Medical Physiology

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Medical Physiology

Medical Physiology

Introduction to Physiology Functional Organization of the Human Body and Control of the Internal Environment

Functional Organization of the Human Body and Control of the “Internal Environment”
Cells as the Living Units of the Body
Extracellular Fluid-The “Internal Environment”
“Homeostatic” Mechanisms of the Major Functional Systems
Control Systems of the Body
Examples of Control Mechanisms of the Body
Characteristics of Control Systems of the Body

Introduction to Physiology The Cell and Its Functions

Organization of the Cell
Physical Structure of the Cell
Membranous Structures of the Cell
Cytoplasm and Its Organelles - Physical Structure of the Cell
Nucleus and Nuclear Membrane - Physical Structure of the Cell
Nucleoli and Formation of Ribosomes
Comparison of the Animal Cell with Precellular Forms of Life
Functional Systems of the Cell
Ingestion by the Cell - Endocytosis - Functional Systems of the Cell
Digestion of Pinocytotic and Phagocytic Foreign Substances Inside the Cell - Function of the Lysosomes
Synthesis and Formation of Cellular Structures by Endoplasmic Reticulum and Golgi Apparatus
Extraction of Energy from Nutrients - Function of the Mitochondria
Locomotion of Cells
Ameboid Movement
Cilia and Ciliary Movements

Introduction to Physiology Genetic Control of Protein Synthesis Cell Function and Cell Reproduction

Genes in the Cell Nucleus
DNA Code in the Cell Nucleus Is Transferred to an RNA Code in the Cell Cytoplasm - The Process of Transcription
Synthesis of Other Substances in the Cell
Control of Gene Function and Biochemical Activity in Cells
The DNA-Genetic System Also Controls Cell Reproduction
Cell Differentiation
Apoptosis-Programmed Cell Death

Membrane Physiology Nerve and Muscle Transport of Substances Through the Cell Membrane

The Lipid Barrier of the Cell Membrane, and Cell Membrane Transport Proteins
Diffusion Through the Cell Membrane
Diffusion Through Protein Channels, and “Gating” of These Channels
Facilitated Diffusion
Factors That Affect Net Rate of Diffusion
Osmosis Across Selectively Permeable Membranes - “Net Diffusion” of Water
“Active Transport” of Substances Through Membranes
Primary Active Transport
Secondary Active Transport - Co-Transport and Counter-Transport
Active Transport Through Cellular Sheets

Membrane Physiology Nerve and Muscle Membrane Potentials and Action Potentials

Basic Physics of Membrane Potentials
Measuring the Membrane Potential
Resting Membrane Potential of Nerves
Nerve Action Potential
Roles of Other Ions During the Action Potential
Propagation of the Action Potential
Re-establishing Sodium and Potassium Ionic Gradients After Action Potentials Are Completed
Plateau in Some Action Potentials
Rhythmicity of Some Excitable Tissues-Repetitive Discharge
Special Characteristics of Signal Transmission in Nerve Trunks
Excitation-The Process of Eliciting the Action Potential
Recording Membrane Potentials and Action Potentials

Membrane Physiology Nerve and Muscle Contraction of Skeletal Muscle

Physiologic Anatomy of Skeletal Muscle
General Mechanism of Muscle Contraction
Molecular Mechanism of Muscle Contraction
Molecular Characteristics of the Contractile Filaments
Effect of Amount of Actin and Myosin Filament Overlap on Tension Developed by the Contracting Muscle
Relation of Velocity of Contraction to Load
Energetics of Muscle Contraction
Characteristics of Whole Muscle Contraction
Mechanics of Skeletal Muscle Contraction
Remodeling of Muscle to Match Function
Rigor Mortis

Excitation of Skeletal Muscle Neuromuscular Transmission and Excitation Contraction Coupling

Transmission of Impulses from Nerve Endings to Skeletal Muscle Fibers: The Neuromuscular Junction
Secretion of Acetylcholine by the Nerve Terminals
Molecular Biology of Acetylcholine Formation and Release
Drugs That Enhance or Block Transmission at the Neuromuscular Junction
Myasthenia Gravis
Muscle Action Potential
Excitation-Contraction Coupling

Contraction and Excitation of Smooth Muscle

Contraction of Smooth Muscle
Types of Smooth Muscle
Contractile Mechanism in Smooth Muscle
Regulation of Contraction of Smooth Muscle by Calcium Ions
Nervous and Hormonal Control of Smooth Muscle Contraction
Neuromuscular Junctions of Smooth Muscle
Membrane Potentials and Action Potentials in Smooth Muscle
Effect of Local Tissue Factors and Hormones to Cause Smooth Muscle Contraction Without Action Potentials
Source of Calcium Ions That Cause Contraction (1) Through the Cell Membrane and (2) from the Sarcoplasmic Reticulum

Heart Muscle The Heart as a Pump and Function of the Heart Valves

Physiology of Cardiac Muscle
Physiologic Anatomy of Cardiac Muscle
Action Potentials in Cardiac Muscle
The Cardiac Cycle
Diastole and Systole
Relationship of the Electrocardiogram to the Cardiac Cycle
Function of the Atria as Primer Pumps
Function of the Ventricles as Pumps
Function of the Valves
Aortic Pressure Curve
Relationship of the Heart Sounds to Heart Pumping
Work Output of the Heart: Graphical Analysis of Ventricular Pumping
Chemical Energy Required for Cardiac Contraction: Oxygen Utilization by the Heart
Regulation of Heart Pumping

Rhythmical Excitation of the Heart

Specialized Excitatory and Conductive System of the Heart
Sinus (Sinoatrial) Node
Internodal Pathways and Transmission of the Cardiac Impulse Through the Atria
Atrioventricular Node, and Delay of Impulse Conduction from the Atria to the Ventricles
Rapid Transmission in the Ventricular Purkinje System
Transmission of the Cardiac Impulse in the Ventricular Muscle
Control of Excitation and Conduction in the Heart
The Sinus Node as the Pacemaker of the Heart
Role of the Purkinje System in Causing Synchronous Contraction of the Ventricular Muscle
Sympathetic and Parasympathetic Nerves

The Normal Electrocardiogram

Characteristics of the Normal Electrocardiogram
Methods for Recording Electrocardiograms
Flow of Current Around the Heart During the Cardiac Cycle
Electrocardiographic Leads: Three Bipolar Limb Leads, Chest Leads (Precordial Leads), Augmented Unipolar Limb Leads

Electrocardiographic Interpretation of Cardiac Muscle and Coronary Blood Flow Abnormalities Vectorial Analysis

Principles of Vectorial Analysis of Electrocardiograms
Vectorial Analysis of the Normal Electrocardiogram
Mean Electrical Axis of the Ventricular QRS - And Its Significance
Conditions That Cause Abnormal Voltages of the QRS Complex
Prolonged and Bizarre Patterns of the QRS Complex - Electrocardiographic
Current of Injury - Electrocardiographic Interpretation of Cardiac
Abnormalities in the T Wave - Electrocardiographic Interpretation of Cardiac Muscle and Coronary Blood Flow Abnormalities

