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0 (hodnocen0 x )

EB

EB

ONLINE

8th ed.

Harlow, United Kingdom : Pearson Education Limited, 2018

1 online zdroj

ISBN 9781292259628 (e-kniha)

ISBN 9781292259543 (print)

For courses in Human Physiology. Move beyond memorization: Prepare students for tomorrow’s challenges Human Physiology: An Integrated Approach is the #1 best-selling 1-semester human physiology text world-wide. The 8th Edition engages students in developing a deeper understanding of human physiology by guiding them to think critically and equipping them to solve real-world problems. Updates, such as new Try It activities and detailed teaching suggestions in the new Ready-to-Go Teaching Modules, help students learn and apply mapping skills, graphing skills, and data interpretation skills.   The text reflects Dr. Silverthorn’s active learning style of instruction and builds upon the thorough integration of "big picture" themes with up-to-date cellular and molecular physiology topics that have always been the foundation of her approach.   Pearson Mastering A&P is not included. Students, if Mastering A&P is a recommended/mandatory component of the course, please ask your instructor for the correct ISBN. Pearson Mastering A&P should only be purchased when required by an instructor. Instructors, contact your Pearson representative for more information. Reach every student by pairing this text with Pearson Mastering A&P Mastering™ is the teaching and learning platform that empowers you to reach every student. By combining trusted author content with digital tools and a flexible platform, Mastering personalizes the learning experience and improves results for each student.

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UNIT I // Basic Cell Processes: Integration and Coordination // CHAPTER 1 // Introduction to Physiology 37 // Physiology Is an Integrative Science 38 RUNNING PROBLEM What to Believe? 38 // EMERGING CONCEPTS The Changing World of Omics 39 // Function and Mechanism 40 Themes in Physiology 41 FOCUS ON ... Mapping 42 // Theme 1: Structure and Function Are Closely Related 44 // Theme 2: Living Organisms Need Energy 44 // Theme 3: Information Flow Coordinates Body Functions 45 // Theme 4: Fiomeostasis Maintains Internal Stability 45 // Homeostasis 45 // What Is the Body’s Internal Environment? 46 Fiomeostasis Depends on Mass Balance 46 Excretion Clears Substances from the Body 48 Fiomeostasis Does Not Mean Equilibrium 49 Control Systems and Homeostasis 49 Local Control Is Restricted to a Tissue 49 Reflex Control Uses Long-Distance Signaling 50 Response Loops Begin with a Stimulus 50 Feedback Loops Modulate the Response Loop 51 Negative Feedback Loops Are Flomeostatic 51 Positive Feedback Loops Are Not Homeostatic 52 // Feedforward Control Allows the Body to Anticipate Change 53 // Biological Rhythms Result from Changes in a Setpoint 53 // The Science of Physiology 54 // Good Scientific Experiments Must Be Carefully Designed 55 // FOCUS ON ... Graphing 56 // The Results of Human Experiments Can Be Difficult to Interpret 58 // CHAPTER SUMMARY 61 [ REVIEW QUESTIONS 62 // CHAPTER 2 // Molecular Interactions 64 // RUNNING PROBLEM Chromium Supplements 65 Molecules and Bonds 65 // Most Biomolecules Contain Carbon, Hydrogen, and Oxygen 65 Electrons Have Four Important Biological Roles 69 Covalent Bonds between Atoms Create Molecules 69 Noncovalent Bonds Facilitate Reversible Interactions 75 Noncovalent Interactions 76 // Hydrophilic Interactions Create Biological Solutions 76 Molecular Shape Is Related to Molecular Function 76 Hydrogen Ions in Solution Can Alter Molecular Shape 77

Protein Interactions 82 // Proteins Are Selective about the Molecules They Bind 82 Protein-Binding Reactions Are Reversible 83 Binding Reactions Obey the Law of Mass Action 83 The Dissociation Constant Indicates Affinity 84 Multiple Factors Alter Protein Binding 84 The Body Regulates the Amount of Protein in Cells 87 Reaction Rate Can Reach a Maximum 87 // CHAPTER SUMMARY 91 | REVIEW QUESTIONS 92 // CHAPTER 3 // Compartmentation: Cells and Tissues 94 // RUNNING PROBLEM Pap Tests Save Lives 95 Functional Compartments of the Body 95 // The Lumens of Some Organs Are Outside the Body 95 Functionally, the Body Has Three Fluid Compartments 97 Biological Membranes 97 // The Cell Membrane Separates Cell from Environment 97 Membranes Are Mostly Lipid and Protein 97 Membrane Lipids Create a Hydrophobic Barrier 98 // Membrane Proteins May Be Loosely or Tightly Bound to the Membrane 98 // Membrane Carbohydrates Attach to Both Lipids and Proteins 100 // Intracellular Compartments 100 // Cells Are Divided into Compartments 101 // The Cytoplasm Includes Cytosol, Inclusions, Fibers, and Organelles 101 // Inclusions Are in Direct Contact with the Cytosol 101 Cytoplasmic Protein Fibers Come in Three Sizes 104 Microtubules Form Cent doles, Cilia, and Flagella 104 EMERGING CONCEPTS Single Cilia Are Sensors 104 The Cytoskeleton Is a Changeable Scaffold 104 Motor Proteins Create Movement 105 // Organelles Create Compartments for Specialized Functions 106 // The Nucleus Is the Cell’s Control Center 107 Tissues of the Body 109 // Extracellular Matrix Fias Many Functions 109 Cell Junctions Hold Cells Together to Form Tissues 109 Epithelia Provide Protection and Regulate Exchange 111 Connective Tissues Provide Support and Barriers 116 Muscle and Neural Tissues Are Excitable 118 Tissue Remodeling 120 // Apoptosis Is a Tidy Form of Cell Death 120 Stem Cells Can Create New Specialized Cells 121

