damage to the tissues inside the mouth , as can happen during dental work . <hl> S . mutans produces a surface adhesin known as P1 , which binds to salivary agglutinin on the surface of the tooth . P1 can also bind to extracellular matrix proteins including fibronectin and collagen . When Streptococcus enters the bloodstream as a result of tooth brushing or dental cleaning , it causes inflammation that can lead to the accumulation of plaque in the arteries and contribute to the development of atherosclerosis , a condition associated with cardiovascular disease , heart attack , and stroke . In some cases , bacteria that spread through the blood vessels can lodge in the heart and cause endocarditis ( an example of a focal infection ) . Tooth decay results from the metabolic activity of microbes that live on the teeth . A layer of proteins and carbohydrates forms when clean teeth come into contact with saliva . Microbes are attracted to this food source and form a biofilm called plaque . <hl> The most important cariogenic species in these biofilms is Streptococcus mutans . <hl> When sucrose , a disaccharide sugar from food , is broken down by bacteria in the mouth , glucose and fructose are produced . The glucose is used to make dextran , which is part of the extracellular matrix of the biofilm . Fructose is fermented , producing organic acids such as lactic acid . These acids dissolve the minerals of the tooth , including enamel , even though it is the hardest material in the body . The acids work even more quickly on exposed dentin ( Figure 24.7 ) . Over time , the plaque biofilm can become thick and eventually calcify . When a heavy plaque deposit becomes hardened in this way , it is called tartar or dental calculus ( Figure 24.8 ) . These substantial plaque biofilms can include a variety of bacterial species , including Streptococcus and Actinomyces species ."}, {"question": {"question_id": "fs-id1167661432517", "question_text": "What type of organism causes thrush?", "question_choices": ["a bacterium", "a virus", "a fungus", "a protozoan"], "cloze_format": "___ is a type of organism that causes thrush.", "normal_format": "What type of organism causes thrush?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The yeast Candida is part of the normal human microbiota , but overgrowths , especially of Candida albicans , can lead to infections in several parts of the body . When Candida infection develops in the oral cavity , it is called oral thrush . Microorganisms present in the small intestine can include lactobacilli , diptherioids and the fungus Candida .", "hl_context": "<hl> The yeast Candida is part of the normal human microbiota , but overgrowths , especially of Candida albicans , can lead to infections in several parts of the body . <hl> <hl> When Candida infection develops in the oral cavity , it is called oral thrush . <hl> Oral thrush is most common in infants because they do not yet have well developed immune systems and have not acquired the robust normal microbiota that keeps Candida in check in adults . Oral thrush is also common in immunodeficient patients and is a common infection in patients with AIDS . The environment of most of the GI tract is harsh , which serves two purposes : digestion and immunity . The stomach is an extremely acidic environment ( pH 1.5 \u2013 3.5 ) due to the gastric juices that break down food and kill many ingested microbes ; this helps prevent infection from pathogens . The environment in the small intestine is less harsh and is able to support microbial communities . <hl> Microorganisms present in the small intestine can include lactobacilli , diptherioids and the fungus Candida . <hl> On the other hand , the large intestine ( colon ) contains a diverse and abundant microbiota that is important for normal function . These microbes include Bacteriodetes ( especially the genera Bacteroides and Prevotella ) and Firmicutes ( especially members of the genus Clostridium ) . Methanogenic archaea and some fungi are also present , among many other species of bacteria . These microbes all aid in digestion and contribute to the production of feces , the waste excreted from the digestive tract , and flatus , the gas produced from microbial fermentation of undigested food . They can also produce valuable nutrients . For example , lactic acid bacteria such as bifidobacteria can synthesize vitamins , such as vitamin B12 , folate , and riboflavin , that humans cannot synthesize themselves . E . coli found in the intestine can also break down food and help the body produce vitamin K , which is important for blood coagulation ."}, {"question": {"question_id": "fs-id1167663887046", "question_text": "In mumps, what glands swell to produce the disease\u2019s characteristic appearance?", "question_choices": ["the sublingual glands", "the gastric glands", "the parotid glands", "the submandibular glands"], "cloze_format": "In mumps, the glands that swell to produce the disease\u2019s characteristic appearance are ___ .", "normal_format": "In mumps, what glands swell to produce the disease\u2019s characteristic appearance?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "bloom": null, "hl_sentences": "The viral disease mumps is an infection of the parotid glands , the largest of the three pairs of salivary glands ( Figure 24.3 ) .", "hl_context": "<hl> The viral disease mumps is an infection of the parotid glands , the largest of the three pairs of salivary glands ( Figure 24.3 ) . <hl> The causative agent is mumps virus ( MuV ) , a paramyxovirus with an envelope that has hemagglutinin and neuraminidase spikes . A fusion protein located on the surface of the envelope helps to fuse the viral envelope to the host cell plasma membrane ."}, {"question": {"question_id": "fs-id1167661369825", "question_text": "Which of the following is true of HSV-1?", "question_choices": ["It causes oral thrush in immunocompromised patients.", "Infection is generally self-limiting.", "It is a bacterium.", "It is usually treated with amoxicillin."], "cloze_format": "Of HSV-1, it is a true statement that ___ .", "normal_format": "Which of the following is true of HSV-1?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "As described in Viral Infections of the Skin and Eyes , infections by herpes simplex virus type 1 ( HSV - 1 ) frequently manifest as oral herpes , also called acute herpes labialis and characterized by cold sores on the lips , mouth , or gums . HSV - 1 can also cause acute herpetic gingivostomatitis , a condition that results in ulcers of the mucous membranes inside the mouth ( Figure 24.12 ) . Herpetic gingivostomatitis is normally self-limiting except in immunocompromised patients .", "hl_context": "<hl> As described in Viral Infections of the Skin and Eyes , infections by herpes simplex virus type 1 ( HSV - 1 ) frequently manifest as oral herpes , also called acute herpes labialis and characterized by cold sores on the lips , mouth , or gums . <hl> <hl> HSV - 1 can also cause acute herpetic gingivostomatitis , a condition that results in ulcers of the mucous membranes inside the mouth ( Figure 24.12 ) . <hl> <hl> Herpetic gingivostomatitis is normally self-limiting except in immunocompromised patients . <hl> Like oral herpes , the infection is generally diagnosed through clinical examination , but cultures or biopsies may be obtained if other signs or symptoms suggest the possibility of a different causative agent . If treatment is needed , mouthwashes or antiviral medications such as acyclovir , famciclovir , or valacyclovir may be used ."}, {"question": {"question_id": "fs-id1167660123439", "question_text": "Which type of E. coli infection can be severe with life-threatening consequences such as hemolytic uremic syndrome?", "question_choices": ["ETEC", "EPEC", "EHEC", "EIEC"], "cloze_format": "The type of E. coli infection that can be severe with life-threatening consequences such as hemolytic uremic syndrome is ___.", "normal_format": "Which type of E. coli infection can be severe with life-threatening consequences such as hemolytic uremic syndrome?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "bloom": null, "hl_sentences": "EHEC can cause disease ranging from relatively mild to life-threatening . Symptoms include bloody diarrhea with severe cramping , but no fever . Although it is often self-limiting , it can lead to hemorrhagic colitis and profuse bleeding .", "hl_context": "<hl> EHEC can cause disease ranging from relatively mild to life-threatening . <hl> <hl> Symptoms include bloody diarrhea with severe cramping , but no fever . <hl> <hl> Although it is often self-limiting , it can lead to hemorrhagic colitis and profuse bleeding . <hl> One possible complication is HUS . Diagnosis involves culture , often using MacConkey with sorbitol agar to differentiate between E . coli O157 : H7 , which does not ferment sorbitol , and other less virulent strains of E . coli that can ferment sorbitol ."}, {"question": {"question_id": "fs-id1167660273629", "question_text": "Which species of Shigella has a type that produces Shiga toxin?", "question_choices": ["S. boydii", "S. flexneri", "S. dysenteriae", "S. sonnei"], "cloze_format": "The specie of Shigella ___ has a type that produces Shiga toxin.", "normal_format": "Which species of Shigella has a type that produces Shiga toxin?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "bloom": null, "hl_sentences": "S . dysenteriae type 1 is able to produce Shiga toxin , which targets the endothelial cells of small blood vessels in the small and large intestine by binding to a glycosphingolipid .", "hl_context": "<hl> S . dysenteriae type 1 is able to produce Shiga toxin , which targets the endothelial cells of small blood vessels in the small and large intestine by binding to a glycosphingolipid . <hl> Once inside the endothelial cells , the toxin targets the large ribosomal subunit , thus affecting protein synthesis of these cells . Hemorrhaging and lesions in the colon can result . The toxin can target the kidney \u2019 s glomerulus , the blood vessels where filtration of blood in the kidney begins , thus resulting in HUS ."}, {"question": {"question_id": "fs-id1167660271315", "question_text": "Which type of bacterium produces an A-B toxin?", "question_choices": ["Salmonella", "Vibrio cholera", "ETEC", "Shigella dysenteriae"], "cloze_format": "The type of bacterium that produces an A-B toxin is ___.", "normal_format": "Which type of bacterium produces an A-B toxin?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Because V . cholerae is killed by stomach acid , relatively large doses are needed for a few microbial cells to survive to reach the intestines and cause infection . The motile cells travel through the mucous layer of the intestines , where they attach to epithelial cells and release cholera enterotoxin . The toxin is an A-B toxin with activity through adenylate cyclase ( see Virulence Factors of Bacterial and Viral Pathogens ) .", "hl_context": "<hl> Because V . cholerae is killed by stomach acid , relatively large doses are needed for a few microbial cells to survive to reach the intestines and cause infection . <hl> <hl> The motile cells travel through the mucous layer of the intestines , where they attach to epithelial cells and release cholera enterotoxin . <hl> <hl> The toxin is an A-B toxin with activity through adenylate cyclase ( see Virulence Factors of Bacterial and Viral Pathogens ) . <hl> Within the intestinal cell , cyclic AMP ( cAMP ) levels increase , which activates a chloride channel and results in the release of ions into the intestinal lumen . This increase in osmotic pressure in the lumen leads to water also entering the lumen . As the water and electrolytes leave the body , it causes rapid dehydration and electrolyte imbalance . Diarrhea is so profuse that it is often called \u201c rice water stool , \u201d and patients are placed on cots with a hole in them to monitor the fluid loss ( Figure 24.19 ) ."}, {"question": {"question_id": "fs-id1167663905538", "question_text": "Which form of hepatitisvirus can only infect an individual who is already infected with another hepatitisvirus?", "question_choices": ["HDV", "HAV", "HBV", "HEV"], "cloze_format": "The form of hepatitisvirus that can only infect an individual who is already infected with another hepatitisvirus is ___.", "normal_format": "Which form of hepatitisvirus can only infect an individual who is already infected with another hepatitisvirus?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "bloom": null, "hl_sentences": "HDV is uncommon in the United States and only occurs in individuals who are already infected with HBV , which it requires for replication .", "hl_context": "<hl> HDV is uncommon in the United States and only occurs in individuals who are already infected with HBV , which it requires for replication . <hl> Therefore , vaccination against HBV is also protective against HDV infection . HDV is transmitted through contact with infected blood ."}, {"question": {"question_id": "fs-id1167661323868", "question_text": "Which cause of viral gastroenteritis commonly causes projectile vomiting?", "question_choices": ["hepatitisvirus", "Astroviruses", "Rotavirus", "Noroviruses"], "cloze_format": "The cause of viral gastroenteritis commonly causes projectile vomiting is the ___.", "normal_format": "Which cause of viral gastroenteritis commonly causes projectile vomiting?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "bloom": null, "hl_sentences": "The signs and symptoms of norovirus infection are similar to those for rotavirus , with watery diarrhea , mild cramps , and fever . Additionally , these viruses sometimes cause projectile vomiting .", "hl_context": "<hl> The signs and symptoms of norovirus infection are similar to those for rotavirus , with watery diarrhea , mild cramps , and fever . <hl> <hl> Additionally , these viruses sometimes cause projectile vomiting . <hl> The illness is usually relatively mild , develops 12 to 48 hours after exposure , and clears within a couple of days without treatment . However , dehydration may occur ."}, {"question": {"question_id": "fs-id1167662499528", "question_text": "Which protozoan is associated with the ability to cause severe dysentery?", "question_choices": ["Giardia lamblia", "Cryptosporidium hominis", "Cyclospora cayetanesis", "Entamoeba histolytica"], "cloze_format": "The protozoan that is associated with the ability to cause severe dysentery is the ___.", "normal_format": "Which protozoan is associated with the ability to cause severe dysentery?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The protozoan parasite Entamoeba histolytica causes amoebiasis , which is known as amoebic dysentery in severe cases . E . histolytica is generally transmitted through water or food that has fecal contamination .", "hl_context": "<hl> The protozoan parasite Entamoeba histolytica causes amoebiasis , which is known as amoebic dysentery in severe cases . <hl> <hl> E . histolytica is generally transmitted through water or food that has fecal contamination . <hl> The disease is most widespread in the developing world and is one of the leading causes of mortality from parasitic disease worldwide . Disease can be caused by as few as 10 cysts being transmitted ."}, {"question": {"question_id": "fs-id1167662480378", "question_text": "Which protozoan has a unique appearance, with a blue halo, when viewed using ultraviolet fluorescence microscopy?", "question_choices": ["Giardia lamblia", "Cryptosporidium hominis", "Cyclospora cayetanesis", "Entamoeba histolytica"], "cloze_format": "The ___ protozoan has a unique appearance, with a blue halo, when viewed using ultraviolet fluorescence microscopy.", "normal_format": "Which protozoan has a unique appearance, with a blue halo, when viewed using ultraviolet fluorescence microscopy?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Microscopic examination is used for diagnosis . The oocysts have a distinctive blue halo when viewed using ultraviolet fluorescence microscopy ( Figure 24.30 ) . The intestinal disease cyclosporiasis is caused by the protozoan Cyclospora cayetanensis .", "hl_context": "<hl> Microscopic examination is used for diagnosis . <hl> A stool O & P examination may be helpful . <hl> The oocysts have a distinctive blue halo when viewed using ultraviolet fluorescence microscopy ( Figure 24.30 ) . <hl> <hl> The intestinal disease cyclosporiasis is caused by the protozoan Cyclospora cayetanensis . <hl> It is endemic to tropical and subtropical regions and therefore uncommon in the United States , although there have been outbreaks associated with contaminated produce imported from regions where the protozoan is more common ."}, {"question": {"question_id": "fs-id1167662682917", "question_text": "The micrograph shows protozoans attached to the intestinal wall of a gerbil. Based on what you know about protozoan intestinal parasites, what is it?", "question_choices": ["Giardia lamblia", "Cryptosporidium hominis", "Cyclospora cayetanesis", "Entamoeba histolytica"], "cloze_format": "The micrograph shows protozoans attached to the intestinal wall of a gerbil. Based on what you know about protozoan intestinal parasites, it is ___.", "normal_format": "The micrograph shows protozoans attached to the intestinal wall of a gerbil. Based on what you know about protozoan intestinal parasites, what is it?"}, "answer": {"ans_text": null, "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "This protist is transmitted through contaminated food and water and reaches the lining of the small intestine , where it causes infection . The intestinal disease cyclosporiasis is caused by the protozoan Cyclospora cayetanensis . The parasite may live in the colon without causing signs or symptoms or may invade the mucosa to cause colitis . The protozoan parasite Entamoeba histolytica causes amoebiasis , which is known as amoebic dysentery in severe cases . Another protozoan intestinal illness is cryptosporidiosis , which is usually caused by Cryptosporidium parvum or C . hominis . Also called backpacker \u2019 s diarrhea or beaver fever , giardiasis is a common disease in the United States caused by the flagellated protist Giardia lamblia , also known as Giardia intestinalis or Giardia duodenalis ( Figure 1.16 ) . To establish infection , G . lamblia uses a large adhesive disk to attach to the intestinal mucosa .", "hl_context": "<hl> This protist is transmitted through contaminated food and water and reaches the lining of the small intestine , where it causes infection . <hl> Signs and symptoms begin within seven to ten days after ingestion . Based on limited data , it appears to be seasonal in ways that differ regionally and that are poorly understood . 19 19 Centers for Disease Control and Prevention . \u201c Cyclosporiasis FAQs for Health Professionals . \u201d Updated June 13 , 2014 . http://www.cdc.gov/parasites/cyclosporiasis/health_professionals/hp-faqs.html . <hl> The intestinal disease cyclosporiasis is caused by the protozoan Cyclospora cayetanensis . <hl> It is endemic to tropical and subtropical regions and therefore uncommon in the United States , although there have been outbreaks associated with contaminated produce imported from regions where the protozoan is more common . Signs and symptoms range from nonexistent to mild diarrhea to severe amoebic dysentery . Severe infection causes the abdomen to become distended and may be associated with fever . <hl> The parasite may live in the colon without causing signs or symptoms or may invade the mucosa to cause colitis . <hl> In some cases , the disease spreads to the spleen , brain , genitourinary tract , or lungs . In particular , it may spread to the liver and cause an abscess . When a liver abscess develops , fever , nausea , liver tenderness , weight loss , and pain in the right abdominal quadrant may occur . Chronic infection may occur and is associated with intermittent diarrhea , mucus , pain , flatulence , and weight loss . <hl> The protozoan parasite Entamoeba histolytica causes amoebiasis , which is known as amoebic dysentery in severe cases . <hl> E . histolytica is generally transmitted through water or food that has fecal contamination . The disease is most widespread in the developing world and is one of the leading causes of mortality from parasitic disease worldwide . Disease can be caused by as few as 10 cysts being transmitted . <hl> Another protozoan intestinal illness is cryptosporidiosis , which is usually caused by Cryptosporidium parvum or C . hominis . <hl> ( Figure 24.29 ) These pathogens are commonly found in animals and can be spread in feces from mice , birds , and farm animals . Contaminated water and food are most commonly responsible for transmission . The protozoan can also be transmitted through human contact with infected animals or their feces . <hl> Also called backpacker \u2019 s diarrhea or beaver fever , giardiasis is a common disease in the United States caused by the flagellated protist Giardia lamblia , also known as Giardia intestinalis or Giardia duodenalis ( Figure 1.16 ) . <hl> <hl> To establish infection , G . lamblia uses a large adhesive disk to attach to the intestinal mucosa . <hl> The disk is comprised of microtubules . During adhesion , the flagella of G . lamblia move in a manner that draws fluid out from under the disk , resulting in an area of lower pressure that promotes its adhesion to the intestinal epithelial cells . Due to its attachment , Giardia also blocks absorption of nutrients , including fats ."}, {"question": {"question_id": "fs-id1167663722846", "question_text": "What is another name for Trichuris trichiura?", "question_choices": ["pinworm", "whipworm", "hookworm", "ascariasis"], "cloze_format": "___ is another name for Trichuris trichiura.", "normal_format": "What is another name for Trichuris trichiura?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "The nematode whipworm Trichuris trichiura is a parasite that is transmitted by ingestion from soil-contaminated hands or food and causes trichuriasis .", "hl_context": "<hl> The nematode whipworm Trichuris trichiura is a parasite that is transmitted by ingestion from soil-contaminated hands or food and causes trichuriasis . <hl> Infection is most common in warm environments , especially when there is poor sanitation and greater risk of fecal contamination of soil , or when food is grown in soil using manure as a fertilizer . The signs and symptoms may be minimal or nonexistent . When a substantial infection develops , signs and symptoms include painful , frequent diarrhea that may contain mucus and blood . It is possible for the infection to cause rectal prolapse , a condition in which a portion of the rectum becomes detached from the inside of the body and protrudes from the anus ( Figure 24.35 ) . Severely infected children may experience reduced growth and their cognitive development may be affected ."}, {"question": {"question_id": "fs-id1167661274411", "question_text": "Which type of helminth infection can be diagnosed using tape?", "question_choices": ["pinworm", "whipworm", "hookworm", "tapeworm"], "cloze_format": "___ is the type of helminth infection can be diagnosed using tape.", "normal_format": "Which type of helminth infection can be diagnosed using tape?"}, "answer": {"ans_text": "A", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Infection is diagnosed in any of three ways . First , because the worms emerge at night to lay eggs , it is possible to inspect the perianal region for worms while an individual is asleep . An alternative is to use transparent tape to remove eggs from the area around the anus first thing in the morning for three days to yield eggs for microscopic examination . Pinworms ( Enterobiasis )", "hl_context": "<hl> Infection is diagnosed in any of three ways . <hl> <hl> First , because the worms emerge at night to lay eggs , it is possible to inspect the perianal region for worms while an individual is asleep . <hl> <hl> An alternative is to use transparent tape to remove eggs from the area around the anus first thing in the morning for three days to yield eggs for microscopic examination . <hl> Finally , it may be possible to detect eggs through examination of samples from under the fingernails , where eggs may lodge due to scratching . Once diagnosis has been made , mebendazole , albendazole , and pyrantel pamoate are effective for treatment . <hl> Pinworms ( Enterobiasis ) <hl>"}], "summary": " Summary 24.1   Anatomy and Normal Microbiota of the Digestive System \n\n The digestive tract, consisting of the oral cavity, pharynx, esophagus, stomach, small intestine, and large intestine, has a normal microbiota that is important for health. \n\n The constant movement of materials through the gastrointestinal canal, the protective layer of mucus, the normal microbiota, and the harsh chemical environment in the stomach and small intestine help to prevent colonization by pathogens. \n\n Infections or microbial toxins in the oral cavity can cause  tooth decay ,  periodontal disease , and various types of  ulcers . \n\n Infections and intoxications of the gastrointestinal tract can cause general symptoms such as nausea, vomiting, diarrhea, and fever. Localized inflammation of the GI tract can result in  gastritis ,  enteritis ,  gastroenteritis ,  hepatitis , or  colitis , and damage to epithelial cells of the colon can lead to  dysentery . \n\n Foodborne illness  refers to infections or intoxications that originate with pathogens or toxins ingested in contaminated food or water. \n\n 24.2   Microbial Diseases of the Mouth and Oral Cavity \n\n Dental caries ,  tartar , and  gingivitis  are caused by overgrowth of oral bacteria, usually  Streptococcus  and  Actinomyces  species, as a result of insufficient dental hygiene. \n\n Gingivitis can worsen, allowing  Porphyromonas ,  Streptococcus , and  Actinomyces  species to spread and cause  periodontitis . When  Prevotella intermedia ,  Fusobacterium  species, and  Treponema vicentii  are involved, it can lead to  acute necrotizing ulcerative gingivitis . \n\n The herpes simplex virus type 1 can cause lesions of the mouth and throat called  herpetic gingivostomatitis. \n\n Other infections of the mouth include  oral thrush , a fungal infection caused by overgrowth of  Candida  yeast, and  mumps , a viral infection of the salivary glands caused by the mumps virus, a paramyxovirus. \n\n 24.3   Bacterial Infections of the Gastrointestinal Tract \n\n Major causes of gastrointestinal illness include  Salmonella  spp.,  Staphylococcus  spp.,  Helicobacter pylori ,  Clostridium perfringens ,  Clostridium difficile ,  Bacillus cereus , and  Yersinia  bacteria. \n\n C. difficile  is an important cause of hospital acquired infection. \n\n Vibrio cholerae  causes  cholera , which can be a severe diarrheal illness. \n\n Different strains of  E. coli , including  ETEC ,  EPEC ,  EIEC , and  EHEC , cause different illnesses with varying degrees of severity. \n\n H. pylori  is associated with  peptic ulcers . \n\n Salmonella enterica  serotypes can cause  typhoid fever , a more severe illness than  salmonellosis . \n\n Rehydration and other supportive therapies are often used as general treatments. \n\n Careful antibiotic use is required to reduce the risk of causing  C. difficile  infections and when treating antibiotic-resistant infections. \n\n 24.4   Viral Infections of the Gastrointestinal Tract \n\n Common viral causes of gastroenteritis include rotaviruses, noroviruses, and astroviruses. \n\n Hepatitis may be caused by several unrelated viruses: hepatitis viruses A, B, C, D, and E. \n\n The hepatitis viruses differ in their modes of transmission, treatment, and potential for chronic infection. \n\n 24.5   Protozoan Infections of the Gastrointestinal Tract \n\n Giardiasis ,  cryptosporidiosis ,  amoebiasis , and  cyclosporiasis  are intestinal infections caused by protozoans. \n\n Protozoan intestinal infections are commonly transmitted through contaminated food and water. \n\n Treatment varies depending on the causative agent, so proper diagnosis is important. \n\n Microscopic examination of stool or biopsy specimens is often used in diagnosis, in combination with other approaches. \n\n 24.6   Helminthic Infections of the Gastrointestinal Tract \n\n Helminths often cause intestinal infections after transmission to humans through exposure to contaminated soil, water, or food. Signs and symptoms are often mild, but severe complications may develop in some cases. \n\n Ascaris lumbricoides  eggs are transmitted through contaminated food or water and hatch in the intestine. Juvenile larvae travel to the lungs and then to the pharynx, where they are swallowed and returned to the intestines to mature. These nematode roundworms cause  ascariasis . \n\n Necator americanus  and  Ancylostoma doudenale  cause  hookworm infection  when larvae penetrate the skin from soil contaminated by dog or cat feces. They travel to the lungs and are then swallowed to mature in the intestines. \n\n Strongyloides stercoralis  are transmitted from soil through the skin to the lungs and then to the intestine where they cause  strongyloidiasis . \n\n Enterobius vermicularis  are nematode pinworms transmitted by the fecal-oral route. After ingestion, they travel to the colon where they cause  enterobiasis . \n\n Trichuris trichiura  can be transmitted through soil or fecal contamination and cause  trichuriasis . After ingestion, the eggs travel to the intestine where the larvae emerge and mature, attaching to the walls of the colon and cecum. \n\n Trichinella  spp. is transmitted through undercooked meat. Larvae in the meat emerge from cysts and mature in the large intestine. They can migrate to the muscles and form new cysts, causing  trichinosis . \n\n Taenia  spp. and  Diphyllobothrium latum  are tapeworms transmitted through undercooked food or the fecal-oral route.  Taenia  infections cause  taeniasis . Tapeworms use their scolex to attach to the intestinal wall. Larvae may also move to muscle or brain tissue. \n\n Echinococcus granulosus  is a cestode transmitted through eggs in the feces of infected animals, especially dogs. After ingestion, eggs hatch in the small intestine, and the larvae invade the intestinal wall and travel through the circulatory system to form dangerous cysts in internal organs, causing  hydatid disease . \n\n Flukes are transmitted through aquatic plants or fish.  Liver flukes  cause disease by interfering with the bile duct.  Intestinal flukes  develop in the intestines, where they attach to the intestinal epithelium. ", "keyterm": "", "bname": "microbiology"}, {"chapter": 17, "intro": " Chapter Outline 17.1   The Westward Spirit 17.2   Homesteading: Dreams and Realities 17.3   Making a Living in Gold and Cattle 17.4   The Loss of American Indian Life and Culture 17.5   The Impact of Expansion on Chinese Immigrants and Hispanic Citizens Introduction \n\n In the middle of the nineteenth century, farmers in the \u201cOld West\u201d\u2014the land across the Allegheny Mountains in Pennsylvania\u2014began to hear about the opportunities to be found in the \u201cNew West.\u201d They had long believed that the land west of the Mississippi was a great desert, unfit for human habitation. But now, the federal government was encouraging them to join the migratory stream westward to this unknown land. For a variety of reasons, Americans increasingly felt compelled to fulfill their \u201cManifest Destiny,\u201d a phrase that came to mean that they were expected to spread across the land given to them by God and, most importantly, spread predominantly American values to the frontier ( Figure 17.1 ). \n\n With great trepidation, hundreds, and then hundreds of thousands, of settlers packed their lives into wagons and set out, following the Oregon, California, and Santa Fe Trails, to seek a new life in the West. Some sought open lands and greater freedom to fulfill the democratic vision originally promoted by Thomas Jefferson and experienced by their ancestors. Others saw economic opportunity. Still others believed it was their job to spread the word of God to the \u201cheathens\u201d on the frontier. Whatever their motivation, the great migration was underway. The American pioneer spirit was born. ", "chapter_text": " 17.1   The Westward Spirit Learning Objectives By the end of this section, you will be able to: \n\n Explain the evolution of American views about westward migration in the mid-nineteenth century \n\n Analyze the ways in which the federal government facilitated Americans\u2019 westward migration in the mid-nineteenth century \n\n While a small number of settlers had pushed westward before the mid-nineteenth century, the land west of the Mississippi was largely unexplored. Most Americans, if they thought of it at all, viewed this territory as an arid wasteland suitable only for Indians whom the federal government had displaced from eastern lands in previous generations. The reflections of early explorers who conducted scientific treks throughout the West tended to confirm this belief. Major Stephen Harriman Long, who commanded an expedition through Missouri and into the Yellowstone region in 1819\u20131820, frequently described the Great Plains as a arid and useless region, suitable as nothing more than a \u201cgreat American desert.\u201d But, beginning in the 1840s, a combination of economic opportunity and ideological encouragement changed the way Americans thought of the West. The federal government offered a number of incentives, making it viable for Americans to take on the challenge of seizing these rough lands from others and subsequently taming them. Still, most Americans who went west needed some financial security at the outset of their journey; even with government aid, the truly poor could not make the trip. The cost of moving an entire family westward, combined with the risks as well as the questionable chances of success, made the move prohibitive for most. While the economic Panic of 1837 led many to question the promise of urban America, and thus turn their focus to the promise of commercial farming in the West, the Panic also resulted in many lacking the financial resources to make such a commitment. For most, the dream to \u201cGo west, young man\u201d remained unfulfilled. \n\n While much of the basis for westward expansion was economic, there was also a more philosophical reason, which was bound up in the American belief that the country\u2014and the \u201cheathens\u201d who populated it\u2014was destined to come under the civilizing rule of Euro-American settlers and their superior technology, most notably railroads and the telegraph. While the extent to which that belief was a heartfelt motivation held by most Americans, or simply a rationalization of the conquests that followed, remains debatable, the clashes\u2014both physical and cultural\u2014that followed this western migration left scars on the country that are still felt today. \n\n MANIFEST DESTINY \n\n The concept of  Manifest Destiny  found its roots in the long-standing traditions of territorial expansion upon which the nation itself was founded. This phrase, which implies divine encouragement for territorial expansion, was coined by magazine editor John O\u2019Sullivan in 1845, when he wrote in the  United States Magazine and Democratic Review  that \u201cit was our manifest destiny to overspread the continent allotted by Providence for the free development of our multiplying millions.\u201d Although the context of O\u2019Sullivan\u2019s original article was to encourage expansion into the newly acquired Texas territory, the spirit it invoked would subsequently be used to encourage westward settlement throughout the rest of the nineteenth century. Land developers, railroad magnates, and other investors capitalized on the notion to encourage westward settlement for their own financial benefit. Soon thereafter, the federal government encouraged this inclination as a means to further develop the West during the Civil War, especially at its outset, when concerns over the possible expansion of slavery deeper into western territories was a legitimate fear. \n\n The idea was simple: Americans were destined\u2014and indeed divinely ordained\u2014to expand democratic institutions throughout the continent. As they spread their culture, thoughts, and customs, they would, in the process, \u201cimprove\u201d the lives of the native inhabitants who might otherwise resist Protestant institutions and, more importantly, economic development of the land. O\u2019Sullivan may have coined the phrase, but the concept had preceded him: Throughout the 1800s, politicians and writers had stated the belief that the United States was destined to rule the continent. O\u2019Sullivan\u2019s words, which resonated in the popular press, matched the economic and political goals of a federal government increasingly committed to expansion. \n\n Manifest Destiny justified in Americans\u2019 minds their right and duty to govern any other groups they encountered during their expansion, as well as absolved them of any questionable tactics they employed in the process. While the commonly held view of the day was of a relatively empty frontier, waiting for the arrival of the settlers who could properly exploit the vast resources for economic gain, the reality was quite different. Hispanic communities in the Southwest, diverse tribes throughout the western states, as well as other settlers from Asia and Western Europe already lived in many parts of the country. American expansion would necessitate a far more complex and involved exchange than simply filling empty space. \n\n Still, in part as a result of the spark lit by O\u2019Sullivan and others, waves of Americans and recently arrived immigrants began to move west in wagon trains. They travelled along several identifiable trails: first the Oregon Trail, then later the Santa Fe and California Trails, among others. The Oregon Trail is the most famous of these western routes. Two thousand miles long and barely passable on foot in the early nineteenth century, by the 1840s, wagon trains were a common sight. Between 1845 and 1870, considered to be the height of migration along the trail, over 400,000 settlers followed this path west from Missouri ( Figure 17.3 ). \n\n Defining American Who Will Set Limits to Our Onward March? America is destined for better deeds. It is our unparalleled glory that we have no reminiscences of battle fields, but in defense [sic] of humanity, of the oppressed of all nations, of the rights of conscience, the rights of personal enfranchisement. Our annals describe no scenes of horrid carnage, where men were led on by hundreds of thousands to slay one another, dupes and victims to emperors, kings, nobles, demons in the human form called heroes. We have had patriots to defend our homes, our liberties, but no aspirants to crowns or thrones; nor have the American people ever suffered themselves to be led on by wicked ambition to depopulate the land, to spread desolation far and wide, that a human being might be placed on a seat of supremacy. . . . The expansive future is our arena, and for our history. We are entering on its untrodden space, with the truths of God in our minds, beneficent objects in our hearts, and with a clear conscience unsullied by the past. We are the nation of human progress, and who will, what can, set limits to our onward march? Providence is with us, and no earthly power can. \n\n \u2014John O\u2019Sullivan, 1839 \n\n Think about how this quotation resonated with different groups of Americans at the time. When looked at through today\u2019s lens, the actions of the westward-moving settlers were fraught with brutality and racism. At the time, however, many settlers felt they were at the pinnacle of democracy, and that with no aristocracy or ancient history, America was a new world where anyone could succeed. Even then, consider how the phrase \u201canyone\u201d was restricted by race, gender, and nationality. \n\n FEDERAL GOVERNMENT ASSISTANCE \n\n To assist the settlers in their move westward and transform the migration from a trickle into a steady flow, Congress passed two significant pieces of legislation in 1862: the Homestead Act and the Pacific Railway Act. Born largely out of President Abraham Lincoln\u2019s growing concern that a potential Union defeat in the early stages of the Civil War might result in the expansion of slavery westward, Lincoln hoped that such laws would encourage the expansion of a \u201cfree soil\u201d mentality across the West. \n\n The  Homestead Act  allowed any head of household, or individual over the age of twenty-one\u2014including unmarried women\u2014to receive a parcel of 160 acres for only a nominal filing fee. All that recipients were required to do in exchange was to \u201cimprove the land\u201d within a period of five years of taking possession. The standards for improvement were minimal: Owners could clear a few acres, build small houses or barns, or maintain livestock. Under this act, the government transferred over 270 million acres of public domain land to private citizens. \n\n The Pacific Railway Act was pivotal in helping settlers move west more quickly, as well as move their farm products, and later cattle and mining deposits, back east. The first of many railway initiatives, this act commissioned the Union Pacific Railroad to build new track west from Omaha, Nebraska, while the Central Pacific Railroad moved east from Sacramento, California. The law provided each company with ownership of all public lands within two hundred feet on either side of the track laid, as well as additional land grants and payment through load bonds, prorated on the difficulty of the terrain it crossed. Because of these provisions, both companies made a significant profit, whether they were crossing hundreds of miles of open plains, or working their way through the Sierra Nevada Mountains of California. As a result, the nation\u2019s first transcontinental railroad was completed when the two companies connected their tracks at Promontory, Utah, in the spring of 1869. Other tracks, including lines radiating from this original one, subsequently created a network that linked all corners of the nation ( Figure 17.4 ). In addition to legislation designed to facilitate western settlement, the U.S. government assumed an active role on the ground, building numerous forts throughout the West to protect and assist settlers during their migration. Forts such as Fort Laramie in Wyoming (built in 1834) and Fort Apache in Arizona (1870) served as protection from nearby Native Americans as well as maintained peace between potential warring tribes. Others located throughout Colorado and Wyoming became important trading posts for miners and fur trappers. Those built in Kansas, Nebraska, and the Dakotas served primarily to provide relief for farmers during times of drought or related hardships. Forts constructed along the California coastline provided protection in the wake of the Mexican-American War as well as during the American Civil War. These locations subsequently serviced the U.S. Navy and provided important support for growing Pacific trade routes. Whether as army posts constructed for the protection of White settlers and to maintain peace among Native tribes, or as trading posts to further facilitate the development of the region, such forts proved to be vital contributions to westward migration. \n\n WHO WERE THE SETTLERS? \n\n In the nineteenth century, as today, it took money to relocate and start a new life. Due to the initial cost of relocation, land, and supplies, as well as months of preparing the soil, planting, and subsequent harvesting before any produce was ready for market, the original wave of western settlers along the Oregon Trail in the 1840s and 1850s consisted of moderately prosperous, White, native-born farming families of the East. But the passage of the Homestead Act and completion of the first transcontinental railroad meant that, by 1870, the possibility of western migration was opened to Americans of more modest means. What started as a trickle became a steady flow of migration that would last until the end of the century. \n\n Nearly 400,000 settlers had made the trek westward by the height of the movement in 1870. The vast majority were men, although families also migrated, despite incredible hardships for women with young children. More recent immigrants also migrated west, with the largest numbers coming from Northern Europe and Canada. Germans, Scandinavians, and Irish were among the most common. These ethnic groups tended to settle close together, creating strong rural communities that mirrored the way of life they had left behind. According to U.S. Census Bureau records, the number of Scandinavians living in the United States during the second half of the nineteenth century exploded, from barely 18,000 in 1850 to over 1.1 million in 1900. During that same time period, the German-born population in the United States grew from 584,000 to nearly 2.7 million and the Irish-born population grew from 961,000 to 1.6 million. As they moved westward, several thousand immigrants established homesteads in the Midwest, primarily in Minnesota and Wisconsin, where, as of 1900, over one-third of the population was foreign-born, and in North Dakota, whose immigrant population stood at 45 percent at the turn of the century. Compared to European immigrants, those from China were much less numerous, but still significant. More than 200,000 Chinese arrived in California between 1876 and 1890, albeit for entirely different reasons related to the Gold Rush. \n\n In addition to a significant European migration westward, several thousand African Americans migrated west following the Civil War, as much to escape the racism and violence of the Old South as to find new economic opportunities. They were known as  exodusters , referencing the biblical flight from Egypt, because they fled the racism of the South, with most of them headed to Kansas from Kentucky, Tennessee, Louisiana, Mississippi, and Texas. Over twenty-five thousand exodusters arrived in Kansas in 1879\u20131880 alone. By 1890, over 500,000 Blacks lived west of the Mississippi River. Although the majority of Black migrants became farmers, approximately twelve thousand worked as cowboys during the Texas cattle drives. Some also became \u201cBuffalo Soldiers\u201d in the wars against Native Americans. \u201cBuffalo Soldiers\u201d were African Americans allegedly so-named by various Native tribes who equated their black, curly hair with that of the buffalo. Many had served in the Union army in the Civil War and were now organized into six, all-Black cavalry and infantry units whose primary duties were to protect settlers from Native American attacks during the westward migration, as well as to assist in building the infrastructure required to support western settlement ( Figure 17.5 ). \n\n While White easterners, immigrants, and African Americans were moving west, several hundred thousand Hispanics had already settled in the American Southwest prior to the U.S. government seizing the land during its war with Mexico (1846\u20131848). The Treaty of Guadalupe Hidalgo, which ended the war in 1848, granted American citizenship to those who chose to stay in the United States, as the land switched from Mexican to U.S. ownership. Under the conditions of the treaty, Mexicans retained the right to their language, religion, and culture, as well as the property they held. As for citizenship, they could choose one of three options: 1) declare their intent to live in the United States but retain Mexican citizenship; 2) become U.S. citizens with all rights under the constitution; or 3) leave for Mexico. Despite such guarantees, within one generation, these new Hispanic American citizens found their culture under attack, and legal protection of their property all but non-existent. \n 17.2   Homesteading: Dreams and Realities Learning Objectives By the end of this section, you will be able to: \n\n Identify the challenges that farmers faced as they settled west of the Mississippi River \n\n Describe the unique experiences of women who participated in westward migration \n\n As settlers and homesteaders moved westward to improve the land given to them through the Homestead Act, they faced a difficult and often insurmountable challenge. The land was difficult to farm, there were few building materials, and harsh weather, insects, and inexperience led to frequent setbacks. The prohibitive prices charged by the first railroad lines made it expensive to ship crops to market or have goods sent out. Although many farms failed, some survived and grew into large \u201cbonanza\u201d farms that hired additional labor and were able to benefit enough from economies of scale to grow profitable. Still, small family farms, and the settlers who worked them, were hard-pressed to do more than scrape out a living in an unforgiving environment that comprised arid land, violent weather shifts, and other challenges ( Figure 17.6 ). \n\n THE DIFFICULT LIFE OF THE PIONEER FARMER \n\n Of the hundreds of thousands of settlers who moved west, the vast majority were homesteaders. These pioneers, like the Ingalls family of  Little House on the Prairie  book and television fame (see inset below), were seeking land and opportunity. Popularly known as \u201csodbusters,\u201d these men and women in the Midwest faced a difficult life on the frontier. They settled throughout the land that now makes up the Midwestern states of Wisconsin, Minnesota, Kansas, Nebraska, and the Dakotas. The weather and environment were bleak, and settlers struggled to eke out a living. A few unseasonably rainy years had led would-be settlers to believe that the \u201cgreat desert\u201d was no more, but the region\u2019s typically low rainfall and harsh temperatures made crop cultivation hard. Irrigation was a requirement, but finding water and building adequate systems proved too difficult and expensive for many farmers. It was not until 1902 and the passage of the Newlands Reclamation Act that a system finally existed to set aside funds from the sale of public lands to build dams for subsequent irrigation efforts. Prior to that, farmers across the Great Plains relied primarily on dry-farming techniques to grow corn, wheat, and sorghum, a practice that many continued in later years. A few also began to employ windmill technology to draw water, although both the drilling and construction of windmills became an added expense that few farmers could afford. \n\n Americana The Enduring Appeal of  Little House on the Prairie The story of western migration and survival has remained a touchstone of American culture, even today. The television show  Frontier Life  on PBS is one example, as are countless other modern-day evocations of the settlers. Consider the enormous popularity of the  Little House  series. The books, originally published in the 1930s and 1940s, have been in print continuously. The television show,  Little House on the Prairie , ran for over a decade and was hugely successful (and was said to be President Ronald Reagan\u2019s favorite show). The books, although fictional, were based on Laura Ingalls Wilder\u2019s own childhood, as she travelled west with her family via covered wagon, stopping in Kansas, Wisconsin, South Dakota, and beyond ( Figure 17.7 ). \n\n Wilder wrote of her stories, \u201cAs you read my stories of long ago I hope you will remember that the things that are truly worthwhile and that will give you happiness are the same now as they were then. Courage and kindness, loyalty, truth, and helpfulness are always the same and always needed.\u201d While Ingalls makes the point that her stories underscore traditional values that remain the same over time, this is not necessarily the only thing that made these books so popular. Perhaps part of their appeal is that they are adventure stories, with wild weather, wild animals, and \"wild Indians\" all playing a role. Does this explain their ongoing popularity? What other factors might make these stories appealing so long after they were originally written? \n\n The first houses built by western settlers were typically made of mud and sod with thatch roofs, as there was little timber for building. Rain, when it arrived, presented constant problems for these  sod houses , with mud falling into food, and vermin, most notably lice, scampering across bedding ( Figure 17.8 ). Weather patterns not only left the fields dry, they also brought tornadoes, droughts, blizzards, and insect swarms. Tales of swarms of locusts were commonplace, and the crop-eating insects would at times cover the ground six to twelve inches deep. One frequently quoted Kansas newspaper reported a locust swarm in 1878 during which the insects devoured \u201ceverything green, stripping the foliage off the bark and from the tender twigs of the fruit trees, destroying every plant that is good for food or pleasant to the eye, that man has planted.\u201d \n\n Farmers also faced the ever-present threat of debt and farm foreclosure by the banks. While land was essentially free under the Homestead Act, all other farm necessities cost money and were initially difficult to obtain in the newly settled parts of the country where market economies did not yet fully reach. Horses, livestock, wagons, wells, fencing, seed, and fertilizer were all critical to survival, but often hard to come by as the population initially remained sparsely settled across vast tracts of land. Railroads charged notoriously high rates for farm equipment and livestock, making it difficult to procure goods or make a profit on anything sent back east. Banks also charged high interest rates, and, in a cycle that replayed itself year after year, farmers would borrow from the bank with the intention of repaying their debt after the harvest. As the number of farmers moving westward increased, the market price of their produce steadily declined, even as the value of the actual land increased. Each year, hard-working farmers produced ever-larger crops, flooding the markets and subsequently driving prices down even further. Although some understood the economics of supply and demand, none could overtly control such forces. \n\n Eventually, the arrival of a more extensive railroad network aided farmers, mostly by bringing much-needed supplies such as lumber for construction and new farm machinery. While John Deere sold a steel-faced plow as early as 1838, it was James Oliver\u2019s improvements to the device in the late 1860s that transformed life for homesteaders. His new, less expensive \u201cchilled plow\u201d was better equipped to cut through the shallow grass roots of the Midwestern terrain, as well as withstand damage from rocks just below the surface. Similar advancements in hay mowers, manure spreaders, and threshing machines greatly improved farm production for those who could afford them. Where capital expense became a significant factor, larger commercial farms\u2014known as \u201c bonanza farms \u201d\u2014began to develop. Farmers in Minnesota, North Dakota, and South Dakota hired migrant farmers to grow wheat on farms in excess of twenty thousand acres each. These large farms were succeeding by the end of the century, but small family farms continued to suffer. Although the land was nearly free, it cost close to $1000 for the necessary supplies to start up a farm, and many would-be landowners lured westward by the promise of cheap land became migrant farmers instead, working other peoples\u2019 land for a wage. The frustration of small farmers grew, ultimately leading to a revolt of sorts, discussed in a later chapter. \n\n AN EVEN MORE CHALLENGING LIFE: A PIONEER WIFE \n\n Although the West was numerically a male-dominated society, homesteading in particular encouraged the presence of women, families, and a domestic lifestyle, even if such a life was not an easy one. Women faced all the physical hardships that men encountered in terms of weather, illness, and danger, with the added complication of childbirth. Often, there was no doctor or midwife providing assistance, and many women died from treatable complications, as did their newborns. While some women could find employment in the newly settled towns as teachers, cooks, or seamstresses, they originally did not enjoy many rights. They could not sell property, sue for divorce, serve on juries, or vote. And for the vast majority of women, their work was not in towns for money, but on the farm. As late as 1900, a typical farm wife could expect to devote nine hours per day to chores such as cleaning, sewing, laundering, and preparing food. Two additional hours per day were spent cleaning the barn and chicken coop, milking the cows, caring for the chickens, and tending the family garden. One wife commented in 1879, \u201c[We are] not much better than slaves. It is a weary, monotonous round of cooking and washing and mending and as a result the insane asylum is a third filled with wives of farmers.\u201d \n\n Despite this grim image, the challenges of farm life eventually empowered women to break through some legal and social barriers. Many lived more equitably as partners with their husbands than did their eastern counterparts, helping each other through both hard times and good. If widowed, a wife typically took over responsibility for the farm, a level of management that was very rare back east, where the farm would fall to a son or other male relation. Pioneer women made important decisions and were considered by their husbands to be more equal partners in the success of the homestead, due to the necessity that all members had to work hard and contribute to the farming enterprise for it to succeed. Therefore, it is not surprising that the first states to grant women\u2019s rights, including the right to vote, were those in the Pacific Northwest and Upper Midwest, where women pioneers worked the land side by side with men. Some women seemed to be well suited to the challenges that frontier life presented them. Writing to her Aunt Martha from their homestead in Minnesota in 1873, Mary Carpenter refused to complain about the hardships of farm life: \u201cI try to trust in God\u2019s promises, but we can\u2019t expect him to work miracles nowadays. Nevertheless, all that is expected of us is to do the best we can, and that we shall certainly endeavor to do. Even if we do freeze and starve in the way of duty, it will not be a dishonorable death.\u201d \n 17.3   Making a Living in Gold and Cattle Learning Objectives By the end of this section, you will be able to: \n\n Identify the major discoveries and developments in western gold, silver, and copper mining in the mid-nineteenth century \n\n Explain why the cattle industry was paramount to the development of the West and how it became the catalyst for violent range wars \n\n Although homestead farming was the primary goal of most western settlers in the latter half of the nineteenth century, a small minority sought to make their fortunes quickly through other means. Specifically, gold (and, subsequently, silver and copper) prospecting attracted thousands of miners looking to \u201cget rich quick\u201d before returning east. In addition, ranchers capitalized on newly available railroad lines to move longhorn steers that populated southern and western Texas. This meat was highly sought after in eastern markets, and the demand created not only wealthy ranchers but an era of cowboys and cattle drives that in many ways defines how we think of the West today. Although neither miners nor ranchers intended to remain permanently in the West, many individuals from both groups ultimately stayed and settled there, sometimes due to the success of their gamble, and other times due to their abject failure. \n\n THE CALIFORNIA GOLD RUSH AND BEYOND \n\n The allure of gold has long sent people on wild chases; in the American West, the possibility of quick riches was no different. The search for gold represented an opportunity far different from the slow plod that homesteading farmers faced. The discovery of gold at Sutter\u2019s Mill in Coloma, California, set a pattern for such strikes that was repeated again and again for the next decade, in what collectively became known as the  California Gold Rush . In what became typical, a sudden disorderly rush of prospectors descended upon a new discovery site, followed by the arrival of those who hoped to benefit from the strike by preying off the newly rich. This latter group of camp followers included saloonkeepers, prostitutes, store owners, and criminals, who all arrived in droves. If the strike was significant in size, a town of some magnitude might establish itself, and some semblance of law and order might replace the vigilante justice that typically grew in the small and short-lived mining outposts. \n\n The original Forty-Niners were individual prospectors who sifted gold out of the dirt and gravel through \u201cpanning\u201d or by diverting a stream through a sluice box ( Figure 17.9 ). To varying degrees, the original California Gold Rush repeated itself throughout Colorado and Nevada for the next two decades. In 1859, Henry T. P. Comstock, a Canadian-born fur trapper, began gold mining in Nevada with other prospectors but then quickly found a blue-colored vein that proved to be the first significant silver discovery in the United States. Within twenty years, the  Comstock Lode , as it was called, yielded more than $300 million in shafts that reached hundreds of feet into the mountain. Subsequent mining in Arizona and Montana yielded copper, and, while it lacked the glamour of gold, these deposits created huge wealth for those who exploited them, particularly with the advent of copper wiring for the delivery of electricity and telegraph communication. \n\n By the 1860s and 1870s, however, individual efforts to locate precious metals were less successful. The lowest-hanging fruit had been picked, and now it required investment capital and machinery to dig mine shafts that could reach remaining ore. With a much larger investment, miners needed a larger strike to be successful. This shift led to larger businesses underwriting mining operations, which eventually led to the development of greater urban stability and infrastructure. Denver, Colorado, was one of several cities that became permanent settlements, as businesses sought a stable environment to use as a base for their mining ventures. \n\n For miners who had not yet struck it rich, this development was not a good one. They were now paid a daily or weekly wage to work underground in very dangerous conditions. They worked in shafts where the temperature could rise to above one hundred degrees Fahrenheit, and where poor ventilation might lead to long-term lung disease. They coped with shaft fires, dynamite explosions, and frequent cave-ins. By some historical accounts, close to eight thousand miners died on the frontier during this period, with over three times that number suffering crippling injuries. Some miners organized into unions and led strikes for better conditions, but these efforts were usually crushed by state militias. \n\n Eventually, as the ore dried up, most mining towns turned into ghost towns. Even today, a visit through the American West shows old saloons and storefronts, abandoned as the residents moved on to their next shot at riches. The true lasting impact of the early mining efforts was the resulting desire of the U.S. government to bring law and order to the \u201cWild West\u201d in order to more efficiently extract natural resources and encourage stable growth in the region. As more Americans moved to the region to seek permanent settlement, as opposed to brief speculative ventures, they also sought the safety and support that government order could bring. Nevada was admitted to the Union as a state in 1864, with Colorado following in 1876, then North Dakota, South Dakota, Montana, and Washington in 1889; and Idaho and Wyoming in 1890. \n\n THE CATTLE KINGDOM \n\n While the cattle industry lacked the romance of the Gold Rush, the role it played in western expansion should not be underestimated. For centuries, wild cattle roamed the Spanish borderlands. At the end of the Civil War, as many as five million longhorn steers could be found along the Texas frontier, yet few settlers had capitalized on the opportunity to claim them, due to the difficulty of transporting them to eastern markets. The completion of the first transcontinental railroad and subsequent railroad lines changed the game dramatically. Cattle ranchers and eastern businessmen realized that it was profitable to round up the wild steers and transport them by rail to be sold in the East for as much as thirty to fifty dollars per head. These ranchers and businessmen began the rampant speculation in the cattle industry that made, and lost, many fortunes. \n\n So began the impressive cattle drives of the 1860s and 1870s. The famous Chisholm Trail provided a quick path from Texas to railroad terminals in Abilene, Wichita, and Dodge City, Kansas, where cowboys would receive their pay. These \u201ccowtowns,\u201d as they became known, quickly grew to accommodate the needs of cowboys and the cattle industry. Cattlemen like Joseph G. McCoy, born in Illinois, quickly realized that the railroad offered a perfect way to get highly sought beef from Texas to the East. McCoy chose Abilene as a locale that would offer cowboys a convenient place to drive the cattle, and went about building stockyards, hotels, banks, and more to support the business. He promoted his services and encouraged cowboys to bring their cattle through Abilene for good money; soon, the city had grown into a bustling western city, complete with ways for the cowboys to spend their hard-earned pay ( Figure 17.10 ). \n\n Between 1865 and 1885, as many as forty thousand cowboys roamed the Great Plains, hoping to work for local ranchers. They were all men, typically in their twenties, and close to one-third of them were Hispanic or African American. It is worth noting that the stereotype of the American cowboy\u2014and indeed the cowboys themselves\u2014borrowed much from the Mexicans who had long ago settled those lands. The saddles, lassos, chaps, and lariats that define cowboy culture all arose from the Mexican ranchers who had used them to great effect before the cowboys arrived. \n\n Life as a cowboy was dirty and decidedly unglamorous. The terrain was difficult; conflicts with Native Americans, especially in Indian Territory (now Oklahoma), were notoriously deadly. But the longhorn cattle were hardy stock, and could survive and thrive while grazing along the long trail, so cowboys braved the trip for the promise of steady employment and satisfying wages. Eventually, however, the era of the free range ended. Ranchers developed the land, limiting grazing opportunities along the trail, and in 1873, the new technology of barbed wire allowed ranchers to fence off their lands and cattle claims. With the end of the free range, the cattle industry, like the mining industry before it, grew increasingly dominated by eastern businessmen. Capital investors from the East expanded rail lines and invested in ranches, ending the reign of the cattle drives. \n\n Americana Barbed Wire and a Way of Life Gone Called the \u201cdevil\u2019s rope\u201d by Native Americans, barbed wire had a profound impact on the American West. Before its invention, settlers and ranchers alike were stymied by a lack of building materials to fence off land. Communal grazing and long cattle drives were the norm. But with the invention of barbed wire, large cattle ranchers and their investors were able to cheaply and easily parcel off the land they wanted\u2014whether or not it was legally theirs to contain. As with many other inventions, several people \u201cinvented\u201d barbed wire around the same time. In 1873, it was Joseph Glidden, however, who claimed the winning design and patented it. Not only did it spell the end of the free range for settlers and cowboys, it kept more land away from Native tribes, who had never envisioned a culture that would claim to own land ( Figure 17.11 ). \n\n In the early twentieth century, songwriter Cole Porter would take a poem by a Montana poet named Bob Fletcher and convert it into a cowboy song called, \u201cDon\u2019t Fence Me In.