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Review of medical physiology 21 edition william f. ganong

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Rene Andrade
Rene Andrade

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Health & Medicine
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Table of Contents 1REVIEW OF MEDICAL PHYSIOLOGY - 21st Ed. (2003) ................................................................................... 1Cover ....................................................................................................................................................................................................... 2Front Matter ........................................................................................................................................................................................... 4Section I. Introduction ....................................................................................................................................................................... 41. The General & Cellular Basis of Medical Physiology ...................................................................................................... 4INTRODUCTION ...................................................................................................................................................................... 22TABLES ................................................................................................................................................................................. 22Table 1-1. Total body water (as percentage of body weight) in relation to age and sex. ............................................................. 23Table 1-2. Concentration of some ions inside and outside mammalian spinal motor neurons. .................................................. 24Table 1-3. Some of the enzymes found in lysosomes and the cell components that are their substrates. ................................... 25Table 1-4. Molecular motors. ............................................................................................................................................. 26Table 1-5. Size of hydrated ions and other substances of biological interest. ........................................................................... 27Table 1-6. Principal mechanisms by which chemical messengers in the ECF bring about changes in cell function. .................... 28Table 1-7. Principal protein kinases. ................................................................................................................................... 29Table 1-8. Some of the ligands for receptors coupled to G proteins. ....................................................................................... 30Table 1-9. Diseases caused by loss or gain of function mutations of heterotrimeric G protein-coupled receptors and G proteins. . 31FIGURES ............................................................................................................................................................................... 31Figure 1-1 ....................................................................................................................................................................... 32Figure 1-2 ....................................................................................................................................................................... 33Figure 1-3 ....................................................................................................................................................................... 34Figure 1-4 ....................................................................................................................................................................... 35Figure 1-5 ....................................................................................................................................................................... 36Figure 1-6 ....................................................................................................................................................................... 37Figure 1-7 ....................................................................................................................................................................... 38Figure 1-8 ....................................................................................................................................................................... 39Figure 1-9 ....................................................................................................................................................................... 40Figure 1-10 ..................................................................................................................................................................... 41Figure 1-11 ...................................................................................................................................................................... 42Figure 1-12 ..................................................................................................................................................................... 43Figure 1-13 ..................................................................................................................................................................... 44Figure 1-14 ..................................................................................................................................................................... 45Figure 1-15 ..................................................................................................................................................................... 46Figure 1-16 ..................................................................................................................................................................... 47Figure 1-17 ..................................................................................................................................................................... 48Figure 1-18 ..................................................................................................................................................................... 49Figure 1-19 ..................................................................................................................................................................... 50Figure 1-20 ..................................................................................................................................................................... 51Figure 1-21 ..................................................................................................................................................................... 52Figure 1-22 ..................................................................................................................................................................... 53Figure 1-23 ..................................................................................................................................................................... 54Figure 1-24 ..................................................................................................................................................................... 55Figure 1-25 ..................................................................................................................................................................... 56Figure 1-26 ..................................................................................................................................................................... 57Figure 1-27 ..................................................................................................................................................................... 58Figure 1-28 ..................................................................................................................................................................... 59Figure 1-29 ..................................................................................................................................................................... 60Figure 1-30 ..................................................................................................................................................................... 61Figure 1-31 ..................................................................................................................................................................... 62Figure 1-32 ..................................................................................................................................................................... 63Figure 1-33 .....................................................................................................................................................................
64Figure 1-34 ..................................................................................................................................................................... 65Figure 1-35 ..................................................................................................................................................................... 66Figure 1-36 ..................................................................................................................................................................... 67Figure 1-37 ..................................................................................................................................................................... 68Figure 1-38 ..................................................................................................................................................................... 69Figure 1-39 ..................................................................................................................................................................... 70Figure 1-40 ..................................................................................................................................................................... 71Figure 1-41 ..................................................................................................................................................................... 72Figure 1-42 ..................................................................................................................................................................... 73Figure 1-43 ..................................................................................................................................................................... 74Figure 1-44 ..................................................................................................................................................................... 75Figure 1-45 ..................................................................................................................................................................... 76Figure 1-46 ..................................................................................................................................................................... 77Figure 1-47 ..................................................................................................................................................................... 78References for Section I: Introduction .................................................................................................................................. 79Section II. Physiology of Nerve & Muscle Cells ................................................................................................................. 792. Excitable Tissue: Nerve ....................................................................................................................................................... 79INTRODUCTION ................................................................................................................................................................... 84TABLES ................................................................................................................................................................................. 84Table 2-1. Nerve fiber types in mammalian nerve. ................................................................................................................ 85Table 2-2. Numerical classification sometimes used for sensory neurons. .............................................................................. 86Table 2-3. Relative susceptibility of mammalian A, B, and C nerve fibers to conduction block produced by various agents. .......... 87Table 2-4. Neurotrophins. .................................................................................................................................................. 88FIGURES ............................................................................................................................................................................... 88Figure 2-1 ....................................................................................................................................................................... 89Figure 2-2 ....................................................................................................................................................................... 90Figure 2-3 ....................................................................................................................................................................... 91Figure 2-4 ....................................................................................................................................................................... 92Figure 2-5 ....................................................................................................................................................................... 93Figure 2-6 ....................................................................................................................................................................... 94Figure 2-7 ....................................................................................................................................................................... 95Figure 2-8 ....................................................................................................................................................................... 96Figure 2-9 ....................................................................................................................................................................... 97Figure 2-10 ..................................................................................................................................................................... 98Figure 2-11 ...................................................................................................................................................................... 99Figure 2-12 ..................................................................................................................................................................... 100Figure 2-13 .................................................................................................................................................................. 101Figure 2-14 .................................................................................................................................................................. 102Figure 2-15 .................................................................................................................................................................. 1033. Excitable Tissue: Muscle .................................................................................................................................................. 103INTRODUCTION ............................................................................................................................................................... 111SMOOTH MUSCLE ............................................................................................................................................................ 111TABLES ........................................................................................................................................................................ 111Table 3-1. Steady-state distribution of ions in the intracellular and extracellula ........................................................................... 112Table 3-2. Sequence of events in contraction and relaxation of skeletal muscle. ......................................................................... 113Table 3-3. Classification of fiber types in skeletal muscles. .................................................................................................. 114Table 3-4. Myofibrillar protein isoforms in adult extrafusal fibers in the rat. ................................................................................ 115Table 3-5. Cardiac ion channels. .................................................................................................................................. 116Table 3-6. Sequence of events in contraction and relaxation of visceral smooth muscle. ............................................................... 117FIGURES ..................................................................................................................................................................... 117Figure 3-1 .............................................................................................................................................................. 118Figure 3-2 .............................................................................................................................................................. 119Figure 3-3 .............................................................................................................................................................. 120Figure 3-4 .............................................................................................................................................................
