StudentS: Need a brush-up on A&P? Anatomy & Physiology | REVEALED® is a study partner that is ready for you anytime, anywhere This unique tool is designed to help you master human anatomy and physiology with content customized to your course, stunning cadaver specimens, vivid animations, and lab-practical quizzing Buy it direct at www.aprevealed.com Now use APR on your device! An Interactive Cadaver Dissection Experience This unique multimedia tool is designed to help you master human anatomy and physiology with: g Content customized to your course g Stunning cadaver specimens g Vivid animations g Lab practical quizzing my y my Course Content An APR application is now available on Apple® and Android™ tablets ng g Maximize efficiency by studying exactly what’s required g Your instructor selects the contentt that’s relevant to your course Dissection g Peel layers of the body to reveal structures beneath the surface Animation g Over 150 animations make anatomy and physiology easier to visualize and understand Histology g Study interactive slides that simulate what you see in lab Imaging g Correlate dissected anatomy with X-ray, MRI, and CT scans Quiz W W W A P R E V E A L E D.C O M THE Virtual Lab Experience Based on the same world-class, superadaptive technology as McGraw-Hill LearnSmart ®, LearnSmart Labs is a must-see, outcomes-based lab simulation It assesses a student’s knowledge and adaptively corrects defciencies, allowing the student to learn faster and retain more knowledge with greater success Whether your need is to overcome the logistical challenges of a traditional lab, provide better lab prep, improve student performance, or create an online experience that rivals the real world, LearnSmart Labs accomplishes it all http://learnsmartadvantagedemo.com/ TM Md Dalim #1227940 2/14/13 Cyan Mag Yelo Black g Gauge proficiency with customized quizzes and lab practicals that cover only what you need for your course www.mhhe.com/widmaier13 THE Virtual Lab Experience! anatomy & physiology McGraw-Hill ConnectPlusTM Anatomy & Physiology interactive learning platform provides a customizable, assignable eBook, auto-graded assessments, an adaptive diagnostic tool, lecture capture, access to instructor resources, and powerful reporting—all in an easy-to-use interface Learn more at www.mcgrawhillconnect.com Based on the same world-class super-adaptive technology as McGraw-Hill LearnSmart™, LearnSmart Labs™ is a must-see, outcomes-based lab simulation It assesses a student’s knowledge and adaptively corrects deficiencies, allowing the student to learn faster and retain more knowledge with greater success First, a student’s knowledge is adaptively leveled on core learning outcomes: Questioning reveals knowledge deficiencies that are corrected by the delivery of content that is conditional on a student’s response Then, a simulated lab experience requires the student to think and act like a scientist: Recording, interpreting, and analyzing data using simulated equipment found in labs and clinics The student is allowed to make mistakes—a powerful part of the learning experience! Learn Fast Learn Easy Learn Smart McGraw-Hill LearnSmart™ is an adaptive diagnostic tool that constantly assesses student knowledge of course material Sophisticated diagnostics adapt to each student’s individual knowledge base, and vary the questions to determine what the student knows, doesn’t know, knows but has forgotten, and how to best improve their knowledge level Students actively learn required course concepts, and instructors can access specific LearnSmart reports to monitor progress For more information, go to www.mhlearnsmart.com A virtual coach provides subtle hints when needed; asks questions about the student’s choices; and allows the student to reflect upon and correct those mistakes Whether your need is to overcome the logistical challenges of a traditional lab, provide better lab prep, improve student performance, or make your online experience one that rivals the real world, LearnSmart Labs accomplishes it all Learn more at www.learnsmartadvantagedemo.com Widmaier ES.indd 2/19/13 3:09 PM Page Page www.mhhe.com/widmaier13 THE Virtual Lab Experience! anatomy & physiology McGraw-Hill ConnectPlusTM Anatomy & Physiology interactive learning platform provides a customizable, assignable eBook, auto-graded assessments, an adaptive diagnostic tool, lecture capture, access to instructor resources, and powerful reporting—all in an easy-to-use interface Learn more at www.mcgrawhillconnect.com Based on the same world-class super-adaptive technology as McGraw-Hill