Guyton and Hall Textbook of Medical Physiology

Director John E. Hall works at the Mississippi Center for Obesity Research, Department of Physiology and Biophysics, Jackson, Mississippi.

• UNIT I: Introduction to Physiology: The Cell and General Physiology1. Functional Organization of the Human Body and Control of the “Internal Environment”Cells Are the Living Units of the BodyExtracellular Fluid-The “Internal Environment”Homeostasis-Maintenance of a Stable Internal EnvironmentControl Systems of the BodyPhysiological Variability2. The Cell and Its FunctionsOrganization of the CellCell StructureFunctional Systems of the CellLocomotion of Cells3. Genetic Control of Protein Synthesis, Cell Function, and Cell ReproductionCell Nucleus Genes Control Protein SynthesisTranscription-Transfer of Cell Nucleus DNA Code to Cytoplasm RNA CodeTranslation-Formation of Proteins on the RibosomesProtein Enzymes Control Synthesis of Other Substances in the CellRegulation of Gene Function and Biochemical Activity in CellsThe DNA-Genetic System Controls Cell ReproductionCell DifferentiationApoptosis-Programmed Cell DeathCancerUNIT II: Membrane Physiology, Nerve, and Muscle4. Transport of Substances Through Cell MembranesThe Cell Membrane Is a Lipid Bilayer With Cell Membrane Transport ProteinsDiffusionActive Transport of Substances Through Membranes5. Membrane Potentials and Action PotentialsBasic Physics of Membrane PotentialsResting Membrane Potential of NeuronsNeuron Action PotentialPropagation of the Action PotentialImportance of Energy Metabolism for Reestablishing Sodium and Potassium Ionic Gradients After Action Potentials Are CompletedPlateau in Some Action PotentialsRhythmicity of Some Excitable Tissues-Repetitive DischargeSpecial Characteristics of Signal Transmission in Nerve TrunksExcitation-The Process of Eliciting the Action Potential6. Contraction of Skeletal MusclePhysiological Anatomy of Skeletal MuscleGeneral Mechanism of Muscle ContractionMolecular Mechanisms of Muscle ContractionEnergetics of Muscle ContractionCharacteristics of Whole Muscle Contraction7. Excitation of Skeletal Muscle: Neuromuscular Transmission and Excitation-Contraction CouplingNeuromuscular Junction and Transmission of Impulses From Nerve Endings to Skeletal Muscle FibersMuscle Action PotentialExcitation-Contraction Coupling8. Excitation and Contraction of Smooth MuscleContraction of Smooth MuscleRegulation of Contraction By Calcium IonsNervous and Hormonal Control of Smooth Muscle ContractionUNIT III: The Heart9. Cardiac Muscle; The Heart as a Pump and Function of the Heart ValvesCardiac Muscle PhysiologyThe Cardiac CycleRegulation of Heart Pumping10. Rhythmical Excitation of the HeartSpecialized Excitatory and Conductive System of the HeartControl of Excitation and Conduction in the Heart11. Fundamentals of ElectrocardiographyWaveforms of the Normal ElectrocardiogramFlow of Current Around the Heart During the Cardiac CycleElectrocardiographic Leads12. Electrocardiographic Interpretation of Cardiac Muscle and Coronary Blood Flow Abnormalities: Vectorial AnalysisVectorial Analysis of ElectrocardiogramsVectorial Analysis of the Normal ElectrocardiogramMean Electrical Axis of the Ventricular QRS and Its SignificanceConditions That Cause Abnormal Voltages of the QRS ComplexProlonged and Bizarre Patterns of the QRS ComplexCurrent of Injury on the ElectrocardiogramAbnormalities in the T Wave13. Cardiac Arrhythmias and Their Electrocardiographic InterpretationAbnormal Sinus RhythmsHeart Block Within the Intracardiac Conduction