Cardiac Arrhythmias and Their Electrocardiographic Interpretation

Cardiac Arrhythmias and Their Electrocardiographic Interpretation
Abnormal Sinus Rhythms
Tachycardia - Abnormal Sinus Rhythms
Bradycardia - Abnormal Sinus Rhythms
Sinus Arrhythmia - Abnormal Sinus Rhythms
Abnormal Rhythms That Result from Block of Heart Signals Within the Intracardiac Conduction Pathways
Premature Contractions
Paroxysmal Tachycardia
Atrial Paroxysmal Tachycardia
Ventricular Paroxysmal Tachycardia
Ventricular Fibrillation
Atrial Fibrillation
Atrial Flutter
Cardiac Arrest

Overview of the Circulation Medical Physics of Pressure Flow and Resistance

Physical Characteristics of the Circulation
Basic Theory of Circulatory Function
Interrelationships Among Pressure, Flow, and Resistance
Blood Flow
Blood Pressure
Resistance to Blood Flow
Effects of Pressure on Vascular Resistance and Tissue Blood Flow

Vascular Distensibility and Functions of the Arterial and Venous Systems

Vascular Distensibility
Arterial Pressure Pulsations
Veins and Their Functions
Venous Pressures-Right Atrial Pressure (Central Venous Pressure) and Peripheral Venous Pressures
Blood Reservoir Function of the Veins

The Microcirculation and the Lymphatic System Capillary Fluid Exchange Interstitial Fluid and Lymph Flow

Structure of the Microcirculation and Capillary System
Flow of Blood in the Capillaries-Vasomotion
Exchange of Water, Nutrients, and Other Substances Between the Blood and Interstitial Fluid
The Interstitium and Interstitial Fluid
Fluid Filtration Across Capillaries Is Determined by Hydrostatic and Colloid Osmotic Pressures, and Capillary Filtration Coefficient
Capillary Hydrostatic Pressure
Interstitial Fluid Hydrostatic Pressure
Plasma Colloid Osmotic Pressure
Interstitial Fluid Colloid Osmotic Pressure
Exchange of Fluid Volume Through the Capillary Membrane
Starling Equilibrium for Capillary Exchange
Lymphatic System
Lymph Channels of the Body
Formation of Lymph
Rate of Lymph Flow

Local and Humoral Control of Blood Flow by the Tissues

Local Control of Blood Flow in Response to Tissue Needs
Mechanisms of Blood Flow Control
Acute Control of Local Blood Flow - Mechanisms of Blood Flow Control
Long-Term Blood Flow Regulation - Mechanisms of Blood Flow Control
Development of Collateral Circulation-A Phenomenon of Long- Term Local Blood Flow Regulation
Humoral Control of the Circulation
Vascular Control by Ions and Other Chemical Factors

Nervous Regulation of the Circulation and Rapid Control of Arterial Pressure

Nervous Regulation of the Circulation
Role of the Nervous System in Rapid Control of Arterial Pressure
Increase in Arterial Pressure During Muscle Exercise and Other Types of Stress
Reflex Mechanisms for Maintaining Normal Arterial Pressure
Central Nervous System Ischemic Response
Special Features of Nervous Control of Arterial Pressure

Dominant Role of the Kidney in Long Term Regulation of Arterial Pressure and in Hypertension The Integrated System for Pressure Control

Renal-Body Fluid System for Arterial Pressure Control
Quantitation of Pressure Diuresis as a Basis for Arterial Pressure Control
Chronic Hypertension (High Blood Pressure) Is Caused by Impaired Renal Fluid Excretion
The Renin-Angiotensin System: Its Role in Pressure Control and in Hypertension
Components of the Renin-Angiotensin System
Types of Hypertension in Which Angiotensin Is Involved
Other Types of Hypertension Caused by Combinations of Volume Loading and Vasoconstriction
“Primary (Essential) Hypertension”
Summary of the Integrated, Multifaceted System for Arterial Pressure Regulation

Cardiac Output Venous Return and Their Regulation

Normal Values for Cardiac Output at Rest and During Activity
Control of Cardiac Output by Venous Return-Role of the Frank-Starling Mechanism of the Heart
The Heart Has Limits for the Cardiac Output That It Can Achieve
What Is the Role of the Nervous System in Controlling Cardiac Output?
Pathologically High and Pathologically Low Cardiac Outputs
High Cardiac Output Caused by Reduced Total Peripheral Resistance
Low Cardiac Output
A More Quantitative Analysis of Cardiac Output Regulation
Cardiac Output Curves Used in the Quantitative Analysis
Venous Return Curves
Analysis of Cardiac Output and Right Atrial Pressure, Using Simultaneous Cardiac Output and Venous Return Curves
Methods for Measuring Cardiac Output

Muscle Blood Flow and Cardiac Output During Exercise the Coronary Circulation and schemic Heart Disease

Blood Flow in Skeletal Muscle and Blood Flow Regulation During Exercise
Rate of Blood Flow Through the Muscles
Control of Blood Flow Through the Skeletal Muscles
Total Body Circulatory Readjustments During Exercise
Coronary Circulation
Physiologic Anatomy of the Coronary Blood Supply
Normal Coronary Blood Flow
Control of Coronary Blood Flow
Special Features of Cardiac Muscle Metabolism
Ischemic Heart Disease
Causes of Death After Acute Coronary Occlusion
Stages of Recovery from Acute Myocardial Infarction
Function of the Heart After Recovery from Myocardial Infarction
Pain in Coronary Heart Disease
Surgical Treatment of Coronary Disease

Cardiac Failure

Acute Effects of Moderate Cardiac Failure
Chronic Stage of Failure-Fluid Retention Helps to Compensate Cardiac Output
Summary of the Changes That Occur After Acute Cardiac Failure- “Compensated Heart Failure”
Dynamics of Severe Cardiac Failure- Decompensated Heart Failure
Unilateral Left Heart Failure
Low-Output Cardiac Failure- Cardiogenic Shock
Edema in Patients with Cardiac Failure
Cardiac Reserve
Quantitative Graphical Method for Analysis of Cardiac Failure

Heart Valves and Heart Sounds Dynamics of Valvular and Congenital Heart Defects

Normal Heart Sounds
Valvular Lesions - Heart Sounds
Abnormal Circulatory Dynamics in Valvular Heart Disease
Abnormal Circulatory Dynamics in Congenital Heart Defects
Use of Extracorporeal Circulation During Cardiac Surgery
Hypertrophy of the Heart in Valvular and Congenital Heart Disease

Circulatory Shock and Physiology of Its Treatment

Physiologic Causes of Shock
Shock Caused by Hypovolemia-Hemorrhagic Shock
Relationship of Bleeding Volume to Cardiac Output and Arterial Pressure
Progressive and Nonprogressive Hemorrhagic Shock
Irreversible Shock
Hypovolemic Shock Caused by Plasma Loss
Hypovolemic Shock Caused by Trauma
Neurogenic Shock-Increased Vascular Capacity
Anaphylactic Shock and Histamine Shock
Septic Shock
Physiology of Treatment in Shock
Circulatory Arrest
Effect of Circulatory Arrest on the Brain

