Vander's Human Physiology: The Mechanisms of Body Function

Cover Page......Page 1
Title Page......Page 4
Copyright Page......Page 5
Dedication......Page 6
Meet the Authors......Page 7
Brief Contents......Page 8
Contents......Page 9
Preface......Page 18
Guided Tour Through a Chapter......Page 19
Updates & Additions......Page 23
Teaching and Learning Supplements......Page 25
Acknowledgments......Page 28
CHAPTER 1: Homeostasis: A Frameworkfor Human Physiology......Page 30
Cells: The Basic Units of Living Organisms......Page 31
Tissues......Page 32
Organs and Organ Systems......Page 33
Body Fluid Compartments......Page 34
Homeostasis: A Defining Feature of Physiology......Page 35
General Characteristics of Homeostatic Control Systems......Page 36
Resetting of Set Points......Page 37
Reflexes......Page 38
Intercellular Chemical Messengers......Page 40
Biological Rhythms......Page 42
Balance in the Homeostasis of Chemical Substances in the Body......Page 43
QUANTITATIVE AND THOUGHT QUESTIONS......Page 46
CHAPTER 2: Chemical Composition of the Body......Page 47
Atomic Weight......Page 48
Ions......Page 49
Free Radicals......Page 50
Hydrogen Bonds......Page 52
Molecular Solubility......Page 53
Concentration......Page 54
Hydrogen Ions and Acidity......Page 55
Carbohydrates......Page 56
Lipids......Page 58
Proteins......Page 60
Nucleic Acids......Page 64
ATP......Page 67
TEST QUESTIONS......Page 70
CHAPTER 3: Cellular Structure, Proteins, and Metabolism......Page 71
Microscopic Observations of Cells......Page 72
Membranes......Page 74
Membrane Structure......Page 75
Cell Organelles......Page 77
Nucleus......Page 78
Ribosomes......Page 79
Golgi Apparatus......Page 80
Lysosomes......Page 81
Cytoskeleton......Page 82
Genetic Code......Page 84
Transcription: mRNA Synthesis......Page 86
Translation: Polypeptide Synthesis......Page 87
Regulation of Protein Synthesis......Page 90
Mutation......Page 91
Protein Secretion......Page 92
Chemical Specificity......Page 95
Saturation......Page 96
Competition......Page 97
Allosteric Modulation......Page 98
Covalent Modulation......Page 99
SECTION D Enzymes and Chemical Energy......Page 100
Reversible and Irreversible Reactions......Page 101
Enzymes......Page 102
Cofactors......Page 103
Enzyme Activity......Page 104
Multienzyme Reactions......Page 105
Glycolysis......Page 107
Krebs Cycle......Page 108
Oxidative Phosphorylation......Page 111
Carbohydrate, Fat, and Protein Metabolism\n......Page 113
Carbohydrate Metabolism......Page 114
Fat Metabolism......Page 116
Protein and Amino Acid Metabolism......Page 118
Essential Nutrients......Page 120
Vitamins......Page 121
TEST QUESTIONS......Page 123
QUANTITATIVE AND THOUGHT QUESTIONS......Page 124
CHAPTER 4: Movement of Molecules Across Cell Membranes......Page 125
Magnitude and Direction of Diffusion......Page 126
Diffusion Through Membranes......Page 128
Mediated-Transport Systems......Page 131
Active Transport......Page 133
Osmosis......Page 137
Extracellular Osmolarity and Cell Volume......Page 139
Endocytosis......Page 141
Epithelial Transport......Page 143
QUANTITATIVE AND THOUGHT QUESTIONS......Page 147
ANSWERS TO PHYSIOLOGICAL INQUIRIES......Page 148
CHAPTER 5: Control of Cells by Chemical Messengers......Page 149
Receptors......Page 150
Signal Transduction Pathways......Page 152
Pathways Initiated by Water-Soluble Messengers......Page 153
Cessation of Activity in Signal Transduction Pathways......Page 162
ANSWERS TO PHYSIOLOGICAL INQUIRIES......Page 165
CHAPTER 6: Neuronal Signaling and the Structure of the Nervous System......Page 166
Structure and Maintenance of Neurons......Page 167
Functional Classes of Neurons......Page 168
Glial Cells......Page 170
Neural Growth and Regeneration......Page 171
The Resting Membrane Potential......Page 173