PathwaysPremature ContractionsParoxysmal TachycardiaVentricular FibrillationAtrial FibrillationAtrial FlutterCardiac ArrestUNIT IV: The Circulation14. Overview of the Circulation: Pressure, Flow, and ResistancePhysical Characteristics of the CirculationBasic Principles of Circulatory FunctionInterrelationships of Pressure, Flow, and Resistance15. Vascular Distensibility and Functions of the Arterial and Venous SystemsVascular DistensibilityArterial Pressure PulsationsVeins and Their Functions16. The Microcirculation and Lymphatic System: Capillary Fluid Exchange, Interstitial Fluid, and Lymph FlowStructure of the Microcirculation and Capillary SystemVasomotion Causes Intermittent Capillary Blood FlowExchange of Substances Between the Blood and Interstitial FluidInterstitium and Interstitial FluidFluid Filtration Across CapillariesLymphatic System17. Local and Humoral Control of Tissue Blood FlowLocal Blood Flow Is Controlled in Response to Tissue NeedsMechanisms of Local Blood Flow ControlHumoral Control of the Circulation18. Nervous Regulation of the Circulation and Rapid Control of Arterial PressureNervous Regulation of the CirculationSpecial Features of Nervous Control of Arterial Pressure19. Role of the Kidneys in Long-Term Control of Arterial Pressure and in Hypertension: The Integrated System for Arterial Pressure RegulationRenal-Body Fluid System for Arterial Pressure ControlRole of the Renin-Angiotensin System in Arterial Pressure ControlSummary of Integrated Multifaceted Systems for Arterial Pressure Regulation20. Cardiac Output, Venous Return, and Their RegulationNormal Values for Cardiac Output at Rest and During ActivityControl of Cardiac Output By Venous Return-Frank-Starling Mechanism of the HeartMethods for Measuring Cardiac Output21. Muscle Blood Flow and Cardiac Output During Exercise; The Coronary Circulation and Ischemic Heart DiseaseBlood Flow Regulation in Skeletal Muscle at Rest and During ExerciseCoronary Circulation22. Heart FailureCirculatory Dynamics in Heart FailureUnilateral Left Heart FailureLow-Output Cardiac Failure-Cardiogenic ShockEdema in Patients With Heart FailureCardiac ReserveQuantitative Graphic Analysis of Cardiac FailureHeart Failure With Preserved Ejection FractionHigh-Output Heart Failure23. Heart Valves and Heart Sounds; Valvular and Congenital Heart DefectsHeart SoundsAbnormal Circulatory Dynamics in Valvular Heart DiseaseAbnormal Circulatory Dynamics in Congenital Heart DefectsUse of Extracorporeal Circulation During Cardiac SurgeryHypertrophy of the Heart in Valvular and Congenital Heart Disease24. Circulatory Shock and Its TreatmentPhysiological Causes of ShockHypovolemic Shock Due to HemorrhageDistributive Shock Is Characterized By Severe Peripheral VasodilationObstructive Shock Is Usually Due to Noncardiac Causes of Reduced Cardiac OutputPhysiology of Treatment in ShockCirculatory ArrestUNIT V: The Body Fluids and Kidneys25. Regulation of Body Fluid Compartments: Extracellular and Intracellular Fluids; EdemaLong-Term Steady-State Fluid and Solute BalanceBody Fluid CompartmentsConstituents of Extracellular and Intracellular FluidsMeasurement of Body Fluid Volume-Indicator-Dilution PrincipleFluid Exchange and Osmotic Equilibrium Between Intracellular and Extracellular FluidVolume and Osmolality of Extracellular and Intracellular Fluids in Abnormal StatesGlucose and Other Solutions for NutritionClinical Abnormalities of Fluid Volume Regulation: Hyponatremia and HypernatremiaEdema: Excess Fluid in the TissuesFluids in Potential Spaces of the Body26. The