Additional Information
Book Details
Abstract
● Thoroughly revised and updated second edition retains
its well accepted unique style of organization of the text
in three parts and twelve sections.
● Presentation of the text with various levels of headings,
subheadings, boldface and italics has been maintained to
help the students easily understand, retain and reproduce.
● Text has been updated incorporating the recent advances
in each section including more aspects of molecular
physiology.
● Applied physiology has been updated with recent concepts
on pathophysiology, and recent advances in the
basic investigations and therapeutic principles.
● To further upgrade the book, many new figures, tables
and flowcharts have been added.
Online Content:
- FAQs with reference for the answers in the book
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Front matter | i | ||
| Concise textbook of physiology | iii | ||
| Copyright | iv | ||
| Dedication | v | ||
| Preface | vii | ||
| Acknowledgements | ix | ||
| Table of contents | xi | ||
| 1 General Physiology | 1 | ||
| 1.1 Functional organization, composition and internal environment of human body | 3 | ||
| Functional organization of the human body | 3 | ||
| Body composition | 4 | ||
| Total body water | 4 | ||
| The body fluid compartments | 4 | ||
| 1. Intracellular fluid compartment | 4 | ||
| 2. Extracellular fluid compartment | 5 | ||
| (I) Plasma | 5 | ||
| (II) Interstitial fluid including lymph | 5 | ||
| (III) Transcellular fluid | 5 | ||
| (IV) Mesenchymal tissue fluid | 5 | ||
| Body electrolytes | 5 | ||
| It is important to note the following: | 5 | ||
| Functions of electrolytes | 5 | ||
| Internal environment and homeostasis | 5 | ||
| Internal environment | 5 | ||
| Homeostasis | 5 | ||
| Mode of action of homeostatic control system | 6 | ||
| Negative feedback mechanism | 6 | ||
| Positive feedback mechanism | 6 | ||
| Adaptive control system | 6 | ||
| Self-assessment | 6 | ||
| 1.2 The cell physiology | 7 | ||
| Cell structure | 7 | ||
| The cell membrane | 7 | ||
| Structure | 7 | ||
| Fluid mosaic model | 8 | ||
| Arrangement of different molecules in cell membrane | 8 | ||
| Arrangement of lipid bilayer of the cell membrane | 8 | ||
| Functional significance of the lipid bilayer. | 8 | ||
| Arrangement of proteins in the cell membrane | 8 | ||
| 1. Peripheral proteins. | 8 | ||
| 2. Integral proteins or transmembrane proteins. | 9 | ||
| Arrangement of carbohydrates in the cell membrane | 9 | ||
| Functions of cell membrane carbohydrates | 9 | ||
| Cytoplasm | 9 | ||
| A. Organelles | 9 | ||
| 1. Mitochondria | 9 | ||
| Structure. | 9 | ||
| 2 Nerve Muscle Physiology | 23 | ||
| 2.1 The nerve | 25 | ||
| Functional anatomy | 25 | ||
| Neuron | 25 | ||
| Neuroglia | 26 | ||
| Peripheral nerve | 26 | ||
| Biological activities | 27 | ||
| Protein synthesis | 27 | ||
| Axoplasmic transport | 27 | ||
| Electrical properties of nerve fibre | 27 | ||
| Excitability | 27 | ||
| Resting membrane potential | 27 | ||
| Action potential | 27 | ||
| Phases of action potential | 27 | ||
| Ionic basis of action potential | 28 | ||
| Characteristics of nerve excitability vis-à-vis characteristics of the stimulus | 29 | ||
| 1. Strength–duration curve | 29 | ||
| 2. All-or-none response | 29 | ||
| 3. Membrane excitability during action potential | 29 | ||
| (I) Refractory period | 29 | ||
| (a) Absolute refractory period (ARP) | 29 | ||
| Ionic basis of ARP | 29 | ||
| (b) Relative refractory period (RRP) | 30 | ||
| Ionic basis of RRP | 30 | ||
| (II) Supernormal period | 30 | ||
| (III) Subnormal period | 30 | ||
| 4. Accommodation | 30 | ||
| 5. Infatiguability | 30 | ||
| Electrotonic potential and local response | 30 | ||
| Inhibition of excitability | 30 | ||
| Conductivity | 31 | ||
| Conduction velocity | 32 | ||
| Recording of membrane potentials and action potentials | 32 | ||
| Instruments used for recording | 32 | ||
| Recording of resting membrane potential | 33 | ||
| Recording of action potential | 33 | ||
| Monophasic recording of action potential | 33 | ||
| Biphasic recording of action potential | 33 | ||
| Compound action potential | 33 | ||
| Nerve fibre types | 33 | ||
| Degeneration and regeneration of neurons | 34 | ||
| Stage of degeneration | 35 | ||
| Stage of regeneration | 36 | ||
| Factors affecting regeneration | 36 | ||
| Regenerative changes | 36 | ||
| Anatomical regeneration | 36 | ||
| 1. Changes in the axon | 36 | ||
| Stage of fibre formation | 36 | ||
| Stage of entry of fibrils into endoneural tube | 36 | ||
| Stage of active growth | 36 | ||
| Stage of myelination | 36 | ||
| 2. Changes in the cell body of neuron | 36 | ||
| Functional regeneration | 36 | ||
| Factors promoting neuronal growth | 36 | ||
| Self-assessment | 37 | ||
| 2.2 Neuromuscular junction | 38 | ||
| Structure of neuromuscular junction | 38 | ||
| Neuromuscular transmission | 38 | ||
| Drugs affecting and disorder of neuromuscular junction | 38 | ||
| Self-assessment | 40 | ||
| 2.3 Skeletal muscle | 41 | ||
| Introduction | 41 | ||
| Functional anatomy and organization | 41 | ||
| Structural organization of muscle | 41 | ||
