Medical Physiology

Front cover......Page 1
IFC......Page 2
Title page......Page 5
Copyright page......Page 6
CONTRI BUTORS......Page 7
PREFACE TO THE SECOND EDITION......Page 9
PREFACE TO THE FIRST EDITION......Page 11
Table of contents......Page 13
SECTION I: INTRODUCTION......Page 15
WHAT IS PHYSIOLOGY?......Page 17
REFERENCES......Page 20
SECTION II: PHYSIOLOGY OF CELLS AND MOLECU LES......Page 21
STRUCTURE OF BIOLOGICAL MEMBRANES......Page 23
FUNCTION OF MEMBRANE PROTEINS......Page 31
CELLULAR ORGANELLES AND THE CYTOSKELETON......Page 35
SYNTHESIS AND RECYCLING OF MEMBRANE PROTEINS......Page 43
SPECIALIZED CELL TYPES......Page 58
REFERENCES......Page 61
MECHANISMS OF CELLULAR COMMUNICATION......Page 62
RECEPTORS COUPLED TO G PROTEINS......Page 66
RECEPTORS THAT ARE CATALYTIC......Page 82
NUCLEAR RECEPTORS......Page 86
REFERENCES......Page 87
FROM GENES TO PROTEINS......Page 89
THE PROMOTER AND REGULATORY ELEMENTS......Page 95
TRANSCRIPTION FACTORS......Page 97
REGULATION OF INDUCIBLE GENE EXPRESSION BY SIGNAL TRANSDUCTION PATHWAYS......Page 106
REGULATION OF GENE EXPRESSION BY CHANGES IN DNA STRUCTURE......Page 112
POST-TRANSCRIPTIONAL REGULATION OF GENE EXPRESSION......Page 113
GLOSSARY......Page 117
THE INTRACELLULAR AND EXTRACELLULAR FLUIDS......Page 120
SOLUTE TRANSPORT ACROSS CELL MEMBRANES......Page 123
REGULATION OF INTRACELLULAR ION CONCENTRATIONS......Page 143
WATER TRANSPORT AND THE REGULATION OF CELL VOLUME......Page 146
TRANSPORT OF SOLUTES AND WATER ACROSS EPITHELIA......Page 155
REFERENCES......Page 159
IONIC BASIS OF MEMBRANE POTENTIALS......Page 161
ELECTRICAL MODEL OF A CELL MEMBRANE......Page 170
MOLECULAR PHYSIOLOGY OF ION CHANNELS......Page 178
REFERENCES......Page 192
MECHANISMS OF NERVE AND MUSCLE ACTION POTENTIALS......Page 193
PHYSIOLOGY OF VOLTAGE-GATED CHANNELS AND THEIR RELATIVES......Page 203
PROPAGATION OF ACTION POTENTIALS......Page 220
REFERENCES......Page 225
MECHANISMS OF SYNAPTIC TRANSMISSION......Page 226
SYNAPTIC TRANSMISSION AT THE NEUROMUSCULAR JUNCTION......Page 231
TOXINS AND DRUGS AFFECTING SYNAPTIC TRANSMISSION......Page 244
REFERENCES......Page 250
SKELETAL MUSCLE......Page 251
CARDIAC MUSCLE......Page 266
SMOOTH MUSCLE......Page 267
DIVERSITY AMONG MUSCLES......Page 274
REFERENCES......Page 277
SECTION III: TH E NERVOUS SYSTEM......Page 279
CHAPTER 10: ORGAN IZATION OF THE NERVOUS SYSTEM......Page 281
CELLS OF THE NERVOUS SYSTEM......Page 282
DEVELOPMENT OF NEURONS AND GLIAL CELLS......Page 288
SUBDIVISIONS OF THE NERVOUS SYSTEM......Page 296
REFERENCES......Page 302
CEREBROSPINAL FLUID......Page 303
BRAIN EXTRACELLULAR SPACE......Page 310
THE BLOOD-BRAIN BARRIER......Page 312
GLIAL CELLS......Page 315
REFERENCES......Page 323
CHAPTER 12: PHYSIOLOGY OF NEURONS......Page 324
SIGNAL CONDUCTION IN DENDRITES......Page 326
CONTROL OF SPIKING PATTERNS IN THE SOMA......Page 329
AXONAL CONDUCTION......Page 330
