Review of Medical Physiology

This book provides a current and concise overview of mammalian and human physiology. Examples from clinical medicine have been integrated throughout the chapters to illuminate important physiologic concepts. The book includes more than 700 attractive and informative illustrations. A valuable self-study guide, which features content summaries, objectives, essay questions, and multiple-choice questions, is provided at the end of the book and is an excellent tool for students when reviewing for the USMLE and other examinations.

William F. Ganong is Lange Professor Emeritus at the University of California, San Francisco.

SECTION I. INTRODUCTION

1. The General & Cellular Basis of Medical Physiology

Introduction

General Principles

Functional Morphology of the Cell

Structure & Function of DNA & RNA

Transport Across Cell Membranes

The Capillary Wall

Intercellular Communication

Homeostasis

Aging

Section I References

SECTION II. PHYSIOLOGY OF NERVE & MUSCLE CELLS

2. Excitable Tissue: Nerve

Introduction

Nerve Cells

Excitation & Conduction

Ionic Basis of Excitation & Conduction

Properties of Mixed Nerves

Nerve Fiber Types & Function

Neurotrophins

Neuroglia

3. Excitable Tissue: Muscle

Introduction

Skeletal Muscle

Morphology

Electrical Phenomena & Ionic Fluxes

Contractile Responses

Energy Sources & Metabolism

Properties of Skeletal Muscles in the Intact Organism

Cardiac Muscle

Morphology

Electrical Properties

Mechanical Properties

Metabolism

Pacemaker Tissue

Smooth MuscleMorphology

Visceral Smooth Muscle

Multi-Unit Smooth Muscle

4. Synaptic & Junctional Transmission

Introduction

Synaptic Transmission

Functional Anatomy

Electrical Events in Postsynaptic Neurons

Inhibition & Facilitation at Synapses

Chemical Transmission of Synaptic Activity

Principal Neurotransmitter Systems

Synpatic Plasticity & Learning

Neuromuscular Transmission

Neuromuscular Junction

Nerve Endings in Smooth & Cardiac Muscle

Denervation Hypersensitivity

5. Initiation of Impulses in Sense Organs

Introduction

Sense Organs & Receptors

The Senses

Generation of Impulses in Different Nerves

"Coding" of Sensory Information

Section II References

Section III. FUNCTIONS OF THE NERVOUS SYSTEM

6. Reflexes

Introduction

Monosynaptic Reflexes: The Stretch Reflex

Polysynaptic Reflexes: The Withdrawal Reflex

General Properties of Reflexes

7. Cutaneous, Deep, & Visceral Sensation

Introduction

Pathways

Touch

Proprioception

Temperature

Pain

Other Sensations

8. Vision

Introduction

Anatomic Considerations

The Image-Forming Mechanism

The Photoreceptor Mechanism

Responses in the Visual Pathways & Cortex

Color Vision

Other Aspects of Visual Function

Eye Movements

9. Hearing & Eqilibrium

Introduction

Anatomic Considerations

Hair Cells

Hearing

Vestibular Function

10. Smell & Taste

Introduction

Smell

Taste

Receptor Organs & Pathways

11. Alert Behavior, Sleep, & the Electrical Activity of the Brain

Introduction

The Thalamus & the Cerebral Cortex

The Reticular Formation & the Reticular Activating System

Evoked Cortical Potentials

The Electroencephalogram

Physiologic Basis of the EEG, Consciousness, & Sleep

12. Control of Posture & Movement

Introduction

General Principles

Corticospinal & Corticobulbar System

Anatomy & Function

Posture-Regulating Systems

Spinal Integration

Medullary Components

Midbrain Components

Coritcal Components

Basal Ganglia

Cerebellum

13. The Autonomic Nervous System

Introduction

Anatomic Organization of Autonomic Outflow

Chemical Transmission at Autonomic Junctions

Responses of Effector Organs to Autonomic Nerve Impulses

14. Central Regulation of Visceral Function

Introduction

Medulla Oblongata

Hypothalamus

Anatomic Considerations

Hypothalamic Function

Relation to Autonomic Function

Relation to Sleep

Relation to Cyclic Phenomena

Hunger

Control of Posterior Pituitary Secretion

Control of Anterior Pituitary Secretion

Temperature Regulation

15. Neural Basis of Instinctual Behavior & Emotions

Introduction

Anatomic Considerations

Limbic Functions

Sexual Behavior

Other Emotions

Motivation & Addiction

Brain Chemistry & Behavior

16. "Higher Functions of the Nervous System": Conditioned Reflexes, Learning, & Related Phenomena

