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UNITI
Introduction to Physiology: The Cell andGeneralPhysiology .
CHAPTER 1
FunctionalOrganization of the Human Bodyand Control of the "Internal Environment" 3
Cellsas the LivingUnits of the Body 3ExtracellularFluid- The "InternalEnvironment" 3
IIHomeostatic"Mechanisms of the MajorFunctionalSystems 4ControlSystems of the Body 6Summary-Automaticityof the Body 9
CHAPTER2TheCeUand Its Functions 11
Organizationof the Cell 11PhysicalStructure of the Cell 12Comparisonof the Animal CellwithPrecellularFormsof Life 17
FunctionalSystems of the Cell 18Locomotionof Cells 23
CHAPTER3GeneticControl of Protein Synthesis, CeUFunction,and CeUReproduction 27Genesin the CellNucleus 27
TheDNACode in the CellNucleus IsTransferredto an RNACode in the CellCytoplasm- The Process of Transcription 30Synthesisof Other Substances in the Cell 35Controlof Gene Function and BiochemicalActivityin Cells 35TheDNA-GeneticSystem AlsoControls CellReproduction 37CellDifferentiation 39
Contents
Apoptosis-Programmed CellDeathCancer
4040
UNIT 11
Membrane Physiology, Nerve, and Muscle
CHAPTER 4
Transport of Substances Through CeUMembranes 45
The LipidBarrierof the CellMembrane,and CellMembrane Transport Proteins 45Diffusion 46
"ActiveTransport" of Substances ThroughMembranes 52
CHAPTER 5Membrane Potentials and Action Potentials 57
BasicPhysicsof Membrane Potentials 57
Measuring the Membrane Potential 58Resting Membrane Potential of Nerves 59Nerve Action Potential 60
Rolesof Other lons Duringthe ActionPotential 64
Propagation of the Action Potential 64Re-establishing Sodium and Potassiumlonic Gradients AfterAction Potentials AreCompleted-Importance of EnergyMetabolism 65
Plateau in Some Action Potentials 66
Rhythmicity of Some ExcitableTissues-Repetitive Discharge 66Special Characteristics of SignalTransmissionin Nerve Trunks 67
Excitation- The Process of ElicitingtheAction Potential 68
RecordingMembrane Potentials andAction Potentials 69
CHAPTER6Contraction of Skeletal Muscle
Physiologic Anatomy of Skeletal MuscleGeneral Mechanism of Muscle Contraction
Molecular Mechanism of Muscle Contraction
Energetics of Muscle ContractionCharacteristics of Whole MuscleContraction
CHAPTER 7
Excitation of Skeletal Muscle:Neuromuscular Transmission andExcitation-Contraction Coupling 83Transmission of Impulses from Nerve Endingsto Skeletal Muscle Fibers:The NeuromuscularJunction 83
Molecular Biologyof Acetylcholine Formationand Release 86
DrugsThat Enhance or BlockTransmissionat the Neuromuscular Junction 86
Myasthenia GravisCauses Muscle Paralysis 86MuscleAction Potential 87
Excitation-Contraction Coupling 88
CHAPTER8Excitation and Contraction of Smooth Muscle 91Contraction of Smooth Muscle 91
Nervous and Hormonal Control of SmoothMuscleContraction 94
UNIT 11/
The Heart
CHAPTER 9
Cardiac Muscle;The Heart as a Pump andFunction of the Heart Valves 101
Physiologyof Cardiac Muscle 101
Cardiac Cycle 104
Relationship of the Heart Sounds to HeartPumping 107Work Output of the Heart 107ChemicalEnergyRequiredfor CardiacContraction:OxygenUtilizationby the Heart 109
Regulation of Heart Pumping 110
CHAPTER10
Rhythmical Excitation of the Heart 115
Specialized Excitatory and Conductive Systemof the Heart 115Control of Excitation and Conduction in theHeart 118
7171
7374
78
CHAPTER 11
The Normal ElectrocardiogramCharacteristics of the Normal
Electrocardiogram
Methods for Recording ElectrocardiogramsFlow of Current Around the Heart
during the Cardiac Cycle
Electrocardiographic Leads79
CHAPTER 12
