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Guyton and HallT E X T B O O K O F
Physiology1 4 fft EDITION
ELSEVIER
JO HN E. HALL MICHAEL E. HALL
1 4 T H E D I T I O N
Guyton and Hall Textbook of Medical Physiology
_____________________John E. Hall, PhDArthur C. Guyton Professor and Chair
Department of Physiology and Biophysics Director, Mississippi Center for Obesity Research
University of Mississippi Medical Center Jackson, Mississippi
Michael E. Hall, MD, MSAssociate Professor
Department of Medicine, Division of Cardiovascular Diseases
Associate Vice Chair for Research Department of Physiology and Biophysics
University of Mississippi Medical Center Jackson, Mississippi
ELSEVIER
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Contents
UNIT IIntroduction to Physiology:The Cell and General Physiology
CHAPTER 1Functional Organization of the Human Body and Control of the "Internal Environment" 3Cells Are the Living Units of the Body 3Extracellular Fluid—the "Internal Environment" 3 Homeostasis—Maintenance of a Nearly Constant
Internal Environment 4Control Systems of the Body 7Summary—Automaticity of the Body 10
CHAPTER 2The Cell and Its Functions 13Organization of the Cell 13Cell Structure 14Comparison of the Animal Cell With Precellular
Forms of Life 20Functional Systems of the Cell 21Locomotion of Cells 26
CHAPTER 3Genetic Control of Protein Synthesis,Cell Function, and Cell Reproduction 31Cell Nucleus Genes Control Protein Synthesis 31Transcription—Transfer of Cell Nucleus DNA
Code to Cytoplasm RNA Code 33Translation—Formation of Proteins on the
Ribosomes 37Synthesis of Other Substances in the Cell 38Control of Gene Function and Biochemical
Activity in Cells 38The DNA-Genetic System Controls
Cell Reproduction 41Cell Differentiation 45Apoptosis—Programmed Cell Death 45Cancer 46
UNIŢIIMembrane Physiology, Nerve, and Muscle
CHAPTER 4Transport of Substances Through Cell Membranes 51The Cell Membrane Is a Lipid Bilayer
With Cell Membrane Transport Proteins 51Diffusion 52Active Transport of Substances Through
Membranes 58
CHAPTER 5Membrane Potentials and Action Potentials 63Basic Physics of Membrane Potentials 63Resting Membrane Potential of Neurons 65Neuron Action Potential 67Propagation of the Action Potential 71Re-Establishing Sodium and Potassium
Ionic Gradients After Action Potentials are Completed—Importance of Energy Metabolism 72
Plateau in Some Action Potentials 72Rhythmicity of Some Excitable Tissues—
Repetitive Discharge 73Special Characteristics of Signal Transmission
in Nerve Trunks 74Excitation—The Process of Eliciting the Action
Potential 75
CHAPTER 6Contraction of Skeletal Muscle 79Physiological Anatomy of Skeletal Muscle 79General Mechanism of Muscle Contraction 81Molecular Mechanism of Muscle Contraction 82Energetics of Muscle Contraction 85Characteristics of Whole Muscle
Contraction 87
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CHAPTER 7Excitation of Skeletal Muscle: NeuromuscularTransmission and Excitation-Contraction Coupling 93Neuromuscular Junction and Transmission
of Impulses From Nerve Endings to Skeletal Muscle Fibers 93
Muscle Action Potential 97Excitation-Contraction Coupling 97
CHAPTER 8Excitation and Contraction of SmoothMuscle 101Contraction of Smooth Muscle 101Regulation of Contraction by Calcium Ions 103Nervous and Hormonal Control of Smooth
Muscle Contraction 105
UNIT IIIThe Heart
CHAPTER 9Cardiac Muscle; The Heart as a Pump and Function of the Heart Valves 113Physiology of Cardiac Muscle 113Cardiac Cycle 117Regulation of Heart Pumping 123
CHAPTER 10Rhythmical Excitation of the Heart 127Specialized Excitatory and
Conductive System of the Heart 127Control of Excitation and Conduction in the
Heart 131
