GUYTON AND HALL MEDICAL PHYSIOLOGY. 13-Ed
Автор: John E. Hall
Год: 2016
Страницы: 1165
Язык: Английский
Издательство: by Elsevier, Inc
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Описание:
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating j and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own , experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions.
Introduction to Physiology: The Cell and General Physiology
CHAPTER 1
Functional Organization of the Human Body and Control of the "Internal Environment" 3
Cells Are the Living Units of the Body 3
Extracellular Fluid—The "Internal Environment" 3
Homeostasis—Maintenance of a Nearly Constant Internal Environment 4
Control Systems cf the Body 6
Summary—Automaticity of the Body 10
CHAPTER 2
The Cell and Its Functions 11
Organization of the Cell 11
Physical Structure of the Cell 12
Comparison of the Animal Cell With Precellular Forms of Life 18
Functional Systems of the Cell 19
Locomotion of Cells 24
CHAPTER 3
Genetic Control of Protein Synthesis, Cell Function, and Cell Reproduction 27
Genes in the Cell Nucleus Control 27
Protein Synthesis The DNA Code in the Cell Nucleus Is Transferred to RNA Code in the Cell Cytoplasm—The Process of 30
Transcription Synthesis of Other Substances in the Cell 35
Control of Gene Function and Biochemical Activity in Cells 35
The DNA-Genetic System Controls Cell Reproduction 37
Cell Differentiation 41
Apoptosis—Programmed Cell Death 41
Cancer 41
Membrane Physiology, Nerve and Muscle
CHAPTER 4
Transport of Substances Through Cell Membranes 47
The Cell Membrane Consists of a Lipid Bilayer With Cell Membrane Transport Proteins 47
Diffusion 47
Active Transport" of Substances Through Membranes 54
CHAPTER 5
Membrane Potentials and Action Potentials 61
Basic Physics of Membrane Potentials 61
Measuring the Membrane Potential 62
Resting Membrane Potential of Neurons 63
Neuron Action Potential 65
Propagation of the Action Potential 69
Re-establishing Sodium and Potassium Ionic Gradients After Action Potentials Are Completed—Importance of Energy Metabolism 69
Plateau in Some Action Potentials 70
Rhythmicity of Some Excitable Tissues—Repetitive Discharge 70
Special Characteristics of Signal Transmission in Nerve Trunks 71
CHAPTER 6
Contraction of Skeletal Muscle 75
Physiological Anatomy of Skeletal Muscle 75
General Mechanism of Muscle Contraction 77
Molecular Mechanism of Muscle Contraction 78
Energetics of Muscle Contraction 82
Characteristics of Whole Muscle 83
CHAPTER 7
Excitation of Skeletal Muscle: Neuromuscular Transmission and Excitation-Contraction Coupling 89
Transmission of Impulses From Nerve Endings to Skeletal Muscle Fibers: The Neuromuscular Junction 89
Muscle Action Potential 93
Excitation-Contraction Coupling 93
CHAPTER 8
Excitation and Contraction of Smooth Muscle 97
Contraction of Smooth Muscle 97
Regulation of Contraction by Calcium Ions 99
Nervous and Hormonal Control of Smooth Muscle Contraction 102
The Heart
CHAPTER 9
Cardiac Muscle; The Heart as a Pump and The Heart Valves 109
Function of the Heart Valves 109
Physiology of Cardiac Muscle 109
Cardiac Cycle 113
Regulation of Heart Pumping 119
CHAPTER 10
Rhythmical Excitation of the Heart 123
Specialized Excitatory and Conductive System of the Heart 123
Control of Excitation and Conduction in the Heart 126
CHAPTER 11
The Normal Electrocardiogram 131
Characteristics of the Normal Electrocardiogram 131
Flow of Current Around the Heart During the Cardiac Cycle 133
Electrocardiographic Leads 134
Methods for Recording Electrocardiograms 137
CHAPTER 12
