Physiology (6th Edition)

Description

Renowned physiology instructor Dr. Linda Costanzo’s friendly, logical, easy-to-follow writing style makes Physiology, 6th Edition ideal for coursework and USMLE preparation. Well-designed figures and tables provide handy visuals for procedures or physiologic equations, and step-by-step explanations clarify challenging concepts. This full-color, manageably-sized text offers a comprehensive and consistent overview of core physiologic concepts at the organ system and cellular levels, making complex principles easy to understand.

• Information is presented in a short, simple, and focused manner – the perfect presentation for success in coursework and on exams.
• Chapter summaries and “Challenge Yourself” questions at the end of each chapter provide an extensive review of the material and reinforce understanding and retention.
• Equations and sample problems are integrated throughout the text.
• NEW! More Clinical Physiology Case Boxes relate to pathophysiology for a clinical context

Table of Contents

1.  Preface
2. Acknowledgments
3. Table Of Contents
4. 1 Cellular Physiology
   1. Volume and Composition of Body Fluids
   2. Distribution of Water in the Body Fluid Compartments
   3. Composition of Body Fluid Compartments
   4. Units for Measuring Solute Concentrations
   5. Electroneutrality of Body Fluid Compartments
   6. Composition of Intracellular Fluid and Extracellular Fluid
   7. Creation of Concentration Differences Across Cell Membranes
   8. Concentration Differences Between Plasma and Interstitial Fluids
   9. Characteristics of Cell Membranes
   10. Phospholipid Component of Cell Membranes
   11. Protein Component of Cell Membranes
   12. Transport Across Cell Membranes
   13. Simple Diffusion
   14. Diffusion of Nonelectrolytes
   15. Concentration Gradient (CA − CB)
   16. Partition Coefficient (K)
   17. Diffusion Coefficient (D)
   18. Thickness of the Membrane (Δx)
   19. Surface Area (A)
   20. Diffusion of Electrolytes
   21. Facilitated Diffusion
   22. Primary Active Transport
   23. Na+-K+ ATPase (Na+-K+ Pump)
   24. Ca2+ ATPase (Ca2+ Pump)
   25. H+-K+ ATPase (H+-K+ Pump)
   26. Secondary Active Transport
   27. Cotransport
   28. Countertransport
   29. Osmosis
   30. Osmolarity
   31. Osmolality
   32. Osmotic Pressure
   33. Diffusion Potentials and Equilibrium Potentials
   34. Ion Channels
   35. Diffusion Potentials
   36. Equilibrium Potentials
   37. Example of Na+ Equilibrium Potential
   38. Example of Cl− Equilibrium Potential
   39. Nernst Equation
   40. Driving Force
   41. Ionic Current
   42. Resting Membrane Potential
   43. Action Potentials
   44. Terminology
   45. Characteristics of Action Potentials
   46. Ionic Basis of the Action Potential
   47. The Nerve Na+ Channel
   48. Refractory Periods
   49. Absolute Refractory Period
   50. Relative Refractory Period
   51. Accommodation
   52. Propagation of Action Potentials
   53. Conduction Velocity
   54. Changes in Conduction Velocity
   55. Synaptic and Neuromuscular Transmission
   56. Types of Synapses
   57. Electrical Synapses
   58. Chemical Synapses
   59. Neuromuscular Junction—Example of a Chemical Synapse
   60. Motor Units
   61. Sequence of Events at the Neuromuscular Junction
   62. Agents That Alter Neuromuscular Function
   63. Types of Synaptic Arrangements
   64. Synaptic Input—Excitatory and Inhibitory Postsynaptic Potentials
   65. Excitatory Postsynaptic Potentials
   66. Inhibitory Postsynaptic Potentials
   67. Integration of Synaptic Information
   68. Spatial Summation
   69. Temporal Summation
   70. Other Phenomena That Alter Synaptic Activity
   71. Neurotransmitters
   72. Acetylcholine
   73. Norepinephrine, Epinephrine, and Dopamine
   74. Serotonin
   75. Histamine
   76. Glutamate
   77. Glycine
   78. γ-Aminobutyric Acid (GABA)
   79. Nitric Oxide
   80. Neuropeptides
   81. Purines
