Guyton and Hall textbook of medical physiology

By: Hall, John E Contributor(s): Hall, Michael E Language: English Publication details: New Delhi Elsevier India, 2020 2021 Edition: 3rd South Asia EditionDescription: xxxi,1011pISBN: 9788131257739Subject(s): BOTONYDDC classification: 612

Contents:

Table of Contents Cover image Title page Copyright Dedication Preface to the third South Asia edition Preface to the second South Asia edition Preface to the first South Asia edition Preface to the 14th edition Videos Competency map SECTION I. General Physiology 1. Functional organization of the human body and control of the “internal environment” Cells are the living units of the body Extracellular fluid—the “internal environment” Homeostasis—maintenance of a nearly constant internal environment PY1.2 Control systems of the body Summary—automaticity of the body Further readings 2. The cell and its functions Organization of the cell Physical structure of the cell PY1.1 Functional systems of the cell PY1.1 Further readings 3. Genetic control of protein synthesis, cell function, and cell reproduction PY1.1 Genes in the cell nucleus control protein synthesis The DNA code in the cell nucleus is transferred to RNA code in the cell cytoplasm—the process of transcription Control of gene function and biochemical activity in cells Genetic testing The DNA–genetic system controls cell reproduction Cell differentiation Apoptosis PY1.4 Further readings 4. Transport of substances through cell membranes Diffusion PY1.5 “Active transport” of substances through membranes PY1.5 Further readings 5. The body fluid compartments Fluid intake and output are balanced during steady-state conditions Body fluid compartments PY1.6 Blood volume Constituents of extracellular and intracellular fluids PY1.6 Measurement of fluid volumes in the different body fluid compartments—the indicator–dilution principle PY1.6 Determination of volumes of specific body fluid compartments Further readings 6. Intracellular and extracellular fluid compartments and edema PY1.6 Basic principles of osmosis  and osmotic pressure Osmotic equilibrium is maintained between intracellular and extracellular fluids Volume and osmolality of extracellular and intracellular  fluids in abnormal states Clinical abnormalities of fluid volume regulation: Hyponatremia and hypernatremia Edema: Excess fluid in the tissues Fluids in the “potential spaces”  of the body Further readings 7. Resting membrane potential Basic physics of membrane potentials PY1.8 Measuring the membrane potential Resting membrane potential of neurons Impermeant anions (the Gibbs–Donnan phenomenon) Further readings SECTION II. Nerve and Muscle Physiology 8. The neuron: Stimulus and excitability Characteristics of a stimulus PY1.8 Excitation—the process of eliciting the action potential Further readings 9. Action potential of the nerve PY1.8 Voltage-gated sodium and potassium channels Summary of the events that cause the action potential Roles of other ions during the action potential Local potentials Refractory period Further readings 10. Propagation of the nerve impulse PY3.2 Special characteristics of signal transmission in nerve trunks Further readings 11. Peripheral nerve damage The nature and causes if peripheral neuropathy Nerve injury Wallerian degeneration PY3.3 Functional assessment of nerve damage using the strength–duration curve PY3.17 Nerve regeneration PY3.3 Further readings 12. Neuromuscular transmission PY3.4 Secretion of acetylcholine by the nerve terminals Molecular biology of acetylcholine formation and release Drugs that enhance or block transmission at the neuromuscular junction PY3.5 Myasthenia gravis PY3.6 Lambert-Eaton syndrome Muscle action potential—comparison with nerve action potential Further readings 13. Excitation–contraction coupling PY3.4; PY3.8 Transverse tubule–sarcoplasmic reticulum system Release of calcium ions by the sarcoplasmic reticulum Further readings 14. Molecular basis of skeletal muscle contraction PY3.4; PY3.9 Physiological anatomy of skeletal muscle General mechanism of muscle contraction Molecular mechanism of muscle contraction Further readings 15. Chemical changes during skeletal muscle contraction PY3.11 Energetics of muscle contraction Further readings 16. Characteristics of skeletal muscle contraction PY3.8, 3.10, 3.12 The amount of actin and myosin filament overlap determines tension developed by the contracting muscle Relation of velocity of contraction to load Mechanics of skeletal muscle contraction Muscular dystrophy PY3.13 Further readings 17. Applied skeletal muscle physiology Blood flow regulation in skeletal muscle at rest and during exercise PY3.11 Muscles in exercise PY3.11 Gender differences in athletic performance PY11.4 Drugs and athletes Further readings SECTION III. Blood and Its Constituents 18. Introduction to blood and plasma proteins PY2.1 Functional roles of the plasma proteins PY2.2 Separation of plasma proteins Plasmapheresis Further readings 19. Red blood cells (erythrocytes) PY2.3 Shape and size of red blood cells Concentration of red blood cells in the blood Quantity of hemoglobin in the cells Life span of red blood cells is about 120 days Erythrocyte sedimentation rate Further readings 20. Erythropoiesis PY2.4 Areas of the body that produce red blood cells Genesis of blood cells Stages of differentiation of red blood cells Erythropoietin regulates red blood cell production Maturation of red blood cells—requirement for vitamin B12 (cyanocobalamin) and folic acid Further readings 21. Hemoglobin Formation of hemoglobin PY2.3 Iron metabolism Further readings 22. Anemia and polycythemia PY2.5 Anemia RBC indices in anemia Polycythemia Further readings 23. Jaundice Hemolytic jaundice is caused by hemolysis of red blood cells PY2.5 Obstructive jaundice is caused by obstruction of bile ducts or liver disease Diagnostic differences between hemolytic and obstructive jaundice Further readings 24. White blood cells PY2.6 Leukocytes (white blood cells) Neutrophils and macrophages defend against infections Monocyte–macrophage cell system (reticuloendothelial system) Eosinophils Basophils Leukopenia Leukemias Further readings 25. Immunity and allergy Acquired (adaptive) immunity PY2.10 Allergy and hypersensitivity Further readings 26. Platelets Thrombopoiesis PY2.7 Hemostasis events PY2.7 Vascular constriction Thrombocytopenia Thromboembolic conditions Bleeding time Further readings 27. Blood coagulation PY2.8 Conversion of prothrombin to thrombin Conversion of fibrinogen to fibrin—formation of the clot Positive feedback of clot formation Initiation of coagulation: Formation of prothrombin activator Intravascular anticoagulants prevent blood clotting in the normal vascular system Plasmin causes lysis of blood clots Conditions that cause excessive bleeding in humans Anticoagulants for clinical use Blood coagulation tests Further readings 28. Blood groups PY2.9 Multiplicity of antigens in the blood cells O–A–B blood types Rh blood types Further readings SECTION IV. Cardiovascular Physiology 29. Organization of the cardiovascular system PY5.7, 5.8 Physical characteristics of the circulation Basic principles of circulatory function Further readings 30. Properties of cardiac muscle PY5.2 Anatomical characteristics of cardiac muscle Physiological characteristics of cardiac muscle Further readings 31. Cardiac action potentials PY5.4 Membrane potentials for the SA node and muscle fibers Control of cardiac action potentials by the sympathetic and parasympathetic nerves Effect of drugs on the cardiac action potential Further readings 32. Origin and conduction of the cardiac impulse PY5.4 Specialized excitatory and conductive system of the heart Control of excitation and conduction in the heart PY5.1 Further readings 33. The normal electrocardiogram Characteristics of the normal electrocardiogram PY5.5 Flow of current around the heart during the cardiac cycle Electrocardiographic leads 34. Clinical applications of the electrocardiogram Abnormal sinus rhythms PY5.6 Abnormal rhythms that result from block of heart signals within the intracardiac conduction pathways Premature contractions Paroxysmal tachycardia Ventricular fibrillation Atrial fibrillation Atrial flutter Cardiac arrest Vectorial analysis of the ECG and its application to ventricular hypertrophy Vectorial analysis of the normal electrocardiogram Mean electrical axis of the ventricular QRS—and its significance Coronary ischemia Further readings 35. Cardiac cycle Diastole and systole Oxygen utilization by the heart Efficiency of cardiac contraction Further readings 36. Cardiac output and venous return PY5.8, 5.9 Normal values for cardiac output at rest and during activity Control of cardiac output by venous return—the Frank–Starling mechanism of the heart Venous return curves Analysis of cardiac output and right atrial pressure using simultaneous cardiac output and venous return curves Methods for measuring cardiac output Further readings 37. Regulation of cardiac output PY5.8, 5.9 Intrinsic regulation of heart pumping—the Frank–Starling mechanism Effect of potassium and calcium ions on heart function Effect of temperature on heart function Increasing the arterial pressure load (up to a limit) does not decrease the cardiac output Further readings 38. Hemodynamics PY5.7 Interrelationships of pressure, flow, and resistance Further readings 39. Microcirculation PY5.10 Structure of the microcirculation and capillary system Flow of blood in the capillaries—vasomotion Exchange of water, nutrients, and other substances between the blood and interstitial fluid Interstitium and interstitial fluid Fluid filtration across capillaries Further readings 40. The lymphatic system PY5.10 Formation of lymph Rate of lymph flow The lymphatic system plays a key role in controlling interstitial fluid protein concentration, volume, and pressure Further readings 41. The venous system PY5.7 Right atrial pressure (central venous pressure) and its regulation PY5.8 Peripheral venous pressure and its determinants Blood reservoir function of the veins Further readings 42. Determinants of arterial blood pressure Arterial pressure pulsations Vascular distensibility PY5.9 Clinical methods for measuring systolic and diastolic pressures Further readings 43. Short-term regulation of  arterial blood pressure PY5.8, 5.9 Autonomic nervous system Role of the nervous system in rapid control of arterial pressure Special features of nervous control of arterial pressure Further readings 44. Long-term regulation of  arterial blood pressure PY5.8, 5.9 Quantification of pressure diuresis as a basis for arterial pressure control The renin–angiotensin system: Its role in arterial pressure control Further readings 45. Local and humoral control of blood flow Variations in blood flow in different tissues and organs PY5.8. 