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Book Details
Abstract
Berne & Levy Physiology has long been respected for its scientifically rigorous approach – one that leads to an in-depth understanding of the body’s dynamic processes. The long-awaited 7th Edition by Drs. Bruce M. Koeppen and Bruce A. Stanton, continues this tradition of excellence. With integrated coverage of biophysics and neurophysiology, key experimental observations and examples, and full-color design and artwork, this mid-size text is "just right" for a strong understanding of this complex field.
- A logical and intuitive organ-system-based approach clearly describes all of the mechanisms that control and regulate bodily function.
- Authored by experts with both science and medical backgrounds.
- More "In the Clinic" and "At the Molecular Level" boxes help readers better understand and apply what they’ve learned.
- New coverage includes expanded discussions of gut and lung microbiota,; the limbic system; the hypthalamus and control of food intake; cardiac and vascular function curves during exercise; new aspects of lipid absorption; GI and metabolic consequences of bariatric surgery, the role of innate lymphoid cells in defense of the respiratory system, molecular mechanisms in normal and pathological muscle contraction; arterial pulse changes with age and the ankle-brachial index; regulation of the blood-brain barrier and cerebral blood flow; the regulation of phosphate; and thyroid hormone mechanism of action.
- Each chapter begins with an all-new bulleted list of questions and ends with key concepts covered in that chapter.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Berne & Levy Physiology | i | ||
| Copyright Page | iv | ||
| Dedication | v | ||
| Section Authors | vi | ||
| Board of Reviewers | viii | ||
| Preface | ix | ||
| Table Of Contents | xi | ||
| 1 Cellular Physiology | 1 | ||
| 1 Principles of Cell and Membrane Function | 2 | ||
| Learning Objectives | 2 | ||
| Overview of Eukaryotic Cells | 2 | ||
| The Plasma Membrane | 2 | ||
| Structure and Composition | 2 | ||
| Membrane Lipids | 3 | ||
| Membrane Proteins | 5 | ||
| Membrane Transport | 6 | ||
| Membrane Transport Proteins | 6 | ||
| Water Channels | 6 | ||
| Ion Channels | 6 | ||
| Solute Carriers | 7 | ||
| Adenosine Triphosphate–Dependent Transporters | 7 | ||
| Vesicular Transport | 8 | ||
| Basic Principles of Solute and Water Transport | 10 | ||
| Diffusion | 10 | ||
| Electrochemical Gradient | 11 | ||
| Active and Passive Transport | 12 | ||
| Osmosis and Osmotic Pressure | 12 | ||
| Osmolarity Versus Osmolality | 14 | ||
| Tonicity | 14 | ||
| Oncotic Pressure | 15 | ||
| Specific Gravity | 15 | ||
| Key Points | 16 | ||
| Additional Readings | 16 | ||
| 2 Homeostasis | 17 | ||
| Learning Objectives | 17 | ||
| Concept of Steady-State Balance | 17 | ||
| Volumes and Composition of Body Fluid Compartments | 18 | ||
| Definition and Volumes of Body Fluid Compartments | 19 | ||
| Movement of Water Between Body Fluid Compartments | 19 | ||
| Example 1: Addition of Isotonic Sodium Chloride to the Extracellular Fluid | 20 | ||
| Example 2: Addition of Hypotonic Sodium Chloride to the Extracellular Fluid | 21 | ||
| Example 3: Addition of Hypertonic Sodium Chloride to the Extracellular Fluid | 21 | ||
| Composition of Body Fluid Compartments | 21 | ||
| Maintenance of Cellular Homeostasis | 22 | ||
| Ionic Composition of Cells | 22 | ||
| Membrane Potential | 23 | ||
| Regulation of Cell Volume | 25 | ||
| Isotonic Cell Volume Regulation | 25 | ||
| Nonisotonic Cell Volume Regulation | 26 | ||
| Principles of Epithelial Transport | 27 | ||
| Epithelial Structure | 27 | ||
| Vectorial Transport | 29 | ||
| Transepithelial Water Movement | 32 | ||
| Regulation of Epithelial Transport | 33 | ||
| Key Concepts | 34 | ||
| Additional Readings | 34 | ||
| 3 Signal Transduction, Membrane Receptors, Second Messengers, and Regulation of Gene Expression | 35 | ||
| Learning Objectives | 35 | ||
| Cell-to-Cell Communication | 36 | ||
| Receptors | 39 | ||
| Receptors and Signal Transduction Pathways | 41 | ||
| Ligand-Gated Ion Channel Signal Transduction Pathways | 42 | ||
| G Protein–Coupled Signal Transduction Pathways | 42 | ||
| Protein Phosphatases and Phosphodiesterases Counteract the Activation of Cyclic Nucleotide Kinases | 47 | ||
| Enzyme Receptor–Linked Signal Transduction Pathways | 47 | ||
| Guanylyl Cyclase Receptors | 48 | ||
| Threonine/Serine Kinase Receptors | 48 | ||
| Tyrosine Kinase Receptors | 48 | ||
| Tyrosine Kinase–Associated Receptors | 48 | ||
| Regulation of Gene Expression by Signal Transduction Pathways | 49 | ||
| Nuclear Receptor Signal Transduction Pathways | 49 | ||
| Cell-Surface Signal Transduction Pathways Control Gene Expression | 49 | ||
| Key Points | 49 | ||
| Additional Readings | 50 | ||
| Journal Articles | 50 | ||
| Book Chapters | 50 | ||
| 2 The Nervous System | 51 | ||
| 4 The Nervous System | 52 | ||
| Learning Objectives | 52 | ||
| Cellular Components of the Nervous System | 52 | ||
| Neurons | 52 | ||
| Axonal Transport | 55 | ||
| Glia | 56 | ||
| The Peripheral Nervous System | 58 | ||
| The Central Nervous System | 58 | ||
| Regional Anatomy of the CNS | 60 | ||
| Cerebrospinal Fluid | 62 | ||
| The Blood-Brain Barrier | 62 | ||
| Nervous Tissue Reactions to Injury | 62 | ||
| Degeneration | 63 | ||
| Regeneration | 64 | ||
| Key Concepts | 64 | ||
| Additional Reading | 64 | ||
| 5 Generation and Conduction of Action Potentials | 65 | ||
| Learning Objectives | 65 | ||
| Membrane Potentials | 65 | ||
| Observations on Membrane Potentials | 65 | ||
| The Passive Response | 65 | ||
| The Local Response | 69 | ||
| Suprathreshold Response: The Action Potential | 69 | ||
| Ionic Basis of Action Potentials | 70 | ||
| Ion Channels and Gates | 70 | ||
| The Characteristics of the Na+ and K+ Channels Explain the Conductance Changes During the Action Potential | 70 | ||
| Accommodation | 74 | ||
| Refractory Periods | 74 | ||
| Conduction of Action Potentials | 75 | ||
| Action Potential as a Self-Reinforcing Signal | 75 | ||
| Action Potential Conduction Velocity Is Correlated With Axon Diameter | 76 | ||
| Myelination Greatly Increases Conduction Velocity | 76 | ||
| Functional Consequences of Myelination | 77 | ||
| Sensory Transduction | 77 | ||
| Receptive Fields | 80 | ||
| Coding of Information by Action Potentials | 81 | ||
| Sensory Coding | 81 | ||
| Key Concepts | 82 | ||
| Additional Readings | 83 | ||
| 6 Synaptic Transmission | 84 | ||
| Learning Objectives | 84 | ||
| Electrical Synapses | 84 | ||
| Chemical Synapses | 86 | ||
| Calcium Entry Is the Signal for Transmitter Release | 87 | ||
| Synaptic Vesicles and the Quantal Nature of Transmitter Release | 88 | ||
| Molecular Apparatus Underlying Vesicular Release | 90 | ||
| Synaptic Vesicles Are Recycled | 91 | ||
| Postsynaptic Potentials | 91 | ||