Electrocardiographic Interpretation of Cardiac Muscle and Coronary Blood How Abnormalities: Vectorial Analysis 139
Principles of Vectorial Analysis of Electrocardiograms 139
Vectorial Analysis of the Normal Electrocardiogram 141
Mean Electrical Axis of the ventricular QRS and Its Significance 144
Conditions That Cause Abnormal Voltages of the QRS Complex 147
Prolonged and Bizarre Patterns of the QRS Complex 148
Current of Injury 148
Abnormalities in the T Wave 152
CHAPTER 13
Cardiac Arrhythmias and Their Electrocardiographic Interpretation 155
Abnormal Sinus Rhythms 155
Abnormal Rhythms That Result From Block of Heart Signals Within the Intracardiac Conduction Pathways 156
Premature Contractions 158
Paroxysmal Tachycardia 160
Ventricular Fibrillation 161
Atrial Fibrillation 164
Atrial Flutter 165
Cardiac Arrest 165
CHAPTER 14
Overview of the Circulation; Biophysics of Pressure. Flow, and Resistance 169
Physical Characteristics of the Circulation 169
Basic Principles of Circulatory Function 170
Interrelationships of Pressure, Flow, and Resistance 171
CHAPTER 15
Vascular Distensibility and Functions of the Arterial and Venous Systems 179
Vascular Distensibility 179
Arterial Pressure Pulsations 180
Veins and Their Functions 184
CHAPTER 16
The Microcirculation and Lymphatic System: Capillary Fluid Exchange, Interstitial Fluid, and Lymph Flow 189
Structure of the Microcirculation and Capillary System 189
Flow of Blood in the Capillaries—Vasomotion 190 Exchange of Water, Nutrients, and Other Substances Between the Blood and Interstitial Fluid 191
Interstitium and Interstitial Fluid 192
Fluid Filtration Across Capillaries Is Determined by Hydrostatic and Colloid Osmotic Pressures and the Capillary Filtration Coefficient 193
Lymphatic System 198
CHAPTER 17
Local and Humoral Control of Tissue Blood Flow 203
Local Control of Blood Flow in Response to Tissue Needs 203
Mechanisms of Blood Flow Control 203
Humoral Control of the Circulation 212
CHAPTER 18
Nervous Regulation of the Circulation and Rapid Control of Arterial Pressure 215
Nervous Regulation of the Circulation 215
Special Features of Nervous Control of Arterial Pressure 224
CHAPTER 19
Role of the Kidneys in Long-Term Control of Arterial Pressure and in Hypertension: The Integrated System for Arterial Pressure Regulation 227
Renal-Body Fluid System for Arterial Pressure Control 227
The Renin-Angiotensin System: Its Role in Arterial Pressure Control 234
Summary of the Integrated, Multifaceted System for Arterial Pressure Regulation 241
CHAPTER 20
Cardiac Output, Venous Return, and Their Regulation 245
Normal Values for Cardiac Output at Rest and During Activity 245
Control of Cardiac Output by Venous Return—The Frank-Starling Mechanism of the Heart 245
Pathologically High or Low Cardiac Outputs 248
Methods for Measuring Cardiac Output 258
CHAPTER 21
Muscle Blood Flow and Cardiac Output During Exercise; the Coronary Circulation and Ischemic Heart Disease 259
Blood Flow Regulation in Skeletal Muscle at Rest and During Exercise 259
Coronary Circulation 262
CHAPTER 22
Cardiac Failure 271
Circulatory Dynamics in Cardiac Failure 271
Unilateral Left Heart Failure 275
Low-Output Cardiac Failure—Cardiogenic Shock 275
Edema in Patients With Cardiac Failure 275
Cardiac Reserve 277
CHAPTER 23
Heart Valves and Heart Sounds; Valvular and Congenital Heart Defects 283
Heart Sounds 283
Abnormal Circulatory Dynamics in Valvular Heart Disease 286
Abnormal Circulatory Dynamics in Congenital Heart Defects 288
Use of Extracorporeal Circulation During Cardiac Surgery 290
Hypertrophy of the Heart in Valvular and Congenital Heart Disease 290
CHAPTER 24