   82. Skeletal Muscle
   83. Muscle Filaments
   84. Thick Filaments
   85. Thin Filaments
   86. Arrangement of Thick and Thin Filaments in Sarcomeres
   87. Cytoskeletal Proteins
   88. Transverse Tubules and the Sarcoplasmic Reticulum
   89. Excitation-Contraction Coupling in Skeletal Muscle
   90. Mechanism of Tetanus
   91. Length-Tension Relationship
   92. Force-Velocity Relationship
   93. Smooth Muscle
   94. Types of Smooth Muscle
   95. Unitary Smooth Muscle
   96. Multiunit Smooth Muscle
   97. Excitation-Contraction Coupling in Smooth Muscle
   98. Steps in Excitation-Contraction Coupling in Smooth Muscle
   99. Mechanisms That Increase Intracellular Ca2+ Concentration in Smooth Muscle
   100. Ca2+-Independent Changes in Smooth Muscle Contraction
   101. Summary
   102. Challenge Yourself
5. 2 Autonomic Nervous System
   1. Organization and General Features of the Autonomic Nervous System
   2. Terminology
   3. Neuroeffector Junctions of the Autonomic Nervous System
   4. Sympathetic Nervous System
   5. Origin of Preganglionic Neurons
   6. Location of Autonomic Ganglia
   7. Length of Preganglionic and Postganglionic Axons
   8. Neurotransmitters and Types of Receptors
   9. Sympathetic Adrenergic Varicosities
   10. Adrenal Medulla
   11. Fight or Flight Response
   12. Parasympathetic Nervous System
   13. Origin of Preganglionic Neurons
   14. Location of Autonomic Ganglia
   15. Length of Preganglionic and Postganglionic Axons
   16. Neurotransmitters and Types of Receptors
   17. Parasympathetic Cholinergic Varicosities
   18. Autonomic Innervation of the Organ Systems
   19. Reciprocal Functions—Sympathetic and Parasympathetic
   20. Sinoatrial Node
   21. Urinary Bladder
   22. Pupil
   23. Coordination of Function Within Organs
   24. Types of Receptors
   25. Hypothalamic and Brain Stem Centers
   26. Autonomic Receptors
   27. G Proteins
   28. Adrenoreceptors
   29. α1 Receptors
   30. α2 Receptors
   31. β1 Receptors
   32. β2 Receptors
   33. Responses of Adrenoreceptors to Norepinephrine and Epinephrine
   34. Cholinoreceptors
   35. Nicotinic Receptors
   36. Muscarinic Receptors
   37. Summary
   38. Challenge Yourself
6. 3 Neurophysiology
   1. Organization of the Nervous System
   2. Spinal Cord
   3. Brain Stem
   4. Cerebellum
   5. Thalamus and Hypothalamus
   6. Cerebral Hemispheres
   7. Cells of the Nervous System
   8. Structure of the Neuron
   9. Cell Body
   10. Dendrites
   11. Axon
   12. Presynaptic Terminals
   13. Glial Cells
   14. General Features of Sensory and Motor Systems
   15. Synaptic Relays
   16. Topographic Organization
   17. Decussations
   18. Types of Nerve Fibers
   19. Sensory Systems
   20. Sensory Pathways
   21. Sensory Receptors
   22. Types of Receptors
   23. Sensory Transduction and Receptor Potentials
   24. Receptive Fields
   25. Sensory Coding
   26. Adaptation of Sensory Receptors
   27. Somatosensory System and Pain
   28. Types of Somatosensory Receptors
   29. Mechanoreceptors
   30. Thermoreceptors
   31. Nociceptors
   32. Somatosensory Pathways
   33. Dorsal Column System
   34. Anterolateral System
   35. Vision
   36. Structures of the Eye
   37. Photoreception
   38. Layers of the Retina
   39. Structure of the Photoreceptors
   40. Steps in Photoreception
   41. Visual Receptive Fields
   42. Photoreceptors, Horizontal Cells, and Bipolar Cells
   43. Amacrine Cells
   44. Ganglion Cells
   45. Lateral Geniculate Cells of the Thalamus
   46. Visual Cortex
   47. Optic Pathways
   48. Audition
   49. Structures of the Ear
   50. Auditory Transduction
   51. Cochlea and Organ of Corti
   52. Steps in Auditory Transduction
   53. Encoding of Sound
   54. Auditory Pathways
   55. Vestibular System
   56. Vestibular Organ
   57. Vestibular Transduction
   58. Semicircular Canals
   59. Otolith Organs
   60. Vestibular Pathways
   61. Vestibulo-Ocular Reflexes