EMERGING CONCEPTS Induced Pluripotent Stems Cells 121 // FOCUS ON ... The Skin 122 Organs 123 // CHAPTER SUMMARY 124 | REVIEW QUESTIONS 126 // CHAPTER 4 // Energy and Cellular Metabolism 128 // RUNNING PROBLEM Tay-Sachs Disease: A Deadly Inheritance 129 // Energy in Biological Systems 129 // Energy Is Used to Perform Work 130 Energy Comes in Two Forms: Kinetic and Potential 130 Energy Can Be Converted from One Form to Another 131 Thermodynamics Is the Study of Energy Use 131 // Chemical Reactions 132 // Energy Is Transferred between Molecules during Reactions 132 // Activation Energy Gets Reactions Started 132 // Energy Is Trapped or Released during Reactions 132 Net Free Energy Change Determines Reaction Reversibility 134 // Enzymes 134 // Enzymes Are Proteins 135 // Reaction Rates Are Variable 135 // Enzymes May Be Activated, Inactivated, or Modulated 135 // Enzymes Lower Activation Energy of Reactions 136 // Enzymatic Reactions Can Be Categorized 137 // Metabolism 138 // Cells Regulate Their Metabolic Pathways 138 // Catabolic Pathways Produce ATP 140 One Glucose Molecule Can Yield 30-32 ATP 145 Anaerobic Metabolism Makes Two ATP 145 Proteins Are the Key to Cell Function 146 DNA Guides the Synthesis ofRNA 149 // Alternative Splicing Creates Multiple Proteins from One DNA Sequence 150 // mRNA Translation Links Amino Acids 150 // EMERGING CONCEPTS Purple Petunias and RNAi 150 // Protein Sorting Directs Proteins to Their Destination 151 // Proteins Undergo Posttranslational Modification 151 // CHAPTER SUMMARY 154 | REVIEW QUESTIONS 155 // CHAPTER 5 // Membrane Dynamics 157 // RUNNING PROBLEM Cystic Fibrosis 158 // Homeostasis Does Not Mean Equilibrium 158 // Osmosis and Tonicity 160 // The Body Is Mostly Water 160 // The Body Is in Osmotic Equilibrium 160 // Osmolarity Describes the Number of Particles in Solution 161 //

Tonicity Describes the Volume Change of a Cell 162 // Transport Processes 167 // Cell Membranes Are Selectively Permeable 167 // Diffusion 168 // Lipophilic Molecules Cross Membranes by Simple Diffusion 170 // Protein-Mediated Transport 172 // Membrane Proteins Have Four Major Functions 172 // Channel Proteins Form Open, Water-Filled Passageways 174 // Carrier Proteins Change Conformation to Move Molecules 175 // Facilitated Diffusion Uses Carrier Proteins 177 // Active Transport Moves Substances against Their Concentration Gradients 178 // Carrier-Mediated Transport Exhibits Specificity, Competition, and Saturation 180 // Vesicular Transport 182 // Phagocytosis Creates Vesicles Using the Cytoskeleton 182 // Endocytosis Creates Smaller Vesicles 183 // CLINICAL FOCUS LDL: The Lethal Lipoprotein 183 // Exocytosis Releases Molecules Too Large for Transport Proteins 183 // Epithelial Transport 185 // Epithelial Transport May Be Paracellular or Transcellular 185 // Transcellular Transport of Glucose Uses Membrane Proteins 186 // Transcytosis Uses Vesicles to Cross an Epithelium 187 // The Resting Membrane Potential 188 // Electricity Review 188 // The Cell Membrane Enables Separation of Electrical Charge in the Body 188 // All Living Cells Have a Membrane Potential 189 // The Resting Membrane Potential Is Due Mostly to Potassium 192 // Changes in Ion Permeability Change the Membrane Potential 193 // Integrated Membrane Processes: Insulin Secretion 194 // CHAPTER SUMMARY 196 | REVIEW QUESTIONS 197 // CHAPTER 6 // Communication, Integration, and Homeostasis 200 // Cell-to-Cell Communication 201 // RUNNING PROBLEM Diabetes Mellitus: A Growing // Epidemic 201 // Gap Junctions Create Cytoplasmic Bridges 201 // Contact-Dependent Signals Require Cell-to-Cell Contact 201 // Local Communication Uses Paracrine and Autocrine Signals 203 // Long-Distance Communication May Be Electrical or Chemical 203 //

Cytokines May Act as Both Local and Long-Distance Signals 203 // Signal Pathways 204 // Receptor Proteins Are Located Inside the Cell or on the / Cell Membrane 204 // Membrane Proteins Facilitate Signal Transduction 206 // The Most Rapid Signal Pathways Change Ion Flow through Channels 207 // Most Signal Transduction Uses G Proteins 209 // Many Lipophobic Hormones Use GPCR-cAMP Pathways 209 // G Protein-Coupled Receptors Also Use Lipid-Derived Second Messengers 209 // Catalytic Receptors Have Enzyme Activity 211 // Integrin Receptors Transfer Information from the Extracellular Matrix 211 // Novel Signal Molecules 211 // Calcium Is an Important Intracellular Signal 212 // Gases Are Ephemeral Signal Molecules 213 // BIOTECHNOLOGY Calcium Signals Glow in the Dark 213 // CLINICAL FOCUS From Dynamite to Medicine 214 // Some Lipids Are important Paracrine Signals 214 // Modulation of Signal Pathways 215 // Receptors Exhibit Saturation, Specificity, and Competition 215 // One Ligand May Have Multiple Receptors 215 // Up and Down-Regulation Enable Cells to Modulate Responses 216 // Cells Must Be Able to Terminate Signal Pathways 217 // Many Diseases and Drugs Target the Proteins of Signal Transduction 217 // Homeostatic Reflex Pathways 217 // Cannon’s Postulates Describe Regulated Variables and Control Systems 218 // Long-Distance Pathways Maintain Homeostasis 218 // Control Systems Vary in Their Speed and Specificity 222 // Complex Reflex Control Pathways Have Several Integrating Centers 224 // CHAPTER SUMMARY 227 | REVIEW QUESTIONS 228 // UNIT 2 // CHAPTER 7 // Introduction to the Endocrine System 230 // Hormones 231 // RUNNING PROBLEM Graves’ Disease 231 // Hormones Have Been Known Since Ancient Times 231 // CLINICAL FOCUS Diabetes: The Discovery of Insulin 232 // What Makes a Chemical a Hormone? 232 Hormones Act by Binding to Receptors 233

