『ガイトン臨床生理学』(原書・第11版)<br>Textbook of Medical Physiology (Textbook of Medical Physiology) (11TH)

『ガイトン臨床生理学』(原書・第11版)
Textbook of Medical Physiology (Textbook of Medical Physiology) (11TH)

  • ただいまウェブストアではご注文を受け付けておりません。 ⇒古書を探す
  • 製本 Hardcover:ハードカバー版/ページ数 1116 p.
  • 言語 ENG
  • 商品コード 9780721602400
  • DDC分類 612

基本説明

世界で最も定評あるガイトンの臨床生理学教科書。旧版邦訳は、1999年医学書院刊。学生から臨床医までに参照される総括的内容。充実した参考文献は生理学全般をカバーしている。
Covers all of the major systems in the human body, while emphasising system interaction, homeostasis and pathophysiology. Previous edition: 2000.

Table of Contents

  UNIT I Introduction to Physiology: The Cell
and General Physiology
Functional Organization of the Human Body 3 (8)
and Control of the ``Internal Environment''
Cells as the Living Units of the Body 3 (1)
Extracellular Fluid---The ``Internal 3 (1)
Environment''
``Homeostatic'' Mechanisms of the Major 4 (2)
Functional Systems
Homeostasis 4 (1)
Extracellular Fluid Transport and 4 (1)
Mixing System---The Blood Circulatory
System
Origin of Nutrients in the 5 (1)
Extracellular Fluid
Removal of Metabolic End Products 5 (1)
Regulation of Body Functions 5 (1)
Reproduction 6 (1)
Control Systems of the Body 6 (3)
Examples of Control Mechanisms 6 (1)
Characteristics of Control Systems 7 (2)
Summary---Automaticity of the Body 9 (2)
The Cell and Its Functions 11 (16)
Organization of the Cell 11 (1)
Physical Structure of the Cell 12 (6)
Membranous Structures of the Cell 12 (2)
Cytoplasm and Its Organelles 14 (3)
Nucleus 17 (1)
Nuclear Membrane 17 (1)
Nucleoli and Formation of Ribosomes 18 (1)
Comparison of the Animal Cell with 18 (1)
Precellular Forms of Life
Functional Systems of the Cell 19 (5)
Ingestion by the Cell---Endocytosis 19 (1)
Digestion of Pinocytotic and Phagocytic 20 (1)
Foreign Substances Inside the
Cell---Function of the Lysosomes
Synthesis and Formation of Cellular 20 (2)
Structures by Endoplasmic Reticulum and
Golgi Apparatus
Extraction of Energy from 22 (2)
Nutrients---Function of the Mitochondria
Locomotion of Cells 24 (3)
Ameboid Movement 24 (1)
Cilia and Ciliary Movement 24 (3)
Genetic Control of Protein Synthesis, Cell 27 (18)
Function, and Cell Reproduction
Genes in the Cell Nucleus 27 (3)
Genetic Code 29 (1)
The DNA Code in the Cell Nucleus Is 30 (5)
Transferred to an RNA Code in the Cell
Cytoplasm---The Process of Transcription
Synthesis of RNA 30 (1)
Assembly of the RNA Chain from 31 (1)
Activated Nucleotides Using the DNA
Strand as a Template---The Process of
``Transcription''
Messenger RNA---The Codons 31 (1)
Transfer RNA---The Anticodons 32 (1)
Ribosomal RNA 33 (1)
Formation of Proteins on the 33 (2)
Ribosomes---The Process of
``Translation''
Synthesis of Other Substances in the Cell 35 (1)
Control of Gene Function and Biochemical 35 (2)
Activity in Cells
Genetic Regulation 35 (1)
Control of Intracellular Function by 36 (1)
Enzyme Regulation
The DNA-Genetic System Also Controls Cell 37 (3)
Reproduction
Cell Reproduction Begins with 37 (1)
Replication of DNA
Chromosomes and Their Replication 38 (1)
Cell Mitosis 38 (1)
Control of Cell Growth and Cell 39 (1)
Reproduction
Cell Differentiation 40 (1)
Apoptosis---Programmed Cell Death 40 (1)
Cancer 40 (5)
UNIT II Membrane Physiology, Nerve, and Muscle
Transport of Substances Through the Cell 45 (12)
Membrane
The Lipid Barrier of the Cell Membrane, 45 (1)
and Cell Membrane Transport Proteins
Diffusion 46 (6)
Diffusion Through the Cell Membrane 46 (1)
Diffusion Through Protein Channels, and 47 (2)
``Gating'' of These Channels
Facilitated Diffusion 49 (1)
Factors That Affect Net Rate of 50 (1)
Diffusion
Osmosis Across Selectively Permeable 51 (1)
Membranes---``Net Diffusion'' of Water
``Active Transport'' of Substances 52 (5)
Through Membranes
Primary Active Transport 53 (1)
Secondary Active 54 (1)
Transport---Co-Transport and
Counter-Transport
Active Transport Through Cellular Sheets 55 (2)
Membrane Potentials and Action Potentials 57 (15)
Basic Physics of Membrane Potentials 57 (1)
Membrane Potentials Caused by Diffusion 57 (1)
Measuring the Membrane Potential 58 (1)
Resting Membrane Potential of Nerves 59 (2)
Origin of the Normal Resting Membrane 60 (1)
Potential
Nerve Action Potential 61 (3)
Voltage-Gated Sodium and Potassium 62 (2)
Channels
Summary of the Events That Cause the 64 (1)
Action Potential
Roles of Other Ions During the Action 64 (1)
Potential
Initiation of the Action Potential 65 (1)
Propagation of the Action Potential 65 (1)
Re-establishing Sodium and Potassium 66 (1)
Ionic Gradients After Action Potentials
Are Completed---Importance of Energy
Metabolism
Plateau in Some Action Potentials 66 (1)
Rhythmicity of Some Excitable 67 (1)
Tissues---Repetitive Discharge
Special Characteristics of Signal 68 (1)
Transmission in Nerve Trunks
Excitation---The Process of Eliciting the 69 (1)
Action Potential
``Refractory Period'' After an Action 70 (1)
Potential
Recording Membrane Potentials and Action 70 (2)
Potentials
Inhibition of 70 (2)
Excitability---``Stabilizers'' and
Local Anesthetics
Contraction of Skeletal Muscle 72 (13)
Physiologic Anatomy of Skeletal Muscle 72 (2)
Skeletal Muscle Fiber 72 (2)
General Mechanism of Muscle Contraction 74 (1)
Molecular Mechanism of Muscle Contraction 74 (4)
Molecular Characteristics of the 75 (2)
Contractile Filaments
Effect of Amount of Actin and Myosin 77 (1)
Filament Overlap on Tension Developed
by the Contracting Muscle
Relation of Velocity of Contraction to 78 (1)
Load
Energetics of Muscle Contraction 78 (2)
Work Output During Muscle Contraction 78 (1)
Sources of Energy for Muscle Contraction 79 (1)
Characteristics of Whole Muscle 80 (5)
Contraction
Mechanics of Skeletal Muscle Contraction 81 (1)
Remodeling of Muscle to Match Function 82 (1)
Rigor Mortis 83 (2)
Excitation of Skeletal Muscle: 85 (7)
Neuromuscular Transmission and
Excitation-Contraction Coupling
Transmission of Impulses from Nerve 85 (3)
Endings to Skeletal Muscle Fibers: The
Neuromuscular Junction
Secretion of Acetylcholine by the Nerve 85 (3)
Terminals
Molecular Biology of Acetyline Formation 88 (1)
and Release
Drugs That Enhance or Block Transmission 88 (1)
at the Neuromuscular Junction
Myasthenia Gravis 89 (1)
Muscle Action Potential 89 (1)
Spread of the Action Potential to the 89 (1)
Interior of the Muscle Fiber by Way of
``Transverse Tubules''
Excitation-Contraction Coupling 89 (3)
Transverse Tubule-Sarcoplasmic 89 (1)
Reticulum System
Release of Calcium Ions by the 90 (2)
Sarcoplasmic Reticulum
Contraction and Excitation of Smooth Muscle 92 (11)
Contraction of Smooth Muscle 92 (3)
Types of Smooth Muscle 92 (1)
Contractile Mechanism in Smooth Muscle 93 (2)
Regulation of Contraction by Calcium 95 (1)
Ions
Nervous and Hormonal Control of Smooth 95 (8)
Muscle Contraction
Neuromuscular Junctions of Smooth Muscle 95 (1)
Membrane Potentials and Action 96 (2)
Potentials in Smooth Muscle
Effect of Local Tissue Factors and 98 (1)
Hormones to Cause Smooth Muscle
Contraction Without Action Potentials
Source of Calcium Ions That Cause 99 (4)
Contraction (1) Through the Cell
Membrane and (2) from the Sarcoplasmic
Reticulum
UNIT III The Heart
Heart Muscle; The Heart as a Pump and 103(13)
Function of the Heart Valves
Physiology of Cardiac Muscle 103(3)
Physiologic Anatomy of Cardiac Muscle 103(1)
Action Potentials in Cardiac Muscle 104(2)
The Cardiac Cycle 106(3)
Diastole and Systole 106(1)
Relationship of the Electrocardiogram 107(1)
to the Cardiac Cycle
Function of the Atria as Primer Pumps 107(1)
Function of the Ventricles as Pumps 108(1)
Function of the Valves 109(1)
Aortic Pressure Curve 109(1)
Relationship of the Heart Sounds to Heart 109(1)
Pumping
Work Output of the Heart 110(1)
Graphical Analysis of Ventricular 110(1)
Pumping
Chemical Energy Required for Cardiac 111(1)
Contraction: Oxygen Utilization by the
Heart
Regulation of Heart Pumping 111(5)
Intrinsic Regulation of Heart 111(2)
Pumping---The Frank-Starling Mechanism
Effect of Potassium and Calcium Ions on 113(1)
Heart Function
Effect of Temperature on Heart Function 114(1)
Increasing the Arterial Pressure Load 114(2)
(up to a Limit) Does Not Decrease the
Cardiac Output
Rhythmical Excitation of the Heart 116(7)
Specialized Excitatory and Conductive 116(4)
System of the Heart
Sinus (Sinoatrial) Node 116(2)
Internodal Pathways and Transmission of 118(1)
the Cardiac Impulse Through the Atria
Atrioventricular Node, and Delay of 118(1)
Impulse Conduction from the Atria to
the Ventricles
Rapid Transmission in the Ventricular 119(1)
Purkinje System
Transmission of the Cardiac Impulse in 119(1)
the Ventricular Muscle
Summary of the Spread of the Cardiac 120(1)
Impulse Through the Heart
Control of Excitation and Conduction in 120(3)
the Heart
The Sinus Node as the Pacemaker of the 120(1)
Heart
Role of the Purkinje System in Causing 121(1)
Synchronous Contraction of the