\u201d As the lyrics below show, the song gave voice to the feeling that, as the fences multiplied, the ethos of the West was forever changed: \n\n Oh, give me land, lots of land, under starry skies above \n\nDon't fence me in \n\nLet me ride thru the wide-open country that I love \n\nDon't fence me in . . . \n\nJust turn me loose \n\nLet me straddle my old saddle underneath the western skies \n\nOn my cayuse \n\nLet me wander over yonder till I see the mountains rise \n\nI want to ride to the ridge where the west commences \n\nGaze at the moon until I lose my senses \n\nI can't look at hobbles and I can't stand fences \n\nDon't fence me in. \n\n VIOLENCE IN THE WILD WEST: MYTH AND REALITY \n\n The popular image of the Wild West portrayed in books, television, and film has been one of violence and mayhem. The lure of quick riches through mining or driving cattle meant that much of the West did indeed consist of rough men living a rough life, although the violence was exaggerated and even glorified in the dime store novels of the day. The exploits of Wyatt Earp, Doc Holiday, and others made for good stories, but the reality was that western violence was more isolated than the stories might suggest. These clashes often occurred as people struggled for the scarce resources that could make or break their chance at riches, or as they dealt with the sudden wealth or poverty that prospecting provided. \n\n Where sporadic violence did erupt, it was concentrated largely in mining towns or during range wars among large and small cattle ranchers. Some mining towns were indeed as rough as the popular stereotype. Men, money, liquor, and disappointment were a recipe for violence. Fights were frequent, deaths were commonplace, and frontier justice reigned. The notorious mining town of Bodie, California, had twenty-nine murders between 1877 and 1883, which translated to a murder rate higher than any other city at that time, and only one person was ever convicted of a crime. The most prolific gunman of the day was John Wesley Hardin, who allegedly killed over twenty men in Texas in various gunfights, including one victim he killed in a hotel for snoring too loudly ( Figure 17.12 ). \n\n Ranching brought with it its own dangers and violence. In the Texas cattle lands, owners of large ranches took advantage of their wealth and the new invention of barbed wire to claim the prime grazing lands and few significant watering holes for their herds. Those seeking only to move their few head of cattle to market grew increasingly frustrated at their inability to find even a blade of grass for their meager herds. Eventually, frustration turned to violence, as several ranchers resorted to vandalizing the barbed wire fences to gain access to grass and water for their steers. Such vandalism quickly led to cattle rustling, as these cowboys were not averse to leading a few of the rancher\u2019s steers into their own herds as they left. \n\n One example of the violence that bubbled up was the infamous  Fence Cutting War  in Clay County, Texas (1883\u20131884). There, cowboys began destroying fences that several ranchers erected along public lands: land they had no right to enclose. Confrontations between the cowboys and armed guards hired by the ranchers resulted in three deaths\u2014hardly a \u201cwar,\u201d but enough of a problem to get the governor\u2019s attention. Eventually, a special session of the Texas legislature addressed the problem by passing laws to outlaw fence cutting, but also forced ranchers to remove fences illegally erected along public lands, as well as to place gates for passage where public areas adjoined private lands. \n\n An even more violent confrontation occurred between large ranchers and small farmers in Johnson County, Wyoming, where cattle ranchers organized a \u201clynching bee\u201d in 1891\u20131892 to make examples of cattle rustlers. Hiring twenty-two \u201cinvaders\u201d from Texas to serve as hired guns, the ranch owners and their foremen hunted and subsequently killed the two rustlers best known for organizing the owners of the smaller Wyoming farms. Only the intervention of federal troops, who arrested and then later released the invaders, allowing them to return to Texas, prevented a greater massacre. \n\n While there is much talk\u2014both real and mythical\u2014of the rough men who lived this life, relatively few women experienced it. While homesteaders were often families, gold speculators and cowboys tended to be single men in pursuit of fortune. The few women who went to these wild outposts were typically prostitutes, and even their numbers were limited. In 1860, in the Comstock Lode region of Nevada, for example, there were reportedly only thirty women total in a town of twenty-five hundred men. Some of the \u201cpainted ladies\u201d who began as prostitutes eventually owned brothels and emerged as businesswomen in their own right; however, life for these young women remained a challenging one as western settlement progressed. A handful of women, numbering no more than six hundred, braved both the elements and male-dominated culture to become teachers in several of the more established cities in the West. Even fewer arrived to support husbands or operate stores in these mining towns. \n\n As wealthy men brought their families west, the lawless landscape began to change slowly. Abilene, Kansas, is one example of a lawless town, replete with prostitutes, gambling, and other vices, transformed when middle-class women arrived in the 1880s with their cattle baron husbands. These women began to organize churches, school, civic clubs, and other community programs to promote family values. They fought to remove opportunities for prostitution and all the other vices that they felt threatened the values that they held dear. Protestant missionaries eventually joined the women in their efforts, and, while they were not widely successful, they did bring greater attention to the problems. As a response, the U.S. Congress passed both the Comstock Law (named after its chief proponent, anti-obscenity crusader Anthony Comstock) in 1873 to ban the spread of \u201clewd and lascivious literature\u201d through the mail and the subsequent Page Act of 1875 to prohibit the transportation of women into the United States for employment as prostitutes. However, the \u201chouses of ill repute\u201d continued to operate and remained popular throughout the West despite the efforts of reformers. \n 17.4   The Loss of American Indian Life and Culture Learning Objectives By the end of this section, you will be able to: \n\n Describe the methods that the U.S. government used to address the \u201cIndian threat\u201d during the settlement of the West \n\n Explain the process of \u201cAmericanization\u201d as it applied to Native peoples in the nineteenth century \n\n As American settlers pushed westward, they inevitably came into conflict with Native tribes that had long been living on the land. Although the threat of attacks was quite slim and nowhere proportionate to the number of U.S. Army actions directed against them, the occasional attack\u2014often one of retaliation\u2014was enough to fuel the popular fear of the \u201csavage\u201d Natives. The clashes, when they happened, were indeed brutal, although most of the brutality occurred at the hands of the settlers. Ultimately, the settlers, with the support of local militias and, later, with the federal government behind them, sought to eliminate the tribes from the lands they desired. The result was devastating for the Native tribes, which lacked the weapons and group cohesion to fight back against such well-armed forces. The Manifest Destiny of the settlers spelled the end of the Indian way of life. \n\n CLAIMING LAND, RELOCATING LANDOWNERS \n\n Back east, the popular vision of the West was of a vast and empty land. But of course this was an exaggerated depiction. On the eve of westward expansion, as many as 250,000 Native Americans, representing a variety of tribes, populated the Great Plains. Previous wars against these tribes in the early nineteenth century, as well as the failure of earlier treaties, had led to a general policy of the forcible removal of many tribes in the eastern United States. The Indian Removal Act of 1830 resulted in the infamous \u201cTrail of Tears,\u201d which saw nearly fifty thousand Seminole, Choctaw, Chickasaw, and Creek people relocated west of the Mississippi River to what is now Oklahoma between 1831 and 1838. Building upon such a history, the U.S. government was prepared, during the era of western settlement, to deal with tribes that settlers viewed as obstacles to expansion. \n\n As settlers sought more land for farming, mining, and cattle ranching, the first strategy employed to deal with the perceived \"Indian threat\" was to negotiate settlements to move tribes out of the path of White settlers. In 1851, the chiefs of most of the Great Plains tribes agreed to the First Treaty of Fort Laramie. This agreement established distinct tribal borders, essentially codifying the reservation system. In return for annual payments of $50,000 to the tribes (originally guaranteed for fifty years, but later revised to last for only ten) as well as the hollow promise of noninterference from westward settlers, Native Americans agreed to stay clear of the path of settlement. Due to government corruption, many annuity payments never reached the tribes, and some reservations were left destitute and near starving. In addition, within a decade, as the pace and number of western settlers increased, even designated reservations became prime locations for farms and mining. Rather than negotiating new treaties, settlers\u2014oftentimes backed by local or state militia units\u2014simply attacked the tribes out of fear or to force them from the land. Some Indians resisted, only to then face massacres. \n\n In 1862, frustrated and angered by the lack of annuity payments and the continuous encroachment on their reservation lands, Dakota Sioux in Minnesota rebelled in what became known as the Dakota War or the War of 1862, killing the White settlers who moved onto their tribal lands. Over one thousand White settlers were captured or killed in the attack, before an armed militia regained control. Of the four hundred Sioux captured by U.S. troops, 303 were sentenced to death, but President Lincoln intervened, releasing all but thirty-eight of the men. The thirty-eight who were found guilty were hanged in the largest mass execution in the country\u2019s history, and the rest of the tribe was banished. Settlers in other regions responded to news of this raid with fear and aggression. In Colorado, Arapahoe and Cheyenne tribes fought back against land encroachment; White militias then formed, decimating even some of the tribes that were willing to cooperate. One of the more vicious examples was near Sand Creek, Colorado, where Colonel John Chivington led a militia raid upon a camp in which the leader had already negotiated a peaceful settlement. The camp was flying both the American flag and the white flag of surrender when Chivington\u2019s troops murdered close to one hundred people, the majority of them women and children, in what became known as the  Sand Creek Massacre . For the rest of his life, Chivington would proudly display his collection of nearly one hundred Native American scalps from that day. Subsequent investigations by the U.S. Army condemned Chivington\u2019s tactics and their results; however, the raid served as a model for some settlers who sought any means by which to eradicate the perceived Indian threat. \n\n Hoping to forestall similar uprisings and all-out wars, the U.S. Congress commissioned a committee to investigate the causes of such incidents. The subsequent report of their findings led to the passage of two additional treaties: the Second Treaty of Fort Laramie and the Treaty of Medicine Lodge Creek, both designed to move the remaining tribes to even more remote reservations. The Second Treaty of Fort Laramie moved the remaining Sioux to the Black Hills in the Dakota Territory and the Treaty of Medicine Lodge Creek moved the Cheyenne, Arapaho, Kiowa, and Comanche to \u201cIndian Territory,\u201d later to become the State of Oklahoma. \n\n The agreements were short-lived, however. With the subsequent discovery of gold in the Black Hills, settlers seeking their fortune began to move upon the newly granted Sioux lands with support from U.S. cavalry troops. By the middle of 1875, thousands of White prospectors were illegally digging and panning in the area. The Sioux protested the invasion of their territory and the violation of sacred ground. The government offered to lease the Black Hills or to pay $6 million if the Indians were willing to sell the land. When the tribes refused, the government imposed what it considered a fair price for the land, ordered the Indians to move, and in the spring of 1876, made ready to force them onto the reservation. \n\n In the Battle of Little Bighorn, perhaps the most famous battle of the American West, a Sioux chieftain, Sitting Bull, urged Native Americans from all neighboring tribes to join his men in defense of their lands ( Figure 17.13 ). At the Little Bighorn River, the U.S. Army\u2019s Seventh Cavalry, led by Colonel George Custer, sought a showdown. Driven by his own personal ambition, on June 25, 1876, Custer foolishly attacked what he thought was a minor encampment. Instead, it turned out to be the main Sioux force. The Sioux warriors\u2014nearly three thousand in strength\u2014surrounded and killed Custer and 262 of his men and support units, in the single greatest loss of U.S. troops to a Native American force in the era of westward expansion. Eyewitness reports of the battle indicated that the victorious Sioux bathed and wrapped Custer\u2019s body in the tradition of a chieftain burial; however, they dismembered many other soldiers\u2019 corpses in order for a few distant observers from Major Marcus Reno\u2019s wounded troops and Captain Frederick Benteen\u2019s company to report back to government officials about the ferocity of the Sioux enemy. \n\n AMERICAN INDIAN SUBMISSION \n\n Despite their success at Little Bighorn, neither the Sioux nor any other Plains tribe followed this battle with any other armed encounter. Rather, they either returned to tribal life or fled out of fear of remaining troops, until the U.S. Army arrived in greater numbers and began to exterminate Indian encampments and force others to accept payment for forcible removal from their lands. Sitting Bull himself fled to Canada, although he later returned in 1881 and subsequently worked in Buffalo Bill\u2019s Wild West show. In Montana, the Blackfoot and Crow were forced to leave their tribal lands. In Colorado, the Utes gave up their lands after a brief period of resistance. In Idaho, most of the Nez Perce gave up their lands peacefully, although in an incredible episode, a band of some eight hundred Indians sought to evade U.S. troops and escape into Canada. \n\n My Story I Will Fight No More: Chief Joseph\u2019s Capitulation Chief Joseph, known to his people as \u201cThunder Traveling to the Loftier Mountain Heights,\u201d was the chief of the Nez Perce tribe, and he had realized that they could not win against the Whites. In order to avoid a war that would undoubtedly lead to the extermination of his people, he hoped to lead his tribe to Canada, where they could live freely. He led a full retreat of his people over fifteen hundred miles of mountains and harsh terrain, only to be caught within fifty miles of the Canadian border in late 1877. His speech has remained a poignant and vivid reminder of what the tribe had lost. \n\n Tell General Howard I know his heart. What he told me before, I have it in my heart. I am tired of fighting. Our Chiefs are killed; Looking Glass is dead, Ta Hool Hool Shute is dead. The old men are all dead. It is the young men who say yes or no. He who led on the young men is dead. It is cold, and we have no blankets; the little children are freezing to death. My people, some of them, have run away to the hills, and have no blankets, no food. No one knows where they are\u2014perhaps freezing to death. I want to have time to look for my children, and see how many of them I can find. Maybe I shall find them among the dead. Hear me, my Chiefs! I am tired; my heart is sick and sad. From where the sun now stands I will fight no more forever. \n\n \u2014Chief Joseph, 1877 \n\n The final episode in the so-called Indian Wars occurred in 1890, at the  Wounded Knee Massacre  in South Dakota. On their reservation, the Lakota Sioux had begun to perform the \u201cGhost Dance,\u201d which told of a Messiah who would deliver the tribe from its hardship, with such frequency that White settlers began to worry that another uprising would occur. The militia prepared to round up the Sioux. The tribe, after the death of Sitting Bull, who had been arrested, shot, and killed in 1890, prepared to surrender at Wounded Knee, South Dakota, on December 29, 1890. Although the accounts are unclear, an apparent accidental rifle discharge by a young male Lakota preparing to lay down his weapon led the U.S. soldiers to begin firing indiscriminately upon the Native Americans. What little resistance the Lakota mounted with a handful of concealed rifles at the outset of the fight diminished quickly, with the troops eventually massacring between 150 and 300 men, women, and children. The U.S. troops suffered twenty-five fatalities, some of which were the result of their own crossfire. Captain Edward Godfrey of the Seventh Cavalry later commented, \u201cI know the men did not aim deliberately and they were greatly excited. I don\u2019t believe they saw their sights. They fired rapidly but it seemed to me only a few seconds till there was not a living thing before us; warriors, squaws, children, ponies, and dogs . . . went down before that unaimed fire.\u201d With this last show of brutality, the Indian Wars came to a close. U.S. government officials had already begun the process of seeking an alternative to the meaningless treaties and costly battles. A more effective means with which to address the public perception of the \u201cIndian threat\u201d was needed.  Americanization  provided the answer. \n\n AMERICANIZATION \n\n Through the years of the Indian Wars of the 1870s and early 1880s, opinion back east was mixed. There were many who felt, as General Philip Sheridan (appointed in 1867 to pacify the Plains Indians) allegedly said, that \"the only good Indian was a dead Indian.\" But increasingly, several American reformers who would later form the backbone of the Progressive Era had begun to criticize the violence, arguing that the Native Americans should be helped through \u201cAmericanization\u201d to become assimilated into American society. Individual land ownership, Christian worship, and education for children became the cornerstones of this new, and final, assault on Native life and culture. \n\n Beginning in the 1880s, clergymen, government officials, and social workers all worked to assimilate Native peoples into American life. The government permitted reformers to remove Native American children from their homes and place them in boarding schools, such as the Carlisle Indian School or the Hampton Institute, where they were taught to abandon their tribal traditions and embrace the tools of American productivity, modesty, and sanctity through total immersion. Such schools not only acculturated Native American boys and girls, but also provided vocational training for males and domestic science classes for females. Adults were also targeted by religious reformers, specifically evangelical Protestants as well as a number of Catholics, who sought to convince Native people to abandon their language, clothing, and social customs for a more Euro-American lifestyle ( Figure 17.14 ). \n\n A vital part of the assimilation effort was land reform. During earlier negotiations, the government had respected that the Native tribes used their land communally. Most Native American belief structures did not allow for the concept of individual land ownership; rather, land was available for all to use, and required responsibility from all to protect it. As a part of their plan to Americanize the tribes, reformers sought legislation to replace this concept with the popular Euro-American notion of real estate ownership and self-reliance. One such law was the Dawes Severalty Act of 1887, named after a reformer and senator from Massachusetts, which struck a deadly blow to the Native American way of life. In what was essentially a new version of the original Homestead Act, the Dawes Act permitted the federal government to divide the lands of any tribe and grant 160 acres of farmland or 320 acres of grazing land to each head of family, with lesser amounts to single persons and others. In a nod towards the paternal relationship with which Whites viewed Native Americans\u2014similar to the justification of the previous treatment of enslaved African Americans\u2014the Dawes Act permitted the federal government to hold an individual Native American\u2019s newly acquired land in trust for twenty-five years. Only then would they obtain full title and be granted the citizenship rights that land ownership entailed. It would not be until 1924 that formal citizenship was granted to all Native Americans. Under the Dawes Act, Native Americans were given the most arid, useless land. Further, inefficiencies and corruption in the government meant that much of the land due to be allotted to Native Americans was simply deemed \u201csurplus\u201d and claimed by settlers. Once all allotments were determined, the remaining tribal lands\u2014as much as eighty million acres\u2014were sold to White American settlers. The final element of \u201cAmericanization\u201d was the symbolic \u201clast arrow\u201d pageant, which often coincided with the formal redistribution of tribal lands under the Dawes Act. At these events, Native Americans were forced to assemble in their tribal garb, carrying a bow and arrow. They would then symbolically fire their \u201clast arrow\u201d into the air, enter a tent where they would strip away their traditional clothing, dress in a White farmer\u2019s coveralls, and emerge to take a plow and an American flag to show that they had converted to a new way of life. It was a seismic shift for the Native Americans, and one that left them bereft of their culture and history. \n 17.5   The Impact of Expansion on Chinese Immigrants and Hispanic Citizens Learning Objectives By the end of this section, you will be able to: \n\n Describe the treatment of Chinese immigrants and Hispanic citizens during the westward expansion of the nineteenth century \n\n As White Americans pushed west, they not only collided with Native American tribes but also with Hispanic Americans and Chinese immigrants. Hispanics in the Southwest had the opportunity to become American citizens at the end of the Mexican-American war, but their status was markedly second-class. Chinese immigrants arrived en masse during the California Gold Rush and numbered in the hundreds of thousands by the late 1800s, with the majority living in California, working menial jobs. These distinct cultural and ethnic groups strove to maintain their rights and way of life in the face of persistent racism and entitlement. But the large number of White settlers and government-sanctioned land acquisitions left them at a profound disadvantage. Ultimately, both groups withdrew into homogenous communities in which their language and culture could survive. \n\n CHINESE IMMIGRANTS IN THE AMERICAN WEST \n\n The initial arrival of Chinese immigrants to the United States began as a slow trickle in the 1820s, with barely 650 living in the U.S. by the end of 1849. However, as gold rush fever swept the country, Chinese immigrants, too, were attracted to the notion of quick fortunes. By 1852, over 25,000 Chinese immigrants had arrived, and by 1880, over 300,000 Chinese lived in the United States, most in California. While they had dreams of finding gold, many instead found employment building the first transcontinental railroad ( Figure 17.15 ). Some even traveled as far east as the former cotton plantations of the Old South, which they helped to farm after the Civil War. Several thousand of these immigrants booked their passage to the United States using a \u201ccredit-ticket,\u201d in which their passage was paid in advance by American businessmen to whom the immigrants were then indebted for a period of work. Most arrivals were men: Few wives or children ever traveled to the United States. As late as 1890, less than 5 percent of the Chinese population in the U.S. was female. Regardless of gender, few Chinese immigrants intended to stay permanently in the United States, although many were reluctantly forced to do so, as they lacked the financial resources to return home. \n\n Prohibited by law since 1790 from obtaining U.S. citizenship through naturalization, Chinese immigrants faced harsh discrimination and violence from American settlers in the West. Despite hardships like the special tax that Chinese miners had to pay to take part in the Gold Rush, or their subsequent forced relocation into Chinese districts, these immigrants continued to arrive in the United States seeking a better life for the families they left behind. Only when the Chinese Exclusion Act of 1882 forbade further immigration from China for a ten-year period did the flow stop. \n\n The Chinese community banded together in an effort to create social and cultural centers in cities such as San Francisco. In a haphazard fashion, they sought to provide services ranging from social aid to education, places of worship, health facilities, and more to their fellow Chinese immigrants. But only American Indians suffered greater discrimination and racial violence, legally sanctioned by the federal government, than did Chinese immigrants at this juncture in American history. As Chinese workers began competing with White Americans for jobs in California cities, the latter began a system of built-in discrimination. In the 1870s, White Americans formed \u201canti-coolie clubs\u201d (\u201ccoolie\u201d being a racial slur directed towards people of any Asian descent), through which they organized boycotts of Chinese-produced products and lobbied for anti-Chinese laws. Some protests turned violent, as in 1885 in Rock Springs, Wyoming, where tensions between White and Chinese immigrant miners erupted in a riot, resulting in over two dozen Chinese immigrants being murdered and many more injured. \n\n Slowly, racism and discrimination became law. The new California constitution of 1879 denied naturalized Chinese citizens the right to vote or hold state employment. Additionally, in 1882, the U.S. Congress passed the Chinese Exclusion Act, which forbade further Chinese immigration into the United States for ten years. The ban was later extended on multiple occasions until its repeal in 1943. Eventually, some Chinese immigrants returned to China. Those who remained were stuck in the lowest-paying, most menial jobs. Several found assistance through the creation of benevolent associations designed to both support Chinese communities and defend them against political and legal discrimination; however, the history of Chinese immigrants to the United States remained largely one of deprivation and hardship well into the twentieth century. \n\n Defining American The Backs that Built the Railroad Below is a description of the construction of the railroad in 1867. Note the way it describes the scene, the laborers, and the effort. \n\n The cars now (1867) run nearly to the summit of the Sierras. . . . four thousand laborers were at work\u2014one-tenth Irish, the rest Chinese. They were a great army laying siege to Nature in her strongest citadel. The rugged mountains looked like stupendous ant-hills. They swarmed with Celestials, shoveling, wheeling, carting, drilling and blasting rocks and earth, while their dull, moony eyes stared out from under immense basket-hats, like umbrellas. At several dining camps we saw hundreds sitting on the ground, eating soft boiled rice with chopsticks as fast as terrestrials could with soup-ladles. Irish laborers received thirty dollars per month (gold) and board; Chinese, thirty-one dollars, boarding themselves. After a little experience the latter were quite as efficient and far less troublesome. \u2014Albert D. Richardson,  Beyond the Mississippi \n\n Several great American advancements of the nineteenth century were built with the hands of many other nations. It is interesting to ponder how much these immigrant communities felt they were building their own fortunes and futures, versus the fortunes of others. Is it likely that the Chinese laborers, many of whom died due to the harsh conditions, considered themselves part of \u201ca great army\u201d? Certainly, this account reveals the unwitting racism of the day, where workers were grouped together by their ethnicity, and each ethnic group was labeled monolithically as \u201cgood workers\u201d or \u201ctroublesome,\u201d with no regard for individual differences among the hundreds of Chinese or Irish workers. \n\n HISPANIC AMERICANS IN THE AMERICAN WEST \n\n The Treaty of Guadalupe Hidalgo, which ended the Mexican-American War in 1848, promised U.S. citizenship to the nearly seventy-five thousand Hispanics now living in the American Southwest; approximately 90 percent accepted the offer and chose to stay in the United States despite their immediate relegation to second-class citizenship status. Relative to the rest of Mexico, these lands were sparsely populated and had been so ever since the country achieved its freedom from Spain in 1821. In fact, New Mexico\u2014not Texas or California\u2014was the center of settlement in the region in the years immediately preceding the war with the United States, containing nearly fifty thousand Mexicans. However, those who did settle the area were proud of their heritage and ability to develop  rancheros  of great size and success. Despite promises made in the treaty, these Californios\u2014as they came to be known\u2014quickly lost their land to White settlers who simply displaced the rightful landowners, by force if necessary. Repeated efforts at legal redress mostly fell upon deaf ears. In some instances, judges and lawyers would permit the legal cases to proceed through an expensive legal process only to the point where Hispanic landowners who insisted on holding their ground were rendered penniless for their efforts. \n\n Much like Chinese immigrants, Hispanic citizens were relegated to the worst-paying jobs under the most terrible working conditions. They worked as  pe\u00f3ns  (manual laborers similar to slaves),  vaqueros  (cattle herders), and cartmen (transporting food and supplies) on the cattle ranches that White landowners possessed, or undertook the most hazardous mining tasks ( Figure 17.16 ). \n\n In a few instances, frustrated Hispanic citizens fought back against the White settlers who dispossessed them of their belongings. In 1889\u20131890 in New Mexico, several hundred Mexican Americans formed  las Gorras Blancas  (the White Caps) to try and reclaim their land and intimidate White Americans, preventing further land seizures. White Caps conducted raids of White farms, burning homes, barns, and crops to express their growing anger and frustration. However, their actions never resulted in any fundamental changes. Several White Caps were captured, beaten, and imprisoned, whereas others eventually gave up, fearing harsh reprisals against their families. Some White Caps adopted a more political strategy, gaining election to local offices throughout New Mexico in the early 1890s, but growing concerns over the potential impact upon the territory\u2019s quest for statehood led several citizens to heighten their repression of the movement. Other laws passed in the United States intended to deprive Mexican Americans of their heritage as much as their lands. \u201cSunday Laws\u201d prohibited \u201cnoisy amusements\u201d such as bullfights, cockfights, and other cultural gatherings common to Hispanic communities at the time. \u201cGreaser Laws\u201d permitted the imprisonment of any unemployed Mexican American on charges of vagrancy. Although Hispanic Americans held tightly to their cultural heritage as their remaining form of self-identity, such laws did take a toll. In California and throughout the Southwest, the massive influx of Anglo-American settlers simply overran the Hispanic populations that had been living and thriving there, sometimes for generations. Despite being U.S. citizens with full rights, Hispanics quickly found themselves outnumbered, outvoted, and, ultimately, outcast. Corrupt state and local governments favored Whites in land disputes, and mining companies and cattle barons discriminated against them, as with the Chinese workers, in terms of pay and working conditions. In growing urban areas such as Los Angeles,  barrios , or clusters of working-class homes, grew more isolated from the White American centers. Hispanic Americans, like the Native Americans and Chinese, suffered the fallout of the White settlers\u2019 relentless push west. ", "questions": [{"question": {"question_id": "fs-idm57715072", "question_text": "Which of the following does not represent a group that participated significantly in westward migration after 1870?", "question_choices": ["African American \u201cexodusters\u201d escaping racism and seeking economic opportunities", "former Southern slaveholders seeking land and new financial opportunities", "recent immigrants from Northern Europe and Canada", "recent Chinese immigrants seeking gold in California"], "cloze_format": "___ does not represent a group that participated significantly in westward migration after 1870.", "normal_format": "Which of the following does not represent a group that participated significantly in westward migration after 1870?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "bloom": null, "hl_sentences": "In addition to a significant European migration westward , several thousand African Americans migrated west following the Civil War , as much to escape the racism and violence of the Old South as to find new economic opportunities . They were known as exodusters , referencing the biblical flight from Egypt , because they fled the racism of the South , with most of them headed to Kansas from Kentucky , Tennessee , Louisiana , Mississippi , and Texas . More recent immigrants also migrated west , with the largest numbers coming from Northern Europe and Canada . Germans , Scandinavians , and Irish were among the most common . More than 200,000 Chinese arrived in California between 1876 and 1890 , albeit for entirely different reasons related to the Gold Rush .", "hl_context": "<hl> In addition to a significant European migration westward , several thousand African Americans migrated west following the Civil War , as much to escape the racism and violence of the Old South as to find new economic opportunities . <hl> <hl> They were known as exodusters , referencing the biblical flight from Egypt , because they fled the racism of the South , with most of them headed to Kansas from Kentucky , Tennessee , Louisiana , Mississippi , and Texas . <hl> Over twenty-five thousand exodusters arrived in Kansas in 1879 \u2013 1880 alone . By 1890 , over 500,000 Blacks lived west of the Mississippi River . Although the majority of Black migrants became farmers , approximately twelve thousand worked as cowboys during the Texas cattle drives . Some also became \u201c Buffalo Soldiers \u201d in the wars against Native Americans . \u201c Buffalo Soldiers \u201d were African Americans allegedly so-named by various Native tribes who equated their black , curly hair with that of the buffalo . Many had served in the Union army in the Civil War and were now organized into six , all-Black cavalry and infantry units whose primary duties were to protect settlers from Native American attacks during the westward migration , as well as to assist in building the infrastructure required to support western settlement ( Figure 17.5 ) . Nearly 400,000 settlers had made the trek westward by the height of the movement in 1870 . The vast majority were men , although families also migrated , despite incredible hardships for women with young children . <hl> More recent immigrants also migrated west , with the largest numbers coming from Northern Europe and Canada . <hl> <hl> Germans , Scandinavians , and Irish were among the most common . <hl> These ethnic groups tended to settle close together , creating strong rural communities that mirrored the way of life they had left behind . According to U . S . Census Bureau records , the number of Scandinavians living in the United States during the second half of the nineteenth century exploded , from barely 18,000 in 1850 to over 1.1 million in 1900 . During that same time period , the German-born population in the United States grew from 584,000 to nearly 2.7 million and the Irish-born population grew from 961,000 to 1.6 million . As they moved westward , several thousand immigrants established homesteads in the Midwest , primarily in Minnesota and Wisconsin , where , as of 1900 , over one-third of the population was foreign-born , and in North Dakota , whose immigrant population stood at 45 percent at the turn of the century . Compared to European immigrants , those from China were much less numerous , but still significant . <hl> More than 200,000 Chinese arrived in California between 1876 and 1890 , albeit for entirely different reasons related to the Gold Rush . <hl>"}, {"question": {"question_id": "fs-idm57869296", "question_text": "Which of the following represents an action that the U.S. government took to help Americans fulfill the goal of western expansion?", "question_choices": ["the passage of the Homestead Act", "the official creation of the philosophy of Manifest Destiny", "the development of stricter immigration policies", "the introduction of new irrigation techniques"], "cloze_format": "___ is an action that the U.S. governement took to help Americans fulfill the goal of western expansion.", "normal_format": "Which of the following represents an action that the U.S. government took to help Americans fulfill the goal of western expansion?"}, "answer": {"ans_text": "the passage of the Homestead Act", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The Homestead Act allowed any head of household , or individual over the age of twenty-one \u2014 including unmarried women \u2014 to receive a parcel of 160 acres for only a nominal filing fee . Under this act , the government transferred over 270 million acres of public domain land to private citizens . To assist the settlers in their move westward and transform the migration from a trickle into a steady flow , Congress passed two significant pieces of legislation in 1862 : the Homestead Act and the Pacific Railway Act .", "hl_context": "<hl> The Homestead Act allowed any head of household , or individual over the age of twenty-one \u2014 including unmarried women \u2014 to receive a parcel of 160 acres for only a nominal filing fee . <hl> All that recipients were required to do in exchange was to \u201c improve the land \u201d within a period of five years of taking possession . The standards for improvement were minimal : Owners could clear a few acres , build small houses or barns , or maintain livestock . <hl> Under this act , the government transferred over 270 million acres of public domain land to private citizens . <hl> <hl> To assist the settlers in their move westward and transform the migration from a trickle into a steady flow , Congress passed two significant pieces of legislation in 1862 : the Homestead Act and the Pacific Railway Act . <hl> Born largely out of President Abraham Lincoln \u2019 s growing concern that a potential Union defeat in the early stages of the Civil War might result in the expansion of slavery westward , Lincoln hoped that such laws would encourage the expansion of a \u201c free soil \u201d mentality across the West ."}, {"question": {"question_id": "fs-idm65032544", "question_text": "What specific types of hardships did an average American farmer not face as he built his homestead in the Midwest?", "question_choices": ["droughts", "insect swarms", "attacks from Native Americans", "limited building supplies"], "cloze_format": "An average American farmer did not face ___ as he built his homestead in the Midwest.", "normal_format": "What specific types of hardships did an average American farmer not face as he built his homestead in the Midwest?"}, "answer": {"ans_text": "attacks from Native Americans", "ans_choice": 2}, "bloom": null, "hl_sentences": "The first houses built by western settlers were typically made of mud and sod with thatch roofs , as there was little timber for building . Rain , when it arrived , presented constant problems for these sod houses , with mud falling into food , and vermin , most notably lice , scampering across bedding ( Figure 17.8 ) . Weather patterns not only left the fields dry , they also brought tornadoes , droughts , blizzards , and insect swarms . Tales of swarms of locusts were commonplace , and the crop-eating insects would at times cover the ground six to twelve inches deep .", "hl_context": "<hl> The first houses built by western settlers were typically made of mud and sod with thatch roofs , as there was little timber for building . <hl> <hl> Rain , when it arrived , presented constant problems for these sod houses , with mud falling into food , and vermin , most notably lice , scampering across bedding ( Figure 17.8 ) . <hl> <hl> Weather patterns not only left the fields dry , they also brought tornadoes , droughts , blizzards , and insect swarms . <hl> <hl> Tales of swarms of locusts were commonplace , and the crop-eating insects would at times cover the ground six to twelve inches deep . <hl> One frequently quoted Kansas newspaper reported a locust swarm in 1878 during which the insects devoured \u201c everything green , stripping the foliage off the bark and from the tender twigs of the fruit trees , destroying every plant that is good for food or pleasant to the eye , that man has planted . \u201d"}, {"question": {"question_id": "fs-idm49405312", "question_text": "Which of the following groups was not impacted by the invention of barbed wire?", "question_choices": ["ranchers", "cowboys", "farmers", "illegal prostitutes"], "cloze_format": "___ was not impacted by the invention of barbed wire.", "normal_format": "Which of the following groups was not impacted by the invention of barbed wire?"}, "answer": {"ans_text": "D", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Not only did it spell the end of the free range for settlers and cowboys , it kept more land away from Native tribes , who had never envisioned a culture that would claim to own land ( Figure 17.11 ) . Ranchers developed the land , limiting grazing opportunities along the trail , and in 1873 , the new technology of barbed wire allowed ranchers to fence off their lands and cattle claims .", "hl_context": "Americana Barbed Wire and a Way of Life Gone Called the \u201c devil \u2019 s rope \u201d by Native Americans , barbed wire had a profound impact on the American West . Before its invention , settlers and ranchers alike were stymied by a lack of building materials to fence off land . Communal grazing and long cattle drives were the norm . But with the invention of barbed wire , large cattle ranchers and their investors were able to cheaply and easily parcel off the land they wanted \u2014 whether or not it was legally theirs to contain . As with many other inventions , several people \u201c invented \u201d barbed wire around the same time . In 1873 , it was Joseph Glidden , however , who claimed the winning design and patented it . <hl> Not only did it spell the end of the free range for settlers and cowboys , it kept more land away from Native tribes , who had never envisioned a culture that would claim to own land ( Figure 17.11 ) . <hl> Life as a cowboy was dirty and decidedly unglamorous . The terrain was difficult ; conflicts with Native Americans , especially in Indian Territory ( now Oklahoma ) , were notoriously deadly . But the longhorn cattle were hardy stock , and could survive and thrive while grazing along the long trail , so cowboys braved the trip for the promise of steady employment and satisfying wages . Eventually , however , the era of the free range ended . <hl> Ranchers developed the land , limiting grazing opportunities along the trail , and in 1873 , the new technology of barbed wire allowed ranchers to fence off their lands and cattle claims . <hl> With the end of the free range , the cattle industry , like the mining industry before it , grew increasingly dominated by eastern businessmen . Capital investors from the East expanded rail lines and invested in ranches , ending the reign of the cattle drives ."}, {"question": {"question_id": "fs-idm47649424", "question_text": "The American cowboy owes much of its model to what other culture?", "question_choices": ["Mexicans", "Native Americans", "Northern European immigrants", "Chinese immigrants"], "cloze_format": "The American cowboy owes much of its model to ___.", "normal_format": "The American cowboy owes much of its model to what other culture?"}, "answer": {"ans_text": "Mexicans", "ans_choice": 0}, "bloom": null, "hl_sentences": "It is worth noting that the stereotype of the American cowboy \u2014 and indeed the cowboys themselves \u2014 borrowed much from the Mexicans who had long ago settled those lands .", "hl_context": "Between 1865 and 1885 , as many as forty thousand cowboys roamed the Great Plains , hoping to work for local ranchers . They were all men , typically in their twenties , and close to one-third of them were Hispanic or African American . <hl> It is worth noting that the stereotype of the American cowboy \u2014 and indeed the cowboys themselves \u2014 borrowed much from the Mexicans who had long ago settled those lands . <hl> The saddles , lassos , chaps , and lariats that define cowboy culture all arose from the Mexican ranchers who had used them to great effect before the cowboys arrived ."}, {"question": {"question_id": "fs-idp20082576", "question_text": "Which of the following was not a primary method by which the American government dealt with American Indians during the period of western settlement?", "question_choices": ["relocation", "appeasement", "extermination", "assimilation"], "cloze_format": "___ was not a primary method by which the American government dealt with American Indians during the period of western settlement.", "normal_format": "Which of the following was not a primary method by which the American government dealt with American Indians during the period of western settlement?"}, "answer": {"ans_text": "appeasement", "ans_choice": 1}, "bloom": null, "hl_sentences": "Beginning in the 1880s , clergymen , government officials , and social workers all worked to assimilate Native peoples into American life . Rather , they either returned to tribal life or fled out of fear of remaining troops , until the U . S . Army arrived in greater numbers and began to exterminate Indian encampments and force others to accept payment for forcible removal from their lands . The Indian Removal Act of 1830 resulted in the infamous \u201c Trail of Tears , \u201d which saw nearly fifty thousand Seminole , Choctaw , Chickasaw , and Creek people relocated west of the Mississippi River to what is now Oklahoma between 1831 and 1838 .", "hl_context": "<hl> Beginning in the 1880s , clergymen , government officials , and social workers all worked to assimilate Native peoples into American life . <hl> The government permitted reformers to remove Native American children from their homes and place them in boarding schools , such as the Carlisle Indian School or the Hampton Institute , where they were taught to abandon their tribal traditions and embrace the tools of American productivity , modesty , and sanctity through total immersion . Such schools not only acculturated Native American boys and girls , but also provided vocational training for males and domestic science classes for females . Adults were also targeted by religious reformers , specifically evangelical Protestants as well as a number of Catholics , who sought to convince Native people to abandon their language , clothing , and social customs for a more Euro-American lifestyle ( Figure 17.14 ) . Despite their success at Little Bighorn , neither the Sioux nor any other Plains tribe followed this battle with any other armed encounter . <hl> Rather , they either returned to tribal life or fled out of fear of remaining troops , until the U . S . Army arrived in greater numbers and began to exterminate Indian encampments and force others to accept payment for forcible removal from their lands . <hl> Sitting Bull himself fled to Canada , although he later returned in 1881 and subsequently worked in Buffalo Bill \u2019 s Wild West show . In Montana , the Blackfoot and Crow were forced to leave their tribal lands . In Colorado , the Utes gave up their lands after a brief period of resistance . In Idaho , most of the Nez Perce gave up their lands peacefully , although in an incredible episode , a band of some eight hundred Indians sought to evade U . S . troops and escape into Canada . Back east , the popular vision of the West was of a vast and empty land . But of course this was an exaggerated depiction . On the eve of westward expansion , as many as 250,000 Native Americans , representing a variety of tribes , populated the Great Plains . Previous wars against these tribes in the early nineteenth century , as well as the failure of earlier treaties , had led to a general policy of the forcible removal of many tribes in the eastern United States . <hl> The Indian Removal Act of 1830 resulted in the infamous \u201c Trail of Tears , \u201d which saw nearly fifty thousand Seminole , Choctaw , Chickasaw , and Creek people relocated west of the Mississippi River to what is now Oklahoma between 1831 and 1838 . <hl> Building upon such a history , the U . S . government was prepared , during the era of western settlement , to deal with tribes that settlers viewed as obstacles to expansion ."}, {"question": {"question_id": "fs-idm27218960", "question_text": "What did the Last Arrow pageant symbolize?", "question_choices": ["the continuing fight of the Native Americans", "the total extermination of the Native Americans from the West", "the final step in the Americanization process", "the rebellion at Little Bighorn"], "cloze_format": "The Last Arrow pageant symbolizes ___.", "normal_format": "What did the Last Arrow pageant symbolize?"}, "answer": {"ans_text": "C", "ans_choice": 2}, "bloom": null, "hl_sentences": "The final element of \u201c Americanization \u201d was the symbolic \u201c last arrow \u201d pageant , which often coincided with the formal redistribution of tribal lands under the Dawes Act .", "hl_context": "A vital part of the assimilation effort was land reform . During earlier negotiations , the government had respected that the Native tribes used their land communally . Most Native American belief structures did not allow for the concept of individual land ownership ; rather , land was available for all to use , and required responsibility from all to protect it . As a part of their plan to Americanize the tribes , reformers sought legislation to replace this concept with the popular Euro-American notion of real estate ownership and self-reliance . One such law was the Dawes Severalty Act of 1887 , named after a reformer and senator from Massachusetts , which struck a deadly blow to the Native American way of life . In what was essentially a new version of the original Homestead Act , the Dawes Act permitted the federal government to divide the lands of any tribe and grant 160 acres of farmland or 320 acres of grazing land to each head of family , with lesser amounts to single persons and others . In a nod towards the paternal relationship with which Whites viewed Native Americans \u2014 similar to the justification of the previous treatment of enslaved African Americans \u2014 the Dawes Act permitted the federal government to hold an individual Native American \u2019 s newly acquired land in trust for twenty-five years . Only then would they obtain full title and be granted the citizenship rights that land ownership entailed . It would not be until 1924 that formal citizenship was granted to all Native Americans . Under the Dawes Act , Native Americans were given the most arid , useless land . Further , inefficiencies and corruption in the government meant that much of the land due to be allotted to Native Americans was simply deemed \u201c surplus \u201d and claimed by settlers . Once all allotments were determined , the remaining tribal lands \u2014 as much as eighty million acres \u2014 were sold to White American settlers . <hl> The final element of \u201c Americanization \u201d was the symbolic \u201c last arrow \u201d pageant , which often coincided with the formal redistribution of tribal lands under the Dawes Act . <hl> At these events , Native Americans were forced to assemble in their tribal garb , carrying a bow and arrow . They would then symbolically fire their \u201c last arrow \u201d into the air , enter a tent where they would strip away their traditional clothing , dress in a White farmer \u2019 s coveralls , and emerge to take a plow and an American flag to show that they had converted to a new way of life . It was a seismic shift for the Native Americans , and one that left them bereft of their culture and history . 17.5 The Impact of Expansion on Chinese Immigrants and Hispanic Citizens Learning Objectives By the end of this section , you will be able to :"}, {"question": {"question_id": "fs-idm30931696", "question_text": "What brought the majority of Chinese immigrants to the U.S.?", "question_choices": ["gold", "work opportunities on the railroads", "the Homestead Act", "Chinese benevolent associations"], "cloze_format": "The majority of Chinese immigrants came to the U.S. because of ___.", "normal_format": "What brought the majority of Chinese immigrants to the U.S.?"}, "answer": {"ans_text": "gold", "ans_choice": 0}, "bloom": null, "hl_sentences": "However , as gold rush fever swept the country , Chinese immigrants , too , were attracted to the notion of quick fortunes . By 1852 , over 25,000 Chinese immigrants had arrived , and by 1880 , over 300,000 Chinese lived in the United States , most in California .", "hl_context": "The initial arrival of Chinese immigrants to the United States began as a slow trickle in the 1820s , with barely 650 living in the U . S . by the end of 1849 . <hl> However , as gold rush fever swept the country , Chinese immigrants , too , were attracted to the notion of quick fortunes . <hl> <hl> By 1852 , over 25,000 Chinese immigrants had arrived , and by 1880 , over 300,000 Chinese lived in the United States , most in California . <hl> While they had dreams of finding gold , many instead found employment building the first transcontinental railroad ( Figure 17.15 ) . Some even traveled as far east as the former cotton plantations of the Old South , which they helped to farm after the Civil War . Several thousand of these immigrants booked their passage to the United States using a \u201c credit-ticket , \u201d in which their passage was paid in advance by American businessmen to whom the immigrants were then indebted for a period of work . Most arrivals were men : Few wives or children ever traveled to the United States . As late as 1890 , less than 5 percent of the Chinese population in the U . S . was female . Regardless of gender , few Chinese immigrants intended to stay permanently in the United States , although many were reluctantly forced to do so , as they lacked the financial resources to return home ."}, {"question": {"question_id": "fs-idm335680", "question_text": "How were Hispanic citizens deprived of their wealth and land in the course of western settlement?", "question_choices": ["Native American raids", "land seizures", "prisoner of war status", "infighting"], "cloze_format": "The Hispanic citizens were deprived of their wealth and land in the course of western settlement by ___.", "normal_format": "How were Hispanic citizens deprived of their wealth and land in the course of western settlement?"}, "answer": {"ans_text": "B", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "In 1889 \u2013 1890 in New Mexico , several hundred Mexican Americans formed las Gorras Blancas ( the White Caps ) to try and reclaim their land and intimidate White Americans , preventing further land seizures .", "hl_context": "In a few instances , frustrated Hispanic citizens fought back against the White settlers who dispossessed them of their belongings . <hl> In 1889 \u2013 1890 in New Mexico , several hundred Mexican Americans formed las Gorras Blancas ( the White Caps ) to try and reclaim their land and intimidate White Americans , preventing further land seizures . <hl> White Caps conducted raids of White farms , burning homes , barns , and crops to express their growing anger and frustration . However , their actions never resulted in any fundamental changes . Several White Caps were captured , beaten , and imprisoned , whereas others eventually gave up , fearing harsh reprisals against their families . Some White Caps adopted a more political strategy , gaining election to local offices throughout New Mexico in the early 1890s , but growing concerns over the potential impact upon the territory \u2019 s quest for statehood led several citizens to heighten their repression of the movement . Other laws passed in the United States intended to deprive Mexican Americans of their heritage as much as their lands . \u201c Sunday Laws \u201d prohibited \u201c noisy amusements \u201d such as bullfights , cockfights , and other cultural gatherings common to Hispanic communities at the time . \u201c Greaser Laws \u201d permitted the imprisonment of any unemployed Mexican American on charges of vagrancy . Although Hispanic Americans held tightly to their cultural heritage as their remaining form of self-identity , such laws did take a toll . In California and throughout the Southwest , the massive influx of Anglo-American settlers simply overran the Hispanic populations that had been living and thriving there , sometimes for generations . Despite being U . S . citizens with full rights , Hispanics quickly found themselves outnumbered , outvoted , and , ultimately , outcast . Corrupt state and local governments favored Whites in land disputes , and mining companies and cattle barons discriminated against them , as with the Chinese workers , in terms of pay and working conditions . In growing urban areas such as Los Angeles , barrios , or clusters of working-class homes , grew more isolated from the White American centers . Hispanic Americans , like the Native Americans and Chinese , suffered the fallout of the White settlers \u2019 relentless push west ."}], "summary": " Summary 17.1   The Westward Spirit \n\n While a few bold settlers had moved westward before the middle of the nineteenth century, they were the exception, not the rule. The \u201cgreat American desert,\u201d as it was called, was considered a vast and empty place, unfit for civilized people. In the 1840s, however, this idea started to change, as potential settlers began to learn more from promoters and land developers of the economic opportunities that awaited them in the West, and Americans extolled the belief that it was their Manifest Destiny\u2014their divine right\u2014to explore and settle the western territories in the name of the United States. \n\n Most settlers in this first wave were White Americans of means. Whether they sought riches in gold, cattle, or farming, or believed it their duty to spread Protestant ideals to native inhabitants, they headed west in wagon trains along paths such as the Oregon Trail. European immigrants, particularly those from Northern Europe, also made the trip, settling in close-knit ethnic enclaves out of comfort, necessity, and familiarity. African Americans escaping the racism of the South also went west. In all, the newly settled areas were neither a fast track to riches nor a simple expansion into an empty land, but rather a clash of cultures, races, and traditions that defined the emerging new America. \n\n 17.2   Homesteading: Dreams and Realities \n\n The concept of Manifest Destiny and the strong incentives to relocate sent hundreds of thousands of people west across the Mississippi. The rigors of this new way of life presented many challenges and difficulties to homesteaders. The land was dry and barren, and homesteaders lost crops to hail, droughts, insect swarms, and more. There were few materials with which to build, and early homes were made of mud, which did not stand up to the elements. Money was a constant concern, as the cost of railroad freight was exorbitant, and banks were unforgiving of bad harvests. For women, life was difficult in the extreme. Farm wives worked at least eleven hours per day on chores and had limited access to doctors or midwives. Still, they were more independent than their eastern counterparts and worked in partnership with their husbands. \n\n As the railroad expanded and better farm equipment became available, by the 1870s, large farms began to succeed through economies of scale. Small farms still struggled to stay afloat, however, leading to a rising discontent among the farmers, who worked so hard for so little success. \n\n 17.3   Making a Living in Gold and Cattle \n\n While homesteading was the backbone of western expansion, mining and cattle also played significant roles in shaping the West. Much rougher in character and riskier in outcomes than farming, these two opportunities brought forward a different breed of settler than the homesteaders. Many of the long-trail cattle riders were Mexican American or African American, and most of the men involved in both pursuits were individuals willing to risk what little they had in order to strike it rich. \n\n In both the mining and cattle industries, however, individual opportunities slowly died out, as resources\u2014both land for grazing and easily accessed precious metals\u2014disappeared. In their place came big business, with the infrastructure and investments to make a profit. These businesses built up small towns into thriving cities, and the influx of middle-class families sought to drive out some of the violence and vice that characterized the western towns. Slowly but inexorably, the \u201cAmerican\u201d way of life, as envisioned by the eastern establishment who initiated and promoted the concept of Manifest Destiny, was spreading west. \n\n 17.4   The Loss of American Indian Life and Culture \n\n The interaction of the American Indians with White settlers during the western expansion movement was a painful and difficult one. For settlers raised on the notion of Manifest Destiny and empty lands, the Native Americans added a terrifying element to what was already a difficult and dangerous new world. For the Native peoples, the arrival of the settlers meant nothing less than the end of their way of life. Rather than cultural exchange, contact led to the virtual destruction of Native American life and culture. While violent acts broke out on both sides, the greatest atrocities were perpetrated by Whites, who had superior weapons and often superior numbers, as well as the support of the U.S. government. \n\n The death of the Native American way of life happened as much at the hands of well-intentioned reformers as those who wished to see the Indians exterminated. Individual land ownership, boarding schools, and pleas to renounce Indian gods and culture were all elements of the reformers\u2019 efforts. With so much of their life stripped away, it was ever more difficult for the Native Americans to maintain their tribal integrity. \n\n 17.5   The Impact of Expansion on Chinese Immigrants and Hispanic Citizens \n\n In the nineteenth century, the Hispanic, Chinese, and White populations of the country collided. Whites moved further west in search of land and riches, bolstered by government subsidies and an inherent and unshakable belief that the land and its benefits existed for their use. In some ways, it was a race to the prize: White Americans believed that they deserved the best lands and economic opportunities the country afforded, and did not consider prior claims to be valid. \n\n Neither Chinese immigrants nor Hispanic Americans could withstand the assault on their rights by the tide of White settlers. Sheer numbers, matched with political backing, gave the Whites the power they needed to overcome any resistance. Ultimately, both ethnic groups retreated into urban enclaves, where their language and traditions could survive. ", "keyterm": "", "bname": "u.s._history"}, {"chapter": 5, "intro": " Chapter Outline 5.1   Common Business Crimes 5.2   Civil vs. Criminal Liability Introduction \n\n Learning Outcome \n\n Analyze sources of criminal exposure in business. ", "chapter_text": " 5.1   Common Business Crimes \n\n People rarely think about their conduct at work as being potentially illegal, or that jail time could result from poor workplace decisions. However, this fact is the reality. Organizations are fined, and executives are sentenced to jail, when business laws are broken. Many of the workplace violations are nonviolent crimes, such as fraud, property crimes, or drug- or alcohol-related infractions. Regardless of the level of violence or the employee\u2019s motivation for committing the crime, breaking the law can lead to negative consequences for the business, its employees, and its customers. \n\n Constitutional Authority to Regulate Business \n\n Congress is given the power to \u201cregulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes.\u201d Our forefathers wanted to facilitate easier trade among the states by allowing Congress to adopt rules that could be uniformly applied. The theory was that if commercial enterprises knew that they would be dealing with essentially the same rules across the nation, it would be much easier to run their businesses and keep commerce flowing more efficiently. \n\n While federal courts initially interpreted the commerce power narrowly, over time, the federal courts have decided that the commerce clause gives the federal government broad powers to regulate commerce, not only on an  interstate  (between the states) level, but also on an  intrastate  (within each state) level, as long as some economic transaction is involved. The federal government does not usually exceed its regulatory powers. \n\n White Collar Crime \n\n White collar crimes  are characterized by deceit, concealment, or violation of trust. They are committed by business professionals. They generally involve fraud, and the employees committing the crimes are motivated by the desire for financial gains or fear of losing business standing, money, or property.  Fraud  is the intentional misrepresentation of material facts for monetary gain. This type of crime is not dependent on threats or violence. \n\n White collar crimes tend to violate state laws, and sometimes federal laws. The violation depends on what is involved in the crime. For instance, criminal acts involving the United States postal system or interstate commerce violate federal law. \n\n Although white collar crimes do not need to include physical violence, these types of crimes can destroy companies, the environment, and the financial stability of clients, employees, and communities. In 2018, Jeremiah Hand and his brothers, Jehu Hand and Adam Hand, were convicted and sentenced to between 9 and 30 months in prison for their respective roles in a  pump-and-dump  scheme. In this scheme, they were dishonest about control over their company\u2019s stock, and even went as far as filing false forms in an effort to raise the value of the stock. Once the value of the stock was raised, they released their shares into the market. \n\n Types of Business Crimes \n\n Business crimes or white collar crimes are not limited to pump-and-dump schemes; they come in many different forms. As previously stated, these crimes often involve deceit, fraud, or misinformation. The types of high-profile crimes include Ponzi schemes, embezzlement, and crimes that intentionally violate environmental laws and regulations. This section will explore these three types of crimes and provide examples from the 2000s. \n\n Ponzi Schemes \n\n Ponzi schemes  (also known as pyramid schemes) are investing scams that promise investors low-risk investment opportunities with a high rate of return. The high rates are paid to old investors with money acquired from the acquisition of new investors. The performance of the market is not a factor in the investors' rate of return. \n\n Bernie Madoff operated a 20-year Ponzi scheme through his company. He paid high returns (above average) using the investments of new clients (investors). In 2008, investors attempted to withdraw funds, but the Madoff organization was not able to provide the reimbursement. Madoff is currently serving a more than 100-year sentence in prison. \n\n Larceny and Embezzlement \n\n Larceny and embezzlement are two forms of theft that can occur within a business.  Larceny  occurs when a person unlawfully takes the personal property of another person or a business. For example, if an employee takes another employee\u2019s computer with the intent of stealing it, he or she may be guilty of larceny. In contrast,  embezzlement  occurs when a person has been entrusted with an item of value and then refuses to return it or does not return the item. For example, if an employee is entrusted with the petty cash at his or her office and that person purposefully takes some of the money for himself or herself, this would be embezzlement. \n\n One high-profile example of embezzlement occurred at Koss Corporation in Milwaukee, Wisconsin. Sujata \u201cSue\u201d Sachdeva was a Vice President of Finance and Principal Accounting Officer at Koss Corporation. Sachdeva was convicted of embezzling $34 million over a 5-year period and sentenced to 11 years in federal prison, as well as restitution to Koss Corporation. Sachdeva was entrusted with the company\u2019s funds and did not utilize the funds as intended. \n\n Environmental Crimes \n\n Many federal statutes regulate the environment. Many of these laws carry both civil and criminal penalties for violations. \n\n The following federal laws can carry criminal penalties: \n\n Clean Air Act \n\n Clean Water Act \n\n Resource Conservation and Recovery Act \n\n Comprehensive Environmental Response, Compensation and Liability Act \n\n Endangered Species Act \n\n The International Petroleum Corporation of Delaware (IPC) is paying restitution for environmental crimes, which included a scheme to violate the Clean Water Act. From 1992 to 2012, IPC processed oil and wastewater. The company admitted to altering required water test samples so they met the limits set by their permit before releasing the waste into the city\u2019s sewer system. The company also admitted to transporting waste that contained benzene, barium, chromium, cadmium, lead, PCE, and trichloroethene for disposal in South Carolina without the required reporting of the information, which also violated environmental laws. \n\n Other Types of Business Crime \n\n The business environment is complex, and some crimes are less common or receive less media attention. These types of crimes include those that violate antitrust laws, racketeering, bribery, money laundering, and spamming. \n\n Violations of Antitrust Laws \n\n Antitrust laws  do not allow activities that restrain trade or promote market domination. These laws are in place to provide guidance and supervision of mergers and acquisitions of companies to prevent market abuse. The goal is to avoid  monopolies , or the control of one organization over a specific market. Monopolies reduce competition and, as a result, can have a detrimental impact on consumer prices. Since the United States is founded on capitalist principles, anti-competitive business conduct is prohibited by law, and some of those laws, such as the Sherman Antitrust Act, do include provisions about criminal punishment. \n\n Racketeering \n\n Racketeering  activities include loan-sharking, money laundering, and blackmailing. In the past, the term has been used to describe organized crime. The term is now applied to other entities, as well. RICO, or the Racketeer Influenced and Corrupt Organizations Act, is a federal law aimed at preventing and prosecuting by both businesses and organized crime syndicates. \u201cRICO is now used against insurance companies, stock brokerages, tobacco companies, banks, and other large commercial enterprises.\u201d (Schodolski, 2018). Racketeering is no longer limited to organized crime. Health insurance companies and other legitimate businesses are being accused of pressure tactics similar to those used in organized crime racketeering. These\u00a0claims involve allegations of lying about the actual cost of care, damaging the business for physicians, bullying patients, and attempting to control the doctor-patient relationship through lies and pressure tactics. \n\n Bribery \n\n Bribery  occurs when monetary payments, goods, services, information, or anything of value is exchanged for favorable or desired actions. You can be charged with bribery for offering a bribe, or taking a bribe. Bribery is illegal within the United States and outside of it. The Foreign Corrupt Practices Act prohibits bribery payments by U.S. companies to foreign government officials with an intent to influence foreign business results. One example of bribery would be a situation in\u00a0which a pharmaceutical company offers special benefits to individuals who agree to prescribe their medications. \n\n Money Laundering \n\n Money laundering  refers to taking \u201cdirty\u201dmoney, or money obtained through criminal activities, and passing it through otherwise legitimate businesses so that it appears \u201cclean.\u201d The money cannot be tied back to the illegal acts. Clean money is\u00a0money that was obtained through legitimate business functions. \n\n Spamming \n\n Sending unsolicited commercial email, or  spam , is illegal. While the onus is on consumers to avail themselves of whatever programs they can to block spam, laws are in place to discourage the sending of spam. The following points are outlined in the anti-spam legislation in Washington state and are similar to other legislation: \n\n Individuals may not initiate the sending or plan the sending of an email that misrepresents the sender as someone he or she is not, represents the sender as being associated with an organization that he or she has no association, or otherwise hides the identity of the sender or origin of the email. Email messages may not have false or misleading information in the subject line of the message. \n\n Commercial emails must include the contact information of the sender and the receiver must be aware that the message is from a commercial source. \n\n States like Washington are putting legislation in place to reduce spam and asking consumers to take an active role in addressing spam. In general, legislators realize that spam is a nuisance and are finding ways to hold companies liable for sending spam messages. \n\n Conclusion \n\n It is important to know that not all people charged with business crimes or white collar crimes are necessarily guilty. A person must be found guilty of the crime before he or she is convicted. Regardless, business crimes and white collar crimes negatively impact the individual, the organization he or she worked for, the community, and customers. \n 5.2   Civil vs. Criminal Liability \n\n A legal case can be civil or criminal. Each case has different components and requirements. Before one can understand the civil and criminal systems, it is important to understand the aspects of both civil and criminal laws. The scope, consequences, and treatments of each vary. \n\n Constitutional Rights \n\n It is important to understand the Constitution, which is the basis of all law. States are allowed to create and categorize crimes and punishment, as long as they do not violate rights protected by the U.S. Constitution. For example, in a fairly recent United States Supreme Court case,  Lawrence v. Texas , the defendants asserted the unconstitutionality of a Texas law (enacted by the Texas legislature) regarding a particular act. When the United States Supreme Court ruled it unconstitutional, Texas could no longer enforce it. Frequent issues litigated in the courts are: \n\n Whether evidence must be suppressed (not allowed to be introduced at trial) because it was obtained pursuant to an unreasonable search and seizure (violating the Fourth Amendment). This category might involve a sub-issue about whether officers had sufficient probable cause to conduct a warrantless search. Without a warrant, and without the suspect\u2019s consent, officers generally may only conduct searches if they have \u201cprobable cause\u201d to do so; any evidence obtained without consent or probable cause can be objected to, and ultimately ruled inadmissible by the court in trial, if illegally obtained.  \n\n Whether evidence must be suppressed because it was obtained while the suspect was \u201cin custody\u201d without advising a suspect of his rights to remain silent, to speak to an attorney, and to the appointment of an attorney if he cannot afford one (Fifth Amendment privilege against self-incrimination and Sixth Amendment right to counsel), as required by the Supreme Court in the famous  Miranda v. Arizona  case. The term often used to describe these rights is \u201cMirandizing,\u201d which is named after the case. \n\n Whether a state law or constitutional provision provides more protection than the U.S. Constitution. \n\n Components of Crime \n\n There are usually two components to criminal conduct that must be proven by the prosecutor. The prosecutor prosecutes the case against the accused:  mens rea  (the criminal, or guilty, or \u201cwrongful\u201d mind) and  actus reus  (the criminal, or guilty, or \u201cwrongful\u201d act). \n\n Each statute creating a crime is supposed to include a description of: \n\n the mental state ( mens rea ) required to establish that the suspect committed the crime, coupled with  \n\n a description of the conduct ( actus reus ) that the suspect must have done. \n\n The statute generally also indicates the category of crime (felony/misdemeanor/gross misdemeanor). \n\n Criminal Procedures \n\n Generally, the first pleading filed by the prosecutor is called the  information . (This step could be described as the criminal counterpart to a civil \u201ccomplaint.\u201d) \n\n The next stage is called the  arraignment , where the defendant appears in court so that the court can determine or confirm his or her identity, inform the defendant of the charge the prosecutor has filed against him or her, and hear the defendant\u2019s plea. \n\n Then, there will be discovery and trial. In criminal cases, the jury will convict only if convinced \u201cbeyond a reasonable doubt\u201d that the defendant committed the crime, and the verdict must be unanimous. This type of case involves a higher burden of proof than in civil cases. \n\n Criminal and Civil Law \n\n Criminal law  addresses behaviors that are offenses against the public, society, or state. Examples of criminal law offenses include assault, drunk driving, and theft. In contrast,  civil laws  address behavior that causes an injury to the private rights of individuals in areas such as child support, divorce, contracts, property, and the person. Examples of civil law offenses include libel, slander, or contract breaches. \n\n Criminal and civil cases differ in who initiates the case, how the case is decided, what punishments or penalties are issued, requirements of proof, and legal protections provided. \n\n Initiation and Roles \n\n Criminal and civil cases are initiated differently, and the titles of the individuals involved differ slightly. Criminal cases are only initiated by the federal or state government in response to a law being broken. The federal or state governments are known as the prosecution. The prosecution is an attorney, or group of attorneys, hired by the government to present a case against the accused. Criminal cases are usually titled something like \u201cState v. [last name of the defendant accused of a crime].\u201d In criminal prosecutions, the victim is not a party to the lawsuit, but might be a witness for the state at the trial. \n\n In contrast, private parties initiate civil cases when they feel that someone has injured them. Again, civil cases stem from breach of contract, custody cases, and attacks on one\u2019s character. Private parties can include an individual, a group, or a business. The person, group, or business who initiates the case is referred to as the plaintiff or complainant. The accused is referred to as the defendant, in both criminal and civil proceedings. \n\n Typically, there is a difference in the burden of proof for the two types of cases. In a criminal case, the defendant must be proven guilty \u201cbeyond a reasonable doubt.\u201d In a civil case, the defendant must be proven liable through a \u201cpreponderance of the evidence.\u201d In other words, the prosecution in a civil case must prove that it is more probable than not that the defendant is liable. \n\n In criminal cases, the defendant is entitled to an attorney and may be appointed an attorney if he or she is not able to afford one. The state appoints the attorney. In contrast, all parties involved in a civil case are required to secure their own legal representation. \n\n Typically, civil and criminal laws use different terminology, and being found guilty or accountable in each type of case results in different consequences. \n\n In a civil action (lawsuit), the plaintiff is the person who is alleging that he or she has actually been harmed (physically, financially, or in another manner), and the defendant is the one who is asked to pay damages or otherwise compensate the plaintiff. Outside of financial compensation, the plaintiff may be ordered to do something or refrain from doing something, which is referred to as injunctive relief. \n\n In the  Liebeck v. McDonald\u2019s  case, a woman sued McDonald\u2019s for serving hot coffee. The woman spilled hot coffee on her lap while trying to add cream and sugar. The woman sued McDonald\u2019s for negligence in a civil suit. The issue centered on whether or not the coffee\u2019s specific temperature was unreasonably hot. McDonald\u2019s lost the lawsuit. The compensatory verdict was $160,000. McDonald\u2019s was found liable. Conversely, if a defendant is convicted of committing a crime, the consequences are usually incarceration (jail/prison) and/or a fine (payment of money to the state). \n\n The word used to describe the legal responsibility for harm in a civil case is liability, not guilt. Guilty is the word used to describe a person found guilty of committing a crime in a criminal case. \n\n Businesses can be charged with criminal acts as well. In 2017, Oliver Schmidt, former manager of a Volkswagen engineering office near Detroit, was arrested. He faced years in prison for attempts to defraud the United States, wire fraud, violation of the Clean Air Act, and a charge of giving an untrue statement under the Clean Air Act. Schmidt\u2019s actions directly violated a business law and, since his actions violated an established law, he was held criminally liable. In December of 2017, Schmidt was sentenced to seven years in prison. \n\n Professional Negligence \n\n Professional negligence is often called  malpractice . A professional\u2019s duty of care is usually a duty to exercise the degree of care, skill, diligence, and knowledge commonly possessed and exercised by a reasonable, careful, and prudent professional of the same type in the state (or sometimes in the community). Along with attorneys and health care providers, the following professionals might be sued for malpractice: accountants, architects, engineers, surveyors, insurance brokers, real estate agents and brokers, and clergy. \n\n For negligence, the usual kind of damages recoverable are  compensatory , or money to compensate for the injuries/damages incurred to make the person  whole  (e.g., money for medical bills, lost wages, loss of future earning capacity, pain and suffering, emotional distress, property damage, etc.). ", "questions": [{"question": {"question_id": "fs-212323421", "question_text": "The crime of larceny includes:", "question_choices": ["The nontresspassory taking and controlling of personal property.", "The trespassory taking and carrying away of real or personal property.", "Joyriding.", "The trespassory taking and control of personal property."], "cloze_format": "The crime of larceny includes ___ .", "normal_format": "What includes in the crime of larceny?"}, "answer": {"ans_text": "d", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Larceny occurs when a person unlawfully takes the personal property of another person or a business .", "hl_context": "Larceny and embezzlement are two forms of theft that can occur within a business . <hl> Larceny occurs when a person unlawfully takes the personal property of another person or a business . <hl> For example , if an employee takes another employee \u2019 s computer with the intent of stealing it , he or she may be guilty of larceny . In contrast , embezzlement occurs when a person has been entrusted with an item of value and then refuses to return it or does not return the item . For example , if an employee is entrusted with the petty cash at his or her office and that person purposefully takes some of the money for himself or herself , this would be embezzlement ."}, {"question": {"question_id": "fs-2123231", "question_text": "Businesses can be charged with crimes.", "question_choices": ["True.", "False."], "cloze_format": "It is ___ that businesses can be charged with crimes", "normal_format": "Businesses can be charged with crimes."}, "answer": {"ans_text": "True.", "ans_choice": 0}, "bloom": null, "hl_sentences": "Businesses can be charged with criminal acts as well . A person must be found guilty of the crime before he or she is convicted . Regardless , business crimes and white collar crimes negatively impact the individual , the organization he or she worked for , the community , and customers .", "hl_context": "<hl> Businesses can be charged with criminal acts as well . <hl> In 2017 , Oliver Schmidt , former manager of a Volkswagen engineering office near Detroit , was arrested . He faced years in prison for attempts to defraud the United States , wire fraud , violation of the Clean Air Act , and a charge of giving an untrue statement under the Clean Air Act . Schmidt \u2019 s actions directly violated a business law and , since his actions violated an established law , he was held criminally liable . In December of 2017 , Schmidt was sentenced to seven years in prison . It is important to know that not all people charged with business crimes or white collar crimes are necessarily guilty . <hl> A person must be found guilty of the crime before he or she is convicted . <hl> <hl> Regardless , business crimes and white collar crimes negatively impact the individual , the organization he or she worked for , the community , and customers . <hl> 5.2 Civil vs . Criminal Liability"}, {"question": {"question_id": "fs-21232315", "question_text": "The burden of proof is a criminal case is:", "question_choices": ["Reasonable suspicion.", "Beyond a reasonable doubt.", "Preponderance of evidence.", "Clear and convincing evidence."], "cloze_format": "The burden of proof in a criminal case is ___ .", "normal_format": "What is a criminal case that is the burden of proof?"}, "answer": {"ans_text": "b", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "In a criminal case , the defendant must be proven guilty \u201c beyond a reasonable doubt . \u201d In a civil case , the defendant must be proven liable through a \u201c preponderance of the evidence . \u201d In other words , the prosecution in a civil case must prove that it is more probable than not that the defendant is liable . In criminal cases , the jury will convict only if convinced \u201c beyond a reasonable doubt \u201d that the defendant committed the crime , and the verdict must be unanimous .", "hl_context": "Typically , there is a difference in the burden of proof for the two types of cases . <hl> In a criminal case , the defendant must be proven guilty \u201c beyond a reasonable doubt . \u201d In a civil case , the defendant must be proven liable through a \u201c preponderance of the evidence . \u201d In other words , the prosecution in a civil case must prove that it is more probable than not that the defendant is liable . <hl> Then , there will be discovery and trial . <hl> In criminal cases , the jury will convict only if convinced \u201c beyond a reasonable doubt \u201d that the defendant committed the crime , and the verdict must be unanimous . <hl> This type of case involves a higher burden of proof than in civil cases ."}, {"question": {"question_id": "fs-212323156", "question_text": "Which of the following is a goal of an arraignment?", "question_choices": ["The defendant is informed of the charge and enters a plea.", "Requires the defendant to bear the burden of proof", "Begins the inquisitorial system of adjudication.", "All of these are correct."], "cloze_format": "The elements of a contract do not include ___ ", "normal_format": "Which of the following element is NOT an element of a contract?"}, "answer": {"ans_text": "The defendant is informed of the charge and enters a plea.", "ans_choice": 0}, "bloom": null, "hl_sentences": "The next stage is called the arraignment , where the defendant appears in court so that the court can determine or confirm his or her identity , inform the defendant of the charge the prosecutor has filed against him or her , and hear the defendant \u2019 s plea .", "hl_context": "<hl> The next stage is called the arraignment , where the defendant appears in court so that the court can determine or confirm his or her identity , inform the defendant of the charge the prosecutor has filed against him or her , and hear the defendant \u2019 s plea . <hl>"}, {"question": {"question_id": "fs-2123231561", "question_text": "The criminal act necessary to commit a crime is known as:", "question_choices": ["Malice aforethought.", "Mens rea.", "Subjective fault.", "Actus reus."], "cloze_format": "The criminal act necessary to commit a crime is known as ___.", "normal_format": "What is the criminal act necessary to commit a crime known as?"}, "answer": {"ans_text": "d", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The prosecutor prosecutes the case against the accused : mens rea ( the criminal , or guilty , or \u201c wrongful \u201d mind ) and actus reus ( the criminal , or guilty , or \u201c wrongful \u201d act ) .", "hl_context": "There are usually two components to criminal conduct that must be proven by the prosecutor . <hl> The prosecutor prosecutes the case against the accused : mens rea ( the criminal , or guilty , or \u201c wrongful \u201d mind ) and actus reus ( the criminal , or guilty , or \u201c wrongful \u201d act ) . <hl>"}], "summary": "", "keyterm": "", "bname": "business_law_i_essentials"}, {"chapter": 36, "intro": " Chapter Outline 36.1   Sensory Processes 36.2   Somatosensation 36.3   Taste and Smell 36.4   Hearing and Vestibular Sensation 36.5   Vision Introduction In more advanced animals, the senses are constantly at work, making the animal aware of stimuli\u2014such as light, or sound, or the presence of a chemical substance in the external environment\u2014and monitoring information about the organism\u2019s internal environment. All bilaterally symmetric animals have a sensory system, and the development of any species\u2019 sensory system has been driven by natural selection; thus, sensory systems differ among species according to the demands of their environments. The shark, unlike most fish predators, is electrosensitive\u2014that is, sensitive to electrical fields produced by other animals in its environment. While it is helpful to this underwater predator, electrosensitivity is a sense not found in most land animals. ", "chapter_text": "36.1   Sensory Processes Learning Objectives By the end of this section, you will be able to:\n\n Identify the general and special senses in humans \n\n Describe three important steps in sensory perception \n\n Explain the concept of just-noticeable difference in sensory perception \n\n Senses provide information about the body and its environment.  Humans have five special senses: olfaction (smell), gustation (taste), equilibrium (balance and body position), vision, and hearing. Additionally, we possess general senses, also called somatosensation, which respond to stimuli like temperature, pain, pressure, and vibration.  Vestibular sensation , which is an organism\u2019s sense of spatial orientation and balance,  proprioception  (position of bones, joints, and muscles), and the sense of limb position that is used to track  kinesthesia  (limb movement) are part of somatosensation. Although the sensory systems associated with these senses are very different, all share a common function: to convert a stimulus (such as light, or sound, or the position of the body) into an electrical signal in the nervous system. This process is called  sensory transduction . There are two broad types of cellular systems that perform sensory transduction. In one, a neuron works with a  sensory receptor , a cell, or cell process that is specialized to engage with and detect a specific stimulus. Stimulation of the sensory receptor activates the associated afferent neuron, which carries information about the stimulus to the central nervous system. In the second type of sensory transduction, a sensory nerve ending responds to a stimulus in the internal or external environment: this neuron constitutes the sensory receptor. Free nerve endings can be stimulated by several different stimuli, thus showing little receptor specificity. For example, pain receptors in your gums and teeth may be stimulated by temperature changes, chemical stimulation, or pressure. \n\n Reception \n\n The first step in sensation is  reception , which is the activation of sensory receptors by stimuli such as mechanical stimuli (being bent or squished, for example), chemicals, or temperature. The receptor can then respond to the stimuli. The region in space in which a given sensory receptor can respond to a stimulus, be it far away or in contact with the body, is that receptor\u2019s  receptive   field . Think for a moment about the differences in receptive fields for the different senses. For the sense of touch, a stimulus must come into contact with body. For the sense of hearing, a stimulus can be a moderate distance away (some baleen whale sounds can propagate for many kilometers). For vision, a stimulus can be very far away; for example, the visual system perceives light from stars at enormous distances. \n\n Transduction \n\n The most fundamental function of a sensory system is the translation of a sensory signal to an electrical signal in the nervous system. This takes place at the sensory receptor, and the change in electrical potential that is produced is called the  receptor potential . How is sensory input, such as pressure on the skin, changed to a receptor potential? In this example, a type of receptor called a  mechanoreceptor  (as shown in  Figure 36.2 ) possesses specialized membranes that respond to pressure. Disturbance of these dendrites by compressing them or bending them opens gated ion channels in the plasma membrane of the sensory neuron, changing its electrical potential. Recall that in the nervous system, a positive change of a neuron\u2019s electrical potential (also called the membrane potential), depolarizes the neuron. Receptor potentials are graded potentials: the magnitude of these graded (receptor) potentials varies with the strength of the stimulus. If the magnitude of depolarization is sufficient (that is, if membrane potential reaches a threshold), the neuron will fire an action potential. In most cases, the correct stimulus impinging on a sensory receptor will drive membrane potential in a positive direction, although for some receptors, such as those in the visual system, this is not always the case. \n\n Sensory receptors for different senses are very different from each other, and they are specialized according to the type of stimulus they sense: they have receptor specificity. For example, touch receptors, light receptors, and sound receptors are each activated by different stimuli. Touch receptors are not sensitive to light or sound; they are sensitive only to touch or pressure. However, stimuli may be combined at higher levels in the brain, as happens with olfaction, contributing to our sense of taste. \n\n Encoding and Transmission of Sensory Information \n\n Four aspects of sensory information are encoded by sensory systems: the type of stimulus, the location of the stimulus in the receptive field, the duration of the stimulus, and the relative intensity of the stimulus. Thus, action potentials transmitted over a sensory receptor\u2019s afferent axons encode one type of stimulus, and this segregation of the senses is preserved in other sensory circuits. For example, auditory receptors transmit signals over their own dedicated system, and electrical activity in the axons of the auditory receptors will be interpreted by the brain as an auditory stimulus\u2014a sound. \n\n The intensity of a stimulus is often encoded in the rate of action potentials produced by the sensory receptor. Thus, an intense stimulus will produce a more rapid train of action potentials, and reducing the stimulus will likewise slow the rate of production of action potentials. A second way in which intensity is encoded is by the number of receptors activated. An intense stimulus might initiate action potentials in a large number of adjacent receptors, while a less intense stimulus might stimulate fewer receptors. Integration of sensory information begins as soon as the information is received in the CNS, and the brain will further process incoming signals. \n\n Perception \n\n Perception  is an individual\u2019s interpretation of a sensation. Although perception relies on the activation of sensory receptors, perception happens not at the level of the sensory receptor, but at higher levels in the nervous system, in the brain. The brain distinguishes sensory stimuli through a sensory pathway: action potentials from sensory receptors travel along neurons that are dedicated to a particular stimulus. These neurons are dedicated to that particular stimulus and synapse with particular neurons in the brain or spinal cord. \n\n All sensory signals, except those from the olfactory system, are transmitted though the central nervous system and are routed to the thalamus and to the appropriate region of the cortex. Recall that the thalamus is a structure in the forebrain that serves as a clearinghouse and relay station for sensory (as well as motor) signals. When the sensory signal exits the thalamus, it is conducted to the specific area of the cortex ( Figure 36.3 ) dedicated to processing that particular sense. \n\n How are neural signals interpreted? Interpretation of sensory signals between individuals of the same species is largely similar, owing to the inherited similarity of their nervous systems; however, there are some individual differences. A good example of this is individual tolerances to a painful stimulus, such as dental pain, which certainly differ. \n\n Scientific Method Connection Just-Noticeable Difference \n\n It is easy to differentiate between a one-pound bag of rice and a two-pound bag of rice. There is a one-pound difference, and one bag is twice as heavy as the other. However, would it be as easy to differentiate between a 20- and a 21-pound bag? \n\n Question:  What is the smallest detectible weight difference between a one-pound bag of rice and a larger bag? What is the smallest detectible difference between a 20-pound bag and a larger bag? In both cases, at what weights are the differences detected? This smallest detectible difference in stimuli is known as the just-noticeable difference (JND). Background:  Research background literature on JND and on Weber\u2019s Law, a description of a proposed mathematical relationship between the overall magnitude of the stimulus and the JND. You will be testing JND of different weights of rice in bags. Choose a convenient increment that is to be stepped through while testing. For example, you could choose 10 percent increments between one and two pounds (1.1, 1.2, 1.3, 1.4, and so on) or 20 percent increments (1.2, 1.4, 1.6, and 1.8). Hypothesis:  Develop a hypothesis about JND in terms of percentage of the whole weight being tested (such as \u201cthe JND between the two small bags and between the two large bags is proportionally the same,\u201d or \u201c. . . is not proportionally the same.\u201d) So, for the first hypothesis, if the JND between the one-pound bag and a larger bag is 0.2 pounds (that is, 20 percent; 1.0 pound feels the same as 1.1 pounds, but 1.0 pound feels less than 1.2 pounds), then the JND between the 20-pound bag and a larger bag will also be 20 percent. (So, 20 pounds feels the same as 22 pounds or 23 pounds, but 20 pounds feels less than 24 pounds.) Test the hypothesis:  Enlist 24 participants, and split them into two groups of 12. To set up the demonstration, assuming a 10 percent increment was selected, have the first group be the one-pound group. As a counter-balancing measure against a systematic error, however, six of the first group will compare one pound to two pounds, and step down in weight (1.0 to 2.0, 1.0 to 1.9, and so on.), while the other six will step up (1.0 to 1.1, 1.0 to 1.2, and so on). Apply the same principle to the 20-pound group (20 to 40, 20 to 38, and so on, and 20 to 22, 20 to 24, and so on). Given the large difference between 20 and 40 pounds, you may wish to use 30 pounds as your larger weight. In any case, use two weights that are easily detectable as different. Record the observations:  Record the data in a table similar to the table below. For the one-pound and 20-pound groups (base weights) record a plus sign (+) for each participant that detects a difference between the base weight and the step weight. Record a minus sign (-) for each participant that finds no difference. If one-tenth steps were not used, then replace the steps in the \u201cStep Weight\u201d columns with the step you are using. \n\n Results of JND Testing (+ = difference; \u2013 = no difference) \n\n Step Weight \n\n One pound \n\n 20 pounds \n\n Step Weight \n\n 1.1 \n\n 22 \n\n 1.2 \n\n 24 \n\n 1.3 \n\n 26 \n\n 1.4 \n\n 28 \n\n 1.5 \n\n 30 \n\n 1.6 \n\n 32 \n\n 1.7 \n\n 34 \n\n 1.8 \n\n 36 \n\n 1.9 \n\n 38 \n\n 2.0 \n\n 40 \n\n Table  36.1     \n\n Analyze the data/report the results:  What step weight did all participants find to be equal with one-pound base weight? What about the 20-pound group? Draw a conclusion:  Did the data support the hypothesis? Are the final weights proportionally the same? If not, why not? Do the findings adhere to Weber\u2019s Law? Weber\u2019s Law states that the concept that a just-noticeable difference in a stimulus is proportional to the magnitude of the original stimulus. \n36.2   Somatosensation Learning Objectives By the end of this section, you will be able to:\n\n Describe four important mechanoreceptors in human skin \n\n Describe the topographical distribution of somatosensory receptors between glabrous and hairy skin \n\n Explain why the perception of pain is subjective \n\n Somatosensation is a mixed sensory category and includes all sensation received from the skin and mucous membranes, as well from as the limbs and joints. Somatosensation is also known as tactile sense, or more familiarly, as the sense of touch. Somatosensation occurs all over the exterior of the body and at some interior locations as well. A variety of receptor types\u2014embedded in the skin, mucous membranes, muscles, joints, internal organs, and cardiovascular system\u2014play a role. \n\n Recall that the epidermis is the outermost layer of skin in mammals. It is relatively thin, is composed of keratin-filled cells, and has no blood supply. The epidermis serves as a barrier to water and to invasion by pathogens. Below this, the much thicker dermis contains blood vessels, sweat glands, hair follicles, lymph vessels, and lipid-secreting sebaceous glands ( Figure 36.4 ). Below the epidermis and dermis is the subcutaneous tissue, or hypodermis, the fatty layer that contains blood vessels, connective tissue, and the axons of sensory neurons. The hypodermis, which holds about 50 percent of the body\u2019s fat, attaches the dermis to the bone and muscle, and supplies nerves and blood vessels to the dermis. \n\n Somatosensory Receptors \n\n Sensory receptors are classified into five categories: mechanoreceptors, thermoreceptors, proprioceptors, pain receptors, and chemoreceptors. These categories are based on the nature of stimuli each receptor class transduces. What is commonly referred to as \u201ctouch\u201d involves more than one kind of stimulus and more than one kind of receptor. Mechanoreceptors in the skin are described as encapsulated (that is, surrounded by a capsule) or unencapsulated (a group that includes free nerve endings). A  free nerve ending , as its name implies, is an unencapsulated dendrite of a sensory neuron. Free nerve endings are the most common nerve endings in skin, and they extend into the middle of the epidermis. Free nerve endings are sensitive to painful stimuli, to hot and cold, and to light touch. They are slow to adjust to a stimulus and so are less sensitive to abrupt changes in stimulation. There are three classes of mechanoreceptors: tactile, proprioceptors, and baroreceptors. Mechanoreceptors sense stimuli due to physical deformation of their plasma membranes. They contain mechanically gated ion channels whose gates open or close in response to pressure, touch, stretching, and sound.\u201d There are four primary tactile mechanoreceptors in human skin: Merkel\u2019s disks, Meissner\u2019s corpuscles, Ruffini endings, and Pacinian corpuscle; two are located toward the surface of the skin and two are located deeper. A fifth type of mechanoreceptor, Krause end bulbs, are found only in specialized regions.  Merkel\u2019s disks  (shown in  Figure 36.5 ) are found in the upper layers of skin near the base of the epidermis, both in skin that has hair and on  glabrous  skin, that is, the hairless skin found on the palms and fingers, the soles of the feet, and the lips of humans and other primates. Merkel\u2019s disks are densely distributed in the fingertips and lips. They are slow-adapting, encapsulated nerve endings, and they respond to light touch. Light touch, also known as discriminative touch, is a light pressure that allows the location of a stimulus to be pinpointed. The receptive fields of Merkel\u2019s disks are small with well-defined borders. That makes them finely sensitive to edges and they come into use in tasks such as typing on a keyboard. Visual Connection \n\n Which of the following statements about mechanoreceptors is false? \n\n Pacini corpuscles are found in both glabrous and hairy skin. \n\n Merkel\u2019s disks are abundant on the fingertips and lips. \n\n Ruffini endings are encapsulated mechanoreceptors. \n\n Meissner\u2019s corpuscles extend into the lower dermis. \n\n Meissner\u2019s corpuscles , (shown in  Figure 36.6 ) also known as tactile corpuscles, are found in the upper dermis, but they project into the epidermis. They, too, are found primarily in the glabrous skin on the fingertips and eyelids. They respond to fine touch and pressure, but they also respond to low-frequency vibration or flutter. They are rapidly adapting, fluid-filled, encapsulated neurons with small, well-defined borders and are responsive to fine details. Like Merkel\u2019s disks, Meissner\u2019s corpuscles are not as plentiful in the palms as they are in the fingertips. \n\n Deeper in the epidermis, near the base, are  Ruffini endings , which are also known as bulbous corpuscles. They are found in both glabrous and hairy skin. These are slow-adapting, encapsulated mechanoreceptors that detect skin stretch and deformations within joints, so they provide valuable feedback for gripping objects and controlling finger position and movement. Thus, they also contribute to proprioception and kinesthesia. Ruffini endings also detect warmth. Note that these warmth detectors are situated deeper in the skin than are the cold detectors. It is not surprising, then, that humans detect cold stimuli before they detect warm stimuli. Pacinian corpuscles  (seen in  Figure 36.7 ) are located deep in the dermis of both glabrous and hairy skin and are structurally similar to Meissner\u2019s corpuscles; they are found in the bone periosteum, joint capsules, pancreas and other viscera, breast, and genitals. They are rapidly adapting mechanoreceptors that sense deep transient (but not prolonged) pressure and high-frequency vibration. Pacinian receptors detect pressure and vibration by being compressed, stimulating their internal dendrites. There are fewer Pacinian corpuscles and Ruffini endings in skin than there are Merkel\u2019s disks and Meissner\u2019s corpuscles. \n\n In proprioception, proprioceptive and kinesthetic signals travel through myelinated afferent neurons running from the spinal cord to the medulla. Neurons are not physically connected, but communicate via neurotransmitters secreted into synapses or \u201cgaps\u201d between communicating neurons. Once in the medulla, the neurons continue carrying the signals to the thalamus. Muscle spindles  are stretch receptors that detect the amount of stretch, or lengthening of muscles. Related to these are  Golgi tendon organs , which are tension receptors that detect the force of muscle contraction. Proprioceptive and kinesthetic signals come from limbs. Unconscious proprioceptive signals run from the spinal cord to the cerebellum, the brain region that coordinates muscle contraction, rather than to the thalamus, like most other sensory information. \n\n Barorecptors detect pressure changes in an organ. They are found in the walls of the carotid artery and the aorta where they monitor blood pressure, and in the lungs where they detect the degree of lung expansion. Stretch receptors are found at various sites in the digestive and urinary systems. \n\n In addition to these two types of deeper receptors, there are also rapidly adapting hair receptors, which are found on nerve endings that wrap around the base of hair follicles. There are a few types of hair receptors that detect slow and rapid hair movement, and they differ in their sensitivity to movement. Some hair receptors also detect skin deflection, and certain rapidly adapting hair receptors allow detection of stimuli that have not yet touched the skin. \n\n Integration of Signals from Mechanoreceptors \n\n The configuration of the different types of receptors working in concert in human skin results in a very refined sense of touch. The nociceptive receptors\u2014those that detect pain\u2014are located near the surface. Small, finely calibrated mechanoreceptors\u2014Merkel\u2019s disks and Meissner\u2019s corpuscles\u2014are located in the upper layers and can precisely localize even gentle touch. The large mechanoreceptors\u2014Pacinian corpuscles and Ruffini endings\u2014are located in the lower layers and respond to deeper touch. (Consider that the deep pressure that reaches those deeper receptors would not need to be finely localized.) Both the upper and lower layers of the skin hold rapidly and slowly adapting receptors. Both primary somatosensory cortex and secondary cortical areas are responsible for processing the complex picture of stimuli transmitted from the interplay of mechanoreceptors. \n\n Density of Mechanoreceptors \n\n The distribution of touch receptors in human skin is not consistent over the body. In humans, touch receptors are less dense in skin covered with any type of hair, such as the arms, legs, torso, and face. Touch receptors are denser in glabrous skin (the type found on human fingertips and lips, for example), which is typically more sensitive and is thicker than hairy skin (4 to 5 mm versus 2 to 3 mm). \n\n How is receptor density estimated in a human subject? The relative density of pressure receptors in different locations on the body can be demonstrated experimentally using a two-point discrimination test. In this demonstration, two sharp points, such as two thumbtacks, are brought into contact with the subject\u2019s skin (though not hard enough to cause pain or break the skin). The subject reports if he or she feels one point or two points. If the two points are felt as one point, it can be inferred that the two points are both in the receptive field of a single sensory receptor. If two points are felt as two separate points, each is in the receptive field of two separate sensory receptors. The points could then be moved closer and re-tested until the subject reports feeling only one point, and the size of the receptive field of a single receptor could be estimated from that distance. \n\n Thermoreception \n\n In addition to Krause end bulbs that detect cold and Ruffini endings that detect warmth, there are different types of cold receptors on some free nerve endings: thermoreceptors, located in the dermis, skeletal muscles, liver, and hypothalamus, that are activated by different temperatures. Their pathways into the brain run from the spinal cord through the thalamus to the primary somatosensory cortex. Warmth and cold information from the face travels through one of the cranial nerves to the brain. You know from experience that a tolerably cold or hot stimulus can quickly progress to a much more intense stimulus that is no longer tolerable. Any stimulus that is too intense can be perceived as pain because temperature sensations are conducted along the same pathways that carry pain sensations \n\n Pain \n\nPain is the name given to  nociception , which is the neural processing of injurious stimuli in response to tissue damage. Pain is caused by true sources of injury, such as contact with a heat source that causes a thermal burn or contact with a corrosive chemical. But pain also can be caused by harmless stimuli that mimic the action of damaging stimuli, such as contact with capsaicins, the compounds that cause peppers to taste hot and which are used in self-defense pepper sprays and certain topical medications. Peppers taste \u201chot\u201d because the protein receptors that bind capsaicin open the same calcium channels that are activated by warm receptors. \n\n Nociception starts at the sensory receptors, but pain, inasmuch as it is the perception of nociception, does not start until it is communicated to the brain. There are several nociceptive pathways to and through the brain. Most axons carrying nociceptive information into the brain from the spinal cord project to the thalamus (as do other sensory neurons) and the neural signal undergoes final processing in the primary somatosensory cortex. Interestingly, one nociceptive pathway projects not to the thalamus but directly to the hypothalamus in the forebrain, which modulates the cardiovascular and neuroendocrine functions of the autonomic nervous system. Recall that threatening\u2014or painful\u2014stimuli stimulate the sympathetic branch of the visceral sensory system, readying a fight-or-flight response. \n\n Link to Learning \n\n View this  video  that animates the five phases of nociceptive pain.\n\n Click to view content \n36.3   Taste and Smell Learning Objectives By the end of this section, you will be able to:\n\n Explain in what way smell and taste stimuli differ from other sensory stimuli \n\n Identify the five primary tastes that can be distinguished by humans \n\n Explain in anatomical terms why a dog\u2019s sense of smell is more acute than a human\u2019s \n\n Taste, also called  gustation , and smell, also called  olfaction , are the most interconnected senses in that both involve molecules of the stimulus entering the body and bonding to receptors. Smell lets an animal sense the presence of food or other animals\u2014whether potential mates, predators, or prey\u2014or other chemicals in the environment that can impact their survival. Similarly, the sense of taste allows animals to discriminate between types of foods. While the value of a sense of smell is obvious, what is the value of a sense of taste? Different tasting foods have different attributes, both helpful and harmful. For example, sweet-tasting substances tend to be highly caloric, which could be necessary for survival in lean times. Bitterness is associated with toxicity, and sourness is associated with spoiled food. Salty foods are valuable in maintaining homeostasis by helping the body retain water and by providing ions necessary for cells to function. \n\n Tastes and Odors \n\n Both taste and odor stimuli are molecules taken in from the environment. The primary tastes detected by humans are sweet, sour, bitter, salty and umami. The first four tastes need little explanation. The identification of  umami  as a fundamental taste occurred fairly recently\u2014it was identified in 1908 by Japanese scientist Kikunae Ikeda while he worked with seaweed broth, but it was not widely accepted as a taste that could be physiologically distinguished until many years later. The taste of umami, also known as savoriness, is attributable to the taste of the amino acid L-glutamate. In fact, monosodium glutamate, or MSG, is often used in cooking to enhance the savory taste of certain foods. What is the adaptive value of being able to distinguish umami? Savory substances tend to be high in protein. \n\n All odors that we perceive are molecules in the air we breathe. If a substance does not release molecules into the air from its surface, it has no smell. And if a human or other animal does not have a receptor that recognizes a specific molecule, then that molecule has no smell. Humans have about 350 olfactory receptor subtypes that work in various combinations to allow us to sense about 10,000 different odors. Compare that to mice, for example, which have about 1,300 olfactory receptor types, and therefore probably sense more odors. Both odors and tastes involve molecules that stimulate specific chemoreceptors. Although humans commonly distinguish taste as one sense and smell as another, they work together to create the perception of flavor. A person\u2019s perception of flavor is reduced if he or she has congested nasal passages. \n\n Reception and Transduction \n\n Odorants  (odor molecules) enter the nose and dissolve in the olfactory epithelium, the mucosa at the back of the nasal cavity (as illustrated in  Figure 36.8 ). The  olfactory epithelium  is a collection of specialized olfactory receptors in the back of the nasal cavity that spans an area about 5 cm 2  in humans. Recall that sensory cells are neurons. An  olfactory receptor , which is a dendrite of a specialized neuron, responds when it binds certain molecules inhaled from the environment by sending impulses directly to the olfactory bulb of the brain. Humans have about 12 million olfactory receptors, distributed among hundreds of different receptor types that respond to different odors. Twelve million seems like a large number of receptors, but compare that to other animals: rabbits have about 100 million, most dogs have about 1 billion, and bloodhounds\u2014dogs selectively bred for their sense of smell\u2014have about 4 billion. The overall size of the olfactory epithelium also differs between species, with that of bloodhounds, for example, being many times larger than that of humans. \n\n Olfactory neurons are  bipolar neurons  (neurons with two processes from the cell body). Each neuron has a single dendrite buried in the olfactory epithelium, and extending from this dendrite are 5 to 20 receptor-laden, hair-like cilia that trap odorant molecules. The sensory receptors on the cilia are proteins, and it is the variations in their amino acid chains that make the receptors sensitive to different odorants. Each olfactory sensory neuron has only one type of receptor on its cilia, and the receptors are specialized to detect specific odorants, so the bipolar neurons themselves are specialized. When an odorant binds with a receptor that recognizes it, the sensory neuron associated with the receptor is stimulated. Olfactory stimulation is the only sensory information that directly reaches the cerebral cortex, whereas other sensations are relayed through the thalamus. \n\n Evolution Connection Pheromones \n\n A  pheromone  is a chemical released by an animal that affects the behavior or physiology of animals of the same species. Pheromonal signals can have profound effects on animals that inhale them, but pheromones apparently are not consciously perceived in the same way as other odors. There are several different types of pheromones, which are released in urine or as glandular secretions. Certain pheromones are attractants to potential mates, others are repellants to potential competitors of the same sex, and still others play roles in mother-infant attachment. Some pheromones can also influence the timing of puberty, modify reproductive cycles, and even prevent embryonic implantation. While the roles of pheromones in many nonhuman species are important, pheromones have become less important in human behavior over evolutionary time compared to their importance to organisms with more limited behavioral repertoires. \n\n The vomeronasal organ (VNO, or Jacobson\u2019s organ) is a tubular, fluid-filled, olfactory organ present in many vertebrate animals that sits adjacent to the nasal cavity. It is very sensitive to pheromones and is connected to the nasal cavity by a duct. When molecules dissolve in the mucosa of the nasal cavity, they then enter the VNO where the pheromone molecules among them bind with specialized pheromone receptors. Upon exposure to pheromones from their own species or others, many animals, including cats, may display the flehmen response (shown in  Figure 36.9 ), a curling of the upper lip that helps pheromone molecules enter the VNO. \n\n Pheromonal signals are sent, not to the main olfactory bulb, but to a different neural structure that projects directly to the amygdala (recall that the amygdala is a brain center important in emotional reactions, such as fear). The pheromonal signal then continues to areas of the hypothalamus that are key to reproductive physiology and behavior. While some scientists assert that the VNO is apparently functionally vestigial in humans, even though there is a similar structure located near human nasal cavities, others are researching it as a possible functional system that may, for example, contribute to synchronization of menstrual cycles in women living in close proximity. \n\n Taste \n\n Detecting a taste (gustation) is fairly similar to detecting an odor (olfaction), given that both taste and smell rely on chemical receptors being stimulated by certain molecules. The primary organ of taste is the taste bud. A  taste bud  is a cluster of gustatory receptors (taste cells) that are located within the bumps on the tongue called  papillae  (singular: papilla) (illustrated in  Figure 36.10 ). There are several structurally distinct papillae. Filiform papillae, which are located across the tongue, are tactile, providing friction that helps the tongue move substances, and contain no taste cells. In contrast, fungiform papillae, which are located mainly on the anterior two-thirds of the tongue, each contain one to eight taste buds and also have receptors for pressure and temperature. The large circumvallate papillae contain up to 100 taste buds and form a V near the posterior margin of the tongue. In addition to those two types of chemically and mechanically sensitive papillae are foliate papillae\u2014leaf-like papillae located in parallel folds along the edges and toward the back of the tongue, as seen in the  Figure 36.10  micrograph. Foliate papillae contain about 1,300 taste buds within their folds. Finally, there are circumvallate papillae, which are wall-like papillae in the shape of an inverted \u201cV\u201d at the back of the tongue. Each of these papillae is surrounded by a groove and contains about 250 taste buds. Each taste bud\u2019s taste cells are replaced every 10 to 14 days. These are elongated cells with hair-like processes called microvilli at the tips that extend into the taste bud pore (illustrate in  Figure 36.11 ). Food molecules ( tastants ) are dissolved in saliva, and they bind with and stimulate the receptors on the microvilli. The receptors for tastants are located across the outer portion and front of the tongue, outside of the middle area where the filiform papillae are most prominent. \n\n In humans, there are five primary tastes, and each taste has only one corresponding type of receptor. Thus, like olfaction, each receptor is specific to its stimulus (tastant). Transduction of the five tastes happens through different mechanisms that reflect the molecular composition of the tastant. A salty tastant (containing NaCl) provides the sodium ions (Na + ) that enter the taste neurons and excite them directly. Sour tastants are acids and belong to the thermoreceptor protein family. Binding of an acid or other sour-tasting molecule triggers a change in the ion channel and these increase hydrogen ion (H + ) concentrations in the taste neurons, thus depolarizing them. Sweet, bitter, and umami tastants require a G-protein coupled receptor. These tastants bind to their respective receptors, thereby exciting the specialized neurons associated with them. \n\n Both tasting abilities and sense of smell change with age. In humans, the senses decline dramatically by age 50 and continue to decline. A child may find a food to be too spicy, whereas an elderly person may find the same food to be bland and unappetizing. \n\n Link to Learning \n\n View this  animation  that shows how the sense of taste works. \n\n Smell and Taste in the Brain \n\nOlfactory neurons project from the olfactory epithelium to the olfactory bulb as thin, unmyelinated axons. The  olfactory bulb  is composed of neural clusters called  glomeruli , and each glomerulus receives signals from one type of olfactory receptor, so each glomerulus is specific to one odorant. From glomeruli, olfactory signals travel directly to the olfactory cortex and then to the frontal cortex and the thalamus. Recall that this is a different path from most other sensory information, which is sent directly to the thalamus before ending up in the cortex. Olfactory signals also travel directly to the amygdala, thereafter reaching the hypothalamus, thalamus, and frontal cortex. The last structure that olfactory signals directly travel to is a cortical center in the temporal lobe structure important in spatial, autobiographical, declarative, and episodic memories. Olfaction is finally processed by areas of the brain that deal with memory, emotions, reproduction, and thought. \n\n Taste neurons project from taste cells in the tongue, esophagus, and palate to the medulla, in the brainstem. From the medulla, taste signals travel to the thalamus and then to the primary gustatory cortex. Information from different regions of the tongue is segregated in the medulla, thalamus, and cortex. \n36.4   Hearing and Vestibular Sensation Learning Objectives By the end of this section, you will be able to:\n\n Describe the relationship of amplitude and frequency of a sound wave to attributes of sound \n\n Trace the path of sound through the auditory system to the site of transduction of sound \n\n Identify the structures of the vestibular system that respond to gravity \n\n Audition , or hearing, is important to humans and to other animals for many different interactions. It enables an organism to detect and receive information about danger, such as an approaching predator, and to participate in communal exchanges like those concerning territories or mating. On the other hand, although it is physically linked to the auditory system, the vestibular system is not involved in hearing. Instead, an animal\u2019s vestibular system detects its own movement, both linear and angular acceleration and deceleration, and balance. \n\n Sound \n\n Auditory stimuli are sound waves, which are mechanical, pressure waves that move through a medium, such as air or water. There are no sound waves in a vacuum since there are no air molecules to move in waves. The speed of sound waves differs, based on altitude, temperature, and medium, but at sea level and a temperature of 20\u00ba C (68\u00ba F), sound waves travel in the air at about 343 meters per second. \n\n As is true for all waves, there are four main characteristics of a sound wave: frequency, wavelength, period, and amplitude. Frequency is the number of waves per unit of time, and in sound is heard as pitch. High-frequency (\u226515.000Hz) sounds are higher-pitched (short wavelength) than low-frequency (long wavelengths; \u2264100Hz) sounds. Frequency is measured in cycles per second, and for sound, the most commonly used unit is hertz (Hz), or cycles per second. Most humans can perceive sounds with frequencies between 30 and 20,000 Hz. Women are typically better at hearing high frequencies, but everyone\u2019s ability to hear high frequencies decreases with age. Dogs detect up to about 40,000 Hz; cats, 60,000 Hz; bats, 100,000 Hz; and dolphins 150,000 Hz, and American shad ( Alosa sapidissima ), a fish, can hear 180,000 Hz. Those frequencies above the human range are called  ultrasound . Amplitude, or the dimension of a wave from peak to trough, in sound is heard as volume and is illustrated in  Figure 36.12 . The sound waves of louder sounds have greater amplitude than those of softer sounds. For sound, volume is measured in decibels (dB). The softest sound that a human can hear is the zero point. Humans speak normally at 60 decibels. \n\n Reception of Sound \n\n In mammals, sound waves are collected by the external, cartilaginous part of the ear called the  pinna , then travel through the auditory canal and cause vibration of the thin diaphragm called the  tympanum  or ear drum, the innermost part of the  outer ear  (illustrated in  Figure 36.13 ). Interior to the tympanum is the  middle ear . The middle ear holds three small bones called the  ossicles , which transfer energy from the moving tympanum to the inner ear. The three ossicles are the  malleus  (also known as the hammer), the  incus  (the anvil), and  stapes  (the stirrup). The aptly named stapes looks very much like a stirrup. The three ossicles are unique to mammals, and each plays a role in hearing. The malleus attaches at three points to the interior surface of the tympanic membrane. The incus attaches the malleus to the stapes. In humans, the stapes is not long enough to reach the tympanum. If we did not have the malleus and the incus, then the vibrations of the tympanum would never reach the inner ear. These bones also function to collect force and amplify sounds. The ear ossicles are homologous to bones in a fish mouth: the bones that support gills in fish are thought to be adapted for use in the vertebrate ear over evolutionary time. Many animals (frogs, reptiles, and birds, for example) use the stapes of the middle ear to transmit vibrations to the middle ear. \n\n Transduction of Sound \n\n Vibrating objects, such as vocal cords, create sound waves or pressure waves in the air. When these pressure waves reach the ear, the ear transduces this mechanical stimulus (pressure wave) into a nerve impulse (electrical signal) that the brain perceives as sound. The pressure waves strike the tympanum, causing it to vibrate. The mechanical energy from the moving tympanum transmits the vibrations to the three bones of the middle ear. The stapes transmits the vibrations to a thin diaphragm called the  oval window , which is the outermost structure of the  inner ear . The structures of the inner ear are found in the  labyrinth , a bony, hollow structure that is the most interior portion of the ear. Here, the energy from the sound wave is transferred from the stapes through the flexible oval window and to the fluid of the cochlea. The vibrations of the oval window create pressure waves in the fluid (perilymph) inside the cochlea. The  cochlea  is a whorled structure, like the shell of a snail, and it contains receptors for transduction of the mechanical wave into an electrical signal (as illustrated in  Figure 36.14 ). Inside the cochlea, the  basilar membrane  is a mechanical analyzer that runs the length of the cochlea, curling toward the cochlea\u2019s center. \n\n The mechanical properties of the basilar membrane change along its length, such that it is thicker, tauter, and narrower at the outside of the whorl (where the cochlea is largest), and thinner, floppier, and broader toward the apex, or center, of the whorl (where the cochlea is smallest). Different regions of the basilar membrane vibrate according to the frequency of the sound wave conducted through the fluid in the cochlea. For these reasons, the fluid-filled cochlea detects different wave frequencies (pitches) at different regions of the membrane. When the sound waves in the cochlear fluid contact the basilar membrane, it flexes back and forth in a wave-like fashion. Above the basilar membrane is the  tectorial membrane . \n\n Visual Connection \n\n Cochlear implants can restore hearing in people who have a nonfunctional cochlear. The implant consists of a microphone that picks up sound. A speech processor selects sounds in the range of human speech, and a transmitter converts these sounds to electrical impulses, which are then sent to the auditory nerve. Which of the following types of hearing loss would not be restored by a cochlear implant? \n\n Hearing loss resulting from absence or loss of hair cells in the organ of Corti. \n\n Hearing loss resulting from an abnormal auditory nerve. \n\n Hearing loss resulting from fracture of the cochlea. \n\n Hearing loss resulting from damage to bones of the middle ear. \n\n The site of transduction is in the  organ of Corti  (spiral organ). It is composed of hair cells held in place above the basilar membrane like flowers projecting up from soil, with their exposed short, hair-like  stereocilia  contacting or embedded in the tectorial membrane above them. The inner hair cells are the primary auditory receptors and exist in a single row, numbering approximately 3,500. The stereocilia from inner hair cells extend into small dimples on the tectorial membrane\u2019s lower surface. The outer hair cells are arranged in three or four rows. They number approximately 12,000, and they function to fine tune incoming sound waves. The longer stereocilia that project from the outer hair cells actually attach to the tectorial membrane. All of the stereocilia are mechanoreceptors, and when bent by vibrations they respond by opening a gated ion channel (refer to  Figure 36.2 ). As a result, the hair cell membrane is depolarized, and a signal is transmitted to the chochlear nerve. Intensity (volume) of sound is determined by how many hair cells at a particular location are stimulated. The hair cells are arranged on the basilar membrane in an orderly way. The basilar membrane vibrates in different regions, according to the frequency of the sound waves impinging on it. Likewise, the hair cells that lay above it are most sensitive to a specific frequency of sound waves. Hair cells can respond to a small range of similar frequencies, but they require stimulation of greater intensity to fire at frequencies outside of their optimal range. The difference in response frequency between adjacent inner hair cells is about 0.2 percent. Compare that to adjacent piano strings, which are about six percent different. Place theory, which is the model for how biologists think pitch detection works in the human ear, states that high frequency sounds selectively vibrate the basilar membrane of the inner ear near the entrance port (the oval window). Lower frequencies travel farther along the membrane before causing appreciable excitation of the membrane. The basic pitch-determining mechanism is based on the location along the membrane where the hair cells are stimulated. The place theory is the first step toward an understanding of pitch perception. Considering the extreme pitch sensitivity of the human ear, it is thought that there must be some auditory \u201csharpening\u201d mechanism to enhance the pitch resolution. \n\n When sound waves produce fluid waves inside the cochlea, the basilar membrane flexes, bending the stereocilia that attach to the tectorial membrane. Their bending results in action potentials in the hair cells, and auditory information travels along the neural endings of the bipolar neurons of the hair cells (collectively, the auditory nerve) to the brain. When the hairs bend, they release an excitatory neurotransmitter at a synapse with a sensory neuron, which then conducts action potentials to the central nervous system. The cochlear branch of the vestibulocochlear cranial nerve sends information on hearing. The auditory system is very refined, and there is some modulation or \u201csharpening\u201d built in. The brain can send signals back to the cochlea, resulting in a change of length in the outer hair cells, sharpening or dampening the hair cells\u2019 response to certain frequencies. \n\n Link to Learning \n\n Watch an  animation  of sound entering the outer ear, moving through the ear structure, stimulating cochlear nerve impulses, and eventually sending signals to the temporal lobe. \n\n Higher Processing \n\n The inner hair cells are most important for conveying auditory information to the brain. About 90 percent of the afferent neurons carry information from inner hair cells, with each hair cell synapsing with 10 or so neurons. Outer hair cells connect to only 10 percent of the afferent neurons, and each afferent neuron innervates many hair cells. The afferent, bipolar neurons that convey auditory information travel from the cochlea to the medulla, through the pons and midbrain in the brainstem, finally reaching the primary auditory cortex in the temporal lobe. \n\n Vestibular Information \n\n The stimuli associated with the vestibular system are linear acceleration (gravity) and angular acceleration and deceleration. Gravity, acceleration, and deceleration are detected by evaluating the inertia on receptive cells in the vestibular system. Gravity is detected through head position. Angular acceleration and deceleration are expressed through turning or tilting of the head. \n\n The vestibular system has some similarities with the auditory system. It utilizes hair cells just like the auditory system, but it excites them in different ways. There are five vestibular receptor organs in the inner ear: the utricle, the saccule, and three semicircular canals. Together, they make up what\u2019s known as the vestibular labyrinth that is shown in  Figure 36.15 . The utricle and saccule respond to acceleration in a straight line, such as gravity. The roughly 30,000 hair cells in the utricle and 16,000 hair cells in the saccule lie below a gelatinous layer, with their stereocilia projecting into the gelatin. Embedded in this gelatin are calcium carbonate crystals\u2014like tiny rocks. When the head is tilted, the crystals continue to be pulled straight down by gravity, but the new angle of the head causes the gelatin to shift, thereby bending the stereocilia. The bending of the stereocilia stimulates the neurons, and they signal to the brain that the head is tilted, allowing the maintenance of balance. It is the vestibular branch of the vestibulocochlear cranial nerve that deals with balance. \n\n The fluid-filled  semicircular canals  are tubular loops set at oblique angles. They are arranged in three spatial planes. The base of each canal has a swelling that contains a cluster of hair cells. The hairs project into a gelatinous cap called the cupula and monitor angular acceleration and deceleration from rotation. They would be stimulated by driving your car around a corner, turning your head, or falling forward. One canal lies horizontally, while the other two lie at about 45 degree angles to the horizontal axis, as illustrated in  Figure 36.15 . When the brain processes input from all three canals together, it can detect angular acceleration or deceleration in three dimensions. When the head turns, the fluid in the canals shifts, thereby bending stereocilia and sending signals to the brain. Upon cessation accelerating or decelerating\u2014or just moving\u2014the movement of the fluid within the canals slows or stops. For example, imagine holding a glass of water. When moving forward, water may splash backwards onto the hand, and when motion has stopped, water may splash forward onto the fingers. While in motion, the water settles in the glass and does not splash. Note that the canals are not sensitive to velocity itself, but to changes in velocity, so moving forward at 60mph with your eyes closed would not give the sensation of movement, but suddenly accelerating or braking would stimulate the receptors. Higher Processing \n\n Hair cells from the utricle, saccule, and semicircular canals also communicate through bipolar neurons to the cochlear nucleus in the medulla. Cochlear neurons send descending projections to the spinal cord and ascending projections to the pons, thalamus, and cerebellum. Connections to the cerebellum are important for coordinated movements. There are also projections to the temporal cortex, which account for feelings of dizziness; projections to autonomic nervous system areas in the brainstem, which account for motion sickness; and projections to the primary somatosensory cortex, which monitors subjective measurements of the external world and self-movement. People with lesions in the vestibular area of the somatosensory cortex see vertical objects in the world as being tilted. Finally, the vestibular signals project to certain optic muscles to coordinate eye and head movements. \n\n Link to Learning \n\n Click through this  interactive tutorial  to review the parts of the ear and how they function to process sound. \n36.5   Vision Learning Objectives By the end of this section, you will be able to:\n\n Explain how electromagnetic waves differs from sound waves \n\n Trace the path of light through the eye to the point of the optic nerve \n\n Explain tonic activity as it is manifested in photoreceptors in the retina \n\n Vision  is the ability to detect light patterns from the outside environment and interpret them into images. Animals are bombarded with sensory information, and the sheer volume of visual information can be problematic. Fortunately, the visual systems of species have evolved to attend to the most-important stimuli. The importance of vision to humans is further substantiated by the fact that about one-third of the human cerebral cortex is dedicated to analyzing and perceiving visual information. Light \n\n As with auditory stimuli, light travels in waves. The compression waves that compose sound must travel in a medium\u2014a gas, a liquid, or a solid. In contrast, light is composed of electromagnetic waves and needs no medium; light can travel in a vacuum ( Figure 36.16 ). The behavior of light can be discussed in terms of the behavior of waves and also in terms of the behavior of the fundamental unit of light\u2014a packet of electromagnetic radiation called a photon. A glance at the electromagnetic spectrum shows that visible light for humans is just a small slice of the entire spectrum, which includes radiation that we cannot see as light because it is below the frequency of visible red light and above the frequency of visible violet light. \n\n Certain variables are important when discussing perception of light. Wavelength (which varies inversely with frequency) manifests itself as hue. Light at the red end of the visible spectrum has longer wavelengths (and is lower frequency), while light at the violet end has shorter wavelengths (and is higher frequency). The wavelength of light is expressed in nanometers (nm); one nanometer is one billionth of a meter. Humans perceive light that ranges between approximately 380 nm and 740 nm. Some other animals, though, can detect wavelengths outside of the human range. For example, bees see near-ultraviolet light in order to locate nectar guides on flowers, and some non-avian reptiles sense infrared light (heat that prey gives off). \n\n Wave amplitude is perceived as luminous intensity, or brightness. The standard unit of intensity of light is the  candela , which is approximately the luminous intensity of a one common candle. \n\n Light waves travel 299,792 km per second in a vacuum, (and somewhat slower in various media such as air and water), and those waves arrive at the eye as long (red), medium (green), and short (blue) waves. What is termed \u201cwhite light\u201d is light that is perceived as white by the human eye. This effect is produced by light that stimulates equally the color receptors in the human eye. The apparent color of an object is the color (or colors) that the object reflects. Thus a red object reflects the red wavelengths in mixed (white) light and absorbs all other wavelengths of light.  \n\n Anatomy of the Eye \n\n The photoreceptive cells of the eye, where transduction of light to nervous impulses occurs, are located in the  retina  (shown in  Figure 36.17 ) on the inner surface of the back of the eye. But light does not impinge on the retina unaltered. It passes through other layers that process it so that it can be interpreted by the retina ( Figure 36.17 b ). The  cornea , the front transparent layer of the eye, and the crystalline  lens , a transparent convex structure behind the cornea, both refract (bend) light to focus the image on the retina. The  iris , which is conspicuous as the colored part of the eye, is a circular muscular ring lying between the lens and cornea that regulates the amount of light entering the eye. In conditions of high ambient light, the iris contracts, reducing the size of the pupil at its center. In conditions of low light, the iris relaxes and the pupil enlarges. \n\n Visual Connection \n\n Which of the following statements about the human eye is false? \n\n Rods detect color, while cones detect only shades of gray. \n\n When light enters the retina, it passes the ganglion cells and bipolar cells before reaching photoreceptors at the rear of the eye. \n\n The iris adjusts the amount of light coming into the eye. \n\n The cornea is a protective layer on the front of the eye. \n\n The main function of the lens is to focus light on the retina and fovea centralis. The lens is dynamic, focusing and re-focusing light as the eye rests on near and far objects in the visual field. The lens is operated by muscles that stretch it flat or allow it to thicken, changing the focal length of light coming through it to focus it sharply on the retina. With age comes the loss of the flexibility of the lens, and a form of farsightedness called  presbyopia  results. Presbyopia occurs because the image focuses behind the retina. Presbyopia is a deficit similar to a different type of farsightedness called  hyperopia  caused by an eyeball that is too short. For both defects, images in the distance are clear but images nearby are blurry.  