Hormone Action Must Be Terminated 233 // The Classification of Hormones 235 // Most Hormones Are Peptides or Proteins 235 // Steroid Hormones Are Derived from Cholesterol 236 // Some Hormones Are Derived from Single Amino Acids 238 // Control of Hormone Release 241 // The Endocrine Cell Is the Sensor in Simple Endocrine Reflexes 241 // Many Endocrine Reflexes Involve the Nervous System 241 // Neurohormones Are Secreted into the Blood by Neurons 241 // The Pituitary Gland Is Actually Two Fused Glands 241 // The Posterior Pituitary Stores and Releases Two Neurohormones 243 // The Anterior Pituitary Secretes Six Hormones 243 // A Portal System Connects the Hypothalamus and Anterior Pituitary 245 // Anterior Pituitary Hormones Control Growth, Metabolism, and Reproduction 245 // Feedback Loops Are Different in the Hypothalamic-Pituitary Pathway 247 // Hormone Interactions 248 // In Synergism, the Effect of Interacting Hormones Is More than Additive 249 // A Permissive Hormone Allows Another Hormone to Exert Its Full Effect 249 // Antagonistic Hormones Have Opposing Effects 249 // Endocrine Pathologies 250 // Hypersecretion Exaggerates a Hormone’s Effects 250 // Hyposecretion Diminishes or Eliminates a Hormone’s Effects 251 // Receptor or Second Messenger Problems Cause Abnormal Tissue Responsiveness 251 // Diagnosis of Endocrine Pathologies Depends on the Complexity of the Reflex 251 // Hormone Evolution 253 // FOCUS ON ... The Pineal Gland 254 // CHAPTER SUMMARY 256 | REVIEW QUESTIONS 257 // CHAPTER 8 // Neurons: Cellular and Network Properties 259 // RUNNING PROBLEM Mysterious Paralysis 260 Organization of the Nervous System 260 Cells of the Nervous System 262 // Neurons Carry Electrical Signals 262 Establishing Synapses Depends on Chemical Signals 265 Glial Cells Provide Support for Neurons 267 Can Stem Cells Repair Damaged Neurons? 269 //

Electrical Signals in Neurons 270 // The Nernst Equation Predicts Membrane Potential fora Single Ion 270 // The GHK Equation Predicts Membrane Potential Using Multiple Ions 270 // Ion Movement Creates Electrical Signals 271 // Gated Channels Control the Ion Permeability of the Neuron 271 // CLINICAL FOCUS Mutant Channels 272 Current Flow Obeys Ohm’s Law 272 Graded Potentials Reflect Stimulus Strength 273 Action Potentials Travel Long Distances 275 // Na+ and K+ Move across the Membrane during Action Potentials 276 // One Action Potential Does Not Alter Ion Concentration Gradients 278 // Axonal Na+ Channels Have Two Gates 278 // Action Potentials Will Not Fire during the Absolute Refractory // Period 279 // Action Potentials Are Conducted 281 Larger Neurons Conduct Action Potentials Faster 281 Conduction Is Faster in Myelinated Axons 283 Chemical Factors Alter Electrical Activity 284 BIOTECHNOLOGY The Body’s Wiring 285 // Cell-To-Cell Communication in the Nervous System 285 // Neurons Communicate at Synapses 285 Neurons Secrete Chemical Signals 286 Neurotransmitters Are Highly Varied 287 CLINICAL FOCUS Myasthenia Gravis 289 BIOTECHNOLOGY Of Snakes, Snails, Spiders, and Sushi 290 Neurotransmitters Are Released from Vesicles 290 Stronger Stimuli Release More Neurotransmitter 293 Integration of Neural Information Transfer 294 Postsynaptic Responses May Be Slow or Fast 294 Pathways Integrate Information from Multiple Neurons 297 Synaptic Activity Can Be Modified 297 Long-Term Potentiation Alters Synapses 300 // Disorders of Synaptic Transmission Are Responsible for Many Diseases 300 // CHAPTER SUMMARY 302 [ REVIEW QUESTIONS 304 // CHAPTER 9 // The Central Nervous System 307 // Emergent Properties of Neural Networks 308 RUNNING PROBLEM Infantile Spasms 308 Evolution of Nervous Systems 308 Anatomy of the Central Nervous System 310 //

The CNS Develops from a Hollow Tube 310 The CNS Is Divided into Gray Matterand White Matter 310 Bone and Connective Tissue Support the CNS 313 The Brain Floats in Cerebrospinal Fluid 313 The Blood-? rain Barrier Protects the Brain 315 Neural Tissue Has Special Metabolic Requirements 316 CLINICAL FOCUS Diabetes: Hypoglycemia and the Brain 317 The Spinal Cord 317 The Brain 318 // The Brain Stem Is the Oldest Part of the Brain 319 The Cerebellum Coordinates Movement 321 The Diencephalon Contains the Centers for Homeostasis 321 The Cerebrum Is the Site of Higher Brain Functions 323 // Brain Function 324 // The Cerebral Cortex Is Organized into Functional Areas 325 // The Spinal Cord and Brain Integrate Sensory Information 326 // Sensory Information Is Processed into Perception 327 The Motor System Governs Output from the CNS 327 // The Behavioral State System Modulates Motor Output 328 Why Do We Sleep? 328 EMERGING CONCEPTS Brain Glymphatics 330 Physiological Functions Exhibit Circadian Rhythms 331 // Emotion and Motivation Involve Complex Neural Pathways 332 // Moods Are Long-Lasting Emotional States 333 // Learning and Memory Change Synaptic Connections in the Brain 333 // Learning Is the Acquisition of Knowledge 334 // Memory Is the Ability to Retain and Recall Information 334 // Language Is the Most Elaborate Cognitive Behavior 336 // Personality Is a Combination of Experience and Inheritance 337 // CHAPTER SUMMARY 339 | REVIEW QUESTIONS 341 // CHAPTER 10 // Sensory Physiology 343 // RUNNING PROBLEM Méničre’s Disease 344 General Properties of Sensory Systems 344 // Receptors Are Sensitive to Particular Forms of Energy 345 // Sensory Transduction Converts Stimuli into Graded Potentials 346 // A Sensory Neuron Has a Receptive Field 346 The CNS Integrates Sensory Information 346 Coding and Processing Distinguish Stimulus Properties 348 // Somatic Senses 351 //