| Structure of a muscle fibre | 41 | ||
| Myofibril | 42 | ||
| Striations of muscle fibres | 42 | ||
| Thick and thin filaments | 42 | ||
| Thick filament | 42 | ||
| Structure of myosin molecule. | 42 | ||
| Thin filament | 42 | ||
| Sarcotubular system | 43 | ||
| Process of muscle excitability and contractility | 43 | ||
| Process of muscle excitation | 43 | ||
| Process of excitation–contraction coupling | 44 | ||
| Process of muscle contraction | 44 | ||
| Sequence of events during muscle contraction and relaxation when stimulated by a nerve | 46 | ||
| Characteristics of muscle contractility | 46 | ||
| Contractility | 46 | ||
| Contractile response | 48 | ||
| Muscle tone | 49 | ||
| Electromyography | 49 | ||
| Self-assessment | 49 | ||
| 2.4 Smooth muscle and cardiac muscle | 50 | ||
| Smooth muscle | 50 | ||
| Functional anatomy and organization | 50 | ||
| Process of excitability and contractility | 51 | ||
| Process of muscle excitation | 51 | ||
| Electrical activity in single-unit (visceral) smooth muscles | 51 | ||
| Resting membrane potential | 51 | ||
| Action potential | 51 | ||
| 1. Spike potential | 51 | ||
| 2. Spike potential superimposed over slow wave potentials | 51 | ||
| 3. action potential with plateau | 51 | ||
| Ionic basis of action potential | 51 | ||
| Electrical activity in multiunit smooth muscles | 52 | ||
| Process of excitation–contraction coupling | 52 | ||
| Process of smooth muscle contraction | 54 | ||
| Characteristics of smooth muscle contraction | 54 | ||
| Excitation and inhibition of smooth muscles | 54 | ||
| Excitation of smooth muscles | 54 | ||
| Inhibition of smooth muscles | 54 | ||
| Cardiac muscle | 54 | ||
| Functional anatomy | 54 | ||
| Process of excitability and contractility | 54 | ||
| Properties of cardiac muscle | 54 | ||
| Comparison of skeletal, smooth and cardiac muscles | 54 | ||
| Self-assessment | 54 | ||
| 3 Blood and Immune System | 55 | ||
| 3.1 Plasma and plasma proteins | 57 | ||
| Plasma | 57 | ||
| Plasma proteins | 57 | ||
| Classification of plasma proteins | 57 | ||
| Properties of plasma proteins | 58 | ||
| Functions of plasma proteins | 58 | ||
| Synthesis of plasma proteins | 58 | ||
| Changes in plasma proteins in health and disease | 59 | ||
| Self-assessment | 59 | ||
| 3.2 Red blood cells and anaemias | 60 | ||
| Characteristic features of red blood cells | 60 | ||
| Functional morphology | 60 | ||
| Normal size, shape and counts of RBCs | 60 | ||
| Normal size | 60 | ||
| Normal shape | 60 | ||
| Normal counts | 61 | ||
| Variations in counts of RBCs | 61 | ||
| Physiological decrease in RBC count | 61 | ||
| Packed cell volume and red cell indices | 61 | ||
| Packed cell volume | 61 | ||
| Red cell indices | 61 | ||
| Rouleaux formation and erythrocyte sedimentation rate | 62 | ||
| Rouleaux formation | 62 | ||
| Erythrocyte sedimentation rate | 62 | ||
| Clinical significance of ESR | 62 | ||
| Factors affecting ESR | 62 | ||
| Pathological variations in ESR | 62 | ||
| Formation of red blood cells | 62 | ||
| Haemoglobin | 65 | ||
| Red cell fragility | 69 | ||
| Lifespan and fate of red blood cells | 69 | ||
| Bilirubin and jaundice | 70 | ||
| Bilirubin formation and its fate | 70 | ||
| Anaemias | 71 | ||
| Definition and classification | 71 | ||
| General clinical features of anaemia | 72 | ||
| Megaloblastic anaemia | 72 | ||
| Self-assessment | 73 | ||
| 3.3 White blood cells | 74 | ||
| Types of white blood cells and their counts | 74 | ||
| Formation of white blood cells | 75 | ||
| Formation of granulocytes and monocytes | 75 | ||
| Formation of lymphocytes | 75 | ||
| Regulation of leucopoiesis | 76 | ||
| Morphology, functions, lifespan and variations in counts of WBCs | 77 | ||
| Neutrophils | 77 | ||
| Eosinophils | 78 | ||
| Basophils | 78 | ||
| Lymphocytes | 79 | ||
| Leukaemias | 81 | ||
| Self-assessment | 81 | ||
| 3.4 Immune mechanisms | 82 | ||
| Architecture of immune system | 82 | ||
| Mononuclear–phagocytic system | 82 | ||
| Lymphoid component | 82 | ||
| A. Primary (central) lymphoid tissues | 82 | ||
| I. Thymus | 82 | ||
| II. Bursa equivalent | 83 | ||
| B. Peripheral lymphoid organs | 83 | ||
| I. Lymph nodes | 83 | ||
| Structural characteristics of lymph node (fig. 3.4-1) | 83 | ||
| Functions of lymph nodes | 83 | ||
| II. Spleen | 83 | ||
| Structural characteristics (fig. 3.4-2) | 83 | ||
| Functions of spleen | 83 | ||
| III. Mucosa-associated lymphoid tissue | 83 | ||
| Immunity | 84 | ||
| Innate immunity | 84 | ||
| Mechanisms of innate immunity | 84 | ||
| Acquired immunity | 84 | ||
| Antigens | 84 | ||
| Antibodies | 85 | ||
| Development of immune response | 86 | ||
| Development of humoral immunity | 86 | ||
| Development of cellular immune response | 88 | ||
| Other immune mechanism–related aspects | 88 | ||
| Self-assessment | 90 | ||
| 3.5 Platelets, haemostasis and blood coagulation | 91 | ||
| Platelets | 91 | ||
| Haemostasis | 91 | ||
| Blood coagulation | 93 | ||
| Clotting factors | 94 | ||
| Mechanism of coagulation | 94 | ||
| A. Formation of prothrombin activator | 94 | ||
| 1. Extrinsic pathway | 94 | ||
| Release of tissue thromboplastins | 94 | ||