The Body Fluid Compartments Extracellular and Intracellular Fluids Interstitial Fluid and Edema

Fluid Intake and Output Are Balanced During Steady-State Conditions
Daily Intake of Water
Daily Loss of Body Water
Body Fluid Compartments
Blood Volume
Constituents of Extracellular and Intracellular Fluids
Measurement of Fluid Volumes in the Different Body Fluid Compartments-The Indicator-Dilution Principle
Determination of Volumes of Specific Body Fluid Compartments
Regulation of Fluid Exchange and Osmotic Equilibrium Between Intracellular and Extracellular Fluid
Basic Principles of Osmosis and Osmotic Pressure
Osmotic Equilibrium Is Maintained Between Intracellular and Extracellular Fluids
Volume and Osmolality of Extracellular and Intracellular Fluids in Abnormal States
Effect of Adding Saline Solution to the Extracellular Fluid
Glucose and Other Solutions Administered for Nutritive Purposes
Clinical Abnormalities of Fluid Volume Regulation: Hyponatremia and Hypernatremia
Edema: Excess Fluid in the Tissues
Intracellular Edema
Extracellular Edema
Summary of Causes of Extracellular Edema
Safety Factors That Normally Prevent Edema
Fluids in the “Potential Spaces” of the Body

Urine Formation by the Kidneys I Glomerular Filtration Renal Blood Flow and Their Control

Multiple Functions of the Kidneys in Homeostasis
Physiologic Anatomy of the Kidneys
General Organization of the Kidneys and Urinary Tract
Renal Blood Supply
The Nephron Is the Functional Unit of the Kidney
Physiologic Anatomy and Nervous Connections of the Bladder
Transport of Urine from the Kidney Through the Ureters and into the Bladder
Filling of the Bladder and Bladder Wall Tone; the Cystometrogram
Micturition Reflex
Abnormalities of Micturition
Urine Formation Results from Glomerular Filtration, Tubular Reabsorption, and Tubular Secretion
Glomerular Filtration-The First Step in Urine Formation
Determinants of the GFR
Renal Blood Flow
Physiologic Control of Glomerular Filtration and Renal Blood Flow
Autoregulation of GFR and Renal Blood Flow

Urine Formation by the Kidneys II Tubular Processing of the Glomerular Filtrate

Reabsorption and Secretion by the Renal Tubules
Tubular Reabsorption Includes Passive and Active Mechanisms
Active Transport - Tubular Reabsorption Includes Passive and Active Mechanisms
Passive Water Reabsorption by Osmosis Is Coupled Mainly to Sodium Reabsorption
Reabsorption of Chloride, Urea, and Other Solutes by Passive Diffusion
Reabsorption and Secretion Along Different Parts of the Nephron
Proximal Tubular Reabsorption
Solute and Water Transport in the Loop of Henle
Distal Tubule
Late Distal Tubule and Cortical Collecting Tubule
Medullary Collecting Duct
Regulation of Tubular Reabsorption
Use of Clearance Methods to Quantify Kidney Function

Regulation of Extracellular Fluid Osmolarity and Sodium Concentration

Kidneys Excrete Excess Water by Forming a Dilute Urine
Kidneys Conserve Water by Excreting a Concentrated Urine
Obligatory Urine Volume
Requirements for Excreting a Concentrated Urine-High ADH Levels and Hyperosmotic Renal Medulla
Countercurrent Mechanism Produces a Hyperosmotic Renal Medullary Interstitium
Role of Distal Tubule and Collecting Ducts in Excreting a Concentrated Urine
Urea Contributes to Hyperosmotic Renal Medullary Interstitium and to a Concentrated Urine
Countercurrent Exchange in the Vasa Recta Preserves Hyperosmolarity of the Renal Medulla
Quantifying Renal Urine Concentration and Dilution: “Free Water” and Osmolar Clearances
Disorders of Urinary Concentrating Ability
Control of Extracellular Fluid Osmolarity and Sodium Concentration
Osmoreceptor-ADH Feedback System
Role of Thirst in Controlling Extracellular Fluid Osmolarity and Sodium Concentration
Salt-Appetite Mechanism for Controlling Extracellular Fluid Sodium Concentration and Volume

Renal Regulation of Potassium Calcium Phosphate and Magnesium Integration of Renal Mechanisms for Control of Blood Volume and Extracellular Fluid Volume

Regulation of Potassium Excretion and Potassium Concentration in Extracellular Fluid
Regulation of Internal Potassium Distribution
Overview of Renal Potassium Excretion
Potassium Secretion by Principal Cells of Late Distal and Cortical Collecting Tubules
Summary of Factors That Regulate Potassium Secretion
Control of Renal Calcium Excretion and Extracellular Calcium Ion Concentration
Control 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 the Interstitial Spaces and Vascular System
Nervous and Hormonal Factors Increase the Effectiveness of Renal-Body Fluid Feedback Control
Role of Angiotensin II In Controlling Renal Excretion
Role of Aldosterone in Controlling Renal Excretion
Role of ADH in Controlling Renal Water Excretion
Role of Atrial Natriuretic Peptide in Controlling Renal Excretion
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 but with Normal Blood Volume

Regulation of Acid Base Balance

Regulation of Acid-Base Balance
Hydrogen Ion Concentration Is Precisely Regulated
Acids and Bases-Their Definitions and Meanings
Defenses Against Changes in Hydrogen Ion Concentration: Buffers, Lungs, and Kidneys
Buffering of Hydrogen Ions in the Body Fluids
Bicarbonate Buffer System
Quantitative Dynamics of the Bicarbonate Buffer System
Phosphate Buffer System
Proteins: Important Intracellular Buffers
Respiratory Regulation of Acid-Base Balance
Renal Control of Acid-Base Balance
Secretion of Hydrogen Ions and Reabsorption of Bicarbonate Ions by the Renal Tubules
Combination of Excess Hydrogen Ions with Phosphate and Ammonia Buffers in the Tubule-A Mechanism for Generating “New” Bicarbonate Ions
Quantifying Renal Acid-Base Excretion
Regulation of Renal Tubular Hydrogen Ion Secretion
Acidosis Decreases the Ratio of HCO3-/H+ in Renal Tubular Fluid
Alkalosis Increases the Ratio of HCO3-/H+ in Renal Tubular Fluid
Clinical Causes of Acid-Base Disorders
Treatment of Acidosis or Alkalosis
Clinical Measurements and Analysis of Acid-Base Disorders
Complex Acid-Base Disorders and Use of the Acid-Base Nomogram for Diagnosis
Use of Anion Gap to Diagnose Acid-Base Disorders

