Index

Note: Page numbers followed by b indicate boxes; f, figures;t , tables.

A Acetyl coenzyme A (acetyl-CoA) (Continued) Acid-base nomogram, 394–395, 394f A bands, of skeletal muscle, 71, 72f pantothenic acid and, 855 Acid-base regulation. See also Hydrogen ions. A fibers, 563–564, 563f pyruvic acid conversion to, 812–813 buffer systems in, 380–381 Aδ cold fibers, 592 steroid synthesis from, 992 ammonia, 388–389, 389f Aδ fast pain fibers, 584, 585, 587 Acetylcholine bicarbonate, 381–383, 382f Aα motor fibers, 656, 659 in basal ganglia, 692–693, 692f gastrointestinal mucus and, 775 Aγ motor fibers, 656, 659 of brain stem reticular neurons, 711 isohydric principle and, 383–384 Abdominal compression reflex, 209 sleep and, 722 phosphate, 383, 388, 388f Abdominal muscles cardiac effects of, 119, 120 protein, 383–384, 413 in expiration, 465, 466f bradycardia as, 144 respiratory, 385 in labor, 1013 as central nervous system transmitter, 551 fundamental definitions for, 379–380 spasm of, in peritonitis, 665 of cholinergic nerve endings, 731–732 kidneys in, 380, 385–388, 386f, 387f Absence syndrome, 726 drugs with potentiating effect on, 740 correction of acidosis by, 387, 391 Absolute refractory period, 69 coronary blood flow and, 247 correction of alkalosis by, 387, Absorbing colon, 797, 798 gastric secretions and, 778, 779 391–392 Absorption. See Kidney(s), reabsorption by; gastrointestinal smooth muscle and, 755, 756 phosphate and ammonia buffers in, Large intestine, absorption in; Small Huntington’s disease and, 694 388–389, 388f, 389f intestine, absorption in. molecular structure of, 731 quantification of, 389–391, 390t Acceleration of head at neuromuscular junction overview of, 379, 380 angular, 677, 677f secretion of, 73, 83–86, 84f precision of, 379, 380 linear, 676–677 synthesis of, 83, 86 respiratory system in, 380, 384–385, 384f Acceleratory forces, in aviation and pancreatic secretions and, 782 Acidophil cells, 896f, 897 spacecraft, 531–533, 531f, 532f pharmacologic actions of, 740 Acidophilic tumors, 897, 903–904 Acclimatization to altitude, 510 as smooth muscle neurotransmitter, 95, 96 Acidosis. See also Acid-base disorders.

alveolar Po2 and, 527, 528–530 synthesis of, 732 bicarbonate reabsorption in, 386, 387, 390 work capacity and, 530, 530t Acetylcholine receptors. See also calcium and Acclimatization to cold, chemical Acetylcholine-gated ion channels. protein-bound, 367 thermogenesis and, 873 in myasthenia gravis, 86 reabsorption of, 369 Acclimatization to heat, 877 principal types of, 733 characteristics of, 391t sweating and, 871, 877 Acetylcholine system, in brain, 712, 713, 713f chronic, ammonium excretion in, Accommodation Acetylcholine-gated ion channels, 48, 389, 391 of eye, 601, 601f 73–74, 83–84, 84f, 85, 85f. See also definition of, 379, 380 autonomic control of, 631–632, 735 Acetylcholine receptors. metabolic, 391, 391t pupillary reaction to, 632 Acetylcholinesterase anion gap in, 395, 395t of mechanoreceptors, 562 at neuromuscular junction, 83, 84f, 85, 86 clinical causes of, 392–393 ACE (angiotensin-converting enzyme) at parasympathetic nerve endings, 732 definition of, 382 inhibitors Acetylcholinesterase inhibitors, 86, 740 in diabetes mellitus, 951 adverse effects of, 320–321 for myasthenia gravis, 86–87 diagnosis of, 394 antihypertensive effects of, 374 Acetyl-CoA. See Acetyl coenzyme hydrogen ion secretion in, 390 Acetate, vasodilation caused by, 200 A (acetyl-CoA). hyperchloremic, 395, 395t Acetazolamide, 398, 503 Acetyl-CoA carboxylase, 825 potassium homeostasis and, 362 Acetoacetic acid, 823–824, 839 Acetylsalicylic acid. See Aspirin renal correction of, 391 in diabetes mellitus, 393, 953 (acetylsalicylic acid). in neonate, 1024 insulin lack and, 944 Achalasia, 765, 799 neuronal depression in, 557 Acetone, 823 Achlorhydria, 778, 800 potassium homeostasis and, 364, 367 on breath, 953–954 Acid(s) renal correction of, 391 ketosis and, 823, 824 definition of, 379 in renal failure, 406 Acetyl coenzyme A (acetyl-CoA), 22 nonvolatile, 385, 387, 388, 390 respiratory, 382, 385, 391, 391t acetoacetic acid produced from, 823 anion gap and, 395 clinical causes of, 392 in acetylcholine synthesis, 732 sour taste of, 645, 646t diagnosis of, 393–394 amino acids converted to, 825 strong and weak, 379–380 hydrogen ion secretion in, 390 cholesterol synthesis from, 827 Acid hydrolases, of lysosomes, 19, 20 renal correction of, 391 in citric acid cycle, 813–814, 813f Acid-base disorders. See also Acidosis; Alkalosis. in shock, 278 after fatty acid oxidation, 822–823 clinical causes of, 392–393 treatment of, 393 from fatty acid beta-oxidation, 822, diagnosis of, 393–395, 394f Acini 822f, 823 mixed, 394–395, 394f of pancreas, 773, 780–781, 939, 939f fatty acid synthesis from, 824, 824f, 825 treatment of, 393 of salivary glands, 773, 774f, 775, 776

1043 Index

Acquired (adaptive) immunity, 433–442. Action potential(s), neuronal (Continued) Adenosine triphosphate (ATP) (Continued) See also Antibodies; Antigen(s); summation and, 554f, 555 control of glycolysis by, 815 Lymphocytes. threshold for, 555, 556–557, 556f conversion into cAMP, 889 basic types of, 433, 434 plateau in depleted in irreversible shock, 278–279 passive, 442 with cardiac muscle, 66, 66f as energy currency, 809–810, 809f, 859–861 tolerance to own tissues in, 442 with smooth muscle, 95f, 96 anaerobic vs. aerobic, 860–861 Acquired immunodeficiency syndrome (AIDS) receptor potentials and, 561–562, 561f functions energized by, 859, 860 helper T cells in, 440–441 recording with oscilloscope, 69, 69f nutrients degraded for, 859 wasting syndrome in, 852 rhythmical, 66–67, 66f phosphocreatine buffer of, 860 Acromegaly, 903–904, 903f skeletal muscle, 74, 83, 87, 88, 88f, 89f summary of, 861, 861f diabetes mellitus in, 952 end plate potential and, 84, 85, 85f energy released per mole of, 809–810 Acrosome, 975, 975f, 977 energy for, 78 from fatty acid oxidation, 823 Acrosome reaction, 977 smooth muscle, 95–96, 95f flagellar movement and, 975 ACTH. See Adrenocorticotropic hormone of bladder, 306–308 gastrointestinal secretions and, 774 (ACTH; corticotropin). excited by stretch, 96 glycogen-lactic acid system and, 1033, 1033f Actin gastrointestinal, 754–755, 754f high-energy bonds of, 21, 809, 859 in ameboid movement, 23 plateau in, 95f, 96 mitochondrial synthesis of, 16, 22, 22f of cardiac muscle, 101, 103 slow wave, 95f, 96 nerve fiber ionic gradients and, 65 Frank-Starling mechanism and, 110 of stomach, 766 in olfactory cilium, 649, 649f ventricular volume and, 108 Action tremor, 687–688, 689 phosphocreatine and, 1033, 1033f in cell membrane support, 16 Active hyperemia, 194 in postganglionic nerve endings, 732 coated pits and, 18–19, 18f Active transport, 14, 18, 52–56 production of, 812 in intestinal microvilli, 794 of amino acids into cells, 832–833 acetyl-CoA and, 812–813 in mitosis, 39 through cellular sheets, 55–56, 55f citric acid cycle and, 813–814, 813f in phagocytosis, 19 vs. diffusion, 45–46, 46f glycolysis and, 812, 812f of platelets, 451, 454 energy from ATP for, 859 oxidative phosphorylation and, of skeletal muscle primary, 52–54, 53f 814–815, 814f contraction mechanism and, 74, 74f, in renal tubular reabsorption, 324–328, summary of, 815 75–76, 75f, 76f 325f, 326f, 327f in protein synthesis, 34, 34f hypertrophy and, 81 in salivary ducts, 775 in RNA synthesis, 30 muscle tension and, 77, 77f secondary, 52–53, 54–55, 55f. See also in skeletal muscle, 73, 74, 75, 76, 78–79 structural features of, 71, 72f, 73f, 74f, Co-transport. of athletes, 1032–1034, 1033f, 1033t 75, 75f thyroid hormones and, 912 in smooth muscle, 93, 94 of smooth muscle, 92, 92f, 93–94 Acupuncture, 588 structure of, 21 Action potential(s). See also Membrane Acute local potentials, 68, 69 uses of, 22–23, 22f potential(s). Acute subthreshold potentials, 68, 68f as vasodilator, in skeletal muscle, 243–244 calcium ions in, 64 Acute tubular necrosis, 400–401 Adenylyl cyclase. See also Cyclic adenosine in gastrointestinal smooth muscle, Adaptation monophosphate (cAMP). 754–755 of olfactory sensations, 650 ACTH and, 932 cardiac, 102–104, 102f of sensory receptors, 562–563, 562f adrenergic or cholinergic receptors and, 733 atrial, 117 of taste, 648 antidiuretic hormone and, 905 duration of contraction and, 104 Adaptive control systems, 9 glucagon and, 948 electrocardiogram and, 122, 122f Adaptive immunity. See Acquired (adaptive) growth hormone secretion and, 902 excitation-contraction coupling immunity. hormonal activity and, 889–890, 889b, 890f and, 103, 104 Addison disease, 934–935 hormone receptors and, 888 plateau in, 66, 66f hyperkalemia in, 361, 365 memory and, 707–708 prolonged ventricular, 147, 148f hyponatremia in, 294–295, 360 in olfactory cilium, 649, 649f in Purkinje fibers, 102f, 103, 117 salt appetite and, 360 in smooth muscle, 97 sinus nodal, 115–116, 116f, 117 volume depletion in, 375 thyroid hormone secretion and, 914 spontaneous rhythmicity in, 66–67, 66f Addisonian crisis, 935 ADH. See Antidiuretic hormone (ADH; ventricular, 102, 102f, 122, 122f Adenine, 27, 28, 28f, 30, 31t vasopressin). nerve, 60–63, 61f Adenohypophysis. See Pituitary gland, anterior. Adhesion molecules anions and, 64 Adenosine in inflammation, 428, 429f energy expenditure by, 65, 66f, 68 blood flow control and, 192–193 in T-cell activation, 440, 440f energy of ATP for, 860 in cardiac muscle, 247 Adipocytes (fat cells), 12, 821 excitation of, 68–69, 68f in gut wall, 761 cytokine hormones produced by, 881 initiation of, 64 in skeletal muscle, 243–244 deficiency of, 822 inspiratory, 505 coronary ischemia and, 248 obesity and, 850 on motor nerve, 73 irreversible shock and, 278–279 Adipokines, 881 olfactory, 649, 650 Adenosine diphosphate (ADP) Adipose tissue, 821 as positive feedback, 8–9, 64 control of glycolysis by, 815 fatty acid diffusion into, 820, 820f propagation of, 64–65, 65f conversion to ATP, 809–810 fatty acid mobilization from, 823, 825 re-establishing ionic gradients in mitochondria, 814f, 815 cortisol and, 929 after, 65 metabolic rate and, 862 fatty acid storage in, 825 refractory period after, 69 oxygen usage and, 500, 501, 501f insulin and, 943 stages of, 61 platelet aggregation and, 452 food intake and feedback from, 849 summary of, 63, 63f Adenosine monophosphate (AMP), lipase in, 821, 826 threshold for, 64–65, 68–69, 68f 809–810. See also Cyclic adenosine triglyceride storage in, 824, 825 velocity of, 68 monophosphate (cAMP). triglyceride synthesis in, 824, 825 neuronal Adenosine triphosphate (ATP), 21–23 Adiposogenital syndrome, 985, 985f of brain stem reticular area, 711 in active transport, 52–53 ADP. See Adenosine diphosphate (ADP). in cerebellum, 684, 685 by calcium pump, 54 Adrenal cortex. See also Adrenocortical facilitation and, 708 renal tubular, 324–325, 325f, 326, 326f hormones. generation in axon, 553–554 by sodium-potassium pump, 53, 53f anatomy of, 921, 921f postganglionic, 732 in cardiac muscle, 248 cholesterol used by, 827 at presynaptic terminal, 547–548 chemical structure of, 809, 810f fetal, 1008 of retinal ganglion cells, 617, 619 ciliary movement and, 25 neonatal hypofunction of, 1026

1044 Index

Adrenal diabetes, 928 AIDS. See Acquired immunodeficiency Aldosterone antagonists, 332, 333f, 398t, 399 Adrenal glands syndrome (AIDS). Aldosterone escape, 925 adenoma of, 935 Air hunger, 522 Aldosteronism, primary, 936 anatomy of, 921, 921f Airflow resistance, in bronchial tree, 473 alkalosis in, 390 Adrenal insufficiency. See Addison disease. Airplane. See Aviation. hypertension caused by, 219–220 Adrenal medulla. See also Epinephrine; Airway obstruction hypokalemia in, 361, 365 Norepinephrine. atelectasis secondary to, 519, 519f Alimentary tract. See Gastrointestinal tract. anatomy of, 921, 921f in emphysema, 517, 518 Alkali, definition of, 379 exercise and, fat utilization in, 825 forced expiratory volume in 1 second Alkaline phosphatase, in hyperparathyroidism, function of, 736 and, 517, 517f 968 basal secretion in, 737 maximum expiratory flow and, Alkalosis. See also Acid-base disorders. duration of action in, 732, 736 516–517, 516f in aldosterone excess, 390 receptors and, 733 sleep apnea caused by, 513 bicarbonate excretion in, 385, 390 hypovolemic shock and, 275 Airway resistance calcium and sympathetic nerve fibers and, 730 in asthma, 520 protein-bound, 367 sympathetic vasoconstrictor system and, 204 hypoxia and, 520 reabsorption of, 369 Adrenergic drugs, 739–740 Akinesia, 693 characteristics of, 391t Adrenergic fibers, 731–732 Alactacid oxygen debt, 1034, 1034f definition of, 379, 380 Adrenergic receptors, 733, 733t. See also Alpha Alarm reaction grand mal attack and, 726 adrenergic receptors; Beta adrenergic arterial pressure elevation in, 205 metabolic, 391t, 392 receptors. sympathetic nervous system in, 738–739 aldosterone excess with, 926 drugs causing block of, 740 Albinos, visual acuity of, 611 bicarbonate excretion in, 387 Adrenocortical hormones, 921–937. See also Albumin, 833. See also Plasma proteins. clinical causes of, 393 Androgens, adrenal; Glucocorticoids; bilirubin transport by, 840, 842 definition of, 382 Mineralocorticoids. cortisol bound to, 923 diagnosis of, 394 abnormalities of, 934–936, 935f, 936f fatty acid transport by, 820, 821 hydrogen ion secretion and, 390 classification of, 921 glomerular filtration of, 313–314, 313t potassium homeostasis and, 362 excretion of, 924 plasma colloid osmotic pressure and, vomiting as cause of, 393, 804 metabolism of, in liver, 924 184, 184t, 833 neuronal excitability in, 557 plasma protein binding of, 923–924 for plasma volume measurement, 290 renal correction of, 391–392 pregnancy and, 1009 thyroid hormones bound to, 909–910 respiratory, 391t, 392 properties of, 922–923, 924t Alcohol clinical causes of, 392 synthesis and secretion of, 921–924, 921f, cirrhosis and, 838 diagnosis of, 394 923f, 924t gastric absorption of, 793 at high altitude, 529 Adrenocorticotropic hormone (ACTH; gastritis caused by, 799 hydrogen ion secretion and, 390 corticotropin), 896, 896t pancreatitis caused by, 801 treatment of, 393 adrenocortical hormone synthesis and, 922 peptic ulcer and, 801 Allergic reactions aldosterone secretion and, 927, 928 Alcoholic headache, 591 in asthma, 520 chemistry of, 931 Aldosterone, 924–928 cortisol and, 931 cortisol secretion and, 931–934, 932f angiotensin II and, 221–222 eosinophils in, 430 deficiency of, 934 arterial pressure control and, 221–222, mast cells and basophils in, 431 excess of, 935, 936 227f, 228 Allergy, 443–444 gluconeogenesis and, 817 in cardiac failure, 260 in infant, 1026 ketogenic effect of, 825 chemical formula of, 922, 923f Allografts, 449 pregnancy and, 1009 circulatory effects of, 925–926, 925f All-or-nothing principle, of action regulation of, by hypothalamus, 931–932 concentration of, in blood, 924 potential, 65 synthesis and secretion of, 933–934 cortisol and, 924–925 Alpha adrenergic receptors, 733, 733t thyroid hormones and, 913–914 deficiency of, 924, 934 in coronary vessels, 248 Adrenogenital syndrome, 936, 936f excess of, 925–926, 925f drugs acting on, 739 Aerobic energy, 860. See also Oxidative alkalosis caused by, 390 drugs blocking, 740 metabolism. hypernatremia caused by, 296 of vascular smooth muscle, norepinephrine for exercise, 1033, 1033f, 1033t, 1034b hypertension caused by, 407 and, 204 recovery after, 1034, 1034f, 1035f metabolic alkalosis caused by, 393 Alpha waves, 723f, 724–725, 724f, 725f Afferent arteriole(s), renal, 304–305, 305f, extracellular fluid osmolarity and, 359–360 Altitude. See High altitude. 307f, 311f extracellular fluid sodium and, Alveolar air, 487–489, 487t glomerular filtration rate and, 315, 316, 316f 359–360, 359f expired air and, 487t, 489, 489f myogenic mechanism and, 321 intestinal sodium absorption and, rate of replacement of, 487–488, 488f physiologic control of, 317–318, 319 795, 797, 926 Alveolar ducts, 489, 489f reabsorption rate and, 336 mechanism of action, 891, 926–927, 926f Alveolar macrophages, 427, 428, 474 tubuloglomerular feedback and, 320, 320f nongenomic actions of, 927 Alveolar membrane, 5. See also Respiratory Affinity constant, 438 obesity and, 225 membrane. Afterdischarge, 567–568 plasma protein binding of, 923 Alveolar pressure, 466–467, 466f crossed extensor reflex and, 663, 663f potassium homeostasis and, 361 Alveolar ventilation, 471–472 flexor reflex and, 662, 662f renal secretion in, 337–338, 364–366, acid-base balance and, 384–385, 384f Afterload, 109 364f, 365f, 366f, 925 carbon dioxide partial pressure and Agglutination pregnancy and, 1009 alveolar, 488–489, 489f by antibodies, 438 properties of, 922, 924t blood, 508, 508f, 510, 510f by complement system, 439 regulation of secretion of, 927–928, 927f during exercise, 510–511, 511f of red blood cells, 446 renal effects of, 925–926, 925f at high altitude, 529 in blood typing, 447, 447t salivary glands and, 926 oxygen partial pressure and Agglutinins, 446, 446f, 446t sodium reabsorption and, 328, 337–338, alveolar, 488, 488f anti-Rh, 447 375, 925 blood, 509, 509f, 510, 510f in blood typing, 447, 447t sweat glands and, 926 pH of blood and, 508, 508f, 510, 510f Agglutinogens, 445, 446t, 447 sweating and, acclimatization of, 871, 877 ventilation-perfusion ratio and, 492–494 Agonist and antagonist muscles, 81 synthesis of, 921–922, 923f Alveolus(i), pulmonary, 489, 489f, 490f neuronal circuits and, 566 tubular reabsorption and, 328, fluid balance with interstitium, 482, 482f Agouti-related protein, 846, 847, 847f, 849 337–338, 338t Alzheimer’s disease, 727–728

1045 Index

Amacrine cells, 610f, 617, 617f α-Amylase(s) Angiostatin, 198 action potentials of, 617 pancreatic, 781, 790 Angiotensin I, 220–221 functions of, 618–619 in neonate, 1025 Angiotensin II, 220–221, 220f neurotransmitters released by, 617 salivary. See Ptyalin. aldosterone secretion and, 921–922, visual contrast and, 618 Amylin, 939 927–928 visual pathway and, 617, 617f Amyloid plaques, in Alzheimer’s endothelial cell receptors for, nitric oxide Ameboid movement, 23–24, 23f, 425 disease, 728 and, 196 Ameloblasts, 969, 970 Amyloidosis, nephrotic syndrome associated extracellular fluid osmolarity and, 359–360 Amiloride, 332, 333f, 399 with, 404 extracellular fluid sodium and, 359–360 Liddle’s syndrome and, 408–409 Anaerobic energy, 860–861 glomerular filtration rate and, 318, 320–321 Amino acids Anaerobic glycolysis, 815–816, 860–861 hypertension involving, 223–224, 223f active transport into cells, 832–833 in muscle, 1033 in hypovolemic shock, 275 in blood, 831–833 Anaerobic metabolism, brain’s lack of, 749 obesity and, 225 equilibrium between proteins and, Anal sphincters, 771, 771f, 772 renal effects of, 221–222, 222f 833–834, 834f Analgesia system of brain and spinal cord, renal reabsorption and, 337, 338–339, 338f, glucagon secretion and, 948 586–588, 587f 338t, 376 glucocorticoids and, 835, 929 Anaphase, 38f, 39 renal sodium and water excretion and, regulation of levels of, 833 Anaphylactic shock, 280, 443 374–375, 374f deamination of, 834–835, 839 sympathomimetic drugs for, 281 thirst and, 358 as energy source, 834–835 Anaphylaxis, 443 as vasoconstrictor, 199 in starvation, 835 Anchoring filaments, of lymphatic capillaries, limited long-term effect of, 200 essential, 832f, 834 187, 187f, 188 nitric oxide and, 196 deficiency of, 843 Androgens. See also Testosterone. Angiotensin II receptor antagonists, 374 facilitated diffusion of, 50 adrenal, 921, 934, 980 Angiotensinases, 221 glucose synthesis from, 817 excess of, tumor-produced, 936 Angiotensin-converting enzyme (ACE) cortisol and, 928 in pregnancy, 1008 inhibitors growth hormone and, 899, 900 synthesis of, 922, 923f adverse effects of, 320–321 insulin and metabolism of, 944–945 athletic performance and, 1040 antihypertensive effects of, 374 insulin secretion and, 946–947 ovarian production of, 980, 991, 992, 992f, Angiotensinogen, 220 nonessential, 832f 993f Angular acceleration, of head, 677, 677f synthesis of, 834, 834f, 840 testicular production of, 979–980, 980f Angular gyrus area, 700, 701, 702, 704f, 705 plasma proteins as source of, 833 Androstenedione Anion gap, 395, 395t as protein digestion products, 791 adrenal synthesis of, 922, 923f Anorexia, 851–852 in protein synthesis ovarian synthesis of, 991 Anorexia nervosa, 851–852 RNA codons for, 29f, 30, 31–32, testicular synthesis of, 979 Anorexigenic substances, 846–847, 847t, 851 31t, 32f Androsterone, 980 Anovulatory cycles, 998, 1001 transfer RNA and, 31, 32, 32f, 34, 34f Anemia, 420–421 ANP. See Atrial natriuretic peptide (ANP). renal reabsorption of, 311–312, 325, 326f aplastic, 420 Anterior commissure, 705 upper limit of, 833 in chronic renal failure, 406 Anterior motor neurons. See Motor neurons, sodium co-transport of, 54–55, 794–795, circulatory effects of, 233, 420–421 anterior. 795f, 797 cyanosis and, 521–522 Anterograde amnesia, 709, 719 storage of, 833 hematocrit in, 287 Anterolateral system, 573, 580–581, 581f structures of, 831, 832f hemolytic, 420 thermal signals in, 593 tyrosine, hormones derived from, 882–884 hypoxia in, 420–421, 521 types of sensations in, 573 Aminoaciduria, 408 macrocytic, in folic acid deficiency, 854 Antibodies, 437–438, 437f. See also Aminopolypeptidase, 791 megaloblastic, 415f, 420 Immunoglobulin(s). Aminostatic theory of hunger and microcytic, hypochromic, 415f, 420 autoantibodies, hyperthyroidism caused feeding, 849 in neonate, 1025 by, 916 Aminotransferases, 834 pernicious, 417, 420, 778, 800, 854 classes of, 438 Amitriptyline, 727 in pregnancy, 1010 infusion of, 442 Ammonia red blood cell characteristics in, 415f mechanisms of action of, 438, 438f, 439f from amino acid deamination, 834, 835 Anesthesia in milk, 1016 hepatic coma and, 835 cardiac arrest during, 153 in neonate, 1025–1026 urea derived from, 835, 839–840, 859 general opsonization and, 425 Ammonia buffer system, 388–389, 389f cardiac arrest caused by, 279, 281 in saliva, 776 Ammonium chloride, for alkalosis, 393 neurogenic shock caused by, 279 Anticholinesterases. See Acetylcholinesterase Ammonium ion paralysis of swallowing in, 799 inhibitors. buffering by, 388–389, 389f respiratory depression caused by, 512 Anticoagulants excretion of, 389, 389f, 390, 391 spinal in blood, 457 Amnesia cardiac output and, 239, 239f for clinical use, 459–460 anterograde, 709, 719 neurogenic shock caused by, 279 in tissues, 453 retrograde, 709 Anesthetics Anticodons, 32 Amniotic fluid, 1011 local, as membrane stabilizers, 69 Antidiuretic hormone (ADH; vasopressin), 896, fetal urine in, 1020 synaptic transmission and, 557 904–905. See also Diabetes insipidus. ingestion of, 1020 Angina pectoris, 252. See also Myocardial arterial blood pressure and, 357, 905 Amorphosynthesis, 577 ischemia. atrial stretch reflex and, 208 AMP (adenosine monophosphate), bypass surgery for, 252 blood volume and, 357, 357f, 905 809–810. See also Cyclic adenosine cardiac hypertrophy leading to, 272 in cardiac failure, 260 monophosphate (cAMP). current of injury in, 141 chemical structure of, 904 Amphetamines drug treatment for, 252 disorders associated with, 354–355 athletic performance and, 1040 nitrates in, 196 extracellular fluid osmolarity and, 905 for weight loss, 851 Angiogenesis, 197, 198 extracellular fluid volume and, 375–376 Ampulla, of semicircular duct, 675f, cancer growth and, 41 factors affecting level of, 357, 357t 676, 676f at high altitude, 529 hypernatremia caused by deficit of, 295 Amygdala, 719–720 inhibitors of, 198 hyponatremia caused by excess of, 295 anterior commissure and, 705 Angiogenin, 198 hypothalamus and, 356, 356f, 716, 904 feeding and, 848 Angioplasty, coronary artery, 253 in hypovolemic shock, 275, 279

1046 Index

Antidiuretic hormone (ADH; vasopressin) Aqueous humor, 606, 606f Arterial blood pressure control, nervous (Continued) formation of, 606, 606f (Continued) osmoreceptor feedback and, 355–357, 355f, outflow of, 607, 607f brain stem in, 739 356f, 357f, 905 Aqueous veins, 607, 607f cardiac output and, 232, 232f salt intake and, 217 Arachidonic acid, 890 in CNS ischemic response, 209, synthesis and release of, 355, 356, 356f Arachnoidal villi, 746f, 747 210–211, 210f urine concentration and, 345, 346, 346f, cerebrospinal fluid pressure and, 747–748 hypothalamus and, 715 347–348, 348t, 350, 350f Arcuate fasciculus, 704–705, 704f parasympathetic, 736 urea and, 350–351, 353 Arcuate nuclei reflex mechanisms in, 205–209, as vasoconstrictor, 199, 905 food intake and, 846–847, 847f, 847t 206f, 207f water reabsorption and, 339, 339f, 904–905 leptin and, 849 respiratory waves and, 210 Antigen(s), 434 gonadotropin-releasing hormone and, 997 skeletal nerves and muscles in, 209–210 antibody binding of, 438 Area postrema, blood-brain barrier and, sympathetic, 735–736 in blood cells, 445 748–749 thirst and, 358 released by macrophages, 436, 437 Arginine, nitric oxide synthesis from, 195, 196f vasomotor waves and, 210–211, 210f self-antigens, 434–435 Argyll Robertson pupil, 632 by renal–body fluid system, 213–220, Antigen-presenting cells, 440, 440f Aromatase, 991, 992, 992f, 993f 227–228, 227f, 371–373, 371f, 372f Antioncogenes, 40 Arousal, pain signals and, 586 chronic hypertension and, 218–220, Antiperistalsis, 803, 804 Arrhythmias, cardiac, 143–153 218f, 220f Antipyretics, 876 atrial fibrillation, 151–152, 152f pressure diuresis in, 213–218, 214f, 215f Antipyrine, 289 in mitral valvular disease, 269 salt in, 217–218, 376. See also Pressure Antithrombin III, 457 atrial flutter, 152–153, 152f, 153f natriuresis. heparin and, 457 atrioventricular block, 144–145, 144f, 145f total peripheral resistance and, Antithyroid substances, 915 cardiac arrest, 153 216–217, 216f, 217f in foods, 917 circulatory arrest and, 281 by renin-angiotensin system, 220–222, Antral follicles, 989–990 cardiac hypertrophy leading to, 272 220f, 221f, 222f Antrum, gastric, 766, 766f causes of, 143 hypertension and, 223–224, 223f Anuria, 399, 401 hyperkalemia and, 926 Arterial pressure pulses, 168–171. See also Aortic baroreceptors, 205–206, 206f in long QT syndromes, 147, 148f Pulse pressure. Aortic bodies, 208, 507, 508, 508f, 509 paroxysmal tachycardia, 148–149 abnormal contours of, 169, 169f high altitude and, 529 atrial, 148, 148f compliance and, 168, 169–170 Aortic coarctation, 224, 269 ventricular, 148–149, 149f damping of, 170 Aortic pressure, 158, 159f partial intraventricular block, 145–146, 145f transmission to peripheral arteries, cardiac cycle and, 105, 105f, 107 as premature contractions. See Premature 169–170, 169f, 170f cardiac output and, 112, 112f contractions. typical record of, 168, 169f pulsations in, 168, 169f sinoatrial block, 144, 144f Arterial system, volume-pressure curve of, abnormal contours of, 169, 169f sinus rhythm abnormalities, 143–144, 167–168, 168f transmission to peripheral arteries, 143f, 144f. See also Bradycardia; Arteries 169–170, 169f, 170f Tachycardia(s). blood volume in, 157 Aortic regurgitation supraventricular tachycardias, 148 distensibility of, 167–168, 168f circulatory dynamics in, 268 torsades de pointes, 147, 148f function of, 157 murmur of, 267, 267f, 268 ventricular fibrillation as. See Ventricular sympathetic innervation of, 201, 202f pressure pulse associated with, 169, 169f fibrillation. Arterioles, 177, 178f. See also Aortic stenosis Arterial blood pressure. See also Blood pressure. Metarterioles. aortic pressure pulse in, 169, 169f acceleratory forces and, 531, 531f blood volume in, 157 circulatory dynamics in, 268 age-related increase in, 171, 171f of brain, 743, 743f, 744, 745 congenital, 269 blood flow and, 165–166, 165f, 166f function of, 157 murmur of, 267, 267f, 268 autoregulation of, 165–166, 165f, hepatic, 837 work output associated with, 108 194–195, 194f, 200, 217, 744–745, 745f in nervous control of arterial pressure, 205 Aortic valve, 105f, 106–107, 107f cerebral, 744–745, 745f renal. See Afferent arteriole(s), renal; aortic pressure curve and, 107 cardiac output and, 112, 112f, 216f, Efferent arteriole(s), renal. second heart sound and, 107, 266, 266f 217, 217f resistance of, fourth power of radius Aphasia, 703–704 in cardiogenic shock, 259 and, 164 Aplastic anemia, 420 in different parts of circulation, 158, 159f sympathetic innervation of, 201, 202f Aplysia, 707, 707f, 708 exercise-related increase in, 244–245 sympathetic tone of, 737 Apocrine glands, autonomic control of, 735 extracellular fluid volume and, 217, 217f vasodilator agents and, 193 Apoferritin, 840 gravitational effect on, 173, 174 bradykinin as, 199 Apolipoprotein(a), 829 mean value of, 171, 171f histamine as, 199–200 Apolipoprotein B, mutations of, 827 measurement of, clinical, 170–171, 170f Arteriosclerosis. See also Atherosclerosis. Apolipoprotein E of neonate, 1024 atherosclerosis-induced, 828 Alzheimer’s disease and, 728 reference level for, 174–175, 174f calcium deposition in, 958 chylomicron removal from blood regulation of. See Arterial blood pressure definition of, 827 and, 820, 820f control. diabetes mellitus and, 953 Apoprotein B, 819 renal blood flow and, 319, 319f, 320, 321 pulse pressure in, 168–169, 169f Apoptosis, 40 renal reabsorption rate and, 336 stroke associated with, 745 Apparent mineralocorticoid excess syndrome, respiratory waves in, 210 Arteriovenous anastomoses, cutaneous, 924–925 shock and, 273 868, 868f Appendix, pain pathways from, 589–590, 589f hypovolemic, 274–275, 274f heat conduction and, 868 Appetite, 845. See also Hunger. thyroid hormones and, 913 Arteriovenous fistula diminished level of, 851–852 urine output and, 337 cardiac failure associated with, gastric secretion and, 779 vascular resistance and, 165 263–264, 264f higher brain centers and, 848 Arterial blood pressure control, 159 cardiac output with, 232, 239, 239f, 240 hypothalamus and, 846–847 aldosterone and, 925, 925f circulatory changes associated with, Appetite area of brain, 776 as homeostatic mechanism, 6, 7–8 239–240, 239f Aquaporins, 47, 905 integrated system for, 226–228, 227f Articulation, of speech, 704 aquaporin-2, antidiuretic hormone nervous, 204–209, 373–374 Artificial kidney. See Dialysis, renal. and, 339, 339f antidiuretic hormone and, 357 Ascites, 298, 300, 838

1047 Index

Ascorbic acid. See Vitamin C. Atrial pressure Autonomic nervous system (Continued) Aspirin (acetylsalicylic acid) cardiac cycle and, 105, 105f, 106 functional characteristics of, 731–737 acidosis caused by, 393 ventricular function curves and, 110–111, cholinergic and adrenergic fibers fever and, 876 110f in, 731–732 gastric absorption of, 793 Atrial stretch receptors, 208–209 excitation and inhibition in, 733–735, 734t gastritis caused by, 799 antidiuretic hormone and, 905 receptors on organs and, 732–733, 733t peptic ulcer and, 801 respiratory waves and, 210 specific organs and, 734t, 735–736 Association areas, 699–701, 699f sodium excretion and, 376 stimulus frequency required in, 736 caudate nucleus and, 691, 692 Atrial syncytium, 102 tone in, 737 granular neurons in, 697 Atrial T wave, 122 gastrointestinal tract and. See Gastrointestinal limbic, 699f, 700 vectorial analysis of, 133–134, 133f tract, autonomic control of. parieto-occipitotemporal, 699–700, Atrial tachycardia, paroxysmal, 148, 148f hypothalamic influence on, 739, 739f 699f, 702 Atrioventricular (A-V) block insulin secretion and, 947 prefrontal, 699f, 700, 702–703 causes of, 144 organization of, 729–731, 730f, 731f Wernicke area and, 701 ectopic pacemaker associated with, 119 pharmacology of, 739–740 Aster, mitotic, 38–39, 38f first-degree, 144–145, 144f rapidity and intensity of effects, 729 Astereognosis, 577 second-degree, 145, 145f smooth muscle and, 94–95, 94f Asthma, 444, 473, 520 third-degree (complete), 145, 145f Autonomic reflexes, 665, 729, 738 airway obstruction in, 517, 520 Atrioventricular (A-V) bundle, 102, 115, 116f, bowel activity and, 772 Astigmatism, 603, 603f, 604f 117, 117f local, 738 Astrocytes, in cerebral blood flow regulation, blocking of impulses in, 144. See also Autoregulation of blood flow, 165–166, 165f, 743, 743f, 744 Atrioventricular (A-V) block. 194–195, 194f, 200, 217 Astronauts. See Spacecraft. ectopic pacemaker in, 119–120 cerebral, 744–745, 745f Ataxia, 689 ischemia of, 144 renal, 317, 319–321, 319f, 320f Atelectasis, 519, 519f one-way conduction through, 117–118 Autoregulatory escape, gastrointestinal blood in oxygen toxicity, 537 premature contractions originating in, 146 flow and, 762 Atheromatous plaques, 827, 828, 828f sympathetic effects on, 120 A-V block. See Atrioventricular (A-V) block. Atherosclerosis, 827–829. See also timing of impulse in, 117f, 118 Aviation. See also High altitude; Spacecraft. Arteriosclerosis. Atrioventricular (A-V) nodal paroxysmal acceleratory forces in, 531–533, 531f Alzheimer’s disease and, 728 tachycardia, 148 acute hypoxia in, 528 cholesterol and, 828, 829 Atrioventricular (A-V) nodal premature breathing air vs. breathing oxygen in, 528 coronary, 248 contractions, 146, 146f deceleratory forces in parachuting in, acute occlusion caused by, Atrioventricular (A-V) node, 115, 116f, 532–533 248–249 117, 117f Axis deviation, 135–137, 135f, 136f, 137f bypass surgery for, 252 as ectopic pacemaker, 119 Axon, 543, 544f, 547, 547f collateral circulation and, 249 inflammation of, 144 Axonal streaming, 551 risk factors for, 829 intrinsic rhythmicity of, 119 Axoneme, 25, 975 diabetes mellitus, 953 ischemia of, 144 Azathioprine, for immunosuppression, in in hypothyroidism, 918 parasympathetic effects on, 119–120 transplantation, 449 prevention of, 829 blocking of conduction by, 144 Azotemia. See Uremia. renal artery, 403 premature contractions originating in, risk factors for, 828–829 146, 146f B systolic pressure increase in, 171 sympathetic effects on, 120 B lymphocytes, 433, 434. See also Antibodies; Athetosis, 691 Atrioventricular (A-V) valves, 105f, 106–107, Lymphocytes. Athletes, bradycardia in, 143–144. See also 107f. See also Mitral valve; Tricuspid as antigen-presenting cells, 440 Sports physiology. valve. helper T cells and, 436, 437, 441, 441f Atmospheric hypoxia, 520, 521, 522. first heart sound and, 107, 265 interleukins and, 441 See also High altitude. Atrophy, of skeletal muscle, 81, 82 memory cells of, 437 Atopic allergies, 443 Audiogram, 642, 642f plasma cells formed by. See Plasma cells. ATP. See Adenosine triphosphate (ATP). Audiometer, 642 preprocessing of, 435, 435f, 442 ATP synthetase, 22, 815 Auditory cortex, 639, 639f, 640–641, 640f specificity of, 435–436, 436f ATPase(s). See also Calcium ATPase; speech and, 704–705, 704f Bacteria Hydrogen ATPase; Hydrogen- Auditory receptive aphasia, 703 in colon, 798, 855 potassium ATPase pump; Sodium- Auerbach’s plexus. See Myenteric plexus. dental caries and, 971 potassium ATPase pump. Augmented unipolar limb leads. See Unipolar evolution of, 17–18, 18f in active transport, 53, 53f, 54 limb leads, augmented. in feces, 798 in kidneys, 324–325, 325f Auscultation, of heart sounds, 266, 266f fever and, 875–876 mitochondrial, 814f, 815 Auscultatory method, for blood pressure lysosomal killing of, 20 of myosin head, 75, 76 measurement, 170–171, 170f phagocytosis of, 19, 20. See also ATP-sensitive potassium channels, of Autocrines, 881 Phagocytosis. pancreatic beta cells, 945, 945f Autograft, 449 Bainbridge reflex, 208–209, 229–230 Atria Autoimmune diseases, 442 Balance. See Equilibrium. action potential in, 117 Autolysis, 19–20 Baldness, 981 cardiac impulse in, 118, 118f Autonomic ganglia Ballistic movements, cerebellar control of, 688 electrocardiogram and, 133–134, 133f drugs blocking transmission through, 740 Barometric pressure, at different altitudes, as primer pumps, 104–106 nicotinic receptors in, 733 527, 528t Atrial fibrillation, 151–152, 152f peripheral sympathetic, 729 Baroreceptor reflexes, 205–209, 206f, 207f, 738 in mitral valvular disease, 269 prevertebral, 729 acute neurogenic hypertension and, Atrial flutter, 152–153, 152f, 153f sympathetic chains of, 729, 730f 224–225 Atrial heart sound, 266, 267f Autonomic nervous system, 729–741. See adaptation and, 562 Atrial natriuretic peptide (ANP) also Parasympathetic nervous system; in cardiac failure, acute stage, 255–256, 256f blood volume and, 376 Sympathetic nervous system. as homeostatic mechanism, 6, 7–8 in cardiac failure, 260–261 in arterial pressure control, acute, 205 in hypovolemic shock, 275 renal reabsorption and, 339 brain stem control of, 739, 739f in integrated pressure response, 227, 227f sodium excretion and, 376 circulatory control by, 201–204, 202f, oscillation of, 210, 210f Atrial paroxysmal tachycardia, 148, 148f 204f, 205 renal sodium and water excretion and, Atrial premature contractions, 146, 146f eye control by, 631–632, 631f 373–374