Electrocardiographic Interpretation ofCardiac Muscle and Coronary Blood FlowAbnormalities: Vectorial Analysis
PrincipIes of Vectorial Analysis ofElectrocardiograms
Vectorial Analysis of the NormalElectrocardiogramMean Electrical Axis of the Ventricular
QRS-and Its Significance
Conditions That Cause Abnormal Voltagesof the QRS Complex
Prolonged and Bizarre Patterns of the QRSComplex
Current of InjuryAbnormalities in the T Wave
CHAPTER13
Cardiac Arrhythmias and TheirElectrocardiographic InterpretationAbnormal Sinus RhythmsAbnormal RhythmsThat Result from Blockof Heart SignalsWithin the IntracardiacConduction pathwaysPremature Contractions
paroxysmalTachycardiaVentricular FibrillationAtrial Fibrillation
Atrial FlutterCardiacArrest
121
121
123
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134
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The Circulation
UNITIV
CHAPTER14
Overview of the Circulation; Biophysics ofPressure, Flow,and Resistance
PhysicalCharacteristics of the CirculationBasicPrincipIesof Circulatory FunctionInterrelationships of Pressure, Flow,andResistance
157157158
159
CHAPTER15 CHAPTER20
Vascular Distensibility and Functions of the Cardiac Output, Venous Return,Arterial and Venous Systems 167 and Their Regulation 229
VascularDistensibility 167 Normal Values for Cardiac Output at RestArterialPressure Pulsations 168 and During Activity 229
VeinsandTheir Functions 171 Control of Cardiac Output by VenousReturn-Role of the Frank-Starling Mechanism
CHAPTER16 of the Heart 229
The Microcirculation and Lymphatic Pathologically High or Low Cardiac Outputs 232
System: CapiUary Fluid Exchange, Methods for Measuring CardiacInterstitial Fluid, and Lymph Flow 177 Output 240Structure of the Microcirculation
and Capillary System 177 CHAPTER21
Flowof Bloodin the Capillaries- Muscle Blood Flow and Cardiac OutputVasomotion 178 During Exercise; the Coronary Circulation
Exchangeof Water, Nutrients, and Otherand Ischemic Heart Disease 243
Substances Between the Blood and Blood Flow Regulation in Skeletal MuscleInterstitial Fluid 179 at Rest and During Exercise 243
Interstitium and Interstitial Fluid 180 Coronary Circulation 246
FluidFiltrationAcrossCapillaries Is CHAPTER22Determined by Hydrostatic and Colloid Cardiac Failure 255Osmotic Pressures, as Well as CapillaryFiltrationCoefficient 181 Circulatory Dynamics in Cardiac Failure 255
LymphaticSystem 186 Unilateral Left Heart Failure 259
CHAPTER17Low-Output Cardiac Failure-Cardiogenic Shock 259
Localand Humoral Control of Tissue Edema in Patients with Cardiac Failure 259BloodFlow 191
LocalControl of Blood Flow in Response toCardiac Reserve 261
TissueNeeds 191 CHAPTER23Mechanisms of Blood Flow Control 191 Heart Valves and Heart Sounds;Humoral Control of the Circulation 199 Valvular and Congenital Heart
Defects 265CHAPTER18 Heart Sounds 265NervousRegulation of the Circulation, Abnormal Circulatory Dynamics in Valvularand Rapid Control of Arterial Pressure 201 Heart Disease 268Nervous Regulation of the Circulation 201
Abnormal Circulatory DynamicsRoleof the Nervous System in Rapid in Congenital Heart Defects 269Controlof Arterial Pressure 204
Use of Extracorporeal Circulation DuringSpecialFeatures of Nervous Control Cardiac Surgery 271ofArterialPressure 209
Hypertrophy of the Heart in Valvular
CHAPTER19 and Congenital Heart Disease 272
Roleof the Kidneys in Long- Term Control of CHAPTER24Arterial Pressure and in Hypertension: The Circulatory Shock and Its Treatment 273Integrated System for Arterial PressureRegulation 213 Physiologic Causes of Shock 273