Graded Potentials......Page 178
Action Potentials......Page 180
Multiple Sclerosis......Page 187
Functional Anatomy of Synapses......Page 188
Mechanisms of Neurotransmitter Release......Page 189
Excitatory Chemical Synapses......Page 190
Synaptic Integration......Page 191
Synaptic Strength......Page 193
Modification of Synaptic Transmission by Drugs and Disease......Page 194
Acetylcholine......Page 195
Biogenic Amines......Page 196
Amino Acid Neurotransmitters......Page 198
Neuropeptides......Page 199
Ethanol: A Pharmacological Hand Grenade......Page 200
SECTION D Structure of the Nervous System......Page 202
Forebrain......Page 203
Cerebellum......Page 205
Peripheral Nervous System......Page 206
Autonomic Nervous System......Page 209
Blood Supply, Blood-Brain Barrier, and Cerebrospinal Fluid......Page 214
Nicotine......Page 215
TEST QUESTIONS......Page 218
ANSWERS TO PHYSIOLOGICAL INQUIRIES......Page 219
CHAPTER 7: Sensory Physiology......Page 220
Sensory Receptors......Page 221
The Receptor Potential......Page 222
Stimulus Type......Page 223
Stimulus Location......Page 224
Neural Pathways in Sensory Systems......Page 227
Ascending Pathways......Page 228
Association Cortex and Perceptual Processing......Page 229
Factors That Affect Perception......Page 230
Sense of Posture and Movement......Page 232
Pain......Page 233
Neural Pathways of the Somatosensory System......Page 235
Light......Page 237
The Optics of Vision......Page 238
Photoreceptor Cells and Phototransduction......Page 241
Neural Pathways of Vision......Page 243
Color Vision......Page 244
Eye Movement......Page 245
Sound......Page 246
Sound Transmission in the Ear......Page 247
Hair Cells of the Organ of Corti......Page 250
The Semicircular Canals......Page 251
Vestibular Information and Pathways......Page 252
Taste......Page 253
Smell......Page 255
Color Blindness......Page 256
TEST QUESTIONS......Page 259
ANSWERS TO PHYSIOLOGICAL INQUIRIES......Page 260
CHAPTER 8: Consciousness, the Brain, and Behavior......Page 261
Electroencephalogram......Page 262
Sleep......Page 263
Neural Substrates of States of Consciousness......Page 264
Coma and Brain Death......Page 266
Selective Attention......Page 267
Neural Mechanisms of Conscious Experiences......Page 268
Motivation......Page 269
Emotion......Page 270
Schizophrenia......Page 271
The Mood Disorders: Depressions and Bipolar Disorders......Page 272
Psychoactive Substances, Dependence, and Tolerance......Page 273
Memory......Page 274
The Neural Basis of Learning and Memory......Page 275
Cerebral Dominance and Language......Page 276
Limbic System Dysfunction......Page 278
Head Trauma and Conscious State......Page 279
TEST QUESTIONS......Page 281
ANSWERS TO PHYSIOLOGICAL INQUIRIES......Page 282
CHAPTER 9: Muscle......Page 283
Structure......Page 284
Sliding-Filament Mechanism......Page 287
Excitation-Contraction Coupling......Page 290
Membrane Excitation: The Neuromuscular Junction......Page 293
Mechanics of Single-Fiber Contraction......Page 295
Twitch Contractions......Page 297
Load-Velocity Relation......Page 298
Length-Tension Relation......Page 299
Skeletal Muscle Energy Metabolism......Page 301
Muscle Fatigue......Page 302
Whole-Muscle Contraction......Page 303
Control of Muscle Tension......Page 304
Muscle Adaptation to Exercise......Page 306
Lever Action of Muscles and Bones......Page 307
Myasthenia Gravis......Page 309
Structure of Smooth Muscle......Page 313
Cross-Bridge Activation......Page 314
Sources of Cytosolic Calcium......Page 315
Membrane Activation......Page 316
Types of Smooth Muscle......Page 318
Excitation-Contraction Coupling in Cardiac Muscle......Page 319
TEST QUESTIONS......Page 322
QUANTITATIVE AND THOUGHT QUESTIONS......Page 323
ANSWERS TO PHYSIOLOGICAL INQUIRIES......Page 324