| Activation of factor X to form activated factor X | 94 | ||
| Effect of activated factor X to form prothrombin activator | 94 | ||
| 2. Intrinsic pathway | 95 | ||
| Activation of factor XII | 95 | ||
| Activation of factor XI | 95 | ||
| Activation of factor IX | 95 | ||
| Activation of factor X | 95 | ||
| Formation of prothrombin activator | 95 | ||
| B. Conversion of prothrombin into thrombin | 95 | ||
| Thrombin | 95 | ||
| C. Conversion of fibrinogen into fibrin | 95 | ||
| Blood clot retraction | 96 | ||
| Role of calcium in blood coagulation | 96 | ||
| Role of vitamin K, liver and vascular wall in haemostasis and coagulation | 96 | ||
| Role of vitamin K | 96 | ||
| Role of liver | 96 | ||
| Role of blood vessels | 96 | ||
| Endothelium | 96 | ||
| Subendothelial tissue | 96 | ||
| Vascular smooth muscle | 96 | ||
| Why circulating blood does not clot? | 96 | ||
| 1. Velocity of circulation | 96 | ||
| 2. Surface effects of endothelium | 96 | ||
| 3. Circulatory anticoagulants | 97 | ||
| 4. Fibrinolytic mechanism | 97 | ||
| 5. Removal of activated clotting factors | 97 | ||
| Thrombosis | 97 | ||
| Antihaemostatic mechanisms | 97 | ||
| Bleeding disorders | 98 | ||
| Classification of bleeding disorders | 98 | ||
| I. Platelet disorders | 98 | ||
| II. Coagulation disorder or defective coagulation mechanism | 98 | ||
| III. Vascular disorders: Damage of capillary endothelium (nonthrombocytopenic purpura) | 99 | ||
| Purpura | 99 | ||
| Causes and types of purpura | 99 | ||
| I. Platelet disorders | 99 | ||
| 1. Deficiency of platelets | 99 | ||
| 2. Functional disorders of platelets (thrombocytopenic purpura) | 99 | ||
| II. Vascular disorders | 99 | ||
| Causes of nonthrombocytopenic purpura | 99 | ||
| Haemophilia | 99 | ||
| 1. Haemophilia A | 99 | ||
| 2. Haemophilia B | 100 | ||
| Disseminated intravascular coagulation | 100 | ||
| Laboratory tests in bleeding disorders | 100 | ||
| Bleeding time | 100 | ||
| 4 Cardiovascular System | 107 | ||
| 4.1 Functional anatomy of heart and physiology of cardiac muscle | 109 | ||
| Functional anatomy of heart | 109 | ||
| Physiology of cardiac muscle | 111 | ||
| Process of excitability and contractility: An electromechanical phenomenon | 111 | ||
| Properties of cardiac muscle | 113 | ||
| Self-assessment | 115 | ||
| 4.2 Origin and spread of cardiac impulse and electrocardiography | 116 | ||
| Origin and spread of cardiac impulse | 116 | ||
| Introduction | 116 | ||
| Anatomic consideration | 116 | ||
| Mechanism of origin of rhythmic cardiac impulse | 117 | ||
| Spread of cardiac impulse | 118 | ||
| Heart rate | 119 | ||
| Factors affecting heart rate | 119 | ||
| Regulation of heart rate | 120 | ||
| Electrocardiography | 120 | ||
| Introduction | 120 | ||
| Recording of ECG | 120 | ||
| Clinical applications of electrocardiography | 123 | ||
| Self-assessment | 123 | ||
| 4.3 Heart as a pump: Cardiac cycle, cardiac output and venous return | 124 | ||
| Cardiac cycle | 124 | ||
| Introduction | 124 | ||
| Phases of cardiac cycle | 124 | ||
| Atrial cycle | 125 | ||
| Atrial systole | 125 | ||
| Atrial diastole | 125 | ||
| Ventricular cycle | 125 | ||
| Ventricular systole | 125 | ||
| 1. Phase of isovolumic (isometric) contraction | 125 | ||
| 2. Phase of ventricular ejection | 125 | ||
| Ventricular diastole | 125 | ||
| 1. Protodiastole | 125 | ||
| 2. Isovolumic or isometric relaxation phase | 126 | ||
| 3. Rapid passive filling phase (0.11 second) | 126 | ||
| 4. Reduced filling and diastasis (0.19 second) | 126 | ||
| 5. Last rapid filling phase (0.1 second) | 126 | ||
| Events during cardiac cycle | 127 | ||
| Duration of systole and diastole vis-á-vis heart rate | 127 | ||
| Arterial pulse | 128 | ||
| Cardiac output and venous return | 128 | ||
| Definition of cardiac output and related terms | 128 | ||
| Measurement of cardiac output | 129 | ||
| Variations in cardiac output | 130 | ||
| Regulation of cardiac output | 130 | ||
| Heart–lung preparation | 133 | ||
| Self-assessment | 133 | ||
| 4.4 Dynamics of circulation: Pressure and flow of blood and lymph | 134 | ||
| Introduction | 134 | ||
| Functional organization and structure of vascular system | 134 | ||
| Organization of vascular system | 134 | ||
| Structure of blood vessels | 134 | ||
| Haemodynamics | 136 | ||
| General principles governing (factors affecting) blood flow | 136 | ||
| Flow–pressure–resistance relationship | 136 | ||
| Poiseuille’s law | 136 | ||
| Blood flow and pressure gradient relationship | 136 | ||
| Critical closing pressure | 137 | ||
| Law of laplace | 137 | ||
| Flow and resistance relationship | 137 | ||
| Peripheral resistance unit (PRU) | 137 | ||
| Total peripheral resistance (TPR) | 138 | ||
| Factors that affect resistance to blood flow | 138 | ||
| I. Blood viscosity and resistance | 138 | ||
| Definition and unit of viscosity | 138 | ||
| II. Radius of blood vessels and resistance | 138 | ||
| Velocity of blood flow | 138 | ||
| Blood flow: Types and distribution | 138 | ||
| Types of blood flow | 138 | ||
| Distribution of blood flow to various regions of the body | 139 | ||