Circulatory Shock and Its Treatment 293
Physiological Causes of Shock 293
Shock Caused by Hypovolemia—Hemorrhagic Shock 294
Neurogenic Shock—Increased Vascular Capacity 299
Anaphylactic Shock and Histamine Shock 300
Septic Shock 300
Physiology of Treatment in Shock 301
Circulatory Arrest 302
The Body Fluids and Kidneys
CHAPTER 25
The Body Fluid Compartments: Extracellular and Intracellular Fluids; Edema 305
Fluid Intake and Output Are Balanced During Steady-State Conditions 305
Body Fluid Compartments 306
Constituents of Extracellular and Intracellular Fluids 307
Measurement of Fluid Volumes in the Different Body Fluid Compartments—The Indicator-Dilution Principle 308
Determination of Volumes of Specific Body Fluid Compartments 309
Regulation of Fluid Exchange and Osmotic Equilibrium Between Intracellular and Extracellular Fluid 310
Volume and Osmolality of Extracellular and Intracellular Fluids in Abnormal States 312
Glucose and Other Solutions Administered for Nutritive Purposes 314
Clinical Abnormalities of Fluid Volume Regulation: Hyponatremia and Hypernatremia 314
Edema: Excess Fluid in the Tissues 316
Fluids in the "Potential Spaces" of the Body 320
CHAPTER 26
The Urinary System: Functional Anatomy and Urine Formation by the Kidneys 323
Multiple Functions of the Kidneys 323
Physiological Anatomy of the Kidneys 324
Micturition 327
Urine Formation Results From Glomerular Filtration, Tubular Reabsorption, and Tubular Secretion 331
CHAPTER 27
Glomerular Filtration. Renal Blood Flow, and Their Control 335
Glomerular Filtration—-The First Step in Urine Formation 335
Determinants of the GFR 337
Renal Blood Flow 340
Physiological Control of Glomerular Filtration and Renal Blood Flow 341
Autoregulation of GFR and Renal Blood Flow 342
CHAPTER 28
Renal Tubular Reabsorption and Secretion 347 Tubular Reabsorption Is Quantitatively Large and Highly Selective 347
Tubular Reabsorption Includes Passive and Active Mechanisms 347
Reabsorption and Secretion Along Different Parts of the Nephron 353
Regulation of Tubular Reabsorption359
Use of Clearance Methods to Quantify Kidney Function 365
CHAPTER 29
Urine Concentration and Dilution; Regulation of Extracellular Fluid Osmolality and Sodium Concentration 371
Kidneys Excrete Excess Water by Forming Dilute Urine 371
Kidneys Conserve Water by Excreting Concentrated Urine 373
Special Characteristics of the Loop of Henle That Cause Solutes to be Trapped in the Renal Medulla 374
Control of Extracellular Fluid Osmolarity and Sodium Concentration 381
Osmoreceptor-ADH Feedback System 381
Importance of Thirst in Controlling Extracellular Fluid Osmolarity and Sodium Concentration 384
CHAPTER 30
Renal Regulation of Potassium. Calcium. Phosphate, and Magnesium; Integration of Renal Mechanisms for Control of Blood Volume and Extracellular Fluid Volume 389
Regulation of Extracellular Fluid Potassium Concentration and Potassium Excretion 389
Control of Renal Calcium Excretion and Extracellular Calcium Ion Concentration 396
Control of Renal Magnesium Excretion and Extracellular Magnesium Ion Concentration 398
Integration of Renal Mechanisms for Control of Extracellular Fluid 398
Importance of Pressure Natriuresis and Pressure Diuresis in Maintaining Body Sodium and Fluid Balance 399
Distribution of Extracellular Fluid Between the Interstitial Spaces and Vascular System 401
Nervous and Hormonal Factors Increase the Effectiveness of Renal-Body Fluid Feedback Control 402
Integrated Responses to Changes in Sodium Intake 405
Conditions That Cause Large Increases in Blood Volume and Extracellular Fluid Volume 405