Pathways for Somatic Perception Project to the Cortex and Cerebellum 351 // Touch Receptors Respond to Many Different Stimuli 353 Skin Temperature Receptors Are Free Nerve Endings 354 Nociceptors Initiate Protective Responses 354 CLINICAL FOCUS Natural Painkillers 356 Chemoreception: Smell and Taste 358 Olfaction Is One of the Oldest Senses 358 Taste Is a Combination of Five Basic Sensations 360 Taste Transduction Uses Receptors and Channels 361 The Ear: Hearing 364 // Hearing Is Our Perception of Sound 365 Sound Transduction Is a Multistep Process 365 The Cochlea Is Filled with Fluid 366 Sounds Are Processed First in the Cochlea 369 Auditory Pathways Project to the Auditory Cortex 369 // 28 // CONTENTS // Hearing Loss May Result from Mechanical or Neural Damage 370 // The Ear: Equilibrium 371 // The Vestibular Apparatus Provides Information about Movement and Position 371 // The Semicircular Canals Sense Rotational Acceleration 371 // The Otolith Organs Sense Linear Acceleration and Head Position 373 // Equilibrium Pathways Project Primarily to the Cerebellum 373 // The Eye and Vision 374 // The Skull Protects the Eye 374 Light Enters the Eye through the Cornea 375 The Lens Focuses Light on the Retina 377 Phototransduction Occurs at the Retina 379 // EMERGING CONCEPTS Melanopsin 380 // Photoreceptors Transduce Light into Electrical Signals 380 // Signal Processing Begins in the Retina 383 // CHAPTER SUMMARY 388 | REVIEW QUESTIONS 389 // CHAPTER 11 // Efferent Division: Autonomic and Somatic Motor Control 391 // RUNNING PROBLEM A Powerful Addiction 392 The Autonomic Division 392 // Autonomic Reflexes Are Important for Homeostasis 393 // Antagonistic Control Is a Hallmark of the Autonomic Division 394 // Autonomic Pathways Have Two Efferent Neurons in Series 394 // Sympathetic and Parasympathetic Branches Originate in Different Regions 395 //

The Autonomic Nervous System Uses a Variety of Chemical Signals 395 // Autonomic Pathways Control Smooth and Cardiac Muscle and Glands 395 // Autonomic Neurotransmitters Are Synthesized in the Axon 398 // Autonomic Receptors Have Multiple Subtypes 399 The Adrenal Medulla Secretes Catecholamines 400 // Autonomic Agonists and Antagonists Are Important Tools in Research and Medicine 400 // Primary Disorders of the Autonomic Nervous System Are Relatively Uncommon 402 // CLINICAL FOCUS Diabetes: Autonomic Neuropathy 402 // Summary of Sympathetic and Parasympathetic Branches 403 // The Somatic Motor Division 404 // A Somatic Motor Pathway Consists of One Neuron 404 // The Neuromuscular Junction Contains Nicotinic Receptors 406 // CHAPTER SUMMARY 407 | REVIEW QUESTIONS 408 // CHAPTER 12 // Muscles 410 // RUNNING PROBLEM Periodic Paralysis 411 Skeletal Muscle 412 // Skeletal Muscles Are Composed of Muscle Fibers 412 Myofibrils Are Muscle Fiber Contractile Structures 413 Muscle Contraction Creates Force 416 Actin and Myosin Slide Past Each Other during Contraction 418 // Myosin C ross bridges Move Actin Filaments 419 Calcium Signals Initiate Contraction 419 Myosin Heads Step along Actin Filaments 420 Acetylcholine Initiates Excitation-Contraction Coupling 421 BIOTECHNOLOGY Watching Myosin Work 421 // Skeletal Muscle Contraction Requires a Steady Supply of ATP 424 // Fatigue Has Multiple Causes 425 // Skeletal Muscle Is Classified by Speed and Fatigue Resistance 426 // Resting Fiber Length Affects Tension 428 // Force of Contraction Increases with Summation 429 // A Motor Unit Is One Motor Neuron and Its Muscle Fibers 429 // Contraction Force Depends on the Types and Numbers of Motor Units 430 // Mechanics of Body Movement 431 // Isotonic Contractions Move Loads; Isometric Contractions Create Force without Movement 431 // Bones and Muscles around Joints Form Levers and Fulerums 433 //

