Vander’s Human Physiology

Cover......Page 1
Human Physiology: The Mechanisms of Body Function......Page 2
Brief Contents......Page 4
Meet the Authors......Page 5
From the Authors......Page 6
Table of Contents......Page 7
Index of Exercise Physiology......Page 16
Guided Tour Through a Chapter......Page 17
Updates and Additions......Page 21
Acknowledgments......Page 26
Chapter 1: Homeostasis: A Framework for Human Physiology......Page 28
1.2 How Is the Body Organized?......Page 29
Epithelial Cells and Epithelial Tissue......Page 30
1.3 Body Fluid Compartments......Page 31
1.4  Homeostasis: A Defining Feature of Physiology......Page 32
1.5  General Characteristics of Homeostatic Control Systems......Page 34
Resetting of Set Points......Page 35
Reflexes......Page 36
1.7  The Role of Intercellular Chemical Messengers in Homeostasis......Page 38
Adaptation and Acclimatization......Page 39
Biological Rhythms......Page 40
1.9 General Principles of Physiology......Page 41
Chapter 1 Clinical Case Study......Page 44
ANSWERS TO PHYSIOLOGICAL Inquiry Questions......Page 46
Chapter 2: Chemical Composition of the Body and Its Relation to Physiology......Page 47
Components of Atoms......Page 48
Atomic Mass......Page 49
Covalent Chemical Bonds......Page 50
Molecular Shape......Page 52
Free Radicals......Page 53
Water......Page 54
Concentration......Page 55
Hydrogen Ions and Acidity......Page 56
Carbohydrates......Page 57
Lipids......Page 58
Proteins......Page 61
Nucleic Acids......Page 65
Chapter 2 Clinical Case Study......Page 68
ASSORTED ASSESSMENT QUESTIONS......Page 69
ANSWERS To PHYSIOLOGICAL INQUIRY QUESTIONS......Page 70
Chapter 3: Cellular Structure, Proteins, and Metabolic Pathways......Page 71
3.1 Microscopic Observations of Cells......Page 72
Membrane Structure......Page 73
Membrane Junctions......Page 76
Endoplasmic Reticulum......Page 78
Mitochondria......Page 79
Lysosomes......Page 80
Vaults......Page 81
Cytoskeleton......Page 82
3.4 Genetic Code......Page 84
Transcription: mRNA Synthesis......Page 85
Translation: Polypeptide Synthesis......Page 87
Regulation of Protein Synthesis......Page 90
3.7 Protein Secretion......Page 91
3.8 Binding Site Characteristics......Page 93
Chemical Specificity......Page 94
Saturation......Page 95
Allosteric Modulation......Page 96
Covalent Modulation......Page 97
SECTION D Chemical Reactions and Enzymes......Page 98
Reversible and Irreversible Reactions......Page 99
3.11 Enzymes......Page 100
Substrate Concentration......Page 101
Enzyme Activity......Page 102
3.13 Multienzyme Reactions......Page 103
SECTION E Metabolic Pathways......Page 104
Glycolysis......Page 105
Krebs Cycle......Page 107
Oxidative Phosphorylation......Page 109
Carbohydrate Metabolism......Page 110
Fat Metabolism......Page 113
Protein and Amino Acid Metabolism......Page 114
Metabolism Summary......Page 115
Vitamins......Page 116
Chapter 3 Clinical Case Study......Page 119
ASSORTED ASSESSMENT QUESTIONS......Page 120
ANSWERS TO PHYSIOLOGICAL Inquiry Questions......Page 121
Chapter 4: Movement of Solutes and Water Across Cell Membranes......Page 122
Magnitude and Direction of Diffusion......Page 123
Diffusion Through Membranes......Page 124
4.2 Mediated-Transport Systems......Page 127
Facilitated Diffusion......Page 128
Active Transport......Page 129
4.3 Osmosis......Page 132
Extracellular Osmolarity and Cell Volume......Page 135
Endocytosis......Page 136