Introduction

Methods

Learning & Memory

Functions of the Neocortex

Section III References

SECTION IV. ENDOCRINOLOGY, METABOLISM, & REPRODUCTIVE FUNCTION

17. Energy Balance, Metabolism, & Nutrition

Introduction

Energy Metabolism

Intermediary Metabolism

Carbohydrate Metabolism

Protein Metabolism

Fat Metabolism

Nutrition

18. The Thyroid Gland

Introduction

Anatomic Considerations

Formation & Secretion of Thyroid Hormones

Transport & Metabolism of Thyroid Hormones

Effects of Thyroid Hormones

Regulation of Thyroid Secretion

Clinical Correlates

19. Endocrine Functions of the Pancreas & Regulation of Carbohydrate Metabolism

Introduction

Islet Cell Structure

Structure, Biosynthesis, & Secretion of Insulin

Fate of Secreted Insulin

Effects of Insulin

Mechanism of Action

Consequences of Insulin Deficiency

Insulin Excess

Regulation of Insulin Secretion

Glucagon

Other Islet Cell Hormones

Effects of Other Hormones & Exercise on Carbohydrate Metabolism

Hypoglycemia & Diabetes Mellitus in Humans

20. The Adrenal Medulla & Adrenal Cortex

Introduction

Adrenal Morphology

Adrenal Medulla

Structure & Function of Medullary Hormones

Regulation of Adrenal Medullary Secretion

Adrenal Cortex

Structure & Biosynthesis of Adrenocortical Hormones

Transport, Metabolism, & Excretion of Adrenocortical Hormones

Effects of Adrenal Androgens & Estrogens

Physiologic Effects of Glucocorticoids

Pharmacologic & Pathologic Effects of Glucocorticoids

Regulation of Glucocorticoid Secretion

Effects of Mineralocorticoids

Regulation of Aldosterone Secretion

Role of Mineralocorticoids in the Regulation of Salt Balance

Summary of the Effects of Adrenocortical Hyper- & Hypofunction in Humans

21. Hormonal Control of Calcium Metabolism & the Physiology of Bone

Introduction

Calcium & Phosphorus Metabolism

Bone Physiology

Vitamin D & the Hydroxycholecalciferols

The Parathyroid Glands

Calcitonin

Effects of Other Hormones & Humoral Agents on Calcium Metabolism

22. The Pituitary Gland

Introduction

Morphology

Intermediate-Lobe Hormones

Growth Hormone

Physiology of Growth

Pituitary Insufficiency

Pituitary Hyperfunction in Humans

23. The Gonads: Development & Function of the Reproductive System

Introduction

Sex Differentiation & Development

Chromosomal Sex

Embryology of the Human Reproductive System

Aberrant Sexual Differentiation

Puberty

Precocious & Delayed Puberty

Menopause

Pituitary Gonadotropins & Prolactin

The Male Reproductive System

Structure

Gametogenesis & Ejaculation

Endocrine Function of the Testes

Control of Testicular Function

Abnormalities of Testicular Function

The Female Reproductive System

The Menstrual Cycle

Ovarian Hormones

Control of Ovarian Function

Abnormalities of Ovarian Function

Pregnancy

Lactation

24. Endocrine Functions of the Kidneys, Heart, and Pineal Gland

Introduction

The Renin-Angiotensin System

Erythropoietin

Hormones of the Heart & Other Natriuretic Factors

Pineal Gland

Section IV References

SECTION V. GASTROINTESTINAL FUNCTION

25. Digestion & Absorption

Introduction

Carbohydrates

Proteins & Nucleic Acids

Lipids

Absorption of Water & Electrolytes

Absorption of Vitamins & Minerals

26. Regulation of Gastrointestinal Function