1048 Index

Bartholin glands, 1000 Bicarbonate (Continued) Bladder. See also Micturition; Micturition reflex. Bartter’s syndrome, 408 gastric acid secretion and, 777–778, 778f anatomy of, physiologic, 306–308, 307f Basal ganglia, 689–694 in gastrointestinal mucus, 775 atonic, 310 as accessory motor system, 689 duodenal, 786 external sphincter of, 308, 308f, 310 anatomical relations of, 690, 690f intestinal absorption of, 795 innervation of, 308, 308f clinical syndromes associated with, 693–694 intestinal secretion of internal sphincter of. See Urethra, posterior. Huntington’s disease, 694 in large intestine, 787, 795, 797 irritation of, intestinal activity and, 772 Parkinson’s disease, 691, 693–694 in small intestine, 787, 795 pressure changes in, 309, 309f dopamine system and, 712, 713, 713f pancreatic secretion of, 780–782, 782f Blastocyst, 1004, 1004f, 1005f gamma efferents and, 659 mucosal protection and, 800 progesterone and, 1008–1009 in integrated motor control, 695 regulation of, 782–783, 783f Bleeding tendencies. See also Hemorrhage. neglect syndrome and, 692, 692f in plasma in factor deficiencies, 457–458 neuronal circuitry of, 690, 690f carbon dioxide transport and, 413 in thrombocytopenia, 458 caudate circuit, 690f, 691–692, 691f measurement of, 393–395, 394f Bleeding time, 460 putamen circuit, 690–691, 690f, 691f renal excretion of, 389, 390 Blind spot, 627 neurotransmitters in, 692–693, 692f in alkalosis, 392 Blindness, in premature infant, 197–198, 1027 overall motor control by, 681 renal reabsorption of, 332–333, 332f, 385, Blood. See also Extracellular fluid. patterns of motor activity and, 690–691, 695 386–388, 386f, 387f cleansing of, by spleen, 175 scaling of movements and, 692 carbonic anhydrase inhibitors and, 398 reservoirs of, 175, 175f timing of movements and, 692 factors affecting, 390–391, 390t viscosity of, 161–162, 163, 164 Basal metabolic rate (BMR), 863–864, 864f, 867 in saliva, 774f, 775 anemia and, 420–421 in pregnancy, 1010 vomiting-related loss of, 393 hematocrit and, 165, 165f testosterone and, 982 Bicarbonate buffer system, 381–383, 382f mountain sickness and, 531 thyroid hormones and, 907, 911, 912, 913f intracellular fluid and, 383 plasma loss and, 279 in hyperthyroidism, 916 Bicarbonate-chloride carrier protein, 502–503 in polycythemia, 421 in hypothyroidism, 918 Bile, 783–786 Blood cells, genesis of, 414–415, 414f. See also Base(s) composition of, 784–785, 784t Leukocytes (white blood cells); as components of DNA, 27, 28, 28f, 29 excretion of calcium in, 840 Red blood cells (erythrocytes) definition of, 379 excretion of hormones in, 886 Blood coagulation. See also Clot entries; strong and weak, 379–380 functions of, 783, 785 Hemostasis. Basement membrane, of capillaries, 177, 178f release into duodenum, 784f, 785 abnormalities of Basilar fibers, of cochlea, 635 secretion of, 783–784, 785 with bleeding, 457–458 hair cells and, 636f, 637, 637f secretin and, 784, 784f, 785 with thromboembolism, 459 traveling wave and, 635, 636 storage and concentration of, 784, 784f, 785 clotting factors in, 452t, 453 Basilar membrane, of cochlea, 634–635, Bile acids. See also Bile salts. hepatic synthesis of, 840 634f, 635f cholesterol and, 827, 829 initiation of, 454–456, 455f, 456f hair cells and, 637 functions of, 783 mechanism of, 453–454 loudness and, 638 Bile canaliculi, 783–784, 837, 837f in neonate, 1025 sound frequency and, 638 Bile ducts, 783–784, 837, 837f outside the body, 460 traveling wave along, 635, 635f, 636f obstruction of, 841–842 positive feedback in, 8, 9 Basket cells, 685 Bile salts. See also Bile acids. prevention of, in normal vascular system, Basophil erythroblasts, 415, 415f cholesterol and, 839 456–457 Basophils, 423, 423t, 424f, 431 cholic acid for, 827 in ruptured vessel, 452, 452f allergies and, 443 concentration in bile, 784, 784t tests of, 460–461, 460f complement fragments and, 439, 439f enterohepatic circulation of, 785 Blood flow, 160–162. See also Circulation. eosinophil chemotactic factor of, 430 in fat digestion and absorption, 785, 792 arterial pressure and, 165–166, 165f, 166f heparin produced by, 431, 439, 457 Bilirubin, 419–420, 783, 840–842 cardiac output and, 159 Bathorhodopsin, 611–612, 611f concentration in bile, 784, 784t cerebral. See Cerebral blood flow. Bends. See Decompression sickness. concentration in plasma, 841 definition of, 160 Beriberi, 853, 854 conjugated, 840, 841–842, 841f diameter of vessel and, 163–164, 163f cardiac failure associated with, 263, 264, fecal color and, 798 in different tissues and organs, 191, 192t 264f, 853 formation and transformations of, gastrointestinal. See Gastrointestinal tract, cardiac output in, 232 840–841, 841f blood flow in.

hypoxia in, 521 jaundice and, 841–842 interstitial fluid Pco2 and, 497, 498f peripheral vasodilation in, 194, 853 in neonate, 1024 interstitial fluid Po2 and, 496–497, 496f Beta adrenergic receptors, 733, 733t in neonate, 1024, 1024f laminar, 161, 161f of bronchiolar smooth muscle, 473 from transfusion reactions, 1025 in liver, 838 of cardiac muscle, sympathetic stimulation unconjugated, 840, 841–842, 841f metabolic oxygen use and, 501 and, 120 Biliverdin, 840 methods for measuring, 160–161, 160f, 161f in coronary vessels, 248 Binocular vision, 605, 605f. See also Stereopsis. in muscle. See Skeletal muscle, blood drugs acting on, 739 2,3-Biphosphoglycerate (BPG), 500, 500f flow in. potassium homeostasis and, 361–362 Bipolar cells, 609, 610f, 616–617, 617f needs of tissues for, 191, 192–193 Beta blockers, 740 transmitters at synapses of, 617 pressure difference and, 159, 160 for angina pectoris, 252 two types of, 618, 619–620 pulmonary. See Pulmonary circulation. hyperkalemia caused by, 361–362 visual pathway and, 617, 617f regulation of. See Blood flow control. Beta waves, 723f, 724–725, 724f, 725f Bipolar disorder, 727 renal. See Renal blood flow. Beta-aminoisobutyricaciduria, 408 Bipolar limb leads, 124–126, 125f, 126f resistance to. See Vascular resistance. Beta-amyloid peptide, in Alzheimer’s vectorial analysis of potentials in, 131, 131f in skin, heat loss and, 868, 868f disease, 728 atrial T wave, 133–134, 133f in thyroid gland, 907 Beta-oxidation of fatty acids, 822, 822f, 839 axes for, 130, 130f thyroid hormones and, 913 Betz cells, 669–670. See also Pyramidal cells. increased voltage in, 136f, 137 in total circulation, 160 Bicarbonate. See also Sodium bicarbonate. mean electrical axis, 134–135, 135f turbulent, 161–162, 161f in bile, 784, 785 P wave, 133, 133f units of, 160 carbon dioxide transported as, 502–503, QRS complex, 131–132, 132f velocity of 502f T wave, 133, 133f cross-sectional area and, 158 in cerebrospinal fluid, at high altitude, 529 Bitemporal hemianopsia, 627 parabolic profile for, 161, 161f diarrhea-related loss of, 392 Bitter taste, 645–646, 646t, 647 turbulence and, 161–162

1049 Index

Blood flow control Blood–cerebrospinal fluid barrier, 748–749 Brain edema, 749 humoral, 199–200 Blue weakness, 616 in acute mountain sickness, 530 local, 191 BMR. See Basal metabolic rate (BMR). hyponatremia with, 295, 296f acute, 191, 192–196, 192f, 193f Body mass index (BMI), 850 negative acceleratory forces causing, autoregulation in, 165–166, 165f, Bohr effect, 500, 500f 531–532 194–195, 194f, 200, 217 double, 1006 respiratory depression in, 512 cardiac output and, 230–231 fetal blood and, 1006 treatment of, 749 long-term, 191–192, 196–198, 197f Bone, 957–960. See also Fractures. Brain stem. See also Medulla; Pons. tissue factors affecting, 97 calcification of, 958 autonomic control centers of, 739, 739f tissue needs and, 158–159 vitamin D and, 962 basal ganglia input from, 692–693, 692f Blood gases. See also Carbon dioxide partial calcium exchange with, 958, 967 cerebellar functions and, 686–687, 694

pressure (Pco2); Oxygen partial in pregnancy, 1009 cerebellar input from, 683, 683f pressure (Po2). deposition and absorption of, 959–960, cerebellar signals to, 684 during exercise, 1037 959f cerebral activation by, 711–713 measurement of, 515–516 estrogenic effects on, 994 continuous excitatory signals in, Blood glucose in fetus, 1020 711–712, 712f cortisol and, 928 growth hormone and, 900 neurohormonal systems in, 711, in Cushing syndrome, 935–936 somatomedins and, 900–901 712–713, 713f diagnosis of diabetes and, 952–953, 953f growth mechanisms of, 900 cerebral inhibition by, 712 glucagon and, 947–948, 948f hydroxyapatite in, 957, 958 chewing and, 763 gluconeogenesis and, 839 organic matrix of, 957 feeding and, 847–848 hepatic buffering of, 839 parathyroid hormone and, 963–964 functions of, 673 hunger and, 766, 849 phosphate in extracellular fluid and, 958 gastrointestinal reflexes and, 757 importance of regulation of, 949–950 radioactive substances in, 957–958 hypothalamus and, 715 insulin secretion and, 946, 946f, 947 rickets and, 968 limbic system and, 715 in neonate, 1023, 1025 salts of, 957–958 motor functions and, 673–674, 673f, 674f of diabetic mother, 1026 strength of, 958, 960 anencephaly and, 678–679 premature, 1027 structure of, 959–960, 960f gamma efferents in, 659, 660 normal level of, 817 testosterone and, 982 stretch reflexes and, 660 renal blood flow and, 321 thyroid hormones and, 912 pain pathways to, 586 summary of regulation of, 949–950 in cretinism, 918 salivatory nuclei in, 776, 776f urinary excretion and, 327 vitamin D and, 962 swallowing and, 764, 765 Blood pressure. See also Arterial blood Bone fluid, 964 vestibular nuclei in, 678, 678f pressure; Capillary pressure; Venous Bone marrow vomiting center in, 803, 803f, 804 pressures. B lymphocyte processing in, 435, 442 Brain waves. See Electroencephalogram definition of, 162 leukopenia and, 431 (EEG). measurement of, high-fidelity, 162, 162f macrophages of, 427–428 Braxton Hicks contractions, 1012 in parts of circulation, 158, 159f response of, to inflammation, 429, 430, 430f Breasts standard units of, 162 Bone marrow aplasia, 420 anatomy of, 1014f Blood transfusion, 280–281. See also Bony labyrinth, 634, 674 development of, 1014 Transfusion; Transfusion reactions. Botulinum toxin, 85 estrogens and, 994, 1014 blood types in, 445, 446t Bowman’s capsule, 305–306, 305f, 310–311, of neonate, 1026 Blood types 311f, 312, 313f progesterone and, 995, 1014 O-A-B, 445–447, 446f, 446t pressure in, 314–315, 314f Breathing. See also Respiration. Rh, 447–449 Boyle’s law, 535 cardiac output curve and, 234, 234f Blood typing, 446–447, 447t BPG (2,3-biphosphoglycerate), 500, 500f work of, 468 Blood vessels. See also Arteries; Arterioles; Bradycardia, sinus, 143–144, 143f Broca’s area, 668–669, 669f, 699f, Capillaries; Veins. Bradykinin, 199, 200 700, 704–705 autonomic control of, 729–730, 730f, 731, in asthma, 520 Brodmann’s areas, 574–575, 575f 734t, 735 glomerular filtration rate and, 319 Bronchi, 472–473 adrenal medullae in, 736 in gut wall, 761 Bronchial circulation, 477 intrinsic tone of, 737 from mast cells and basophils, 431 shunt blood and, 496, 496f Blood volume, 287. See also Extracellular fluid as pain stimulus, 583, 584 Bronchioles, 472–473 volume. in salivary glands, 776 particles entrapped in, 474 antidiuretic hormone and, 357, 357f, 905 Brain. See also Basal ganglia; Cerebellum; Bronchospasm aortic valve disease and, 268 Cerebral cortex; Nervous system. in anaphylaxis, 443 atrial natriuretic peptide and, 376 acceleration injury to, 746 in asthma, 444 atrial reflexes and, 208 activating systems of, 711–713 Brown fat, 865, 873 cardiac output and, 233, 238, 238f neurohormonal systems, 711, Brown-Séquard syndrome, 590 conditions causing large increases in, 712–713, 713f Brunner glands, 786, 800 376–377 reticular excitatory area, 711–712, 712f Brush border, intestinal, 790, 791, 794, 794f vs. extracellular fluid volume, 373, 373f blood flow in. See Cerebral blood flow. Buccal glands, 775 hemorrhage and. See also Hypovolemic capillaries of, tight junctions of, 178 Buffer nerves, from baroreceptors, 207 shock. carbon dioxide in blood and, 200 Buffer systems, 380–381 compensatory mechanisms, 275–276 childhood development of, 1027–1028 ammonia, 388–389, 389f at high altitude, 529 glucose for, 949 bicarbonate, 381–383, 382f in lungs, 157, 478–479 insulin and, 942–943 intracellular fluid and, 383 mean circulatory filling pressure and, growth of, thyroid hormones and, 912 gastrointestinal mucus and, 775 236, 236f interstitial fluid pressure in, 183 isohydric principle and, 383–384 measurement of, 290 metabolism of, 749–750 phosphate, 383, 388, 388f mitral valve disease and, 269 reticular inhibitory area and, 712, 712f proteins, 383–384 of neonate, 1024 vegetative functions of, 714, hemoglobin, 383, 413 in pregnancy, 1010, 1010f 715–717, 716f respiratory, 385 regulation of, 371–373, 372f Brain damage Bulboreticular facilitatory region, 711 testosterone and, 982 Cheyne-Stokes breathing in, 512 gamma efferents and, 659–660 venous return and, 238, 238f circulatory arrest causing, 282 stretch reflexes and, 660 Blood-brain barrier, 748–749 neurogenic shock caused by, 279–280 Bulbourethral glands, 307f, 973, 973f, 979

1050 Index

Bulk flow Calcium (Continued) Capillaries (Continued) in artificial kidney, 409 intestinal absorption of, 796, 956–957, 957f glomerular. See Glomerular capillaries. into peritubular capillary, 323–324, 324f parathyroid hormone and, 796, 964–965 increase in number of, 197, 197f Bumetanide, 331, 331f, 397 vitamin D and, 796, 855, 962, 964–965 at high altitude, 529 Bundle branch block neonatal need for, 1025, 1026, 1027 intercellular clefts of, 177–178, 178f axis deviation in, 136–137, 136f, 137f in nonosseous tissues, 958 diffusion through, 179–180 QRS prolongation in, 138, 142 peptide hormone secretion and, 882 lymphatic, 186f, 187, 187f, 188, 188f T wave and, 142 plasma protein binding of, 312 pumping by, 188–189 Bundle branches, 115, 116f, 118. See also at postganglionic nerve endings, 732 organization of, 177, 178f Purkinje fibers. renal excretion of, 368, 369t, 957, 957f peritubular. See Peritubular capillaries Bundle of His. See Atrioventricular (A-V) renal reabsorption of, 339, 368–369, 368f permeability decrease in, cortisol- bundle. parathyroid hormone and, 964 induced, 930 Burns as second messenger, in hormone action, permeability increase in plasma loss in, 279 890, 891 bradykinin-induced, 199 water loss caused by, 285 in skeletal muscle contraction, 75–76, in circulatory shock, 277 88–89, 88f, 89f edema caused by, 297 C in smooth muscle, 93–94, 94f, 97–98 histamine-induced, 199–200 C cells, thyroid, 966 sodium channels and, 64, 69 pores in, 157, 158, 177–178, 178f C fibers, 563–564, 563f sodium counter-transport of, 55, 55f diffusion through, 4–5, 179–180 analgesia system and, 587 vasoconstriction induced by, 200 fluid filtration and, 181 cold receptors and, 592 Calcium ATPase, 324–325 permeabilities for various molecules, pain sensation and, 584, 585, 586 of cardiac muscle, 104, 104f 179–180, 180t visceral, 588 Calcium carbonate, of vestibular system, 675 pressures in sympathetic, 729–730 Calcium ion channels. See also Calcium- gravity and, 173–174 warmth receptors and, 592 sodium channels hydrostatic. See Capillary pressure. C peptide, 940, 940f of cardiac muscle, 102–103, 104f pulmonary, 158 Cachexia, 852 hormone receptors and, 891 systemic, 158 Caffeine, 557 memory system of Aplysia and, 707, 708 pulmonary. See Pulmonary capillaries. athletic performance and, 1040 of smooth muscle, 97 of skeletal muscle, blood flow during Caisson disease. See Decompression sickness. voltage-gated, 64 exercise, 243 Cajal, interstitial cells of, 754 at neuromuscular junction, 83, 84f, 86 surface area of, 177 Calbindin, 962 of pancreatic beta cells, 945, 945f wall structure of, 177, 178f Calcarine fissure, 623, 624, 624f at presynaptic terminal, 548 Capillary filtration coefficient, 181, 185 Calcitonin, 965f, 966 of smooth muscle, 96 Capillary fluid shift, for arterial pressure renal calcium reabsorption and, 368–369 Calcium pumps, 54 regulation, 227, 227f Calcitriol, 304 of cardiac muscle, 104, 104f Capillary pressure, 181, 181f, 184t, 185t Calcium, 856 renal, 368–369, 368f edema caused by increased in, 297 action potential and, 64 of skeletal muscle, 74, 88–89, 88f, 89f increased blood volume and, 238 in gastrointestinal smooth muscle, of smooth muscle, 97, 98 lymph flow and, 188 754–755 Calcium release channels, 88, 88f, 103 measurement of, 181–182, 182f blood coagulation and, 453, 453f, 454, 455, Calcium-sensing receptor (CaSR), 965 Carbachol, 86 455f, 456, 456f Calcium-sodium channels. Carbaminohemoglobin, 503 prevention of, 460 in cardiac muscle, 102–103 Carbohydrates in bone, 957 in gastrointestinal smooth muscle, 754–755 absence of, fat utilization in, 823, 825 deposition of, 958 Calmodulin, 93–94, 94f absorption of, 796 exchange with extracellular fluid, hormone action and, 891 in athlete’s diet, 1034, 1035, 1035f 958, 967 Calorie, 862 in cell, 12, 13 parathyroid hormone and, 963–964 Calorimeter, 862, 863 of cell membrane, 14 in cardiac muscle Calsequestrin, 88, 88f dental caries and, 971 excitation-contraction coupling and, cAMP. See Cyclic adenosine monophosphate dietary sources of, 789–790 103–104, 104f (cAMP). digestion of, 789–790, 790f sympathetic stimulation and, 120 cAMP-dependent protein kinase, 889 pancreatic enzyme for, 781, 790 exchangeable, 958, 967 Cancer as energy source. See Glucose, energy excretion of, in bile, 840 anorexia-cachexia in, 852 production from. exocytosis and, 21 genetic mechanisms of, 40–41 excess of, fat metabolism and, 825 of gastrointestinal secretions, 774 Capacitance, vascular, 167. See also Vascular in foods in extracellular fluid and plasma, compliance. energy available in, 843–844 955–957, 957f sympathetic control of, 168 metabolic utilization of, 844–845 calcitonin and, 965f, 966 Capillaries growth hormone and, 899–900 cardiac muscle contraction and, blood flow in metabolism of. See also Glucose. 103–104, 104f, 112 average, 179 insulin and, 941–943, 942f, 947 excess or deficiency of, 367, 856, 956, 956f intermittent character of, 178–179 liver’s functions in, 839 forms of, 955, 956f velocity of, 158 thyroid hormones and, 912 as nerve membrane stabilizer, 69 blood volume in, 157 storage of. See Glycogen. normal range of, 7, 7t cerebral, 743, 743f, 745 synthesis of, in Golgi apparatus, 20 parathyroid hormone and, 963–966, 963f, barriers at, 748–749 triglycerides synthesized from, 824–825, 824f 965f, 967 edema and, 749 Carbon dioxide regulation of, 367–368, 368f diffusion across walls of, 4–5, 4f, diffusing capacity for, 491–492, 492f in rickets, 968 179–180, 179f diffusion coefficient of, 487t of smooth muscle, 97–98 concentration difference and, 180 diffusion of. See also Diffusion, of gases. summary of, 966–967 molecular size and, 179–180, 180t through capillary membrane, 179 vitamin D activation and, 961–962, 961f distance from any single cell, 4–5, 177 from cells to capillaries to alveoli, fecal excretion of, 367, 368, 956–957, 957f fluid filtration across, 181–186, 181f 497–498, 497f, 498f, 502 fetal accumulation of, 1020, 1020f excess, causing edema, 297 in extracellular fluid in gastrointestinal smooth muscle into potential spaces, 300 acid-base balance and, 384 action potential and, 754–755 function of, 157 normal range of, 7t tonic contraction and, 755 in gastrointestinal tract, pores of, 178 regulation of, 6, 7

1051 Index

Carbon dioxide (Continued) Cardiac failure (Continued) Cardiac muscle (Continued) in large intestine, 804 causes of, 255 vs. skeletal muscle, 102–104 lipid solubility of, 46 chemical energy expended in, 109, 110 spiraling layers of, 118 from metabolism Cheyne-Stokes breathing in, 512 as syncytium, 101–102, 102f of carbohydrates, 812–813, 813f, 814, circulatory dynamics in, 255–258 three types of, 101 816–817, 816f acute stage, 255–256, 256f, 262, 262f velocity of signal conduction in, 103 mitochondrial, 22 chronic stage, 256–257, 256f in atria, 117 placental diffusion of, 1007 compensated, 256f, 257, 262, 262f by Purkinje fibers, 117 removal by lungs, 5 decompensated, 257–258, 257f, Cardiac output, 229 respiratory control by, 507–508, 507f, 508f 262–263, 263f anemia and, 233, 420–421 transport in blood, 495, 502–504, 502f, graphical analysis of, 262–264, 262f, arterial pressure and, 112, 112f, 216f, 503f, 504f 263f, 264f 217, 217f pH change caused by, 504 definition of, 255 with arteriovenous fistula, 232, 239, in urea synthesis, 835 edema caused by, 298 239f, 240 as vasoconstrictor, 200 efficiency of heart in, 110 blood volume and, 238, 238f as vasodilator, 97, 200 extracellular fluid volume in, 375, 376–377 definition of, 160 in skeletal muscle, 243–244 high-output, graphical analysis of, during exercise, 210, 230, 230f, 232, 244, Carbon dioxide dissociation curve, 503, 503f 263–264, 264f 245, 245f

Carbon dioxide partial pressure (Pco2). See also hypertension and, 218 athletic training and, 1038, 1038f, Hypercapnia. hypertrophy leading to, 272 1039, 1039f alveolar, 488–489, 489f left-sided at high altitude, 529 in deep-sea diving, 537 pulmonary circulation in, 478–479, 481 limits achievable, 231, 231f ventilation-perfusion ratio and, pulmonary edema in, 259, 482, 483 measurement methods for, 240–241, 492–494, 493f unilateral, 259 240f, 241f blood low-output, 259 after myocardial infarction, 250 cerebral blood flow and, 743–744, 744f peripheral edema in, 259–261, 260f of neonate, 1024 chemoreceptors and, 208, 509 pulmonary edema in, 256 normal values of, 160, 229 exercise and, 511, 511f, 1037 as acute edema, 259, 261 pathologically high, 232–233, 233f measurement of, 515–516 decompensated, 258 pathologically low, 232, 233–234, 233f respiratory control and, 507–508, 508f, left-sided, 259 in pregnancy, 1010 510, 510f, 512–513, 512f quantitative graphical analysis of, regulation of in extracellular fluid, 382, 384, 385 262–264, 262f by local tissue flows, 159, 230–231, 234 in acidosis, 390, 391, 392 in acute stage, 262, 262f by nervous system, 111, 111f, 232, 232f in alkalosis, 390, 392 during compensation, 262, 262f quantitative analysis of, 234. See also high levels of, 537 with decompensation, 262–263, 263f Cardiac output curves; Venous return in interstitial fluid, 497–498, 498f in high-output failure, 263–264, 264f curves. oxygen-hemoglobin dissociation curve and, red blood cell production in, 416 by venous return. See Venous return, 500, 500f right-sided, emphysema leading to, 518 cardiac output and. plasma measurement of, 393–395, 394f in thiamine deficiency, 263, 264, 264f, 853 shock and, 273 solubility coefficient and, 486 unilateral, 259 hypovolemic, 274–275, 274f Carbon monoxide Cardiac hypertrophy, 272. See also Ventricular septic, 280 diffusing capacity for, 492, 492f hypertrophy. skeletal muscle contraction and, 209–210 hemoglobin combination with, athletic training and, 1039 sympathetic inhibition and, 239, 239f 501–502, 501f cardiac output and, 231 sympathetic stimulation and, 238–239, 239f Carbonate ions, in bone, 957–958 in congenital heart disease, 272 thyroid hormones and, 913 Carbonic acid after myocardial infarction, 256 total peripheral resistance and, 230–231, in bicarbonate buffer system, 32, 381 in valvular heart disease, 272 230f cerebral blood flow and, 744 Cardiac index, 229 reduced, 232–233 intestinal bicarbonate absorption and, 795 age and, 229, 230f volume-loading hypertension and, 219, 220f pancreatic secretions and, 781, Cardiac muscle, 101–104 Cardiac output curves, 231, 231f, 234–235 782–783, 782f action potentials in. See Action potential(s), combinations of patterns of, 235, 235f in red blood cells, 502–503 cardiac. exercise and, 245, 245f Carbonic anhydrase contractile strength of external pressure on heart and, 234, gastric acid secretion and, 777–778 body temperature and, 112 234f, 235 in kidney, 381 exercise and, 245 in heart failure. See Cardiac failure, bicarbonate reabsorption and, 386–387, sympathetic stimulation of, 111, 120, circulatory dynamics in. 386f, 389f 203, 231 in hypovolemic shock, 276, 276f pancreatic secretions and, 781, 782f thyroid hormones and, 913 with simultaneous venous return curves, in red blood cells, 413, 502, 502f, 503 vagal stimulation and, 111, 203 238–240, 238f zinc in, 856 contraction of Cardiac reserve, 257, 261–262, 261f Carbonic anhydrase inhibitors, 398, 398t, 503 chemical energy for, 109–110 patent ductus arteriosus and, 270 Carboxypolypeptidase, 781, 791 duration of, 104 in valvular disease, 269 Carcinogens, 41 efficiency of, 110 Cardiac surgery, extracorporeal circulation Cardiac. See also Heart. coronary artery arrangement in, 247, 247f during, 271–272 Cardiac arrest, 153 coronary blood flow control and, 247 Cardiogenic shock, 233, 250, 259, 273. See also circulatory arrest and, 281 excitation-contraction coupling in, Circulatory shock. Cardiac catheterization, premature 103–104, 104f Cardiopulmonary resuscitation (CPR), 151, 153 contractions caused by, 146 Frank-Starling mechanism and, 110, 111 Cardiotachometer, 144 Cardiac cycle, 104–107, 105f histology of, 101, 102f in sinus arrhythmia, 144, 144f current flows around heart in, 123–124, hypertrophy of, 272. See also Cardiac Cardiotonic drugs, 258, 261 124f hypertrophy. Caries, dental, 971 volume-pressure diagram during, 108–109, infarcted, 249–250 fluorine and, 971 108f, 109f metabolism of, 248 Carnitine, 822 Cardiac failure, 255–264 recording electrical potentials from, Carotenoids, 853 acute, in anemia, 421 123–124, 124f Carotid bodies, 208, 507, 508, 508f, 509, 509f aortic valve lesions with, 268, 269 refractory period of, 103, 103f high altitude and, 529 blood volume in, 376–377 shock-related lesions in, 277–278 rhythmical output signal and, 568, 569f

1052 Index

Carotid sinus baroreceptors, 205–206, 206f, 207 Cell-mediated immunity, 433, 434, 435f, Cerebral cortex (Continued) Carotid sinus syndrome, 144 439–440, 440f. See also T lymphocytes. functional areas of, 667, 668f, 698, 698f, 699f. Carrier proteins, 14, 45, 46 Cellulose, 790, 798 See also Association areas. active transport and, 46, 46f, 52–53 Cementum, 969, 969f, 970 for facial recognition, 700–701, 700f facilitated diffusion and, 46, 46f, 49–50, 49f mineral exchange in, 971 in nondominant hemisphere, 702 Carrier-mediated diffusion. See Facilitated Central fissure, of cerebral cortex, 575, 575f hearing and. See Auditory cortex. diffusion. Central nervous system (CNS). See also Brain; histologic structure of, 697, 698f Cartilage, growth hormone and, 900–901 Spinal cord. language and, 699–700, 699f, 703–705, 704f. Caspases, 40 childhood development of, 1027–1028 See also Speech. CaSR (calcium-sensing receptor), 965 fetal development of, 1020 layers of, 697 Catalases, 536–537 major levels of function in, 545–546 limbic, 714–715, 714f, 720 Cataracts, 604 thyroid hormones and, 913 motor control by. See Motor cortex. Catecholamines. See Epinephrine; muscle tremor and, 913 pain perception and, 586 Norepinephrine. Central nervous system ischemic response, somatosensory. See Somatosensory cortex. Catechol-O-methyl transferase 209, 210–211, 210f, 227, 227f thalamus and, 697–698, 698f epinephrine degradation by, 732 in cardiac failure, acute stage, 255–256, 256f thought and, 705–706 norepinephrine degradation by, 732 in hypovolemic shock, 274, 275 vasomotor center controlled by, 204 Caudate circuit, 690f, 691–692, 691f Central venous catheter, 174 vision and. See Visual cortex. Caudate nucleus, 670, 690, 690f, 691, 691f Central venous pressure, 172. See also Right Cerebral ischemia dopamine system and, 713, 713f atrial pressure. arterial pressure response to, 209 Huntington’s disease and, 694 Centrifugal acceleratory forces, 531–532 vasomotor paralysis caused by, 279–280 neurotransmitters in, 692–693, 692f Centrioles, 12f, 17, 38–39, 38f Cerebrocerebellum, 686, 688–689 Parkinson’s disease and, 693 Centromere, 38, 38f, 39 Cerebrospinal fluid (CSF), 746–749 Caveolae Centrosome, 38 absorption of, 747 of capillary endothelial cells, 178, 178f Cephalic phase barrier between blood and, 748–749 of smooth muscle fibers, 98, 98f of gastric secretion, 779, 780f bicarbonate in, at high altitude, 529 Caveolins, 178, 178f of pancreatic secretion, 782 cushioning function of, 746 CCK. See Cholecystokinin (CCK). Cephalins flow of, 746, 746f, 747 Cecum, ileocecal sphincter and, 770 chemical structure of, 826, 826f formation of, 746, 747 Celiac disease, 801 thromboplastin and, 826 obstruction to flow of, 748 Celiac ganglion, 729, 730f, 757 Cerebellum, 681–689 osmolarity of, 747 Cell(s), 3, 11–25, 11f, 12f anatomical folds of, 682, 682f thirst and, 358 basic characteristics common to, 3 anatomical functional areas of, perivascular spaces and, 746, 747, 747f basic substances of, 11, 12 681–682, 682f spaces occupied by, 746, 746f compared to precellular life, 17–18, 18f auditory pathways and, 639 Cerebrospinal fluid pressure, 747–748 cytoplasm of, 11, 11f, 14 ballistic movements and, 688 decreased, headache caused by, 591 cytoskeleton of, 11, 16–17, 17f basal ganglia and, 690f elevated damaged, lysosomal removal of, 19–20 clinical abnormalities of, 689 blood pressure response to, 209, functional systems of, 18–23 smooth progression of movements 210–211, 210f for digestion, 19–20, 19f. See also and, 688 papilledema secondary to, 748 Lysosomes. correction of motor errors by, 686 in pathological conditions, 748 for energy extraction, 21–23, 22f damping function of, 687–688, 689 respiratory depression secondary for ingestion, 18–19, 18f deep nuclei of, 683–684, 684f, 685 to, 512 for synthesis, 20–21, 20f functional unit of, 684–685, 684f measurement of, 748 life cycle of, 37 gamma efferents and, 659 normal level of, 747 locomotion of, 23–25, 23f, 24f inhibitory cells in, 685, 686 Cerebrovascular disease, dementia in, 728 membranous structures of, 13–14, 13f input pathways to, 682–683, 683f CFU (colony-forming unit), 414f, 415 nuclear membrane of, 11, 11f, 13, 17, 17f in integrated motor control, 694 cGMP. See Cyclic guanosine monophosphate nucleoli of, 12f, 17, 17f, 32 motor cortex fibers leading to, 670 (cGMP). nucleus of, 11, 11f, 17, 17f output signals from, 683–684, 684f Channels. See Ion channels; Protein channels. evolution of, 18 overall motor control by, 681, 686–689, 687f Chemical gating. See Ligand-gated channels. number of, in human body, 3 representation of body in, 682, 682f Chemical messengers, 881 organelles of, 12, 12f, 14–17. See also turn-on and turn-off signals from, Chemical pain stimuli, 583 Endoplasmic reticulum; Golgi 685–686, 694 tissue damage and, 584 apparatus; Lysosomes; Mitochondria; vestibular system and, 677, 678, 678f visceral, 588 Peroxisomes. Cerebral blood flow, 743–746 Chemical synapses, 546–547 overall structure of, 11, 11f, 12, 12f autoregulation of, 744–745, 745f Chemical thermogenesis, 873 secretory vesicles of, 16, 16f, 21 blockage of, 745–746. See also Stroke. Chemiosmotic mechanism, of ATP formation, Cell death, apoptotic, 40 cessation of, 743 22, 814–815, 814f Cell differentiation, 39–40 in hypovolemic shock, 274–275 starting with fatty acids, 823 Cell growth, 39 local neuronal activity and, 744, 745f Chemoreceptor reflexes, 208 of cancer cells, 41 measurement of, 744 in cardiac failure, acute stage, 255–256, 256f Cell membrane, 11, 11f, 13–14, 13f, 45, 46f microcirculation in, 745 in integrated pressure response, 227, 227f cholesterol in, 13, 14, 827 normal rate of, 743 oscillation of, 210 diffusion through. See Diffusion through regulation of, 195, 743–745, 744f, 745f Chemoreceptor trigger zone, 803f, 804 cell membrane. vessel architecture for, 743, 743f Chemoreceptors, 208, 508–510, 508f, 509f, oxygen toxicity to, 537 Cerebral cortex, 545–546 559, 560b phospholipids in, 826, 827 anatomic divisions of, 574–575, 575f at high altitude, 529 replenishment of, 21 brain stem excitatory signals and, Chemosensitive area, of respiratory center, Cell reproduction, 37–39, 38f 711–712, 712f 507–508, 507f control of, 39 connections between hemispheres of, Chemotaxis Cell volume 702, 705 ameboid movement and, 24 hypernatremia-related changes in, 296 corticofugal signals from complement protein C5a and, 439, 439f hyponatremia-related changes in, 295, 296f from primary visual cortex, 624 of eosinophils, 430 in intracellular edema, 296 sensory input and, 581–582 of neutrophils and macrophages, 424f, osmotic equilibrium and, 291–292, 292f dimensions of, 697 425, 428 sodium-potassium pump and, 53 equilibrium status and, 678 Chenodeoxycholic acid, 785

1053 Index

Chest leads, 126, 126f Cholesterol ester hydrolase, 792–793 Circulatory shock (Continued) Chewing, 763 Cholesterol esterase, 781 causes of, 273 Chewing reflex, 763 Cholesterol esters, 826 circulatory arrest and, 281 Cheyne-Stokes breathing, 512–513, 512f dietary, 792 definition of, 273 Chief cells digestion of, 792–793 gastrointestinal vasoconstriction during, 762 gastric. See Peptic (chief) cells. steroid synthesis from, 882 heatstroke with, 876 parathyroid, 963, 963f Cholic acid, 785, 827 hemorrhagic. See Hypovolemic shock. Child, growth and development of, 1027–1028, Choline, in lecithin synthesis, 826 histamine-induced, 280 1027f. See also Infant. Choline acetyltransferase, 551, 732 hypovolemic. See Hypovolemic shock Chills, and fever, 876, 876f Cholinergic drugs, 740 neurogenic, 279–280 Chloride. See also Sodium chloride. Cholinergic fibers, 731–732 sympathomimetic drugs for, 281 absorption of to sweat glands, 870 renal ischemia in, 401 in large intestine, 795, 797 Cholinesterase, 551 septic, 280 in small intestine, 795 Chondroitin sulfate, 20 stages of, 274 anion gap and, 395 Chorda tympani, 647, 648f tissue deterioration in, 273–274, 277–278, in cerebrospinal fluid, 747 Chordae tendineae, 107, 107f 278f diffusion through capillary pores, 179, 180t Chorea, 691 treatment of, 280–281 gastric acid secretion and, 777–778, 778f Choroid, 611 Circulatory system, 4–5, 4f intestinal absorption of, 794, 795, 795f, 797 Choroid plexus, 746, 747, 747f Circus movement, 149–150, 149f, 152 intestinal water secretion and, 787 barriers at, 748–749 after myocardial infarction, 251 neuronal somal membrane and, 552, Chromatic aberration, 631 Cirrhosis, 838 552f, 553 Chromatids, 38–39 edema in, 298, 377–378, 833 plasma concentration of, with reduced GFR, Chromatin material, 17, 17f Citrate 404, 405f Chromosomes, 17, 38 as anticoagulant, 456, 460 in red blood cells, 502–503 transcriptional regulation and, 36, 38 phosphofructokinase inhibition by, 815 renal reabsorption of, 328 Chronic obstructive pulmonary disease vasodilation caused by, 200 in saliva, 774f, 775, 776 (COPD), ventilation-perfusion Citric acid, in seminal vesicles, 976 in sweat gland secretions, 870–871 abnormalities in, 494 Citric acid cycle, 22, 813–814, 813f, 815 Chloride ion channels Chylomicron remnants, 820, 820f acetoacetic acid and, 823 intestinal, 795 Chylomicrons amino acid degradation products in, 835 diarrhea and, 796 formation of, 797, 819 fatty acid oxidation and, 822–823 of postsynaptic neuronal membrane, 548, pathways involving, 820f fatty acid synthesis and, 825 550, 554 removal from blood, 819–820 with excess glucose, 943 presynaptic inhibition and, 554 transport of, 819 Clathrin, 18–19, 18f Chloride shift, 502–503 Chyme at neuromuscular junction, 86 Chloride-bicarbonate exchanger, 795 in colon, 770, 797 Clearance methods, renal, 340–343, 340t, Chloride-iodide counter-transporter, 908 in small intestine, 768, 769, 770, 781, 782 341f, 342f, 343t Cholecalciferol. See Vitamin D. cholecystokinin and, 783 Climacteric, male, 984 Cholecystokinin (CCK), 758, 758t water absorption and, 794 Climbing fibers, 684, 684f, 685, 686 food intake and, 846, 846f, 847f, 848 in stomach, 765, 766, 767–768 Clonus, 660, 660f gallbladder emptying and, 768, Chymotrypsin, 781, 791 Clostridial infections, hyperbaric oxygen 785, 784f Chymotrypsinogen, 781 therapy for, 540 molecular structure of, 780 Cilia, 24–25, 24f. See also Stereocilia. Clot dissolution or fibrous organization, 453 pancreatic secretions and, 782, 783 of fallopian tubes, 993–994, 1003, 1004 Clot formation, 452, 452f, 454. See also Blood small intestine peristalsis and, 769 of respiratory epithelium, 473 coagulation. stomach emptying and, 768 of vestibular hair cells, 675, 675f, 676 outside the body, 460 Cholera, 796, 802 Ciliary body, aqueous humor formed by, Clot lysis, 457 Cholesterol, 826–827 606, 606f Clot retraction, 452, 452f, 454 absorption of, bile salts and, 785 Ciliary ganglion, 631, 631f thrombocytopenia and, 458 adrenocortical hormone synthesis from, Ciliary muscle Clotting factors, 452, 452t, 453 922, 923f control of, 601, 631–632, 734t, 735 deficiencies of, 457–458 in bile, 783, 784, 784t, 786 innervation of, 631 initiation of coagulation and, 454–456, gallstones and, 786, 786f Ciliary processes, 606, 606f 455f, 456f bile salts synthesized from, 785 Circle of Willis, 743 Clotting time, 460 blood level of Circulation. See also Blood flow; Systemic CNS. See Central nervous system (CNS). atherosclerosis and, 828, 829 circulation. Coagulation. See Blood coagulation. control of, 827 basic principles of, 4, 4f, 158–159 Coated pits, 18–19, 18f insulin and, 944 fetal, 1022–1023, 1022f adrenocortical hormone synthesis and, 922 thyroid hormones and, 912, 918 microcirculation, 177–178, 178f at neuromuscular junction, 86

of capillary membrane, 178, 178f neonatal Cobalamin. See Vitamin B12. of cell membranes, 13, 14, 827 readjustments in, 1022–1023 Cocaine- and amphetamine-related transcript, in chylomicron remnants, 820 special problems in, 1024, 1024f 846, 847f in chylomicrons, 819 nervous regulation of, 201–204, 202f, Cochlea. See Hearing, cochlea in. dietary, 792 204f. See also Arterial blood pressure Cochlear nerve, 634f, 636–637, 636f, 638 endogenous, 826, 827 control, nervous. Cochlear nuclei, 639, 639f genetic disorders affecting, 827 parts of, 157, 158f Codons, 29f, 30, 31–32, 31t, 32f intestinal absorption of, 793 cross-sectional areas of, 157, 158, 158t Coenzyme A. See Acetyl coenzyme as lipid, 819 pressures in, 158, 159f A (acetyl-CoA). in lipoproteins, 821, 821t volumes of blood in, 157, 158f Colchicine, 39 in seminiferous tubules, 977 Circulatory arrest, 281–282 Cold environment, 877. See also Temperature, steroid hormone synthesis from, 827, 882 vasomotor failure in, 277 body. structure of, 826f, 827 Circulatory shock, 234, 273–282. See also acclimatization to, 873 synthesis of, 826–827 Cardiogenic shock. thyroid-stimulating hormone and, 915 in endoplasmic reticulum, 20 in aldosterone deficiency, 925 Cold receptors, 592–593, 592f. See also in liver, 822, 826, 839 anaphylactic, 280 Thermoreceptive senses. uses of, 827 sympathomimetic drugs for, 281 Cold-sensitive neurons, 871 Cholesterol desmolase, 922, 923f arterial pressure in, 273 Colitis, ulcerative, 771, 802–803

1054 Index

Collagen Cones (Continued) Corpus luteum, 989f, 990–991 ascorbic acid and, 855 photochemistry of, 611, 613, 613f, inhibin secreted by, 991, 997 of bone, 957, 958 614, 614f in pregnancy, 1008 digestion of, 791 spectral sensitivities of, 615, 615f relaxin secreted by, 1009 of lungs, 467 structure of, 609, 610f Cortical level of nervous system, 545–546 of sarcolemma, 71 Congenital heart disease. See also Patent ductus Cortical nephrons, 306, 307f of teeth, 970 arteriosus Corticofugal signals, 581–582 Collagen fiber bundles, 180, 180f, 181 axis deviation in, 135–136, 136f from primary visual cortex, 624 Collateral circulation, 198 cardiac hypertrophy in, 272 Corticopontocerebellar tract, 682, 687 in heart, 249, 249f causes of, 271 Corticorubral tract, 670–671, 671f Collecting duct, 306, 306f, 307f circulatory dynamics in, 269–271, 270f, 271f Corticospinal (pyramidal) tract, 655f, 656, transport properties of, 333–334, 333f valvular, 267 669–670, 670f urine concentration and, 348t, 350, Conn syndrome. See Aldosteronism, primary cerebellum and, 687, 687f 350f, 352f, 353 Connecting tubule, 306, 306f corticorubrospinal pathway and, 670–671 Collecting tubule, 306, 306f, 332–333, Consciousness, 706 lesions in, 673 332f, 333f Constipation, 802 Corticosteroids. See Adrenocortical hormones. aldosterone and, 337 Constricted lung diseases, 516, 516f Corticosterone urine concentration and, 346, 346f, 348t, Constrictor waves, gastric, 766 activity of, 928 352f, 353 Contact junctions, of smooth muscle, 95 properties of, 922, 924t Colloid, of thyroid gland, 907, 907f, 908, 909 Contact lenses, 604 synthesis of, 922, 923f Colloid goiter, 917 Contraception Corticotropes, 896, 896t, 897, 933–934 Colloid osmotic pressure. See also Osmotic hormonal, 1001 Corticotropin. See Adrenocorticotropic pressure rhythm method of, 1001 hormone (ACTH; corticotropin) interstitial fluid, 181, 181f, 184, 184t, 185t Contractility, cardiac. See Cardiac muscle, Corticotropin-releasing factor (CRF). See in lungs, 481, 482t contractile strength of. Corticotropin-releasing hormone lymph flow and, 188, 189 Contrecoup injury, 746 (CRH). plasma, 181, 181f, 184, 184t, 185t Control systems of body, 6–9. See also Corticotropin-releasing hormone (CRH), albumin and, 184, 184t, 833 Feedback; Homeostasis. 898, 898t, 931–932 lymph flow and, 188 adaptive, 9 appetite suppression by, 849 plasma substitutes and, 281 for arterial blood pressure, 6, 7–8. See also Cortisol, 921 reabsorption in kidney and, 335–337, 335f, Arterial blood pressure control. anti-inflammatory effects of, 930–931 336t, 337f for extracellular fluid characteristics, 7 in allergic reactions, 931 Colon. See Large intestine (colon). carbon dioxide concentration, 6, 7 carbohydrate metabolism and, 928 Colonoileal reflex, 757 oxygen concentration, 6 chemical formula of, 922, 923f Colony-forming unit (CFU), 414f, 415 gain of, 7–8 circadian rhythm of secretion, 933, 933f Color blindness, 616, 616f Convective heat loss, 869, 869f concentration in blood, 924 Color blobs, 625, 625f clothing and, 869–870 deficiency of, 934 Color vision, 615–616, 615f, 616f in water, 869 excess of, 935–936 dorsal lateral geniculate nucleus and, 624 wind and, 869 fat metabolism and, 929 ganglion cells in, 619, 620–621 Convergence, in neuronal pathways, 566, 566f gluconeogenesis and, 817 pigments in, 609, 614, 614f Converting enzyme, 220–221, 220f insulin secretion and, 947 visual cortex and, 624f, 625, 625f, 626, 627 COPD (chronic obstructive pulmonary lymphocytopenia caused by, 931 white light and, 616 disease), ventilation-perfusion mechanism of action, 931 Colostrum, 1014 abnormalities in, 494 mineralocorticoid activity of, 924–925 Coma Cord righting reflex, 664 plasma protein binding of, 923 hepatic, 835 Cordotomy, 586 properties of, 922, 924t vs. sleep, 721 Corona radiata, 989f, 990, 1003, 1004f protein metabolism and, 928–929 Committed stem cells, 414, 415, 423–424 Coronary arteries, 246, 246f regulation of, by ACTH, 931–934, 932f Compensatory pause, 146 acute occlusion of, 248–249. See also stress and, 929, 930, 930f Complement system, 433, 438–439, 439f Myocardial infarction. synthesis of, 922, 923f opsonization and, 425 causes of death after, 250–251 Cortisol-binding globulin, 923 Complete atrioventricular block, 145, 145f collateral circulation and, 249, 251, 256 Cortisone, 922, 924t Complete protein, 835 arrangement within cardiac muscle, Co-transport, 54–55, 55f. See also Sodium Complex cells, of visual cortex, 626, 627 247, 247f co-transport. Complex spike, 684 collateral circulation involving, 249, 249f renal tubular, 325–326, 326f Compliance, pulmonary Coronary artery bypass surgery, 252, 259 Cough reflex, 473, 512 of lungs, 467, 467f Coronary artery disease, 246, 248–250 Coumarins, 459–460 of lungs plus thorax, 468 catheter-based treatment of, 253, 259 Counter-transport, 54, 55, 55f Compliance, vascular. See Vascular compliance. pain in, 252. See also Angina pectoris. renal tubular, 326, 326f Conceptus, 1005 Coronary artery spasm, 249 Coup injury, 746 Concussion, brain edema secondary to, 749 Coronary blood flow Coupled chemical reactions, 809 Conductance of blood vessels, 163 control of, 247–248 Cowper glands. See Bulbourethral glands. in parallel circuit, 164 adenosine in, 193 CPR (cardiopulmonary resuscitation), 151, 153 Conduction system. See Heart, excitatory and epicardial vs. subendocardial, 247, 247f Cramp, muscle, 665 conductive system of during exercise, 246 Cramping pain, visceral, 588–589 Conductive heat loss, 869, 869f in hypovolemic shock, 274–275, 276 Creatine phosphate. See Phosphocreatine. clothing and, 869–870 phasic changes in, 246, 246f Creatinine in water, 869 at rest, 246 chronic renal failure and, 406 Cones, 609 Coronary blood supply, 246, 246f excretion of, 329 of central fovea, 619 Coronary embolus, 248–249 with reduced GFR, 404, 405f color blindness and, 616 Coronary steal, 251–252 placental diffusion of, 1007 dark adaptation by, 614–615 Coronary thrombosis, 248–249 plasma concentration of, 341, 341f, 342f electrotonic conduction in, 617–618 collateral development following, 198 with reduced GFR, 404, 405f neural circuitry and, 616–617, 617f spasm leading to, 249 Creatinine clearance, 341 pathway to ganglion cells, 617, 617f Coronary venous blood flow, 246 Cretinism, 918, 1026 neurotransmitter released by, 617 Corpus albicans, 991 CRF (corticotropin-releasing factor). See number of, 619 Corpus callosum, 702, 705 Corticotropin-releasing hormone (CRH).