REFERENCES......Page 336
NEURONAL SYNAPSES......Page 337
NEUROTRANSMITTER SYSTEMS OF THE BRAIN......Page 345
FAST, AMINO ACID–MEDIATED SYNAPSES IN THE CENTRAL NERVOUS SYSTEM......Page 352
PLASTICITY OF CENTRAL SYNAPSES......Page 358
REFERENCES......Page 363
ORGANIZATION OF THE VISCERAL CONTROL SYSTEM......Page 365
SYNAPTIC PHYSIOLOGY OF THE AUTONOMIC NERVOUS SYSTEM......Page 371
CNS CONTROL OF THE VISCERA......Page 378
REFERENCES......Page 384
CHAPTER 15: SENSORY TRANSDUCTION......Page 385
CHEMORECEPTION......Page 386
VISUAL TRANSDUCTION......Page 392
VESTIBULAR AND AUDITORY TRANSDUCTION: HAIR CELLS......Page 403
SOMATIC SENSORY RECEPTORS, PROPRIOCEPTION, AND PAIN......Page 414
REFERENCES......Page 421
ELEMENTS OF NEURAL CIRCUITS......Page 422
SIMPLE, STEREOTYPED RESPONSES: SPINAL REFLEX CIRCUITS......Page 424
RHYTHMIC ACTIVITY: CENTRAL PATTERN GENERATORS......Page 428
SPATIAL REPRESENTATIONS: SENSORY AND MOTOR MAPS IN THE BRAIN......Page 430
TEMPORAL REPRESENTATIONS: TIME-MEASURING CIRCUITS......Page 437
REFERENCES......Page 440
SECTION IV: THE CARDIOVASCULAR SYSTEM......Page 441
ELEMENTS OF THE CARDIOVASCULAR SYSTEM......Page 443
HEMODYNAMICS......Page 445
HOW BLOOD FLOWS......Page 449
ORIGINS OF PRESSURE IN THE CIRCULATION......Page 451
HOW TO MEASURE BLOOD PRESSURE, BLOOD FLOW, AND CARDIAC VOLUMES......Page 453
REFERENCES......Page 461
BLOOD COMPOSITION......Page 462
BLOOD VISCOSITY......Page 469
HEMOSTASIS AND FIBRINOLYSIS......Page 472
REFERENCES......Page 480
THE ARTERIAL DISTRIBUTION AND VENOUS COLLECTION SYSTEMS......Page 481
ELASTIC PROPERTIES OF BLOOD VESSELS......Page 487
REFERENCES......Page 495
CHAPTER 20: THE MICROCIRCULATION......Page 496
CAPILLARY EXCHANGE OF SOLUTES......Page 498
CAPILLARY EXCHANGE OF WATER......Page 503
LYMPHATICS......Page 509
REGULATION OF THE MICROCIRCULATION......Page 512
REFERENCES......Page 517
ELECTROPHYSIOLOGY OF CARDIAC CELLS......Page 518
THE ELECTROCARDIOGRAM......Page 528
CARDIAC ARRHYTHMIAS......Page 532
REFERENCES......Page 542
THE CARDIAC CYCLE......Page 543
CARDIAC DYNAMICS......Page 553
FROM CONTRACTILE FILAMENTS TO A REGULATED PUMP......Page 558
REFERENCES......Page 567
SHORT-TERM REGULATION OF ARTERIAL PRESSURE......Page 568
REGULATION OF CARDIAC OUTPUT......Page 580
MATCHING OF VENOUS RETURN AND CARDIAC OUTPUT......Page 584
INTERMEDIATE AND LONG-TERM CONTROL OF THE CIRCULATION......Page 588
REFERENCES......Page 590
CHAPTER 24: SPECIAL CIRCULATIONS......Page 591
THE BRAIN......Page 592
THE HEART......Page 595
THE SKELETAL MUSCLE......Page 597
THE SPLANCHNIC CIRCULATION......Page 600
THE SKIN......Page 604
REFERENCES......Page 606
INTERACTION AMONG THE DIFFERENT CARDIOVASCULAR CONTROL SYSTEMS......Page 607
RESPONSE TO ERECT POSTURE......Page 610
RESPONSES TO ACUTE EMOTIONAL STRESS......Page 612
RESPONSE TO EXERCISE......Page 615
RESPONSE TO HEMORRHAGE......Page 618
REFERENCES......Page 622