   62. Testing Vestibulo-Ocular Reflexes
   63. Olfaction
   64. Olfactory Epithelium and Receptors
   65. Olfactory Transduction
   66. Encoding Olfactory Stimuli
   67. Olfactory Pathways
   68. Taste
   69. Taste Buds and Receptors
   70. Taste Transduction
   71. Encoding Taste Stimuli
   72. Taste Pathways
   73. Motor Systems
   74. Organization of Motor Function by the Spinal Cord
   75. Motor Units
   76. Types of Motoneurons
   77. Types of Muscle Fibers
   78. Muscle Spindles
   79. Intrafusal Muscle Fibers of Muscle Spindles
   80. Innervation of Muscle Spindles
   81. Function of Muscle Spindles
   82. Spinal Cord Reflexes
   83. Stretch Reflex
   84. Golgi Tendon Reflex
   85. Flexor-Withdrawal Reflex
   86. Control of Posture and Movement by the Brain Stem
   87. Cerebellum
   88. Layers of the Cerebellar Cortex
   89. Input to the Cerebellar Cortex
   90. Interneurons of the Cerebellum
   91. Output of the Cerebellar Cortex
   92. Disorders of the Cerebellum
   93. Basal Ganglia
   94. Diseases of the Basal Ganglia
   95. Motor Cortex
   96. Higher Functions of the Nervous System
   97. Electroencephalogram
   98. Learning and Memory
   99. Cerebrospinal Fluid
   100. Formation of Cerebrospinal Fluid
   101. Functions of Cerebrospinal Fluid
   102. Summary
   103. Challenge Yourself
7. 4 Cardiovascular Physiology
   1. Circuitry of the Cardiovascular System
   2. Left and Right Sides of the Heart
   3. Blood Vessels
   4. Circuitry
   5. Hemodynamics
   6. Types and Characteristics of Blood Vessels
   7. Velocity of Blood Flow
   8. Relationships Between Blood Flow, Pressure, and Resistance
   9. Resistance to Blood Flow
   10. Poiseuille Equation
   11. Series and Parallel Resistances
   12. Laminar Flow and Reynolds Number
   13. Shear
   14. Compliance of Blood Vessels
   15. Pressures in the Cardiovascular System
   16. Pressure Profile in the Vasculature
   17. Arterial Pressure in the Systemic Circulation
   18. Venous Pressures in the Systemic Circulation
   19. Pressures in the Pulmonary Circulation
   20. Cardiac Electrophysiology
   21. Cardiac Action Potentials
   22. Origin and Spread of Excitation Within the Heart
   23. Concepts Associated With Cardiac Action Potentials
   24. Action Potentials of Ventricles, Atria, and the Purkinje System
   25. Action Potentials in the Sinoatrial Node
   26. Latent Pacemakers
   27. Conduction Velocity
   28. Conduction of the Cardiac Action Potential
   29. Mechanism of Propagation of Cardiac Action Potential
   30. Excitability and Refractory Periods
   31. Autonomic Effects on the Heart and Blood Vessels
   32. Autonomic Effects on Heart Rate
   33. Autonomic Effects on Conduction Velocity in the Atrioventricular Node
   34. Electrocardiogram
   35. Cardiac Muscle Contraction
   36. Myocardial Cell Structure
   37. Excitation-Contraction Coupling
   38. Contractility
   39. Mechanisms for Changing Contractility
   40. Effects of the Autonomic Nervous System on Contractility
   41. Effect of Heart Rate on Contractility
   42. Effect of Cardiac Glycosides on Contractility
   43. Length-Tension Relationship in Cardiac Muscle
   44. Stroke Volume, Ejection Fraction, and Cardiac Output
   45. Stroke Volume
   46. Ejection Fraction
   47. Cardiac Output
   48. Frank-Starling Relationship
   49. Ventricular Pressure-Volume Loops
   50. Normal Ventricular Pressure-Volume Loop
   51. Changes in Ventricular Pressure-Volume Loops
   52. Cardiac Work
   53. Myocardial Oxygen Consumption
   54. Measurement of Cardiac Output— Fick Principle
   55. Cardiac Cycle
   56. Atrial Systole (A)
   57. Isovolumetric Ventricular Contraction (B)
   58. Rapid Ventricular Ejection (C)
   59. Reduced Ventricular Ejection (D)
   60. Isovolumetric Ventricular Relaxation (E)
   61. Rapid Ventricular Filling (F)
   62. Reduced Ventricular Filling (Diastasis) (G)
   63. Relationships Between Cardiac Output and Venous Return