CHAPTER 10: Control of Body Movement......Page 325
Motor Control Hierarchy......Page 326
Interneurons......Page 328
Local Afferent Input......Page 329
Cerebral Cortex......Page 333
Subcortical and Brainstem Nuclei......Page 334
Cerebellum......Page 336
Descending Pathways......Page 337
Abnormal Muscle Tone......Page 338
Walking......Page 339
Tetanus......Page 340
TEST QUESTIONS......Page 342
ANSWERS TO PHYSIOLOGICAL INQUIRIES......Page 343
CHAPTER 11: The Endocrine System......Page 344
Amine Hormones......Page 346
Steroid Hormones......Page 348
Hormone Transport in the Blood......Page 352
Hormone Receptors......Page 353
Pharmacological Effects of Hormones......Page 354
Control by Neurons......Page 355
Hyposecretion......Page 356
Hyporesponsiveness and Hyperresponsiveness......Page 357
Control Systems Involving the Hypothalamus and Pituitary......Page 359
Anterior Pituitary Hormones and the Hypothalamus......Page 360
Control of Thyroid Function......Page 366
Actions of Thyroid Hormones......Page 367
Growth and Development......Page 368
Hypothyroidism and Hyperthyroidism......Page 369
Functions of Cortisol in Stress......Page 371
Other Hormones Released During Stress......Page 372
Adrenal Insufficiency and Cushing’s Syndrome......Page 373
Bone Growth......Page 375
Growth Hormone and Insulin-Like Growth Factors......Page 376
Sex Hormones......Page 378
Acromegaly and Gigantism......Page 379
Bone......Page 381
Parathyroid Hormone......Page 382
1,25-Dihydroxyvitamin D......Page 383
Hyper- and Hypocalcemia......Page 384
TEST QUESTIONS......Page 386
ANSWERS TO PHYSIOLOGICAL INQUIRIES......Page 387
CHAPTER 12: Cardiovascular Physiology......Page 388
System Overview......Page 389
Pressure, Flow, and Resistance......Page 391
Anatomy......Page 394
Cardiac Muscle......Page 395
Heartbeat Coordination......Page 396
Sequence of Excitation......Page 397
Cardiac Action Potentials and Excitation of the SA Node......Page 398
Excitation-Contraction Coupling......Page 400
Mechanical Events of the Cardiac Cycle......Page 402
Systole......Page 404
Heart Sounds......Page 406
Control of Heart Rate......Page 407
Control of Stroke Volume......Page 408
Hypertrophic Cardiomyopathy......Page 411
Arteries......Page 413
Arterial Blood Pressure......Page 414
Measurement of Systemic Arterial Pressure......Page 416
Arterioles......Page 417
Local Controls......Page 418
Extrinsic Controls......Page 419
Endothelial Cells and Vascular Smooth Muscle......Page 420
Capillaries......Page 421
Velocity of Capillary Blood Flow......Page 423
Diffusion Across the Capillary Wall: Exchanges of Nutrients and Metabolic End Products......Page 424
Bulk Flow Across the Capillary Wall: Distribution of the Extracellular Fluid......Page 426
Determinants of Venous Pressure......Page 428
Mechanism of Lymph Flow......Page 430
Causes of Edema......Page 432
SECTION D Integration of Cardiovascular Function: Regulation of Systemic Arterial Pressure......Page 434
Arterial Baroreceptors......Page 437
Operation of the Arterial Baroreceptor Reflex......Page 438
Blood Volume and Long-Term Regulation of Arterial Pressure......Page 439
Other Cardiovascular Reflexes and Responses......Page 440
Elevated Intracranial Pressure......Page 441
Hemorrhage and Other Causes of Hypotension......Page 442
The Upright Posture......Page 443
Exercise......Page 444
Maximal Oxygen Consumption and Training......Page 446
Heart Failure......Page 448
Coronary Artery Disease and Heart Attacks......Page 451
Erythrocytes......Page 454
Leukocytes......Page 457
Regulation of Blood Cell Production......Page 458
Formation of a Platelet Plug......Page 460
Blood Coagulation: Clot Formation......Page 461
Anticlotting Systems......Page 464
Anticlotting Drugs......Page 465
TEST QUESTIONS......Page 468
ANSWERS TO PHYSIOLOGICAL INQUIRIES......Page 469