121Figure 3-5 ............................................................................................................................................................. 122Figure 3-6 ............................................................................................................................................................. 123Figure 3-7 ............................................................................................................................................................. 124Figure 3-8 ............................................................................................................................................................. 125Figure 3-9 ............................................................................................................................................................. 126Figure 3-10 ............................................................................................................................................................ 127Figure 3-11 ............................................................................................................................................................ 128Figure 3-12 ............................................................................................................................................................ 129Figure 3-13 ............................................................................................................................................................ 130Figure 3-14 ............................................................................................................................................................ 131Figure 3-15 ............................................................................................................................................................ 132Figure 3-16 ............................................................................................................................................................ 133Figure 3-17 ............................................................................................................................................................ 134Figure 3-18 ............................................................................................................................................................ 135Figure 3-19 ............................................................................................................................................................ 1364. Synaptic & Junctional Transmission ............................................................................................................................. 136INTRODUCTION ............................................................................................................................................................... 149NEUROMUSCULAR TRANSMISSION ............................................................................................................................. 149TABLES ....................................................................................................................................................................... 149Table 4-1. Neurotransmitters and neuromodulators in the nervous system of mammals. .............................................................. 151Table 4-2. Mechanism of action of selected neurotransmitters. ............................................................................................. 152Table 4-3. Mammalian tachykinins. ............................................................................................................................... 153Table 4-4. Opioid peptides and their precursors. ............................................................................................................... 154Table 4-5. Physiologic effects produced by stimulation of opiate receptors. .............................................................................. 155FIGURES ..................................................................................................................................................................... 155Figure 4-1 ............................................................................................................................................................. 156Figure 4-2 ............................................................................................................................................................. 157Figure 4-3 ............................................................................................................................................................. 158Figure 4-4 ............................................................................................................................................................. 159Figure 4-5 ............................................................................................................................................................. 160Figure 4-6 ............................................................................................................................................................. 161Figure 4-7 ............................................................................................................................................................. 162Figure 4-8 ............................................................................................................................................................. 163Figure 4-9 ............................................................................................................................................................. 164Figure 4-10 ............................................................................................................................................................ 165Figure 4-11 ............................................................................................................................................................ 166Figure 4-12 ............................................................................................................................................................ 167Figure 4-13 ............................................................................................................................................................ 168Figure 4-14 ............................................................................................................................................................ 169Figure 4-15 ............................................................................................................................................................ 170Figure 4-16 ............................................................................................................................................................ 171Figure 4-17 ............................................................................................................................................................ 172Figure 4-18 ............................................................................................................................................................ 173Figure 4-19 ............................................................................................................................................................ 174Figure 4-20 ............................................................................................................................................................ 175Figure 4-21 ............................................................................................................................................................ 176Figure 4-22 ............................................................................................................................................................ 177Figure 4-23 ............................................................................................................................................................ 178Figure 4-24 ............................................................................................................................................................ 179Figure 4-25 ............................................................................................................................................................ 180Figure 4-26 ............................................................................................................................................................ 181Figure 4-27 ............................................................................................................................................................ 182Figure 4-28 ............................................................................................................................................................ 183Figure 4-29 ............................................................................................................................................................
184Figure 4-30 ............................................................................................................................................................ 185Figure 4-31 ............................................................................................................................................................ 186Figure 4-32 ............................................................................................................................................................ 187Figure 4-33 ............................................................................................................................................................ 188Figure 4-34 ............................................................................................................................................................ 189Figure 4-35 ............................................................................................................................................................ 190Figure 4-36 ............................................................................................................................................................ 191Figure 4-37 ............................................................................................................................................................ 1925. Initiation of Impulses in Sense Organs ........................................................................................................................ 192INTRODUCTION ............................................................................................................................................................... 195TABLES .............................................................................................................................................................................. 196FIGURES ............................................................................................................................................................................ 196Figure 5-1 .................................................................................................................................................................... 197Figure 5-2 .................................................................................................................................................................... 198Figure 5-3 .................................................................................................................................................................... 199Figure 5-4 .................................................................................................................................................................... 200References for Section II. Physiology of Nerve & Muscle Cells .................................................................................. 201Section III. Functions of the Nervous System ................................................................................................................. 2016. Reflexes ................................................................................................................................................................................ 201INTRODUCTION ............................................................................................................................................................... 205FIGURES ............................................................................................................................................................................ 205Figure 6-1 .................................................................................................................................................................... 206Figure 6-2 .................................................................................................................................................................... 207Figure 6-3 .................................................................................................................................................................... 208Figure 6-4 .................................................................................................................................................................... 209Figure 6-5 .................................................................................................................................................................... 210Figure 6-6 .................................................................................................................................................................... 211Figure 6-7 ..................................................................................................................................................................... 212Figure 6-8 .................................................................................................................................................................... 213Figure 6-9 .................................................................................................................................................................... 214Figure 6-10 .................................................................................................................................................................. 2157. Cutaneous, Deep, & Visceral Sensation ...................................................................................................................... 215INTRODUCTION ............................................................................................................................................................... 221FIGURES ............................................................................................................................................................................ 221Figure 7-1 .................................................................................................................................................................... 222Figure 7-2 .................................................................................................................................................................... 223Figure 7-3 .................................................................................................................................................................... 224Figure 7-4 .................................................................................................................................................................... 225Figure 7-5 .................................................................................................................................................................... 226Figure 7-6 .................................................................................................................................................................... 227Figure 7-7 .................................................................................................................................................................... 2288. Vision ..................................................................................................................................................................................... 228INTRODUCTION ............................................................................................................................................................... 236TABLES .............................................................................................................................................................................. 237FIGURES ............................................................................................................................................................................ 237Figure 8-1 .................................................................................................................................................................... 238Figure 8-2 .................................................................................................................................................................... 239Figure 8-3 .................................................................................................................................................................... 240Figure 8-4 .................................................................................................................................................................... 241Figure 8-5 .................................................................................................................................................................... 242Figure 8-6 .................................................................................................................................................................... 243Figure 8-7 .................................................................................................................................................................... 244Figure 8-8 .................................................................................................................................................................... 245Figure 8-9 ....................................................................................................................................................................
246Figure 8-10 .................................................................................................................................................................. 247Figure 8-11 ................................................................................................................................................................... 248Figure 8-12 .................................................................................................................................................................. 249Figure 8-13 .................................................................................................................................................................. 250Figure 8-14 .................................................................................................................................................................. 251Figure 8-15 .................................................................................................................................................................. 252Figure 8-16 .................................................................................................................................................................. 253Figure 8-17 .................................................................................................................................................................. 254Figure 8-18 .................................................................................................................................................................. 255Figure 8-19 .................................................................................................................................................................. 256Figure 8-20 .................................................................................................................................................................. 257Figure 8-21 .................................................................................................................................................................. 258Figure 8-22 .................................................................................................................................................................. 259Figure 8-23 .................................................................................................................................................................. 260Figure 8-24 .................................................................................................................................................................. 261Figure 8-25 .................................................................................................................................................................. 262Figure 8-26 .................................................................................................................................................................. 263Figure 8-27 .................................................................................................................................................................. 264Figure 8-28 .................................................................................................................................................................. 265Figure 8-29 .................................................................................................................................................................. 266Figure 8-30 .................................................................................................................................................................. 267Figure 8-31 .................................................................................................................................................................. 2689. Hearing & Equilibrium ....................................................................................................................................................... 268INTRODUCTION ............................................................................................................................................................... 273TABLES .............................................................................................................................................................................. 274FIGURES ............................................................................................................................................................................ 274Figure 9-1 .................................................................................................................................................................... 275Figure 9-2 .................................................................................................................................................................... 276Figure 9-3 .................................................................................................................................................................... 277Figure 9-4 .................................................................................................................................................................... 278Figure 9-5 .................................................................................................................................................................... 279Figure 9-6 .................................................................................................................................................................... 280Figure 9-7 .................................................................................................................................................................... 281Figure 9-8 .................................................................................................................................................................... 282Figure 9-9 .................................................................................................................................................................... 283Figure 9-10 .................................................................................................................................................................. 284Figure 9-11 ................................................................................................................................................................... 285Figure 9-12 .................................................................................................................................................................. 286Figure 9-13 .................................................................................................................................................................. 287Figure 9-14 .................................................................................................................................................................. 288Figure 9-15 .................................................................................................................................................................. 289Figure 9-16 .................................................................................................................................................................. 29010. Smell & Taste .................................................................................................................................................................... 290INTRODUCTION ............................................................................................................................................................... 293TASTE ................................................................................................................................................................................ 293TABLES ....................................................................................................................................................................... 293Table 10-1. Some olfactory thresholds. .......................................................................................................................... 294Table 10-2. Some taste thresholds. ............................................................................................................................... 295FIGURES ..................................................................................................................................................................... 295Figure 10-1 ............................................................................................................................................................ 296Figure 10-2 ............................................................................................................................................................ 297Figure 10-3 ............................................................................................................................................................ 298Figure 10-4 ............................................................................................................................................................ 299Figure 10-5 ............................................................................................................................................................