1055 Index

CRH (corticotropin-releasing hormone), 898, D Dentate nucleus, 683, 684, 684f, 688 898t, 931–932 DAG (diacylglycerol), 890 lesions of, 689 appetite suppression by, 849 Dark adaptation curve, 614–615, 614f Dentin, 969, 969f, 970 Cribriform plate, 651 Dead space caries and, 971 Crisis, febrile, 876, 876f anatomic, 471–472 development of, 970, 970f Crista ampullaris, 675f, 676, 676f, 677 physiologic, 471–472, 493, 494 mineral exchange in, 971 Critical closing pressure, 166, 166f Dead space air, expired air and, 489, 489f Dentinal tubules, 970 Crossed extensor reflex, 663, 663f Dead space volume, 471, 471f Deoxycorticosterone, 922, 923f, 924t Crown, of tooth, 969, 969f Deafness, 642, 642f Deoxyribonucleic acid. See DNA Cryptorchidism, 977–978 Deamination of amino acids, 834–835, 839 (deoxyribonucleic acid). Crypts of Lieberkühn, 773, 786–787, 786f Decarboxylases, 814 Deoxyribose, 27, 28f of large intestine, 787 Decerebrate rigidity, 674 Depolarization, of action potential, 61, 61f, extreme diarrhea and, 796, 802 Decibel unit, 638–639, 638f 64–65 CSF. See Cerebrospinal fluid (CSF). Decidua, 1005 calcium channels and, 64 Cupula, 676, 676f, 677 Decidual cells, 1005, 1008 Depolarization waves, 121–123, 122f. See also Curare, 85 Declarative memory, 706 P wave; QRS complex. Curariform drugs, 86 Decompression sickness, 537, 538–539, 538f current flow in chest and, 124, 124f Current of injury, 138–141 Decremental conduction, 556, 556f slow conduction of, T wave and, 142 fibrillation tendency and, 250–251 Deep cerebellar nuclei, 683–684, 684f, 685, 688 l-Deprenyl, 693 J point and, 138–140, 139f lesions of, 689 Depression, mental, 726–727 myocardial ischemia or infarction and, 138, Deep nuclear cells, 684–685, 684f, 687 Depth of focus, 602, 602f 140–141, 140f, 141f Deep receptors, 560b, 580 Depth perception, 605, 605f, 630 QRS complex and, 138, 139f Deep sensations, 571 Dermatomes, 582, 582f Cushing disease, 935 Deep-sea diving, 535–540 Desmopressin, 354–355 Cushing reaction, 209 decompression after, 537–539 Detoxification, enzymes for, 20 Cushing syndrome, 935–936, 935f depth of Detrusor muscle, 306–308, 307f, 309 diabetes mellitus in, 952 gas volume vs., 535 micturition reflex and, 309 ketosis in, 825 pressure vs., 535, 536f parasympathetic fibers to, 308 osteoporosis in, 969 high partial pressures in, 535–539 Deuteranope, 616 Cyanide poisoning, 521 of carbon dioxide, 537 Dexamethasone, 922–923, 924t Cyanosis, 521–522 of nitrogen, 535 Dexamethasone suppression test, 935 Cyclic adenosine monophosphate (cAMP). of oxygen, 499, 535–537, 536f Dextran solution, 281 See also Adenylyl cyclase. with SCUBA apparatus, 539, 539f α-Dextrinase, 790 ACTH and, 932 Defecation, 771–772 DHEA. See Dehydroepiandrosterone adrenergic or cholinergic receptors parasympathetic stimulation and, 787 (DHEA). and, 733 Defecation reflexes, 771–772, 771f, 803 Diabetes insipidus, 295 aldosterone and, 927 parasympathetic, 738, 757, 771, 771f central, 354 antidiuretic hormone and, 905 spinal, 757 nephrogenic, 354–355, 408 chloride channels and, 796 Defibrillation Diabetes mellitus, 939, 950–954 glucagon and, 948 atrial, 152 acidosis in, 393 gonadotropic hormones and, 983, 988–989 ventricular, 151, 151f arteriosclerosis and, 953 growth hormone and, 902 in cardiopulmonary resuscitation, 151 atherosclerosis and, 829 hormonal activity and, 889–890, 889b, 890f Deglutition. See Swallowing. brain metabolism in, 749–750 hormone secretion and, 882 Dehydration diagnosis of, 952–953, 953f memory and, 707–708 aldosterone secretion in, 795 end-stage renal disease caused by, in olfactory cilium, 649, 649f in diabetes mellitus, 950 402, 403 parathyroid hormone and, 964–965 diarrhea with, 796 fatty acids in blood in, 821 phosphorylase activation and, 36, 812 hypernatremia caused by, 295, 295t gigantism with, 903 in postsynaptic neuron, 549, 549f in hyponatremia, 294–295, 295t glomerular filtration rate in, 321 as second messenger, 888 hypovolemic shock in, 279 hyperkalemia in, 361 in smooth muscle, 97 fluid therapy for, 280 ketosis in, 823 thyroid hormone and, 914 in neonate, 1024 maternal, 1026 Cyclic guanosine monophosphate (cGMP) Dehydroepiandrosterone (DHEA), 922, 923f, metabolic utilization of nutrients in, 845 nitric oxide and, 195, 196 924t, 934, 980 triglycerides in liver in, 822 penile erection and, 978–979 placental estrogen synthesis from, 1008 type I, 950–951 phosphodiesterase-5 inhibitors and, Dehydrogenases, 813, 814, 815 C peptide in, 940 196, 986 Deiodinase, 909 clinical characteristics of, 952t photoreceptor sodium channels and, deficiency of, 917 fetal morbidity in mothers with, 1026 612–613, 612f, 613–614, 613f Delayed compliance of vessels, 168, 168f treatment of, 953 in postsynaptic neuron, 549, 549f Delayed-reaction allergy, 443 type II, 950, 951–952 in smooth muscle, 97 Delta waves, 723f, 724–725, 725f clinical characteristics of, 952t Cyclosporine, for immunosuppression, in Dementia, 726 large babies of mothers with, 1026 transplantation, 449 in Alzheimer’s disease, 727–728 treatment of, 953 Cystic duct, 783–784 cerebrovascular disease and, 728 urinary glucose excretion in, 327 Cystinuria, essential, 408 in Huntington’s disease, 694 urine output in, 397 Cystitis, 403–404 Demyelination Diacylglycerol (DAG), 890 Cystometrogram, 309, 309f osmotic-mediated, 295 Dialysis, renal, 409–410, 409f

Cytochrome oxidase, 814 in vitamin B12 deficiency, 854 hypertension associated with, 219 cyanide poisoning and, 521 Dendrites, 543, 544f, 547, 547f Dialyzing fluid, 409–410, 410t Cytochromes, of electron transport chain, 814 excitation and inhibition transmitted by, Diapedesis, 415 Cytokines, 881 555–556, 556f by lymphocytes, 425 enzyme-linked receptors for, 888 Dendritic cells, 440 by monocytes, 425 fever and, 875–876 Denervation, of skeletal muscle, 82 by neutrophils, 424f, 425, 428, 429f Cytosine, 27, 28, 28f, 30, 31t Denervation supersensitivity, 737, 737f Diarrhea, 802–803 Cytoskeleton, 11, 16–17, 17f Dense bars, of neuromuscular junction, 83, 84f calcium loss in, 966 Cytosol, 14 Dense bodies, of smooth muscle, 92, 92f hyponatremia caused by, 294–295 Cytotoxic T cells, 440, 441, 441f Dental lamina, 970–971 intestinal absorption capacity and, 797–798

1056 Index

Diarrhea (Continued) Digitalis Down syndrome, Alzheimer’s disease metabolic acidosis caused by, 392 in cardiogenic shock, 259 characteristics in, 728 psychogenic, 802 diuresis caused by, 263 Dreaming, 712–713, 721 as response to irritation, 787 in heart failure, 258 Drinking, threshold for, 358 severe, 796, 797–798 with acute pulmonary edema, 261 Dropped beats, 145, 145f Diastole, 105, 105f decompensated, 263, 263f Ductus arteriosus, 269–270, 270f, 1022, 1022f. duration of, heart rate and, 105 ventricular tachycardia caused by, 149 See also Patent ductus arteriosus. filling of ventricles during, 105f, 106 Digitalis toxicity, T-wave changes in, 142, 142f closure of, 270, 1023 Diastolic blood pressure, 158, 168 Dihydropyridine receptors, 88, 88f Ductus venosus, 1022, 1022f, 1023 age-related increase in, 171, 171f Dihydrotestosterone, 979, 980, 982–983 Duodenocolic reflex, 771 measurement of, 170–171, 170f chemical structure of, 980f Duodenum. See also Small intestine. Diastolic pressure curve, 108, 108f Diisopropyl fluorophosphate, 86 mucus secreted in, 786 Dicer enzyme, 32–33, 33f Diopters, 600, 600f peptic ulcer of, 800, 800f, 801 Diet. See Food intake. Dipeptidases, 791 stomach emptying and, 767–768 Differentiation, cellular, 39–40 Disaccharides Dural sinuses, negative pressure in, 173 Differentiation inducers, of hematopoietic dietary sources of, 789–790 Dwarfism, 902–903 stem cells, 415 digestion of, 787, 789, 790, 790f Dynamic proprioception, 580 Diffuse junctions, of smooth muscle, 94–95 Discharge zone, 565–566, 565f Dynein, of cilia, 25 Diffusing capacity, 491–492, 492f Disse, spaces of, 837, 837f, 838 Dynorphin, 587 at high altitude, 529 Disseminated intravascular coagulation, 459 Dysarthria, 689 Diffusion in septic shock, 280 Dysbarism. See Decompression sickness. of gases. See also Carbon dioxide, diffusion Dissociation constant, 381 Dysdiadochokinesia, 689 of; Oxygen, diffusion of. Distal tubule, 306, 306f. See also Macula densa. Dyslexia, 701, 703 physics of, 485–487, 486f calcium reabsorption in, 368–369 Dysmetria, 689 through respiratory membrane, diluting segment of, 331 Dyspnea, 522 485, 486, 487, 489–492, 492f potassium secretion by, 364, 366, 366f as molecular and ionic motion, 46 transport properties of, 331–333, 332f, 333f E osmosis and, 290 urine concentration and, 346, 346f, 348t, Ear. See Hearing. Diffusion across capillary walls, 4–5, 4f, 350, 350f, 352f, 353 ECG. See Electrocardiogram (ECG). 179–180, 179f Distensibility, vascular, 167–168, 168f. See also Echocardiography, cardiac output estimated concentration difference and, 180 Vascular compliance. by, 240 molecular size and, 179–180, 180t Diuretics, 397–399, 398f, 398t Eclampsia, 1011 Diffusion coefficient of a gas, 487, 487t for essential hypertension, 226 Ectopic beat. See Premature contractions. respiratory membrane and, 490–491 in heart failure, 258 Ectopic foci, causes of, 146 Diffusion potential, 57–58, 57f with acute pulmonary edema, 261 Ectoplasm, 16 resting membrane potential and, hyponatremia caused by, 294–295 Eddy currents, 161 60, 60f metabolic alkalosis caused by, 393 Edema, 296–300 Diffusion through cell membrane, 18, 45, Divergence, in neuronal pathways, 566, 566f capillary filtration and, 185–186 46–47, 46f. See also Ion channels; Diving. See Deep-sea diving. cerebral. See Brain edema. Protein channels. DNA (deoxyribonucleic acid), 27, 27f. See also extracellular, 297 vs. active transport, 45–46 Transcription. in cirrhosis, 298 facilitated, 46, 46f, 49–50, 49f methylation of, 36 excess fluid and, 373, 373f in glucose reabsorption, 326, 326f mitochondrial, 16 general causes of, 297 in sodium reabsorption, 325 nuclear location of, 17, 17f in heart failure, 298 in pores and channels, 46–48, 46f, 47f, replication of, 37–38 in kidney disease, 298 48f, 49f structure of, 27–29, 28f, 29f plasma protein decrease with, 298 rate of, 49, 49f viral, 18 safety factors preventing, 298–300, factors affecting, 50–51, 50f DNA ligase, 37–38 299f, 373 simple, 46, 46f DNA polymerase, 37–38 specific causes of, 297–298 vs. facilitated diffusion, 49, 49f DNA proofreading, 37–38 generalized, in renal failure, 406 of water, 46, 47, 51–52, 51f DNA repair, 37–38 histamine-induced, 199–200 Diffusion through interstitium, 180–181 Dominant hemisphere, 701–702 hypoproteinemic, in neonate, 1027 Diffusion through respiratory membrane, 485, corpus callosum and, 705 hypoxia associated with, 521 486, 487, 489–492, 492f. Donnan effect, 184, 287 interstitial fluid pressure and, 189 See also Carbon dioxide, diffusion of; l-Dopa, 693, 727 interstitial free fluid in, 181, 299 Oxygen, diffusion of. Dopamine intracellular, 296 Digestion, 789–793 in basal ganglia, 692–693, 692f myxedema, 917–918, 918f of carbohydrates, 789–790, 790f Parkinson’s disease and, 693 in nephrotic syndrome, 377 pancreatic enzyme for, 781, 790 as central nervous system transmitter, 551 nonpitting, 299 of fats, 789, 791–793, 791f in norepinephrine synthesis, 732 of optic disc, 748 of proteins, 789, 790–791, 791f prolactin secretion and, 1015 pitting, 299 enterogastric reflexes and, 767, 768 schizophrenia and, 727 in potential spaces, 300 pancreatic enzymes in, 781, 791 Dopamine system, in brain, 712, 713, 713f Edinger-Westphal nucleus, 631, 631f, 632 Digestive enzymes, 773 Doppler flowmeter, 160–161, 161f EEG. See Electroencephalogram (EEG). gastric. See Pepsin. Dorsal column–medial lemniscal system, Effectors, 543 intestinal, 787, 790 573–580 Efference copy, 683, 687 pancreatic, 780–781 anatomy of, 573–574, 573f, 574f, 575f Efferent arteriole(s), renal, 304–305, 305f, 306, carbohydrates and, 781, 790 overview of, 573 307f, 311f cholecystokinin and, 783 position sense and, 580 angiotensin II and, 338, 339 fats and, 781, 792–793, 792f rapidly changing sensations in, 579 glomerular filtration rate and, 315, 316, 316f loss of, 801 signal transmission and analysis in, 577–579, physiologic control of, 317–318 optimal pH for, 783 578f reabsorption rate and, 336 phases of secretion, 782 spatial orientation of fibers in, 574 tubuloglomerular feedback and, 320, 320f proteins and, 781, 791, 791f types of sensations in, 573 Efficiency, of cardiac contraction, 110 regulation of, 782–783, 783f Dorsal lateral geniculate nucleus, Effusion, 300 salivary, 774f, 775, 790 623–624, 623f Einthoven’s law, 125 Digestive vesicle, 19, 19f, 426 Dorsal respiratory group, 505–506, 506f Einthoven’s triangle, 125, 125f

1057 Index

Ejaculation, 979 Electrocardiogram (ECG), vectorial analysis Endoplasmic reticulum, 12f, 14–15, 15f as sympathetic function, 738, 979 of (Continued) gastrointestinal secretions and, 774, 774f Ejaculatory duct, 973, 973f, 976 projected vector in, 130, 130f, 131, 131f Golgi apparatus and, 15, 15f, 20–21 Ejection, period of, 105f, 106, 108, 108f, 109f QRS complex in, 131–132, 132f of muscle fiber. See Sarcoplasmic reticulum. Ejection fraction, 106 T wave in, 133, 133f nuclear membrane and, 17, 17f Elastase, 791 vectorcardiogram in, 134, 134f platelets and, 451, 454 Elastic recoil, 465 ventricular contraction and, 122–123 ribosomes and, 14, 20, 20f, 33–34, 34f Elastin, of lungs, 467 in ventricular fibrillation, 150–151, 151f secretory vesicles and, 16 Electric shock in ventricular hypertrophy, 135–136, 135f, specific functions of, 20, 20f defibrillation with 136f, 137–138 Endoplasmic reticulum vesicles, 15, 15f, atrial, 152 voltage abnormalities in, 136f, 137, 137f 20–21, 20f ventricular, 151, 151f voltage and time calibration of, 123 Endorphins, 587 fibrillation caused by, 150, 150f Electroconvulsive therapy, 727 β-endorphin, 933–934, 933f Electrical alternans, 145–146, 145f Electroencephalogram (EEG), 723, 724 Endostatin, 198 Electrical synapses, 546 epilepsy and, 725, 725f, 726 Endothelial cells Electrocardiogram (ECG) frequencies of waves in, 723, 724–725, 724f of arteries and arterioles in angina pectoris, 141 normal types of waves in, 723f, 724 nitric oxide and, 195–196, 196f atrial contraction and, 122 in sleep and wakefulness, 723, 724, 725, 725f shear stress on, 195–196 in atrial fibrillation, 152, 152f voltages in, 723, 724–725 of capillaries, 177–178, 178f in atrial flutter, 152–153, 153f Electrolytes. See also specific electrolytes. diffusion through, 179–180 in atrioventricular block in gastrointestinal secretions, 774–775 clotting and, 452, 457, 459 first-degree, 144–145, 144f in large intestine, 797–798 of hepatic sinusoids, 837 second-degree, 145, 145f diarrhea and, 797, 802 of lymphatic capillaries, 187, 187f, 188–189 third-degree (complete), 145, 145f renal regulation of, 303, 304f, 311–312 platelet fusion with, 452 in bundle branch block, 136–137, 136f, in stomach contents, 768 Endothelial damage 137f, 138 Electromagnetic flowmeter, 160, 160f atherosclerosis and, 827–828, 828f, 829 T wave and, 142 for cardiac output measurement, 240, 240f endothelin release in, 196 cardiac cycle and, 105, 105f Electromagnetic receptors, 559, 560b Endothelial-derived relaxing or constricting current flows and, 123–124, 124f Electron transport chain, 814–815, 814f factors, 195–196, 196f in electrical alternans, 145–146, 145f Electrotonic conduction, 555, 556, 556f Endothelin, 196 high-voltage, 135f, 136f, 137 in retinal neurons, 617–618 glomerular filtration rate and, 318 premature ventricular contractions with, ELISA (enzyme-linked immunosorbent Endotoxin 146–147 assay), 892, 892f in circulatory shock, 277 leads used for, 124–127, 125f, 126f. See also Emboli, 459 clotting activated by, 459 Bipolar limb leads. Embryo. See also Fetus; Implantation. fever and, 875–876 axes of, 130, 130f ameboid movement by cells of, 24 End-stage renal disease (ESRD), 401–402, 402f, in long QT syndrome, 147, 148f cell differentiation in, 40 402t. See also Renal failure, chronic. low-voltage, 137, 137f early nutrition of, 995, 1005, 1008 dialysis for, 409–410, 409f, 410t in myocardial ischemia or infarction Emission, 979 hypertension associated with, 219 current of injury and, 140–141, 140f, 141f Emmetropia, 602, 602f transplantation for, 409 in mild ischemia, 142, 142f Emotional arousal, thyroid-stimulating End-systolic volume, 106, 108, 109f normal, 121–123, 121f hormone and, 915 Energy abundance, insulin and, 939–940 vectorial analysis of, 131–134, 132f, 133f Emotions. See Limbic system. Energy equivalent of oxygen, 863 normal voltages in, 123 Emphysema, pulmonary, 517–518, 518f Energy expenditure, 863–865. See also in paroxysmal tachycardia low-voltage ECG associated with, 137 Metabolic rate. atrial, 148, 148f respiratory surface area in, 491 in cachexia, 852 ventricular, 148–149, 149f ventilation-perfusion abnormalities in, components of, 863, 863f in partial intraventricular block, 494, 518 for daily activities, 863 145–146, 145f Enamel, of teeth, 969–970, 969f for essential metabolic functions, position of heart in chest and, 135 development of, 970, 970f 863–864, 864f with premature contractions mineral exchange in, 971 hypothalamus and, 846, 849 atrial, 146, 146f resistance to caries, 971 for nonshivering thermogenesis, 865 A-V nodal or A-V bundle, 146, 146f End plate potential, 84, 85–86, 85f for physical activities, 864, 864t ventricular, 146–147, 147f End-diastolic pressure, 108 for processing food, 864–865 QRS prolongation in, 137–138, 141 as preload, 109 of pulmonary ventilation, 468 QRS with bizarre patterns in, 138, 141 End-diastolic volume, 106, 108, 109f for skeletal muscle contraction, 73, 74, 75, recording methods for, 123 Endocochlear potential, 637–638 76, 78–79 in sinoatrial nodal block, 144, 144f Endocrine glands Energy release in sinus bradycardia, 143f anatomical loci of, 881, 882f heat as end product of, 862 in sinus tachycardia, 143, 143f autonomic control of, 734t, 735 rate of, 861–862. See also Metabolic rate. torsades de pointes in, 147, 148f energy from ATP for, 859 Energy sources. See Adenosine triphosphate vectorial analysis of, 129–142 in infancy, problems of, 1026 (ATP), as energy currency; Fats, as atrial T wave in, 133–134, 133f overview of, 883t energy source; Food(s), energy axes in, 130, 130f regulatory functions of, 5–6 available in; Glucose, energy axis deviation in, 135–137 Endocrine hormones, 881. See also Hormones. production from; Protein(s), as current of injury in, 138–141, 139f, Endocytosis, 18–19, 18f energy source; Triglycerides, energy 140f, 141f adrenocortical hormone synthesis and, 922 production from. direction of vector in, 129, 130f in ameboid movement, 23, 23f Enhancers, 35f, 36 instantaneous mean vector in, 129, 129f in capillary endothelium, 178 Enkephalins, 587, 587f mean electrical axis in, 134–137, 135f Endogenous pyrogen, 875–876 in basal ganglia, 692–693, 692f of normal ECG, 131–134, 132f, 133f Endolymph, 637–638, 676, 677 Enteric lipase, 792 P wave in, 133–134, 133f Endometrial cycle, 995–996, 995f Enteric nervous system, 755, 756, 756f of potentials in each lead, 130–131, Endometriosis, infertility secondary to, 1001 autonomic influences on, 735, 755, 756–757 130f, 131f Endometrium defecation reflex and, 771 with premature ventricular contractions, estrogen and, 993 gallbladder emptying and, 785 147, 147f implantation in. See Implantation. gastric pepsinogen secretion and, 779 principles of, 129–131 progesterone and, 994 glandular secretions and, 773

1058 Index

Enteric nervous system (Continued) Erythrocytes. See Red blood cells (erythrocytes). Exercise (Continued) neurotransmitters of, 756–757 Erythropoietin, 304, 416–417, 416f energy expenditure in, 864, 864t pancreatic secretions and, 782 kidney disease and, 304, 406, 416 fat utilization in, 825 peristalsis and, 759 Esophageal reflux, 765 gastrointestinal vasoconstriction during, 762 reflexes in, 757 Esophageal secretions, 776–777 glucagon secretion and, 948–949 sensory fibers and, 755, 757 Esophageal sphincter growth hormone secretion and, 901, 902 small intestine and, 769 lower, 765 hyperkalemia caused by, 362 stomach emptying and, 767 upper, 764 lactic acid produced in, for cardiac Enteritis, 802 Esophagus energy, 816 Enterochromaffin-like cells, 779 achalasia of, 799 life-prolonging effect of, 1041 Enterocytes. See also Villi, intestinal. ulcer of, 800 lymphatic pump during, 188 of crypts, secretions of, 786–787 ESRD. See End-stage renal disease (ESRD). obesity and, 850, 851 digestive enzymes of, 787, 790, 791, 792 β-Estradiol, 991–992, 992f oxygen debt in, 861 replacement of, 787 hepatic degradation of, 993 oxygen diffusing capacity during, 491 Enterogastric reflexes, 757, 767–768 Estriol, 991–992, 992f, 993 oxygen transport during, 498–499, 499f reverse, 780 Estrogen(s), 987, 988f, 991 oxygen uptake by blood during, 495–496 Enterohepatic circulation, of bile salts, 785 breast development and, 994, 1014 oxygen-hemoglobin dissociation curve Enterokinase, 781 chemistry of, 991–992, 992f, 993f and, 500 Enzyme-linked immunosorbent assay in contraceptive drugs, 1001 pulmonary circulation and, 480, 481f (ELISA), 892, 892f excretion of, 993 respiratory regulation during, 510–511, Enzymes, 11, 27 fat deposition and, 994, 1031 510f, 511f G-protein activation of, 887, 887f functions of, 993–994 sweat glands and, 870 hormone receptors linked to, 888, 888f gonadotropin inhibition by, 997, 998 valvular heart lesions and, 269 membrane proteins as, 13, 14 hepatic degradation of, 993 Exercise testing, of cardiac reserve, 261–262 reaction rates and, 861–862, 862f hypersecretion of, 999–1000 Exocytosis, 19, 21 regulation of, 35, 36–37 life cycle variations in, 999, 999f in ameboid movement, 23, 23f synthetic functions of, 35 in luteal phase, 991 of catecholamines, 884 Eosinophilic chemotactic factor, in asthma, 520 in male, 980 of gastrointestinal secretions, 774 Eosinophils, 423, 423t, 424f, 430 menstrual cycle and, 995 of peptide hormones, 882 Epididymis, 973, 973f osteoporosis and, 969 of protein hormones, 882 spermatozoal maturation in, 975, 976 in ovarian follicles, 989, 990 Exophthalmos, in hyperthyroidism, 916, 916f Epidural space, negative pressure in, 183 plasma protein binding of, 993 Expanded tip tactile receptors, 560f, 572 Epilepsy, 725–726, 725f. See also Seizures. in pregnancy, 1007f, 1008 Expiratory compliance curve, 467, 467f neuronal circuits in, 569 preovulatory surge of luteinizing hormone Expiratory reserve volume, 469, 469f Epinephrine and, 997–998 Expired air, 487t, 489, 489f adrenal medullar secretion of, 730, 732, protein deposition in tissues and, 836 External work, cardiac, 108–109, 108f, 109f 736, 884, 921 spermatogenesis and, 975 Exteroreceptive sensations, 571, 678 basal level of, 737 synthesis of Extracellular fluid, 3–4, 286, 286f, 287. See also in hypovolemic shock, 275 in adrenal cortex, 922 Interstitial fluid; Plasma. adrenergic receptors and, 733 in ovaries, 992, 992f, 993f calcium in. See Calcium, in extracellular bronchiolar dilation and, 473 uterine contractility and, 1011–1012 fluid and plasma. coronary blood flow and, 247, 248 Estrone, 991–992, 992f, 993 in chronic renal failure, 406, 406f fatty acid mobilization caused by, 825 Ethacrynic acid, 397 composition of, 7, 7t, 45, 45f, 287, 288f, 288t gastrointestinal smooth muscle and, 755, Eunuchism, 985 distribution between interstitium and blood, 756, 757 female, 999 373, 373f glomerular filtration rate and, 318 Evans blue dye, 290 as internal environment, 3, 9 glucose availability and, 812 Evaporative heat loss, 869, 869f. See also intracellular fluid and, 3–4 insulin secretion and, 947 Sweating. exchange between compartments, 290 metabolic rate and, 867 hypothalamic control of, 872, 872f osmotic equilibrium of, 291–292, 292f phosphorylase activation by, 812 by panting, 871 mixing of, 4–5 for shock, 281 at very high air temperatures, 869 nutrients in, origins of, 5 sweat glands and, 870 Excitation-contraction coupling osmolality of, 52 as sympathomimetic drug, 739 in cardiac muscle, 103–104, 104f osmolarity of. See Extracellular fluid synthesis of, 732, 884 in skeletal muscle, 87, 88–89, 88f, 89f osmolarity. thermogenesis and, 873 Excitatory postsynaptic potential, 553, 553f, pH of, 7, 7t, 380t. See also Acid-base as vasoconstrictor, 199, 204 554, 554f regulation. in skeletal muscle, 244 dendrites and, 556 potassium concentration in, 364, 364f, vasodilation in skeletal muscles and, 204, 244 summation of, 553, 554f, 555 365f, 366f Eplerenone, 332, 333f, 399 Excitatory presynaptic terminals, 547 regulation of, 7 Equilibrium. See also Posture; Vestibular Excitatory receptors, 547, 549–550 carbon dioxide concentration, 6, 7 apparatus. Excitatory stimulus, 565 oxygen concentration, 6 cerebellum and, 686–687 reciprocal inhibition and, 566–567, 567f sodium in. See Sodium, extracellular fluid. exteroceptive information and, 678 Excitatory transmitter, 548 transport through body, 4–5, 4f footpad pressure and, 678 Excited zone, 565–566, 565f volume of. See Extracellular fluid volume. neck proprioceptors and, 678 Excretion rate, calculation of, 340t Extracellular fluid osmolarity. See also Plasma, sensation of, 571 Exercise. See also Sports physiology. osmolarity of. static, 676–677 anaerobic glycolysis in, 860–861 in abnormal states, 292–294, 293f, visual information and, 678 arterial pressure increase in, 205, 210, 293t, 294t Erectile dysfunction, 985–986 232, 232f glucose and, 950 phosphodiesterase-5 inhibitors for, 196 blood flow control to skeletal muscle and, potassium distribution and, 362 Erection 191, 195, 196–197, 198, 243–244 regulation of, 345, 355 female, 1000 cardiac output during, 210, 230, 230f, 232, angiotensin II and aldosterone in, penile, 196, 738, 978–979, 979f 244, 245, 245f 359–360, 359f Erythroblastosis fetalis, 415f, 420, 447–448, athletic training and, 1038, 1038f, by osmoreceptor-ADH system, 345, 1024 1039, 1039f 355–357, 355f, 356f, 357f, 358–359, Erythroblasts, 415f, 420. See also circulatory readjustments in, 244–245 360, 905 Proerythroblasts. coronary blood flow during, 246 by thirst, 357–360, 358t, 359f

1059 Index

Extracellular fluid volume.See also Blood Fallopian tubes (Continued) Fatty acids, as energy source (Continued) volume. estrogenic effects on, 993–994 cortisol and, 929 in abnormal states, 292–294, 293f, 293t, 294t infertility associated with, 1002 regulation of, 825–826 aldosterone and, 925, 925f progesterone and, 995 unavailability of carbohydrates and, 824 antidiuretic hormone and, 375–376 transport of fertilized ovum in, 1004, 1004f free. See Free fatty acids. arterial blood pressure and, 217, 217f transport of sperm in, 1000, 1003 glucagon and, 948 angiotensin II and, 221, 374–375 Familial hypercholesterolemia, 828–829 glucose conversion to, 817 conditions causing large increases in, Fanconi’s syndrome, 408 insulin and, 942 376–378 Farsightedness, 602, 602f, 603, 603f hepatic degradation of, 821–822 depletion of, alkalosis secondary to, 390 Fasciculus, 72f nonesterified, 820 diuretics and, 397, 398f Fast muscle fibers, 79 placental diffusion of, 1007 hypertension and, 218, 219, 220f Fast pain, 583 in plasma measurement of, 289, 289t Fast sodium channels, 64 cortisol and, 929 regulation of, 370–371 in cardiac muscle, 66, 102, 115 forms of, 820 by renal–body fluid system, 371–373, 372f sinus nodal action potential and, 116 growth hormone and, 899, 900, 901 salt and, 217–218 ventricular action potential and, 115–116 protein binding of, 312, 820, 821 salt appetite and, 360 Fastigial nucleus, 683, 684, 684f transport of, 820–821, 822 testosterone and, 982 lesions of, 689 synthesis of thirst and, 358 Fasting blood glucose, 952 from carbohydrate excess, 825 Extracorporeal circulation, in cardiac surgery, Fast-sharp pain pathway, 584–585, 585f insulin and, 943 271–272 Fast-twitch muscle fibers, 1036, 1036t in liver, 824, 824f Extrafusal muscle fibers, 656f, 657, 659 Fat cells. See Adipocytes (fat cells). three most common, 819 Extrapyramidal system, 671 Fatigue transport into mitochondria, 822 Extrasystole. See Premature contractions. of neuromuscular junction, 85–86 from triglyceride hydrolysis, 789, 792 Extrinsic pathway of coagulation, 454–455, of skeletal muscle, 80–81 triglyceride synthesis from, in intestinal 455f, 456 of synapses, 557 epithelium, 797, 819 Eye movements, 627 in reverberatory circuit, 567–568 Fatty liver disease, nonalcoholic, 838 fixation movements, 628–630, 629f, 678 stabilizing effect of, 569–570, 569f Fatty streaks, 827–828 muscular control of, 627–628, 628f Fats. See also Lipids; Triglycerides. Feces neural pathways for, 628, 628f absorption of, 797 bile in, 840 vestibular apparatus and, 677 bile salts and, 785 clay-colored, 842 voluntary, premotor cortex and, 669 deposits of, 821–822. See also Adipose tissue. composition of, 798 Eyes. See also Visual entries. estrogen and, 994, 1031 fat in, 802 accommodation of, 601, 601f dietary formation of, 797–798 autonomic control of, 631–632, 735 gallstones and, 786 intestinal mucus and, 787 pupillary reaction to, 632 types of, 791–792 nitrogen in, 845 autonomic control of, 631–632, 631f, digestion of, 789, 791–793, 791f water loss in, 285, 286t 734t, 735 bile acids and, 783 Feedback equilibrium maintenance and, 678 bile salts and, 785 enzyme regulation and, 37 fluid system of, 606–608, 606f, 607f gallbladder emptying and, 785 genetic regulation and, 37 focusing of. See Accommodation. pancreatic enzymes for, 781, 783f negative, 7–8, 8f, 9 headache associated with, 592 in stomach, 792 delayed, 9 lens of. See Lens, of eye. emulsification of, 792, 792f in hormone systems, 885 ophthalmoscopic examination of, as energy source. See also Triglycerides, positive, 8–9, 8f 605–606, 605f energy production from. in hormone systems, 885 optics of, 600–605 for athletes, 1035, 1035f Feedback gain, 7–8 accommodation in, 601, 601f in diabetes mellitus, 951 body temperature and, 874 camera analogy in, 600, 600f growth hormone and, 899 Feed-forward control, 9 depth of focus in, 602, 602f with high-fat diet, 824 Feeding center, hypothalamic, 845 depth perception in, 605, 605f, 630 hormonal regulation of, 825 Female fertility, 1000–1002 pupillary diameter in, 601–602, 602f insulin and, 943–944, 944f, 947 Female hormones, 987–988. See also Ovarian refractive errors in, 602–604, 602f, liver and, 821–822 cycle; Ovarian hormones. 603f, 604f in feces, 798 plasma concentrations of, 988, 988f visual acuity in, 604–605, 604f in foods Female sexual act, 1000 protruding, in hyperthyroidism, 916, 916f energy available in, 843–844 Female sexual organs, 987, 987f, 988f pupillary diameter of, 601–602, 602f metabolic utilization of, 844–845 in pregnancy, 1009–1010 autonomic control of, 632 glucose storage as, 817 Fenestrated capillaries, glomerular, 312 dark adaptation by, 615 glucose synthesis from, 817 Fenn effect, 76 malabsorption of, 802 Ferritin, 418f, 419–420, 840 F metabolism of, in liver, 839 Fertility, female, 1000–1002 Facial recognition areas, 700–701, 700f neonatal utilization of, 1025, 1026 Fertilization, 977, 1003–1004, 1004f Facilitated diffusion, 46, 46f, 49–50, 49f stomach emptying and, 768 cervical mucus and, 1002 in glucose reabsorption, 326, 326f storage of, 850. See also Adipose tissue. female orgasm and, 1000 in sodium reabsorption, 325 depleted in starvation, 852, 852f limitation to one sperm, 977 Facilitated zone, 565–566, 565f insulin and, 943 prostaglandins and, 976 Facilitation of neurons, 545, 555, 565–566 as thermal insulation, 868 time during cycle and, 1000–1001 memory and, 707–708, 707f Fatty acids Fetal cells, transplantation of, for Parkinson’s F-actin, 75, 75f absorption of, 797 disease, 693 FAD (flavin adenine dinucleotide), 854 bile salts and, 785 Fetal zone, of adrenal cortex, 1008 Fainting amino acid conversion to, 835 Fetus. See also Embryo. acute venous dilation in, 233 beta-oxidation of, 822, 822f, 839 circulation in, 1022–1023, 1022f emotional, 204 chemical structures of, 819 growth of, 1019, 1019f in long QT syndromes, 147 cholecystokinin release and, 783 hemoglobin of, 1006 in Stokes-Adams syndrome, 119, 145 chylomicron release of, 819–820, 820f hormones of, uterine contraction and, 1012 Fallopian tubes as energy source, 822–825, 822f nutrition of, 1005, 1005f. See also Placenta. anatomy of, 987, 987f, 988f in absence of carbohydrates, 823, 825 human chorionic somatomammotropin entry of ovum into, 1003, 1004f for cardiac muscle, 248 and, 1009

1060 Index

Fetus (Continued) Fluid filtration across capillaries, 181–186, 181f. Free nerve endings, 560f, 571 organ system development, 1019–1020 See also Net filtration pressure. fiber types leading from, 572 respiratory movements of, 1019–1020 Fluid retention, renal, in cardiac failure, 256, as pain receptors, 583 testosterone in, 980, 981, 981f, 984 257, 262 spatial summation and, 564, 564f