CHAPTER 13: Respiratory Physiology......Page 471
The Airways and Blood Vessels......Page 472
Relation of the Lungs to the Thoracic (Chest) Wall......Page 473
Ventilation and Lung Mechanics......Page 475
How Is a Stable Balance Achieved Between Breaths?......Page 477
Inspiration......Page 478
Expiration......Page 480
Lung Compliance......Page 481
Airway Resistance......Page 482
Lung Volumes and Capacities......Page 483
Alveolar Ventilation......Page 485
Partial Pressures of Gases......Page 486
Alveolar Gas Pressures......Page 488
Gas Exchange Between Alveoli and Blood......Page 489
Matching of Ventilation and Blood Flow in Alveoli......Page 490
Gas Exchange Between Tissues and Blood......Page 491
What Is the Effect of PO2 on Hemoglobin Saturation?......Page 492
Effects of Blood PCO2, H+ Concentration, Temperature, and DPG Concentration on Hemoglobin Saturation......Page 495
Transport of Carbon Dioxide in Blood......Page 496
Transport of Hydrogen Ions Between Tissuesand Lungs......Page 497
Neural Generation of Rhythmical Breathing......Page 498
Control of Ventilation by PO2, PCO2, and H+ Concentration......Page 499
Control of Ventilation During Exercise......Page 503
Other Ventilatory Responses......Page 504
Why Do Ventilation-Perfusion Abnormalities Affect O2 More than CO2?......Page 505
Acclimatization to High Altitude......Page 506
Sleep Apnea......Page 507
QUANTITATIVE AND THOUGHT QUESTIONS......Page 512
ANSWERS TO PHYSIOLOGICAL INQUIRIES......Page 513
CHAPTER 14: The Kidneys and Regulation of Water and Inorganic Ions......Page 514
Renal Functions......Page 515
Structure of the Kidneys and Urinary System......Page 516
Basic Renal Processes......Page 518
Glomerular Filtration......Page 521
Tubular Reabsorption......Page 523
Metabolism by the Tubules......Page 525
The Concept of Renal Clearance......Page 526
Micturition......Page 527
Incontinence......Page 528
Total-Body Balance of Sodium and Water......Page 529
Coupling of Water Reabsorption to Sodium Reabsorption......Page 530
Urine Concentration: The Countercurrent Multiplier System......Page 532
Renal Sodium Regulation......Page 535
Control of Sodium Reabsorption......Page 536
Baroreceptor Control of Vasopressin Secretion......Page 539
Osmoreceptor Control of Vasopressin Secretion......Page 540
Potassium Regulation......Page 541
Renal Regulation of Potassium......Page 542
Summary—Division of Labor......Page 543
Hyperaldosteronism......Page 544
Sources of Hydrogen Ion Gain or Loss......Page 546
Renal Mechanisms......Page 547
Addition of New Bicarbonate to the Plasma......Page 548
Renal Responses to Acidosis and Alkalosis......Page 549
Classification of Acidosis and Alkalosis......Page 550
Kidney Disease......Page 552
Hemodialysis, Peritoneal Dialysis, and Transplantation......Page 553
TEST QUESTIONS......Page 554
QUANTITATIVE AND THOUGHT QUESTIONS......Page 555
ANSWERS TO PHYSIOLOGICAL INQUIRIES......Page 556
CHAPTER 15: The Digestion and Absorption of Food......Page 557
Overview: Functions of the Gastrointestinal Organs......Page 559
Structure of the Gastrointestinal Tract Wall......Page 563
Carbohydrate......Page 565
Fat......Page 566
Vitamins......Page 568
Basic Principles......Page 569
Mouth, Pharynx, and Esophagus......Page 572
Stomach......Page 574
Pancreatic Secretions......Page 580
Bile Secretion and Liver Function......Page 582
Small Intestine......Page 583
Large Intestine......Page 585
Ulcers......Page 586
Gallstones......Page 588
Constipation and Diarrhea......Page 589
TEST QUESTIONS......Page 593
ANSWERS TO PHYSIOLOGICAL INQUIRIES......Page 594
CHAPTER 16: Regulation of Organic Metabolism and Energy Balance......Page 595
Events of the Absorptive and Postabsorptive States......Page 596
Absorptive State......Page 597
Postabsorptive State......Page 598