   64. Cardiac Function Curve
   65. Vascular Function Curve
   66. Mean Systemic Pressure
   67. Slope of the Vascular Function Curve
   68. Combining Cardiac and Vascular Function Curves
   69. Inotropic Effects
   70. Effects of Changes in Blood Volume
   71. Effects of Changes in Total Peripheral Resistance
   72. Regulation of Arterial Pressure
   73. Baroreceptor Reflex
   74. Baroreceptors
   75. Brain Stem Cardiovascular Centers
   76. Integrated Function of the Baroreceptor Reflex
   77. Response of the Baroreceptor Reflex to Hemorrhage
   78. Test of Baroreceptor Reflex: Valsalva Maneuver
   79. Renin–Angiotensin II–Aldosterone System
   80. Other Regulatory Mechanisms
   81. Peripheral Chemoreceptors in Carotid and Aortic Bodies
   82. Central Chemoreceptors
   83. Antidiuretic Hormone
   84. Cardiopulmonary (Low-Pressure) Baroreceptors
   85. Microcirculation
   86. Exchange of Substances Across the Capillary Wall
   87. Fluid Exchange Across Capillaries
   88. Starling Equation
   89. Changes in Starling Forces
   90. Lymph
   91. Special Circulations
   92. Mechanisms for Control of Regional Blood Flow
   93. Local Control of Blood Flow
   94. Neural and Hormonal Control of Blood Flow
   95. Coronary Circulation
   96. Cerebral Circulation
   97. Pulmonary Circulation
   98. Renal Circulation
   99. Skeletal Muscle Circulation
   100. Skin Circulation
   101. Temperature Regulation
   102. Mechanisms for Generating Heat
   103. Thyroid Hormones
   104. Sympathetic Nervous System
   105. Shivering
   106. Mechanisms for Dissipating Heat
   107. Regulation of Body Temperature
   108. Fever
   109. Disturbances of Temperature Regulation
   110. Integrative Functions of the Cardiovascular System
   111. Responses to Exercise
   112. Central Command
   113. Local Responses in Muscle
   114. Overall Responses to Exercise
   115. Responses to Hemorrhage
   116. Decreased Arterial Pressure—Initiating Event
   117. Responses of the Baroreceptor Reflex
   118. Responses of the Renin–Angiotensin II–Aldosterone System
   119. Responses in the Capillaries
   120. Responses of Antidiuretic Hormone
   121. Other Responses in Hemorrhage
   122. Responses to Changes in Posture
   123. Pooling of Blood in the Extremities— Initiating Event
   124. Response of the Baroreceptor Reflex
   125. Summary
   126. Challenge Yourself
8. 5 Respiratory Physiology
   1. Structure of the Respiratory System
   2. Airways
   3. Conducting Zone
   4. Respiratory Zone
   5. Pulmonary Blood Flow
   6. Lung Volumes and Capacities
   7. Lung Volumes
   8. Lung Capacities
   9. Dead Space
   10. Anatomic Dead Space
   11. Physiologic Dead Space
   12. Ventilation Rates
   13. Alveolar Ventilation Equation
   14. Alveolar Gas Equation
   15. Forced Expiratory Volumes
   16. Mechanics of Breathing
   17. Muscles Used for Breathing
   18. Muscles of Inspiration
   19. Muscles of Expiration
   20. Compliance
   21. Compliance of the Lungs
   22. Compliance of the Chest Wall
   23. Pressure-Volume Curves for the Lungs, Chest Wall, and Combined Lung and Chest Wall
   24. Diseases of Lung Compliance
   25. Surface Tension of Alveoli
   26. Surfactant
   27. Air Flow, Pressure, and Resistance Relationships
   28. Airway Resistance
   29. Changes in Airway Resistance
   30. Breathing Cycle
   31. Rest
   32. Inspiration
   33. Expiration
   34. Forced Expiration
   35. Gas Exchange
   36. Gas Laws
   37. General Gas Law
   38. Boyle’s Law
   39. Dalton’s Law of Partial Pressures
   40. Henry’s Law for Concentrations of Dissolved Gases
   41. Diffusion of Gases—Fick’s Law
   42. Forms of Gases in Solution
   43. Overview—Gas Transport in the Lungs
   44. Diffusion-Limited and Perfusion-Limited Gas Exchange
   45. Diffusion-Limited Gas Exchange
   46. Perfusion-Limited Gas Exchange
   47. O2 Transport—Perfusion Limited and Diffusion Limited
