Preface | p. xi |
Introduction | p. 1 |
The General & Cellular Basis of Medical Physiology | p. 1 |
Introduction | p. 1 |
General Principles | p. 1 |
Functional Morphology of the Cell | p. 8 |
Structure & Function of DNA & RNA | p. 18 |
Transport Across Cell Membranes | p. 28 |
The Capillary Wall | p. 36 |
Intercellular Communication | p. 36 |
Homeostasis | p. 49 |
Aging | p. 49 |
Section I References | p. 49 |
Physiology of Nerve & Muscle Cells | p. 51 |
Excitable Tissue: Nerve | p. 51 |
Introduction | p. 51 |
Nerve Cells | p. 51 |
Excitation & Conduction | p. 54 |
Ionic Basis of Excitation & Conduction | p. 58 |
Properties of Mixed Nerves | p. 60 |
Nerve Fiber Types & Function | p. 60 |
Neurotrophins | p. 62 |
Neuroglia | p. 63 |
Excitable Tissue: Muscle | p. 65 |
Introduction | p. 65 |
Skeletal Muscle | p. 65 |
Cardiac Muscle | p. 78 |
Smooth Muscle | p. 82 |
Synaptic & Junctional Transmission | p. 86 |
Introduction | p. 86 |
Synaptic Transmission | p. 87 |
Neuromuscular Transmission | p. 118 |
Initiation of Impulses in Sense Organs | p. 122 |
Introduction | p. 122 |
Sense Organs & Receptors | p. 122 |
The Senses | p. 122 |
Generation of Impulses in Different Nerves | p. 124 |
"Coding" of Sensory Information | p. 125 |
Section II References | p. 128 |
Functions of the Nervous System | p. 129 |
Reflexes | p. 129 |
Introduction | p. 129 |
Monosynaptic Reflexes: The Stretch Reflex | p. 130 |
Polysynaptic Reflexes: The Withdrawal Reflex | p. 135 |
General Properties of Reflexes | p. 137 |
Cutaneous, Deep, & Visceral Sensation | p. 139 |
Introduction | p. 139 |
Pathways | p. 139 |
Touch | p. 142 |
Proprioception | p. 143 |
Temperature | p. 143 |
Pain | p. 143 |
Other Sensations | p. 148 |
Vision | p. 150 |
Introduction | p. 150 |
Anatomic Considerations | p. 150 |
The Image-Forming Mechanism | p. 155 |
The Photoreceptor Mechanism | p. 159 |
Responses in the Visual Pathways & Cortex | p. 163 |
Color Vision | p. 166 |
Other Aspects of Visual Function | p. 168 |
Eye Movements | p. 171 |
Hearing & Equilibrium | p. 173 |
Introduction | p. 173 |
Anatomic Considerations | p. 173 |
Hair Cells | p. 176 |
Hearing | p. 178 |
Vestibular Function | p. 186 |
Smell & Taste | p. 188 |
Introduction | p. 188 |
Smell | p. 188 |
Taste | p. 191 |
Receptor Organs & Pathways | p. 191 |
Alert Behavior, Sleep, & the Electrical Activity of the Brain | p. 195 |
Introduction | p. 195 |
The Thalamus & the Cerebral Cortex | p. 195 |
The Reticular Formation & the Reticular Activating System | p. 195 |
Evoked Cortical Potentials | p. 196 |
The Electroencephalogram | p. 197 |
Physiologic Basis of the EEG, Consciousness, & Sleep | p. 199 |
Control of Posture & Movement | p. 205 |
Introduction | p. 205 |
General Principles | p. 205 |
Corticospinal & Corticobulbar System | p. 206 |
Cerebellum | p. 220 |
The Autonomic Nervous System | p. 226 |
Introduction | p. 226 |
Anatomic Organization of Autonomic Outflow | p. 226 |
Chemical Transmission at Autonomic Junctions | p. 228 |
Responses of Effector Organs to Autonomic Nerve Impulses | p. 231 |
Central Regulation of Visceral Function | p. 235 |
Introduction | p. 235 |
Medulla Oblongata | p. 235 |
Hypothalamus | p. 236 |
Relation to Cyclic Phenomena | p. 238 |
Hunger | p. 240 |
Thirst | p. 243 |
Control of Posterior Pituitary Secretion | p. 245 |
Control of Anterior Pituitary Secretion | p. 251 |
Temperature Regulation | p. 254 |
Neural Basis of Instinctual Behavior & Emotions | p. 260 |
Introduction | p. 260 |
Anatomic Considerations | p. 260 |
Limbic Functions | p. 260 |
Sexual Behavior | p. 261 |
Other Emotions | p. 263 |
Motivation & Addiction | p. 264 |
Brain Chemistry & Behavior | p. 266 |
"Higher Functions of the Nervous System": Conditioned Reflexes, Learning, & Related Phenomena | p. 270 |
Introduction | p. 270 |
Methods | p. 270 |
Learning & Memory | p. 270 |
Functions of the Neocortex | p. 276 |