Endocrine and Neural Control of the Absorptive and Postabsorptive States......Page 600
Insulin......Page 601
Epinephrine and Sympathetic Nerves to Liver and Adipose Tissue......Page 604
Growth Hormone......Page 605
Energy Homeostasis in Exercise and Stress......Page 606
Diabetes Mellitus......Page 607
Increased Plasma Cholesterol......Page 609
Basic Concepts of Energy Expenditure......Page 612
Metabolic Rate......Page 613
Regulation of Total-Body Energy Stores......Page 614
Control of Food Intake......Page 615
Overweight and Obesity......Page 617
Eating Disorders: Anorexia Nervosa and Bulimia Nervosa......Page 618
Regulation of Body Temperature......Page 619
Temperature-Regulating Reflexes......Page 620
Fever and Hyperthermia......Page 623
Heat Exhaustion and Heat Stroke......Page 625
TEST QUESTIONS......Page 626
ANSWERS TO PHYSIOLOGICAL INQUIRIES......Page 627
CHAPTER 17: Reproduction......Page 628
SECTION A General Terminology and Concepts; Sex Determination and Differentiation......Page 629
General Principles of Gametogenesis......Page 630
Sex Determination......Page 631
Differentiation of Internal and External Genitalia......Page 632
Sexual Differentiation of the Central Nervous System and Homosexuality......Page 633
Anatomy......Page 634
Spermatogenesis......Page 635
Erection......Page 638
Ejaculation......Page 639
Testosterone......Page 640
Andropause......Page 641
Hypogonadism......Page 642
Oogenesis......Page 644
Follicle Growth......Page 646
Control of Ovarian Function......Page 648
Follicle Development and Estrogen Synthesis During the Early and Middle Follicular Phases......Page 649
LH Surge and Ovulation......Page 650
The Luteal Phase......Page 651
Uterine Changes in the Menstrual Cycle......Page 652
Other Effects of Estrogen and Progesterone......Page 654
Puberty......Page 655
Fertilization......Page 656
Early Development, Implantation, and Placentation......Page 657
Hormonal and Other Changes During Pregnancy......Page 661
Parturition......Page 663
Lactation......Page 665
Contraception......Page 667
Menopause......Page 668
Congenital Adrenal Hyperplasia......Page 669
Precocious Puberty......Page 670
QUANTITATIVE AND THOUGHT QUESTIONS......Page 673
ANSWERS TO PHYSIOLOGICAL INQUIRIES......Page 674
CHAPTER 18: Defense Mechanisms of the Body......Page 675
Cells Mediating Immune Defenses......Page 676
Inflammation......Page 677
Overview......Page 683
Lymphoid Organs and Lymphocyte Origins......Page 684
Lymphocyte Receptors......Page 687
Antigen Presentation to T Cells......Page 689
Development of Immune Tolerance......Page 691
Antibody-Mediated Immune Responses: Defenses Against Bacteria, Extracellular Viruses, and Toxins......Page 692
Defenses Against Virus-Infected Cells and Cancer Cells......Page 696
Systemic Manifestations of Infection......Page 697
Factors That Alter the Body’s Resistance to Infection......Page 699
Acquired Immune Deficiency Syndrome (AIDS)......Page 700
Transfusion Reactions......Page 701
Allergy (Hypersensitivity)......Page 702
Excessive Infl ammatory Responses......Page 704
Systemic Lupus Erythematosus......Page 707
TEST QUESTIONS......Page 710
ANSWERS TO PHYSIOLOGICAL INQUIRIES......Page 711
CHAPTER 19: Medical Physiology: Integration Using Clinical Cases......Page 712
Physical Examination......Page 713
Laboratory Tests......Page 714
Diagnosis......Page 715
Physiological Integration......Page 716
Laboratory Tests......Page 717
Diagnosis......Page 718
Therapy......Page 719
Diagnosis......Page 720
Therapy......Page 722
APPENDIX A: Answers to Test & Quantitative and Thought Questions......Page 725
APPENDIX B: Index of Exercise Physiology......Page 741
APPENDIX C: Index of Clinical Terms......Page 742
GLOSSARY......Page 746
REFERENCES......Page 776
CREDITS......Page 778
INDEX......Page 780