| Synaptic Integration | 94 | ||
| Modulation of Synaptic Activity | 95 | ||
| Paired-Pulse Facilitation | 95 | ||
| Posttetanic Potentiation | 96 | ||
| Synaptic Depression | 96 | ||
| Presynaptic Receptors Can Modulate Transmitter Release | 97 | ||
| Long-Term Changes in Synaptic Strength | 97 | ||
| Neurotransmitters | 98 | ||
| Small-Molecule Neurotransmitters | 98 | ||
| Acetylcholine | 98 | ||
| Amino Acids | 99 | ||
| Biogenic Amines | 100 | ||
| Purines | 101 | ||
| Peptides | 101 | ||
| Opioid Peptides | 102 | ||
| Substance P | 102 | ||
| Gas Neurotransmitters | 103 | ||
| Neurotransmitter Receptors | 103 | ||
| Acetylcholine Receptors | 105 | ||
| Inhibitory Amino Acid Receptors: GABA and Glycine | 105 | ||
| Excitatory Amino Acid Receptors: Glutamate | 105 | ||
| Purine (ATP) Receptors | 106 | ||
| Biogenic Amine Receptors: Serotonin, Dopamine, Noradrenaline, Adrenaline, Histamine | 106 | ||
| Neuropeptide Receptors | 106 | ||
| Gas Neurotransmitter Receptors | 106 | ||
| Key Concepts | 107 | ||
| Additional Reading | 107 | ||
| 7 The Somatosensory System | 108 | ||
| Learning Objectives | 108 | ||
| Subdivisions of the Somatosensory System | 108 | ||
| Discriminatory Touch and Proprioception | 110 | ||
| Innervation of the Skin | 110 | ||
| Low-Threshold Mechanoreceptors | 110 | ||
| Receptive Field Properties | 110 | ||
| Innervation of the Body | 113 | ||
| Innervation of the Face | 113 | ||
| Central Somatosensory Pathways for Discriminatory Touch and Proprioception | 114 | ||
| Dorsal Column–Medial Lemniscus Pathway | 115 | ||
| Trigeminal Pathway for Fine-Touch Sensation From the Face | 115 | ||
| Spinocerebellar and Proprioceptive Pathways | 116 | ||
| Thalamic and Cortical Somatosensory Areas | 116 | ||
| Thalamus | 116 | ||
| Somatosensory Cortex | 117 | ||
| Effects of Lesions of the Somatosensory Cortex | 118 | ||
| Pain and Temperature Sensation | 118 | ||
| Nociceptors and Primary Afferents | 118 | ||
| Spinal Cord Gray Matter and Trigeminal Nucleus | 119 | ||
| Central Pain Pathways | 119 | ||
| Effects of Interruption of the Spinothalamic Tract and Lesions of the Thalamus on Somatosensory Sensation | 121 | ||
| Neuropathic Pain | 121 | ||
| Transduction in the Somatosensory System | 122 | ||
| Mechanotransduction | 122 | ||
| Thermal Transduction | 122 | ||
| Modulation of the Transduction Process | 123 | ||
| Centrifugal Control of Somatosensation | 123 | ||
| Key Concepts | 125 | ||
| Additional Readings | 126 | ||
| 8 The Special Senses | 127 | ||
| Learning Objectives | 127 | ||
| The Visual System | 127 | ||
| Structure of the Eye | 127 | ||
| Retina | 129 | ||
| Layers of the Retina | 129 | ||
| Structure of Photoreceptors: Rods and Cones | 130 | ||
| Regional Variations in the Retina | 131 | ||
| Visual Transduction | 131 | ||
| Visual Adaptation | 132 | ||
| Light Adaptation | 133 | ||
| Dark Adaptation | 133 | ||
| Color Vision | 134 | ||
| Retinal Circuitry | 134 | ||
| Contrasts in Rod and Cone Pathway Functions | 134 | ||
| Synaptic Interactions and Receptive Field Organization | 135 | ||
| P, M, and W Cells | 137 | ||
| The Visual Pathway | 138 | ||
| Lateral Geniculate Nucleus | 139 | ||
| Striate Cortex | 139 | ||
| Extrastriate Visual Cortex | 141 | ||
| Other Visual Pathways | 143 | ||
| The Auditory and Vestibular Systems | 143 | ||
| Audition | 143 | ||
| Sound | 143 | ||
| The Ear | 144 | ||
| External Ear | 144 | ||
| Middle Ear | 144 | ||
| Inner Ear | 146 | ||
| Sound Transduction | 146 | ||
| Cochlear Nerve Fibers | 148 | ||
| Characteristic Frequencies | 148 | ||
| Encoding | 149 | ||
| Central Auditory Pathway | 150 | ||
| Functional Organization of the Central Auditory System | 150 | ||
| Receptive Fields and Tonotopic Maps | 150 | ||
| Binaural Interactions | 150 | ||
| Cortical Organization | 150 | ||
| The Vestibular System | 151 | ||
| The Vestibular Apparatus | 151 | ||
| Structure of the Vestibular Labyrinth | 151 | ||
| Innervation of Sensory Epithelia of the Vestibular Apparatus | 153 | ||
| Vestibular Transduction | 153 | ||
| Semicircular Canals | 153 | ||
| Otolith Organs | 154 | ||
| Central Vestibular Pathways | 155 | ||
| The Chemical Senses | 155 | ||
| Taste | 155 | ||
| Taste Receptors | 155 | ||
| Distribution and Innervation of Taste Buds | 155 | ||
| Central Taste Pathways | 156 | ||
| Olfaction | 156 | ||
| Olfactory Receptors | 157 | ||
| Central Pathways | 157 | ||
| Key Points | 159 | ||
| Additional Reading | 160 | ||
| 9 Organization of Motor Function | 161 | ||
| Learning Objectives | 161 | ||
| Principles of Spinal Cord Organization | 161 | ||
| Somatic Motor Neurons | 162 | ||
| α Motor Neurons | 163 | ||
| γ Motor Neurons | 163 | ||
| Topographic Organization of Motor Neurons in the Ventral Horn | 163 | ||
| Spinal Reflexes | 164 | ||
| The Myotatic or Stretch Reflex | 165 | ||
| Structure of the Muscle Spindle | 165 | ||
| Muscle Spindles Detect Changes in Muscle Length | 166 | ||
| γ Motor Neurons Adjust the Sensitivity of the Spindle | 166 | ||
| The Phasic (or Ia) Stretch Reflex | 168 | ||
| The Tonic Stretch Reflex | 169 | ||
| Inverse Myotatic or Group Ib Reflex | 169 | ||
| Flexion Reflexes and Locomotion | 171 | ||
| Determining Spinal Cord Organization Through the Use of Reflexes | 172 | ||
| Descending Motor Pathways | 175 | ||
| Classification of Descending Motor Pathways | 175 | ||
| The Lateral System | 175 | ||
| Lateral Corticospinal and Corticobulbar Tracts | 175 | ||
| Rubrospinal Tract | 177 | ||
| The Medial System | 177 | ||
| Pontine and Medullary Reticulospinal Tracts | 177 | ||
| Lateral and Medial Vestibulospinal Tracts | 177 | ||
| The Tectospinal Tract | 177 | ||
| Monoaminergic Pathways | 177 | ||
| Motor Deficits Caused by Lesions of Descending Motor Pathways | 178 | ||
| The Decerebrate Preparation | 178 | ||
| Brainstem Control of Posture and Movement | 178 | ||
| Postural Reflexes | 179 | ||
| Brainstem Control of Locomotion | 179 | ||
| Motor Control by the Cerebral Cortex | 179 | ||
| Cortical Motor Areas | 181 | ||
| Somatotopic Organization of Cortical Motor Areas | 181 | ||
| Primary Motor Cortex | 181 | ||
| Supplementary Motor Area | 181 | ||
| Premotor Area | 183 | ||
| Cingulate Motor Areas | 183 | ||
| Connections of the Cortical Motor Areas | 183 | ||
| Activity of Motor Cortex Cells | 184 | ||
| Activity in Other Cortical Motor Areas | 184 | ||
| Motor Control by the Cerebellum | 185 | ||
| Overview of the Role of the Cerebellum in Motor Control | 185 | ||
| Behavioral Consequences of Cerebellar Damage | 187 | ||
| Cerebellar Organization | 187 | ||
| Cerebellar Cortex | 188 | ||
| Afferent Systems | 188 | ||
| Cellular Elements and Efferent Fibers of the Cortex | 191 | ||
| Microcircuitry of the Cortex | 191 | ||
| Cerebellar Nuclei | 193 | ||
| Activity of Purkinje Cells in the Cerebellar Cortex in the Context of Motor Coordination | 193 | ||