Myopia  (nearsightedness) occurs when an eyeball is elongated and the image focus falls in front of the retina. In this case, images in the distance are blurry but images nearby are clear. \n\n There are two types of photoreceptors in the retina:  rods  and  cones , named for their general appearance as illustrated in  Figure 36.18 . Rods are strongly photosensitive and are located in the outer edges of the retina. They detect dim light and are used primarily for peripheral and nighttime vision. Cones are weakly photosensitive and are located near the center of the retina. They respond to bright light, and their primary role is in daytime, color vision. \n\n The  fovea  is the region in the center back of the eye that is responsible for acute vision. The fovea has a high density of cones. When you bring your gaze to an object to examine it intently in bright light, the eyes orient so that the object\u2019s image falls on the fovea. However, when looking at a star in the night sky or other object in dim light, the object can be better viewed by the peripheral vision because it is the rods at the edges of the retina, rather than the cones at the center, that operate better in low light. In humans, cones far outnumber rods in the fovea. \n\n Link to Learning \n\n Review the  anatomical structure  of the eye, clicking on each part to practice identification. \n\n Transduction of Light \n\n The rods and cones are the site of transduction of light to a neural signal. Both rods and cones contain photopigments. In vertebrates, the main photopigment,  rhodopsin , has two main parts   Figure 36.19 ): an opsin, which is a membrane protein (in the form of a cluster of \u03b1-helices that span the membrane), and retinal\u2014a molecule that absorbs light. When light hits a photoreceptor, it causes a shape change in the retinal, altering its structure from a bent ( cis ) form of the molecule to its linear ( trans ) isomer. This isomerization of retinal activates the rhodopsin, starting a cascade of events that ends with the closing of Na +  channels in the membrane of the photoreceptor. Thus, unlike most other sensory neurons (which become depolarized by exposure to a stimulus) visual receptors become hyperpolarized and thus driven away from threshold ( Figure 36.20 ). Trichromatic Coding \n\n There are three types of cones (with different photopsins), and they differ in the wavelength to which they are most responsive, as shown in  Figure 36.21 . Some cones are maximally responsive to short light waves of 420 nm, so they are called S cones (\u201cS\u201d for \u201cshort\u201d); others respond maximally to waves of 530 nm (M cones, for \u201cmedium\u201d); a third group responds maximally to light of longer wavelengths, at 560 nm (L, or \u201clong\u201d cones). With only one type of cone, color vision would not be possible, and a two-cone (dichromatic) system has limitations. Primates use a three-cone (trichromatic) system, resulting in full color vision. \n\n The color we perceive is a result of the ratio of activity of our three types of cones. The colors of the visual spectrum, running from long-wavelength light to short, are red (700 nm), orange (600 nm), yellow (565 nm), green (497 nm), blue (470 nm), indigo (450 nm), and violet (425 nm). Humans have very sensitive perception of color and can distinguish about 500 levels of brightness, 200 different hues, and 20 steps of saturation, or about 2 million distinct colors. \n\n Retinal Processing \n\n Visual signals leave the cones and rods, travel to the bipolar cells, and then to ganglion cells. A large degree of processing of visual information occurs in the retina itself, before visual information is sent to the brain. \n\n Photoreceptors in the retina continuously undergo  tonic activity . That is, they are always slightly active even when not stimulated by light. In neurons that exhibit tonic activity, the absence of stimuli maintains a firing rate at a baseline; while some stimuli increase firing rate from the baseline, and other stimuli decrease firing rate. In the absence of light, the bipolar neurons that connect rods and cones to ganglion cells are continuously and actively inhibited by the rods and cones. Exposure of the retina to light hyperpolarizes the rods and cones and removes their inhibition of bipolar cells. The now active bipolar cells in turn stimulate the ganglion cells, which send action potentials along their axons (which leave the eye as the optic nerve). Thus, the visual system relies on change in retinal activity, rather than the absence or presence of activity, to encode visual signals for the brain. Sometimes horizontal cells carry signals from one rod or cone to other photoreceptors and to several bipolar cells. When a rod or cone stimulates a horizontal cell, the horizontal cell inhibits more distant photoreceptors and bipolar cells, creating lateral inhibition. This inhibition sharpens edges and enhances contrast in the images by making regions receiving light appear lighter and dark surroundings appear darker. Amacrine cells can distribute information from one bipolar cell to many ganglion cells. \n\n You can demonstrate this using an easy demonstration to \u201ctrick\u201d your retina and brain about the colors you are observing in your visual field. Look fixedly at  Figure 36.22  for about 45 seconds. Then quickly shift your gaze to a sheet of blank white paper or a white wall. You should see an afterimage of the Norwegian flag in its correct colors. At this point, close your eyes for a moment, then reopen them, looking again at the white paper or wall; the afterimage of the flag should continue to appear as red, white, and blue. What causes this? According to an explanation called opponent process theory, as you gazed fixedly at the green, black, and yellow flag, your retinal ganglion cells that respond positively to green, black, and yellow increased their firing dramatically. When you shifted your gaze to the neutral white ground, these ganglion cells abruptly decreased their activity and the brain interpreted this abrupt downshift as if the ganglion cells were responding now to their \u201copponent\u201d colors: red, white, and blue, respectively, in the visual field. Once the ganglion cells return to their baseline activity state, the false perception of color will disappear. \n\n Higher Processing \n\n The myelinated axons of ganglion cells make up the optic nerves. Within the nerves, different axons carry different qualities of the visual signal. Some axons constitute the magnocellular (big cell) pathway, which carries information about form, movement, depth, and differences in brightness. Other axons constitute the parvocellular (small cell) pathway, which carries information on color and fine detail. Some visual information projects directly back into the brain, while other information crosses to the opposite side of the brain. This crossing of optical pathways produces the distinctive optic chiasma (Greek, for \u201ccrossing\u201d) found at the base of the brain and allows us to coordinate information from both eyes. \n\n Once in the brain, visual information is processed in several places, and its routes reflect the complexity and importance of visual information to humans and other animals. One route takes the signals to the thalamus, which serves as the routing station for all incoming sensory impulses except olfaction. In the thalamus, the magnocellular and parvocellular distinctions remain intact, and there are different layers of the thalamus dedicated to each. When visual signals leave the thalamus, they travel to the primary visual cortex at the rear of the brain. From the visual cortex, the visual signals travel in two directions. One stream that projects to the parietal lobe, in the side of the brain, carries magnocellular (\u201cwhere\u201d) information. A second stream projects to the temporal lobe and carries both magnocellular (\u201cwhere\u201d) and parvocellular (\u201cwhat\u201d) information. \n\n Another important visual route is a pathway from the retina to the  superior colliculus  in the midbrain, where eye movements are coordinated and integrated with auditory information. Finally, there is the pathway from the retina to the  suprachiasmatic nucleus  (SCN) of the hypothalamus. The SCN is a cluster of cells that is considered to be the body\u2019s internal clock, which controls our  circadian  (day-long) cycle. The SCN sends information to the pineal gland, which is important in sleep/wake patterns and annual cycles. \n\n Link to Learning \n\n View this  interactive presentation  to review what you have learned about how vision functions. ", "questions": [{"question": {"question_id": "fs-idp233292000", "question_text": "Where does perception occur?", "question_choices": ["spinal cord", "cerebral cortex", "receptors", "thalamus"], "cloze_format": "Perception occurs in the ___.", "normal_format": "Where does perception occur?"}, "answer": {"ans_text": "cerebral cortex", "ans_choice": 1}, "bloom": null, "hl_sentences": "The importance of vision to humans is further substantiated by the fact that about one-third of the human cerebral cortex is dedicated to analyzing and perceiving visual information .", "hl_context": "Vision is the ability to detect light patterns from the outside environment and interpret them into images . Animals are bombarded with sensory information , and the sheer volume of visual information can be problematic . Fortunately , the visual systems of species have evolved to attend to the most-important stimuli . <hl> The importance of vision to humans is further substantiated by the fact that about one-third of the human cerebral cortex is dedicated to analyzing and perceiving visual information . <hl> Light"}, {"question": {"question_id": "fs-idp217125664", "question_text": "If a person\u2019s cold receptors no longer convert cold stimuli into sensory signals, that person has a problem with the process of ________.", "question_choices": ["reception", "transmission", "perception", "transduction"], "cloze_format": "If a person\u2019s cold receptors no longer convert cold stimuli into sensory signals, that person has a problem with the process of ________.", "normal_format": "If a person\u2019s cold receptors no longer convert cold stimuli into sensory signals, that person has a problem with the process of which of the following?"}, "answer": {"ans_text": "transduction", "ans_choice": 3}, "bloom": null, "hl_sentences": "Although the sensory systems associated with these senses are very different , all share a common function : to convert a stimulus ( such as light , or sound , or the position of the body ) into an electrical signal in the nervous system .", "hl_context": "Senses provide information about the body and its environment . Humans have five special senses : olfaction ( smell ) , gustation ( taste ) , equilibrium ( balance and body position ) , vision , and hearing . Additionally , we possess general senses , also called somatosensation , which respond to stimuli like temperature , pain , pressure , and vibration . Vestibular sensation , which is an organism \u2019 s sense of spatial orientation and balance , proprioception ( position of bones , joints , and muscles ) , and the sense of limb position that is used to track kinesthesia ( limb movement ) are part of somatosensation . <hl> Although the sensory systems associated with these senses are very different , all share a common function : to convert a stimulus ( such as light , or sound , or the position of the body ) into an electrical signal in the nervous system . <hl> This process is called sensory transduction . There are two broad types of cellular systems that perform sensory transduction . In one , a neuron works with a sensory receptor , a cell , or cell process that is specialized to engage with and detect a specific stimulus . Stimulation of the sensory receptor activates the associated afferent neuron , which carries information about the stimulus to the central nervous system . In the second type of sensory transduction , a sensory nerve ending responds to a stimulus in the internal or external environment : this neuron constitutes the sensory receptor . Free nerve endings can be stimulated by several different stimuli , thus showing little receptor specificity . For example , pain receptors in your gums and teeth may be stimulated by temperature changes , chemical stimulation , or pressure ."}, {"question": {"question_id": "fs-idp56627088", "question_text": "After somatosensory transduction, the sensory signal travels through the brain as a(n) _____ signal.", "question_choices": ["electrical", "pressure", "optical", "thermal"], "cloze_format": "After somatosensory transduction, the sensory signal travels through the brain as a(n) _____ signal.", "normal_format": "After somatosensory transduction, the sensory signal travels through the brain as a what kind of signal?"}, "answer": {"ans_text": "electrical", "ans_choice": 0}, "bloom": null, "hl_sentences": "The most fundamental function of a sensory system is the translation of a sensory signal to an electrical signal in the nervous system . Although the sensory systems associated with these senses are very different , all share a common function : to convert a stimulus ( such as light , or sound , or the position of the body ) into an electrical signal in the nervous system .", "hl_context": "<hl> The most fundamental function of a sensory system is the translation of a sensory signal to an electrical signal in the nervous system . <hl> This takes place at the sensory receptor , and the change in electrical potential that is produced is called the receptor potential . How is sensory input , such as pressure on the skin , changed to a receptor potential ? In this example , a type of receptor called a mechanoreceptor ( as shown in Figure 36.2 ) possesses specialized membranes that respond to pressure . Disturbance of these dendrites by compressing them or bending them opens gated ion channels in the plasma membrane of the sensory neuron , changing its electrical potential . Recall that in the nervous system , a positive change of a neuron \u2019 s electrical potential ( also called the membrane potential ) , depolarizes the neuron . Receptor potentials are graded potentials : the magnitude of these graded ( receptor ) potentials varies with the strength of the stimulus . If the magnitude of depolarization is sufficient ( that is , if membrane potential reaches a threshold ) , the neuron will fire an action potential . In most cases , the correct stimulus impinging on a sensory receptor will drive membrane potential in a positive direction , although for some receptors , such as those in the visual system , this is not always the case . Senses provide information about the body and its environment . Humans have five special senses : olfaction ( smell ) , gustation ( taste ) , equilibrium ( balance and body position ) , vision , and hearing . Additionally , we possess general senses , also called somatosensation , which respond to stimuli like temperature , pain , pressure , and vibration . Vestibular sensation , which is an organism \u2019 s sense of spatial orientation and balance , proprioception ( position of bones , joints , and muscles ) , and the sense of limb position that is used to track kinesthesia ( limb movement ) are part of somatosensation . <hl> Although the sensory systems associated with these senses are very different , all share a common function : to convert a stimulus ( such as light , or sound , or the position of the body ) into an electrical signal in the nervous system . <hl> This process is called sensory transduction . There are two broad types of cellular systems that perform sensory transduction . In one , a neuron works with a sensory receptor , a cell , or cell process that is specialized to engage with and detect a specific stimulus . Stimulation of the sensory receptor activates the associated afferent neuron , which carries information about the stimulus to the central nervous system . In the second type of sensory transduction , a sensory nerve ending responds to a stimulus in the internal or external environment : this neuron constitutes the sensory receptor . Free nerve endings can be stimulated by several different stimuli , thus showing little receptor specificity . For example , pain receptors in your gums and teeth may be stimulated by temperature changes , chemical stimulation , or pressure ."}, {"question": {"question_id": "fs-idm75363216", "question_text": "_____ are found only in _____ skin, and detect skin deflection.", "question_choices": ["Meissner\u2019s corpuscles: hairy", "Merkel\u2019s disks: glabrous", "hair receptors: hairy", "Krause end bulbs: hairy"], "cloze_format": "_____ are found only in _____ skin, and detect skin deflection.", "normal_format": "What can detect skin deflection, and what skin can it be found?"}, "answer": {"ans_text": "Merkel\u2019s disks: glabrous", "ans_choice": 1}, "bloom": "2", "hl_sentences": "Merkel \u2019 s disks ( shown in Figure 36.5 ) are found in the upper layers of skin near the base of the epidermis , both in skin that has hair and on glabrous skin , that is , the hairless skin found on the palms and fingers , the soles of the feet , and the lips of humans and other primates .", "hl_context": "Sensory receptors are classified into five categories : mechanoreceptors , thermoreceptors , proprioceptors , pain receptors , and chemoreceptors . These categories are based on the nature of stimuli each receptor class transduces . What is commonly referred to as \u201c touch \u201d involves more than one kind of stimulus and more than one kind of receptor . Mechanoreceptors in the skin are described as encapsulated ( that is , surrounded by a capsule ) or unencapsulated ( a group that includes free nerve endings ) . A free nerve ending , as its name implies , is an unencapsulated dendrite of a sensory neuron . Free nerve endings are the most common nerve endings in skin , and they extend into the middle of the epidermis . Free nerve endings are sensitive to painful stimuli , to hot and cold , and to light touch . They are slow to adjust to a stimulus and so are less sensitive to abrupt changes in stimulation . There are three classes of mechanoreceptors : tactile , proprioceptors , and baroreceptors . Mechanoreceptors sense stimuli due to physical deformation of their plasma membranes . They contain mechanically gated ion channels whose gates open or close in response to pressure , touch , stretching , and sound . \u201d There are four primary tactile mechanoreceptors in human skin : Merkel \u2019 s disks , Meissner \u2019 s corpuscles , Ruffini endings , and Pacinian corpuscle ; two are located toward the surface of the skin and two are located deeper . A fifth type of mechanoreceptor , Krause end bulbs , are found only in specialized regions . <hl> Merkel \u2019 s disks ( shown in Figure 36.5 ) are found in the upper layers of skin near the base of the epidermis , both in skin that has hair and on glabrous skin , that is , the hairless skin found on the palms and fingers , the soles of the feet , and the lips of humans and other primates . <hl> Merkel \u2019 s disks are densely distributed in the fingertips and lips . They are slow-adapting , encapsulated nerve endings , and they respond to light touch . Light touch , also known as discriminative touch , is a light pressure that allows the location of a stimulus to be pinpointed . The receptive fields of Merkel \u2019 s disks are small with well-defined borders . That makes them finely sensitive to edges and they come into use in tasks such as typing on a keyboard . Visual Connection"}, {"question": {"question_id": "fs-idp59279184", "question_text": "If you were to burn your epidermis, what receptor type would you most likely burn?", "question_choices": ["free nerve endings", "Ruffini endings", "Pacinian corpuscle", "hair receptors"], "cloze_format": "If you were to burn your epidermis, the receptor type you would most likely burn are ___.", "normal_format": "If you were to burn your epidermis, what receptor type would you most likely burn?"}, "answer": {"ans_text": "free nerve endings", "ans_choice": 0}, "bloom": null, "hl_sentences": "A free nerve ending , as its name implies , is an unencapsulated dendrite of a sensory neuron . Free nerve endings are the most common nerve endings in skin , and they extend into the middle of the epidermis . Free nerve endings are sensitive to painful stimuli , to hot and cold , and to light touch .", "hl_context": "Sensory receptors are classified into five categories : mechanoreceptors , thermoreceptors , proprioceptors , pain receptors , and chemoreceptors . These categories are based on the nature of stimuli each receptor class transduces . What is commonly referred to as \u201c touch \u201d involves more than one kind of stimulus and more than one kind of receptor . Mechanoreceptors in the skin are described as encapsulated ( that is , surrounded by a capsule ) or unencapsulated ( a group that includes free nerve endings ) . <hl> A free nerve ending , as its name implies , is an unencapsulated dendrite of a sensory neuron . <hl> <hl> Free nerve endings are the most common nerve endings in skin , and they extend into the middle of the epidermis . <hl> <hl> Free nerve endings are sensitive to painful stimuli , to hot and cold , and to light touch . <hl> They are slow to adjust to a stimulus and so are less sensitive to abrupt changes in stimulation . There are three classes of mechanoreceptors : tactile , proprioceptors , and baroreceptors . Mechanoreceptors sense stimuli due to physical deformation of their plasma membranes . They contain mechanically gated ion channels whose gates open or close in response to pressure , touch , stretching , and sound . \u201d There are four primary tactile mechanoreceptors in human skin : Merkel \u2019 s disks , Meissner \u2019 s corpuscles , Ruffini endings , and Pacinian corpuscle ; two are located toward the surface of the skin and two are located deeper . A fifth type of mechanoreceptor , Krause end bulbs , are found only in specialized regions . Merkel \u2019 s disks ( shown in Figure 36.5 ) are found in the upper layers of skin near the base of the epidermis , both in skin that has hair and on glabrous skin , that is , the hairless skin found on the palms and fingers , the soles of the feet , and the lips of humans and other primates . Merkel \u2019 s disks are densely distributed in the fingertips and lips . They are slow-adapting , encapsulated nerve endings , and they respond to light touch . Light touch , also known as discriminative touch , is a light pressure that allows the location of a stimulus to be pinpointed . The receptive fields of Merkel \u2019 s disks are small with well-defined borders . That makes them finely sensitive to edges and they come into use in tasks such as typing on a keyboard . Visual Connection"}, {"question": {"question_id": "fs-idp207279936", "question_text": "Which of the following has the fewest taste receptors?", "question_choices": ["fungiform papillae", "circumvallate papillae", "foliate papillae", "filiform papillae"], "cloze_format": "___ have the fewest taste receptors.", "normal_format": "Which of the following has the fewest taste receptors?"}, "answer": {"ans_text": "filiform papillae", "ans_choice": 3}, "bloom": null, "hl_sentences": "Filiform papillae , which are located across the tongue , are tactile , providing friction that helps the tongue move substances , and contain no taste cells .", "hl_context": "Detecting a taste ( gustation ) is fairly similar to detecting an odor ( olfaction ) , given that both taste and smell rely on chemical receptors being stimulated by certain molecules . The primary organ of taste is the taste bud . A taste bud is a cluster of gustatory receptors ( taste cells ) that are located within the bumps on the tongue called papillae ( singular : papilla ) ( illustrated in Figure 36.10 ) . There are several structurally distinct papillae . <hl> Filiform papillae , which are located across the tongue , are tactile , providing friction that helps the tongue move substances , and contain no taste cells . <hl> In contrast , fungiform papillae , which are located mainly on the anterior two-thirds of the tongue , each contain one to eight taste buds and also have receptors for pressure and temperature . The large circumvallate papillae contain up to 100 taste buds and form a V near the posterior margin of the tongue . In addition to those two types of chemically and mechanically sensitive papillae are foliate papillae \u2014 leaf-like papillae located in parallel folds along the edges and toward the back of the tongue , as seen in the Figure 36.10 micrograph . Foliate papillae contain about 1,300 taste buds within their folds . Finally , there are circumvallate papillae , which are wall-like papillae in the shape of an inverted \u201c V \u201d at the back of the tongue . Each of these papillae is surrounded by a groove and contains about 250 taste buds . Each taste bud \u2019 s taste cells are replaced every 10 to 14 days . These are elongated cells with hair-like processes called microvilli at the tips that extend into the taste bud pore ( illustrate in Figure 36.11 ) . Food molecules ( tastants ) are dissolved in saliva , and they bind with and stimulate the receptors on the microvilli . The receptors for tastants are located across the outer portion and front of the tongue , outside of the middle area where the filiform papillae are most prominent ."}, {"question": {"question_id": "fs-idp12473408", "question_text": "How many different taste molecules do taste cells each detect?", "question_choices": ["one", "five", "ten", "It depends on the spot on the tongue"], "cloze_format": "Taste cells each detect ___ different taste molecules.", "normal_format": "How many different taste molecules do taste cells each detect?"}, "answer": {"ans_text": "one", "ans_choice": 0}, "bloom": null, "hl_sentences": "In humans , there are five primary tastes , and each taste has only one corresponding type of receptor .", "hl_context": "<hl> In humans , there are five primary tastes , and each taste has only one corresponding type of receptor . <hl> Thus , like olfaction , each receptor is specific to its stimulus ( tastant ) . Transduction of the five tastes happens through different mechanisms that reflect the molecular composition of the tastant . A salty tastant ( containing NaCl ) provides the sodium ions ( Na + ) that enter the taste neurons and excite them directly . Sour tastants are acids and belong to the thermoreceptor protein family . Binding of an acid or other sour-tasting molecule triggers a change in the ion channel and these increase hydrogen ion ( H + ) concentrations in the taste neurons , thus depolarizing them . Sweet , bitter , and umami tastants require a G-protein coupled receptor . These tastants bind to their respective receptors , thereby exciting the specialized neurons associated with them ."}, {"question": {"question_id": "fs-idp54312992", "question_text": "Salty foods activate the taste cells by _____.", "question_choices": ["exciting the taste cell directly", "causing hydrogen ions to enter the cell", "causing sodium channels to close", "binding directly to the receptors"], "cloze_format": "Salty foods activate the taste cells by _____.", "normal_format": "How do salty foods activate the taste cells by?"}, "answer": {"ans_text": "exciting the taste cell directly", "ans_choice": 0}, "bloom": null, "hl_sentences": "A salty tastant ( containing NaCl ) provides the sodium ions ( Na + ) that enter the taste neurons and excite them directly .", "hl_context": "In humans , there are five primary tastes , and each taste has only one corresponding type of receptor . Thus , like olfaction , each receptor is specific to its stimulus ( tastant ) . Transduction of the five tastes happens through different mechanisms that reflect the molecular composition of the tastant . <hl> A salty tastant ( containing NaCl ) provides the sodium ions ( Na + ) that enter the taste neurons and excite them directly . <hl> Sour tastants are acids and belong to the thermoreceptor protein family . Binding of an acid or other sour-tasting molecule triggers a change in the ion channel and these increase hydrogen ion ( H + ) concentrations in the taste neurons , thus depolarizing them . Sweet , bitter , and umami tastants require a G-protein coupled receptor . These tastants bind to their respective receptors , thereby exciting the specialized neurons associated with them ."}, {"question": {"question_id": "fs-idp166670496", "question_text": "All sensory signals except _____ travel to the _____ in the brain before the cerebral cortex.", "question_choices": ["vision; thalamus", "olfaction; thalamus", "vision; cranial nerves", "olfaction; cranial nerves"], "cloze_format": "All sensory signals except _____ travel to the _____ in the brain before the cerebral cortex.", "normal_format": "Where do all sensory signals except which of the following travel to in the brain before the cerebral cortex?"}, "answer": {"ans_text": "olfaction; thalamus", "ans_choice": 1}, "bloom": null, "hl_sentences": "One route takes the signals to the thalamus , which serves as the routing station for all incoming sensory impulses except olfaction . All sensory signals , except those from the olfactory system , are transmitted though the central nervous system and are routed to the thalamus and to the appropriate region of the cortex .", "hl_context": "Once in the brain , visual information is processed in several places , and its routes reflect the complexity and importance of visual information to humans and other animals . <hl> One route takes the signals to the thalamus , which serves as the routing station for all incoming sensory impulses except olfaction . <hl> In the thalamus , the magnocellular and parvocellular distinctions remain intact , and there are different layers of the thalamus dedicated to each . When visual signals leave the thalamus , they travel to the primary visual cortex at the rear of the brain . From the visual cortex , the visual signals travel in two directions . One stream that projects to the parietal lobe , in the side of the brain , carries magnocellular ( \u201c where \u201d ) information . A second stream projects to the temporal lobe and carries both magnocellular ( \u201c where \u201d ) and parvocellular ( \u201c what \u201d ) information . <hl> All sensory signals , except those from the olfactory system , are transmitted though the central nervous system and are routed to the thalamus and to the appropriate region of the cortex . <hl> Recall that the thalamus is a structure in the forebrain that serves as a clearinghouse and relay station for sensory ( as well as motor ) signals . When the sensory signal exits the thalamus , it is conducted to the specific area of the cortex ( Figure 36.3 ) dedicated to processing that particular sense ."}, {"question": {"question_id": "fs-idp80425760", "question_text": "In sound, pitch is measured in _____, and volume is measured in _____.", "question_choices": ["nanometers (nm); decibels (dB)", "decibels (dB); nanometers (nm)", "decibels (dB); hertz (Hz)", "hertz (Hz); decibels (dB)"], "cloze_format": "In sound, pitch is measured in _____, and volume is measured in _____.", "normal_format": "In sound, what is pitch is measured in, and what is volume measured in?"}, "answer": {"ans_text": "hertz (Hz); decibels (dB)", "ans_choice": 3}, "bloom": "1", "hl_sentences": "Frequency is measured in cycles per second , and for sound , the most commonly used unit is hertz ( Hz ) , or cycles per second . For sound , volume is measured in decibels ( dB ) .", "hl_context": "As is true for all waves , there are four main characteristics of a sound wave : frequency , wavelength , period , and amplitude . Frequency is the number of waves per unit of time , and in sound is heard as pitch . High-frequency ( \u2265 15.000 Hz ) sounds are higher-pitched ( short wavelength ) than low-frequency ( long wavelengths ; \u2264 100Hz ) sounds . <hl> Frequency is measured in cycles per second , and for sound , the most commonly used unit is hertz ( Hz ) , or cycles per second . <hl> Most humans can perceive sounds with frequencies between 30 and 20,000 Hz . Women are typically better at hearing high frequencies , but everyone \u2019 s ability to hear high frequencies decreases with age . Dogs detect up to about 40,000 Hz ; cats , 60,000 Hz ; bats , 100,000 Hz ; and dolphins 150,000 Hz , and American shad ( Alosa sapidissima ) , a fish , can hear 180,000 Hz . Those frequencies above the human range are called ultrasound . Amplitude , or the dimension of a wave from peak to trough , in sound is heard as volume and is illustrated in Figure 36.12 . The sound waves of louder sounds have greater amplitude than those of softer sounds . <hl> For sound , volume is measured in decibels ( dB ) . <hl> The softest sound that a human can hear is the zero point . Humans speak normally at 60 decibels ."}, {"question": {"question_id": "fs-idp138052832", "question_text": "Auditory hair cells are indirectly anchored to the _____.", "question_choices": ["basilar membrane", "oval window", "tectorial membrane", "ossicles"], "cloze_format": "Auditory hair cells are indirectly anchored to the _____.", "normal_format": "What are Auditory hair cells indirectly anchored to?"}, "answer": {"ans_text": "basilar membrane", "ans_choice": 0}, "bloom": "1", "hl_sentences": "It is composed of hair cells held in place above the basilar membrane like flowers projecting up from soil , with their exposed short , hair-like stereocilia contacting or embedded in the tectorial membrane above them .", "hl_context": "The site of transduction is in the organ of Corti ( spiral organ ) . <hl> It is composed of hair cells held in place above the basilar membrane like flowers projecting up from soil , with their exposed short , hair-like stereocilia contacting or embedded in the tectorial membrane above them . <hl> The inner hair cells are the primary auditory receptors and exist in a single row , numbering approximately 3,500 . The stereocilia from inner hair cells extend into small dimples on the tectorial membrane \u2019 s lower surface . The outer hair cells are arranged in three or four rows . They number approximately 12,000 , and they function to fine tune incoming sound waves . The longer stereocilia that project from the outer hair cells actually attach to the tectorial membrane . All of the stereocilia are mechanoreceptors , and when bent by vibrations they respond by opening a gated ion channel ( refer to Figure 36.2 ) . As a result , the hair cell membrane is depolarized , and a signal is transmitted to the chochlear nerve . Intensity ( volume ) of sound is determined by how many hair cells at a particular location are stimulated . The hair cells are arranged on the basilar membrane in an orderly way . The basilar membrane vibrates in different regions , according to the frequency of the sound waves impinging on it . Likewise , the hair cells that lay above it are most sensitive to a specific frequency of sound waves . Hair cells can respond to a small range of similar frequencies , but they require stimulation of greater intensity to fire at frequencies outside of their optimal range . The difference in response frequency between adjacent inner hair cells is about 0.2 percent . Compare that to adjacent piano strings , which are about six percent different . Place theory , which is the model for how biologists think pitch detection works in the human ear , states that high frequency sounds selectively vibrate the basilar membrane of the inner ear near the entrance port ( the oval window ) . Lower frequencies travel farther along the membrane before causing appreciable excitation of the membrane . The basic pitch-determining mechanism is based on the location along the membrane where the hair cells are stimulated . The place theory is the first step toward an understanding of pitch perception . Considering the extreme pitch sensitivity of the human ear , it is thought that there must be some auditory \u201c sharpening \u201d mechanism to enhance the pitch resolution ."}, {"question": {"question_id": "fs-idp66662144", "question_text": "Which of the following are found both in the auditory system and the vestibular system?", "question_choices": ["basilar membrane", "hair cells", "semicircular canals", "ossicles"], "cloze_format": "(The) ___ is/are found both in the auditory system and the vestibular system.", "normal_format": "Which of the following are found both in the auditory system and the vestibular system?"}, "answer": {"ans_text": "hair cells", "ans_choice": 1}, "bloom": null, "hl_sentences": "The vestibular system has some similarities with the auditory system . It utilizes hair cells just like the auditory system , but it excites them in different ways .", "hl_context": "<hl> The vestibular system has some similarities with the auditory system . <hl> <hl> It utilizes hair cells just like the auditory system , but it excites them in different ways . <hl> There are five vestibular receptor organs in the inner ear : the utricle , the saccule , and three semicircular canals . Together , they make up what \u2019 s known as the vestibular labyrinth that is shown in Figure 36.15 . The utricle and saccule respond to acceleration in a straight line , such as gravity . The roughly 30,000 hair cells in the utricle and 16,000 hair cells in the saccule lie below a gelatinous layer , with their stereocilia projecting into the gelatin . Embedded in this gelatin are calcium carbonate crystals \u2014 like tiny rocks . When the head is tilted , the crystals continue to be pulled straight down by gravity , but the new angle of the head causes the gelatin to shift , thereby bending the stereocilia . The bending of the stereocilia stimulates the neurons , and they signal to the brain that the head is tilted , allowing the maintenance of balance . It is the vestibular branch of the vestibulocochlear cranial nerve that deals with balance ."}, {"question": {"question_id": "fs-idp10755680", "question_text": "Why do people over 55 often need reading glasses?", "question_choices": ["Their cornea no longer focuses correctly.", "Their lens no longer focuses correctly.", "Their eyeball has elongated with age, causing images to focus in front of their retina.", "Their retina has thinned with age, making vision more difficult."], "cloze_format": "People over 55 often need reading glasses because ___.", "normal_format": "Why do people over 55 often need reading glasses?"}, "answer": {"ans_text": "Their lens no longer focuses correctly.", "ans_choice": 1}, "bloom": null, "hl_sentences": "With age comes the loss of the flexibility of the lens , and a form of farsightedness called presbyopia results .", "hl_context": "The main function of the lens is to focus light on the retina and fovea centralis . The lens is dynamic , focusing and re-focusing light as the eye rests on near and far objects in the visual field . The lens is operated by muscles that stretch it flat or allow it to thicken , changing the focal length of light coming through it to focus it sharply on the retina . <hl> With age comes the loss of the flexibility of the lens , and a form of farsightedness called presbyopia results . <hl> Presbyopia occurs because the image focuses behind the retina . Presbyopia is a deficit similar to a different type of farsightedness called hyperopia caused by an eyeball that is too short . For both defects , images in the distance are clear but images nearby are blurry . Myopia ( nearsightedness ) occurs when an eyeball is elongated and the image focus falls in front of the retina . In this case , images in the distance are blurry but images nearby are clear ."}, {"question": {"question_id": "fs-idp186617760", "question_text": "Why is it easier to see images at night using peripheral, rather than the central, vision?", "question_choices": ["Cones are denser in the periphery of the retina.", "Bipolar cells are denser in the periphery of the retina.", "Rods are denser in the periphery of the retina.", "The optic nerve exits at the periphery of the retina."], "cloze_format": "The reason that it is easier to see images at night using peripheral, rather than the central, vision is that ___ .", "normal_format": "Why is it easier to see images at night using peripheral, rather than the central, vision?"}, "answer": {"ans_text": "Rods are denser in the periphery of the retina.", "ans_choice": 2}, "bloom": null, "hl_sentences": "However , when looking at a star in the night sky or other object in dim light , the object can be better viewed by the peripheral vision because it is the rods at the edges of the retina , rather than the cones at the center , that operate better in low light . They detect dim light and are used primarily for peripheral and nighttime vision . They respond to bright light , and their primary role is in daytime , color vision .", "hl_context": "The fovea is the region in the center back of the eye that is responsible for acute vision . The fovea has a high density of cones . When you bring your gaze to an object to examine it intently in bright light , the eyes orient so that the object \u2019 s image falls on the fovea . <hl> However , when looking at a star in the night sky or other object in dim light , the object can be better viewed by the peripheral vision because it is the rods at the edges of the retina , rather than the cones at the center , that operate better in low light . <hl> In humans , cones far outnumber rods in the fovea . There are two types of photoreceptors in the retina : rods and cones , named for their general appearance as illustrated in Figure 36.18 . Rods are strongly photosensitive and are located in the outer edges of the retina . <hl> They detect dim light and are used primarily for peripheral and nighttime vision . <hl> Cones are weakly photosensitive and are located near the center of the retina . <hl> They respond to bright light , and their primary role is in daytime , color vision . <hl>"}, {"question": {"question_id": "fs-idm49878656", "question_text": "A person catching a ball must coordinate her head and eyes. What part of the brain is helping to do this?", "question_choices": ["hypothalamus", "pineal gland\t", "thalamus", "superior colliculus"], "cloze_format": "The part of the brain that is helping to do this is the ___ .", "normal_format": "A person catching a ball must coordinate her head and eyes. What part of the brain is helping to do this?"}, "answer": {"ans_text": "superior colliculus", "ans_choice": 3}, "bloom": null, "hl_sentences": "Another important visual route is a pathway from the retina to the superior colliculus in the midbrain , where eye movements are coordinated and integrated with auditory information .", "hl_context": "<hl> Another important visual route is a pathway from the retina to the superior colliculus in the midbrain , where eye movements are coordinated and integrated with auditory information . <hl> Finally , there is the pathway from the retina to the suprachiasmatic nucleus ( SCN ) of the hypothalamus . The SCN is a cluster of cells that is considered to be the body \u2019 s internal clock , which controls our circadian ( day-long ) cycle . The SCN sends information to the pineal gland , which is important in sleep / wake patterns and annual cycles ."}], "summary": "", "keyterm": "", "bname": "biology"}, {"chapter": 3, "intro": " Chapter Outline 3.1   Human Genetics 3.2   Cells of the Nervous System 3.3   Parts of the Nervous System 3.4   The Brain and Spinal Cord 3.5   The Endocrine System Introduction \n\n Have you ever taken a device apart to find out how it works? Many of us have done so, whether to attempt a repair or simply to satisfy our curiosity. A device\u2019s internal workings are often distinct from its user interface on the outside. For example, we don\u2019t think about microchips and circuits when we turn up the volume on a mobile phone; instead, we think about getting the volume just right. Similarly, the inner workings of the human body are often distinct from the external expression of those workings. It is the job of psychologists to find the connection between these\u2014for example, to figure out how the firings of millions of neurons become a thought. This chapter strives to explain the biological mechanisms that underlie behavior. These physiological and anatomical foundations are the basis for many areas of psychology. In this chapter, you will learn how genetics influence both physiological and psychological traits. You will become familiar with the structure and function of the nervous system. And, finally, you will learn how the nervous system interacts with the endocrine system. ", "chapter_text": " 3.1   Human Genetics Learning Objectives By the end of this section, you will be able to:\n\n Explain the basic principles of the theory of evolution by natural selection \n\n Describe the differences between genotype and phenotype \n\n Discuss how gene-environment interactions are critical for expression of physical and psychological characteristics \n\n Psychological researchers study genetics in order to better understand the biological basis that contributes to certain behaviors. While all humans share certain biological mechanisms, we are each unique. And while our bodies have many of the same parts\u2014brains and hormones and cells with genetic codes\u2014these are expressed in a wide variety of behaviors, thoughts, and reactions. \n\n Why do two people infected by the same disease have different outcomes: one surviving and one succumbing to the ailment? How are genetic diseases passed through family lines? Are there genetic components to psychological disorders, such as depression or schizophrenia? To what extent might there be a psychological basis to health conditions such as childhood obesity? \n\n To explore these questions, let\u2019s start by focusing on a specific disease,  sickle-cell anemia , and how it might affect two infected sisters. Sickle-cell anemia is a genetic condition in which red blood cells, which are normally round, take on a crescent-like shape ( Figure 3.2 ). The changed shape of these cells affects how they function: sickle-shaped cells can clog blood vessels and block blood flow, leading to high fever, severe pain, swelling, and tissue damage. \n\n Many people with sickle-cell anemia\u2014and the particular genetic mutation that causes it\u2014die at an early age. While the notion of \u201csurvival of the fittest\u201d may suggest that people suffering from this disease have a low survival rate and therefore the disease will become less common, this is not the case. Despite the negative evolutionary effects associated with this genetic mutation, the sickle-cell gene remains relatively common among people of African descent. Why is this? The explanation is illustrated with the following scenario. \n\n Imagine two young women\u2014Luwi and Sena\u2014sisters in rural Zambia, Africa. Luwi carries the gene for sickle-cell anemia; Sena does not carry the gene. Sickle-cell carriers have one copy of the sickle-cell gene but do not have full-blown sickle-cell anemia. They experience symptoms only if they are severely dehydrated or are deprived of oxygen (as in mountain climbing). Carriers are thought to be immune from malaria (an often deadly disease that is widespread in tropical climates) because changes in their blood chemistry and immune functioning prevent the malaria parasite from having its effects (Gong, Parikh, Rosenthal, & Greenhouse, 2013). However, full-blown sickle-cell anemia, with two copies of the sickle-cell gene, does not provide immunity to malaria. \n\n While walking home from school, both sisters are bitten by mosquitos carrying the malaria parasite. Luwi does not get malaria because she carries the sickle-cell mutation. Sena, on the other hand, develops malaria and dies just two weeks later. Luwi survives and eventually has children, to whom she may pass on the sickle-cell mutation. \n\n Link to Learning \n\n Visit this  website  to learn more about how a mutation in DNA leads to sickle-cell anemia. \n\n Malaria is rare in the United States, so the sickle-cell gene benefits nobody: the gene manifests primarily in health problems\u2014minor in carriers, severe in the full-blown disease\u2014with no health benefits for carriers. However, the situation is quite different in other parts of the world. In parts of Africa where malaria is prevalent, having the sickle-cell mutation does provide health benefits for carriers (protection from malaria).  \n\n This is precisely the situation that Charles  Darwin  describes in the  theory of evolution by natural selection  ( Figure 3.3 ). In simple terms, the theory states that organisms that are better suited for their environment will survive and reproduce, while those that are poorly suited for their environment will die off. In our example, we can see that as a carrier, Luwi\u2019s mutation is highly adaptive in her African homeland; however, if she resided in the United States (where malaria is much less common), her mutation could prove costly\u2014with a high probability of the disease in her descendants and minor health problems of her own. Dig Deeper Two Perspectives on Genetics and Behavior It\u2019s easy to get confused about two fields that study the interaction of genes and the environment, such as the fields of  evolutionary psychology  and  behavioral genetics . How can we tell them apart? \n\n In both fields, it is understood that genes not only code for particular traits, but also contribute to certain patterns of cognition and behavior. Evolutionary psychology focuses on how universal patterns of behavior and cognitive processes have evolved over time. Therefore, variations in cognition and behavior would make individuals more or less successful in reproducing and passing those genes to their offspring. Evolutionary psychologists study a variety of psychological phenomena that may have evolved as adaptations, including fear response, food preferences, mate selection, and cooperative behaviors (Confer et al., 2010).  \n\n Whereas evolutionary psychologists focus on universal patterns that evolved over millions of years, behavioral geneticists study how individual differences arise, in the present, through the interaction of genes and the environment. When studying human behavior, behavioral geneticists often employ twin and adoption studies to research questions of interest. Twin studies compare the rates that a given behavioral trait is shared among identical and fraternal twins; adoption studies compare those rates among biologically related relatives and adopted relatives. Both approaches provide some insight into the relative importance of genes and environment for the expression of a given trait. \n\n Link to Learning \n\n Watch this  interview  with renowned  evolutionary psychologist  David Buss for an explanation of how a psychologist approaches evolution and how this approach fits within the field of social science. \n\n Genetic Variation \n\n Genetic variation, the genetic difference between individuals, is what contributes to a species\u2019 adaptation to its environment. In humans, genetic variation begins with an egg, about 100 million sperm, and fertilization. Fertile women ovulate roughly once per month, releasing an egg from follicles in the ovary. During the egg's journey from the ovary through the fallopian tubes, to the uterus, a sperm may fertilize an egg. The egg and the sperm each contain 23 chromosomes.  Chromosomes  are long strings of genetic material known as  deoxyribonucleic acid (DNA) . DNA is a helix-shaped molecule made up of nucleotide base pairs. In each chromosome, sequences of DNA make up  genes  that control or partially control a number of visible characteristics, known as traits, such as eye color, hair color, and so on. A single gene may have multiple possible variations, or alleles. An  allele  is a specific version of a gene. So, a given gene may code for the trait of hair color, and the different alleles of that gene affect which hair color an individual has. When a sperm and egg fuse, their 23 chromosomes pair up and create a zygote with 23 pairs of chromosomes. Therefore, each parent contributes half the genetic information carried by the offspring; the resulting physical characteristics of the offspring (called the phenotype) are determined by the interaction of genetic material supplied by the parents (called the genotype). A person\u2019s  genotype  is the genetic makeup of that individual.  Phenotype , on the other hand, refers to the individual\u2019s inherited physical characteristics, which are a combination of genetic and environmental influences ( Figure 3.4 ). Most traits are controlled by multiple genes, but some traits are controlled by one gene. A characteristic like  cleft chin , for example, is influenced by a single gene from each parent. In this example, we will call the gene for cleft chin \u201cB,\u201d and the gene for smooth chin \u201cb.\u201d Cleft chin is a dominant trait, which means that having the  dominant allele  either from one parent (Bb) or both parents (BB) will always result in the phenotype associated with the dominant allele. When someone has two copies of the same allele, they are said to be  homozygous  for that allele. When someone has a combination of alleles for a given gene, they are said to be  heterozygous . For example, smooth chin is a recessive trait, which means that an individual will only display the smooth chin phenotype if they are homozygous for that  recessive allele  (bb). Imagine that a woman with a cleft chin mates with a man with a smooth chin. What type of chin will their child have? The answer to that depends on which alleles each parent carries. If the woman is homozygous for cleft chin (BB), her offspring will always have cleft chin. It gets a little more complicated, however, if the mother is heterozygous for this gene (Bb). Since the father has a smooth chin\u2014therefore homozygous for the recessive allele (bb)\u2014we can expect the offspring to have a 50% chance of having a cleft chin and a 50% chance of having a smooth chin ( Figure 3.5 ). \n\n Sickle-cell anemia is just one of many genetic disorders caused by the pairing of two recessive genes. For example,  phenylketonuria  (PKU) is a condition in which individuals lack an enzyme that normally converts harmful amino acids into harmless byproducts. If someone with this condition goes untreated, he or she will experience significant deficits in cognitive function, seizures, and increased risk of various psychiatric disorders. Because PKU is a recessive trait, each parent must have at least one copy of the recessive allele in order to produce a child with the condition ( Figure 3.6 ).  So far, we have discussed traits that involve just one gene, but few human characteristics are controlled by a single gene. Most traits are  polygenic : controlled by more than one gene. Height is one example of a polygenic trait, as are skin color and weight. Where do harmful genes that contribute to diseases like PKU come from? Gene mutations provide one source of harmful genes. A  mutation  is a sudden, permanent change in a gene. While many mutations can be harmful or lethal, once in a while, a mutation benefits an individual by giving that person an advantage over those who do not have the mutation. Recall that the theory of evolution asserts that individuals best adapted to their particular environments are more likely to reproduce and pass on their genes to future generations. In order for this process to occur, there must be competition\u2014more technically, there must be variability in genes (and resultant traits) that allow for variation in adaptability to the environment. If a population consisted of identical individuals, then any dramatic changes in the environment would affect everyone in the same way, and there would be no variation in selection. In contrast, diversity in genes and associated traits allows some individuals to perform slightly better than others when faced with environmental change. This creates a distinct advantage for individuals best suited for their environments in terms of successful reproduction and genetic transmission.  \n\n Gene-Environment Interactions \n\n Genes do not exist in a vacuum. Although we are all biological organisms, we also exist in an environment that is incredibly important in determining not only when and how our genes express themselves, but also in what combination. Each of us represents a unique interaction between our genetic makeup and our environment; range of reaction is one way to describe this interaction.  Range of reaction  asserts that our genes set the boundaries within which we can operate, and our environment interacts with the genes to determine where in that range we will fall. For example, if an individual\u2019s genetic makeup predisposes her to high levels of intellectual potential and she is reared in a rich, stimulating environment, then she will be more likely to achieve her full potential than if she were raised under conditions of significant deprivation. According to the concept of range of reaction, genes set definite limits on potential, and environment determines how much of that potential is achieved. Some disagree with this theory and argue that genes do not set a limit on a person\u2019s potential.   Another perspective on the interaction between genes and the environment is the concept of  genetic environmental correlation . Stated simply, our genes influence our environment, and our environment influences the expression of our genes ( Figure 3.7 ). Not only do our genes and environment interact, as in range of reaction, but they also influence one another bidirectionally. For example, the child of an NBA player would probably be exposed to basketball from an early age. Such exposure might allow the child to realize his or her full genetic, athletic potential. Thus, the parents\u2019 genes, which the child shares, influence the child\u2019s environment, and that environment, in turn, is well suited to support the child\u2019s genetic potential. In another approach to gene-environment interactions, the field of  epigenetics  looks beyond the genotype itself and studies how the same genotype can be expressed in different ways. In other words, researchers study how the same genotype can lead to very different phenotypes. As mentioned earlier, gene expression is often influenced by environmental context in ways that are not entirely obvious. For instance, identical twins share the same genetic information ( identical twins  develop from a single fertilized egg that split, so the genetic material is exactly the same in each; in contrast,  fraternal twins  develop from two different eggs fertilized by different sperm, so the genetic material varies as with non-twin siblings). But even with identical genes, there remains an incredible amount of variability in how gene expression can unfold over the course of each twin\u2019s life. Sometimes, one twin will develop a disease and the other will not. In one example, Tiffany, an identical twin, died from cancer at age 7, but her twin, now 19 years old, has never had cancer. Although these individuals share an identical genotype, their phenotypes differ as a result of how that genetic information is expressed over time. The epigenetic perspective is very different from range of reaction, because here the genotype is not fixed and limited. Link to Learning \n\n Visit this  site  for an engaging video primer on the  epigenetics  of twin studies. \n\n Genes  affect more than our physical characteristics. Indeed, scientists have found genetic linkages to a number of behavioral characteristics, ranging from basic personality traits to sexual orientation to spirituality (for examples, see Mustanski et al., 2005; Comings, Gonzales, Saucier, Johnson, & MacMurray, 2000). Genes are also associated with temperament and a number of psychological disorders, such as depression and schizophrenia. So while it is true that genes provide the biological blueprints for our cells, tissues, organs, and body, they also have significant impact on our experiences and our behaviors. \n\n Let\u2019s look at the following findings regarding schizophrenia in light of our three views of gene-environment interactions. Which view do you think best explains this evidence?  \n\n In a study of people who were given up for adoption, adoptees whose biological mothers had schizophrenia  and  who had been raised in a disturbed family environment were much more likely to develop  schizophrenia  or another psychotic disorder than were any of the other groups in the study: \n\n Of adoptees whose biological mothers had schizophrenia (high genetic risk) and who were raised in disturbed family environments, 36.8% were likely to develop schizophrenia. \n\n Of adoptees whose biological mothers had schizophrenia (high genetic risk) and who were raised in healthy family environments, 5.8% were likely to develop schizophrenia. \n\n Of adoptees with a low genetic risk (whose mothers did not have schizophrenia) and who were raised in disturbed family environments, 5.3% were likely to develop schizophrenia. \n\n Of adoptees with a low genetic risk (whose mothers did not have schizophrenia) and who were raised in healthy family environments, 4.8% were likely to develop schizophrenia (Tienari et al., 2004). \n\n The study shows that adoptees with high genetic risk were especially likely to develop schizophrenia only if they were raised in disturbed home environments. This research lends credibility to the notion that both genetic vulnerability and environmental stress are necessary for schizophrenia to develop, and that genes alone do not tell the full tale. \n 3.2   Cells of the Nervous System Learning Objectives By the end of this section, you will be able to:\n\n Identify the basic parts of a neuron \n\n Describe how neurons communicate with each other \n\n Explain how drugs act as agonists or antagonists for a given neurotransmitter system \n\n Psychologists striving to understand the human mind may study the nervous system. Learning how the cells and organs (like the brain) function, help us understand the biological basis behind human psychology. The  nervous system  is composed of two basic cell types: glial cells (also known as glia) and neurons. Glial cells, which outnumber neurons ten to one, are traditionally thought to play a supportive role to neurons, both physically and metabolically.  Glial cells  provide scaffolding on which the nervous system is built, help neurons line up closely with each other to allow neuronal communication, provide insulation to neurons, transport nutrients and waste products, and mediate immune responses.  Neurons , on the other hand, serve as interconnected information processors that are essential for all of the tasks of the nervous system. This section briefly describes the structure and function of neurons. \n\n Neuron Structure \n\n Neurons  are the central building blocks of the nervous system, 100 billion strong at birth. Like all cells, neurons consist of several different parts, each serving a specialized function ( Figure 3.8 ). A neuron\u2019s outer surface is made up of a  semipermeable membrane . This membrane allows smaller molecules and molecules without an electrical charge to pass through it, while stopping larger or highly charged molecules. \n\n The nucleus of the neuron is located in the  soma , or cell body. The soma has branching extensions known as  dendrites . The neuron is a small information processor, and dendrites serve as input sites where signals are received from other neurons. These signals are transmitted electrically across the soma and down a major extension from the soma known as the  axon , which ends at multiple  terminal buttons . The terminal buttons contain  synaptic vesicles  that house  neurotransmitters , the chemical messengers of the nervous system.  \n\n Axons range in length from a fraction of an inch to several feet. In some axons, glial cells form a fatty substance known as the  myelin sheath , which coats the axon and acts as an insulator, increasing the speed at which the signal travels. The myelin sheath is crucial for the normal operation of the neurons within the nervous system: the loss of the insulation it provides can be detrimental to normal function. To understand how this works, let\u2019s consider an example. Multiple sclerosis (MS), an autoimmune disorder, involves a large-scale loss of the myelin sheath on axons throughout the nervous system. The resulting interference in the electrical signal prevents the quick transmittal of information by neurons and can lead to a number of symptoms, such as dizziness, fatigue, loss of motor control, and sexual dysfunction. While some treatments may help to modify the course of the disease and manage certain symptoms, there is currently no known cure for multiple sclerosis. \n\n In healthy individuals, the neuronal signal moves rapidly down the axon to the terminal buttons, where synaptic vesicles release neurotransmitters into the synapse ( Figure 3.9 ). The  synapse  is a very small space between two neurons and is an important site where communication between neurons occurs. Once neurotransmitters are released into the synapse, they travel across the small space and bind with corresponding receptors on the dendrite of an adjacent neuron.  Receptors , proteins on the cell surface where neurotransmitters attach, vary in shape, with different shapes \u201cmatching\u201d different neurotransmitters. \n\n How does a neurotransmitter \u201cknow\u201d which receptor to bind to? The neurotransmitter and the receptor have what is referred to as a lock-and-key relationship\u2014specific neurotransmitters fit specific receptors similar to how a key fits a lock. The neurotransmitter binds to any receptor that it fits. \n\n Neuronal Communication \n\n Now that we have learned about the basic structures of the neuron and the role that these structures play in neuronal communication, let\u2019s take a closer look at the signal itself\u2014how it moves through the neuron and then jumps to the next neuron, where the process is repeated. \n\n We begin at the neuronal membrane. The  neuron  exists in a fluid environment\u2014it is surrounded by extracellular fluid and contains intracellular fluid (i.e., cytoplasm). The neuronal membrane keeps these two fluids separate\u2014a critical role because the electrical signal that passes through the neuron depends on the intra- and extracellular fluids being electrically different. This difference in charge across the membrane, called the  membrane potential , provides energy for the signal. \n\n The electrical charge of the fluids is caused by charged molecules (ions) dissolved in the fluid. The semipermeable nature of the neuronal membrane somewhat restricts the movement of these charged molecules, and, as a result, some of the charged particles tend to become more concentrated either inside or outside the cell. \n\n Between signals, the neuron membrane\u2019s potential is held in a state of readiness, called the  resting potential . Like a rubber band stretched out and waiting to spring into action, ions line up on either side of the cell membrane, ready to rush across the membrane when the neuron goes active and the membrane opens its gates (i.e., a  sodium-potassium pump  that allows movement of ions across the membrane). Ions in high-concentration areas are ready to move to low-concentration areas, and positive ions are ready to move to areas with a negative charge. In the resting state, sodium (Na + ) is at higher concentrations outside the cell, so it will tend to move into the cell. Potassium (K + ), on the other hand, is more concentrated inside the cell, and will tend to move out of the cell ( Figure 3.10 ). In addition, the inside of the cell is slightly negatively charged compared to the outside. This provides an additional force on sodium, causing it to move into the cell. From this resting potential state, the neuron receives a signal and its state changes abruptly ( Figure 3.11 ). When a neuron receives signals at the dendrites\u2014due to neurotransmitters from an adjacent neuron binding to its receptors\u2014small pores, or gates, open on the neuronal membrane, allowing Na +  ions, propelled by both charge and concentration differences, to move into the cell. With this influx of positive ions, the internal charge of the cell becomes more positive. If that charge reaches a certain level, called the  threshold of excitation , the neuron becomes active and the action potential begins. Many additional pores open, causing a massive influx of Na +  ions and a huge positive spike in the membrane potential, the peak action potential. At the peak of the spike, the sodium gates close and the potassium gates open. As positively charged potassium ions leave, the cell quickly begins repolarization. At first, it hyperpolarizes, becoming slightly more negative than the resting potential, and then it levels off, returning to the resting potential. This positive spike constitutes the  action potential : the electrical signal that typically moves from the cell body down the axon to the axon terminals. The electrical signal moves down the axon like a wave; at each point, some of the sodium ions that enter the cell diffuse to the next section of the axon, raising the charge past the threshold of excitation and triggering a new influx of sodium ions. The action potential moves all the way down the axon to the terminal buttons. \n\n The action potential is an  all-or-none  phenomenon. In simple terms, this means that an incoming signal from another neuron is either sufficient or insufficient to reach the threshold of excitation. There is no in-between, and there is no turning off an action potential once it starts. Think of it like sending an email or a text message. You can think about sending it all you want, but the message is not sent until you hit the send button. Furthermore, once you send the message, there is no stopping it. \n\n Because it is all or none, the  action potential  is recreated, or propagated, at its full strength at every point along the axon. Much like the lit fuse of a firecracker, it does not fade away as it travels down the axon. It is this all-or-none property that explains the fact that your brain perceives an injury to a distant body part like your toe as equally painful as one to your nose. \n\n As noted earlier, when the action potential arrives at the terminal button, the synaptic vesicles release their neurotransmitters into the synapse. The neurotransmitters travel across the synapse and bind to receptors on the dendrites of the adjacent neuron, and the process repeats itself in the new neuron (assuming the signal is sufficiently strong to trigger an action potential). Once the signal is delivered, excess neurotransmitters in the synapse drift away, are broken down into inactive fragments, or are reabsorbed in a process known as  reuptake . Reuptake involves the neurotransmitter being pumped back into the neuron that released it, in order to clear the synapse ( Figure 3.12 ). Clearing the synapse serves both to provide a clear \u201con\u201d and \u201coff\u201d state between signals and to regulate the production of neurotransmitter (full synaptic vesicles provide signals that no additional neurotransmitters need to be produced). \n\n Neuronal communication is often referred to as an electrochemical event. The movement of the action potential down the length of the axon is an electrical event, and movement of the neurotransmitter across the synaptic space represents the chemical portion of the process. \n\n Link to Learning \n\n Click through this  interactive simulation  for a closer look at neuronal communication. \n\n Neurotransmitters and Drugs \n\n There are several different types of  neurotransmitters  released by different neurons, and we can speak in broad terms about the kinds of functions associated with different neurotransmitters ( Table 3.1 ). Much of what psychologists know about the functions of neurotransmitters comes from research on the effects of drugs in psychological disorders. Psychologists who take a  biological perspective  and focus on the physiological causes of behavior assert that psychological disorders like depression and schizophrenia are associated with imbalances in one or more neurotransmitter systems. In this perspective, psychotropic medications can help improve the symptoms associated with these disorders.  Psychotropic medications  are drugs that treat psychiatric symptoms by restoring neurotransmitter balance. \n\n Neurotransmitter \n\n Involved in \n\n Potential Effect on Behavior \n\n Acetylcholine \n\n Muscle action, memory \n\n Increased arousal, enhanced cognition \n\n Beta-endorphin \n\n Pain, pleasure \n\n Decreased anxiety, decreased tension \n\n Dopamine \n\n Mood, sleep, learning \n\n Increased pleasure, suppressed appetite \n\n Gamma-aminobutyric acid (GABA) \n\n Brain function, sleep \n\n Decreased anxiety, decreased tension \n\n Glutamate \n\n Memory, learning \n\n Increased learning, enhanced memory \n\n Norepinephrine \n\n Heart, intestines, alertness  \n\n Increased arousal, suppressed appetite \n\n Serotonin \n\n Mood, sleep \n\n Modulated mood, suppressed appetite \n\n Table  3.1   Major Neurotransmitters and How They Affect Behavior \n\n Psychoactive drugs can act as agonists or antagonists for a given neurotransmitter system.  Agonists  are chemicals that mimic a neurotransmitter at the receptor site and, thus, strengthen its effects. An  antagonist , on the other hand, blocks or impedes the normal activity of a neurotransmitter at the receptor. Agonist and antagonist drugs are prescribed to correct the specific neurotransmitter imbalances underlying a person\u2019s condition. For example, Parkinson's disease, a progressive nervous system disorder, is associated with low levels of dopamine. Therefore dopamine agonists, which mimic the effects of dopamine by binding to dopamine receptors, are one treatment strategy. \n\n Certain symptoms of schizophrenia are associated with overactive dopamine neurotransmission. The antipsychotics used to treat these symptoms are antagonists for dopamine\u2014they block dopamine\u2019s effects by binding its receptors without activating them. Thus, they prevent dopamine released by one neuron from signaling information to adjacent neurons. \n\n In contrast to agonists and antagonists, which both operate by binding to receptor sites, reuptake inhibitors prevent unused neurotransmitters from being transported back to the neuron. This leaves more neurotransmitters in the synapse for a longer time, increasing its effects. Depression, which has been consistently linked with reduced serotonin levels, is commonly treated with selective serotonin reuptake inhibitors (SSRIs). By preventing reuptake, SSRIs strengthen the effect of serotonin, giving it more time to interact with serotonin receptors on dendrites. Common SSRIs on the market today include Prozac, Paxil, and Zoloft. The drug LSD is structurally very similar to serotonin, and it affects the same neurons and receptors as serotonin. Psychotropic drugs are not instant solutions for people suffering from psychological disorders. Often, an individual must take a drug for several weeks before seeing improvement, and many psychoactive drugs have significant negative side effects. Furthermore, individuals vary dramatically in how they respond to the drugs. To improve chances for success, it is not uncommon for people receiving pharmacotherapy to undergo psychological and/or behavioral therapies as well. Some research suggests that combining drug therapy with other forms of therapy tends to be more effective than any one treatment alone (for one such example, see March et al., 2007). \n 3.3   Parts of the Nervous System Learning Objectives By the end of this section, you will be able to:\n\n Describe the difference between the central and peripheral nervous systems \n\n Explain the difference between the somatic and autonomic nervous systems \n\n Differentiate between the sympathetic and parasympathetic divisions of the autonomic nervous system \n\n The  nervous system  can be divided into two major subdivisions: the  central nervous system (CNS)  and the  peripheral nervous system (PNS) , shown in  Figure 3.13 . The CNS is comprised of the brain and spinal cord; the PNS connects the CNS to the rest of the body. In this section, we focus on the peripheral nervous system; later, we look at the brain and spinal cord. \n\n Peripheral Nervous System \n\n The peripheral nervous system is made up of thick bundles of axons, called nerves, carrying messages back and forth between the CNS and the muscles, organs, and senses in the periphery of the body (i.e., everything outside the CNS). The PNS has two major subdivisions: the somatic nervous system and the autonomic nervous system. \n\n The  somatic nervous system  is associated with activities traditionally thought of as conscious or voluntary. It is involved in the relay of sensory and motor information to and from the CNS; therefore, it consists of motor neurons and sensory neurons. Motor neurons, carrying instructions from the CNS to the muscles, are efferent fibers (efferent means \u201cmoving away from\u201d). Sensory neurons, carrying sensory information to the CNS, are afferent fibers (afferent means \u201cmoving toward\u201d). Each nerve is basically a two-way superhighway, containing thousands of axons, both efferent and afferent. \n\n The  autonomic nervous system  controls our internal organs and glands and is generally considered to be outside the realm of voluntary control. It can be further subdivided into the sympathetic and parasympathetic divisions ( Figure 3.14 ). The  sympathetic nervous system  is involved in preparing the body for stress-related activities; the  parasympathetic nervous system  is associated with returning the body to routine, day-to-day operations. The two systems have complementary functions, operating in tandem to maintain the body\u2019s homeostasis.  