Ventricular Muscle
Control of Heart Rhythmicity and 121(2)
Impulse Conduction by the Cardiac
Nerves: The Sympathetic and
Parasympathetic Nerves
The Normal Electrocardiogram 123(8)
Characteristics of the Normal 123(3)
Electrocardiogram
Depolarization Waves Versus 123(2)
Repolarization Waves
Relationship of Atrial and Ventricular 125(1)
Contraction to the Waves of the
Electrocardiogram
Voltage and Time Calibration of the 125(1)
Electrocardiogram
Methods for Recording Electrocardiograms 126(1)
Pen Recorder 126(1)
Flow of Current Around the Heart During 126(1)
the Cardiac Cycle
Recording Electrical Potentials from a 126(1)
Partially Depolarized Mass of Syncytial
Cardiac Muscle
Flow of Electrical Currents in the 126(1)
Chest Around the Heart
Electrocardiographic Leads 127(4)
Three Bipolar Limb Leads 127(2)
Chest Leads (Precordial Leads) 129(1)
Augmented Unipolar Limb Leads 129(2)
Electrocardiographic Interpretation of 131(16)
Cardiac Muscle and Coronary Blood Flow
Abnormalities: Vectorial Analysis
Principles of Vectorial Analysis of 131(3)
Electrocardiograms
Use of Vectors to Represent Electrical 131(1)
Potentials
Direction of a Vector is Denoted in 131(1)
Terms of Degrees
Axis for Each Standard Bipolar Lead and 132(1)
Each Unipolar Limb Lead
Vectorial Analysis of Potentials 133(1)
Recorded in Different Leads
Vectorial Analysis of the Normal 134(3)
Electrocardiogram
Vectors That Occur at Successive 134(1)
Intervals During Depolarization of the
Ventricles---The QRS Complex
Electrocardiogram During 134(2)
Repolarization---The T Wave
Depolarization of the Atria---The P Wave 136(1)
Vectorcardiogram 136(1)
Mean Electrical Axis of the Ventricular 137(3)
QRS---And Its Significance
Determining the Electrical Axis from 137(1)
Standard Lead Electrocardiograms
Abnormal Ventricular Conditions That 138(2)
Cause Axis Deviation
Conditions That Cause Abnormal Voltages 140(1)
of the QRS Complex
Increased Voltage in the Standard 140(1)
Bipolar Limb Leads
Decreased Voltage of the 140(1)
Electrocardiogram
Prolonged and Bizarre Patterns of the QRS 141(1)
Complex
Prolonged QRS Complex as a Result of 141(1)
Cardiac Hypertrophy or Dilatation
Prolonged QRS Complex Resulting from 141(1)
Purkinje System Blocks
Conditions That Cause Bizarre QRS 141(1)
Complexes
Current of Injury 141(4)
Effect of Current of Injury on the QRS 141(1)
Complex
The J Point---The Zero Reference 142(1)
Potential for Analyzing Current of
Injury
Coronary Ischemia as a Cause of Injury 143(2)
Potential
Abnormalities in the T Wave 145(2)
Effect of Slow Conduction of the 145(1)
Depolarization Wave on the
Characteristics of the T Wave
Shortened Depolarization in Portions of 145(2)
the Ventricular Muscle as a Cause of T
Wave Abnormalities
Cardiac Arrhythmias and Their 147(14)
Electrocardiographic Interpretation
Abnormal Sinus Rhythms 147(1)
Tachycardia 147(1)
Bradycardia 147(1)
Sinus Arrhythmia 148(1)
Abnormal Rhythms That Result from Block 148(2)
of Heart Signals Within the Intracardiac
Conduction Pathways
Sinoatrial Block 148(1)
Atrioventricular Block 148(1)
Incomplete Atrioventricular Heart Block 149(1)
Incomplete Intraventricular 150(1)
Block---Electrical Alternans
Premature Contractions 150(1)
Premature Atrial Contractions 150(1)
A-V Nodal or A-V Bundle Premature 150(1)
Contractions
Premature Ventricular Contractions 151(1)
Paroxysmal Tachycardia 151(1)
Atrial Paroxysmal Tachycardia 152(1)
Ventricular Paroxysmal Tachycardia 152(1)
Ventricular Fibrillation 152(3)
Phenomenon of Re-entry---``Circus 153(1)
Movements'' as the Basis for
Ventricular Fibrillation
Chain Reaction Mechanism of Fibrillation 153(1)
Electrocardiogram in Ventricular 154(1)
Fibrillation
Electroshock Defibrillation of the 154(1)
Ventricle
Hand Pumping of the Heart 155(1)
(Cardiopulmonary Resuscitation) as an
Aid to Defibrillation
Atrial Fibrillation 155(1)
Atrial Flutter 156(1)
Cardiac Arrest 156(5)
UNIT IV The Circulation
Overview of the Circulation; Medical 161(10)
Physics of Pressure, Flow, and Resistance
Physical Characteristics of the 161(2)
Circulation
Basic Theory of Circulatory Function 163(1)
Interrelationships Among Pressure, Flow, 164(7)
and Resistance
Blood Flow 164(2)
Blood Pressure 166(1)
Resistance to Blood Flow 167(3)
Effects of Pressure on Vascular 170(1)
Resistance and Tissue Blood Flow
Vascular Distensibility and Functions of 171(10)
the Arterial and Venous Systems
Vascular Distensibility 171(2)
Vascular Compliance (or Vascular 171(1)
Capacitance)
Volume-Pressure Curves of the Arterial 172(1)
and Venous Circulations
Arterial Pressure Pulsations 173(3)
Transmission of Pressure Pulses to the 174(1)
Peripheral Arteries
Clinical Methods for Measuring Systolic 175(1)
and Diastolic Pressures
Veins and Their Functions 176(5)
Venous Pressures---Right Atrial 176(3)
Pressure (Central Venous Pressure) and
Peripheral Venous Pressures
Blood Reservoir Function of the Veins 179(2)
The Microcirculation and the Lymphatic 181(14)
System: Capillary Fluid Exchange,
Interstitial Fluid, and Lymph Flow
Structure of the Microcirculation and 181(1)
Capillary System
Flow of Blood in the 182(1)
Capillaries---Vasomotion
Average Function of the Capillary System 183(1)
Exchange of Water, Nutrients, and Other 183(1)
Substances Between the Blood and
Interstitial Fluid
Diffusion Through the Capillary Membrane 183(1)
The Interstitium and Interstitial Fluid 184(1)
Fluid Filtration Across Capillaries Is 185(5)
Determined by Hydrostatic and Colloid
Osmotic Pressures, and Capillary
Filtration Coefficient
Capillary Hydrostatic Pressure 186(1)
Interstitial Fluid Hydrostatic Pressure 187(1)
Plasma Colloid Osmotic Pressure 188(1)
Interstitial Fluid Colloid Osmotic 188(1)
Pressure
Exchange of Fluid Volume Through the 189(1)
Capillary Membrane
Starling Equilibrium for Capillary 189(1)
Exchange
Lymphatic System 190(5)
Lymph Channels of the Body 190(1)
Formation of Lymph 191(1)
Rate of Lymph Flow 192(1)
Role of the Lymphatic System in 193(2)
Controlling Interstitial Fluid Protein
Concentration, Interstitial Fluid
Volume, and Interstitial Fluid Pressure
Local and Humoral Control of Blood Flow by 195(9)
the Tissues
Local Control of Blood Flow in Response 195(1)
to Tissue Needs
Mechanisms of Blood Flow Control 196(5)
Acute Control of Local Blood Flow 196(4)
Long-Term Blood Flow Regulation 200(1)
Development of Collateral 201(1)
Circulation---A Phenomenon of Long-Term
Local Blood Flow Regulation
Humoral Control of the Circulation 201(3)
Vasoconstrictor Agents 201(1)
Vasodilator Agents 202(1)
Vascular Control by Ions and Other 202(2)
Chemical Factors
Nervous Regulation of the Circulation, and 204(12)
Rapid Control of Arterial Pressure
Nervous Regulation of the Circulation 204(4)
Autonomic Nervous System 204(4)
Role of the Nervous System in Rapid 208(5)
Control of Arterial Pressure
Increase in Arterial Pressure During 208(1)
Muscle Exercise and Other Types of
Stress
Reflex Mechanisms for Maintaining 209(3)
Normal Arterial Pressure
Central Nervous System Ischemic 212(1)
Response---Control of Arterial Pressure
by the Brain's Vasomotor Center in
Response to Diminished Brain Blood Flow
Special Features of Nervous Control of 213(3)
Arterial Pressure
Role of the Skeletal Nerves and 213(1)
Skeletal Muscles in Increasing Cardiac
Output and Arterial Pressure
Respiratory Waves in the Arterial 214(1)
Pressure
Arterial Pressure ``Vasomotor'' 214(2)
Waves---Oscillation of Pressure Reflex
Control Systems
Dominant Role of the Kidney in Long-Term 216(16)
Regulation of Arterial Pressure and in
Hypertension: The Integrated System for
Pressure Control
Renal-Body Fluid System for Arterial 216(7)
Pressure Control
Quantitation of Pressure Diuresis as a 217(3)
Basis for Arterial Pressure Control
Chronic Hypertension (High Blood 220(3)
Pressure) Is Caused by Impaired Renal
Fluid Excretion
The Renin-Angiotensin System: Its Role In 223(7)
Pressure Control and in Hypertension
Components of the Renin-Angiotensin 223(3)
System
Types of Hypertension in Which 226(1)
Angiotensin Is Involved: Hypertension
Caused by a Renin-Secreting Tumor or by
Infusion of Angiotensin II
Other Types of Hypertension Caused by 227(1)
Combinations of Volume Loading and
Vasoconstriction
``Primary (Essential) Hypertension'' 228(2)
Summary of the Integrated, Multifaceted 230(2)
System for Arterial Pressure Regulation
Cardiac Output, Venous Return, and Their 232(14)
Regulation
Normal Values for Cardiac Output at Rest 232(1)
and During Activity
Control of Cardiac Output by Venous 232(4)
Return---Role of the Frank-Starling
Mechanism of the Heart
Cardiac Output Regulation Is the Sum of 233(1)
Blood Flow Regulation in All the Local
Tissues of the Body---Tissue Metabolism
Regulates Most Local Blood Flow
The Heart Has Limits for the Cardiac 234(1)
Output That It Can Achieve
What Is the Role of the Nervous System 235(1)
in Controlling Cardiac Output?