Urinary System: Functional Anatomy and Urine Formation By the KidneysFunctions of the KidneysPhysiological Anatomy of the KidneysUrine Formation Results From Glomerular Filtration, Tubular Reabsorption, and Tubular SecretionMicturition27. Glomerular Filtration, Renal Blood Flow, and Their ControlGlomerular Filtration-The First Step in Urine FormationDeterminants of GFRRenal Blood FlowPhysiological Control of GFR and Renal Blood FlowAutoregulation of GFR and Renal Blood Flow28. Renal Tubular Reabsorption and SecretionTubular Reabsorption Is Quantitatively Large and Highly SelectivePassive and Active Mechanisms of ReabsorptionReabsorption and Secretion Along Different Parts of the NephronRegulation of Tubular ReabsorptionUse of Clearance Methods to Quantify Kidney Function29. Urine Concentration and Dilution; Regulation of Extracellular Fluid Osmolarity and Sodium ConcentrationExcretion of Excess Water by Dilute UrineConservation of Water by Concentrated UrineCountercurrent Multiplier MechanismControl of Extracellular Fluid Osmolarity and Sodium Concentration30. Renal Regulation of Potassium, Calcium, Phosphate, and Magnesium; Integration of Renal Mechanisms for Control of Blood Volume and Extracellular Fluid VolumeRegulation of Internal Potassium DistributionRenal Potassium ExcretionRenal Calcium Excretion and Extracellular Calcium Ion ConcentrationRenal Phosphate ExcretionRenal Magnesium Excretion and Extracellular Magnesium Ion ConcentrationIntegration of Renal Mechanisms for Control of Extracellular Fluid and Distribution of Extracellular FluidNervous and Hormonal Factors in Renal-Body Fluid Feedback ControlResponses to Changes in Sodium IntakeConditions Causing Large Increases in Blood and Extracellular Fluid Volume31. Acid-Base RegulationHydrogen Ion Concentration RegulationAcids and Bases-DefinitionsDefenses Against Changes in H+ Concentration: Buffers, Lungs, and KidneysBuffering of H+Bicarbonate Buffer SystemPhosphate Buffer SystemProteins as Intracellular BuffersRespiratory Regulation of Acid-Base BalanceRenal Control of Acid-Base BalanceSecretion and Reabsorption of H+ and HCO3− in TubulesGeneration of “New” HCO3− in the TubuleQuantification of Renal Acid-Base ExcretionRenal Adjustment in Acidosis and Alkalosis32. Diuretics and Kidney DiseasesMechanisms of Action of DiureticsKidney DiseasesAcute Kidney InjuryChronic Kidney Disease (CKD) and Loss of NephronsUNIT VI: Blood Cells, Immunity, and Blood Coagulation33. Red Blood Cells, Anemia, and PolycythemiaRed Blood Cells (Erythrocytes)Iron MetabolismAnemiasPolycythemia34. Resistance of the Body to Infection: I. Leukocytes, Granulocytes, the Monocyte-Macrophage System, and InflammationLeukocytes (White Blood Cells)Neutrophils and Macrophages Defend Against InfectionsMonocyte-Macrophage Cell System (Reticuloendothelial System)Inflammation: Role of Neutrophils and MacrophagesEosinophilsBasophilsLeukopeniaLeukemias35. Resistance of the Body to Infection: II. Immunity and AllergyAcquired (Adaptive) ImmunityAllergy and HypersensitivitySex Differences in Innate and Adaptive Immunity36. Blood Types, Transfusion, and Tissue and Organ TransplantationAntigenicity Causes Immune Reactions of BloodO-A-B Blood TypesRh Blood TypesTransfusion Reactions Resulting From Mismatched Blood TypesTransplantation of Tissues and OrgansImmunological Aspects of Transplantation37. Hemostasis and Blood CoagulationHemostasis EventsMechanism of Blood CoagulationConditions That Cause Excessive Bleeding in HumansThromboembolic ConditionsAnticoagulants for Clinical UseBlood