300Figure 10-6 ............................................................................................................................................................ 30111. Alert Behavior, Sleep, & the Electrical Activity of the Brain ................................................................................... 301INTRODUCTION ............................................................................................................................................................... 305FIGURES ............................................................................................................................................................................ 305Figure 11-1 ................................................................................................................................................................... 306Figure 11-2 ................................................................................................................................................................... 307Figure 11-3 ................................................................................................................................................................... 308Figure 11-4 ................................................................................................................................................................... 309Figure 11-5 ................................................................................................................................................................... 310Figure 11-6 ................................................................................................................................................................... 311Figure 11-7 ................................................................................................................................................................... 312Figure 11-8 ................................................................................................................................................................... 313Figure 11-9 ................................................................................................................................................................... 314Figure 11-10 ................................................................................................................................................................. 315Figure 11-11 ................................................................................................................................................................. 316Figure 11-12 ................................................................................................................................................................. 31712. Control of Posture & Movement ................................................................................................................................... 317INTRODUCTION ............................................................................................................................................................... 325CEREBELLUM ................................................................................................................................................................... 325TABLES ....................................................................................................................................................................... 325Table 12-1. Summary of levels involved in various neural functions. ....................................................................................... 326Table 12-2. Principal postural reflexes. ........................................................................................................................... 327Table 12-3. The basal ganglia. ..................................................................................................................................... 328Table 12-4. Examples of trinucleotide repeat diseases. ....................................................................................................... 329Table 12-5. Function of principal afferent systems to the cerebellum. ...................................................................................... 330FIGURES ..................................................................................................................................................................... 330Figure 12-1 ............................................................................................................................................................ 331Figure 12-2 ............................................................................................................................................................ 332Figure 12-3 ............................................................................................................................................................ 333Figure 12-4 ............................................................................................................................................................ 334Figure 12-5 ............................................................................................................................................................ 335Figure 12-6 ............................................................................................................................................................ 336Figure 12-7 ............................................................................................................................................................ 337Figure 12-8 ............................................................................................................................................................ 338Figure 12-9 ............................................................................................................................................................ 339Figure 12-10 .......................................................................................................................................................... 340Figure 12-11 .......................................................................................................................................................... 341Figure 12-12 .......................................................................................................................................................... 342Figure 12-13 .......................................................................................................................................................... 343Figure 12-14 .......................................................................................................................................................... 344Figure 12-15 .......................................................................................................................................................... 345Figure 12-16 .......................................................................................................................................................... 346Figure 12-17 .......................................................................................................................................................... 34713. The Autonomic Nervous System ................................................................................................................................. 347INTRODUCTION ............................................................................................................................................................... 349TABLES .............................................................................................................................................................................. 349Table 13-1. Fast and slow responses of postganglionic neurons in sympathetic ganglia. ...................................................... 350Table 13-2. Responses of effector organs to autonomic nerve impulses and circulating catecholamines. ............................... 352Table 13-3. Some drugs and toxins that affect autonomic acitvity. ....................................................................................... 353FIGURES ............................................................................................................................................................................ 353Figure 13-1 .................................................................................................................................................................. 354Figure 13-2 .................................................................................................................................................................. 355Figure 13-3 .................................................................................................................................................................. 35614. Central Regulation of Visceral Function ....................................................................................................................
356INTRODUCTION ............................................................................................................................................................... 366HYPOTHALAMUS .............................................................................................................................................................. 366TABLES ....................................................................................................................................................................... 366Table 14-1. Summary of principal hypothalamic regulatory mechanisms. ................................................................................. 367Table 14-2. Principal hypothalamic polypeptides that appear to play a role in the regulation of the appetite for food. ............................. 368Table 14-3. Summary of stimuli affecting vasopressin secretion. ........................................................................................... 369Table 14-4. Symptoms and signs in 60 autopsied patients with hypothalamic disease. ................................................................ 370Table 14-5. Body heat production and heat loss. ............................................................................................................... 371Table 14-6. Temperature-regulating mechanisms. ............................................................................................................. 372FIGURES ..................................................................................................................................................................... 372Figure 14-1 ............................................................................................................................................................ 373Figure 14-2 ............................................................................................................................................................ 374Figure 14-3 ............................................................................................................................................................ 375Figure 14-4 ............................................................................................................................................................ 376Figure 14-5 ............................................................................................................................................................ 377Figure 14-6 ............................................................................................................................................................ 378Figure 14-7 ............................................................................................................................................................ 379Figure 14-8 ............................................................................................................................................................ 380Figure 14-9 ............................................................................................................................................................ 381Figure 14-10 .......................................................................................................................................................... 382Figure 14-11 .......................................................................................................................................................... 383Figure 14-12 .......................................................................................................................................................... 384Figure 14-13 .......................................................................................................................................................... 385Figure 14-14 .......................................................................................................................................................... 386Figure 14-15 .......................................................................................................................................................... 387Figure 14-16 .......................................................................................................................................................... 388Figure 14-17 .......................................................................................................................................................... 389Figure 14-18 .......................................................................................................................................................... 390Figure 14-19 .......................................................................................................................................................... 391Figure 14-20 .......................................................................................................................................................... 392Figure 14-21 .......................................................................................................................................................... 393Figure 14-22 .......................................................................................................................................................... 394Figure 14-23 .......................................................................................................................................................... 395Figure 14-24 .......................................................................................................................................................... 39615. Neural Basis of Instinctual Behavior & Emotions .................................................................................................... 396INTRODUCTION ............................................................................................................................................................... 401FIGURES ............................................................................................................................................................................ 401Figure 15-1 .................................................................................................................................................................. 402Figure 15-2 .................................................................................................................................................................. 403Figure 15-3 .................................................................................................................................................................. 404Figure 15-4 .................................................................................................................................................................. 405Figure 15-5 .................................................................................................................................................................. 406Figure 15-6 .................................................................................................................................................................. 407Figure 15-7 .................................................................................................................................................................. 408Figure 15-8 .................................................................................................................................................................. 40916. ............................................................................................................................................................................................... 409INTRODUCTION ............................................................................................................................................................... 414TABLES .............................................................................................................................................................................. 414Table 16-1. Types of memory. ......................................................................................................................................... 415Table 16-2. Possible sequence of events in the pathogenesis of Alzheimier's disease. ......................................................... 416Table 16-3. Aphasias. Characteristic responses of patients with lesions in various areas when shown a picture of a chair. ....... 417FIGURES ............................................................................................................................................................................ 417Figure 16-1 .................................................................................................................................................................. 418Figure 16-2 ..................................................................................................................................................................
419Figure 16-3 .................................................................................................................................................................. 420Figure 16-4 .................................................................................................................................................................. 421Figure 16-5 .................................................................................................................................................................. 422Figure 16-6 .................................................................................................................................................................. 423Figure 16-7 .................................................................................................................................................................. 424References for Section III. Functions of the Nervous System ..................................................................................... 426Section IV. Endocrinology, Metabolism, & Reproductive Function ......................................................................... 42617. Energy Balance, Metabolism, & Nutrition .................................................................................................................. 426INTRODUCTION ............................................................................................................................................................... 438TABLES .............................................................................................................................................................................. 438Table 17-1. Factors affecting the metabolic rate. .............................................................................................................. 439Table 17-2. Amino acids found in proteins. Those in bold type are the nutr .......................................................................... 440Table 17-3. Purine- and pyrimidine-containing compounds. ............................................................................................... 441Table 17-4. Lipids. ........................................................................................................................................................ 442Table 17-5. The principal lipoproteins. The plasma lipids include these co .......................................................................... 443Table 17-6. Derivatives of PGH2, their receptors, and tissues in which their effects are prominent. ........................................ 444Table 17-7. Groups of enzymes involved in the metabolism of arachidonic acid and their eicosanoid products. ....................... 445Table 17-8. Food and Nutrition Board, National Academy of Sciences—N ................................................................. 446Table 17-9. Trace elements believed essential for life. ...................................................................................................... 447Table 17-10. Vitamins essential or probably essential to human nutrition. ............................................................................ 448FIGURES ............................................................................................................................................................................ 448Figure 17-1 .................................................................................................................................................................. 449Figure 17-2 .................................................................................................................................................................. 450Figure 17-3 .................................................................................................................................................................. 451Figure 17-4 .................................................................................................................................................................. 452Figure 17-5 .................................................................................................................................................................. 453Figure 17-6 .................................................................................................................................................................. 454Figure 17-7 .................................................................................................................................................................. 455Figure 17-8 .................................................................................................................................................................. 456Figure 17-9 .................................................................................................................................................................. 457Figure 17-10 ................................................................................................................................................................. 458Figure 17-11 ................................................................................................................................................................. 459Figure 17-12 ................................................................................................................................................................. 460Figure 17-13 ................................................................................................................................................................. 461Figure 17-14 ................................................................................................................................................................. 462Figure 17-15 ................................................................................................................................................................. 463Figure 17-16 ................................................................................................................................................................. 464Figure 17-17 ................................................................................................................................................................. 465Figure 17-18 ................................................................................................................................................................. 466Figure 17-19 ................................................................................................................................................................. 467Figure 17-20 ................................................................................................................................................................. 468Figure 17-21 ................................................................................................................................................................. 469Figure 17-22 ................................................................................................................................................................. 470Figure 17-23 ................................................................................................................................................................. 471Figure 17-24 ................................................................................................................................................................. 472Figure 17-25 ................................................................................................................................................................. 473Figure 17-26 ................................................................................................................................................................. 474Figure 17-27 ................................................................................................................................................................. 475Figure 17-28 ................................................................................................................................................................. 476Figure 17-29 ................................................................................................................................................................. 477Figure 17-30 ................................................................................................................................................................. 478Figure 17-31 ................................................................................................................................................................. 479Figure 17-32 ................................................................................................................................................................. 480Figure 17-33 .................................................................................................................................................................