Renal-Body Fluid System for Arterial Shock Caused by Hypovolemia-PressureControl 213 Hemorrhagic Shock 274
TheRenin-Angiotensin System: Its Role Neurogenic Shock-Increased VascularinArterial Pressure Control 220 Capacity 279
Summary of the Integrated, Multifaceted Anaphylactic Shock and Histamine Shock 280
System for Arterial Pressure Regulation 226 Septic Shock 280
Physiologyof Treatment in Shock 280Circulatory Arrest 281
UNITV
The Body Fluids and Kidneys
CHAPTER25
The Body Fluid Compartments: ExtraceUularand IntraceUular Fluids; Edema 285
FluidIntake and Output Are BalancedDuring Steady-State Conditions 285
Body FluidCompartments 286ExtracellularFluidCompartment 287BloodVolume 287Constituents of Extracellularand IntracellularFluids 287
Measurement of FluidVolumesin the DifferentBody FluidCompartments-the Indicator-Dilution PrincipIe 287Determination of Volumes of Specific BodyFluidCompartments 289Regulation of FluidExchangeand OsmoticEquilibriumBetween Intracellularand ExtracellularFluid 290
BasicPrincipIesof Osmosis and OsmoticPressure 290
Osmotic EquilibriumIs Maintained BetweenIntracellular and ExtracellularFluids 291
Volume and Osmolality of Extracellularand Intracellular Fluids inAbnormal States 292Glucose and Other Solutions Administeredfor Nutritive Purposes 294ClinicalAbnormalities of FluidVolumeRegulation:Hyponatremia and Hypernatremia 294Edema:ExcessFluid in the Tissues 296
Fluidsinthe "PotentialSpaces"of the Body 300
CHAPTER26
Urine Formation by the Kidneys:l. Glomerular Filtration, Renal Blood Flow,and TheirControl 303
MultipleFunctionsof the Kidneys 303PhysiologicAnatomy of the Kidneys 304Micturition 307
PhysiologicAnatomy of the Bladder 307Transport of Urine from the KidneyThroughthe Ureters and into the Bladder 308
Fittingof the Bladderand BladderWallTone;the Cystometrogram 309Micturition Reflex 309
Abnormalities of Micturition 310Urine Formation Results from GlomerularFiltration,Tubular Reabsorption, and TubularSecretion 310
Glomerular Filtration- The First Step inUrine Formation 312Determinants of the GFR 314Renal Blood Flow 316
PhysiologicControl of Glomerular Filtrationand RenalBlood Flow 317
Autoregulation of GFRand Renal Blood Flow 319
CHAPTER27
Urine Formation by the Kidneys: 11.TubularReabsorption and Secretion 323
RenalTubular Reabsorption and Secretion 323Tubular Reabsorption Includes Passiveand Active Mechanisms 323
Reabsorption and Secretion Along DifferentParts of the Nephron 329
Regulation of Tubular Reabsorption 334Use of Clearance Methods to Quantify KidneyFunction 340
CHAPTER 28
Urine Concentration and Dilution; Regulationof ExtraceUular Fluid Osmolarity and SodiumConcentration 345
KidneysExcrete ExcessWater by FormingDilute Urine 345
KidneysConserveWater by ExcretingConcentrated Urine 346
Quantifying Renal Urine Concentrationand Dilution:"FreeWater" and OsmolarClearances 354
Disorders of Urinary Concentrating Ability 354Control of ExtracellularFluidOsmolarity andSodium Concentration 355
Osmoreceptor-ADH Feedback System 355
Importance ofThirst in ControllingExtracellularFluidOsmolarity and SodiumConcentration 357
Salt-Appetite Mechanism for ControllingExtracellularFluidSodium Concentration andVolume 360
CHAPTER29
Renal Regulation of Potassium, Calcium,Phosphate, and Magnesium; Integrationof Renal Mechanisms for Control of BloodVolume and ExtraceUular FluidVolume 361
Regulation of ExtracellularFluidPotassiumConcentration and Potassium Excretion 361
Control of Renal Calcium Excretionand Extracellular Calcium Ion Concentration 367
Control of Renal Magnesium Excretion andExtracellular Magnesium Ion Concentration 369