LearnSmart™, LearnSmart Labs™ is a must-see, outcomes-based lab simulation It assesses a student’s knowledge and adaptively corrects deficiencies, allowing the student to learn faster and retain more knowledge with greater success First, a student’s knowledge is adaptively leveled on core learning outcomes: Questioning reveals knowledge deficiencies that are corrected by the delivery of content that is conditional on a student’s response Then, a simulated lab experience requires the student to think and act like a scientist: Recording, interpreting, and analyzing data using simulated equipment found in labs and clinics The student is allowed to make mistakes—a powerful part of the learning experience! Learn Fast Learn Easy Learn Smart McGraw-Hill LearnSmart™ is an adaptive diagnostic tool that constantly assesses student knowledge of course material Sophisticated diagnostics adapt to each student’s individual knowledge base, and vary the questions to determine what the student knows, doesn’t know, knows but has forgotten, and how to best improve their knowledge level Students actively learn required course concepts, and instructors can access specific LearnSmart reports to monitor progress For more information, go to www.mhlearnsmart.com A virtual coach provides subtle hints when needed; asks questions about the student’s choices; and allows the student to reflect upon and correct those mistakes Whether your need is to overcome the logistical challenges of a traditional lab, provide better lab prep, improve student performance, or make your online experience one that rivals the real world, LearnSmart Labs accomplishes it all Learn more at www.learnsmartadvantagedemo.com Widmaier ES.indd 2/19/13 3:09 PM Page Page Rev Confirming Pages THIRTEENTH EDITION VA N D E R ’ S Human Physiology THE MECHANISMS OF BODY FUNC TION ERIC P WIDMAIER B O S TO N U N I V E R S I T Y HERSHEL RAFF M E D I C A L CO L L E G E O F W I S CO N S I N AU R O R A S T LU K E’ S M E D I C A L C E N T E R KEVIN T STRANG U N I V E R S I T Y O F W I S CO N S I N M A D I S O N TM wid78305_fm_i-xxiv.indd i 14/02/13 5:15 PM Rev Confirming Pages TM VANDER’S HUMAN PHYSIOLOGY: THE MECHANISMS OF BODY FUNCTION, THIRTEENTH EDITION Published by McGraw-Hill, a business unit of The McGraw-Hill Companies, Inc., 1221 Avenue of the Americas, New York, NY 10020 Copyright © 2014 by The McGraw-Hill Companies, Inc All rights reserved Printed in the United States of America Previous editions © 2011, 2008, and 2006 No part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written consent of The McGraw-Hill Companies, Inc., including, but not limited to, in any network or other electronic storage or transmission, or broadcast for distance learning Some ancillaries, including electronic and print components, may not be available to customers outside the United States This book is printed on acid-free paper DOW/DOW ISBN 978–0–07–337830–5 MHID 0–07–337830–5 Senior Vice President, Products & Markets: Kurt L Strand Vice President, General Manager, Products & Markets: Marty Lange Vice President, Content Production & Technology Services: Kimberly Meriwether David Managing Director: Michael S Hackett Director: James F Connely Brand Manager: Marija Magner Senior Developmental Editor: Fran Simon Director, Content Production: Terri Schiesl Project Manager: Sherry L Kane Senior Buyer: Sandy Ludovissy Designer: Tara McDermott Cover/Interior Designer: Elise Lansdon Cover Images: (girl drinking water) © JGI/Blend Images LLC/RF; (MRI midsagittal section) © ISM/ Phototake; ( freeze fractured bundle) © Steve Gschmeissner/Photo Researchers; (stress test) © Michael Krasowitz/ Getty Images; (leather spine) © Siede Preis/Getty Images/RF Senior Content Licensing Specialist: John C Leland Photo Research: David Tietz/Editorial Image, LLC Compositor: Laserwords Private Limited Typeface: 10/12 Janson Text LT Std Printer: R R Donnelley All credits appearing on page or at the end of the book are considered to be an extension of the copyright page Library of Congress Cataloging-in-Publication Data Widmaier, Eric P Vander’s human physiology : the mechanisms of body function – Thirteenth edition / Eric P Widmaier, Department of Biology, Boston University, Hershel Raff, Medical College of Wisconsin, Aurora St Luke’s Medical Center, Kevin T Strang, Department of Neuroscience, University of Wisconsin pages cm Includes index ISBN 978–0–07–337830–5 — ISBN 0–07–337830–5 (hard copy : alk paper) Human physiology I Raff, Hershel, 1953- II Strang, Kevin T III Vander, Arthur J., 1933– Human physiology IV Title V Title: Human physiology