CHAPTER 11Fundamentals of Electrocardiography 135Waveforms of the Normal Electrocardiogram 135 Flow of Current Around the Heart During the
Cardiac Cycle 137Electrocardiographic Leads 138
CHAPTER 12Electrocardiographic Interpretation of Cardiac Muscle and Coronary Blood FlowAbnormalities: Vectorial Analysis 143Vectorial Analysis of Electrocardiograms 143Vectorial Analysis of the Normal
Electrocardiogram 145Mean Electrical Axis of the Ventricular
QRS and its Significance 148
Conditions That Cause Abnormal Voltagesof the QRS Complex 150
Prolonged and Bizarre Patterns of the QRS Complex 151
Current of Injury 152Abnormalities in the T Wave 156
CHAPTER 13Cardiac Arrhythmias and Their Electrocardiographic Interpretation 157Abnormal Sinus Rhythms 157Heart Block Within the Intracardiac
Conduction Pathways 158Premature Contractions 160Paroxysmal Tachycardia 162Ventricular Fibrillation 163Atrial Fibrillation 166Atrial Flutter 167Cardiac Arrest 167
UNIT IVThe Circulation
CHAPTER 14Overview of the Circulation: Pressure,Flow, and Resistance 171Physical Characteristics of the Circulation 171Basic Principles of Circulatory Function 173Interrelationships of Pressure, Flow, and
Resistance 173
CHAPTER 15Vascular Distensibility and Functions of the Arterial and Venous Systems 183Vascular Distensibility 183Arterial Pressure Pulsations 184Veins and Their Functions 188
CHAPTER 16The Microcirculation and Lymphatic System:Capillary Fluid Exchange, Interstitial Fluid, and Lymph Flow 193Structure of the Microcirculation and
Capillary System 193Flow of Blood in the Capillaries—Vasomotion 194 Exchange of Water, Nutrients, and Other
Substances Between the Blood and Interstitial Fluid 195
Interstitium and Interstitial Fluid 196Fluid Filtration Across Capillaries 197Lymphatic System 201
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Local and Humoral Control of TissueBlood Flow 205Local Control of Blood Flow in Response
to Tissue Needs 205Mechanisms of Blood Flow Control 205Humoral Control of the Circulation 214
CHAPTER 18Nervous Regulation of the Circulationand Rapid Control of Arterial Pressure 217Nervous Regulation of the Circulation 217Special Features of Nervous Control of
Arterial Pressure 226
CHAPTER 17
CHAPTER 19Role of the Kidneys in Long-Term Control of Arterial Pressure and in Hypertension: The Integrated Systemfor Arterial Pressure Regulation 229Renal-Body Fluid System for Arterial
Pressure Control 229Role of the Renin-Angiotensin System in
Arterial Pressure Control 236Summary of Integrated Multifaceted
Systems for Arterial Pressure Regulation 243
CHAPTER 20Cardiac Output, Venous Return, and Their Regulation 245Normal Values for Cardiac
Output at Rest and During Activity 245Control of Cardiac Output by Venous
Return—Frank-Starling Mechanism of the Heart 245
Methods For Measuring Cardiac Output 256
CHAPTER 21Muscle Blood Flow and Cardiac Output During Exercise; the Coronary Circulationand Ischemic Heart Disease 259Blood Flow Regulation in Skeletal Muscle
at Rest and During Exercise 259Coronary Circulation 262
CHAPTER 22Cardiac Failure 271Circulatory Dynamics in Cardiac Failure 271Unilateral Left Heart Failure 275Low-Output Cardiac Failure—Cardiogenic
Shock 275Edema in Patients With Cardiac Failure 275Cardiac Reserve 277
Quantitative Graphic Analysis of CardiacFailure 278
Heart Failure With Diastolic Dysfunction and Normal Ejection Fraction 280
High-Output Cardiac Failure 280
CHAPTER 23Heart Valves and Heart Sounds; Valvular and Congenital Heart Defects 283Heart Sounds 283Abnormal Circulatory Dynamics in Valvular
Heart Disease 286Abnormal Circulatory Dynamics in
Congenital Heart Defects 288Use of Extracorporeal Circulation During
Cardiac Surgery 291Hypertrophy of the Heart in Valvular and
Congenital Heart Disease 291