5.10 Mechanisms of blood flow control Humoral control of the circulation Further readings 46. Coronary circulation Physiological anatomy of the  coronary blood supply PY5.10 Normal coronary blood flow—averages 5% of cardiac output Control of coronary blood flow Special features of cardiac muscle metabolism Ischemic heart disease Causes of death after acute coronary occlusion Stages of recovery from acute myocardial infarction Function of the heart after recovery from myocardial infarction Pain in coronary heart disease Surgical treatment of coronary artery disease Further readings 47. Cerebral circulation Anatomy of cerebral blood flow Regulation of cerebral  blood flow PY5.10 Cerebral microcirculation “Cerebral stroke” occurs when cerebral blood vessels are blocked Further readings 48. Splanchnic circulation Anatomy of the gastrointestinal blood supply PY5.10 Effect of gut activity and metabolic factors on gastrointestinal blood flow Nervous control of gastrointestinal blood flow. Further readings 49. Fetal and neonatal circulation Circulatory readjustments at birth PY5.10 Special functional problems in the circulation of the neonate Abnormal circulatory dynamics in congenital heart defects Further readings 50. Valvular heart disease Causes of heart sounds Valvular lesions Abnormal circulatory dynamics  in valvular heart disease PY5.11 Hypertrophy of the heart in valvular heart disease Further readings 51. Cardiac failure Circulatory dynamics in cardiac  failure PY5.11 Unilateral left heart failure Low-output cardiac failure—cardiogenic shock Edema in patients with cardiac failure Cardiac reserve Further readings 52. Circulatory shock Physiological causes of shock PY5.11 Causes of shock Physiology of treatment in shock Circulatory arrest Further readings SECTION V. Respiratory Physiology 53. Organization of the respiratory system Anatomical organization of the lungs and airways PY6.1 Physical laws applicable in respiratory physiology Nonrespiratory functions of the lungs Further readings 54. Mechanics of breathing Mechanics of pulmonary ventilation PY6.2 Minute respiratory volume Alveolar ventilation Further readings 55. Lung volumes and capacities Lung function tests PY6.7 Pulmonary volumes and  capacities PY6.2 Mucus lining the respiratory passageways, and cilia action to clear the passageways Flow–volume curves Further readings 56. Ventilation Minute respiratory volume (minute ventilation) Alveolar ventilation PY6.2 Maximum voluntary ventilation Breathing reserve Gas pressures in a mixture of gases—”partial pressures” of individual gases Pressures of gases dissolved in water and tissues Relationship between alveolar ventilation and partial pressures of oxygen and carbon dioxide Causes of hypoventilation and hyperventilation Further readings 57. Pulmonary circulation Physiological anatomy of the pulmonary circulatory system PY6.1 Pressures in the pulmonary system Pulmonary vascular resistance Blood volume of the lungs Blood flow through the lungs and its distribution Effect of hydrostatic pressure gradients in the lungs on regional pulmonary blood flow Pulmonary capillary dynamics Further readings 58. Diffusion of gases Physics of gas diffusion and gas partial pressures Diffusion of gases through the respiratory membrane PY6.2 Diffusion and perfusion limitations of gas transfer Further readings 59. Oxygen transport Compositions of alveolar air and atmospheric air are different Methods of oxygen transport PY6.3 Hypoxia and oxygen therapy PY6.6, 6.5 Further readings 60. Carbon dioxide transport Transport of CO2 in the blood PY6.3 Respiratory exchange ratio Further readings 61. Chemical regulation of respiration Chemical control of respiration PY6.3 Peripheral chemoreceptor system—role of oxygen in respiratory control Regulation of respiration during exercise Further readings 62. Neural regulation of respiration Respiratory center PY6.3 Other factors that affect  respiration PY6.6 Further readings 63. Respiration in unusual environments Effects of low oxygen pressure  on the body PY6.4 Physiology of deep-sea diving and other hyperbaric conditions PY6.4 Changes that occur with  deep-sea diving PY6.5 Self-contained underwater breathing apparatus (SCUBA) diving Further readings 64. Applied respiratory physiology Respiratory disorders PY6.6 Hypercapnia—excess carbon dioxide in the body fluids PY6.6 Artificial respiration PY6.5 Oxygen therapy Hyperbaric oxygen therapy Further readings SECTION VI. Gastrointestinal Physiology 65. Organization of the gastrointestinal system PY4.1 General principles of gastrointestinal motility Types of smooth muscle Contractile mechanism in smooth muscle Neural control of gastrointestinal function—enteric nervous system PY4.1 Gastrointestinal blood flow—“splanchnic circulation” Gut-Brain-Axis PY4.6 Further readings 66. Salivary glands and secretion PY4.2 General principles of alimentary tract secretion Secretion of saliva Further readings 67. Gastric secretions PY4.2 Esophageal secretion Gastric secretion Pathophysiology and treatment modalities for acid peptic disease Gastric function tests PY4.8 Further readings 68. Exocrine pancreas PY4.2 Pancreatic secretion Further readings 69. Functions of the liver PY4.7 Physiological anatomy of the liver Hepatic vascular and lymph systems Metabolic functions of the liver Bile secretion by the liver PY4.2 Measurement of bilirubin in the bile as a clinical diagnostic tool Liver function tests PY4.8 Further readings 70. Digestion and absorption of carbohydrates PY4.4 General principles of digestion PY4.4 Digestion of the various foods by hydrolysis Basic principles of gastrointestinal absorption Absorption in the small intestine Further readings 71. Digestion and absorption of proteins PY4.4 Hydrolysis of proteins Basic principles of gastrointestinal absorption Further readings 72. Digestion and absorption of fats PY4.4 Digestion of the various foods by hydrolysis Absorption in the small intestine Steatorrhea Further readings 73. Functions of the small and large intestine PY4.2 Secretions of the small intestine PY4.2 Secretion of mucus by the large intestine PY4.2 Absorption in the large intestine: Formation of feces PY4.3, 4.4 Further readings 74. Gastrointestinal motility PY4.3 Functional movements in the gastrointestinal tract PY4.3 Ingestion of food Motor functions of the stomach Migrating motor complex Movements of the small intestine Movements of the colon Other autonomic reflexes that affect bowel activity Further readings 75. Physiology of gastrointestinal diseases PY4.9 Disorders of swallowing and the esophagus Disorders of the stomach Disorders of the small intestine Disorders of the large intestine General disorders of the gastrointestinal tract Further readings SECTION VII. Renal Physiology 76. Functional anatomy of the kidney Multiple functions of the kidneys PY7.1 Physiological anatomy of the kidneys Further readings 77. Urine formation by the kidneys: Renal blood flow, glomerular filtration, and their control General principles: Urine formation results from glomerular filtration, tubular reabsorption, and tubular secretion PY7.1 Renal blood flow Autoregulation of GFR and renal  blood flow Glomerular filtration—the first  step in urine formation PY7.2 Use of clearance methods to measure glomerular filtration rate (GFR) and renal blood flow (RBF) PY7.4 Determinants of the GFR Physiological control of glomerular filtration and renal blood flow PY7.5 Further readings 78. Tubular function Renal tubular reabsorption and secretion PY7.3 Glomerulotubular balance Tubular reabsorption includes passive and active mechanisms Further readings 79. Concentration and dilution of urine Antidiuretic hormone controls urine concentration PY7.3 Kidneys conserve water by excreting concentrated urine Quantifying renal urine concentration and dilution: “free water” and osmolar clearances Disorders of urinary concentrating ability Further readings 80. Control of extracellular fluid osmolarity and sodium concentration PY7.5 Osmoreceptor–ADH feedback system Importance of thirst in controlling extracellular fluid osmolarity and sodium concentration Salt-appetite mechanism