Muscle Disorders Have Multiple Causes 435 // Smooth Muscle 436 // Smooth Muscle Is More Variable Than Skeletal Muscle 437 // Smooth Muscle Lacks Sarcomeres 438 // Myosin Phosphorylation Controls Contraction 439 // MLCP Controls Ca2+ Sensitivity 441 // Calcium Initiates Smooth Muscle Contraction 441 // Some Smooth Muscles Have Unstable Membrane Potentials 442 // Chemical Signals Influence Smooth Muscle Activity 443 // Cardiac Muscle 445 // CHAPTER SUMMARY 446 | REVIEW QUESTIONS 447 // CHAPTER 13 // Integrative Physiology I: Control of Body Movement 450 // Neural Reflexes 451 // Neural Reflex Pathways Can Be Classified in Different Ways 451 // RUNNING PROBLEM Tetanus 451 // Autonomic Reflexes 453 Skeletal Muscle Reflexes 453 // Golgi Tendon Organs Respond to Muscle Tension 454 // Muscle Spindles Respond to Muscle Stretch 454 // Stretch Reflexes and Reciprocal Inhibition Control Movement around a Joint 456 // Flexion Reflexes Pull Limbs Away from Painful Stimuli 457’ // The Integrated Control of Body Movement 458 // Movement Can Be Classified as Reflex, Voluntary, or Rhythmic 459 // The CNS Integrates Movement 461 // Control of Movement in Visceral Muscles 464 // EMERGING CONCEPTS Visualization Techniques in Sports 464 // CHAPTER SUMMARY 465 | REVIEW QUESTIONS 466 // UNITS // Integration of Function // CHAPTER 14 // Cardiovascular Physiology 468 // RUNNING PROBLEM Myocardial Infarction 469 // Overview of the Cardiovascular System 469 // The Cardiovascular System Transports Materials throughout the Body 469 // The Cardiovascular System Consists of the Heart, Blood Vessels, and Blood 470 // Pressure, Volume, Flow, and Resistance 472 // The Pressure of Fluid in Motion Decreases over Distance 472 Pressure Changes in Liquids without a Change in Volume 472 Blood Flows from Higher Pressure to Lower Pressure 474 Resistance Opposes Flow 474 //

Velocity Depends on the Flow Rate and the Cross-Sectional Area 475 // Cardiac Muscle and the Heart 476 // The Heart Has Four Chambers 476 Heart Valves Ensure One-Way Flow in the Heart 479 The Coronary Circulation Supplies Blood o the Heart 481 Cardiac Muscle Cells Contract without Innervation 482 Calcium Entry Is a Feature of Cardiac EC Coupling 483 Cardiac Muscle Contraction Can Be Graded 483 Myocardial Action Potentials Vary 484 The Heart as a Pump 488 // Electrical Signals Coordinate Contraction 488 Pacemakers Set the Heart Rate 489 // CLINICAL FOCUS Fibrillation 491 The Electrocardiogram Reflects Electrical Activity 491 The Heart Contracts and Relaxes during a Cardiac Cycle 495 CLINICAL FOCUS Gallops, Clicks, and Murmurs 498 Pressure-Volume Curves Represent One Cardiac Cycle 498 // Stroke Volume Is the Volume of Blood Pumped per Contraction 500 // Cardiac Output Is a Measure of Cardiac Performance 500 The Autonomic Division Modulates Heart Rate 500 Multiple Factors Influence Stroke Volume 502 // Contractility Is Controlled by the Nervous and Endocrine Systems 503 // EMERGING CONCEPTS Stem Cells for Heart Disease 506 EDV and Arterial Blood Pressure Determine Afterload 506 // CHAPTER SUMMARY 508 | REVIEW QUESTIONS 510 // CHAPTER 15 // Blood Flow and the Control of Blood Pressure 512 // RUNNING PROBLEM Essential Hypertension 513 The Blood Vessels 514 // Blood Vessels Contain Vascular Smooth Muscle 514 Arteries and Arterioles Carry Blood Away from the Heart 514 Exchange Takes Place in the Capillaries 515 Blood Flow Converges in the Venules and Veins 516 // Angiogenesis Creates New Blood Vessels 516 // Blood Pressure 517 // Blood Pressure Is Highest in Arteries and Lowest in Veins 517 // Arterial Blood Pressure Reflects the Driving Pressure for Blood Flow 518 // Blood Pressure Is Estimated by Sphygmomanometry 519 // Cardiac Output and Peripheral Resistance Determine Mean Arterial Pressure 520 //

Changes in Blood Volume Affect Blood Pressure 520 // CLINICAL FOCUS SHOCK 521 Resistance in the Arterioles 522 // Myogenic Autoregulation Adjusts Blood Flow 522 Paracrine Signals Influence Vascular Smooth Muscle 524 // The Sympathetic Branch Controls Most Vascular Smooth Muscle 525 // Distribution of Blood to the Tissues 525 // Cerebral Blood Flow Stays Nearly Constant 527 Coronary Blood Flow Parallels the Work of the Heart 527 // Regulation of Cardiovascular Function 528 // The Baroreceptor Reflex Controls Blood Pressure 528 Orthostatic Hypotension Triggers the Baroreceptor Reflex 530 Other Systems Influence Cardiovascular Function 531 // Exchange at the Capillaries 531 // Velocity of Blood Flow Is Lowest in the Capillaries 532 // Most Capillary Exchange Takes Place by Diffusion and Transcytosis 532 // Capillary Filtration and Absorption Take Place by Bulk Flow 533 The Lymphatic System 535 // Edema Results from Alterations in Capillary Exchange 536 Cardiovascular Disease 537 // Risk Factors for CVD Include Smoking and Obesity 537 CLINICAL FOCUS Diabetes and Cardiovascular Disease 538 Atherosclerosis Is an Inflammatory Process 538 Hypertension Represents a Failure of Homeostasis 538 // EMERGING CONCEPTS Inflammatory Markers for Cardiovascular Disease 540 // CHAPTER SUMMARY 541 | REVIEW QUESTIONS 543 // CHAPTER 16 Blood 546 // RUNNING PROBLEM Blood Doping in Athletes 547 Plasma and the Cellular Elements of Blood 547 // Plasma Is Extracellular Matrix 547 // Cellular Elements Include RBCs, WBCs, and Platelets 549 // Blood Cell Production 549 // Blood Cells Are Produced in the Bone Marrow 549 Hematopoiesis Is Controlled by Cytokines 550 Colony-Stimulating Factors Regulate Leukopoiesis 551 Thrombopoietin Regulates Platelet Production 551 Erythropoietin Regulates RBC Production 551 Red Blood Cells 553 // Mature RBCs Lack a Nucleus 553 Hemoglobin Synthesis Requires Iron 553