Conditions That Cause Large Increases in Extracellular Fluid Volume but With Normal Blood Volume 406
CHAPTER 31
Acid-Base Regulation 409
H* Concentration Is Precisely Regulated 409
Acids and Bases—Their Definitions and Meanings 409
Defending Against Changes in H* Concentration: Buffers, Lungs, and Kidneys 410
Buffering of H* in the Body Fluids 410
Bicarbonate Buffer System 411
Phosphate Buffer System 413
Proteins Are Important Intracellular Buffers 413
Respiratory Regulation of Acid-Base Balance 414
Renal Control of Acid-Base Balance 415
Secretion of H* and Reabsorption of HC03~ by the Renal Tubules 416
Combination of Excess H4 With Phosphate and Ammonia Buffers in the Tubule Generates "New" HC03 418
Quantifying Renal Acid-Base Excretion 420
Renal Correction of Acidosis—Increased Excretioh of H* and Addition of HC03~ to the Extracellular Fluid 421
Renal Correction of Alkalosis—Decreased Tubular Secretion of H* and Increased Excretion of HC03" 422
Clinical Causes of Acid-Base Disorders 422
CHAPTER 32
Diuretics, Kidney Diseases 427
Diuretics and Their Mechanisms of Action 427
Kidney Diseases 429
Acute Kidney Injury 429
Chronic Kidney Disease Is Often Associated With Irreversible Loss of Functional Nephrons 432
Treatment of Renal Failure by Transplantation or by Dialysis With an Artificial Kidney 440
Blood Cells, Immunity, and Blood Coagulation
CHAPTER 33
Red Blood Cells, Anemia, and Polycythemia 445
Red Blood Cells (Erythrocytes) 445
Anemias 452
Polycythemia 453
CHAPTER 34
Resistance of the Body to Infection: Leukocytes, Granulocytes, the Monocyte-Macrophage System, and Inflammation 455
Leukocytes (White Blood Cells) 455
Neutrophils and Macrophages Defend Against Infections 457
Monocyte-Macrop iage Cell System (Reticuloendothelial System) 458
Inflammation: Role of Neutrophils and Macrophages 460
Eosinophils 462
Basophils 462
Leukopenia 463
Leukemias 463
CHAPTER 35
Resistance of the Body to Infection: Immunity and Allergy 465
Acquired (Adaptive) Immunity 465
Allergy and Hypersensitivity 475
CHAPTER 36
Blood Types; Transfusion; Tissue and Organ Transplantation 477
Antigenicity Causes Immune Reactions of Blood 477
O-A-B Blood Types 477
Rh Blood Types 479
Transplantation of Tissues and Organs 481
CHAPTER 37
Hemostasis and Blood Coagulation 483
Hemostasis Events 483
Mechanism of Blood Coagulation 485
Conditions That Cause Excessive Bleeding in Humans 490
Thromboembolic Conditions 491
Anticoagulants for Clinical Use 492
Blood Coagulation Tests 493
Respiration
CHAPTER 38
Pulmonary Ventilation 497
Mechanics of Pulmonary Ventilation 497
Pulmonary Volumes and Capacities 501
Alveolar Ventilation 503
Functions of the Respiratory Passageways 504
CHAPTER 39
Pulmonary Circulation, Pulmonary Edema, Pleural Fluid 509
Physiological Anatomy of the Pulmonary Circulatory System 509
Pressures in the Pulmonary System 509
Blood Volume of the Lungs 510
Blood Flow Through the Lungs and Its Distribution 510
Effect of Hydrostatic Pressure Gradients in the Lungs on Regional Pulmonary Blood Flow 511
Pulmonary Capillary Dynamics 513
Fluid in the Pleural Cavity 515
CHAPTER 40
Principles of Gas Exchange; Diffusion of Oxygen and Carbon Dioxide Through the Respiratory Membrane 517
Physics of Gas Diffusion and Gas Partial Pressures 517
Compositions of Alveolar Air and Atmospheric Air Are Different 519
Diffusion of Gases Through the Respiratory Membrane 521
CHAPTER 41
Transport of Oxygen and Carbon Dioxide in Blood and Tissue Fluids 527
Transport of Oxygen From the Lungs to the Body Tissues 527
Transport of Carbon Dioxide in the Blood 534
Respiratory Exchange Ratio 536
CHAPTER 42
Regulation of Respiration 539
Respiratory Center 539