   48. Oxygen Transport in Blood
   49. Forms of O2 in Blood
   50. Dissolved O2
   51. O2 Bound to Hemoglobin
   52. O2-Binding Capacity and O2 Content
   53. O2 Delivery to Tissues
   54. O2-Hemoglobin Dissociation Curve
   55. Sigmoidal Shape
   56. P50
   57. Loading and Unloading of O2
   58. Pulse Oximetry
   59. Changes in the O2-Hemoglobin Dissociation Curve
   60. Shifts to the Right
   61. Shifts to the Left
   62. Carbon Monoxide
   63. Erythropoietin
   64. Carbon Dioxide Transport in Blood
   65. Forms of CO2 in Blood
   66. Dissolved CO2
   67. Carbaminohemoglobin
   68. HCO3−
   69. Ventilation/Perfusion Relationships
   70. Pulmonary Blood Flow
   71. Pulmonary Blood Flow, Pressure, and Resistance Relationships
   72. Regulation of Pulmonary Blood Flow
   73. Distribution of Pulmonary Blood Flow
   74. Shunts
   75. Ventilation/Perfusion Ratios
   76. Normal Value for V̇/Q̇
   77. Distribution of V̇/Q̇ in the Lung
   78. Ventilation/Perfusion Defects
   79. Control of Breathing
   80. Brain Stem Control of Breathing
   81. Medullary Respiratory Center
   82. Apneustic Center
   83. Pneumotaxic Center
   84. Cerebral Cortex
   85. Chemoreceptors
   86. Central Chemoreceptors
   87. Peripheral Chemoreceptors
   88. Other Receptors
   89. Integrative Functions
   90. Responses to Exercise
   91. Arterial Po2 and Pco2
   92. Venous Pco2
   93. Muscle and Joint Receptors
   94. Cardiac Output and Pulmonary Blood Flow
   95. O2-Hemoglobin Dissociation Curve
   96. Adaptation to High Altitude
   97. Hyperventilation
   98. Polycythemia
   99. 2,3-DPG and O2-Hemoglobin Dissociation Curve
   100. Pulmonary Vasoconstriction
   101. Acute Altitude Sickness
   102. Hypoxemia and Hypoxia
   103. Hypoxemia
   104. Hypoxia
   105. Summary
   106. Challenge Yourself
9. 6 Renal Physiology
   1. Anatomy and Blood Supply
   2. Gross Anatomic Features of the Kidney
   3. Structure of the Nephron
   4. Renal Vasculature
   5. Body Fluids
   6. Distribution of Water Among the Body Fluids
   7. Total Body Water
   8. Intracellular Fluid
   9. Extracellular Fluid
   10. Measuring Volumes of Body Fluid Compartments
   11. Shifts of Water Between Body Fluid Compartments
   12. Isosmotic Volume Contraction—Diarrhea
   13. Hyperosmotic Volume Contraction— Water Deprivation
   14. Hyposmotic Volume Contraction— Adrenal Insufficiency
   15. Isosmotic Volume Expansion—Infusion of NaCl
   16. Hyperosmotic Volume Expansion— High-NaCl Intake
   17. Hyposmotic Volume Expansion—SIADH
   18. Renal Clearance
   19. Clearance of Various Substances
   20. Clearance Ratios
   21. Renal Blood Flow
   22. Regulation of Renal Blood Flow
   23. Autoregulation of Renal Blood Flow
   24. Measurement of Renal Plasma Flow and Renal Blood Flow
   25. Measuring True Renal Plasma Flow— Fick Principle
   26. Measuring Effective Renal Plasma Flow— Clearance of PAH
   27. Measuring Renal Blood Flow
   28. Glomerular Filtration
   29. Characteristics of the Glomerular Filtration Barrier
   30. Layers of the Glomerular Capillary
   31. Endothelium
   32. Basement Membrane
   33. Epithelium
   34. Negative Charge on the Glomerular Capillary Barrier
   35. Starling Forces Across Glomerular Capillaries
   36. Starling Equation
   37. Changes in Starling Pressures
   38. Measurement of Glomerular Filtration Rate
   39. Clearance of Inulin
   40. Other Markers for Glomerular Filtration Rate
   41. Filtration Fraction
   42. Reabsorption and Secretion
   43. Measurement of Reabsorption and Secretion
   44. Glucose—Example of Reabsorption
   45. Cellular Mechanism for Glucose Reabsorption
   46. Glucose Titration Curve and Tm
   47. Glucosuria
   48. Urea—Example of Passive Reabsorption
   49. Para-Aminohippuric Acid—Example of Secretion
   50. Weak Acids and Bases—Non-Ionic Diffusion
   51. Terminology Associated With the Single Nephron
   52. [TF/P]X Ratio
   53. [TF/P]inulin
   54. [TF/P]X/[TF/P]inulin