4.5 Epithelial Transport......Page 138
Chapter 4 Clinical Case Study......Page 141
ASSORTED ASSESSMENT QUESTIONS......Page 142
ANSWERS TO PHYSIOLOGICAL Inquiry Questions......Page 144
Chapter 5: Cell Signaling in Physiology......Page 145
Interactions Between Receptors and Ligands......Page 146
Pathways Initiated by Lipid-Soluble Messengers......Page 149
Pathways Initiated by Water-Soluble Messengers......Page 150
Major Second Messengers......Page 153
Other Messengers......Page 156
Cessation of Activity in Signal Transduction Pathways......Page 158
Chapter 5 Clinical Case Study......Page 160
ASSORTED ASSESSMENT QUESTIONS......Page 161
ANSWERS TO PHYSIOLOGICAL Inquiry Questions......Page 162
Chapter 6: Neuronal Signaling and the Structure of the Nervous System......Page 163
6.1  Structure and Maintenance of Neurons......Page 164
6.2 Functional Classes of Neurons......Page 165
6.3 Glial Cells......Page 167
Growth and Development of Neurons......Page 168
Regeneration of Axons......Page 169
6.5 Basic Principles of Electricity......Page 170
Nature and Magnitude of the Resting Membrane Potential......Page 171
Contribution of Ion Concentration Differences......Page 172
Contribution of Different Ion Permeabilities......Page 174
Summary of the Development of a Resting Membrane Potential......Page 175
Graded Potentials......Page 176
Action Potentials......Page 177
Electrical Synapses......Page 185
6.9  Mechanisms of Neurotransmitter Release......Page 186
Excitatory Chemical Synapses......Page 187
6.11 Synaptic Integration......Page 188
Presynaptic Mechanisms......Page 190
Modification of Synaptic Transmission by Drugs and Disease......Page 191
6.13  Neurotransmitters and Neuromodulators......Page 192
Biogenic Amines......Page 193
Amino Acid Neurotransmitters......Page 195
Neuropeptides......Page 196
6.14 Neuroeffector Communication......Page 197
6.15 Central Nervous System: Brain......Page 199
Forebrain: The Cerebrum......Page 200
Brainstem: The Midbrain, Pons, and Medulla Oblongata......Page 202
6.17 Peripheral Nervous System......Page 203
6.18 Autonomic Nervous System......Page 204
Meninges and Cerebrospinal Fluid......Page 208
The Blood–Brain Barrier......Page 211
Chapter 6 Clinical Case Study......Page 212
ASSORTED ASSESSMENT QUESTIONS......Page 213
ANSWERS TO PHYSIOLOGICAL Inquiry Questions......Page 215
Chapter 7: Sensory Physiology......Page 216
7.1 Sensory Receptors......Page 217
The Receptor Potential......Page 218
Stimulus Type......Page 219
Stimulus Location......Page 220
7.3  Ascending Neural Pathways in Sensory  Systems......Page 223
Factors That Affect Perception......Page 225
Posture and Movement......Page 227
Pain and Itch......Page 228
Neural Pathways of the Somatosensory System......Page 231
Light......Page 232
Overview of Eye Anatomy......Page 233
The Optics of Vision......Page 234
Photoreceptor Cells and Phototransduction......Page 236
Neural Pathways of Vision......Page 238
Color Blindness......Page 241
Eye Movement......Page 242
Sound......Page 243
Sound Transmission in the Ear......Page 244
Neural Pathways in Hearing......Page 247
7.8 Vestibular System......Page 248
The Utricle and Saccule......Page 249
Vestibular Information and Pathways......Page 250
Gustation......Page 251
Olfaction......Page 252
Chapter 7 Clinical Case Study......Page 256
ASSORTED ASSESSMENT QUESTIONS......Page 258
ANSWERS TO Physiological Inquiry Questions......Page 259