Chemical Control of Respiration 541
Peripheral Chemoreceptor System for Control of Respiratory Activity—Role of Oxygen in Respiratory Control 542
Regulation of Respiration During Exercise 545
Other Factors That Affect Respiration 546
CHAPTER 43
Respiratory Insufficiency— Pathophysiology, Diagnosis, Oxygen Therapy 549
Useful Methods for Studying Respiratory Abnormalities 549
Pathophysiology of Specific Pulmonary Abnormalities 551
Hypoxia and Oxygen Therapy 554
Hypercapnia—-Excess Carbon Dioxide in the Body Fluids 556
Artificial Respiration 556
Aviation, Space, and Deep-Sea Diving Physiology
CHAPTER 44
Aviation, High Altitude, and Space Physiology 561
Effects of Low Oxygen Pressure on the Body 561
Effects of Acceleratory Forces on the Body in Aviation and Space Physiology "Artificial Climate" in the Sealed Spacecraft 567
Weightlessness in Space 567
CHAPTER 45
Physiology of Deep-Sea Diving and Other Hyperbaric Conditions 569
Effect of High Partial Pressures of Individual Gases on the Body 569
Self-Contained Underwater Breathing Apparatus (SCUBA) Diving 573
Special Physiological Problems in Submarines 574
Hyperbaric Oxygen Therapy 574
The Nervous System: A. General Principles and Sensory Physiology
CHAPTER 46
Organization of the Nervous System, Basic Functions of Synapses, and Neurotransmitters General Design of the Nervous System 577
Major Levels of Central Nervous System Function 579
Comparison of the Nervous System to a Computer 580
Central Nervous System Synapses 580
Some Special Characteristics of Synaptic Transmission 592
CHAPTER 47
Sensory Receptors, Neuronal Circuits for Processing Information 595
Types of Sensory Receptors and the Stimuli They Detect 595
Transduction of Sensory Stimuli Into Nerve Impulses 596
Transmission of Signals of Different Intensity in Nerve Tracts—Spatial and Temporal Summation 600
Transmission and Processing of Signals in Neuronal Pools 601
Instability and Stability of Neuronal Circuits605
CHAPTER 48
Somatic Sensations: I. General Organization, the Tactile and Position Senses 607
Classification of Somatic Senses 607
Detection and Transmission of Tactile Sensations 607
Sensory Pathways for Transmitting Somatic Signals Into the Central Nervous System 609
Transmission in the Dorsal Column-Medial Lemniscal System 609
Transmission of Less Critical Sensory Signals in the Anterolateral Pathway 616
Some Special Aspects of Somatosensory Function 618
CHAPTER 49
Somatic Sensations: II. Pain, Headache, and Thermal Sensations 621
Types of Pain and Their Qualities—Fast Pain and Slow Pain 621
Pain Receptors and Their Stimulation 621
Dual Pathways for Transmission of Pain Signals Into the Central Nervous System 622
Pain Suppression (Analgesia) System in the Brain and Spinal Cord 625
Referred Pain 626
Visceral Pain 626
Some Clinical Abnormalities of Pain and Other Somatic Sensations 628
Headache 629
Thermal Sensations 630
The Nervous System: B. The Special Senses
CHAPTER 50
The Eye: I. Optics of Vision 635
Physical Principles of Optics 635
Optics of the Eye 638
Fluid System of the Eye—Intraocular Fluid 644
CHAPTER 51
The Eye: II. Receptor and Neural Function of the Retina 647
Anatomy and Function of the Structural Elements of the Retina 647
Photochemistry of Vision 649
Color Vision 654
Neural Function of the Retina 655
CHAPTER 52
The Eye: III. Central Neurophysiology of Vision 661
Visual Pathways 661
Organization and Function of the Visual Cortex 662
Neuronal Patterns of Stimulation During Analysis of the V'suai Image 664
Eye Movements and Their Control Autonomic Control of Accommodation and 666
Pupillary Aperture 669
CHAPTER 53