| Motor Control by the Basal Ganglia | 194 | ||
| Organization of the Basal Ganglia and Related Nuclei | 194 | ||
| Connections and Operation of the Basal Ganglia | 195 | ||
| Direct Pathway | 195 | ||
| Indirect Pathway | 197 | ||
| Actions of Neurons in the Pars Compacta of the Substantia Nigra on the Striatum | 197 | ||
| Subdivision of the Striatum Into Striosomes and Matrix | 197 | ||
| Role of the Basal Ganglia in Motor Control | 197 | ||
| Eye Movement | 198 | ||
| Types of Eye Movement | 198 | ||
| Vestibuloocular Reflex | 198 | ||
| Optokinetic Reflex | 199 | ||
| Saccades | 199 | ||
| Smooth Pursuit | 199 | ||
| Nystagmus | 199 | ||
| Vergence | 200 | ||
| Neural Circuitry and Activity Underlying Eye Movement | 200 | ||
| Motor Neurons of the Extraocular Muscles | 200 | ||
| Circuits Underlying the Vestibuloocular Reflex | 200 | ||
| Circuits Underlying the Optokinetic Reflex | 202 | ||
| Circuits Underlying Saccades | 202 | ||
| Circuits Underlying Smooth Pursuit | 203 | ||
| Circuits Underlying Vergence | 203 | ||
| Key Points | 205 | ||
| Additional Readings | 207 | ||
| 10 Integrative Functions of the Nervous System | 208 | ||
| Learning Objectives | 208 | ||
| The Cerebral Cortex | 208 | ||
| The Neocortex | 208 | ||
| Neuronal Cell Types in the Neocortex | 208 | ||
| Cytoarchitecture of Cortical Layers | 210 | ||
| Cortical Afferent and Efferent Fibers | 210 | ||
| Regional Variations in Neocortical Structure | 211 | ||
| Archicortex and Paleocortex | 211 | ||
| Functions of the Lobes of the Cerebral Cortex | 212 | ||
| Frontal Lobe | 212 | ||
| Parietal Lobe | 213 | ||
| Occipital Lobe | 213 | ||
| Temporal Lobe | 214 | ||
| The Electrical Activity of the Cortex | 214 | ||
| Evoked Potentials | 215 | ||
| Sleep-Wake Cycle | 216 | ||
| Cerebral Dominance and Language | 217 | ||
| Interhemispheric Communication and the Corpus Callosum | 218 | ||
| Learning and Memory | 220 | ||
| Long-Term Potentiation | 221 | ||
| Memory | 222 | ||
| Neural Plasticity | 222 | ||
| Key Points | 224 | ||
| Additional Reading | 225 | ||
| 11 The Autonomic Nervous System and Its Central Control | 226 | ||
| Learning Objectives | 226 | ||
| Organization of the Autonomic Nervous System | 226 | ||
| The Sympathetic Nervous System | 227 | ||
| The Parasympathetic Nervous System | 229 | ||
| Visceral Afferent Fibers | 229 | ||
| The Enteric Nervous System | 230 | ||
| Autonomic Ganglia | 230 | ||
| Neurotransmitters | 230 | ||
| Neurotransmitters in Autonomic Ganglia | 230 | ||
| Neurotransmitters Between Postganglionic Neurons and Autonomic Effectors | 231 | ||
| Sympathetic Postganglionic Neurons | 231 | ||
| Parasympathetic Postganglionic Neurons | 233 | ||
| Central Control of Autonomic Function | 233 | ||
| Examples of Autonomic Control of Particular Organs | 234 | ||
| Pupil | 234 | ||
| Urinary Bladder | 234 | ||
| Autonomic Centers in the Brain | 235 | ||
| The Hypothalamus and Preoptic Area | 235 | ||
| Temperature Regulation | 236 | ||
| Regulation of Feeding and Body Weight | 237 | ||
| Regulation of Water Intake | 239 | ||
| Other Autonomic Control Structures | 239 | ||
| Neural Influences on the Immune System | 239 | ||
| Key Points | 240 | ||
| Additional Readings | 240 | ||
| 3 Muscle | 241 | ||
| 12 Skeletal Muscle Physiology | 242 | ||
| Learning Objectives | 242 | ||
| Skeletal Muscle Physiology | 242 | ||
| Organization of Skeletal Muscle | 242 | ||
| Control of Skeletal Muscle Activity | 246 | ||
| Motor Nerves and Motor Units | 246 | ||
| Excitation-Contraction Coupling | 247 | ||
| Actin-Myosin Interaction: Cross-Bridge Formation | 251 | ||
| Cross-Bridge Cycling: Sarcomere Shortening | 252 | ||
| Skeletal Muscle Types | 254 | ||
| Modulation of the Force of Contraction | 257 | ||
| Recruitment | 257 | ||
| Tetany | 257 | ||
| Modulation of Force by Reflex Arcs | 258 | ||
| Stretch Reflex | 258 | ||
| Golgi Tendon Organ | 258 | ||
| Skeletal Muscle Tone | 258 | ||
| Energy Sources During Contraction | 258 | ||
| Adenosine Triphosphate | 258 | ||
| Creatine Phosphate | 259 | ||
| Carbohydrates | 259 | ||
| Fatty Acids and Triglycerides | 259 | ||
| Oxygen Debt | 259 | ||
| Fatigue | 259 | ||
| Growth and Development | 261 | ||
| Denervation, Reinnervation, and Cross-Innervation | 262 | ||
| Response to Exercise | 264 | ||
| Delayed-Onset Muscle Soreness | 264 | ||
| Biophysical Properties of Skeletal Muscle | 264 | ||
| Length-Tension Relationship | 264 | ||
| Force-Velocity Relationship | 265 | ||
| Key Points | 266 | ||
| Additional Readings | 267 | ||
| 13 Cardiac Muscle | 268 | ||
| Learning Objectives | 268 | ||
| Basic Organization of Cardiac Muscle Cells | 268 | ||
| Control of Cardiac Muscle Activity | 270 | ||
| Excitation-Contraction Coupling | 271 | ||
| Contraction Mechanism | 272 | ||
| Relaxation of Cardiac Muscle | 272 | ||
| Regulation of the Force of Contraction | 273 | ||
| Intracellular Calcium | 273 | ||
| β-Adrenergic Agonists | 273 | ||
| Stretch | 274 | ||
| Cardiac Muscle Metabolism | 275 | ||
| Cardiac Muscle Hypertrophy | 276 | ||
| Key Points | 278 | ||
| Additional Readings | 279 | ||
| 14 Smooth Muscle | 280 | ||
| Learning Objectives | 280 | ||
| Overview of Smooth Muscle | 280 | ||
| Types of Smooth Muscle | 280 | ||
| Structure of Smooth Muscle Cells | 281 | ||
| Cell-to-Cell Contact | 282 | ||
| Cells and Membranes | 283 | ||
| Contractile Apparatus | 283 | ||
| Cytoskeleton | 283 | ||
| Control of Smooth Muscle Activity | 284 | ||
| Innervation of Smooth Muscle | 284 | ||
| Regulation of Contraction | 285 | ||
| Phasic Versus Tonic Contraction | 288 | ||
| Energetics and Metabolism | 290 | ||
| Regulation of Myoplasmic Calcium Concentration | 290 | ||
| Sarcoplasmic Reticulum | 292 | ||
| Sarcolemma | 293 | ||
| Myogenic Response | 294 | ||
| Development and Hypertrophy | 294 | ||
| Synthetic and Secretory Functions | 294 | ||
| Biophysical Properties of Smooth Muscle | 296 | ||
| Length-Tension Relationship | 296 | ||
| Force-Velocity Relationship | 296 | ||
| Key Concepts | 298 | ||
| Additional Reading | 299 | ||
| 4 The Cardiovascular System | 300 | ||
| 15 Overview of Circulation | 301 | ||
| Learning Objectives | 301 | ||
| The Heart | 301 | ||
| The Cardiovascular Circuit | 301 | ||
| Blood Vessels | 301 | ||
| Key Points | 303 | ||
| Additional Readings | 303 | ||
| 16 Elements of Cardiac Function | 304 | ||
| Learning Objectives | 304 | ||
| Electrical Properties of the Heart | 304 | ||
| The Cardiac Action Potential | 304 | ||
| Resting Membrane Voltage | 305 | ||
| Fast-Response Action Potentials | 306 | ||
| Genesis of the Upstroke (Phase 0) | 306 | ||
| Genesis of Early Repolarization (Phase 1) | 306 | ||
| Genesis of the Plateau (Phase 2) | 307 | ||
| Genesis of Final Repolarization (Phase 3) | 310 | ||
| Restoration of Ionic Concentrations (Phase 4) | 311 | ||
| Slow-Response Action Potentials | 311 | ||
| Conduction in Cardiac Fibers | 312 | ||