SECTION V: THE RESPIRATORY SYSTEM......Page 625
COMPARATIVE PHYSIOLOGY OF RESPIRATION......Page 627
ORGANIZATION OF THE RESPIRATORY SYSTEM IN HUMANS......Page 633
LUNG VOLUMES AND CAPACITIES......Page 638
REFERENCES......Page 643
STATIC PROPERTIES OF THE LUNG......Page 644
DYNAMIC PROPERTIES OF THE LUNG......Page 654
REFERENCES......Page 665
pH AND BUFFERS......Page 666
ACID-BASE CHEMISTRY WHEN CO2/HCO-3 IS THE ONLY BUFFER......Page 671
ACID-BASE CHEMISTRY IN THE PRESENCE OF CO2/HCO−3 AND NON-HCO−3 BUFFERS—THE DAVENPORT DIAGRAM......Page 673
pH REGULATION OF INTRACELLULAR FLUID......Page 681
REFERENCES......Page 685
CARRIAGE OF OXYGEN......Page 686
CARRIAGE OF CARBON DIOXIDE......Page 694
REFERENCES......Page 698
DIFFUSION OF GASES......Page 699
DIFFUSION AND PERFUSION LIMITATIONS ON GAS TRANSPORT......Page 704
REFERENCES......Page 713
VENTILATION......Page 714
PERFUSION OF THE LUNG......Page 722
MATCHING VENTILATION AND PERFUSION......Page 728
REFERENCES......Page 738
OVERVIEW OF THE RESPIRATORY CONTROL SYSTEM......Page 739
NEURONS THAT CONTROL VENTILATION......Page 741
GENERATION OF THE RESPIRATORY RHYTHM......Page 745
CHEMICAL CONTROL OF VENTILATION......Page 749
MODULATION OF VENTILATORY CONTROL......Page 756
REFERENCES......Page 759
SECTION VI: THE URINARY SYSTEM......Page 761
FUNCTIONAL ANATOMY OF THE KIDNEY......Page 763
MAIN ELEMENTS OF RENAL FUNCTION......Page 770
MEASURING RENAL CLEARANCE AND TRANSPORT......Page 771
THE URETERS AND BLADDER......Page 776
REFERENCES......Page 780
GLOMERULAR FILTRATION......Page 781
RENAL BLOOD FLOW......Page 786
CONTROL OF RENAL BLOOD FLOW AND GLOMERULAR FILTRATION......Page 791
REFERENCES......Page 795
Na+ AND Cl− TRANSPORT BY DIFFERENT SEGMENTS OF THE NEPHRON......Page 796
Na+, Cl-, AND WATER TRANSPORT AT THE CELLULAR AND MOLECULAR LEVEL......Page 797
REGULATION OF Na+ AND Cl− TRANSPORT......Page 805
REFERENCES......Page 810
UREA......Page 811
GLUCOSE......Page 813
OTHER ORGANIC SOLUTES......Page 815
PHOSPHATE......Page 825
CALCIUM......Page 829
MAGNESIUM......Page 832
REFERENCES......Page 834
POTASSIUM BALANCE AND THE OVERALL RENAL HANDLING OF POTASSIUM......Page 835
POTASSIUM TRANSPORT BY DIFFERENT SEGMENTS OF THE NEPHRON......Page 838
POTASSIUM TRANSPORT AT THE CELLULAR AND MOLECULAR LEVEL......Page 839
REGULATION OF RENAL POTASSIUM EXCRETION......Page 842
REFERENCES......Page 847
WATER BALANCE AND THE OVERALL RENAL HANDLING OF WATER......Page 849
WATER TRANSPORT BY DIFFERENT SEGMENTS OF THE NEPHRON......Page 851
GENERATING A HYPEROSMOTIC MEDULLA AND URINE......Page 852
REGULATION BY ARGININE VASOPRESSIN......Page 860
REFERENCES......Page 863
ACID-BASE BALANCE AND THE OVERALL RENAL HANDLING OF ACID......Page 865
ACID-BASE TRANSPORT BY DIFFERENT SEGMENTS OF THE NEPHRON......Page 869
ACID-BASE TRANSPORT AT THE CELLULAR AND MOLECULAR LEVEL......Page 871
REGULATION OF RENAL ACID SECRETION......Page 876
REFERENCES......Page 879