Chapter 8: Consciousness, the Brain, and Behavior......Page 261
Electroencephalogram......Page 262
Sleep......Page 263
Neural Substrates of States of Consciousness......Page 265
Coma and Brain Death......Page 267
Selective Attention......Page 268
Neural Mechanisms of Conscious Experiences......Page 269
Motivation......Page 270
Emotion......Page 271
Schizophrenia......Page 272
The Mood Disorders: Depression and Bipolar Disorders......Page 273
Psychoactive Substances, Tolerance, and Substance  Use Disorders......Page 274
Memory......Page 275
The Neural Basis of Learning and Memory......Page 276
8.6  Cerebral Dominance and Language......Page 277
Chapter 8 Clinical Case Study......Page 280
ANSWERS TO PHYSIOLOGICAL INQUIRY QUESTIONS......Page 282
Chapter 9: Muscle......Page 284
Cellular Structure......Page 285
Connective Tissue Structure......Page 286
Sarcomere Structure......Page 287
Other Myofibril Structures......Page 288
Membrane Excitation: The Neuromuscular Junction......Page 289
Excitation–Contraction Coupling......Page 292
Sliding-Filament Mechanism......Page 294
9.3  Mechanics of Single-Fiber Contraction......Page 296
Twitch Contractions......Page 297
Frequency–Tension Relation......Page 299
Length–Tension Relation......Page 300
Creatine Phosphate......Page 302
Muscle Fatigue......Page 303
9.5 Types of Skeletal Muscle Fibers......Page 304
Control of Muscle Tension......Page 305
Muscle Adaptation to Exercise......Page 307
Lever Action of Muscles and Bones......Page 308
9.7 Skeletal Muscle Disorders......Page 309
Muscular Dystrophy......Page 310
Myasthenia Gravis......Page 311
9.8 Structure of Smooth Muscle......Page 314
Cross-Bridge Activation......Page 315
Sources of Cytosolic Ca2+......Page 316
Membrane Activation......Page 317
Types of Smooth Muscle......Page 319
Excitation-Contraction Coupling in Cardiac Muscle......Page 320
Chapter 9 Clinical Case Study......Page 323
ASSORTED ASSESSMENT QUESTIONS......Page 325
ANSWERS TO PHYSIOLOGICAL Inquiry Questions......Page 326
Chapter 10: Control of Body Movement......Page 328
10.1 Motor Control Hierarchy......Page 329
Local Afferent Input......Page 331
Cerebral Cortex......Page 335
Subcortical and Brainstem Nuclei......Page 336
Descending Pathways......Page 338
10.4 Muscle Tone......Page 339
10.5  Maintenance of Upright Posture and Balance......Page 340
10.6 Walking......Page 341
Chapter 10 Clinical Case Study......Page 343
ASSORTED ASSESSMENT QUESTIONS......Page 344
ANSWERS TO PHYSIOLOGICAL Inquiry Questions......Page 345
Chapter 11: The Endocrine System......Page 347
11.1  Hormones and Endocrine Glands......Page 348
Peptide and Protein Hormones......Page 350
Steroid Hormones......Page 351
Hormone Receptors......Page 354
Events Elicited by Hormone-Receptor Binding......Page 355
Control by Plasma Concentrations of Mineral Ions or  Organic Nutrients......Page 356
Hyposecretion......Page 357
Hyporesponsiveness and Hyperresponsiveness......Page 358
11.8  Control Systems Involving the Hypothalamus and Pituitary Gland......Page 360
Anterior Pituitary Gland Hormones and the Hypothalamus......Page 361
11.9 Synthesis of Thyroid Hormone......Page 366
11.11 Actions of Thyroid Hormone......Page 368
11.12  Hypothyroidism and Hyperthyroidism......Page 369
11.13  Physiological Functions of Cortisol......Page 371
11.14 Functions of Cortisol in Stress......Page 372
11.15  Adrenal Insufficiency and Cushing’s  Syndrome......Page 373