481Figure 17-34 ................................................................................................................................................................. 48218. The Thyroid Gland ........................................................................................................................................................... 482INTRODUCTION ............................................................................................................................................................... 489TABLES .............................................................................................................................................................................. 489Table 18-1. Binding of thyroid hormones to plasma proteins in normal adult humans. ........................................................... 490Table 18-2. Effect of variations in the concentrations of thyroid hormone- ............................................................................ 491Table 18-3. Physiologic effects of thyroid hormones. ......................................................................................................... 492Table 18-4. Causes of congenital hypothyroidism. ............................................................................................................ 493Table 18-5. Causes of hyperthyroidism. ........................................................................................................................... 494FIGURES ............................................................................................................................................................................ 494Figure 18-1 .................................................................................................................................................................. 495Figure 18-2 .................................................................................................................................................................. 496Figure 18-3 .................................................................................................................................................................. 497Figure 18-4 .................................................................................................................................................................. 498Figure 18-5 .................................................................................................................................................................. 499Figure 18-6 .................................................................................................................................................................. 500Figure 18-7 .................................................................................................................................................................. 501Figure 18-8 .................................................................................................................................................................. 502Figure 18-9 .................................................................................................................................................................. 503Figure 18-10 ................................................................................................................................................................. 504Figure 18-11 ................................................................................................................................................................. 505Figure 18-12 ................................................................................................................................................................. 506Figure 18-13 ................................................................................................................................................................. 507Figure 18-14 ................................................................................................................................................................. 508Figure 18-15 ................................................................................................................................................................. 509Figure 18-16 ................................................................................................................................................................. 510Figure 18-17 ................................................................................................................................................................. 51119. Endocrine Functions of the Pancreas & Regulation of Carbohydrate Metabolism ......................................... 511INTRODUCTION ................................................................................................................................................................ 521TABLES .............................................................................................................................................................................. 521Table 19-1. Structure of human insulin (molecular weight 5808) and (below) ....................................................................... 522Table 19-2. Substances with insulinlike activity in human plasma. ...................................................................................... 523Table 19-3. Principal actions of insulin. ........................................................................................................................... 524Table 19-4. Effects of insulin on various tissues. ............................................................................................................... 525Table 19-5. Glucose transporters in mammals. ................................................................................................................ 526Table 19-6. Factors affecting insulin secretion. ................................................................................................................. 527Table 19-7. Adipokines. ................................................................................................................................................. 528Table 19-8. Factors affecting glucagon secretion. ............................................................................................................. 529Table 19-9. Insulin-glucagon molar ratios (I/G) in blood in various conditions. ...................................................................... 530FIGURES ............................................................................................................................................................................ 530Figure 19-1 .................................................................................................................................................................. 531Figure 19-2 .................................................................................................................................................................. 532Figure 19-3 .................................................................................................................................................................. 533Figure 19-4 .................................................................................................................................................................. 534Figure 19-5 .................................................................................................................................................................. 535Figure 19-6 .................................................................................................................................................................. 536Figure 19-7 .................................................................................................................................................................. 537Figure 19-8 .................................................................................................................................................................. 538Figure 19-9 .................................................................................................................................................................. 539Figure 19-10 ................................................................................................................................................................. 540Figure 19-11 ................................................................................................................................................................. 541Figure 19-12 ................................................................................................................................................................. 542Figure 19-13 ................................................................................................................................................................. 543Figure 19-14 .................................................................................................................................................................
544Figure 19-15 ................................................................................................................................................................. 545Figure 19-16 ................................................................................................................................................................. 546Figure 19-17 ................................................................................................................................................................. 547Figure 19-18 ................................................................................................................................................................. 548Figure 19-19 ................................................................................................................................................................. 54920. The Adrenal Medulla & Adrenal Cortex ...................................................................................................................... 549INTRODUCTION ............................................................................................................................................................... 559ADRENAL CORTEX .......................................................................................................................................................... 559TABLES ....................................................................................................................................................................... 559Table 20-1. Principal adrenocortical hormones in adult humans. ........................................................................................... 560Table 20-2. Relative potencies of corticosteroids compared with cortisol. ................................................................................. 561Table 20-3. Nomenclature for adrenal steroidogenic enzymes and their location in adrenal cells. .................................................... 562Table 20-4. Typical effects of cortisol on the white and red blood cell counts in humans (cells/μL). ............................................. 563Table 20-5. Typical plasma electrolyte levels in normal humans and patients with adrenocortical diseases. ....................................... 564Table 20-6. Stimuli that increase aldosterone secretion. ..................................................................................................... 565Table 20-7. Second messengers involved in the regulation of aldosterone secretion. ................................................................... 566FIGURES ..................................................................................................................................................................... 566Figure 20-1 ............................................................................................................................................................ 567Figure 20-2 ............................................................................................................................................................ 568Figure 20-3 ............................................................................................................................................................ 569Figure 20-4 ............................................................................................................................................................ 570Figure 20-5 ............................................................................................................................................................ 571Figure 20-6 ............................................................................................................................................................ 572Figure 20-7 ............................................................................................................................................................ 573Figure 20-8 ............................................................................................................................................................ 574Figure 20-9 ............................................................................................................................................................ 575Figure 20-10 .......................................................................................................................................................... 576Figure 20-11 .......................................................................................................................................................... 577Figure 20-12 .......................................................................................................................................................... 578Figure 20-13 .......................................................................................................................................................... 579Figure 20-14 .......................................................................................................................................................... 580Figure 20-15 .......................................................................................................................................................... 581Figure 20-16 .......................................................................................................................................................... 582Figure 20-17 .......................................................................................................................................................... 583Figure 20-18 .......................................................................................................................................................... 584Figure 20-19 .......................................................................................................................................................... 585Figure 20-20 .......................................................................................................................................................... 586Figure 20-21 .......................................................................................................................................................... 587Figure 20-22 .......................................................................................................................................................... 588Figure 20-23 .......................................................................................................................................................... 589Figure 20-24 .......................................................................................................................................................... 590Figure 20-25 .......................................................................................................................................................... 591Figure 20-26 .......................................................................................................................................................... 592Figure 20-27 .......................................................................................................................................................... 593Figure 20-28 .......................................................................................................................................................... 594Figure 20-29 .......................................................................................................................................................... 59521. Hormonal Control of Calcium Metabolism & the Physiology of Bone ................................................................ 595INTRODUCTION ............................................................................................................................................................... 601TABLES .............................................................................................................................................................................. 602FIGURES ............................................................................................................................................................................ 602Figure 21-1 .................................................................................................................................................................. 603Figure 21-2 .................................................................................................................................................................. 604Figure 21-3 .................................................................................................................................................................. 605Figure 21-4 ..................................................................................................................................................................
