Table of Contents

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

About the Author

William F. Ganong, MD

Jack and DeLoris Lange Professor of Physiology Emeritus

University of California

San Francisco, California

Reviews

"The book covers all aspects of the physiology of the human body. The physiology of the nervous system is presented early in the book, which is advisable since the nervous system plays a significant role in the function of the other body systems." "A major strength is the regular revision, which provides as up-to-date information as possible in a book of this type." ..."it is an excellent source of current and complete information on medical physiology."