Pathologically High and Pathologically 236(7)
Low Cardiac Outputs
High Cardiac Output Caused by Reduced 236(1)
Total Peripheral Resistance
Low Cardiac Output 237(1)
A More Quantitative Analysis of Cardiac 237(1)
Output Regulation
Cardiac Output Curves Used in the 237(1)
Quantitative Analysis
Venous Return Curves 238(3)
Analysis of Cardiac Output and Right 241(2)
Atrial Pressure, Using Simultaneous
Cardiac Output and Venous Return Curves
Methods for Measuring Cardiac Output 243(3)
Pulsatile Output of the Heart as 243(1)
Measured by an Electromagnetic or
Ultrasonic Flowmeter
Measurement of Cardiac Output Using the 244(1)
Oxygen Fick Principle
Indicator Dilution Method for Measuring 244(2)
Cardiac Output
Muscle Blood Flow and Cardiac Output During 246(12)
Exercise; the Coronary Circulation and
Ischemic Heart Disease
Blood Flow in Skeletal Muscle and Blood 246(3)
Flow Regulation During Exercise
Rate of Blood Flow Through the Muscles 246(1)
Control of Blood Flow Through the 247(1)
Skeletal Muscles
Total Body Circulatory Readjustments 247(2)
During Exercise
Coronary Circulation 249(9)
Physiologic Anatomy of the Coronary 249(1)
Blood Supply
Normal Coronary Blood Flow 249(1)
Control of Coronary Blood Flow 250(1)
Special Features of Cardiac Muscle 251(1)
Metabolism
Ischemic Heart Disease 252(1)
Causes of Death After Acute Coronary 253(1)
Occlusion
Stages of Recovery from Acute 254(1)
Myocardial Infarction
Function of the Heart After Recovery 255(1)
from Myocardial Infarction
Pain in Coronary Heart Disease 255(1)
Surgical Treatment of Coronary Disease 256(2)
Cardiac Failure 258(11)
Dynamics of the Circulation in Cardiac 258(4)
Failure
Acute Effects of Moderate Cardiac 258(1)
Failure
Chronic Stage of Failure---Fluid 259(1)
Retention Helps to Compensate Cardiac
Output
Summary of the Changes That Occur After 260(1)
Acute Cardiac Failure---``Compensated
Heart Failure''
Dynamics of Severe Cardiac 260(2)
Failure---Decompensated Heart Failure
Unilateral Left Heart Failure 262(1)
Low-Output Cardiac Failure---Cardiogenic 262(1)
Shock
Edema in Patients with Cardiac Failure 263(1)
Cardiac Reserve 264(5)
Quantitative Graphical Method for 265(4)
Analysis of Cardiac Failure
Heart Valves and Heart Sounds; Dynamics of 269(9)
Valvular and Congenital Heart Defects
Heart Sounds 269(3)
Normal Heart Sounds 269(2)
Valvular Lesions 271(1)
Abnormal Circulatory Dynamics in Valvular 272(2)
Heart Disease
Dynamics of the Circulation in Aortic 272(1)
Stenosis and Aortic Regurgitation
Dynamics of Mitral Stenosis and Mitral 273(1)
Regurgitation
Circulatory Dynamics During Exercise in 273(1)
Patients with Valvular Lesions
Abnormal Circulatory Dynamics in 274(2)
Congenital Heart Defects
Patent Ductus Arteriosus---A 274(1)
Left-to-Right Shunt
Tetralogy of Fallot---A Right-to-Left 274(2)
Shunt
Causes of Congenital Anomalies 276(1)
Use of Extracorporeal Circulation During 276(1)
Cardiac Surgery
Hypertrophy of the Heart in Valvular and 276(2)
Congenital Heart Disease
Circulatory Shock and Physiology of Its 278(13)
Treatment
Physiologic Causes of Shock 278(1)
Circulatory Shock Caused by Decreased 278(1)
Cardiac Output
Circulatory Shock That Occurs Without 278(1)
Diminished Cardiac Output
What Happens to the Arterial Pressure 279(1)
in Circulatory Shock?
Tissue Deterioration Is the End Result 279(1)
of Circulatory Shock, Whatever the Cause
Stages of Shock 279(1)
Shock Caused by Hypovolemia---Hemorrhagic 279(6)
Shock
Relationship of Bleeding Volume to 279(1)
Cardiac Output and Arterial Pressure
Progressive and Nonprogressive 280(4)
Hemorrhagic Shock
Irreversible Shock 284(1)
Hypovolemic Shock Caused by Plasma Loss 284(1)
Hypovolemic Shock Caused by Trauma 285(1)
Neurogenic Shock---Increased Vascular 285(1)
Capacity
Anaphylactic Shock and Histamine Shock 285(1)
Septic Shock 286(1)
Physiology of Treatment in Shock 286(1)
Replacement Therapy 286(1)
Treatment of Shock with Sympathomimetic 287(1)
Drugs---Sometimes Useful, Sometimes Not
Other Therapy 287(1)
Circulatory Arrest 287(4)
Effect of Circulatory Arrest on the 287(4)
Brain
UNIT V The Body Fluids and Kidneys
The Body Fluid Compartments: Extracellular 291(16)
and Intracellular Fluids; Interstitial
Fluid and Edema
Fluid Intake and Output Are Balanced 291(1)
During Steady-State Conditions
Daily Intake of Water 291(1)
Daily Loss of Body Water 291(1)
Body Fluid Compartments 292(1)
Intracellular Fluid Compartment 293(1)
Extracellular Fluid Compartment 293(1)
Blood Volume 293(1)
Constituents of Extracellular and 293(2)
Intracellular Fluids
Ionic Composition of Plasma and 293(2)
Interstitial Fluid Is Similar
Important Constituents of the 295(1)
Intracellular Fluid
Measurement of Fluid Volumes in the 295(1)
Different Body Fluid Compartments---The
Indicator-Dilution Principle
Determination of Volumes of Specific Body 295(1)
Fluid Compartments
Regulation of Fluid Exchange and Osmotic 296(1)
Equilibrium Between Intracellular and
Extracellular Fluid
Basic Principles of Osmosis and Osmotic 296(2)
Pressure
Osmotic Equilibrium Is Maintained Between 298(1)
Intracellular and Extracellular Fluids
Volume and Osmolality of Extracellular 299(2)
and Intracellular Fluids in Abnormal
States
Effect of Adding Saline Solution to the 299(2)
Extracellular Fluid
Glucose and Other Solutions Administered 301(1)
for Nutritive Purposes
Clinical Abnormalities of Fluid Volume 301(1)
Regulation: Hyponatremia and Hypernatremia
Causes of Hyponatremia: Excess Water or 301(1)
Loss of Sodium
Causes of Hypernatremia: Water Loss or 302(1)
Excess Sodium
Edema: Excess Fluid in the Tissues 302(3)
Intracellular Edema 302(1)
Extracellular Edema 302(1)
Summary of Causes of Extracellular Edema 303(1)
Safety Factors That Normally Prevent 304(1)
Edema
Fluids in the ``Potential Spaces'' of the 305(2)
Body
Urine Formation by the Kidneys: I. 307(20)
Glomerular Filtration, Renal Blood Flow,
and Their Control
Multiple Functions of the Kidneys in 307(1)
Homeostasis
Physiologic Anatomy of the Kidneys 308(3)
General Organization of the Kidneys and 308(1)
Urinary Tract
Renal Blood Supply 309(1)
The Nephron Is the Functional Unit of 310(1)
the Kidney
Micturition 311(1)
Physiologic Anatomy and Nervous 311(1)
Connections of the Bladder
Transport of Urine from the Kidney 312(1)
Through the Ureters and into the Bladder
Innervation of the Bladder 312(1)
Filling of the Bladder and Bladder Wall 312(1)
Tone; the Cystometrogram
Micturition Reflex 313(1)
Facilitation or Inhibition of 313(1)
Micturition by the Brain
Abnormalities of Micturition 313(1)
Urine Formation Results from Glomerular 314(2)
Filtration, Tubular Reabsorption, and
Tubular Secretion
Filtration, Reabsorption, and Secretion 315(1)
of Different Substances
Glomerular Filtration---The First Step in 316(1)
Urine Formation
Composition of the Glomerular Filtrate 316(1)
GFR Is About 20 Per Cent of the Renal 316(1)
Plasma Flow
Glomerular Capillary Membrane 316(1)
Determinants of the GFR 317(3)
Increased Glomerular Capillary 318(1)
Filtration Coefficient Increases GFR
Increased Bowman's Capsule Hydrostatic 318(1)
Pressure Decreases GFR
Increased Glomerular Capillary Colloid 318(1)
Osmotic Pressure Decreases GFR
Increased Glomerular Capillary 319(1)
Hydrostatic Pressure Increases GFR
Renal Blood Flow 320(1)
Renal Blood Flow and Oxygen Consumption 320(1)
Determinants of Renal Blood Flow 320(1)
Blood Flow in the Vasa Recta of the 321(1)
Renal Medulla Is Very Low Compared with
Flow in the Renal Cortex
Physiologic Control of Glomerular 321(2)
Filtration and Renal Blood Flow
Sympathetic Nervous System Activation 321(1)
Decreases GFR
Hormonal and Autacoid Control of Renal 322(1)
Circulation
Autoregulation of GFR and Renal Blood Flow 323(4)
Importance of GFR Autoregulation in 323(1)
Preventing Extreme Changes in Renal
Excretion
Role of Tubuloglomerular Feedback in 323(2)
Autoregulation of GFR
Myogenic Autoregulation of Renal Blood 325(1)
Flow and GFR
Other Factors That Increase Renal Blood 325(2)
Flow and GFR: High Protein Intake and
Increased Blood Glucose
Urine Formation by the Kidneys: II. Tubular 327(21)
Processing of the Glomerular Filtrate
Reabsorption and Secretion by the Renal 327(1)
Tubules
Tubular Reabsorption Is Selective and 327(1)
Quantitatively Large
Tubular Reabsorption Includes Passive and 328(5)
Active Mechanisms
Active Transport 328(4)
Passive Water Reabsorption by Osmosis 332(1)
Is Coupled Mainly to Sodium Reabsorption
Reabsorption of Chloride, Urea, and 332(1)
Other Solutes by Passive Diffusion
Reabsorption and Secretion Along 333(6)
Different Parts of the Nephron
Proximal Tubular Reabsorption 333(1)
Solute and Water Transport in the Loop 334(2)
of Henle
Distal Tubule 336(1)
Late Distal Tubule and Cortical 336(1)
Collecting Tubule
Medullary Collecting Duct 337(1)
Summary of Concentrations of Different 338(1)
Solutes in the Different Tubular
Segments
Regulation of Tubular Reabsorption 339(4)
Glomerulotubular Balance---The Ability 339(1)
of the Tubules to Increase Reabsorption
Rate in Response to Increased Tubular
Load
Peritubular Capillary and Renal 339(2)
Interstitial Fluid Physical Forces
Effect of Arterial Pressure on Urine 341(1)
Output---The Pressure-Natriuresis and