CHAPTER 24Circulatory Shock and Its Treatment 293Physiological Causes of Shock 293Shock Caused by Hypovolemia—
Hemorrhagic Shock 294Neurogenic Shock—Increased Vascular
Capacity 299Anaphylactic Shock and Histamine Shock 300Septic Shock 300Physiology of Treatment in Shock 301Circulatory Arrest 301
UNITVThe Body Fluids and Kidneys
CHAPTER 25Regulation of Body Fluid Compartments: Extracellular and Intracellular Fluids;Edema 305Fluid Intake and Output Are Balanced During
Steady-State Conditions 305Body Fluid Compartments 306Constituents of Extracellular and
Intracellular Fluids 307Measurement of Body Fluid Compartment
Volumes—Indicator-Dilution Principle 308Fluid Exchange and Osmotic Equilibrium
Between Intracellular and Extracellular Fluid 310 Volume and Osmolality of Extracellular and
Intracellular Fluids in Abnormal States 312Glucose and Other Solutions Administered
For Nutritive Purposes 313
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Clinical Abnormalities of Fluid Volume Regulation: Hyponatremia and Hypernatremia
Edema: Excess Fluid in the Tissues Fluids in Potential Spaces of the Body
CHAPTER 26The Urinary System: Functional Anatomy and Urine Formation by the KidneysMultiple Functions of the Kidneys Physiologic Anatomy of the Kidneys MicturitionUrine Formation Results from Glomerular
Filtration, Tubular Reabsorption, and Tubular Secretion
CHAPTER 27Glomerular Filtration, Renal Blood Flow, and Their ControlGlomerular Filtration—The First Step in
Urine Formation Determinants of the Glomerular
Filtration Rate Renal Blood FlowPhysiological Control of Glomerular
Filtration and Renal Blood Flow Autoregulation of Glomerular Filtration
Rate and Renal Blood Flow
CHAPTER 28Renal Tubular Reabsorption and SecretionTubular Reabsorption Is
Quantitatively Large and Highly Selective Tubular Reabsorption Includes Passive and
Active Mechanisms Reabsorption and Secretion Along
Different Parts of the Nephron Regulation of Tubular Reabsorption Use of Clearance Methods to Quantify
Kidney Function
CHAPTER 29Urine Concentration and Dilution; Regulation of Extracellular Fluid Osmolarity and Sodium ConcentrationKidneys Excrete Excess Water by Forming
Dilute UrineKidneys Conserve Water by Excreting
Concentrated Urine Countercurrent Multiplier Mechanism
Produces Hyperosmotic Renal Medullary Interstitium
Loop of Henle Characteristics That Cause Solutes to Be Trapped in the Renal Medulla
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Control of Extracellular Fluid Osmolarity and Sodium Concentration
Osmoreceptor-ADH Feedback System Importance of Thirst in Controlling Extracelluli
Fluid Osmolarity and Sodium Concentration
CHAPTER 30Renal Regulation of Potassium, Calcium, Phosphate, and Magnesium;Integration of Renal Mechanisms for Control of Blood Volume and Extracellular Fluid VolumeRegulation of Extracellular Fluid Potassium
Concentration and Potassium Excretion Regulation of Renal Calcium Excretion and
Extracellular Calcium Ion Concentration Regulation of Renal Phosphate Excretion Regulation of Renal Magnesium Excretion
and Extracellular Magnesium Ion Concentration
Integration of Renal Mechanisms for Control of Extracellular Fluid
Importance of Pressure Natriuresis and Pressure Diuresis in Maintaining Body Sodium and Fluid Balance
Distribution of Extracellular Fluid Between Interstitial Spaces and Vascular System
Nervous and Hormonal Factors Increase Effectiveness of Renal-Body Fluid Feedback Control
Integrated Responses to Changes in Sodium Intake
Conditions That Cause Large Increases in Blood Volume and Extracellular Fluid Volume
Conditions That Cause Large Increases in Extracellular Fluid Volume With Normal or Reduced Blood Volume
CHAPTER 31 Acid-Base RegulationHydrogen Ion Concentration Is Precisely
RegulatedAcids and Bases—Definitions and Meanings Defending Against Changes in H+