Introduction

General Considerations

Gastrointestinal Hormones

Mouth & Esophagus

Stomach

Exocrine Portion of the Pancreas

Liver & Biliary System

Small Intestine

Colon

Section V References

SECTION VI. CIRCULATION

27. Circulating Body Fluids

Introduction

Blood

Bone Marrow

White Blood Cells

Immunity

Platelets

Red Blood Cells

Blood Types

Plasma

Hemostasis

Lymph

28. Origin of the Heartbeat & the Electrical Activity of the Heart

Introduction

Origin & Spread of Cardiac Excitation

The Electrocardiogram

Cardiac Arrhythmias

Electrocardiographic Findings in Other Cardiac & Systemic Diseases

29. The Heart as a Pump

Introduction

Mechanical Events of the Cardiac Cycle

Cardiac Output

30. Dynamics of Blood & Lymph Flow

Introduction

Functional Morphology

Biophysical Considerations

Arterial & Arteriolar Circulation

Capillary Circulation

Lymphatic Circulation & Intestinal Fluid Volume

Venous Circulation

31. Cardiovascular Regulatory Mechanisms

Introduction

Local Regulation

Substances Secreted by the Endothelium

Systemic Regulation by Hormones

Systemic Regulation by the Nervous System

32. Circulation Through Special Regions

Introduction

Cerebral Circulation

Anatomic Considerations

Cerebrospinal Fluid

The Blood-Brain Barrier

Cerebral Blood Flow & Its Regulation

Brain Metabolism & Oxygen Requirements

Coronary Circulation

Splanchnic Circulation

Cutaneous Circulation

Placental & Fetal Circulation

33. Cardiovascular Homeostasis in Health & Disease

Introduction

Compensation for Gravitational Effects

Exercise

Inflammation & Wound Healing

Shock

Hypertension

Heart Failure

Section VI References

SECTION VII. RESPIRATION

34. Pulmonary Function

Introduction

Properties of Gases

Anatomy of the Lungs

Mechanics of Respiration

Gas Exchange in the Lungs

Pulmonary Circulation

Other Functions of the Respiratory System

35. Gas Transport Between the Lungs & the Tissues

Introduction

Oxygen Transport

Carbod Dioxide Transport

36. Regulation of Respiration

Introduction

Neural Control of Breathing

Regulation of Respiratory Activity

Chemical Control of Breathing

Nonchemical Influences on Respiration

37. Respiratory Adjustments in Health & Disease

Introduction

Effects of Exercise

Hypoxia

Hypoxic Hypoxia

Other Forms of Hypoxia

Oxygen Treatment

Hypercapnia & Hypocapnia

Other Respiratory Abnormalities

Diseases Affecting the Pulmonary Circulation

Effects of Increased Barometric Pressure

Artificial Respiration

Section VII References

SECTION VIII. FORMATION & EXCRETION OF URINE

38. Renal Function & Micturition

Introduction

Functional Anatomy

Renal Circulation

Glomerular Filtration

Tubular Function

Water Excretion

Acidification of the Urine & Bicarbonate Excretion

Regulation of NA+ & Cl- Excretion

Regulation of K+ Excretion

Diuretics

Effects of Disordered Renal Function

Filling of the Bladder

Emptying of the Bladder

39. Regulation of Extracellular Fluid Composition & Volume

Introduction

Defense of Tonicity

Defense of Volume

Defense of Specific Ionic Composition

Defense of H+ Concentration

Section VIII References

Self-Study: Objectives, Essay Questions, & Multiple-Choice Questions

Answers to Quantitative & Multiple-Choice Questions

Appendix

Index