Pressure-Diuresis Mechanisms
Hormonal Control of Tubular Reabsorption 342(1)
Sympathetic Nervous System Activation 343(1)
Increases Sodium Reabsorption
Use of Clearance Methods to Quantify 343(5)
Kidney Function
Inulin Clearance Can Be Used to 344(1)
Estimate GFR
Creatine Clearance and Plasma 344(1)
Creatinine Clearance Can Be Used to
Estimate GFR
PAH Clearance Can Be Used to Estimate 345(1)
Renal Plasma Flow
Filtration Fraction Is Calculated from 346(1)
GFR Divided by Renal Plasma Flow
Calculation of Tubular Reabsorption or 346(2)
Secretion from Renal Clearance
Regulation of Extracellular Fluid 348(17)
Osmolarity and Sodium Concentration
The Kidneys Excrete Excess Water by 348(2)
Forming a Dilute Urine
Antidiuretic Hormone Controls Urine 348(1)
Concentration
Renal Mechanisms for Excreting a Dilute 349(1)
Urine
The Kidneys Conserve Water by Excreting a 350(7)
Concentrated Urine
Obligatory Urine Volume 350(1)
Requirements for Excreting a 350(1)
Concentrated Urine---High ADH Levels
and Hyperosmotic Renal Medulla
Countercurrent Mechanism Produces a 351(1)
Hyperosmotic Renal Medullary
Interstitium
Role of Distal Tubule and Collecting 352(1)
Ducts in Excreting a Concentrated Urine
Urea Contributes to Hyperosmotic Renal 353(1)
Medullary Interstitium and to a
Concentrated Urine
Countercurrent Exchange in the Vasa 354(1)
Recta Preserves Hyperosmolarity of the
Renal Medulla
Summary of Urine Concentrating 355(2)
Mechanism and Changes in Osmolarity in
Different Segments of the Tubules
Quantifying Renal Urine Concentration and 357(1)
Dilution: ``Free Water'' and Osmolar
Clearances
Disorders of Urinary Concentrating Ability 357(1)
Control of Extracellular Fluid Osmolarity 358(1)
and Sodium Concentration
Estimating Plasma Osmolarity from 358(1)
Plasma Sodium Concentration
Osmoreceptor-ADH Feedback System 358(3)
ADH Synthesis in Supraoptic and 359(1)
Paraventricular Nuclei of the
Hypothalamus and ADH Release from the
Posterior Pituitary
Cardiovascular Reflex Stimulation of 360(1)
ADH Release by Decreased Arterial
Pressure and/or Decreased Blood Volume
Quantitative Importance of 360(1)
Cardiovascular Reflexes and Osmolarity
in Stimulating ADH Secretion
Other Stimuli for ADH Secretion 360(1)
Role of Thirst in Controlling 361(2)
Extracellular Fluid Osmolarity and Sodium
Concentration
Central Nervous System Centers for 361(1)
Thirst
Stimuli for Thirst 361(1)
Threshold for Osmolar Stimulus of 362(1)
Drinking
Integrated Responses of 362(1)
Osmoreceptor-ADH and Thirst Mechanisms
in Controlling Extracellular Fluid
Osmolarity and Sodium Concentration
Role of Angiotensin II and Aldosterone 362(1)
in Controlling Extracellular Fluid
Osmolarity and Sodium Concentration
Salt-Appetite Mechanism for Controlling 363(2)
Extracellular Fluid Sodium Concentration
and Volume
Renal Regulation of Potassium, Calcium, 365(18)
Phosphate, and Magnesium; Integration of
Renal Mechanisms for Control of Blood
Volume and Extracellular Fluid Volume
Regulation of Potassium Excretion and 365(6)
Potassium Concentration in Extracellular
Fluid
Regulation of Internal Potassium 366(1)
Distribution
Overview of Renal Potassium Excretion 367(1)
Potassium Secretion by Principal Cells 367(1)
of Late Distal and Cortical Collecting
Tubules
Summary of Factors That Regulate 368(3)
Potassium Secretion: Plasma Potassium
Concentration, Aldosterone, Tubular
Flow Rate, and Hydrogen Ion
Concentration
Control of Renal Calcium Excretion and 371(2)
Extracellular Calcium Ion Concentration
Control of Calcium Excretion by the 372(1)
Kidneys
Regulation of Renal Phosphate Excretion 372(1)
Control of Renal Magnesium Excretion and 373(1)
Extracellular Magnesium Ion Concentration
Integration of Renal Mechanisms for 373(1)
Control of Extracellular Fluid
Sodium Excretion Is Precisely Matched 373(1)
to Intake Under Steady-State Conditions
Sodium Excretion Is Controlled by 374(1)
Altering Glomerular Filtration or
Tubular Sodium Reabsorption Rates
Importance of Pressure Natriuresis and 374(2)
Pressure Diuresis in Maintaining Body
Sodium and Fluid Balance
Pressure Natriuresis and Diuresis Are 375(1)
Key Components of a Renal-Body Fluid
Feedback for Regulating Body Fluid
Volumes and Arterial Pressure
Precision of Blood Volume and 376(1)
Extracellular Fluid Volume Regulation
Distribution of Extracellular Fluid 376(1)
Between the Interstitial Spaces and
Vascular System
Nervous and Hormonal Factors Increase the 377(3)
Effectiveness of Renal-Body Fluid
Feedback Control
Sympathetic Nervous System Control of 377(1)
Renal Excretion: Arterial Baroreceptor
and Low-Pressure Stretch Receptor
Reflexes
Role of Angiotensin II in Controlling 377(1)
Renal Excretion
Role of Aldosterone in Controlling 378(1)
Renal Excretion
Role of ADH in Controlling Renal Water 379
Excretion
Role of Atrial Natriuretic Peptide in 378(2)
Controlling Renal Excretion
Integrated Responses to Changes in Sodium 380(1)
Intake
Conditions That Cause Large Increases in 380(1)
Blood Volume and Extracellular Fluid
Volume
Increased Blood Volume and 380(1)
Extracellular Fluid Volume Caused by
Heart Diseases
Increased Blood Volume Caused by 380(1)
Increased Capacity of Circulation
Conditions That Cause Large Increases in 381(2)
Extracellular Fluid Volume but with
Normal Blood Volume
Nephrotic Syndrome---Loss of Plasma 381(1)
Proteins in Urine and Sodium Retention
by the Kidneys
Liver Cirrhosis---Decreased Synthesis 381(2)
of Plasma Proteins by the Liver and
Sodium Retention by the Kidneys
Regulation of Acid-Base Balance 383(19)
Hydrogen Ion Concentration Is Precisely 383(1)
Regulated
Acids and Bases---Their Definitions and 383(1)
Meanings
Defenses Against Changes in Hydrogen Ion 384(1)
Concentration: Buffers, Lungs, and Kidneys
Buffering of Hydrogen Ions in the Body 385(1)
Fluids
Bicarbonate Buffer System 385(2)
Quantitative Dynamics of the 385(2)
Bicarbonate Buffer System
Phosphate Buffer System 387(1)
Proteins: Important Intracellular Buffers 387(1)
Respiratory Regulation of Acid-Base 388(2)
Balance
Pulmonary Expiration of CO2 Balances 388(1)
Metabolic Formation of CO2
Increasing Alveolar Ventilation 388(1)
Decreases Extracellular Fluid Hydrogen
Ion Concentration and Raises pH
Increased Hydrogen Ion Concentration 389(1)
Stimulates Alveolar Ventilation
Renal Control of Acid-Base Balance 390(1)
Secretion of Hydrogen Ions and 390(2)
Reabsorption of Bicarbonate Ions by the
Renal Tubules
Hydrogen Ions Are Secreted by Secondary 391(1)
Active Transport in the Early Tubular
Segments
Filtered Bicarbonate Ions Are 391(1)
Reabsorbed by Interaction with Hydrogen
Ions in the Tubules
Primary Active Secretion of Hydrogen 392(1)
Ions in the Intercalated Cells of Late
Distal and Collecting Tubules
Combination of Excess Hydrogen Ions with 392(2)
Phosphate and Ammonia Buffers in the
Tubule---A Mechanism for Generating
``New'' Bicarbonate Ions
Phosphate Buffer System Carries Excess 393(1)
Hydrogen Ions into the Urine and
Generates New Bicarbonate
Excretion of Excess Hydrogen Ions and 393(1)
Generation of New Bicarbonate by the
Ammonia Buffer System
Quantifying Renal Acid-Base Excretion 394(2)
Regulation of Renal Tubular Hydrogen 395(1)
Ion Secretion
Renal Correction of Acidosis---Increased 396(1)
Excretion of Hydrogen Ions and Addition
of Bicarbonate Ions to the Extracellular
Fluid
Acidosis Decreases the Ratio of 396(1)
HCO3-/H+ in Renal Tubular Fluid
Renal Correction of Alkalosis---Decreased 396(1)
Tubular Secretion of Hydrogen Ions and
Increased Excretion of Bicarbonate Ions
Alkalosis Increases the Ratio of 396(1)
HCO3-/H+ in Renal Tubular Fluid
Clinical Causes of Acid-Base Disorders 397(1)
Respiratory Acidosis Is Caused by 397(1)
Decreased Ventilation and Increased PCO2
Respiratory Alkalosis Results from 397(1)
Increased Ventilation and Decreased PCO2
Metabolic Acidosis Results from 397(1)
Decreased Extracellular Fluid
Bicarbonate Concentration
Treatment of Acidosis or Alkalosis 398(1)
Clinical Measurements and Analysis of 398(4)
Acid-Base Disorders
Complex Acid-Base Disorders and Use of 399(1)
the Acid-Base Nomogram for Diagnosis
Use of Anion Gap to Diagnose Acid-Base 400(2)
Disorders
Kidney Diseases and Diuretics 402(17)
Diuretics and Their Mechanisms of Action 402(2)
Osmotic Diuretics Decrease Water 402(1)
Reabsorption by Increasing Osmotic
Pressure of Tubular Fluid
``Loop'' Diuretics Decrease Active 403(1)
Sodium-Chloride-Potassium Reabsorption
in the Thick Ascending Loop of Henle
Thiazide Diuretics Inhibit 404(1)
Sodium-Chloride Reabsorption in the
Early Distal Tubule
Carbonic Anhydrase Inhibitors Block 404(1)
Sodium-Bicarbonate Reabsorption in the
Proximal Tubules
Competitive Inhibitors of Aldosterone 404(1)
Decrease Sodium Reabsorption from and
Potassium Secretion into the Cortical
Collecting Tubule
Diuretics That Block Sodium Channels in 404(1)
the Collecting Tubules Decrease Sodium
Reabsorption
Kidney Diseases 404(1)
Acute Renal Failure 404(2)
Prerenal Acute Renal Failure Caused by 405(1)
Decreased Blood Flow to the Kidney
Intrarenal Acute Renal Failure Caused 405(1)
by Abnormalities within the Kidney
Postrenal Acute Renal Failure Caused by 406(1)
Abnormalities of the Lower Urinary Tract
Physiologic Effects of Acute Renal 406(1)