Section III References | p. 280 |
Endocrinology, Metabolism, & Reproductive Function | p. 282 |
Energy Balance, Metabolism, & Nutrition | p. 282 |
Introduction | p. 282 |
Energy Metabolism | p. 282 |
Intermediary Metabolism | p. 285 |
Carbohydrate Metabolism | p. 289 |
Protein Metabolism | p. 295 |
Fat Metabolism | p. 302 |
Nutrition | p. 313 |
The Thyroid Gland | p. 320 |
Introduction | p. 320 |
Anatomic Considerations | p. 320 |
Formation & Secretion of Thyroid Hormones | p. 321 |
Transport & Metabolism of Thyroid Hormones | p. 324 |
Effects of Thyroid Hormones | p. 326 |
Regulation of Thyroid Secretion | p. 329 |
Clinical Correlates | p. 331 |
Endocrine Functions of the Pancreas & Regulation of Carbohydrate Metabolism | p. 336 |
Introduction | p. 336 |
Islet Cell Structure | p. 336 |
Structure, Biosynthesis, & Secretion of Insulin | p. 337 |
Fate of Secreted Insulin | p. 338 |
Effects of Insulin | p. 339 |
Mechanism of Action | p. 341 |
Consequences of Insulin Deficiency | p. 343 |
Insulin Excess | p. 347 |
Regulation of Insulin Secretion | p. 348 |
Glucagon | p. 351 |
Other Islet Cell Hormones | p. 354 |
Effects of Other Hormones & Exercise on Carbohydrate Metabolism | p. 355 |
Hypoglycemia & Diabetes Mellitus in Humans | p. 356 |
The Adrenal Medulla & Adrenal Cortex | p. 359 |
Introduction | p. 359 |
Adrenal Morphology | p. 359 |
Adrenal Medulla | p. 361 |
Adrenal Cortex | p. 364 |
Physiologic Effects of Glucocorticoids | p. 372 |
Pharmacologic & Pathologic Effects of Glucocorticoids | p. 374 |
Regulation of Glucocorticoid Secretion | p. 375 |
Effects of Mineralocorticoids | p. 378 |
Regulation of Aldosterone Secretion | p. 381 |
Role of Mineralocorticoids in the Regulation of Salt Balance | p. 383 |
Summary of the Effects of Adrenocortical Hyper- & Hypofunction in Humans | p. 383 |
Hormonal Control of Calcium Metabolism & the Physiology of Bone | p. 385 |
Introduction | p. 385 |
Calcium & Phosphorus Metabolism | p. 385 |
Bone Physiology | p. 387 |
Vitamin D & the Hydroxycholecalciferols | p. 390 |
The Parathyroid Glands | p. 393 |
Calcitonin | p. 396 |
Effects of Other Hormones & Humoral Agents on Calcium Metabolism | p. 398 |
The Pituitary Gland | p. 399 |
Introduction | p. 399 |
Morphology | p. 400 |
Intermediate-Lobe Hormones | p. 401 |
Growth Hormone | p. 402 |
Physiology of Growth | p. 409 |
Pituitary Insufficiency | p. 412 |
Pituitary Hyperfunction in Humans | p. 413 |
The Gonads: Development & Function of the Reproductive System | p. 415 |
Introduction | p. 415 |
Sex Differentiation & Development | p. 415 |
Pituitary Gonadotropins & Prolactin | p. 425 |
The Male Reproductive System | p. 428 |
The Female Reproductive System | p. 437 |
Pregnancy | p. 452 |
Lactation | p. 455 |
Endocrine Functions of the Kidneys, Heart, & Pineal Gland | p. 458 |
Introduction | p. 458 |
The Renin-Angiotensin System | p. 458 |
Erythropoietin | p. 463 |
Hormones of the Heart & Other Natriuretic Factors | p. 464 |
Pineal Gland | p. 467 |
Section IV References | p. 469 |
Gastrointestinal Function | p. 471 |
Digestion & Absorption | p. 471 |
Introduction | p. 471 |
Carbohydrates | p. 471 |
Proteins & Nucleic Acids | p. 475 |
Lipids | p. 477 |
Absorption of Water & Electrolytes | p. 479 |
Absorption of Vitamins & Minerals | p. 481 |
Regulation of Gastrointestinal Function | p. 483 |
Introduction | p. 483 |
General Considerations | p. 483 |
Gastrointestinal Hormones | p. 486 |
Mouth & Esophagus | p. 492 |
Stomach | p. 495 |
Exocrine Portion of the Pancreas | p. 501 |
Liver & Biliary System | p. 502 |
Small Intestine | p. 508 |
Colon | p. 512 |
Section V References | p. 516 |
Circulation | p. 517 |
Circulating Body Fluids | p. 517 |
Introduction | p. 517 |
Blood | p. 517 |
Lymph | p. 548 |
Origin of the Heartbeat & the Electrical Activity of the Heart | p. 549 |
Introduction | p. 549 |
Origin & Spread of Cardiac Excitation | p. 550 |
The Electrocardiogram | p. 552 |