for controlling extracellular fluid sodium concentration and volume Further readings 81. Renal regulation of potassium, calcium, phosphate, and magnesium Regulation of extracellular fluid potassium concentration and  potassium excretion PY7.5 Control of renal calcium excretion and extracellular calcium ion concentration Control of renal magnesium excretion and extracellular magnesium ion concentration Further readings 82. Acid–base regulation PY1.7, PY7.5 H+ concentration is precisely regulated Acids and bases—their definitions and meanings Defending against changes in H+ concentration: Buffers, lungs, and kidneys Buffering of H+ in the body fluids Bicarbonate buffer system Phosphate buffer system Proteins are important intracellular buffers Respiratory regulation of acid–base balance Renal control of acid–base balance Secretion of H+ and reabsorption of HCO3− by the renal tubules Combination of excess H+ with phosphate and ammonia buffers in the tubule generates “new” HCO3− Regulation of renal tubular H+ secretion Renal correction of acidosis—increased excretion of H+ and addition of HCO3− to the extracellular fluid Renal correction of alkalosis—decreased tubular secretion of H+ and increased excretion of HCO3− Clinical causes of acid–base disorders Treatment of acidosis or alkalosis Clinical measurements and analysis of acid–base disorders Further readings 83. Micturition Physiological anatomy of the bladder PY7.6 Transport of urine from the kidney through the ureters and into the bladder Filling of the bladder and bladder wall tone; the cystometrogram PY7.9 Micturition reflex Abnormalities of micturition Further readings 84. Applied physiology of the renal system Renal function tests PY7.8 Concentration and dilution tests of renal function Diuretics and their mechanisms of action Kidney diseases Acute kidney injury Chronic kidney disease is often associated with irreversible loss of functional nephrons Specific tubular disorders Treatment of renal failure by transplantation or by dialysis with an artificial kidney PY7.7 Further readings SECTION VIII. The Endocrine System 85. Organization of the endocrine system Definition of a hormone Coordination of body functions by chemical messengers PY1.3, py8.2 Feedback control of hormone secretion Further readings 86. Hormone–receptor interactions Chemical structure and  synthesis of hormones PY1.3, 8.6 Hormone secretion, transport, and clearance from the blood Mechanisms of action of hormones Measurement of hormone concentrations in the blood Further readings 87. Anterior pituitary gland and hypothalamus PY8.2 Pituitary gland and its relation to the hypothalamus Hypothalamus controls pituitary secretion Physiological functions of growth hormone Further readings 88. Posterior pituitary gland PY8.2 Posterior pituitary hormones are synthesized by cell bodies in the hypothalamus Posterior pituitary gland and its relation to the hypothalamus Disorders of posterior pituitary hormone secretions Further readings 89. Thyroid gland, thymus and pineal gland PY8.2, 8.3 Synthesis and secretion of the thyroid metabolic hormones Metabolism and excretion of the thyroid hormones Physiological functions of the thyroid hormones Regulation of thyroid hormone secretion Diseases of the thyroid Endocrine functions of the thymus gland PY8.3 Pineal gland PY8.3 Further readings 90. Calcium homeostasis PY8.1 Physiological effects of calcium Outline of calcium metabolism PY8.1 Mechanism of bone calcification Parathyroid hormone Vitamin D Calcitonin Summary of control of calcium ion concentration Pathophysiology of parathyroid hormone, vitamin D, and bone disease Further readings 91. Adrenal cortex PY8.2, 8.4 Anatomy of the adrenal glands Corticosteroids: Mineralocorticoids, glucocorticoids, and androgens Synthesis and secretion of adrenocortical hormones Functions of the mineralocorticoids—aldosterone Functions of glucocorticoids Adrenal androgens Abnormalities of adrenocortical secretion Further readings 92. Adrenal medulla PY8.2, 8.4 Special nature of the sympathetic nerve endings in the adrenal medullae Biosynthesis of epinephrine and norepinephrine, its removal, and its duration of action Factors that control the secretion of catecholamines from the adrenal medulla Adrenergic receptors—alpha and beta receptors Physiological effects of catecholamines Further readings 93. Endocrine pancreas and glucose homeostasis Insulin and its metabolic effects PY8.2 Glucagon and its functions Somatostatin inhibits glucagon and insulin secretion Summary of blood glucose regulation Diabetes mellitus Further readings SECTION IX. Reproductive Physiology 94. Physiological anatomy of the male sexual organs and spermatogenesis PY9.3 Spermatogenesis PY9.9 Further readings 95. Testosterone and other male sex hormones Functions of testosterone PY9.7 Basic intracellular mechanism of action of testosterone PY9.2 Control of male sexual functions by hormones from the hypothalamus and anterior pituitary gland Abnormalities of male sexual function PY9.1 Further readings 96. Female physiology before pregnancy and female hormones Physiological anatomy of the female sexual organs PY9.2 Oogenesis and follicular development in the ovaries Female hormonal system PY9.5 Female monthly sexual cycle (menstrual cycle) PY9.4 Regulation of the female monthly rhythm—interplay between the ovarian and hypothalamic–pituitary hormones Functions of the ovarian hormones—estradiol and progesterone Puberty and menarche Menopause PY9.11 Rhythm method of contraception Hormonal suppression of fertility—”the pill” PY9.6 Further readings 97. The Sexual Act and fertilization Psychic element of male sexual stimulation Integration of the male Sexual Act in the spinal cord Stages of the male Sexual Act Erectile dysfunction in the male Female Sexual Act Fertilization PY9.8 What determines the sex of the fetus that is created? Clinical approach to the infertile couple PY9.12 Cryptorchidism Further readings 98. Physiology of pregnancy PY9.8 Entry of the ovum into the fallopian tube (uterine tube) Fertilization of the ovum Transport of the fertilized ovum in the fallopian tube Implantation of the blastocyst in the uterus Early nutrition of the embryo Anatomy and function of the placenta Hormonal factors in pregnancy Response of the mother’s body to pregnancy Further readings 99. Parturition and lactation PY9.8 Parturition Lactation Further readings SECTION X. Central Nervous System 100. Organization of the central nervous system PY10.1 General design of the nervous system Major levels of central nervous system function Further readings PART I. Sensory System 101. Synapses Types of synapses—chemical and electrical Physiological anatomy of the synapse PY10.2 Chemical substances that function as synaptic transmitters Electrical events during neuronal inhibition Some special characteristics of synaptic transmission (box 101.1) Further readings 102. Sensory receptors PY10.2 Types of sensory receptors and the stimuli they detect Transduction of sensory stimuli into nerve impulses Nerve fibers that transmit different types of signals and their physiological classification Transmission of signals of different intensity in nerve tracts—spatial and temporal summation Further readings 103. Somatic sensory pathways PY10.2, 10.3 Classification of somatic senses Detection and transmission of tactile sensations Sensory pathways for transmitting somatic signals into the central nervous system PY10.6 Transmission in the dorsal column–medial lemniscal system Transmission of less critical sensory signals in the anterolateral pathway Some special aspects of somatosensory function Further readings 104. Pain and temperature Types of pain and their qualities—fast pain and slow pain Pain receptors and their stimulation PY10.2 Dual pathways for transmission of pain signals into the central nervous system Pain suppression (“analgesia”) system in the brain and spinal cord Referred pain Visceral pain Some clinical abnormalities of pain and other somatic sensations PY10.3, 10.6 Thermal sensations Further readings 105. Somatosensory cortex Somatosensory areas I and II PY10.3 Layers of the somatosensory cortex and their function Functions of somatosensory area I PY10.6 Somatosensory association areas Overall characteristics of signal transmission and analysis in the dorsal column–medial lemniscal–cortical system Further readings PART II. Special Senses 106. Taste and smell PY10.13, 10.14 Sense of taste Sense of smell Further readings 107. Hearing PY10.15, 10.16, 10.19 Middle ear Cochlea Central auditory mechanisms Hearing abnormalities Tympanogram and tympanometry Auditory evoked potentials Further readings 108. Optics of vision PY10.17 Physical principles of optics Optics of the eye Fluid system of the eye—intraocular fluid Further readings 109. The retina PY10.17 Anatomy and function of the structural elements of the retina Photochemistry of vision Color vision Neural function of the retina Further readings 110. Visual pathways and central processing PY10.18, 10.19 Organization and function of the visual cortex Neuronal patterns of stimulation during analysis of the visual image Fields of vision; perimetry Eye movements and their control Autonomic control of accommodation and pupillary aperture Visual evoked potentials (VEP) Further readings PART III. Motor System 111. Introduction to the motor system: Spinal cord PY10.4 Organization of the spinal cord for motor functions Autonomic reflexes in the spinal cord Spinal cord