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
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Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong
Review of medical physiology 21 edition william f. ganong

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Review of medical physiology 21 edition william f. ganong

  • 1. Table of Contents 1REVIEW OF MEDICAL PHYSIOLOGY - 21st Ed. (2003) ................................................................................... 1Cover ....................................................................................................................................................................................................... 2Front Matter ........................................................................................................................................................................................... 4Section I. Introduction ....................................................................................................................................................................... 41. The General & Cellular Basis of Medical Physiology ...................................................................................................... 4INTRODUCTION ...................................................................................................................................................................... 22TABLES ................................................................................................................................................................................. 22Table 1-1. Total body water (as percentage of body weight) in relation to age and sex. ............................................................. 23Table 1-2. Concentration of some ions inside and outside mammalian spinal motor neurons. .................................................. 24Table 1-3. Some of the enzymes found in lysosomes and the cell components that are their substrates. ................................... 25Table 1-4. Molecular motors. ............................................................................................................................................. 26Table 1-5. Size of hydrated ions and other substances of biological interest. ........................................................................... 27Table 1-6. Principal mechanisms by which chemical messengers in the ECF bring about changes in cell function. .................... 28Table 1-7. Principal protein kinases. ................................................................................................................................... 29Table 1-8. Some of the ligands for receptors coupled to G proteins. ....................................................................................... 30Table 1-9. Diseases caused by loss or gain of function mutations of heterotrimeric G protein-coupled receptors and G proteins. . 31FIGURES ............................................................................................................................................................................... 31Figure 1-1 ....................................................................................................................................................................... 32Figure 1-2 ....................................................................................................................................................................... 33Figure 1-3 ....................................................................................................................................................................... 34Figure 1-4 ....................................................................................................................................................................... 35Figure 1-5 ....................................................................................................................................................................... 36Figure 1-6 ....................................................................................................................................................................... 37Figure 1-7 ....................................................................................................................................................................... 38Figure 1-8 ....................................................................................................................................................................... 39Figure 1-9 ....................................................................................................................................................................... 40Figure 1-10 ..................................................................................................................................................................... 41Figure 1-11 ...................................................................................................................................................................... 42Figure 1-12 ..................................................................................................................................................................... 43Figure 1-13 ..................................................................................................................................................................... 44Figure 1-14 ..................................................................................................................................................................... 45Figure 1-15 ..................................................................................................................................................................... 46Figure 1-16 ..................................................................................................................................................................... 47Figure 1-17 ..................................................................................................................................................................... 48Figure 1-18 ..................................................................................................................................................................... 49Figure 1-19 ..................................................................................................................................................................... 50Figure 1-20 ..................................................................................................................................................................... 51Figure 1-21 ..................................................................................................................................................................... 52Figure 1-22 ..................................................................................................................................................................... 53Figure 1-23 ..................................................................................................................................................................... 54Figure 1-24 ..................................................................................................................................................................... 55Figure 1-25 ..................................................................................................................................................................... 56Figure 1-26 ..................................................................................................................................................................... 57Figure 1-27 ..................................................................................................................................................................... 58Figure 1-28 ..................................................................................................................................................................... 59Figure 1-29 ..................................................................................................................................................................... 60Figure 1-30 ..................................................................................................................................................................... 61Figure 1-31 ..................................................................................................................................................................... 62Figure 1-32 ..................................................................................................................................................................... 63Figure 1-33 .....................................................................................................................................................................
  • 2. 64Figure 1-34 ..................................................................................................................................................................... 65Figure 1-35 ..................................................................................................................................................................... 66Figure 1-36 ..................................................................................................................................................................... 67Figure 1-37 ..................................................................................................................................................................... 68Figure 1-38 ..................................................................................................................................................................... 69Figure 1-39 ..................................................................................................................................................................... 70Figure 1-40 ..................................................................................................................................................................... 71Figure 1-41 ..................................................................................................................................................................... 72Figure 1-42 ..................................................................................................................................................................... 73Figure 1-43 ..................................................................................................................................................................... 74Figure 1-44 ..................................................................................................................................................................... 75Figure 1-45 ..................................................................................................................................................................... 76Figure 1-46 ..................................................................................................................................................................... 77Figure 1-47 ..................................................................................................................................................................... 78References for Section I: Introduction .................................................................................................................................. 79Section II. Physiology of Nerve & Muscle Cells ................................................................................................................. 792. Excitable Tissue: Nerve ....................................................................................................................................................... 79INTRODUCTION ................................................................................................................................................................... 84TABLES ................................................................................................................................................................................. 84Table 2-1. Nerve fiber types in mammalian nerve. ................................................................................................................ 85Table 2-2. Numerical classification sometimes used for sensory neurons. .............................................................................. 86Table 2-3. Relative susceptibility of mammalian A, B, and C nerve fibers to conduction block produced by various agents. .......... 87Table 2-4. Neurotrophins. .................................................................................................................................................. 88FIGURES ............................................................................................................................................................................... 88Figure 2-1 ....................................................................................................................................................................... 89Figure 2-2 ....................................................................................................................................................................... 90Figure 2-3 ....................................................................................................................................................................... 91Figure 2-4 ....................................................................................................................................................................... 92Figure 2-5 ....................................................................................................................................................................... 93Figure 2-6 ....................................................................................................................................................................... 94Figure 2-7 ....................................................................................................................................................................... 95Figure 2-8 ....................................................................................................................................................................... 96Figure 2-9 ....................................................................................................................................................................... 97Figure 2-10 ..................................................................................................................................................................... 98Figure 2-11 ...................................................................................................................................................................... 99Figure 2-12 ..................................................................................................................................................................... 100Figure 2-13 .................................................................................................................................................................. 101Figure 2-14 .................................................................................................................................................................. 102Figure 2-15 .................................................................................................................................................................. 1033. Excitable Tissue: Muscle .................................................................................................................................................. 103INTRODUCTION ............................................................................................................................................................... 111SMOOTH MUSCLE ............................................................................................................................................................ 111TABLES ........................................................................................................................................................................ 111Table 3-1. Steady-state distribution of ions in the intracellular and extracellula ........................................................................... 112Table 3-2. Sequence of events in contraction and relaxation of skeletal muscle. ......................................................................... 113Table 3-3. Classification of fiber types in skeletal muscles. .................................................................................................. 114Table 3-4. Myofibrillar protein isoforms in adult extrafusal fibers in the rat. ................................................................................ 115Table 3-5. Cardiac ion channels. .................................................................................................................................. 116Table 3-6. Sequence of events in contraction and relaxation of visceral smooth muscle. ............................................................... 117FIGURES ..................................................................................................................................................................... 117Figure 3-1 .............................................................................................................................................................. 118Figure 3-2 .............................................................................................................................................................. 119Figure 3-3 .............................................................................................................................................................. 120Figure 3-4 .............................................................................................................................................................