Integration of Renal Mechanisms for Controlof Extracellular Fluid 370
Importance of Pressure Natriuresis andPressure Diuresis in Maintaining Body Sodiumand Fluid Balance 371
Distribution of Extracellular FluidBetween the Interstitial Spaces andVascularSystem 373Nervous and Hormonal Factors Increase the
Effectiveness of Renal-Body Fluid FeedbackControl 373
Integrated Responses to Changes in SodiumIntake 376
Conditions That Cause Large Increases inBloodVolume and Extracellular Fluid Volume 376
Conditions That Cause Large Increases inExtracellular Fluid Volume but with NormalBloodVolume 377
CHAPTER 30
Acid-BaseRegulation 379W Concentration Is precisely Regulated 379Acidsand Bases- Their Definitions andMeanings 379
DefendingAgainst Changes in H+Concentration:Buffers.Lungs,and Kidneys 380
Bufferingof H+in the Body Fluids 380BicarbonateBufferSystem 381
PhosphateBufferSystem 383ProteinsAreImportant Intracellular Buffers 383
RespiratoryRegulationof Acid-BaseBalance 384RenalControlof Acid-BaseBalance 385
Secretionof H+and Reabsorption of HC03"bythe RenalTubules 386Combinationof ExcessH+with PhosphateandAmmoniaBuffersin the Tubule Generates"New"HCO- 388
3
Quantifying Renal Acid-Base Excretion 389RenalCorrection of Acidosis-Increased
Excretionof H+and Addition of HC03"tothe Extracellular Fluid 391
RenalCorrection of Alkalosis-DecreasedTubular Secretion of H+and Increased
Excretionof HC03" 391ClinicalCauses of Acid-Base Disorders 392
Treatment of Acidosis or Alkalosis 393
ClinicalMeasurements and Analysis ofAcid-BaseDisorders 393
CHAPTER31
Diuretics, Kidney Diseases 397Diuretics and Their Mechanisms of Action 397
KidneyDiseases 399Acute RenalFailure 399Chronic RenalFailure:An IrreversibleDecreasein the Number of Functional Nephrons 401SpecificTubular Disorders 408Treatment of Renal Failureby Transplantationor by Dialysiswith an Artificial Kidney 409
UNITVI
Blood CeUs,Immunity, and BloodCoagulation
CHAPTER32
RedBloodCeUs,Anemia,and Polycythemia 413Red Blood Cells (Erythrocytes) 413Anemias 420
Polycythemia 421
CHAPTER33
Resistance of the Body to Infedion:l. Leukocytes, Granulocytes, the Monocyte-Macrophage System, and Inflammation 423Leukocytes (White BloodCells) 423Neutrophils and Macrophages DefendAgainst Infections 425Monocyte-Macrophage CellSystem(Reticuloendothelial System) 426Inflammation: Roleof Neutrophilsand Macrophages 428Eosinophils 430Basophils 431Leukopenia 431Leukemias 431
CHAPTER34
Resistance of the Body to Infedion:11.Immunity and AUergy Innate Immunity 433
Acquired (Adaptive) Immunity 433
Allergyand Hypersensitivity 443
CHAPTER35
Blood Types;Transfusion; Tissue and OrganTransplantation 445Antigenicity Causes Immune Reactions ofBlood 445
O-A-B Blood Types 445Rh Blood Types 447
Transplantation of Tissues and Organs 449
CHAPTER 36
Hemostasis and Blood Coagulation 451Events in Hemostasis 451VascularConstriction 451
Mechanism of BloodCoagulation 453Conditions That Cause ExcessiveBleedinginHumans 457Thromboembolic Conditions in theHuman Being 459Anticoagulants for ClínicalUse 459
BloodCoagulation Tests 460
UNITVII
Respiration
CHAPTER 37
Pulmonary Ventilation 465Mechanics of Pulmonary Ventilation 465
Pulmonary Volumes and Capacities 469Minute RespiratoryVolume EqualsRespiratoryRate TimesTidalVolume 471AlveolarVentilation 471
Functions of the Respiratory Passageways 472
CHAPTER 38
Pulmonary Circulation, Pulmonary Edema,Pleural Fluid 477
PhysiologicAnatomy of the PulmonaryCirculatory System 477
Pressures in the Pulmonary System 477BloodVolume of the Lungs 478
Blood FlowThrough the Lungsand ItsDistribution 479