transection and spinal shock Hemisection of the cord Tabes dorsalis Syringomyelia Further readings 112. Cortical and brainstem control of motor function: The pyramidal tract PY10.4 Motor cortex and corticospinal (pyramidal) tract Further readings 113. Muscle spindle Muscle sensory receptors—muscle spindles and golgi tendon organs—and their roles in muscle control PY10.4 Further readings 114. Motor reflexes PY10.4 Reflexes Flexor reflex and the withdrawal reflexes Crossed extensor reflex Reciprocal inhibition and reciprocal innervation Spinal cord reflexes that cause muscle spasm Further readings 115. Regulation of tone and posture PY10.4 Support of the body against gravity—roles of the reticular and vestibular nuclei Postural and locomotive reflexes of the cord Further readings 116. Cerebellum Cerebellum and its motor functions PY10.4, PY10.7 Further readings 117. Vestibular apparatus Maintenance of equilibrium PY10.4 Functions of the vestibular system Detection of head rotation by the semicircular ducts Vestibular mechanisms for stabilizing the eyes Tests for vestibular function Further readings 118. Basal ganglia Neuronal circuitry of the basal ganglia Function of the basal ganglia in executing patterns of motor activity—the putamen circuit PY10.4, PY10.7 Role of the basal ganglia for cognitive control of sequences of motor patterns—the caudate circuit Function of the basal ganglia to change the timing and to scale the intensity of movements Functions of specific neurotransmitter substances in the basal ganglial system Summary of integrated functions of the basal ganglia Clinical syndromes resulting from damage to the basal ganglia Further readings PART IV. Other Functions and Activities of the Brain 119. The autonomic nervous system General organization of the autonomic nervous system PY10.5 Basic characteristics of sympathetic and parasympathetic function Stimulation of discrete organs in some instances and “mass stimulation” in other instances by the sympathetic and parasympathetic systems Pharmacology of the autonomic nervous system Disorders of the autonomic nervous systems Further readings 120. Functions of the hypothalamus PY10.7 Vegetative and endocrine control functions of the hypothalamus Further readings 121. Cerebrospinal fluid Cushioning function of the cerebrospinal fluid Formation, flow, and absorption of cerebrospinal fluid Cerebrospinal fluid pressure Obstruction to flow of cerebrospinal fluid can cause hydrocephalus Blood–cerebrospinal fluid and blood–brain barriers Brain edema Lumbar puncture Further readings 122. Electroencephalography, epilepsy and meditation PY10.12, 11.12 Electroencephalography Seizures and epilepsy Meditation Further readings 123. Sleep, coma and brain death PY11.11 Two types of sleep—slow-wave sleep and rapid eye movement sleep Basic theories of sleep Sleep has important physiological functions Disorders of sleep Coma and brain death Further readings 124. The limbic system and behavior PY10.10 Activating—driving systems of the brain Limbic system PY10.7 Functional anatomy of the limbic system Specific functions of other parts of the limbic system Depression and manic–depressive psychoses—decreased activity of the norepinephrine and serotonin neurotransmitter systems Schizophrenia—possible exaggerated function of part of the dopamine system Further readings 125. Learning and memory PY10.9 Learning Thoughts, consciousness, and memory Alzheimer disease—amyloid plaques and depressed memory Further readings 126. Cortical function, cerebral lateralization, and speech Physiological anatomy of the cerebral cortex Functions of specific cortical areas Function of the brain in communication—language input and language output PY10.9 Function of the corpus callosum and anterior commissure to transfer thoughts, memories, training, and other information between the two cerebral hemispheres Further readings SECTION XI. Integrative Physiology 127. Components of energy expenditure Components of 24-hour energy expenditure Metabolic rate and its measurement Further readings 128. Body temperature regulation and cutaneous circulation Normal body temperatures Body temperature is controlled by balancing heat production and heat loss PY11.1 Cutaneous circulation Sweating and its regulation by the autonomic nervous system Other mechanisms of heat loss in lower animals—panting Regulation of body temperature—role of the hypothalamus Behavioral control of body temperature PY11.2 Abnormalities of body temperature regulation PY11.3 Further readings 129. Physiology of starvation and obesity PY11.5 Starvation Obesity Further readings 130. Physiology of physical activity and inactivity PY11.5 Physical activity during the day occurs across multiple domains Physical activity increases energy expenditure Physical activity has health benefits Models of physical inactivity in humans Consequences of physical inactivity Sedentary behavior such as prolonged sitting can offset some of the gains of physical activity and exercise with regard to health Further readings 131. Physiological responses to exercise in extreme heat and cold Cardiovascular changes during acute exercise PY11.8 Respiratory changes during acute exercise Increase in muscle temperature (Tm) within physiological limits increases muscle performance Regulation of cardiovascular and respiratory function during acute exercise Exercise under conditions of heat stress Exercise under conditions of extreme cold Further readings 132. Physiology of stress PY8.5 A current understanding of the stress system Further readings 133. Transition from fetus to newborn,  and infancy PY11.6 Cardiovascular and circulatory changes The body fluids and the renal system Blood cells and immunity Respiratory system Central nervous system Gastrointestinal tract Thermal adaptation Physiology of growth: Hormones and related factors Further readings 134. Physiological changes with aging PY11.7 Definition of aging Chronological and biological aging Theories of aging System-wise changes that occur with aging Further readings Index Videos Chapter 18 Preparation of Blood Smear Staining of Smear Chapter 19 Hemocytometery RBC Count Estimation Wintrobe Method Westergren Method Hematocrit Estimation Chapter 20 Reticulocyte Count Chapter 21 Hemoglobin Estimation Chapter 24 TLC Estimation DLC Estimation Eosinophil Count Estimation Chapter 26 Platelet Count Estimation Chapter 27 Bleeding Time Estimation Clotting Time Estimation Chapter 28 ABO Grouping Rh Grouping Chapter 31 Cardiac Action Potentials Chapter 32 Transmission of cardiac impulse through different parts of the heart Chapter 35 Phases of the cardiac cycle Ventricular Diastole (Left Ventricular Volume and Pressure Changes with Cardiac Cycle) Ventricular Systole (Left Ventricular Volume and Pressure Changes with Cardiac Cycle) Chapter 36 Thermodilution Technique Dye Dilution Technique Chapter 42 Auscultatory Method Chapter 43 Regulation of Blood Pressure Chapter 54 Muscles that Cause Expansion and Contraction of the Lungs Intrapulmonary or Alveolar or Airway Pressure Hysteresis Loop Measurement of Anatomic Dead Space by The Fowlers Method Chapter 55 Measurement of Functional Residual Capacity Flow Volume Curves FVC and FEV1 in Normal Subjects Measurement of Closing Volume Whole Body Plethysmography Chapter 57 Pulmonary Capillary Wedge Pressure Chapter 59 Oxygen Haemoglobin Dissociation Curve Chapter 60 Carbon Dioxide Transport Chapter 61 Peripheral Chemoreceptors Chapter 62 Cheyne Stokes Breathing Chapter 77 Glomerular Filtration Rate and Factors affecting it Clearance PAH Clearance for assessment of Renal Plasma Flow Clearance of PAH Chapter 78 Renal Handling of Glucose Renal Handling of Sodium Chapter 79 Renal Handling of Urea Renal Handling of Sodium Counter Current Counter Current Exchanger in the Kidney Chapter 80 Renal Handling of Sodium Renal Handling of Glucose Chapter 82 Secretion of H1 in PCT, TAL and early DCT Secretion of H1 in the late DT and collecting duct Acid Base Balance Chapter 127 Metabolic Rate and its measurement Online PGMEE Patterned Questions Competency map

Summary: Chapters have been rearranged and often split to work towards one chapter-one lecture model so that the text is linked to curriculum objectives which appeals to both students and faculty. Narrative length has been reduced while ensuring the original flow and explanation of concepts is not affected. Updated Learning Objectives (e.g. Applied physiology of the Renal System) and Glossary of Terms in the beginning of every chapter. Short, easy-to-read, masterfully edited chapters and a user-friendly full-color design facilitates better learning and retention. Features expanded clinical coverage including obesity, metabolic and cardiovascular disorders, Alzheimer’s disease, and other degenerative diseases. Complex Concepts/Processes are summarized in flowcharts/flow diagram for better understanding. Contains more than 1000 carefully crafted diagrams and drawings ensures better understanding of Physiology. Offers Clinically Oriented perspective - bridging basic physiology with pathophysiology, including cellular and molecular mechanism important for Clinical medicine. Updated throughout based on the Guyton and Hall Textbook of Physiology 14th edition to reflect the latest knowledge in the field. The information of the book has been updated to include all areas of the new MCI curriculum (these are either embedded within the existing chapters or as several new chapters at the end of the book).