  • 3. 121Figure 3-5 ............................................................................................................................................................. 122Figure 3-6 ............................................................................................................................................................. 123Figure 3-7 ............................................................................................................................................................. 124Figure 3-8 ............................................................................................................................................................. 125Figure 3-9 ............................................................................................................................................................. 126Figure 3-10 ............................................................................................................................................................ 127Figure 3-11 ............................................................................................................................................................ 128Figure 3-12 ............................................................................................................................................................ 129Figure 3-13 ............................................................................................................................................................ 130Figure 3-14 ............................................................................................................................................................ 131Figure 3-15 ............................................................................................................................................................ 132Figure 3-16 ............................................................................................................................................................ 133Figure 3-17 ............................................................................................................................................................ 134Figure 3-18 ............................................................................................................................................................ 135Figure 3-19 ............................................................................................................................................................ 1364. Synaptic & Junctional Transmission ............................................................................................................................. 136INTRODUCTION ............................................................................................................................................................... 149NEUROMUSCULAR TRANSMISSION ............................................................................................................................. 149TABLES ....................................................................................................................................................................... 149Table 4-1. Neurotransmitters and neuromodulators in the nervous system of mammals. .............................................................. 151Table 4-2. Mechanism of action of selected neurotransmitters. ............................................................................................. 152Table 4-3. Mammalian tachykinins. ............................................................................................................................... 153Table 4-4. Opioid peptides and their precursors. ............................................................................................................... 154Table 4-5. Physiologic effects produced by stimulation of opiate receptors. .............................................................................. 155FIGURES ..................................................................................................................................................................... 155Figure 4-1 ............................................................................................................................................................. 156Figure 4-2 ............................................................................................................................................................. 157Figure 4-3 ............................................................................................................................................................. 158Figure 4-4 ............................................................................................................................................................. 159Figure 4-5 ............................................................................................................................................................. 160Figure 4-6 ............................................................................................................................................................. 161Figure 4-7 ............................................................................................................................................................. 162Figure 4-8 ............................................................................................................................................................. 163Figure 4-9 ............................................................................................................................................................. 164Figure 4-10 ............................................................................................................................................................ 165Figure 4-11 ............................................................................................................................................................ 166Figure 4-12 ............................................................................................................................................................ 167Figure 4-13 ............................................................................................................................................................ 168Figure 4-14 ............................................................................................................................................................ 169Figure 4-15 ............................................................................................................................................................ 170Figure 4-16 ............................................................................................................................................................ 171Figure 4-17 ............................................................................................................................................................ 172Figure 4-18 ............................................................................................................................................................ 173Figure 4-19 ............................................................................................................................................................ 174Figure 4-20 ............................................................................................................................................................ 175Figure 4-21 ............................................................................................................................................................ 176Figure 4-22 ............................................................................................................................................................ 177Figure 4-23 ............................................................................................................................................................ 178Figure 4-24 ............................................................................................................................................................ 179Figure 4-25 ............................................................................................................................................................ 180Figure 4-26 ............................................................................................................................................................ 181Figure 4-27 ............................................................................................................................................................ 182Figure 4-28 ............................................................................................................................................................ 183Figure 4-29 ............................................................................................................................................................
  • 4. 184Figure 4-30 ............................................................................................................................................................ 185Figure 4-31 ............................................................................................................................................................ 186Figure 4-32 ............................................................................................................................................................ 187Figure 4-33 ............................................................................................................................................................ 188Figure 4-34 ............................................................................................................................................................ 189Figure 4-35 ............................................................................................................................................................ 190Figure 4-36 ............................................................................................................................................................ 191Figure 4-37 ............................................................................................................................................................ 1925. Initiation of Impulses in Sense Organs ........................................................................................................................ 192INTRODUCTION ............................................................................................................................................................... 195TABLES .............................................................................................................................................................................. 196FIGURES ............................................................................................................................................................................ 196Figure 5-1 .................................................................................................................................................................... 197Figure 5-2 .................................................................................................................................................................... 198Figure 5-3 .................................................................................................................................................................... 199Figure 5-4 .................................................................................................................................................................... 200References for Section II. Physiology of Nerve & Muscle Cells .................................................................................. 201Section III. Functions of the Nervous System ................................................................................................................. 2016. Reflexes ................................................................................................................................................................................ 201INTRODUCTION ............................................................................................................................................................... 205FIGURES ............................................................................................................................................................................ 205Figure 6-1 .................................................................................................................................................................... 206Figure 6-2 .................................................................................................................................................................... 207Figure 6-3 .................................................................................................................................................................... 208Figure 6-4 .................................................................................................................................................................... 209Figure 6-5 .................................................................................................................................................................... 210Figure 6-6 .................................................................................................................................................................... 211Figure 6-7 ..................................................................................................................................................................... 212Figure 6-8 .................................................................................................................................................................... 213Figure 6-9 .................................................................................................................................................................... 214Figure 6-10 .................................................................................................................................................................. 2157. Cutaneous, Deep, & Visceral Sensation ...................................................................................................................... 215INTRODUCTION ............................................................................................................................................................... 221FIGURES ............................................................................................................................................................................ 221Figure 7-1 .................................................................................................................................................................... 222Figure 7-2 .................................................................................................................................................................... 223Figure 7-3 .................................................................................................................................................................... 224Figure 7-4 .................................................................................................................................................................... 225Figure 7-5 .................................................................................................................................................................... 226Figure 7-6 .................................................................................................................................................................... 227Figure 7-7 .................................................................................................................................................................... 2288. Vision ..................................................................................................................................................................................... 228INTRODUCTION ............................................................................................................................................................... 236TABLES .............................................................................................................................................................................. 237FIGURES ............................................................................................................................................................................ 237Figure 8-1 .................................................................................................................................................................... 238Figure 8-2 .................................................................................................................................................................... 239Figure 8-3 .................................................................................................................................................................... 240Figure 8-4 .................................................................................................................................................................... 241Figure 8-5 .................................................................................................................................................................... 242Figure 8-6 .................................................................................................................................................................... 243Figure 8-7 .................................................................................................................................................................... 244Figure 8-8 .................................................................................................................................................................... 245Figure 8-9 ....................................................................................................................................................................
  • 5. 246Figure 8-10 .................................................................................................................................................................. 247Figure 8-11 ................................................................................................................................................................... 248Figure 8-12 .................................................................................................................................................................. 249Figure 8-13 .................................................................................................................................................................. 250Figure 8-14 .................................................................................................................................................................. 251Figure 8-15 .................................................................................................................................................................. 252Figure 8-16 .................................................................................................................................................................. 253Figure 8-17 .................................................................................................................................................................. 254Figure 8-18 .................................................................................................................................................................. 255Figure 8-19 .................................................................................................................................................................. 256Figure 8-20 .................................................................................................................................................................. 257Figure 8-21 .................................................................................................................................................................. 258Figure 8-22 .................................................................................................................................................................. 259Figure 8-23 .................................................................................................................................................................. 260Figure 8-24 .................................................................................................................................................................. 261Figure 8-25 .................................................................................................................................................................. 262Figure 8-26 .................................................................................................................................................................. 263Figure 8-27 .................................................................................................................................................................. 264Figure 8-28 .................................................................................................................................................................. 265Figure 8-29 .................................................................................................................................................................. 266Figure 8-30 .................................................................................................................................................................. 267Figure 8-31 .................................................................................................................................................................. 2689. Hearing & Equilibrium ....................................................................................................................................................... 268INTRODUCTION ............................................................................................................................................................... 273TABLES .............................................................................................................................................................................. 274FIGURES ............................................................................................................................................................................ 274Figure 9-1 .................................................................................................................................................................... 275Figure 9-2 .................................................................................................................................................................... 276Figure 9-3 .................................................................................................................................................................... 277Figure 9-4 .................................................................................................................................................................... 278Figure 9-5 .................................................................................................................................................................... 279Figure 9-6 .................................................................................................................................................................... 280Figure 9-7 .................................................................................................................................................................... 281Figure 9-8 .................................................................................................................................................................... 282Figure 9-9 .................................................................................................................................................................... 283Figure 9-10 .................................................................................................................................................................. 284Figure 9-11 ................................................................................................................................................................... 285Figure 9-12 .................................................................................................................................................................. 286Figure 9-13 .................................................................................................................................................................. 287Figure 9-14 .................................................................................................................................................................. 288Figure 9-15 .................................................................................................................................................................. 289Figure 9-16 .................................................................................................................................................................. 29010. Smell & Taste .................................................................................................................................................................... 290INTRODUCTION ............................................................................................................................................................... 293TASTE ................................................................................................................................................................................ 293TABLES ....................................................................................................................................................................... 293Table 10-1. Some olfactory thresholds. .......................................................................................................................... 294Table 10-2. Some taste thresholds. ............................................................................................................................... 295FIGURES ..................................................................................................................................................................... 295Figure 10-1 ............................................................................................................................................................ 296Figure 10-2 ............................................................................................................................................................ 297Figure 10-3 ............................................................................................................................................................ 298Figure 10-4 ............................................................................................................................................................ 299Figure 10-5 ............................................................................................................................................................