11.16  Other Hormones Released During Stress......Page 374
11.17 Bone Growth......Page 375
Growth Hormone and Insulin-Like  Growth Factors......Page 376
Cortisol......Page 378
Bone......Page 379
Parathyroid Hormone......Page 380
1,25-Dihydroxyvitamin D......Page 381
Hypercalcemia......Page 382
Hypocalcemia......Page 383
Chapter 11 Clinical Case Study......Page 384
ASSORTED ASSESSMENT QUESTIONS......Page 386
ANSWERS TO PHYSIOLOGICAL Inquiry Questions......Page 387
Chapter 12: Cardiovascular  Physiology......Page 389
Blood......Page 390
The Blood Cells......Page 391
Blood Flow......Page 394
Circulation......Page 395
12.2 Pressure, Flow, and Resistance......Page 396
12.3 Anatomy......Page 399
Cardiac Muscle......Page 400
Sequence of Excitation......Page 402
Cardiac Action Potentials and Excitation  of the SA Node......Page 403
Excitation–Contraction Coupling......Page 405
12.5  Mechanical Events of the  Cardiac Cycle......Page 407
Early Diastole......Page 410
Heart Sounds......Page 411
Control of Heart Rate......Page 412
Control of Stroke Volume......Page 413
12.7  Measurement of Cardiac Function......Page 415
SECTION C The Vascular System......Page 417
Arterial Blood Pressure......Page 419
12.9 Arterioles......Page 421
Local Controls......Page 423
Extrinsic Controls......Page 424
Endothelial Cells and Vascular Smooth Muscle......Page 425
12.10 Capillaries......Page 426
Anatomy of the Capillary Network......Page 427
Velocity of Capillary Blood Flow......Page 428
Diffusion Across the Capillary Wall: Exchanges  of Nutrients and Metabolic End Products......Page 429
Bulk Flow Across the Capillary Wall: Distribution of the Extracellular Fluid......Page 430
Determinants of Venous Pressure......Page 433
12.12 The Lymphatic System......Page 434
Mechanism of Lymph Flow......Page 436
SECTION D  Integration of Cardiovascular Function: Regulation of Systemic Arterial Pressure......Page 438
Arterial Baroreceptors......Page 441
The Medullary Cardiovascular Center......Page 442
Other Baroreceptors......Page 443
12.15  Other Cardiovascular Reflexes and Responses......Page 444
12.16  Hemorrhage and Other Causes of Hypotension......Page 446
12.17 The Upright Posture......Page 447
12.18 Exercise......Page 448
12.19 Hypertension......Page 451
12.20 Heart Failure......Page 452
12.22  Coronary Artery Disease and Heart Attacks......Page 454
Causes and Prevention......Page 455
Stroke and TIA......Page 456
12.23 Formation of a Platelet Plug......Page 458
12.24  Blood Coagulation: Clot Formation......Page 459
Factors That Oppose Clot Formation......Page 462
12.26 Anticlotting Drugs......Page 463
Chapter 12 Clinical Case Study......Page 465
ASSORTED ASSESSMENT QUESTIONS......Page 468
ANSWERS TO PHYSIOLOGICAL INQUIRY QUESTIONS......Page 469
Chapter 13: Respiratory Physiology......Page 472
The Airways and Blood Vessels......Page 473
Site of Gas Exchange: The Alveoli......Page 474
13.2 Principles of Ventilation......Page 476
Boyle’s Law......Page 477
How Is a Stable Balance of Transmural Pressures Achieved Between Breaths?......Page 478
Lung Compliance......Page 480
Airway Resistance......Page 483
Dead Space......Page 485
13.5  Exchange of Gases in Alveoli and Tissues......Page 487
Partial Pressures of Gases......Page 488
Alveolar Gas Pressures......Page 489
Gas Exchange Between Alveoli and Blood......Page 490
Matching of Ventilation and Blood Flow in Alveoli......Page 491
13.6 Transport of Oxygen in Blood......Page 492