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Table of Contents
Cover image
Title page
Copyright
Dedication
Preface to the third South Asia edition
Preface to the second South Asia edition
Preface to the first South Asia edition
Preface to the 14th edition
Videos
Competency map
SECTION I. General Physiology
1. Functional organization of the human body and control of the “internal environment”
Cells are the living units of the body
Extracellular fluid—the “internal environment”
Homeostasis—maintenance of a nearly constant internal environment PY1.2
Control systems of the body
Summary—automaticity of the body
Further readings
2. The cell and its functions
Organization of the cell
Physical structure of the cell PY1.1
Functional systems of the cell PY1.1
Further readings
3. Genetic control of protein synthesis, cell function, and cell reproduction PY1.1
Genes in the cell nucleus control protein synthesis
The DNA code in the cell nucleus is transferred to RNA code in the cell cytoplasm—the process of transcription
Control of gene function and biochemical activity in cells
Genetic testing
The DNA–genetic system controls cell reproduction
Cell differentiation
Apoptosis PY1.4
Further readings
4. Transport of substances through cell membranes
Diffusion PY1.5
“Active transport” of substances through membranes PY1.5
Further readings
5. The body fluid compartments
Fluid intake and output are balanced during steady-state conditions
Body fluid compartments PY1.6
Blood volume
Constituents of extracellular and intracellular fluids PY1.6
Measurement of fluid volumes in the different body fluid compartments—the indicator–dilution principle PY1.6
Determination of volumes of specific body fluid compartments
Further readings
6. Intracellular and extracellular fluid compartments and edema PY1.6
Basic principles of osmosis  and osmotic pressure
Osmotic equilibrium is maintained between intracellular and extracellular fluids
Volume and osmolality of extracellular and intracellular  fluids in abnormal states
Clinical abnormalities of fluid volume regulation: Hyponatremia and hypernatremia
Edema: Excess fluid in the tissues
Fluids in the “potential spaces”  of the body
Further readings
7. Resting membrane potential
Basic physics of membrane potentials PY1.8
Measuring the membrane potential
Resting membrane potential of neurons
Impermeant anions (the Gibbs–Donnan phenomenon)
Further readings
SECTION II. Nerve and Muscle Physiology
8. The neuron: Stimulus and excitability
Characteristics of a stimulus PY1.8
Excitation—the process of eliciting the action potential
Further readings
9. Action potential of the nerve PY1.8
Voltage-gated sodium and potassium channels
Summary of the events that cause the action potential
Roles of other ions during the action potential
Local potentials
Refractory period
Further readings
10. Propagation of the nerve impulse PY3.2
Special characteristics of signal transmission in nerve trunks
Further readings
11. Peripheral nerve damage
The nature and causes if peripheral neuropathy
Nerve injury
Wallerian degeneration PY3.3
Functional assessment of nerve damage using the strength–duration curve PY3.17
Nerve regeneration PY3.3
Further readings
12. Neuromuscular transmission PY3.4
Secretion of acetylcholine by the nerve terminals
Molecular biology of acetylcholine formation and release
Drugs that enhance or block transmission at the neuromuscular junction PY3.5
Myasthenia gravis PY3.6
Lambert-Eaton syndrome
Muscle action potential—comparison with nerve action potential
Further readings
13. Excitation–contraction coupling PY3.4; PY3.8
Transverse tubule–sarcoplasmic reticulum system
Release of calcium ions by the sarcoplasmic reticulum
Further readings
14. Molecular basis of skeletal muscle contraction PY3.4; PY3.9
Physiological anatomy of skeletal muscle
General mechanism of muscle contraction
Molecular mechanism of muscle contraction
Further readings
15. Chemical changes during skeletal muscle contraction PY3.11
Energetics of muscle contraction
Further readings
16. Characteristics of skeletal muscle contraction PY3.8, 3.10, 3.12
The amount of actin and myosin filament overlap determines tension developed by the contracting muscle
Relation of velocity of contraction to load
Mechanics of skeletal muscle contraction
Muscular dystrophy PY3.13
Further readings
17. Applied skeletal muscle physiology
Blood flow regulation in skeletal muscle at rest and during exercise PY3.11
Muscles in exercise PY3.11
Gender differences in athletic performance PY11.4
Drugs and athletes
Further readings
SECTION III. Blood and Its Constituents
18. Introduction to blood and plasma proteins PY2.1
Functional roles of the plasma proteins PY2.2
Separation of plasma proteins
Plasmapheresis
Further readings
19. Red blood cells (erythrocytes) PY2.3
Shape and size of red blood cells
Concentration of red blood cells in the blood
Quantity of hemoglobin in the cells
Life span of red blood cells is about 120 days
Erythrocyte sedimentation rate
Further readings
20. Erythropoiesis PY2.4
Areas of the body that produce red blood cells
Genesis of blood cells
Stages of differentiation of red blood cells
Erythropoietin regulates red blood cell production
Maturation of red blood cells—requirement for vitamin B12 (cyanocobalamin) and folic acid
Further readings
21. Hemoglobin
Formation of hemoglobin PY2.3
Iron metabolism
Further readings
22. Anemia and polycythemia PY2.5
Anemia
RBC indices in anemia
Polycythemia
Further readings
23. Jaundice
Hemolytic jaundice is caused by hemolysis of red blood cells PY2.5
Obstructive jaundice is caused by obstruction of bile ducts or liver disease
Diagnostic differences between hemolytic and obstructive jaundice
Further readings
24. White blood cells PY2.6
Leukocytes (white blood cells)
Neutrophils and macrophages defend against infections
Monocyte–macrophage cell system (reticuloendothelial system)
Eosinophils
Basophils
Leukopenia
Leukemias
Further readings
25. Immunity and allergy
Acquired (adaptive) immunity PY2.10
Allergy and hypersensitivity
Further readings
26. Platelets
Thrombopoiesis PY2.7
Hemostasis events PY2.7
Vascular constriction
Thrombocytopenia
Thromboembolic conditions
Bleeding time
Further readings
27. Blood coagulation PY2.8
Conversion of prothrombin to thrombin
Conversion of fibrinogen to fibrin—formation of the clot
Positive feedback of clot formation
Initiation of coagulation: Formation of prothrombin activator
Intravascular anticoagulants prevent blood clotting in the normal vascular system
Plasmin causes lysis of blood clots
Conditions that cause excessive bleeding in humans
Anticoagulants for clinical use
Blood coagulation tests
Further readings
28. Blood groups PY2.9
Multiplicity of antigens in the blood cells
O–A–B blood types
Rh blood types
Further readings
SECTION IV. Cardiovascular Physiology
29. Organization of the cardiovascular system PY5.7, 5.8
Physical characteristics of the circulation
Basic principles of circulatory function
Further readings
30. Properties of cardiac muscle PY5.2
Anatomical characteristics of cardiac muscle
Physiological characteristics of cardiac muscle
Further readings
31. Cardiac action potentials PY5.4
Membrane potentials for the SA node and muscle fibers
Control of cardiac action potentials by the sympathetic and parasympathetic nerves
Effect of drugs on the cardiac action potential
Further readings
32. Origin and conduction of the cardiac impulse PY5.4
Specialized excitatory and conductive system of the heart
Control of excitation and conduction in the heart PY5.1
Further readings
33. The normal electrocardiogram
Characteristics of the normal electrocardiogram PY5.5
Flow of current around the heart during the cardiac cycle
Electrocardiographic leads
34. Clinical applications of the electrocardiogram
Abnormal sinus rhythms PY5.6
Abnormal rhythms that result from block of heart signals within the intracardiac conduction pathways
Premature contractions
Paroxysmal tachycardia
Ventricular fibrillation
Atrial fibrillation
Atrial flutter
Cardiac arrest
Vectorial analysis of the ECG and its application to ventricular hypertrophy
Vectorial analysis of the normal electrocardiogram
Mean electrical axis of the ventricular QRS—and its significance
Coronary ischemia
Further readings
35. Cardiac cycle
Diastole and systole
Oxygen utilization by the heart
Efficiency of cardiac contraction
Further readings
36. Cardiac output and venous return PY5.8, 5.9
Normal values for cardiac output at rest and during activity
Control of cardiac output by venous return—the Frank–Starling mechanism of the heart
Venous return curves
Analysis of cardiac output and right atrial pressure using simultaneous cardiac output and venous return curves
Methods for measuring cardiac output
Further readings
37. Regulation of cardiac output PY5.8, 5.9
Intrinsic regulation of heart pumping—the Frank–Starling mechanism
Effect of potassium and calcium ions on heart function
Effect of temperature on heart function
Increasing the arterial pressure load (up to a limit) does not decrease the cardiac output
Further readings
38. Hemodynamics PY5.7
Interrelationships of pressure, flow, and resistance
Further readings
39. Microcirculation PY5.10
Structure of the microcirculation and capillary system
Flow of blood in the capillaries—vasomotion
Exchange of water, nutrients, and other substances between the blood and interstitial fluid
Interstitium and interstitial fluid
Fluid filtration across capillaries
Further readings
40. The lymphatic system PY5.10
Formation of lymph
Rate of lymph flow
The lymphatic system plays a key role in controlling interstitial fluid protein concentration, volume, and pressure
Further readings
41. The venous system PY5.7
Right atrial pressure (central venous pressure) and its regulation PY5.8
Peripheral venous pressure and its determinants
Blood reservoir function of the veins
Further readings
42. Determinants of arterial blood pressure
Arterial pressure pulsations
Vascular distensibility PY5.9
Clinical methods for measuring systolic and diastolic pressures
Further readings
43. Short-term regulation of  arterial blood pressure PY5.8, 5.9
Autonomic nervous system
Role of the nervous system in rapid control of arterial pressure
Special features of nervous control of arterial pressure
Further readings
44. Long-term regulation of  arterial blood pressure PY5.8, 5.9
Quantification of pressure diuresis as a basis for arterial pressure control
The renin–angiotensin system: Its role in arterial pressure control
Further readings
45. Local and humoral control of blood flow
Variations in blood flow in different tissues and organs PY5.8. 5.10
Mechanisms of blood flow control
Humoral control of the circulation
Further readings
46. Coronary circulation
Physiological anatomy of the  coronary blood supply PY5.10
Normal coronary blood flow—averages 5% of cardiac output
Control of coronary blood flow
Special features of cardiac muscle metabolism
Ischemic heart disease
Causes of death after acute coronary occlusion
Stages of recovery from acute myocardial infarction
Function of the heart after recovery from myocardial infarction
Pain in coronary heart disease
Surgical treatment of coronary artery disease
Further readings
47. Cerebral circulation
Anatomy of cerebral blood flow
Regulation of cerebral  blood flow PY5.10
Cerebral microcirculation
“Cerebral stroke” occurs when cerebral blood vessels are blocked
Further readings
48. Splanchnic circulation
Anatomy of the gastrointestinal blood supply PY5.10
Effect of gut activity and metabolic factors on gastrointestinal blood flow
Nervous control of gastrointestinal blood flow.