RBCs Live about Four Months 553 FOCUS ON ... Bone Marrow 554 RBC Disorders Decrease Oxygen Transport 555 // CLINICAL FOCUS Diabetes: Hemoglobin and Hyperglycemia 558 // Platelets 558 // Hemostasis and Coagulation 559 // Hemostasis Prevents Blood Loss from Damaged Vessels 559 Platelet Activation Begins the Clotting Process 559 Coagulation Converts a Platelet Plug into a Clot 560 Anticoagulants Prevent Coagulation 563 // CHAPTER SUMMARY 565 | REVIEW QUESTIONS 566 // CHAPTER 17 // Mechanics of Breathing 568 // RUNNING PROBLEM Emphysema 569 The Respiratory System 569 // Bones and Muscles of the Thorax Surround the Lungs 570 Pleural Sacs Enclose the Lungs 570 Airways Connect Lungs to the External Environment 573 The Airways Warm, Humidify, and Filter Inspired Air 574 CLINICAL FOCUS Congestive Heart Failure 574 Alveoli Are the Site of Gas Exchange 574 Pulmonary Circulation Is High-Flow, Low-Pressure 575 Gas Laws 576 // Air Is a Mixture of Gases 576 Gases Move Down Pressure Gradients 576 Boyle’s Law Describes Pressure-Volume Relationships 576 Ventilation 578 // Lung Volumes Change during Ventilation 578 During Ventilation, Air Flows because of Pressure Gradients 580 Inspiration Occurs When Alveolar Pressure Decreases 580 Expiration Occurs When Alveolar Pressure Increases 582 Intrapleural Pressure Changes during Ventilation 583 // Lung Compliance and Elastance May Change in Disease States 584 // Surfactant Decreases the Work of Breathing 585 // Airway Diameter Determines Airway Resistance 586 // Rate and Depth of Breathing Determine the Efficiency of Breathing 587 // Alveolar Gas Composition Varies Little during Normal Breathing 589 // Ventilation and Alveolar Blood Flow Are Matched 589 Auscultation and Spirometry Assess Pulmonary Function 592 // CHAPTER SUMMARY 594 | REVIEW QUESTIONS 595 // CHAPTER 18 // Gas Exchange and Transport 598 //

RUNNING PROBLEM High Altitude 599 Gas Exchange in the Lungs and Tissues 599 // Lower Alveolar Po2 Decreases Oxygen Uptake 600 Diffusion Problems Cause Hypoxia 601 BIOTECHNOLOGY The Pulse Oximeter 603 Gas Solubility Affects Diffusion 603 Gas Transport In the Blood 605 Hemoglobin Binds to Oxygen 605 Oxygen Binding Obeys the Law of Mass Action 606 Hemoglobin Transports Most Oxygen to the Tissues 607 Po2 Determines Oxygen-Hb Binding 607 EMERGING CONCEPTS Blood Substitutes 608 Oxygen Binding Is Expressed as a Percentage 608 Several Factors Affect 02-Hb Binding 609 Carbon Dioxide Is Transported in Three Ways 611 Regulation of Ventilation 614 // Neurons in the Medulla Control Breathing 615 CO2, Oxygen, and pH Influence Ventilation 616 Protective Reflexes Guard the Lungs 618 Higher Brain Centers Affect Patterns of Ventilation 618 // CHAPTER SUMMARY 620 | REVIEW QUESTIONS 621 // CHAPTER 19 The Kidneys 623 // Functions of the Kidneys 624 // RUNNING PROBLEM Gout 624 // Anatomy of the Urinary System 625 // The Urinary System Consists of Kidneys, Ureters, Bladder, and Urethra 625 // The Nephron Is the Functional Unit of the Kidney 625 // Overview of Kidney Function 628 // Kidneys Filter, Reabsorb, and Secrete 628 // The Nephron Modifies Fluid Volume and Osmolarity 628 // Filtration 630 // The Renal Corpuscle Contains Filtration Barriers 631 EMERGING CONCEPTS Diabetes: Diabetic Nephropathy 631 Capillary Pressure Causes Filtration 632 GFR Is Relatively Constant 634 GFR Is Subject to Autoregulation 634 Hormones and Autonomic Neurons Also Influence GFR 636 Reabsorption 636 // Reabsorption May Be Active or Passive 636 Renal Transport Can Reach Saturation 638 BIOTECHNOLOGY Artificial Kidneys 639 Peritubular Capillary Pressures Favor Reabsorption 640 // Secretion 641 // Competition Decreases Penicillin Secretion 642 // Excretion 643 // Clearance Is a Noninvasive Way to Measure GFR 643

Clearance Helps Us Determine Renal Handling 645 // Micturition 648 // CHAPTER SUMMARY 650 | REVIEW QUESTIONS 651 // CHAPTER 20 // Integrative Physiology II: Fluid and Electrolyte Balance 654 // Fluid and Electrolyte Homeostasis 655 // ECF Osmolarity Affects Cell Volume 655 // Multiple Systems Integrate Fluid and Electrolyte Balance 655 // RUNNING PROBLEM Hyponatremia 655 Water Balance 656 // Daily Water Intake and Excretion Are Balanced 656 The Kidneys Conserve Water 657 The Renal Medulla Creates Concentrated Urine 657 CLINICAL FOCUS Diabetes: Osmotic Diuresis 659 Vasopressin Controls Water Reabsorption 659 Blood Volume and Osmolarity Activate Osmoreceptors 661 The Loop of He nie Is a Countercurrent Multiplier 661 Sodium Balance and ECF Volume 665 Aldosterone Controls Sodium Balance 666 Low Blood Pressure Stimulates Aldosterone Secretion 666 ANGII Has Many Effects 668 Natriuretic Peptides Promote Na+ and Water Excretion 668 // Potassium Balance 671 // Behavioral Mechanisms in Salt and Water Balance 672 // Drinking Replaces Fluid Loss 672 // Low Na+ Stimulates Salt Appetite 672 // Avoidance Behaviors Help Prevent Dehydration 672 // Integrated Control of Volume, Osmolarity, and Blood Pressure 672 // Osmolarity and Volume Can Change Independently 673 Dehydration Triggers Homeostatic Responses 674 Kidneys Assist in Blood Pressure Homeostasis 677 Endocrine Problems Disrupt Fluid Balance 677 // Acid-Base Balance 677 // pH Changes Can Denature Proteins 677 // Acids and Bases in the Body Come from Many Sources 678 // pH Homeostasis Depends on Buffers, Lungs, and Kidneys 678 // Buffer Systems Include Proteins, Phosphate Ions, and HC03- 679 // Ventilation Can Compensate for pH Disturbances 680 Kidneys Use Ammonia and Phosphate Buffers 681 The Proximal Tubule Secretes H+ and Reabsorbs HC03- 681 The Distal Nephron Controls Acid Excretion 682 //