FEV1 (forced expiratory volume in 1 second), decompensated, 257–258, 263 tickle and itch detection by, 572–573 517, 517f high-output, 264 as warmth receptors, 592 Fever, 875–877, 875f peripheral edema and, 260–261 Free radicals

brain lesions or surgery and, 876 Fluid therapy, calculations for, 292–294, 293f, high alveolar Po2 and, 536–537 chills associated with, 876, 876f 293t, 294t oxygen-derived, high alveolar Po2 and, cortisol and, 930 Fluorine, 856–857 536–537 crisis of, 876, 876f dental caries and, 971 Free-water clearance, 354 heart rate and, 143 9α-Fluorocortisol, 922, 924t Frequency principle, 638 hypothalamic set-point and, 875–876, 876f Fluorosis, 857 Frequency summation, of skeletal muscle metabolic rate and, 864 Flush, febrile, 876, 876f contractions, 80, 80f pyrogens and, 875–876 FMN (flavin mononucleotide), 854 Frostbite, 877 in septic shock, 280 Foam cells, 827–828, 828f Fructose, 790 Fibrillar proteins, 11, 16–17 Focal epilepsy, 725, 726 intestinal absorption of, 796 Fibrin, 453–454, 453f Focal length, 597f, 598–599, 599f in liver, 810, 810f in platelet plug formation, 452, 452f Focal line, 598, 598f, 599f in seminal vesicles, 976 Fibrinogen, 453–454, 453f, 833 Focal point, 597–598, 597f FSH. See Follicle-stimulating hormone (FSH). in seminal vesicle fluid, 976 Folds of Kerckring, 793, 793f Functional residual capacity (FRC), 469, 469f Fibrinolysin, in menstrual fluid, 996 Folic acid, 854 in asthma, 520 Fibrin-stabilizing factor, 451, 454 in fetus, 1020 determination of, 470–471 Fibroblast growth factor, angiogenesis and, 198 impaired absorption of, 802 in neonate, 1024 Fibroblasts, ameboid movement by, 24 red blood cell production and, 417, 420, 854 Furosemide, 331, 331f, 397 Fibromuscular hyperplasia, 403 Follicle(s) Fusiform cells, of cerebral cortex, 697, 698f Fick principle, 240–241, 240f ovarian. See Ovarian follicle(s). FVC (forced expiratory vital capacity), 517, Fields of vision, 627, 627f thyroid, 907, 907f 517f Fifth cranial nerve, reticular excitatory signals thyroglobulin storage in, 909 and, 711–712, 712f Follicle-stimulating hormone (FSH), 896, 896t G Fight or flight reaction, 739 in female, 987, 988–989, 988f G cells, gastric acid secretion and, 779 Filaments, of cytoskeleton, 16 follicular phase and, 989–990, 998 G proteins Filariasis, lymphatic, 297 luteal phase and, 991 calcium-sensing receptor coupled to, 965 Filling pressure. See Mean circulatory filling after menopause, 999 hormone receptors linked to, pressure; Mean systemic filling in pregnancy, 1009 887–888, 887f pressure. preovulatory surge of, 988f, 997, 998 adenylyl cyclase-cAMP and, 889, Filtration coefficient, capillary, 181, 185 regulation of cycle and, 996, 890, 890f glomerular, 312, 314 997–998, 997f inhibitory, 888 peritubular, 336 in male, 983–984, 983f in olfactory cilium, 649, 649f Filtration fraction, glomerular, 312, 315 spermatogenesis and, 975, 983, 983f, 984 in postsynaptic neuron, 548–549, 549f calculation of, 342 Follicular phase, 989–990, 989f, 990f, 998 stimulatory, 888 reabsorption rate and, 336 Food(s) GABA (gamma-aminobutyric acid), 551 Filtration pressure, mean, at pulmonary compositions of, 843, 844t in basal ganglia, 692–693, 692f capillary, 482, 482t energy available in, 809–810, 843–844, 844t Huntington’s disease and, 692–693, Filtration pressure, net, 181, 184, 185–186 regulation of intake and, 843, 845–849, 692f, 694 abnormal, edema and, 185–186 846f, 847f, 847t of granular neurons, 697 First heart sound, 265–266, 267f metabolic utilization of, 844–845 presynaptic inhibition and, 554 First-degree incomplete heart block, thermogenic effect of, 864–865, 867 G-actin, 75 144–145, 144f Food intake, regulation of, 843, 845–849 Gain, of control system, 7–8 Fitness, life-prolonging effect of, 1041. See also factors affecting quantity, 848–849 for body temperature, 874 Exercise. neural centers for, 845–848, 846f, 847f, 847t Galactose, 790 Fixation movements of eyes, 628–630, Foot processes, of astrocytes, 743f, 744 absorption of, 796 629f, 678 Foramen ovale, 1022, 1022f, 1023 in liver, 810, 810f Flagellum of sperm, 24, 975, 975f, 977 Forced expiratory vital capacity (FVC), 517, 517f Gallbladder, 783–784, 784f, 785

Flatus, 798, 804 Forced expiratory volume in 1 second (FEV1), emptying of, 784f, 785 Flavin adenine dinucleotide (FAD), 854 517, 517f Galloping reflex, 664 Flavin mononucleotide (FMN), 854 Foreign chemicals, renal excretion of, 303, Gallstones, 786, 786f Flavoprotein, 814, 823 311–312, 330 blocking pancreatic duct, 801 Flexor reflex, 661–663, 662f, 663f Fornix, 714f, 718–719 obstructive jaundice and, 841 Flocculonodular lobe, 678, 678f, 681, 682f Fourth (atrial) heart sound, 266, 267f Gamma globulins, 833, 840. See also equilibrium and, 686 Fovea, 609, 610f, 616, 617, 617f, 619 Antibodies. inputs to, 683, 683f accommodation and, 631 in neonate, 1025 lesions of, 689 involuntary visual fixation and, 629, 629f Gamma-aminobutyric acid. See GABA vestibular nuclei and, 682f, 683 visual cortex representation of, 624 (gamma-aminobutyric acid). Flowmeters, 160–161, 160f, 161f Fractures Ganglia, autonomic. See Autonomic ganglia. electromagnetic, for cardiac output in hypoparathyroidism, 968 Ganglion cells, of retina, 610f, 617, 617f measurement, 240, 240f muscle spasm associated with, 664–665 cortical input from, 625, 626 Fluid absorption into capillaries, 181, 186. repair of, 960 excitation of, 617, 619–621, 620f See also Net reabsorption pressure. vertebral, acceleratory forces causing, 532–533 number of, 619 Fluid balance Frank-Starling mechanism, 110–111, 229 thalamic input from, 624 of intake and output, 285–286, 286t FRC. See Functional residual capacity (FRC). three types of, 619 in neonate, 1024 Free energy, 809 visual pathway and, 617, 617f Fluid compartments, 286, 286f. See also Free fatty acids. See also Fatty acids. Gap junctions, 546 Extracellular fluid; Intracellular fluid; in adipose tissue, 825 in cardiac muscle, 101–102, 117 Potential spaces. in blood, 820–821, 822 in gastrointestinal smooth muscle, 753 measurement of volumes in, 287–290, during exercise, 825 in unitary smooth muscle, 91 289f, 289t insulin and, 943–944, 944f Gas, gastrointestinal, 798, 804

1061 Index

Gas exchange. See Respiratory membrane; Gastrointestinal secretion(s), 773–788. See also Glands. See Endocrine glands. Ventilation-perfusion ratio. Digestive enzymes. Glans penis, 978 Gas gangrene, hyperbaric oxygen therapy autonomic control of, 734t, 735, 773–774 Glaucoma, 607–608 for, 540 autonomic reflexes and, 738 Glial feet, 745. See also Foot processes. Gases daily volume of, 775t Global aphasia, 703, 704 diffusion coefficients of, 487, 487t esophageal, 776–777 Globin, 840 diffusion of functions of, 773 Globulins, 833. See also Immunoglobulin(s). physics of, 485–487, 486f gastric, 777–780, 777f, 778f, 780f. See also Globus pallidus, 690, 690f, 691–692, 691f through respiratory membrane, Oxyntic (gastric) glands. Huntington’s disease and, 694 485, 486, 487, 489–492, 492f glands providing lesions in, 691 solubility coefficients of, 485–486, 486t complex, 773, 774f neurotransmitters in, 692–693, 692f volume-pressure relationship, 535 secretion mechanism of, 774–775 Glomerular capillaries, 304–306, 311, Gastric. See also Stomach. stimulation of, 773–774 311f, 312–314, 313f Gastric acid. See Hydrochloric acid, types of, 773 colloid osmotic pressure in, 314, 314f, 315, gastric. typical cell of, 774f 315f, 316 Gastric atrophy, 800 of large intestine, 787 fenestrae of, 178, 312 Gastric banding surgery, 851 of liver. See Bile. hydrostatic pressure in, 182, 312, 314, Gastric barrier, 778, 799–800 pancreatic. See Pancreatic secretions. 314f, 315–316 Gastric bypass surgery, 851 pH of, 775t selective permeability of, 178, 179–180, Gastric glands. See Oxyntic (gastric) glands. saliva as, 775–776. See also Salivary glands. 313–314, 313f, 313t Gastric inhibitory peptide (GIP), 758, 758t of small intestine, 786–787, 786f Glomerular filtrate, composition of, 312 gastric secretion and, 780 Gastrointestinal smooth muscle Glomerular filtration, 310–314, 311f stomach emptying and, 768 electrical activity of, 753–755, 754f of representative substances, 323, 324t Gastric phase sympathetic nervous system and, 757 Glomerular filtration rate (GFR) of gastric secretion, 779, 780f as syncytium, 753 advantages of normal high level, 312 of pancreatic secretion, 782 tonic contraction of, 755 aging and, 403, 403f Gastric secretion, 777–780 wall structure and, 753, 754f autoregulation of, 319–321, 319f, 320f gastric glands and. See Oxyntic (gastric) Gastrointestinal tract. See also Enteric nervous in cardiac failure, 260 glands. system. in chronic renal failure, 404–405, 405f, 405t inhibition by intestinal factors, 780 anatomy of, 753, 754f determinants of, 312, 314–316, 314f, 315f, in interdigestive period, 780 autonomic control of, 755, 756–757 316f, 316t phases of, 779, 780f glands and, 734t, 735, 738, 773–774 estimation of pyloric glands and, 777, 778, 779 autonomic reflexes affecting with creatinine concentration, 341, surface mucous cells and, 777, 779 bowel activity and, 772 341f, 342f Gastric ulcer, 800. See also Peptic ulcer. glands and, 738 with inulin clearance, 340–341, 340t, 341f Gastrin, 758, 758t blood flow in, 759–762 as fraction of plasma flow, 312 gastric acid secretion and, 778, 779 arterial blood supply, 760–761, 760f physiologic control of, 317–319, 318t molecular structure of, 779, 780 during exercise or shock, 762 in pregnancy, 1011 secretion of, 777, 778 gut activity and, 761 Glomerulonephritis duodenal, 779 through intestinal villi, 761–762, 761f acute, 400 small intestine peristalsis and, 769 nervous control of, 762 autoimmune, 442 stomach emptying and, 767, 768 splanchnic circulation and, 759–760, 760f chronic, 403 Gastrin cells, 779 functional aspects of, 753 hypertension in, 407 Gastritis, 799–800 glands in. See Gastrointestinal secretion(s). nephrotic syndrome in, 404 Gastrocolic reflex, 757, 771 homeostatic functions of, 5 end-stage renal disease caused by, 402 Gastroenteric reflex, 769 reflexes affecting, 757 Glomerulosclerosis, 403 Gastroesophageal sphincter, 765 sensory nerve fibers from, 755, 756f, 757 Glomerulotubular balance, 319, 334–335 Gastroileal reflex, 769–770 wall structure of, 753, 754f. See also Glomerulus(i), in olfactory bulb, 649f, 651 Gastrointestinal hormones, 757–759, Gastrointestinal smooth muscle. Glomerulus(i), of kidney, 305–306 758t, 761 Gated channels, 47, 48, 48f, 49f age-related loss of, 403, 403f glandular secretions and, 774 G-CSF (granulocyte colony-stimulating factor), Glomus cells, 509 insulin secretion and, 947 in inflammation, 430, 430f Glossopharyngeal nerve small intestine peristalsis and, 769 GDP. See Guanosine diphosphate (GDP). carotid baroreceptors and, 205, 206f stomach emptying and, 768 Gene(s), 27–29 carotid bodies and, 508f, 509 Gastrointestinal motility nuclear location of, 17 in circulatory control, 203 autonomic influences on, 735 schema of control by, 27, 27f swallowing and, 764f, 765 of colon, 770–772, 770f, 771f. See also silencing of, 33 taste signals and, 647, 648f Defecation. Gene expression, 27 Glossopharyngeal neuralgia, 590 enteric nervous system and. See Myenteric cell differentiation and, 40 Glucagon, 947–949 plexus. regulation of, 35–36, 35f chemistry of, 947 hormonal control of, 757–759, 758t microRNA in, 32–33, 33f fat metabolism and, 948 movements in. See Mixing movements, Gene transcription. See Transcription. glucose metabolism and, 947–948 gastrointestinal; Peristalsis; Propulsive Genetic code, 29, 29f for hypoglycemic shock, 954 movements. Geniculocalcarine tract, 623, 623f, 625 insulin and, 947, 949 muscle properties and. See Gastrointestinal Germ cells, primordial, 973, 974f phosphorylase activation by, 812, 948 smooth muscle. Germinal epithelium, 987 regulation of secretion of, 948–949, 948f parasympathetic tone and, 737 GFR. See Glomerular filtration rate (GFR). secretion of, by alpha cells, 939, 947 reflexes affecting, 757 GH. See Growth hormone (GH; somatotropin). small intestine motility and, 769 sensory nerve fibers and, 757 Ghrelin, 846, 846f, 847f, 848 somatostatin and, 949 of small intestine, 768–770, 768f, 770f growth hormone secretion and, 901 Glucagon-like peptide, appetite and, 848 of stomach GHRH (growth hormone–releasing hormone), Glucocorticoids, 921, 928. See also Cortisol. mixing function of, 765, 766 898, 898t, 901–902 deficiency of, 934, 935 peristalsis in, 766, 767 Giant pyramidal cells, 669–670 excess of, 935–936 swallowing and, 763–765, 764f Gigantism, 903 gluconeogenesis and, 817 thyroid hormones and, 913 Gigantocellular neurons, 713, 713f for immunosuppression, in Gastrointestinal obstruction, 804, 804f GIP. See Gastric inhibitory peptide (GIP). transplantation, 449 plasma loss in, 279 Gitelman’s syndrome, 408 ketogenic effect of, 825

1062 Index

Glucocorticoids (Continued) Glutamate Golgi tendon organs, 560f, 657, 661, 661f nongenomic effects of, 931 at Aδ pain fiber endings, 585 cerebellar input from, 661 pregnancy and, 1009 in basal ganglia, 692–693 feedback to motor cortex, 672 properties of, 922–923, 924t at C pain fiber endings, 586 nerve fibers from, 564, 656f protein metabolism and, 835 as central nervous system transmitter, 551 Gonadotropes, 896, 896t for shock, 281 cochlear hair cells and, 637 Gonadotropic hormones. See also synthesis of, 922 of granular neurons, 697 Follicle-stimulating hormone (FSH); Glucokinase, 811, 811f, 942, 945, 945f as photoreceptor transmitter, 617 Luteinizing hormone (LH). Gluconeogenesis, 817 schizophrenia and, 727 female infertility and, 1001 from amino acids, 835 umami taste and, 646 female sexual cycle and, 988–991, 990f blood glucose concentration and, 839 Glutamic acid, 834 life cycle variation in, 998f cortisol and, 928 Glutamine in male, 983–984, 983f glucagon and, 947, 948 as amino radical donor, 834 pineal gland and, 986 insulin and, 942, 944 ammonium ion produced from, Gonadotropin-releasing hormone (GnRH), in kidneys, 304 388–389, 389f 898, 898t in neonate, 1025 Gluten enteropathy, 801 in childhood, 999 Glucose Glycerol, 789, 819 in female, 987, 988, 996–997, 997f absorption of, 796 as energy source, 822 in male, 983, 983f for athletes, 1035 glucose synthesis from, 817 genetic deficiency of, 985, 985f for brain cells, 749–750 triglyceride hydrolysis and, 820 puberty and, 984 from carbohydrate digestion, 790, 790f Glycerol esters, in plasma, 820 Gradient-time transport, 327–328 central role of, in carbohydrate metabolism, Glycerol-3-phosphate, 822 Grand mal epilepsy, 725–726, 725f 810, 810f α-Glycerophosphate, 820, 824, 824f, 825 Granular cells, of cerebral cortex, 697, 698f in cerebrospinal fluid, 747 Glycine, as central nervous system Granular endoplasmic reticulum, 14, 15f, circulatory shock and, 277, 281 transmitter, 551 20, 20f cortisol and utilization of, 928 Glycinuria, simple, 408 Granule cell layer, of cerebellum, 684–685, diffusion through capillary pores, 179, 180t Glycocalyx, 14 684f energy production from, 812 endothelial, clotting activation and, 456–457 Granule cells, in olfactory bulb, 650, 652 acetyl-CoA and, 812–813 Glycogen, 12, 14, 20, 811–812 Granulocyte colony-stimulating factor citric acid cycle and, 813–814, 813f glucose storage as, 811, 817 (G-CSF), in inflammation, 430, 430f efficiency of, 815 as anaerobic energy source, 860–861 Granulocyte-monocyte colony-stimulating glycolysis and, 812, 812f compared to fat storage, 824–825 factor (GM-CSF), in inflammation, oxidative phosphorylation and, depleted in starvation, 852 430, 430f 814–815, 814f insulin and, 941, 942 Granulocytes, 423, 423t, 424, 424f. See also by pentose phosphate pathway, in muscle, 941 Basophils; Eosinophils; Neutrophils. 816–817, 816f in skeletal muscle, 78, 80–81, 811, 941 produced in inflammation, 429, 430, 430f as preferred source, 825 during exercise, 1032, 1032t, 1035 Granulosa cell tumor, 1000 summary of, 815 recovery of, 1034, 1035f Granulosa cells, 987, 989, 989f, 990. See also in extracellular fluid, normal range of, Glycogenesis, 811, 811f Corona radiata. 7, 7t Glycogen-lactic acid system, 1033–1034, 1033f, of corpus luteum, 991 facilitated diffusion of, 50, 810–811 1034b, 1036 estrogen synthesis in, 992, 993f insulin and, 811 Glycogenolysis, 811–812, 811f inhibin secreted by, 991, 997 placental, 1007 glucagon and, 947–948 Graves disease, 916 in renal reabsorption, 326, 326f Glycolipids, of cell membrane, 14 Gravitational pressure fatty acids derived from, 817 Glycolysis, 22, 812, 812f, 815 arterial pressure and, 174 in fetal metabolism, 1007, 1020 anaerobic, 815–816, 860–861, 1033 reference level and, 174–175, 174f for gonads, 949 in cardiac muscle, 248 venous pressure and, 172–173, 173f, 174 insulin and, 941–943, 942f feedback control of, 815 Gravity. See also Vestibular apparatus. phosphorylation of, 811 glycerol used in, 822 acceleratory forces and, 531–533, 531f, 532f placental diffusion of, 1007 in shocked tissue, 278 brain stem nuclei and, 673–674 plasma level of. See Blood glucose. in skeletal muscle, 78, 79, 1033 weightlessness and, 533–534 renal reabsorption of, 311–312, hypertrophy and, 81 Gray ramus(i), 729–730, 730f 325–326, 326f Glycoproteins, of cell membrane, 14 Greater circulation, 157 transport maximum for, 326–327, 327f Glycosuria, renal, 408–409 Ground substance, 20 sodium co-transport of, 54–55, 55f, GM-CSF (granulocyte-monocyte colony- of bone, 957, 958 325–326, 326f, 794–795, 795f, 796, 811 stimulating factor), in inflammation, Growth, thyroid hormones and, 912 solutions of, 294 430, 430f Growth factors, 39 isotonic, 291–292 GMP (guanosine monophosphate). See Cyclic Growth hormone (GH; somatotropin), 895, storage of. See Glycogen. guanosine monophosphate (cGMP). 896t, 898–904 transport through cell membrane, 810–811. GnRH. See Gonadotropin-releasing hormone abnormalities of secretion of, 902–904, 903f See also Facilitated diffusion; Sodium (GnRH). aging and, 901, 904 co-transport. Goblet cells, of gastrointestinal tract, 773 carbohydrate utilization and, 899–900 insulin and, 811, 941–942, 942f, 943 in crypts of Lieberkühn, 786, 786f cartilage and bone growth and, 900 urinary, 950, 952 Goiter cells secreting, 896, 896t, 897 vasodilation caused by lack of, 194 antithyroid substances and, 915, 917 daily variations in secretion, 901, 901f Glucose phosphatase, 810, 811 endemic, 917 diabetogenic effect of, 900 Glucose tolerance test, 952–953, 953f hypothyroidism with, 917 fat utilization and, 899 Glucose transporters, 50, 325–326, 326f. See idiopathic nontoxic, 917 general growth-promoting effect of, also Sodium co-transport. toxic. See Hyperthyroidism. 898–899, 899f of pancreatic beta cells, 945, 945f Goitrogenic substances, 917 in hypoglycemia, 901, 949 Glucose-dependent insulinotropic peptide, 758 Goldblatt hypertension, 223–224, 223f, 403 insulin and, 900, 945, 945f, 947 gastric secretion and, 780 Goldman equation, 58 ketogenic effect of, 825 stomach emptying and, 768 Goldman-Hodgkin-Katz equation, 58 metabolic effects of, 899 Glucose-6-phosphate, 810, 811 Golgi apparatus, 12f, 15, 15f, 16 metabolic rate and, 864 glycogen synthesis from, 811, 811f gastrointestinal secretions and, 774, 774f plasma concentration of, 901 Glucostatic theory of hunger and feeding, 849 platelets and, 451, 454 protein deposition in tissues and, 899, 904 Glucuronic acid, steroids conjugated to, 924 specific functions of, 20–21, 20f protein synthesis and, 835, 899

1063 Index

Growth hormone (GH; somatotropin) Hearing, loudness and (Continued) Heat production. See Thermogenesis (heat (Continued) attenuation reflex and, 634 production). regulation of secretion of, 901–902, 901t, 902f auditory pathways and, 639 Heat-sensitive neurons, 871 short duration of action, 901 ossicular system in, 633–634, 633f Heatstroke, 876–877, 1040 somatomedins and, 900–901 of sound patterns, 640–641 Helicobacter pylori, 801 spermatogenesis and, 975 speech and, 703, 704–705, 704f Helicotrema, 635, 635f therapy with tympanic membrane in, 633–634, 633f traveling wave toward, 635, 636 for dwarfism, 902–903 Heart. See also Cardiac entries. Helium, in deep diving, 539 in older people, 904 athletic training and, 1038, 1038f, 1038t, Helium dilution method, 470–471 Growth hormone–inhibitory hormone, 898, 1039, 1039f, 1039t Helper T cells, 436, 437, 440–441, 441f 898t, 901–902, 949 autonomic regulation of, 110, 111, 111f, cyclosporine and, 449 Growth hormone–releasing hormone 119–120, 734t, 735 Hematocrit, 165, 165f, 287 (GHRH), 898, 898t, 901–902 blood flow through, 101, 101f in blood volume calculation, 290 Growth inducers, of hematopoietic stem as blood reservoir, 175 at high altitude, 529, 530 cells, 415 electrical currents in region of, 124, 124f splenic reservoir of red cells and, 175 GTP. See Guanosine triphosphate (GTP). enlargement of. See Cardiac hypertrophy. viscosity of blood and, 165, 165f GTP-binding proteins. See G proteins. excitatory and conductive system of, Hematopoietic stem cells, pluripotential, Guanine, 27, 28, 28f, 30, 31t 115–118, 116f. See also Bundle 414–415, 414f, 423–424 Guanosine diphosphate (GDP), hormone branches; Purkinje fibers. Heme, 840 receptors and, 887, 887f cardiac cycle and, 104–105 Hemiballismus, 691 Guanosine monophosphate (GMP). See Cyclic control of, 118–120 Hemoglobin. See also Oxygen-hemoglobin guanosine monophosphate (cGMP). muscle fibers of, 101 dissociation curve. Guanosine triphosphate (GTP), 810, 859 spread and timing of impulse, 118, 118f acid-base buffering by, 383, 413 hormone receptors and, 887, 887f velocity of conduction in, 103, 117 combination with carbon monoxide, Guanylyl cyclase fetal, 1019 501–502, 501f penile erection and, 978–979 Frank-Starling mechanism and, 110–111, combination with oxygen, 418, 498–499, in smooth muscle, 97 229 498f, 499f Gynecomastia, tumor-induced, 985 lactic acid as energy for, 816 degradation of, 419–420, 840 oxygen consumption by, 109 deoxygenated, in cyanosis, 521–522 H regulation of pumping by, 110–112, 231 fetal, 1006 H band, 72f rupture of, 251 oxygen transport by, vs. dissolved Habituation, 706, 707, 718 structure of, 101f state, 498, 501 Hagfish, 213 work output of, 107–109, 108f, 109f, 110 oxygen transport capacity of, 413 Hair(s) during exercise, 1038, 1038f oxygen-buffering function of, 6, 499

estrogens and, 994 Heart failure. See Cardiac failure. high alveolar Po2 and, 536, 537 olfactory, 649 Heart rate quantity in red blood cells, 413 testosterone and, 981 arterial pressure regulation and, 205 quantity in whole blood, 413 Hair cells atrial reflex control of, 208–209 at high altitude, 529 of cochlea, 634–635, 636–638, 636f, 637f body temperature and, 112, 143 red blood cells and, 413 loudness and, 638 duration of cardiac cycle and, 105 structure of, 418, 418f retrograde pathways to, 641–642 duration of contraction and, 104 synthesis of, 417, 417f of vestibular apparatus, 675–676, 675f, 676f, from electrocardiogram, 123 Hemoglobin S, 420 677, 677f exercise and, 244, 245 Hemolysins, 446 Hair end-organ, 560f, 572 athletic training and, 1039, 1039f Hemolysis, in transfusion reactions, 446 adaptation of, 562, 562f hypothalamus and, 715 Hemolytic anemia, 420 Haldane effect, 503–504, 504f in hypovolemic shock, 274 Hemolytic jaundice, 841–842 Hallucinations, hippocampal seizures with, 719 irregular, 144, 144f Hemophilia, 458 Hand skills, cortical control of, 669 in atrial fibrillation, 152 Hemorrhage. See also Bleeding tendencies. Hashimoto disease, 917 parasympathetic regulation of, 201 adjustment to Haustrations, 770 right atrial wall stretch and, 110, 229–230 blood volume and, 373–374 Haversian canal, 959–960, 960f slow, 143–144, 143f delayed compliance in, 168 Hay fever, 443 sympathetic stimulation of, 111, 120, 143 renin-angiotensin system in, 221, 221f HDLs. See High-density lipoproteins (HDLs). cardiac output and, 231 sympathetic control in, 168 Head orientation, maculae and, 674–676 vasomotor center and, 203 vasopressin in, 199 Head rotation thyroid hormones and, 913 venous constriction in, 175 cortical control of, 669 vagal stimulation and, 111, 119–120 anemia secondary to, 420 vestibular system and, 676, 677, 677f, 678 Heart sounds, 107, 265–268 Hemorrhagic shock. See Hypovolemic shock. Headache, 590–592, 591f auscultation of, 266, 266f Hemosiderin, 418f, 419 Head-down position, for shock, 281 frequencies of, 265, 266f Hemostasis. See also Blood coagulation. Hearing, 633–643 normal, 265–266 definition of, 451 abnormalities of, 642, 642f with patent ductus arteriosus, 267f, 270 events in, 451 attenuation reflex in, 634 with valvular lesions, 267–268, 267f clot dissolution or fibrosis, 453 bone conduction and, 634, 642, 642f Heart-lung machines, 271–272 clot formation, 452, 452f central mechanisms in, 639–642, 639f, 640f Heat. See also Warmth receptors. platelet plug formation, 451–452 retrograde pathways in, 641–642 as metabolic end product, 862 vascular constriction, 451 cochlea in, 634–639 metabolic rate measurement and, Henderson-Hasselbalch equation, 382

functional anatomy and, 634–635, 862–863 blood CO2 measurement and, 515 634f, 635f from nonshivering thermogenesis, 865 Henry’s law, 485–486 organ of Corti and, 634–635, 634f, Heat loss, 868–871 Heparin, 457 636–638, 636f, 637f, 641–642 blood flow to skin and, 868, 868f clinical use of, 459, 460 ossicular system and, 633–634, 633f evaporative. See Evaporative heat loss; from mast cells and basophils, 431, 439, 457 traveling wave and, 635, 635f, 636f Sweating. Hepatic arterioles, 837 direction of sound and, 641 insulator system of body and, 868 Hepatic artery, 837f, 838 frequency of sound and, 638–639, 638f mechanisms of, 868–870, 869f Hepatic coma, 835 auditory cortex and, 640 panting in, 871 Hepatic vein, 837f, 838 auditory pathways and, 639–640 at very high air temperatures, 869 elevated pressure in, 838 loudness and, 638–639, 638f to water vs. air, 869, 876 Hepatitis, jaundice in, 841

1064 Index

Hepatocyte growth factor, 838 Hormone response element, 888, 889f Hydrogen bonding Hepatocytes, bile secretion by, 783 for cortisol, 931 in DNA, 28, 29 Hereditary spherocytosis, 420 for thyroid hormones, 910, 911f, 913f in DNA replication, 37 Hering-Breuer inflation reflex, 506 Hormone-gated receptors, of smooth in protein synthesis, 32 Hering’s nerves muscle, 97 in proteins, 831 baroreceptors and, 205–206, 206f Hormones, 881–893. See also Endocrine glands. in transcription, 30 chemoreceptors and, 208 anatomical loci of sources of, 881, 882f Hydrogen gas, in large intestine, 804 Hermaphroditism, 1026 chemical messenger systems and, 881 Hydrogen ions. See also Acid-base disorders; Herpes zoster, 590 clearance from blood, 886 Acid-base regulation; pH. Hexagonal reference system, 130 concentrations of, in blood, 884–885 acids and, 379–380 Hexokinase, 811 measurement of, 891–892, 892f arterial blood, chemoreceptors and, 208 High altitude general classes of, 881–884 arteriolar dilation or constriction and, 200 acclimatization to, 510 insulin secretion stimulated by, 947 cerebral blood flow and, 744

alveolar Po2 and, 527, 528–530 mechanisms of action, 886–891 concentration in body fluids, 380, 380t work capacity and, 530, 530t genetic machinery and, 888–889, 891 precise regulation of, 379 acute hypoxia at, 528 intracellular signaling in, 887–889, 887f, in oxidative phosphorylation, 814–815, 814f

alveolar Pco2 at, 527, 528t, 529 888f, 889f primary active transport of, 54 alveolar Po2 at, 499, 527, 528t receptors in, 886–889 renal excretion of, with reduced GFR, acclimatization of natives, 529–530, 530f second messengers in, 888, 889–891, 404, 405f acclimatization over time, 528–529 889b, 890b, 890f renal secretion of, 311–312, 326, 326f, breathing pure oxygen, 528, 528t overview of, 883t 332–333, 334 alveolar ventilation at, 510 regulatory functions of, 5–6 aldosterone excess and, 926 arterial oxygen saturation at, 527, 528f, 528t secretion of, 884–885, 885f bicarbonate reabsorption and, 385, barometric pressures at, 527, 528t cyclical variations in, 885 386–388, 386f, 387f, 390–391, 390t mountain sickness at feedback control of, 885 factors affecting, 390–391, 390t acute, 530 structures of, 881–884 respiratory control by, 507, 507f, 508, 508f chronic, 530–531 synthesis of, 881–884 chemoreceptors and, 509 polycythemia at, 421 transport of, in blood, 885–886 high altitude and, 529 red blood cell production at, 416 Hormone-sensitive lipase, 820, 825 sodium counter-transport of, 55, 55f, tissue vascularity increase at, 197–198 insulin and, 943 326, 326f work capacity at, 530, 530t Horner’s syndrome, 632 intestinal, 794–795 High-density lipoproteins (HDLs), 821 Human chorionic gonadotropin sour taste and, 645 atherosclerosis and, 829 for female infertility, 1001 vasodilation associated with, 97 High-energy phosphate compounds. See fetal testes and, 984, 1008 Hydrogen peroxide, oxidation by, 15–16

Adenosine triphosphate (ATP); in pregnancy, 1007–1008, 1007f high alveolar Po2 and, 536–537 Phosphocreatine. Human chorionic somatomammotropin, of iodide, 908 High-fat diet, adaptation to, 824 1009, 1014 in leukocytes, 426 Hindbrain, motor control and, 694 Human chorionic thyrotropin, 1009 Hydrogen-potassium ATPase pump, 324–325 Hippocampus, 714, 714f, 718–719 Human growth hormone, 902–903. See also gastric acid secretion and, 777–778, 778f learning and, 719 Growth hormone (GH; somatotropin). potassium reabsorption and, 364. memory storage and, 709, 719 Human leukocyte antigen (HLA) complex, 449 Hydrolase enzymes, in lysosomes, 15, 19–20 olfaction and, 651 Human placental lactogen, 1009 Hydrolysis, 789 schizophrenia and, 727 Humidification of air, 487, 487t Hydronephrosis, 315 Hirschsprung disease, 802 Humoral immunity, 433, 434, 435f, Hydrostatic pressure His bundle. See Atrioventricular (A-V) bundle. 437–439, 437f. See also Antibodies; in capillaries. See Capillary pressure. Histamine B lymphocytes. in interstitium. See Interstitial fluid anaphylaxis and, 443 Hunger, 845. See also Appetite. hydrostatic pressure. in asthma, 520 hypothalamus and, 716 reabsorption in kidney and, 335–337, 335f, bronchiolar constriction caused by, 473 Hunger contractions, 766 336t, 337f gastric acid secretion and, 778, 779, 801 Hunger pangs, 766 venous pressure and, 172–173 hay fever and, 443 Huntington’s disease, 694 Hydroxyapatite from mast cells and basophils, 431, 439 Hyaline membrane disease, 1022. See also of bone, 957, 958 shock induced by, 280 Neonatal respiratory distress syndrome. of teeth, 969, 970, 971 urticaria and, 443 Hyaluronic acid, 20 β-Hydroxybutyric acid, 823 as vasodilator, 199–200 in proteoglycan filaments, 180 ketosis and, 823, 852 Histiocytes, 426, 428 Hyaluronidase, in acrosome, 975, 977 Hydroxyl ions, of neutrophils and Histones, 36, 38, 40 Hydrocephalus, 748 macrophages, 426 Hives, 443 Hydrochloric acid, gastric Hydroxymethylglutaryl CoA (HMG-CoA) HLA (human leukocyte antigen deficiency of, 778, 800 reductase, 827 complex), 449 emotional stimuli and, 780 statins and, 829 HMG-CoA reductase, 827 organisms destroyed by, 433 17α-Hydroxyprogesterone, 992 statins and, 829 pepsinogen secretion and, 778, 779 Hyperalgesia, 583–584, 590 Homeostasis, 4. See also Control systems peptic ulcer and, 800, 801 Hyperbaric oxygen therapy, 540 of body. treatment and, 801 Hyperbarism, 535 automaticity of body and, 9 pH of, 380, 380t, 777 Hyperbilirubinemia, physiologic, 1024, 1024f circulatory system and, 4–5, 4f pepsin activity and, 791 Hypercalcemia, 367, 956. See also Calcium, in nutrients and, 5 protein digestion and, 791 extracellular fluid and plasma. in premature infant, 1027 secretin release caused by, 782 in hyperparathyroidism, 968 protection of body and, 6 secretion of, 777–778, 777f, 778f Hypercapnia, 522 regulatory systems and, 5–6 stimulation of, 778, 779 dyspnea secondary to, 522 removal of metabolic products and, 5 Hydrocortisone. See Cortisol. Hyperchloremic metabolic acidosis, 395, 395t reproduction and, 6 Hydrogen atoms Hypercholesterolemia, familial, 828–829 Homonymous hemianopsia, 627 from fatty acid oxidation, 823 Hypereffective heart, 231, 231f Horizontal cells, 609, 610f, 617, 617f oxidation of, 814–815 Hyperemia function of, 618 from pentose phosphate pathway, active, 194 inhibitory, 620, 620f 816–817, 816f reactive, 194 neurotransmitters released by, 617 Hydrogen ATPase, 324–325, 387–388, 387f Hyperglycemia, gigantism with, 903

1065 Index

Hyperinsulinemia, 951, 952 Hypoglycemia Hypovolemic shock (Continued) Hyperinsulinism, 953 cortisol secretion in, 949 cardiac output and, 274–275, 274f Hyperkalemia, 361 epinephrine and, 949 in dehydration, 279 acidosis secondary to, 391 growth hormone secretion in, 901, 949 fluid therapy for, 280 aldosterone deficiency and, 926 Hypoglycemic shock, 943 gastrointestinal vasoconstriction in, 762 in mineralocorticoid deficiency, 924 Hypogonadism irreversible, 278–279, 278f Hyperlipidemia, coronary artery disease female, 999 nonprogressive (compensated), 275–276 and, 829 male, 985, 985f in plasma loss, 279 Hypernatremia, 294, 295–296, 295t Hypokalemia, 361 progressive, 275, 275f, 276–278, 276f Hyperopia, 602, 602f, 603, 603f aldosterone excess and, 925–926 in trauma, 279 Hyperosmotic dehydration, 295, 295t alkalosis secondary to, 391 treatment of, 280–281 Hyperosmotic overhydration, 295t, 296 Hyponatremia, 294–295, 295t, 296f Hypoxia Hyperosmotic solution, 292 Hypo-osmotic dehydration, 294–295, 295t acute, at high altitude, 528 Hyperparathyroidism Hypo-osmotic overhydration, 295, 295t anaerobic energy during, 860 primary, 967–968 Hypo-osmotic solution, 292 in anemia, 420–421, 521 secondary, 968 Hypoparathyroidism, 967 causes of, 520, 521 in chronic renal failure, 407 Hypophosphatemia dyspnea secondary to, 522 Hyperpolarization congenital, 969 effects on the body, 521 of cardiac fibers, 66f, 67, 120 renal, 408 erythropoietin secretion in, 304, 416 atrioventricular nodal, 120 Hypotension, antidiuretic hormone and, 905 in neonate, 1021 sinus nodal, 116, 120 Hypothalamic inhibitory hormones, neuronal depression in, 557 of photoreceptor membrane, 612–613, 897–898, 898t polycythemia secondary to, 421 617–618 Hypothalamic releasing hormones, of postsynaptic membrane, 554 897–898, 898t I of smooth muscle, 97 Hypothalamic-hypophysial portal vessels, I bands, of skeletal muscle, 71, 72f gastrointestinal, 755 897–898, 897f I cells, intestinal, 783 Hypersensitivity, 443–444 Hypothalamus, 714, 714f, 715–718, 716f IDLs (intermediate-density lipoproteins), 821 Hypertension amygdala and, 719 Ig. See Immunoglobulin entries. acute neurogenic, 224–225 autonomic control by, 739, 739f Iggo dome receptor, 572, 572f in aldosteronism, primary, 219–220 behavioral functions of, 717 IL. See Interleukin entries. Alzheimer’s disease and, 728 blood-brain barrier and, 748–749 Ileocecal sphincter, 756, 769–770, 770f in aortic coarctation, 224 hunger and satiety centers of, 845–846, 846f Ileocecal valve atherosclerosis and, 829 anorexia and, 852 feedback control of, 770 cerebral blood flow and, 744–745, 745f leptin and, 849 function of, 769–770, 770f chronic neurons and neurotransmitters in, ileal peristalsis and, 769, 770f definition of, 218 846–847, 847f, 847t, 849 Image formation. See also Visual image(s). impaired renal fluid excretion and, obesity and, 850–851 by lenses, 599–600, 599f 218–220, 218f, 220f lesions in, 717 on retina, 601 lethal effects of, 218 osmoreceptors in, 355, 356f, 905 Imipramine, 727 coronary artery disease and, 829 pain signals and, 587 Immune system, homeostatic functions of, 6 endothelial damage in, 196 pineal gland and, 986 Immunity. See Acquired (adaptive) immunity; essential (primary), 225–226, 226f pituitary and Innate immunity. treatment of, 226 anterior, 716–717, 897–898, 897f, 898t, Immunization, 433, 437, 442. genetic causes of, 225 901–902 Immunoglobulin(s), 437–438, 437f. See also Goldblatt types of, 223–224, 223f posterior, 895, 897, 904, 904f, 905, 906 Antibodies. kidney disease and, 406, 407 reward and punishment functions of, Immunoglobulin E (IgE), 431, 438 dialysis and, 219 717–718 allergy and, 443–444 as end-stage renal disease, 402 sleep and, 722 Immunoglobulin G (IgG), 438 as nephrosclerosis, 403 temperature regulation and. See Immunoglobulin M (IgM), 438 left ventricular hypertrophy in, 135–136, Temperature, body, hypothalamic transfusion reaction caused by, 446 135f, 137 regulation of. Immunosuppression in preeclampsia, 224, 1011 vasodilator system and, 204 by cortisol, 930, 931 pregnancy-induced, 1009 vasomotor center controlled by, 204 for transplantation, 449–450 renal artery stenosis and, 223–224, 223f vegetative and endocrine control functions Impedance matching, by ossicular system, renal ischemia and, 224 of, 715–717 633–634 renin-angiotensin system and, 223–224, visual fibers to, 623 Impermeant solutes, 291, 292 223f Hypothermia, 877 Implantation, 1004, 1004f, 1005f stroke secondary to, 745 artificial, 877 endometrial nutrients and, 995, 1004, 1008 volume-loading, 218–219, 218f, 220f deep body temperature receptors Inanition, 851 combined with vasoconstriction, and, 872 hypothalamic feeding center and, 845 224–225 Hypothyroidism, 917–918, 918f Incisura, in aortic pressure curve, 107, Hyperthyroidism, 916, 916f cardiac output in, 234 169f, 170f cardiac output in, 233 in fetal life, infancy, or childhood, 918 aortic regurgitation and, 169 in neonate, 1026 menstrual irregularities in, 999 Incomplete intraventricular block, Hypertonic solutions, 292, 292f in neonate, 1026 145–146, 145f fluid shifts and osmolarities caused Hypotonia Incontinence, overflow, 310 by, 293, 293f deep cerebellar nuclei and, 689 Incus, 633, 633f Hyperventilation, alkalosis secondary to, 392 motor cortex lesions with, 673 Indicator-dilution method, 241, 241f, 287–290, Hypocalcemia, 367, 956, 956f. See also Calcium, Hypotonic solutions, 292, 292f 289f, 289t in extracellular fluid and plasma. fluid shifts and osmolarities caused Indifferent electrode, 126 hyperparathyroidism secondary to, 968 by, 293, 293f Infant. See also Child; Neonate. Hypochlorhydria, 800 Hypoventilation, hypoxia secondary to, 520 allergy in, 1026 Hypochromic anemia, 419 hypercapnia and, 522 endocrine problems in, 1026 microcytic, 415f, 420 oxygen therapy in, 521 premature, 1026–1027 Hypoeffective heart, 231, 231f Hypovolemic shock, 274–279 retrolental fibroplasia in, 197–198, 1027 Hypogastric plexus, 729, 730f arterial pressure and, 274–275, 274f Inferior colliculus, 639–640, 639f bladder and, 308 bleeding volume and, 274–275, 274f Inferior olivary nuclei, 670, 683

1066 Index

Inferior olive Insulin (Continued) Interstitial fluid hydrostatic pressure, basal ganglia and, 690f receptor activation by, 940–941, 941f 181, 181f, 182–184, 184t, 185t cerebellum and, 683, 684, 684f, 686, 687 small intestine peristalsis and, 769 lymph flow and, 187–188, 187f, 189 Inferior salivatory nucleus, 648 somatostatin and, 949 negative, 182, 183–184, 189 Infertility in switching between carbohydrates edema and, 298–299, 299f, 300 female, 1001–1002 and lipids, 947 in lungs, 481, 482, 482t male, 977, 978 synthesis of, 940, 940f in potential spaces, 300 Inflammation, 428 treatment of diabetes with, 953 Interstitial nephritis, 403 atherosclerosis and, 828, 829 Insulin receptors, 940–941, 941f Interstitium, 180–181, 180f chemotaxis of leukocytes in, 424f, 425 Insulin resistance, 950, 951–952, 952b, 953 excess extracellular fluid in, 373, 373f complement system in, 439 growth hormone–induced, 900 free fluid in, 180f, 181, 183, 299 cortisol and, 930–931 Insulin shock, 953–954 ground substance in, 20 in allergic reactions, 931 Insulinase, 940 Intestinal obstruction, plasma loss in, 279. intracellular edema secondary to, 296 Insulin-like growth factor 1 (somatomedin C), See also Gastrointestinal macrophages and neutrophils in, 428–430, 900–901 obstruction. 429f, 430f Insulin-like growth factors (somatomedins), Intestinal phase mast cells in, 431 900–901 of gastric secretion, 779, 780, 780f stages of, 930 Insulinoma, 953 of pancreatic secretion, 782 walling-off effect of, 428 Insulin-receptor substrates, 940–941, 941f Intestine. See Large intestine (colon); Inflammatory cytokines, anorexia-cachexia Integral membrane proteins, 13f, 14 Small intestine. and, 852 Integrins, on neutrophils, 428 Intra-abdominal pressure, venous pressure Infrared radiation, 868–869 Intelligence, 701 in legs and, 172 Ingestion of food, 763 Intention tremor, 687–688, 689 Intracellular edema, 296 mastication in, 763 Intercalated cells, renal, 332–333, 332f Intracellular fluid, 3, 286, 286f swallowing in, 763–765, 764f hydrogen ion secretion by, 54, 333, buffers in Inhibin 387–388, 387f phosphate as, 383 in female, 991, 997, 998 potassium reabsorption by, 364 proteins as, 383–384 in male, 984 Intercalated disks, 101–102, 102f composition of, 45, 45f, 287, 288f, 288t Inhibition circuit, reciprocal, 566–567, 567f of Purkinje fibers, 117 extracellular fluid and, 3–4 Inhibitory neuronal circuits, 569 Interleukin(s), 881 exchange between compartments, 290 Inhibitory postsynaptic potential, 553f, Interleukin-1 (IL-1) osmotic equilibrium of, 291–292, 292f 554–555 fever and, 875–876, 930 of neuronal somal, 553 dendrites and, 556 in inflammation, 430, 430f osmolality of, 52 summation and, 555 in lymphocyte activation, 436, 441f osmolarity of, 288t, 291 Inhibitory presynaptic terminals, 547 Interleukin-2 (IL-2), from helper T cells, in abnormal states, 292–294, 293f, Inhibitory receptors, 547, 549, 550 440, 441 293t, 294t Inhibitory transmitter, 548 Interleukin-3 (IL-3), hematopoietic stem cells pH of, 380, 380t Inhibitory zone, 566 and, 415 volume calculation of, 290 Injury potential. See Current of injury. Intermediate-density lipoproteins in abnormal states, 292–294, 293f, Innate immunity, 433. See also Complement (IDLs), 821 293t, 294t system; Natural killer lymphocytes; Intermediolateral horn, 729, 730f Intracranial pressure. See Cerebrospinal fluid Phagocytosis. Internal capsule, of brain, 690, 690f pressure. Inositol, in cephalin synthesis, 826 International normalized ratio (INR), 461 Intrafusal muscle fibers, 656, 656f, 657–658,

Inositol triphosphate (IP3), 890 Interneurons, in motor control, spinal, 657f, 659, 660 INR (international normalized ratio), 461 655f, 656 Intramural plexus. See Enteric nervous Insensible water loss, 285, 286t Internodal pathways, cardiac, 115, 116f, system. heat loss caused by, 869 117, 117f Intraocular pressure, 607–608, 607f Inspiratory capacity, 469, 469f Interphase, 37, 38 Intrapleural pressure, cardiac output curve Inspiratory compliance curve, 467, 467f Interphase nucleus, 17, 17f and, 234, 234f, 235, 235f Inspiratory reserve volume, 469, 469f Interplexiform cells, 617 Intrapleural space, negative pressure Insulin, 939–947 Interposed nucleus, 683, 684, 687 in, 183 appetite and, 846, 846f, 847f, 848 lesions of, 689 Intravenous solutions, nutritive, 294. See also blood cholesterol and, 827 Interstitial cells of Cajal, 754 Saline solutions. carbohydrate absence and, 825 Interstitial fluid, 180–181, 180f, 286, 286f, 287. Intraventricular block, partial, 145–146, 145f carbohydrate metabolism and, 941–943, See also Lymphatic system. Intrinsic factor, 417, 420, 800

942f, 947 carbon dioxide partial pressure (Pco2) in, secretion of, 777, 778 chemistry of, 940, 940f 497–498, 498f Intrinsic pathway of coagulation, circulatory shock and, 277 composition of, 287, 288t 454–456, 456f control of secretion of, 945–947, 946f fibrinogen leaking into, 453–454 Inulin, water reabsorption and, 334 cortisol and, 928 osmolarity of, 288t, 291 Inulin clearance, 340–341, 340t, 341f, 343

energy abundance and, 939–940 oxygen partial pressure (Po2) in, Inulin space, 289 energy storage and, 849 496–497, 496f Iodide factors affecting secretion of, 946t pH of, 380, 380t antithyroid activity of, 915, 917 fat storage and, 943 plasma proteins in, 184, 185, 189 dietary fat synthesis and, 825 protein concentration in, 185, 187, 189 absorption of, 907 fat utilization and, 943–944, 944f, 947 renal, physical forces and, 335–337, 335f, deficiency of, 917, 918 glucagon and, 949 336t, 337f requirement for, 856, 907 glucose transport into cells and, 811, 941 renal medullary, hyperosmotic, 347–349, oxidation of, 908, 908f growth hormone and, 900, 945, 945f, 947 349f, 350–352, 350f, 351f, 352f, 353 radioactive, for hyperthyroidism, 917 mechanisms of secretion of, 945, 945f impaired formation of, 354 in thyroid hormone synthesis, 908–909, overtreatment with, brain metabolism transport between plasma and, 4–5, 4f 908f, 909f, 914 and, 749–750 volume of, 189 Iodide trapping, 908, 914 plasma half-life of, 940 calculation of, 290 deficient mechanism of, 917 plasma level of, 952 Interstitial fluid colloid osmotic pressure, high iodide concentration and, 915 potassium homeostasis and, 361 181, 181f, 184, 184t, 185t thiocyanate and, 915 protein storage and, 835, 945 in lungs, 481, 482t Iodinase, 908–909 protein synthesis and, 835, 944 lymph flow and, 188, 189 Iodine, 856. See also Iodide.