The Sense of Hearing 673
Tympanic Membrane and the Ossicular System 673
Cochlea 674
Central Auditory Mechanisms 679
Hearing Abnormalities 682
CHAPTER 54
The Chemical Senses—Taste and Smell 685
Sense of Taste 685
Sense of Smell 688
The Nervous System: C. Motor and Integrative Neurophysiology
CHAPTER 55
Motor Functions of the Spinal Cord; the Cord Reflexes 695
Organization of the Spinal Cord for Motor Functions 695
Muscle Sensory Receptors—Muscle Spindles and Golgi Tendon Organs—and Their Roles in Muscle Control 697
Flexor Reflex and the Withdrawal Reflexes 702
Crossed Extensor Reflex 703
Reciprocal Inhibition and Reciprocal Innervation 703
Reflexes of Posture and Locomotion 704
Scratch Reflex 705
Spinal Cord Reflexes That Cause Muscle Spasm 705
Autonomic Reflexes in the Spinal Cord 705
Spinal Cord Transection and Spinal Shock 705
CHAPTER 56
Cortical and Brain Stem Control of Motor Function 707
Motor Cortex and Corticospinal 707
Tract Control of Motor Functions by the Brain Stem 713
Vestibular Sensations and Maintenance of Equilibrium 714
Functions of Brain Stem Nuclei in Controlling Subconscious, Stereotyped Movements 719
CHAPTER 57
Contributions of the Cerebellum and Basal Ganglia to Overall Motor Control 721
The Cerebellum and Its Motor Functions 721
The Basal Ganglia and Their Motor Functions 730
Integration of the Many Parts of the Total Motor Control System 735
CHAPTER 58
Cerebral Cortex, Intellectual Functions of the Brain, Learning, and Memory 737
Physiological Anatomy of the Cerebral Cortex 737
Functions of Specific Cortical Areas 738
Function of the Brain in Communication—Language Input and Language Output 743
Function of the Corpus Callosum and Anterior Commissure to Transfer Thoughts, Memories, Training, and Other Information Between the Two Cerebral Hemispheres 745
Thoughts, Consciousness, and Memory 745
CHAPTER 59
Behavioral and Motivational Mechanisms of the Brain—The Limbic System and the Hypothalamus 751
Activating—Driving Systems of the Brain 751
Limbic System 754
The Hypothalamus, a Major Control Headquarters for the Limbic System 755
Specific Functions of Other Parts of the Limbic System 759
CHAPTER 60
States of Brain Activity—Sleep, Brain Waves, Epilepsy, Psychoses, and Dementia 763
Sleep 763
Brain Waves 766
Seizures and Epilepsy 768
Psychotic Behavior—Roles of Specific Neurotransmitter Systems 770
Alzheimer,s Disease—Amyloid Plaques and Depressed Memory 771
CHAPTER 61
The Autonomic Nervous System and the Adrenal Medulla 773
General Organization of the Autonomic Nervous System 773
Basic Characteristics of Sympathetic and Parasympathetic Function 775
Autonomic Reflexes 782
Stimulation of Discrete Organs in Some Instances and Mass Stimulation in Other Instances by the Sympathetic and Parasympathetic Systems 783
Pharmacology of the Autonomic Nervous System 784
CHAPTER 62
Cerebral Blood Flow, Cerebrospinal Fluid, and Brain Metabolism 787
Cerebral Blood Flow 787
Cerebrospinal Fluid System 790
Brain Metabolism 794
Gastrointestinal Physiology
CHAPTER 63
General Principles of Gastrointestinal Function—Motility, Nervous Control, and Blood Circulation 797
General Principles of Gastrointestinal Motility 797
Neural Control of Gastrointestinal Function—Enteric Nervous System 799
Hormonal Control of Gastrointestinal Motility 802
Functional Types of Movements in the Gastrointestinal Tract 803
Gastrointestinal Blood Flow—Splanchnic Circulation 804
CHAPTER 64
Propulsion and Mixing of Food in the Alimentary Tract 807
Ingestion of Food 807
Motor Functions of the Stomach 809
Movements of the Small Intestine 812
Movements of the Colon 814