Coagulation TestsUNIT VII: Respiration38. Pulmonary VentilationMechanics of Pulmonary VentilationPulmonary Volumes and CapacitiesAlveolar Ventilation39. Pulmonary Circulation, Pulmonary Edema, and Pleural FluidPhysiological Anatomy of the Pulmonary Circulatory SystemPressures in the Pulmonary Circulatory SystemBlood Volume of the LungsBlood Flow Through the Lungs and Its DistributionEffect of Hydrostatic Pressure Gradients in the Lungs on Regional Pulmonary Blood FlowPulmonary Capillary DynamicsFluid in the Pleural Cavity40. Principles of Gas Exchange; Diffusion of Oxygen and Carbon Dioxide Through Respiratory MembranesCompositions of Alveolar Air and Atmospheric Air Are DifferentDiffusion of Gases Through the Respiratory Membrane41. Transport of Oxygen and Carbon Dioxide in Blood and Tissue FluidsTransport of Oxygen From the Lungs to the Body TissuesTransport of CO2 in BloodRespiratory Exchange Ratio42. Regulation of RespirationRespiratory CenterChemical Control of RespirationPeripheral Chemoreceptor System-Role of Oxygen in Respiratory ControlRegulation of Respiration During Exercise43. Respiratory Insufficiency-Pathophysiology, Diagnosis, Oxygen TherapyMethods for Studying Respiratory AbnormalitiesPathophysiology of Specific Pulmonary AbnormalitiesHypoxia and Oxygen TherapyHypercapnia-Excess Carbon Dioxide in the Body FluidsRespiratory Resuscitation and Mechanical VentilatorsUNIT VIII: Aviation, Space, and Deep-Sea Diving Physiology44. Aviation, High Altitude, and Space PhysiologyEffects of Low Oxygen Pressure on the Body45. Physiology of Deep-Sea Diving and Other Hyperbaric ConditionsEffect of High Partial Pressures of Individual Gases on the BodySelf-Contained Underwater Breathing Apparatus (SCUBA) DivingUNIT IX: The Nervous System: A. General Principles and Sensory Physiology46. Organization of the Nervous System, Basic Functions of Synapses and NeurotransmittersGeneral Design of the Nervous SystemMajor Levels of Central Nervous System FunctionComparison of the Nervous System to a ComputerCentral Nervous System SynapsesSpecial Characteristics of Synaptic Transmission47. Sensory Receptors and Neuronal Circuits for Processing InformationTypes of Sensory Receptors and the Stimuli They DetectTransduction of Sensory Stimuli Into Nerve ImpulsesSignal Intensity Transmission in Nerve Tracts-Spatial and Temporal SummationTransmission and Processing of Signals in Neuronal PoolsInstability and Stability of Neuronal Circuits48. Somatic Sensations: I. General Organization, Tactile and Position SensesClassification of Somatic SensesDetection and Transmission of Tactile SensationsSensory Pathways for Transmitting Somatic Signals Into the Central Nervous SystemTransmission in the Dorsal Column-Medial Lemniscal SystemTransmission of Sensory Signals in the Anterolateral Pathway49. Somatic Sensations: II. Pain, Headache, and Thermal SensationsFast Pain and Slow Pain and Their QualitiesPain Receptors (Nociceptors) and Their StimulationDual Pathways for Transmission of Pain Signals Into the Central Nervous SystemPain Suppression (Analgesia) System in the Brain and Spinal CordReferred PainVisceral PainThermal SensationsUNIT X: The Nervous System: B. The Special Senses50. The Eye: I. Optics of VisionPhysical Principles of OpticsOptics of the EyeFluid System of the Eye-Intraocular Fluid51. The Eye: II. Receptor and Neural Function of the RetinaAnatomy and Function of Structural Elements of the RetinaPhotochemistry of VisionColor VisionNeural Function of the Retina52. The Eye: III. Central Neurophysiology of VisionVisual