Homeostasis  is a state of equilibrium, in which biological conditions (such as body temperature) are maintained at optimal levels. \n\n The sympathetic nervous system is activated when we are faced with stressful or high-arousal situations. The activity of this system was adaptive for our ancestors, increasing their chances of survival. Imagine, for example, that one of our early ancestors, out hunting small game, suddenly disturbs a large bear with her cubs. At that moment, his body undergoes a series of changes\u2014a direct function of sympathetic activation\u2014preparing him to face the threat. His pupils dilate, his heart rate and blood pressure increase, his bladder relaxes, his liver releases glucose, and adrenaline surges into his bloodstream. This constellation of physiological changes, known as the  fight or flight response , allows the body access to energy reserves and heightened sensory capacity so that it might fight off a threat or run away to safety. \n\n Link to Learning \n\n Reinforce what you\u2019ve learned about the nervous system by playing this BBC-produced  interactive game  about the nervous system. \n\n While it is clear that such a response would be critical for survival for our ancestors, who lived in a world full of real physical threats, many of the high-arousal situations we face in the modern world are more psychological in nature. For example, think about how you feel when you have to stand up and give a presentation in front of a roomful of people, or right before taking a big test. You are in no real physical danger in those situations, and yet you have evolved to respond to any perceived threat with the  fight or flight  response. This kind of response is not nearly as adaptive in the modern world; in fact, we suffer negative health consequences when faced constantly with psychological threats that we can neither fight nor flee. Recent research suggests that an increase in susceptibility to heart disease (Chandola, Brunner, & Marmot, 2006) and impaired function of the immune system (Glaser & Kiecolt-Glaser, 2005) are among the many negative consequences of persistent and repeated exposure to stressful situations. \n\n Once the threat has been resolved, the parasympathetic nervous system takes over and returns bodily functions to a relaxed state. Our hunter\u2019s heart rate and blood pressure return to normal, his pupils constrict, he regains control of his bladder, and the liver begins to store glucose in the form of glycogen for future use. These processes are associated with activation of the parasympathetic nervous system. \n 3.4   The Brain and Spinal Cord Learning Objectives By the end of this section, you will be able to:\n\n Explain the functions of the spinal cord \n\n Identify the hemispheres and lobes of the brain \n\n Describe the types of techniques available to clinicians and researchers to image or scan the brain \n\n The brain is a remarkably complex organ comprised of billions of interconnected neurons and glia. It is a bilateral, or two-sided, structure that can be separated into distinct lobes. Each lobe is associated with certain types of functions, but, ultimately, all of the areas of the brain interact with one another to provide the foundation for our thoughts and behaviors. In this section, we discuss the overall organization of the brain and the functions associated with different brain areas, beginning with what can be seen as an extension of the brain, the spinal cord. \n\n The Spinal Cord It can be said that the  spinal cord  is what connects the brain to the outside world. Because of it, the brain can act. The spinal cord is like a relay station, but a very smart one. It not only routes messages to and from the brain, but it also has its own system of automatic processes, called reflexes.  \n\n The top of the spinal cord merges with the brain stem, where the basic processes of life are controlled, such as breathing and digestion. In the opposite direction, the spinal cord ends just below the ribs\u2014contrary to what we might expect, it does not extend all the way to the base of the spine. \n\n The spinal cord is functionally organized in 30 segments, corresponding with the vertebrae. Each segment is connected to a specific part of the body through the peripheral nervous system. Nerves branch out from the spine at each vertebra. Sensory nerves bring messages in; motor nerves send messages out to the muscles and organs. Messages travel to and from the brain through every segment. \n\n Some sensory messages are immediately acted on by the spinal cord, without any input from the brain. Withdrawal from heat and knee jerk are two examples. When a sensory message meets certain parameters, the spinal cord initiates an automatic reflex. The signal passes from the sensory nerve to a simple processing center, which initiates a motor command. Seconds are saved, because messages don\u2019t have to go the brain, be processed, and get sent back. In matters of survival, the spinal reflexes allow the body to react extraordinarily fast. \n\n The spinal cord is protected by bony vertebrae and cushioned in cerebrospinal fluid, but injuries still occur. When the spinal cord is damaged in a particular segment, all lower segments are cut off from the brain, causing paralysis. Therefore, the lower on the spine damage is, the fewer functions an injured individual loses. The Two Hemispheres The surface of the brain, known as the  cerebral cortex , is very uneven, characterized by a distinctive pattern of folds or bumps, known as  gyri  (singular: gyrus), and grooves, known as  sulci  (singular: sulcus), shown in  Figure 3.15 . These gyri and sulci form important landmarks that allow us to separate the brain into functional centers. The most prominent sulcus, known as the  longitudinal fissure , is the deep groove that separates the brain into two halves or  hemispheres : the left hemisphere and the right hemisphere. \n\n There is evidence of some specialization of function\u2014referred to as  lateralization \u2014in each hemisphere, mainly regarding differences in language ability. Beyond that, however, the differences that have been found have been minor. What we do know is that the left hemisphere controls the right half of the body, and the right hemisphere controls the left half of the body. \n\n The two hemispheres are connected by a thick band of neural fibers known as the  corpus callosum , consisting of about 200 million axons. The corpus callosum allows the two hemispheres to communicate with each other and allows for information being processed on one side of the brain to be shared with the other side. Normally, we are not aware of the different roles that our two hemispheres play in day-to-day functions, but there are people who come to know the capabilities and functions of their two hemispheres quite well. In some cases of severe epilepsy, doctors elect to sever the corpus callosum as a means of controlling the spread of seizures ( Figure 3.16 ). While this is an effective treatment option, it results in individuals who have split brains. After surgery, these split-brain patients show a variety of interesting behaviors. For instance, a split-brain patient is unable to name a picture that is shown in the patient\u2019s left visual field because the information is only available in the largely nonverbal right hemisphere. However, they are able to recreate the picture with their left hand, which is also controlled by the right hemisphere. When the more verbal left hemisphere sees the picture that the hand drew, the patient is able to name it (assuming the left hemisphere can interpret what was drawn by the left hand). \n\n Link to Learning \n\n This  interactive animation  on the Nobel Prize website walks users through the hemispheres of the brain. \n\n Much of what we know about the functions of different areas of the brain comes from studying changes in the behavior and ability of individuals who have suffered damage to the brain. For example, researchers study the behavioral changes caused by strokes to learn about the functions of specific brain areas. A stroke, caused by an interruption of blood flow to a region in the brain, causes a loss of brain function in the affected region. The damage can be in a small area, and, if it is, this gives researchers the opportunity to link any resulting behavioral changes to a specific area. The types of deficits displayed after a stroke will be largely dependent on where in the brain the damage occurred. \n\n Consider Theona, an intelligent, self-sufficient woman, who is 62 years old. Recently, she suffered a stroke in the front portion of her right hemisphere. As a result, she has great difficulty moving her left leg. (As you learned earlier, the right hemisphere controls the left side of the body; also, the brain\u2019s main motor centers are located at the front of the head, in the frontal lobe.) Theona has also experienced behavioral changes. For example, while in the produce section of the grocery store, she sometimes eats grapes, strawberries, and apples directly from their bins before paying for them. This behavior\u2014which would have been very embarrassing to her before the stroke\u2014is consistent with damage in another region in the frontal lobe\u2014the prefrontal cortex, which is associated with judgment, reasoning, and impulse control. \n\n Forebrain Structures The two hemispheres of the cerebral cortex are part of the  forebrain  ( Figure 3.17 ), which is the largest part of the brain. The forebrain contains the cerebral cortex and a number of other structures that lie beneath the cortex (called subcortical structures): thalamus, hypothalamus, pituitary gland, and the limbic system (collection of structures). The cerebral cortex, which is the outer surface of the brain, is associated with higher level processes such as consciousness, thought, emotion, reasoning, language, and memory. Each cerebral hemisphere can be subdivided into four lobes, each associated with different functions. \n\n Lobes of the Brain The four lobes of the brain are the frontal, parietal, temporal, and occipital lobes ( Figure 3.18 ). The  frontal lobe  is located in the forward part of the brain, extending back to a fissure known as the central sulcus. The frontal lobe is involved in reasoning, motor control, emotion, and language. It contains the  motor cortex , which is involved in planning and coordinating movement; the  prefrontal cortex , which is responsible for higher-level cognitive functioning; and  Broca\u2019s area , which is essential for language production. \n\n People who suffer damage to Broca\u2019s area have great difficulty producing language of any form ( Figure 3.18 ). For example, Padma was an electrical engineer who was socially active and a caring, involved mother. About twenty years ago, she was in a car accident and suffered damage to her Broca\u2019s area. She completely lost the ability to speak and form any kind of meaningful language. There is nothing wrong with her mouth or her vocal cords, but she is unable to produce words. She can follow directions but can\u2019t respond verbally, and she can read but no longer write. She can do routine tasks like running to the market to buy milk, but she could not communicate verbally if a situation called for it. \n\n Probably the most famous case of frontal lobe damage is that of a man by the name of Phineas  Gage . On September 13, 1848, Gage (age 25) was working as a railroad foreman in Vermont. He and his crew were using an iron rod to tamp explosives down into a blasting hole to remove rock along the railway\u2019s path. Unfortunately, the iron rod created a spark and caused the rod to explode out of the blasting hole, into Gage\u2019s face, and through his skull ( Figure 3.19 ). Although lying in a pool of his own blood with brain matter emerging from his head, Gage was conscious and able to get up, walk, and speak. But in the months following his accident, people noticed that his personality had changed. Many of his friends described him as no longer being himself. Before the accident, it was said that Gage was a well-mannered, soft-spoken man, but he began to behave in odd and inappropriate ways after the accident. Such changes in personality would be consistent with loss of impulse control\u2014a frontal lobe function. \n\n Beyond the damage to the frontal lobe itself, subsequent investigations into the rod's path also identified probable damage to pathways between the frontal lobe and other brain structures, including the limbic system. With connections between the planning functions of the frontal lobe and the emotional processes of the limbic system severed, Gage had difficulty controlling his emotional impulses. However, there is some evidence suggesting that the dramatic changes in Gage\u2019s personality were exaggerated and embellished. Gage's case occurred in the midst of a 19 th  century debate over localization\u2014regarding whether certain areas of the brain are associated with particular functions. On the basis of extremely limited information about Gage, the extent of his injury, and his life before and after the accident, scientists tended to find support for their own views, on whichever side of the debate they fell (Macmillan, 1999). The brain\u2019s  parietal lobe  is located immediately behind the frontal lobe, and is involved in processing information from the body\u2019s senses. It contains the  somatosensory cortex , which is essential for processing sensory information from across the body, such as touch, temperature, and pain. The somatosensory cortex is organized topographically, which means that spatial relationships that exist in the body are maintained on the surface of the somatosensory cortex ( Figure 3.20 ). For example, the portion of the cortex that processes sensory information from the hand is adjacent to the portion that processes information from the wrist. \n\n The  temporal lobe  is located on the side of the head (temporal means \u201cnear the temples\u201d), and is associated with hearing, memory, emotion, and some aspects of language. The  auditory cortex , the main area responsible for processing auditory information, is located within the temporal lobe.  Wernicke\u2019s area , important for speech comprehension, is also located here. Whereas individuals with damage to Broca\u2019s area have difficulty producing language, those with damage to Wernicke\u2019s area can produce sensible language, but they are unable to understand it ( Figure 3.21 ). \n\n The  occipital lobe  is located at the very back of the brain, and contains the primary visual cortex, which is responsible for interpreting incoming visual information. The occipital cortex is organized retinotopically, which means there is a close relationship between the position of an object in a person\u2019s visual field and the position of that object\u2019s representation on the cortex. You will learn much more about how visual information is processed in the occipital lobe when you study sensation and perception. \n\n Other Areas of the Forebrain Other areas of the  forebrain , located beneath the cerebral cortex, include the thalamus and the limbic system. The  thalamus  is a sensory relay for the brain. All of our senses, with the exception of smell, are routed through the thalamus before being directed to other areas of the brain for processing ( Figure 3.22 ). \n\n The  limbic system  is involved in processing both emotion and memory. Interestingly, the sense of smell projects directly to the limbic system; therefore, not surprisingly, smell can evoke emotional responses in ways that other sensory modalities cannot. The limbic system is made up of a number of different structures, but three of the most important are the hippocampus, the amygdala, and the hypothalamus ( Figure 3.23 ). The  hippocampus  is an essential structure for learning and memory. The  amygdala  is involved in our experience of emotion and in tying emotional meaning to our memories. The  hypothalamus  regulates a number of homeostatic processes, including the regulation of body temperature, appetite, and blood pressure. The hypothalamus also serves as an interface between the nervous system and the endocrine system and in the regulation of sexual motivation and behavior. \n\n The Case of Henry Molaison (H.M.) \n\n In 1953, Henry Gustav  Molaison  (H. M.) was a 27-year-old man who experienced severe seizures. In an attempt to control his seizures, H. M. underwent brain surgery to remove his hippocampus and amygdala. Following the surgery, H.M\u2019s seizures became much less severe, but he also suffered some unexpected\u2014and devastating\u2014consequences of the surgery: he lost his ability to form many types of new memories. For example, he was unable to learn new facts, such as who was president of the United States. He was able to learn new skills, but afterward he had no recollection of learning them. For example, while he might learn to use a computer, he would have no conscious memory of ever having used one. He could not remember new faces, and he was unable to remember events, even immediately after they occurred. Researchers were fascinated by his experience, and he is considered one of the most studied cases in medical and psychological history (Hardt, Einarsson, & Nader, 2010; Squire, 2009). Indeed, his case has provided tremendous insight into the role that the hippocampus plays in the consolidation of new learning into explicit memory. Link to Learning \n\n Clive Wearing, an accomplished musician, lost the ability to form new memories when his hippocampus was damaged through illness. Check out the first few minutes of this  documentary video  for an introduction to this man and his condition. \n\n Midbrain and Hindbrain Structures The  midbrain  is comprised of structures located deep within the brain, between the forebrain and the hindbrain. The  reticular formation  is centered in the midbrain, but it actually extends up into the forebrain and down into the hindbrain. The reticular formation is important in regulating the sleep/wake cycle, arousal, alertness, and motor activity. \n\n The  substantia nigra  (Latin for \u201cblack substance\u201d) and the  ventral tegmental area (VTA)  are also located in the midbrain ( Figure 3.24 ). Both regions contain cell bodies that produce the neurotransmitter dopamine, and both are critical for movement. Degeneration of the substantia nigra and VTA is involved in Parkinson\u2019s disease. In addition, these structures are involved in mood, reward, and addiction (Berridge & Robinson, 1998; Gardner, 2011; George, Le Moal, & Koob, 2012). The  hindbrain  is located at the back of the head and looks like an extension of the spinal cord. It contains the medulla, pons, and cerebellum ( Figure 3.25 ). The  medulla  controls the automatic processes of the autonomic nervous system, such as breathing, blood pressure, and heart rate. The word pons literally means \u201cbridge,\u201d and as the name suggests, the  pons  serves to connect the brain and spinal cord. It also is involved in regulating brain activity during sleep. The medulla, pons, and midbrain together are known as the brainstem. \n\n The  cerebellum  (Latin for \u201clittle brain\u201d) receives messages from muscles, tendons, joints, and structures in our ear to control balance, coordination, movement, and motor skills. The cerebellum is also thought to be an important area for processing some types of memories. In particular, procedural memory, or memory involved in learning and remembering how to perform tasks, is thought to be associated with the cerebellum. Recall that H. M. was unable to form new explicit memories, but he could learn new tasks. This is likely due to the fact that H. M.\u2019s cerebellum remained intact. \n\n What Do You Think? Brain Dead and on Life Support What would you do if your spouse or loved one was declared brain dead but his or her body was being kept alive by medical equipment? Whose decision should it be to remove a feeding tube? Should medical care costs be a factor? \n\n On February 25, 1990, a Florida woman named Terri  Schiavo  went into cardiac arrest, apparently triggered by a bulimic episode. She was eventually revived, but her brain had been deprived of oxygen for a long time. Brain scans indicated that there was no activity in her cerebral cortex, and she suffered from severe and permanent cerebral atrophy. Basically, Schiavo was in a vegetative state. Medical professionals determined that she would never again be able to move, talk, or respond in any way. To remain alive, she required a feeding tube, and there was no chance that her situation would ever improve. \n\n On occasion, Schiavo\u2019s eyes would move, and sometimes she would groan. Despite the doctors\u2019 insistence to the contrary, her parents believed that these were signs that she was trying to communicate with them. \n\n After 12 years, Schiavo\u2019s husband argued that his wife would not have wanted to be kept alive with no feelings, sensations, or brain activity. Her parents, however, were very much against removing her feeding tube. Eventually, the case made its way to the courts, both in the state of Florida and at the federal level. By 2005, the courts found in favor of Schiavo\u2019s husband, and the feeding tube was removed on March 18, 2005. Schiavo died 13 days later. \n\n Why did Schiavo\u2019s eyes sometimes move, and why did she groan? Although the parts of her brain that control thought, voluntary movement, and feeling were completely damaged, her brainstem was still intact. Her medulla and pons maintained her breathing and caused involuntary movements of her eyes and the occasional groans. Over the 15-year period that she was on a feeding tube, Schiavo\u2019s medical costs may have topped $7 million (Arnst, 2003). \n\n These questions were brought to popular conscience 25 years ago in the case of Terri Schiavo, and they persist today. In 2013, a 13-year-old girl who suffered complications after tonsil surgery was declared brain dead. There was a battle between her family, who wanted her to remain on life support, and the hospital\u2019s policies regarding persons declared brain dead. In another complicated 2013\u201314 case in Texas, a pregnant EMT professional declared brain dead was kept alive for weeks, despite her spouse\u2019s directives, which were based on her wishes should this situation arise. In this case, state laws designed to protect an unborn fetus came into consideration until doctors determined the fetus unviable. Decisions surrounding the medical response to patients declared brain dead are complex. What do you think about these issues? \n\n Brain Imaging You have learned how brain injury can provide information about the functions of different parts of the brain. Increasingly, however, we are able to obtain that information using  brain imaging  techniques on individuals who have not suffered brain injury. In this section, we take a more in-depth look at some of the techniques that are available for imaging the brain, including techniques that rely on radiation, magnetic fields, or electrical activity within the brain. \n\n Techniques Involving Radiation \n\n A  computerized tomography (CT) scan  involves taking a number of x-rays of a particular section of a person\u2019s body or brain ( Figure 3.26 ). The x-rays pass through tissues of different densities at different rates, allowing a computer to construct an overall image of the area of the body being scanned. A CT scan is often used to determine whether someone has a tumor, or significant brain atrophy. \n\n Positron emission tomography (PET)  scans create pictures of the living, active brain ( Figure 3.27 ). An individual receiving a PET scan drinks or is injected with a mildly radioactive substance, called a tracer. Once in the bloodstream, the amount of tracer in any given region of the brain can be monitored. As brain areas become more active, more blood flows to that area. A computer monitors the movement of the tracer and creates a rough map of active and inactive areas of the brain during a given behavior. PET scans show little detail, are unable to pinpoint events precisely in time, and require that the brain be exposed to radiation; therefore, this technique has been replaced by the fMRI as an alternative diagnostic tool. However, combined with CT, PET technology is still being used in certain contexts. For example, CT/PET scans allow better imaging of the activity of neurotransmitter receptors and open new avenues in schizophrenia research. In this hybrid CT/PET technology, CT contributes clear images of brain structures, while PET shows the brain\u2019s activity. \n\n Techniques Involving Magnetic Fields \n\n In  magnetic resonance imaging (MRI) , a person is placed inside a machine that generates a strong magnetic field. The magnetic field causes the hydrogen atoms in the body\u2019s cells to move. When the magnetic field is turned off, the hydrogen atoms emit electromagnetic signals as they return to their original positions. Tissues of different densities give off different signals, which a computer interprets and displays on a monitor.  Functional magnetic resonance imaging (fMRI)  operates on the same principles, but it shows changes in brain activity over time by tracking blood flow and oxygen levels. The fMRI provides more detailed images of the brain\u2019s structure, as well as better accuracy in time, than is possible in PET scans ( Figure 3.28 ). With their high level of detail, MRI and fMRI are often used to compare the brains of healthy individuals to the brains of individuals diagnosed with psychological disorders. This comparison helps determine what structural and functional differences exist between these populations. \n\n Link to Learning \n\n Visit this  virtual lab  to learn more about MRI and fMRI. \n\n Techniques Involving Electrical Activity \n\n In some situations, it is helpful to gain an understanding of the overall activity of a person\u2019s brain, without needing information on the actual location of the activity.  Electroencephalography (EEG)  serves this purpose by providing a measure of a brain\u2019s electrical activity. An array of electrodes is placed around a person\u2019s head ( Figure 3.29 ). The signals received by the electrodes result in a printout of the electrical activity of his or her brain, or brainwaves, showing both the frequency (number of waves per second) and amplitude (height) of the recorded brainwaves, with an accuracy within milliseconds. Such information is especially helpful to researchers studying sleep patterns among individuals with sleep disorders. \n 3.5   The Endocrine System Learning Objectives By the end of this section, you will be able to:\n\n Identify the major glands of the endocrine system \n\n Identify the hormones secreted by each gland \n\n Describe each hormone\u2019s role in regulating bodily functions \n\n The  endocrine system  consists of a series of glands that produce chemical substances known as  hormones  ( Figure 3.30 ). Like neurotransmitters, hormones are chemical messengers that must bind to a receptor in order to send their signal. However, unlike neurotransmitters, which are released in close proximity to cells with their receptors, hormones are secreted into the bloodstream and travel throughout the body, affecting any cells that contain receptors for them. Thus, whereas neurotransmitters\u2019 effects are localized, the effects of hormones are widespread. Also, hormones are slower to take effect, and tend to be longer lasting. \n\n Hormones are involved in regulating all sorts of bodily functions, and they are ultimately controlled through interactions between the hypothalamus (in the central nervous system) and the pituitary gland (in the endocrine system). Imbalances in hormones are related to a number of disorders. This section explores some of the major glands that make up the endocrine system and the hormones secreted by these glands. \n\n Major Glands The  pituitary gland  descends from the hypothalamus at the base of the brain, and acts in close association with it. The pituitary is often referred to as the \u201cmaster gland\u201d because its messenger hormones control all the other glands in the endocrine system, although it mostly carries out instructions from the hypothalamus. In addition to messenger hormones, the pituitary also secretes growth hormone, endorphins for pain relief, and a number of key hormones that regulate fluid levels in the body. \n\n Located in the neck, the  thyroid gland  releases hormones that regulate growth, metabolism, and appetite. In hyperthyroidism, or Grave\u2019s disease, the thyroid secretes too much of the hormone thyroxine, causing agitation, bulging eyes, and weight loss. In hypothyroidism, reduced hormone levels cause sufferers to experience tiredness, and they often complain of feeling cold. Fortunately, thyroid disorders are often treatable with medications that help reestablish a balance in the hormones secreted by the thyroid. \n\n The  adrenal glands  sit atop our kidneys and secrete hormones involved in the stress response, such as epinephrine (adrenaline) and norepinephrine (noradrenaline). The  pancreas  is an internal organ that secretes hormones that regulate blood sugar levels: insulin and glucagon. These pancreatic hormones are essential for maintaining stable levels of blood sugar throughout the day by lowering blood glucose levels (insulin) or raising them (glucagon). People who suffer from  diabetes  do not produce enough insulin; therefore, they must take medications that stimulate or replace insulin production, and they must closely control the amount of sugars and carbohydrates they consume. The  gonads  secrete sexual hormones, which are important in reproduction, and mediate both sexual motivation and behavior. The female gonads are the ovaries; the male gonads are the testes. Ovaries secrete estrogens and progesterone, and the testes secrete androgens, such as testosterone. Dig Deeper Athletes and Anabolic Steroids Although it is against Federal laws and many professional athletic associations (The National Football League, for example) have banned their use, anabolic steroid drugs continue to be used by amateur and professional athletes.  The drugs are believed to enhance athletic performance. Anabolic steroid drugs mimic the effects of the body\u2019s own steroid hormones, like testosterone and its derivatives. These drugs have the potential to provide a competitive edge by increasing muscle mass, strength, and endurance, although not all users may experience these results. Moreover, use of performance-enhancing drugs (PEDs) does not come without risks. Anabolic steroid use has been linked with a wide variety of potentially negative outcomes, ranging in severity from largely cosmetic (acne) to life threatening (heart attack). Furthermore, use of these substances can result in profound changes in mood and can increase aggressive behavior (National Institute on Drug Abuse, 2001). Baseball player Alex Rodriguez (A-Rod) has been at the center of a media storm regarding his use of illegal PEDs. Rodriguez\u2019s performance on the field was unparalleled while using the drugs; his success played a large role in negotiating a contract that made him the highest paid player in professional baseball. Although Rodriguez maintains that he has not used PEDs for the several years, he received a substantial suspension in 2013 that, if upheld, will cost him more than 20 million dollars in earnings (Gaines, 2013). What are your thoughts on athletes and doping? Why or why not should the use of PEDs be banned? What advice would you give an athlete who was considering using PEDs? ", "questions": [{"question": {"question_id": "fs-id1392546", "question_text": "A(n) ________ is a sudden, permanent change in a sequence of DNA.", "question_choices": ["allele", "chromosome", "epigenetic", "mutation"], "cloze_format": "A(n) ________ is a sudden, permanent change in a sequence of DNA.", "normal_format": "Which is a sudden, permanent change in a sequence of DNA?"}, "answer": {"ans_text": "mutation", "ans_choice": 3}, "bloom": null, "hl_sentences": "A mutation is a sudden , permanent change in a gene .", "hl_context": "Sickle-cell anemia is just one of many genetic disorders caused by the pairing of two recessive genes . For example , phenylketonuria ( PKU ) is a condition in which individuals lack an enzyme that normally converts harmful amino acids into harmless byproducts . If someone with this condition goes untreated , he or she will experience significant deficits in cognitive function , seizures , and increased risk of various psychiatric disorders . Because PKU is a recessive trait , each parent must have at least one copy of the recessive allele in order to produce a child with the condition ( Figure 3.6 ) . So far , we have discussed traits that involve just one gene , but few human characteristics are controlled by a single gene . Most traits are polygenic : controlled by more than one gene . Height is one example of a polygenic trait , as are skin color and weight . Where do harmful genes that contribute to diseases like PKU come from ? Gene mutations provide one source of harmful genes . <hl> A mutation is a sudden , permanent change in a gene . <hl> While many mutations can be harmful or lethal , once in a while , a mutation benefits an individual by giving that person an advantage over those who do not have the mutation . Recall that the theory of evolution asserts that individuals best adapted to their particular environments are more likely to reproduce and pass on their genes to future generations . In order for this process to occur , there must be competition \u2014 more technically , there must be variability in genes ( and resultant traits ) that allow for variation in adaptability to the environment . If a population consisted of identical individuals , then any dramatic changes in the environment would affect everyone in the same way , and there would be no variation in selection . In contrast , diversity in genes and associated traits allows some individuals to perform slightly better than others when faced with environmental change . This creates a distinct advantage for individuals best suited for their environments in terms of successful reproduction and genetic transmission ."}, {"question": {"question_id": "fs-id1235765", "question_text": "________ refers to a person\u2019s genetic makeup, while ________ refers to a person\u2019s physical characteristics.", "question_choices": ["Phenotype; genotype", "Genotype; phenotype", "DNA; gene", "Gene; DNA"], "cloze_format": "________ refers to a person\u2019s genetic makeup, while ________ refers to a person\u2019s physical characteristics.", "normal_format": "What respectively refers to a person\u2019s genetic makeup and a person\u2019s physical characteristics?"}, "answer": {"ans_text": "Genotype; phenotype", "ans_choice": 1}, "bloom": null, "hl_sentences": "Therefore , each parent contributes half the genetic information carried by the offspring ; the resulting physical characteristics of the offspring ( called the phenotype ) are determined by the interaction of genetic material supplied by the parents ( called the genotype ) . A person \u2019 s genotype is the genetic makeup of that individual .", "hl_context": "Genetic variation , the genetic difference between individuals , is what contributes to a species \u2019 adaptation to its environment . In humans , genetic variation begins with an egg , about 100 million sperm , and fertilization . Fertile women ovulate roughly once per month , releasing an egg from follicles in the ovary . During the egg's journey from the ovary through the fallopian tubes , to the uterus , a sperm may fertilize an egg . The egg and the sperm each contain 23 chromosomes . Chromosomes are long strings of genetic material known as deoxyribonucleic acid ( DNA ) . DNA is a helix-shaped molecule made up of nucleotide base pairs . In each chromosome , sequences of DNA make up genes that control or partially control a number of visible characteristics , known as traits , such as eye color , hair color , and so on . A single gene may have multiple possible variations , or alleles . An allele is a specific version of a gene . So , a given gene may code for the trait of hair color , and the different alleles of that gene affect which hair color an individual has . When a sperm and egg fuse , their 23 chromosomes pair up and create a zygote with 23 pairs of chromosomes . <hl> Therefore , each parent contributes half the genetic information carried by the offspring ; the resulting physical characteristics of the offspring ( called the phenotype ) are determined by the interaction of genetic material supplied by the parents ( called the genotype ) . <hl> <hl> A person \u2019 s genotype is the genetic makeup of that individual . <hl> Phenotype , on the other hand , refers to the individual \u2019 s inherited physical characteristics , which are a combination of genetic and environmental influences ( Figure 3.4 ) . Most traits are controlled by multiple genes , but some traits are controlled by one gene . A characteristic like cleft chin , for example , is influenced by a single gene from each parent . In this example , we will call the gene for cleft chin \u201c B , \u201d and the gene for smooth chin \u201c b . \u201d Cleft chin is a dominant trait , which means that having the dominant allele either from one parent ( Bb ) or both parents ( BB ) will always result in the phenotype associated with the dominant allele . When someone has two copies of the same allele , they are said to be homozygous for that allele . When someone has a combination of alleles for a given gene , they are said to be heterozygous . For example , smooth chin is a recessive trait , which means that an individual will only display the smooth chin phenotype if they are homozygous for that recessive allele ( bb ) . Imagine that a woman with a cleft chin mates with a man with a smooth chin . What type of chin will their child have ? The answer to that depends on which alleles each parent carries . If the woman is homozygous for cleft chin ( BB ) , her offspring will always have cleft chin . It gets a little more complicated , however , if the mother is heterozygous for this gene ( Bb ) . Since the father has a smooth chin \u2014 therefore homozygous for the recessive allele ( bb ) \u2014 we can expect the offspring to have a 50 % chance of having a cleft chin and a 50 % chance of having a smooth chin ( Figure 3.5 ) ."}, {"question": {"question_id": "fs-id1322643", "question_text": "________ is the field of study that focuses on genes and their expression.", "question_choices": ["Social psychology", "Evolutionary psychology", "Epigenetics", "Behavioral neuroscience"], "cloze_format": "________ is the field of study that focuses on genes and their expression.", "normal_format": "Which is the field of study that focuses on genes and their expression?"}, "answer": {"ans_text": "Epigenetics", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "In another approach to gene-environment interactions , the field of epigenetics looks beyond the genotype itself and studies how the same genotype can be expressed in different ways . In other words , researchers study how the same genotype can lead to very different phenotypes .", "hl_context": "Genes do not exist in a vacuum . Although we are all biological organisms , we also exist in an environment that is incredibly important in determining not only when and how our genes express themselves , but also in what combination . Each of us represents a unique interaction between our genetic makeup and our environment ; range of reaction is one way to describe this interaction . Range of reaction asserts that our genes set the boundaries within which we can operate , and our environment interacts with the genes to determine where in that range we will fall . For example , if an individual \u2019 s genetic makeup predisposes her to high levels of intellectual potential and she is reared in a rich , stimulating environment , then she will be more likely to achieve her full potential than if she were raised under conditions of significant deprivation . According to the concept of range of reaction , genes set definite limits on potential , and environment determines how much of that potential is achieved . Some disagree with this theory and argue that genes do not set a limit on a person \u2019 s potential . Another perspective on the interaction between genes and the environment is the concept of genetic environmental correlation . Stated simply , our genes influence our environment , and our environment influences the expression of our genes ( Figure 3.7 ) . Not only do our genes and environment interact , as in range of reaction , but they also influence one another bidirectionally . For example , the child of an NBA player would probably be exposed to basketball from an early age . Such exposure might allow the child to realize his or her full genetic , athletic potential . Thus , the parents \u2019 genes , which the child shares , influence the child \u2019 s environment , and that environment , in turn , is well suited to support the child \u2019 s genetic potential . <hl> In another approach to gene-environment interactions , the field of epigenetics looks beyond the genotype itself and studies how the same genotype can be expressed in different ways . <hl> <hl> In other words , researchers study how the same genotype can lead to very different phenotypes . <hl> As mentioned earlier , gene expression is often influenced by environmental context in ways that are not entirely obvious . For instance , identical twins share the same genetic information ( identical twins develop from a single fertilized egg that split , so the genetic material is exactly the same in each ; in contrast , fraternal twins develop from two different eggs fertilized by different sperm , so the genetic material varies as with non-twin siblings ) . But even with identical genes , there remains an incredible amount of variability in how gene expression can unfold over the course of each twin \u2019 s life . Sometimes , one twin will develop a disease and the other will not . In one example , Tiffany , an identical twin , died from cancer at age 7 , but her twin , now 19 years old , has never had cancer . Although these individuals share an identical genotype , their phenotypes differ as a result of how that genetic information is expressed over time . The epigenetic perspective is very different from range of reaction , because here the genotype is not fixed and limited . Link to Learning"}, {"question": {"question_id": "fs-id1513776", "question_text": "Humans have ________ pairs of chromosomes.", "question_choices": ["15", "23", "46", "78"], "cloze_format": "Humans have ________ pairs of chromosomes.", "normal_format": "Humans have how many pairs of chromosomes?"}, "answer": {"ans_text": "23", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "When a sperm and egg fuse , their 23 chromosomes pair up and create a zygote with 23 pairs of chromosomes .", "hl_context": "Genetic variation , the genetic difference between individuals , is what contributes to a species \u2019 adaptation to its environment . In humans , genetic variation begins with an egg , about 100 million sperm , and fertilization . Fertile women ovulate roughly once per month , releasing an egg from follicles in the ovary . During the egg's journey from the ovary through the fallopian tubes , to the uterus , a sperm may fertilize an egg . The egg and the sperm each contain 23 chromosomes . Chromosomes are long strings of genetic material known as deoxyribonucleic acid ( DNA ) . DNA is a helix-shaped molecule made up of nucleotide base pairs . In each chromosome , sequences of DNA make up genes that control or partially control a number of visible characteristics , known as traits , such as eye color , hair color , and so on . A single gene may have multiple possible variations , or alleles . An allele is a specific version of a gene . So , a given gene may code for the trait of hair color , and the different alleles of that gene affect which hair color an individual has . <hl> When a sperm and egg fuse , their 23 chromosomes pair up and create a zygote with 23 pairs of chromosomes . <hl> Therefore , each parent contributes half the genetic information carried by the offspring ; the resulting physical characteristics of the offspring ( called the phenotype ) are determined by the interaction of genetic material supplied by the parents ( called the genotype ) . A person \u2019 s genotype is the genetic makeup of that individual . Phenotype , on the other hand , refers to the individual \u2019 s inherited physical characteristics , which are a combination of genetic and environmental influences ( Figure 3.4 ) . Most traits are controlled by multiple genes , but some traits are controlled by one gene . A characteristic like cleft chin , for example , is influenced by a single gene from each parent . In this example , we will call the gene for cleft chin \u201c B , \u201d and the gene for smooth chin \u201c b . \u201d Cleft chin is a dominant trait , which means that having the dominant allele either from one parent ( Bb ) or both parents ( BB ) will always result in the phenotype associated with the dominant allele . When someone has two copies of the same allele , they are said to be homozygous for that allele . When someone has a combination of alleles for a given gene , they are said to be heterozygous . For example , smooth chin is a recessive trait , which means that an individual will only display the smooth chin phenotype if they are homozygous for that recessive allele ( bb ) . Imagine that a woman with a cleft chin mates with a man with a smooth chin . What type of chin will their child have ? The answer to that depends on which alleles each parent carries . If the woman is homozygous for cleft chin ( BB ) , her offspring will always have cleft chin . It gets a little more complicated , however , if the mother is heterozygous for this gene ( Bb ) . Since the father has a smooth chin \u2014 therefore homozygous for the recessive allele ( bb ) \u2014 we can expect the offspring to have a 50 % chance of having a cleft chin and a 50 % chance of having a smooth chin ( Figure 3.5 ) ."}, {"question": {"question_id": "fs-id1270809", "question_text": "The ________ receive(s) incoming signals from other neurons.", "question_choices": ["soma", "terminal buttons", "myelin sheath", "dendrites"], "cloze_format": "The ________ receive(s) incoming signals from other neurons.", "normal_format": "Which receive(s) incoming signals from other neurons?"}, "answer": {"ans_text": "dendrites", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Once neurotransmitters are released into the synapse , they travel across the small space and bind with corresponding receptors on the dendrite of an adjacent neuron . The neuron is a small information processor , and dendrites serve as input sites where signals are received from other neurons .", "hl_context": "In healthy individuals , the neuronal signal moves rapidly down the axon to the terminal buttons , where synaptic vesicles release neurotransmitters into the synapse ( Figure 3.9 ) . The synapse is a very small space between two neurons and is an important site where communication between neurons occurs . <hl> Once neurotransmitters are released into the synapse , they travel across the small space and bind with corresponding receptors on the dendrite of an adjacent neuron . <hl> Receptors , proteins on the cell surface where neurotransmitters attach , vary in shape , with different shapes \u201c matching \u201d different neurotransmitters . The nucleus of the neuron is located in the soma , or cell body . The soma has branching extensions known as dendrites . <hl> The neuron is a small information processor , and dendrites serve as input sites where signals are received from other neurons . <hl> These signals are transmitted electrically across the soma and down a major extension from the soma known as the axon , which ends at multiple terminal buttons . The terminal buttons contain synaptic vesicles that house neurotransmitters , the chemical messengers of the nervous system ."}, {"question": {"question_id": "fs-id1291404", "question_text": "A(n) ________ facilitates or mimics the activity of a given neurotransmitter system.", "question_choices": ["axon", "SSRI", "agonist", "antagonist"], "cloze_format": "A(n) ________ facilitates or mimics the activity of a given neurotransmitter system.", "normal_format": "What facilitates or mimics the activity of a given neurotransmitter system?"}, "answer": {"ans_text": "agonist", "ans_choice": 2}, "bloom": null, "hl_sentences": "Psychoactive drugs can act as agonists or antagonists for a given neurotransmitter system .", "hl_context": "<hl> Psychoactive drugs can act as agonists or antagonists for a given neurotransmitter system . <hl> Agonists are chemicals that mimic a neurotransmitter at the receptor site and , thus , strengthen its effects . An antagonist , on the other hand , blocks or impedes the normal activity of a neurotransmitter at the receptor . Agonist and antagonist drugs are prescribed to correct the specific neurotransmitter imbalances underlying a person \u2019 s condition . For example , Parkinson's disease , a progressive nervous system disorder , is associated with low levels of dopamine . Therefore dopamine agonists , which mimic the effects of dopamine by binding to dopamine receptors , are one treatment strategy ."}, {"question": {"question_id": "fs-id1292929", "question_text": "Multiple sclerosis involves a breakdown of the ________.", "question_choices": ["soma", "myelin sheath", "synaptic vesicles", "dendrites"], "cloze_format": "Multiple sclerosis involves a breakdown of the ________.", "normal_format": "Multiple sclerosis involves a breakdown of what?"}, "answer": {"ans_text": "myelin sheath", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Multiple sclerosis ( MS ) , an autoimmune disorder , involves a large-scale loss of the myelin sheath on axons throughout the nervous system .", "hl_context": "Axons range in length from a fraction of an inch to several feet . In some axons , glial cells form a fatty substance known as the myelin sheath , which coats the axon and acts as an insulator , increasing the speed at which the signal travels . The myelin sheath is crucial for the normal operation of the neurons within the nervous system : the loss of the insulation it provides can be detrimental to normal function . To understand how this works , let \u2019 s consider an example . <hl> Multiple sclerosis ( MS ) , an autoimmune disorder , involves a large-scale loss of the myelin sheath on axons throughout the nervous system . <hl> The resulting interference in the electrical signal prevents the quick transmittal of information by neurons and can lead to a number of symptoms , such as dizziness , fatigue , loss of motor control , and sexual dysfunction . While some treatments may help to modify the course of the disease and manage certain symptoms , there is currently no known cure for multiple sclerosis ."}, {"question": {"question_id": "fs-id1292360", "question_text": "An action potential involves Na+ moving ________ the cell and K+ moving ________ the cell.", "question_choices": ["inside; outside", "outside; inside", "inside; inside", "outside; outside"], "cloze_format": "An action potential involves Na+ moving ________ the cell and K+ moving ________ the cell.", "normal_format": "Which of the following correctly compares the moving of Na+ and K+?"}, "answer": {"ans_text": "inside; outside", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "In the resting state , sodium ( Na + ) is at higher concentrations outside the cell , so it will tend to move into the cell . Potassium ( K + ) , on the other hand , is more concentrated inside the cell , and will tend to move out of the cell ( Figure 3.10 ) .", "hl_context": "Between signals , the neuron membrane \u2019 s potential is held in a state of readiness , called the resting potential . Like a rubber band stretched out and waiting to spring into action , ions line up on either side of the cell membrane , ready to rush across the membrane when the neuron goes active and the membrane opens its gates ( i . e . , a sodium-potassium pump that allows movement of ions across the membrane ) . Ions in high-concentration areas are ready to move to low-concentration areas , and positive ions are ready to move to areas with a negative charge . <hl> In the resting state , sodium ( Na + ) is at higher concentrations outside the cell , so it will tend to move into the cell . <hl> <hl> Potassium ( K + ) , on the other hand , is more concentrated inside the cell , and will tend to move out of the cell ( Figure 3.10 ) . <hl> In addition , the inside of the cell is slightly negatively charged compared to the outside . This provides an additional force on sodium , causing it to move into the cell . From this resting potential state , the neuron receives a signal and its state changes abruptly ( Figure 3.11 ) . When a neuron receives signals at the dendrites \u2014 due to neurotransmitters from an adjacent neuron binding to its receptors \u2014 small pores , or gates , open on the neuronal membrane , allowing Na + ions , propelled by both charge and concentration differences , to move into the cell . With this influx of positive ions , the internal charge of the cell becomes more positive . If that charge reaches a certain level , called the threshold of excitation , the neuron becomes active and the action potential begins . Many additional pores open , causing a massive influx of Na + ions and a huge positive spike in the membrane potential , the peak action potential . At the peak of the spike , the sodium gates close and the potassium gates open . As positively charged potassium ions leave , the cell quickly begins repolarization . At first , it hyperpolarizes , becoming slightly more negative than the resting potential , and then it levels off , returning to the resting potential . This positive spike constitutes the action potential : the electrical signal that typically moves from the cell body down the axon to the axon terminals . The electrical signal moves down the axon like a wave ; at each point , some of the sodium ions that enter the cell diffuse to the next section of the axon , raising the charge past the threshold of excitation and triggering a new influx of sodium ions . The action potential moves all the way down the axon to the terminal buttons ."}, {"question": {"question_id": "fs-id1546286", "question_text": "Our ability to make our legs move as we walk across the room is controlled by the ________ nervous system.", "question_choices": ["autonomic", "somatic", "sympathetic", "parasympathetic"], "cloze_format": "Our ability to make our legs move as we walk across the room is controlled by the ________ nervous system.", "normal_format": "Our ability to make our legs move as we walk across the room is controlled by which nervous system?"}, "answer": {"ans_text": "somatic", "ans_choice": 1}, "bloom": null, "hl_sentences": "The somatic nervous system is associated with activities traditionally thought of as conscious or voluntary .", "hl_context": "<hl> The somatic nervous system is associated with activities traditionally thought of as conscious or voluntary . <hl> It is involved in the relay of sensory and motor information to and from the CNS ; therefore , it consists of motor neurons and sensory neurons . Motor neurons , carrying instructions from the CNS to the muscles , are efferent fibers ( efferent means \u201c moving away from \u201d ) . Sensory neurons , carrying sensory information to the CNS , are afferent fibers ( afferent means \u201c moving toward \u201d ) . Each nerve is basically a two-way superhighway , containing thousands of axons , both efferent and afferent ."}, {"question": {"question_id": "fs-id1571626", "question_text": "If your ________ is activated, you will feel relatively at ease.", "question_choices": ["somatic nervous system", "sympathetic nervous system", "parasympathetic nervous system", "spinal cord"], "cloze_format": "If your ________ is activated, you will feel relatively at ease.", "normal_format": "If which of the following is activated, you will feel relatively at ease?"}, "answer": {"ans_text": "parasympathetic nervous system", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Once the threat has been resolved , the parasympathetic nervous system takes over and returns bodily functions to a relaxed state . The sympathetic nervous system is involved in preparing the body for stress-related activities ; the parasympathetic nervous system is associated with returning the body to routine , day-to-day operations .", "hl_context": "<hl> Once the threat has been resolved , the parasympathetic nervous system takes over and returns bodily functions to a relaxed state . <hl> Our hunter \u2019 s heart rate and blood pressure return to normal , his pupils constrict , he regains control of his bladder , and the liver begins to store glucose in the form of glycogen for future use . These processes are associated with activation of the parasympathetic nervous system . 3.4 The Brain and Spinal Cord Learning Objectives By the end of this section , you will be able to : The autonomic nervous system controls our internal organs and glands and is generally considered to be outside the realm of voluntary control . It can be further subdivided into the sympathetic and parasympathetic divisions ( Figure 3.14 ) . <hl> The sympathetic nervous system is involved in preparing the body for stress-related activities ; the parasympathetic nervous system is associated with returning the body to routine , day-to-day operations . <hl> The two systems have complementary functions , operating in tandem to maintain the body \u2019 s homeostasis . Homeostasis is a state of equilibrium , in which biological conditions ( such as body temperature ) are maintained at optimal levels ."}, {"question": {"question_id": "fs-id1561065", "question_text": "The central nervous system is comprised of ________.", "question_choices": ["sympathetic and parasympathetic nervous systems", "organs and glands", "somatic and autonomic nervous systems", "brain and spinal cord"], "cloze_format": "The central nervous system is comprised of ________.", "normal_format": "What is the central nervous system comprised of?"}, "answer": {"ans_text": "brain and spinal cord", "ans_choice": 3}, "bloom": null, "hl_sentences": "The CNS is comprised of the brain and spinal cord ; the PNS connects the CNS to the rest of the body .", "hl_context": "The nervous system can be divided into two major subdivisions : the central nervous system ( CNS ) and the peripheral nervous system ( PNS ) , shown in Figure 3.13 . <hl> The CNS is comprised of the brain and spinal cord ; the PNS connects the CNS to the rest of the body . <hl> In this section , we focus on the peripheral nervous system ; later , we look at the brain and spinal cord ."}, {"question": {"question_id": "fs-id1473654", "question_text": "Sympathetic activation is associated with ________.", "question_choices": ["pupil dilation", "storage of glucose in the liver", "increased heart rate", "both A and C"], "cloze_format": "Sympathetic activation is associated with ________.", "normal_format": "What is sympathetic activation associated with?"}, "answer": {"ans_text": "both A and C", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "At that moment , his body undergoes a series of changes \u2014 a direct function of sympathetic activation \u2014 preparing him to face the threat . His pupils dilate , his heart rate and blood pressure increase , his bladder relaxes , his liver releases glucose , and adrenaline surges into his bloodstream .", "hl_context": "The sympathetic nervous system is activated when we are faced with stressful or high-arousal situations . The activity of this system was adaptive for our ancestors , increasing their chances of survival . Imagine , for example , that one of our early ancestors , out hunting small game , suddenly disturbs a large bear with her cubs . <hl> At that moment , his body undergoes a series of changes \u2014 a direct function of sympathetic activation \u2014 preparing him to face the threat . <hl> <hl> His pupils dilate , his heart rate and blood pressure increase , his bladder relaxes , his liver releases glucose , and adrenaline surges into his bloodstream . <hl> This constellation of physiological changes , known as the fight or flight response , allows the body access to energy reserves and heightened sensory capacity so that it might fight off a threat or run away to safety ."}, {"question": {"question_id": "fs-id1294984", "question_text": "The ________ is a sensory relay station where all sensory information, except for smell, goes before being sent to other areas of the brain for further processing.", "question_choices": ["amygdala", "hippocampus", "hypothalamus", "thalamus"], "cloze_format": "The ________ is a sensory relay station where all sensory information, except for smell, goes before being sent to other areas of the brain for further processing.", "normal_format": "What is a sensory relay station where all sensory information, except for smell, goes before being sent to other areas of the brain for further processing?"}, "answer": {"ans_text": "thalamus", "ans_choice": 3}, "bloom": null, "hl_sentences": "The thalamus is a sensory relay for the brain .", "hl_context": "Other Areas of the Forebrain Other areas of the forebrain , located beneath the cerebral cortex , include the thalamus and the limbic system . <hl> The thalamus is a sensory relay for the brain . <hl> All of our senses , with the exception of smell , are routed through the thalamus before being directed to other areas of the brain for processing ( Figure 3.22 ) ."}, {"question": {"question_id": "fs-id1381990", "question_text": "Damage to the ________ disrupts one\u2019s ability to comprehend language, but it leaves one\u2019s ability to produce words intact.", "question_choices": ["amygdala", "Broca\u2019s Area", "Wernicke\u2019s Area", "occipital lobe"], "cloze_format": "Damage to the ________ disrupts one\u2019s ability to comprehend language, but it leaves one\u2019s ability to produce words intact.", "normal_format": "Damage to what disrupts one\u2019s ability to comprehend language, but it leaves one\u2019s ability to produce words intact?"}, "answer": {"ans_text": "Wernicke\u2019s Area", "ans_choice": 2}, "bloom": "2", "hl_sentences": "Wernicke \u2019 s area , important for speech comprehension , is also located here .", "hl_context": "The temporal lobe is located on the side of the head ( temporal means \u201c near the temples \u201d ) , and is associated with hearing , memory , emotion , and some aspects of language . The auditory cortex , the main area responsible for processing auditory information , is located within the temporal lobe . <hl> Wernicke \u2019 s area , important for speech comprehension , is also located here . <hl> Whereas individuals with damage to Broca \u2019 s area have difficulty producing language , those with damage to Wernicke \u2019 s area can produce sensible language , but they are unable to understand it ( Figure 3.21 ) ."}, {"question": {"question_id": "fs-id1507369", "question_text": "A(n) ________ uses magnetic fields to create pictures of a given tissue.", "question_choices": ["EEG", "MRI", "PET scan", "CT scan"], "cloze_format": "A(n) ________ uses magnetic fields to create pictures of a given tissue.", "normal_format": "Which uses magnetic fields to create pictures of a given tissue?"}, "answer": {"ans_text": "MRI", "ans_choice": 1}, "bloom": null, "hl_sentences": "In magnetic resonance imaging ( MRI ) , a person is placed inside a machine that generates a strong magnetic field .", "hl_context": "<hl> In magnetic resonance imaging ( MRI ) , a person is placed inside a machine that generates a strong magnetic field . <hl> The magnetic field causes the hydrogen atoms in the body \u2019 s cells to move . When the magnetic field is turned off , the hydrogen atoms emit electromagnetic signals as they return to their original positions . Tissues of different densities give off different signals , which a computer interprets and displays on a monitor . Functional magnetic resonance imaging ( fMRI ) operates on the same principles , but it shows changes in brain activity over time by tracking blood flow and oxygen levels . The fMRI provides more detailed images of the brain \u2019 s structure , as well as better accuracy in time , than is possible in PET scans ( Figure 3.28 ) . With their high level of detail , MRI and fMRI are often used to compare the brains of healthy individuals to the brains of individuals diagnosed with psychological disorders . This comparison helps determine what structural and functional differences exist between these populations ."}, {"question": {"question_id": "fs-id1504561", "question_text": "The two major hormones secreted from the pancreas are:", "question_choices": ["estrogen and progesterone", "norepinephrine and epinephrine", "thyroxine and oxytocin", "glucagon and insulin"], "cloze_format": "The two major hormones secreted from the pancreas are ___ and ___.", "normal_format": "Which are the two major hormones secreted from the pancreas?"}, "answer": {"ans_text": "glucagon and insulin", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The pancreas is an internal organ that secretes hormones that regulate blood sugar levels : insulin and glucagon .", "hl_context": "The adrenal glands sit atop our kidneys and secrete hormones involved in the stress response , such as epinephrine ( adrenaline ) and norepinephrine ( noradrenaline ) . <hl> The pancreas is an internal organ that secretes hormones that regulate blood sugar levels : insulin and glucagon . <hl> These pancreatic hormones are essential for maintaining stable levels of blood sugar throughout the day by lowering blood glucose levels ( insulin ) or raising them ( glucagon ) . People who suffer from diabetes do not produce enough insulin ; therefore , they must take medications that stimulate or replace insulin production , and they must closely control the amount of sugars and carbohydrates they consume . The gonads secrete sexual hormones , which are important in reproduction , and mediate both sexual motivation and behavior . The female gonads are the ovaries ; the male gonads are the testes . Ovaries secrete estrogens and progesterone , and the testes secrete androgens , such as testosterone . Dig Deeper Athletes and Anabolic Steroids Although it is against Federal laws and many professional athletic associations ( The National Football League , for example ) have banned their use , anabolic steroid drugs continue to be used by amateur and professional athletes . The drugs are believed to enhance athletic performance . Anabolic steroid drugs mimic the effects of the body \u2019 s own steroid hormones , like testosterone and its derivatives . These drugs have the potential to provide a competitive edge by increasing muscle mass , strength , and endurance , although not all users may experience these results . Moreover , use of performance-enhancing drugs ( PEDs ) does not come without risks . Anabolic steroid use has been linked with a wide variety of potentially negative outcomes , ranging in severity from largely cosmetic ( acne ) to life threatening ( heart attack ) . Furthermore , use of these substances can result in profound changes in mood and can increase aggressive behavior ( National Institute on Drug Abuse , 2001 ) . Baseball player Alex Rodriguez ( A-Rod ) has been at the center of a media storm regarding his use of illegal PEDs . Rodriguez \u2019 s performance on the field was unparalleled while using the drugs ; his success played a large role in negotiating a contract that made him the highest paid player in professional baseball . Although Rodriguez maintains that he has not used PEDs for the several years , he received a substantial suspension in 2013 that , if upheld , will cost him more than 20 million dollars in earnings ( Gaines , 2013 ) . What are your thoughts on athletes and doping ? Why or why not should the use of PEDs be banned ? What advice would you give an athlete who was considering using PEDs ?"}, {"question": {"question_id": "fs-id1555916", "question_text": "The ________ secretes messenger hormones that direct the function of the rest of the endocrine glands.", "question_choices": ["ovary", "thyroid", "pituitary", "pancreas"], "cloze_format": "The ________ secretes messenger hormones that direct the function of the rest of the endocrine glands.", "normal_format": "Which of the following secretes messenger hormones that direct the function of the rest of the endocrine glands?"}, "answer": {"ans_text": "pituitary", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The pituitary is often referred to as the \u201c master gland \u201d because its messenger hormones control all the other glands in the endocrine system , although it mostly carries out instructions from the hypothalamus . Hormones are involved in regulating all sorts of bodily functions , and they are ultimately controlled through interactions between the hypothalamus ( in the central nervous system ) and the pituitary gland ( in the endocrine system ) .", "hl_context": "Major Glands The pituitary gland descends from the hypothalamus at the base of the brain , and acts in close association with it . <hl> The pituitary is often referred to as the \u201c master gland \u201d because its messenger hormones control all the other glands in the endocrine system , although it mostly carries out instructions from the hypothalamus . <hl> In addition to messenger hormones , the pituitary also secretes growth hormone , endorphins for pain relief , and a number of key hormones that regulate fluid levels in the body . <hl> Hormones are involved in regulating all sorts of bodily functions , and they are ultimately controlled through interactions between the hypothalamus ( in the central nervous system ) and the pituitary gland ( in the endocrine system ) . <hl> Imbalances in hormones are related to a number of disorders . This section explores some of the major glands that make up the endocrine system and the hormones secreted by these glands ."}, {"question": {"question_id": "fs-id1392120", "question_text": "The ________ gland secretes epinephrine.", "question_choices": ["adrenal", "thyroid", "pituitary", "master"], "cloze_format": "The ________ gland secretes epinephrine.", "normal_format": "Which gland secretes epinephrine?"