| Conduction of the Fast Response | 312 | ||
| Conduction of the Slow Response | 313 | ||
| Cardiac Excitability | 313 | ||
| Fast Response | 313 | ||
| Slow Response | 314 | ||
| Effects of Cycle Length | 314 | ||
| Natural Excitation of the Heart and the Electrocardiogram | 315 | ||
| Sinoatrial Node | 315 | ||
| Ionic Basis of Automaticity | 316 | ||
| Overdrive Suppression | 318 | ||
| Atrial Conduction | 318 | ||
| Atrioventricular Conduction | 318 | ||
| Ventricular Conduction | 319 | ||
| Reentry | 320 | ||
| Triggered Activity | 321 | ||
| Early Afterdepolarizations | 322 | ||
| Delayed Afterdepolarizations | 322 | ||
| Electrocardiography | 322 | ||
| Scalar Electrocardiography | 323 | ||
| Standard Limb Leads | 324 | ||
| Arrhythmias | 325 | ||
| Altered Sinoatrial Rhythms | 326 | ||
| Atrioventricular Conduction Blocks | 326 | ||
| Premature Depolarizations | 326 | ||
| Ectopic Tachycardias | 328 | ||
| Fibrillation | 329 | ||
| The Cardiac Pump | 330 | ||
| Relationship of Heart Structure to Function | 330 | ||
| The Myocardial Cell | 330 | ||
| Functional Anatomy | 331 | ||
| Cardiac Muscle | 331 | ||
| Excitation-Contraction Coupling | 331 | ||
| Myocardial Contractile Machinery and Contractility | 332 | ||
| Indices of Contractility | 333 | ||
| Cardiac Chambers | 334 | ||
| Cardiac Valves | 334 | ||
| Atrioventricular Valves | 334 | ||
| Semilunar Valves | 335 | ||
| The Pericardium | 336 | ||
| Heart Sounds | 336 | ||
| The Cardiac Cycle | 336 | ||
| Ventricular Systole | 336 | ||
| Isovolumic Contraction | 336 | ||
| Ejection | 336 | ||
| Ventricular Diastole | 337 | ||
| Isovolumic Relaxation | 337 | ||
| Rapid Filling Phase | 337 | ||
| Diastasis | 337 | ||
| Atrial Systole | 337 | ||
| Pressure-Volume Relationship | 338 | ||
| Measurement of Cardiac Output | 339 | ||
| The Fick Principle | 339 | ||
| Cardiac Oxygen Consumption and Work | 340 | ||
| Cardiac Efficiency | 341 | ||
| Myocardial Adenosine Triphosphate and Its Relation to Mechanical Function | 341 | ||
| Substrate Utilization | 342 | ||
| Key Points | 343 | ||
| Additional Readings | 344 | ||
| 17 Properties of the Vasculature | 345 | ||
| Learning Objectives | 345 | ||
| Hemodynamics | 345 | ||
| Velocity of the Bloodstream | 345 | ||
| Relationship Between Velocity and Pressure | 345 | ||
| Relationship Between Pressure and Flow | 346 | ||
| Poiseuille’s Law | 346 | ||
| Resistance to Flow | 347 | ||
| Resistances in Series and in Parallel | 348 | ||
| Resistance of Vessels in Series | 348 | ||
| Resistance of Vessels in Parallel | 348 | ||
| Laminar and Turbulent Flow | 349 | ||
| Shear Stress on the Vessel Wall | 349 | ||
| Rheologic Properties of Blood | 350 | ||
| The Arterial System | 351 | ||
| Arterial Elasticity | 351 | ||
| Determinants of Arterial Blood Pressure | 351 | ||
| Mean Arterial Pressure | 352 | ||
| Arterial Pulse Pressure | 353 | ||
| Stroke Volume | 353 | ||
| Arterial Compliance | 354 | ||
| Total Peripheral Resistance and Arterial Diastolic Pressure | 354 | ||
| Effect of Arterial Compliance on Myocardial Energy Consumption | 354 | ||
| Peripheral Arterial Pressure Curves | 355 | ||
| Blood Pressure Measurement in Humans | 355 | ||
| The Venous System | 356 | ||
| Capacitance and Resistance | 356 | ||
| Gravity | 357 | ||
| Muscular Activity and Venous Valves | 358 | ||
| Microcirculation and Lymphatic System | 359 | ||
| Microcirculation | 359 | ||
| Functional Properties of Capillaries | 359 | ||
| Vasoactive Role of the Capillary Endothelium | 360 | ||
| Passive Role of the Capillary Endothelium | 361 | ||
| Transcapillary Exchange | 361 | ||
| Diffusion. | 361 | ||
| Capillary Filtration. | 363 | ||
| Hydrostatic Forces. | 363 | ||
| Osmotic Forces. | 363 | ||
| Balance of Hydrostatic and Osmotic Forces. | 365 | ||
| Capillary Filtration Coefficient. | 366 | ||
| Disturbances in Hydrostatic-Osmotic Balance. | 366 | ||
| Pinocytosis. | 367 | ||
| Lymphatic System | 367 | ||
| Coronary Circulation | 367 | ||
| Functional Anatomy of Coronary Vessels | 367 | ||
| Factors That Influence Coronary Blood Flow | 368 | ||
| Physical Factors | 368 | ||
| Neural and Neurohumoral Factors | 370 | ||
| Metabolic Factors | 371 | ||
| Effects of Diminished Coronary Blood Flow | 372 | ||
| Coronary Collateral Circulation and Vasodilators | 372 | ||
| Cutaneous Circulation | 373 | ||
| Regulation of Skin Blood Flow | 373 | ||
| Neural Factors | 373 | ||
| The Role of Temperature in the Regulation of Skin Blood Flow | 374 | ||
| Skin Color: Relationship to Skin Blood Volume, Oxyhemoglobin, and Blood Flow | 375 | ||
| Skeletal Muscle Circulation | 375 | ||
| Regulation of Skeletal Muscle Blood Flow | 375 | ||
| Neural Factors | 375 | ||
| Local Factors | 376 | ||
| Cerebral Circulation | 376 | ||
| Regulation of Cerebral Blood Flow | 377 | ||
| Blood-Brain Barrier | 377 | ||
| Neural Factors | 377 | ||
| Local Factors | 378 | ||
| Intestinal Circulation | 379 | ||
| Anatomy | 379 | ||
| Neural Regulation | 379 | ||
| Autoregulation | 379 | ||
| Functional Hyperemia | 380 | ||
| Hepatic Circulation | 380 | ||
| Anatomy | 380 | ||
| Hemodynamics | 381 | ||
| Regulation of Flow | 381 | ||
| Fetal Circulation | 382 | ||
| In Utero | 382 | ||
| Circulatory Changes That Occur at Birth | 382 | ||
| Key Points | 384 | ||
| Additional Readings | 385 | ||
| 18 Regulation of the Heart and Vasculature | 386 | ||
| Learning Objectives | 386 | ||
| Regulation of Heart Rate and Myocardial Performance | 386 | ||
| Nervous Control of the Heart Rate | 386 | ||
| Parasympathetic Pathways | 387 | ||
| Sympathetic Pathways | 388 | ||
| Control by Higher Centers | 388 | ||
| Baroreceptor Reflex | 388 | ||
| Bainbridge Reflex, Atrial Receptors, and Atrial Natriuretic Peptide | 389 | ||
| Respiratory Sinus Arrhythmia | 390 | ||
| Chemoreceptor Reflex | 390 | ||
| Ventricular Receptor Reflexes | 392 | ||
| Regulation of Myocardial Performance | 392 | ||
| Intrinsic Regulation of Myocardial Performance | 392 | ||
| Frank-Starling Mechanism | 393 | ||
| Balance Between Right and Left Ventricular Output | 394 | ||
| Rate-Induced Regulation | 395 | ||
| Extrinsic Regulation of Myocardial Performance | 396 | ||
| Nervous Control | 396 | ||
| Sympathetic Influences | 396 | ||
| Parasympathetic Influences | 398 | ||
| Chemical Control | 398 | ||
| Adrenomedullary Hormones | 398 | ||
| Adrenocortical Hormones | 398 | ||
| Thyroid Hormones | 398 | ||
| Insulin | 399 | ||
| Glucagon | 399 | ||
| Anterior Pituitary Hormones | 399 | ||
| Blood Gases | 399 | ||
| Oxygen | 399 | ||
| Carbon Dioxide and Acidosis | 399 | ||
| Regulation of the Peripheral Circulation | 400 | ||
| Intrinsic or Local Control of Peripheral Blood Flow | 400 | ||
| Autoregulation and Myogenic Regulation | 400 | ||
| Endothelium-Mediated Regulation | 401 | ||
| Metabolic Regulation | 401 | ||
| Candidate Vasodilator Substances | 401 | ||
| Basal Vessel Tone | 401 | ||
| Reactive Hyperemia | 401 | ||