| Pressure and flow in various functional segments of systemic vascular tree | 139 | ||
| Pressure and flow functions of elastic arteries | 139 | ||
| Pressure and flow functions of muscular arteries | 140 | ||
| Pressure and flow functions of arterioles | 140 | ||
| Microcirculation | 141 | ||
| Lymphatic circulation | 141 | ||
| Normal lymph flow | 143 | ||
| Venous circulation | 143 | ||
| Blood pressure | 144 | ||
| Definitions (terminology) | 144 | ||
| Determinants of (factors affecting) arterial blood pressure | 145 | ||
| Variations in blood pressure | 145 | ||
| Measurement of blood pressure | 146 | ||
| Regulation of blood pressure | 147 | ||
| Self-assessment | 148 | ||
| 4.5 Cardiovascular regulation | 149 | ||
| Introduction | 149 | ||
| Neural control mechanisms | 149 | ||
| Autonomic nerve supply to heart and blood vessels | 150 | ||
| Autonomic nerve supply to heart | 150 | ||
| Sympathetic supply | 150 | ||
| Parasympathetic supply | 150 | ||
| Autonomic nerve supply to blood vessels | 150 | ||
| Vasoconstriction effect | 150 | ||
| Vasodilation effect | 150 | ||
| Afferent impulses to medullary cardiovascular control centres | 153 | ||
| Afferent impulses from higher centres controlling vasomotor centre and cardiac vagal centre | 153 | ||
| Cerebral cortex | 153 | ||
| Hypothalamus | 153 | ||
| Reticular formation | 154 | ||
| Afferent impulses from respiratory centres | 154 | ||
| Cardiovascular reflex mechanisms affecting medullary control centres | 154 | ||
| Baroreceptor reflex mechanisms | 154 | ||
| Classification and location of baroreceptors | 154 | ||
| Functional classification | 154 | ||
| Carotid and aortic arch baroreceptors | 154 | ||
| Location of carotid and aortic arch baroreceptors | 154 | ||
| Innervation of baroreceptors (fig. 4.5-8) | 154 | ||
| Response of carotid and aortic baroreceptors to pressure | 154 | ||
| The effect of different arterial pressure levels on the discharge rate | 155 | ||
| The carotid baroreceptors respond both to the mean pressure and the pulse pressure. | 155 | ||
| Carotid baroreceptors respond much more to a rapidly changing pressure | 155 | ||
| Pressure–buffer system of baroreceptors. | 155 | ||
| Baroreceptors resetting. | 155 | ||
| Cardiac baroreceptors | 156 | ||
| Atrial stretch receptors | 156 | ||
| Role of atrial stretch receptors | 156 | ||
| 1. As low-pressure receptors. | 156 | ||
| 2. Atrial reflex control of heart rate (bainbridge reflex). | 156 | ||
| 3. Atrial reflex control of blood volume (volume reflex). | 156 | ||
| Ventricular receptors | 156 | ||
| Pulmonary baroreceptors | 156 | ||
| Role of chemoreceptor reflexes in cardiovascular control | 156 | ||
| Functions of chemoreceptors | 156 | ||
| 1. Respiratory control. | 156 | ||
| 2. Cardiovascular control. | 156 | ||
| Note. | 156 | ||
| Direct effects on vasomotor area | 157 | ||
| Humoral control mechanisms | 157 | ||
| Circulating vasodilators | 157 | ||
| Circulating vasoconstrictors | 157 | ||
| Local control mechanisms | 158 | ||
| Self-assessment | 159 | ||
| 4.6 Regional circulation | 160 | ||
| Introduction | 160 | ||
| Coronary circulation | 160 | ||
| Coronary artery disease | 162 | ||
| Cerebral circulation | 162 | ||
| Cerebral blood vessels | 162 | ||
| Arteries of the brain | 162 | ||
| Cerebral blood flow: Characteristic features | 163 | ||
| Cutaneous circulation | 163 | ||
| Skeletal muscle circulation | 165 | ||
| Splanchnic circulation | 165 | ||
| Self-assessment | 167 | ||
| 4.7 Cardiovascular homeostasis in health and disease | 168 | ||
| Cardiovascular homeostasis in health | 168 | ||
| Cardiovascular adjustments during gravitational changes | 168 | ||
| Cardiovascular adjustments during muscular exercise | 169 | ||
| Cardiovascular homeostasis in diseases | 169 | ||
| Circulatory shock | 169 | ||
| Treatment of shock with physiological basis | 172 | ||
| Self-assessment | 172 | ||
| Functions of cardiovascular system | 108 | ||
| Physiology of cardiovascular system | 108 | ||
| 5 Respiratory System | 173 | ||
| 5.1 Respiratory tract: Structure and functions | 175 | ||
| Functional anatomy | 175 | ||
| Functions of respiratory system | 177 | ||
| Self-assessment | 177 | ||
| 5.2 Pulmonary ventilation | 178 | ||
| Introduction | 178 | ||
| Mechanics of pulmonary ventilation | 178 | ||
| Mechanism of breathing | 178 | ||
| Pressure and volume changes during respiratory cycle | 178 | ||
| Lung volumes and capacities | 181 | ||
| Static lung volumes and capacities | 181 | ||
| Dynamic lung volumes and capacities | 182 | ||
| Pulmonary elastance and compliance | 183 | ||
| Pulmonary elastance | 183 | ||
| Work of breathing | 185 | ||
| Self-assessment | 185 | ||
| 5.3 Pulmonary circulation | 186 | ||
| Functional anatomy | 186 | ||
| Characteristic features of pulmonary circulation | 186 | ||
| Regulation of pulmonary blood flow | 187 | ||
| Neural control | 187 | ||
| Chemical control | 187 | ||
| Self-assessment | 187 | ||
| 5.4 Pulmonary diffusion | 188 | ||
| Introduction | 188 | ||
| Physics of gas diffusion and gas partial pressures | 188 | ||
| Alveolar ventilation | 189 | ||
| Alveolar ventilation–perfusion ratio | 190 | ||
| Alveolar air | 190 | ||