Concentration: Buffers, Lungs, and Kidneys Buffering of H+ in the Body Fluids Bicarbonate Buffer System Phosphate Buffer System Proteins Are Important Intracellular Buffers Respiratory Regulation of Acid-Base Balance Renal Control of Acid-Base Balance Secretion of H+ and Reabsorption of
HC03- by the Renal Tubules
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Combination of Excess H+ With Phosphate and Ammonia Buffers In the Tubule Generates "New" HC03_ 412
Quantifying Renal Acid-Base Excretion 414Regulation of Renal Tubular H+ Secretion 414Renal Correction of Acidosis—Increased
Excretion of H+ and Addition of HC03~ to the Extracellular Fluid 415
Renal Correction of Alkalosis—Decreased Tubular Secretion of H+ and Increased Excretion of HC03‘ 416
CHAPTER 32Diuretics and Kidney Diseases 421Diuretics and Their Mechanisms
of Action 421Kidney Diseases 423Acute Kidney Injury 423Chronic Kidney Disease Is Often Associated
With Irreversible Loss of Functional Nephrons 426
UNIT VIBlood Cells, Immunity, and Blood Coagulation
CHAPTER 33Red Blood Cells, Anemia, and Polycythemia 439Red Blood Cells (Erythrocytes) 439Anemias 446Polycythemia 447
CHAPTER 34Resistance of the Body to Infection: I. Leukocytes, Granulocytes, the Monocyte-Macrophage System,and Inflammation 449Leukocytes (White Blood Cells) 449Neutrophils and Macrophages Defend Against
Infections 450Monocyte-Macrophage Cell System
(Reticuloendothelial System) 452Inflammation: Role of Neutrophils and
Macrophages 454Eosinophils 456Basophils 457Leukopenia 457Leukemias 457
CHAPTER 35Resistance of the Body to Infection: II.Immunity and Allergy 459Acquired (Adaptive) Immunity 459Allergy and Hypersensitivity 469
Blood Types; Transfusion; and Tissue and Organ Transplantation 471Antigenicity Causes Immune Reactions of Blood 471 O-A-B Blood Types 471Rh Blood Types 473Transfusion Reactions Resulting From
Mismatched Blood Types 474Transplantation of Tissues and Organs 475
CHAPTER 37Hemostasis and Blood Coagulation 477Hemostasis Events 477Mechanism of Blood Coagulation 479Conditions That Cause Excessive Bleeding in
Humans 484Thromboembolic Conditions 486Anticoagulants for Clinical Use 486Blood Coagulation Tests 487
CHAPTER 36
UNIT VIIRespiration
CHAPTER 38Pulmonary Ventilation 491Mechanics of Pulmonary Ventilation 491Pulmonary Volumes and Capacities 495Alveolar Ventilation 497
CHAPTER 39Pulmonary Circulation, Pulmonary Edema, and Pleural Fluid 503Physiological Anatomy of the Pulmonary
Circulatory System 503Pressures in the Pulmonary System 503Blood Volume of the Lungs 504Blood Flow Through the Lungs and its
Distribution 504Effect of Hydrostatic Pressure Gradients in the
Lungs on Regional Pulmonary Blood Flow 505Pulmonary Capillary Dynamics 507Fluid in the Pleural Cavity 509
CHAPTER 40Principles of Gas Exchange;Diffusion of Oxygen and Carbon Dioxide Through the Respiratory Membrane 511Compositions of Alveolar Air and
Atmospheric Air Are Different 513Diffusion of Gases Through the Respiratory
Membrane 515
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CHAPTER 41Transport of Oxygen and Carbon Dioxide in Blood and Tissue FluidsTransport of Oxygen From
the Lungs to the Body Tissues Transport of C02 in Blood Respiratory Exchange Ratio
CHAPTER 42Regulation of RespirationRespiratory CenterChemical Control of RespirationPeripheral Chemoreceptor System—
Role of Oxygen in Respiratory Control Regulation of Respiration During
Exercise
CHAPTER 43Respiratory Insufficiency—Pathophysiology, Diagnosis, Oxygen TherapyUseful Methods for Studying Respiratory
AbnormalitiesPathophysiology of Specific Pulmonary
AbnormalitiesHypoxia and Oxygen Therapy Hypercapnia—Excess Carbon Dioxide in the
Body Fluids Artificial Respiration