Kidney Diseases and Diuretics

Diuretics and Their Mechanisms of Action
Kidney Diseases
Acute Renal Failure
Prerenal Acute Renal Failure Caused by Decreased Blood Flow to the Kidney
Intrarenal Acute Renal Failure Caused by Abnormalities Within the Kidney
Postrenal Acute Renal Failure Caused by Abnormalities of the Lower Urinary Tract
Physiologic Effects of Acute Renal Failure
Chronic Renal Failure: An Irreversible Decrease in the Number of Functional Nephrons
Vicious Circle of Chronic Renal Failure Leading to End-Stage Renal Disease
Injury to the Renal Vasculature as a Cause of Chronic Renal Failure
Injury to the Glomeruli as a Cause of Chronic Renal Failure- lomerulonephritis
Injury to the Renal Interstitium as a Cause of Chronic Renal Failure- Pyelonephritis
Nephrotic Syndrome-Excretion of Protein in the Urine Because of Increased Glomerular Permeability
Nephron Function in Chronic Renal Failure
Effects of Renal Failure on the Body Fluids-Uremia
Hypertension and Kidney Disease
Specific Tubular Disorders
Treatment of Renal Failure by Dialysis with an Artificial Kidney

Red Blood Cells Anemia and Polycythemia

Red Blood Cells (Erythrocytes)
Formation of Hemoglobin
Iron Metabolism - Red Blood Cells (Erythrocytes)
Life Span and Destruction of Red Blood Cells
Effects of Anemia on Function of the Circulatory System
Effect of Polycythemia on Function of the Circulatory System

Resistance of the Body to Infection I Leukocytes Granulocytes the Monocyte Macrophage System and Inflammation

Leukocytes (White Blood Cells)
General Characteristics of Leukocytes
Genesis of the White Blood Cells
Life Span of the White Blood Cells
Neutrophils and Macrophages Defend Against Infections
Monocyte-Macrophage Cell System (Reticuloendothelial System)
Inflammation: Role of Neutrophils and Macrophages
Leukemias and Effects of Leukemia on the Body

Resistance of the Body to Infection II Immunity and Allergy

Innate Immunity
Acquired (Adaptive) Immunity
Lymphocytes Are Responsible for Acquired Immunity
Preprocessing of the T and B Lymphocytes
T Lymphocytes and B-Lymphocyte Antibodies React Highly Specifically Against Specific Antigens
Origin of the Many Clones of Lymphocytes
Specific Attributes of the B-Lymphocyte System - Humoral Immunity and the Antibodies
Special Attributes of the T-Lymphocyte System - Activated T Cells and Cell-Mediated Immunity
Several Types of T Cells and Their Different Functions
Tolerance of the Acquired Immunity System to One’s Own Tissues - Role of Preprocessing in the Thymus and Bone Marrow
Immunization by Injection of Antigens
Passive Immunity
Allergy and Hypersensitivity
Allergies in the “Allergic” Person, Who Has Excess IgE Antibodies

Blood Types Transfusion Tissue and Organ Transplantation

Antigenicity Causes Immune Reactions of Blood
O-A-B Blood Types
Rh Blood Types
Rh Immune Response
Transfusion Reactions Resulting from Mismatched Blood Types
Transplantation of Tissues and Organs

Hemostasis and Blood Coagulation

Events in Hemostasis
Mechanism of Blood Coagulation
Conversion of Prothrombin to Thrombin
Conversion of Fibrinogen to Fibrin- Formation of the Clot
Vicious Circle of Clot Formation - Mechanism of Blood Coagulation
Initiation of Coagulation: Formation of Prothrombin Activator
Prevention of Blood Clotting in the Normal Vascular System- Intravascular Anticoagulants
Lysis of Blood Clots- Plasmin
Conditions That Cause Excessive Bleeding in Human Beings
Thromboembolic Conditions in the Human Being
Anticoagulants for Clinical Use
Blood Coagulation Tests

Pulmonary Ventilation

Mechanics of Pulmonary Ventilation
Muscles That Cause Lung Expansion and Contraction
Movement of Air In and Out of the Lungs and the Pressures That Cause the Movement
Effect of the Thoracic Cage on Lung Expansibility
Pulmonary Volumes and Capacities
Minute Respiratory Volume Equals Respiratory Rate Times Tidal Volume
Alveolar Ventilation
Functions of the Respiratory Passageways
Normal Respiratory Functions of the Nose
Vocalization - Functions of the Respiratory Passageways

Pulmonary Circulation Pulmonary Edema Pleural Fluid

Physiologic Anatomy of the Pulmonary Circulatory System
Pressures in the Pulmonary System
Blood Flow Through the Lungs and Its Distribution
Effect of Hydrostatic Pressure Gradients in the Lungs on Regional Pulmonary Blood Flow
Pulmonary Capillary Dynamics
Capillary Exchange of Fluid in the Lungs, and Pulmonary Interstitial Fluid Dynamics
Pulmonary Edema
Fluid in the Pleural Cavity

Physical Principles of Gas Exchange Diffusion of Oxygen and Carbon Dioxide Through the Respiratory Membrane

Physics of Gas Diffusion and Gas Partial Pressures
Composition of Alveolar Air - Its Relation to Atmospheric Air
Diffusion of Gases Through the Respiratory Membrane
Factors That Affect the Rate of Gas Diffusion Through the Respiratory Membrane
Diffusing Capacity of the Respiratory Membrane
Effect of the Ventilation-Perfusion Ratio on Alveolar Gas Concentration

Transport of Oxygen and Carbon Dioxide in Blood and Tissue Fluids

Transport of Oxygen from the Lungs to the Body Tissues
Diffusion of Oxygen from the Alveoli to the Pulmonary Capillary Blood
Transport of Oxygen in the Arterial Blood
Diffusion of Oxygen from the Peripheral Capillaries into the Tissue Fluid
Diffusion of Oxygen from the Peripheral Capillaries to the Tissue Cells
Diffusion of Carbon Dioxide from the Peripheral Tissue Cells into the Capillaries and from the Pulmonary Capillaries into the Alveoli
Role of Hemoglobin in Oxygen Transport
Reversible Combination of Oxygen with Hemoglobin
Effect of Hemoglobin to “Buffer” the Tissue PO2
Factors That Shift the Oxygen-Hemoglobin Dissociation Curve - Their Importance for Oxygen Transport
Metabolic Use of Oxygen by the Cells
Transport of Oxygen in the Dissolved State
Combination of Hemoglobin with Carbon Monoxide -Displacement of Oxygen
Transport of Carbon Dioxide in the Blood
Respiratory Exchange Ratio

Regulation of Respiration

Respiratory Center
Chemical Control of Respiration
Peripheral Chemoreceptor System for Control of Respiratory Activity - Role of Oxygen in Respiratory Control
Regulation of Respiration During Exercise
Other Factors That Affect Respiration
Sleep Apnea

Respiratory Insufficiency Pathophysiology Diagnosis Oxygen Therapy

Respiratory Insufficiency-Pathophysiology, Diagnosis, Oxygen Therapy
Study of Blood Gases and Blood pH
Measurement of Maximum Expiratory Flow
Forced Expiratory Vital Capacity and Forced Expiratory Volume
Physiologic Peculiarities of Specific Pulmonary Abnormalities
Chronic Pulmonary Emphysema
Hypoxia and Oxygen Therapy
Artificial Respiration

