Medical Physiology
A Systems Approach

Hershel Raff,
Michael G. Levitzky,
Purchase

Contributors xi
Preface xiii

SECTION I
INTRODUCTION 1

1. General Physiological Concepts 1
Hershel Raff and Michael Levitzky

SECTION II
CELL PHYSIOLOGY 9

2. Cells and Cellular Processes 9
David Landowne

3. Cell Membranes and Transport Processes 15
David Landowne

4. Channels and the Control of Membrane Potential 33
David Landowne

5. Sensory Generator Potentials 43
David Landowne

6. Action Potentials 47
David Landowne

7. Synapses 59
David Landowne

SECTION III
MUSCLE PHYSIOLOGY 79

8. Overview of Muscle Function 79
Kathleen H. McDonough

9. Skeletal Muscle Structure and Function 83
Kathleen H. McDonough

10. Cardiac Muscle Structure and Function 93
Kathleen H. McDonough

11. Smooth Muscle Structure and Function 99
Kathleen H. McDonough

SECTION IV
CNS/NEURAL PHYSIOLOGY 105

12. Introduction to the Nervous System 105
Susan M. Barman

13. General Sensory Systems: Touch, Pain, and Temperature 115
Susan M. Barman

14. Spinal Reflexes 125
Susan M. Barman

15. Special Senses I: Vision 133
Susan M. Barman

16. Special Senses II: Hearing and Equilibrium 147
Susan M. Barman

17. Special Senses III: Smell and Taste 159
Susan M. Barman

18. Control of Posture and Movement 167
Susan M. Barman

19. Autonomic Nervous System 177
Susan M. Barman

20. Electrical Activity of the Brain, Sleep–Wake States, and Circadian Rhythms 185
Susan M. Barman

21. Learning, Memory, Language, and Speech 191
Susan M. Barman

SECTION V
CARDIOVASCULAR PHYSIOLOGY 199

22. Overview of the Cardiovascular System 199
Lois Jane Heller and David E. Mohrman

23. Cardiac Muscle Cells 211
Lois Jane Heller and David E. Mohrman

24. The Heart Pump 223
Lois Jane Heller and David E. Mohrman

25. Cardiac Function Assessments 235
Lois Jane Heller and David E. Mohrman

26. Peripheral Vascular System 251
David E. Mohrman and Lois Jane Heller

27. Vascular Control 263
David E. Mohrman and Lois Jane Heller

28. Venous Return and Cardiac Output 275
David E. Mohrman and Lois Jane Heller

29. Arterial Pressure Regulation 285
David E. Mohrman and Lois Jane Heller

30. Cardiovascular Responses to Physiological Stress 295
Lois Jane Heller and David E. Mohrman

SECTION VI
PULMONARY PHYSIOLOGY 305

31. Function and Structure of the Respiratory System 305
Michael Levitzky

32. Mechanics of the Respiratory System 313
Michael Levitzky

33. Alveolar Ventilation 331
Michael Levitzky

34. Pulmonary Perfusion 341
Michael Levitzky

35. Ventilation–Perfusion Relationships and Respiratory Gas Exchange 353
Michael Levitzky

36. Transport of Oxygen and Carbon Dioxide 363
Michael Levitzky

37. Acid–Base Regulation and Causes of Hypoxia 375
Michael Levitzky

38. Control of Breathing 385
Michael Levitzky

SECTION VII
RENAL PHYSIOLOGY 397

39. Renal Functions, Basic Processes, and Anatomy 397
Douglas C. Eaton and John P. Pooler

40. Renal Blood Flow and Glomerular Filtration 409
Douglas C. Eaton and John P. Pooler

41. Clearance 417
Douglas C. Eaton and John P. Pooler

42. Tubular Transport Mechanisms 423
Douglas C. Eaton and John P. Pooler

43. Renal Handling of Organic Substances 429
Douglas C. Eaton and John P. Pooler

44. Basic Renal Processes for Sodium, Chloride, and Water 437
Douglas C. Eaton and John P. Pooler

45. Regulation of Sodium and Water Excretion 449
Douglas C. Eaton and John P. Pooler

46. Regulation of Potassium Balance 463
Douglas C. Eaton and John P. Pooler

47. Regulation of Acid Base Balance 471
Douglas C. Eaton and John P. Pooler

48. Regulation of Calcium and Phosphate Balance 485
Douglas C. Eaton and John P. Pooler

SECTION VIII
GI PHYSIOLOGY 491

49. Overview of the GI System Functional
Anatomy and Regulation 491
Kim E. Barrett

50. Gastric Secretion 507
Kim E. Barrett

51. Pancreatic and Salivary Secretion 517
Kim E. Barrett

52. Water and Electrolyte Absorption and Secretion 527
Kim E. Barrett

53. Intestinal Mucosal Immunology and Ecology 535
Kim E. Barrett

54. Intestinal Motility 543
Kim E. Barrett

55. Functional Anatomy of the Liver and Biliary System 559
Kim E. Barrett

56. Bile Formation, Secretion, and Storage 565
Kim E. Barrett

57. Handling of Bilirubin and Ammonia by the Liver 575
Kim E. Barrett

58. Digestion and Absorption of Carbohydrates, Proteins, and Water-soluble Vitamins 583
Kim E. Barrett

59. Lipid Assimilation 593
Kim E. Barrett

SECTION IX
ENDOCRINE AND METABOLIC PHYSIOLOGY 601

60. General Principles of Endocrine Physiology 601
Patricia E. Molina

61. The Hypothalamus and Posterior Pituitary Gland 613
Patricia E. Molina

62. Anterior Pituitary Gland 623
Patricia E. Molina

63. Thyroid Gland 633
Patricia E. Molina

64. Parathyroid Gland and Calcium and Phosphate Regulation 643
Patricia E. Molina

65. Adrenal Gland 655
Patricia E. Molina

66. Endocrine Pancreas 671
Patricia E. Molina

67. Male Reproductive System 683
Patricia E. Molina

68. Female Reproductive System 695
Patricia E. Molina

69. Endocrine Integration of Energy and Electrolyte Balance 715
Patricia E. Molina

SECTION X
INTEGRATIVE PHYSIOLOGY 729

70. Control of Body Temperature 729
Hershel Raff and Michael Levitzky

71. Hypoxia and Hyperbaria 735
Michael Levitzky and Hershel Raff

72. Exercise 745
Michael Levitzky and Kathleen H. McDonough

73. Aging 753
Hershel Raff

Answers to Study Questions 757
Index 761