| Diffusion of gases through respiratory membrane | 190 | ||
| Self-assessment | 190 | ||
| 5.5 Transport of gases | 193 | ||
| Transport of oxygen | 193 | ||
| Uptake of oxygen by pulmonary blood | 193 | ||
| Transport of oxygen in arterial blood | 193 | ||
| Release of oxygen in tissues | 193 | ||
| Transport of carbon dioxide | 197 | ||
| Diffusion of CO₂ in the blood | 197 | ||
| Transport of CO₂ in the blood | 197 | ||
| Release of CO₂ in the lungs | 199 | ||
| Other facts about CO₂ transport | 199 | ||
| Self-assessment | 200 | ||
| 5.6 Regulation of respiration | 201 | ||
| Introduction | 201 | ||
| Neural regulation of respiration | 202 | ||
| Automatic control system | 202 | ||
| Neural genesis of respiratory rhythm | 202 | ||
| I. Medullary respiratory centres | 202 | ||
| 1. Dorsal respiratory group neurons | 202 | ||
| 2. Ventral respiratory group neurons | 202 | ||
| Interaction of I- and E-neurons | 202 | ||
| Role of VRG neurons | 202 | ||
| II. Pontine respiratory centres | 203 | ||
| 1. Apneustic centre | 203 | ||
| 2. Pneumotaxic centre | 203 | ||
| III. Reticular activating system | 203 | ||
| Afferent impulses to respiratory centres | 203 | ||
| Chemical regulation of respiration | 205 | ||
| Chemoreceptors | 205 | ||
| Peripheral chemoreceptors | 206 | ||
| Some other aspects related to chemical regulation of respiration | 206 | ||
| Self-assessment | 209 | ||
| 5.7 Respiration: Applied aspects | 210 | ||
| Introduction | 210 | ||
| Respiratory adjustments to stresses in health | 210 | ||
| Disturbances of respiration | 210 | ||
| Abnormal respiratory patterns | 210 | ||
| Disturbances related to respiratory gases | 210 | ||
| High-altitude physiology | 214 | ||
| Hypoxia at high altitude | 214 | ||
| Physiology of high atmospheric pressure | 214 | ||
| Introduction | 214 | ||
| Physiological problems due to effect of high pressure on respiratory gases | 215 | ||
| 1. Effects of increased pO₂ (oxygen toxicity) | 215 | ||
| 2. Effects of increased pN₂ (nitrogen narcosis) | 215 | ||
| Physiological problems of ascent | 215 | ||
| Decompression sickness | 215 | ||
| Air embolism | 215 | ||
| Prevention of physiological problems occurring at depth and on ascent | 215 | ||
| Artificial respiration and cardiopulmonary resuscitation | 215 | ||
| Artificial respiration | 215 | ||
| Cardiopulmonary resuscitation | 216 | ||
| Self-assessment | 216 | ||
| 5.8 Physiology of exercise | 217 | ||
| Introduction | 217 | ||
| Responses to exercise | 217 | ||
| Oxygen consumption during exercise | 218 | ||
| Cardiovascular responses to exercise | 218 | ||
| Respiratory responses to exercise | 220 | ||
| Changes at the tissue level | 221 | ||
| Endocrinal responses to exercise | 221 | ||
| Effects of training | 221 | ||
| Self-assessment | 222 | ||
| 6 Excretory System | 223 | ||
| Functions of excretory kidney | 224 | ||
| 6.1 Kidneys: Functional anatomy and blood flow | 225 | ||
| Functional anatomy of kidneys | 225 | ||
| Renal blood flow | 228 | ||
| Renal blood vessels | 228 | ||
| Characteristics of renal blood flow | 229 | ||
| Self-assessment | 230 | ||
| 6.2 Physiology of excretory system | 231 | ||
| Urine formation | 231 | ||
| Glomerular filtration | 231 | ||
| Normal glomerular filtration rate | 232 | ||
| Tubular reabsorption and secretion | 232 | ||
| Transport across different segments of renal tubule | 232 | ||
| Transport across proximal tubule | 232 | ||
| Transport across loop of henle | 232 | ||
| Transport across distal tubules and collecting duct | 232 | ||
| Renal handling of common solutes and water | 232 | ||
| Renal handling of sodium and water | 233 | ||
| Sodium reabsorption | 233 | ||
| Mechanisms of Na⁺ reabsorption | 233 | ||
| Water reabsorption | 233 | ||
| Obligatory and facultative reabsorption of water | 234 | ||
| Renal handling of potassium | 234 | ||
| Functions of K⁺ | 234 | ||
| Transport of potassium across major nephron | 234 | ||
| Factors that regulate urinary K⁺ excretion | 234 | ||
| Renal handling of glucose | 235 | ||
| Glucose reabsorption | 235 | ||
| Renal handling of proteins, peptides and amino acids | 236 | ||
| Protein reabsorption | 236 | ||
| Renal handling of urea | 236 | ||
| 7 Gastrointestinal System | 251 | ||
| Functions of gastrointestinal system | 252 | ||
| 7.1 Organization, general principles and functions of gastrointestinal system | 253 | ||
| Functional anatomy | 253 | ||
| Self-assessment | 255 | ||
| 7.2 Physiological activities in mouth, pharynx and esophagus | 256 | ||
| Introduction | 256 | ||
| Mastication | 256 | ||
| Lubrication of food by saliva | 256 | ||
| Salivary glands | 256 | ||
| Saliva | 256 | ||
| Deglutition (swallowing) | 259 | ||
| Phases of swallowing | 259 | ||
| Disorders of swallowing | 259 | ||
| Self-assessment | 260 | ||
| 7.3 Physiological activities in stomach | 261 | ||
| Functional anatomy | 261 | ||
| Physiology of gastric secretion | 262 | ||
| Gastric juice | 262 | ||
| Regulation of gastric secretion | 263 | ||
| Phases of gastric secretion and their regulation | 264 | ||
| Physiology of gastric motility | 266 | ||
| General considerations | 266 | ||
| Initiation of gastric motility | 266 | ||