Acid-Base Disturbances May Be Respiratory or Metabolic 683 // CHAPTER SUMMARY 687 | REVIEW QUESTIONS 688 // UNIT 4 // Metabolism, Growth, and Aging // CHAPTER 21 // The Digestive System 690 // RUNNING PROBLEM Cholera in India 691 Anatomy of the Digestive System 691 // The Digestive System Is a Tube 691 The Gl Tract Wall Has Four Layers 694 Digestive Function and Processes 695 // We Secrete More Fluid than We Ingest 696 Digestion and Absorption Make Food Usable 697 Motility: Gl Smooth Muscle Contracts Spontaneously 697 // Gl Smooth Muscle Exhibits Different Patterns of Contraction 699 // CLINICAL FOCUS Diabetes: Delayed Gastric Emptying 699 // Regulation of Gl Function 700 // The Enteric Nervous System Can Act Independently 700 // Gl Peptides Include Hormones, Neuropeptides, and Cytokines 701 // Integrated Function: The Cephalic Phase 703 // Chemical and Mechanical Digestion Begins in the Mouth 704 // Saliva Is an Exocrine Secretion 704 // Swallowing Moves Food from Mouth to Stomach 704 // Integrated Function: The Gastric Phase 705 // The Stomach Stores Food 705 // Gastric Secretions Protect and Digest 706 // The Stomach Balances Digestion and Defense 709 // Integrated Function: The Intestinal Phase 709 // Intestinal Secretions Promote Digestion 710 // The Pancreas Secretes Enzymes and Bicarbonate 710 // The Liver Secretes Bile 712 // Most Digestion Occurs in the Small Intestine 712 // FOCUS ON ... The Liver 713 // Bile Salts Facilitate Fat Digestion 714 Carbohydrates Are Absorbed as Monosaccharides 714 // Proteins Are Digested into Small Peptides and Amino Acids 716 // Some Larger Peptides Can Be Absorbed Intact 717 // Nucleic Acids Are Digested into Bases and Monosaccharides 719 // The Intestine Absorbs Vitamins and Minerals 719 The Intestine Absorbs Ions and Water 719 Regulation of the Intestinal Phase 719 The Large Intestine Concentrates Waste 720

Diarrhea Can Cause Dehydration 722 EMERGING CONCEPTS The Human Microbiome Project 723 Immune Functions of the Gl Tract 723 M Cells Sample Gut Contents 723 Vomiting Is a Protective Reflex 723 // CHAPTER SUMMARY 725 ] REVIEW QUESTIONS 726 // CHAPTER 22 // Metabolism and Energy Balance 728 // Appetite and Satiety 729 // RUNNING PROBLEM Eating Disorders 729 // BIOTECHNOLOGY Discovering Peptides: Research in Reverse 730 // Energy Balance 730 // Energy Input Equals Energy Output 731 Oxygen Consumption Reflects Energy Use 731 // CLINICAL FOCUS Estimating Fat-The Body Mass Index 732 // Many Factors Influence Metabolic Rate 733 Energy Is Stored in Fat and Glycogen 733 // Metabolism 734 // Ingested Energy May Be Used or Stored 734 // Enzymes Control the Direction of Metabolism 734 // Fed-State Metabolism 736 // Carbohydrates Make A TP 736 // Amino Acids Make Proteins 736 // Fats Store Energy 736 // CLINICAL FOCUS Antioxidants Protect the Body 739 // Plasma Cholesterol Predicts Heart Disease 739 // Fasted-State Metabolism 740 // Glycogen Converts to Glucose 740 // Proteins Can Be Used to Make ATP 741 // Lipids Store More Energy than Glucose or Protein 742 // Homeostatic Control of Metabolism 743 // The Pancreas Secretes Insulin and Glucagon 743 // The Insulin-to-Glucagon Ratio Regulates Metabolism 743 // Insulin Is the Dominant Hormone of the Fed State 744 // Insulin Promotes Anabolism 744 // Glucagon Is Dominant in the Fasted State 747 // Diabetes Mellitus Is a Family of Diseases 748 // Type 1 Diabetics Are Prone to Ketoacidosis 751 // Type 2 Diabetics Often Have Elevated Insulin Levels 753 // Metabolic Syndrome Links Diabetes and Cardiovascular Disease 754 // Multiple Hormones Influence Metabolism 755 // Regulation of Body Temperature 755 // Body Temperature Balances Heat Production, Gain, and Loss 755 // Body Temperature Is Homeostatically Regulated 756 //