  • 6. 300Figure 10-6 ............................................................................................................................................................ 30111. Alert Behavior, Sleep, & the Electrical Activity of the Brain ................................................................................... 301INTRODUCTION ............................................................................................................................................................... 305FIGURES ............................................................................................................................................................................ 305Figure 11-1 ................................................................................................................................................................... 306Figure 11-2 ................................................................................................................................................................... 307Figure 11-3 ................................................................................................................................................................... 308Figure 11-4 ................................................................................................................................................................... 309Figure 11-5 ................................................................................................................................................................... 310Figure 11-6 ................................................................................................................................................................... 311Figure 11-7 ................................................................................................................................................................... 312Figure 11-8 ................................................................................................................................................................... 313Figure 11-9 ................................................................................................................................................................... 314Figure 11-10 ................................................................................................................................................................. 315Figure 11-11 ................................................................................................................................................................. 316Figure 11-12 ................................................................................................................................................................. 31712. Control of Posture & Movement ................................................................................................................................... 317INTRODUCTION ............................................................................................................................................................... 325CEREBELLUM ................................................................................................................................................................... 325TABLES ....................................................................................................................................................................... 325Table 12-1. Summary of levels involved in various neural functions. ....................................................................................... 326Table 12-2. Principal postural reflexes. ........................................................................................................................... 327Table 12-3. The basal ganglia. ..................................................................................................................................... 328Table 12-4. Examples of trinucleotide repeat diseases. ....................................................................................................... 329Table 12-5. Function of principal afferent systems to the cerebellum. ...................................................................................... 330FIGURES ..................................................................................................................................................................... 330Figure 12-1 ............................................................................................................................................................ 331Figure 12-2 ............................................................................................................................................................ 332Figure 12-3 ............................................................................................................................................................ 333Figure 12-4 ............................................................................................................................................................ 334Figure 12-5 ............................................................................................................................................................ 335Figure 12-6 ............................................................................................................................................................ 336Figure 12-7 ............................................................................................................................................................ 337Figure 12-8 ............................................................................................................................................................ 338Figure 12-9 ............................................................................................................................................................ 339Figure 12-10 .......................................................................................................................................................... 340Figure 12-11 .......................................................................................................................................................... 341Figure 12-12 .......................................................................................................................................................... 342Figure 12-13 .......................................................................................................................................................... 343Figure 12-14 .......................................................................................................................................................... 344Figure 12-15 .......................................................................................................................................................... 345Figure 12-16 .......................................................................................................................................................... 346Figure 12-17 .......................................................................................................................................................... 34713. The Autonomic Nervous System ................................................................................................................................. 347INTRODUCTION ............................................................................................................................................................... 349TABLES .............................................................................................................................................................................. 349Table 13-1. Fast and slow responses of postganglionic neurons in sympathetic ganglia. ...................................................... 350Table 13-2. Responses of effector organs to autonomic nerve impulses and circulating catecholamines. ............................... 352Table 13-3. Some drugs and toxins that affect autonomic acitvity. ....................................................................................... 353FIGURES ............................................................................................................................................................................ 353Figure 13-1 .................................................................................................................................................................. 354Figure 13-2 .................................................................................................................................................................. 355Figure 13-3 .................................................................................................................................................................. 35614. Central Regulation of Visceral Function ....................................................................................................................
  • 7. 356INTRODUCTION ............................................................................................................................................................... 366HYPOTHALAMUS .............................................................................................................................................................. 366TABLES ....................................................................................................................................................................... 366Table 14-1. Summary of principal hypothalamic regulatory mechanisms. ................................................................................. 367Table 14-2. Principal hypothalamic polypeptides that appear to play a role in the regulation of the appetite for food. ............................. 368Table 14-3. Summary of stimuli affecting vasopressin secretion. ........................................................................................... 369Table 14-4. Symptoms and signs in 60 autopsied patients with hypothalamic disease. ................................................................ 370Table 14-5. Body heat production and heat loss. ............................................................................................................... 371Table 14-6. Temperature-regulating mechanisms. ............................................................................................................. 372FIGURES ..................................................................................................................................................................... 372Figure 14-1 ............................................................................................................................................................ 373Figure 14-2 ............................................................................................................................................................ 374Figure 14-3 ............................................................................................................................................................ 375Figure 14-4 ............................................................................................................................................................ 376Figure 14-5 ............................................................................................................................................................ 377Figure 14-6 ............................................................................................................................................................ 378Figure 14-7 ............................................................................................................................................................ 379Figure 14-8 ............................................................................................................................................................ 380Figure 14-9 ............................................................................................................................................................ 381Figure 14-10 .......................................................................................................................................................... 382Figure 14-11 .......................................................................................................................................................... 383Figure 14-12 .......................................................................................................................................................... 384Figure 14-13 .......................................................................................................................................................... 385Figure 14-14 .......................................................................................................................................................... 386Figure 14-15 .......................................................................................................................................................... 387Figure 14-16 .......................................................................................................................................................... 388Figure 14-17 .......................................................................................................................................................... 389Figure 14-18 .......................................................................................................................................................... 390Figure 14-19 .......................................................................................................................................................... 391Figure 14-20 .......................................................................................................................................................... 392Figure 14-21 .......................................................................................................................................................... 393Figure 14-22 .......................................................................................................................................................... 394Figure 14-23 .......................................................................................................................................................... 395Figure 14-24 .......................................................................................................................................................... 39615. Neural Basis of Instinctual Behavior & Emotions .................................................................................................... 396INTRODUCTION ............................................................................................................................................................... 401FIGURES ............................................................................................................................................................................ 401Figure 15-1 .................................................................................................................................................................. 402Figure 15-2 .................................................................................................................................................................. 403Figure 15-3 .................................................................................................................................................................. 404Figure 15-4 .................................................................................................................................................................. 405Figure 15-5 .................................................................................................................................................................. 406Figure 15-6 .................................................................................................................................................................. 407Figure 15-7 .................................................................................................................................................................. 408Figure 15-8 .................................................................................................................................................................. 40916. ............................................................................................................................................................................................... 409INTRODUCTION ............................................................................................................................................................... 414TABLES .............................................................................................................................................................................. 414Table 16-1. Types of memory. ......................................................................................................................................... 415Table 16-2. Possible sequence of events in the pathogenesis of Alzheimier's disease. ......................................................... 416Table 16-3. Aphasias. Characteristic responses of patients with lesions in various areas when shown a picture of a chair. ....... 417FIGURES ............................................................................................................................................................................ 417Figure 16-1 .................................................................................................................................................................. 418Figure 16-2 ..................................................................................................................................................................
  • 8. 419Figure 16-3 .................................................................................................................................................................. 420Figure 16-4 .................................................................................................................................................................. 421Figure 16-5 .................................................................................................................................................................. 422Figure 16-6 .................................................................................................................................................................. 423Figure 16-7 .................................................................................................................................................................. 424References for Section III. Functions of the Nervous System ..................................................................................... 426Section IV. Endocrinology, Metabolism, & Reproductive Function ......................................................................... 42617. Energy Balance, Metabolism, & Nutrition .................................................................................................................. 426INTRODUCTION ............................................................................................................................................................... 438TABLES .............................................................................................................................................................................. 438Table 17-1. Factors affecting the metabolic rate. .............................................................................................................. 439Table 17-2. Amino acids found in proteins. Those in bold type are the nutr .......................................................................... 440Table 17-3. Purine- and pyrimidine-containing compounds. ............................................................................................... 441Table 17-4. Lipids. ........................................................................................................................................................ 442Table 17-5. The principal lipoproteins. The plasma lipids include these co .......................................................................... 443Table 17-6. Derivatives of PGH2, their receptors, and tissues in which their effects are prominent. ........................................ 444Table 17-7. Groups of enzymes involved in the metabolism of arachidonic acid and their eicosanoid products. ....................... 445Table 17-8. Food and Nutrition Board, National Academy of Sciences—N ................................................................. 446Table 17-9. Trace elements believed essential for life. ...................................................................................................... 447Table 17-10. Vitamins essential or probably essential to human nutrition. ............................................................................ 448FIGURES ............................................................................................................................................................................ 448Figure 17-1 .................................................................................................................................................................. 449Figure 17-2 .................................................................................................................................................................. 450Figure 17-3 .................................................................................................................................................................. 451Figure 17-4 .................................................................................................................................................................. 452Figure 17-5 .................................................................................................................................................................. 453Figure 17-6 .................................................................................................................................................................. 454Figure 17-7 .................................................................................................................................................................. 455Figure 17-8 .................................................................................................................................................................. 456Figure 17-9 .................................................................................................................................................................. 457Figure 17-10 ................................................................................................................................................................. 458Figure 17-11 ................................................................................................................................................................. 459Figure 17-12 ................................................................................................................................................................. 460Figure 17-13 ................................................................................................................................................................. 461Figure 17-14 ................................................................................................................................................................. 462Figure 17-15 ................................................................................................................................................................. 463Figure 17-16 ................................................................................................................................................................. 464Figure 17-17 ................................................................................................................................................................. 465Figure 17-18 ................................................................................................................................................................. 466Figure 17-19 ................................................................................................................................................................. 467Figure 17-20 ................................................................................................................................................................. 468Figure 17-21 ................................................................................................................................................................. 469Figure 17-22 ................................................................................................................................................................. 470Figure 17-23 ................................................................................................................................................................. 471Figure 17-24 ................................................................................................................................................................. 472Figure 17-25 ................................................................................................................................................................. 473Figure 17-26 ................................................................................................................................................................. 474Figure 17-27 ................................................................................................................................................................. 475Figure 17-28 ................................................................................................................................................................. 476Figure 17-29 ................................................................................................................................................................. 477Figure 17-30 ................................................................................................................................................................. 478Figure 17-31 ................................................................................................................................................................. 479Figure 17-32 ................................................................................................................................................................. 480Figure 17-33 .................................................................................................................................................................