}, "answer": {"ans_text": "adrenal", "ans_choice": 0}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "The adrenal glands sit atop our kidneys and secrete hormones involved in the stress response , such as epinephrine ( adrenaline ) and norepinephrine ( noradrenaline ) .", "hl_context": "<hl> The adrenal glands sit atop our kidneys and secrete hormones involved in the stress response , such as epinephrine ( adrenaline ) and norepinephrine ( noradrenaline ) . <hl> The pancreas is an internal organ that secretes hormones that regulate blood sugar levels : insulin and glucagon . These pancreatic hormones are essential for maintaining stable levels of blood sugar throughout the day by lowering blood glucose levels ( insulin ) or raising them ( glucagon ) . People who suffer from diabetes do not produce enough insulin ; therefore , they must take medications that stimulate or replace insulin production , and they must closely control the amount of sugars and carbohydrates they consume . The gonads secrete sexual hormones , which are important in reproduction , and mediate both sexual motivation and behavior . The female gonads are the ovaries ; the male gonads are the testes . Ovaries secrete estrogens and progesterone , and the testes secrete androgens , such as testosterone . Dig Deeper Athletes and Anabolic Steroids Although it is against Federal laws and many professional athletic associations ( The National Football League , for example ) have banned their use , anabolic steroid drugs continue to be used by amateur and professional athletes . The drugs are believed to enhance athletic performance . Anabolic steroid drugs mimic the effects of the body \u2019 s own steroid hormones , like testosterone and its derivatives . These drugs have the potential to provide a competitive edge by increasing muscle mass , strength , and endurance , although not all users may experience these results . Moreover , use of performance-enhancing drugs ( PEDs ) does not come without risks . Anabolic steroid use has been linked with a wide variety of potentially negative outcomes , ranging in severity from largely cosmetic ( acne ) to life threatening ( heart attack ) . Furthermore , use of these substances can result in profound changes in mood and can increase aggressive behavior ( National Institute on Drug Abuse , 2001 ) . Baseball player Alex Rodriguez ( A-Rod ) has been at the center of a media storm regarding his use of illegal PEDs . Rodriguez \u2019 s performance on the field was unparalleled while using the drugs ; his success played a large role in negotiating a contract that made him the highest paid player in professional baseball . Although Rodriguez maintains that he has not used PEDs for the several years , he received a substantial suspension in 2013 that , if upheld , will cost him more than 20 million dollars in earnings ( Gaines , 2013 ) . What are your thoughts on athletes and doping ? Why or why not should the use of PEDs be banned ? What advice would you give an athlete who was considering using PEDs ?"}, {"question": {"question_id": "fs-id1352957", "question_text": "The ________ secretes hormones that regulate the body\u2019s fluid levels.", "question_choices": ["adrenal", "pituitary", "testes", "thyroid"], "cloze_format": "The ________ secretes hormones that regulate the body\u2019s fluid levels.", "normal_format": "Which secretes hormones that regulate the body\u2019s fluid levels?"}, "answer": {"ans_text": "pituitary", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "In addition to messenger hormones , the pituitary also secretes growth hormone , endorphins for pain relief , and a number of key hormones that regulate fluid levels in the body .", "hl_context": "Major Glands The pituitary gland descends from the hypothalamus at the base of the brain , and acts in close association with it . The pituitary is often referred to as the \u201c master gland \u201d because its messenger hormones control all the other glands in the endocrine system , although it mostly carries out instructions from the hypothalamus . <hl> In addition to messenger hormones , the pituitary also secretes growth hormone , endorphins for pain relief , and a number of key hormones that regulate fluid levels in the body . <hl>"}], "summary": " Summary 3.1   Human Genetics Genes are sequences of DNA that code for a particular trait. Different versions of a gene are called alleles\u2014sometimes alleles can be classified as dominant or recessive. A dominant allele always results in the dominant phenotype. In order to exhibit a recessive phenotype, an individual must be homozygous for the recessive allele. Genes affect both physical and psychological characteristics. Ultimately, how and when a gene is expressed, and what the outcome will be\u2014in terms of both physical and psychological characteristics\u2014is a function of the interaction between our genes and our environments. \n\n 3.2   Cells of the Nervous System \n\n Glia and neurons are the two cell types that make up the nervous system. While glia generally play supporting roles, the communication between neurons is fundamental to all of the functions associated with the nervous system. Neuronal communication is made possible by the neuron\u2019s specialized structures. The soma contains the cell nucleus, and the dendrites extend from the soma in tree-like branches. The axon is another major extension of the cell body; axons are often covered by a myelin sheath, which increases the speed of transmission of neural impulses. At the end of the axon are terminal buttons that contain synaptic vesicles filled with neurotransmitters. \n\n Neuronal communication is an electrochemical event. The dendrites contain receptors for neurotransmitters released by nearby neurons. If the signals received from other neurons are sufficiently strong, an action potential will travel down the length of the axon to the terminal buttons, resulting in the release of neurotransmitters into the synapse. Action potentials operate on the all-or-none principle and involve the movement of Na +  and K +  across the neuronal membrane. Different neurotransmitters are associated with different functions. Often, psychological disorders involve imbalances in a given neurotransmitter system. Therefore, psychotropic drugs are prescribed in an attempt to bring the neurotransmitters back into balance. Drugs can act either as agonists or as antagonists for a given neurotransmitter system. \n\n 3.3   Parts of the Nervous System \n\n The brain and spinal cord make up the central nervous system. The peripheral nervous system is comprised of the somatic and autonomic nervous systems. The somatic nervous system transmits sensory and motor signals to and from the central nervous system. The autonomic nervous system controls the function of our organs and glands, and can be divided into the sympathetic and parasympathetic divisions. Sympathetic activation prepares us for fight or flight, while parasympathetic activation is associated with normal functioning under relaxed conditions. \n\n 3.4   The Brain and Spinal Cord \n\n The brain consists of two hemispheres, each controlling the opposite side of the body. Each hemisphere can be subdivided into different lobes: frontal, parietal, temporal, and occipital. In addition to the lobes of the cerebral cortex, the forebrain includes the thalamus (sensory relay) and limbic system (emotion and memory circuit). The midbrain contains the reticular formation, which is important for sleep and arousal, as well as the substantia nigra and ventral tegmental area. These structures are important for movement, reward, and addictive processes. The hindbrain contains the structures of the brainstem (medulla, pons, and midbrain), which control automatic functions like breathing and blood pressure. The hindbrain also contains the cerebellum, which helps coordinate movement and certain types of memories. \n\n Individuals with brain damage have been studied extensively to provide information about the role of different areas of the brain, and recent advances in technology allow us to glean similar information by imaging brain structure and function. These techniques include CT, PET, MRI, fMRI, and EEG. \n\n 3.5   The Endocrine System \n\n The glands of the endocrine system secrete hormones to regulate normal body functions. The hypothalamus serves as the interface between the nervous system and the endocrine system, and it controls the secretions of the pituitary. The pituitary serves as the master gland, controlling the secretions of all other glands. The thyroid secretes thyroxine, which is important for basic metabolic processes and growth; the adrenal glands secrete hormones involved in the stress response; the pancreas secretes hormones that regulate blood sugar levels; and the ovaries and testes produce sex hormones that regulate sexual motivation and behavior. ", "keyterm": "", "bname": "psychology"}, {"chapter": 7, "intro": " Chapter Outline 7.1   Energy in Living Systems 7.2   Glycolysis 7.3   Oxidation of Pyruvate and the Citric Acid Cycle 7.4   Oxidative Phosphorylation 7.5   Metabolism without Oxygen 7.6   Connections of Carbohydrate, Protein, and Lipid Metabolic Pathways 7.7   Regulation of Cellular Respiration Introduction The electrical energy plant in   Figure 7.1  converts energy from one form to another form that can be more easily used. This type of generating plant starts with underground thermal energy (heat) and transforms it into electrical energy that will be transported to homes and factories. Like a generating plant, plants and animals also must take in energy from the environment and convert it into a form that their cells can use. Energy enters an organism\u2019s body in one form and is converted into another form that can fuel the organism\u2019s life functions. In the process of photosynthesis, plants and other photosynthetic producers take in energy in the form of light (solar energy) and convert it into chemical energy, glucose, which stores this energy in its chemical bonds. Then, a series of metabolic pathways, collectively called cellular respiration, extracts the energy from the bonds in glucose and converts it into a form that all living things can use\u2014both producers, such as plants, and consumers, such as animals. ", "chapter_text": "7.1   Energy in Living Systems Learning Objectives By the end of this section, you will be able to:\n\n Discuss the importance of electrons in the transfer of energy in living systems \n\n Explain how ATP is used by the cell as an energy source \n\n Energy production within a cell involves many coordinated chemical pathways. Most of these pathways are combinations of oxidation and reduction reactions. Oxidation and reduction occur in tandem. An oxidation reaction strips an electron from an atom in a compound, and the addition of this electron to another compound is a reduction reaction. Because oxidation and reduction usually occur together, these pairs of reactions are called oxidation reduction reactions, or  redox reactions . Electrons and Energy \n\n The removal of an electron from a molecule, oxidizing it, results in a decrease in potential energy in the oxidized compound. The electron (sometimes as part of a hydrogen atom), does not remain unbonded, however, in the cytoplasm of a cell. Rather, the electron is shifted to a second compound, reducing the second compound. The shift of an electron from one compound to another removes some potential energy from the first compound (the oxidized compound) and increases the potential energy of the second compound (the reduced compound). The transfer of electrons between molecules is important because most of the energy stored in atoms and used to fuel cell functions is in the form of high-energy electrons. The transfer of energy in the form of electrons allows the cell to transfer and use energy in an incremental fashion\u2014in small packages rather than in a single, destructive burst. This chapter focuses on the extraction of energy from food; you will see that as you track the path of the transfers, you are tracking the path of electrons moving through metabolic pathways. \n\n Electron Carriers \n\n In living systems, a small class of compounds functions as electron shuttles: They bind and carry high-energy electrons between compounds in pathways. The principal electron carriers we will consider are derived from the B vitamin group and are derivatives of nucleotides. These compounds can be easily reduced (that is, they accept electrons) or oxidized (they lose electrons). Nicotinamide adenine dinucleotide (NAD) ( Figure 7.2 ) is derived from vitamin B3, niacin. NAD +  is the oxidized form of the molecule; NADH is the reduced form of the molecule after it has accepted two electrons and a proton (which together are the equivalent of a hydrogen atom with an extra electron). \n\n NAD +  can accept electrons from an organic molecule according to the general equation: \n\n RH \n\n Reducing\u00a0 \n\n agent \n\n \u00a0+\u00a0 \n\n NAD \n\n + \n\n Oxidizing \n\n agent \n\n \u2192 \u00a0 \n\n NADH \n\n Reduced \n\n \u00a0+ \n\n R \n\n Oxidized \n\n RH \n\n Reducing\u00a0 \n\n agent \n\n \u00a0+\u00a0 \n\n NAD \n\n + \n\n Oxidizing \n\n agent \n\n \u2192 \u00a0 \n\n NADH \n\n Reduced \n\n \u00a0+ \n\n R \n\n Oxidized \n\n When electrons are added to a compound, they are reduced. A compound that reduces another is called a reducing agent. In the above equation, RH is a reducing agent, and NAD +  is reduced to NADH. When electrons are removed from compound, it oxidized. A compound that oxidizes another is called an oxidizing agent. In the above equation, NAD +  is an oxidizing agent, and RH is oxidized to R. \n\n Similarly, flavin adenine dinucleotide (FAD + ) is derived from vitamin B 2 , also called riboflavin. Its reduced form is FADH 2 . A second variation of NAD, NADP, contains an extra phosphate group. Both NAD +  and FAD +  are extensively used in energy extraction from sugars, and NADP plays an important role in anabolic reactions and photosynthesis. \n\n ATP in Living Systems \n\n A living cell cannot store significant amounts of free energy. Excess free energy would result in an increase of heat in the cell, which would result in excessive thermal motion that could damage and then destroy the cell. Rather, a cell must be able to handle that energy in a way that enables the cell to store energy safely and release it for use only as needed. Living cells accomplish this by using the compound adenosine triphosphate (ATP). ATP is often called the \u201cenergy currency\u201d of the cell, and, like currency, this versatile compound can be used to fill any energy need of the cell. How? It functions similarly to a rechargeable battery. \n\n When ATP is broken down, usually by the removal of its terminal phosphate group, energy is released. The energy is used to do work by the cell, usually by the released phosphate binding to another molecule, activating it. For example, in the mechanical work of muscle contraction, ATP supplies the energy to move the contractile muscle proteins. Recall the active transport work of the sodium-potassium pump in cell membranes. ATP alters the structure of the integral protein that functions as the pump, changing its affinity for sodium and potassium. In this way, the cell performs work, pumping ions against their electrochemical gradients. \n\n ATP Structure and Function \n\n At the heart of ATP is a molecule of adenosine monophosphate (AMP), which is composed of an adenine molecule bonded to a ribose molecule and to a single phosphate group ( Figure 7.3 ). Ribose is a five-carbon sugar found in RNA, and AMP is one of the nucleotides in RNA. The addition of a second phosphate group to this core molecule results in the formation of adenosine  di phosphate (ADP); the addition of a third phosphate group forms adenosine  tri phosphate (ATP). \n\n The addition of a phosphate group to a molecule requires energy. Phosphate groups are negatively charged and thus repel one another when they are arranged in series, as they are in ADP and ATP. This repulsion makes the ADP and ATP molecules inherently unstable. The release of one or two phosphate groups from ATP, a process called  dephosphorylation , releases energy. \n\n Energy from ATP \n\n Hydrolysis is the process of breaking complex macromolecules apart. During hydrolysis, water is split, or lysed, and the resulting hydrogen atom (H + ) and a hydroxyl group (OH - ) are added to the larger molecule. The hydrolysis of ATP produces ADP, together with an inorganic phosphate ion (P i ), and the release of free energy. To carry out life processes, ATP is continuously broken down into ADP, and like a rechargeable battery, ADP is continuously regenerated into ATP by the reattachment of a third phosphate group. Water, which was broken down into its hydrogen atom and hydroxyl group during ATP hydrolysis, is regenerated when a third phosphate is added to the ADP molecule, reforming ATP. \n\n Obviously, energy must be infused into the system to regenerate ATP. Where does this energy come from? In nearly every living thing on earth, the energy comes from the metabolism of glucose. In this way, ATP is a direct link between the limited set of exergonic pathways of glucose catabolism and the multitude of endergonic pathways that power living cells. \n\n Phosphorylation \n\n Recall that, in some chemical reactions, enzymes may bind to several substrates that react with each other on the enzyme, forming an intermediate complex. An intermediate complex is a temporary structure, and it allows one of the substrates (such as ATP) and reactants to more readily react with each other; in reactions involving ATP, ATP is one of the substrates and ADP is a product. During an endergonic chemical reaction, ATP forms an intermediate complex with the substrate and enzyme in the reaction. This intermediate complex allows the ATP to transfer its third phosphate group, with its energy, to the substrate, a process called phosphorylation.  Phosphorylation  refers to the addition of the phosphate (~P). This is illustrated by the following generic reaction: \n\n A\u00a0+\u00a0enzyme\u00a0+\u00a0ATP \u2192 \u00a0 [   \n\n A\u00a0 \u2212 \u00a0enzyme\u00a0 \n\n\u2212 \u00a0 \u223c P \n\n ] \u00a0 \u2192 \u00a0B\u00a0+\u00a0enzyme\u00a0+\u00a0ADP\u00a0+\u00a0phosphate\u00a0ion \n\n A\u00a0+\u00a0enzyme\u00a0+\u00a0ATP \u2192 \u00a0 [   \n\n A\u00a0 \u2212 \u00a0enzyme\u00a0 \n\n\u2212 \u00a0 \u223c P \n\n ] \u00a0 \u2192 \u00a0B\u00a0+\u00a0enzyme\u00a0+\u00a0ADP\u00a0+\u00a0phosphate\u00a0ion \n\n When the intermediate complex breaks apart, the energy is used to modify the substrate and convert it into a product of the reaction. The ADP molecule and a free phosphate ion are released into the medium and are available for recycling through cell metabolism. \n\n Substrate Phosphorylation \n\n ATP is generated through two mechanisms during the breakdown of glucose. A few ATP molecules are generated (that is, regenerated from ADP) as a direct result of the chemical reactions that occur in the catabolic pathways. A phosphate group is removed from an intermediate reactant in the pathway, and the free energy of the reaction is used to add the third phosphate to an available ADP molecule, producing ATP ( Figure 7.4 ). This very direct method of phosphorylation is called  substrate-level phosphorylation . \n\n Oxidative Phosphorylation \n\n Most of the ATP generated during glucose catabolism, however, is derived from a much more complex process, chemiosmosis, which takes place in mitochondria ( Figure 7.5 ) within a eukaryotic cell or the plasma membrane of a prokaryotic cell.  Chemiosmosis , a process of ATP production in cellular metabolism, is used to generate 90 percent of the ATP made during glucose catabolism and is also the method used in the light reactions of photosynthesis to harness the energy of sunlight. The production of ATP using the process of chemiosmosis is called  oxidative phosphorylation  because of the involvement of oxygen in the process. \n\n Career Connection Mitochondrial Disease Physician \n\n What happens when the critical reactions of cellular respiration do not proceed correctly? Mitochondrial diseases are genetic disorders of metabolism. Mitochondrial disorders can arise from mutations in nuclear or mitochondrial DNA, and they result in the production of less energy than is normal in body cells. In type 2 diabetes, for instance, the oxidation efficiency of NADH is reduced, impacting oxidative phosphorylation but not the other steps of respiration. Symptoms of mitochondrial diseases can include muscle weakness, lack of coordination, stroke-like episodes, and loss of vision and hearing. Most affected people are diagnosed in childhood, although there are some adult-onset diseases. Identifying and treating mitochondrial disorders is a specialized medical field. The educational preparation for this profession requires a college education, followed by medical school with a specialization in medical genetics. Medical geneticists can be board certified by the American Board of Medical Genetics and go on to become associated with professional organizations devoted to the study of mitochondrial diseases, such as the Mitochondrial Medicine Society and the Society for Inherited Metabolic Disease. \n7.2   Glycolysis Learning Objectives By the end of this section, you will be able to:\n\n Describe the overall result in terms of molecules produced in the breakdown of glucose by glycolysis \n\n Compare the output of glycolysis in terms of ATP molecules and NADH molecules produced \n\n You have read that nearly all of the energy used by living cells comes to them in the bonds of the sugar, glucose.  Glycolysis  is the first step in the breakdown of glucose to extract energy for cellular metabolism. Nearly all living organisms carry out glycolysis as part of their metabolism. The process does not use oxygen and is therefore  anaerobic . Glycolysis takes place in the cytoplasm of both prokaryotic and eukaryotic cells. Glucose enters heterotrophic cells in two ways. One method is through secondary active transport in which the transport takes place against the glucose concentration gradient. The other mechanism uses a group of integral proteins called GLUT proteins, also known as glucose transporter proteins. These transporters assist in the facilitated diffusion of glucose. Glycolysis begins with the six carbon ring-shaped structure of a single glucose molecule and ends with two molecules of a three-carbon sugar called  pyruvate . Glycolysis consists of two distinct phases. The first part of the glycolysis pathway traps the glucose molecule in the cell and uses energy to modify it so that the six-carbon sugar molecule can be split evenly into the two three-carbon molecules. The second part of glycolysis extracts energy from the molecules and stores it in the form of ATP and NADH, the reduced form of NAD. \n\n First Half of Glycolysis (Energy-Requiring Steps) \n\n Step 1. The first step in glycolysis ( Figure 7.6 ) is catalyzed by hexokinase, an enzyme with broad specificity that catalyzes the phosphorylation of six-carbon sugars. Hexokinase phosphorylates glucose using ATP as the source of the phosphate, producing glucose-6-phosphate, a more reactive form of glucose. This reaction prevents the phosphorylated glucose molecule from continuing to interact with the GLUT proteins, and it can no longer leave the cell because the negatively charged phosphate will not allow it to cross the hydrophobic interior of the plasma membrane. \n\n Step 2. In the second step of glycolysis, an isomerase converts glucose-6-phosphate into one of its isomers, fructose-6-phosphate. An  isomerase  is an enzyme that catalyzes the conversion of a molecule into one of its isomers. (This change from phosphoglucose to phosphofructose allows the eventual split of the sugar into two three-carbon molecules.). \n\n Step 3. The third step is the phosphorylation of fructose-6-phosphate, catalyzed by the enzyme phosphofructokinase. A second ATP molecule donates a high-energy phosphate to fructose-6-phosphate, producing fructose-1,6- bi sphosphate. In this pathway, phosphofructokinase is a rate-limiting enzyme. It is active when the concentration of ADP is high; it is less active when ADP levels are low and the concentration of ATP is high. Thus, if there is \u201csufficient\u201d ATP in the system, the pathway slows down. This is a type of end product inhibition, since ATP is the end product of glucose catabolism. \n\n Step 4. The newly added high-energy phosphates further destabilize fructose-1,6-bisphosphate. The fourth step in glycolysis employs an enzyme, aldolase, to cleave 1,6-bisphosphate into two three-carbon isomers: dihydroxyacetone-phosphate and glyceraldehyde-3-phosphate. \n\n Step 5. In the fifth step, an isomerase transforms the dihydroxyacetone-phosphate into its isomer, glyceraldehyde-3-phosphate. Thus, the pathway will continue with two molecules of a single isomer. At this point in the pathway, there is a net investment of energy from two ATP molecules in the breakdown of one glucose molecule. \n\n Second Half of Glycolysis (Energy-Releasing Steps) \n\n So far, glycolysis has cost the cell two ATP molecules and produced two small, three-carbon sugar molecules. Both of these molecules will proceed through the second half of the pathway, and sufficient energy will be extracted to pay back the two ATP molecules used as an initial investment and produce a profit for the cell of two additional ATP molecules and two even higher-energy NADH molecules. \n\n Step 6. The sixth step in glycolysis ( Figure 7.7 ) oxidizes the sugar (glyceraldehyde-3-phosphate), extracting high-energy electrons, which are picked up by the electron carrier NAD + , producing NADH. The sugar is then phosphorylated by the addition of a second phosphate group, producing 1,3-bisphosphoglycerate. Note that the second phosphate group does not require another ATP molecule. \n\n Here again is a potential limiting factor for this pathway. The continuation of the reaction depends upon the availability of the oxidized form of the electron carrier, NAD + . Thus, NADH must be continuously oxidized back into NAD +  in order to keep this step going. If NAD +  is not available, the second half of glycolysis slows down or stops. If oxygen is available in the system, the NADH will be oxidized readily, though indirectly, and the high-energy electrons from the hydrogen released in this process will be used to produce ATP. In an environment without oxygen, an alternate pathway (fermentation) can provide the oxidation of NADH to NAD + . \n\n Step 7. In the seventh step, catalyzed by phosphoglycerate kinase (an enzyme named for the reverse reaction), 1,3-bisphosphoglycerate donates a high-energy phosphate to ADP, forming one molecule of ATP. (This is an example of substrate-level phosphorylation.) A carbonyl group on the 1,3-bisphosphoglycerate is oxidized to a carboxyl group, and 3-phosphoglycerate is formed. \n\n Step 8. In the eighth step, the remaining phosphate group in 3-phosphoglycerate moves from the third carbon to the second carbon, producing 2-phosphoglycerate (an isomer of 3-phosphoglycerate). The enzyme catalyzing this step is a mutase (isomerase). \n\n Step 9. Enolase catalyzes the ninth step. This enzyme causes 2-phosphoglycerate to lose water from its structure; this is a dehydration reaction, resulting in the formation of a double bond that increases the potential energy in the remaining phosphate bond and produces phosphoenolpyruvate (PEP). \n\n Step 10. The last step in glycolysis is catalyzed by the enzyme pyruvate kinase (the enzyme in this case is named for the reverse reaction of pyruvate\u2019s conversion into PEP) and results in the production of a second ATP molecule by substrate-level phosphorylation and the compound pyruvic acid (or its salt form, pyruvate). Many enzymes in enzymatic pathways are named for the reverse reactions, since the enzyme can catalyze both forward and reverse reactions (these may have been described initially by the reverse reaction that takes place in vitro, under non-physiological conditions). \n\n Link to Learning \n\n Gain a better understanding of the breakdown of glucose by glycolysis by visiting this  site  to see the process in action. \n\n Outcomes of Glycolysis \n\n Glycolysis starts with glucose and ends with two pyruvate molecules, a total of four ATP molecules and two molecules of NADH. Two ATP molecules were used in the first half of the pathway to prepare the six-carbon ring for cleavage, so the cell has a net gain of two ATP molecules and 2 NADH molecules for its use. If the cell cannot catabolize the pyruvate molecules further, it will harvest only two ATP molecules from one molecule of glucose. Mature mammalian red blood cells are not capable of  aerobic respiration \u2014the process in which organisms convert energy in the presence of oxygen\u2014and glycolysis is their sole source of ATP. If glycolysis is interrupted, these cells lose their ability to maintain their sodium-potassium pumps, and eventually, they die. \n\n The last step in glycolysis will not occur if pyruvate kinase, the enzyme that catalyzes the formation of pyruvate, is not available in sufficient quantities. In this situation, the entire glycolysis pathway will proceed, but only two ATP molecules will be made in the second half. Thus, pyruvate kinase is a rate-limiting enzyme for glycolysis.\t \n7.3   Oxidation of Pyruvate and the Citric Acid Cycle Learning Objectives By the end of this section, you will be able to:\n\n Explain how a circular pathway, such as the citric acid cycle, fundamentally differs from a linear pathway, such as glycolysis \n\n Describe how pyruvate, the product of glycolysis, is prepared for entry into the citric acid cycle \n\n If oxygen is available, aerobic respiration will go forward. In eukaryotic cells, the pyruvate molecules produced at the end of glycolysis are transported into mitochondria, which are the sites of cellular respiration. There, pyruvate will be transformed into an acetyl group that will be picked up and activated by a carrier compound called coenzyme A (CoA). The resulting compound is called  acetyl CoA . CoA is made from vitamin B5, pantothenic acid. Acetyl CoA can be used in a variety of ways by the cell, but its major function is to deliver the acetyl group derived from pyruvate to the next stage of the pathway in glucose catabolism. \n\n Breakdown of Pyruvate \n\n In order for pyruvate, the product of glycolysis, to enter the next pathway, it must undergo several changes. The conversion is a three-step process ( Figure 7.8 ). \n\n Step 1. A carboxyl group is removed from pyruvate, releasing a molecule of carbon dioxide into the surrounding medium. The result of this step is a two-carbon hydroxyethyl group bound to the enzyme (pyruvate dehydrogenase). This is the first of the six carbons from the original glucose molecule to be removed. This step proceeds twice (remember: there are  two  pyruvate molecules produced at the end of glycolsis) for every molecule of glucose metabolized; thus, two of the six carbons will have been removed at the end of both steps. \n\n Step 2. The hydroxyethyl group is oxidized to an acetyl group, and the electrons are picked up by NAD + , forming NADH. The high-energy electrons from NADH will be used later to generate ATP. \n\n Step 3. The enzyme-bound acetyl group is transferred to CoA, producing a molecule of acetyl CoA. \n\n Note that during the second stage of glucose metabolism, whenever a carbon atom is removed, it is bound to two oxygen atoms, producing carbon dioxide, one of the major end products of cellular respiration. \n\n Acetyl CoA to CO 2 \n\n In the presence of oxygen, acetyl CoA delivers its acetyl group to a four-carbon molecule, oxaloacetate, to form citrate, a six-carbon molecule with three carboxyl groups; this pathway will harvest the remainder of the extractable energy from what began as a glucose molecule. This single pathway is called by different names: the  citric acid cycle  (for the first intermediate formed\u2014citric acid, or citrate\u2014when acetate joins to the oxaloacetate), the  TCA cycle  (since citric acid or citrate and isocitrate are tricarboxylic acids), and the  Krebs cycle , after Hans Krebs, who first identified the steps in the pathway in the 1930s in pigeon flight muscles. \n\n Citric Acid Cycle \n\n Like the conversion of pyruvate to acetyl CoA, the citric acid cycle takes place in the matrix of mitochondria. Almost all of the enzymes of the citric acid cycle are soluble, with the single exception of the enzyme succinate dehydrogenase, which is embedded in the inner membrane of the mitochondrion. Unlike glycolysis, the citric acid cycle is a closed loop: The last part of the pathway regenerates the compound used in the first step. The eight steps of the cycle are a series of redox, dehydration, hydration, and decarboxylation reactions that produce two carbon dioxide molecules, one GTP/ATP, and reduced forms of NADH and FADH 2  ( Figure 7.9 ). This is considered an aerobic pathway because the NADH and FADH 2  produced must transfer their electrons to the next pathway in the system, which will use oxygen. If this transfer does not occur, the oxidation steps of the citric acid cycle also do not occur. Note that the citric acid cycle produces very little ATP directly and does not directly consume oxygen. \n\n Steps in the Citric Acid Cycle \n\n Step 1. Prior to the start of the first step, a transitional phase occurs during which pyruvic acid is converted to acetyl CoA. Then, the first step of the cycle begins: This is a condensation step, combining the two-carbon acetyl group with a four-carbon oxaloacetate molecule to form a six-carbon molecule of citrate. CoA is bound to a sulfhydryl group (-SH) and diffuses away to eventually combine with another acetyl group. This step is irreversible because it is highly exergonic. The rate of this reaction is controlled by negative feedback and the amount of ATP available. If ATP levels increase, the rate of this reaction decreases. If ATP is in short supply, the rate increases. \n\n Step 2. In step two, citrate loses one water molecule and gains another as citrate is converted into its isomer, isocitrate. \n\n Step 3. In step three, isocitrate is oxidized, producing a five-carbon molecule, \u03b1-ketoglutarate, together with a molecule of CO 2  and two electrons, which reduce NAD +  to NADH. This step is also regulated by negative feedback from ATP and NADH, and a positive effect of ADP. \n\n Steps 3 and 4. Steps three and four are both oxidation and decarboxylation steps, which release electrons that reduce NAD +  to NADH and release carboxyl groups that form CO 2   molecules. \u03b1-Ketoglutarate is the product of step three, and a succinyl group is the product of step four. CoA binds the succinyl group to form succinyl CoA. The enzyme that catalyzes step four is regulated by feedback inhibition of ATP, succinyl CoA, and NADH. \n\n Step 5. In step five, a phosphate group is substituted for coenzyme A, and a high-energy bond is formed. This energy is used in substrate-level phosphorylation (during the conversion of the succinyl group to succinate) to form either guanine triphosphate (GTP) or ATP. There are two forms of the enzyme, called isoenzymes, for this step, depending upon the type of animal tissue in which they are found. One form is found in tissues that use large amounts of ATP, such as heart and skeletal muscle. This form produces ATP. The second form of the enzyme is found in tissues that have a high number of anabolic pathways, such as liver. This form produces GTP. GTP is energetically equivalent to ATP; however, its use is more restricted. In particular, protein synthesis primarily uses GTP. \n\n Step 6. Step six is a dehydration process that converts succinate into fumarate. Two hydrogen atoms are transferred to FAD, producing FADH 2 . The energy contained in the electrons of these atoms is insufficient to reduce NAD +  but adequate to reduce FAD. Unlike NADH, this carrier remains attached to the enzyme and transfers the electrons to the electron transport chain directly. This process is made possible by the localization of the enzyme catalyzing this step inside the inner membrane of the mitochondrion. \n\n Step 7. Water is added to fumarate during step seven, and malate is produced. The last step in the citric acid cycle regenerates oxaloacetate by oxidizing malate. Another molecule of NADH is produced in the process. \n\n Link to Learning \n\n Click through each step of the citric acid cycle  here . \n\n Products of the Citric Acid Cycle \n\n Two carbon atoms come into the citric acid cycle from each acetyl group, representing four out of the six carbons of one glucose molecule. Two carbon dioxide molecules are released on each turn of the cycle; however, these do not necessarily contain the most recently added carbon atoms. The two acetyl carbon atoms will eventually be released on later turns of the cycle; thus, all six carbon atoms from the original glucose molecule are eventually incorporated into carbon dioxide. Each turn of the cycle forms three NADH molecules and one FADH 2  molecule. These carriers will connect with the last portion of aerobic respiration to produce ATP molecules. One GTP or ATP is also made in each cycle. Several of the intermediate compounds in the citric acid cycle can be used in synthesizing non-essential amino acids; therefore, the cycle is amphibolic (both catabolic and anabolic). \n7.4   Oxidative Phosphorylation Learning Objectives By the end of this section, you will be able to:\n\n Describe how electrons move through the electron transport chain and what happens to their energy levels \n\n Explain how a proton (H + ) gradient is established and maintained by the electron transport chain \n\n You have just read about two pathways in glucose catabolism\u2014glycolysis and the citric acid cycle\u2014that generate ATP. Most of the ATP generated during the aerobic catabolism of glucose, however, is not generated directly from these pathways. Rather, it is derived from a process that begins with moving electrons through a series of electron transporters that undergo redox reactions. This causes hydrogen ions to accumulate within the matrix space. Therefore, a concentration gradient forms in which hydrogen ions diffuse out of the matrix space by passing through ATP synthase. The current of hydrogen ions powers the catalytic action of ATP synthase, which phosphorylates ADP, producing ATP. Electron Transport Chain \n\n The electron transport chain ( Figure 7.10 ) is the last component of aerobic respiration and is the only part of glucose metabolism that uses atmospheric oxygen. Oxygen continuously diffuses into plants; in animals, it enters the body through the respiratory system. Electron transport is a series of redox reactions that resemble a relay race or bucket brigade in that electrons are passed rapidly from one component to the next, to the endpoint of the chain where the electrons reduce molecular oxygen, producing water. There are four complexes composed of proteins, labeled I through IV in   Figure 7.10 , and the aggregation of these four complexes, together with associated mobile, accessory electron carriers, is called the electron transport chain. The electron transport chain is present in multiple copies in the inner mitochondrial membrane of eukaryotes and the plasma membrane of prokaryotes. \n\n Complex I \n\n To start, two electrons are carried to the first complex aboard NADH. This complex, labeled I, is composed of flavin mononucleotide (FMN) and an iron-sulfur (Fe-S)-containing protein. FMN, which is derived from vitamin B 2,  also called riboflavin, is one of several prosthetic groups or co-factors in the electron transport chain. A  prosthetic group  is a non-protein molecule required for the activity of a protein. Prosthetic groups are organic or inorganic, non-peptide molecules bound to a protein that facilitate its function; prosthetic groups include co-enzymes, which are the prosthetic groups of enzymes. The enzyme in complex I is NADH dehydrogenase and is a very large protein, containing 45 amino acid chains. Complex I can pump four hydrogen ions across the membrane from the matrix into the intermembrane space, and it is in this way that the hydrogen ion gradient is established and maintained between the two compartments separated by the inner mitochondrial membrane. \n\n Q and Complex II \n\n Complex II directly receives FADH 2 , which does not pass through complex I. The compound connecting the first and second complexes to the third is  ubiquinone  (Q). The Q molecule is lipid soluble and freely moves through the hydrophobic core of the membrane. Once it is reduced, (QH 2 ), ubiquinone delivers its electrons to the next complex in the electron transport chain. Q receives the electrons derived from NADH from complex I and the electrons derived from FADH 2  from complex II, including succinate dehydrogenase. This enzyme and FADH 2  form a small complex that delivers electrons directly to the electron transport chain, bypassing the first complex. Since these electrons bypass and thus do not energize the proton pump in the first complex, fewer ATP molecules are made from the FADH 2  electrons. The number of ATP molecules ultimately obtained is directly proportional to the number of protons pumped across the inner mitochondrial membrane. \n\n Complex III \n\n The third complex is composed of cytochrome b, another Fe-S protein, Rieske center (2Fe-2S center), and cytochrome c proteins; this complex is also called cytochrome oxidoreductase. Cytochrome proteins have a prosthetic group of heme. The heme molecule is similar to the heme in hemoglobin, but it carries electrons, not oxygen. As a result, the iron ion at its core is reduced and oxidized as it passes the electrons, fluctuating between different oxidation states: Fe ++  (reduced) and Fe +++  (oxidized). The heme molecules in the cytochromes have slightly different characteristics due to the effects of the different proteins binding them, giving slightly different characteristics to each complex. Complex III pumps protons through the membrane and passes its electrons to cytochrome c for transport to the fourth complex of proteins and enzymes (cytochrome c is the acceptor of electrons from Q; however, whereas Q carries pairs of electrons, cytochrome c can accept only one at a time). \n\n Complex IV \n\n The fourth complex is composed of cytochrome proteins c, a, and a 3 . This complex contains two heme groups (one in each of the two cytochromes, a, and a 3 ) and three copper ions (a pair of Cu A  and one Cu B  in cytochrome a 3 ). The cytochromes hold an oxygen molecule very tightly between the iron and copper ions until the oxygen is completely reduced. The reduced oxygen then picks up two hydrogen ions from the surrounding medium to make water (H 2 O). The removal of the hydrogen ions from the system contributes to the ion gradient used in the process of chemiosmosis. \n\n Chemiosmosis \n\n In chemiosmosis, the free energy from the series of redox reactions just described is used to pump hydrogen ions (protons) across the membrane. The uneven distribution of H +  ions across the membrane establishes both concentration and electrical gradients (thus, an electrochemical gradient), owing to the hydrogen ions\u2019 positive charge and their aggregation on one side of the membrane. \n\n If the membrane were open to diffusion by the hydrogen ions, the ions would tend to diffuse back across into the matrix, driven by their electrochemical gradient. Recall that many ions cannot diffuse through the nonpolar regions of phospholipid membranes without the aid of ion channels.  Similarly, hydrogen ions in the matrix space can only pass through the inner mitochondrial membrane through an integral membrane protein called ATP synthase ( Figure 7.11 ). This complex protein acts as a tiny generator, turned by the force of the hydrogen ions diffusing through it, down their electrochemical gradient. The turning of parts of this molecular machine facilitates the addition of a phosphate to ADP, forming ATP, using the potential energy of the hydrogen ion gradient. Visual Connection \n\n Dinitrophenol (DNP) is an uncoupler that makes the inner mitochondrial membrane leaky to protons. It was used until 1938 as a weight-loss drug. What effect would you expect DNP to have on the change in pH across the inner mitochondrial membrane? Why do you think this might be an effective weight-loss drug? \n\n Chemiosmosis ( Figure 7.12 ) is used to generate 90 percent of the ATP made during aerobic glucose catabolism; it is also the method used in the light reactions of photosynthesis to harness the energy of sunlight in the process of photophosphorylation. Recall that the production of ATP using the process of chemiosmosis in mitochondria is called oxidative phosphorylation. The overall result of these reactions is the production of ATP from the energy of the electrons removed from hydrogen atoms. These atoms were originally part of a glucose molecule. At the end of the pathway, the electrons are used to reduce an oxygen molecule to oxygen ions. The extra electrons on the oxygen attract hydrogen ions (protons) from the surrounding medium, and water is formed. \n\n Visual Connection \n\n Cyanide inhibits cytochrome c oxidase, a component of the electron transport chain. If cyanide poisoning occurs, would you expect the pH of the intermembrane space to increase or decrease? What effect would cyanide have on ATP synthesis? \n\n ATP Yield \n\n The number of ATP molecules generated from the catabolism of glucose varies. For example, the number of hydrogen ions that the electron transport chain complexes can pump through the membrane varies between species. Another source of variance stems from the shuttle of electrons across the membranes of the mitochondria. (The NADH generated from glycolysis cannot easily enter mitochondria.) Thus, electrons are picked up on the inside of mitochondria by either NAD +  or FAD + . As you have learned earlier, these FAD +  molecules can transport fewer ions; consequently, fewer ATP molecules are generated when FAD +  acts as a carrier. NAD +  is used as the electron transporter in the liver and FAD +  acts in the brain. \n\n Another factor that affects the yield of ATP molecules generated from glucose is the fact that intermediate compounds in these pathways are used for other purposes. Glucose catabolism connects with the pathways that build or break down all other biochemical compounds in cells, and the result is somewhat messier than the ideal situations described thus far. For example, sugars other than glucose are fed into the glycolytic pathway for energy extraction. Moreover, the five-carbon sugars that form nucleic acids are made from intermediates in glycolysis. Certain nonessential amino acids can be made from intermediates of both glycolysis and the citric acid cycle. Lipids, such as cholesterol and triglycerides, are also made from intermediates in these pathways, and both amino acids and triglycerides are broken down for energy through these pathways. Overall, in living systems, these pathways of glucose catabolism extract about 34 percent of the energy contained in glucose. \n7.5   Metabolism without Oxygen Learning Objectives By the end of this section, you will be able to:\n\n Discuss the fundamental difference between anaerobic cellular respiration and fermentation \n\n Describe the type of fermentation that readily occurs in animal cells and the conditions that initiate that fermentation \n\n In aerobic respiration, the final electron acceptor is an oxygen molecule, O 2 . If aerobic respiration occurs, then ATP will be produced using the energy of high-energy electrons carried by NADH or FADH 2  to the electron transport chain. If aerobic respiration does not occur, NADH must be reoxidized to NAD +  for reuse as an electron carrier for the glycolytic pathway to continue. How is this done? Some living systems use an organic molecule as the final electron acceptor. Processes that use an organic molecule to regenerate NAD +  from NADH are collectively referred to as  fermentation . In contrast, some living systems use an inorganic molecule as a final electron acceptor. Both methods are called  anaerobic cellular respiration  in which organisms convert energy for their use in the absence of oxygen. \n\n Anaerobic Cellular Respiration \n\n Certain prokaryotes, including some species of bacteria and Archaea, use anaerobic respiration. For example, the group of Archaea called methanogens reduces carbon dioxide to methane to oxidize NADH. These microorganisms are found in soil and in the digestive tracts of ruminants, such as cows and sheep. Similarly, sulfate-reducing bacteria and Archaea, most of which are anaerobic (  Figure 7.13 ), reduce sulfate to hydrogen sulfide to regenerate NAD +  from NADH. \n\n Link to Learning \n\n Visit this  site  to see anaerobic cellular respiration in action. \n\n Lactic Acid Fermentation \n\n The fermentation method used by animals and certain bacteria, like those in yogurt, is lactic acid fermentation (  Figure 7.14 ). This type of fermentation is used routinely in mammalian red blood cells and in skeletal muscle that has an insufficient oxygen supply to allow aerobic respiration to continue (that is, in muscles used to the point of fatigue). In muscles, lactic acid accumulation must be removed by the blood circulation and the lactate brought to the liver for further metabolism. The chemical reactions of lactic acid fermentation are the following: \n\n Pyruvic acid \n\n + \n\n NADH \n\n \u2194 \n\n lactic acid \n\n + \n\n NAD \n\n + \n\n Pyruvic acid \n\n + \n\n NADH \n\n \u2194 \n\n lactic acid \n\n + \n\n NAD \n\n + \n\n The enzyme used in this reaction is lactate dehydrogenase (LDH). The reaction can proceed in either direction, but the reaction from left to right is inhibited by acidic conditions. Such lactic acid accumulation was once believed to cause muscle stiffness, fatigue, and soreness, although more recent research disputes this hypothesis. Once the lactic acid has been removed from the muscle and circulated to the liver, it can be reconverted into pyruvic acid and further catabolized for energy. \n\n Visual Connection \n\n Tremetol, a metabolic poison found in the white snake root plant, prevents the metabolism of lactate. When cows eat this plant, it is concentrated in the milk they produce. Humans who consume the milk become ill. Symptoms of this disease, which include vomiting, abdominal pain, and tremors, become worse after exercise. Why do you think this is the case? \n\n Alcohol Fermentation \n\n Another familiar fermentation process is alcohol fermentation (  Figure 7.15 ) that produces ethanol, an alcohol. The first chemical reaction of alcohol fermentation is the following (CO 2  does not participate in the second reaction): \n\n Pyruvic acid \n\n \u2192 \n\n CO \n\n 2 \n\n + \n\n acetaldehyde \n\n + \n\n NADH \n\n \u2192 \n\n ethanol \n\n + \n\n NAD \n\n + \n\n Pyruvic acid \n\n \u2192 \n\n CO \n\n 2 \n\n + \n\n acetaldehyde \n\n + \n\n NADH \n\n \u2192 \n\n ethanol \n\n + \n\n NAD \n\n + \n\n The first reaction is catalyzed by pyruvate decarboxylase, a cytoplasmic enzyme, with a coenzyme of thiamine pyrophosphate (TPP, derived from vitamin B 1  and also called thiamine). A carboxyl group is removed from pyruvic acid, releasing carbon dioxide as a gas. The loss of carbon dioxide reduces the size of the molecule by one carbon, making acetaldehyde. The second reaction is catalyzed by alcohol dehydrogenase to oxidize NADH to NAD +  and reduce acetaldehyde to ethanol. The fermentation of pyruvic acid by yeast produces the ethanol found in alcoholic beverages. Ethanol tolerance of yeast is variable, ranging from about 5 percent to 21 percent, depending on the yeast strain and environmental conditions. \n\n Other Types of Fermentation \n\n Other fermentation methods occur in bacteria. Many prokaryotes are facultatively anaerobic. This means that they can switch between aerobic respiration and fermentation, depending on the availability of oxygen. Certain prokaryotes, like  Clostridia , are obligate anaerobes. Obligate anaerobes live and grow in the absence of molecular oxygen. Oxygen is a poison to these microorganisms and kills them on exposure. It should be noted that all forms of fermentation, except lactic acid fermentation, produce gas. The production of particular types of gas is used as an indicator of the fermentation of specific carbohydrates, which plays a role in the laboratory identification of the bacteria. Various methods of fermentation are used by assorted organisms to ensure an adequate supply of NAD +  for the sixth step in glycolysis. Without these pathways, that step would not occur and no ATP would be harvested from the breakdown of glucose. \n7.6   Connections of Carbohydrate, Protein, and Lipid Metabolic Pathways Learning Objectives By the end of this section, you will be able to:\n\n Discuss the ways in which carbohydrate metabolic pathways, glycolysis, and the citric acid cycle interrelate with protein and lipid metabolic pathways \n\n Explain why metabolic pathways are not considered closed systems \n\n You have learned about the catabolism of glucose, which provides energy to living cells. But living things consume more than glucose for food. How does a turkey sandwich end up as ATP in your cells? This happens because all of the catabolic pathways for carbohydrates, proteins, and lipids eventually connect into glycolysis and the citric acid cycle pathways (see   Figure 7.17 ). Metabolic pathways should be thought of as porous\u2014that is, substances enter from other pathways, and intermediates leave for other pathways. These pathways are not closed systems. Many of the substrates, intermediates, and products in a particular pathway are reactants in other pathways. Connections of Other Sugars to Glucose Metabolism \n\n Glycogen, a polymer of glucose, is an energy storage molecule in animals. When there is adequate ATP present, excess glucose is shunted into glycogen for storage. Glycogen is made and stored in both liver and muscle. The glycogen will be hydrolyzed into glucose monomers (G-1-P) if blood sugar levels drop. The presence of glycogen as a source of glucose allows ATP to be produced for a longer period of time during exercise. Glycogen is broken down into G-1-P and converted into G-6-P in both muscle and liver cells, and this product enters the glycolytic pathway. Sucrose is a disaccharide with a molecule of glucose and a molecule of fructose bonded together with a glycosidic linkage. Fructose is one of the three dietary monosaccharides, along with glucose and galactose (which is part of the milk sugar, the disaccharide lactose), which are absorbed directly into the bloodstream during digestion. The catabolism of both fructose and galactose produces the same number of ATP molecules as glucose. \n\n Connections of Proteins to Glucose Metabolism \n\n Proteins are hydrolyzed by a variety of enzymes in cells. Most of the time, the amino acids are recycled into the synthesis of new proteins. If there are excess amino acids, however, or if the body is in a state of starvation, some amino acids will be shunted into the pathways of glucose catabolism ( Figure 7.16 ). Each amino acid must have its amino group removed prior to entry into these pathways. The amino group is converted into ammonia. In mammals, the liver synthesizes urea from two ammonia molecules and a carbon dioxide molecule. Thus, urea is the principal waste product in mammals produced from the nitrogen originating in amino acids, and it leaves the body in urine. \n\n Connections of Lipid and Glucose Metabolisms \n\n The lipids that are connected to the glucose pathways are cholesterol and triglycerides. Cholesterol is a lipid that contributes to cell membrane flexibility and is a precursor of steroid hormones. The synthesis of cholesterol starts with acetyl groups and proceeds in only one direction. The process cannot be reversed. \n\n Triglycerides are a form of long-term energy storage in animals. Triglycerides are made of glycerol and three fatty acids. Animals can make most of the fatty acids they need. Triglycerides can be both made and broken down through parts of the glucose catabolism pathways. Glycerol can be phosphorylated to glycerol-3-phosphate, which continues through glycolysis. Fatty acids are catabolized in a process called beta-oxidation that takes place in the matrix of the mitochondria and converts their fatty acid chains into two carbon units of acetyl groups. The acetyl groups are picked up by CoA to form acetyl CoA that proceeds into the citric acid cycle. \n\n Evolution Connection Pathways of Photosynthesis and Cellular Metabolism \n\n The processes of photosynthesis and cellular metabolism consist of several very complex pathways. It is generally thought that the first cells arose in an aqueous environment\u2014a \u201csoup\u201d of nutrients\u2014probably on the surface of some porous clays. If these cells reproduced successfully and their numbers climbed steadily, it follows that the cells would begin to deplete the nutrients from the medium in which they lived as they shifted the nutrients into the components of their own bodies. This hypothetical situation would have resulted in natural selection favoring those organisms that could exist by using the nutrients that remained in their environment and by manipulating these nutrients into materials upon which they could survive. Selection would favor those organisms that could extract maximal value from the nutrients to which they had access. \n\n An early form of photosynthesis developed that harnessed the sun\u2019s energy using water as a source of hydrogen atoms, but this pathway did not produce free oxygen (anoxygenic photosynthesis). (Early photosynthesis did not produce free oxygen because it did not use water as the source of hydrogen ions; instead, it used materials like hydrogen sulfide and consequently produced sulfur). It is thought that glycolysis could take advantage of the simple sugars being produced, but these reactions were unable to fully extract the energy stored in the carbohydrates.  The development of glycolysis probably predated the evolution of photosynthesis, as it was well suited to extract energy from materials spontaneously accumulating in the \u201cprimeval soup.\u201d A later form of photosynthesis used water as a source of electrons and hydrogen, and generated free oxygen. Over time, the atmosphere became oxygenated, but not before the oxygen released oxidized metals in the ocean and created a \u201crust\u201d layer in the sediment, permitting the dating of the rise of the first oxygenic photosynthesizers. Living things adapted to exploit this new atmosphere that allowed aerobic respiration as we know it to evolve. When the full process of oxygenic photosynthesis developed and the atmosphere became oxygenated, cells were finally able to use the oxygen expelled by photosynthesis to extract considerably more energy from the sugar molecules using the citric acid cycle and oxidative phosphorylation. \n7.7   Regulation of Cellular Respiration Learning Objectives By the end of this section, you will be able to:\n\n Describe how feedback inhibition would affect the production of an intermediate or product in a pathway \n\n Identify the mechanism that controls the rate of the transport of electrons through the electron transport chain \n\n Cellular respiration must be regulated in order to provide balanced amounts of energy in the form of ATP. The cell also must generate a number of intermediate compounds that are used in the anabolism and catabolism of macromolecules.  Without controls, metabolic reactions would quickly come to a stand still as the forward and backward reactions reached a state of equilibrium. Resources would be used inappropriately. A cell does not need the maximum amount of ATP that it can make all the time: At times, the cell needs to shunt some of the intermediates to pathways for amino acid, protein, glycogen, lipid, and nucleic acid production. In short, the cell needs to control its metabolism. Regulatory Mechanisms \n\n A variety of mechanisms is used to control cellular respiration. Some type of control exists at each stage of glucose metabolism. Access of glucose to the cell can be regulated using the  GLUT proteins  that transport glucose ( Figure 7.18 ). Different forms of the GLUT protein control passage of glucose into the cells of specific tissues. \n\n Some reactions are controlled by having two different enzymes\u2014one each for the two directions of a reversible reaction. Reactions that are catalyzed by only one enzyme can go to equilibrium, stalling the reaction. In contrast, if two different enzymes (each specific for a given direction) are necessary for a reversible reaction, the opportunity to control the rate of the reaction increases, and equilibrium is not reached. \n\n A number of enzymes involved in each of the pathways\u2014in particular, the enzyme catalyzing the first committed reaction of the pathway\u2014are controlled by attachment of a molecule to an allosteric site on the protein. The molecules most commonly used in this capacity are the nucleotides ATP, ADP, AMP, NAD + , and NADH. These regulators, allosteric effectors, may increase or decrease enzyme activity, depending on the prevailing conditions. The allosteric effector alters the steric structure of the enzyme, usually affecting the configuration of the active site. This alteration of the protein\u2019s (the enzyme\u2019s) structure either increases or decreases its affinity for its substrate, with the effect of increasing or decreasing the rate of the reaction. The attachment signals to the enzyme. This binding can increase or decrease the enzyme\u2019s activity, providing feedback. This feedback type of control is effective as long as the chemical affecting it is attached to the enzyme. Once the overall concentration of the chemical decreases, it will diffuse away from the protein, and the control is relaxed. \n\n Control of Catabolic Pathways \n\n Enzymes, proteins, electron carriers, and pumps that play roles in glycolysis, the citric acid cycle, and the electron transport chain tend to catalyze non-reversible reactions. In other words, if the initial reaction takes place, the pathway is committed to proceeding with the remaining reactions. Whether a particular enzyme activity is released depends upon the energy needs of the cell (as reflected by the levels of ATP, ADP, and AMP). \n\n Glycolysis \n\n The control of glycolysis begins with the first enzyme in the pathway, hexokinase ( Figure 7.19 ). This enzyme catalyzes the phosphorylation of glucose, which helps to prepare the compound for cleavage in a later step. The presence of the negatively charged phosphate in the molecule also prevents the sugar from leaving the cell. When hexokinase is inhibited, glucose diffuses out of the cell and does not become a substrate for the respiration pathways in that tissue. The product of the hexokinase reaction is glucose-6-phosphate, which accumulates when a later enzyme, phosphofructokinase, is inhibited. \n\n Phosphofructokinase is the main enzyme controlled in glycolysis. High levels of ATP, citrate, or a lower, more acidic pH decrease the enzyme\u2019s activity. An increase in citrate concentration can occur because of a blockage in the citric acid cycle. Fermentation, with its production of organic acids like lactic acid, frequently accounts for the increased acidity in a cell; however, the products of fermentation do not typically accumulate in cells. \n\n The last step in glycolysis is catalyzed by pyruvate kinase. The pyruvate produced can proceed to be catabolized or converted into the amino acid alanine. If no more energy is needed and alanine is in adequate supply, the enzyme is inhibited. The enzyme\u2019s activity is increased when fructose-1,6-bisphosphate levels increase. (Recall that fructose-1,6-bisphosphate is an intermediate in the first half of glycolysis.) The regulation of pyruvate kinase involves phosphorylation by a kinase (pyruvate kinase kinase), resulting in a less-active enzyme. Dephosphorylation by a phosphatase reactivates it. Pyruvate kinase is also regulated by ATP (a negative allosteric effect). \n\n If more energy is needed, more pyruvate will be converted into acetyl CoA through the action of pyruvate dehydrogenase. If either acetyl groups or NADH accumulate, there is less need for the reaction and the rate decreases. Pyruvate dehydrogenase is also regulated by phosphorylation: A kinase phosphorylates it to form an inactive enzyme, and a phosphatase reactivates it. The kinase and the phosphatase are also regulated. \n\n Citric Acid Cycle \n\n The citric acid cycle is controlled through the enzymes that catalyze the reactions that make the first two molecules of NADH ( Figure 7.9 ). These enzymes are isocitrate dehydrogenase and  \u03b1 -ketoglutarate dehydrogenase. When adequate ATP and NADH levels are available, the rates of these reactions decrease. When more ATP is needed, as reflected in rising ADP levels, the rate increases.  \u03b1 -Ketoglutarate dehydrogenase will also be affected by the levels of succinyl CoA\u2014a subsequent intermediate in the cycle\u2014causing a decrease in activity. A decrease in the rate of operation of the pathway at this point is not necessarily negative, as the increased levels of the  \u03b1 -ketoglutarate not used by the citric acid cycle can be used by the cell for amino acid (glutamate) synthesis. \n\n Electron Transport Chain \n\n Specific enzymes of the electron transport chain are unaffected by feedback inhibition, but the rate of electron transport through the pathway is affected by the levels of ADP and ATP. Greater ATP consumption by a cell is indicated by a buildup of ADP. As ATP usage decreases, the concentration of ADP decreases, and now, ATP begins to build up in the cell. This change is the relative concentration of ADP to ATP triggers the cell to slow down the electron transport chain. Link to Learning \n\n Visit this  site  to see an animation of the electron transport chain and ATP synthesis. \n\n  For a summary of feedback controls in cellular respiration, see   Table 7.1 . \n\n Summary of Feedback Controls in Cellular Respiration \n\n Pathway \n\n Enzyme affected \n\n Elevated levels of effector \n\n Effect on pathway activity \n\n glycolysis \n\n hexokinase \n\n glucose-6-phosphate \n\n decrease \n\n phosphofructokinase \n\n low-energy charge (ATP, AMP), fructose-6-phosphate via fructose-2,6-bisphosphate \n\n increase \n\n high-energy charge (ATP, AMP), citrate, acidic pH \n\n decrease \n\n pyruvate kinase \n\n fructose-1,6-bisphosphate \n\n increase \n\n high-energy charge (ATP, AMP), alanine \n\n decrease \n\n pyruvate to acetyl CoA conversion \n\n pyruvate dehydrogenase \n\n ADP, pyruvate \n\n increase \n\n acetyl CoA, ATP, NADH \n\n decrease \n\n citric acid cycle \n\n isocitrate dehydrogenase \n\n ADP \n\n increase \n\n ATP, NADH \n\n decrease \n\n \u03b1 -ketoglutarate dehydrogenase \n\n Calcium ions, ADP \n\n increase \n\n ATP, NADH, succinyl CoA \n\n decrease \n\n electron transport chain \n\n ADP \n\n increase \n\n ATP \n\n decrease \n\n Table  7.1     ", "questions": [{"question": {"question_id": "fs-id1957993", "question_text": "The energy currency used by cells is ________.", "question_choices": ["ATP", "ADP", "AMP", "adenosine"], "cloze_format": "The energy currency used by cells is ________.", "normal_format": "Which is the energy currency used by cells?"}, "answer": {"ans_text": "ATP", "ans_choice": 0}, "bloom": null, "hl_sentences": "ATP is often called the \u201c energy currency \u201d of the cell , and , like currency , this versatile compound can be used to fill any energy need of the cell .", "hl_context": "A living cell cannot store significant amounts of free energy . Excess free energy would result in an increase of heat in the cell , which would result in excessive thermal motion that could damage and then destroy the cell . Rather , a cell must be able to handle that energy in a way that enables the cell to store energy safely and release it for use only as needed . Living cells accomplish this by using the compound adenosine triphosphate ( ATP ) . <hl> ATP is often called the \u201c energy currency \u201d of the cell , and , like currency , this versatile compound can be used to fill any energy need of the cell . <hl> How ? It functions similarly to a rechargeable battery ."}, {"question": {"question_id": "fs-id1419484", "question_text": "A reducing chemical reaction ________.", "question_choices": ["reduces the compound to a simpler form", "adds an electron to the substrate", "removes a hydrogen atom from the substrate", "is a catabolic reaction"], "cloze_format": "A reducing chemical reaction ________.", "normal_format": "Which of the following is correct about a reducing chemical reaction?"}, "answer": {"ans_text": "adds an electron to the substrate", "ans_choice": 1}, "bloom": "2", "hl_sentences": "An oxidation reaction strips an electron from an atom in a compound , and the addition of this electron to another compound is a reduction reaction .", "hl_context": "Energy production within a cell involves many coordinated chemical pathways . Most of these pathways are combinations of oxidation and reduction reactions . Oxidation and reduction occur in tandem . <hl> An oxidation reaction strips an electron from an atom in a compound , and the addition of this electron to another compound is a reduction reaction . <hl> Because oxidation and reduction usually occur together , these pairs of reactions are called oxidation reduction reactions , or redox reactions . Electrons and Energy"}, {"question": {"question_id": "fs-id1470359", "question_text": "During the second half of glycolysis, what occurs?", "question_choices": ["ATP is used up.", "Fructose is split in two.", "ATP is made.", "Glucose becomes fructose."], "cloze_format": "During the second half of glycolysis ___.", "normal_format": "During the second half of glycolysis, what occurs?"}, "answer": {"ans_text": "ATP is made.", "ans_choice": 2}, "bloom": "2", "hl_sentences": "The last step in glycolysis will not occur if pyruvate kinase , the enzyme that catalyzes the formation of pyruvate , is not available in sufficient quantities . In this situation , the entire glycolysis pathway will proceed , but only two ATP molecules will be made in the second half . Both of these molecules will proceed through the second half of the pathway , and sufficient energy will be extracted to pay back the two ATP molecules used as an initial investment and produce a profit for the cell of two additional ATP molecules and two even higher-energy NADH molecules .", "hl_context": "<hl> The last step in glycolysis will not occur if pyruvate kinase , the enzyme that catalyzes the formation of pyruvate , is not available in sufficient quantities . <hl> <hl> In this situation , the entire glycolysis pathway will proceed , but only two ATP molecules will be made in the second half . <hl> Thus , pyruvate kinase is a rate-limiting enzyme for glycolysis . 7.3 Oxidation of Pyruvate and the Citric Acid Cycle Learning Objectives By the end of this section , you will be able to : So far , glycolysis has cost the cell two ATP molecules and produced two small , three-carbon sugar molecules . <hl> Both of these molecules will proceed through the second half of the pathway , and sufficient energy will be extracted to pay back the two ATP molecules used as an initial investment and produce a profit for the cell of two additional ATP molecules and two even higher-energy NADH molecules . <hl>"}, {"question": {"question_id": "fs-id2569068", "question_text": "What is removed from pyruvate during its conversion into an acetyl group?", "question_choices": ["oxygen", "ATP", "B vitamin", "carbon dioxide"], "cloze_format": "___ is removed from pyruvate during its conversion into an acetyl group.", "normal_format": "What is removed from pyruvate during its conversion into an acetyl group?"}, "answer": {"ans_text": "carbon dioxide", "ans_choice": 3}, "bloom": "2", "hl_sentences": "The loss of carbon dioxide reduces the size of the molecule by one carbon , making acetaldehyde . A carboxyl group is removed from pyruvate , releasing a molecule of carbon dioxide into the surrounding medium .", "hl_context": "The first reaction is catalyzed by pyruvate decarboxylase , a cytoplasmic enzyme , with a coenzyme of thiamine pyrophosphate ( TPP , derived from vitamin B 1 and also called thiamine ) . A carboxyl group is removed from pyruvic acid , releasing carbon dioxide as a gas . <hl> The loss of carbon dioxide reduces the size of the molecule by one carbon , making acetaldehyde . <hl> The second reaction is catalyzed by alcohol dehydrogenase to oxidize NADH to NAD + and reduce acetaldehyde to ethanol . The fermentation of pyruvic acid by yeast produces the ethanol found in alcoholic beverages . Ethanol tolerance of yeast is variable , ranging from about 5 percent to 21 percent , depending on the yeast strain and environmental conditions . Step 1 . <hl> A carboxyl group is removed from pyruvate , releasing a molecule of carbon dioxide into the surrounding medium . <hl> The result of this step is a two-carbon hydroxyethyl group bound to the enzyme ( pyruvate dehydrogenase ) . This is the first of the six carbons from the original glucose molecule to be removed . This step proceeds twice ( remember : there are two pyruvate molecules produced at the end of glycolsis ) for every molecule of glucose metabolized ; thus , two of the six carbons will have been removed at the end of both steps ."