UNIT VIIIAviation, Space, and Deep-Sea Diving Physiology
CHAPTER 44Aviation, High Altitude, and Space PhysiologyEffects of Low Oxygen Pressure
on the Body
CHAPTER 45Physiology of Deep-Sea Diving and Other Hyperbaric ConditionsEffect of High Partial Pressures of Individual
Gases on the BodySelf-Contained Underwater Breathing
Apparatus (SCUBA) Diving
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UNIT IXThe Nervous System: A. General Principle Sensory Physiology
CHAPTER 46Organization of the Nervous System,Basic Functions of Synapses, and NeurotransmittersGeneral Design of the Nervous System Major Levels of Central Nervous
System FunctionComparison of the Nervous System to
a ComputerCentral Nervous System Synapses Special Characteristics of Synaptic
Transmission
CHAPTER 47Sensory Receptors, Neuronal Circuits for Processing InformationTypes of Sensory Receptors
and the Stimuli They Detect Transduction of Sensory Stimuli Into
Nerve ImpulsesSignal Intensity Transmission in Nerve
Tracts—Spatial and Temporal Summation Transmission and Processing of Signals in
Neuronal PoolsInstability and Stability of Neuronal Circuits
CHAPTER 48Somatic Sensations: I. General Organization Tactile and Position SensesSensory Pathways for Transmitting Somatic
Signals Into the Central Nervous System Transmission in the Dorsal Column-Medial
Lemniscal SystemTransmission of Sensory Signals in the
Anterolateral Pathway
CHAPTER 49Somatic Sensations: II. Pain, Headache, and Thermal SensationsFast Pain and Slow Pain and
Their QualitiesPain Receptors and Their Stimulation Dual Pathways for Transmission of Pain
Signals Into the Central Nervous System Pain Suppression (Analgesia) System in the
Brain and Spinal Cord Referred Pain Visceral Pain Thermal Sensations
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UNIT XThe Nervous System: B. The Special Senses
CHAPTER 50The Eye: I. Optics of Vision 627Physical Principles of Optics 627Optics of the Eye 630Fluid System of the Eye—Intraocular Fluid 635
CHAPTER 51The Eye: II. Receptor and Neural Functionof the Retina 639Anatomy and Function of the Structural
Elements of the Retina 639Photochemistry of Vision 641Color Vision 645Neural Function of the Retina 646
CHAPTER 52The Eye: III. Central Neurophysiology ofVision 653Visual Pathways 653Organization and Function of the Visual
Cortex 654Neuronal Patterns of Stimulation During
Analysis of Visual Images 656Eye Movements and Their Control 657Autonomic Control of Accommodation
and Pupillary Aperture 660
CHAPTER 53The Sense of Hearing 663Tympanic Membrane and the
Ossicular System 663Cochlea 664Central Auditory Mechanisms 669
CHAPTER 54The Chemical Senses—Taste and Smell 675Sense of Taste 675Sense of Smell 679
UNIT XIThe Nervous System: C. Motor and Integrative Neurophysiology
CHAPTER 55Spinal Cord Motor Functions; theCord Reflexes 685Organization of the Spinal Cord for Motor
Functions 685
Muscle Sensory Receptors—Muscle Spindles and Golgi Tendon Organs—andTheir Roles in Muscle Control 686
Flexor Reflex and the Withdrawal Reflexes 691Crossed Extensor Reflex 693Reciprocal Inhibition and Reciprocal
Innervation 693Reflexes of Posture and Locomotion 693
CHAPTER 56Cortical and Brain Stem Control of MotorFunction 697Motor Cortex and Corticospinal Tract 697Control of Motor Functions by the Brain Stem 703 Vestibular Sensations and Maintenance of
Equilibrium 704
CHAPTER 57Cerebellum and Basal Ganglia Contributions to Overall Motor Control 711The Cerebellum and Its Motor Functions 711The Basal Ganglia and Their Motor Functions 720 Integration of the Many Parts of the
Total Motor Control System 724
CHAPTER 58Cerebral Cortex, Intellectual Functionsof the Brain, Learning, and Memory 727Physiologic Anatomy of the
Cerebral Cortex 727Functions of Specific Cortical Areas 728The Corpus Callosum and Anterior