Other Autonomic Reflexes That Affect Bowel Activity 816
CHAPTER 65
Secretory Functions of the Alimentary Tract 817
General Principles of Alimentary Tract Secretion 817
Secretion of Saliva 819
Esophageal Secretion 821
Gastric Secretion 821
Pancreatic Secretion 825
Bile Secretion by the Liver 827
Secretions of the Small Intestine 830
Secretion of Mucus by the Large Intestine 831
CHAPTER 66
Digestion and Absorption in the Gastrointestinal Tract 833
Digestion of the Various Foods by Hydrolysis 833 Basic Principles of Gastrointestinal Absorption 837
Absorption in the Small Intestine 837
Absorption in the Large Intestine: Formation of Feces 841
CHAPTER 67
Physiology of Gastrointestinal Disorders 843
Disorders of Swallowing and the Esophagus 843
Disorders of the Stomach 843
Disorders of the Small Intestine 845
Disorders of the Large Intestine 846
General Disorders of the Gastrointestinal Tract 847
Metabolism and Temperature Regulation
CHAPTER 68
Metabolism of Carbohydrates and Formation of Adenosine Triphosphate 853
Release of Energy From Foods and "Free Energy" 853
Adenosine Triphosphate Is the "Energy" Currency" of the Body 853
Central Role of Glucose in Carbohydrate Metabolism 854
Transport of Glucose Through the Cell Membrane 854
Glycogen Is Stored in the Liver and Muscle 855 Release of Energy From Glucose by the
Glycolytic Pathway 856
Formation of Large Quantities of ATP by Oxidation of Hydrogen—the Process of Oxidative Phosphorylation 858
Summary of ATP Formation During the Breakdown of Glucose 859
Anaerobic Release of Energy—Anaerobic Glycolysis 860
Release of Energy From Glucose by the Pentose Phosphate Pathway 861
Formation of Carbohydrates From Proteins and Fats—Gluconeogenesis 861
CHAPTER 69
Lipid Metabolism 863
Basic Chemical Structure of Triglycerides (Neutral Fat) 863
Transport of Lipids in the Body Fluids 863
Fat Deposits 865
Use of Triglycerides for Energy: Formation of Adenosine Triphosphate 866
Regulation of Energy Release From Triglycerides 869
Phospholipids and Cholesterol 870
Atherosclerosis 872
CHAPTER 70
Protein Metabolism 875
Basic Properties of Proteins 875
Transport and Storage of Amino Acids 875
Functional Roles of the Plasma Proteins 877
Hormonal Regulation of Protein Metabolism 880
CHAPTER 71
The Liver as an Organ 881
Physiological Anatomy of the Liver 881
Hepatic Vascular and Lymph Systems 881
Metabolic Functions of the Liver 883
Protein Metabolism 883
Measurement of Bilirubin in the Bile as a Clinical Diagnostic Tool 884
CHAPTER 72
Dietary Balances; Regulation of Feeding; Obesity and Starvation; Vitamins and Minerals 887
Energy Intake and Output Are Balanced Under Steady-State Conditions 887
Dietary Balances 887
Regulation of Food Intake and Energy Storage 889
Obesity 894
Inanition, Anorexia, and Cachexia 896
Starvation 897
Vitamins 897
Mineral Metabolism 900
CHAPTER 73
Energetics and Metabolic Rate 903
Adenosine Triphosphate Functions as an "Energy Currency" in Metabolism 903
Control of Energy Release in the Cell 905
Metabolic Rate 906 Energy Metabolism—Factors That Influence Energy Output 907
CHAPTER 74
Body Temperature Regulation and Fever 911
Normal Body Temperatures 911
Body Temperature Is Controlled by Balancing Heat Production and Heat Loss 911
Regulation of Body Temperature—Role of the Hypothalamus 915
Abnormalities of Body Temperature Regulation 919
Endocrinology and Reproduction
CHAPTER 75
Introduction to Endocrinology 925
Coordination of Body Functions by Chemical Messengers 925
Chemical Structure and Synthesis of Hormones 925
Hormone Secretion, Transport, and Clearance From the Blood 929
Mechanisms of Action of Hormones 930