WATER BALANCE......Page 880
CONTROL OF EXTRACELLULAR FLUID VOLUME......Page 881
CONTROL OF WATER CONTENT (EXTRACELLULAR OSMOLALITY)......Page 888
REFERENCES......Page 894
SECTION VII: THE GASTROINTESTINAL SYSTEM......Page 895
OVERVIEW OF DIGESTIVE PROCESSES......Page 897
REGULATION OF GASTROINTESTINAL FUNCTION......Page 900
GASTROINTESTINAL MOTILITY......Page 902
REFERENCES......Page 908
FUNCTIONAL ANATOMY OF THE STOMACH......Page 909
ACID SECRETION......Page 911
PEPSINOGEN SECRETION......Page 919
PROTECTION OF THE GASTRIC SURFACE EPITHELIUM AND NEUTRALIZATION OF ACID IN THE DUODENUM......Page 920
FILLING AND EMPTYING OF THE STOMACH......Page 923
OVERVIEW OF EXOCRINE GLAND PHYSIOLOGY......Page 926
PANCREATIC ACINAR CELL......Page 929
COMPOSITION, FUNCTION, AND CONTROL OF PANCREATIC SECRETION......Page 934
SALIVARY ACINAR CELL......Page 941
SALIVARY DUCT CELL......Page 942
COMPOSITION, FUNCTION, AND CONTROL OF SALIVARY SECRETION......Page 943
REFERENCES......Page 945
FUNCTIONAL ANATOMY......Page 947
OVERVIEW OF FLUID AND ELECTROLYTE MOVEMENT IN THE INTESTINES......Page 949
CELLULAR MECHANISMS OF NA+ ABSORPTION......Page 951
CELLULAR MECHANISMS OF CL- ABSORPTIONAND SECRETION......Page 954
CELLULAR MECHANISMS OF K+ ABSORPTION AND SECRETION......Page 956
REGULATION OF INTESTINALION TRANSPORT......Page 958
REFERENCES......Page 961
CARBOHYDRATE DIGESTION......Page 963
CARBOHYDRATE ABSORPTION......Page 968
PROTEIN DIGESTION......Page 969
PROTEIN, PEPTIDE, AND AMINO ACID ABSORPTION......Page 971
LIPID DIGESTION......Page 973
LIPID ABSORPTION......Page 978
DIGESTION AND ABSORPTION OF VITAMINS AND MINERALS......Page 982
NUTRITIONAL REQUIREMENTS......Page 990
REFERENCES......Page 993
FUNCTIONAL ANATOMY OF THE LIVER AND BILIARY TREE......Page 994
UPTAKE, PROCESSING, AND SECRETION OF COMPOUNDS BY HEPATOCYTES......Page 1000
BILE FORMATION......Page 1007
ENTEROHEPATIC CIRCULATION OF BILE ACIDS......Page 1011
THE LIVER AS A METABOLIC ORGAN......Page 1014
REFERENCES......Page 1021
SECTION VIII: THE EN DOCRINE SYSTEM......Page 1023
PRINCIPLES OF ENDOCRINE FUNCTION......Page 1025
PEPTIDE HORMONES......Page 1032
AMINE HORMONES......Page 1035
STEROID AND THYROID HORMONES......Page 1037
REFERENCES......Page 1041
GROWTH HORMONE......Page 1042
GROWTH-PROMOTING HORMONES......Page 1048
REGULATION OF BODY MASS......Page 1053
REFERENCES......Page 1057
SYNTHESIS OF THYROID HORMONES......Page 1058
ACTION OF THYROID HORMONES......Page 1062
THE HYPOTHALAMIC-PITUITARY THYROID AXIS......Page 1066
REFERENCES......Page 1070
THE ADRENAL CORTEX: CORTISOL......Page 1071
THE ADRENAL CORTEX: ALDOSTERONE......Page 1079
THE ADRENAL MEDULLA......Page 1083
REFERENCES......Page 1087
INSULIN......Page 1088
GLUCAGON......Page 1103
SOMATOSTATIN......Page 1106
REFERENCES......Page 1107
CALCIUM AND PHOSPHATE BALANCE......Page 1108
PHYSIOLOGY OF BONE......Page 1110
PARATHYROID HORMONE......Page 1112