}, {"question": {"question_id": "fs-id2169636", "question_text": "What do the electrons added to NAD+ do?", "question_choices": ["They become part of a fermentation pathway.", "They go to another pathway for ATP production.", "They energize the entry of the acetyl group into the citric acid cycle.", "They are converted to NADP."], "cloze_format": "What the electrons added to NAD+ do, is that ___.", "normal_format": "What do the electrons added to NAD+ do?"}, "answer": {"ans_text": "They go to another pathway for ATP production.", "ans_choice": 1}, "bloom": "4", "hl_sentences": "Thus , NADH must be continuously oxidized back into NAD + in order to keep this step going . If NAD + is not available , the second half of glycolysis slows down or stops . If oxygen is available in the system , the NADH will be oxidized readily , though indirectly , and the high-energy electrons from the hydrogen released in this process will be used to produce ATP . The sixth step in glycolysis ( Figure 7.7 ) oxidizes the sugar ( glyceraldehyde - 3 - phosphate ) , extracting high-energy electrons , which are picked up by the electron carrier NAD + , producing NADH .", "hl_context": "Here again is a potential limiting factor for this pathway . The continuation of the reaction depends upon the availability of the oxidized form of the electron carrier , NAD + . <hl> Thus , NADH must be continuously oxidized back into NAD + in order to keep this step going . <hl> <hl> If NAD + is not available , the second half of glycolysis slows down or stops . <hl> <hl> If oxygen is available in the system , the NADH will be oxidized readily , though indirectly , and the high-energy electrons from the hydrogen released in this process will be used to produce ATP . <hl> In an environment without oxygen , an alternate pathway ( fermentation ) can provide the oxidation of NADH to NAD + . Step 6 . <hl> The sixth step in glycolysis ( Figure 7.7 ) oxidizes the sugar ( glyceraldehyde - 3 - phosphate ) , extracting high-energy electrons , which are picked up by the electron carrier NAD + , producing NADH . <hl> The sugar is then phosphorylated by the addition of a second phosphate group , producing 1,3- bisphosphoglycerate . Note that the second phosphate group does not require another ATP molecule ."}, {"question": {"question_id": "fs-id1438300", "question_text": "GTP or ATP is produced during the conversion of ________.", "question_choices": ["isocitrate into \u03b1-ketoglutarate", "succinyl CoA into succinate", "fumarate into malate", "malate into oxaloacetate"], "cloze_format": "GTP or ATP is produced during the conversion of ________.", "normal_format": "GTP or ATP is produced during the conversion of which?"}, "answer": {"ans_text": "succinyl CoA into succinate", "ans_choice": 1}, "bloom": null, "hl_sentences": "This energy is used in substrate-level phosphorylation ( during the conversion of the succinyl group to succinate ) to form either guanine triphosphate ( GTP ) or ATP .", "hl_context": "Step 5 . In step five , a phosphate group is substituted for coenzyme A , and a high-energy bond is formed . <hl> This energy is used in substrate-level phosphorylation ( during the conversion of the succinyl group to succinate ) to form either guanine triphosphate ( GTP ) or ATP . <hl> There are two forms of the enzyme , called isoenzymes , for this step , depending upon the type of animal tissue in which they are found . One form is found in tissues that use large amounts of ATP , such as heart and skeletal muscle . This form produces ATP . The second form of the enzyme is found in tissues that have a high number of anabolic pathways , such as liver . This form produces GTP . GTP is energetically equivalent to ATP ; however , its use is more restricted . In particular , protein synthesis primarily uses GTP ."}, {"question": {"question_id": "fs-id1393295", "question_text": "How many NADH molecules are produced on each turn of the citric acid cycle?", "question_choices": ["one", "two", "three", "four"], "cloze_format": "The number of NADH molecules that are produced on each turn of the citric acid cycle is ___ .", "normal_format": "How many NADH molecules are produced on each turn of the citric acid cycle?"}, "answer": {"ans_text": "three", "ans_choice": 2}, "bloom": "2", "hl_sentences": "Each turn of the cycle forms three NADH molecules and one FADH 2 molecule .", "hl_context": "Two carbon atoms come into the citric acid cycle from each acetyl group , representing four out of the six carbons of one glucose molecule . Two carbon dioxide molecules are released on each turn of the cycle ; however , these do not necessarily contain the most recently added carbon atoms . The two acetyl carbon atoms will eventually be released on later turns of the cycle ; thus , all six carbon atoms from the original glucose molecule are eventually incorporated into carbon dioxide . <hl> Each turn of the cycle forms three NADH molecules and one FADH 2 molecule . <hl> These carriers will connect with the last portion of aerobic respiration to produce ATP molecules . One GTP or ATP is also made in each cycle . Several of the intermediate compounds in the citric acid cycle can be used in synthesizing non-essential amino acids ; therefore , the cycle is amphibolic ( both catabolic and anabolic ) . 7.4 Oxidative Phosphorylation Learning Objectives By the end of this section , you will be able to :"}, {"question": {"question_id": "fs-id3026200", "question_text": "What compound receives electrons from NADH?", "question_choices": ["FMN", "ubiquinone", "cytochrome c1", "oxygen"], "cloze_format": "The ___ compound receives electrons from NADH.", "normal_format": "What compound receives electrons from NADH?"}, "answer": {"ans_text": "FMN", "ans_choice": 0}, "bloom": "2", "hl_sentences": "To start , two electrons are carried to the first complex aboard NADH . This complex , labeled I , is composed of flavin mononucleotide ( FMN ) and an iron-sulfur ( Fe-S ) - containing protein .", "hl_context": "<hl> To start , two electrons are carried to the first complex aboard NADH . <hl> <hl> This complex , labeled I , is composed of flavin mononucleotide ( FMN ) and an iron-sulfur ( Fe-S ) - containing protein . <hl> FMN , which is derived from vitamin B 2 , also called riboflavin , is one of several prosthetic groups or co-factors in the electron transport chain . A prosthetic group is a non-protein molecule required for the activity of a protein . Prosthetic groups are organic or inorganic , non-peptide molecules bound to a protein that facilitate its function ; prosthetic groups include co-enzymes , which are the prosthetic groups of enzymes . The enzyme in complex I is NADH dehydrogenase and is a very large protein , containing 45 amino acid chains . Complex I can pump four hydrogen ions across the membrane from the matrix into the intermembrane space , and it is in this way that the hydrogen ion gradient is established and maintained between the two compartments separated by the inner mitochondrial membrane ."}, {"question": {"question_id": "fs-id1770002", "question_text": "Chemiosmosis involves ________.", "question_choices": ["the movement of electrons across the cell membrane", "the movement of hydrogen atoms across a mitochondrial membrane", "the movement of hydrogen ions across a mitochondrial membrane", "the movement of glucose through the cell membrane"], "cloze_format": "Chemiosmosis involves ________.", "normal_format": "What does Chemiosmosis involve?"}, "answer": {"ans_text": "the movement of hydrogen ions across a mitochondrial membrane", "ans_choice": 2}, "bloom": null, "hl_sentences": "In chemiosmosis , the free energy from the series of redox reactions just described is used to pump hydrogen ions ( protons ) across the membrane .", "hl_context": "<hl> In chemiosmosis , the free energy from the series of redox reactions just described is used to pump hydrogen ions ( protons ) across the membrane . <hl> The uneven distribution of H + ions across the membrane establishes both concentration and electrical gradients ( thus , an electrochemical gradient ) , owing to the hydrogen ions \u2019 positive charge and their aggregation on one side of the membrane ."}, {"question": {"question_id": "fs-id2348312", "question_text": "Which of the following fermentation methods can occur in animal skeletal muscles?", "question_choices": ["lactic acid fermentation", "alcohol fermentation", "mixed acid fermentation", "propionic fermentation"], "cloze_format": "The fermentation method that can occur in animal skeletal muscles is ___ .", "normal_format": "Which of the following fermentation methods can occur in animal skeletal muscles?"}, "answer": {"ans_text": "lactic acid fermentation", "ans_choice": 0}, "bloom": "3", "hl_sentences": "The fermentation method used by animals and certain bacteria , like those in yogurt , is lactic acid fermentation ( Figure 7.14 ) . This type of fermentation is used routinely in mammalian red blood cells and in skeletal muscle that has an insufficient oxygen supply to allow aerobic respiration to continue ( that is , in muscles used to the point of fatigue ) .", "hl_context": "<hl> The fermentation method used by animals and certain bacteria , like those in yogurt , is lactic acid fermentation ( Figure 7.14 ) . <hl> <hl> This type of fermentation is used routinely in mammalian red blood cells and in skeletal muscle that has an insufficient oxygen supply to allow aerobic respiration to continue ( that is , in muscles used to the point of fatigue ) . <hl> In muscles , lactic acid accumulation must be removed by the blood circulation and the lactate brought to the liver for further metabolism . The chemical reactions of lactic acid fermentation are the following :"}, {"question": {"question_id": "fs-id2228167", "question_text": "A major connection for sugars in glycolysis is ________.", "question_choices": ["glucose-6-phosphate", "fructose-1,6-bisphosphate", "dihydroxyacetone phosphate", "phosphoenolpyruvate"], "cloze_format": "A major connection for sugars in glycolysis is ________.", "normal_format": "Which is a major connection for sugars in glycolysis?"}, "answer": {"ans_text": "glucose-6-phosphate", "ans_choice": 0}, "bloom": null, "hl_sentences": "In the second step of glycolysis , an isomerase converts glucose - 6 - phosphate into one of its isomers , fructose - 6 - phosphate . ( This change from phosphoglucose to phosphofructose allows the eventual split of the sugar into two three-carbon molecules . The first step in glycolysis ( Figure 7.6 ) is catalyzed by hexokinase , an enzyme with broad specificity that catalyzes the phosphorylation of six-carbon sugars . Hexokinase phosphorylates glucose using ATP as the source of the phosphate , producing glucose - 6 - phosphate , a more reactive form of glucose .", "hl_context": "Step 2 . <hl> In the second step of glycolysis , an isomerase converts glucose - 6 - phosphate into one of its isomers , fructose - 6 - phosphate . <hl> An isomerase is an enzyme that catalyzes the conversion of a molecule into one of its isomers . <hl> ( This change from phosphoglucose to phosphofructose allows the eventual split of the sugar into two three-carbon molecules . <hl> ) . Step 1 . <hl> The first step in glycolysis ( Figure 7.6 ) is catalyzed by hexokinase , an enzyme with broad specificity that catalyzes the phosphorylation of six-carbon sugars . <hl> <hl> Hexokinase phosphorylates glucose using ATP as the source of the phosphate , producing glucose - 6 - phosphate , a more reactive form of glucose . <hl> This reaction prevents the phosphorylated glucose molecule from continuing to interact with the GLUT proteins , and it can no longer leave the cell because the negatively charged phosphate will not allow it to cross the hydrophobic interior of the plasma membrane ."}, {"question": {"question_id": "fs-id2065416", "question_text": "Beta-oxidation is ________.", "question_choices": ["the breakdown of sugars", "the assembly of sugars", "the breakdown of fatty acids", "the removal of amino groups from amino acids"], "cloze_format": "Beta-oxidation is ________.", "normal_format": "What is beta-oxidation?"}, "answer": {"ans_text": "the breakdown of fatty acids", "ans_choice": 2}, "bloom": "2", "hl_sentences": "Fatty acids are catabolized in a process called beta-oxidation that takes place in the matrix of the mitochondria and converts their fatty acid chains into two carbon units of acetyl groups .", "hl_context": "Triglycerides are a form of long-term energy storage in animals . Triglycerides are made of glycerol and three fatty acids . Animals can make most of the fatty acids they need . Triglycerides can be both made and broken down through parts of the glucose catabolism pathways . Glycerol can be phosphorylated to glycerol - 3 - phosphate , which continues through glycolysis . <hl> Fatty acids are catabolized in a process called beta-oxidation that takes place in the matrix of the mitochondria and converts their fatty acid chains into two carbon units of acetyl groups . <hl> The acetyl groups are picked up by CoA to form acetyl CoA that proceeds into the citric acid cycle ."}, {"question": {"question_id": "fs-id1864534", "question_text": "The effect of high levels of ADP is to ________.", "question_choices": ["increase the activity of the enzyme", "decrease the activity of the enzyme", "have no effect on the activity of the enzyme", "slow down the pathway"], "cloze_format": "The effect of high levels of ADP is to ________.", "normal_format": "What is the effect of high levels of ADP?"}, "answer": {"ans_text": "increase the activity of the enzyme", "ans_choice": 0}, "bloom": null, "hl_sentences": "In this pathway , phosphofructokinase is a rate-limiting enzyme . It is active when the concentration of ADP is high ; it is less active when ADP levels are low and the concentration of ATP is high .", "hl_context": "Step 3 . The third step is the phosphorylation of fructose - 6 - phosphate , catalyzed by the enzyme phosphofructokinase . A second ATP molecule donates a high-energy phosphate to fructose - 6 - phosphate , producing fructose -1,6- bi sphosphate . <hl> In this pathway , phosphofructokinase is a rate-limiting enzyme . <hl> <hl> It is active when the concentration of ADP is high ; it is less active when ADP levels are low and the concentration of ATP is high . <hl> Thus , if there is \u201c sufficient \u201d ATP in the system , the pathway slows down . This is a type of end product inhibition , since ATP is the end product of glucose catabolism ."}, {"question": {"question_id": "fs-id2890387", "question_text": "The control of which enzyme exerts the most control on glycolysis?", "question_choices": ["hexokinase", "phosphofructokinase", "glucose-6-phosphatase", "aldolase"], "cloze_format": "The control of the ___ enzyme exerts the most control on glycolysis.", "normal_format": "The control of which enzyme exerts the most control on glycolysis?"}, "answer": {"ans_text": "phosphofructokinase", "ans_choice": 1}, "bloom": null, "hl_sentences": "Phosphofructokinase is the main enzyme controlled in glycolysis .", "hl_context": "<hl> Phosphofructokinase is the main enzyme controlled in glycolysis . <hl> High levels of ATP , citrate , or a lower , more acidic pH decrease the enzyme \u2019 s activity . An increase in citrate concentration can occur because of a blockage in the citric acid cycle . Fermentation , with its production of organic acids like lactic acid , frequently accounts for the increased acidity in a cell ; however , the products of fermentation do not typically accumulate in cells ."}], "summary": "", "keyterm": "", "bname": "biology"}, {"chapter": 18, "intro": " Chapter Objectives \n\n  After studying this chapter, you will be able to:\n\n Identify the primary functions of blood, its fluid and cellular components, and its physical characteristics \n\n Identify the most important proteins and other solutes present in blood plasma \n\n Describe the formation of the formed element components of blood \n\n Discuss the structure and function of red blood cells and hemoglobin \n\n Classify and characterize white blood cells \n\n Describe the structure of platelets and explain the process of hemostasis \n\n Explain the significance of AB and Rh blood groups in blood transfusions \n\n Discuss a variety of blood disorders \n\n Introduction  Single-celled organisms do not need blood. They obtain nutrients directly from and excrete wastes directly into their environment. The human organism cannot do that. Our large, complex bodies need blood to deliver nutrients to and remove wastes from our trillions of cells. The heart pumps blood throughout the body in a network of blood vessels. Together, these three components\u2014blood, heart, and vessels\u2014makes up the cardiovascular system. This chapter focuses on the medium of transport: blood. ", "chapter_text": " 18.1   An Overview of Blood  Learning Objectives By the end of this section, you will be able to: \n\n Identify the primary functions of blood in transportation, defense, and maintenance of homeostasis \n\n Name the fluid component of blood and the three major types of formed elements, and identify their relative proportions in a blood sample \n\n Discuss the unique physical characteristics of blood \n\n Identify the composition of blood plasma, including its most important solutes and plasma proteins \n\n Recall that  blood  is a connective tissue. Like all connective tissues, it is made up of cellular elements and an extracellular matrix. The cellular elements\u2014referred to as the  formed elements \u2014include  red blood cells (RBCs) ,  white blood cells (WBCs) , and cell fragments called  platelets . The extracellular matrix, called  plasma , makes blood unique among connective tissues because it is fluid. This fluid, which is mostly water, perpetually suspends the formed elements and enables them to circulate throughout the body within the cardiovascular system. \n\n Functions of Blood \n\n The primary function of blood is to deliver oxygen and nutrients to and remove wastes from body cells, but that is only the beginning of the story. The specific functions of blood also include defense, distribution of heat, and maintenance of homeostasis. \n\n Transportation \n\n Nutrients from the foods you eat are absorbed in the digestive tract. Most of these travel in the bloodstream directly to the liver, where they are processed and released back into the bloodstream for delivery to body cells. Oxygen from the air you breathe diffuses into the blood, which moves from the lungs to the heart, which then pumps it out to the rest of the body. Moreover, endocrine glands scattered throughout the body release their products, called hormones, into the bloodstream, which carries them to distant target cells. Blood also picks up cellular wastes and byproducts, and transports them to various organs for removal. For instance, blood moves carbon dioxide to the lungs for exhalation from the body, and various waste products are transported to the kidneys and liver for excretion from the body in the form of urine or bile. \n\n Defense \n\n Many types of WBCs protect the body from external threats, such as disease-causing bacteria that have entered the bloodstream in a wound. Other WBCs seek out and destroy internal threats, such as cells with mutated DNA that could multiply to become cancerous, or body cells infected with viruses. \n\n When damage to the vessels results in bleeding, blood platelets and certain proteins dissolved in the plasma, the fluid portion of the blood, interact to block the ruptured areas of the blood vessels involved. This protects the body from further blood loss. \n\n Maintenance of Homeostasis \n\n Recall that body temperature is regulated via a classic negative-feedback loop. If you were exercising on a warm day, your rising core body temperature would trigger several homeostatic mechanisms, including increased transport of blood from your core to your body periphery, which is typically cooler. As blood passes through the vessels of the skin, heat would be dissipated to the environment, and the blood returning to your body core would be cooler. In contrast, on a cold day, blood is diverted away from the skin to maintain a warmer body core. In extreme cases, this may result in frostbite. \n\n Blood also helps to maintain the chemical balance of the body. Proteins and other compounds in blood act as buffers, which thereby help to regulate the pH of body tissues. Blood also helps to regulate the water content of body cells. \n\n Composition of Blood \n\n You have probably had blood drawn from a superficial vein in your arm, which was then sent to a lab for analysis. Some of the most common blood tests\u2014for instance, those measuring lipid or glucose levels in plasma\u2014determine which substances are present within blood and in what quantities. Other blood tests check for the composition of the blood itself, including the quantities and types of formed elements. \n\n One such test, called a  hematocrit , measures the percentage of RBCs, clinically known as erythrocytes, in a blood sample. It is performed by spinning the blood sample in a specialized centrifuge, a process that causes the heavier elements suspended within the blood sample to separate from the lightweight, liquid plasma ( Figure 18.2 ). Because the heaviest elements in blood are the erythrocytes, these settle at the very bottom of the hematocrit tube. Located above the erythrocytes is a pale, thin layer composed of the remaining formed elements of blood. These are the WBCs, clinically known as leukocytes, and the platelets, cell fragments also called thrombocytes. This layer is referred to as the  buffy coat  because of its color; it normally constitutes less than 1 percent of a blood sample. Above the buffy coat is the blood plasma, normally a pale, straw-colored fluid, which constitutes the remainder of the sample. \n\n The volume of erythrocytes after centrifugation is also commonly referred to as  packed cell volume (PCV) . In normal blood, about 45 percent of a sample is erythrocytes. The hematocrit of any one sample can vary significantly, however, about 36\u201350 percent, according to gender and other factors. Normal hematocrit values for females range from 37 to 47, with a mean value of 41; for males, hematocrit ranges from 42 to 52, with a mean of 47. The percentage of other formed elements, the WBCs and platelets, is extremely small so it is not normally considered with the hematocrit. So the mean plasma percentage is the percent of blood that is not erythrocytes: for females, it is approximately 59 (or 100 minus 41), and for males, it is approximately 53 (or 100 minus 47). \n\n Characteristics of Blood \n\n When you think about blood, the first characteristic that probably comes to mind is its color. Blood that has just taken up oxygen in the lungs is bright red, and blood that has released oxygen in the tissues is a more dusky red. This is because hemoglobin is a pigment that changes color, depending upon the degree of oxygen saturation. \n\n Blood is viscous and somewhat sticky to the touch. It has a viscosity approximately five times greater than water. Viscosity is a measure of a fluid\u2019s thickness or resistance to flow, and is influenced by the presence of the plasma proteins and formed elements within the blood. The viscosity of blood has a dramatic impact on blood pressure and flow. Consider the difference in flow between water and honey. The more viscous honey would demonstrate a greater resistance to flow than the less viscous water. The same principle applies to blood. \n\n The normal temperature of blood is slightly higher than normal body temperature\u2014about 38 \u00b0C (or 100.4 \u00b0F), compared to 37 \u00b0C (or 98.6 \u00b0F) for an internal body temperature reading, although daily variations of 0.5 \u00b0C are normal. Although the surface of blood vessels is relatively smooth, as blood flows through them, it experiences some friction and resistance, especially as vessels age and lose their elasticity, thereby producing heat. This accounts for its slightly higher temperature. The pH of blood averages about 7.4; however, it can range from 7.35 to 7.45 in a healthy person. Blood is therefore somewhat more basic (alkaline) on a chemical scale than pure water, which has a pH of 7.0. Blood contains numerous buffers that actually help to regulate pH. \n\n Blood constitutes approximately 8 percent of adult body weight. Adult males typically average about 5 to 6 liters of blood. Females average 4\u20135 liters. \n\n Blood Plasma \n\n Like other fluids in the body, plasma is composed primarily of water: In fact, it is about 92 percent water. Dissolved or suspended within this water is a mixture of substances, most of which are proteins. There are literally hundreds of substances dissolved or suspended in the plasma, although many of them are found only in very small quantities. \n\n Interactive Link \n\n Visit this  site  for a list of normal levels established for many of the substances found in a sample of blood. Serum, one of the specimen types included, refers to a sample of plasma after clotting factors have been removed. What types of measurements are given for levels of glucose in the blood? Plasma Proteins \n\n About 7 percent of the volume of plasma\u2014nearly all that is not water\u2014is made of proteins. These include several plasma proteins (proteins that are unique to the plasma), plus a much smaller number of regulatory proteins, including enzymes and some hormones. The major components of plasma are summarized in  Figure 18.3 . \n\n The three major groups of plasma proteins are as follows: \n\n Albumin  is the most abundant of the plasma proteins. Manufactured by the liver, albumin molecules serve as binding proteins\u2014transport vehicles for fatty acids and steroid hormones. Recall that lipids are hydrophobic; however, their binding to albumin enables their transport in the watery plasma. Albumin is also the most significant contributor to the osmotic pressure of blood; that is, its presence holds water inside the blood vessels and draws water from the tissues, across blood vessel walls, and into the bloodstream. This in turn helps to maintain both blood volume and blood pressure. Albumin normally accounts for approximately 54 percent of the total plasma protein content, in clinical levels of 3.5\u20135.0 g/dL blood. \n\n The second most common plasma proteins are the  globulins . A heterogeneous group, there are three main subgroups known as alpha, beta, and gamma globulins. The alpha and beta globulins transport iron, lipids, and the fat-soluble vitamins A, D, E, and K to the cells; like albumin, they also contribute to osmotic pressure. The gamma globulins are proteins involved in immunity and are better known as an  antibodies  or  immunoglobulins . Although other plasma proteins are produced by the liver, immunoglobulins are produced by specialized leukocytes known as plasma cells. (Seek additional content for more information about immunoglobulins.) Globulins make up approximately 38 percent of the total plasma protein volume, in clinical levels of 1.0\u20131.5 g/dL blood. \n\n The least abundant plasma protein is  fibrinogen . Like albumin and the alpha and beta globulins, fibrinogen is produced by the liver. It is essential for blood clotting, a process described later in this chapter. Fibrinogen accounts for about 7 percent of the total plasma protein volume, in clinical levels of 0.2\u20130.45 g/dL blood. \n\n Other Plasma Solutes \n\n In addition to proteins, plasma contains a wide variety of other substances. These include various electrolytes, such as sodium, potassium, and calcium ions; dissolved gases, such as oxygen, carbon dioxide, and nitrogen; various organic nutrients, such as vitamins, lipids, glucose, and amino acids; and metabolic wastes. All of these nonprotein solutes combined contribute approximately 1 percent to the total volume of plasma. \n\n Career Connection Phlebotomy and Medical Lab Technology \n\n Phlebotomists are professionals trained to draw blood (phleb- = \u201ca blood vessel\u201d; -tomy = \u201cto cut\u201d). When more than a few drops of blood are required, phlebotomists perform a venipuncture, typically of a surface vein in the arm. They perform a capillary stick on a finger, an earlobe, or the heel of an infant when only a small quantity of blood is required. An arterial stick is collected from an artery and used to analyze blood gases. After collection, the blood may be analyzed by medical laboratories or perhaps used for transfusions, donations, or research. While many allied health professionals practice phlebotomy, the American Society of Phlebotomy Technicians issues certificates to individuals passing a national examination, and some large labs and hospitals hire individuals expressly for their skill in phlebotomy. Medical or clinical laboratories employ a variety of individuals in technical positions: \n\n Medical technologists (MT), also known as clinical laboratory technologists (CLT), typically hold a bachelor\u2019s degree and certification from an accredited training program. They perform a wide variety of tests on various body fluids, including blood. The information they provide is essential to the primary care providers in determining a diagnosis and in monitoring the course of a disease and response to treatment. \n\n Medical laboratory technicians (MLT) typically have an associate\u2019s degree but may perform duties similar to those of an MT. \n\n Medical laboratory assistants (MLA) spend the majority of their time processing samples and carrying out routine assignments within the lab. Clinical training is required, but a degree may not be essential to obtaining a position. \n 18.2   Production of the Formed Elements  Learning Objectives By the end of this section, you will be able to: \n\n Trace the generation of the formed elements of blood from bone marrow stem cells \n\n Discuss the role of hemopoietic growth factors in promoting the production of the formed elements \n\n The lifespan of the formed elements is very brief. Although one type of leukocyte called memory cells can survive for years, most erythrocytes, leukocytes, and platelets normally live only a few hours to a few weeks. Thus, the body must form new blood cells and platelets quickly and continuously. When you donate a unit of blood during a blood drive (approximately 475 mL, or about 1 pint), your body typically replaces the donated plasma within 24 hours, but it takes about 4 to 6 weeks to replace the blood cells. This restricts the frequency with which donors can contribute their blood. The process by which this replacement occurs is called  hemopoiesis , or hematopoiesis (from the Greek root haima- = \u201cblood\u201d; -poiesis = \u201cproduction\u201d). \n\n Sites of Hemopoiesis \n\n Prior to birth, hemopoiesis occurs in a number of tissues, beginning with the yolk sac of the developing embryo, and continuing in the fetal liver, spleen, lymphatic tissue, and eventually the red bone marrow. Following birth, most hemopoiesis occurs in the red marrow, a connective tissue within the spaces of spongy (cancellous) bone tissue. In children, hemopoiesis can occur in the medullary cavity of long bones; in adults, the process is largely restricted to the cranial and pelvic bones, the vertebrae, the sternum, and the proximal epiphyses of the femur and humerus. \n\n Throughout adulthood, the liver and spleen maintain their ability to generate the formed elements. This process is referred to as extramedullary hemopoiesis (meaning hemopoiesis outside the medullary cavity of adult bones). When a disease such as bone cancer destroys the bone marrow, causing hemopoiesis to fail, extramedullary hemopoiesis may be initiated. \n\n Differentiation of Formed Elements from Stem Cells \n\n All formed elements arise from stem cells of the red bone marrow. Recall that stem cells undergo mitosis plus cytokinesis (cellular division) to give rise to new daughter cells: One of these remains a stem cell and the other differentiates into one of any number of diverse cell types. Stem cells may be viewed as occupying a hierarchal system, with some loss of the ability to diversify at each step. The  totipotent stem cell  is the zygote, or fertilized egg. The totipotent (toti- = \u201call\u201d) stem cell gives rise to all cells of the human body. The next level is the  pluripotent stem cell , which gives rise to multiple types of cells of the body and some of the supporting fetal membranes. Beneath this level, the mesenchymal cell is a stem cell that develops only into types of connective tissue, including fibrous connective tissue, bone, cartilage, and blood, but not epithelium, muscle, and nervous tissue. One step lower on the hierarchy of stem cells is the  hematopoietic stem cell , or  hemocytoblast . All of the formed elements of blood originate from this specific type of cell. \n\n Hemopoiesis begins when the hematopoietic stem cell is exposed to appropriate chemical stimuli collectively called  hemopoietic growth factors , which prompt it to divide and differentiate. One daughter cell remains a hematopoietic stem cell, allowing hemopoiesis to continue. The other daughter cell becomes either of two types of more specialized stem cells ( Figure 18.4 ): \n\n Lymphoid stem cells  give rise to a class of leukocytes known as lymphocytes, which include the various T cells, B cells, and natural killer (NK) cells, all of which function in immunity. However, hemopoiesis of lymphocytes progresses somewhat differently from the process for the other formed elements. In brief, lymphoid stem cells quickly migrate from the bone marrow to lymphatic tissues, including the lymph nodes, spleen, and thymus, where their production and differentiation continues. B cells are so named since they mature in the bone marrow, while T cells mature in the thymus. \n\n Myeloid stem cells  give rise to all the other formed elements, including the erythrocytes; megakaryocytes that produce platelets; and a myeloblast lineage that gives rise to monocytes and three forms of granular leukocytes: neutrophils, eosinophils, and basophils. \n\n Lymphoid and myeloid stem cells do not immediately divide and differentiate into mature formed elements. As you can see in  Figure 18.4 , there are several intermediate stages of precursor cells (literally, forerunner cells), many of which can be recognized by their names, which have the suffix -blast. For instance, megakaryoblasts are the precursors of megakaryocytes, and proerythroblasts become reticulocytes, which eject their nucleus and most other organelles before maturing into erythrocytes. \n\n Hemopoietic Growth Factors Development from stem cells to precursor cells to mature cells is again initiated by hemopoietic growth factors. These include the following: \n\n Erythropoietin (EPO)  is a glycoprotein hormone secreted by the interstitial fibroblast cells of the kidneys in response to low oxygen levels. It prompts the production of erythrocytes. Some athletes use synthetic EPO as a performance-enhancing drug (called blood doping) to increase RBC counts and subsequently increase oxygen delivery to tissues throughout the body. EPO is a banned substance in most organized sports, but it is also used medically in the treatment of certain anemia, specifically those triggered by certain types of cancer, and other disorders in which increased erythrocyte counts and oxygen levels are desirable. \n\n Thrombopoietin , another glycoprotein hormone, is produced by the liver and kidneys. It triggers the development of megakaryocytes into platelets. \n\n Cytokines  are glycoproteins secreted by a wide variety of cells, including red bone marrow, leukocytes, macrophages, fibroblasts, and endothelial cells. They act locally as autocrine or paracrine factors, stimulating the proliferation of progenitor cells and helping to stimulate both nonspecific and specific resistance to disease. There are two major subtypes of cytokines known as colony-stimulating factors and interleukins.\n\n     Colony-stimulating factors (CSFs)  are glycoproteins that act locally, as autocrine or paracrine factors. Some trigger the differentiation of myeloblasts into granular leukocytes, namely, neutrophils, eosinophils, and basophils. These are referred to as granulocyte CSFs. A different CSF induces the production of monocytes, called monocyte CSFs. Both granulocytes and monocytes are stimulated by GM-CSF; granulocytes, monocytes, platelets, and erythrocytes are stimulated by multi-CSF. Synthetic forms of these hormones are often administered to patients with various forms of cancer who are receiving chemotherapy to revive their WBC counts. \n\n Interleukins  are another class of cytokine signaling molecules important in hemopoiesis. They were initially thought to be secreted uniquely by leukocytes and to communicate only with other leukocytes, and were named accordingly, but are now known to be produced by a variety of cells including bone marrow and endothelium. Researchers now suspect that interleukins may play other roles in body functioning, including differentiation and maturation of cells, producing immunity and inflammation. To date, more than a dozen interleukins have been identified, with others likely to follow. They are generally numbered IL-1, IL-2, IL-3, etc. \n\n Everyday Connection Blood Doping \n\nIn its original intent, the term blood doping was used to describe the practice of injecting by transfusion supplemental RBCs into an individual, typically to enhance performance in a sport. Additional RBCs would deliver more oxygen to the tissues, providing extra aerobic capacity, clinically referred to as VO 2  max. The source of the cells was either from the recipient (autologous) or from a donor with compatible blood (homologous). This practice was aided by the well-developed techniques of harvesting, concentrating, and freezing of the RBCs that could be later thawed and injected, yet still retain their functionality. These practices are considered illegal in virtually all sports and run the risk of infection, significantly increasing the viscosity of the blood and the potential for transmission of blood-borne pathogens if the blood was collected from another individual. \n\n With the development of synthetic EPO in the 1980s, it became possible to provide additional RBCs by artificially stimulating RBC production in the bone marrow. Originally developed to treat patients suffering from anemia, renal failure, or cancer treatment, large quantities of EPO can be generated by recombinant DNA technology. Synthetic EPO is injected under the skin and can increase hematocrit for many weeks. It may also induce polycythemia and raise hematocrit to 70 or greater. This increased viscosity raises the resistance of the blood and forces the heart to pump more powerfully; in extreme cases, it has resulted in death. Other drugs such as cobalt II chloride have been shown to increase natural EPO gene expression. Blood doping has become problematic in many sports, especially cycling. Lance Armstrong, winner of seven Tour de France and many other cycling titles, was stripped of his victories and admitted to blood doping in 2013. \n\n Interactive Link \n\n Watch this  video  to see doctors discuss the dangers of blood doping in sports. What are the some potential side effects of blood doping? \n\n Bone Marrow Sampling and Transplants \n\n Sometimes, a healthcare provider will order a  bone marrow biopsy , a diagnostic test of a sample of red bone marrow, or a  bone marrow transplant , a treatment in which a donor\u2019s healthy bone marrow\u2014and its stem cells\u2014replaces the faulty bone marrow of a patient. These tests and procedures are often used to assist in the diagnosis and treatment of various severe forms of anemia, such as thalassemia major and sickle cell anemia, as well as some types of cancer, specifically leukemia. \n\n In the past, when a bone marrow sample or transplant was necessary, the procedure would have required inserting a large-bore needle into the region near the iliac crest of the pelvic bones (os coxae). This location was preferred, since its location close to the body surface makes it more accessible, and it is relatively isolated from most vital organs. Unfortunately, the procedure is quite painful. \n\n Now, direct sampling of bone marrow can often be avoided. In many cases, stem cells can be isolated in just a few hours from a sample of a patient\u2019s blood. The isolated stem cells are then grown in culture using the appropriate hemopoietic growth factors, and analyzed or sometimes frozen for later use. \n\n For an individual requiring a transplant, a matching donor is essential to prevent the immune system from destroying the donor cells\u2014a phenomenon known as tissue rejection. To treat patients with bone marrow transplants, it is first necessary to destroy the patient\u2019s own diseased marrow through radiation and/or chemotherapy. Donor bone marrow stem cells are then intravenously infused. From the bloodstream, they establish themselves in the recipient\u2019s bone marrow. \n 18.3   Erythrocytes  Learning Objectives By the end of this section, you will be able to: \n\n Describe the anatomy of erythrocytes \n\n Discuss the various steps in the lifecycle of an erythrocyte \n\n Explain the composition and function of hemoglobin \n\n The  erythrocyte , commonly known as a red blood cell (or RBC), is by far the most common formed element: A single drop of blood contains millions of erythrocytes and just thousands of leukocytes. Specifically, males have about 5.4 million erythrocytes per microliter ( \u00b5 L) of blood, and females have approximately 4.8 million per  \u00b5 L. In fact, erythrocytes are estimated to make up about 25 percent of the total cells in the body. As you can imagine, they are quite small cells, with a mean diameter of only about 7\u20138 micrometers ( \u00b5 m) ( Figure 18.5 ). The primary functions of erythrocytes are to pick up inhaled oxygen from the lungs and transport it to the body\u2019s tissues, and to pick up some (about 24 percent) carbon dioxide waste at the tissues and transport it to the lungs for exhalation. Erythrocytes remain within the vascular network. Although leukocytes typically leave the blood vessels to perform their defensive functions, movement of erythrocytes from the blood vessels is abnormal. \n\n Shape and Structure of Erythrocytes \n\n As an erythrocyte matures in the red bone marrow, it extrudes its nucleus and most of its other organelles. During the first day or two that it is in the circulation, an immature erythrocyte, known as a  reticulocyte , will still typically contain remnants of organelles. Reticulocytes should comprise approximately 1\u20132 percent of the erythrocyte count and provide a rough estimate of the rate of RBC production, with abnormally low or high rates indicating deviations in the production of these cells. These remnants, primarily of networks (reticulum) of ribosomes, are quickly shed, however, and mature, circulating erythrocytes have few internal cellular structural components. Lacking mitochondria, for example, they rely on anaerobic respiration. This means that they do not utilize any of the oxygen they are transporting, so they can deliver it all to the tissues. They also lack endoplasmic reticula and do not synthesize proteins. Erythrocytes do, however, contain some structural proteins that help the blood cells maintain their unique structure and enable them to change their shape to squeeze through capillaries. This includes the protein spectrin, a cytoskeletal protein element. \n\n Erythrocytes are biconcave disks; that is, they are plump at their periphery and very thin in the center ( Figure 18.6 ). Since they lack most organelles, there is more interior space for the presence of the hemoglobin molecules that, as you will see shortly, transport gases. The biconcave shape also provides a greater surface area across which gas exchange can occur, relative to its volume; a sphere of a similar diameter would have a lower surface area-to-volume ratio. In the capillaries, the oxygen carried by the erythrocytes can diffuse into the plasma and then through the capillary walls to reach the cells, whereas some of the carbon dioxide produced by the cells as a waste product diffuses into the capillaries to be picked up by the erythrocytes. Capillary beds are extremely narrow, slowing the passage of the erythrocytes and providing an extended opportunity for gas exchange to occur. However, the space within capillaries can be so minute that, despite their own small size, erythrocytes may have to fold in on themselves if they are to make their way through. Fortunately, their structural proteins like spectrin are flexible, allowing them to bend over themselves to a surprising degree, then spring back again when they enter a wider vessel. In wider vessels, erythrocytes may stack up much like a roll of coins, forming a rouleaux, from the French word for \u201croll.\u201d \n\n Hemoglobin \n\n Hemoglobin  is a large molecule made up of proteins and iron. It consists of four folded chains of a protein called  globin , designated alpha 1 and 2, and beta 1 and 2 ( Figure 18.7 a ). Each of these globin molecules is bound to a red pigment molecule called  heme , which contains an ion of iron (Fe 2+ ) ( Figure 18.7 b ). Each iron ion in the heme can bind to one oxygen molecule; therefore, each hemoglobin molecule can transport four oxygen molecules. An individual erythrocyte may contain about 300 million hemoglobin molecules, and therefore can bind to and transport up to 1.2 billion oxygen molecules (see  Figure 18.7 b ). \n\n In the lungs, hemoglobin picks up oxygen, which binds to the iron ions, forming  oxyhemoglobin . The bright red, oxygenated hemoglobin travels to the body tissues, where it releases some of the oxygen molecules, becoming darker red  deoxyhemoglobin , sometimes referred to as reduced hemoglobin. Oxygen release depends on the need for oxygen in the surrounding tissues, so hemoglobin rarely if ever leaves all of its oxygen behind. In the capillaries, carbon dioxide enters the bloodstream. About 76 percent dissolves in the plasma, some of it remaining as dissolved CO 2 , and the remainder forming bicarbonate ion. About 23\u201324 percent of it binds to the amino acids in hemoglobin, forming a molecule known as  carbaminohemoglobin . From the capillaries, the hemoglobin carries carbon dioxide back to the lungs, where it releases it for exchange of oxygen. \n\n Changes in the levels of RBCs can have significant effects on the body\u2019s ability to effectively deliver oxygen to the tissues. Ineffective hematopoiesis results in insufficient numbers of RBCs and results in one of several forms of anemia. An overproduction of RBCs produces a condition called polycythemia. The primary drawback with polycythemia is not a failure to directly deliver enough oxygen to the tissues, but rather the increased viscosity of the blood, which makes it more difficult for the heart to circulate the blood. \n\n In patients with insufficient hemoglobin, the tissues may not receive sufficient oxygen, resulting in another form of anemia. In determining oxygenation of tissues, the value of greatest interest in healthcare is the percent saturation; that is, the percentage of hemoglobin sites occupied by oxygen in a patient\u2019s blood. Clinically this value is commonly referred to simply as \u201cpercent sat.\u201d \n\n Percent saturation is normally monitored using a device known as a pulse oximeter, which is applied to a thin part of the body, typically the tip of the patient\u2019s finger. The device works by sending two different wavelengths of light (one red, the other infrared) through the finger and measuring the light with a photodetector as it exits. Hemoglobin absorbs light differentially depending upon its saturation with oxygen. The machine calibrates the amount of light received by the photodetector against the amount absorbed by the partially oxygenated hemoglobin and presents the data as percent saturation. Normal pulse oximeter readings range from 95\u2013100 percent. Lower percentages reflect  hypoxemia , or low blood oxygen. The term hypoxia is more generic and simply refers to low oxygen levels. Oxygen levels are also directly monitored from free oxygen in the plasma typically following an arterial stick. When this method is applied, the amount of oxygen present is expressed in terms of partial pressure of oxygen or simply P O2  or PO2 and is typically recorded in units of millimeters of mercury, mm Hg. \n\n The kidneys filter about 180 liters (~380 pints) of blood in an average adult each day, or about 20 percent of the total resting volume, and thus serve as ideal sites for receptors that determine oxygen saturation. In response to hypoxemia, less oxygen will exit the vessels supplying the kidney, resulting in hypoxia (low oxygen concentration) in the tissue fluid of the kidney where oxygen concentration is actually monitored. Interstitial fibroblasts within the kidney secrete EPO, thereby increasing erythrocyte production and restoring oxygen levels. In a classic negative-feedback loop, as oxygen saturation rises, EPO secretion falls, and vice versa, thereby maintaining homeostasis. Populations dwelling at high elevations, with inherently lower levels of oxygen in the atmosphere, naturally maintain a hematocrit higher than people living at sea level. Consequently, people traveling to high elevations may experience symptoms of hypoxemia, such as fatigue, headache, and shortness of breath, for a few days after their arrival. In response to the hypoxemia, the kidneys secrete EPO to step up the production of erythrocytes until homeostasis is achieved once again. To avoid the symptoms of hypoxemia, or altitude sickness, mountain climbers typically rest for several days to a week or more at a series of camps situated at increasing elevations to allow EPO levels and, consequently, erythrocyte counts to rise. When climbing the tallest peaks, such as Mt. Everest and K2 in the Himalayas, many mountain climbers rely upon bottled oxygen as they near the summit. \n\n Lifecycle of Erythrocytes \n\n Production of erythrocytes in the marrow occurs at the staggering rate of more than 2 million cells per second. For this production to occur, a number of raw materials must be present in adequate amounts. These include the same nutrients that are essential to the production and maintenance of any cell, such as glucose, lipids, and amino acids. However, erythrocyte production also requires several trace elements: \n\n Iron. We have said that each heme group in a hemoglobin molecule contains an ion of the trace mineral iron. On average, less than 20 percent of the iron we consume is absorbed. Heme iron, from animal foods such as meat, poultry, and fish, is absorbed more efficiently than non-heme iron from plant foods. Upon absorption, iron becomes part of the body\u2019s total iron pool. The bone marrow, liver, and spleen can store iron in the protein compounds  ferritin  and  hemosiderin . Ferroportin transports the iron across the intestinal cell plasma membranes and from its storage sites into tissue fluid where it enters the blood. When EPO stimulates the production of erythrocytes, iron is released from storage, bound to transferrin, and carried to the red marrow where it attaches to erythrocyte precursors. \n\n Copper. A trace mineral, copper is a component of two plasma proteins, hephaestin and ceruloplasmin. Without these, hemoglobin could not be adequately produced. Located in intestinal villi, hephaestin enables iron to be absorbed by intestinal cells. Ceruloplasmin transports copper. Both enable the oxidation of iron from Fe 2+  to Fe 3+ , a form in which it can be bound to its transport protein,  transferrin , for transport to body cells. In a state of copper deficiency, the transport of iron for heme synthesis decreases, and iron can accumulate in tissues, where it can eventually lead to organ damage. \n\n Zinc. The trace mineral zinc functions as a co-enzyme that facilitates the synthesis of the heme portion of hemoglobin. \n\n B vitamins. The B vitamins folate and vitamin B 12  function as co-enzymes that facilitate DNA synthesis. Thus, both are critical for the synthesis of new cells, including erythrocytes. \n\n Erythrocytes live up to 120 days in the circulation, after which the worn-out cells are removed by a type of myeloid phagocytic cell called a  macrophage , located primarily within the bone marrow, liver, and spleen. The components of the degraded erythrocytes\u2019 hemoglobin are further processed as follows: \n\n Globin, the protein portion of hemoglobin, is broken down into amino acids, which can be sent back to the bone marrow to be used in the production of new erythrocytes. Hemoglobin that is not phagocytized is broken down in the circulation, releasing alpha and beta chains that are removed from circulation by the kidneys. \n\n The iron contained in the heme portion of hemoglobin may be stored in the liver or spleen, primarily in the form of ferritin or hemosiderin, or carried through the bloodstream by transferrin to the red bone marrow for recycling into new erythrocytes. \n\n The non-iron portion of heme is degraded into the waste product  biliverdin , a green pigment, and then into another waste product,  bilirubin , a yellow pigment. Bilirubin binds to albumin and travels in the blood to the liver, which uses it in the manufacture of bile, a compound released into the intestines to help emulsify dietary fats. In the large intestine, bacteria breaks the bilirubin apart from the bile and converts it to urobilinogen and then into stercobilin. It is then eliminated from the body in the feces. Broad-spectrum antibiotics typically eliminate these bacteria as well and may alter the color of feces. The kidneys also remove any circulating bilirubin and other related metabolic byproducts such as urobilins and secrete them into the urine. \n\n The breakdown pigments formed from the destruction of hemoglobin can be seen in a variety of situations. At the site of an injury, biliverdin from damaged RBCs produces some of the dramatic colors associated with bruising. With a failing liver, bilirubin cannot be removed effectively from circulation and causes the body to assume a yellowish tinge associated with jaundice. Stercobilins within the feces produce the typical brown color associated with this waste. And the yellow of urine is associated with the urobilins. \n\n The erythrocyte lifecycle is summarized in  Figure 18.8 . \n\n Disorders of Erythrocytes The size, shape, and number of erythrocytes, and the number of hemoglobin molecules can have a major impact on a person\u2019s health. When the number of RBCs or hemoglobin is deficient, the general condition is called  anemia . There are more than 400 types of anemia and more than 3.5 million Americans suffer from this condition. Anemia can be broken down into three major groups: those caused by blood loss, those caused by faulty or decreased RBC production, and those caused by excessive destruction of RBCs. Clinicians often use two groupings in diagnosis: The kinetic approach focuses on evaluating the production, destruction, and removal of RBCs, whereas the morphological approach examines the RBCs themselves, paying particular emphasis to their size. A common test is the mean corpuscle volume (MCV), which measures size. Normal-sized cells are referred to as normocytic, smaller-than-normal cells are referred to as microcytic, and larger-than-normal cells are referred to as macrocytic. Reticulocyte counts are also important and may reveal inadequate production of RBCs. The effects of the various anemias are widespread, because reduced numbers of RBCs or hemoglobin will result in lower levels of oxygen being delivered to body tissues. Since oxygen is required for tissue functioning, anemia produces fatigue, lethargy, and an increased risk for infection. An oxygen deficit in the brain impairs the ability to think clearly, and may prompt headaches and irritability. Lack of oxygen leaves the patient short of breath, even as the heart and lungs work harder in response to the deficit. \n\n Blood loss anemias are fairly straightforward. In addition to bleeding from wounds or other lesions, these forms of anemia may be due to ulcers, hemorrhoids, inflammation of the stomach (gastritis), and some cancers of the gastrointestinal tract. The excessive use of aspirin or other nonsteroidal anti-inflammatory drugs such as ibuprofen can trigger ulceration and gastritis. Excessive menstruation and loss of blood during childbirth are also potential causes. \n\n Anemias caused by faulty or decreased RBC production include sickle cell anemia, iron deficiency anemia, vitamin deficiency anemia, and diseases of the bone marrow and stem cells. \n\n A characteristic change in the shape of erythrocytes is seen in  sickle cell disease  (also referred to as sickle cell anemia). A genetic disorder, it is caused by production of an abnormal type of hemoglobin, called hemoglobin S, which delivers less oxygen to tissues and causes erythrocytes to assume a sickle (or crescent) shape, especially at low oxygen concentrations ( Figure 18.9 ). These abnormally shaped cells can then become lodged in narrow capillaries because they are unable to fold in on themselves to squeeze through, blocking blood flow to tissues and causing a variety of serious problems from painful joints to delayed growth and even blindness and cerebrovascular accidents (strokes). Sickle cell anemia is a genetic condition particularly found in individuals of African descent. \n\n Iron deficiency anemia is the most common type and results when the amount of available iron is insufficient to allow production of sufficient heme. This condition can occur in individuals with a deficiency of iron in the diet and is especially common in teens and children as well as in vegans and vegetarians. Additionally, iron deficiency anemia may be caused by either an inability to absorb and transport iron or slow, chronic bleeding. \n\n Vitamin-deficient anemias generally involve insufficient vitamin B12 and folate.\n\n        Megaloblastic anemia involves a deficiency of vitamin B12 and/or folate, and often involves diets deficient in these essential nutrients. Lack of meat or a viable alternate source, and overcooking or eating insufficient amounts of vegetables may lead to a lack of folate.\n\n     \n\n Pernicious anemia is caused by poor absorption of vitamin B12 and is often seen in patients with Crohn\u2019s disease (a severe intestinal disorder often treated by surgery), surgical removal of the intestines or stomach (common in some weight loss surgeries), intestinal parasites, and AIDS. \n\n Pregnancies, some medications, excessive alcohol consumption, and some diseases such as celiac disease are also associated with vitamin deficiencies. It is essential to provide sufficient folic acid during the early stages of pregnancy to reduce the risk of neurological defects, including spina bifida, a failure of the neural tube to close. \n\n Assorted disease processes can also interfere with the production and formation of RBCs and hemoglobin. If myeloid stem cells are defective or replaced by cancer cells, there will be insufficient quantities of RBCs produced.\n\n Aplastic anemia is the condition in which there are deficient numbers of RBC stem cells. Aplastic anemia is often inherited, or it may be triggered by radiation, medication, chemotherapy, or infection. \n\n Thalassemia  is an inherited condition typically occurring in individuals from the Middle East, the Mediterranean, African, and Southeast Asia, in which maturation of the RBCs does not proceed normally. The most severe form is called Cooley\u2019s anemia. \n\n Lead exposure from industrial sources or even dust from paint chips of iron-containing paints or pottery that has not been properly glazed may also lead to destruction of the red marrow. \n\n Various disease processes also can lead to anemias. These include chronic kidney diseases often associated with a decreased production of EPO, hypothyroidism, some forms of cancer, lupus, and rheumatoid arthritis. \n\n In contrast to anemia, an elevated RBC count is called  polycythemia  and is detected in a patient\u2019s elevated hematocrit. It can occur transiently in a person who is dehydrated; when water intake is inadequate or water losses are excessive, the plasma volume falls. As a result, the hematocrit rises. For reasons mentioned earlier, a mild form of polycythemia is chronic but normal in people living at high altitudes. Some elite athletes train at high elevations specifically to induce this phenomenon. Finally, a type of bone marrow disease called polycythemia vera (from the Greek vera = \u201ctrue\u201d) causes an excessive production of immature erythrocytes. Polycythemia vera can dangerously elevate the viscosity of blood, raising blood pressure and making it more difficult for the heart to pump blood throughout the body. It is a relatively rare disease that occurs more often in men than women, and is more likely to be present in elderly patients those over 60 years of age. \n 18.4   Leukocytes and Platelets  Learning Objectives By the end of this section, you will be able to: \n\n Describe the general characteristics of leukocytes \n\n Classify leukocytes according to their lineage, their main structural features, and their primary functions \n\n Discuss the most common malignancies involving leukocytes \n\n Identify the lineage, basic structure, and function of platelets \n\n The  leukocyte , commonly known as a white blood cell (or WBC), is a major component of the body\u2019s defenses against disease. Leukocytes protect the body against invading microorganisms and body cells with mutated DNA, and they clean up debris. Platelets are essential for the repair of blood vessels when damage to them has occurred; they also provide growth factors for healing and repair. See  Figure 18.5  for a summary of leukocytes and platelets. Characteristics of Leukocytes \n\n Although leukocytes and erythrocytes both originate from hematopoietic stem cells in the bone marrow, they are very different from each other in many significant ways. For instance, leukocytes are far less numerous than erythrocytes: Typically there are only 5000 to 10,000 per  \u00b5 L. They are also larger than erythrocytes and are the only formed elements that are complete cells, possessing a nucleus and organelles. And although there is just one type of erythrocyte, there are many types of leukocytes. Most of these types have a much shorter lifespan than that of erythrocytes, some as short as a few hours or even a few minutes in the case of acute infection. \n\n One of the most distinctive characteristics of leukocytes is their movement. Whereas erythrocytes spend their days circulating within the blood vessels, leukocytes routinely leave the bloodstream to perform their defensive functions in the body\u2019s tissues. For leukocytes, the vascular network is simply a highway they travel and soon exit to reach their true destination. When they arrive, they are often given distinct names, such as macrophage or microglia, depending on their function. As shown in  Figure 18.10 , they leave the capillaries\u2014the smallest blood vessels\u2014or other small vessels through a process known as  emigration  (from the Latin for \u201cremoval\u201d) or  diapedesis  (dia- = \u201cthrough\u201d; -pedan = \u201cto leap\u201d) in which they squeeze through adjacent cells in a blood vessel wall. \n\n Once they have exited the capillaries, some leukocytes will take up fixed positions in lymphatic tissue, bone marrow, the spleen, the thymus, or other organs. Others will move about through the tissue spaces very much like amoebas, continuously extending their plasma membranes, sometimes wandering freely, and sometimes moving toward the direction in which they are drawn by chemical signals. This attracting of leukocytes occurs because of  positive chemotaxis  (literally \u201cmovement in response to chemicals\u201d), a phenomenon in which injured or infected cells and nearby leukocytes emit the equivalent of a chemical \u201c911\u201d call, attracting more leukocytes to the site. In clinical medicine, the differential counts of the types and percentages of leukocytes present are often key indicators in making a diagnosis and selecting a treatment. \n\n Classification of Leukocytes \n\n When scientists first began to observe stained blood slides, it quickly became evident that leukocytes could be divided into two groups, according to whether their cytoplasm contained highly visible granules: \n\n Granular leukocytes  contain abundant granules within the cytoplasm. They include neutrophils, eosinophils, and basophils (you can view their lineage from myeloid stem cells in  Figure 18.4 ). \n\n While granules are not totally lacking in  agranular leukocytes , they are far fewer and less obvious. Agranular leukocytes include monocytes, which mature into macrophages that are phagocytic, and lymphocytes, which arise from the lymphoid stem cell line. \n\n Granular Leukocytes \n\n We will consider the granular leukocytes in order from most common to least common. All of these are produced in the red bone marrow and have a short lifespan of hours to days. They typically have a lobed nucleus and are classified according to which type of stain best highlights their granules ( Figure 18.11 ). \n\n The most common of all the leukocytes,  neutrophils  will normally comprise 50\u201370 percent of total leukocyte count. They are 10\u201312  \u00b5 m in diameter, significantly larger than erythrocytes. They are called neutrophils because their granules show up most clearly with stains that are chemically neutral (neither acidic nor basic). The granules are numerous but quite fine and normally appear light lilac. The nucleus has a distinct lobed appearance and may have two to five lobes, the number increasing with the age of the cell. Older neutrophils have increasing numbers of lobes and are often referred to as  polymorphonuclear  (a nucleus with many forms), or simply \u201cpolys.\u201d Younger and immature neutrophils begin to develop lobes and are known as \u201cbands.\u201d \n\n Neutrophils are rapid responders to the site of infection and are efficient phagocytes with a preference for bacteria. Their granules include  lysozyme , an enzyme capable of lysing, or breaking down, bacterial cell walls; oxidants such as hydrogen peroxide; and  defensins , proteins that bind to and puncture bacterial and fungal plasma membranes, so that the cell contents leak out. Abnormally high counts of neutrophils indicate infection and/or inflammation, particularly triggered by bacteria, but are also found in burn patients and others experiencing unusual stress. A burn injury increases the proliferation of neutrophils in order to fight off infection that can result from the destruction of the barrier of the skin. Low counts may be caused by drug toxicity and other disorders, and may increase an individual\u2019s susceptibility to infection. \n\n Eosinophils  typically represent 2\u20134 percent of total leukocyte count. They are also 10\u201312  \u00b5 m in diameter. The granules of eosinophils stain best with an acidic stain known as eosin. The nucleus of the eosinophil will typically have two to three lobes and, if stained properly, the granules will have a distinct red to orange color. \n\n The granules of eosinophils include antihistamine molecules, which counteract the activities of histamines, inflammatory chemicals produced by basophils and mast cells. Some eosinophil granules contain molecules toxic to parasitic worms, which can enter the body through the integument, or when an individual consumes raw or undercooked fish or meat. Eosinophils are also capable of phagocytosis and are particularly effective when antibodies bind to the target and form an antigen-antibody complex. High counts of eosinophils are typical of patients experiencing allergies, parasitic worm infestations, and some autoimmune diseases. Low counts may be due to drug toxicity and stress. \n\n Basophils  are the least common leukocytes, typically comprising less than one percent of the total leukocyte count. They are slightly smaller than neutrophils and eosinophils at 8\u201310  \u00b5 m in diameter. The granules of basophils stain best with basic (alkaline) stains. Basophils contain large granules that pick up a dark blue stain and are so common they may make it difficult to see the two-lobed nucleus. \n\n In general, basophils intensify the inflammatory response. They share this trait with mast cells. In the past, mast cells were considered to be basophils that left the circulation. However, this appears not to be the case, as the two cell types develop from different lineages. \n\n The granules of basophils release histamines, which contribute to inflammation, and heparin, which opposes blood clotting. High counts of basophils are associated with allergies, parasitic infections, and hypothyroidism. Low counts are associated with pregnancy, stress, and hyperthyroidism. \n\n Agranular Leukocytes \n\n Agranular leukocytes contain smaller, less-visible granules in their cytoplasm than do granular leukocytes. The nucleus is simple in shape, sometimes with an indentation but without distinct lobes. There are two major types of agranulocytes: lymphocytes and monocytes (see  Figure 18.4 ). Lymphocytes  are the only formed element of blood that arises from lymphoid stem cells. Although they form initially in the bone marrow, much of their subsequent development and reproduction occurs in the lymphatic tissues. Lymphocytes are the second most common type of leukocyte, accounting for about 20\u201330 percent of all leukocytes, and are essential for the immune response. The size range of lymphocytes is quite extensive, with some authorities recognizing two size classes and others three. Typically, the large cells are 10\u201314  \u00b5 m and have a smaller nucleus-to-cytoplasm ratio and more granules. The smaller cells are typically 6\u20139  \u00b5 m with a larger volume of nucleus to cytoplasm, creating a \u201chalo\u201d effect. A few cells may fall outside these ranges, at 14\u201317  \u00b5 m. This finding has led to the three size range classification. \n\n The three major groups of lymphocytes include natural killer cells, B cells, and T cells.  