Aviation High Altitude and Space Physiology

Effects of Low Oxygen Pressure on the Body
Alveolar PO2 at Different Elevations
Effect of Breathing Pure Oxygen on Alveolar PO2 at Different Altitudes
Acute Effects of Hypoxia
Acclimatization to Low PO2
Natural Acclimatization of Native Human Beings Living at High Altitudes
Reduced Work Capacity at High Altitudes and Positive Effect of Acclimatization
Acute Mountain Sickness and High-Altitude Pulmonary Edema
Chronic Mountain Sickness
Effects of Acceleratory Forces on the Body in Aviation and Space Physiology
“Artificial Climate” in the Sealed Spacecraft
Weightlessness in Space

Physiology of Deep Sea Diving and Other Hyperbaric Conditions

Physiology of Deep-Sea Diving and Other Hyperbaric Conditions
Effect of High Partial Pressures of Individual Gases on the Body
Nitrogen Narcosis at High Nitrogen Pressures
Oxygen Toxicity at High Pressures
Carbon Dioxide Toxicity at Great Depths in the Sea
Decompression of the Diver After Excess Exposure to High Pressure
Scuba (Self-Contained Underwater Breathing Apparatus) Diving
Special Physiologic Problems in Submarines
Hyperbaric Oxygen Therapy

Organization of the Nervous System Basic Functions of Synapses Transmitter Substances

General Design of the Nervous System
Major Levels of Central Nervous System Function
Comparison of the Nervous System with a Computer
Central Nervous System Synapses
Types of Synapses-Chemical and Electrical - Central Nervous System Synapses
Physiologic Anatomy of the Synapse - Central Nervous System Synapses
Chemical Substances That Function as Synaptic Transmitters - Central Nervous System Synapses
Electrical Events During Neuronal Excitation - Central Nervous System Synapses
Electrical Events During Neuronal Inhibition - Central Nervous System Synapses
Special Functions of Dendrites for Exciting Neurons - Central Nervous System Synapses
Relation of State of Excitation of the Neuron to Rate of Firing - Central Nervous System Synapses
Some Special Characteristics of Synaptic Transmission

Sensory Receptors Neuronal Circuits for Processing Information

Types of Sensory Receptors and the Sensory Stimuli They Detect
Transduction of Sensory Stimuli into Nerve Impulses
Nerve Fibers That Transmit Different Types of Signals, and Their Physiologic Classification
Transmission of Signals of Different Intensity in Nerve Tracts-Spatial and Temporal Summation
Transmission and Processing of Signals in Neuronal Pools
Relaying of Signals Through Neuronal Pools
Prolongation of a Signal by a Neuronal Pool-“Afterdischarge”
Instability and Stability of Neuronal Circuits

Somatic Sensations I General Organization the Tactile and Position Senses

Classification of Somatic Senses
Detection and Transmission of Tactile Sensations
Sensory Pathways for Transmitting Somatic Signals into the Central Nervous System
Anatomy of the Dorsal Column-Medial Lemniscal System
Somatosensory Cortex
Somatosensory Association Areas
Overall Characteristics of Signal Transmission and Analysis in the Dorsal Column-Medial Lemniscal System
Interpretation of Sensory Stimulus Intensity
Judgment of Stimulus Intensity
Position Senses(proprioceptive senses)
Transmission of Less Critical Sensory Signals in the Anterolateral Pathway
Some Special Aspects of Somatosensory Function

Somatic Sensations II Pain Headache and Thermal Sensations

Types of Pain and Their Qualities-Fast Pain and Slow Pain
Pain 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
Causes of True Visceral Pain
Some Clinical Abnormalities of Pain and Other Somatic Sensations
Headache of Intracranial Origin
Types of Intracranial Headache
Extracranial Types of Headache
Thermal Receptors and Their Excitation
Transmission of Thermal Signals in the Nervous System

The Eye I Optics of Vision

Physical Principles of Optics - Eye
The Eye as a Camera - Optics of the Eye
Mechanism of “Accommodation” - Optics of the Eye
Pupillary Diameter - Optics of the Eye
Errors of Refraction - Optics of the Eye
Visual Acuity - Optics of the Eye
Determination of Distance of an Object from the Eye- “Depth Perception”
Fluid System of the Eye- Intraocular Fluid

The Eye II Receptor and Neural Function of the Retina

Anatomy and Function of the Structural Elements of the Retina

The Eye I Optics of Vision

Photochemistry of Eye Vision

The Eye II Receptor and Neural Function of the Retina

Rhodopsin Retinal Visual Cycle, and Excitation of the Rods - Photochemistry of Eye Vision
Automatic Regulation of Retinal Sensitivity-Light and Dark Adaptation - Photochemistry of Eye Vision
Color Vision: Tricolor Mechanism of Color Detection, Color Blindness
Neural Circuitry of the Retina - Neural Function of the Retina
Ganglion Cells and Optic Nerve Fibers - Neural Function of the Retina
Excitation of the Ganglion Cells - Neural Function of the Retina

The Eye III Central Neurophysiology of Vision

Visual Pathways
Organization and Function of the Visual Cortex
Neuronal Patterns of Stimulation During Analysis of the Visual Image
Fields of Vision; Perimetry
Eye Movements and Their Control
Fixation Movements of the Eyes
“Fusion” of the Visual Images from the Two Eyes
Autonomic Control of Accommodation and Pupillary Aperture
Control of Accommodation (Focusing the Eyes)
Control of Pupillary Diameter

The Sense of Hearing

Tympanic Membrane and the Ossicular System
Functional Anatomy of the Cochlea
Transmission of Sound Waves in the Cochlea-“Traveling Wave”
Function of the Organ of Corti
Determination of Sound Frequency- The “Place” Principle - Cochlea
Determination of Loudness
Auditory Nervous Pathways
Function of the Cerebral Cortex in Hearing
Determination of the Direction from Which Sound Comes
Centrifugal Signals from the Central Nervous System to Lower Auditory Centers
Hearing Abnormalities: Types of Deafness

The Chemical Senses Taste and Smell

Sense of Taste
Primary Sensations of Taste
Taste Bud and Its Function
Transmission of Taste Signals into the Central Nervous System
Taste Preference and Control of the Diet
Sense of Smell
Olfactory Membrane - Sense of Smell
Stimulation of the Olfactory Cells - Sense of Smell
Transmission of Smell Signals into the Central Nervous System

Motor Functions of the Spinal Cord the Cord Reflexes

Organization of the Spinal Cord for Motor Functions
Muscle Sensory Receptors- Muscle Spindles and Golgi Tendon Organs-And Their Roles in Muscle Control
Receptor Function of the Muscle Spindle
Muscle Stretch Reflex
Role of the Muscle Spindle in Voluntary Motor Activity
Clinical Applications of the Stretch Reflex
Golgi Tendon Reflex
Function of the Muscle Spindles and Golgi Tendon Organ
Flexor Reflex and the Withdrawal Reflexes
Crossed Extensor Reflex
Reciprocal Inhibition and Reciprocal Innervation
Postural and Locomotive Reflexes of the Cord
Scratch Reflex
Spinal Cord Reflexes That Cause Muscle Spasm
Autonomic Reflexes in the Spinal Cord
Spinal Cord Transection and Spinal Shock