   55. Sodium Balance
   56. Overall Handling of Na+
   57. Proximal Convoluted Tubule
   58. Early Proximal Convoluted Tubule
   59. Late Proximal Convoluted Tubule
   60. Isosmotic Reabsorption
   61. TF/P Ratios Along the Proximal Tubule
   62. Glomerulotubular Balance
   63. Changes in Extracellular Fluid Volume
   64. Osmotic Diuretics
   65. Loop of Henle
   66. Thin Descending Limb and Thin Ascending Limb
   67. Thick Ascending Limb
   68. Distal Tubule and Collecting Duct
   69. Early Distal Tubule
   70. Late Distal Tubule and Collecting Duct
   71. Regulation of Na+ Balance
   72. Response to Increased Na+ Intake
   73. Response to Decreased Na+ Intake
   74. Potassium Balance
   75. Internal K+ Balance
   76. Insulin
   77. Acid-Base Abnormalities
   78. Adrenergic Agonists and Antagonists
   79. Osmolarity
   80. Cell Lysis
   81. Exercise
   82. External K+ Balance—Renal Mechanisms
   83. K+ Reabsorption by α-Intercalated Cells
   84. K+ Secretion by Principal Cells
   85. Phosphate, Calcium, and Magnesium Balance
   86. Phosphate
   87. Calcium
   88. Magnesium
   89. Water Balance—Concentration and Dilution of Urine
   90. Regulation of Body Fluid Osmolarity
   91. Response to Water Deprivation
   92. Response to Water Drinking
   93. Corticopapillary Osmotic Gradient
   94. Countercurrent Multiplication
   95. Single Effect
   96. Flow of Tubular Fluid
   97. Urea Recycling
   98. Vasa Recta
   99. Antidiuretic Hormone
   100. Production of Hyperosmotic Urine
   101. Steps in Production of Hyperosmotic Urine
   102. SIADH
   103. Production of Hyposmotic Urine
   104. Steps in Production of Hyposmotic Urine
   105. Central Diabetes Insipidus
   106. Nephrogenic Diabetes Insipidus
   107. Free-Water Clearance
   108. Measurement of CH2O
   109. Significance of CH2O
   110. Summary
   111. Challenge Yourself
10. 7 Acid-Base Physiology
    1. pH of Body Fluids
    2. Acid Production in the Body
    3. CO2
    4. Fixed Acid
    5. Buffering
    6. Principles of Buffering
    7. Henderson-Hasselbalch Equation
    8. Titration Curves
    9. Extracellular Fluid Buffers
    10. HCO3−/CO2 Buffer
    11. HPO4−2/H2PO4− Buffer
    12. Intracellular Fluid Buffers
    13. Organic Phosphates
    14. Proteins
    15. Renal Mechanisms in Acid-Base Balance
    16. Reabsorption of Filtered HCO3−
    17. Mechanism of HCO3− Reabsorption in the Proximal Tubule
    18. Effect of Filtered Load of HCO3−
    19. Effect of Extracellular Fluid Volume
    20. Effect of Pco2
    21. Excretion of H+ as Titratable Acid
    22. Mechanism of Excretion of Titratable Acid
    23. Amount of Urinary Buffer
    24. pK of Urinary Buffers
    25. Excretion of H+ as NH4+
    26. Mechanism of Excretion of H+ as NH4+
    27. Effect of Urinary pH on Excretion of NH4+
    28. Effect of Acidosis on NH3 Synthesis
    29. Effect of Plasma K+ Concentration on NH3 Synthesis
    30. Comparison of Titratable Acid and NH4+ Excretion
    31. Acid-Base Disorders
    32. Anion Gap of Plasma
    33. Increased Anion Gap
    34. Normal Anion Gap
    35. Acid-Base Map
    36. Rules for Compensatory Responses
    37. Metabolic Acidosis
    38. Metabolic Alkalosis
    39. Respiratory Acidosis
    40. Respiratory Alkalosis
    41. Summary
    42. Challenge Yourself
11. 8 Gastrointestinal Physiology
    1. Structure of the Gastrointestinal Tract
    2. Innervation of the Gastrointestinal Tract
    3. Parasympathetic Innervation
    4. Sympathetic Innervation
    5. Intrinsic Innervation
    6. Gastrointestinal Regulatory Substances
    7. Characteristics of Gastrointestinal Peptides
    8. Gastrointestinal Hormones
    9. Gastrin
    10. Cholecystokinin
    11. Secretin
    12. Glucose-Dependent Insulinotropic Peptide
    13. Candidate Hormones
    14. Paracrines
    15. Neurocrines
    16. Satiety
    17. Motility
    18. Slow Waves
    19. Chewing and Swallowing
    20. Chewing
    21. Swallowing