What Is the Effect of PO2 on Hemoglobin Saturation?......Page 493
Effects of Other Factors on Hemoglobin Saturation  and Oxygen-Carrying Capacity......Page 495
13.7  Transport of Carbon Dioxide in Blood......Page 497
Neural Generation of Rhythmic Breathing......Page 498
Control of Ventilation by PO2, PCO2, and H+ Concentration......Page 500
Control of Ventilation During Exercise......Page 504
Other Ventilatory Responses......Page 505
Emphysema......Page 506
13.11  Nonrespiratory Functions of the Lungs......Page 507
Chapter 13 Clinical Case Study......Page 511
ASSORTED ASSESSMENT QUESTIONS......Page 512
ANSWERS TO PHYSIOLOGICAL Inquiry Questions......Page 514
Chapter 14: The Kidneys and  Regulation of Water  and Inorganic Ions......Page 515
14.2  Structure of the Kidneys and Urinary System......Page 516
14.3 Basic Renal Processes......Page 520
Glomerular Filtration......Page 521
Tubular Reabsorption......Page 524
14.4 The Concept of Renal Clearance......Page 526
Involuntary (Spinal) Control......Page 527
Incontinence......Page 528
Primary Active Na+ Reabsorption......Page 530
Coupling of Water Reabsorption to Na+ Reabsorption......Page 531
Urine Concentration: The Countercurrent Multiplier System......Page 533
Control of GFR......Page 537
Control of Na+ Reabsorption......Page 538
Osmoreceptor Control of Vasopressin Secretion......Page 540
Baroreceptor Control of Vasopressin Secretion......Page 541
14.11 Thirst and Salt Appetite......Page 542
Renal Regulation of K+......Page 543
14.15 Diuretics......Page 544
14.16  Sources of Hydrogen Ion Gain or Loss......Page 547
14.18  Integration of Homeostatic Controls......Page 548
Addition of New HCO3- to the Plasma......Page 549
14.20  Classification of Acidosis and Alkalosis......Page 550
Chapter 14 Clinical Case Study......Page 552
ASSORTED ASSESSMENT QUESTIONS......Page 555
ANSWERS TO PHYSIOLOGICAL Inquiry Questions......Page 556
Chapter 15: The Digestion and Absorption of Food......Page 558
15.1  Overview of the Digestive System......Page 559
15.2  Structure of the Gastrointestinal Tract Wall......Page 562
Neural Regulation......Page 563
Phases of Gastrointestinal Control......Page 564
Saliva......Page 565
Swallowing......Page 566
Secretions of the Stomach......Page 568
Gastric Motility......Page 572
Anatomy......Page 574
Secretions......Page 575
Digestion and Absorption in the Small Intestine......Page 580
Motility of the Small Intestine......Page 585
Anatomy......Page 586
Motility of the Large Intestine and Defecation......Page 587
Ulcers......Page 588
Gallstones......Page 589
Constipation and Diarrhea......Page 591
Chapter 15 Clinical Case Study......Page 595
ASSORTED ASSESSMENT QUESTIONS......Page 597
ANSWERS TO PHYSIOLOGICAL Inquiry Questions......Page 598
Chapter 16: Regulation of Organic Metabolism and Energy Balance......Page 599
Absorptive State......Page 600
Postabsorptive State......Page 603
16.2  Endocrine and Neural Control of the Absorptive  and Postabsorptive States......Page 605
Insulin......Page 607
Glucagon......Page 609
Cortisol......Page 610
16.3  Energy Homeostasis in Exercise and Stress......Page 611
Metabolic Rate......Page 614
Regulation of Food Intake......Page 616
Overweight and Obesity......Page 618
What Should We Eat?......Page 619
Mechanisms of Heat Loss or Gain......Page 620
Temperature-Regulating Reflexes......Page 621
16.7 Fever and Hyperthermia......Page 623
Chapter 16 Clinical Case Study......Page 626