| Types of gastric motility | 266 | ||
| Functions of stomach | 267 | ||
| Applied aspects | 267 | ||
| Gastric mucosal barrier and pathophysiology of peptic ulcer | 267 | ||
| Physiology of vomiting | 268 | ||
| Self-assessment | 269 | ||
| 7.4 Pancreas, liver and gall bladder | 270 | ||
| Pancreas | 270 | ||
| Functional anatomy | 270 | ||
| Pancreatic juice | 271 | ||
| Liver and gall bladder | 273 | ||
| Liver: Physiological anatomy | 273 | ||
| Hepatic biliary system | 273 | ||
| Functions of liver | 274 | ||
| Bile | 275 | ||
| Applied aspects | 276 | ||
| Liver function tests | 277 | ||
| Self-assessment | 278 | ||
| 7.5 Physiological activities in small intestine | 279 | ||
| Functional anatomy | 279 | ||
| Small intestinal secretions | 280 | ||
| Motility of small intestine | 280 | ||
| Self-assessment | 282 | ||
| 7.6 Physiological activities in large intestine | 283 | ||
| Functional anatomy | 283 | ||
| Large intestinal secretions and bacterial activity | 284 | ||
| Motility of large intestine | 284 | ||
| Applied aspects | 285 | ||
| Self-assessment | 285 | ||
| 7.7 Digestion and absorption | 286 | ||
| Digestion and absorption of carbohydrates | 286 | ||
| Digestion and absorption of proteins | 287 | ||
| Digestion and absorption of fats | 289 | ||
| Absorption of water, electrolytes, minerals and vitamins | 290 | ||
| Self-assessment | 293 | ||
| 8 Endocrine System | 295 | ||
| Organization of endocrine system | 295 | ||
| 8.1 General principles of endocrine system | 297 | ||
| Hormones: Definition and classification | 297 | ||
| Hormones: General considerations | 297 | ||
| Hormone: Receptors and mechanism of action | 299 | ||
| Hormone receptors | 299 | ||
| Mechanism of action of hormones | 300 | ||
| Measurement of hormones | 301 | ||
| Self-assessment | 302 | ||
| 8.2 Endocrinal functions of hypothalamus and pituitary gland | 303 | ||
| Introduction and functional anatomy | 303 | ||
| Endocrinal aspects of hypothalamus | 305 | ||
| Anterior pituitary hormones | 305 | ||
| Growth hormone | 306 | ||
| Human prolactin | 307 | ||
| Structure, secretion and plasma concentration | 307 | ||
| Control of prolactin secretion | 307 | ||
| Physiological effects of prolactin | 308 | ||
| Applied aspects: Abnormalities of anterior pituitary hormones | 308 | ||
| Abnormalities of growth hormone secretion | 308 | ||
| Posterior pituitary hormones | 308 | ||
| Antidiuretic hormone | 309 | ||
| Abnormalities of adh secretion | 311 | ||
| Oxytocin | 311 | ||
| Structure, synthesis, storage and release of oxytocin | 311 | ||
| Actions of oxytocin | 311 | ||
| Control of oxytocin secretion | 311 | ||
| Self-assessment | 312 | ||
| 8.3 Thyroid gland | 313 | ||
| Functional anatomy | 313 | ||
| Thyroid hormones | 313 | ||
| Introduction | 313 | ||
| Applied aspects of thyroid hormones | 313 | ||
| Abnormalities of thyroid gland | 313 | ||
| Graves disease | 317 | ||
| Self-assessment | 318 | ||
| 8.4 Endocrinal control of calcium metabolism and bone physiology | 319 | ||
| Introduction | 319 | ||
| Calcium, phosphorus and magnesium metabolism | 319 | ||
| Calcium metabolism | 319 | ||
| Phosphorus metabolism | 319 | ||
| Magnesium metabolism | 322 | ||
| Bone physiology | 322 | ||
| Functions and composition of bone | 322 | ||
| Calcitropic hormones | 323 | ||
| Parathyroid hormone | 323 | ||
| Vitamin D | 323 | ||
| Calcitonin | 323 | ||
| Pth-related protein and other hormones affecting calcium metabolism | 325 | ||
| Applied aspects | 325 | ||
| Hyperparathyroidism and hypercalcaemia | 325 | ||
| Hypoparathyroidism and hypocalcaemia | 325 | ||
| Tetany | 325 | ||
| Metabolic bone diseases | 326 | ||
| Rickets | 326 | ||
| Clinical features of rickets | 326 | ||
| Management | 326 | ||
| Osteomalacia | 326 | ||
| Clinical features | 326 | ||
| 1. Skeletal abnormalities | 326 | ||
| 2. Tetany | 326 | ||
| 9 Reproductive System | 349 | ||
| 9.1 Sexual growth and development | 351 | ||
| Prepubertal sexual growth and development | 351 | ||
| Sex determination | 351 | ||
| Sex differentiation | 351 | ||
| Puberty and adolescence | 352 | ||
| Self-assessment | 356 | ||
| 9.2 Male reproductive physiology | 357 | ||
| An overview of male reproductive system | 357 | ||
| Functional anatomy of testes | 358 | ||
| Structure of testes | 358 | ||
| Functions of testes | 359 | ||
| Spermatogenesis | 359 | ||
| Endocrine functions of testes | 361 | ||
| Control of testicular functions | 361 | ||
| Self-assessment | 362 | ||
| 9.3 Female reproductive physiology | 363 | ||
| An overview of female reproductive system | 363 | ||
| Ovaries | 364 | ||
| Functional anatomy | 364 | ||
| Functions of ovaries | 365 | ||
| Oogenesis | 365 | ||
| Endocrine function of ovaries | 365 | ||
| Oestrogens | 365 | ||
| Synthesis, plasma levels and transport of oestrogens | 365 | ||
| Sites | 365 | ||
| Plasma levels | 365 | ||
| Transport | 365 | ||
| Metabolism and excretion of oestrogens | 365 | ||
| Functions of oestrogens | 365 | ||
| I. Reproductive actions | 366 | ||
| A. At puberty | 366 | ||
| B. In an adult woman | 366 | ||
| II. Other actions | 366 | ||
| Progesterone | 366 | ||
| Synthesis, plasma levels and transport of progesterone | 366 | ||