| Coordination of Arterial and Arteriolar Dilation | 402 | ||
| Extrinsic Control of Peripheral Blood Flow | 402 | ||
| Sympathetic Neural Vasoconstriction | 402 | ||
| Sympathetic Constrictor Influence on Resistance and Capacitance Vessels | 402 | ||
| Parasympathetic Neural Influence | 403 | ||
| Humoral Factors | 403 | ||
| Vascular Reflexes | 403 | ||
| Arterial Baroreceptors | 403 | ||
| Cardiopulmonary Baroreceptors | 405 | ||
| Peripheral Chemoreceptors | 406 | ||
| Hypothalamus | 406 | ||
| Cerebrum | 406 | ||
| Skin and Viscera | 406 | ||
| Pulmonary Reflexes | 406 | ||
| Central Chemoreceptors | 406 | ||
| Balance Between Extrinsic and Intrinsic Factors in Regulation of Peripheral Blood Flow | 407 | ||
| Key Points | 408 | ||
| Additional Readings | 409 | ||
| 19 Integrated Control of the Cardiovascular System | 410 | ||
| Learning Objectives | 410 | ||
| Regulation of Cardiac Output and Blood Pressure | 410 | ||
| Vascular Function Curve | 410 | ||
| Effects of Cardiac Arrest on Arterial and Venous Pressure | 411 | ||
| Factors That Influence the Vascular Function Curve | 413 | ||
| Dependence of Venous Pressure on Cardiac Output | 413 | ||
| Blood Volume | 413 | ||
| Venomotor Tone | 413 | ||
| Blood Reservoirs | 414 | ||
| Peripheral Resistance | 414 | ||
| Interrelationships Between Cardiac Output and Venous Return | 414 | ||
| Relating the Cardiac Function Curve to the Vascular Function Curve | 415 | ||
| Coupling Between the Heart and the Vasculature | 415 | ||
| Myocardial Contractility | 416 | ||
| Blood Volume | 416 | ||
| Peripheral Resistance | 417 | ||
| A More Complete Theoretical Model: The Two-Pump System | 418 | ||
| Role of the Heart Rate in Control of Cardiac Output | 420 | ||
| Ancillary Factors That Affect the Venous System and Cardiac Output | 421 | ||
| Circulatory Effects of Respiratory Activity | 421 | ||
| Interplay of Central and Peripheral Factors in Control of the Circulation | 422 | ||
| Exercise | 422 | ||
| Mild to Moderate Exercise | 422 | ||
| Peripheral Resistance | 422 | ||
| Cardiac Output | 424 | ||
| Venous Return | 424 | ||
| Coupling Between Heart and Vasculature During Exercise | 425 | ||
| Arterial Pressure | 425 | ||
| Severe Exercise | 425 | ||
| Postexercise Recovery | 426 | ||
| Limits of Exercise Performance | 426 | ||
| Physical Training and Conditioning | 427 | ||
| Hemorrhage | 427 | ||
| Course of Arterial Blood Pressure Changes | 427 | ||
| Compensatory Mechanisms | 427 | ||
| Baroreceptor Reflexes | 427 | ||
| Chemoreceptor Reflexes | 428 | ||
| Cerebral Ischemia | 429 | ||
| Reabsorption of Tissue Fluids | 429 | ||
| Endogenous Vasoconstrictors | 429 | ||
| Renal Conservation of Salt and Water | 429 | ||
| Decompensatory Mechanisms | 430 | ||
| Cardiac Failure | 430 | ||
| Acidosis | 430 | ||
| Central Nervous System Depression | 430 | ||
| Aberrations in Blood Clotting | 431 | ||
| Depression of the Mononuclear Phagocytic System | 431 | ||
| Interactions of Positive and Negative Feedback Mechanisms | 431 | ||
| Key Points | 431 | ||
| Additional Readings | 432 | ||
| 5 The Respiratory System | 433 | ||
| 20 Introduction to the Respiratory System | 434 | ||
| Learning Objectives | 434 | ||
| Lung Anatomical Structure/Function Relationships | 434 | ||
| Upper Airways: Nose, Sinuses, and Pharynx | 434 | ||
| Lower Airways: Trachea, Bronchi, Bronchioles, and Respiratory Unit | 435 | ||
| Circulatory Systems in the Lung | 438 | ||
| Pulmonary Circulation | 438 | ||
| Structure of the Pulmonary Circulation | 440 | ||
| Structures of the Extra-Alveolar and Alveolar Vessels and the Pulmonary Microcirculation | 440 | ||
| Structure of the Alveolar-Capillary Network | 441 | ||
| Bronchial Circulation | 441 | ||
| Innervation | 441 | ||
| Central Control of Respiration | 442 | ||
| Muscles of Respiration | 443 | ||
| Lung Embryology, Development, Aging, and Repair | 443 | ||
| Key Points | 445 | ||
| Additional Readings | 446 | ||
| 21 Static Lung and Chest Wall Mechanics | 447 | ||
| Learning Objectives | 447 | ||
| Pressures in the Respiratory System | 447 | ||
| How a Pressure Gradient Is Created | 447 | ||
| Lung Volumes and Their Measurement | 448 | ||
| Measurement of Lung Volumes | 449 | ||
| Determinants of Lung Volume | 450 | ||
| Pressure-Volume Relationships | 451 | ||
| Lung Compliance | 452 | ||
| Surface Tension and Surfactant | 452 | ||
| Surface Tension | 452 | ||
| Surfactant | 453 | ||
| Key Points | 455 | ||
| Additional Readings | 455 | ||
| 22 Dynamic Lung and Chest Wall Mechanics | 456 | ||
| Learning Objectives | 456 | ||
| Dynamic Lung Mechanics | 456 | ||
| Airflow in Airways | 456 | ||
| Patterns of Airflow | 456 | ||
| Airway Resistance | 457 | ||
| Factors That Contribute to Airway Resistance | 458 | ||
| Neurohumoral Regulation of Airway Resistance | 458 | ||
| Measurement of Expiratory Flow | 458 | ||
| The Spirogram | 458 | ||
| Flow-Volume Loop | 459 | ||
| Determinants of Maximal Flow | 460 | ||
| Flow Limitation and the Equal Pressure Point | 460 | ||
| Dynamic Compliance | 461 | ||
| Work of Breathing | 463 | ||
| Key Concepts | 464 | ||
| Additional Reading | 465 | ||
| Journal Articles | 465 | ||
| Books/Book Chapters | 465 | ||
| 23 Ventilation, Perfusion, and Ventilation/Perfusion Relationships | 466 | ||
| Learning Objectives | 466 | ||
| Ventilation | 466 | ||
| Dead Space Ventilation: Anatomical and Physiological | 466 | ||
| Anatomical Dead Space | 466 | ||
| Physiological Dead Space | 467 | ||
| Alveolar Ventilation | 467 | ||
| Composition of Air | 467 | ||
| Alveolar Gas Composition | 468 | ||
| Arterial Gas Composition | 469 | ||
| Distribution of Ventilation | 470 | ||
| Pulmonary Vascular Resistance | 471 | ||
| Distribution of Pulmonary Blood Flow | 472 | ||
| Active Regulation of Blood Flow | 472 | ||
| Ventilation/Perfusion Relationships | 473 | ||
| Regional Differences in Ventilation/Perfusion Ratios | 473 | ||
| Alveolar-Arterial Difference for Oxygen | 474 | ||
| Arterial Blood Hypoxemia, Hypoxia, and Hypercarbia | 474 | ||
| Ventilation/Perfusion Abnormalities and Shunts | 475 | ||
| Anatomical Shunts | 475 | ||
| Physiological Shunts | 476 | ||
| Low Ventilation/Perfusion | 476 | ||
| Alveolar Hypoventilation | 477 | ||
| Diffusion Abnormalities | 477 | ||
| Mechanisms of Hypercapnia | 477 | ||
| Effect of 100% Oxygen on Arterial Blood Gas Abnormalities | 477 | ||
| Regional Differences | 478 | ||
| Key Points | 478 | ||
| Additional Readings | 479 | ||
| 24 Oxygen and Carbon Dioxide Transport | 480 | ||
| Learning Objectives | 480 | ||
| Gas Diffusion | 480 | ||
| Diffusion of Gases From Regions of Higher to Lower Partial Pressure in the Lungs | 480 | ||
| Oxygen and Carbon Dioxide Exchange in the Lung Is Perfusion Limited | 481 | ||
| Oxygen Transport | 482 | ||
| Hemoglobin | 482 | ||
| Oxyhemoglobin Dissociation Curve | 483 | ||
| Physiological Factors That Shift the Oxyhemoglobin Dissociation Curve | 483 | ||