    22. Esophageal Motility
    23. Gastric Motility
    24. Structure and Innervation of the Stomach
    25. Receptive Relaxation
    26. Mixing and Digestion
    27. Gastric Emptying
    28. Small Intestinal Motility
    29. Segmentation Contractions
    30. Peristaltic Contractions
    31. Vomiting
    32. Large Intestinal Motility
    33. Segmentation Contractions
    34. Mass Movements
    35. Defecation
    36. Gastrocolic Reflex
    37. Secretion
    38. Salivary Secretion
    39. Structure of the Salivary Glands
    40. Formation of Saliva
    41. Effect of Flow Rate on Composition of Saliva
    42. Regulation of Salivary Secretion
    43. Gastric Secretion
    44. Structure and Cell Types of the Gastric Mucosa
    45. HCl Secretion
    46. Cellular Mechanism
    47. Substances That Alter HCl Secretion
    48. Stimulation of H+ Secretion
    49. Inhibition of HCl Secretion
    50. Peptic Ulcer Disease
    51. Pepsinogen Secretion
    52. Intrinsic Factor Secretion
    53. Pancreatic Secretion
    54. Structure of the Pancreatic Exocrine Glands
    55. Formation of Pancreatic Secretion
    56. Effect of Flow Rate on Composition of Pancreatic Juice
    57. Regulation of Pancreatic Secretion
    58. Bile Secretion
    59. Overview of the Biliary System
    60. Composition of Bile
    61. Function of the Gallbladder
    62. Enterohepatic Circulation of Bile Salts
    63. Digestion and Absorption
    64. Carbohydrates
    65. Digestion of Carbohydrates
    66. Absorption of Carbohydrates
    67. Disorders of Carbohydrate Digestion and Absorption
    68. Proteins
    69. Digestion of Proteins
    70. Absorption of Proteins
    71. Disorders of Protein Digestion and Absorption
    72. Lipids
    73. Digestion of Lipids
    74. Stomach
    75. Small Intestine
    76. Absorption of Lipids
    77. Abnormalities of Lipid Digestion and Absorption
    78. Vitamins
    79. Fat-Soluble Vitamins
    80. Water-Soluble Vitamins
    81. Calcium
    82. Iron
    83. Intestinal Fluid and Electrolyte Transport
    84. Intestinal Absorption
    85. Jejunum
    86. Ileum
    87. Colon
    88. Intestinal Secretion
    89. Diarrhea
    90. Decreased Surface Area for Absorption
    91. Osmotic Diarrhea
    92. Secretory Diarrhea
    93. Liver Physiology
    94. Bile Formation and Secretion
    95. Bilirubin Production and Excretion
    96. Metabolic Functions of the Liver
    97. Detoxification of Substances
    98. Summary
    99. Challenge Yourself
12. 9 Endocrine Physiology
    1. Hormone Synthesis
    2. Peptide and Protein Hormone Synthesis
    3. Steroid Hormone Synthesis
    4. Amine Hormone Synthesis
    5. Regulation of Hormone Secretion
    6. Negative Feedback
    7. Positive Feedback
    8. Regulation of Hormone Receptors
    9. Down-Regulation
    10. Up-Regulation
    11. Mechanisms of Hormone Action and Second Messengers
    12. G Proteins
    13. Adenylyl Cyclase Mechanism
    14. Phospholipase C Mechanism
    15. Catalytic Receptor Mechanisms
    16. Guanylyl Cyclase
    17. Serine/Threonine Kinases
    18. Tyrosine Kinases
    19. Steroid and Thyroid Hormone Mechanism
    20. Hypothalamic-Pituitary Relationships
    21. Relationship of the Hypothalamus to the Posterior Pituitary
    22. Relationship of the Hypothalamus to the Anterior Pituitary
    23. Anterior Lobe Hormones
    24. TSH, FSH, and LH Family
    25. ACTH Family
    26. Growth Hormone
    27. Chemistry of Growth Hormone
    28. Regulation of Growth Hormone Secretion
    29. Actions of Growth Hormone
    30. Pathophysiology of Growth Hormone
    31. Prolactin
    32. Chemistry of Prolactin
    33. Regulation of Prolactin Secretion
    34. Actions of Prolactin
    35. Pathophysiology of Prolactin
    36. Posterior Lobe Hormones
    37. Synthesis and Secretion of Antidiuretic Hormone and Oxytocin
    38. Synthesis and Processing
    39. Secretion
    40. Antidiuretic Hormone