Cortical and Brain Stem Control of Motor Function

Motor Cortex and Corticospinal Tract
Some Specialized Areas of Motor Control Found in the Human Motor Cortex
Transmission of Signals from the Motor Cortex to the Muscles
Incoming Fiber Pathways to the Motor Cortex
Red Nucleus Serves as an Alternative Pathway for Transmitting Cortical Signals to the Spinal Cord
“Extrapyramidal” System
Excitation of the Spinal Cord Motor Control Areas by the Primary Motor Cortex and Red Nucleus
Role of the Brain Stem in Controlling Motor Function
Support of the Body Against Gravity- Roles of the Reticular and Vestibular Nuclei
Vestibular Apparatus
Function of the Utricle and Saccule in the Maintenance of Static Equilibrium
Detection of Head Rotation by the Semicircular Ducts
Vestibular Mechanisms for Stabilizing the Eyes
Other Factors Concerned with Equilibrium - Vestibular Mechanisms
Functions of Brain Stem Nuclei in Controlling Subconscious, Stereotyped Movements

Contributions of the Cerebellum and Basal Ganglia to Overall Motor Control

Cerebellum and Its Motor Functions
Anatomical Functional Areas of the Cerebellum
Neuronal Circuit of the Cerebellum
Function of the Cerebellum in Overall Motor Control
Clinical Abnormalities of the Cerebellum
Basal Ganglia-Their Motor Functions
Clinical Syndromes Resulting from Damage to the Basal Ganglia
Integration of the Many Parts of the Total Motor Control System

Cerebral Cortex Intellectual Functions of the Brain Learning and Memory

Physiologic Anatomy of the Cerebral Cortex
Functions of Specific Cortical Areas
Association Areas - Functions of Specific Cortical Areas
Comprehensive Interpretative Function of the Posterior Superior Temporal Lobe-“Wernicke’s Area” (a General Interpretative Area)
Functions of the Parieto-occipitotemporal Cortex in the Nondominant Hemisphere
Higher Intellectual Functions of the Prefrontal Association Areas
Function of the Brain in Communication-Language Input and Language Output
Function of the Corpus Callosum and Anterior Commissure
Thoughts, Consciousness, and Memory
Memory-Roles of Synaptic Facilitation and Synaptic Inhibition
Short-Term Memory
Intermediate Long-Term Memory
Long-Term Memory
Consolidation of Memory

Behavioral and Motivational Mechanisms of the Brain The Limbic System and the Hypothalamus

Activating-Driving Systems of the Brain
Control of Cerebral Activity by Continuous Excitatory Signals from the Brain Stem
Neurohormonal Control of Brain Activity
Limbic System
Functional Anatomy of the Limbic System; Key Position of the Hypothalamus
Hypothalamus, a Major Control Headquarters for the Limbic System
Vegetative and Endocrine Control Functions of the Hypothalamus
Behavioral Functions of the Hypothalamus and Associated Limbic Structures
“Reward” and “Punishment” Function of the Limbic System
Importance of Reward or Punishment in Behavior
Functions of the Hippocampus
Functions of the Amygdala
Function of the Limbic Cortex

States of Brain Activity Sleep Brain Waves Epilepsy Psychoses

Sleep and Two Types of Sleep
Slow-Wave Sleep
REM Sleep (Paradoxical Sleep, Desynchronized Sleep)
Basic Theories of Sleep
Physiologic Effects of Sleep
Brain Waves
Origin of Brain Waves
Psychotic Behavior and Dementia-Roles of Specific Neurotransmitter Systems

The Autonomic Nervous System and the Adrenal Medulla

General Organization of the Autonomic Nervous System
Cholinergic and Adrenergic Fibers- Secretion of Acetylcholine or Norepinephrine
Receptors on the Effector Organs
Excitatory and Inhibitory Actions of Sympathetic and Parasympathetic Stimulation
Effects of Sympathetic and Parasympathetic Stimulation on Specific Organs
Function of the Adrenal Medullae
Relation of Stimulus Rate to Degree of Sympathetic and Parasympathetic Effect
Sympathetic and Parasympathetic “Tone”
Denervation Supersensitivity of Sympathetic and Parasympathetic Organs After Denervation
Stimulation of Discrete Organs in Some Instances and Mass Stimulation
Pharmacology of the Autonomic Nervous System

Cerebral Blood Flow Cerebrospinal Fluid and Brain Metabolism

Normal Rate of Cerebral Blood Flow
Regulation of Cerebral Blood Flow
Cerebral Microcirculation
Cerebral “Stroke” Occurs When Cerebral Blood Vessels Are Blocked
Cerebrospinal Fluid System
Cushioning Function of the Cerebrospinal Fluid
Formation, Flow, and Absorption of Cerebrospinal Fluid
Cerebrospinal Fluid Pressure
Obstruction to Flow of Cerebrospinal Fluid Can Cause Hydrocephalus
Blood-Cerebrospinal Fluid and Blood-Brain Barriers
Brain Edema
Brain Metabolism

General Principles of Gastrointestinal Function Motility Nervous Control and Blood Circulation

General Principles of Gastrointestinal Motility
Neural Control of Gastrointestinal Function- Enteric Nervous System
Differences Between the Myenteric and Submucosal Plexuses
Types of Neurotransmitters Secreted by Enteric Neurons
Hormonal Control of Gastrointestinal Motility
Functional Types of Movements in the Gastrointestinal Tract
Gastrointestinal Blood Flow- “Splanchnic Circulation”
Anatomy of the Gastrointestinal Blood Supply
Effect of Gut Activity and Metabolic Factors on Gastrointestinal Blood Flow
Nervous Control of Gastrointestinal Blood Flow

Propulsion and Mixing of Food in the Alimentary Tract

Ingestion of Food
Motor Functions of the Stomach
Stomach Emptying and Regulation of Stomach Emptying
Movements of the Small Intestine
Mixing Contractions (Segmentation Contractions) - Movements of the Small Intestine
Propulsive Movements of the Small Intestine
Function of the Ileocecal Valve
Movements of the Colon
Other Autonomic Reflexes That Affect Bowel Activity

Secretory Functions of the Alimentary Tract

General Principles of Alimentary Tract Secretion
Anatomical Types of Glands
Basic Mechanisms of Stimulation of the Alimentary Tract Glands
Basic Mechanism of Secretion by Glandular Cells
Lubricating and Protective Properties of Mucus, and Importance of Mucus in the Gastrointestinal Tract
Secretion of Saliva
Nervous Regulation of Salivary Secretion
Esophageal Secretion
Characteristics of the Gastric Secretions
Pyloric Glands-Secretion of Mucus and Gastrin
Surface Mucous Cells
Stimulation of Gastric Acid Secretion
Regulation of Pepsinogen Secretion and Phases of Gastric Secretion
Inhibition of Gastric Secretion by Other Post-Stomach Intestinal Factors
Chemical Composition of Gastrin and Other Gastrointestinal Hormones
Pancreatic Secretion
Pancreatic Digestive Enzymes
Secretion of Bicarbonate Ions
Regulation of Pancreatic Secretion
Secretion of Bile by the Liver; Functions of the Biliary Tree
Physiologic Anatomy of Biliary Secretion
Function of Bile Salts in Fat Digestion and Absorption
Liver Secretion of Cholesterol and Gallstone Formation
Secretions of the Small Intestine
Secretions of the Large Intestine