PathwaysOrganization and Function of the Visual CortexNeuronal Patterns of Stimulation During Analysis of Visual ImagesEye Movements and Their ControlAutonomic Control of Accommodation and Pupillary Aperture53. The Sense of HearingTympanic Membrane and the Ossicular SystemCochleaCentral Auditory Mechanisms54. The Chemical Senses-Taste and SmellSense of TasteSense of SmellUNIT XI: The Nervous System: C. Motor and Integrative Neurophysiology55. Spinal Cord Motor Functions; The Cord ReflexesOrganization of the Spinal Cord for Motor FunctionsMuscle Sensory Receptors-Muscle Spindles and Golgi Tendon Organs-Their Roles in Muscle ControlFlexor Reflex and the Withdrawal ReflexesCrossed Extensor ReflexReciprocal Inhibition and InnervationReflexes of Posture and Locomotion56. Cortical and Brain Stem Control of Motor FunctionMotor Cortex and Corticospinal TractControl of Motor Functions By the Brain StemVestibular Sensations and Maintenance of Equilibrium57. Cerebellum and Basal Ganglia Contributions to Overall Motor ControlThe Cerebellum and Its Motor FunctionsThe Basal Ganglia and Their Motor FunctionsIntegration of the Entire Motor Control System58. Cerebral Cortex, Intellectual Functions of the Brain, Learning, and MemoryPhysiological Anatomy of the Cerebral CortexFunctions of Specific Cortical AreasThe Corpus Callosum and Anterior CommissureThoughts, Consciousness, and Memory59. The Limbic System and the Hypothalamus-Behavioral and Motivational Mechanisms of the BrainActivating-Driving Systems of the BrainLimbic SystemThe Hypothalamus, a Major Control Headquarters for the Limbic SystemFunctions of Other Parts of the Limbic System60. States of Brain Activity-Sleep, Brain Waves, Epilepsy, Psychoses, and Dementia SleepUNIT XII: Gastrointestinal Physiology63. General Principles of Gastrointestinal Function-Motility, Nervous and Hormonal Control, Blood Circulation, and MicrobiotaGastrointestinal MotilityNeural Control-Enteric Nervous SystemHormonal ControlGastrointestinal Microbiota64. Propulsion and Mixing of Food in the Alimentary TractIngestion of FoodStomach MovementsSmall Intestine MovementsColon MovementsAutonomic Reflexes Influencing Bowel Activity65. Secretory Functions of the Alimentary TractPrinciples of SecretionSaliva SecretionGastric SecretionPancreatic SecretionBile Secretion by the LiverSmall Intestine SecretionMucus Secretion by the Large Intestine66. Digestion and Absorption in the Gastrointestinal TractHydrolysis of FoodsGastrointestinal Absorption PrinciplesAbsorption in the Small IntestineAbsorption in the Large Intestine and Feces Formation67. Physiology of Gastrointestinal DisordersUNIT XIII: Metabolism and Temperature Regulation68. Metabolism of Carbohydrates and Formation of Adenosine Triphosphate69. Lipid Metabolism70. Protein Metabolism71. The Liver72. Dietary Balances; Regulation of Feeding; Obesity and Starvation; Vitamins and Minerals73. Energetics and Metabolic Rate74.Body Temperature Regulation and FeverUNIT XIV: Endocrinology and Reproduction75. Introduction to Endocrinology76. Pituitary Hormones and Their Control By the Hypothalamus77. Thyroid Metabolic Hormones78. Adrenocortical Hormones79. Insulin, Glucagon, and Diabetes Mellitus80. Parathyroid Hormone, Calcitonin, Calcium and Phosphate Metabolism, Vitamin D, Bone, and Teeth81. Reproductive and Hormonal Functions of the Male (and Function of the Pineal Gland)82. Female Physiology Before Pregnancy and Female Hormones83. Pregnancy and Lactation84. Fetal and Neonatal PhysiologyUNIT XV: Sports Physiology85. Sports Physiology