Failure
Chronic Renal Failure: An Irreversible 406(7)
Decrease in the Number of Functional
Nephrons
Vicious Circle of Chronic Renal Failure 407(1)
Leading to End-Stage Renal Disease
Injury to the Renal Vasculature as a 408(1)
Cause of Chronic Renal Failure
Injury to the Glomeruli as a Cause of 408(1)
Chronic Renal
Failure---Glomerulonephritis
Injury to the Renal Interstitium as a 409(1)
Cause of Chronic Renal
Failure---Pyelonephritis
Nephrotic Syndrome---Excretion of 409(1)
Protein in the Urine Because of
Increased Glomerular Permeability
Nephron Function in Chronic Renal 409(2)
Failure
Effects of Renal Failure on the Body 411(1)
Fluids---Uremia
Hypertension and Kidney Disease 412(1)
Specific Tubular Disorders 413(1)
Treatment of Renal Failure by Dialysis 414(5)
with an Artificial Kidney
UNIT VI Blood Cells, Immunity, and Blood
Clotting
Red Blood Cells, Anemia, and Polycythemia 419(10)
Red Blood Cells (Erythrocytes) 419(7)
Production of Red Blood Cells 420(4)
Formation of Hemoglobin 424(1)
Iron Metabolism 425(1)
Life Span and Destruction of Red Blood 426(1)
Cells
Anemias 426(1)
Effects of Anemia on Function of the 427(1)
Circulatory System
Polycythemia 427(2)
Effect of Polycythemia on Function of 428(1)
the Circulatory System
Resistance of the Body to Infection: I. 429(10)
Leukocytes, Granulocytes, the
Monocyte-Macrophage System, and Inflammation
Leukocytes (White Blood Cells) 429(2)
General Characteristics of Leukocytes 429(1)
Genesis of the White Blood Cells 430(1)
Life Span of the White Blood Cells 431(1)
Neutrophils and Macrophages Defend 431(1)
Against Infections
Phagocytosis 431(1)
Monocyte-Macrophage Cell System 432(2)
(Reticuloendothelial System)
Inflammation: Role of Neutrophils and 434(2)
Macrophages
Inflammation 434(1)
Macrophage and Neutrophil Responses 434(2)
During Inflammation
Eosinophils 436(1)
Basophils 436(1)
Leukopenia 436(1)
The Leukemias 437(2)
Effects of Leukemia on the Body 437(2)
Resistance of the Body to Infection: II. 439(12)
Immunity and Allergy
Innate Immunity 439(1)
Acquired (Adaptive) Immunity 439(10)
Basic Types of Acquired Immunity 440(1)
Both Types of Acquired Immunity Are 440(1)
Initiated by Antigens
Lymphocytes Are Responsible for 440(1)
Acquired Immunity
Preprocessing of the T and B Lymphocytes 440(2)
T Lymphocytes and B-Lymphocyte 442(1)
Antibodies React Highly Specifically
Against Specific Antigens---Role of
Lymphocyte Clones
Origin of the Many Clones of Lymphocytes 442(1)
Specific Attributes of the B-Lymphocyte 443(3)
System---Humoral Immunity and the
Antibodies
Special Attributes of the T-Lymphocyte 446(1)
System---Activated T Cells and
Cell-Mediated Immunity
Several Types of T Cells and Their 446(2)
Different Functions
Tolerance of the Acquired Immunity 448(1)
System to One's Own Tissues---Role of
Preprocessing in the Thymus and Bone
Marrow
Immunization by Injection of Antigens 448(1)
Passive Immunity 449(1)
Allergy and Hypersensitivity 449(2)
Allergy Caused by Activated T Cells: 449(1)
Delayed-Reaction Allergy
Allergies in the ``Allergic'' Person, 449(2)
Who Has Excess IgE Antibodies
Blood Types; Transfusion; Tissue and Organ 451(6)
Transplantation
Antigenicity Causes Immune Reactions of 451(1)
Blood
O-A-B Blood Types 451(2)
A and B Antigens---Agglutinogens 451(1)
Agglutinins 452(1)
Agglutination Process In Transfusion 452(1)
Reactions
Blood Typing 453(1)
Rh Blood Types 453(2)
Rh Immune Response 453(1)
Transfusion Reactions Resulting from 454(1)
Mismatched Blood Types
Transplantation of Tissues and Organs 455(2)
Attempts to Overcome Immune Reactions 455(2)
in Transplanted Tissue
Hemostasis and Blood Coagulation 457(14)
Events in Hemostasis 457(2)
Vascular Constriction 457(1)
Formation of the Platelet Plug 457(1)
Blood Coagulation in the Ruptured Vessel 458(1)
Fibrous Organization or Dissolution of 458(1)
the Blood Clot
Mechanism of Blood Coagulation 459(5)
Conversion of Prothrombin to Thrombin 459(1)
Conversion of Fibrinogen to 460(1)
Fibrin---Formation of the Clot
Vicious Circle of Clot Formation 460(1)
Initiation of Coagulation: Formation of 461(2)
Prothrombin Activator
Prevention of Blood Clotting in the 463(1)
Normal Vascular System---Intravascular
Anticoagulants
Lysis of Blood Clots---Plasmin 464(1)
Conditions That Cause Excessive Bleeding 464(1)
in Human Beings
Decreased Prothrombin, Factor VII, 464(1)
Factor IX, and Factor X Caused by
Vitamin K Deficiency
Hemophilia 465(1)
Thrombocytopenia 465(1)
Thromboembolic Conditions in the Human 465(1)
Being
Femoral Venous Thrombosis and Massive 466(1)
Pulmonary Embolism
Disseminated Intravascular Coagulation 466(1)
Anticoagulants for Clinical Use 466(1)
Heparin as an Intravenous Anticoagulant 466(1)
Coumarins as Anticoagulants 466(1)
Prevention of Blood Coagulation Outside 466(1)
the Body
Blood Coagulation Tests 467(4)
Bleeding Time 467(1)
Clotting Time 467(1)
Prothrombin Time 467(4)
UNIT VII Respiration
Pulmonary Ventilation 471(12)
Mechanics of Pulmonary Ventilation 471(4)
Muscles That Cause Lung Expansion and 471(1)
Contraction
Movement of Air In and Out of the Lungs 472(2)
and the Pressures That Cause the
Movement
Effect of the Thoracic Cage on Lung 474(1)
Expansibility
Pulmonary Volumes and Capacities 475(2)
Recording Changes in Pulmonary 475(1)
Volume---Spirometry
Abbreviations and Symbols Used in 476(1)
Pulmonary Function Tests
Determination of Functional Residual 476(1)
Capacity, Residual Volume, and Total
Lung Capacity---Helium Dilution Method
Minute Respiratory Volume Equals 477(1)
Respiratory Rate Times Tidal Volume
Alveolar Ventilation 477(1)
``Dead Space'' and Its Effect on 477(1)
Alveolar Ventilation
Rate of Alveolar Ventilation 478(1)
Functions of the Respiratory Passageways 478(5)
Trachea, Bronchi, and Bronchioles 478(2)
Normal Respiratory Functions of the Nose 480(3)
Pulmonary Circulation, Pulmonary Edema, 483(8)
Pleural Fluid
Physiologic Anatomy of the Pulmonary 483(1)
Circulatory System
Pressures in the Pulmonary System 483(1)
Blood Volume of the Lungs 484(1)
Blood Flow Through the Lungs and Its 485(1)
Distribution
Effect of Hydrostatic Pressure Gradients 485(2)
in the Lungs on Regional Pulmonary Blood
Flow
Zones 1, 2, and 3 of Pulmonary Blood 485(1)
Flow
Effect of Increased Cardiac Output on 486(1)
Pulmonary Blood Flow and Pulmonary
Arterial Pressure During Heavy Exercise
Function of the Pulmonary Circulation 487(1)
When the Left Atrial Pressure Rises as
a Result of Left-Sided Heart Failure
Pulmonary Capillary Dynamics 487(2)
Capillary Exchange of Fluid in the 487(1)
Lungs, and Pulmonary Interstitial Fluid
Dynamics
Pulmonary Edema 488(1)
Fluid in the Pleural Cavity 489(2)
Physical Principles of Gas Exchange; 491(11)
Diffusion of Oxygen and Carbon Dioxide
Through the Respiratory Membrane
Physics of Gas Diffusion and Gas Partial 491(2)
Pressures
Molecular Basis of Gas Diffusion 491(1)
Gas Pressures in a Mixture of 491(1)
Gases---``Partial Pressures'' of
Individual Gases
Pressures of Gases Dissolved in Water 492(1)
and Tissues
Vapor Pressure of Water 492(1)
Diffusion of Gases Through 493(1)
Fluids---Pressure Difference Causes Net
Diffusion
Diffusion of Gases Through Tissues 493(1)
Composition of Alveolar Air---Its 493(3)
Relation to Atmospheric Air
Rate at Which Alveolar Air Is Renewed 494(1)
by Atmospheric Air
Oxygen Concentration and Partial 494(1)
Pressure in the Alveoli
CO2 Concentration and Partial Pressure 495(1)
in the Alveoli
Expired Air 495(1)
Diffusion of Gases Through the 496(3)
Respiratory Membrane
Factors That Affect the Rate of Gas 498(1)
Diffusion Through the Respiratory
Membrane
Diffusing Capacity of the Respiratory 498(1)
Membrane
Effect of the Ventilation-Perfusion Ratio 499(3)
on Alveolar Gas Concentration
PO2-PCO2, VA/Q Diagram 500(1)
Concept of the ``Physiological Shunt'' 500(1)
(When VA/Q Is Greater Than Normal)
Abnormalities of Ventilation-Perfusion 501(1)
Ratio
Transport of Oxygen and Carbon Dioxide in 502(12)
Blood and Tissue Fluids
Transport of Oxygen from the Lungs to the 502(8)
Body Tissues
Diffusion of Oxygen from the Alveoli to 502(1)
the Pulmonary Capillary Blood
Transport of Oxygen in the Arterial 503(1)
Blood
Diffusion of Oxygen from the Peripheral 503(1)
Capillaries into the Tissue Fluid
Diffusion of Oxygen from the Peripheral 504(1)
Capillaries to the Tissue Cells
Diffusion of Carbon Dioxide from the 504(1)
Peripheral Tissue Cells into the
Capillaries and from the Pulmonary
Capillaries into the Alveoli
Role of Hemoglobin in Oxygen Transport 505(1)
Reversible Combination of Oxygen with 505(2)
Hemoglobin
Effect of Hemoglobin to ``Buffer'' the 507(1)
Tissue PO2
Factors That Shift the 507(1)
Oxygen-Hemoglobin Dissociation
Curve---Their Importance for Oxygen
Transport
Metabolic Use of Oxygen by the Cells 508(1)
Transport of Oxygen in the Dissolved 509(1)
State
Combination of Hemoglobin with Carbon 509(1)
Monoxide---Displacement of Oxygen
Transport of Carbon Dioxide in the Blood 510(2)
Chemical Forms In Which Carbon Dioxide 510(1)
Is Transported
Carbon Dioxide Dissociation Curve 511(1)
When Oxygen Binds with Hemoglobin, 511(1)
Carbon Dioxide Is Released (the Haldane
Effect) to Increase CO2 Transport