Natural killer (NK) cells  are capable of recognizing cells that do not express \u201cself\u201d proteins on their plasma membrane or that contain foreign or abnormal markers. These \u201cnonself\u201d cells include cancer cells, cells infected with a virus, and other cells with atypical surface proteins. Thus, they provide generalized, nonspecific immunity. The larger lymphocytes are typically NK cells. \n\n B cells and T cells, also called  B lymphocytes  and  T lymphocytes , play prominent roles in defending the body against specific pathogens (disease-causing microorganisms) and are involved in specific immunity. One form of B cells (plasma cells) produces the antibodies or immunoglobulins that bind to specific foreign or abnormal components of plasma membranes. This is also referred to as humoral (body fluid) immunity. T cells provide cellular-level immunity by physically attacking foreign or diseased cells. A  memory cell  is a variety of both B and T cells that forms after exposure to a pathogen and mounts rapid responses upon subsequent exposures. Unlike other leukocytes, memory cells live for many years. B cells undergo a maturation process in the  b one marrow, whereas T cells undergo maturation in the  t hymus. This site of the maturation process gives rise to the name B and T cells. The functions of lymphocytes are complex and will be covered in detail in the chapter covering the lymphatic system and immunity. Smaller lymphocytes are either B or T cells, although they cannot be differentiated in a normal blood smear. Abnormally high lymphocyte counts are characteristic of viral infections as well as some types of cancer. Abnormally low lymphocyte counts are characteristic of prolonged (chronic) illness or immunosuppression, including that caused by HIV infection and drug therapies that often involve steroids. \n\n Monocytes  originate from myeloid stem cells. They normally represent 2\u20138 percent of the total leukocyte count. They are typically easily recognized by their large size of 12\u201320  \u00b5 m and indented or horseshoe-shaped nuclei. Macrophages are monocytes that have left the circulation and phagocytize debris, foreign pathogens, worn-out erythrocytes, and many other dead, worn out, or damaged cells. Macrophages also release antimicrobial defensins and chemotactic chemicals that attract other leukocytes to the site of an infection. Some macrophages occupy fixed locations, whereas others wander through the tissue fluid. \n\n Abnormally high counts of monocytes are associated with viral or fungal infections, tuberculosis, and some forms of leukemia and other chronic diseases. Abnormally low counts are typically caused by suppression of the bone marrow. \n\n Lifecycle of Leukocytes \n\n Most leukocytes have a relatively short lifespan, typically measured in hours or days. Production of all leukocytes begins in the bone marrow under the influence of CSFs and interleukins. Secondary production and maturation of lymphocytes occurs in specific regions of lymphatic tissue known as germinal centers. Lymphocytes are fully capable of mitosis and may produce clones of cells with identical properties. This capacity enables an individual to maintain immunity throughout life to many threats that have been encountered in the past. \n\n Disorders of Leukocytes \n\n Leukopenia  is a condition in which too few leukocytes are produced. If this condition is pronounced, the individual may be unable to ward off disease. Excessive leukocyte proliferation is known as  leukocytosis . Although leukocyte counts are high, the cells themselves are often nonfunctional, leaving the individual at increased risk for disease. \n\n Leukemia  is a cancer involving an abundance of leukocytes. It may involve only one specific type of leukocyte from either the myeloid line (myelocytic leukemia) or the lymphoid line (lymphocytic leukemia). In chronic leukemia, mature leukocytes accumulate and fail to die. In acute leukemia, there is an overproduction of young, immature leukocytes. In both conditions the cells do not function properly. \n\n Lymphoma  is a form of cancer in which masses of malignant T and/or B lymphocytes collect in lymph nodes, the spleen, the liver, and other tissues. As in leukemia, the malignant leukocytes do not function properly, and the patient is vulnerable to infection. Some forms of lymphoma tend to progress slowly and respond well to treatment. Others tend to progress quickly and require aggressive treatment, without which they are rapidly fatal. \n\n Platelets \n\n You may occasionally see platelets referred to as  thrombocytes , but because this name suggests they are a type of cell, it is not accurate. A platelet is not a cell but rather a fragment of the cytoplasm of a cell called a  megakaryocyte  that is surrounded by a plasma membrane. Megakaryocytes are descended from myeloid stem cells (see  Figure 18.4 ) and are large, typically 50\u2013100  \u00b5 m in diameter, and contain an enlarged, lobed nucleus. As noted earlier, thrombopoietin, a glycoprotein secreted by the kidneys and liver, stimulates the proliferation of megakaryoblasts, which mature into megakaryocytes. These remain within bone marrow tissue ( Figure 18.12 ) and ultimately form platelet-precursor extensions that extend through the walls of bone marrow capillaries to release into the circulation thousands of cytoplasmic fragments, each enclosed by a bit of plasma membrane. These enclosed fragments are platelets. Each megakarocyte releases 2000\u20133000 platelets during its lifespan. Following platelet release, megakaryocyte remnants, which are little more than a cell nucleus, are consumed by macrophages. Platelets are relatively small, 2\u20134  \u00b5 m in diameter, but numerous, with typically 150,000\u2013160,000 per  \u00b5 L of blood. After entering the circulation, approximately one-third migrate to the spleen for storage for later release in response to any rupture in a blood vessel. They then become activated to perform their primary function, which is to limit blood loss. Platelets remain only about 10 days, then are phagocytized by macrophages. \n\n Platelets are critical to hemostasis, the stoppage of blood flow following damage to a vessel. They also secrete a variety of growth factors essential for growth and repair of tissue, particularly connective tissue. Infusions of concentrated platelets are now being used in some therapies to stimulate healing. \n\n Disorders of Platelets \n\n Thrombocytosis  is a condition in which there are too many platelets. This may trigger formation of unwanted blood clots (thrombosis), a potentially fatal disorder. If there is an insufficient number of platelets, called  thrombocytopenia , blood may not clot properly, and excessive bleeding may result. \n\n Interactive Link \n\n View University of Michigan Webscopes at  https://virtualslides.med.umich.edu/Histology/Cardiovascular%20System/081-2_HISTO_40X.svs/view.apml?cwidth=860&cheight=733&chost=virtualslides.med.umich.edu&listview=1&title=&csis=1  and explore the blood slides in greater detail. The Webscope feature allows you to move the slides as you would with a mechanical stage. You can increase and decrease the magnification. There is a chance to review each of the leukocytes individually after you have attempted to identify them from the first two blood smears. In addition, there are a few multiple choice questions. Are you able to recognize and identify the various formed elements? You will need to do this is a systematic manner, scanning along the image. The standard method is to use a grid, but this is not possible with this resource. Try constructing a simple table with each leukocyte type and then making a mark for each cell type you identify. Attempt to classify at least 50 and perhaps as many as 100 different cells. Based on the percentage of cells that you count, do the numbers represent a normal blood smear or does something appear to be abnormal? \n 18.5   Hemostasis  Learning Objectives By the end of this section, you will be able to: \n\n Describe the three mechanisms involved in hemostasis \n\n Explain how the extrinsic and intrinsic coagulation pathways lead to the common pathway, and the coagulation factors involved in each \n\n Discuss disorders affecting hemostasis \n\n Platelets are key players in  hemostasis , the process by which the body seals a ruptured blood vessel and prevents further loss of blood. Although rupture of larger vessels usually requires medical intervention, hemostasis is quite effective in dealing with small, simple wounds. There are three steps to the process: vascular spasm, the formation of a platelet plug, and coagulation (blood clotting). Failure of any of these steps will result in  hemorrhage \u2014excessive bleeding. \n\n Vascular Spasm \n\n When a vessel is severed or punctured, or when the wall of a vessel is damaged, vascular spasm occurs. In  vascular spasm , the smooth muscle in the walls of the vessel contracts dramatically. This smooth muscle has both circular layers; larger vessels also have longitudinal layers. The circular layers tend to constrict the flow of blood, whereas the longitudinal layers, when present, draw the vessel back into the surrounding tissue, often making it more difficult for a surgeon to locate, clamp, and tie off a severed vessel. The vascular spasm response is believed to be triggered by several chemicals called endothelins that are released by vessel-lining cells and by pain receptors in response to vessel injury. This phenomenon typically lasts for up to 30 minutes, although it can last for hours. \n\n Formation of the Platelet Plug \n\n In the second step, platelets, which normally float free in the plasma, encounter the area of vessel rupture with the exposed underlying connective tissue and collagenous fibers. The platelets begin to clump together, become spiked and sticky, and bind to the exposed collagen and endothelial lining. This process is assisted by a glycoprotein in the blood plasma called von Willebrand factor, which helps stabilize the growing  platelet plug . As platelets collect, they simultaneously release chemicals from their granules into the plasma that further contribute to hemostasis. Among the substances released by the platelets are: \n\n adenosine diphosphate (ADP), which helps additional platelets to adhere to the injury site, reinforcing and expanding the platelet plug \n\n serotonin, which maintains vasoconstriction \n\n prostaglandins and phospholipids, which also maintain vasoconstriction and help to activate further clotting chemicals, as discussed next \n\n A platelet plug can temporarily seal a small opening in a blood vessel. Plug formation, in essence, buys the body time while more sophisticated and durable repairs are being made. In a similar manner, even modern naval warships still carry an assortment of wooden plugs to temporarily repair small breaches in their hulls until permanent repairs can be made. \n\n Coagulation \n\n Those more sophisticated and more durable repairs are collectively called  coagulation , the formation of a blood clot. The process is sometimes characterized as a cascade, because one event prompts the next as in a multi-level waterfall. The result is the production of a gelatinous but robust clot made up of a mesh of  fibrin \u2014an insoluble filamentous protein derived from fibrinogen, the plasma protein introduced earlier\u2014in which platelets and blood cells are trapped.  Figure 18.14  summarizes the three steps of hemostasis. \n\n Clotting Factors Involved in Coagulation \n\n In the coagulation cascade, chemicals called  clotting factors  (or coagulation factors) prompt reactions that activate still more coagulation factors. The process is complex, but is initiated along two basic pathways: \n\n The extrinsic pathway, which normally is triggered by trauma. \n\n The intrinsic pathway, which begins in the bloodstream and is triggered by internal damage to the wall of the vessel. \n\n Both of these merge into a third pathway, referred to as the common pathway (see  Figure 18.14 b ). All three pathways are dependent upon the 12 known clotting factors, including Ca 2+  and vitamin K ( Table 18.1 ). Clotting factors are secreted primarily by the liver and the platelets. The liver requires the fat-soluble vitamin K to produce many of them. Vitamin K (along with biotin and folate) is somewhat unusual among vitamins in that it is not only consumed in the diet but is also synthesized by bacteria residing in the large intestine. The calcium ion, considered factor IV, is derived from the diet and from the breakdown of bone. Some recent evidence indicates that activation of various clotting factors occurs on specific receptor sites on the surfaces of platelets. The 12 clotting factors are numbered I through XIII according to the order of their discovery. Factor VI was once believed to be a distinct clotting factor, but is now thought to be identical to factor V. Rather than renumber the other factors, factor VI was allowed to remain as a placeholder and also a reminder that knowledge changes over time. \n\n Clotting Factors \n\n Factor number \n\n Name \n\n Type of molecule \n\n Source \n\n Pathway(s) \n\n I \n\n Fibrinogen \n\n Plasma protein \n\n Liver \n\n Common; converted into fibrin \n\n II \n\n Prothrombin \n\n Plasma protein  \n\n Liver* \n\n Common; converted into thrombin \n\n III \n\n Tissue thromboplastin or tissue factor \n\n Lipoprotein mixture \n\n Damaged cells and platelets \n\n Extrinsic \n\n IV \n\n Calcium ions \n\n Inorganic ions in plasma \n\n Diet, platelets, bone matrix \n\n Entire process \n\n V \n\n Proaccelerin \n\n Plasma protein \n\n Liver, platelets \n\n Extrinsic and intrinsic \n\n VI \n\n Not used \n\n Not used \n\n Not used \n\n Not used \n\n VII \n\n Proconvertin \n\n Plasma protein \n\n Liver * \n\n Extrinsic \n\n VIII \n\n Antihemolytic factor A \n\n Plasma protein factor \n\n Platelets and endothelial cells \n\n Intrinsic; deficiency results in hemophilia A \n\n IX \n\n Antihemolytic factor B (plasma thromboplastin component) \n\n Plasma protein \n\n Liver* \n\n Intrinsic; deficiency results in hemophilia B \n\n X \n\n Stuart\u2013Prower factor (thrombokinase) \n\n Protein \n\n Liver* \n\n Extrinsic and intrinsic \n\n XI \n\n Antihemolytic factor C (plasma thromboplastin antecedent) \n\n Plasma protein \n\n Liver \n\n Intrinsic; deficiency results in hemophilia C \n\n XII \n\n Hageman factor \n\n Plasma protein \n\n Liver \n\n Intrinsic; initiates clotting in vitro also activates plasmin \n\n XIII \n\n Fibrin-stabilizing factor \n\n Plasma protein \n\n Liver, platelets \n\n Stabilizes fibrin; slows fibrinolysis \n\n Table  18.1     *Vitamin K required. \n\n Extrinsic Pathway \n\n The quicker responding and more direct  extrinsic pathway  (also known as the  tissue factor  pathway) begins when damage occurs to the surrounding tissues, such as in a traumatic injury. Upon contact with blood plasma, the damaged extravascular cells, which are extrinsic to the bloodstream, release factor III (thromboplastin). Sequentially, Ca 2+  then factor VII (proconvertin), which is activated by factor III, are added, forming an enzyme complex. This enzyme complex leads to activation of factor X (Stuart\u2013Prower factor), which activates the common pathway discussed below. The events in the extrinsic pathway are completed in a matter of seconds. \n\n Intrinsic Pathway \n\n The  intrinsic pathway  (also known as the contact activation pathway) is longer and more complex. In this case, the factors involved are intrinsic to (present within) the bloodstream. The pathway can be prompted by damage to the tissues, resulting from internal factors such as arterial disease; however, it is most often initiated when factor XII (Hageman factor) comes into contact with foreign materials, such as when a blood sample is put into a glass test tube. Within the body, factor XII is typically activated when it encounters negatively charged molecules, such as inorganic polymers and phosphate produced earlier in the series of intrinsic pathway reactions. Factor XII sets off a series of reactions that in turn activates factor XI (antihemolytic factor C or plasma thromboplastin antecedent) then factor IX (antihemolytic factor B or plasma thromboplasmin). In the meantime, chemicals released by the platelets increase the rate of these activation reactions. Finally, factor VIII (antihemolytic factor A) from the platelets and endothelial cells combines with factor IX (antihemolytic factor B or plasma thromboplasmin) to form an enzyme complex that activates factor X (Stuart\u2013Prower factor or thrombokinase), leading to the common pathway. The events in the intrinsic pathway are completed in a few minutes. \n\n Common Pathway \n\n Both the intrinsic and extrinsic pathways lead to the  common pathway , in which fibrin is produced to seal off the vessel. Once factor X has been activated by either the intrinsic or extrinsic pathway, the enzyme prothrombinase converts factor II, the inactive enzyme prothrombin, into the active enzyme  thrombin . (Note that if the enzyme thrombin were not normally in an inactive form, clots would form spontaneously, a condition not consistent with life.) Then, thrombin converts factor I, the soluble fibrinogen, into the insoluble fibrin protein strands. Factor XIII then stabilizes the fibrin clot. \n\n Fibrinolysis \n\n The stabilized clot is acted upon by contractile proteins within the platelets. As these proteins contract, they pull on the fibrin threads, bringing the edges of the clot more tightly together, somewhat as we do when tightening loose shoelaces (see  Figure 18.14 a ). This process also wrings out of the clot a small amount of fluid called  serum , which is blood plasma without its clotting factors. \n\n To restore normal blood flow as the vessel heals, the clot must eventually be removed.  Fibrinolysis  is the gradual degradation of the clot. Again, there is a fairly complicated series of reactions that involves factor XII and protein-catabolizing enzymes. During this process, the inactive protein plasminogen is converted into the active  plasmin , which gradually breaks down the fibrin of the clot. Additionally, bradykinin, a vasodilator, is released, reversing the effects of the serotonin and prostaglandins from the platelets. This allows the smooth muscle in the walls of the vessels to relax and helps to restore the circulation. \n\n Plasma Anticoagulants \n\n An  anticoagulant  is any substance that opposes coagulation. Several circulating plasma anticoagulants play a role in limiting the coagulation process to the region of injury and restoring a normal, clot-free condition of blood. For instance, a cluster of proteins collectively referred to as the protein C system inactivates clotting factors involved in the intrinsic pathway. TFPI (tissue factor pathway inhibitor) inhibits the conversion of the inactive factor VII to the active form in the extrinsic pathway.  Antithrombin  inactivates factor X and opposes the conversion of prothrombin (factor II) to thrombin in the common pathway. And as noted earlier, basophils release  heparin , a short-acting anticoagulant that also opposes prothrombin. Heparin is also found on the surfaces of cells lining the blood vessels. A pharmaceutical form of heparin is often administered therapeutically, for example, in surgical patients at risk for blood clots. \n\n Interactive Link \n\n View these  animations  to explore the intrinsic, extrinsic, and common pathways that are involved the process of coagulation. The coagulation cascade restores hemostasis by activating coagulation factors in the presence of an injury. How does the endothelium of the blood vessel walls prevent the blood from coagulating as it flows through the blood vessels? \n\n Disorders of Clotting \n\n Either an insufficient or an excessive production of platelets can lead to severe disease or death. As discussed earlier, an insufficient number of platelets, called thrombocytopenia, typically results in the inability of blood to form clots. This can lead to excessive bleeding, even from minor wounds. \n\n Another reason for failure of the blood to clot is the inadequate production of functional amounts of one or more clotting factors. This is the case in the genetic disorder  hemophilia , which is actually a group of related disorders, the most common of which is hemophilia A, accounting for approximately 80 percent of cases. This disorder results in the inability to synthesize sufficient quantities of factor VIII. Hemophilia B is the second most common form, accounting for approximately 20 percent of cases. In this case, there is a deficiency of factor IX. Both of these defects are linked to the X chromosome and are typically passed from a healthy (carrier) mother to her male offspring, since males are XY. Females would need to inherit a defective gene from each parent to manifest the disease, since they are XX. Patients with hemophilia bleed from even minor internal and external wounds, and leak blood into joint spaces after exercise and into urine and stool. Hemophilia C is a rare condition that is triggered by an autosomal (not sex) chromosome that renders factor XI nonfunctional. It is not a true recessive condition, since even individuals with a single copy of the mutant gene show a tendency to bleed. Regular infusions of clotting factors isolated from healthy donors can help prevent bleeding in hemophiliac patients. At some point, genetic therapy will become a viable option. \n\n In contrast to the disorders characterized by coagulation failure is thrombocytosis, also mentioned earlier, a condition characterized by excessive numbers of platelets that increases the risk for excessive clot formation, a condition known as  thrombosis . A  thrombus  (plural = thrombi) is an aggregation of platelets, erythrocytes, and even WBCs typically trapped within a mass of fibrin strands. While the formation of a clot is normal following the hemostatic mechanism just described, thrombi can form within an intact or only slightly damaged blood vessel. In a large vessel, a thrombus will adhere to the vessel wall and decrease the flow of blood, and is referred to as a mural thrombus. In a small vessel, it may actually totally block the flow of blood and is termed an occlusive thrombus. Thrombi are most commonly caused by vessel damage to the endothelial lining, which activates the clotting mechanism. These may include venous stasis, when blood in the veins, particularly in the legs, remains stationary for long periods. This is one of the dangers of long airplane flights in crowded conditions and may lead to deep vein thrombosis. Thrombophilia, also called hypercoagulation, is a condition in which there is a tendency to form thrombosis. This may be familial (genetic) or acquired. Acquired forms include the autoimmune disease lupus, immune reactions to heparin, polycythemia vera, thrombocytosis, sickle cell disease, pregnancy, and even obesity. A thrombus can seriously impede blood flow to or from a region and will cause a local increase in blood pressure. If flow is to be maintained, the heart will need to generate a greater pressure to overcome the resistance. \n\n When a portion of a thrombus breaks free from the vessel wall and enters the circulation, it is referred to as an  embolus . An embolus that is carried through the bloodstream can be large enough to block a vessel critical to a major organ. When it becomes trapped, an embolus is called an embolism. In the heart, brain, or lungs, an embolism may accordingly cause a heart attack, a stroke, or a pulmonary embolism. These are medical emergencies. \n\n Among the many known biochemical activities of aspirin is its role as an anticoagulant. Aspirin (acetylsalicylic acid) is very effective at inhibiting the aggregation of platelets. It is routinely administered during a heart attack or stroke to reduce the adverse effects. Physicians sometimes recommend that patients at risk for cardiovascular disease take a low dose of aspirin on a daily basis as a preventive measure. However, aspirin can also lead to serious side effects, including increasing the risk of ulcers. A patient is well advised to consult a physician before beginning any aspirin regimen. \n\n A class of drugs collectively known as thrombolytic agents can help speed up the degradation of an abnormal clot. If a thrombolytic agent is administered to a patient within 3 hours following a thrombotic stroke, the patient\u2019s prognosis improves significantly. However, some strokes are not caused by thrombi, but by hemorrhage. Thus, the cause must be determined before treatment begins. Tissue plasminogen activator is an enzyme that catalyzes the conversion of plasminogen to plasmin, the primary enzyme that breaks down clots. It is released naturally by endothelial cells but is also used in clinical medicine. New research is progressing using compounds isolated from the venom of some species of snakes, particularly vipers and cobras, which may eventually have therapeutic value as thrombolytic agents. \n 18.6   Blood Typing  Learning Objectives By the end of this section, you will be able to: \n\n Describe the two basic physiological consequences of transfusion of incompatible blood \n\n Compare and contrast ABO and Rh blood groups \n\n Identify which blood groups may be safely transfused into patients with different ABO types \n\n Discuss the pathophysiology of hemolytic disease of the newborn \n\n Blood transfusions in humans were risky procedures until the discovery of the major human blood groups by Karl Landsteiner, an Austrian biologist and physician, in 1900. Until that point, physicians did not understand that death sometimes followed blood transfusions, when the type of donor blood infused into the patient was incompatible with the patient\u2019s own blood. Blood groups are determined by the presence or absence of specific marker molecules on the plasma membranes of erythrocytes. With their discovery, it became possible for the first time to match patient-donor blood types and prevent transfusion reactions and deaths. \n\n Antigens, Antibodies, and Transfusion Reactions \n\n Antigens are substances that the body does not recognize as belonging to the \u201cself\u201d and that therefore trigger a defensive response from the leukocytes of the immune system. (Seek more content for additional information on immunity.) Here, we will focus on the role of immunity in blood transfusion reactions. With RBCs in particular, you may see the antigens referred to as isoantigens or agglutinogens (surface antigens) and the antibodies referred to as isoantibodies or agglutinins. In this chapter, we will use the more common terms antigens and antibodies. \n\n Antigens are generally large proteins, but may include other classes of organic molecules, including carbohydrates, lipids, and nucleic acids. Following an infusion of incompatible blood, erythrocytes with foreign antigens appear in the bloodstream and trigger an immune response. Proteins called antibodies (immunoglobulins), which are produced by certain B lymphocytes called plasma cells, attach to the antigens on the plasma membranes of the infused erythrocytes and cause them to adhere to one another. \n\n Because the arms of the Y-shaped antibodies attach randomly to more than one nonself erythrocyte surface, they form clumps of erythrocytes. This process is called  agglutination . \n\n The clumps of erythrocytes block small blood vessels throughout the body, depriving tissues of oxygen and nutrients. \n\n As the erythrocyte clumps are degraded, in a process called  hemolysis , their hemoglobin is released into the bloodstream. This hemoglobin travels to the kidneys, which are responsible for filtration of the blood. However, the load of hemoglobin released can easily overwhelm the kidney\u2019s capacity to clear it, and the patient can quickly develop kidney failure. \n\n More than 50 antigens have been identified on erythrocyte membranes, but the most significant in terms of their potential harm to patients are classified in two groups: the ABO blood group and the Rh blood group. \n\n The ABO Blood Group \n\n Although the  ABO blood group  name consists of three letters, ABO blood typing designates the presence or absence of just two antigens, A and B. Both are glycoproteins. People whose erythrocytes have A antigens on their erythrocyte membrane surfaces are designated blood type A, and those whose erythrocytes have B antigens are blood type B. People can also have both A and B antigens on their erythrocytes, in which case they are blood type AB. People with neither A nor B antigens are designated blood type O. ABO blood types are genetically determined. \n\n Normally the body must be exposed to a foreign antigen before an antibody can be produced. This is not the case for the ABO blood group. Individuals with type A blood\u2014without any prior exposure to incompatible blood\u2014have preformed antibodies to the B antigen circulating in their blood plasma. These antibodies, referred to as anti-B antibodies, will cause agglutination and hemolysis if they ever encounter erythrocytes with B antigens. Similarly, an individual with type B blood has pre-formed anti-A antibodies. Individuals with type AB blood, which has both antigens, do not have preformed antibodies to either of these. People with type O blood lack antigens A and B on their erythrocytes, but both anti-A and anti-B antibodies circulate in their blood plasma. \n\n Rh Blood Groups The  Rh blood group  is classified according to the presence or absence of a second erythrocyte antigen identified as Rh. (It was first discovered in a type of primate known as a rhesus macaque, which is often used in research, because its blood is similar to that of humans.) Although dozens of Rh antigens have been identified, only one, designated D, is clinically important. Those who have the Rh D antigen present on their erythrocytes\u2014about 85 percent of Americans\u2014are described as Rh positive (Rh + ) and those who lack it are Rh negative (Rh \u2212 ). Note that the Rh group is distinct from the ABO group, so any individual, no matter their ABO blood type, may have or lack this Rh antigen. When identifying a patient\u2019s blood type, the Rh group is designated by adding the word positive or negative to the ABO type. For example, A positive (A + ) means ABO group A blood with the Rh antigen present, and AB negative (AB \u2212 ) means ABO group AB blood without the Rh antigen. Table 18.2  summarizes the distribution of the ABO and Rh blood types within the United States. Summary of ABO and Rh Blood Types within the United States  \n\n Blood Type \n\n African-Americans \n\n Asian-Americans \n\n Caucasian-Americans \n\n Latino/Latina-Americans \n\n A + \n\n 24 \n\n 27 \n\n 33 \n\n 29 \n\n A \u2212 \n\n 2 \n\n 0.5 \n\n 7 \n\n 2 \n\n B + \n\n 18 \n\n 25 \n\n 9 \n\n 9 \n\n B \u2212 \n\n 1 \n\n 0.4 \n\n 2 \n\n 1 \n\n AB + \n\n 4 \n\n 7 \n\n 3 \n\n 2 \n\n AB \u2212 \n\n 0.3 \n\n 0.1 \n\n 1 \n\n 0.2 \n\n O + \n\n 47 \n\n 39 \n\n 37 \n\n 53 \n\n O \u2212 \n\n 4 \n\n 1 \n\n 8 \n\n 4 \n\n Table  18.2     In contrast to the ABO group antibodies, which are preformed, antibodies to the Rh antigen are produced only in Rh \u2212  individuals after exposure to the antigen. This process, called sensitization, occurs following a transfusion with Rh-incompatible blood or, more commonly, with the birth of an Rh +  baby to an Rh \u2212  mother. Problems are rare in a first pregnancy, since the baby\u2019s Rh +  cells rarely cross the placenta (the organ of gas and nutrient exchange between the baby and the mother). However, during or immediately after birth, the Rh \u2212  mother can be exposed to the baby\u2019s Rh +  cells ( Figure 18.15 ). Research has shown that this occurs in about 13\u221214 percent of such pregnancies. After exposure, the mother\u2019s immune system begins to generate anti-Rh antibodies. If the mother should then conceive another Rh +  baby, the Rh antibodies she has produced can cross the placenta into the fetal bloodstream and destroy the fetal RBCs. This condition, known as  hemolytic disease of the newborn (HDN)  or erythroblastosis fetalis, may cause anemia in mild cases, but the agglutination and hemolysis can be so severe that without treatment the fetus may die in the womb or shortly after birth. \n\n A drug known as RhoGAM, short for Rh immune globulin, can temporarily prevent the development of Rh antibodies in the Rh \u2212  mother, thereby averting this potentially serious disease for the fetus. RhoGAM antibodies destroy any fetal Rh +  erythrocytes that may cross the placental barrier. RhoGAM is normally administered to Rh \u2212  mothers during weeks 26\u221228 of pregnancy and within 72 hours following birth. It has proven remarkably effective in decreasing the incidence of HDN. Earlier we noted that the incidence of HDN in an Rh +  subsequent pregnancy to an Rh \u2212  mother is about 13\u201314 percent without preventive treatment. Since the introduction of RhoGAM in 1968, the incidence has dropped to about 0.1 percent in the United States. \n\n Determining ABO Blood Types Clinicians are able to determine a patient\u2019s blood type quickly and easily using commercially prepared antibodies. An unknown blood sample is allocated into separate wells. Into one well a small amount of anti-A antibody is added, and to another a small amount of anti-B antibody. If the antigen is present, the antibodies will cause visible agglutination of the cells ( Figure 18.16 ). The blood should also be tested for Rh antibodies. \n\n ABO Transfusion Protocols \n\n To avoid transfusion reactions, it is best to transfuse only matching blood types; that is, a type B +  recipient should ideally receive blood only from a type B +  donor and so on. That said, in emergency situations, when acute hemorrhage threatens the patient\u2019s life, there may not be time for cross matching to identify blood type. In these cases, blood from a  universal donor \u2014an individual with type O \u2212  blood\u2014may be transfused. Recall that type O erythrocytes do not display A or B antigens. Thus, anti-A or anti-B antibodies that might be circulating in the patient\u2019s blood plasma will not encounter any erythrocyte surface antigens on the donated blood and therefore will not be provoked into a response. One problem with this designation of universal donor is if the O \u2212  individual had prior exposure to Rh antigen, Rh antibodies may be present in the donated blood. Also, introducing type O blood into an individual with type A, B, or AB blood will nevertheless introduce antibodies against both A and B antigens, as these are always circulating in the type O blood plasma. This may cause problems for the recipient, but because the volume of blood transfused is much lower than the volume of the patient\u2019s own blood, the adverse effects of the relatively few infused plasma antibodies are typically limited. Rh factor also plays a role. If Rh \u2212  individuals receiving blood have had prior exposure to Rh antigen, antibodies for this antigen may be present in the blood and trigger agglutination to some degree. Although it is always preferable to cross match a patient\u2019s blood before transfusing, in a true life-threatening emergency situation, this is not always possible, and these procedures may be implemented. \n\n A patient with blood type AB +  is known as the  universal recipient . This patient can theoretically receive any type of blood, because the patient\u2019s own blood\u2014having both A and B antigens on the erythrocyte surface\u2014does not produce anti-A or anti-B antibodies. In addition, an Rh +  patient can receive both Rh +  and Rh \u2212  blood. However, keep in mind that the donor\u2019s blood will contain circulating antibodies, again with possible negative implications.  Figure 18.17  summarizes the blood types and compatibilities. \n\n At the scene of multiple-vehicle accidents, military engagements, and natural or human-caused disasters, many victims may suffer simultaneously from acute hemorrhage, yet type O blood may not be immediately available. In these circumstances, medics may at least try to replace some of the volume of blood that has been lost. This is done by intravenous administration of a saline solution that provides fluids and electrolytes in proportions equivalent to those of normal blood plasma. Research is ongoing to develop a safe and effective artificial blood that would carry out the oxygen-carrying function of blood without the RBCs, enabling transfusions in the field without concern for incompatibility. These blood substitutes normally contain hemoglobin- as well as perfluorocarbon-based oxygen carriers. ", "questions": [{"question": {"question_id": "fs-id2443596", "question_text": "Which of the following statements about blood is true?", "question_choices": ["Blood is about 92 percent water.", "Blood is slightly more acidic than water. ", "Blood is slightly more viscous than water. ", "Blood is slightly more salty than seawater."], "cloze_format": "The true statement about blood is that ___ .", "normal_format": "Which of the following statements about blood is true?"}, "answer": {"ans_text": "Blood is slightly more viscous than water. ", "ans_choice": 2}, "bloom": "1", "hl_sentences": "The pH of blood averages about 7.4 ; however , it can range from 7.35 to 7.45 in a healthy person . Blood is viscous and somewhat sticky to the touch . It has a viscosity approximately five times greater than water .", "hl_context": "The normal temperature of blood is slightly higher than normal body temperature \u2014 about 38 \u00b0 C ( or 100.4 \u00b0 F ) , compared to 37 \u00b0 C ( or 98.6 \u00b0 F ) for an internal body temperature reading , although daily variations of 0.5 \u00b0 C are normal . Although the surface of blood vessels is relatively smooth , as blood flows through them , it experiences some friction and resistance , especially as vessels age and lose their elasticity , thereby producing heat . This accounts for its slightly higher temperature . <hl> The pH of blood averages about 7.4 ; however , it can range from 7.35 to 7.45 in a healthy person . <hl> Blood is therefore somewhat more basic ( alkaline ) on a chemical scale than pure water , which has a pH of 7.0 . Blood contains numerous buffers that actually help to regulate pH . <hl> Blood is viscous and somewhat sticky to the touch . <hl> <hl> It has a viscosity approximately five times greater than water . <hl> Viscosity is a measure of a fluid \u2019 s thickness or resistance to flow , and is influenced by the presence of the plasma proteins and formed elements within the blood . The viscosity of blood has a dramatic impact on blood pressure and flow . Consider the difference in flow between water and honey . The more viscous honey would demonstrate a greater resistance to flow than the less viscous water . The same principle applies to blood ."}, {"question": {"question_id": "fs-id4201161", "question_text": "Which of the following statements about albumin is true?", "question_choices": ["It draws water out of the blood vessels and into the body\u2019s tissues.", "It is the most abundant plasma protein. ", "It is produced by specialized leukocytes called plasma cells. ", "All of the above are true."], "cloze_format": "The statement about albumin that is true is that ___.", "normal_format": "Which of the following statements about albumin is true?"}, "answer": {"ans_text": "It is the most abundant plasma protein. ", "ans_choice": 1}, "bloom": "1", "hl_sentences": "Albumin is the most abundant of the plasma proteins .", "hl_context": "<hl> Albumin is the most abundant of the plasma proteins . <hl> Manufactured by the liver , albumin molecules serve as binding proteins \u2014 transport vehicles for fatty acids and steroid hormones . Recall that lipids are hydrophobic ; however , their binding to albumin enables their transport in the watery plasma . Albumin is also the most significant contributor to the osmotic pressure of blood ; that is , its presence holds water inside the blood vessels and draws water from the tissues , across blood vessel walls , and into the bloodstream . This in turn helps to maintain both blood volume and blood pressure . Albumin normally accounts for approximately 54 percent of the total plasma protein content , in clinical levels of 3.5 \u2013 5.0 g / dL blood ."}, {"question": {"question_id": "fs-id2643719", "question_text": "Which of the following plasma proteins is not produced by the liver?", "question_choices": ["fibrinogen", "alpha globulin", "beta globulin", "immunoglobulin"], "cloze_format": "The plasma protein that is not produced by the liver is ___.", "normal_format": "Which of the following plasma proteins is not produced by the liver?"}, "answer": {"ans_text": "immunoglobulin", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "Like albumin and the alpha and beta globulins , fibrinogen is produced by the liver . Although other plasma proteins are produced by the liver , immunoglobulins are produced by specialized leukocytes known as plasma cells .", "hl_context": "The least abundant plasma protein is fibrinogen . <hl> Like albumin and the alpha and beta globulins , fibrinogen is produced by the liver . <hl> It is essential for blood clotting , a process described later in this chapter . Fibrinogen accounts for about 7 percent of the total plasma protein volume , in clinical levels of 0.2 \u2013 0.45 g / dL blood . The second most common plasma proteins are the globulins . A heterogeneous group , there are three main subgroups known as alpha , beta , and gamma globulins . The alpha and beta globulins transport iron , lipids , and the fat-soluble vitamins A , D , E , and K to the cells ; like albumin , they also contribute to osmotic pressure . The gamma globulins are proteins involved in immunity and are better known as an antibodies or immunoglobulins . <hl> Although other plasma proteins are produced by the liver , immunoglobulins are produced by specialized leukocytes known as plasma cells . <hl> ( Seek additional content for more information about immunoglobulins . ) Globulins make up approximately 38 percent of the total plasma protein volume , in clinical levels of 1.0 \u2013 1.5 g / dL blood ."}, {"question": {"question_id": "fs-id2813781", "question_text": "Which of the formed elements arise from myeloid stem cells?", "question_choices": ["B cells", "natural killer cells", "platelets", "all of the above"], "cloze_format": "The formed elements that arise from myeloid stem cells are the ___ .", "normal_format": "Which of the formed elements arise from myeloid stem cells?"}, "answer": {"ans_text": "platelets", "ans_choice": 2}, "bloom": "1", "hl_sentences": "Myeloid stem cells give rise to all the other formed elements , including the erythrocytes ; megakaryocytes that produce platelets ; and a myeloblast lineage that gives rise to monocytes and three forms of granular leukocytes : neutrophils , eosinophils , and basophils .", "hl_context": "<hl> Myeloid stem cells give rise to all the other formed elements , including the erythrocytes ; megakaryocytes that produce platelets ; and a myeloblast lineage that gives rise to monocytes and three forms of granular leukocytes : neutrophils , eosinophils , and basophils . <hl>"}, {"question": {"question_id": "fs-id2663985", "question_text": "Interleukins are associated primarily with which of the following?", "question_choices": ["production of various lymphocytes", "immune responses", "inflammation", "all of the above"], "cloze_format": "Interleukins are associated primarily with ___.", "normal_format": "Interleukins are associated primarily with which of the following?"}, "answer": {"ans_text": "all of the above", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "Researchers now suspect that interleukins may play other roles in body functioning , including differentiation and maturation of cells , producing immunity and inflammation .", "hl_context": "Interleukins are another class of cytokine signaling molecules important in hemopoiesis . They were initially thought to be secreted uniquely by leukocytes and to communicate only with other leukocytes , and were named accordingly , but are now known to be produced by a variety of cells including bone marrow and endothelium . <hl> Researchers now suspect that interleukins may play other roles in body functioning , including differentiation and maturation of cells , producing immunity and inflammation . <hl> To date , more than a dozen interleukins have been identified , with others likely to follow . They are generally numbered IL - 1 , IL - 2 , IL - 3 , etc ."}, {"question": {"question_id": "fs-id2080536", "question_text": "Which of the following statements about mature, circulating erythrocytes is true?", "question_choices": ["They have no nucleus.", "They are packed with mitochondria. ", "They survive for an average of 4 days. ", "All of the above"], "cloze_format": "The statement about mature, circulating erythrocytes that is true is that ___.", "normal_format": "Which of the following statements about mature, circulating erythrocytes is true?"}, "answer": {"ans_text": "They have no nucleus.", "ans_choice": 0}, "bloom": "1", "hl_sentences": "Erythrocytes live up to 120 days in the circulation , after which the worn-out cells are removed by a type of myeloid phagocytic cell called a macrophage , located primarily within the bone marrow , liver , and spleen . As an erythrocyte matures in the red bone marrow , it extrudes its nucleus and most of its other organelles .", "hl_context": "<hl> Erythrocytes live up to 120 days in the circulation , after which the worn-out cells are removed by a type of myeloid phagocytic cell called a macrophage , located primarily within the bone marrow , liver , and spleen . <hl> The components of the degraded erythrocytes \u2019 hemoglobin are further processed as follows : <hl> As an erythrocyte matures in the red bone marrow , it extrudes its nucleus and most of its other organelles . <hl> During the first day or two that it is in the circulation , an immature erythrocyte , known as a reticulocyte , will still typically contain remnants of organelles . Reticulocytes should comprise approximately 1 \u2013 2 percent of the erythrocyte count and provide a rough estimate of the rate of RBC production , with abnormally low or high rates indicating deviations in the production of these cells . These remnants , primarily of networks ( reticulum ) of ribosomes , are quickly shed , however , and mature , circulating erythrocytes have few internal cellular structural components . Lacking mitochondria , for example , they rely on anaerobic respiration . This means that they do not utilize any of the oxygen they are transporting , so they can deliver it all to the tissues . They also lack endoplasmic reticula and do not synthesize proteins . Erythrocytes do , however , contain some structural proteins that help the blood cells maintain their unique structure and enable them to change their shape to squeeze through capillaries . This includes the protein spectrin , a cytoskeletal protein element ."}, {"question": {"question_id": "fs-id2516785", "question_text": "A molecule of hemoglobin ________.", "question_choices": ["is shaped like a biconcave disk packed almost entirely with iron", "contains four glycoprotein units studded with oxygen ", "consists of four globin proteins, each bound to a molecule of heme ", "can carry up to 120 molecules of oxygen"], "cloze_format": "A molecule of hemoglobin ________.", "normal_format": "What is a characteristic of a molecule of hemoglobin?"}, "answer": {"ans_text": "consists of four globin proteins, each bound to a molecule of heme ", "ans_choice": 2}, "bloom": "1", "hl_sentences": "Hemoglobin is a large molecule made up of proteins and iron . It consists of four folded chains of a protein called globin , designated alpha 1 and 2 , and beta 1 and 2 ( Figure 18.7 a ) . Each of these globin molecules is bound to a red pigment molecule called heme , which contains an ion of iron ( Fe 2 + ) ( Figure 18.7 b ) .", "hl_context": "<hl> Hemoglobin is a large molecule made up of proteins and iron . <hl> <hl> It consists of four folded chains of a protein called globin , designated alpha 1 and 2 , and beta 1 and 2 ( Figure 18.7 a ) . <hl> <hl> Each of these globin molecules is bound to a red pigment molecule called heme , which contains an ion of iron ( Fe 2 + ) ( Figure 18.7 b ) . <hl> Each iron ion in the heme can bind to one oxygen molecule ; therefore , each hemoglobin molecule can transport four oxygen molecules . An individual erythrocyte may contain about 300 million hemoglobin molecules , and therefore can bind to and transport up to 1.2 billion oxygen molecules ( see Figure 18.7 b ) ."}, {"question": {"question_id": "fs-id2319973", "question_text": "The production of healthy erythrocytes depends upon the availability of ________.", "question_choices": ["copper", "zinc", "vitamin B12", "copper, zinc, and vitamin B12"], "cloze_format": "The production of healthy erythrocytes depends upon the availability of ________.", "normal_format": "The production of healthy erythrocytes depends upon the availability of which?"}, "answer": {"ans_text": "copper, zinc, and vitamin B12", "ans_choice": 3}, "bloom": "1", "hl_sentences": "B vitamins . Zinc . Copper . Iron . Production of erythrocytes in the marrow occurs at the staggering rate of more than 2 million cells per second . However , erythrocyte production also requires several trace elements :", "hl_context": "<hl> B vitamins . <hl> The B vitamins folate and vitamin B 12 function as co-enzymes that facilitate DNA synthesis . Thus , both are critical for the synthesis of new cells , including erythrocytes . <hl> Zinc . <hl> The trace mineral zinc functions as a co-enzyme that facilitates the synthesis of the heme portion of hemoglobin . <hl> Copper . <hl> A trace mineral , copper is a component of two plasma proteins , hephaestin and ceruloplasmin . Without these , hemoglobin could not be adequately produced . Located in intestinal villi , hephaestin enables iron to be absorbed by intestinal cells . Ceruloplasmin transports copper . Both enable the oxidation of iron from Fe 2 + to Fe 3 + , a form in which it can be bound to its transport protein , transferrin , for transport to body cells . In a state of copper deficiency , the transport of iron for heme synthesis decreases , and iron can accumulate in tissues , where it can eventually lead to organ damage . <hl> Iron . <hl> We have said that each heme group in a hemoglobin molecule contains an ion of the trace mineral iron . On average , less than 20 percent of the iron we consume is absorbed . Heme iron , from animal foods such as meat , poultry , and fish , is absorbed more efficiently than non-heme iron from plant foods . Upon absorption , iron becomes part of the body \u2019 s total iron pool . The bone marrow , liver , and spleen can store iron in the protein compounds ferritin and hemosiderin . Ferroportin transports the iron across the intestinal cell plasma membranes and from its storage sites into tissue fluid where it enters the blood . When EPO stimulates the production of erythrocytes , iron is released from storage , bound to transferrin , and carried to the red marrow where it attaches to erythrocyte precursors . <hl> Production of erythrocytes in the marrow occurs at the staggering rate of more than 2 million cells per second . <hl> For this production to occur , a number of raw materials must be present in adequate amounts . These include the same nutrients that are essential to the production and maintenance of any cell , such as glucose , lipids , and amino acids . <hl> However , erythrocyte production also requires several trace elements : <hl>"}, {"question": {"question_id": "fs-id1546796", "question_text": "Aging and damaged erythrocytes are removed from the circulation by ________.", "question_choices": ["myeoblasts", "monocytes", "macrophages", "mast cells"], "cloze_format": "Aging and damaged erythrocytes are removed from the circulation by ________.", "normal_format": "Aging and damaged erythrocytes are removed from the circulation by what?"}, "answer": {"ans_text": "macrophages", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "Erythrocytes live up to 120 days in the circulation , after which the worn-out cells are removed by a type of myeloid phagocytic cell called a macrophage , located primarily within the bone marrow , liver , and spleen .", "hl_context": "<hl> Erythrocytes live up to 120 days in the circulation , after which the worn-out cells are removed by a type of myeloid phagocytic cell called a macrophage , located primarily within the bone marrow , liver , and spleen . <hl> The components of the degraded erythrocytes \u2019 hemoglobin are further processed as follows :"}, {"question": {"question_id": "fs-id2686554", "question_text": "A patient has been suffering for 2 months with a chronic, watery diarrhea. A blood test is likely to reveal ________.", "question_choices": ["a hematocrit below 30 percent", "hypoxemia", "anemia", "polycythemia"], "cloze_format": "A patient has been suffering for 2 months with a chronic, watery diarrhea. A blood test is likely to reveal ________.", "normal_format": "A patient has been suffering for 2 months with a chronic, watery diarrhea. Which is a blood test likely to reveal?"}, "answer": {"ans_text": "polycythemia", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "It can occur transiently in a person who is dehydrated ; when water intake is inadequate or water losses are excessive , the plasma volume falls . As a result , the hematocrit rises . For reasons mentioned earlier , a mild form of polycythemia is chronic but normal in people living at high altitudes . Polycythemia vera can dangerously elevate the viscosity of blood , raising blood pressure and making it more difficult for the heart to pump blood throughout the body .", "hl_context": "In contrast to anemia , an elevated RBC count is called polycythemia and is detected in a patient \u2019 s elevated hematocrit . <hl> It can occur transiently in a person who is dehydrated ; when water intake is inadequate or water losses are excessive , the plasma volume falls . <hl> <hl> As a result , the hematocrit rises . <hl> <hl> For reasons mentioned earlier , a mild form of polycythemia is chronic but normal in people living at high altitudes . <hl> Some elite athletes train at high elevations specifically to induce this phenomenon . Finally , a type of bone marrow disease called polycythemia vera ( from the Greek vera = \u201c true \u201d ) causes an excessive production of immature erythrocytes . <hl> Polycythemia vera can dangerously elevate the viscosity of blood , raising blood pressure and making it more difficult for the heart to pump blood throughout the body . <hl> It is a relatively rare disease that occurs more often in men than women , and is more likely to be present in elderly patients those over 60 years of age . 18.4 Leukocytes and Platelets Learning Objectives By the end of this section , you will be able to :"}, {"question": {"question_id": "fs-id2016087", "question_text": "The process by which leukocytes squeeze through adjacent cells in a blood vessel wall is called ________.", "question_choices": ["leukocytosis", "positive chemotaxis", "emigration ", "cytoplasmic extending"], "cloze_format": "The process by which leukocytes squeeze through adjacent cells in a blood vessel wall is called ________.", "normal_format": "What is the process by which leukocytes squeeze through adjacent cells in a blood vessel wall called?"}, "answer": {"ans_text": "emigration ", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "As shown in Figure 18.10 , they leave the capillaries \u2014 the smallest blood vessels \u2014 or other small vessels through a process known as emigration ( from the Latin for \u201c removal \u201d ) or diapedesis ( dia - = \u201c through \u201d ; - pedan = \u201c to leap \u201d ) in which they squeeze through adjacent cells in a blood vessel wall .", "hl_context": "One of the most distinctive characteristics of leukocytes is their movement . Whereas erythrocytes spend their days circulating within the blood vessels , leukocytes routinely leave the bloodstream to perform their defensive functions in the body \u2019 s tissues . For leukocytes , the vascular network is simply a highway they travel and soon exit to reach their true destination . When they arrive , they are often given distinct names , such as macrophage or microglia , depending on their function . <hl> As shown in Figure 18.10 , they leave the capillaries \u2014 the smallest blood vessels \u2014 or other small vessels through a process known as emigration ( from the Latin for \u201c removal \u201d ) or diapedesis ( dia - = \u201c through \u201d ; - pedan = \u201c to leap \u201d ) in which they squeeze through adjacent cells in a blood vessel wall . <hl>"}, {"question": {"question_id": "fs-id1638969", "question_text": "Which of the following describes a neutrophil?", "question_choices": ["abundant, agranular, especially effective against cancer cells", "abundant, granular, especially effective against bacteria", "rare, agranular, releases antimicrobial defensins", "rare, granular, contains multiple granules packed with histamine"], "cloze_format": "A neutrophil is described by ___ .", "normal_format": "Which of the following describes a neutrophil?"}, "answer": {"ans_text": "abundant, granular, especially effective against bacteria", "ans_choice": 1}, "bloom": "1", "hl_sentences": "Neutrophils are rapid responders to the site of infection and are efficient phagocytes with a preference for bacteria . The most common of all the leukocytes , neutrophils will normally comprise 50 \u2013 70 percent of total leukocyte count .", "hl_context": "<hl> Neutrophils are rapid responders to the site of infection and are efficient phagocytes with a preference for bacteria . <hl> Their granules include lysozyme , an enzyme capable of lysing , or breaking down , bacterial cell walls ; oxidants such as hydrogen peroxide ; and defensins , proteins that bind to and puncture bacterial and fungal plasma membranes , so that the cell contents leak out . Abnormally high counts of neutrophils indicate infection and / or inflammation , particularly triggered by bacteria , but are also found in burn patients and others experiencing unusual stress . A burn injury increases the proliferation of neutrophils in order to fight off infection that can result from the destruction of the barrier of the skin . Low counts may be caused by drug toxicity and other disorders , and may increase an individual \u2019 s susceptibility to infection . <hl> The most common of all the leukocytes , neutrophils will normally comprise 50 \u2013 70 percent of total leukocyte count . <hl> They are 10 \u2013 12 \u00b5 m in diameter , significantly larger than erythrocytes . They are called neutrophils because their granules show up most clearly with stains that are chemically neutral ( neither acidic nor basic ) . The granules are numerous but quite fine and normally appear light lilac . The nucleus has a distinct lobed appearance and may have two to five lobes , the number increasing with the age of the cell . Older neutrophils have increasing numbers of lobes and are often referred to as polymorphonuclear ( a nucleus with many forms ) , or simply \u201c polys . \u201d Younger and immature neutrophils begin to develop lobes and are known as \u201c bands . \u201d"}, {"question": {"question_id": "fs-id2621758", "question_text": "T and B lymphocytes ________.", "question_choices": ["are polymorphonuclear", "are involved with specific immune function", "proliferate excessively in leukopenia ", "are most active against parasitic worms"], "cloze_format": "T and B lymphocytes ________.", "normal_format": "What is a characteristic of T and B lymphocytes?"}, "answer": {"ans_text": "are involved with specific immune function", "ans_choice": 1}, "bloom": "1", "hl_sentences": "B cells and T cells , also called B lymphocytes and T lymphocytes , play prominent roles in defending the body against specific pathogens ( disease-causing microorganisms ) and are involved in specific immunity .", "hl_context": "<hl> B cells and T cells , also called B lymphocytes and T lymphocytes , play prominent roles in defending the body against specific pathogens ( disease-causing microorganisms ) and are involved in specific immunity . <hl> One form of B cells ( plasma cells ) produces the antibodies or immunoglobulins that bind to specific foreign or abnormal components of plasma membranes . This is also referred to as humoral ( body fluid ) immunity . T cells provide cellular-level immunity by physically attacking foreign or diseased cells . A memory cell is a variety of both B and T cells that forms after exposure to a pathogen and mounts rapid responses upon subsequent exposures . Unlike other leukocytes , memory cells live for many years . B cells undergo a maturation process in the b one marrow , whereas T cells undergo maturation in the t hymus . This site of the maturation process gives rise to the name B and T cells . The functions of lymphocytes are complex and will be covered in detail in the chapter covering the lymphatic system and immunity . Smaller lymphocytes are either B or T cells , although they cannot be differentiated in a normal blood smear . Abnormally high lymphocyte counts are characteristic of viral infections as well as some types of cancer . Abnormally low lymphocyte counts are characteristic of prolonged ( chronic ) illness or immunosuppression , including that caused by HIV infection and drug therapies that often involve steroids ."}, {"question": {"question_id": "fs-id2767040", "question_text": "Thrombocytes are more accurately called ________.", "question_choices": ["clotting factors", "megakaryoblasts", "megakaryocytes ", "platelets"], "cloze_format": "Thrombocytes are more accurately called ________.", "normal_format": "What are thrombocytes more accurately called?"}, "answer": {"ans_text": "platelets", "ans_choice": 3}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "You may occasionally see platelets referred to as thrombocytes , but because this name suggests they are a type of cell , it is not accurate .", "hl_context": "<hl> You may occasionally see platelets referred to as thrombocytes , but because this name suggests they are a type of cell , it is not accurate . <hl> A platelet is not a cell but rather a fragment of the cytoplasm of a cell called a megakaryocyte that is surrounded by a plasma membrane . Megakaryocytes are descended from myeloid stem cells ( see Figure 18.4 ) and are large , typically 50 \u2013 100 \u00b5 m in diameter , and contain an enlarged , lobed nucleus . As noted earlier , thrombopoietin , a glycoprotein secreted by the kidneys and liver , stimulates the proliferation of megakaryoblasts , which mature into megakaryocytes . These remain within bone marrow tissue ( Figure 18.12 ) and ultimately form platelet-precursor extensions that extend through the walls of bone marrow capillaries to release into the circulation thousands of cytoplasmic fragments , each enclosed by a bit of plasma membrane . These enclosed fragments are platelets . Each megakarocyte releases 2000 \u2013 3000 platelets during its lifespan . Following platelet release , megakaryocyte remnants , which are little more than a cell nucleus , are consumed by macrophages . Platelets are relatively small , 2 \u2013 4 \u00b5 m in diameter , but numerous , with typically 150,000 \u2013 160,000 per \u00b5 L of blood . After entering the circulation , approximately one-third migrate to the spleen for storage for later release in response to any rupture in a blood vessel . They then become activated to perform their primary function , which is to limit blood loss . Platelets remain only about 10 days , then are phagocytized by macrophages ."}, {"question": {"question_id": "fs-id2766568", "question_text": "The first step in hemostasis is ________.", "question_choices": ["vascular spasm", "conversion of fibrinogen to fibrin", "activation of the intrinsic pathway", "activation of the common pathway"], "cloze_format": "The first step in hemostasis is ________.", "normal_format": "What is the first step in hemostasis? "}, "answer": {"ans_text": "vascular spasm", "ans_choice": 0}, "bloom": "1", "hl_sentences": "Although rupture of larger vessels usually requires medical intervention , hemostasis is quite effective in dealing with small , simple wounds . There are three steps to the process : vascular spasm , the formation of a platelet plug , and coagulation ( blood clotting ) .", "hl_context": "Platelets are key players in hemostasis , the process by which the body seals a ruptured blood vessel and prevents further loss of blood . <hl> Although rupture of larger vessels usually requires medical intervention , hemostasis is quite effective in dealing with small , simple wounds . <hl> <hl> There are three steps to the process : vascular spasm , the formation of a platelet plug , and coagulation ( blood clotting ) . <hl> Failure of any of these steps will result in hemorrhage \u2014 excessive bleeding ."}, {"question": {"question_id": "fs-id2291510", "question_text": "Prothrombin is converted to thrombin during the ________.", "question_choices": ["intrinsic pathway", "extrinsic pathway", "common pathway", "formation of the platelet plug"], "cloze_format": "Prothrombin is converted to thrombin during the ________.", "normal_format": "During which is prothrombin converted to thrombin?"}, "answer": {"ans_text": "common pathway", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "Antithrombin inactivates factor X and opposes the conversion of prothrombin ( factor II ) to thrombin in the common pathway . Once factor X has been activated by either the intrinsic or extrinsic pathway , the enzyme prothrombinase converts factor II , the inactive enzyme prothrombin , into the active enzyme thrombin .", "hl_context": "An anticoagulant is any substance that opposes coagulation . Several circulating plasma anticoagulants play a role in limiting the coagulation process to the region of injury and restoring a normal , clot-free condition of blood . For instance , a cluster of proteins collectively referred to as the protein C system inactivates clotting factors involved in the intrinsic pathway . TFPI ( tissue factor pathway inhibitor ) inhibits the conversion of the inactive factor VII to the active form in the extrinsic pathway . <hl> Antithrombin inactivates factor X and opposes the conversion of prothrombin ( factor II ) to thrombin in the common pathway . <hl> And as noted earlier , basophils release heparin , a short-acting anticoagulant that also opposes prothrombin . Heparin is also found on the surfaces of cells lining the blood vessels . A pharmaceutical form of heparin is often administered therapeutically , for example , in surgical patients at risk for blood clots . Both the intrinsic and extrinsic pathways lead to the common pathway , in which fibrin is produced to seal off the vessel . <hl> Once factor X has been activated by either the intrinsic or extrinsic pathway , the enzyme prothrombinase converts factor II , the inactive enzyme prothrombin , into the active enzyme thrombin . <hl> ( Note that if the enzyme thrombin were not normally in an inactive form , clots would form spontaneously , a condition not consistent with life . ) Then , thrombin converts factor I , the soluble fibrinogen , into the insoluble fibrin protein strands . Factor XIII then stabilizes the fibrin clot ."}, {"question": {"question_id": "fs-id2123883", "question_text": "Hemophilia is characterized by ________.", "question_choices": ["inadequate production of heparin", "inadequate production of clotting factors ", "excessive production of fibrinogen ", "excessive production of platelets"], "cloze_format": "Hemophilia is characterized by ________.", "normal_format": "What is hemophilia characterized by?"}, "answer": {"ans_text": "inadequate production of clotting factors ", "ans_choice": 1}, "references_are_paraphrase": 0, "bloom": null, "hl_sentences": "Another reason for failure of the blood to clot is the inadequate production of functional amounts of one or more clotting factors . This is the case in the genetic disorder hemophilia , which is actually a group of related disorders , the most common of which is hemophilia A , accounting for approximately 80 percent of cases .", "hl_context": "<hl> Another reason for failure of the blood to clot is the inadequate production of functional amounts of one or more clotting factors . <hl> <hl> This is the case in the genetic disorder hemophilia , which is actually a group of related disorders , the most common of which is hemophilia A , accounting for approximately 80 percent of cases . <hl> This disorder results in the inability to synthesize sufficient quantities of factor VIII . Hemophilia B is the second most common form , accounting for approximately 20 percent of cases . In this case , there is a deficiency of factor IX . Both of these defects are linked to the X chromosome and are typically passed from a healthy ( carrier ) mother to her male offspring , since males are XY . Females would need to inherit a defective gene from each parent to manifest the disease , since they are XX . Patients with hemophilia bleed from even minor internal and external wounds , and leak blood into joint spaces after exercise and into urine and stool . Hemophilia C is a rare condition that is triggered by an autosomal ( not sex ) chromosome that renders factor XI nonfunctional . It is not a true recessive condition , since even individuals with a single copy of the mutant gene show a tendency to bleed . Regular infusions of clotting factors isolated from healthy donors can help prevent bleeding in hemophiliac patients . At some point , genetic therapy will become a viable option ."}, {"question": {"question_id": "fs-id2307982", "question_text": "The process in which antibodies attach to antigens, causing the formation of masses of linked cells, is called ________.", "question_choices": ["sensitization", "coagulation", "agglutination", "hemolysis"], "cloze_format": "The process in which antibodies attach to antigens, causing the formation of masses of linked cells, is called ________.", "normal_format": "What is the process called in which antibodies attach to antigens, causing the formation of masses of linked cells?"}, "answer": {"ans_text": "agglutination", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "Because the arms of the Y-shaped antibodies attach randomly to more than one nonself erythrocyte surface , they form clumps of erythrocytes . This process is called agglutination . Proteins called antibodies ( immunoglobulins ) , which are produced by certain B lymphocytes called plasma cells , attach to the antigens on the plasma membranes of the infused erythrocytes and cause them to adhere to one another .", "hl_context": "<hl> Because the arms of the Y-shaped antibodies attach randomly to more than one nonself erythrocyte surface , they form clumps of erythrocytes . <hl> <hl> This process is called agglutination . <hl> Antigens are generally large proteins , but may include other classes of organic molecules , including carbohydrates , lipids , and nucleic acids . Following an infusion of incompatible blood , erythrocytes with foreign antigens appear in the bloodstream and trigger an immune response . <hl> Proteins called antibodies ( immunoglobulins ) , which are produced by certain B lymphocytes called plasma cells , attach to the antigens on the plasma membranes of the infused erythrocytes and cause them to adhere to one another . <hl>"}, {"question": {"question_id": "fs-id1517312", "question_text": "People with ABO blood type O ________.", "question_choices": ["have both antigens A and B on their erythrocytes", "lack both antigens A and B on their erythrocytes", "have neither anti-A nor anti-B antibodies circulating in their blood plasma ", "are considered universal recipients"], "cloze_format": "People with ABO blood type O ________.", "normal_format": "Which of the following is correct about people with ABO blood type O?"}, "answer": {"ans_text": "lack both antigens A and B on their erythrocytes", "ans_choice": 1}, "bloom": null, "hl_sentences": "People with type O blood lack antigens A and B on their erythrocytes , but both anti-A and anti-B antibodies circulate in their blood plasma .", "hl_context": "Normally the body must be exposed to a foreign antigen before an antibody can be produced . This is not the case for the ABO blood group . Individuals with type A blood \u2014 without any prior exposure to incompatible blood \u2014 have preformed antibodies to the B antigen circulating in their blood plasma . These antibodies , referred to as anti-B antibodies , will cause agglutination and hemolysis if they ever encounter erythrocytes with B antigens . Similarly , an individual with type B blood has pre-formed anti-A antibodies . Individuals with type AB blood , which has both antigens , do not have preformed antibodies to either of these . <hl> People with type O blood lack antigens A and B on their erythrocytes , but both anti-A and anti-B antibodies circulate in their blood plasma . <hl>"}, {"question": {"question_id": "fs-id2174184", "question_text": "Hemolytic disease of the newborn is a risk during a subsequent pregnancy in which ________.", "question_choices": ["a type AB mother is carrying a type O fetus", "a type O mother is carrying a type AB fetus", "an Rh+ mother is carrying an Rh\u2212 fetus", "an Rh\u2212 mother is carrying a second Rh+ fetus"], "cloze_format": "Hemolytic disease of the newborn is a risk during a subsequent pregnancy in which ________.", "normal_format": "Which of the following in hemolytic disease of the newborn causes a risk during a subsequent pregnancy?"}, "answer": {"ans_text": "an Rh+ mother is carrying an Rh\u2212 fetus", "ans_choice": 2}, "references_are_paraphrase": 0, "bloom": "1", "hl_sentences": "If the mother should then conceive another Rh + baby , the Rh antibodies she has produced can cross the placenta into the fetal bloodstream and destroy the fetal RBCs . This condition , known as hemolytic disease of the newborn ( HDN ) or erythroblastosis fetalis , may cause anemia in mild cases , but the agglutination and hemolysis can be so severe that without treatment the fetus may die in the womb or shortly after birth .", "hl_context": "Table 18.2 In contrast to the ABO group antibodies , which are preformed , antibodies to the Rh antigen are produced only in Rh \u2212 individuals after exposure to the antigen . This process , called sensitization , occurs following a transfusion with Rh-incompatible blood or , more commonly , with the birth of an Rh + baby to an Rh \u2212 mother . Problems are rare in a first pregnancy , since the baby \u2019 s Rh + cells rarely cross the placenta ( the organ of gas and nutrient exchange between the baby and the mother ) . However , during or immediately after birth , the Rh \u2212 mother can be exposed to the baby \u2019 s Rh + cells ( Figure 18.15 ) . Research has shown that this occurs in about 13 \u2212 14 percent of such pregnancies . After exposure , the mother \u2019 s immune system begins to generate anti-Rh antibodies . <hl> If the mother should then conceive another Rh + baby , the Rh antibodies she has produced can cross the placenta into the fetal bloodstream and destroy the fetal RBCs . <hl> <hl> This condition , known as hemolytic disease of the newborn ( HDN ) or erythroblastosis fetalis , may cause anemia in mild cases , but the agglutination and hemolysis can be so severe that without treatment the fetus may die in the womb or shortly after birth . <hl>"}], "summary": "", "keyterm": "", "bname": "anatomy_and_physiology"}]