1067 Index

Ion channels, 14. See also Acetylcholine-gated Joint spaces, effusion in, 300 Kidney disease, 399. See also Renal failure. ion channels; Calcium ion channels; Junctional potential, 96 anemia in, 304 Chloride ion channels; Potassium ion Juxtaglomerular apparatus, 195, 320, 320f, 331 edema in, 298 channels; Protein channels; Sodium Juxtaglomerular cells, 220, 320, 320f hypertension and, 406, 407 ion channels; Voltage-gated channels. Juxtamedullary nephrons, 306, 307f in end-stage renal disease, 402 of adrenergic or cholinergic receptors, 732–733 countercurrent mechanism and, 306, 307f, 348 in nephrosclerosis, 403 G-protein–activated nephrotic syndrome in, 404 hormones and, 887 K osteomalacia and rickets in, 969 in postsynaptic membrane, 549, 549f Kallidin, 199, 761 tubular disorders, 408–409 of interstitial cells of Cajal, 754 Kallikrein, 199 Kidney function testing, clearance methods in postsynaptic membrane, 548, 550 in salivary glands, 776 for, 341f, 342f G-protein–activated, 549, 549f Keratoconus, 604 Kidney stones, in hypoparathyroidism, 968 receptors linked to, 887 Kernicterus, 448 Kidney transplantation, 409 Ionizing radiation, cancer caused by, 41 Keto acids Kilocalorie, 862 Ionophore component, of postsynaptic amino acid synthesis from, 834, 834f, 840 Kinesiology, 81 receptor, 548 conversion of amino acids to, 834, 835 Kinesthesia, 580 Ions, in cell, 11 in diabetes mellitus, 953 Kinetic energy, of blood flow, cardiac work

IP3 (inositol triphosphate), 890 oxidation of, 835 and, 108 Iris, innervation of, 631, 631f, 632 Ketogenesis, 835 Kininogen, high-molecular-weight, 455 Iron, 418–419, 856 α-Ketoglutaric acid, 834 Kinins, 199 absorption of, 419, 796 Ketone bodies, 823, 824 Kinocilium, 675–676, 675f atherosclerosis and, 829 insulin lack and, 944 Klüver-Bucy syndrome, 720 daily loss of, 419 in starvation, 852 Knee jerk, 660, 660f fetal accumulation of, 1020, 1020f Ketosis, 823–824 Korotkoff sounds, 170–171 functions of, 418 hormonally induced, 825 Krause’s corpuscle, 560f from hemoglobin degradation, 840 by growth hormone, 899 Krebs cycle. See Citric acid cycle. neonatal need for, 1025 insulin lack and, 944 Kupffer cells, 427, 427f, 837, 839 in pregnancy, 1010 in starvation, 852 Kwashiorkor, 843, 854 transport, storage and metabolism Kidney(s). See also Renal entries. growth hormone in, 901, 902f of, 418–419, 418f, 840 acid-base balance and. See Acid-base Kyphosis, in acromegaly, 903–904 Iron lung, 522f, 523 regulation, kidneys in. Iron sulfide proteins, 814 anatomy of, physiologic, 304–306, 305f, L Irritant receptors, in airways, 512 306f, 307f Labeled line principle, 559 Ischemia. See also Cerebral ischemia; arterioles of. See Afferent arteriole(s), renal; Labor, 1012–1013, 1012f Myocardial ischemia; Renal ischemia. Efferent arteriole(s), renal. Labor pains, 1013 intracellular edema secondary to, 296 blood flow control in, 195 Lacrimal glands, autonomic control as pain stimulus, 584 blood pressure and. See Arterial blood pressure of, 734t, 735 visceral, 588 control, by renal–body fluid system; Lactase, 787, 790 Ischemic heart disease, 246, 248–250. See also Renin-angiotensin system. Lactation, 1014–1016 Myocardial ischemia. blood supply of, 304–305, 305f metabolic drain on mother from, 1016 Islets of Langerhans, 939, 939f drugs and, 330 oxytocin and, 716, 905–906 adenoma of, 953 fetal, 1020 parathyroid enlargement in, 965 Isograft, 449 functions of, 303–304 Lactic acid Isogravimetric method, for capillary pressure gluconeogenesis in, 817 from anaerobic glycolysis, 816, 860–861 measurement, 182, 182f homeostatic functions of, 5 as energy source for heart, 816 Isohydric principle, 383–384 interstitial fluid pressure in, 183 ischemic pain and, 584 Isomaltase, 787 irritation of, intestinal activity and, 772 from muscle glycogen, 1033–1034, 1033f Isometric contraction in neonate, 1024 reconversion to pyruvic acid, 816 of skeletal muscle, 79, 79f oxygen consumption by, 316, 317f removal of, 1033–1034 of ventricle, 106 reabsorption by, 311f, 312, 323, 324f shock and, 278 Isometric relaxation, of ventricle, 106 arterial pressure and, 337 in skeletal muscle, 78 Isopropyl norepinephrine, 733 calculation from renal clearance, 340t, as vasodilator, 243–244 Isosmotic solutions, 292 342–343, 343t in sweat, 870 Isosthenuria, 405, 406f in different parts of nephron, 329–334 Lactic acid oxygen debt, 1034, 1034f Isotonic contraction, of skeletal muscle, 79, 79f glomerulotubular balance and, 334–335 Lactic dehydrogenase, zinc in, 856 Isotonic solutions, 291–292, 292f hormonal control of, 337–339, 338f, Lactose, 789–790 Isovolumic contraction, 105f, 106, 108, 108f, 109f 338t, 339f Lactotropes, 896, 896t Isovolumic relaxation, 105f, 106, 108, 108f, 109f hydrostatic and osmotic forces in, Laminar flow, of blood, 161, 161f, 162 Itch detection, 572–573 335–337, 335f, 336t, 337f Language, 699–700, 699f, 702, 703–705, anterolateral system and, 573 mechanisms of, 323–329 704f. See also Speech. scratch reflex and, 664 regulation of, 334–339 Large intestine (colon) of representative substances, 323, 324t. absorption in, 797–798 J See also specific substances. active transport in, 55–56, 55f J point, 138–140, 139f summary of, 334, 334f of chloride, 795, 797, 926 J receptors, in lung, 512 transport maximum for, 326–327, 327f, of sodium, 795, 797, 926 Jacksonian epilepsy, 726 327t bacterial action in, 798, 804 Janus kinases (JAKs), leptin receptor and, 888, secretion by, 311f, 312, 323, 334 disorders of, 802–803. See also Diarrhea. 888f calculation from renal clearance, 340t, functions of, 770 Jaundice, 841–842 342–343 gas in, 798, 804 neonatal, 1024, 1024f counter-transport in, 326, 326f movements of, 770–772, 770f, 771f. in transfusion reactions, 448 of hydrogen ions, 311–312, 326, 326f, See also Defecation. Joint angulation, position receptors and, 580 332–333, 334 obstruction of, 804, 804f Joint receptors of organic acids and bases, 329f, 330 secretions of, 787 adaptation of, 562, 562f of potassium, 311–312, 332, 333, 333f, bicarbonate in, 795 of neck, 678 337–338 storage function of, 797 predictive function of, 563 transport maximum for, 326, 327, 327t Larynx, 474–475, 474f Ruffini’s endings as, 572 shock-related lesions in, 277–278 Lateral geniculate body, 623–624, 623f

1068 Index

Lateral inhibition, 578–579, 578f Liddle’s syndrome, 408–409 Liver (Continued) in auditory system, 640 Lidocaine, for paroxysmal tachycardia, 148 excretory functions of, 840 in cerebellum, 685 Ligand-gated channels, 47, 48 fatty acid degradation in, 823 in motor system, 656 Ligands, 14, 19 glucose buffer function of, 839, 949 in retina, 618, 618f, 620, 620f Light and dark adaptation, 614–615, 614f glycogen in, 811, 811f Lateral lemniscus, 639, 639f Limb leads. See Bipolar limb leads. homeostatic functions of, 5 Lateral motor system of the cord, 671 Limbic association area, 699f, 700 insulin action on, 942 Law of the gut, 759 Limbic cortex, 714–715, 714f, 720 iron storage in, 840 LDLs. See Low-density lipoproteins (LDLs). Limbic system, 714–715, 714f. See also lipids in, 821–822 Learned patterns of movement, 690, 695 Amygdala; Hippocampus; lymphatic system in, 837, 837f, 838 Learning Hypothalamus. macrophages in, 427 hippocampus in, 719 Alzheimer’s disease and, 727 metabolic functions of, 839–840 neuronal connectivity and, 708 gonadotropin-releasing hormone and, 997 monosaccharides in, 810, 810f reflexive, 709 manic-depressive illness and, 727 neonatal function of, 1025 reward or punishment and, 718 motivation and, 695 protein synthesis in Lecithin olfaction and, 651 cortisol and, 929 in bile, 784, 784t, 786, 792 Parkinson’s disease and, 693 of plasma proteins, 833 chemical structure of, 826, 826f psychomotor seizure and, 726 regeneration of, 838 Left atrial pressure, 478, 478f reward and punishment functions shock-related injury to, 277, 278f in left-sided heart failure, 481 of, 717–718 sinusoids of, 837, 837f pulmonary edema and, 482–483, 482f schizophrenia and, 727 blood flow in, 838 Left bundle branch block Liminal zone, 565–566, 565f phagocytosis of bacteria in, 839 left axis deviation in, 136, 136f Linear acceleration, of head, 676–677 reticuloendothelial cells of, 759–760, 837 T wave and, 142 Linear acceleratory forces, 532–533, 532f vascular system of, 837f, 838 Left ventricle Lingual glands, 792 vitamin storage in, 840 volume-pressure curves of, 108–109, Lingual lipase, 792 Liver disease, 838. See also Cirrhosis. 108f, 109f Lipase(s) bilirubin and, 840, 841–842 work done by, 107–109, 108f, 109f in adipose tissue, 821, 826, 943 clotting factor deficiencies in, 457–458 Left ventricular dilatation, QRS prolongation glucagon and, 948 Local sign principle, 662–663 in, 137–138 enteric, 792 Lochia, 1013–1014 Left ventricular hypertrophy. See also Cardiac hormone-sensitive, 820, 821, 825 Locomotive reflexes, 663–664 hypertrophy; Ventricular hypertrophy. insulin and, 943 Locus ceruleus, and norepinephrine system, aortic valve lesions and, 268 intestinal, 787 551, 712–713, 713f electrocardiogram with, 135–136, 135f, 137 lingual, 792 Long QT syndromes, 147, 148f QRS prolongation in, 137–138 in macrophages, 426 Loop diuretics, 331, 331f, 397–398, 398t Left-to-right shunt, 269. See also Patent ductus pancreatic, 781, 792–793, 792f Loop of Henle, 306, 306f arteriosus. Lipase inhibitor, for weight loss, 851 calcium reabsorption in, 368–369 Lengthening reaction, 661 Lipid bilayer, 13–14, 13f, 45, 46, 46f. See also glomerulotubular balance of, 335 Lens, of eye Cell membrane. magnesium reabsorption in, 370 accommodation of, 601, 601f Lipids. See also Cholesterol; Fats; Phospholipids. transport properties of, 330–331, 330f, 331f autonomic control of, 631–632, 735 absorption of, bile salts and, 785 urine concentration and, 346, 346f, pupillary reaction to, 632 of cell membranes, 12, 13 352–353, 352f in analogy to camera, 600, 600f glycolipids, 14 hyperosmotic medulla and, 348–349, cataracts in, 604 in cells, 12 348t, 349f Lenses, physical principles of classification of, 819 Loudness, 638–639, 638f concave, 598, 598f synthesis of, in endoplasmic reticulum, attenuation reflex and, 634 convex, 597–598, 597f 20, 20f auditory pathways and, 639 cylindrical, 598, 598f, 599f transport of, in body fluids, 819–821 Low-density lipoproteins (LDLs), 821 focal length of, 597f, 598–599, 599f Lipodystrophy, 822 adrenocortical hormone synthesis and, 922 focal point of, 597–598, 597f Lipopolysaccharide. See Endotoxin. atherosclerosis and, 828–829 image formation by, 599–600, 599f Lipoprotein(a), 829 receptors for refractive power of, 599f, 600, 600f Lipoprotein lipase, 819–820, 820f mutations affecting, 827, 828–829 Leptin, 846, 846f, 847f insulin and, 943 statins and, 829 as cytokine hormone, 881 Lipoproteins, 821. See also High-density Low-pressure receptors, 208 fat storage and, 849 lipoproteins (HDLs); Low-density Lumirhodopsin, 611–612, 611f obesity and, 851, 865 lipoproteins (LDLs). Lung(s). See also Pulmonary entries. Leptin receptor, 888, 888f insulin and, 944 as blood reservoir, 175, 478 Leukemias, 431–432 phospholipids in, 826 blood volume in, 157, 478–479 Leukocyte pyrogen, 875–876 Lipostatic theory of hunger and feeding, 849 circulation of. See Pulmonary circulation. Leukocytes (white blood cells), 423–425. β-Lipotropin, 933–934, 933f compliance of, 467, 467f See also specific cell types. Lissauer, tract of hypoxia and, 520 ameboid movement by, 24 pain signals in, 585f thoracic cage and, 468 concentration of, in blood, 423 thermal signals in, 593 consolidation of, 518 genesis of, 423–424, 424f Liver, 837–842. See also Hepatic entries. elastic forces of, 465, 467 life span of, 424–425 acetoacetic acid formed in, 823–824 surface tension and, 467–468 types of, 423 adrenocortical hormones metabolized work and, 468 as percentages, 423, 423t in, 924 macrophages in, 427 Leukopenia, 431 amino acid storage by, 833 massive collapse of, 519, 519f Leukorrhea, during menstruation, 996 anatomic organization of, 837, 837f neonatal expansion of, 1021, 1021f Leukotrienes, bronchoconstriction caused B lymphocyte processing in, 435 recoil pressure of, 467 by, 443 bile salt synthesis by, 785 shock-related injury to, 277–278 Lever systems, in skeletal muscle function, bile secretion by, 783–784, 784f, 785 Lupus erythematosus, 442 81, 81f as blood reservoir, 175, 838 chronic glomerulonephritis in, 403 Leydig cell tumors, 985 capillaries of, permeability of, 178, Luteal phase, 989f, 990–991 Leydig cells, 974f, 975, 979–980, 980f 179–180 Lutein cells, 990–991 LH. See Luteinizing hormone (LH). coagulation factors formed in, 840 Luteinization, 990–991 Licorice, 924–925 detoxifying function of, 840 Luteinization-inhibiting factor, 991

1069 Index

Luteinizing hormone (LH), 896, 896t Macrophages, 425–426 Mean filtration pressure, at pulmonary in female, 987, 988–989, 988f alveolar, 427, 428, 474 capillary, 482, 482t follicular phase and, 989–990 ameboid movement by, 24, 425 Mean pulmonary filling pressure, in left-sided luteal phase and, 991 as antigen-presenting cells, 440 heart failure, 259 after menopause, 999 atherosclerosis and, 827–828, 828f Mean QRS vector, 129, 135, 135f ovulation and, 990, 990f chemotaxis by, 439 Mean systemic filling pressure, 235, 235f, in pregnancy, 1009 helper T cells and, 441 236–237, 236f, 238–239, 238f preovulatory surge of, 885, 988f, hemoglobin uptake by, 419–420 in decompensated cardiac failure, 262–263 997–998, 1001 hepatic (Kupffer cells), 427, 427f, 837, 839 exercise and, 244–245 regulation of cycle and, 996, 996f, in inflammation, 428–430, 430f after myocardial infarction, 255–256 997–998, 997f in lymphocyte activation, 436, 437 fluid retention and, 256, 258 in male, 983–984, 983f in milk, 1016 in neurogenic shock, 279 spermatogenesis and, 975 in monocyte-macrophage system, 426–428, Meat, digestion of Lymph 427f collagen in, 791 formation of, 187 opsonization and, 439 elastin in, 791 in liver, 838 pinocytosis in, 18 Mechanical pain stimuli, 583 intestinal absorption into, 187 pyrogens released by, 875–876 Mechanical ventilation, 522–523, 522f rate of flow, 187–189, 187f tissue, 426–428 Mechanical work, energy of ATP for, 22, 23 Lymph nodes development from monocytes, 429 Mechanoreceptive senses, 571 macrophages in, 426–427 hemoglobin incorporated by, 840 Mechanoreceptors, 559, 560b. See also specific structure of, 426–427, 427f platelet removal by, 451–452 receptor types. Lymphatic capillaries, 186f, 187, 187f, response to infection, 428 adaptation of, 562–563, 562f 188, 188f Macula densa, 195, 306, 306f, 320, 320f, 331 of skin and deep tissues, 559, 560b, 560f pumping by, 188–189 glomerular filtration rate and, 319–320, Meconium, 1020 Lymphatic pump, 188, 189 320f Medial forebrain bundle, 715, 717 Lymphatic system, 181, 186–189, 186f Maculae, 674–675, 675f, 676–677 Medial geniculate nucleus, 639, 639f, 640 cerebral substitute for, 747 hair cells of, 675–676, 675f Medial lemniscus(i), 573, 574, 574f, 575f chylomicrons in, 797, 819 linear acceleration and, 676–677 Medial longitudinal fasciculus, 628, 628f, 630 edema and, 297, 300 Magnesium, 856 vestibular signals in, 678 interstitial fluid pressure and, 183–184, 189 in bone, 957–958 Medial motor system of the cord, 671 interstitial fluid protein concentration extracellular fluid concentration of, 369, Median eminence, 897, 897f, 898 and, 187, 189 370, 856 Medulla. See also Brain stem. interstitial fluid volume and, 189 intestinal absorption of, 796 chemoreceptor trigger zone in, 804 intestinal villi and, 769, 793f, 794 renal excretion of, 369–370 circulatory control by, 202, 202f, 203, 204f in liver, 837, 837f, 838 Magnet reaction, 663 baroreceptor signals and, 206 net filtration and, 185 Magnocellular neurons, 356, 897 pyramids of, 669, 670f potential spaces drained by, 300 Major basic protein, 430 respiratory control by, 505–508, 506f, 507f, pulmonary, 477, 481, 482, 482f Major histocompatibility complex (MHC) 508f, 509. See also Respiratory center. valves in, 187, 187f, 188, 188f proteins, 440, 440f, 441f reticular inhibitory area in, 712, 712f Lymphedema, 297 Malabsorption, 801–802 swallowing and, 764, 765 Lymphoblast, 423–424, 424f Male climacteric, 984 Medullary collecting duct, 333–334, 333f Lymphocytes, 423, 423t, 424, 434, 435f. Male hormones Medullary reticular nuclei, 673, 673f, 674 See also B lymphocytes; androgenic. See Androgens; Testosterone. decerebrate rigidity and, 674 T lymphocytes. hypothalamic-pituitary axis and, Medullary reticulospinal tract, 674, 674f activation of clones of, 436 983–984, 983f Megacolon, 802 life span of, 425 Male hypogonadism, 985, 985f Megaesophagus, 799 preprocessing of, 434–435 Male sexual act, 978–979 Megakaryocytes, 423, 424, 451 tolerance and, 442 Male sexual organs, 973, 973f Megaloblastic anemia, 415f, 420 specificity of, 435–436, 436f Malleus, 633, 633f Meiosis Lymphocytic leukemias, 431 Malnutrition, and metabolic rate, 864. See also in ovary, 1003 Lymphocytic lineage, 423–424, 424f Starvation. in testis, 974, 974f Lymphocytopenia, cortisol-induced, 931 Malocclusion, 971–972 Meissner’s corpuscles, 560f, 571, 572 Lymphoid tissues, 434 Malonyl-CoA, 824, 824f, 825 vibrations detected by, 572, 579 cortisol-induced atrophy of, 931 Maltase, 787, 790 Meissner’s plexus. See Submucosal plexus. Lymphokines, 436, 440–441, 441f, 881 Maltose, 790 Melanin Lysine monohydrochloride, for alkalosis, 393 Manic-depressive psychosis, 727 Addison disease and, 934 Lysis Mannitol, for brain edema, 749 of retina, 609–611 by antibodies, 438 Marginal ulcer, 800 of skin, 934 by complement system, 439, 439f Margination, 424f, 428, 429f Melanocortin receptors, 846–847, 847f, in transfusion reaction, 446 Mark time reflex, 664 849, 851 Lysoferrin, 20 Mass discharge, 738 anorexia and, 852 Lysosomes, 12f, 15, 19–20, 19f Mass movements, in colon, 770–771 Melanocyte-stimulating hormone, 933–934, amino acids released by, 833 Mass reflex, 665 933f circulatory shock and, 277 Mast cells, 431 α form of, 846, 847, 847f, 849, 933–934, 933f glucocorticoids and, 281 allergies and, 443 obesity and, 851 inflammation and, 930 asthma and, 520 β form of, 933–934, 933f of leukocytes, 426 complement fragments and, 439, 439f γ form of, 933–934, 933f in thyroid hormone release, 909 eosinophil chemotactic factor of, 430 Melatonin, pineal gland secretion of, 986 Lysozyme, 20, 433 heparin produced by, 431, 439, 457 Membrane. See Cell membrane. in saliva, 776 Mastication, 763 Membrane potential(s). See also Action Lytic complex, 439, 446 Maximum expiratory flow, 516–517, 516f potential(s); Receptor potentials; Mayer waves, 210–211 Resting membrane potential. M M-CSF (monocyte colony-stimulating factor), diffusion potential, 57–58, 57f M line, 73f in inflammation, 430, 430f resting membrane potential and, 60, 60f Machinery murmur, 270 Mean circulatory filling pressure, 236, 236f measurement of, 58–59, 58f, 59f Macrocytes, 417 Mean electrical axis of ventricles, 134–137, 135f oscilloscope in, 69, 69f Macromotor units, 82 conditions causing deviation of, 135–137 of olfactory cells, 650

1070 Index

Membrane transport, 45–56. See also Active Methylmercaptan, 650 Mixing waves, gastric, 766 transport; Diffusion. Methylprednisone, 922, 924t Modality of sensation, 559 basic mechanisms of, 45–46, 46f MHC (major histocompatibility complex) Modiolus, 635, 636–637, 637f energy of ATP for, 22–23, 22f proteins, 440, 440f, 441f Molecular layer, of cerebellum, 684–685, 684f Membranous labyrinth, 674, 675f Micelles, 785, 786, 792, 793, 797 Monoamine oxidase, of adrenergic nerve Memory, 545, 706–707 Michaelis-Menten equation, 861 endings, 732 Alzheimer’s disease and, 727–728 Microcirculation, 177–178, 178f. See also Monoamine oxidase inhibitors, 727 classification of, 706–707 Capillaries. Monocyte colony-stimulating factor (M-CSF), hippocampus and, 709, 719 Microcytic, hypochromic anemia, 415f, 420 in inflammation, 430, 430f intermediate long-term, 706, 707–708 Microglia, 428 Monocyte-macrophage system, 426–428, 427f long-term, 706, 708 Microgravity, 533–534 Monocytes, 423, 423t, 424, 425 thalamus and, 712 Microprocessor complex, 32–33 atherosclerosis and, 827–828, 828f reward or punishment and, 718 MicroRNA (miRNA), 31, 32–33, 33f diapedesis by, 425 short-term, 706, 707 Microtubules, 11, 16, 17, 17f in inflammation, 429 consolidation of, 708–709 of cilia, 24, 25 increased production of, 429, 430, 430f Wernicke area and, 701 of flagellum, 975, 975f Monoglycerides, 791f, 792, 792f working, 703, 706 of mitotic apparatus, 17, 38–39 absorption of, 797 Memory B cells, 437 Microvilli bile salts and, 785, 792 Memory T cells, 440 of intestinal epithelium, 790, 791, 794, 794f resynthesis of triglycerides from, 797, 819 Memory traces, 706 gluten and, 801 Monosaccharides, 789, 790 Menarche, 988, 998–999 of taste bud, 646, 647f absorption of, 796 Meningitis, headache of, 591 Micturition, 306 in liver cells, 810, 810f Menopause, 987, 998f, 999, 999f abnormalities of, 310 Morphine, respiratory depression caused by, 512 osteoporosis secondary to, 969, 994 Micturition reflex, 306, 309–310, 738 Morula, 1008–1009 Menstrual cycle, 988, 995–996, 995f. See also neurologic injury and, 310 Mossy fibers, 684–685, 684f Ovarian cycle. Micturition waves, 309, 309f Motilin, 758–759, 758t absent, 999 Middle cerebral artery, blockage of, 745 small intestine peristalsis and, 769 anovulatory, 998, 1001 Migraine headache, 591 Motion sickness irregular, 999 Milk nausea in, 804 thyroid hormones and, 914, 999 composition of, 1016, 1016t in spacecraft, 533 Menstruation, 995–996 ejection of, 906, 1015–1016 vomiting in, 804 leukorrhea during, 996 Mineral(s), 855–857. See also specific minerals. Motivation, 695. See also Limbic system; prevented by human chorionic body content of, 856t Punishment centers; Reward centers. gonadotropin, 1007, 1008 daily requirements of, 856t Motor aphasia, 704 Merkel’s discs, 572, 572f Mineralocorticoid receptor, 891, 926, 926f Motor apraxia, 669 Meromyosin, 72f Mineralocorticoid receptor antagonists, 399 Motor cortex, 667–673. See also Premotor area; Mesencephalon Mineralocorticoids, 921. See also Aldosterone. Supplementary motor area. motor function and, 670f, 673 deficiency of, 924, 934 basal ganglia and, 689, 690f, 691 reticular substance of, 711 properties of, 922–923, 924t cerebellar input from, 682, 683, 686, 687, 687f Mesenteric ganglia, 757 synthesis of, 921–922 cerebrocerebellum and, 688 Mesolimbic dopaminergic system, 727 Minimal change nephropathy, 313–314, 404 columnar arrangement of neurons in, Messenger RNA (mRNA), 29f, 31–32, 32f. See Minute respiratory volume, 471 671–672 also Transcription; Translation. Minute work output, cardiac, 107–108 lesions in, 673 microRNA and, 32–33, 33f Miosis, 632 pathways from, 669–670, 670f Metabolic clearance rate, of hormone, 886 miRNA. See MicroRNA (miRNA). red nucleus and, 670–671, 671f Metabolic end products, removal of, 5 Mirror neurons, 668 prefrontal association area and, 700 Metabolic rate, 862–863. See also Energy Mitochondria, 12f, 16, 16f, 21–23, 22f representations of body in, 667, 668f expenditure. citric acid cycle in, 813 role of, 694–695 ADP in control of, 862 exchangeable calcium in, 967 sensory pathways to, 670 basal. See Basal metabolic rate (BMR). fatty acid metabolism in, 822–823 somatosensory feedback to, 672 blood flow to tissue and, 192, 192f fatty acid transport into, 822 somatosensory input to, 575, 575f, 577, 670 cardiac output and, 234 high altitude and, 529 specialized areas of, 668–669, 669f epinephrine and, 736 oxidative phosphorylation in, 814–815, 814f speech and, 704–705 estrogens and, 994 of photoreceptors, 609, 610f spinal cord excitation by, 671–673, 672f factors determining, 867 of platelets, 451, 454 subareas of, 667–668, 668f

interstitial fluid Pco2 and, 498, 498f of presynaptic terminals, 547, 547f vasomotor center excitation by, 204 after a meal, 864–865 of skeletal muscle, 73, 73f voluntary movements and, 667, 673, 686 measurement of, 862–863 in fast vs. slow fibers, 79 Motor end plate, 83, 84f. See also in neonate, 1025 of sperm, 975, 975f Neuromuscular junction. thermogenesis and, 873 thyroid hormones and, 911–912 Motor functions, 543–544, 544f Metabolic syndrome, 951 Mitochondrial uncoupling protein, 873 basal ganglia in. See Basal ganglia. Metabolism Mitosis, 17, 37, 38–39, 38f brain stem in, 673–674, 673f, 674f blood flow and, cerebral, 743 prevention of, with colchicine, 39 anencephaly and, 678–679 of cardiac muscle, 248 Mitral cells, 651, 651f, 652 gamma efferents in, 659, 660 definition of, 862 Mitral regurgitation stretch reflexes and, 660 Metaphase, 38f, 39 circulatory dynamics in, 268–269 cerebellum in. See Cerebellum. Metarhodopsin, 611–612, 611f, 613, 614 murmur of, 267–268, 267f cerebral cortex in. See Motor cortex. Metarterioles, 177, 178f Mitral stenosis cognitive control of, 691–692, 695 in local blood flow control, 193, 193f circulatory dynamics in, 268–269 integrated control of, 694–695 sympathetic innervation of, 201 murmur of, 267f, 268 spinal cord in, 655 vasomotion of, 178–179, 193 pulmonary capillary pressure in, 483 excitation by cortex for, 671–673, 672f Metastatic calcification, in Mitral valve, 106–107, 107f organization of, 655–657, 655f, 656f hyperparathyroidism, 968 first heart sound and, 265, 266, 266f pathways from cortex for, 669–671, Methacholine, 86 Mixed acid-base disorders, 394–395, 394f 670f, 671f Methane, in large intestine, 804 Mixing movements, gastrointestinal, 759 reflexes and. See Spinal cord reflexes. Methoxamine, as sympathomimetic drug, 739 of colon, 770 sensory receptors and. See Golgi tendon Methyl alcohol, acidosis caused by, 393 of small intestine, 768–769, 768f organs; Muscle spindles.

1071 Index

Motor imagery, 686 Musculoskeletal system, homeostatic functions Myosin light chain kinase, 93–94, 94f Motor nerve fibers, classification of, 563f, of, 5 calmodulin and, 891 655, 656 Mutations, 38 Myosin phosphatase, 94, 94f Motor neurons, anterior, 547, 547f, 552, 655, cancer caused by, 40–41 Myxedema, 917–918, 918f 655f. See also Spinal cord reflexes. Myasthenia gravis, 86–87, 442 alpha, 655, 656, 656f, 659 Mydriasis, 632 N corticospinal tract and, 669, 672, 672f Myelin sheath, 67, 67f, 68, 68f. See also NAD+. See Nicotinamide adenine dinucleotide gamma, 655, 656, 656f, 657, 657f, 658, Demyelination. (NAD+). 659, 660 sphingomyelin of, 826 Naming objects, cortical area for, 699f, 700 inhibition of, Golgi tendon organ and, 661 thiamine deficiency and, 853 Nasal cavity, 472f, 474 pathways converging on, 672, 672f Myelinated nerve fibers, 67, 67f Nasal field of vision, 627 pontine reticulospinal tract and, 673–674 absolute refractory period of, 69 Nasal glands, autonomic control of, 735 Renshaw cells and, 656 classification of, 563, 563f Nasal sinuses, headache associated with, rubrospinal tract and, 671, 672, 672f saltatory conduction in, 68, 68f 591–592, 591f Motor units, 80, 656 velocity of conduction in, 68, 563 NASH (nonalcoholic steatohepatitis), 838 after poliomyelitis, 82 Myeloblasts, 423–424, 424f Natriuretic drugs, for essential hypertension, 226 Mountain sickness Myelocytic lineage, 423–424, 424f Natural killer lymphocytes, 433 acute, 530 Myelogenous leukemias, 431 Nausea, 804 chronic, 530–531 Myenteric plexus, 755, 756, 756f Nearsightedness, 602–603, 602f, 603f Movement receptors, 563 of colon, deficient in megacolon, 802 Neck proprioceptors, 678 mRNA. See Messenger RNA (mRNA). of esophagus, 765 Necrosis Mucin, salivary, 775 gastroenteric reflex and, 769 cellular, 40 Mucopolysaccharides, in cardiac parasympathetic neurons in, 757 in hypovolemic shock, 277–278, 278f T tubules, 103 peristalsis and, 759 Negative feedback, 7–8, 8f, 9 Mucous cells reflexes of, from cecum to ileum, 770 delayed, 9 of gastric surface, 777, 779 of small intestine, 769, 780 in hormone systems, 885 of gastrointestinal tract, 773 Myenteric reflexes, 759 Neglect syndrome, 692, 692f of pyloric glands, 778 defecation and, 771 Neocortex, 715 Mucous glands, 773 peristaltic rush and, 769 Neonatal respiratory distress syndrome, 468, esophageal, 776–777 stomach emptying and, 767 519, 1022, 1026 Mucous neck cells, gastric, 777, 777f, 778 Myocardial infarction, 249–250 Neonate. See also Infant. Mucus acute anterior wall, 140, 140f circulation of gastrointestinal tract, 773, 775 recovery from, 141, 141f readjustments in, 1022–1023 in large intestine, 787 acute posterior wall, 140–141, 140f special problems in, 1024, 1024f in saliva, 774f, 775, 776 recovery from, 141, 141f immunity in, 1025–1026 in small intestine, 786 cardiogenic shock secondary to, 259 jaundice in, 1024, 1024f in stomach, 777, 778, 779, 780, 799–800 causes of death after, 250–251 liver function in, 1025 in respiratory passages, 473 circulatory effects of. See Cardiac failure, nutrition of, 1023, 1025, 1026 Multiple fiber summation, 80 circulatory dynamics in. renal function in, 1024 Mumps orchitis, 977 current of injury in, 140–141, 140f, 141f respiration in, 1021–1022, 1021f, 1024, 1026 Murmurs, cardiac low-voltage ECG after series of, 137, 137f special functional problems in, 1023–1026 with patent ductus arteriosus, 267f, 270 recovery from temperature regulation in, 873, 1025, 1025f in valvular heart disease, 267–268 function of heart after, 252, 256–257, 256f prematurity and, 1027 Muscarinic receptors, 733 rest during, 251–252 weight loss in, 1023 drugs acting on, 740 stages of, 251–252, 251f Neospinothalamic tract, 585 drugs blocking, 740 subendocardial, 249–250 Neostigmine, 86 Muscle. See Cardiac muscle; Skeletal muscle; Myocardial ischemia. See also Angina pectoris. for myasthenia gravis, 86–87 Smooth muscle. ectopic foci caused by, 146 Nephritis, interstitial, 403 Muscle contraction electrocardiogram in Nephrogenic diabetes insipidus, 295 energy of ATP for, 22, 22f, 23, 859 current of injury and, 138, 140–141, Nephron(s), 305–306, 306f, 307f. See also Distal heat dissipated in, 862 140f, 141f tubule; Loop of Henle; Proximal tubule. Muscle cramps, 665 in mild ischemia, 142, 142f age-related loss of, 403 Muscle impulse, 64–65 metabolism of cardiac muscle in, 248 transport and permeability properties Muscle spasm pain in, 252 of, 348t headache caused by, 591 vasospastic, 248 Nephrosclerosis, 403 pain caused by, 584 Myofibrils, of skeletal muscle, 71, 72f, 73f, 74f benign, 403 spinal cord reflexes causing, 664–665 T tubules and, 87, 87f, 88 malignant, 403 Muscle spasticity, stroke leading to, 673 Myogenic mechanism, 321 Nephrotic syndrome, 404 Muscle spindles, 560f, 656f, 657 renal blood flow and, 321 edema in, 298, 377 adaptation of, 562, 562f Myoglobin, 79, 1036 Nernst equation, 50, 57–58 cerebellar input from, 661, 683, 683f Myopia, 602–603, 602f, 603f Nernst potential, of neuron membrane, 552–553 feedback to motor cortex, 672 Myosin Nerve fibers, physiologic classification of, joint angulation and, 580 in ameboid movement, 23 563–564, 563f nerve fibers from, 564, 656, 656f as ATP-degrading enzyme, 859 Nerve impulse, 64–65. See also Action receptor function of, 657–658, 657f of cardiac muscle, 101, 103 potential(s), nerve. stretch reflex and, 658–659, 658f, 659f, 672 Frank-Starling mechanism and, 110 Nerve trunks clinical applications of, 660, 660f ventricular volume and, 108 myelinated fibers in, 67, 67f Muscle stretch reflex, 658–659, 658f, 659f, coated pits and, 18–19, 18f saltatory conduction in, 68, 68f 672, 694 in mitosis, 39 velocity of conduction in, 68 clinical applications of, 660, 660f of platelets, 451, 454 unmyelinated fibers in, 67, 67f Muscle tone of skeletal muscle Nervous system. See also Central nervous central control of, 694 contraction mechanism and, 74, 74f, system (CNS); Enteric nervous system; of skeletal muscle, 80 75–76, 76f Synapses. Muscle weakness hypertrophy and, 81 compared with computer, 546, 546f aldosterone excess and, 925–926 muscle tension and, 77, 77f general design of, 543–545, 544f cortisol excess and, 929 structural features of, 71, 72f, 73f, 74–75, 74f integrative function of, 544–545 Muscularis mucosae, contractions of, 769 of smooth muscle, 92–94, 92f regulatory functions of, 5