Change in Blood Acidity During Carbon 512(1)
Dioxide Transport
Respiratory Exchange Ratio 512(2)
Regulation of Respiration 514(10)
Respiratory Center 514(2)
Dorsal Respiratory Group of 514(1)
Neurons---Its Control of Inspiration
and of Respiratory Rhythm
A Pneumotaxic Center Limits the 514(1)
Duration of Inspiration and Increases
the Respiratory Rate
Ventral Respiratory Group of 515(1)
Neurons---Functions in Both Inspiration
and Expiration
Lung Inflation Signals Limit 515(1)
Inspiration---The Hering-Breuer
Inflation Reflex
Control of Overall Respiratory Center 516(1)
Activity
Chemical Control of Respiration 516(2)
Direct Chemical Control of Respiratory 516(2)
Center Activity by Carbon Dioxide and
Hydrogen Ions
Peripheral Chemoreceptor System for 518(2)
Control of Respiratory Activity---Role of
Oxygen in Respiratory Control
Effect of Low Arterial PO2 to Stimulate 519(1)
Alveolar Ventilation When Arterial
Carbon Dioxide and Hydrogen Ion
Concentrations Remain Normal
Chronic Breathing of Low Oxygen 519(1)
Stimulates Respiration Even More---The
Phenomenon of ``Acclimatization''
Composite Effects of PCO2, pH, and PO2 519(1)
on Alveolar Ventilation
Regulation of Respiration During Exercise 520(1)
Other Factors That Affect Respiration 521(3)
Sleep Apnea 522(2)
Respiratory 524(13)
Insufficiency---Pathophysiology, Diagnosis,
Oxygen Therapy
Useful Methods for Studying Respiratory 524(1)
Abnormalities
Study of Blood Gases and Blood pH 524(1)
Measurement of Maximum Expiratory Flow 525(1)
Forced Expiratory Vital Capacity and 526(1)
Forced Expiratory Volume
Physiologic Peculiarities of Specific 526(4)
Pulmonary Abnormalities
Chronic Pulmonary Emphysema 526(1)
Pneumonia 527(1)
Atelectasis 528(1)
Asthma 529(1)
Tuberculosis 530(1)
Hypoxia and Oxygen Therapy 530(1)
Oxygen Therapy in Different Types of 530(1)
Hypoxia
Cyanosis 531(1)
Hypercapnia 531(1)
Dyspnea 532(1)
Artificial Respiration 532(5)
UNIT VIII Aviation, Space, and Deep-Sea
Diving Physiology
Aviation, High-Altitude, and Space 537(8)
Physiology
Effects of Low Oxygen Pressure on the Body 537(4)
Alveolar PO2 at Different Elevations 537(1)
Effect of Breathing Pure Oxygen on 538(1)
Alveolar PO2 at Different Altitudes
Acute Effects of Hypoxia 538(1)
Acclimatization to Low PO2 539(1)
Natural Acclimatization of Native Human 540(1)
Beings Living at High Altitudes
Reduced Work Capacity at High Altitudes 540(1)
and Positive Effect of Acclimatization
Acute Mountain Sickness and 540(1)
High-Altitude Pulmonary Edema
Chronic Mountain Sickness 541(1)
Effects of Acceleratory Forces on the 541(2)
Body in Aviation and Space Physiology
Centrifugal Acceleratory Forces 541(1)
Effects of Linear Acceleratory Forces 542(1)
on the Body
``Artificial Climate'' in the Sealed 543(1)
Spacecraft
Weightlessness in Space 543(2)
Physiology of Deep-Sea Diving and Other 545(10)
Hyperbaric Conditions
Effect of High Partial Pressures of 545(4)
Individual Gases on the Body
Nitrogen Narcosis at High Nitrogen 545(1)
Pressures
Oxygen Toxicity at High Pressures 546(1)
Carbon Dioxide Toxicity at Great Depths 547(1)
in the Sea
Decompression of the Diver After Excess 547(2)
Exposure to High Pressure
Scuba (Self-Contained Underwater 549(1)
Breathing Apparatus) Diving
Special Physiologic Problems in Submarines 550(1)
Hyperbaric Oxygen Therapy 550(5)
UNIT IX The Nervous System: A. General
Principles and Sensory Physiology
Organization of the Nervous System, Basic 555(17)
Functions of Synapses, ``Transmitter
Substances''
General Design of the Nervous System 555(2)
Central Nervous System Neuron: The 555(1)
Basic Functional Unit
Sensory Part of the Nervous 555(1)
System---Sensory Receptors
Motor Part of the Nervous 556(1)
System---Effectors
Processing of 556(1)
Information---``Integrative'' Function
of the Nervous System
Storage of Information---Memory 557(1)
Major Levels of Central Nervous System 557(1)
Function
Spinal Cord Level 557(1)
Lower Brain or Subcortical Level 558(1)
Higher Brain or Cortical Level 558(1)
Comparison of the Nervous System with a 558(1)
Computer
Central Nervous System Synapses 559(11)
Types of Synapses---Chemical and 559(1)
Electrical
Physiologic Anatomy of the Synapse 559(3)
Chemical Substances That Function as 562(2)
Synaptic Transmitters
Electrical Events During Neuronal 564(2)
Excitation
Electrical Events During Neuronal 566(2)
Inhibition
Special Functions of Dendrites for 568(1)
Exciting Neurons
Relation of State of Excitation of the 569(1)
Neuron to Rate of Firing
Some Special Characteristics of Synaptic 570(2)
Transmission
Sensory Receptors, Neuronal Circuits for 572(13)
Processing Information
Types of Sensory Receptors and the 572(1)
Sensory Stimuli They Detect
Differential Sensitivity of Receptors 572(1)
Transduction of Sensory Stimuli into 573(3)
Nerve Impulses
Local Electrical Currents at Nerve 573(2)
Endings---Receptor Potentials
Adaptation of Receptors 575(1)
Nerve Fibers That Transmit Different 576(1)
Types of Signals, and Their Physiologic
Classification
Transmission of Signals of Different 577(1)
Intensity in Nerve Tracts---Spatial and
Temporal Summation
Transmission and Processing of Signals in 578(5)
Neuronal Pools
Relaying of Signals Through Neuronal 579(2)
Pools
Prolongation of a Signal by a Neuronal 581(2)
Pool---``Afterdischarge''
Instability and Stability of Neuronal 583(2)
Circuits
Inhibitory Circuits as a Mechanism for 583(1)
Stabilizing Nervous System Function
Synaptic Fatigue as a Means for 583(2)
Stabilizing the Nervous System
Somatic Sensations: I. General 585(13)
Organization, the Tactile and Position
Senses
Classification of Somatic Senses 585(1)
Detection and Transmission of Tactile 585(2)
Sensations
Detection of Vibration 587(1)
Tickle and Itch 587(1)
Sensory Pathways for Transmitting Somatic 587(1)
Signals into the Central Nervous System
Dorsal Column--Medial Lemniscal System 588(1)
Anterolateral System 588(1)
Transmission in the Dorsal 588(7)
Column---Medial Lemniscal System
Anatomy of the Dorsal Column---Medial 588(1)
Lemniscal System
Somatosensory Cortex 589(3)
Somatosensory Association Areas 592(1)
Overall Characteristics of Signal 592(2)
Transmission and Analysis in the Dorsal
Column--Medial Lemniscal System
Position Senses 594
Interpretation of Sensory Stimulus 593(1)
Intensity
Judgment of Stimulus Intensity 594(1)
Position Senses 594(1)
Transmission of Less Critical Sensory 595(1)
Signals in the Anterolateral Pathway
Anatomy of the Anterolateral Pathway 595(1)
Some Special Aspects of Somatosensory 596(2)
Function
Function of the Thalamus in Somatic 596(1)
Sensation
Cortical Control of Sensory 597(1)
Sensitivity---``Corticofugal'' Signals
Segmental Fields of Sensation---The 597(1)
Dermatomes
Somatic Sensations: II. Pain, Headache, and 598(15)
Thermal Sensations
Types of Pain and Their Qualities---Fast 598(1)
Pain and Slow Pain
Pain Receptors and Their Stimulation 598(2)
Rate of Tissue Damage as a Stimulus for 599(1)
Pain
Dual Pathways for Transmission of Pain 600(2)
Signals into the Central Nervous System
Dual Pain Pathways in the Cord and 600(2)
Brain Stem---The Neospinothalamic Tract
and the Paleospinothalamic Tract
Pain Suppression (``Analgesia'') System 602(1)
in the Brain and Spinal Cord
Brain's Opiate System---Endorphins and 602(1)
Enkephalins
Inhibition of Pain Transmission by 603(1)
Simultaneous Tactile Sensory Signals
Treatment of Pain by Electrical 603(1)
Stimulation
Referred Pain 603(1)
Visceral Pain 603(2)
Causes of True Visceral Pain 604(1)
``Parietal Pain'' Caused by Visceral 604(1)
Disease
Localization of Visceral 604(1)
Pain---``Visceral'' and the
``Parietal'' Pain Transmission Pathways
Some Clinical Abnormalities of Pain and 605(1)
Other Somatic Sensations
Hyperalgesia 605(1)
Herpes Zoster (Shingles) 605(1)
Tic Douloureux 605(1)
Brown-Sequard Syndrome 606(1)
Headache 606(1)
Headache of Intracranial Origin 606(1)
Thermal Sensations 607(6)
Thermal Receptors and Their Excitation 607(2)
Transmission of Thermal Signals in the 609(4)
Nervous System
UNIT X The Nervous System: B. The Special
Senses
The Eye: I. Optics of Vision 613(13)
Physical Principles of Optics 613(4)
Refraction of Light 613(1)
Application of Refractive Principles to 613(2)
Lenses
Focal Length of a Lens 615(1)
Formation of an Image by a Convex Lens 616(1)
Measurement of the Refractive Power of 616(1)
a Lens---``Diopter''
Optics of the Eye 617(5)
The Eye as a Camera 617(1)
Mechanism of ``Accommodation'' 617(1)
Pupillary Diameter 618(1)
Errors of Refraction 619(2)
Visual Acuity 621(1)
Determination of Distance of an Object 621(1)
from the Eye---``Depth Perception''
Ophthalmoscope 622(1)
Fluid System of the Eye---Intraocular 623(3)
Fluid
Formation of Aqueous Humor by the 623(1)
Ciliary Body
Outflow of Aqueous Humor from the Eye 623(1)
Intraocular Pressure 624(2)
The Eye: II. Receptor and Neural Function 626(14)
of the Retina
Anatomy and Function of the Structural 626(2)
Elements of the Retina
Photochemistry of Vision 628(4)
Rhodopsin-Retinal Visual Cycle, and 629(2)
Excitation of the Rods
Automatic Regulation of Retinal 631(1)
Sensitivity---Light and Dark Adaptation
Color Vision 632(1)
Tricolor Mechanism of Color Detection 632(1)
Color Blindness 633(1)