  • 9. 481Figure 17-34 ................................................................................................................................................................. 48218. The Thyroid Gland ........................................................................................................................................................... 482INTRODUCTION ............................................................................................................................................................... 489TABLES .............................................................................................................................................................................. 489Table 18-1. Binding of thyroid hormones to plasma proteins in normal adult humans. ........................................................... 490Table 18-2. Effect of variations in the concentrations of thyroid hormone- ............................................................................ 491Table 18-3. Physiologic effects of thyroid hormones. ......................................................................................................... 492Table 18-4. Causes of congenital hypothyroidism. ............................................................................................................ 493Table 18-5. Causes of hyperthyroidism. ........................................................................................................................... 494FIGURES ............................................................................................................................................................................ 494Figure 18-1 .................................................................................................................................................................. 495Figure 18-2 .................................................................................................................................................................. 496Figure 18-3 .................................................................................................................................................................. 497Figure 18-4 .................................................................................................................................................................. 498Figure 18-5 .................................................................................................................................................................. 499Figure 18-6 .................................................................................................................................................................. 500Figure 18-7 .................................................................................................................................................................. 501Figure 18-8 .................................................................................................................................................................. 502Figure 18-9 .................................................................................................................................................................. 503Figure 18-10 ................................................................................................................................................................. 504Figure 18-11 ................................................................................................................................................................. 505Figure 18-12 ................................................................................................................................................................. 506Figure 18-13 ................................................................................................................................................................. 507Figure 18-14 ................................................................................................................................................................. 508Figure 18-15 ................................................................................................................................................................. 509Figure 18-16 ................................................................................................................................................................. 510Figure 18-17 ................................................................................................................................................................. 51119. Endocrine Functions of the Pancreas & Regulation of Carbohydrate Metabolism ......................................... 511INTRODUCTION ................................................................................................................................................................ 521TABLES .............................................................................................................................................................................. 521Table 19-1. Structure of human insulin (molecular weight 5808) and (below) ....................................................................... 522Table 19-2. Substances with insulinlike activity in human plasma. ...................................................................................... 523Table 19-3. Principal actions of insulin. ........................................................................................................................... 524Table 19-4. Effects of insulin on various tissues. ............................................................................................................... 525Table 19-5. Glucose transporters in mammals. ................................................................................................................ 526Table 19-6. Factors affecting insulin secretion. ................................................................................................................. 527Table 19-7. Adipokines. ................................................................................................................................................. 528Table 19-8. Factors affecting glucagon secretion. ............................................................................................................. 529Table 19-9. Insulin-glucagon molar ratios (I/G) in blood in various conditions. ...................................................................... 530FIGURES ............................................................................................................................................................................ 530Figure 19-1 .................................................................................................................................................................. 531Figure 19-2 .................................................................................................................................................................. 532Figure 19-3 .................................................................................................................................................................. 533Figure 19-4 .................................................................................................................................................................. 534Figure 19-5 .................................................................................................................................................................. 535Figure 19-6 .................................................................................................................................................................. 536Figure 19-7 .................................................................................................................................................................. 537Figure 19-8 .................................................................................................................................................................. 538Figure 19-9 .................................................................................................................................................................. 539Figure 19-10 ................................................................................................................................................................. 540Figure 19-11 ................................................................................................................................................................. 541Figure 19-12 ................................................................................................................................................................. 542Figure 19-13 ................................................................................................................................................................. 543Figure 19-14 .................................................................................................................................................................
  • 10. 544Figure 19-15 ................................................................................................................................................................. 545Figure 19-16 ................................................................................................................................................................. 546Figure 19-17 ................................................................................................................................................................. 547Figure 19-18 ................................................................................................................................................................. 548Figure 19-19 ................................................................................................................................................................. 54920. The Adrenal Medulla & Adrenal Cortex ...................................................................................................................... 549INTRODUCTION ............................................................................................................................................................... 559ADRENAL CORTEX .......................................................................................................................................................... 559TABLES ....................................................................................................................................................................... 559Table 20-1. Principal adrenocortical hormones in adult humans. ........................................................................................... 560Table 20-2. Relative potencies of corticosteroids compared with cortisol. ................................................................................. 561Table 20-3. Nomenclature for adrenal steroidogenic enzymes and their location in adrenal cells. .................................................... 562Table 20-4. Typical effects of cortisol on the white and red blood cell counts in humans (cells/μL). ............................................. 563Table 20-5. Typical plasma electrolyte levels in normal humans and patients with adrenocortical diseases. ....................................... 564Table 20-6. Stimuli that increase aldosterone secretion. ..................................................................................................... 565Table 20-7. Second messengers involved in the regulation of aldosterone secretion. ................................................................... 566FIGURES ..................................................................................................................................................................... 566Figure 20-1 ............................................................................................................................................................ 567Figure 20-2 ............................................................................................................................................................ 568Figure 20-3 ............................................................................................................................................................ 569Figure 20-4 ............................................................................................................................................................ 570Figure 20-5 ............................................................................................................................................................ 571Figure 20-6 ............................................................................................................................................................ 572Figure 20-7 ............................................................................................................................................................ 573Figure 20-8 ............................................................................................................................................................ 574Figure 20-9 ............................................................................................................................................................ 575Figure 20-10 .......................................................................................................................................................... 576Figure 20-11 .......................................................................................................................................................... 577Figure 20-12 .......................................................................................................................................................... 578Figure 20-13 .......................................................................................................................................................... 579Figure 20-14 .......................................................................................................................................................... 580Figure 20-15 .......................................................................................................................................................... 581Figure 20-16 .......................................................................................................................................................... 582Figure 20-17 .......................................................................................................................................................... 583Figure 20-18 .......................................................................................................................................................... 584Figure 20-19 .......................................................................................................................................................... 585Figure 20-20 .......................................................................................................................................................... 586Figure 20-21 .......................................................................................................................................................... 587Figure 20-22 .......................................................................................................................................................... 588Figure 20-23 .......................................................................................................................................................... 589Figure 20-24 .......................................................................................................................................................... 590Figure 20-25 .......................................................................................................................................................... 591Figure 20-26 .......................................................................................................................................................... 592Figure 20-27 .......................................................................................................................................................... 593Figure 20-28 .......................................................................................................................................................... 594Figure 20-29 .......................................................................................................................................................... 59521. Hormonal Control of Calcium Metabolism & the Physiology of Bone ................................................................ 595INTRODUCTION ............................................................................................................................................................... 601TABLES .............................................................................................................................................................................. 602FIGURES ............................................................................................................................................................................ 602Figure 21-1 .................................................................................................................................................................. 603Figure 21-2 .................................................................................................................................................................. 604Figure 21-3 .................................................................................................................................................................. 605Figure 21-4 ..................................................................................................................................................................