1072 Index

Net acid excretion, 390 Nicotinamide adenine dinucleotide phosphate Nucleus, 11, 11f, 17, 17f Net filtration, 185 (NADP+) evolution of, 18 Net filtration pressure, 181, 184, 185–186 in fatty acid synthesis, 824, 824f Nucleus accumbens, Parkinson’s disease and, abnormal, edema and, 185–186 niacin requirement and, 853–854 693 glomerular, 314, 314f pentose phosphate pathway and, 816f, 817 Nucleus ambiguus, 506 Net reabsorption pressure, 185, 186 Nicotine, 86 Nucleus parabrachialis, 506 Neuroendocrine hormones, 881 Nicotinic acid. See Niacin. Nucleus retroambiguus, 506 Neurogenic bladder, 310 Nicotinic drugs, 740 Nucleus tractus solitarius. See also Tractus Neurogenic shock, 279–280 Nicotinic receptors, 733 solitarius. sympathomimetic drugs for, 281 Night blindness, 612 energy expenditure and, 846 Neurohormonal systems, in brain, 711, Nitrates, for angina pectoris, 196, 252 respiration and, 505 712–713, 713f Nitric oxide sleep and, 722 Neurohypophysis. See Pituitary gland, posterior. as central nervous system transmitter, 551 Nystagmus, cerebellar, 689 Neuromuscular junction glomerular filtration rate and, 318 of skeletal muscle, 83 penile erection and, 978–979 O acetylcholine action at, 73, 83–86, 84f vasodilation by, 195–196, 196f Oat bran, 829 acetylcholine synthesis at, 83, 86 Nitric oxide synthase, 195, 196f Obesity, 850–851 drugs acting at, 85, 86 Nitrogen coronary artery disease and, 829 fatigue of, 85–86 dissolved in body fluids, 537, 537t. See also cortisol excess causing, 929 myasthenia gravis and, 86–87 Decompression sickness. end-stage renal disease associated with, 402 structure of, 83, 84f excretion of, 845 fat storage in, 825–826 of smooth muscle, 94–95, 94f high partial pressures of, 535 genetic factors in, 851 Neuron(s). See also Axon; Dendrites; Soma of Nitrogen balance, 845 leptin and, 849, 851 neuron; Synapses. Nitrogen narcosis, 535, 539 melanocortin system and, 846–847, 851 central nervous system, 543, 544f Nociceptive reflex, 662 in rodents, 826, 847 continuously discharging, 568 Nociceptors. See Pain receptors. hypertension and, 225–226 excitation of, 552–555, 552f, 553f, 554f. Nodes of Ranvier, 67, 67f, 68, 68f left axis deviation in, 135 See also Action potential(s), neuronal. Nonalcoholic steatohepatitis (NASH), 838 sympathetic activation in, 865 dendrite functions in, 555–556, 556f Nondominant hemisphere, 702 treatment of, 851 drug effects on, 557 corpus callosum and, 705 type II diabetes and, 951, 952 rate of firing and, 556–557, 556f Nonpitting edema, 299 Obstructive jaundice, 841–842 excitatory state of, 556–557, 556f Nonprotein nitrogen Occlusion, of teeth, 969 facilitation of, 545, 555 chronic renal failure and, 406 Oddi, sphincter of, 780–781, 784f, 785 inhibition of, 553f, 554–555 placental diffusion of, 1007 Odontoblasts, 970 inhibitory state of, 556–557 Nonshivering thermogenesis, 865, 873 Odor blindness, 650 metabolism of, 749 Nonsteroidal antiinflammatory agents, gastric Ohm’s law, 159, 160, 230–231 morphologic variations in, 547 mucosa and, 801 Oleic acid, 819 motor. See Motor neurons, anterior. Nonvolatile acids, 385, 387, 388, 390 Olfaction. See also Smell. rate of firing of, for different neuron types, anion gap and, 395 amygdala and, 719 556–557, 556f Norepinephrine hippocampus and, 719 resting membrane potential of soma, 552, 552f adrenal medullar secretion of, 736, 884, 921 Olfactory bulb, 649f, 651, 651f Neuronal circuits basal level of, 737 granule cells in, 650, 652 inhibitory, 569 of adrenergic nerve endings, 731–732 Olfactory cells, 649, 649f, 651 instability and stability of, 569–570, 569f adrenergic receptors and, 733 stimulation of, 649–650, 649f Neuronal pools, 564–568 in basal ganglia, 692–693, 692f Olfactory cilia, 649, 649f grossly inhibitory, 569 cardiac effects of, 120 Olfactory membrane, 648–649, 649f, 651 prolongation of signal by, 567–568 as central nervous system transmitter, 551 Olfactory nerve, 649 relaying of signals through, 565–567, 565f, coronary blood flow and, 247, 248 Oliguria, 399 566f, 567f depression and, 726–727 Olivocerebellar tract, 670, 683, 683f Neuropeptide Y, 846, 847, 847f, 849, 851 drugs blocking release of, 740 Oncogenes, 40, 41 Neuropeptides, 550, 550b, 551–552 drugs blocking synthesis of, 740 Oncotic pressure. See Colloid osmotic pressure. Neurophysins, 904 drugs causing release of, 740 Oocyte Neurotransmitters, 546, 547, 550–552, 550b, 881 fatty acid mobilization caused by, 825 primary, 987, 1003 in basal ganglia, 692–693, 692f gastrointestinal smooth muscle and, 755, secondary, 1003 in enteric nervous system, 756–757 756, 757 Ophthalmoscope, 605–606, 605f in hypothalamus, feeding and, 847f, 847t glomerular filtration rate and, 318 Opsins, 614 neurohormonal control of brain activity by, metabolic rate and, 867 Opsonization, 19, 425 712–713, 713f molecular structure of, 731 phagocytosis and, 439, 439f release from presynaptic terminal, 548 for shock, 281 Optic chiasm, 623, 623f of retinal neurons, 617 as smooth muscle neurotransmitter, destruction of, 627 Neutral fats. See Triglycerides. 95, 96, 97 Optic disc, edematous, 748 Neutrophilia, 428–429 sweat glands and, 870 Optic nerves, 623, 623f Neutrophils, 423, 423t, 424f as sympathomimetic drug, 739 destruction of, 627 chemotaxis by, 439 synthesis of, 732, 884 peripheral vs. central retina and, 619 diapedesis by, 424f, 425, 428, 429f thermogenesis and, 873 Optic radiation, 623, 623f in infection, 425–426 as vasoconstrictor, 199, 203, 203f, 204 Optic tracts, 623, 623f in inflammation, 428–430, 429f in skeletal muscle, 244 interruption of, 627 in milk, 1016 Norepinephrine system, in brain, 712–713, 713f Opticokinetic movements, 629 opsonization and, 439 Nose, 474 Optics Niacin, 853–854 Nuclear bag muscle fibers, 657–658, 657f of eye, 600–605 Nicotinamide adenine dinucleotide (NAD+), Nuclear chain muscle fibers, 657–658, 657f physical principles of, 597–600 813, 814 Nuclear membrane, 11, 11f, 13, 17, 17f Orexigenic substances, 846, 847, 847t, 851 in deamination, 834 Nuclear pores, 17, 17f Organ of Corti, 634–635, 634f, 636–638, in fatty acid oxidation, 822f, 823 Nucleolus(i), 12f, 17, 17f, 32 636f, 637f glucocorticoids and, 928 Nucleotides damage to, 642 lactic acid formation and, 816 deoxyribose, 27–29, 28f, 29f retrograde pathways in, 641–642 niacin requirement and, 853–854 ribose, 29f, 30 Organum vasculosum, 905

1073 Index

Orgasm Ovaries Oxygen consumption, in cellular female, 1000 anatomy of, 987, 987f, 988f metabolism (Continued) male, 979 cholesterol used by, 827 diffusion limited, 501

Orlistat, 851 Overdrive suppression, 145 interstitial fluid Po2 and, 496f, 497 Oscillatory circuits. See Reverberatory circuits. Overflow incontinence, 310 intracellular Po2 and, 500–501, 501f Oscilloscope, for recording membrane Overhydration coronary blood flow and, 247, 248 potentials, 69, 69f hypernatremia causing, 295t, 296 during exercise, 510, 510f, 1036, 1036f, 1036t Osmolality, 52, 291 hyponatremia in, 295, 295t heat generation and, 1040 of stomach contents, 767, 768 Ovulation, 989f, 990, 990f, 1003, 1004f maximal, 1037, 1037f, 1039 Osmolar clearance, 354 infertility due to failure of, 1001 work output and, 1038, 1038f Osmolarity, 52, 291. See also Extracellular fluid preovulatory surge and, 885, 988f, 997–998 by heart, 109, 249 osmolarity. suppression of, 1001 metabolic rate determination from, 863 of body fluids, 288t, 291 timing of fertilization and, 1000–1001 basal, 863 plasma, 288t, 291 Ovum(a) Oxygen debt, 861, 1034, 1034f

estimated from sodium concentration, development of, 987, 989–990, 989f Oxygen free radicals, high alveolar Po2 and, 294, 355 entry into fallopian tube, 1003, 1004f 536–537 Osmoles, 290–291 fertilized, 1003–1004, 1004f Oxygen lack theory, of local blood flow Osmoreceptor cells, 355, 356, 356f, 358, 905 mature, 1003 regulation, 192, 193, 193f

Osmosis, 51, 51f, 290 release of. See Ovulation. Oxygen partial pressure (Po2) active transport combined with, 55–56, 55f Oxalate, as anticoagulant, 456, 460 alveolar, 488, 488f renal reabsorption and, 324, 328 Oxaloacetic acid, in citric acid cycle, altitude and. See High altitude, alveolar

sodium-potassium pump and, 53 813, 813f Po2 at. Osmotic coefficient, 291 deficiency of, 824 high levels of, 499, 535–537, 536f Osmotic diuresis, 950 starting with fatty acids, 822–823 intracellular, 497 Osmotic diuretics, 397, 398t Oxidases, of peroxisomes, 15–16 with oxygen therapy, 521, 521f Osmotic equilibrium, of intracellular and Oxidative metabolism. See also Aerobic energy. solubility coefficient and, 486 extracellular fluids, 291–292, 292f at high altitude, 529 in tissues, hemoglobin buffering of, 499 Osmotic pressure, 51–52, 51f, 291. See also hypoxia caused by defects in, 521 ventilation-perfusion ratio and, Colloid osmotic pressure. in skeletal muscle, 78, 79 492–494, 493f of cerebrospinal fluid, 747 for exercise, 1033, 1033f, 1033t arterial Ossicular system, 633–634, 633f Oxidative phosphorylation, 814–815, 814f chemoreceptors and, 208 damage to, 642 pentose phosphate pathway and, 816–817 during exercise, 1037 Osteitis fibrosa cystica, 968 uncoupled, 865, 873 measurement of, 515–516 Osteoblasts, 900, 958, 959–960, 959f Oxygen atmospheric, 527, 528t. See also High altitude. calcitonin and, 966 brain’s special need for, 749 in tissues of cementum, 971 diffusing capacity for, 491, 492f cerebral blood flow and, 744

fracture repair and, 960 carbon monoxide method, 492 with high alveolar Po2, 536 parathyroid hormone and, 963–964 diffusion coefficient of, 487t Oxygen saturation, arterial, 530 Osteoclasts, 900, 959–960, 959f diffusion of. See also Diffusion, of gases. at different altitudes, 527, 528f, 528t calcitonin and, 966 from alveoli to capillaries, 5, 495–496, local blood flow and, 192, 192f of cementum, 971 496f Oxygen therapy, 520, 521, 521f estrogen and, 994 from capillaries to cells, 497, 501 in heart failure, with acute pulmonary parathyroid hormone and, 963, 964–965 from capillaries to interstitial fluid, edema, 261 Osteocytes, 958, 959f 496–497, 496f hyperbaric, 540 parathyroid hormone and, 963, 964 through capillary membrane, 179, 180 in premature infant, 1027 Osteocytic membrane system, 964 energy equivalent of, 863 for shock, 281 calcitonin and, 966 in extracellular fluid Oxygen toxicity, 501 Osteoid, 958 normal range of, 7t at high pressures, 535–537, 539 Osteolysis, 963–964 regulation of, 6 Oxygen-diffusing capacity, 1037, 1037t Osteomalacia, 969 lipid solubility of, 46 Oxygen-hemoglobin dissociation curve, 498, in renal disease, 406–407, 969 in local blood flow control 498f, 499f Osteon, 959–960 acute, 192, 192f, 193 fetal, 1006, 1006f Osteoporosis, 969 long-term, 197–198 hemoglobin buffering and, 499 in postmenopausal women, 969, 994 in skeletal muscle, 243 at high pressures, 535–536, 536f Osteoprotegerin, 959, 994 smooth muscle and, 97 of high-altitude residents, 530, 530f Osteoprotegerin ligand, 959, 964 placental diffusion of, 1006–1007, 1006f shift in, factors causing, 499–500, 500f Oval window, 633–634, 633f, 635, 635f, 636 respiratory control by, 507, 508–510, Oxyntic cells. See Parietal (oxyntic) cells. Ovarian cycle, 988–991. See also Female 509f, 510f Oxyntic (gastric) glands, 766, 777–778, 777f, 779 hormones; Menstrual cycle. tissue concentration of, capillary blood flow hydrogen ion transport in, 54 follicular phase of, 989–990, 989f, 990f and, 178–179 peptic cells of, 777, 777f, 778, 779 gonadotropic hormones and, 988–989 transport of, 495–502 structure of, 777, 777f hypothalamic-pituitary hormones and, from alveoli to capillaries, 495–496, 496f Oxyphil cells, 963, 963f 996–998, 996f, 997f in blood, 496, 496f, 501 Oxytocin, 896, 905–906 luteal phase of, 990–991 from capillaries to tissue cells, 497, 501 chemical structure of, 904 ovulation in, 990, 990f from capillaries to tissue fluid, copulation and, 1000 plasma levels of hormones in, 988, 988f 496–497, 496f fertilization and, 1003 summary of, 991 in dissolved state, 498, 501, 521, hypothalamus and, 716, 904 suppression of, during nursing, 1015 535–536, 536f labor and, 905 Ovarian follicle(s), 988f during exercise, 498–499 lactation and, 716, 905–906, 1015–1016 atretic, 990 hemoglobin in, 495, 498–500, 498f, uterine contraction and, 1012, 1013 development of, 989–990, 989f 499f, 500f mature, 989f, 990 Oxygen consumption P primary, 989 by brain tissue, 744 P wave, 121, 121f primordial, 987, 989, 989f cardiac output and, 230, 230f atrial contraction and, 122 Ovarian hormones, 991–996, 992f, 993f. in cellular metabolism, 500–501 cardiac cycle and, 105, 105f See also Estrogen(s); Progestins. ADP concentration and, 500, 501, 501f normal voltage of, 123 abnormalities of, 999–1000 blood flow limited, 501 vectorial analysis of, 133f

1074 Index

Pacemaker Para-aminohippuric acid (PAH), 330 Parietal lobe, somatosensory signals and, 575 cardiac, 118–119 renal plasma flow and, 341–342, 342f Parietal pain, 589–590, 589f arrhythmias and, 143 Parachute jumps, deceleratory forces in, Parieto-occipitotemporal association area, artificial implanted, 145, 153 532–533 699–700, 699f ectopic, 119 Paracrines, 881 in nondominant hemisphere, 702 in paroxysmal tachycardia, 148 Paradoxical sleep, 722 prefrontal association area and, 700 gastrointestinal smooth muscle, 754 Parafollicular cells, thyroid, 966 Parkinson’s disease, 691, 693–694, 727 Pacemaker waves, of smooth muscle, 96 Parallax, 605 Parotid glands, 775, 790 Pacinian corpuscles, 560f, 561–562, 561f, 572 Parallel fibers, of cerebellum, 684–685 Paroxysmal tachycardia, 148–149 adaptation of, 562, 562f, 563 Parasitic infections, eosinophils in, 430 atrial, 148, 148f joint angulation and, 580 Parasympathetic denervation, 737 ventricular, 148–149, 149f stimulus intensity and, 579 Parasympathetic nervous system. See also Partial intraventricular block, 145–146, 145f vibrations detected by, 572, 579 Autonomic nervous system; Vagus Partial pressures. See also Carbon dioxide

Packed red cell volume. See Hematocrit. nerves. partial pressure (Pco2); Oxygen partial Paget disease, calcitonin in, 966 anatomy of, physiologic, 730–731, 731f pressure (Po2). PAH. See Para-aminohippuric acid (PAH). in arterial pressure control, 206 of dissolved gases, 485–486 Pain bladder and, 308, 308f, 309 in gas mixture, 485 analgesia system of brain and spinal cord, bronchiolar constriction caused by, 473 net diffusion and, 486–487 586–588, 587f cardiac innervation by, 111, 111f, 119, of water vapor, 486 brain stem excitatory area and, 711 201, 202f Parturition, 1011–1014, 1012f in coronary artery disease, 252. See also cardiac regulation by, 111, 111f, 119–120 involution of uterus after, 1013–1014 Angina pectoris. bradycardia and, 144 Passive immunity, 442 dual pathways for transmission of, cardiac output and, 231 Past pointing, 689 584–586, 585f vasomotor center and, 203 Patch-clamp method, 48, 49f surgical interruption of, 586 circulatory control by, 201, 202f Patent ductus arteriosus, 269–271, 270f, 1023 electrical stimulation for treatment of, 588 coronary blood flow and, 247 aortic pressure pulse associated with, fast vs. slow, 583 erection and 169, 169f of headache, 590–592, 591f in female, 1000 murmur of, 267f, 270

of herpes zoster, 590 penile, 978–979 Pco2. See Carbon dioxide partial pressure hyperalgesia and, 583–584, 590 eye control by, 601, 631, 632, 730–731 (Pco2). inhibition by tactile signals, 587–588 gastric secretions and, 778 Pellagra, 854 of labor, 1013 gastrointestinal regulation by, 755, 756–757 Pelvic nerves parietal, 589–590, 589f blood flow and, 762 bladder and, 308, 309 protective function of, 583 defecation and, 738, 757, 771, 771f parasympathetic fibers in, 731 referred, 588, 588f large intestine mucus and, 787 defecation reflex and, 771, 771f headache as, 591 peristalsis and, 759 to intestine, 757, 787 from visceral organs, 588, 589, 589f psychogenic diarrhea and, 802 Pendrin, 908, 908f of tic douloureux, 590 gastrointestinal secretions and, 773–774 Pendular movements, 687–688 tissue damage and, 583, 584 localized activation of, 738 Penetrating arterioles, of brain, 743, 743f visceral, 588–590, 589f salivary glands and, 776, 776f Penile erection, 196, 738, 978–979, 979f Pain fibers, 564 sexual lubrication and, 979 Pentagastrin, 780 fast and slow, 584–585 ureteral peristalsis and, 309 Pentose phosphate pathway, 816–817, 816f spatial summation and, 564, 564f Parasympathetic tone, 737 Pepsin, 778, 791, 791f Pain receptors, 559, 560b, 583 Parasympathomimetic drugs, 740 deficiency of, 800 nonadapting nature of, 583–584 Parathyroid glands, 962–963, 963f excess of, 800 thermal excitation of, 592, 592f Parathyroid hormone (PTH), 962–966 Pepsinogen, 777, 778 types of stimuli acting on, 583 bone resorption and, 959 regulation of secretion of, 779 Pain reflex, 662 calcium homeostasis and, 367–369, 368f Peptic (chief) cells, 777, 777f, 778, 779 Pain sense, 571 extracellular fluid concentration in, Peptic ulcer, 780, 786, 800, 800f, 801 anterolateral system and, 573 963–966, 963f, 965f, 967 obstruction caused by, 804 localization of, 577 intestinal absorption in, 796, 964 treatment of, 801 Paleocortex, 715 renal reabsorption in, 339, 964 Peptidases Paleospinothalamic tract, 585, 586 chemistry of, 963 of enterocytes, 787, 791 Palmitic acid, 819 control of secretion of, 965–966, 965f zinc in, 856 Pancreas deficiency of, 967 Peptide hormones, 881, 882 acini of, 773, 780–781, 939, 939f excess of clearance from blood, 886 physiologic anatomy of, 939, 939f in chronic renal failure, 407 Peptide linkages, 789, 790, 831 Pancreatic duct, 780–781 primary, 967–968 energy required for, 859, 862 Pancreatic polypeptide, 939 secondary, 968 formation of, 34, 35 Pancreatic secretions, 780–783, 782f, 783f phosphate homeostasis and, 369 Peptide YY, 846f, 848 alkalinity of, 800 extracellular fluid concentration in, Peptidyl transferase, 34 amylase, 781, 790 963–965, 963f Peptones, 783, 783f, 791 in neonate, 1025 renal excretion in, 964 Perforins, 441 deficiency of, 801 in pregnancy, 1009 Periaqueductal gray, pain signals and, lipases, 781, 792–793, 792f summary of effects of, 965–966, 965f 586–587, 587f proteolytic enzymes, 781, 791, 791f vitamin D and, 961–962, 961f Pericardial effusion, 300 Pancreatitis, 781, 801 Parathyroid poisoning, 968 low-voltage ECG associated with, 137 Panhypopituitarism, 902 Paraventricular nuclei Perilymph, 637–638 in adult, 903 food intake and, 846, 849 Perimetry, 627, 627f with gigantism, 903 pituitary hormones and, 897, 904, 904f, Periodic breathing, 512–513, 512f dwarfism in, 902–903 905, 906 Periodontal membrane, 970 Panting, 871 Parietal (oxyntic) cells, 777, 777f Peripheral chemoreceptor system. Pantothenic acid, 812–813, 855 ghrelin released by, 848 See Chemoreceptor reflexes; Papilla of Vater, 780–781 hydrochloric acid secretion by, 777–778, Chemoreceptors. blockage at, 801 777f, 778f Peripheral circulation, 157 Papillary muscles, 107, 107f stimulation of, 778, 779 Peripheral membrane proteins, 13f, 14 Papilledema, 748 intrinsic factor secretion by, 778 Peripheral resistance unit (PRU), 162–163

1075 Index

Peripheral vascular resistance. See Total Phosphate, in extracellular fluid and Pituitary gland (Continued) peripheral resistance; Vascular plasma (Continued) anterior resistance. parathyroid hormone and, 963–965, 963f cell types in, 896–897, 896f, 896t Peristalsis, 759, 759f in rickets, 968 hormone deficiencies of, 902–903 of colon, 771 fecal excretion of, 957 hormones of, 895, 895f, 896, 896t, 898. See of esophagus, 764f, 765 fetal accumulation of, 1020, 1020f also specific hormones. of pharynx, 764, 765 intestinal absorption of, 796, 957, 962 hypothalamus and, 716–717, 897–898, of rectum, 771 parathyroid hormone and, 964–965 897f, 898t, 901–902 of small intestine, 769 vitamin D and, 962, 964–965 pregnancy and, 1009 of ileum, 769–770, 770f phospholipids as donors of, 826 embryology of, 895 of stomach, 766 renal excretion of, 369, 957, 962, 964 intermediate lobe of, 934 emptying and, 766, 767 with reduced GFR, 404, 405f posterior Peristaltic reflex, 759 renal failure and, chronic, 407 hormones of, 895, 896, 897. See also Peristaltic rush, 769 Phosphate buffer system, 383, 388, 388f specific hormones.

Peristaltic waves, in small intestine, 769 Phosphatidylinositol biphosphate (PIP2), 890 hypothalamus and, 895, 897, 904, 904f, Peritoneointestinal reflex, 772 aldosterone and, 927 905, 906 Peritonitis Phosphocreatine, 78, 860 PKC (protein kinase C), 890, 890f abdominal muscle spasm in, 665 depleted in irreversible shock, 278–279 Place principle, 638 intestinal paralysis secondary to, 772 in strenuous muscle activity, 860, 861, Placenta, 1005–1007 septic shock secondary to, 280 1032–1034, 1033f anatomy of, 1005–1007, 1006f Peritubular capillaries, 304–305, 305f, 306, 307f, summary of use of, 861, 861f blood flow through, 1010 311, 311f. See also Vasa recta. Phosphodiesterase-5 inhibitors, 196, 986 breaks in membrane of, 1005–1006 reabsorption and, 323–324, 324f Phosphofructokinase, inhibition of, 815 carbon dioxide diffusion through, 1007 physical forces and, 335–337, 335f, Phosphogluconate pathway, 816–817, 816f diffusion conductance of, 1005–1006, 1005f 336t, 337f Phospholipase, pancreatic, 781 duration in pregnancy and, 1005, 1005f

Perivascular spaces, of brain, 746, 747, 747f Phospholipase A2, 792–793 hormones secreted by, 1007–1009 Periventricular nuclei, 586–587, 587f Phospholipase C, hormonal activity and, 890, nutrient diffusion through, 1007 Pernicious anemia, 417, 420, 778, 800, 854 890b, 890f oxygen diffusion through, 1006–1007, 1006f Peroxidases, 536–537 parathyroid, 965 preeclampsia and, 1011 iodide oxidation by, 908, 908f thyroid, 914 separation and delivery of, 1013 deficient, 917 Phospholipids, 12, 13, 819, 826. See also waste product diffusion through, 1007

Peroxide radical, high alveolar Po2 and, Lecithin. Plaque, dental, 971 536–537 chemical structures of, 826, 826f Plaques, atheromatous, 827, 828, 828f Peroxisomes, 15–16 in chylomicrons, 819 Plasma. See also Extracellular fluid. of neutrophils and macrophages, 426 dietary, 792 composition of, 287, 288f, 288t Petit mal epilepsy, 725f, 726 digestion of, 792–793 as fluid compartment, 4–5, 286, 286f, 287 pH. See also Acid-base regulation; insulin and, 944 hypovolemic shock in loss of, 279 Hydrogen ions. in lipoproteins, 821, 821t with trauma, 279 bicarbonate buffer system and, 382 second messenger system using, 890, osmolarity of, 288t, 291. See also blood 890b, 890f Extracellular fluid osmolarity. acid-base disorders and, 393, 394–395, synthesis of, 826 estimated from sodium concentration, 394f in endoplasmic reticulum, 20 294, 355 carbon dioxide transport and, 504 in liver, 822, 839 viscosity of, 165 measurement of, 515–516 thyroid hormones and, 912 Plasma cells, 423, 424, 437, 441f oxygen-hemoglobin dissociation curve uses of, 826 Plasma colloid osmotic pressure, 181, 181f, 184, and, 499–500, 500f structural, 827 184t, 185t respiratory control and, 508, 508f, Phosphoric acid, as component of DNA, 27, 28f albumin and, 184, 184t, 833 510, 510f Phosphorus, 856 lymph flow and, 188 of body fluids, 380, 380t Phosphorylase, 811, 811f Plasma membrane definition of, 380 activation of, 36, 812 of cell. See Cell membrane. of gastrointestinal secretions, 775t Photopsins, 614 of skeletal muscle fiber, 71 Phagocytes, in spleen, 175 Photoreceptors. See Cones; Rods. Plasma proteins. See also Albumin. Phagocytosis, 18, 19, 423, 425–426 Physiologic dead space, 471–472, 493, 494 as amino acid source, 833, 834f after apoptosis, 40 Physiologic shunt, 493, 494 calcium bound to, 367 aqueous humor cleansed by, 607 Physiology, 3 capillaries impermeable to, 4–5 bactericidal agents and, 20, 426 Physostigmine, 86 carbon dioxide transport by, 503 by eosinophils, 430 Pia mater, perivascular space and, 747, 747f colloid osmotic pressure and, 184, 184t in inflammatory response, 428, 429 Pial arteries, 743, 743f of complement system, 438 innate immunity and, 433 Pigment layer, of retina, 609–611, 610f cortisol and, 929 monocyte-macrophage system and, 426–428 Piloerection, for temperature regulation, edema caused by decrease in, 297, 298, 300 opsonization and, 439, 439f 872–873 in cirrhosis, 377–378, 833 Phagocytotic vesicle, 19, 19f, 425–426 Piloerector muscles, nerve fibers to, 729–730, in nephrotic syndrome, 377 Pharyngoesophageal sphincter, 764 730f, 731 equilibrium between tissue proteins and, Phasic receptors, 563 Pineal gland, 986 833–834, 834f Phenylthiocarbamide, 646 blood-brain barrier and, 748–749 estrogens bound to, 993 Phonation, 474–475 Pinocytosis, 18–19, 18f glomerular filtration of, 312, 313, 313t. Phonocardiogram, 266, 267f in intestinal epithelium, 794, 794f See also Proteinuria. cardiac cycle and, 105, 105f of proteins in renal tubule, 326 glucocorticoids and, 835 of valvular murmurs, 267f, 268 in thyroid gland, 908f, 909 hormone transport by, 885–886 Phosphagen energy system, 1033, 1034b, 1036 Pinocytotic vesicle, 18–19, 19f of adrenocortical steroids, 923–924 Phosphate, 856. See also Hypophosphatemia. in intestinal epithelium, 794, 794f of steroids, 885–886

in bone, 957 PIP2. See Phosphatidylinositol biphosphate (PIP2). of testosterone, 980 deposition of, 958 Pitting edema, 299 of thyroid hormones, 882, 885–886 parathyroid hormone and, 963–964 Pituicytes, 904 immunoglobulins as, 437–438 in extracellular fluid and plasma, 955 Pituitary gland, 895–906 in interstitial fluid, 184, 185, 189 forms of, 955 adenoma of, 935, 936 interstitial fluid cations and, 287 level of, 955–956 anatomy of, 895, 895f intestinal obstruction and loss of, 279

1076 Index

Plasma proteins (Continued) Position senses, 571, 573, 580, 580f Potassium leak channels, 59, 59f, 60, 63 lymphatic return of, 186 Positive and supportive reaction, 663 Potassium-sparing diuretics, 332, 333f, 399 magnesium bound to, 369 Positive feedback, 8–9, 8f Potential energy, of ventricular contraction, major types of, 833 in hormone systems, 885 108f, 109 in neonate, 1025, 1027 Postcentral gyrus, 575f, 576, 577 Potential spaces nephrotic syndrome and, 377, 404 Posterior parietal cortex fluids in, 300 in potential spaces, 300 lesions of, 692 pleural, 483 progesterone bound to, 993 spatial coordinates of body and, 692, 699, 699f Power law for stimulus intensity, 579, 580f synthesis of, 833, 840 Postganglionic neurons, autonomic auditory, 638 thyroid hormones bound to, 909–910 drugs that block, 740 P-Q interval, 121f, 123 Plasma substitutes, 281 drugs that stimulate, 740 P-R interval, 121f, 123 Plasma transfusion, 280–281 muscarinic receptors of, 733 prolonged, 144–145, 144f Plasma volume, measurement of, 290 parasympathetic, 731 Precapillary sphincters, 177 Plasmalemmal vesicles, of capillary endothelial enteric nervous system and, 757 in local blood flow control, 193, 193f cells, 178, 178f sympathetic, 729–730, 730f sympathetic innervation of, 201 Plasmin, 457 adrenal medulla and, 730 vasomotion of, 178–179, 193 Plasminogen, 457 gastrointestinal tract and, 757 Precordial leads, 126, 126f Platelet factor 3, 455 transmitters of, 731, 732 Prednisolone, 924t Platelet plug formation, 451–452, 452f Postsynaptic neuron, 546, 548–549. See also Prednisone, 922 Platelets, 423, 424, 451–452 Neurotransmitters. Preeclampsia, 1011 in clot, 452, 452f, 454 excitatory receptors of, 547, 549–550 hypertension in, 224 clot retraction and, 454 inhibitory receptors of, 547, 549, 550 Prefrontal association area, 699f, 700, 702–703 concentration of, in blood, 423 second messengers in, 548–549, 549f Prefrontal cortex deficiency of, 458 Postsynaptic potentials, 553–555, 553f, 554f feeding and, 848 endothelial surface and, 452, 457 summation of, 553, 554f, 555 schizophrenia and, 727 intrinsic clotting pathway and, 455 Postural instability, in Parkinson’s disease, 693 Prefrontal lobotomy, 702, 703 life span of, 425 Postural reflexes, 663–664 Preganglionic neurons prothrombin receptors on, 453 Posture, and baroreceptor reflexes, 206–207. as cholinergic neurons, 731 Pleural effusion, 300, 483 See also Equilibrium. parasympathetic, 731 low-voltage ECG associated with, 137 Potassium sympathetic, 729, 730f Pleural fluid, 465–466, 483, 483f aldosterone secretion and, 921–922 Pregnancy Pleural pressure, 466, 466f in bone, 957–958 circulatory system during, 1010–1011, 1010f Pleural space, 483 cardiac action potential and, 102–103, hormones secreted in, 1007–1009, 1007f Pluripotential hematopoietic stem cells, 115–116 maternal body’s response to, 1009–1011, 414–415, 414f, 423–424 in cerebrospinal fluid, 747 1010f Pneumonia, 518–519, 518f, 519f dietary, benefit of, 367 metabolism in, 1010 Pneumotaxic center, 505, 506, 506f in extracellular fluid nutrition in, 1010

Po2. See Oxygen partial pressure (Po2). aldosterone secretion and, 927 parathyroid enlargement in, 965 Podocytes, 312–313, 313f fibrillation tendency and, 250 toxemia of, 224 Poiseuille’s law, 163–164 heart function and, 112 weight gain in, 1010 Poison ivy, 443 normal range of, 7, 7t, 361 Pregnanediol, 993, 1001 Polar body regulation of, 361–362, 362f, 362t Pregnenolone, 922, 923f, 932 first, 1003 gastric acid secretion and, 777–778, 778f Prekallikrein, 455 second, 1003 intestinal absorption of, 796 Preload, 109 Polarography, 515 neuronal somal membrane and, 552–553, Prelymphatics, 186 Poliomyelitis, macromotor units subsequent to, 82 552f Premature contractions, 146–147 Polycystic ovary syndrome, 952 renal excretion of, 361, 362–363, 363f atrial, 146, 146f Polycythemia, 421 renal reabsorption of, 331, 331f, 332–333, A-V nodal or A-V bundle, 146, 146f hematocrit in, 165, 165f, 287 362, 363f, 364 causes of, 146 Polycythemia vera, 421 renal secretion of, 311–312, 332, 333, 333f, definition of, 146 cyanosis in, 521–522 362–367, 363f in long QT syndromes, 147, 148f Polymorphonuclear leukocytes, 423, 423t, acidosis and, 364, 367 ventricular, 146–147, 147f 424f. See also Basophils; Eosinophils; aldosterone and, 337–338, 364–366, 364f, refractory period and, 103, 103f Neutrophils. 365f, 366f in ventricular paroxysmal tachycardia, Polypeptide hormones, 881, 882, 885f concentration in extracellular fluid and, 148–149 Polypeptides 364, 364f, 365f, 366f Premature infant, 1026–1027 classification into proteins and peptides, 882 distal tubular flow rate and, 364, 366, 366f retrolental fibroplasia in, 197–198, 1027 from protein digestion, 791, 791f in saliva, 774f, 775, 776 Premotor area, 667–668, 668f, 698, 699f Polyribosomes, 33 sports-related loss of, 1040 basal ganglia and, 690f, 691–692, 691f Polysaccharides, 789–790 in sweat, 870 Broca’s area and, 668–669, 669f, 700, Pons. See also Brain stem. in skeletal muscle, 243–244 702, 704 respiratory control by, 505, 506, 506f Potassium ion channels, 47, 47f, 48, 48f cerebellar communication with, 682, reticular substance of, 711–712 of cardiac muscle, 66, 115 686, 688 swallowing and, 764 in sinus node, 116 hand skills and, 669 Pontine reticular nuclei, 673–674, 673f ventricular action potential and, voluntary eye movement and, 669 Pontine reticulospinal tract, 673–674, 674f 115–116 Preprohormones, 882 Pontocerebellar tracts, 670, 682 of cochlear hair cells, 637 Prerenal acute renal failure, 399–400, 400b Pores. See also Ion channels. memory and, 708 Presbyopia, 601 in capillaries. See Capillaries, pores in. of pancreatic beta cells, 945, 945f Pressure in cell membrane, 14 in postsynaptic neuron membrane fluid. See Hydrostatic pressure; Osmotic nuclear, 17, 17f excitation and, 549 pressure. Portal hypertension, 838 G-protein–activated, 549, 549f gas. See Partial pressures. Portal vein, 759–760, 759f, 837, 837f, 838 inhibition and, 550, 554 Pressure buffer system, 207, 207f blockage in, 838 of smooth muscle, 97 Pressure diuresis, 213–218, 214f, 215f, 319, 337, colon bacilli in, 839 voltage-gated 371–373 Portal vessels, hypothalamic-hypophysial, in cardiac muscle, 66 aldosterone oversecretion and, 375, 925 897–898, 897f of nerve membrane, 61, 62–63, 62f antidiuretic hormone and, 375–376

1077 Index

Pressure gradient, blood flow and, 159, 160 Proopiomelanocortin neurons, 846, 847, 847f, Protein(s), synthesis of (Continued) Pressure natriuresis, 213, 215, 216, 319, 337, 849, 933–934 endoplasmic reticulum and, 20, 20f, 371–373, 371f obesity and, 865 33–34, 34f aldosterone oversecretion and, 375, 925 Prophase, 38f, 39 energy of ATP for, 22, 22f, 23, 859 angiotensin II and, 374, 374f Proprioceptive senses, 571. See also Position growth hormone and, 899, 902 antidiuretic hormone and, 375–376 senses. insulin and, 835, 944 obesity and, 225–226 equilibrium and, 678 in neonate, 1025 Pressure sensations, 571. See also Tactile Propriospinal fibers, 656–657, 672f triglycerides synthesized from, 825 receptors; Tactile sensations. Propulsive movements. See also Peristalsis. Protein C, 456–457 on footpads, equilibrium and, 678 of colon, 770–771 Protein channels, 45, 46–48, 46f, 48f. See also pathways into central nervous system, 573 of small intestine, 769 Ion channels. Pressure-volume curves, of neonatal lungs, Propylthiouracil, antithyroid activity of, gating of, 47, 48, 48f, 49f 1021, 1021f 915, 917 selective permeability of, 47, 47f Presynaptic facilitation, memory and, Prosopagnosia, 700 Protein hormones, 881, 882, 885f 707, 707f, 708 Prostaglandin(s) Protein kinase A, 932 Presynaptic inhibition, 554 fertilization and, 1003 Protein kinase C (PKC), 890, 890f by enkephalin, 587 fever and, 876 Protein kinases memory and, 707 glomerular filtration rate and, 318, 319 calmodulin-dependent, 891 Presynaptic membrane, calcium channels in, platelet synthesis of, 451 glucagon and, 948 548 in seminal vesicles, 976 hormone action and, 882, 891 memory and, 707, 707f, 708 Prostate gland, 307f, 973, 973f Protein sparers, 843–844 Presynaptic neuron, 546 cancer of, 985 Proteinuria, in minimal change nephropathy, Presynaptic terminals, 547–548, 547f. function of, 976 313–314 See also Neurotransmitters. life cycle changes in, 984–985 Proteoglycan filaments, 180–181, 180f long-term memory and, 708 testosterone and, 982–983 fluid flow and, 299 transmitter release from, 548, 550 Protanope, 616 of glomerular capillary wall, 312, 313 transmitter synthesis in, 550–551 Proteases, in thyroid hormone release, interstitial fluid pressure and, 299 Pretectal nuclei, visual fibers to, 623 908f, 909 as spacer for cells, 299 Prevertebral ganglia, 729 Proteasomes, muscle atrophy and, 82 Proteoglycans, 14, 20 Primary motor cortex, 667, 668f Protein(s). See also Plasma proteins. of bone, 957, 958 damage to, 673 absorption of, 797 Proteolytic enzymes Primordial follicle, 987, 989, 989f amino acids stored as, 833 in acrosome, 975, 977 Primordial germ cells, 973, 974f as bases, 379 of phagocytic cells, 426 Principal cells, renal, 332, 332f as buffers, 383–384 Proteoses, 783, 791 aldosterone and, 337 hemoglobin as, 383, 413 Prothrombin, 453, 453f, 454 potassium and, 362–364, 363f in cell, 11 Prothrombin activator, 453, 453f, 454–456, Procaine, 69 in cell membrane, 13, 13f, 14, 45, 46f 455f, 456f Procarboxypolypeptidase, 781 chemical structures of, 790, 831 Prothrombin time, 460–461, 460f Procoagulants, 453 deposition of Protoplasm, 11 Proelastase, 791 estrogens and, 994 Proximal tubule, 306, 306f Proerythroblasts, 415, 415f. See also testosterone and, 835–836, 982–983, 1031 glomerulotubular balance of, 334–335 Erythroblasts. in diabetes mellitus, depletion of, 951 reabsorption in, 329–330, 329f, 330f erythropoietin and, 416–417 dietary of amino acids, 325–326 hemoglobin synthesis in, 417 complete vs. partial, 835, 843 of calcium, 368, 368f, 369 Progesterone, 987, 988f, 991 deficiency of, 843, 901, 902f of glucose, 325–326 adrenal secretion of, 934 energy available in, 843–844 of phosphate, 369 breast development and, 995, 1014 gastrin release stimulated by, 779 of potassium, 362, 363f chemistry of, 992, 992f, 993f glomerular filtration rate and, 321 of sodium, 327–328 in contraceptive drugs, 1001 metabolic utilization of, 844–845 of water, 328 degradation of, 993 recommended intake of, 835, 843 secretion by, 329f, 330 endometrial nutrients and, 1005 digestion of, 789, 790–791, 791f urine concentration and, 346, 346f, 348t, 352 excretion of, 993 enterogastric reflexes and, 767, 768 PRU (peripheral resistance unit), 162–163 fallopian tube relaxation and, 1004 pancreatic enzymes in, 781, 791 Pseudopodium, 23, 23f functions of, 994–995 as energy source, 834–835 Psychomotor seizure, 725f, 726 gonadotropin inhibition and, 997, 998 in starvation, 835, 843–844 Psychosis, 726 menstrual cycle and, 995–996 equilibrium between plasma and tissues, manic-depressive, 727 ovarian cycle and, 990, 991 833–834, 834f Pteroylglutamic acid. See Folic acid. plasma protein binding of, 993 in feces, 798 PTH. See Parathyroid hormone (PTH). in pregnancy, 1007f, 1008–1009 in interstitial fluid, 185, 187, 189 Ptyalin, 774f, 775, 790 synthesis of, 992, 992f, 993f in lipoproteins, 821, 821t Puberty uterine contractility and, 1011–1012 in lymph, 187 female, 988, 993, 998–999, 998f, 999f Progestins, 991, 992, 992f. See also metabolism of, 834–835, 834f anovulatory cycles at, 998 Progesterone. cortisol and, 928–929, 936 gonadotropic hormone levels at, 998–999, 998f in contraceptive drugs, 1001 hormonal regulation of, 835–836 regulation of onset, 984, 999 Prohormone convertase, 933–934, 933f insulin and, 944–945 Pudendal nerve Prohormones, 882 liver’s functions in, 839–840 external anal sphincter and, 771 Prolactin, 896, 896t obligatory loss of, 835 external bladder sphincter and, 308, 308f, 310 lactation and, 1014–1015, 1015f renal reabsorption of, 326 Pulmonary. See also Lungs. pregnancy and, 1009 specific dynamic action of, 864–865 Pulmonary artery(ies), 477 Prolactin inhibitory hormone, 898, starvation-related depletion of, 852, 852f distensibility of, 167 898t, 1015 storage of Pulmonary artery pressure, 158, 159f, 477, 478, Prometaphase, 38f, 39 insulin and, 835, 945 478f. See also Pulmonary hypertension. Promoter, 30, 35–36, 35f in neonate, 1025 elevated, in mitral valve disease, 269 Pronucleus structural, 27 during exercise, 480, 481f female, 1003–1004, 1004f synthesis of. See also Transcription; left-sided heart failure and, 481 male, 1003–1004, 1004f Translation. Pulmonary artery stretch receptors, 208 Proopiomelanocortin, 933–934, 933f chemical steps in, 34, 34f sodium excretion and, 376