Effectof Hydrostatic Pressure Gradients inthe Lungson RegionalPulmonary Blood Flow 479
Pulmonary Capillary Dynamics 481Fluid in the Pleural Cavity 483
CHAPTER39
Physical Principles of Gas Exchange;Diffusion of Oxygen and Carbon DioxideThrough the Respiratory Membrane 485Physicsof Gas Diffusionand GasPartial Pressures 485
Compositions of AlveolarAirand AtmosphericAirAre Different 487
Diffusionof Gases Through the RespiratoryMembrane 489Effectof the Ventilation-Perfusion Ratio onAlveolarGas Concentration 492
CHAPTER40
Transport of Oxygen and Carbon Dioxide inBlood and Tissue Fluids 495
Transport of Oxygen from the Lungsto theBodyTissues 495Transport of Carbon Dioxidein the Blood 502
Respiratory ExchangeRatio 504CHAPTER 41
Regulation of Respiration 505
Respiratory Center 505
Chemical Control of Respiration 507Peripheral Chemoreceptor System for Controlof RespiratoryActivity-Role of Oxygen inRespiratory Control 508
Regulation of Respiration During Exercise 510Other FactorsThat Affect Respiration 512
CHAPTER42
Respiratory Insufficiency-Pathophysiology,Diagnosis, Oxygen Therapy 515
Useful Methods for Studying RespiratoryAbnormalíties 515
Pathophysiology of Specific PulmonaryAbnormalities 517
Hypoxia and Oxygen Therapy 520Hypercapnia-Excess Carbon Dioxidein theBody Fluids 522Artificial Respiration 522
UNITVIII
Aviation, Space, and Deep-Sea DivingPhysiology
CHAPTER43
Aviation,High-Altitude, andSpace Physiology 527
Effectsof LowOxygen Pressure on the Body 527
Effectsof Acceleratory Forceson the BodyinAviationand Space Physiology 531"ArtificialClimate" in the Sealed Spacecraft 533
Weightlessness in Space 533
CHAPTER 44
Physiology of Deep-Sea Diving andOther Hyperbaric Conditions 535Effectof High Partíal Pressures of IndividualGases on the Body 535Scuba (Self-Contained Underwater BreathingApparatus) Diving 539Special PhysiologicProblems in Submarines 540
Hyperbaric Oxygen Therapy 540
UNITIX
The Nervous System: A.General Principlesand Sensory Physiology
CHAPTER45
Organization of the Nervous System, BasicFunctions of Synapses, andNeurotransmitters 543
GeneralDesign of the Nervous System 543Major Levels of Central Nervous SystemFunction 545
Comparison of the Nervous System with aComputer 546
Central Nervous System Synapses 546
Some Special Characteristics of SynapticTransmission 557
CHAPTER46
SensoryReceptors, Neuronal Circuits forProcessingInformation 559Typesof Sensory Receptors and theStimuliThey Detect 559Transductionof SensoryStimulíinto Nerve Impulses 560NerveFibersThat Transmit DifferentTypes ofSignalsand Their PhysiologicClassification 563Transmissionof Signals of Different IntensityinNerveTracts-Spatial and TemporalSummation 564
Transmissionand Processingof Signals inNeuronalPools 564
Instabilityand Stability of Neuronal Circuits 569CHAPTER 47
SomaticSensations: l. General Organization,the Tactileand Position Senses 571Classificationof Somatic Senses 571
Detectionand Transmissionof TactileSensations 571
Sensorypathways for Transmitting SomaticSignals¡nto the Central Nervous System 573Transmissionin the Dorsal Column-MediallemniscalSystem 573Transmissionof LessCritical Sensory Signalsinthe Anterolateral pathway 580SomeSpecialAspects of SomatosensoryFunction 581
CHAPTER48
SomaticSensations: 11.Pain, Headache, andThermalSensations 583
Typesof Painand Their Qualities-Fast PainandSlowPain 583
Pain Receptors and Their Stimulation 583
Dual Pathways for Transmission of PainSignals into the Central Nervous System 584Pain Suppression ("Analgesia")System in theBrainand Spinal Cord 586Referred Pain 588