    41. Regulation of Antidiuretic Hormone Secretion
    42. Actions of Antidiuretic Hormone
    43. Pathophysiology of Antidiuretic Hormone
    44. Oxytocin
    45. Regulation of Oxytocin Secretion
    46. Actions of Oxytocin
    47. Thyroid Hormones
    48. Synthesis and Transport of Thyroid Hormones
    49. Synthesis of Thyroid Hormones
    50. Binding of Thyroid Hormones in the Circulation
    51. Activation of T4 in Target Tissues
    52. Regulation of Thyroid Hormone Secretion
    53. Actions of Thyroid Hormones
    54. Pathophysiology of Thyroid Hormone
    55. Hyperthyroidism
    56. Hypothyroidism
    57. Goiter
    58. Adrenal Medulla and Cortex
    59. Synthesis of Adrenocortical Steroid Hormones
    60. Structures of Adrenocortical Steroids
    61. Biosynthetic Pathways in the Adrenal Cortex
    62. Regulation of Secretion of Adrenocortical Steroids
    63. Regulation of Glucocorticoid and Adrenal Androgen Secretion
    64. Regulation of Aldosterone Secretion
    65. Actions of Adrenocortical Steroids
    66. Actions of Glucocorticoids
    67. Actions of Mineralocorticoids
    68. Actions of Adrenal Androgens
    69. Pathophysiology of the Adrenal Cortex
    70. Addison Disease
    71. Secondary Adrenocortical Insufficiency
    72. Cushing Syndrome
    73. Conn Syndrome
    74. 21β-Hydroxylase Deficiency
    75. 17α-Hydroxylase Deficiency
    76. Endocrine Pancreas
    77. Insulin
    78. Structure and Synthesis of Insulin
    79. Regulation of Insulin Secretion
    80. Mechanism of Action of Insulin
    81. Actions of Insulin
    82. Pathophysiology of Insulin
    83. Glucagon
    84. Structure and Synthesis of Glucagon
    85. Regulation of Glucagon Secretion
    86. Actions of Glucagon
    87. Somatostatin
    88. Regulation of Calcium and Phosphate Metabolism
    89. Forms of Ca2+ in Blood
    90. Overall Calcium Homeostasis
    91. Parathyroid Hormone
    92. Structure of Parathyroid Hormone
    93. Regulation of Parathyroid Hormone Secretion
    94. Actions of Parathyroid Hormone
    95. Pathophysiology of Parathyroid Hormone
    96. Calcitonin
    97. Vitamin D
    98. Synthesis of Vitamin D
    99. Regulation of Vitamin D Synthesis
    100. Actions of Vitamin D
    101. Pathophysiology of Vitamin D
    102. Summary
    103. Challenge Yourself
13. 10 Reproductive Physiology
    1. Sexual Differentiation
    2. Genetic Sex
    3. Gonadal Sex
    4. Phenotypic Sex
    5. Puberty
    6. Gonadotropin Secretion Over the Lifetime
    7. Pulsatile Secretion of GnRH, FSH, and LH
    8. Characteristics of Puberty
    9. Male Reproductive Physiology
    10. Structure of the Testes
    11. Spermatogenesis
    12. Storage of Sperm, Ejaculation, and Function of Sex Accessory Glands
    13. Synthesis and Secretion of Testosterone
    14. Regulation of the Testes
    15. GnRH
    16. FSH and LH
    17. Negative Feedback
    18. Actions of Androgens
    19. Female Reproductive Physiology
    20. Oogenesis
    21. Synthesis and Secretion of Estrogen and Progesterone
    22. Regulation of the Ovaries
    23. GnRH
    24. FSH and LH
    25. Negative and Positive Feedback
    26. Actions of Estrogen and Progesterone
    27. Development of the Female Reproductive Tract
    28. Menstrual Cycle
    29. Breasts
    30. Pregnancy
    31. Other Actions of Estrogen and Progesterone
    32. Events of the Menstrual Cycle
    33. Pregnancy
    34. Events of Early Pregnancy
    35. Hormones of Pregnancy
    36. Parturition
    37. Lactation
    38. Hormonal Contraception
    39. Menopause
    40. Summary
    41. Challenge Yourself
    42. Appendix I Common Abbreviations and Symbols
    43. Appendix II Normal Values and Constants
    44. Challenge Yourself Answers
    45. Chapter 1
    46. Chapter 2
    47. Chapter 3
    48. Chapter 4
    49. Chapter 5
    50. Chapter 6
    51. Chapter 7
    52. Chapter 8
    53. Chapter 9
    54. Chapter 10
    55. Index