Cardiac Arrhythmias | p. 556 |
Electrocardiographic Findings in Other Cardiac & Systemic Diseases | p. 563 |
The Heart as a Pump | p. 567 |
Introduction | p. 567 |
Mechanical Events of the Cardiac Cycle | p. 567 |
Cardiac Output | p. 572 |
Dynamics of Blood & Lymph Flow | p. 579 |
Introduction | p. 579 |
Functional Morphology | p. 579 |
Biophysical Considerations | p. 584 |
Arterial & Arteriolar Circulation | p. 589 |
Capillary Circulation | p. 593 |
Lymphatic Circulation & Interstitial Fluid Volume | p. 595 |
Venous Circulation | p. 596 |
Cardiovascular Regulatory Mechanisms | p. 599 |
Introduction | p. 599 |
Local Regulation | p. 599 |
Substances Secreted by the Endothelium | p. 600 |
Systemic Regulation by Hormones | p. 603 |
Systemic Regulation by the Nervous System | p. 604 |
Circulation Through Special Regions | p. 614 |
Introduction | p. 614 |
Cerebral Circulation | p. 614 |
Coronary Circulation | p. 623 |
Splanchnic Circulation | p. 627 |
Cutaneous Circulation | p. 628 |
Placental & Fetal Circulation | p. 630 |
Cardiovascular Homeostasis in Health & Disease | p. 633 |
Introduction | p. 633 |
Compensations for Gravitational Effects | p. 633 |
Exercise | p. 635 |
Inflammation & Wound Healing | p. 638 |
Shock | p. 639 |
Hypertension | p. 644 |
Heart Failure | p. 646 |
Section VI References | p. 648 |
Respiration | p. 649 |
Pulmonary Function | p. 649 |
Introduction | p. 649 |
Properties of Gases | p. 649 |
Anatomy of the Lungs | p. 650 |
Mechanics of Respiration | p. 651 |
Gas Exchange in the Lungs | p. 662 |
Pulmonary Circulation | p. 664 |
Other Functions of the Respiratory System | p. 666 |
Gas Transport Between the Lungs & the Tissues | p. 669 |
Introduction | p. 669 |
Oxygen Transport | p. 669 |
Carbon Dioxide Transport | p. 672 |
Regulation of Respiration | p. 675 |
Introduction | p. 675 |
Neural Control of Breathing | p. 675 |
Regulation of Respiratory Activity | p. 676 |
Chemical Control of Breathing | p. 676 |
Nonchemical Influences on Respiration | p. 682 |
Respiratory Adjustments in Health & Disease | p. 685 |
Introduction | p. 685 |
Effects of Exercise | p. 685 |
Hypoxia | p. 687 |
Hypoxic Hypoxia | p. 688 |
Other Forms of Hypoxia | p. 694 |
Oxygen Treatment | p. 695 |
Hypercapnia & Hypocapnia | p. 696 |
Other Respiratory Abnormalities | p. 696 |
Diseases Affecting the Pulmonary Circulation | p. 698 |
Effects of Increased Barometric Pressure | p. 698 |
Artificial Respiration | p. 699 |
Section VII References | p. 700 |
Formation & Excretion of Urine | p. 702 |
Renal Function & Micturition | p. 702 |
Introduction | p. 702 |
Functional Anatomy | p. 702 |
Renal Circulation | p. 706 |
Glomerular Filtration | p. 709 |
Tubular Function | p. 711 |
Water Excretion | p. 717 |
Acidification of the Urine & Bicarbonate Excretion | p. 723 |
Regulation of Na[superscript +] & Cl[superscript -] Excretion | p. 726 |
Regulation of K[superscript +] Excretion | p. 727 |
Diuretics | p. 728 |
Effects of Disordered Renal Function | p. 729 |
Filling of the Bladder | p. 730 |
Emptying of the Bladder | p. 730 |
Regulation of Extracellular Fluid Composition & Volume | p. 733 |
Introduction | p. 733 |
Defense of Tonicity | p. 733 |
Defense of Volume | p. 733 |
Defense of Specific Ionic Composition | p. 734 |
Defense of H[superscript +] Concentration | p. 734 |
Section VIII References | p. 742 |
Self-Study: Objectives, Essay Questions, & Multiple-Choice Questions (black edges) | p. 743 |
Answers to Quantitative & Multiple-Choice Questions (black edges) | p. 810 |
Appendix | p. 813 |
General References | p. 813 |
Normal Values & the Statistical Evaluation of Data | p. 813 |
Abbreviations & Symbols Commonly Used in Physiology | p. 816 |
Some Standard Respiratory Symbols | p. 823 |
Equivalents of Metric, United States, & English Measures | p. 823 |
Greek Alphabet | p. 824 |
Index | p. 825 |
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