Further readings
49. Fetal and neonatal circulation
Circulatory readjustments at birth PY5.10
Special functional problems in the circulation of the neonate
Abnormal circulatory dynamics in congenital heart defects
Further readings
50. Valvular heart disease
Causes of heart sounds
Valvular lesions
Abnormal circulatory dynamics  in valvular heart disease PY5.11
Hypertrophy of the heart in valvular heart disease
Further readings
51. Cardiac failure
Circulatory dynamics in cardiac  failure PY5.11
Unilateral left heart failure
Low-output cardiac failure—cardiogenic shock
Edema in patients with cardiac failure
Cardiac reserve
Further readings
52. Circulatory shock
Physiological causes of shock PY5.11
Causes of shock
Physiology of treatment in shock
Circulatory arrest
Further readings
SECTION V. Respiratory Physiology
53. Organization of the respiratory system
Anatomical organization of the lungs and airways PY6.1
Physical laws applicable in respiratory physiology
Nonrespiratory functions of the lungs
Further readings
54. Mechanics of breathing
Mechanics of pulmonary ventilation PY6.2
Minute respiratory volume
Alveolar ventilation
Further readings
55. Lung volumes and capacities
Lung function tests PY6.7
Pulmonary volumes and  capacities PY6.2
Mucus lining the respiratory passageways, and cilia action to clear the passageways
Flow–volume curves
Further readings
56. Ventilation
Minute respiratory volume (minute ventilation)
Alveolar ventilation PY6.2
Maximum voluntary ventilation
Breathing reserve
Gas pressures in a mixture of gases—”partial pressures” of individual gases
Pressures of gases dissolved in water and tissues
Relationship between alveolar ventilation and partial pressures of oxygen and carbon dioxide
Causes of hypoventilation and hyperventilation
Further readings
57. Pulmonary circulation
Physiological anatomy of the pulmonary circulatory system PY6.1
Pressures in the pulmonary system
Pulmonary vascular resistance
Blood volume of the lungs
Blood flow through the lungs and its distribution
Effect of hydrostatic pressure gradients in the lungs on regional pulmonary blood flow
Pulmonary capillary dynamics
Further readings
58. Diffusion of gases
Physics of gas diffusion and gas partial pressures
Diffusion of gases through the respiratory membrane PY6.2
Diffusion and perfusion limitations of gas transfer
Further readings
59. Oxygen transport
Compositions of alveolar air and atmospheric air are different
Methods of oxygen transport PY6.3
Hypoxia and oxygen therapy PY6.6, 6.5
Further readings
60. Carbon dioxide transport
Transport of CO2 in the blood PY6.3
Respiratory exchange ratio
Further readings
61. Chemical regulation of respiration
Chemical control of respiration PY6.3
Peripheral chemoreceptor system—role of oxygen in respiratory control
Regulation of respiration during exercise
Further readings
62. Neural regulation of respiration
Respiratory center PY6.3
Other factors that affect  respiration PY6.6
Further readings
63. Respiration in unusual environments
Effects of low oxygen pressure  on the body PY6.4
Physiology of deep-sea diving and other hyperbaric conditions PY6.4
Changes that occur with  deep-sea diving PY6.5
Self-contained underwater breathing apparatus (SCUBA) diving
Further readings
64. Applied respiratory physiology
Respiratory disorders PY6.6
Hypercapnia—excess carbon dioxide in the body fluids PY6.6
Artificial respiration PY6.5
Oxygen therapy
Hyperbaric oxygen therapy
Further readings
SECTION VI. Gastrointestinal Physiology
65. Organization of the gastrointestinal system PY4.1
General principles of gastrointestinal motility
Types of smooth muscle
Contractile mechanism in smooth muscle
Neural control of gastrointestinal function—enteric nervous system PY4.1
Gastrointestinal blood flow—“splanchnic circulation”
Gut-Brain-Axis PY4.6
Further readings
66. Salivary glands and secretion PY4.2
General principles of alimentary tract secretion
Secretion of saliva
Further readings
67. Gastric secretions PY4.2
Esophageal secretion
Gastric secretion
Pathophysiology and treatment modalities for acid peptic disease
Gastric function tests PY4.8
Further readings
68. Exocrine pancreas PY4.2
Pancreatic secretion
Further readings
69. Functions of the liver PY4.7
Physiological anatomy of the liver
Hepatic vascular and lymph systems
Metabolic functions of the liver
Bile secretion by the liver PY4.2
Measurement of bilirubin in the bile as a clinical diagnostic tool
Liver function tests PY4.8
Further readings
70. Digestion and absorption of carbohydrates PY4.4
General principles of digestion PY4.4
Digestion of the various foods by hydrolysis
Basic principles of gastrointestinal absorption
Absorption in the small intestine
Further readings
71. Digestion and absorption of proteins PY4.4
Hydrolysis of proteins
Basic principles of gastrointestinal absorption
Further readings
72. Digestion and absorption of fats PY4.4
Digestion of the various foods by hydrolysis
Absorption in the small intestine
Steatorrhea
Further readings
73. Functions of the small and large intestine PY4.2
Secretions of the small intestine PY4.2
Secretion of mucus by the large intestine PY4.2
Absorption in the large intestine: Formation of feces PY4.3, 4.4
Further readings
74. Gastrointestinal motility PY4.3
Functional movements in the gastrointestinal tract PY4.3
Ingestion of food
Motor functions of the stomach
Migrating motor complex
Movements of the small intestine
Movements of the colon
Other autonomic reflexes that affect bowel activity
Further readings
75. Physiology of gastrointestinal diseases PY4.9
Disorders of swallowing and the esophagus
Disorders of the stomach
Disorders of the small intestine
Disorders of the large intestine
General disorders of the gastrointestinal tract
Further readings
SECTION VII. Renal Physiology
76. Functional anatomy of the kidney
Multiple functions of the kidneys PY7.1
Physiological anatomy of the kidneys
Further readings
77. Urine formation by the kidneys: Renal blood flow, glomerular filtration, and their control
General principles: Urine formation results from glomerular filtration, tubular reabsorption, and tubular secretion PY7.1
Renal blood flow
Autoregulation of GFR and renal  blood flow
Glomerular filtration—the first  step in urine formation PY7.2
Use of clearance methods to measure glomerular filtration rate (GFR) and renal blood flow (RBF) PY7.4
Determinants of the GFR
Physiological control of glomerular filtration and renal blood flow PY7.5
Further readings
78. Tubular function
Renal tubular reabsorption and secretion PY7.3
Glomerulotubular balance
Tubular reabsorption includes passive and active mechanisms
Further readings
79. Concentration and dilution of urine
Antidiuretic hormone controls urine concentration PY7.3
Kidneys conserve water by excreting concentrated urine
Quantifying renal urine concentration and dilution: “free water” and osmolar clearances
Disorders of urinary concentrating ability
Further readings
80. Control of extracellular fluid osmolarity and sodium concentration PY7.5
Osmoreceptor–ADH feedback system
Importance of thirst in controlling extracellular fluid osmolarity and sodium concentration
Salt-appetite mechanism for controlling extracellular fluid sodium concentration and volume
Further readings
81. Renal regulation of potassium, calcium, phosphate, and magnesium
Regulation of extracellular fluid potassium concentration and  potassium excretion PY7.5
Control of renal calcium excretion and extracellular calcium ion concentration
Control of renal magnesium excretion and extracellular magnesium ion concentration
Further readings
82. Acid–base regulation PY1.7, PY7.5
H+ concentration is precisely regulated
Acids and bases—their definitions and meanings
Defending against changes in H+ concentration: Buffers, lungs, and kidneys
Buffering of H+ in the body fluids
Bicarbonate buffer system
Phosphate buffer system
Proteins are important intracellular buffers
Respiratory regulation of acid–base balance
Renal control of acid–base balance
Secretion of H+ and reabsorption of HCO3− by the renal tubules
Combination of excess H+ with phosphate and ammonia buffers in the tubule generates “new” HCO3−
Regulation of renal tubular H+ secretion
Renal correction of acidosis—increased excretion of H+ and addition of HCO3− to the extracellular fluid
Renal correction of alkalosis—decreased tubular secretion of H+ and increased excretion of HCO3−
Clinical causes of acid–base disorders
Treatment of acidosis or alkalosis
Clinical measurements and analysis of acid–base disorders
Further readings
83. Micturition
Physiological anatomy of the bladder PY7.6
Transport of urine from the kidney through the ureters and into the bladder
Filling of the bladder and bladder wall tone; the cystometrogram PY7.9