| Sites | 366 | ||
| Plasma levels | 366 | ||
| Transport | 366 | ||
| Metabolism and excretion of progesterone | 366 | ||
| Metabolism | 366 | ||
| Functions of progesterone | 366 | ||
| I. Reproductive actions | 367 | ||
| 1. Action on uterus. | 367 | ||
| 2. Endocervix. | 367 | ||
| 3. Vagina. | 367 | ||
| 4. Fallopian tubes. | 367 | ||
| 5. Breast. | 367 | ||
| 6. During pregnancy. | 367 | ||
| II. Other actions | 367 | ||
| Thermogenic effect. | 367 | ||
| Other ovarian hormones | 367 | ||
| Female sexual cycle | 367 | ||
| Ovarian cycle | 367 | ||
| Pre-ovulatory phase | 367 | ||
| Ovulation | 367 | ||
| Postovulatory phase | 367 | ||
| Endometrial cycle | 368 | ||
| Cyclic changes in cervix | 368 | ||
| Cyclic changes in vagina | 368 | ||
| Hormonal control of female sexual cycle | 368 | ||
| Self-assessment | 370 | ||
| 9.4 Physiology of pregnancy and parturition | 371 | ||
| Physiology of pregnancy | 371 | ||
| Fertilization and implantation | 371 | ||
| Placenta and pregnancy tests | 372 | ||
| Pregnancy tests | 374 | ||
| Physiological changes in mother during pregnancy | 375 | ||
| Physiology of parturition | 376 | ||
| Mechanics of parturition | 376 | ||
| Control of parturition | 376 | ||
| Self-assessment | 377 | ||
| 9.5 Physiology of lactation | 378 | ||
| Functional anatomy of breast | 378 | ||
| Physiology of lactation | 378 | ||
| Phases of lactation | 378 | ||
| Self-assessment | 379 | ||
| 9.6 Physiology of contraception | 380 | ||
| Introduction | 380 | ||
| Contraceptive methods in females | 380 | ||
| Spacing methods | 380 | ||
| Terminal methods | 381 | ||
| Pregnancy vaccines | 382 | ||
| Contraceptive methods in males | 382 | ||
| Spacing methods | 382 | ||
| Terminal methods | 382 | ||
| Self-assessment | 383 | ||
| 10 Nervous System | 385 | ||
| 10.1 Central nervous system | 387 | ||
| Brain | 387 | ||
| Cerebrum | 387 | ||
| External features | 387 | ||
| Sulci and gyri | 387 | ||
| Lobes and functional areas | 388 | ||
| Frontal lobe | 388 | ||
| I. Precentral cortex | 389 | ||
| Areas in precentral cortex | 389 | ||
| II. Prefrontal cortex | 389 | ||
| Parietal lobe | 390 | ||
| Areas of parietal lobe | 390 | ||
| Primary sensory area (first somatic sensory area) | 390 | ||
| Secondary sensory area | 390 | ||
| Sensory-association areas | 390 | ||
| Temporal lobe | 390 | ||
| Areas of temporal lobe | 390 | ||
| Primary auditory area | 390 | ||
| Auditory-association area | 390 | ||
| Occipital lobe | 390 | ||
| Areas of occipital lobe | 390 | ||
| Summary of cortical functional areas | 391 | ||
| Histological structure of cerebral cortex | 391 | ||
| Interior of cerebrum | 391 | ||
| Basal ganglia | 391 | ||
| Components of basal ganglia | 391 | ||
| Functions of basal ganglia | 391 | ||
| Control of voluntary motor activity | 391 | ||
| Control of reflex muscular activity | 391 | ||
| Control of muscle tone | 391 | ||
| Role in arousal mechanism | 391 | ||
| Disorders of basal ganglia | 391 | ||
| Parkinson disease | 391 | ||
| Treatment | 391 | ||
| White matter of cerebrum | 394 | ||
| Diencephalon | 394 | ||
| Thalamus | 395 | ||
| Internal structure | 395 | ||
| Functions and connections | 395 | ||
| Hypothalamus | 396 | ||
| Subdivisions and nuclei of hypothalamus | 396 | ||
| Connections of hypothalamus (fig. 10.1-13) | 396 | ||
| Functions of hypothalamus | 396 | ||
| Applied aspects | 398 | ||
| Brainstem | 398 | ||
| Medulla oblongata | 398 | ||
| Pons | 399 | ||
| Midbrain | 399 | ||
| Hindbrain | 399 | ||
| Cerebellum | 400 | ||
| Anatomical divisions | 400 | ||
| Phylogenetical divisions | 400 | ||
| Functional divisions | 401 | ||
| Histological structure | 401 | ||
| Neural circuits and neuronal activity in cerebellum | 402 | ||
| Functions of cerebellum | 402 | ||
| Cerebellar lesions | 403 | ||
| Spinal cord | 403 | ||
| Anatomy of spinal cord | 403 | ||
| Gross anatomy | 403 | ||
| Internal structure | 403 | ||
| 1. Spinal grey matter | 404 | ||
| 2. White matter of spinal cord | 404 | ||
| Tracts of spinal cord | 404 | ||
| Ascending tracts | 404 | ||
| Descending tracts | 405 | ||
| Spinal segments and spinal nerves | 406 | ||
| Spinal segments | 406 | ||
| Spinal nerves | 407 | ||
| Functions of spinal cord | 407 | ||
| Lesions of spinal cord | 407 | ||
| Self-assessment | 408 | ||
| 10.2 Synaptic transmission | 409 | ||
| Synapse: Definition and types | 409 | ||
| Chemical synapse | 409 | ||
| Structure of a chemical synapse | 409 | ||
| Process of chemical synaptic transmission | 410 | ||
| Properties of synaptic transmission | 411 | ||
| Neurotransmitters | 413 | ||
| Self-assessment | 414 | ||
| 10.3 Somatosensory system | 415 | ||
| General sensory mechanism | 415 | ||
| Introduction | 415 | ||
| Receptors | 415 | ||
| Somatosensory system | 417 | ||
| Somatic sensations | 417 | ||
| Pathways in somatosensory system (transmission of sensations) | 421 | ||
| Role of thalamus in somatosensory system | 424 | ||
| Somatic sensory cortex | 424 | ||
| Encoding: Recognition of type of sensation | 424 | ||
| Self-assessment | 425 | ||
| 10.4 Somatic motor system | 426 | ||
| Introduction | 426 | ||