VisceralPain 588Some ClínicalAbnormalities of Painand Other Somatic Sensations 590Headache 590Thermal Sensations 592
UNITX
The Nervous System: B.The Special Senses
CHAPTER49
The Eye:1.Optics of Vision 597Physical PrincipIesof Optics 597
Optics of the Eye 600Ophthalmoscope 605FluidSystem of the Eye-Intraocular Fluid 606
CHAPTER50
The Eye:11.Receptor and Neural Functionof the Retina 609
Anatomy and Function of the StructuralElements of the Retina 609
Photochemistry of Vision 611ColorVision 615
Neural Fundion ofthe Retina 616
CHAPTER51
The Eye:111.Central Neurophysiologyof Vision 623
Visual Pathways 623
Organization and Function of the VisualCortex 624
Neuronal Patterns of Stimulation DuringAnalysisof the Visuallmage 626Fieldsof Vision;Perimetry 627
Eye Movements and Their Control 627Autonomic Control of Accommodationand PupillaryAperture 631
CHAPTER 52
The Senseof Hearing 633
Tympanic Membrane and the Ossicular System 633Cochlea 634
Central Auditory Mechanisms 639
Hearing Abnormalities 642
CHAPTER53The Chemical Senses- Taste and SmeU
Sense ofTaste
Sense of Smell
645
645648
UNITXI
The Nervous System: C. Motor andIntegrative Neurophysiology
CHAPTER 54
Motor Functions of the Spinal Cord; the CordReflexes 655
Organization of the Spinal Cord for MotorFunctions 655
MuscleSensory Receptors-Muscle Spindlesand GolgiTendon Organs-And Their Rolesin Muscle Control 657FlexorReflexand the Withdrawal Reflexes 661Crossed Extensor Reflex 663
Reciprocallnhibition and Reciprocallnnervation 663Reflexesof Posture and Locomotion 663Scratch Reflex 664
Spinal Cord ReflexesThat Cause Muscle Spasm 664Autonomic Reflexesin the SpinalCord 665
Spinal CordTransection and Spinal Shock 665
CHAPTER55Cortical and Brain Stem Control of MotorFunction 667
Motor Cortex and CorticospinalTract 667Roleof the BrainStem in Controlling MotorFunction 673
Vestibular Sensations and Maintenance ofEquilibrium 674Functions of BrainStem Nuclei in ControllingSubconscious, Stereotyped Movements 678
CHAPTER56Contributions of the CerebeUum and BasalGanglia to OveraU Motor Control 681Cerebellum and Its Motor Functions 681
Basal Ganglia- Their Motor Functions 689Integration of the Many Parts of the TotalMotor Control System 694
CHAPTER 57
Cerebral Cortex, InteUectual Functions of theBrain, Learning, and Memory 697PhysiologicAnatomy of the Cerebral Cortex 697Functions of SpecificCorticalAreas 698
Function of the Brainin Communication-Language Input and Language Output 703Function of the Corpus Callosum and AnteriorCommissure to TransferThoughts, Memories,Training,and Other Information Between theTwo Cerebral Hemispheres 704Thoughts, Consciousness, and Memory 705
CHAPTER 58
Behavioral and Motivational Mechanisms of theBrain- The limbic System and theHypothalamus 711Activating-DrivingSystemsof the Brain 711
LimbicSystem 714FunctionalAnatomy of the LimbicSystem; KeyPosition of the Hypothalamus 714Hypothalamus, a Major Control Headquartersfor the LimbicSystem 715
Specific Functions of Other Parts of the LimbicSystem 718
CHAPTER59
States of Brain Activity-Sleep, BrainWaves,Epilepsy, Psychoses 721
Sleep 721
Epilepsy 725Psychotic Behaviorand Dementia-Rolesof Specific Neurotransmitter Systems 726Schizophrenia-Possible ExaggeratedFunction of Part of the Dopamine System 727
CHAPTER60
The Autonomic Nervous System and theAdrenal MeduUa 729
General Organization of the AutonomicNervous System 729BasicCharacteristics of Sympathetic andParasympathetic Function 731Autonomic Reflexes 738
Stimulation of Discrete Organs in SomeInstances and Mass Stimulation in OtherInstances by the Sympathetic andParasympathetic Systems 738Pharmacology of the Autonomic NervousSystem 739