QP34.5.W47 2014 612–dc23 2012041775 The Internet addresses listed in the text were accurate at the time of publication The inclusion of a website does not indicate an endorsement by the authors or McGraw-Hill, and McGraw-Hill does not guarantee the accuracy of the information presented at these sites www.mhhe.com wid78305_fm_i-xxiv.indd ii 14/02/13 5:15 PM Rev Confirming Pages Meet the Authors ERIC P WIDMAIER received his Ph.D in 1984 in Endocrinology from the University of California at San Francisco His postdoctoral training was in endocrinology and physiology at the Worcester Foundation for Experimental Biology and The Salk Institute in La Jolla, California His research is focused on the control of body mass and metabolism in mammals, the mechanisms of hormone action, and molecular mechanisms of intestinal and hypothalamic adaptation to high-fat diets He is currently Professor of Biology at Boston University, where he teaches Human Physiology and has been recognized with the Gitner Award for Distinguished Teaching by the College of Arts and Sciences, and the Metcalf Prize for Excellence in Teaching by Boston University He is the author of numerous scientific and lay publications, including books about physiology for the general reader He lives outside Boston with his wife Maria and children Caroline and Richard HERSHEL RAFF received his Ph.D in Environmental Physiology from the Johns Hopkins University in 1981 and did postdoctoral training in Endocrinology at the University of California at San Francisco He is now a Professor of Medicine (Endocrinology, Metabolism, and Clinical Nutrition), Surgery, and Physiology at the Medical College of Wisconsin and Director of the Endocrine Research Laboratory at Aurora St Luke’s Medical Center At the Medical College of Wisconsin, he teaches physiology and pharmacology to medical and graduate students, and is the Endocrinology/Reproduction Unit Director for the new integrated curriculum He was an inaugural inductee into the Society of Teaching Scholars, received the Beckman Basic Science Teaching Award three times, received the Outstanding Teacher Award from the Graduate School, and has been one of the MCW’s Outstanding Medical Student Teachers for each year the award has been given He is also an Adjunct Professor of Biomedical Sciences at Marquette University He is the former Associate Editor of Advances in Physiology Education Dr Raff’s basic research focuses on the adaptation to low oxygen (hypoxia) His clinical interest focuses on pituitary and adrenal diseases, with a special focus on laboratory tests for the diagnosis of Cushing’s syndrome He resides outside Milwaukee with his wife Judy and son Jonathan KEVIN T STRANG received his Master’s Degree in Zoology (1988) and his Ph.D in Physiology (1994) from the University of Wisconsin at Madison His research area is cellular mechanisms of contractility modulation in cardiac muscle He teaches a large undergraduate systems physiology course as well as first-year medical physiology in the UW-Madison School of Medicine and Public Health He was elected to UW-Madison’s Teaching Academy and as a Fellow of the Wisconsin Initiative for Science Literacy He is a frequent guest speaker at colleges and high schools on the physiology of alcohol consumption He has twice been awarded the UW Medical Alumni Association’s Distinguished Teaching Award for Basic Sciences, and also received the University of Wisconsin System’s Underkofler/Alliant Energy Excellence in Teaching Award In 2012 he was featured in The Princeton Review publication, “The Best 300 Professors.” Interested in teaching technology, Dr Strang has produced numerous animations of figures from Vander’s Human Physiology available to instructors and students He lives in Madison with his wife Sheryl and his children Jake and Amy T O O U R FA M I L I E S : M A R I A , R I C H A R D , A N D C A R O L I N E ; J U D Y A N D J O N A T H A N ; SH ERY L , JA K E , A N D A M Y iii wid78305_fm_i-xxiv.indd iii 14/02/13 5:15 PM Rev Confirming Pages Brief Contents FROM THE AUTHORS XV ■ GUIDED TOUR THROUGH A CHAPTER LEARNING SUPPLEMENTS XXII ■ ACKNOWLEDGMENTS XXIV ■1 ■2 ■3 ■4 ■5 ■6 ■7 ■8 ■9 Homeostasis: A Framework for Human Physiology Chemical Composition of the Body 20 ■ 10 ■ 11 Cellular Structure, Proteins, and Metabolism 45 SECTION A Cell Structure 46 SECTION B Protein Synthesis, Degradation, and Secretion 58 SECTION C Interactions Between Proteins and Ligands 68 SECTION D Enzymes and Chemical Energy 73 SECTION E Metabolic Pathways 79 Movement of Molecules Across Cell Membranes 96 ■ 12 Control of Cells