1078 Index

Pulmonary capacities, 469–471, 469f, 470t Pulp QRS complex (Continued) Pulmonary capillaries, 489, 490, 490f of spleen, 175, 175f ventricular contraction and, 122–123 damage to, causing pulmonary edema, 482 of teeth, 969, 969f, 970 voltage abnormalities of, 137, 137f fluid exchange at, 481–483, 482f, 482t Pulse deficit, premature contractions and, 146 QRS vectorcardiogram, 134, 134f J receptors adjacent to, 512 Pulse pressure. See also Arterial pressure pulses. Q-T interval, 121f, 123 length of time blood stays in, 481 definition of, 168 prolonged, 147, 148f oxygen therapy and, 521f determinants of, 168–169 Quinidine pressure in, 158, 159f, 478, 478f, 481 Punishment centers, 717–718 for paroxysmal tachycardia, 148 as sheet of flow, 481, 489 memory and, 709 for ventricular tachycardia, 149 Pulmonary circulation, 157, 158f, 477–484 Pupillary diameter, 601–602, 602f anatomy of, physiologic, 477 autonomic control of, 632, 734t, 735 R blood flow distribution dark adaptation by, 615 R wave, 121, 121f, 132 alveolar oxygen concentration and, 479 Pupillary light reflex, 623, 631f, 632, 735 Radiation, heat loss by, 868–869, 869f hydrostatic pressure zones and, in central nervous system disease, 632 Radioimmunoassay, 891–892, 892f 479–481, 479f, 480f Pupillary reaction to accommodation, 632 Rage pattern, 718 ventilation-perfusion ratio and, Purines, 27, 37 amygdala and, 719 492–494 Purkinje cells, 684–685, 684f, 686 limbic cortex and, 720 blood volume in, 157, 478–479 Purkinje fibers, 115, 117–118 sympathetic discharge in, 739 capillary dynamics in, 481–483, 482f action potentials in, 102f, 103, 117 RANK ligand, 959 exercise and, 480, 481f blocks in. See also Bundle branch block. Raphe magnus nucleus, 586–587, 587f left-sided heart failure and, 478–479, 481 multiple small, 138 Raphe nuclei pressures in, 158, 159f, 477–478, 478f QRS prolongation caused by, 138 serotonin system and, 713, 713f two components of, 477 ectopic pacemaker in, 119–120 sleep and, 722 Pulmonary congestion intrinsic rhythmicity of, 119 Rapid ejection, period of, 106 in heart failure, left-sided, 259 synchronous ventricular contraction and, 119 Rate of movement sense, 571, 580 patent ductus arteriosus with, 270 Pursuit movement, 629 Rate receptors, 563 Pulmonary edema, 482–483, 482f Pus, formation of, 430 Rathke’s pouch, 895 in acute mountain sickness, 530 Putamen, 670, 690, 690f, 691f Reabsorption pressure, net, 185, 186 common causes of, 482 Huntington’s disease and, 694 Reactive hyperemia, 194 in decompression sickness, 538 lesions in, 691 Reading, 700, 702, 704f, 705 in heart failure, 256, 298 neurotransmitters in, 692–693, 692f Reagins, 443, 444 as acute edema, 261 Parkinson’s disease and, 693 Receptor field, of nerve fiber, 564 aortic valve lesions and, 268, 269 Putamen circuit, 690–691, 690f, 691f Receptor potentials, 560–562, 561f decompensated, 258 PVCs (premature ventricular contractions), of cochlear hair cells, 637–638 left-sided, 259, 482, 483 146–147, 147f of rods, 612–613 after myocardial infarction, 250, 256 refractory period and, 103, 103f of taste cells, 647 oxygen therapy in, 521, 521f Pyelonephritis, 403–404 Receptor proteins in oxygen toxicity, 537 Pyloric glands, 777, 778, 779 of olfactory cilium, 649, 649f patent ductus arteriosus with, 270 Pyloric pump, 767, 768 postsynaptic, 547f, 548–550, 549f in shock, hypovolemic, 277 Pyloric sphincter, 756, 767, 768 down-regulation or up-regulation of, in valvular heart disease Pylorus, 767 569–570 aortic valve, 268, 269 Pyramidal cells, 697, 698f in taste villus, 647 mitral valve, 269 in motor cortex, 669–670, 671, 672 Receptors, cell membrane, 14 Pulmonary embolism, 459 somatosensory feedback to, 672 carbohydrates as, 14 Pulmonary function, abbreviations and Pyramidal tract. See Corticospinal phagocytosis and, 19 symbols for, 470t (pyramidal) tract. pinocytosis and, 18–19 Pulmonary function studies, 469–471, 469f Pyridoxal phosphate, 854 Reciprocal inhibition, 566–567, 567f, 663 Pulmonary hypertension. See also Pulmonary Pyridoxine, 854–855 flexor reflex and, 662, 662f, 663, 663f artery pressure. amino acid synthesis and, 834, 854 Reciprocal innervation, 663, 672 emphysema leading to, 518 Pyrimidines, 27, 37 Recoil pressure, of lungs, 467 endothelin receptor blockers for, 196 Pyrogens, 875–876 Red blood cell count, in neonate, 1024, 1024f at high altitude, 530, 531 Pyrophosphate, 958 Red blood cells (erythrocytes), 413–420 Pulmonary membrane. See Respiratory Pyruvic acid, 22 A and B antigens on, 445–447, 446f, 446t, membrane. alanine derived from, 834, 834f 447t Pulmonary valve, 107 conversion back to glucose, 816 concentration of, in blood, 413 congenital stenosis of, 136, 136f, 137 conversion to acetyl-CoA, 812–813 cortisol and, 931 second heart sound and, 107, 266, 266f conversion to lactic acid, 816 destruction of, 840, 841 Pulmonary vascular resistance from glycolysis, 812, 812f fetal, 1019, 1020 alveolar oxygen concentration and, 479 production from lactic acid, 816 functions of, 413 decrease at birth, 1023 hemoglobin concentration in, 413. See also total, 163 Q Hemoglobin. Pulmonary veins, 477 Q wave, 121, 121f, 132 life span of, 419–420, 840 Pulmonary venous pressure, 478 after myocardial infarction, 141, 141f metabolic systems of, 419 Pulmonary ventilation, 465–475 QRS complex, 121, 121f production of, 414–417, 414f, 415f acid-base disorders and, 392 bizarre patterns of, 138, 141 regulation of, 416–417, 416f alveolar. See Alveolar ventilation. cardiac cycle and, 105, 105f radiolabeled, in blood volume definition of, 465 current of injury and, 138, 139f measurement, 290 energy required for, 468 monophasic action potential and, 122, 122f shape and size of, 413, 415f during exercise, 1037, 1037t normal voltage of, 123 spleen as reservoir for, 175 mechanics of, 465–468, 466f, 467f prolonged splenic removal of, 175 minute respiratory volume in, 471 definition of, 138 testosterone and, 982 respiratory passageways in, 472–475, after myocardial infarctions, 137, 137f, 141 Red muscle, 79 472f premature ventricular contractions with, 146 Red nucleus, 670–671, 671f, 678f volume and capacity measurements of, from Purkinje system blocks, 136f, 138 basal ganglia and, 690f 469–471, 469f, 470t in ventricular hypertrophy or dilatation, cerebellar input from, 687, 687f Pulmonary volumes, 469–471, 469f, 470t 137–138 cerebellar input to, 684, 687 Pulmonary wedge pressure, 478 vectorial analysis of, 131–132, 132f dynamic neurons in, 672

1079 Index

Red pulp, of spleen, 175, 427–428 Renal output curve, 213, 214f Respiratory disorders (Continued) Reduced eye, 600 angiotensin II and, 222, 222f specific pathophysiologies, 517–520 Re-entry, 149–150 chronic, 215–216, 215f asthma, 520 fibrillation and, 150 determinants of pressure and, 214–215, 215f atelectasis, 519, 519f Referred pain, 588, 588f infinite feedback gain and, 214, 214f emphysema, 517–518, 518f headache as, 591 Renal tubular acidosis, 392, 408 pneumonia, 518–519, 518f, 519f from visceral organs, 588, 589, 589f Renal tubules. See also Distal tubule; Loop of tuberculosis, 520 Reflexes Henle; Proximal tubule. Respiratory distress syndrome, neonatal, 468, autonomic, 665, 729, 738 active transport in, 55–56, 55f 519, 1022, 1026 local, 738 hydrogen ion transport in, 54, 55 Respiratory exchange ratio, 504, 844–845 spinal. See Spinal cord reflexes. Renin, 220 Respiratory membrane, 489–490, 490f Reflexive learning, 709 decreased, in primary aldosteronism, 936 diffusing capacity of, 491–492 Refraction of light, 597, 597f. See also Lenses. glomerular filtration rate and, 320 at high altitude, 529 Refractive errors, 602–604, 602f, 603f, 604f increased, hypertension caused by, 407 diffusion of gases through, 485, 486, 487, Refractive index, 597 Renin-angiotensin system 489–492, 492f of parts of eye, 600, 600f aldosterone secretion and, 927 impaired, hypoxia caused by, 520, 521, Refractive power, 599f, 600, 600f arterial pressure control and, 220–222, 220f, 521f, 522 of eye, 600, 600f 221f, 222f Respiratory muscles, 465, 466f Refractory period in integrated response, 227, 227f, 228 Respiratory passages, 472–475, 472f of cardiac muscle, 103, 103f in cardiac failure, 260 humidification in, 487, 487t of nerve fiber, 69 hypertension and, 223–224, 223f Respiratory quotient, 844–845 Regression of tissues, lysosome role in, 19 in hypovolemic shock, 275 Respiratory rate, minute respiratory volume Regulatory T cells, 442 Renointestinal reflex, 772 and, 471 Regurgitation, valvular, 267 Renshaw cells, 656–657 Respiratory tract, insensible water loss through, Reinforcement, 718 Repolarization, in action potential, 61, 61f 285, 286t Reissner’s membrane, 634–635, 634f Repolarization waves, 121–123, 122f. See also Respiratory unit, 489, 489f Relative refractory period, of cardiac action T wave. Respiratory waves, 210 potential, 103, 103f long QT syndromes and, 147, 148f Response element. See Hormone response Relaxin, 1009 Reproduction, homeostatic function of, 6 element. Release sites, on presynaptic membrane, 548 Residual body, of digestive vesicle, 19, 19f Resting membrane potential Renal. See also Kidney(s). Residual volume, 469, 469f of gastrointestinal smooth muscle, 753–754, Renal artery stenosis, 223–224, 223f, 407 in asthma, 520 754f, 755 Renal blood flow, 315, 316–317, 317t. determination of, 471 of nerve fiber, 59–60, 59f, 60f See also Renal ischemia. Resistance, vascular. See Vascular resistance. of neuronal soma, 552, 552f age-related decrease in, 403 Respiration. See also Breathing. of skeletal muscle fiber, 87 autoregulation of, 317, 319–321, 319f, 320f artificial, 522–523, 522f of smooth muscle, 95 estimation of, 340t, 341–342, 342f in athletes, 1035f, 1036–1038, 1037f, 1037t Resuscitators, respiratory, 522–523, 522f filtration fraction calculated from, 342 functions carried out in, 465 Reticular activating system. See Reticular medullary, 317, 351–352 in neonates, 1021–1022, 1021f, 1024, 1026 substance, excitatory area in. physiologic control of, 317–319 in pregnancy, 1010 Reticular lamina, hair cells and, 637–638, in pregnancy, 1011 regulation of. See Respiratory control. 637f Renal clearance methods, 340–343, 340t, 341f, thyroid hormones and, 913 Reticular nuclei, 673–674, 673f, 678 342f, 343t Respiratory acidosis. See Acidosis, respiratory. alpha waves and, 724 Renal failure Respiratory alkalosis. See Alkalosis, respiratory. limbic system and, 715 acute, 399 Respiratory bronchiole, 472–473, 489, 489f Reticular substance body fluid effects of, 406, 406f Respiratory center, 505–507, 506f autonomic regulation and, 739 causes of, 399–401, 400b brain edema and, 512 basal ganglia and, 690f in hypovolemic shock, 277–278 chemoreceptor transmission to, 507, 508, cerebellar input to, 684 physiologic effects of, 401 508f, 509 excitatory area in, 711–712, 712f in transfusion reactions, 448–449 Cheyne-Stokes breathing and, 512 acetylcholine system and, 713 chronic, 399, 401–407. See also End-stage direct chemical control of, 507–508, auditory pathways and, 639 renal disease (ESRD). 507f, 508f sleep and, 722, 723 anemia in, 406 exercise-related stimulation of, 510, 511 hypothalamus and, 715 body fluid effects of, 406–407, 406f high altitude and, 529 inhibitory area in, 712, 712f causes of, 401, 402b panting and, 871 limbic system and, 715 glomerulonephritis leading to, 403 sleep apnea and, 513 motor fibers leading to, 670 hypertension leading to, 218 Respiratory control, 505–513 pain perception and, 586 metabolic acidosis in, 393 anesthesia and, 512 vestibular apparatus and, 678f nephron function in, 404–405, 405f, brain edema and, 512 Reticulocerebellar tracts, 670, 683, 683f 405t, 406f in central sleep apnea, 513 Reticulocytes, 415, 415f, 417 osteomalacia in, 406–407 during exercise, 510–511, 510f, 511f Reticuloendothelial cells progression to end stage, 401–402, irritant receptors in, 512 of liver sinusoids, 759–760, 837 402f, 402t J receptors in, 512 of spleen, 175 pyelonephritis leading to, 403–404 in periodic breathing, 512–513, 512f Reticuloendothelial system, 426–428. See also transplantation for, 409 peripheral chemoreceptors in, 507, 508–510, Macrophages, tissue. vascular lesions leading to, 403 508f, 509f, 510f Reticulospinal tracts, 670, 672f, 673–674, 674f, dialysis for, 409–410, 409f, 410t respiratory center in. See Respiratory center. 678, 678f nephrotic syndrome in, 404 voluntary, 512 Retina, 609–621 Renal function curves, sodium-loading, 226, Respiratory disorders, 515 anatomic and functional elements of, 226f. See also Renal output curve. constricted, 516, 516f 609–611, 610f. See also Cones; Renal glycosuria, 408–409 hypoxia in, 520 Ganglion cells, of retina; Rods. Renal ischemia methods for studying, 515 blood supply of, 611 acute renal failure caused by, 399–400, blood gases and pH, 515–516 electrotonic conduction in, 617–618 400b, 401 forced expiratory vital capacity, 517, 517f glucose for, 949 chronic renal failure associated forced expiratory volume, 517, 517f layers of, 609, 610f with, 403 maximum expiratory flow, 516–517, 516f light and dark adaptation by, 614–615, 614f hypertension caused by, 407 pulmonary function studies, 469–471, 469f neural function of, 616–621, 617f, 618f, 620f

1080 Index

Retina (Continued) Right-sided heart failure, emphysema leading Salty taste, 645, 646, 646t peripheral vs. central, 619. See also Fovea. to, 518 Sarcolemma, of skeletal muscle, 71, 87f photochemistry of, 611–615, 611f, 612f, 613f. Right-to-left shunt, 269 Sarcomere(s), of skeletal muscle, 71, 72f, 73f, 74 See also Color vision. in tetralogy of Fallot, 271, 271f addition or subtraction of, 82 Retinal, 611–612, 611f, 613 Rigor mortis, 82 length of, tension and, 77, 77f identical in rods and cones, 614 RISC (RNA-induced silencing complex), 32–33 Sarcoplasm, 73 Retinal artery, central, 611 RNA (ribonucleic acid), 27, 27f Sarcoplasmic reticulum Retinal detachment, 611 building blocks of, 30 of cardiac muscle, 103–104, 104f Retinal isomerase, 611f, 612 noncoding, 32–33 of skeletal muscle, 73, 73f Retinitis pigmentosa, 627 in nucleolus, 17 in fast fibers, 79 Retinoid X receptor, 910, 911f, 962 synthesis of, 29f, 30–31 release of calcium by, 74, 88–89, 88f Retinol, 853 types of, 31. See also specific types. T tubules and, 87f, 88, 88f Retrograde amnesia, 709 viral, 18 uptake of calcium by, 74, 78, 88–89, 88f Retrolental fibroplasia, 197–198, 1027 RNA codons, 29f, 30, 31–32, 31t, 32f of smooth muscle, 97–98, 98f Reverberatory circuits, 567–568, 567f, 568f RNA polymerase, 29f, 30, 35 Satiety, 845 continuous output from, 568, 568f RNA-induced silencing complex (RISC), 32–33 Satiety center, 716, 845, 849 in focal epilepsy, 726 Rods, 609 Saturated fat, blood cholesterol and, 827 rhythmical output from, 568 absorption curve for, 614, 614f Saturation diving, 539 Reverse enterogastric reflex, 780 dark adaptation by, 614–615 Scala media, 634–635, 634f, 635f, 637

Reverse T3 (RT3), 908f, 909, 909f electrotonic conduction in, 617–618 Scala tympani, 634–635, 634f, 635f, 636, 637 Reverse transcriptase, 41 ganglion cells excited by, 619 Scala vestibuli, 634–635, 634f, 635f, 636, 637 Reward centers, 717, 718 neural circuitry and, 616–617, 617f Schistosomiasis, 430 memory and, 709 pathway to ganglion cells, 617, 617f Schizophrenia, 727 Reynolds’ number, 161–162 neurotransmitter released by, 617 Schlemm, canal of, 607, 607f, 608 Rh blood types, 447–449 number of, 619 Schwann cells, 67, 67f erythroblastosis fetalis and, 420, 447–448, of peripheral retina, 619 at neuromuscular junction, 83 1024 photochemistry of, 611–614, 611f, 612f, 613f at smooth muscle nerve endings, 95 Rh immunoglobulin globin, 448 structure of, 609, 610f Scotomata, 627 Rheumatic fever, 442 Rods of Corti, 637, 637f Scotopsin, 611–612, 611f valvular lesions caused by, 266–267 Root, of tooth, 969, 969f Scratch reflex, 664 Rhodopsin, 609, 611–614, 611f, 613f Round window, 635, 635f SCUBA diving, 539, 539f

absorption curve for, 614, 614f RT3 (reverse T3), 908f, 909, 909f Scurvy, 855 Rhodopsin kinase, 614 Rubrospinal tract, 670–671, 671f, 687, 687f Second heart sound, 265–266, 267f Rhythm method of contraception, 1001 Ruffini’s corpuscles, 572 Second messengers, 14. See also Cyclic

Riboflavin (vitamin B2), 854 joint angulation and, 580 adenosine monophosphate (cAMP); Ribonucleic acid. See RNA (ribonucleic acid). Ruffini’s endings, 560f, 572 Cyclic guanosine monophosphate Ribose, 30 Rugae, of bladder mucosa, 308 (cGMP). Ribosomal RNA, 31, 32 Ryanodine receptor channels adrenergic or cholinergic receptors and, 733 Ribosomes in cardiac muscle, 103 hormonal functions and, 888, 889–891 endoplasmic reticulum and, 14, 20, 20f, in skeletal muscle, 88 adenylyl cyclase-cAMP and, 889–890, 33–34, 34f 889b, 890f formation of, 32 S aldosterone and, 927 insulin and, 944 S cells, intestinal, 782 calcium-calmodulin and, 891 nucleoli and, 17, 32 S wave, 121, 121f, 132 phospholipase C and, 890, 890b, 890f protein synthesis on, 32f, 33–35, 34f Saccades, 629, 688 thyroid hormones and, 910, 914 structure of, 32 Saccule, 674–675, 675f, 676–677 in postsynaptic neurons, 548–549, 549f Rickets, 968–969 Safety factor in smooth muscle, 97 in hypophosphatemia, 408 for nerve impulse propagation, 65 in taste cells, 647 parathyroid enlargement in, 965 local anesthetics and, 69 Second-degree heart block, 145, 145f vitamin D–resistant, 969 of neuromuscular junction, 85–86 Secretin, 758, 758t Rickettsia, 17–18, 18f Sagittal sinus, negative pressure in, 173 bile secretion and, 784, 784f, 785 Right atrial pressure, 172 Saline solutions duodenal mucous glands and, 786 cardiac output and, 172. See also Cardiac fluid shifts and osmolarities caused by, gastric secretion and, 780 output curves. 293–294, 293f molecular structure of, 780 exercise and, 245 isotonic, 291–292, 293, 293f pancreatic secretions and, 782–783, 800 in heart failure Saliva, 775–776 small intestine motility and, 769 compensated, 257 daily volume of, 775 stomach emptying and, 768 decompensated, 258 ions in, 775–776 Secretory granules. See Secretory vesicles. measurement of, 174–175, 174f lingual lipase in, 792 Secretory vesicles, 16, 16f, 21 peripheral venous pressure and, 172 oral hygiene and, 776 of gastrointestinal glands, 774 venous return and. See Venous return curves. proteins in, 775 of polypeptide and protein hormones, 882 Right atrium, stretch of, heart rate increase ptyalin in, 774f, 775, 790 Segmentation contractions and, 110 Salivary glands, 773, 774f, 775 of colon, 770 Right bundle branch block, right axis deviation aldosterone and, 926 of small intestine, 768–769, 768f in, 136–137, 137f blood supply to, 776 Seizures. See also Epilepsy. Right ventricle nervous regulation of, 730–731, 731f, 734t, hippocampal, 719 external work output of, 108 735, 776, 776f in oxygen poisoning, 536 maximum systolic pressure, 108 taste signals and, 648, 776 Self-antigens, 434–435 Right ventricular dilatation, QRS prolongation Salpingitis, infertility secondary to, 1002 Semen, 976–977 in, 137–138 Salt appetite, 360 ejaculation of, 979 Right ventricular hypertrophy Salt intake. See also Sodium; Sodium chloride. Semicircular ducts, 674, 675f, 676, 676f, electrocardiogram with, 136, 136f, 137 pressure diuresis and, 217–218. See also 677, 677f QRS prolongation in, 137–138 Pressure natriuresis. flocculonodular lobes and, 678, 689 in mitral valve disease, 269 renin-angiotensin system and, 222, 222f, 228 Semilunar valves, 106–107, 107f. See also Right ventricular pressure curve, 477, 478f Salt sensitivity, 216, 372 Aortic valve; Pulmonary valve. Right-handedness, 702 essential hypertension and, 226, 226f second heart sound and, 107, 265–266 Righting reflex, 664 Saltatory conduction, 68, 68f Seminal vesicles, 973, 973f, 976

1081 Index

Seminiferous tubules, 973–974, 973f, 974f Short interfering RNA (siRNA), 33 Skeletal muscle (Continued) estrogen in, 980 Shunt hypertrophy of, 81–82 injury to, 977 congenital, 269. See also Patent ductus exercise training and, 1035–1036 negative feedback control of, 984 arteriosus. innervation of, 80, 83 Sensitization, memory and, 706 physiologic, 493, 494 insulin and, 941–942, 946f Sensory areas, of cerebral cortex, 698, 698f, oxygen therapy and, 521 isometric vs. isotonic contraction of, 79, 79f 699f Shunt flow, 496 length of Sensory nerve fibers Sibutramine, for weight loss, 851 vs. force, 77, 77f classification of, 563–564, 563f Sickle cell anemia, 415f, 420 remodeling of, 82 in spinal cord, 655, 655f, 656–657, 656f hemoglobin structure in, 418 lever systems using, 81, 81f summation in, 564, 564f, 565f Signal transducer and activator of transcription maximum strength of, 80 Sensory pathways. See also Anterolateral (STAT) proteins, 888 motor units of, 80 system; Dorsal column–medial Silencing RNA (siRNA), 33 after poliomyelitis, 82 lemniscal system. Siliconized containers, 460 remodeling of, to match function, 81–82 into central nervous system, 569 Simple cells, of visual cortex, 626, 627 respiratory, 465, 466f corticofugal, 581–582 Simple spike, 685 dyspnea associated with, 522 inhibitory feedback in, 569 Sinoatrial block, 144, 144f sensory receptors in. See Golgi tendon Sensory receptors, 543, 544f. See also Tactile Sinoatrial node. See Sinus node. organs; Muscle spindles. receptors. Sinus arrhythmia, 144, 144f vs. smooth muscle, 91, 92–93, 94 adaptation of, 562–563, 562f Sinus bradycardia, 143–144, 143f staircase effect of, 80 differential sensitivity of, 559 Sinus node, 115–116, 116f strenuous bursts of activity with, 860–861 receptor potentials of, 560–562, 561f action potentials in, 115–116, 116f structural organization of, 71–73, 72f, 73f types of, 559, 560b, 560f atrial stretch and, 229–230 summation in, 80, 80f Sensory signals as pacemaker, 118–119 sympathetic vasodilator system and, 204 brain stem excitatory area and, 711–712 parasympathetic stimulation and, 119, 120 tension developed in, 77, 77f hippocampal activation by, 718–719 sympathetic stimulation and, 120 testosterone and, 835–836, 982 Sensory stimulus intensity Sinus tachycardia, 143, 143f tetanization in, 80, 80f enormous range of, 579 Sinuses, nasal, headache associated with, thyroid hormones and, 913 judgment of, 579, 580f 591–592, 591f tone of, 80 Septic shock, 280 siRNA (silencing RNA), 33 velocity of contraction vs. load on, 77–78, 77f disseminated intravascular coagulation Size principle, 80 work output of, 78 in, 459 Skeletal motor nerve axis, 543–544, 544f Skill learning, 709 Serotonin Skeletal muscle, 71–82. See also Motor Skill memory, 706–707 in basal ganglia, 692–693, 692f functions; Neuromuscular junction. Skin as central nervous system transmitter, 551 action potentials in. See Action potential(s), blood flow control in, 195 depression and, 726–727 skeletal muscle. cholesterol in, 827 endogenous analgesia system and, 587 agonist-antagonist coactivation of, 81 in defense against infection, 433 from mast cells and basophils, 431 neuronal circuits and, 566 estrogens and, 994 memory and, 707–708 in arterial pressure control, 209–210 heat loss through reticular inhibitory area and, 712 in athletes. See Sports physiology, blood flow and, 868, 868f sleep and, 722 muscles in mechanisms of, 868–870, 869f small intestine peristalsis and, 769 atrophy of, 81, 82 homeostatic functions of, 6 Serotonin system, in brain, 712, 713, 713f blood flow in, 191, 192t, 243 insensible water loss through, 285, 286t Sertoli cells, 974, 974f, 975, 976 control of, 191, 195, 196–197, 198, testosterone and, 982 estrogen formed by, 980 243–244 tissue macrophages in, 426 follicle-stimulating hormone and, 984 during exercise, 1038, 1038f, 1038t vitamin D synthesis in, 960 inhibin secreted by, 984 during rhythmical contractions, 243, Skin graft, interstitial fluid pressure and, 183 Serum, 454 244f, 1038f Skin temperature, 867 Sex chromosomes, 974–975, 981, 1003, 1004 total body circulation and, 244–245 local reflexes regulating, 875 Sex determination, 1004 capillary pores in, permeability of, 179, 180t set-point and, 874, 874f Sex hormone–binding globulin, 980 vs. cardiac muscle, 102–104 Sleep, 721–725 Sexual act central nervous system control of, basic theories of, 722–723 female, 1000 543–544, 544f brain waves in, 723, 724, 725, 725f lubrication for contraction mechanism of, 74–78, 74f, cycle between wakefulness and, 722–723 by female glands, 1000 75f, 76f growth hormone secretion and, 901, 901f by male glands, 979 sequential steps of, 73–74 metabolic rate and, 864 male, 978–979 contracture of, 82 physiologic functions of, 723–724 Sexual behavior decreased mass of, cardiac output and, 234 rapid eye movement (REM), 712–713, amygdala and, 720 denervation of, 82 721–722 hypothalamus and, 717 different functional types of, 79, 79f, 81 brain waves in, 725, 725f Sexual function, thyroid hormones and, 914 efficiency of, 78–79 deprivation of, 723 Sexual reflexes, 738, 978, 1000 energy sources for, 73, 74, 75, 76, 78–79 possible cause of, 722 Sexual sensation in athletes, 1032, 1033f, 1033t, 1034b, slow-wave, 721–725 anterolateral system and, 573 1035, 1035f brain waves in, 725, 725f male structures associated with, 978 excitation-contraction coupling in, 87, thyroid hormones and, 913 Shaken baby syndrome, 746 88–89, 88f, 89f Sleep apnea, 513 Shingles, 590 fast and slow fibers in, 79, 1036, 1036t Slit pores, of glomerular capillaries, 312–313, Shivering, 867 fatigue in, 80–81 313f fever and, 876, 876f fatty acid diffusion into, 820 Slow calcium channels, 64 hypothalamic stimulation of, 873 force of in cardiac muscle, 102–103 set-point and, 874, 874f vs. length, 77, 77f Slow ejection, period of, 106 primary motor center for, 873 vs. velocity of contraction, 77–78, 77f Slow muscle fibers, 79 skin receptors and, 872 glucose in, insulin and, 941–942, 946f Slow pain, 583 Shock. See Anaphylactic shock; Cardiogenic glycogen in, 78, 80–81, 811, 941 Slow sodium-calcium channels, in cardiac shock; Circulatory shock; Hypovolemic during exercise, 1032, 1032t, 1035 muscle, 66, 115 shock; Septic shock recovery of, 1034, 1035f sinus nodal action potential and, 116 Shock lung syndrome, 277–278 hyperplasia of, 82 ventricular action potential and, 115–116

1082 Index

Slow waves, of gastrointestinal smooth muscle, Smooth muscle (Continued) Sodium chloride (Continued) 753–754, 754f, 755 stress-relaxation of, 93 renal retention of, angiotensin II and, in small intestine, 769 reverse, 93 221–222, 222f in stomach, 766 structural organization of, 91, 91f, 92, 92f renal transport of Slow-chronic pain pathway, 584–585, 585f, 586 of trachea, bronchi, and bronchioles, in distal tubule, 331–332, 332f Slow-reacting substance of anaphylaxis, 472–473 urine concentration and, 348–349, 348t, 353 443, 444 types of, 91, 91f. See also specific types. replacement of, in athletes, 1040 in asthma, 520 vascular. See also Blood flow control. tubuloglomerular feedback and, 319–320, bronchiolar constriction caused by, 473 autoregulation of blood flow and, 320f, 321 Slow-twitch muscle fibers, 1036, 1036t 194–195 Sodium co-transport, 54–55, 55f Sludged blood intrinsic tone of, 737 of amino acids and peptides, 54–55, in circulatory shock, 277 local factors controlling, 97 794–795, 795f, 797 in septic shock, 280 nitric oxide and, 195, 196f of glucose, 325–326, 326f, 794–795, 795f, Small interfering RNA (siRNA), 33 Sneeze reflex, 473, 512 796, 811 Small intestine. See also Duodenum. Sodium. See also Hypernatremia; Sodium counter-transport, 55, 55f absorption in Hyponatremia; Salt intake; Sodium Sodium gluconate, for acidosis, 393 active transport in, 55–56, 55f chloride. Sodium ion channels, 47, 48, 48f. See also anatomical basis of, 793–794, 793f, 794f in bone, 957–958 Calcium-sodium channels. of ions, 794–796, 795f in cerebrospinal fluid, 747 acetylcholine-gated, 73–74, 84, 84f, 85, 85f of nutrients, 796–797 dietary intake of epithelial, aldosterone and, 926–927, 926f total area of, 794 arterial pressure and, 376 in olfactory cilium, 649, 649f total capacity of, 794 integrated responses to, 376 of photoreceptors, 612–613, 612f, total volume of, 793 potassium intake and, 367 613–614, 613f of water, 794 recommendations for, 367 of postsynaptic neuronal membrane, 548, 549 carbohydrate digestion in, 790 diffusion through capillary pores, 179, 180t of smooth muscle, 97 digestive enzymes of, 787, 790 extracellular fluid, regulation of, 345, 355 voltage-gated, of muscle fiber, 73–74 disorders of, 801–802 angiotensin II and aldosterone in, voltage-gated, of nerve membrane, 48, 49f, fat digestion in. See Fats, digestion of. 359–360, 359f, 927, 928 61–63, 61f, 62f, 64 malabsorption by, 801–802 by osmoreceptor-ADH system, 345, calcium ion concentration and, 64 movements of, 768–770, 768f, 770f 355–357, 358–359, 360 local anesthetics and, 69 obstruction of, 804, 804f salt appetite and, 360 propagation of impulse and, 64–65 peptic ulcer of, 800, 801 by thirst, 357–360, 358t, 359f refractory period and, 69 secretions of, 786–787 extracellular fluid volume and, 370–371, Sodium lactate, for acidosis, 393 secretory cells of, 773, 774f 375–376 Sodium space, 289 Smell, 648–652. See also Olfaction. intestinal absorption of, 794–795, 795f, 797 Sodium-calcium counter-transporter, renal, adaptation of, 650 in colon, 795, 797 368–369, 368f affective nature of, 650 intestinal secretion of, 787 Sodium-calcium exchanger, in cardiac muscle, intensities detectable by, 650 neuronal somal membrane and, 552, 552f 104, 104f olfactory cell stimulation in, 649–650, 649f plasma concentration of digitalis activity and, 258 olfactory membrane in, 648–649, 649f aldosterone and, 925 Sodium-chloride co-transport, thiazide primary sensations of, 650 with reduced GFR, 404, 405, 405f diuretics and, 398 signal transmission into central nervous postsynaptic potentials and, 553, 553f Sodium-chloride-potassium co-transport, loop system, 651–652, 651f renal adaptation to intake of, 303, 304f diuretics and, 397–398 taste and, 645 renal excretion of. See also Pressure Sodium-hydrogen counter-transport, renal, threshold for, 650 natriuresis. 386–387, 386f Smoking angiotensin II and, 374–375, 374f Sodium-iodide symporter, 908, 908f atherosclerosis and, 829 balance of intake and, 370 Sodium-loading renal function curves, peptic ulcer and, 801 diuretics and, 397, 398f 226, 226f pulmonary ventilation in exercise and, regulation of, 370–371 Sodium-potassium ATPase pump, 53–54, 53f 1037–1038 renal reabsorption of, 324, 325, 325f in cardiac muscle, 104, 104f Smooth endoplasmic reticulum, 14, 15f, 20, 20f aldosterone and, 328, 337–338, 375 digitalis activity and, 258 Smooth muscle, 91–98 angiotensin II and, 338–339, 338f gastric acid secretion and, 777, 778f action potentials in. See Action potential(s), arterial pressure and, 337 intestinal absorption and, 794–795 smooth muscle. atrial natriuretic peptide and, 339 iodide trapping and, 908, 908f autonomic innervation and control of, chloride ions and, 328, 328f potassium secretion and, 362, 363–364, 94–95, 94f diuretics and, 397 363f, 367 contractile mechanism in, 92–93, 92f estrogen and, 994 in re-establishing ionic gradients, 65 calcium ions and, 93–94, 94f, 97–98 with gradient-time transport, 327–328 renal reabsorption and, 324, 325, 325f, contraction without action potentials, 96, 97 hydrogen ions and, 326, 331, 331f, 390 327–328 energy requirement of, 93 oxygen consumption and, 316, 317f of bicarbonate, 386–387, 386f of gut, stretch-induced excitation of, 96 in pregnancy, 1009, 1011 in collecting tubule, 332, 333f, 337 hormonal effects on, 97 by principal cells, 332 in distal tubule, 331–332, 332f, 333f junctional potential of, 96 sympathetic activation and, 339 in loop of Henle, 331, 331f latch mechanism of, 93, 94 with transport maximum, 328 resting membrane potential and, 59, 59f, latent period of, 97–98 urine concentration and, 353 60, 60f of lymphatic vessels, 188 water reabsorption and, 328 synthesis of, 926–927, 926f maximum force of contraction, 93 in saliva, 774f, 775, 776 thyroid hormones and, 912 of metarterioles, 177, 193 salty taste of ions of, 645 Solubility coefficients, of gases, 485–486, 486t multi-unit, 91, 91f, 95, 96 in sweat gland secretions, 870–871 Solvent drag, 328 neuromuscular junctions of, 94–95, 94f Sodium bicarbonate. See also Bicarbonate. Soma of neuron, 547, 547f pacemaker waves of, 96 for acidosis, 393 ion concentration differences and, 552–553, peristalsis in, 759 metabolic alkalosis caused by, 393 552f of precapillary sphincter, 177, 193 Sodium channel blockers, 332, 333f, 398t, 399 resting membrane potential of, 552, 552f resting membrane potential of, 95 Sodium chloride. See also Chloride; Salt intake; uniform electrical potential in, 553 vs. skeletal muscle, 91, 92–93, 94 Sodium. Somatic senses. See also Sensory pathways. slow wave rhythm of, 95f, 96 diarrheal loss of, 796 classification of, 571 stimulatory factors for, 94, 97 mineralocorticoid deficiency and, 924 definition of, 571

1083 Index

Somatomedin C, 900–901 Spinal cord (Continued) Sprue, 801–802, 854 Somatomedins, 900–901 motor functions of, 655 anemia in, 420, 802 Somatosensory association areas, 577 excitation by cortex for, 671–673, 672f Staircase effect, 80 Somatosensory cortex, 574–577, 575f, 576f in integrated control system, 694 Stapedius muscle, 634 basal ganglia and, 691, 691f organization for, 655–657, 655f, 656f Stapes, 633–634, 633f, 635, 635f, 636 cerebellar communication with, 682, pathways from cortex for, 669–671, conduction deafness and, 642 686, 688 670f, 671f Staphylococcal infection, inflammatory corticospinal tract and, 669 reflexes in. See Spinal cord reflexes. response to, 428 motor cortex and, 667, 668f sensory receptors and. See Golgi tendon Starches thermal signals to, 593 organs. dietary, 789–790 Somatostatin, 898, 898t, 901–902, 949 temperature receptors in, 872 digestion of, 790, 790f gastric secretion and, 780 transection of, 665 in neonate, 1025 pancreatic secretion of, 939 Spinal cord injury Starling equilibrium, for capillary exchange, Somatotropes, 896, 896t, 897 defecation abnormalities in, 803 185–186, 185t Somatotropin. See Growth hormone (GH; micturition abnormalities in, 310 Starling forces, 181 somatotropin). Spinal cord level, 545 Starvation, 852, 852f. See also Malnutrition, Sound. See Hearing. Spinal cord reflexes, 694 and metabolic rate. Sour taste, 645, 646, 646t autonomic, 665 fatty acids in blood in, 821 salivation and, 776 defecation reflex, 771, 771f, 803 growth hormone secretion in, 901 Spacecraft cortical input and, 672 ketosis in, 823 acceleratory forces in, 531, 532, 532f crossed extensor reflex, 663, 663f protein degradation in, 835 atmosphere in, 533 in fetus, 1020 triglycerides in liver in, 822 motion sickness in, 533 flexor reflex, 661–663, 662f, 663f STAT (signal transducer and activator of weightlessness in, 533–534 gastrointestinal, 757 transcription) proteins, 888 Spaces of Disse, 837, 837f, 838 memory and, 706 Static position sense, 571, 580 Spasticity, stroke leading to, 673 muscle spasm caused by, 664–665 Statins, 829 Spatial coordinates of body muscle stretch reflex, 658–659, 658f, 659f Statoconia, 675–676, 675f posterior parietal cortex and, 692, 699, 699f neuronal organization for, 655–657, 655f, 656f Stearic acid, 819 prefrontal cortex and, 700 postural and locomotive, 663–664 ATP from oxidation of, 823 Spatial summation scratch reflex, 664 Steatohepatitis, nonalcoholic (NASH), 838 in neurons, 555 sexual act and, 978, 1000 Steatorrhea in sensory fibers, 564, 564f spinal shock and, 665 calcium and vitamin D deficiency in, 969 auditory, 638 in temperature regulation, 875 in sprue, 802 thermal, 593 tendon reflex, 661 Stellate cells Special senses, definition of, 571 Spinal nerves of cerebellum, 685 Speech, 474–475, 703–704. See also Language. dermatomes associated with, 582, 582f of cerebral cortex. See Granular cells. articulation in, 704 parasympathetic fibers and, 730–731, 731f Stem cells Broca’s area and, 668–669, 669f, skeletal motor function and. See Motor bone, 960 702, 704, 704f neurons, anterior. pluripotential hematopoietic, 414–415, 414f, cerebellar lesions and, 689 sympathetic chains and, 729, 730f 423–424 Sperm count, 978 Spinal shock, 665 Stent, coronary artery, 253 Spermatids, 974, 974f, 975 Spindle, mitotic, 17, 38–39 Stepping movements, 664 Spermatocytes, 974, 974f Spinocerebellar tracts, 683, 683f, 687, 687f Stercobilin, 840–841, 841f, 842 Spermatogenesis, 973–976, 974f lesions in, 683, 683f, 689 Stereocilia abnormal, 977–978 Spinocerebellum, 686, 687–688, 687f of cochlea, 637–638 estrogen in, 980 Spino-olivary pathway, 683 of vestibular apparatus, 675–676, 675f follicle-stimulating hormone and, 975, 983, Spinoreticular pathway, 683 Stereopsis, 605, 605f, 625, 630 983f, 984 Spinothalamic tracts, 573f, 575f, 580, 581 Sterility. See Infertility. temperature and, 977, 978 Spiral ganglion of Corti, 634f, 636–637, Steroid hormones, 882. See also Adrenocortical Spermatogonia, 973–976, 974f 636f, 639 hormones; Androgens; Ovarian Spermatozoa, 974, 974f, 975, 975f. See also Spirometry, 469, 469f, 470–471 hormones. Fertilization. forced vital capacity in, 517, 517f cholesterol used for, 827, 882 abnormal, 978, 978f Spironolactone, 332, 333f, 399 mechanism of action, 891 capacitation of, 976–977 Splanchnic circulation, 759–760, 760f nongenomic actions of, 927 in fallopian tube, 1000, 1003 vasoconstriction in, in exercise or shock, 762 receptors for, 891 maturation of, 975, 976 Spleen structures of, 885f mature, physiology of, 976 as blood reservoir, 175, 175f Stimulatory field, 565 in semen, 976–977 macrophages of, 427–428 Stokes-Adams syndrome, 119, 145 storage of, in testes, 975–976 Sports physiology, 1031–1041. See also Stomach. See also Gastric entries. Spherocytosis, hereditary, 420 Exercise. absorption in, 793 Sphincter of Oddi, 780–781, 784f, 785 body fluids and salt in, 1040 anatomy of, 766, 766f Sphingolipids, of capillary membrane, 178, 178f body heat in, 1039–1040 emptying of. See Stomach emptying. Sphingomyelin, 67 cardiovascular system in, 1038–1039, 1038f, fat digestion in, 792 chemical structure of, 826, 826f 1038t, 1039f, 1039t gastrin secretion by, 758, 758t function of, 826 drugs in, 1040 mixing function of, 765, 766 Spike potentials energy for specific sports in, 1033, 1034b motilin secretion by, 758–759 of gastrointestinal smooth muscle, female and male athletes in, 1031 peristalsis of, 766 753–755, 754f muscles in, 1031–1036 emptying and, 766, 767 of visceral smooth muscle, 95–96, 95f endurance of, 1032, 1032t, 1033 protein digestion in, 791, 791f Spinal anesthesia. See Anesthesia, spinal. metabolic systems in, 1032, 1033f, secretions of. See Gastric secretion. Spinal cord 1033t, 1034b starch digestion in, 790 ascending tracts of, 590f nutrients used in, 1035, 1035f storage function of, 765, 766 cerebellar functions and, 686–687 power of, 1032, 1032t, 1033 ulcers of. See Peptic ulcer. cerebellar input from, 683, 683f strength of, 1031, 1032 Stomach emptying, 765, 766–767 descending tracts of, 590f training effect on, 1035–1036, 1035f regulation of, 767–768, 780 lateral motor system of, 671 respiration in, 1035f, 1036–1038, 1037f, peptic ulcer and, 800 medial motor system of, 671 1037t Storage colon, 797