CHAPTER 61
Cerebral Blood Flow,Cerebrospinal Fluid,and Brain Metabolism 743Cerebral Blood Flow 743
Cerebrospinal FluidSystem 746BrainMetabolism 749
UNIT XII
Gastrointestinal Physiology
CHAPTER62
GeneralPrinciples of GastrointestinalFunction-Motility, Nervous Control, andBloodCirculation 753
GeneralPrinciplesof Gastrointestinal Motility 753NeuralControl of Gastrointestinal Function-EntericNervous System 755FunctionalTypes of Movements in theGastrointestinalTract 759
Gastrointestinal Blood Flow-IISplanchnicCirculation" 759
CHAPTER63
Propulsionand Mixingof Food in theAlimentaryTract 763
Ingestionof Food 763MotorFunctionsof the Stomach 765Movementsof the Smalllntestine 768
Movementsof the Colon 770
OtherAutonomic ReflexesThat Affect BowelActivity 772
CHAPTER64
SecretoryFunctions of the Alimentary Tract 773
General Principles of Alimentary TractSecretion 773
Secretion of Saliva 775
Esophageal Secretion 776Gastric Secretion 777
Pancreatic Secretion 780
Secretion of Bile by the Liver; Functions of theBiliaryTree 783Secretions of the Smalllntestine 786
Secretion of Mucus by the Large Intestine 787
CHAPTER65
Digestionand Absorption in theGastrointestinal Tract 789
Digestionof the VariousFoods by Hydrolysis 789BasicPrinciplesof Gastrointestinal Absorption 793
Absorptionin the Smalllntestine 794Absorptionin the LargeIntestine: Formation ofFeces 797
CHAPTER66
Physiologyof Gastrointestinal Disorders 799
Disordersof Swallowing and of the Esophagus 799
Disorders of the Stomach 799
Disorders of the Smalllntestine 801
Disorders of the LargeIntestine 802General Disorders of the GastrointestinalTract 803
UNITXIII
MetaboLism and Temperature Regulation
CHAPTER 67
Metabolism of Carbohydrates, and Formationof AdenosineTriphosphate 809Central Roleof Glucose in CarbohydrateMetabolism 810
Transport of Glucose Through the CellMembrnne 810
Glycogen 15Stored in Liverand Muscle 811Release of Energy from Glucose by theGlycolytic pathway 812Release of Energy from Glucose by thePentose Phosphate pathway 816Formation of Carbohydrates from Proteinsand Fats-"Gluconeogenesis" 817BloodGlucose 817
CHAPTER 68
LipidMetabolism 819Transport of Lipidsin the Body Fluids 819Fat Deposits 821Use ofTriglycerides for Energy:Formation ofAdenosine Triphosphate 822Regulation of EnergyRelease fromTriglycerides 825Phospholipids and Cholesterol 826Atherosclerosis 827
CHAPTER 69
Protein Metabolism 831
BasicProperties 831Transport and Storage of AminoAcids 831Functional Rolesof the Plasma Proteins 833
Hormonal Regulation of Protein Metabolism 835
CHAPTER 70
The Liveras an Organ 837
PhysiologicAnatomy of the Liver 837Hepatic Vascularand LymphSystems 837Metabolic Functions of the Liver 839Measurement of Bilirubinin the Bileas aClinicalDiagnosticTool 840
CHAPTER71
Dietary Balances; Regulation of Feeding;Obesity and Starvation; Vitamins andMinerals 843
Energy Intake and Output Are Balanced UnderSteady-State Conditions 843Dietary Balances 843
Regulation of Food Intake and EnergyStorage 845Obesity 850Inanition,Anorexia,and Cachexia 851Starvation 852Vitamins 852
MineralMetabolism 855
CHAPTER72
Energetics and Metabolic Rate 859Adenosine Triphosphate (ATP)Functions asan IIEnergyCurrency" in Metabolism 859Control of EnergyRelease in the Cell 861Metabolic Rate 862
EnergyMetabolism-Factors That InfluenceEnergyOutput 863
CHAPTER73
BodyTemperature Regulation,and Fever 867
Normal BodyTemperatures 867
BodyTemperature 15Controlled byBalancing Heat Production andHeat Loss 867