| Hydrogen Ion Concentration and Carbon Dioxide | 484 | ||
| 2,3-Diphosphoglycerate | 484 | ||
| Fetal Hemoglobin (HgbF) | 484 | ||
| Carbon Monoxide | 484 | ||
| Oxygen Saturation, Content, and Delivery | 485 | ||
| Erythropoiesis | 485 | ||
| Carbon Dioxide Transport | 485 | ||
| Glucose Metabolism and Carbon Dioxide Production | 485 | ||
| Bicarbonate and Carbon Dioxide Transport | 485 | ||
| Regulation of Hydrogen Ion Concentration and Acid-Base Balance | 486 | ||
| Carbon Dioxide Dissociation Curve | 487 | ||
| Key Points | 487 | ||
| Additional Readings | 488 | ||
| 25 Control of Respiration | 489 | ||
| Learning Objectives | 489 | ||
| Ventilatory Control: An Overview | 489 | ||
| Response to Carbon Dioxide | 490 | ||
| Control of Ventilation: The Details | 490 | ||
| The Respiratory Control Center | 490 | ||
| Central Chemoreceptors | 492 | ||
| Peripheral Chemoreceptors | 492 | ||
| Pulmonary Mechanoreceptors | 493 | ||
| Chest Wall and Lung Reflexes | 493 | ||
| Sensory Receptors and Reflexes | 494 | ||
| Exercise | 495 | ||
| Abnormalities in the Control of Breathing | 495 | ||
| Key Points | 497 | ||
| Additional Readings | 497 | ||
| 26 Nonphysiological Functions of the Lung | 498 | ||
| Learning Objectives | 498 | ||
| Host Defense | 498 | ||
| Mucociliary Clearance System | 498 | ||
| Periciliary Fluid Layer | 498 | ||
| Mucus Layer | 498 | ||
| Ciliated Cells and Cilia | 500 | ||
| Particle Deposition and Clearance | 500 | ||
| Mucosal Immune System: Adaptive and Innate Immunity | 501 | ||
| Mucosal Immune System | 501 | ||
| Specialized Adaptive Lymphoid Cells | 502 | ||
| Plasma Cells Producing Immunoglobulin A | 502 | ||
| T Lymphocytes With γδ T Cell Receptors | 503 | ||
| Specialized Innate Lymphoid Cells | 504 | ||
| Macrophages and Dendritic Cells | 505 | ||
| Macrophages | 505 | ||
| Dendritic Cells | 505 | ||
| Natural Killer and Invariant Natural Killer T Lymphoid Cells | 505 | ||
| Epithelial Cells and Commensal Microbiota Protect the Lumen of the Airways | 506 | ||
| Epithelial Cells | 506 | ||
| Lung Microbiome-Commensal Microbiota | 506 | ||
| Clinical Manifestations Associated With Abnormalities in Mucosal Innate and Adaptive Immunity | 507 | ||
| Metabolic Functions of the Lung | 507 | ||
| Key Points | 508 | ||
| Additional Readings | 509 | ||
| 6 Gastrointestinal Physiology | 510 | ||
| 27 Functional Anatomy and General Principles of Regulation in the Gastrointestinal Tract | 511 | ||
| Learning Objectives | 511 | ||
| Functional Anatomy | 511 | ||
| Cellular Specialization | 512 | ||
| Mucosa | 512 | ||
| Submucosa | 513 | ||
| Muscle Layers | 513 | ||
| Serosa | 513 | ||
| Regulatory Mechanisms in the Gastrointestinal Tract | 514 | ||
| Endocrine Regulation | 514 | ||
| Paracrine Regulation | 514 | ||
| Neural Regulation of Gastrointestinal Function | 515 | ||
| Extrinsic Neural Innervation | 516 | ||
| Intrinsic Neural Innervation | 517 | ||
| Response of the GI Tract to a Meal | 518 | ||
| Key Concepts | 519 | ||
| Additional Reading | 519 | ||
| 28 The Cephalic, Oral, and Esophageal Phases of the Integrated Response to a Meal | 520 | ||
| Learning Objectives | 520 | ||
| Cephalic and Oral Phases | 520 | ||
| Properties of Secretion | 521 | ||
| General Considerations | 521 | ||
| Constituents of Secretions | 521 | ||
| Salivary Secretion | 521 | ||
| Functional Anatomy of the Salivary Glands | 521 | ||
| Composition of Saliva | 522 | ||
| Metabolism and Blood Flow of Salivary Glands | 523 | ||
| Regulation of Salivary Secretion | 524 | ||
| Ionic Mechanisms of Salivary Secretion | 524 | ||
| Ion Transport in Acinar Cells | 524 | ||
| Ion Transport in Ductular Cells | 524 | ||
| Swallowing | 524 | ||
| Esophageal Phase | 526 | ||
| Functional Anatomy of the Esophagus and Associated Structures | 526 | ||
| Motor Activity During the Esophageal Phase | 526 | ||
| Key Concepts | 528 | ||
| Additional Reading | 528 | ||
| 29 The Gastric Phase of the Integrated Response to a Meal | 529 | ||
| Learning Objectives | 529 | ||
| Functional Anatomy of the Stomach | 529 | ||
| Gastric Secretion | 530 | ||
| Composition of Gastric Secretions | 530 | ||
| Inorganic Constituents of Gastric Juice | 531 | ||
| Organic Constituents of Gastric Juice | 531 | ||
| Cellular Mechanisms of Gastric Acid Secretion | 531 | ||
| Secretion of HCO3− | 533 | ||
| Secretion of Mucus | 533 | ||
| Regulation of Gastric Secretion | 533 | ||
| Digestion in the Stomach | 535 | ||
| Gastric Mucosal Protection and Defense | 536 | ||
| Gastrointestinal Motility | 536 | ||
| Functional Anatomy of Gastrointestinal Smooth Muscle | 537 | ||
| Electrophysiology of Gastrointestinal Smooth Muscle | 537 | ||
| Specialized Patterns of Motility | 539 | ||
| Gastric Motility | 539 | ||
| Functional Anatomy of the Stomach | 539 | ||
| Control of Gastric Motility in the Gastric Phase | 539 | ||
| Key Concepts | 540 | ||
| Additional Reading | 540 | ||
| 30 The Small Intestinal Phase of the Integrated Response to a Meal | 541 | ||
| Learning Objectives | 541 | ||
| Gastric Emptying in the Small Intestinal Phase | 541 | ||
| Pancreatic Secretion | 542 | ||
| Characteristics and Control of Ductular Secretion | 543 | ||
| Characteristics and Control of Acinar Secretion | 545 | ||
| Biliary Secretion | 546 | ||
| Carbohydrate Assimilation | 547 | ||
| Digestion of Carbohydrates | 547 | ||
| Uptake of Carbohydrates | 548 | ||
| Protein Assimilation | 549 | ||
| Digestion of Proteins | 549 | ||
| Uptake of Peptides and Amino Acids | 551 | ||
| Lipid Assimilation | 551 | ||
| Emulsification and Solubilization of Lipids | 552 | ||
| Digestion of Lipids | 552 | ||
| Uptake of Lipids and Subsequent Handling | 553 | ||
| Water and Electrolyte Secretion and Absorption | 553 | ||
| Absorption of Minerals and Water-Soluble Vitamins | 555 | ||
| Motor Patterns of the Small Intestine | 555 | ||
| Key Concepts | 557 | ||
| Additional Reading | 558 | ||
| 31 The Colonic Phase of the Integrated Response to a Meal | 559 | ||
| Learning Objectives | 559 | ||
| Overview of the Large Intestine | 559 | ||
| Signals That Regulate Colonic Function | 559 | ||
| Patterns of Colonic Motility | 560 | ||
| Functional Anatomy of the Colonic Musculature | 560 | ||
| Colonic Motility Responses | 561 | ||
| Transport Mechanisms in the Colon | 562 | ||
| Colonic Microbiota | 563 | ||
| Defecation | 565 | ||
| Key Concepts | 567 | ||
| Additional Reading | 567 | ||
| 32 Transport and Metabolic Functions of the Liver | 568 | ||
| Learning Objectives | 568 | ||
| Overview of the Liver and Its Functions | 568 | ||
| Metabolic Functions of the Liver | 568 | ||
| The Liver and Detoxification | 569 | ||
| Role of the Liver in Excretion | 569 | ||
| Structural Features of the Liver and Biliary System | 569 | ||
| Bile Formation and Secretion | 572 | ||
| Bile Acid Synthesis | 572 | ||
| Hepatic Aspects of Enterohepatic Circulation of Bile Acids | 572 | ||