Measurement of Hormone Concentrations in the Blood 936
CHAPTER 76
Pituitary Hormones and Their Control by the Hypothalamus 939
Pituitary Gland and Its Relation to the Hypothalamus 939
Hypothalamus Controls Pituitary Secretion 940
Physiological Functions of Growth Hormone 942
Posterior Pituitary Gland and Its Relation to the Hypothalamus 948
CHAPTER 77
Thyroid Metabolic Hormones 951
Synthesis and Secretion of the Thyroid Metabolic Hormones 951
Physiological Functions of the Thyroid Hormones 954
Regulation of Thyroid Hormone Secretion 958
Diseases of the Thyroid 960
CHAPTER 78
Adrenocortical Hormones 965
Corticosteroids: Mineralocorticoids, Glucocorticoids, and Androgens 965
Synthesis and Secretion of Adrenocortical Hormones 965
Functions of the Mineralocorticoids— Aldosterone 968
Functions of Glucocorticoids 972
Adrenal Androgens 978
Abnormalities of Adrenocortical Secretion 979
CHAPTER 79
Insulin, Glucagon, and Diabetes Mellitus 983
Physiological Anatomy of the Pancreas 983
Insulin and Its Metabolic Effects 983
Glucagon and Its Functions 992
Somatostatin Inhibits Glucagon and Insulin Secretion 993
Summary of Blood Glucose Regulation 993
Diabetes Mellitus 994
CHAPTER 80
Parathyroid Hormone, Calcitonin, Calcium and Phosphate Metabolism, Vitamin D, Bone, and Teeth 1001
Overview of Calcium and Phosphate Regulation in the Extracellular Fluid and Plasma 1001
Bone and Its Relation to Extracellular Calcium and Phosphate 1003
Vitamin D 1007
Parathyroid Hormone 1009
Calcitonin 1012
Summary of Control of Calcium Ion Concentration 1013
Pathophysiology of Parathyroid Hormone, Vitamin D, and Bone Disease 1014
Physiology of the Teeth 1016
CHAPTER 81
Reproductive and Hormonal Functions of the Male (and Function of the Pineal Gland) 1021
Physiological Anatomy of the Male Sexual Organs 1021
Spermatogenesis 1021
Male Sexual Act 1026
Testosterone and Other Male Sex Hormones 1028
Abnormalities of Male Sexual Function 1033
Erectile Dysfunction in the Male 1034
The Function of the Pineal Gland in Controlling Seasonal Fertility in Some Animals 1034
CHAPTER 82
Female Physiology Before Pregnancy and Female Hormones 1037
Physiological Anatomy of the Female Sexual Organs 1037
Oogenesis and Follicular Development in the Ovaries 1037
Female Hormonal System 1039
Monthly Ovarian Cycle; Function of the Gonadotropic Hormones 1039
Functions of the Ovarian Hormones— Estradiol and Progesterone 1042
Regulation of the Female Monthly Rhythm—Interplay Between the Ovarian and Hypothalamic-Pituitary Hormones 1047
Abnormalities of Secretion by the Ovaries 1051 Female Sexual Act 1051
Female Fertility 1052
Hormonal Suppression of Fertility— "The Pill" 1053
Abnormal Conditions That Cause Female Sterility 1053
CHAPTER 83
Pregnancy and Lactation 1055
Maturation and Fertilization of the Ovum 1055
Early Nutrition of the Embryo 1057
Anatomy and Function of the Placenta 1057
Hormonal Factors in Pregnancy 1059
Response of the Mother's Body to Pregnancy 1062
Parturition 1064
Lactation 1066
CHAPTER 84
Fetal and Neonatal Physiology 1071
Growth and Functional Development of the Fetus 1071
Development of the Organ Systems 1071
Fetal Metabolism 1072
Adjustments of the Infant to Extrauterine Life 1073
Special Functional Problems in the Neonate 1076
Special Problems of Prematurity 1079
Growth and Development of the Child 1080
Sports Physiology
CHAPTER 85
Sports Physiology 1085
Female and Male Athletes 1085
Muscles in Exercise 1085
Respiration in Exercise 1090
Cardiovascular System in Exercise 1092
Body Heat in Exercise 1094
Body Fluids and Salt in Exercise 1094
Drugs and Athletes 1095
Body Fitness Prolongs Life 1095
Index 1097