| Components of somatic motor control system | 427 | ||
| I. Highest level of motor control | 427 | ||
| II. Middle level of motor control | 427 | ||
| III. Lowest level of motor control | 428 | ||
| Spinal cord | 428 | ||
| Motor neurons | 428 | ||
| Motor functions | 428 | ||
| Skeletal muscles: The effector organ of somatic motor system | 428 | ||
| Reflex activity | 429 | ||
| General considerations | 429 | ||
| Spinal cord reflexes | 429 | ||
| Clinical reflexes | 432 | ||
| Regulation of posture | 432 | ||
| Mechanisms involved in maintenance of posture | 432 | ||
| Role of tone in antigravity muscles in maintenance of posture | 432 | ||
| Maintenance of muscle tone | 434 | ||
| Postural reflexes | 434 | ||
| Role of different regions of nervous system for maintenance of posture | 434 | ||
| Mechanism of standing in man | 436 | ||
| Vestibular apparatus and equilibrium | 437 | ||
| Vestibular pathways | 437 | ||
| Self-assessment | 440 | ||
| 10.5 Autonomic nervous system | 441 | ||
| Anatomical considerations | 441 | ||
| Autonomic nervous system: Divisions | 441 | ||
| Physiological considerations | 444 | ||
| Self-assessment | 446 | ||
| 10.6 Meninges, cerebrospinal fluid, bloodbrain barrier and cerebral blood flow | 447 | ||
| Meninges of the brain | 447 | ||
| Cerebrospinal fluid | 447 | ||
| Blood–brain barrier and blood–CSF barrier | 448 | ||
| Blood–brain barrier | 448 | ||
| Blood–CSF barrier | 448 | ||
| Cerebral blood flow | 449 | ||
| 10.7 Limbic system and physiology of emotional, behavioural and motivational mechanisms | 450 | ||
| Limbic system | 450 | ||
| Physiological anatomy | 450 | ||
| Functions of limbic system | 451 | ||
| Physiology of emotions | 451 | ||
| Physiology of motivation | 453 | ||
| Self-assessment | 453 | ||
| 10.8 Reticular formation, electrical activity of the brain, alert behaviour and sleep | 454 | ||
| Reticular formation and reticular activating system | 454 | ||
| Electrical activity of the brain | 455 | ||
| Evoked cortical potentials | 455 | ||
| Electroencephalogram | 455 | ||
| Wakefulness and sleep | 457 | ||
| Wakefulness | 457 | ||
| Sleep | 457 | ||
| Self-assessment | 458 | ||
| 10.9 Some higher functions of nervous system | 459 | ||
| Language and speech | 459 | ||
| Neurophysiology of language and speech | 459 | ||
| Speech disorders | 461 | ||
| Learning and memory | 461 | ||
| Learning | 461 | ||
| A. Nonassociative learning | 461 | ||
| Habituation | 461 | ||
| Sensitization | 461 | ||
| B. Associative learning | 461 | ||
| Classical conditioning | 462 | ||
| Characteristic features of a classical conditioned reflex | 462 | ||
| Physiological basis of conditioned reflexes | 462 | ||
| Operant conditioning | 462 | ||
| Memory | 462 | ||
| Types of memory | 462 | ||
| I. Physiologically: On the basis of how information is stored and recalled | 462 | ||
| II. Depending on permanency of storage | 462 | ||
| Mechanism (physiological and cellular or molecular basis) of memory | 462 | ||
| Mechanism of implicit memory | 462 | ||
| Mechanism of short-term storage of implicit memory | 462 | ||
| Mechanism of long-term storage of implicit memory | 463 | ||
| Interhemispheric transfer of learning and memory | 463 | ||
| Higher intellectual functions of the prefrontal association cortex | 463 | ||
| Self-assessment | 463 | ||
| Organization of nervous system | 385 | ||
| Anatomical divisions of the nervous system | 386 | ||
| Functional divisions of the nervous system | 386 | ||
| Somatic nervous system | 386 | ||
| Autonomic nervous system | 386 | ||
| 11 Special Senses | 465 | ||
| 11.1 Sense of vision | 467 | ||
| Introduction and functional anatomy | 467 | ||
| Introduction | 467 | ||
| Functional anatomy | 467 | ||
| Maintenance of clear refractive media of the eye | 468 | ||
| The image-forming mechanism | 469 | ||
| Optics of the eye | 470 | ||
| Common defects of the image-forming mechanism | 470 | ||
| Physiology of vision | 471 | ||
| Photoreceptors and visual pigments | 471 | ||
| Phototransduction | 472 | ||
| Processing and transmission of visual impulse in visual pathway | 472 | ||
| Processing and analysis of visual impulse in the visual cortex | 473 | ||
| Visual perception | 473 | ||
| Field of vision and binocular vision | 475 | ||
| Aqueous humour and intraocular pressure | 476 | ||
| Maintenance of intraocular pressure | 476 | ||
| Physiology of pupil | 476 | ||
| Self-assessment | 477 | ||
| 11.2 Sense of hearing | 478 | ||
| Functional anatomy | 478 | ||
| The ear | 478 | ||
| Auditory pathways | 480 | ||
| Physiology of hearing | 481 | ||
| Applied aspects | 484 | ||
| Self-assessment | 484 | ||
| 11.3 Chemical senses: Smell and taste | 485 | ||
| Sense of smell | 485 | ||
| Sense of taste | 487 | ||
| Self-assessment | 489 | ||
| Index | 491 | ||
| A | 491 | ||
| B | 491 | ||
| C | 492 | ||
| D | 493 | ||
| E | 493 | ||
| F | 493 | ||
| G | 494 | ||
| H | 494 | ||
| I | 495 | ||
| J | 495 | ||
| K | 495 | ||
| L | 495 | ||
| M | 495 | ||
| N | 496 | ||
| O | 496 | ||
| P | 496 | ||
| Q | 497 | ||
| R | 497 | ||
| S | 498 | ||
| T | 498 | ||
| U | 499 | ||
| V | 499 | ||
| W | 499 | ||
| X | 499 | ||
| Y | 499 | ||
| Z | 499 |