VITAMIN D......Page 1117
CALCITONIN AND OTHER HORMONES......Page 1122
REFERENCES......Page 1124
SECTION IX: THE REPRODUCTIVE SYSTEM......Page 1125
GENETIC ASPECTS OF SEXUAL DIFFERENTIATION......Page 1127
DIFFERENTIATION OF THE GONADS......Page 1131
DIFFERENTIATION OF THE INTERNAL GENITAL DUCTS......Page 1133
DIFFERENTIATION OF THE EXTERNAL GENITALIA......Page 1136
ENDOCRINE AND PARACRINE CONTROL MECHANISMS IN SEXUAL DIFFERENTIATION......Page 1138
REFERENCES......Page 1141
PUBERTY......Page 1142
HYPOTHALAMIC-PITUITARY-GONADAL AXIS AND CONTROL OF MALE SEXUAL FUNCTION......Page 1144
TESTOSTERONE......Page 1148
BIOLOGY OF SPERMATOGENESIS AND SEMEN......Page 1151
MALE SEX ACT......Page 1155
REFERENCES......Page 1159
PUBERTY......Page 1160
HYPOTHALAMIC-PITUITARY-GONADAL AXIS AND CONTROL OF THE FEMALE MENSTRUAL RHYTHM......Page 1164
OVARIAN STEROIDS......Page 1170
THE OVARIAN CYCLE: FOLLICULOGENESIS, OVULATION, AND FORMATION OF THE CORPUS LUTEUM......Page 1174
THE ENDOMETRIAL CYCLE......Page 1178
THE FEMALE SEX ACT......Page 1180
MENOPAUSE......Page 1182
REFERENCES......Page 1183
TRANSPORT OF GAMETES AND FERTILIZATION......Page 1184
IMPLANTATION OF THE DEVELOPING EMBRYO......Page 1186
PHYSIOLOGY OF THE PLACENTA......Page 1191
THE MATERNAL-PLACENTAL-FETAL UNIT......Page 1194
RESPONSE OF THE MOTHER TO PREGNANCY......Page 1197
PARTURITION......Page 1199
LACTATION......Page 1201
REFERENCES......Page 1205
BIOLOGY OF FETAL GROWTH......Page 1207
DEVELOPMENT AND MATURATION OF THE CARDIOPULMONARY SYSTEM......Page 1211
CARDIOPULMONARY ADJUSTMENTS AT BIRTH......Page 1217
NEONATAL PHYSIOLOGY......Page 1220
SECTION X: PHYSIOLOGY OF EVERYDAY LIFE......Page 1225
FORMS OF ENERGY......Page 1227
ENERGY BALANCE......Page 1230
ENERGY INTERCONVERSION FROM CYCLING BETWEEN SIX-CARBON AND THREE-CARBON MOLECULES......Page 1231
ENERGY CAPTURE (ANABOLISM)......Page 1236
ENERGY LIBERATION (CATABOLISM)......Page 1239
INTEGRATIVE METABOLISM OF FASTING......Page 1246
REFERENCES......Page 1250
HEAT AND TEMPERATURE: THE ADVANTAGES OF HOMEOTHERMY......Page 1251
MODES OF HEAT TRANSFER......Page 1252
ACTIVE REGULATION OF HEAT TRANSFER......Page 1256
HYPERTHERMIA, HYPOTHERMIA, AND FEVER......Page 1258
REFERENCES......Page 1262
MOTOR UNITS AND MUSCLE FUNCTION......Page 1263
CONVERSION OF CHEMICAL ENERGY TO MECHANICAL WORK......Page 1267
MUSCLE FATIGUE......Page 1271
DETERMINANTS OF MAXIMAL O2 UPTAKE AND CONSUMPTION......Page 1272
SWEATING......Page 1274
AEROBIC TRAINING......Page 1278
REFERENCES......Page 1281
THE ENVIRONMENT......Page 1282
DIVING PHYSIOLOGY......Page 1285
HIGH-ALTITUDE PHYSIOLOGY......Page 1289
FLIGHT AND SPACE PHYSIOLOGY......Page 1291
REFERENCES......Page 1293
CONCEPTS IN AGING......Page 1295
CELLULAR AND MOLECULAR MECHANISMS OF AGING......Page 1297
AGING OF THE HUMAN PHYSIOLOGICAL SYSTEMS......Page 1302
AGING SLOWLY......Page 1305
REFERENCES......Page 1306
INDEX......Page 1307