Digestion and Absorption in the Gastrointestinal Tract

Digestion of the Various Foods by Hydrolysis
Digestion of Carbohydrates
Digestion of Proteins
Digestion of Fats
Basic Principles of Gastrointestinal Absorption
Absorption in the Small Intestine
Absorption of Water in the Small Intestine
Absorption of Ions in the Small Intestine
Absorption of Nutrients in the Small Intestine
Absorption in the Large Intestine: Formation of Feces

Physiology of Gastrointestinal Disorders

Disorders of Swallowing and of the Esophagus
Disorders of the Stomach
Peptic Ulcer - Disorders of the Stomach
Specific Causes of Peptic Ulcer in the Human Being
Disorders of the Small Intestine
Abnormal Digestion of Food in the Small Intestine-Pancreatic Failure
Malabsorption by the Small Intestinal Mucosa-Sprue
Disorders of the Large Intestine
General Disorders of the Gastrointestinal Tract

Metabolism of Carbohydrates and Formation of Adenosine Triphosphate

Release of Energy from Foods, and the Concept of “Free Energy”
Role of Adenosine Triphosphate in Metabolism
Central Role of Glucose in Carbohydrate Metabolism
Transport of Glucose Through the Cell Membrane
Glycogen Is Stored in Liver and Muscle
Release of Energy from the Glucose Molecule by the Glycolytic Pathway
Summary of ATP Formation During the Breakdown of Glucose
Effect of ATP and ADP Cell Concentrations in Controlling the Rate of Glycolysis
Anaerobic Release of Energy- “Anaerobic Glycolysis”
Release of Energy from Glucose by the Pentose Phosphate Pathway
Formation of Carbohydrates from Proteins and Fats- “Gluconeogenesis”
Blood Glucose

Lipid Metabolism

Lipid Metabolism
Transport of Lipids in the Body Fluids
Fat Deposits: Adipose Tissue, Liver Lipids
Use of Triglycerides for Energy: Formation of Adenosine Triphosphate
Formation of Acetoacetic Acid in the Liver and Its Transport in the Blood
Synthesis of Triglycerides from Carbohydrates
Synthesis of Triglycerides from Proteins
Regulation of Energy Release from Triglycerides
Cellular Structural Functions of Phospholipids and Cholesterol- Especially for Membranes
Basic Causes of Atherosclerosis - The Roles of Cholesterol and Lipoproteins
Few Major Risk Factors for Atherosclerosis
Prevention of Atherosclerosis

Protein Metabolism

Basic Properties of Protein Metabolism: Amino Acids
Transport and Storage of Amino Acids
Functional Roles of the Plasma Proteins
Essential and Nonessential Amino Acids
Use of Proteins for Energy
Obligatory Degradation of Proteins
Hormonal Regulation of Protein Metabolism

The Liver as an Organ

Physiologic Anatomy of the Liver
Hepatic Vascular and Lymph Systems
Metabolic Functions of the Liver
Measurement of Bilirubin in the Bile as a Clinical Diagnostic Tool
Jaundice-Excess Bilirubin in the Extracellular Fluid

Dietary Balances Regulation of Feeding Obesity and Starvation Vitamins and Minerals

Energy Intake and Output Are Balanced Under Steady- State Conditions
Dietary Balances: Energy Available in Foods
Methods for Determining Metabolic Utilization of Proteins, Carbohydrates, and Fats
Regulation of Food Intake and Energy Storage
Neural Centers Regulate Food Intake
Factors That Regulate Quantity of Food Intake
Decreased Physical Activity and Abnormal Feeding Regulation as Causes of Obesity
Treatment of Obesity
Inanition, Anorexia, and Cachexia
Vitamin A
Thiamine (Vitamin B1)
Riboflavin (Vitamin B2)
Vitamin B12
Folic Acid (Pteroylglutamic Acid)
Pyridoxine (Vitamin B6)
Pantothenic Acid
Ascorbic Acid (Vitamin C)
Vitamin D
Vitamin E
Vitamin K
Mineral Metabolism

Energetics and Metabolic Rate

Adenosine Triphosphate (ATP) Functions as an “Energy Currency” in Metabolism
Phosphocreatine Functions as an Accessory Storage Depot for Energy and as an “ATP Buffer”
Anaerobic Versus Aerobic Energy
Summary of Energy Utilization by the Cells
Control of Energy Release in the Cell
Metabolic Rate
Measurement of the Whole-Body Metabolic Rate
Energy Metabolism-Factors That Influence Energy Output
Overall Energy Requirements for Daily Activities
Basal Metabolic Rate (BMR)- The Minimum Energy Expenditure for the Body to Exist
Energy Used for Physical Activities

Body Temperature Temperature Regulation and Fever

Normal Body Temperatures
Body Temperature Is Controlled by Balancing Heat Production Against Heat Loss
Regulation of Body Temperature-Role of the Hypothalamus
Neuronal Effector Mechanisms That Decrease or Increase Body Temperature
Concept of a “Set-Point” for Temperature Control
Behavioral Control of Body Temperature
Abnormalities of Body Temperature Regulation
Exposure of the Body to Extreme Cold

Introduction to Endocrinology

Coordination of Body Functions by Chemical Messengers
Chemical Structure and Synthesis of Hormones
Hormone Secretion, Transport, and Clearance from the Blood
Hormone Receptors and Their Activation
Intracellular Signaling After Hormone Receptor Activation
Second Messenger Mechanisms for Mediating Intracellular Hormonal Functions
Hormones That Act Mainly on the Genetic Machinery of the Cell
Measurement of Hormone Concentrations in the Blood

Pituitary Hormones and Their Control by the Hypothalamus

Pituitary Gland and Its Relation to the Hypothalamus
Hypothalamus Controls Pituitary Secretion
Physiological Functions of Growth Hormone
Growth Hormone Promotes Growth of Many Body Tissues
Growth Hormone Has Several Metabolic Effects
Growth Hormone Stimulates Cartilage and Bone Growth
Growth Hormone Exerts Much of Its Effect Through Intermediate Substances Called “Somatomedins”
Regulation of Growth Hormone Secretion
Abnormalities of Growth Hormone Secretion
Posterior Pituitary Gland and Its Relation to the Hypothalamus
Physiological Functions of ADH
Oxytocic Hormone

Thyroid Metabolic Hormones

Thyroid Metabolic Hormones
Synthesis and Secretion of the Thyroid Metabolic Hormones
Physiologic Functions of the Thyroid Hormones
Thyroid Hormones Increase the Transcription of Large Numbers of Genes
Thyroid Hormones Increase Cellular Metabolic Activity
Effect of Thyroid Hormone on Growth
Effects of Thyroid Hormone on Specific Bodily Mechanisms
Regulation of Thyroid Hormone Secretion
Diseases of the Thyroid
Symptoms of Hyperthyroidism