Regulation of BodyTemperature-Roleof the Hypothalamus 871Abnormalities of BodyTemperatureRegulation 875
UNIT XIV
Endocrinology and Reproduction
CHAPTER 74
Introduction to Endocrinology 881
Coordination of Body Functions by ChemicalMessengers 881
Chemical Structure and Synthesis ofHormones 881
Hormone Secretion,Transport, and Clearancefrom the Blood 884Mechanisms of Action of Hormones 886Measurement of Hormone Concentrationsin the Blood 891
CHAPTER75
Pituitary HormonesandTheirControl by theHypothalamus 895Pituitary Gland and Its Relation to theHypothalamus 895Hypothalamus Controls Pituitary Secretion 897PhysiologicalFunctions of Growth Hormone 898Posterior Pituitary Gland and Its Relation tothe Hypothalamus 904
CHAPTER76
Thyroid Metabolic Hormones 907
Synthesis and Secretion of the ThyroidMetabolic Hormones 907
PhysiologicalFunctions of the ThyroidHormones 910
Regulation of Thyroid Hormone Secretion 914
Diseases of the Thyroid 916
CHAPTER77Adrenocortical Hormones 921
Synthesis and Secretion of AdrenocorticalHormones 921
Functions of the Mineralocorticoids-Aldosterone 924
Functions of the Glucocorticoids 928
AdrenalAndrogens 934Abnormalities of Adrenocortical Secretion 934
CHAPTER78
Insulin, Glucagon, and Diabetes MeUitus 939Insulin and Its Metabolic Effects 939
Glucagon and Its Functions 947
Somatostatin Inhibits Glucagon and InsulinSecretion 949
Summary of Blood Glucose Regulation 949Diabetes Mellitus 950
CHAPTER 79
Parathyroid Hormone, Calcitonin, Calciumand Phosphate Metabolism, Vitamin D,Bone,andTeeth 955Overviewof CalciumandPhosphate Regulation in the ExtracellularFluidand Plasma 955Bone and Its Relation to ExtracellularCalciumand Phosphate 957Vitamin D 960
Parathyroid Hormone 962Calcitonin 966
Summary of Control of Calcium IonConcentration 966
Pathophysiologyof Parathyroid Hormone,Vitamin D,and Bone Disease
Physiologyof the Teeth
CHAPTER80
Reproductive and Hormonal Functions ofthe Male (and Function of the Pineal Gland)
PhysiologicAnatomy of the Male SexualOrgans
SpermatogenesisMaleSexualAct
Testosteroneand Other Male SexHormones
Abnormalitiesof Male Sexual Function
ErectileDysfunction in the Male
PinealGland-Its Function in ControllingSeasonalFertility in SomeAnimals
CHAPTER81
FemalePhysiology Before Pregnancy andFemaleHormones
PhysiologicAnatomy of the FemaleSexualOrgans
FemaleHormonal System
MonthlyOvarian Cycle; Function of theGonadotropicHormonesFunctionsof the Ovarian Hormones-Estradioland Progesterone
Regulationof the FemaleMonthlyRhythm-Interplay Between the OvarianandHypothalamic-Pituitary Hormones
Abnormalitiesof Secretion by the OvariesFemaleSexual Act
FemaleFertility
CHAPTER 82
Pregnancyand LactationMaturationand Fertilization of the Ovum
EarlyNutrition of the Embryo
967
969
973
973973
978979984985
986
987
987
987
988
991
996999
10001000
1003
10031005
Function of the Placenta
Hormonal Factors in PregnancyResponseof the Mother's Body to PregnancyParturitionLactation
CHAPTER83
Fetal and Neonatal Physiology
Growth and Functional Developm~nt of theFetus
Development of the Organ Systems
Adjustments of the Infant to Extrauterine life
Special Functional Problems in the Neonate
Special Problems of Prematurity
Growth and Development of the Child
10051007100910111014
1019
10191019
102110231026
1027
Sports Physiology
UNIT XV
CHAPTER 84
Sports PhysiologyMuscles in Exercise
Respiration in Exercise
Cardiovascular System in Exercise
Body Heat in Exercise
Body Fluids and Salt in Exercise
Drugs and AthletesBody FitnessProlongs life
Index
1031
1031
1036
1038
1039
1040
1040
1041
1043
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