Movement and Metabolism Produce Heat 758 The Body’s Thermostat Can Be Reset 759 // CHAPTER SUMMARY 761 | REVIEW QUESTIONS 762 // CHAPTER 23 // Endocrine Control of Growth and Metabolism 764 // Review of Endocrine Principles 765 RUNNING PROBLEM Hyperparathyroidism 765 Adrenal Glucocorticoids 765 // The Adrenal Cortex Secretes Steroid Hormones 765 // Cortisol Secretion Is Controlled by ACTH 767 // Cortisol Is Essential for Life 767 // Cortisol Is a Useful Therapeutic Drug 769 // Cortisol Pathologies Result from Too Much or Too Little Hormone 769 // CRH and ACTH Have Additional Physiological Functions 770 // Thyroid Hormones 770 // Thyroid Hormones Contain Iodine 770 // TSH Controls the Thyroid Gland 772 // Thyroid Pathologies Affect Quality of Life 773 // Growth Hormone 775 // Growth Hormone Is Anabolic 775 // Growth Hormone Is Essential for Normal Growth 777 // Genetically Engineered hGH Raises Ethical Questions 777 // Tissue and Bone Growth 777 // Tissue Growth Requires Hormones and Paracrine Factors 777 // Bone Growth Requires Adequate Dietary Calcium 778 CLINICAL FOCUS New Growth Charts 778 Calcium Balance 779 // Plasma Calcium Is Closely Regulated 780 Three Hormones Control Calcium Balance 782 Multiple Factors Control Bone Remodeling 783 Calcium and Phosphate Homeostasis Are Linked 784 Osteoporosis Is a Disease of Bone Loss 786 // CHAPTER SUMMARY 787 | REVIEW QUESTIONS 788 // CHAPTER 24 // The Immune System 790 // Overview 791 // RUNNING PROBLEM HPV: To Vaccinate or Not? 791 Anatomy of the Immune System 793 // Lymphoid Tissues Are Everywhere 793 Leukocytes Are the Immune Cells 793 // Development of Immune Cells 797 FOCUS ON ... The Thymus Gland 798 // Lymphocytes Mediate the Adaptive Immune Response 798 The Immune System Must Recognize “Self” 798 Early Pathogen Exposure Strengthens Immunity 799 // Molecules of the Innate Immune Response 799 //

Many Molecules of the Innate immune Response Are Always Present 799 Antigen Presentation and Recognition Molecules 800 // Major Histocompatibility Complexes, MHC 801 Antigen-Recognition Molecules 801 ? Lymphocytes Produce Antibodies 801 // Pathogens of the Human Body 802 // Bacteria and Viruses Require Different Defense Mechanisms 802 // Viruses Can Only Replicate inside Host Cells 803 // The Immune Response 803 // Barriers Are the Body’s First Line of Defense 803 Innate Immunity Provides Nonspecific Responses 803 // Antigen-Presenting Cells Bridge Innate and Adaptive Responses 805 // Adaptive Immunity Creates Antigen-Specific Responses 805 Antibody Functions 806 Integrated Immune Responses 809 // Bacterial Invasion Causes Inflammation 809 Viral Infections Require Intracellular Defense 810 Specific Antigens Trigger Allergic Responses 813 MHC Proteins Allow Recognition of Foreign Tissue 814 Immune System Pathologies 815 // Autoimmune Disease Results from Antibodies against Self-Antigen 816 // immune Surveillance Removes Abnormal Cells 816 // Neuro-Endocrine-lmmune Interactions 816 // Stress Alters Immune System Function 817 Modern Medicine Includes Mind-Body Therapeutics 818 // CHAPTER SUNIWIARY 819 | REVIEW QUESTIONS 821 // CHAPTER 25 // Integrative Physiology III: Exercise 823 // RUNNING PROBLEM Malignant Hyperthermia 824 // Metabolism and Exercise 824 // Hormones Regulate Metabolism during Exercise 825 Oxygen Consumption Is Related to Exercise Intensity 826 Several Factors Limit Exercise 827 // Ventilatory Responses to Exercise 827 Cardiovascular Responses to Exercise 828 // Cardiac Output Increases during Exercise 828 Muscle Blood Flow Increases during Exercise 828 Blood Pressure Rises Slightly during Exercise 829 The Baroreceptor Reflex Adjusts to Exercise 829 // Feedforward Responses to Exercise 830 Temperature Regulation During Exercise 831

Exercise and Health 831 // Exercise Lowers the Risk of Cardiovascular Disease 832 Type 2 Diabetes Mellitus May Improve with Exercise 832 // Stress and the Immune System May Be Influenced by Exercise 833 // CHAPTER SUMMARY 834 | REVIEW QUESTIONS 835 // CHAPTER 26 // Reproduction and Development 837 // RUNNING PROBLEM Infertility 838 // Sex Determination 838 // Sex Chromosomes Determine Genetic Sex 839 Sexual Differentiation Occurs Early in Development 839 CLINICAL FOCUS X-Linked Inherited Disorders 842 Basic Patterns of Reproduction 843 CLINICAL FOCUS Determining Sex 843 Gametogenesis Begins in Utero 843 The Brain Directs Reproduction 844 Environmental Factors Influence Reproduction 847 Male Reproduction 847 // Testes Produce Sperm and Hormones 850 // Spermatogenesis Requires Gonadotropins and Testosterone 851 // Male Accessory Glands Contribute Secretions to Semen 852 // Androgens Influence Secondary Sex Characteristics 852 // Female Reproduction 852 // The Ovary Produces Eggs and Hormones 853 A Menstrual Cycle Lasts about One Month 853 // Hormonal Control of the Menstrual Cycle Is Complex 856 // Hormones Influence Female Secondary Sex Characteristics 860 // Procreation 860 // The Human Sexual Response Has Four Phases 860 The Male Sex Act Includes Erection and Ejaculation 861 // Sexual Dysfunction Affects Males and Females 861 // Contraceptives Are Designed to Prevent Pregnancy 862 // Infertility Is the Inability to Conceive 863 // Pregnancy and Parturition 863 // Fertilization Requires Capacitation 863 // The Developing Embryo Implants in the Endometrium 864 // The Placenta Secretes Flormones During Pregnancy 864 // Pregnancy Ends with Labor and Delivery 867 // The Mammary Glands Secrete Milk During Lactation 867 // Growth and Aging 870 // Puberty Marks the Beginning of the Reproductive Years 870 // Menopause and Andropause Are a Consequence of Aging 870 // CHAPTER SUMMARY 871 // REVIEW QUESTIONS 873

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(MiAaPQ)ECB5573692