Micturition reflex
Abnormalities of micturition
Further readings
84. Applied physiology of the renal system
Renal function tests PY7.8
Concentration and dilution tests of renal function
Diuretics and their mechanisms of action
Kidney diseases
Acute kidney injury
Chronic kidney disease is often associated with irreversible loss of functional nephrons
Specific tubular disorders
Treatment of renal failure by transplantation or by dialysis with an artificial kidney PY7.7
Further readings
SECTION VIII. The Endocrine System
85. Organization of the endocrine system
Definition of a hormone
Coordination of body functions by chemical messengers PY1.3, py8.2
Feedback control of hormone secretion
Further readings
86. Hormone–receptor interactions
Chemical structure and  synthesis of hormones PY1.3, 8.6
Hormone secretion, transport, and clearance from the blood
Mechanisms of action of hormones
Measurement of hormone concentrations in the blood
Further readings
87. Anterior pituitary gland and hypothalamus PY8.2
Pituitary gland and its relation to the hypothalamus
Hypothalamus controls pituitary secretion
Physiological functions of growth hormone
Further readings
88. Posterior pituitary gland PY8.2
Posterior pituitary hormones are synthesized by cell bodies in the hypothalamus
Posterior pituitary gland and its relation to the hypothalamus
Disorders of posterior pituitary hormone secretions
Further readings
89. Thyroid gland, thymus and pineal gland PY8.2, 8.3
Synthesis and secretion of the thyroid metabolic hormones
Metabolism and excretion of the thyroid hormones
Physiological functions of the thyroid hormones
Regulation of thyroid hormone secretion
Diseases of the thyroid
Endocrine functions of the thymus gland PY8.3
Pineal gland PY8.3
Further readings
90. Calcium homeostasis PY8.1
Physiological effects of calcium
Outline of calcium metabolism PY8.1
Mechanism of bone calcification
Parathyroid hormone
Vitamin D
Calcitonin
Summary of control of calcium ion concentration
Pathophysiology of parathyroid hormone, vitamin D, and bone disease
Further readings
91. Adrenal cortex PY8.2, 8.4
Anatomy of the adrenal glands
Corticosteroids: Mineralocorticoids, glucocorticoids, and androgens
Synthesis and secretion of adrenocortical hormones
Functions of the mineralocorticoids—aldosterone
Functions of glucocorticoids
Adrenal androgens
Abnormalities of adrenocortical secretion
Further readings
92. Adrenal medulla PY8.2, 8.4
Special nature of the sympathetic nerve endings in the adrenal medullae
Biosynthesis of epinephrine and norepinephrine, its removal, and its duration of action
Factors that control the secretion of catecholamines from the adrenal medulla
Adrenergic receptors—alpha and beta receptors
Physiological effects of catecholamines
Further readings
93. Endocrine pancreas and glucose homeostasis
Insulin and its metabolic effects PY8.2
Glucagon and its functions
Somatostatin inhibits glucagon and insulin secretion
Summary of blood glucose regulation
Diabetes mellitus
Further readings
SECTION IX. Reproductive Physiology
94. Physiological anatomy of the male sexual organs and spermatogenesis PY9.3
Spermatogenesis PY9.9
Further readings
95. Testosterone and other male sex hormones
Functions of testosterone PY9.7
Basic intracellular mechanism of action of testosterone PY9.2
Control of male sexual functions by hormones from the hypothalamus and anterior pituitary gland
Abnormalities of male sexual function PY9.1
Further readings
96. Female physiology before pregnancy and female hormones
Physiological anatomy of the female sexual organs PY9.2
Oogenesis and follicular development in the ovaries
Female hormonal system PY9.5
Female monthly sexual cycle (menstrual cycle) PY9.4
Regulation of the female monthly rhythm—interplay between the ovarian and hypothalamic–pituitary hormones
Functions of the ovarian hormones—estradiol and progesterone
Puberty and menarche
Menopause PY9.11
Rhythm method of contraception
Hormonal suppression of fertility—”the pill” PY9.6
Further readings
97. The Sexual Act and fertilization
Psychic element of male sexual stimulation
Integration of the male Sexual Act in the spinal cord
Stages of the male Sexual Act
Erectile dysfunction in the male
Female Sexual Act
Fertilization PY9.8
What determines the sex of the fetus that is created?
Clinical approach to the infertile couple PY9.12
Cryptorchidism
Further readings
98. Physiology of pregnancy PY9.8
Entry of the ovum into the fallopian tube (uterine tube)
Fertilization of the ovum
Transport of the fertilized ovum in the fallopian tube
Implantation of the blastocyst in the uterus
Early nutrition of the embryo
Anatomy and function of the placenta
Hormonal factors in pregnancy
Response of the mother’s body to pregnancy
Further readings
99. Parturition and lactation PY9.8
Parturition
Lactation
Further readings
SECTION X. Central Nervous System
100. Organization of the central nervous system PY10.1
General design of the nervous system
Major levels of central nervous system function
Further readings
PART I. Sensory System
101. Synapses
Types of synapses—chemical and electrical
Physiological anatomy of the synapse PY10.2
Chemical substances that function as synaptic transmitters
Electrical events during neuronal inhibition
Some special characteristics of synaptic transmission (box 101.1)
Further readings
102. Sensory receptors PY10.2
Types of sensory receptors and the stimuli they detect
Transduction of sensory stimuli into nerve impulses
Nerve fibers that transmit different types of signals and their physiological classification
Transmission of signals of different intensity in nerve tracts—spatial and temporal summation
Further readings
103. Somatic sensory pathways PY10.2, 10.3
Classification of somatic senses
Detection and transmission of tactile sensations
Sensory pathways for transmitting somatic signals into the central nervous system PY10.6
Transmission in the dorsal column–medial lemniscal system
Transmission of less critical sensory signals in the anterolateral pathway
Some special aspects of somatosensory function
Further readings
104. Pain and temperature
Types of pain and their qualities—fast pain and slow pain
Pain receptors and their stimulation PY10.2
Dual pathways for transmission of pain signals into the central nervous system
Pain suppression (“analgesia”) system in the brain and spinal cord
Referred pain
Visceral pain
Some clinical abnormalities of pain and other somatic sensations PY10.3, 10.6
Thermal sensations
Further readings
105. Somatosensory cortex
Somatosensory areas I and II PY10.3
Layers of the somatosensory cortex and their function
Functions of somatosensory area I PY10.6
Somatosensory association areas
Overall characteristics of signal transmission and analysis in the dorsal column–medial lemniscal–cortical system
Further readings
PART II. Special Senses
106. Taste and smell PY10.13, 10.14
Sense of taste
Sense of smell
Further readings
107. Hearing PY10.15, 10.16, 10.19
Middle ear
Cochlea
Central auditory mechanisms
Hearing abnormalities
Tympanogram and tympanometry
Auditory evoked potentials
Further readings
108. Optics of vision PY10.17
Physical principles of optics
Optics of the eye
Fluid system of the eye—intraocular fluid
Further readings
109. The retina PY10.17
Anatomy and function of the structural elements of the retina
Photochemistry of vision
Color vision
Neural function of the retina
Further readings
110. Visual pathways and central processing PY10.18, 10.19
Organization and function of the visual cortex
Neuronal patterns of stimulation during analysis of the visual image
Fields of vision; perimetry
Eye movements and their control
Autonomic control of accommodation and pupillary aperture
Visual evoked potentials (VEP)
Further readings
PART III. Motor System
111. Introduction to the motor system: Spinal cord PY10.4
Organization of the spinal cord for motor functions
Autonomic reflexes in the spinal cord
Spinal cord transection and spinal shock
Hemisection of the cord
Tabes dorsalis
Syringomyelia
Further readings
112. Cortical and brainstem control of motor function: The pyramidal tract PY10.4
Motor cortex and corticospinal (pyramidal) tract
Further readings
113. Muscle spindle
Muscle sensory receptors—muscle spindles and golgi tendon organs—and their roles in muscle control PY10.4
Further readings
114. Motor reflexes PY10.4
Reflexes
Flexor reflex and the withdrawal reflexes
Crossed extensor reflex
Reciprocal inhibition and reciprocal innervation
Spinal cord reflexes that cause muscle spasm
Further readings
115. Regulation of tone and posture PY10.4
Support of the body against gravity—roles of the reticular and vestibular nuclei
Postural and locomotive reflexes of the cord
Further readings
116. Cerebellum