Commissure Transfer Thoughts,Memories, Training, and Other Information Between the Two Cerebral Hemispheres 735
Thoughts, Consciousness, and Memory 735
CHAPTER 59The Limbic System and the Hypothalamus— Behavioral and Motivational Mechanismsof the Brain 741Activating—Driving Systems of the Brain 741Limbic System 744The Hypothalamus, a Major Control
Headquarters for the Limbic System 745Specific Functions of Other Parts of
the Limbic System 749
CHAPTER 60States of Brain Activity—Sleep, Brain Waves, Epilepsy, Psychoses, and Dementia 753Sleep 753
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CHAPTER 61The Autonomic Nervous System and theAdrenal Medulla 763General Organization of the Autonomic
Nervous System 763Basic Characteristics of Sympathetic and
Parasympathetic Function 765Selective Stimulation of Target Organs by
Sympathetic and Parasympathetic Systems or "Mass Discharge" 773
CHAPTER 62Cerebral Blood Flow, CerebrospinalFluid, and Brain Metabolism 777Cerebral Blood Flow 777Cerebrospinal Fluid System 780Brain Metabolism 783
UNIT XIIGastrointestinal Physiology
CHAPTER 63General Principles of Gastrointestinal Function—Motility, Nervous Control, and Blood Circulation 787General Principles of
Gastrointestinal Motility 787Neural Control of Gastrointestinal
Function—Enteric Nervous System 789Hormonal Control of Gastrointestinal Motility 791 Functional Movements in the Gastrointestinal
Tract 793Gastrointestinal Blood Flow—Splanchnic
Circulation 794
CHAPTER 64Propulsion and Mixing of Food in the Alimentary Tract 797Ingestion of Food 797Motor Functions of the Stomach 799Movements of the Small Intestine 802Movements of the Colon 804Other Autonomic Reflexes That Affect Bowel
Activity 806
CHAPTER 65Secretory Functions of the Alimentary Tract 807General Principles of Alimentary Tract Secretion 807 Secretion of Saliva 809
Gastric Secretion 811Pancreatic Secretion 814Bile Secretion by the Liver 817Secretions of the Small Intestine 820
CHAPTER 66Digestion and Absorption in the Gastrointestinal Tract 823Digestion of Various Foods by Hydrolysis 823Basic Principles of Gastrointestinal
Absorption 827Absorption in the Small Intestine 828Absorption in the Large Intestine:
Formation of Feces 831
CHAPTER 67Physiology of Gastrointestinal Disorders 833
UNIT XIIIMetabolism and Temperature Regulation
CHAPTER 68Metabolism of Carbohydrates andFormation of Adenosine Triphosphate 843
CHAPTER 69Lipid Metabolism 853Basic Chemical Structure of Triglycerides
(Neutral Fat) 853Transport of Lipids in the Body Fluids 853
CHAPTER 70Protein Metabolism 865
CHAPTER 71The Liver 871
CHAPTER 72Dietary Balances; Regulation of Feeding; Obesity and Starvation; Vitamins andMinerals 877Energy Intake and Output
Balanced Under Steady-State Conditions 877Regulation of Food Intake and Energy Storage 879
CHAPTER 73Energetics and Metabolic Rate 893
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Body Temperature Regulationand Fever 901Normal Body Temperatures 901Body Temperature Is Controlled by Balancing
Heat Production and Heat Loss 901Regulation of Body Temperature—Role of the
Hypothalamus 905Abnormalities of Body Temperature
Regulation 909
CHAPTER 74
UNIT XIVEndocrinology and Reproduction
CHAPTER 75Introduction to Endocrinology 915Coordination of Body
Functions by Chemical Messengers 915Chemical Structure and Synthesis of Hormones 915 Hormone Secretion, Transport, and
Clearance From the Blood 919Mechanisms of Action of Hormones 920
CHAPTER 76Pituitary Hormones and Their Control by the Hypothalamus 929Pituitary Gland and Its Relation to the
Hypothalamus 929Hypothalamus Controls Pituitary Secretion 930Physiological Functions of Growth Hormone 932Posterior Pituitary Gland and Its Relation
to the Hypothalamus 938