Neural Function of the Retina 633(7)
Neural Circuitry of the Retina 633(3)
Ganglion Cells and Optic Nerve Fibers 636(1)
Excitation of the Ganglion Cells 637(3)
The Eye: III. Central Neurophysiology of 640(11)
Vision
Visual Pathways 640(1)
Function of the Dorsal Lateral 640(1)
Geniculate Nucleus of the Thalamus
Organization and Function of the Visual 641(2)
Cortex
Layered Structure of the Primary Visual 642(1)
Cortex
Two Major Pathways for Analysis of 643(1)
Visual Information---(1) The Fast
``Position'' and ``Motion'' Pathway;
(2) The Accurate Color Pathway
Neuronal Patterns of Stimulation During 643(1)
Analysis of the Visual Image
Detection of Color 644(1)
Effect of Removing the Primary Visual 644(1)
Cortex
Fields of Vision; Perimetry 644(1)
Eye Movements and Their Control 645(3)
Fixation Movements of the Eyes 645(2)
``Fusion'' of the Visual Images from 647(1)
the Two Eyes
Autonomic Control of Accommodation and 648(3)
Pupillary Aperture
Control of Accommodation (Focusing the 649(1)
Eyes)
Control of Pupillary Diameter 649(2)
The Sense of Hearing 651(12)
Tympanic Membrane and the Ossicular System 651(1)
Conduction of Sound from the Tympanic 651(1)
Membrane to the Cochlea
Transmission of Sound Through Bone 652(1)
Cochlea 652(5)
Functional Anatomy of the Cochlea 652(2)
Transmission of Sound Waves in the 654(1)
Cochlea---``Traveling Wave''
Function of the Organ of Corti 655(1)
Determination of Sound Frequency---The 656(1)
``Place'' Principle
Determination of Loudness 656(1)
Central Auditory Mechanisms 657(3)
Auditory Nervous Pathways 657(1)
Function of the Cerebral Cortex in 658(2)
Hearing
Determination of the Direction from 660(1)
Which Sound Comes
Centrifugal Signals from the Central 660(1)
Nervous System to Lower Auditory Centers
Hearing Abnormalities 660(3)
Types of Deafness 660(3)
The Chemical Senses---Taste and Smell 663(10)
Sense of Taste 663(4)
Primary Sensations of Taste 663(1)
Taste Bud and Its Function 664(1)
Transmission of Taste Signals into the 665(1)
Central Nervous System
Taste Preference and Control of the Diet 666(1)
Sense of Smell 667(6)
Olfactory Membrane 667(1)
Stimulation of the Olfactory Cells 667(1)
Transmission of Smell Signals into the 668(5)
Central Nervous System
UNIT XI The Nervous System: C. Motor and
Integrative Neurophysiology
Motor Functions of the Spinal Cord; the 673(12)
Cord Reflexes
Organization of the Spinal Cord for Motor 673(2)
Functions
Muscle Sensory Receptors---Muscle 675(5)
Spindles and Golgi Tendon Organs---And
Their Roles in Muscle Control
Receptor Function of the Muscle Spindle 675(1)
Muscle Stretch Reflex 676(2)
Role of the Muscle Spindle in Voluntary 678(1)
Motor Activity
Clinical Applications of the Stretch 678(1)
Reflex
Golgi Tendon Reflex 679(1)
Function of the Muscle Spindles and 680(1)
Golgi Tendon Organs in Conjunction with
Motor Control from Higher Levels of the
Brain
Flexor Reflex and the Withdrawal Reflexes 680(1)
Crossed Extensor Reflex 681(1)
Reciprocal Inhibition and Reciprocal 681(1)
Innervation
Reflexes of Posture and Locomotion 682(1)
Postural and Locomotive Reflexes of the 682(1)
Cord
Scratch Reflex 683(1)
Spinal Cord Reflexes That Cause Muscle 683(1)
Spasm
Autonomic Reflexes in the Spinal Cord 683(1)
Spinal Cord Transection and Spinal Shock 684(1)
Cortical and Brain Stem Control of Motor 685(13)
Function
Motor Cortex and Corticospinal Tract 685(6)
Primary Motor Cortex 685(1)
Premotor Area 686(1)
Supplementary Motor Area 686(1)
Some Specialized Areas of Motor Control 686(1)
Found in the Human Motor Cortex
Transmission of Signals from the Motor 687(1)
Cortex to the Muscles
Incoming Fiber Pathways to the Motor 688(1)
Cortex
Red Nucleus Serves as an Alternative 688(1)
Pathway for Transmitting Cortical
Signals to the Spinal Cord
``Extrapyramidal'' System 689(1)
Excitation of the Spinal Cord Motor 689(2)
Control Areas by the Primary Motor
Cortex and Red Nucleus
Role of the Brain Stem in Controlling 691(1)
Motor Function
Support of the Body Against 691(1)
Gravity---Roles of the Reticular and
Vestibular Nuclei
Vestibular Sensations and Maintenance of 692(5)
Equilibrium
Vestibular Apparatus 692(2)
Function of the Utricle and Saccule in 694(1)
the Maintenance of Static Equilibrium
Detection of Head Rotation by the 695(1)
Semicircular Ducts
Vestibular Mechanisms for Stabilizing 696(1)
the Eyes
Other Factors Concerned with Equilibrium 696(1)
Functions of Brain Stem Nuclei in 697(1)
Controlling Subconscious, Stereotyped
Movements
Contributions of the Cerebellum and Basal 698(16)
Ganglia to Overall Motor Control
Cerebellum and Its Motor Functions 698(9)
Anatomical Functional Areas of the 699(1)
Cerebellum
Neuronal Circuit of the Cerebellum 700(3)
Function of the Cerebellum in Overall 703(3)
Motor Control
Clinical Abnormalities of the Cerebellum 706(1)
Basal Ganglia---Their Motor Functions 707(5)
Function of the Basal Ganglia In 708(1)
Executing Patterns of Motor
Activity---The Putamen Circuit
Role of the Basal Ganglia for Cognitive 709(1)
Control of Sequences of Motor
Patterns---The Caudate Circuit
Function of the Basal Ganglia to Change 709(1)
the Timing and to Scale the Intensity
of Movements
Functions of Specific Neurotransmitter 710(2)
Substances in the Basal Ganglial System
Integration of the Many Parts of the 712(2)
Total Motor Control System
Spinal Level 712(1)
Hindbrain Level 712(1)
Motor Cortex Level 712(1)
What Drives Us to Action? 713(1)
Cerebral Cortex, Intellectual Functions of 714(14)
the Brain, Learning and Memory
Physiologic Anatomy of the Cerebral Cortex 714(1)
Functions of Specific Cortical Areas 715(5)
Association Areas 716(2)
Comprehensive Interpretative Function 718(1)
of the Posterior Superior Temporal
Lobe---``Wernicke's Area'' (a General
Interpretative Area)
Functions of the 719(1)
Parieto-occipitotemporal Cortex in the
Nondominant Hemisphere
Higher Intellectual Functions of the 719(1)
Prefrontal Association Areas
Function of the Brain in 720(2)
Communication---Language Input and
Language Output
Function of the Corpus Callosum and 722(1)
Anterior Commissure to Transfer Thoughts,
Memories, Training, and Other Information
Between the Two Cerebral Hemispheres
Thoughts, Consciousness, and Memory 723(5)
Memory---Roles of Synaptic Facilitation 723(1)
and Synaptic Inhibition
Short-Term Memory 724(1)
Intermediate Long-Term Memory 724(1)
Long-Term Memory 725(1)
Consolidation of Memory 725(3)
Behavioral and Motivational Mechanisms of 728(11)
the Brain---The Limbic System and the
Hypothalamus
Activating-Driving Systems of the Brain 728(3)
Control of Cerebral Activity by 728(2)
Continuous Excitatory Signals from the
Brain Stem
Neurohormonal Control of Brain Activity 730(1)
Limbic System 731(1)
Functional Anatomy of the Limbic System; 731(1)
Key Position of the Hypothalamus
Hypothalamus, a Major Control 732(4)
Headquarters for the Limbic System
Vegetative and Endocrine Control 733(1)
Functions of the Hypothalamus
Behavioral Functions of the 734(1)
Hypothalamus and Associated Limbic
Structures
``Reward'' and ``Punishment'' Function 735(1)
of the Limbic System
Importance of Reward or Punishment in 736(1)
Behavior
Specific Functions of Other Parts of the 736(3)
Limbic System
Functions of the Hippocampus 736(1)
Functions of the Amygdala 737(1)
Function of the Limbic Cortex 738(1)
States of Brain Activity---Sleep, Brain 739(9)
Waves, Epilepsy, Psychoses
Sleep 739(2)
Slow-Wave Sleep 739(1)
REM Sleep (Paradoxical Sleep, 740(1)
Desynchronized Sleep)
Basic Theories of Sleep 740(1)
Physiologic Effects of Sleep 741(1)
Brain Waves 741(2)
Origin of Brain Waves 742(1)
Effect of Varying Levels of Cerebral 743(1)
Activity on the Frequency of the EEG
Changes in the EEG at Different Stages 743(1)
of Wakefulness and Sleep
Epilepsy 743(2)
Grand Mal Epilepsy 743(1)
Petit Mal Epilepsy 744(1)
Focal Epilepsy 744(1)
Psychotic Behavior and Dementia---Roles 745(3)
of Specific Neurotransmitter Systems
Depression and Manic-Depressive 745(1)
Psychoses---Decreased Activity of the
Norepinephrine and Serotonin
Neurotransmitter Systems
Schizophrenia---Possible Exaggerated 745(1)
Function of Part of the Dopamine System
Alzheimer's Disease---Amyloid Plaques 746(2)
and Depressed Memory
The Autonomic Nervous System and the 748(13)
Adrenal Medulla
General Organization of the Autonomic 748(2)
Nervous System
Physiologic Anatomy of the Sympathetic 748(1)
Nervous System
Preganglionic and Postganglionic 748(2)
Sympathetic Neurons
Physiologic Anatomy of the 750(1)
Parasympathetic Nervous System
Basic Characteristics of Sympathetic and 750(7)
Parasympathetic Function
Cholinergic and Adrenergic 750(2)
Fibers---Secretion of Acetylcholine or
Norepinephrine
Receptors on the Effector Organs 752(1)
Excitatory and Inhibitory Actions of 753(1)
Sympathetic and Parasympathetic
Stimulation
Effects of Sympathetic and 753(2)
Parasympathetic Stimulation on Specific
Organs
Function of the Adrenal Medullae 755(1)
Relation of Stimulus Rate to Degree of 756(1)
Sympathetic and Parasympathetic Effect
Sympathetic and Parasympathetic ``Tone'' 756(1)
Denervation Supersensitivity of 756(1)
Sympathetic and Parasympathetic Organs
after Denervation
Autonomic Reflexes 757(1)