ASSORTED ASSESSMENT QUESTIONS......Page 628
ANSWERS TO PHYSIOLOGICAL Inquiry Questions......Page 629
Chapter 17: Reproduction......Page 631
17.1 Gametogenesis......Page 632
Differentiation of Internal and External Genitalia......Page 634
Estrogens and Progesterone......Page 638
Hypothalamo–Pituitary–Gonadal Control......Page 639
17.5 Anatomy......Page 641
17.6 Spermatogenesis......Page 642
Production of Mature Sperm......Page 643
17.7 Transport of Sperm......Page 644
Ejaculation......Page 645
Control of the Testes......Page 646
Secondary Sex Characteristics and Growth......Page 647
17.10 Hypogonadism......Page 648
17.11 Andropause......Page 649
17.12 Anatomy......Page 650
Oogenesis......Page 651
Follicle Growth......Page 652
Formation of the Corpus Luteum......Page 653
17.14 Control of Ovarian Function......Page 654
Follicle Development and Estrogen Synthesis During the Early and Middle Follicular Phases......Page 655
The Luteal Phase......Page 656
17.15  Uterine Changes in the Menstrual Cycle......Page 658
17.16  Additional Effects of Gonadal Steroids......Page 659
17.17 Puberty......Page 660
17.19 Menopause......Page 661
Fertilization......Page 663
Early Development, Implantation, and Placentation......Page 664
17.21  Hormonal and Other Changes During  Pregnancy......Page 668
Preeclampsia and Pregnancy Sickness......Page 669
Parturition......Page 670
Lactation......Page 672
Contraception......Page 674
17.24  Summary of Reproductive Hormones Through Life......Page 675
Chapter 17 Clinical Case Study......Page 678
ASSORTED ASSESSMENT QUESTIONS......Page 679
ANSWERS TO PHYSIOLOGICAL Inquiry Questions......Page 681
Chapter 18: The Immune System......Page 682
Immune Cells......Page 683
Inflammation......Page 684
Interferons......Page 689
Toll-Like Receptors......Page 690
Lymphoid Organs and Lymphocyte Origins......Page 691
Humoral and Cell-Mediated Responses: Functions of B Cells and T Cells......Page 693
Lymphocyte Receptors......Page 695
Antigen Presentation to T Cells......Page 697
NK Cells......Page 698
Antibody-Mediated Immune Responses: Defenses Against Bacteria, Extracellular Viruses, and Toxins......Page 699
Defenses Against Virus-Infected Cells and Cancer Cells......Page 703
18.4  Systemic Manifestations of Infection......Page 704
18.5  Factors That Alter the Resistance to Infection......Page 706
Acquired Immune Deficiency Syndrome (AIDS)......Page 707
Transfusion Reactions......Page 708
Hypersensitivities......Page 709
Excessive Inflammatory Responses......Page 711
Chapter 18 Clinical Case Study......Page 717
ASSORTED ASSESSMENT QUESTIONS......Page 719
ANSWERS TO PHYSIOLOGICAL Inquiry Questions......Page 720
Chapter 19: Medical Physiology: Integration Using Clinical Cases......Page 721
19.2 Physical Examination......Page 722
19.4 Diagnosis......Page 723
19.6 Therapy......Page 725
19.8 Physical Examination......Page 726
19.10 Diagnosis......Page 727
19.12 Therapy......Page 728
19.15 Laboratory Tests......Page 729
19.16 Diagnosis......Page 730
19.17 Physiological Integration......Page 731
19.18 Therapy......Page 732
19.20 Physical Examination......Page 733
19.23 Physiological Integration......Page 734
19.24 Therapy......Page 735
APPENDIX A: Answers to Test Questions......Page 737
APPENDIX B: Index of Clinical Terms......Page 753
APPENDIX C:  Concentration Ranges of Commonly Measured Variables in Blood......Page 757
GLOSSARY/INDEX......Page 759