1084 Index

Strabismus, 630–631, 630f Superior colliculus (Continued) Sympathetic nervous system (Continued) Streamline flow, 161 turning to visual disturbance and, 630 eye control by, 631, 632 Streptococcal infection visual fibers to, 623 Horner’s syndrome and, 632 glomerulonephritis secondary to, 400 Superior olivary nuclei, 639, 639f, 641–642 fatty acid mobilization caused by, 825 inflammatory response to, 428 Superior salivatory nucleus, 648 gastrointestinal regulation by, 755, 757 Streptococcus mutans, 971 Superoxide duodenal mucus and, 786

Streptokinase, 259 high alveolar Po2 and, 536–537 glandular secretions and, 774 Stress of neutrophils and macrophages, 426 ileocecal sphincter and, 770 ACTH secretion and, 932–933 Superoxide dismutases, 536–537 reflexes in, 757 arterial pressure increase in, 205 Supplementary motor area, 668, 668f, 669, stomach emptying and, 767 cortisol and, 929, 930, 930f, 932–933 698, 699f vasoconstriction in, 762 fat utilization in, 825 basal ganglia and, 690f, 691–692, 691f glomerular filtration rate and, 317–318 Stress response, of sympathetic nervous Suppressor T cells, 441, 441f, 442 glucose availability and, 812 system, 738–739 Suprachiasmatic nucleus, visual fibers to, 623 heat conduction to skin and, 868 Stress-relaxation of blood vessels, 227, 227f Supraoptic nucleus, pituitary hormones and, in hypovolemic shock, 274–275 increased blood volume and, 238 897, 904, 904f, 905, 906 vasomotor failure and, 277 intravascular pressure and, 168, 168f Suprathreshold stimulus, 565 localized activation of, 738 reverse, in hypovolemic shock, 275 Supraventricular tachycardias, 148 male sexual act and, 979 Stress-relaxation of smooth muscle, 93 Surface tension, in alveoli, 467–468 mass discharge of, 738 reverse, 93 of premature babies, 468 metabolic rate and, 867 Stretch receptors Surfactant, 468, 490 nonshivering thermogenesis and, 865 atrial. See Atrial stretch receptors. neonatal respiratory distress and, 468, 519, obesity and, 225 of bronchi and bronchioles, 506 1022 renal function and, 373–374 Stretch reflex. See Muscle stretch reflex. Surround inhibition, 578–579, 578f sodium reabsorption in, 339 Stria vascularis, 637 Sustentacular cells salivary glands and, 776 Striate cortex, 624 of olfactory membrane, 649, 649f segmental distribution of fibers in, 730 Striated muscle. See also Skeletal muscle. of taste bud, 646 sweat glands and, 729–730, 730f, 731, 734t, band structure of, 71 Swallowing, 763–765, 764f 735, 870–871 cardiac muscle as, 101 disorders of, 799 temperature regulation by, 872–873 Stroke esophageal secretions and, 776–777 ureteral peristalsis and, 309 cerebral circulation and, 745–746 Swallowing center, 764, 764f, 765 vasoconstriction caused by, 165f, 166, 166f hypertension and, 218 Swallowing reflex, 764, 765 norepinephrine and epinephrine in, motor control system and, 673 Sweat 199, 204 Stroke volume output, 106, 109f composition of, 870–871 in skeletal muscle, 244 aortic valve lesions and, 268 water loss in, 285, 286t Sympathetic tone, 737 athletic training and, 1039, 1039f Sweat glands, 870, 870f Sympathetic vasoconstrictor tone, 203, 203f pulse pressure and, 168–169 aldosterone and, 926 Sympathetic vasodilator system, 204, 204f Stroke work output, 107–108 autonomic control of, 729–730, 730f, 731, Sympathomimetic drugs, 739–740 Stroke work output curve, 110, 110f 734t, 735, 870–871 for shock, 281 Strychnine, 557 Sweating, 870–871. See also Evaporative Synapses, 543, 544f, 546–557. See also Stumble reflex, 664 heat loss. Dendrites; Neurotransmitters; Subarachnoid space, 747, 747f acclimatization to heat and, 871, 877 Postsynaptic neuron; Postsynaptic Subcortical level of nervous system, 545 hypothalamic control of, 870, 872, 872f potentials; Presynaptic terminals. Subcutaneous tissues, macrophages in, 426 set-point and, 874, 874f acid-base abnormalities and, 557 Subendocardial infarction, 249–250 local, 875 drug effects on, 557 Subliminal zone, 565–566 skin receptors and, 872 facilitation of, 545 Sublingual glands, 775 Sweet taste, 645, 646, 646t, 647 fatigue of, 557 Submandibular glands, 774f, 775 Sympathetic chains, 729, 730f in reverberatory circuit, 567–568 Submarines, 540 Sympathetic denervation, 737 stabilizing effect of, 569–570, 569f Submucosal plexus, 755, 756, 756f Sympathetic nervous system. See also hypoxia and, 557 parasympathetic neurons in, 757 Autonomic nervous system. information processing role of, 545 of small intestine, 769 adrenal function and. See Adrenal medulla. memory and, 706, 707, 707f Subneural clefts, 83, 84f alarm response of, 738–739 long-term, 708 Substance P, 586 anatomy of, physiologic, 729–730, 730f one-way conduction at, 546, 547 Substantia gelatinosa, 585, 585f bladder and, 308, 308f physiologic anatomy of, 547–550, 547f Substantia nigra, 690, 690f, 691, 691f blood reservoirs and, 175 types of, 546–547 dopamine system and, 713, 713f bronchiolar dilation and, 473 Synaptic afterdischarge, 567 Huntington’s disease and, 694 in cardiac failure Synaptic body, of rod or cone, 609, 610f neurotransmitters in, 692–693, 692f acute stage, 255–256, 256f, 257, 262 Synaptic cleft, 547, 547f, 550 Parkinson’s disease and, 691, 693–694 decline to normal, 257 of neuromuscular junction, 83 Subthalamus, 690, 690f, 691, 691f decompensated, 262–263 Synaptic delay, 557 lesions in, 691, 693–694 fluid retention and, 260 Synaptic space, 83 Subthreshold stimulus, 565 cardiac innervation by, 111, 111f, Synaptic trough, 83, 84f Subthreshold zone, 565–566 119, 201, 202f Synaptic vesicles, of neuromuscular junction, Sucrase, 787, 790 cardiac regulation by, 111, 111f, 120 83, 84f, 86 Sucrose, 789–790 cardiac output and, 231, 238–239, 239f Syncytium Sulfonylurea drugs, 945 after myocardial infarction, 251 of cardiac muscle, 101–102, 102f Summation tachycardia and, 143 of gastrointestinal smooth muscle, 753 in neuronal pools, 566 vasomotor center and, 203 of unitary smooth muscle, 91 of postsynaptic potentials, 553, 554f, 555, cerebral blood flow and, 745 Synovial spaces, negative pressure in, 183 556–557 circulatory control by, 201–204, 202f Systemic circulation, 157. See also Circulation. in sensory fibers, 564, 564f, 565f mean circulatory filling pressure and, blood volume distribution in, 157, 158f thermal, 593 236, 236f pressures in different portions of, of skeletal muscle contractions, 80, 80f volume-pressure curves and, 168, 168f 158, 159f Superior cervical ganglion, 631, 631f coronary blood flow and, 247, 248 Systole, 105, 105f Superior colliculus energy expenditure and, 849 duration of, heart rate and, 105 involuntary visual fixation and, 629 exercise-related discharge of, 244–245 emptying of ventricles during, 105f, 106

1085 Index

Systolic blood pressure, 158, 168 Temperature, body (Continued) Thalamocortical system, 697–698 age-related increase in, 171, 171f core temperature, 867 alpha waves and, 724 measurement of, 170–171, 170f range of, 867, 867f petit mal epilepsy and, 726 Systolic pressure curve, 108, 108f set-point of, 872f, 873–874, 874f Thalamus. See also Ventrobasal complex of Systolic stretch, 250, 250f, 251 food intake and regulation of, 849, 873 thalamus. gain of control system for, 8 alpha waves and, 724 T heart function and, 112 basal ganglia and, 690, 690f, 691–692, 691f T3. See Triiodothyronine (T3). heart rate and, 143 in Parkinson’s disease, 693–694 T4. See Thyroxine (T4). hypothalamic regulation of, 715, 871–875 cerebellar input to, 684 T lymphocytes, 433, 434. See also Lymphocytes. anterior hypothalamic-preoptic area cerebral cortex and, 697–698, 698f, 712 activation of, 439–440, 440f in, 871, 873 memory and, 709 delayed-reaction allergy associated with, 443 atmospheric temperature range and, motor cortex input from, 670, 687, 687f memory cells of, 440 871, 871f olfactory signals and, 651 preprocessing of, 434–435, 435f, 442 deep body receptors and, 872, 874 pain pathways to, 585–586, 585f specificity of, 435–436 fever and, 875–876, 876f surgical interruption of, 586 transfusion of, 442 low temperatures and, 877 pain perception and, 586 types of, 440–442, 441f. See also specific neuronal effectors in, 872–873, 872f reticular excitatory signals and, 711, 712f types. posterior hypothalamus in, 872 sleep and, 722 T tubules. See Transverse (T) tubules. set-point in, 872f, 873–874, 874f, 876, 876f somatosensory association areas and, 577 T wave, 121, 121f, 122–123 skin receptors and, 872, 874 somatosensory pathways to abnormalities in, 141–142, 142f spinal reflexes and, 875 anterolateral, 573, 581, 581f atrial, 122, 133–134, 133f neonatal regulation of, 873, 1025, 1025f dorsal column–medial lemniscal, 573, cardiac cycle and, 105, 105f prematurity and, 1027 574, 574f, 576 monophasic action potential and, 122, 122f normal range of, 7, 7t, 867, 867f joint rotation and, 580, 580f normal voltage of, 123 ovulation and, 1001, 1002f thermal signals in, 593 vectorial analysis of, 133, 133f rectal, 867f somatosensory role of, 581 Tabes dorsalis, 310 skin temperature, 867 taste signals and, 647–648, 648f Tabetic bladder, 310 local reflexes regulating, 875 visual pathways in, 623–624, 623f Tachycardia(s) set-point and, 874, 874f Theca cells, 989, 989f, 990 incomplete intraventricular block sympathetic regulation of, 738 androgen synthesis in, 992, 993f caused by, 145–146 Temporal field of vision, 627 of corpus luteum, 990–991 paroxysmal, 148–149 Temporal summation Theobromine, 557 atrial, 148, 148f in neurons, 555 Theophylline, 557 ventricular, 148–149, 149f in sensory fibers, 564, 565f Thermal pain stimuli, 583, 584, 584f sinus, 143, 143f Tendon fibers, muscle fibers and, 71 Thermode, 871 Tactile receptors, 560b, 560f, 571–572, 572f Tendon receptors. See Golgi tendon organs. Thermogenesis (heat production), 867, 873 feedback to motor cortex, 672 Tendon reflex, 661 during exercise, 1039–1040 flexor reflex and, 662 Teniae coli, 770 hypothalamic inhibition of, 872, 872f nerve fibers from, 564, 572 Tension-time index, 109 at low temperatures, 877 position senses and, 580 Tensor tympani muscle, 633, 634 nonshivering, 865, 873 Tactile sensations, 571–573 Teratoma, 985 Thermogenic effect of food, 864–865, 867 pain inhibition associated with, 587–588 Testicular tumors, Leydig cell, 985 Thermogenin, 873 Tactile stimuli, salivation and, 776 Testis(es) Thermoreceptive senses, 571 Tamponade, cardiac, cardiac output curve and, anatomy of, 973, 973f anterolateral system and, 573 234, 234f cholesterol used by, 827 localization of, 577 Tandem pore domain potassium channel, 59, 59f descent of, 981 Thermoreceptors, 559, 560b, 592–593, 592f Tank respirator, 522f, 523 fetal, human chorionic gonadotropin and, nerve fibers from, 564 Taste, 645–648 984, 1008 transmission pathways from, 593 adaptation of, 648 storage of sperm in, 975–976 Theta waves, 723f, 724–725, 725f

factors affecting experience of, 645 temperature of, 977, 978 Thiamine. See Vitamin B1 (thiamine). preference in, 648 Testis determining factor, 981 Thiazide diuretics, 332, 332f, 398, 398t primary sensations of, 645–648 Testosterone Thiocyanate ions thresholds for, 646, 646t chemical structure of, 980f antithyroid activity of, 915 salivation and, 648, 776 degradation and excretion of, 980 in saliva, 776 signal transmission into central nervous in fetal development, 980, 981, 981f, 984, Third heart sound, 266 system, 647–648, 648f 1008 Thirst taste buds and, 646–647, 647f functions of, 980–982 extracellular fluid osmolarity and, 357–360, Taste blindness, 646 luteinizing hormone and, 983, 984 358t, 359f Taste cells, 646, 647, 647f mechanism of action of, 982–983 hypothalamic control of, 716 Taste hairs, 646 metabolic rate and, 864 Thirst center, 358, 716 Taste pore, 646, 647f metabolism of, 980 Thoracic duct, 186, 186f, 819 TATA box, 35, 35f nongenomic effects of, 983 rate of flow through, 187 Tectorial membrane, 636f, 637, 637f ovarian synthesis of, 991, 992, 992f Thoracic duct lymph Tectospinal tracts, 670, 672f plasma level of, over life cycle, 980, 981f fat in, 187, 760 Teeth, 969–972 protein deposition in tissues and, 835–836, protein concentration of, 187 abnormalities of, 971–972 982–983, 1031 Thought, 705–706 development of, 970–971, 970f secretion of, 979–980, 980f communication of, 703–704 functions of, 969 spermatogenesis and, 975 elaboration of, 703 mineral exchange in, 971 Tetanization, 80, 80f holistic theory of, 706 parts of, 969, 969f Tetany, hypocalcemic, 64, 367, 956, 956f prefrontal association area and, 700, 703 Telophase, 38f, 39 in hypoparathyroidism, 967 Wernicke area and, 701, 704–705 Temperature, body, 867–877. See also Heat in premature infant, 1027 Threshold for drinking, 358 loss; Thermogenesis (heat production); in rickets, 968–969 Thrill, in aortic stenosis, 267 Thermoreceptors. Tetracaine, 69 Thrombin, 453, 453f, 454 abnormalities of, 875–877, 875f, 876f. Tetraethylammonium ion, 63 adsorbed to fibrin fibers, 457 See also Fever. Tetralogy of Fallot, 271, 271f thrombomodulin binding of, 456–457 behavioral control of, 875 Tetrodotoxin, 63 Thrombocytes. See Platelets.

1086 Index

Thrombocytopenia, 458 Thyroid-stimulating hormone (TSH; Touch, 571. See also Tactile receptors; Tactile Thrombocytopenic purpura, 458 thyrotropin) (Continued) sensations. Thromboembolic conditions, 459 iodide trapping and, 908, 914 pathways into central nervous system, 573 Thrombomodulin, 456–457 pregnancy and, 1009 Toxic substances Thromboplastin, chemical structure of, 826 thermogenesis and, 873 acute tubular necrosis caused by, 401 Thrombosthenin, 451, 454 Thyroid-stimulating immunoglobulins, 916 bitter taste of, 646

Thromboxane 2A Thyrotoxicosis. See Hyperthyroidism. t-PA. See Tissue plasminogen activator (t-PA). platelet aggregation and, 452 Thyrotropes, 896, 896t Trace elements, 856–857 vasoconstriction caused by, 451 Thyrotropin. See Thyroid-stimulating hormone Trachea, 472, 472f Thrombus, 459. See also Coronary thrombosis. (TSH; thyrotropin). Tractus solitarius, 203. See also Nucleus tractus Thymine, 27, 28, 28f, 31t Thyrotropin-releasing hormone (TRH), 898, solitarius. Thymus, T lymphocyte processing in, 434–435, 898t, 914–915 autonomic control by, 739 435f, 442 test dose of, 918 baroreceptors and, 205, 206 Thyroglobulin, 882, 907, 908–909, 908f thermogenesis and, 873, 915 swallowing and, 764

cleaving of hormones from, 909, 914 Thyroxine (T4), 907. See also Thyroid hormones. taste signals and, 647–648, 648f hypothyroidism and, 917 compared to triiodothyronine, 907 Tranquilizers, reward or punishment centers organification of, 908–909 converted to triiodothyronine, 910 and, 718 storage of, 909 diagnostic measurement of, 916, 918 Transamination Thyroid adenoma, 916 heat production and, 873 in amino acid synthesis, 834, 834f, 840 Thyroid gland mechanism of action, 891 in deamination, 834–835 anatomy of, 907, 907f metabolic rate and, 864, 867 Transcellular fluid, 286 blood flow in, 907 in pregnancy, 1009 Transcortin, 923 calcitonin secretion in, 966 protein metabolism and, 836 Transcription, 27, 27f, 29f, 30–31 diseases of, 916–918, 916f, 918f Thyroxine-binding globulin, 882, 909–910 hormonal action and, 888, 889f, 891 histology of, 907, 907f Thyroxine-binding prealbumin, 909–910 by cortisol, 931 inhibitors of, 915 Tic douloureux, 590 by growth hormone, 899 Thyroid hormones, 907–919. See also Tickle sense, 571, 572. See also Tactile sensations. by insulin, 944

Reverse T3 (RT3); Thyroxine (T4); anterolateral system and, 573 by thyroid hormones, 910, 911f Triiodothyronine (T3). scratch reflex and, 664 in postsynaptic neuron, 549, 549f cold climate and, 873 Tidal volume, 469, 469f regulation of, 35–36, 35f daily rate of secretion, 909 minute respiratory volume and, 471 Transcription factors, 35–36, 35f functions of, 910–914 Tight junctions thyroid hormone receptors as, 891 basal metabolic rate and, 907, 911, 912, 913f of brain capillaries, 749 Transcytosis, in capillary endothelium, 178 blood cholesterol and, 827 of gastric mucosa, 799–800 Transducin, 613, 613f body weight and, 912 renal tubular, 324, 325f, 327–328 Transfer RNA (tRNA), 31, 32, 32f, 34, 34f carbohydrate metabolism and, 912 Tissue capillarity, high altitude and, 529 Transferrin, 418, 418f, 419–420, 840 cardiovascular system and, 913 Tissue factor, 455, 455f, 456 Transfusion, for shock, 280–281 central nervous system and, 913 prothrombin time and, 461 irreversible, 278, 278f fat metabolism and, 825, 912 Tissue gel, 180–181 Transfusion reactions, 445, 446, 448–449 gastrointestinal motility and, 913 Tissue plasminogen activator (t-PA) acute renal failure in, 448–449 gene transcription and, 910, 911f for cardiogenic shock, 259 Rh blood types and, 447 growth and, 912 clot lysis and, 457 Translation, 27, 27f, 33–35, 34f. See also liver fats and, 912 for pulmonary embolism, 459 Protein(s), synthesis of. metabolic activity and, 911–912 for thrombotic occlusion, 459 growth hormone and, 899 muscles and, 913 Tissue thromboplastin. See Tissue factor. Transmitter substances. See Neurotransmitters. nongenomic effects in, 910 Tissue typing, 449 Transmitter vesicles, 547–548, 550 other endocrine glands and, 913–914 Titin, 73, 73f memory and, 708 plasma lipids and, 912 Titratable acid, 389–390 of neuropeptides, 551 respiration and, 913 TNF (tumor necrosis factor), in inflammation, recycling of, 550–551 sexual function and, 914 430, 430f Transplantation of tissues and organs, 449–450 sleep and, 913 Tolerance, immune, 442 kidney transplantation, 409 vitamin requirements and, 912 Tone Transport. See Active transport; Diffusion; long duration of action, 910, 910f muscle. See Muscle tone. Membrane transport. mechanism of action, 891 sympathetic and parasympathetic, 737 Transport maximum, renal tubular, 326–327, protein binding of, 882, 909–910 Tonic contraction, of gastrointestinal smooth 327f, 327t protein metabolism and, 836, 911 muscle, 755, 756 Transport proteins, 45, 46f. See also Carrier protein synthesis and, 910, 911f Tonic receptors, 562 proteins; Protein channels. receptors for, 891, 910, 911f Tonic seizures, 725 Transport vesicles, 20–21, 20f regulation of secretion of, 914–915, 915f Tonic-clonic seizures, 725 Transpulmonary pressure, 466f, 467 release of Tonometry, 607, 607f Transverse (T) tubules from thyroid, 909 Tonotopic maps, 640 of cardiac muscle, 103–104, 104f to tissues from plasma, 910 Torsades de pointes, 147, 148f of skeletal muscle, 73f, 87, 87f, 88–89, 88f slow onset of, 910, 910f Total body water Trauma structures of, 909f measurement of, 289 growth hormone secretion in, 901, 902 synthesis of, 882, 907, 908–909, 908f, 909f regulation of, 345 hypovolemic shock in, 279 inhibitors of, 915 Total lung capacity, 469, 469f Tremor transport of, to tissues, 909–910 determination of, 471 intention tremor, 687–688, 689 Thyroiditis Total peripheral resistance, 163. See also in Parkinson’s disease, 693 autoimmune, 917 Vascular resistance. thyroid hormones and, 913 idiopathic goiter and, 917 cardiac output and, 230–231, 230f Treppe, 80 Thyroid-stimulating hormone (TSH; elevated, 232–233 TRH. See Thyrotropin-releasing hormone thyrotropin), 896, 896t, 914–915, 915f in hypovolemic shock, 274 (TRH). antithyroid substances and, 915 renal–body fluid system and, 216–217, 216f, Triamterene, 332, 333f, 399 in foods, 917 217f Trichinosis, 430 diagnostic measurement of, 916 renin-angiotensin system and, 223 Tricuspid valve, 106–107 endemic goiter and, 917 volume-loading hypertension and, 219, first heart sound and, 265, 266, 266f hyperthyroidism and, 916 220, 220f as reference level for pressure, 174–175, 174f

1087 Index

Tricyclic antidepressants, 727 U Urine (Continued) Trigeminal nerve, sensory nuclei of, 574 Ubiquinone, 814 formation of, 310–312, 311f. See also Trigeminal neuralgia, 590 Ubiquitin, muscle atrophy and, 82 Kidney(s), reabsorption by; Kidney(s), Triglycerides. See also Fatty acids. Ulcerative colitis, 771, 802–803 secretion by. in cell, 12 Ultimobranchial glands, 966 osmolarity of, specific gravity and, 347, 347f as neutral fat globules, 14 Ultrafiltration, into peritubular capillary, pH of, 380, 380t chemical structure of, 819 323–324, 325 minimal, 388 in chylomicrons, 819–820 Ultrasonic flowmeter, 160–161, 161f specific gravity of, 347, 347f dietary, 791–792, 791f for cardiac output measurement, 240 transport from kidney to bladder, 308–309 digestion of, 789, 791f Umami taste, 646 volume of bile salts and, 792 Umbilical arteries, 1005, 1006f, 1022, 1022f obligatory, 347, 353 emulsification for, 792 Umbilical vein, 1005, 1006f in pregnancy, 1010 by pancreatic lipase, 792, 792f Unipolar limb leads, augmented, 126–127, 127f water loss in, 286, 286t in stomach, 792 axes of, 130, 130f Urine output, arterial blood pressure and, 337 energy production from, 822–825. See also vectorial analysis of potentials in, 131 Urobilin, 840–841 Fats, as energy source. Unitary (visceral) smooth muscle, 91, 91f, 94f Urobilinogen, 840–841, 841f, 842 regulation of, 825–826 action potentials in, 95, 96 Urogenital diaphragm, 307f, 308 functions of, 819 excited by stretch, 96 Urticaria, 443 hydrolysis of, 820, 822 number of fibers in, 96 Uterine milk, 995, 1004 in lipoproteins, 821, 821t spontaneous, 95f, 96 Uterus, 987, 987f, 988f. See also Implantation; in liver, 821–822 Unmyelinated nerve fibers, 67, 67f Labor. resynthesis of, in intestinal epithelium, classification of, 563, 563f, 564 contractility of, 1011–1012 797, 819 Unsaturated fats hypothalamus and, 716 storage of, 821–822. See also Adipose tissue. atherosclerosis prevention and, 829 contraction of, oxytocin and, 905 synthesis of, 821–822 blood cholesterol and, 827 estrogenic effects on, 993 from carbohydrates, 824–825, 824f formed in liver, 822 involution of, after parturition, 1013–1014 from proteins, 825 vitamin E and, 855 parturition and, 1011–1013, 1012f thyroid hormones and, 912 Uracil, 30, 31t progesterone and, 994 Trigone, 307f, 308, 308f, 309 Urea Utilization coefficient, 499

Triiodothyronine (T3), 907. See also Reverse T3 artificial kidney and, 410 Utricle, 674–675, 675f, 676–677 (RT3); Thyroid hormones. chronic renal failure and, 406 Uvula, of cerebellum, 678 compared to thyroxine, 907 diffusion through membrane channels, 47 mechanism of action, 891 formation by liver, 835, 839–840 V thyroxine converted to, 910 ATP expended for, 859 Vagal reflex, to stop paroxysmal tachycardia, tRNA. See Transfer RNA (tRNA). placental diffusion of, 1007 148 Trophoblast cells, 1004, 1004f, 1005, 1005f reabsorption of, in kidney, 328–329, 328f, Vagina, 987, 987f, 988f estrogen and progesterone secreted by, 1008 333–334 estrogenic effects on, 993 glucose for fetus and, 1007 in sweat, 870 Vagovagal reflexes human chorionic gonadotropin secreted by, urine concentration and, 348t, 350–351, gastric muscular tone and, 766 1007–1008, 1007f 351f, 353 gastric secretion and, 779 nutrition of embryo and, 1005, 1005f Urea recycling, 353 Vagus nerves placenta and, 1005, 1006f Urea transporters, 328–329, 333–334, aortic baroreceptors and, 205 Tropical sprue, 801 350, 353 aortic bodies and, 508f, 509 Tropomyosin, in skeletal muscle, 75–76, 75f Uremia, 406 arterial pressure and, 206, 736 Troponin plasma composition in, 410t bronchoconstriction and, 473 calmodulin and, 891 Ureterorenal reflex, 309 cardiac effects of in cardiac muscle, 103 Ureters, 307f, 308–309, 308f atrioventricular block as, 144 in skeletal muscle, 75–76, 75f pain sensation in, 309 bradycardia as, 144 Trypsin, 781, 791 Urethra, 306, 307f cardiac regulation by, 111, 111f, 119–120, Trypsin inhibitor, 781 posterior, 307f, 308, 308f 201, 202f Trypsinogen, 781 micturition reflex and, 309 atrial stretch and, 208–209 Tryptophan deficiency, 854 voluntary urination and, 310 sensory signals and, 203 TSH. See Thyroid-stimulating hormone (TSH; Urethral glands, 973, 979 vasomotor center and, 203, 208 thyrotropin). Urinary tract infection, septic shock secondary coronary blood flow and, 247 Tuber cinereum, 897 to, 280 duodenal mucous glands and, 786 Tuberculosis, 520 Urinary tract obstruction food intake and, 846f, 848 bacterial defenses in, 426 acute renal failure in, 399, 401 gallbladder emptying and, 785 Tubular glands, 773, 777f. See also Oxyntic infection secondary to, 403–404 gastric secretions and, 779, 780, 780f (gastric) glands; Pyloric glands. Urine pepsinogen in, 779 Tubulin, 16 concentration of, 345, 346–353 ulcers and, 801 Tubuloglomerular feedback, 195, 319–321, 320f basic requirements for, 347–348 gastrointestinal innervation by, 756–757 Tufted cells, 651, 652 in chronic renal failure, 405, 406f reflexes and, 757 Tumor necrosis factor (TNF), in inflammation, countercurrent mechanism and, 348–349, gastrointestinal regulation by, stomach 430, 430f 349f, 351–352, 352f, 353 emptying and, 767 Turbulent blood flow, 161–162, 161f disorders of, 354–355 pancreatic secretions and, 782 Twitches, skeletal muscle, 79 distal tubule and collecting ducts and, parasympathetic fibers in, 730, 731f Two-point discrimination, 578, 578f 350, 350f respiratory control and, 506 Tympanic membrane, 633–634, 633f maximal level of, 347 swallowing and, 764f, 765 damage to, 642 obligatory volume and, 347, 353 taste signals and, 647 Tyrosine quantification of, 354 in vasovagal syncope, 204 hormones derived from, 882–884 specific gravity and, 347, 347f Valvulae conniventes, 793, 793f in norepinephrine synthesis, 732 summary of, 352–353, 352f Valvular heart disease in thyroid hormone synthesis, 908–909, urea and, 350–351, 351f cardiac hypertrophy in, 272 909f, 914 dilution of, 345–346, 346f circulatory dynamics in, 268–269 Tyrosine kinases in chronic renal failure, 405 congenital, 267 insulin receptor and, 940–941, 941f disorders of, 354–355 exercise and, 269 leptin receptor and, 888 quantification of, 354 murmurs caused by, 267–268

1088 Index

Valvular heart disease (Continued) Vasodilation (Continued) Venous return curves (Continued) regurgitation in, 267 ions with effect of, 200 normal, 235–236, 235f rheumatic, 266–267 in local blood flow control, 191, 192–193, resistance to venous return and, 237, 237f, stenosis in, 267 194, 196–197 238f van den Bergh reaction, 841–842 nitric oxide and, 195–196, 196f with simultaneous cardiac output curves, van’t Hoff’s law, 291 tissue factors and, 97 238–240, 238f Varicose veins, 174 in septic shock, 280 Venous sinuses, of spleen, 175, 175f, Varicosities Vasodilator agents, 199–200 427–428, 427f of postganglionic nerve endings, 732 for angina pectoris, 252 Venous system of smooth muscle nerve endings, 94f, 95 in cardiac muscle, 247 damming of blood in, after myocardial Vas deferens, 973, 973f, 975–976 for essential hypertension, 226 infarction, 250, 255 Vasa recta, 306, 307f in gastrointestinal tract, 761 lymph emptying into, 186, 186f blood flow in, 317 limited long-term effect of, 200 volume-pressure curve of, 167–168, 168f countercurrent exchange in, 348, in skeletal muscle, 243–244 Venous thrombosis, femoral, 459 351–352, 352f Vasodilator area, of medulla, 202f, 203 Venous valves, 173–174, 174f Vascular capacitance, 167. See also Vascular Vasodilator system, sympathetic, 204, 204f incompetent, 174 compliance. Vasodilator theory, of local blood flow Ventilation. See Alveolar ventilation; sympathetic control of, 168 regulation, 192–193 Mechanical ventilation; Pulmonary Vascular compliance, 167. See also Vascular Vasomotion, of precapillary vessels, ventilation. capacitance. 178–179, 193 Ventilation-perfusion ratio, 492–494 arterial, 167 Vasomotor center of brain stem, 202–204, 204f abnormalities of, 493–494 pressure pulse reduction by, 168, 170 baroreceptors and, 6 atelectasis and, 519 pressure pulse velocity and, 169–170 chemoreceptors and, 208 in emphysema, 494, 518 pulse pressure and, 168–169 CNS ischemic response and, 209 in pneumonia, 518–519, 519f venous, 167 exercise and, 244 in tuberculosis, 520 Vascular distensibility, 167–168, 168f progressive shock and, 277 hypoxia and, 520 Vascular endothelial growth factor respiratory waves and, 210 Ventral lateral geniculate nucleus, 623 (VEGF), 198 Vasomotor waves, 210–211, 210f Ventral posterior medial nucleus of thalamus, Vascular resistance, 162–165. See also Total Vasopressin. See Antidiuretic hormone (ADH; 647–648, 648f peripheral resistance. vasopressin). Ventral respiratory group, 505, 506, 506f arterial pressure and, 165, 166 Vasovagal syncope, 204 Ventricles, cardiac arterial pressure pulses and, 170 Vectorcardiogram, 134, 134f as pumps, 106 conductance and, 163, 164 Vegetative functions, of brain, 714 synchronous contraction of, 119 diameter of vessel and, 164 VEGF (vascular endothelial growth factor), 198 transmission of impulse in, 118, 118f hematocrit and, 164–165, 165f Veins Ventricular dilatation pressure difference and, 159, 160 as blood reservoir, 175 chemical energy expended and, 109 pulmonary. See Pulmonary vascular blood volume in, 157, 158 circus movement secondary to, 251 resistance. distensibility of, 167–168, 168f QRS prolongation in, 137–138 in series and parallel circuits, 164, 164f exercise-related contraction of, 244–245 Ventricular escape, 119–120, 145 units of, 162–163 functions of, 157, 171, 173–174, 175 Ventricular fibrillation, 149–151, 150f, 151f venous pressure and, 172 in nervous control of arterial pressure, 205 circulatory arrest in, 281 Vascular smooth muscle. See also Blood flow in hypovolemic shock, 274 in long QT syndromes, 147 control. sympathetic innervation of, 201, 202f after myocardial infarction, 250–251 aldosterone and, 927 temperature receptors in, 872 paroxysmal tachycardia leading to, 149 autoregulation of blood flow and, 194–195 Venous admixture, 496, 496f Ventricular function curves, 110–111, local factors controlling, 97 Venous dilation, acute, cardiac output and, 233 110f nitric oxide and, 195, 196f Venous plexus, cutaneous, 868, 868f Ventricular hypertrophy. See also Cardiac Vascularity of tissues, blood flow regulation as blood reservoir, 175 hypertrophy; Left ventricular and, 197–198, 197f heat conduction and, 868 hypertrophy. Vasoactive intestinal peptide Venous pooling of blood, 279 axis deviation in, 135–136, 135f, 136f gastric secretion and, 780 Venous pressures, 172–175. See also Blood high voltage in, 136f, 137 penile erection and, 978–979 pressure. QRS prolongation in, 137–138 Vasoconstriction compression points and, 172, 172f Ventricular paroxysmal tachycardia, cutaneous, for temperature regulation, 872, gravity and, 172–173, 173f, 174–175, 174f 148–149, 149f 875, 876 measurement of, 174–175, 174f Ventricular pressure, cardiac cycle and, 105, of injured vessel, 451 reference level for, 174–175, 174f 105f, 106 ions with effect of, 200 Venous pump, 171, 173–174 Ventricular rupture, 251 tissue blood flow and, 165f, 166, 166f Venous return Ventricular syncytium, 102 Vasoconstrictor agent(s), 199 artificial respiration and, 523 Ventricular tachycardia, paroxysmal, angiotensin II as, 199, 221 calculation of, 237 148–149, 149f nitric oxide and, 196 in cardiac failure, 256, 257 Ventricular volume, cardiac cycle and, 105, antidiuretic hormone as, 199, 905 cardiac output and, 110, 112, 229–230 105f, 106 endothelin as, 196 in pathological conditions, 232–234, 233f Ventricular volume output curve, 110, 110f limited long-term effect of, 200 mean filling pressure and, 236–237, 236f Ventrobasal complex of thalamus, 574, Vasoconstrictor area, of medulla, 202, pressure gradient for, 237 574f, 575f 202f, 203 resistance to, 237, 237f, 238f anterolateral pathway and, 581, 581f baroreceptor signals and, 206 exercise and, 245 joint rotation and, 580f Vasoconstrictor system, sympathetic, 201–204, increased blood volume and, 238 pain fibers terminating in, 585 202f sympathetic stimulation and, 238–239 signals to motor cortex from, 670 adrenal medullae and, 204 shock caused by decrease in, 273, 279, 280 thermal signals terminating in, 593 cerebral ischemia and, 209 Venous return curves, 234, 235–237 Venules, 177, 178f hypothalamus and, 204 combinations of patterns of, 237, 238f function of, 157 Vasoconstrictor tone, sympathetic, 203, 203f exercise and, 245, 245f Vermis, cerebellar, 681–682, 682f, 684, 686 Vasodilation in heart failure. See Cardiac failure, Vertebral fracture, acceleratory forces causing, by carbon dioxide increase, 200 quantitative graphical analysis of. 531, 532–533 cutaneous, for temperature regulation, mean systemic filling pressure and, 235, Very low-density lipoproteins (VLDLs), 872, 875, 877 235f, 236–237, 236f, 238f 820f, 821

1089 Index

Vesicointestinal reflex, 772 Vitamin(s) (Continued) Volume reflex, atrial, 208 Vesicoureteral reflux, 309, 403–404 deficiencies of Volume-loading hypertension, 218–219, Vesicular channels, in capillary endothelium, of B vitamins, vasodilation in, 194 218f, 220f 178 combined, 854 Volume-pressure curves, of arterial and venous Vesicular follicles, 989 in starvation, 852 systems, 167–168, 168f Vestibular apparatus, 674–676, 675f, 676f. in fetus, 1020 Volume-pressure diagram, of cardiac cycle, See also Equilibrium. storage in body, 852–853 108–109, 108f, 109f connections with central nervous system, thyroid hormones and, 912 Volume-pressure work, cardiac, 108 678, 678f, 694 Vitamin A, 853 Vomiting, 803–804, 803f head rotation and, 676, 677, 677f in retina, 611, 611f, 612 aversion to foods causing, 651 linear acceleration and, 676–677 stored in liver, 840, 852 hyponatremia caused by, 294–295

motion sickness and, 804 Vitamin B1 (thiamine) metabolic acidosis caused by, 393 static equilibrium and, 676, 678 colon bacteria and, 798 metabolic alkalosis caused by, 393, 804 Vestibular membrane, 634–635 deficiency of, 853. See also Beriberi. obstruction as cause of, 804, 804f Vestibular nerve, 676, 678, 678f metabolic function of, 853 Vomiting center, 803, 803f, 804

Vestibular nuclei, 673f, 674, 678, 678f Vitamin B2 (riboflavin), 854 nausea and, 804 cerebellar input to, 683, 684 Vitamin B6 (pyridoxine), 854–855 von Willebrand factor, platelets and, 452 motor fibers leading to, 670 amino acid synthesis and, 834, 854 von Willebrand’s disease, 458

vomiting and, 804 Vitamin B12, 854 Vestibulocerebellar tracts, 670, 683, 683f colon bacteria and, 798 W Vestibulocerebellum, 686–687 in fetus, 1020 W ganglion cells, 619, 630 Vestibulospinal tracts, 670, 672f, 674, 674f, intrinsic factor and, 778, 800, 854. See also Walking movements, 664 678, 678f Pernicious anemia. Warfarin, 459–460 Vibration sense, 571, 572. See also Tactile red blood cell production and, 417, 420 Warmth receptors, 592–593, 592f. See also sensations. stored in liver, 840 Thermoreceptive senses. pathways into central nervous system, Vitamin C, 855 Waste products, renal excretion of, 303, 573, 579 in fetus, 1020 311–312, 330 Villi, intestinal. See also Enterocytes. neonatal need for, 1025 Water absorption by, of water and electrolytes, osteoporosis secondary to, 969 in cell, 11 786–787 Vitamin D, 855, 960–962, 961f diffusion through capillary pores, 179–180, central lacteal of, 793f, 794 actions of, 962 180t contractions of, 769 calcium absorption and, 796, 855, 962, diffusion through cell membrane, 46, 47, epithelium of, 786 964–965 51–52, 51f, 290 gluten enteropathy and, 801 calcium excretion and, 962 in feces, 798 pits between. See Crypts of Lieberkühn. deficiency of in gastrointestinal secretions, 774–775 structure of, 793–794, 793f hyperparathyroidism secondary to, 968 intake of, daily, 285, 286t vasculature of, 761, 761f rickets in, 968–969 intestinal absorption of countercurrent flow in, 761–762 in fetus, 1020 in colon, 797–798 Villi, placental, 1005, 1006f for hypoparathyroidism, 967 in small intestine, 794, 795 glucose diffusion and, 1007 neonatal need for, 1025, 1026 intestinal secretion of, 786–787 Virchow-Robin space, 743, 743f parathyroid hormone and, 961–962, loss of, daily, 285–286, 286t Viruses, 17–18, 18f 961f in pancreatic secretions, 781, 782, 783f neutralization of, by complement, 439 phosphate absorption and, 962, 964–965 reabsorption by kidneys, 324, 328, 328f Viscera phosphate excretion and, 962 angiotensin II and, 338–339, 338f control of. See Autonomic nervous system. in pregnancy, 1010 antidiuretic hormone and, 339, 339f, insensitive to pain, 589 receptors for, 962 345, 716 temperature receptors in, 872 renal calcium reabsorption and, 368–369 atrial natriuretic peptide and, 339 Visceral pain, 588–590, 589f renal hydroxylation of, 304, 961 estrogen and, 994 Visceral reflexes, 729 impaired in renal failure, 406–407 inulin concentration and, 334, 334f Visceral sensations, 571 parathyroid hormone and, 964–965 in loop of Henle, 330–331, 330f Visceral smooth muscle, 91. See also Unitary stored in liver, 840, 852 in pregnancy, 1011 (visceral) smooth muscle. Vitamin D–resistant rickets, 969 renal excretion of, hypothalamus Viscosity. See Blood, viscosity of. Vitamin E, 855 and, 716 Visual acuity, 604–605, 604f in fetus, 1020 renal regulation of, 303 accommodation and, 631 Vitamin K, 855 total body in central retina, 619 clotting factor deficiencies and, 458, 855 measurement of, 289 Visual association areas, 624–625 colon bacteria and, 798, 855 regulation of, 345 Visual contrast, 618, 626 in fetus, 1020 vapor pressure of, 486, 487 Visual cortex, 623, 624–626, 624f, 625f hepatic requirement for, 840 altitude and, 527 fusion of two images and, 630 impaired absorption of, 458, 802 in alveoli, 527 reading and, 704f, 705 in pregnancy, 1010 Weber-Fechner principle, 579 Visual fields, 627, 627f prothrombin activation and, 453 Weight, body. See also Obesity. Visual image(s) for surgical patients, 458 hypertension and, 225 analysis of warfarin and, 459–460 thyroid hormones and, 912 neuronal patterns in, 626–627, 626f Vitreous humor, 606, 606f Weight loss two pathways for, 626 VLDLs (very low-density lipoproteins), abnormal, 851–852 fusion of, 625, 630–631 820f, 821 in obese patients, 851 lack of, 630–631, 630f Vocal folds, 474–475, 474f Weightlessness, 533–534 Visual information, interpretation of, 701, Vocalization, 474–475 Wernicke aphasia, 703, 704 701f Volley principle, 638 Wernicke area, 699–700, 699f, 701, 701f Visual pathways, 623–624, 623f Voltage clamp, 62–63, 62f aphasia related to, 703, 704 Visual purple. See Rhodopsin. Voltage-gated channels, 47, 48, 49f. auditory areas and, 702, 704–705, Visual receptive aphasia, 703 See also Calcium ion channels, 704f Vital capacity, 469, 469f voltage-gated; Potassium ion channels, hemispheric dominance and, 701, Vitamin(s), 852–855. See also specific voltage-gated; Sodium ion channels, 702, 705 vitamins. voltage-gated. meaning of sounds and, 641 daily requirements of, 852, 853t of nerve membrane, 61–63, 61f, 62f visual information and, 701, 702, 704f, 705

1090 Index

White blood cell count, in neonate, Work output Z 1024 of heart, 107–109, 108f, 109f, 110 Z disc, of skeletal muscle, 71, 72f, 73, 73f White blood cells. See Leukocytes of skeletal muscle, 78 contraction mechanism and, 74, 74f, (white blood cells). Working memory, 703, 706 75, 76 White muscle, 79 Zinc, 856 White pulp, of spleen, 175 X Zona fasciculata, 921f, 922 White ramus(i), 729, 730f X ganglion cells, 619, 624, 625 Zona glomerulosa, 921–922, 921f Withdrawal reflexes, 662–663 Xenograft, 449 Zona pellucida, fertilization and, 977, Word blindness, 701, 703 1003 Word deafness, 703 Y Zona reticularis, 921f, 922 Work, of breathing, 468 Y ganglion cells, 619, 624, 625, 626, 630

1091