Stimulation of Discrete Organs in Some 757(2)
Instances and Mass Stimulation in Other
Instances by the Sympathetic and
Parasympathetic Systems
``Alarm'' or ``Stress'' Response of the 758(1)
Sympathetic Nervous System
Medullary, Pontine, and Mesencephalic 758(1)
Control of the Autonomic Nervous System
Pharmacology of the Autonomic Nervous 759(2)
System
Drugs That Act on Adrenergic Effector 759(1)
Organs---Sympathomimetic Drugs
Drugs That Act on Cholinergic Effector 759(1)
Organs
Drugs That Stimulate or Block 759(2)
Sympathetic and Parasympathetic
Postganglionic Neurons
Cerebral Blood Flow, Cerebrospinal Fluid, 761(10)
and Brain Metabolism
Cerebral Blood Flow 761(2)
Normal Rate of Cerebral Blood Flow 761(1)
Regulation of Cerebral Blood Flow 761(2)
Cerebral Microcirculation 763(1)
Cerebral Stroke Occurs When Cerebral 763(1)
Blood Vessels are Blocked
Cerebrospinal Fluid System 763(4)
Cushioning Function of the 763(1)
Cerebrospinal Fluid
Formation, Flow, and Absorption of 764(1)
Cerebrospinal Fluid
Cerebrospinal Fluid Pressure 765(1)
Obstruction to Flow of Cerebrospinal 766(1)
Fluid Can Cause Hydrocephalus
Blood--Cerebrospinal Fluid and 766(1)
Blood-Brain Barriers
Brain Edema 766(1)
Brain Metabolism 767(4)
UNIT XII Gastrointestinal Physiology
General Principles of Gastrointestinal 771(10)
Function---Motility, Nervous Control, and
Blood Circulation
General Principles of Gastrointestinal 771(2)
Motility
Physiological Anatomy of the 771(2)
Gastrointestinal Wall
Neural Control of Gastrointestinal 773(3)
Function---Enteric Nervous System
Differences Between the Myenteric and 774(1)
Submucosal Plexuses
Types of Neurotransmitters Secreted by 775(1)
Enteric Neurons
Hormonal Control of Gastrointestinal 776(1)
Motility
Functional Types of Movements in the 776(1)
Gastrointestinal Tract
Propulsive Movements---Peristalsis 776(1)
Mixing Movements 777(1)
Gastrointestinal Blood 777(4)
Flow---``Splanchnic Circulation''
Anatomy of the Gastrointestinal Blood 778(1)
Supply
Effect of Gut Activity and Metabolic 778(1)
Factors on Gastrointestinal Blood Flow
Nervous Control of Gastrointestinal 779(2)
Blood Flow
Propulsion and Mixing of Food in the 781(10)
Alimentary Tract
Ingestion of Food 781(3)
Mastication (Chewing) 781(1)
Swallowing (Deglutition) 782(2)
Motor Functions of the Stomach 784(2)
Storage Function of the Stomach 784(1)
Mixing and Propulsion Of Food in the 784(1)
Stomach---The Basic Electrical Rhythm
of the Stomach Wall
Stomach Emptying 785(1)
Regulation of Stomach Emptying 785(1)
Movements of the Small Intestine 786(2)
Mixing Contractions (Segmentation 786(1)
Contractions)
Propulsive Movements 787(1)
Function of the Ileocecal Valve 788(1)
Movements of the Colon 788(2)
Defecation 789(1)
Other Autonomic Reflexes That Affect 790(1)
Bowel Activity
Secretory Functions of the Alimentary Tract 791(17)
General Principles of Alimentary Tract 791(2)
Secretion
Anatomical Types of Glands 791(1)
Basic Mechanisms of Stimulation of the 791(1)
Alimentary Tract Glands
Basic Mechanism of Secretion by 791(2)
Glandular Cells
Lubricating and Protective Properties 793(1)
of Mucus, and Importance of Mucus in
the Gastrointestinal Tract
Secretion of Saliva 793(2)
Nervous Regulation of Salivary Secretion 794(1)
Esophageal Secretion 795
Gastric Secretion 794(5)
Characteristics of the Gastric 794(3)
Secretions
Pyloric Glands---Secretion of Mucus and 797(1)
Gastrin
Surface Mucous Cells 797(1)
Stimulation of Gastric Acid Secretion 797(1)
Regulation of Pepsinogen Secretion 798(1)
Inhibition of Gastric Secretion by 798(1)
Other Post-Stomach Intestinal Factors
Chemical Composition of Gastrin And 799(1)
Other Gastrointestinal Hormones
Pancreatic Secretion 799(3)
Pancreatic Digestive Enzymes 799(1)
Secretion of Bicarbonate Ions 800(1)
Regulation of Pancreatic Secretion 800(2)
Secretion of Bile by the Liver; Functions 802(3)
of the Biliary Tree
Physiologic Anatomy of Biliary Secretion 802(2)
Function of Bile Salts in Fat Digestion 804(1)
and Absorption
Liver Secretion of Cholesterol and 804(1)
Gallstone Formation
Secretions of the Small Intestine 805(1)
Secretion of Mucus by Brunner's Glands 805(1)
in the Duodenum
Secretion of Intestinal Digestive 805(1)
Juices by the Crypts of Lieberkuhn
Regulation of Small Intestine 806(1)
Secretion---Local Stimuli
Secretions of the Large Intestine 806(2)
Digestion and Absorption in the 808(11)
Gastrointestinal Tract
Digestion of the Various Foods by 808(4)
Hydrolysis
Digestion of Carbohydrates 809(1)
Digestion of Proteins 810(1)
Digestion of Fats 811(1)
Basic Principles of Gastrointestinal 812(1)
Absorption
Anatomical Basis of Absorption 812(1)
Absorption in the Small Intestine 813(4)
Absorption of Water 814(1)
Absorption of Ions 814(1)
Absorption of Nutrients 815(2)
Absorption in the Large Intestine: 817(2)
Formation of Feces
Physiology of Gastrointestinal Disorders 819(10)
Disorders of Swallowing and of the 819(1)
Esophagus
Disorders of the Stomach 819(2)
Peptic Ulcer 820(1)
Specific Causes of Peptic Ulcer in the 821(1)
Human Being
Disorders of the Small Intestine 821(1)
Abnormal Digestion of Food in the Small 821(1)
Intestine---Pancreatic Failure
Malabsorption by the Small Intestine 822(1)
Mucosa---Sprue
Disorders of the Large Intestine 822(1)
Constipation 822(1)
Diarrhea 822(1)
Paralysis of Defecation in Spinal Cord 823(1)
Injuries
General Disorders of the Gastrointestinal 823(6)
Tract
Vomiting 823(1)
Nausea 824(1)
Gastrointestinal Obstruction 824(5)
UNIT XIII Metabolism and Temperature
Regulation
Metabolism of Carbohydrates, and Formation 829(11)
of Adenosine Triphosphate
Release of Energy from Foods, and the 829(1)
Concept of ``Free Energy''
Role of Adenosine Triphosphate in 829(1)
Metabolism
Central Role of Glucose in Carbohydrate 830(1)
Metabolism
Transport of Glucose Through the Cell 831(1)
Membrane
Insulin Increases Facilitated Diffusion 831(1)
of Glucose
Phosphorylation of Glucose 831(1)
Glycogen Is Stored in Liver and Muscle 831(1)
Glycogenesis---The Process of Glycogen 832(1)
Formation
Removal of Stored 832(1)
Glycogen---Glycogenolysis
Release of Energy from the Glucose 832(5)
Molecule by the Glycolytic Pathway
Summary of ATP Formation During the 836(1)
Breakdown of Glucose
Control of Energy Release from Stored 836(1)
Glycogen When the Body Needs Additional
Energy
Anaerobic Release of 836(1)
Energy---``Anaerobic Glycolysis''
Release of Energy from Glucose by the 837(1)
Pentose Phosphate Pathway
Glucose Conversion to Glycogen or Fat 838(1)
Formation of Carbohydrates from Proteins 838(1)
and Fats---``Gluconeogenesis''
Blood Glucose 839(1)
Lipid Metabolism 840(12)
Transport of Lipids in the Body Fluids 840(2)
Transport of Triglycerides and Other 840(1)
Lipids from the Gastrointestinal Tract
by Lymph---The Chylomicrons
Removal of the Chylomicrons from the 841(1)
Blood
``Free Fatty Acids'' Are Transported in 841(1)
the Blood in Combination with Albumin
Lipoproteins---Their Special Function 841(1)
in Transporting Cholesterol and
Phospholipids
Fat Deposits 842(1)
Adipose Tissue 842(1)
Liver Lipids 842(1)
Use of Triglycerides for Energy: 842(4)
Formation of Adenosine Triphosphate
Formation of Acetoacetic Acid in the 844(1)
Liver and Its Transport in the Blood
Synthesis of Triglycerides from 844(1)
Carbohydrates
Synthesis of Triglycerides from Proteins 845(1)
Regulation of Energy Release from 846(1)
Triglycerides
Obesity 846(1)
Phospholipids and Cholesterol 846(2)
Phospholipids 846(1)
Cholesterol 847(1)
Cellular Structural Functions of 848(1)
Phospholipids and
Cholesterol---Especially for Membranes
Atheroscelerosis 848(4)
Basic Causes of Atherosclerosis---The 850(1)
Roles of Cholesterol and Lipoproteins
Other Major Risk Factors for 850(1)
Atherosclerosis
Prevention of Atherosclerosis 850(2)
Protein Metabolism 852(7)
Basic Properties 852(2)
Amino Acids 852(2)
Transport and Storage of Amino Acids 854(1)
Blood Amino Acids 854(1)
Storage of Amino Acids as Proteins in 854(1)
the Cells
Functional Roles of the Plasma Proteins 855(2)
Essential and Nonessential Amino Acids 855(2)
Obligatory Degradation of Proteins 857(1)
Hormonal Regulation of Protein Metabolism 857(2)
The Liver as an Organ 859(6)
Physiologic Anatomy of the Liver 859(1)
Hepatic Vascular and Lymph Systems 859(2)
Blood Flows Through the Liver from the 860(1)
Portal Vein and Hepatic Artery
The Liver Functions as a Blood Reservoir 860(1)
The Liver Has Very High Lymph Flow 860(1)
Regulation of Liver Mass---Regeneration 860(1)
Hepatic Macrophage System Serves a 861(1)
Blood-Cleansing Function
Metabolic Functions of the Liver 861(1)
Carbohydrate Metabolism 861(1)
Fat Metabolism 861(1)
Protein Metabolism 862(1)
Other Metabolic Functions of the Liver 862(1)
Measurement of Bilirubin in the Bile as a 862(3)
Clinical Diagnostic Tool
Jaundice---Excess Bilirubin in the 863(2)
Extracellular Fluid
Dietary Balances; Regulation of Feeding; 865(16)
Obesity and Starvation; Vitamins and
Minerals
Energy Intake and Output Are Balanced 865(1)
Under Steady-State Conditions
Dietary Balances 865(1)
Energy Available in Foods 865(1)
Methods for Determining Metabolic 866
Utilization of Proteins, Carbohydrates,
and Fats
Regulation of Food Intake and Energy 865(7)
Storage