Adrenocortical Hormones

Adrenocortical Hormones
Synthesis and Secretion of Adrenocortical Hormones
Functions of the Mineralocorticoids- Aldosterone
Renal and Circulatory Effects of Aldosterone
Aldosterone Stimulates Sodium and Potassium Transport
Cellular Mechanism of Aldosterone Action
Possible Nongenomic Actions of Aldosterone and Other Steroid Hormones
Regulation of Aldosterone Secretion
Functions of the Glucocorticoids
Effects of Cortisol on Carbohydrate Metabolism
Effects of Cortisol on Protein Metabolism
Effects of Cortisol on Fat Metabolism
Cortisol is Important in Resisting Stress and Inflammation
Other Effects of Cortisol
Cellular Mechanism of Cortisol Action
Regulation of Cortisol Secretion by Adrenocorticotropic Hormone from the Pituitary Gland
Adrenal Androgens
Abnormalities of Adrenocortical Secretion
Hypoadrenalism-Addison’s Disease
Hyperadrenalism-Cushing’s Syndrome
Primary Aldosteronism (Conn’s Syndrome)
Adrenogenital Syndrome

Insulin Glucagon and Diabetes Mellitus

Insulin and Its Metabolic Effects
Effect of Insulin on Carbohydrate Metabolism
Effect of Insulin on Fat Metabolism
Effect of Insulin on Protein Metabolism and on Growth
Mechanisms of Insulin Secretion
Control of Insulin Secretion
Other Factors That Stimulate Insulin Secretion
Role of Insulin (and Other Hormones) in “Switching” Between Carbohydrate and Lipid Metabolism
Glucagon and Its Functions
Somatostatin Inhibits Glucagon and Insulin Secretion
Summary of Blood Glucose Regulation
Diabetes Mellitus
Type I Diabetes-Lack of Insulin Production by Beta Cells of the Pancreas
Type II Diabetes-Resistance to the Metabolic Effects of Insulin
Physiology of Diagnosis of Diabetes Mellitus
Treatment of Diabetes

Parathyroid Hormone Calcitonin Calcium and Phosphate Metabolism Vitamin D Bone and Teeth

Overview of Calcium and Phosphate Regulation in the Extracellular Fluid and Plasma
Bone and Its Relation to Extracellular Calcium and Phosphate
Precipitation and Absorption of Calcium and Phosphate in Bone-Equilibrium with the Extracellular Fluids
Calcium Exchange Between Bone and Extracellular Fluid
Deposition and Absorption of Bone-Remodeling of Bone
Vitamin D and Actions of Vitamin D
Parathyroid Hormone
Effect of Parathyroid Hormone on Calcium and Phosphate Concentrations in the Extracellular Fluid
Control of Parathyroid Secretion by Calcium Ion Concentration
Summary of Control of Calcium Ion Concentration
Primary Hyperparathyroidism
Secondary Hyperparathyroidism
Rickets-Vitamin D Deficiency
Osteoporosis-Decreased Bone Matrix
Physiology of the Teeth
Function of the Different Parts of the Teeth
Mineral Exchange in Teeth
Dental Abnormalities

Reproductive and Hormonal Functions of the Male and Function of the Pineal Gland

Physiologic Anatomy of the Male Sexual Organs
Steps of Spermatogenesis
Function of the Seminal Vesicles
Function of the Prostate Gland
Abnormal Spermatogenesis and Male Fertility
Neuronal Stimulus for Performance of the Male Sexual Act
Stages of the Male Sexual Act
Secretion, Metabolism, and Chemistry of the Male Sex Hormone
Functions of Testosterone
Basic Intracellular Mechanism of Action of Testosterone
Control of Male Sexual Functions by Hormones from the Hypothalamus and Anterior Pituitary Gland
Abnormalities of Male Sexual Function
Prostate Gland and Its Abnormalities
Hypogonadism in the Male
Testicular Tumors and Hypergonadism in the Male
Pineal Gland-Its Function in Controlling Seasonal Fertility in Some Animals

Female Physiology Before Pregnancy and Female Hormones

Physiologic Anatomy of the Female Sexual Organs
Female Hormonal System
Monthly Ovarian Cycle; Function of the Gonadotropic Hormones
Gonadotropic Hormones and Their Effects on the Ovaries
Ovarian Follicle Growth- “Follicular” Phase of the Ovarian Cycle
Corpus Luteum-“Luteal” Phase of the Ovarian Cycle
Functions of the Ovarian Hormones-Estradiol and Progesterone
Chemistry of the Sex Hormones
Functions of the Estrogens- Their Effects on the Primary and Secondary Female Sex Characteristics
Functions of Progesterone
Monthly Endometrial Cycle and Menstruation
Regulation of the Female Monthly Rhythm-Interplay Between the Ovarian and Hypothalamic-Pituitary Hormones
Feedback Oscillation of the Hypothalamic-Pituitary-Ovarian System
Puberty and Menarche
Abnormalities of Secretion by the Ovaries
Female Sexual Act
Female Fertility

Pregnancy and Lactation

Maturation and Fertilization of the Ovum
Early Nutrition of the Embryo
Function of the Placenta: Developmental and Physiologic Anatomy of the Placenta
Hormonal Factors in Pregnancy
Response of the Mother’s Body to Pregnancy
Changes in the Maternal Circulatory System During Pregnancy
Increased Uterine Excitability Near Term - Parturition
Onset of Labor-A Positive Feedback Mechanism for Its Initiation - Parturition
Abdominal Muscle Contractions During Labor
Mechanics of Parturition
Separation and Delivery of the Placenta
Labor Pains
Involution of the Uterus After Parturition
Development of the Breasts - Lactation
Initiation of Lactation-Function of Prolactin
Ejection (or “Let-Down”) Process in Milk Secretion-Function of Oxytocin
Milk Composition and the Metabolic Drain on the Mother Caused by Lactation

Fetal and Neonatal Physiology

Growth and Functional Development of the Fetus
Adjustments of the Infant to Extrauterine Life
Onset of Breathing - Adjustments of the Infant to Extrauterine Life
Circulatory Readjustments at Birth - Adjustments of the Infant to Extrauterine Life
Nutrition of the Neonate - Adjustments of the Infant to Extrauterine Life
Special Functional Problems in the Neonate
Special Problemsof Prematurity
Growth and Development of the Child

Sports Physiology

Sports Physiology
Muscles in Exercise: Strength, Power, and Endurance of Muscles
Muscle Metabolic Systems in Exercise
Phosphocreatine-Creatine System - Muscles in Exercise
Nutrients Used During Muscle Activity - Muscles in Exercise
Effect of Athletic Training on Muscles and Muscle Performance
Respiration in Exercise
Cardiovascular System in Exercise
Body Heat in Exercise
Body Fluids and Salt in Exercise
Drugs and Athletes
Body Fitness Prolongs Life

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