| Other Bile Constituents | 573 | ||
| Bile Modification in Ductules | 575 | ||
| Role of the Gallbladder | 575 | ||
| Bilirubin Formation and Excretion by the Liver | 576 | ||
| Ammonia Handling by the Liver | 577 | ||
| Clinical Assessment of Liver Function | 578 | ||
| Key Concepts | 579 | ||
| Additional Reading | 579 | ||
| 7 The Renal System | 580 | ||
| 33 Elements of Renal Function | 581 | ||
| Learning Objectives | 581 | ||
| Overview of Renal Function | 581 | ||
| Functional Anatomy of the Kidneys | 582 | ||
| Gross Anatomy | 582 | ||
| Ultrastructure of the Nephron | 583 | ||
| Ultrastructure of the Glomerulus | 586 | ||
| Ultrastructure of the Juxtaglomerular Apparatus | 589 | ||
| Innervation of the Kidneys | 590 | ||
| Assessment of Renal Function | 590 | ||
| Renal Clearance | 591 | ||
| Glomerular Filtration Rate | 592 | ||
| Glomerular Filtration | 592 | ||
| Determinants of Ultrafiltrate Composition | 593 | ||
| Dynamics of Ultrafiltration | 594 | ||
| Renal Blood Flow | 595 | ||
| Regulation of Renal Blood Flow and Glomerular Filtration Rate | 597 | ||
| Sympathetic Nerves | 597 | ||
| Angiotensin II | 598 | ||
| Prostaglandins | 598 | ||
| Nitric Oxide | 599 | ||
| Endothelin | 599 | ||
| Bradykinin | 599 | ||
| Adenosine | 600 | ||
| Natriuretic Peptides | 600 | ||
| Adenosine Triphosphate | 600 | ||
| Glucocorticoids | 600 | ||
| Histamine | 600 | ||
| Dopamine | 600 | ||
| Hormones | 601 | ||
| Key Concepts | 601 | ||
| Additional Reading | 602 | ||
| Journal Articles | 602 | ||
| Book Chapters | 602 | ||
| 34 Solute and Water Transport Along the Nephron | 603 | ||
| Learning Objectives | 603 | ||
| Solute and Water Reabsorption Along the Nephron | 603 | ||
| Proximal Tubule | 603 | ||
| Na+ Reabsorption | 604 | ||
| Water Reabsorption | 608 | ||
| Protein Reabsorption | 609 | ||
| Secretion of Organic Anions and Organic Cations | 610 | ||
| Henle’s Loop | 612 | ||
| Distal Tubule and Collecting Duct | 614 | ||
| Regulation of NaCl and Water Reabsorption | 615 | ||
| Key Concepts | 621 | ||
| Additional Reading | 621 | ||
| Journal Articles | 621 | ||
| Book Chapters | 622 | ||
| 35 Control of Body Fluid Osmolality and Volume | 623 | ||
| Learning Objectives | 623 | ||
| Control of Body Fluid Osmolality: Urine Concentration and Dilution | 623 | ||
| Arginine Vasopressin | 625 | ||
| Osmotic Control of AVP Secretion | 626 | ||
| Hemodynamic (Nonosmotic) Control of AVP Secretion | 627 | ||
| AVP Actions on the Kidneys | 627 | ||
| Thirst | 629 | ||
| Renal Mechanisms for Dilution and Concentration of Urine | 630 | ||
| Medullary Interstitium | 634 | ||
| Vasa Recta Function | 635 | ||
| Assessment of Renal Diluting and Concentrating Ability | 635 | ||
| Control of Extracellular Fluid Volume and Regulation of Renal NaCl Excretion | 636 | ||
| Concept of Effective Circulating Volume | 637 | ||
| Volume-Sensing Systems | 637 | ||
| Volume Sensors in the Low-Pressure Cardiopulmonary Circuit | 638 | ||
| Volume Sensors in the High-Pressure Arterial Circuit | 638 | ||
| Volume Sensor Signals | 638 | ||
| Renal Sympathetic Nerves | 638 | ||
| Renin-Angiotensin-Aldosterone System | 639 | ||
| Natriuretic Peptides | 641 | ||
| Arginine Vasopressin | 641 | ||
| Control of NaCl Excretion During Euvolemia | 641 | ||
| Mechanisms for Maintaining Constant Delivery of NaCl to the Distal Tubule | 642 | ||
| Regulation of Distal Tubule and Collecting Duct NaCl Reabsorption | 642 | ||
| Control of NaCl Excretion With Volume Expansion | 642 | ||
| Control of NaCl Excretion With Volume Contraction | 644 | ||
| Key Concepts | 645 | ||
| Additional Reading | 646 | ||
| Water Balance | 646 | ||
| NaCl Balance | 646 | ||
| 36 Potassium, Calcium, and Phosphate Homeostasis | 647 | ||
| Learning Objectives | 647 | ||
| K+ Homeostasis | 647 | ||
| Regulation of Plasma [K+] | 648 | ||
| Epinephrine | 649 | ||
| Insulin | 649 | ||
| Aldosterone | 650 | ||
| Alterations in Plasma [K+] | 650 | ||
| Acid-Base Balance | 650 | ||
| Plasma Osmolality | 650 | ||
| Cell Lysis | 650 | ||
| Exercise | 650 | ||
| K+ Excretion by the Kidneys | 650 | ||
| Cellular Mechanism of K+ Secretion by Principal Cells and Intercalated Cells | 651 | ||
| Regulation of K+ Secretion by the Distal Tubule and Collecting Duct | 653 | ||
| Plasma [K+] | 653 | ||
| Aldosterone | 654 | ||
| AVP | 655 | ||
| Factors That Perturb K+ Excretion | 655 | ||
| Flow of Tubular Fluid | 655 | ||
| Acid-Base Balance | 656 | ||
| Glucocorticoids | 657 | ||
| Overview of Calcium and Inorganic Phosphate Homeostasis | 657 | ||
| Calcium | 658 | ||
| Overview of Calcium Homeostasis | 660 | ||
| Calcium Transport Along the Nephron | 661 | ||
| Regulation of Urinary Calcium Excretion | 662 | ||
| Calcium-Sensing Receptor | 663 | ||
| Phosphate | 663 | ||
| Overview of Phosphate Homeostasis | 664 | ||
| Phosphate Transport Along the Nephron | 664 | ||
| Regulation of Urinary Phosphate Excretion | 666 | ||
| Integrative Review of Parathyroid Hormone and Calcitriol on Ca++ and Pi Homeostasis | 667 | ||
| Key Concepts | 668 | ||
| Additional Reading | 669 | ||
| Journal Articles | 669 | ||
| Book Chapters | 669 | ||
| 37 Role of the Kidneys in the Regulation of Acid-Base Balance | 670 | ||
| Learning Objectives | 670 | ||
| The HCO3− Buffer System | 670 | ||
| Overview of Acid-Base Balance | 671 | ||
| Net Acid Excretion by the Kidneys | 672 | ||
| HCO3− Reabsorption Along the Nephron | 673 | ||
| Regulation of H+ Secretion | 674 | ||
| Formation of New HCO3− | 677 | ||
| Response to Acid-Base Disorders | 679 | ||
| Extracellular and Intracellular Buffers | 679 | ||
| Respiratory Compensation | 680 | ||
| Renal Compensation | 680 | ||
| Simple Acid-Base Disorders | 681 | ||
| Types of Acid-Base Disorders | 681 | ||
| Metabolic Acidosis | 681 | ||
| Metabolic Alkalosis | 681 | ||
| Respiratory Acidosis | 682 | ||
| Respiratory Alkalosis | 682 | ||
| Analysis of Acid-Base Disorders | 683 | ||
| Key Concepts | 684 | ||
| Additional Reading | 684 | ||
| Book Chapters | 684 | ||
| Journal Articles | 684 | ||
| 8 The Endocrine and Reproductive Systems | 685 | ||
| 38 Introduction to the Endocrine System | 686 | ||
| Learning Objectives | 686 | ||
| Configuration of Feedback Loops Within the Endocrine System | 686 | ||
| Chemical Nature of Hormones | 689 | ||
| Proteins/Peptides | 689 | ||
| Catecholamines | 692 | ||
| Steroid Hormones | 692 | ||
| Iodothyronines | 694 | ||
| Transport of Hormones in the Circulation | 695 | ||
| Cellular Responses to Hormones | 696 | ||
| Key Points | 697 | ||
| Additional Readings | 697 | ||
| 39 Hormonal Regulation of Energy Metabolism | 698 | ||
| Learning Objectives | 698 | ||
| Continual Energy Supply and Demand: The Challenge | 698 | ||
| Integrated Overview of Energy Metabolism | 699 | ||
| Digestive Phase | 699 | ||
| Fasting Phase | 702 | ||
| Pancreatic Hormones Involved in Metabolic Homeostasis During Different Metabolic Phases | 704 | ||