CHAPTER 77Thyroid Metabolic Hormones 941Synthesis and Secretion of the
Thyroid Metabolic Hormones 941Physiological Functions of the Thyroid
Hormones 944Regulation of Thyroid Hormone Secretion 948
CHAPTER 78Adrenocortical Hormones 955Corticosteroids: Mineralocorticoids,
Glucocorticoids, and Androgens 955Synthesis and Secretion of Adrenocortical
Hormones 955Functions of Mineralocorticoids—
Aldosterone 958Functions of Glucocorticoids 962
Insulin, Glucagon, and Diabetes Mellitus 973Insulin and Its Metabolic Effects 973Glucagon and Its Functions 982Summary of Blood Glucose Regulation 983
CHAPTER 79
CHAPTER 80Parathyroid Hormone, Calcitonin, Calcium and Phosphate Metabolism,Vitamin D, Bone, and Teeth 991Overview of Calcium and
Phosphate Regulation in Extracellular Fluid and Plasma 991
Bone and Its Relationship to Extracellular Calcium and Phosphate 993
Vitamin D 997Parathyroid Hormone 999Calcitonin 1002Summary of Control of Calcium Ion
Concentration 1003Physiology of the Teeth 1006
CHAPTER 81Reproductive and Hormonal Functions of the Male (and Functionof the Pineal Gland) 1011Spermatogenesis 1011Male Sexual Act 1016Testosterone and Other Male Sex Hormones 1018
CHAPTER 82Female Physiology Before Pregnancy andFemale Hormones 1027Physiologic Anatomy
of the Female Sexual Organs 1027Oogenesis and Follicular Development
in the Ovaries 1027Female Hormonal System 1027Monthly Ovarian Cycle and Function of
Gonadotropic Hormones 1028Functions of Ovarian Hormones—
Estradiol and Progesterone 1032Regulation of Female Monthly Rhythm—
Interplay Between Ovarian and Hypothalamic-Pituitary Hormones 1037
Female Sexual Act 1041
CHAPTER 83Pregnancy and Lactation 1045Maturation and Fertilization of the Ovum 1045Early Nutrition of the Embryo 1047
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Anatomy and Function of the Placenta 1047 ■ UNIT XVHormonal Factors in Pregnancy Parturition
10491054
Sports Physiology
Lactation 1056 CHAPTER 85
CHAPTER 84 Sports Physiology 1073
Fetal and Neonatal Physiology 1061
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Video and Audio Contents
CHAPTER 2The Cell and Its FunctionsVideo 2-1 Endocytosis
CHAPTER 5Membrane Potentials and Action PotentialsVideo 5-1 Action Potential
CHAPTER 6Contraction of Skeletal MuscleVideo 6-1 The Cross Bridge Cycle
CHAPTER 9Cardiac Muscle; The Heart as a Pump and Function of the Heart ValvesVideo 9-1 The Cardiac Cycle
CHAPTER 23Heart Valves and Heart Sounds; Valvular and Congenital Heart DefectsAudio 23-1 Normal Heart Sound Audio 23-2 Aortic Stenosis Audio 23-3 Aortic Regurgitation Audio 23-4 Mitral Regurgitation Audio 23-5 Mitral Stenosis
CHAPTER 29Urine Concentration and Dilution; Regulation of Extracellular Fluid Osmolarity and Sodium ConcentrationVideo 29-1 The Countercurrent Multiplier
CHAPTER 34Resistance of the Body to Infection: I. Leukocytes, Granulocytes, the Monocyte-Macrophage System, and InflammationVideo 34-1 Chemotaxis
CHAPTER 38 Pulmonary VentilationVideo 38-1 Mechanics of Pulmonary Ventilation
CHAPTER 46Organization of the Nervous System, Basic Functions of Synapses, and NeurotransmittersVideo 46-1 Chemical Synaptic Transmission Video 46-2 Neurotransmission
CHAPTER 48Somatic Sensations: I. General Organization, Tactile and Position SensesVideo 48-1 Fine Touch Video 48-2 Pain Pathways
CHAPTER 50The Eye: I. Optics of VisionVideo 50-1 Eye-Lens Accommodation
CHAPTER 55Spinal Cord Motor Functions; the Cord ReflexesVideo 55-1 Muscle Spindle Video 55-2 Patella Reflex
CHAPTER 63General Principles of Gastrointestinal Function— Motility, Nervous Control, and Blood CirculationVideo 63-1 Peristalsis
CHAPTER 82Female Physiology Before Pregnancy and Female HormonesVideo 82-1 The Menstrual Cycle
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