Cerebellum and its motor functions PY10.4, PY10.7
Further readings
117. Vestibular apparatus
Maintenance of equilibrium PY10.4
Functions of the vestibular system
Detection of head rotation by the semicircular ducts
Vestibular mechanisms for stabilizing the eyes
Tests for vestibular function
Further readings
118. Basal ganglia
Neuronal circuitry of the basal ganglia
Function of the basal ganglia in executing patterns of motor activity—the putamen circuit PY10.4, PY10.7
Role of the basal ganglia for cognitive control of sequences of motor patterns—the caudate circuit
Function of the basal ganglia to change the timing and to scale the intensity of movements
Functions of specific neurotransmitter substances in the basal ganglial system
Summary of integrated functions of the basal ganglia
Clinical syndromes resulting from damage to the basal ganglia
Further readings
PART IV. Other Functions and Activities of the Brain
119. The autonomic nervous system
General organization of the autonomic nervous system PY10.5
Basic characteristics of sympathetic and parasympathetic function
Stimulation of discrete organs in some instances and “mass stimulation” in other instances by the sympathetic and parasympathetic systems
Pharmacology of the autonomic nervous system
Disorders of the autonomic nervous systems
Further readings
120. Functions of the hypothalamus PY10.7
Vegetative and endocrine control functions of the hypothalamus
Further readings
121. Cerebrospinal fluid
Cushioning function of the cerebrospinal fluid
Formation, flow, and absorption of cerebrospinal fluid
Cerebrospinal fluid pressure
Obstruction to flow of cerebrospinal fluid can cause hydrocephalus
Blood–cerebrospinal fluid and blood–brain barriers
Brain edema
Lumbar puncture
Further readings
122. Electroencephalography, epilepsy and meditation PY10.12, 11.12
Electroencephalography
Seizures and epilepsy
Meditation
Further readings
123. Sleep, coma and brain death PY11.11
Two types of sleep—slow-wave sleep and rapid eye movement sleep
Basic theories of sleep
Sleep has important physiological functions
Disorders of sleep
Coma and brain death
Further readings
124. The limbic system and behavior PY10.10
Activating—driving systems of the brain
Limbic system PY10.7
Functional anatomy of the limbic system
Specific functions of other parts of the limbic system
Depression and manic–depressive psychoses—decreased activity of the norepinephrine and serotonin neurotransmitter systems
Schizophrenia—possible exaggerated function of part of the dopamine system
Further readings
125. Learning and memory PY10.9
Learning
Thoughts, consciousness, and memory
Alzheimer disease—amyloid plaques and depressed memory
Further readings
126. Cortical function, cerebral lateralization, and speech
Physiological anatomy of the cerebral cortex
Functions of specific cortical areas
Function of the brain in communication—language input and language output PY10.9
Function of the corpus callosum and anterior commissure to transfer thoughts, memories, training, and other information between the two cerebral hemispheres
Further readings
SECTION XI. Integrative Physiology
127. Components of energy expenditure
Components of 24-hour energy expenditure
Metabolic rate and its measurement
Further readings
128. Body temperature regulation and cutaneous circulation
Normal body temperatures
Body temperature is controlled by balancing heat production and heat loss PY11.1
Cutaneous circulation
Sweating and its regulation by the autonomic nervous system
Other mechanisms of heat loss in lower animals—panting
Regulation of body temperature—role of the hypothalamus
Behavioral control of body temperature PY11.2
Abnormalities of body temperature regulation PY11.3
Further readings
129. Physiology of starvation and obesity PY11.5
Starvation
Obesity
Further readings
130. Physiology of physical activity and inactivity PY11.5
Physical activity during the day occurs across multiple domains
Physical activity increases energy expenditure
Physical activity has health benefits
Models of physical inactivity in humans
Consequences of physical inactivity
Sedentary behavior such as prolonged sitting can offset some of the gains of physical activity and exercise with regard to health
Further readings
131. Physiological responses to exercise in extreme heat and cold
Cardiovascular changes during acute exercise PY11.8
Respiratory changes during acute exercise
Increase in muscle temperature (Tm) within physiological limits increases muscle performance
Regulation of cardiovascular and respiratory function during acute exercise
Exercise under conditions of heat stress
Exercise under conditions of extreme cold
Further readings
132. Physiology of stress PY8.5
A current understanding of the stress system
Further readings
133. Transition from fetus to newborn,  and infancy PY11.6
Cardiovascular and circulatory changes
The body fluids and the renal system
Blood cells and immunity
Respiratory system
Central nervous system
Gastrointestinal tract
Thermal adaptation
Physiology of growth: Hormones and related factors
Further readings
134. Physiological changes with aging PY11.7
Definition of aging
Chronological and biological aging
Theories of aging
System-wise changes that occur with aging
Further readings
Index
Videos
Chapter 18
Preparation of Blood Smear
Staining of Smear
Chapter 19
Hemocytometery
RBC Count Estimation
Wintrobe Method
Westergren Method
Hematocrit Estimation
Chapter 20
Reticulocyte Count
Chapter 21
Hemoglobin Estimation
Chapter 24
TLC Estimation
DLC Estimation
Eosinophil Count Estimation
Chapter 26
Platelet Count Estimation
Chapter 27
Bleeding Time Estimation
Clotting Time Estimation
Chapter 28
ABO Grouping
Rh Grouping
Chapter 31
Cardiac Action Potentials
Chapter 32
Transmission of cardiac impulse through different parts of the heart
Chapter 35
Phases of the cardiac cycle
Ventricular Diastole (Left Ventricular Volume and Pressure Changes with Cardiac Cycle)
Ventricular Systole (Left Ventricular Volume and Pressure Changes with Cardiac Cycle)
Chapter 36
Thermodilution Technique
Dye Dilution Technique
Chapter 42
Auscultatory Method
Chapter 43
Regulation of Blood Pressure
Chapter 54
Muscles that Cause Expansion and Contraction of the Lungs
Intrapulmonary or Alveolar or Airway Pressure
Hysteresis Loop
Measurement of Anatomic Dead Space by The Fowlers Method
Chapter 55
Measurement of Functional Residual Capacity
Flow Volume Curves
FVC and FEV1 in Normal Subjects
Measurement of Closing Volume
Whole Body Plethysmography
Chapter 57
Pulmonary Capillary Wedge Pressure
Chapter 59
Oxygen Haemoglobin Dissociation Curve
Chapter 60
Carbon Dioxide Transport
Chapter 61
Peripheral Chemoreceptors
Chapter 62
Cheyne Stokes Breathing
Chapter 77
Glomerular Filtration Rate and Factors affecting it
Clearance
PAH Clearance for assessment of Renal Plasma Flow
Clearance of PAH
Chapter 78
Renal Handling of Glucose
Renal Handling of Sodium
Chapter 79
Renal Handling of Urea
Renal Handling of Sodium
Counter Current
Counter Current Exchanger in the Kidney
Chapter 80
Renal Handling of Sodium
Renal Handling of Glucose
Chapter 82
Secretion of H1 in PCT, TAL and early DCT
Secretion of H1 in the late DT and collecting duct
Acid Base Balance
Chapter 127
Metabolic Rate and its measurement
Online PGMEE Patterned Questions
Competency map

Chapters have been rearranged and often split to work towards one chapter-one lecture model so that the text is linked to curriculum objectives which appeals to both students and faculty.
Narrative length has been reduced while ensuring the original flow and explanation of concepts is not affected.
Updated Learning Objectives (e.g. Applied physiology of the Renal System) and Glossary of Terms in the beginning of every chapter.
Short, easy-to-read, masterfully edited chapters and a user-friendly full-color design facilitates better learning and retention.
Features expanded clinical coverage including obesity, metabolic and cardiovascular disorders, Alzheimer’s disease, and other degenerative diseases.
Complex Concepts/Processes are summarized in flowcharts/flow diagram for better understanding.
Contains more than 1000 carefully crafted diagrams and drawings ensures better understanding of Physiology.
Offers Clinically Oriented perspective - bridging basic physiology with pathophysiology, including cellular and molecular mechanism important for Clinical medicine.
Updated throughout based on the Guyton and Hall Textbook of Physiology 14th edition to reflect the latest knowledge in the field.
The information of the book has been updated to include all areas of the new MCI curriculum (these are either embedded within the existing chapters or as several new chapters at the end of the book).

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