| Insulin | 704 | ||
| Insulin Receptor | 706 | ||
| Glucagon | 708 | ||
| Catecholamines: Epinephrine and Norepinephrine | 709 | ||
| Hormonal Regulation of Specific Metabolic Reactions and Pathways | 710 | ||
| Hepatocyte Metabolism: Digestive vs. Fasting Phases | 710 | ||
| Skeletal Muscle and Adipose Tissue Metabolism: Digestive vs. Fasting Phases | 712 | ||
| Protein Metabolism in All Hormone Target Cells: Digestive vs. Fasting Phases | 714 | ||
| Metabolic Roles of Lipoproteins: Digestive vs. Fasting Phases | 714 | ||
| Digestive Phase: Chylomicrons and Chylomicron Remnants | 714 | ||
| Fasting Phase: VLDL, IDL, and LDL | 716 | ||
| Leptin and Energy Balance | 716 | ||
| Leptin | 716 | ||
| Structure, Synthesis, and Secretion | 716 | ||
| Energy Storage | 717 | ||
| Body Mass Index | 719 | ||
| Central Mechanisms Involved in Energy Balance | 719 | ||
| Key Concepts | 720 | ||
| Additional Reading | 721 | ||
| 40 Hormonal Regulation of Calcium and Phosphate Metabolism | 722 | ||
| Learning Objectives | 722 | ||
| Crucial Roles of Calcium and Phosphate in Cellular Physiology | 722 | ||
| Physiological Regulation of Calcium and Phosphate: Parathyroid Hormone and 1,25-Dihydroxyvitamin D | 723 | ||
| Parathyroid Glands | 723 | ||
| Parathyroid Hormone | 723 | ||
| Structure, Synthesis, and Secretion | 724 | ||
| Parathyroid Hormone Receptor | 724 | ||
| Vitamin D | 724 | ||
| Structure, Synthesis, and Transport of Active Vitamin D Metabolites | 725 | ||
| 1,25-Dihydroxyvitamin D Receptor | 727 | ||
| Regulation of [Ca++] and [Pi] by Small Intestine and Bone | 727 | ||
| Ca++ and Pi Transport by Small Intestine | 727 | ||
| Ca++ and Pi in Bone | 728 | ||
| Physiology of Bone | 728 | ||
| Regulation of Serum Phosphate by FGF23 | 730 | ||
| Regulation by Gonadal and Adrenal Steroid Hormones | 731 | ||
| Integrated Physiological Regulation of Ca++/Pi Metabolism | 731 | ||
| Hypocalcemic Challenge | 731 | ||
| Hypophosphatemic Challenge | 731 | ||
| Key Concepts | 731 | ||
| Additional Reading | 732 | ||
| 41 The Hypothalamus and Pituitary Gland | 733 | ||
| Learning Objectives | 733 | ||
| Anatomy | 733 | ||
| The Neurohypophysis | 733 | ||
| Synthesis of ADH and Oxytocin | 734 | ||
| Actions and Regulation of ADH and Oxytocin | 734 | ||
| The Adenohypophysis | 734 | ||
| Endocrine Axes | 734 | ||
| Endocrine Function of the Adenohypophysis | 739 | ||
| Corticotropes | 739 | ||
| Thyrotropes | 743 | ||
| The Gonadotrope | 744 | ||
| The Somatotrope | 745 | ||
| Growth Hormone Actions | 748 | ||
| The Lactotrope | 751 | ||
| Key Concepts | 752 | ||
| Additional Reading | 752 | ||
| 42 The Thyroid Gland | 753 | ||
| Learning Objectives | 753 | ||
| Anatomy and Histology of the Thyroid Gland | 753 | ||
| Production of Thyroid Hormones | 753 | ||
| Iodide Balance | 754 | ||
| Overview of Thyroid Hormone Synthesis | 755 | ||
| Synthesis of Iodothyronines on a Thyroglobulin Backbone | 755 | ||
| Secretion of Thyroid Hormones | 756 | ||
| Transport and Metabolism of Thyroid Hormones | 757 | ||
| Regulation of Thyroid Function | 759 | ||
| Physiological Effects of Thyroid Hormone | 759 | ||
| Cardiovascular Effects | 760 | ||
| Effects on Basal Metabolic Rate and Thermogenesis | 761 | ||
| Respiratory Effects | 761 | ||
| Skeletal Muscle Effects | 761 | ||
| Effects on the Autonomic Nervous System and Catecholamine Action | 762 | ||
| Effects on Growth and Maturation | 762 | ||
| Effects on Bone, Hard Tissue, and Dermis | 762 | ||
| Effects on the Nervous System | 762 | ||
| Effects on Reproductive Organs and Endocrine Glands | 762 | ||
| Key Concepts | 765 | ||
| Additional Reading | 765 | ||
| 43 The Adrenal Gland | 766 | ||
| Learning Objectives | 766 | ||
| Anatomy | 766 | ||
| Adrenal Medulla | 767 | ||
| Synthesis of Epinephrine | 767 | ||
| Mechanism of Action of Catecholamines | 768 | ||
| Physiological Actions of Adrenomedullary Catecholamines | 769 | ||
| Metabolism of Catecholamines | 771 | ||
| Adrenal Cortex | 771 | ||
| Zona Fasciculata | 771 | ||
| Transport and Metabolism of Cortisol | 773 | ||
| Mechanism of Action of Cortisol | 775 | ||
| Physiological Actions of Cortisol | 776 | ||
| Metabolic Actions | 776 | ||
| Cardiovascular Actions | 776 | ||
| Antiinflammatory and Immunosuppressive Actions | 776 | ||
| Effects of Cortisol on the Reproductive Systems | 777 | ||
| Effects of Cortisol on Bone | 778 | ||
| Actions of Cortisol on Connective Tissue | 778 | ||
| Actions of Cortisol on the Kidney | 778 | ||
| Actions of Cortisol on Muscle | 778 | ||
| Actions of Cortisol on the Gastrointestinal Tract | 778 | ||
| Psychological Effects of Cortisol | 778 | ||
| Effects of Cortisol During Fetal Development | 778 | ||
| Regulation of Cortisol Production | 778 | ||
| Zona Reticularis | 779 | ||
| Androgen Synthesis by the Zona Reticularis | 779 | ||
| Metabolism and Fate of DHEAS and DHEA | 779 | ||
| Physiological Actions of Adrenal Androgens | 780 | ||
| Regulation of Zona Reticularis Function | 780 | ||
| Zona Glomerulosa | 780 | ||
| Transport and Metabolism of Aldosterone | 782 | ||
| Mechanism of Aldosterone Action | 782 | ||
| Physiological Actions of Aldosterone | 782 | ||
| Key Concepts | 785 | ||
| Additional Reading | 786 | ||
| 44 The Male and Female Reproductive Systems | 787 | ||
| Learning Objectives | 787 | ||
| The Male Reproductive System | 787 | ||
| The Testis | 787 | ||
| Histophysiology | 787 | ||
| Intratubular Compartment | 788 | ||
| Developing Sperm Cells | 788 | ||
| The Sertoli Cell | 790 | ||
| Peritubular Compartment | 790 | ||
| The Leydig Cell | 790 | ||
| Fates and Actions of Androgens | 792 | ||
| Intratesticular Androgen | 792 | ||
| Peripheral Conversion to Estrogen | 792 | ||
| Peripheral Conversion to Dihydrotestosterone | 792 | ||
| Peripheral Testosterone Actions | 792 | ||
| Mechanism of Androgen Action | 792 | ||
| Transport and Metabolism of Androgens | 794 | ||
| Hypothalamic-Pituitary-Testicular Axis | 794 | ||
| Regulation of Leydig Cell Function | 794 | ||
| Regulation of Sertoli Cell Function | 795 | ||
| Male Reproductive Tract | 795 | ||
| Andropause | 797 | ||
| The Female Reproductive System | 797 | ||
| The Ovary | 797 | ||
| Growth, Development, and Function of the Ovarian Follicle | 799 | ||
| Resting Primordial Follicle | 799 | ||
| Growth and Structure | 799 | ||
| The Gamete | 800 | ||
| Growing Preantral Follicles | 801 | ||
| Index | 830 | ||
| A | 830 | ||
| B | 833 | ||
| C | 835 | ||
| D | 839 | ||
| E | 840 | ||
| F | 842 | ||
| G | 843 | ||
| H | 844 | ||
| I | 846 | ||
| J | 848 | ||
| K | 848 | ||
| L | 848 | ||
| M | 849 | ||
| N | 852 | ||
| O | 853 | ||
| P | 854 | ||
| Q | 858 | ||
| R | 858 | ||
| S | 859 | ||
| T | 863 | ||
| U | 865 | ||
| V | 865 | ||
| W | 867 | ||
| X | 867 | ||
| Y | 867 | ||
| Z | 867 | ||
| Inside Back Cover | ibc1 | ||
| IFC for international edition | IFC-1 |