by Chemical Messengers 120 Neuronal Signaling and the Structure of the Nervous System 138 SECTION A Neural Tissue 139 SECTION B Membrane Potentials 145 SECTION C Synapses 160 SECTION D Structure of the Nervous System 173 Sensory Physiology 191 SECTION A General Principles 192 SECTION B Specific Sensory Systems 203 Consciousness, the Brain, and Behavior 234 Muscle 257 SECTION A Skeletal Muscle 258 SECTION B Smooth and Cardiac Muscle 286 ■ 13 ■ 14 XVI ■ UPDATES AND ADDITIONS Control of Body Movement 300 The Endocrine System 319 SECTION A General Characteristics of Hormones and Hormonal Control Systems 320 SECTION B The Hypothalamus and Pituitary Gland 333 SECTION C The Thyroid Gland 340 SECTION D The Endocrine Response to Stress 344 SECTION E Endocrine Control of Growth 349 SECTION F Endocrine Control of Ca21 Homeostasis 353 Cardiovascular Physiology 362 SECTION A Overview of the Circulatory System 363 SECTION B The Heart 368 SECTION C The Vascular System 387 SECTION D Integration of Cardiovascular Function: Regulation of Systemic Arterial Pressure 407 SECTION E Cardiovascular Patterns in Health and Disease 415 SECTION F Blood and Hemostasis 428 ■ 15 ■ 16 SECTION A Basic Principles of Renal Physiology 491 SECTION B Regulation of Ion and Water Balance 506 SECTION C Hydrogen Ion Regulation 524 ■ TEACHING AND The Digestion and Absorption of Food 533 Regulation of Organic Metabolism and Energy Balance 572 SECTION A Control and Integration of Carbohydrate, Protein, and Fat Metabolism 573 SECTION B Regulation of TotalBody Energy Balance and Temperature 587 ■ 17 Reproduction 602 SECTION A Gametogenesis, Sex Determination, and Sex Differentiation; General Principles of Reproductive Endocrinology 603 SECTION B Male Reproductive Physiology 612 SECTION C Female Reproductive Physiology 622 ■ 18 ■ 19 The Immune System 652 Medical Physiology: Integration Using Clinical Cases 692 CASE A CASE B CASE C CASE D Respiratory Physiology 446 The Kidneys and Regulation of Water and Inorganic Ions 490 XX Woman with Palpitations and Heat Intolerance 693 Man with Chest Pain After a Long Airplane Flight 697 Man with Abdominal Pain, Fever, and Circulatory Failure 699 College Student with Nausea, Flushing, and Sweating 703 APPENDIX A A-1 APPENDIX B A-17 GLOSSARY CREDITS INDEX G-1 C-1 I-1 iv wid78305_fm_i-xxiv.indd iv 14/02/13 5:16 PM Rev Confirming Pages Table of Contents FROM THE AUTHORS XV ■ GUIDED TOUR THROUGH A CHAPTER LEARNING SUPPLEMENTS XXII ■ ACKNOWLEDGMENTS XXIV XVI ■ UPDATES AND ADDITIONS XX ■ TEACHING AND 2.2 Molecules 23 Homeostasis: A Framework for Human Physiology 1.1 The Scope of Human Physiology 1.2 How Is the Body Organized? Muscle Cells and Tissue Neurons and Nervous Tissue Epithelial Cells and Epithelial Tissue Connective-Tissue Cells and Connective Tissue Organs and Organ Systems 1.3 Body Fluid Compartments 1.4 Homeostasis: A Defining Feature of Physiology 1.5 General Characteristics of Homeostatic Control Systems Feedback Systems Resetting of Set Points Feedforward Regulation 1.6 Components of Homeostatic Control Systems 10 Reflexes 10 Local Homeostatic Responses 11 Covalent Chemical Bonds 23 Ionic Bonds 25 Hydrogen Bonds 25 Molecular Shape 26 Ionic Molecules 26 Free Radicals 26 2.3 Solutions 27 Water 27 Molecular Solubility 28 Concentration 28 Hydrogen Ions and Acidity 29 2.4 Classes of Organic Molecules 30 Carbohydrates 30 Lipids 31 Proteins 34 Nucleic Acids 38 ATP 40 Chapter Clinical Case Study 43 ASSORTED ASSESSMENT QUESTIONS 43 ANSWERS TO PHYSIOLOGICAL INQUIRIES 44 1.7 The Role of Intercellular Chemical Messengers in Homeostasis 11 1.8 Processes Related to Homeostasis 12 Adaptation and Acclimatization 12 Biological Rhythms 13 Balance of Chemical Substances in the Body 14 1.9 General Principles of Physiology 15 Chapter Clinical Case Study 17 ASSORTED ASSESSMENT QUESTIONS 19 ANSWERS TO PHYSIOLOGICAL INQUIRIES 19 SECTION Cellular Structure, Proteins, and Metabolism 45 A Cell Structure 46 3.1 Microscopic Observations of Cells 46 3.2 Membranes 48 Membrane Structure 49 Membrane Junctions 51 3.3 Cell Organelles 51 Chemical Composition of the Body 20 2.1 Atoms 21 Components of Atoms 21 Atomic Number 22 Atomic Mass 22 Ions 23 Atomic Composition of the Body 23 Nucleus 51 Ribosomes 53 Endoplasmic Reticulum 53 Golgi Apparatus 54 Endosomes 54 Mitochondria 54 Lysosomes 55 Peroxisomes 56 Vaults 56 Cytoskeleton 56 v wid78305_fm_i-xxiv.indd v 14/02/13 5:16 PM Rev Confirming Pages S E C T I O N B Protein Synthesis, Degradation, and Secretion 58 3.4 Genetic Code 58 3.5 Protein Synthesis 59 Transcription: mRNA Synthesis 59 Translation: Polypeptide Synthesis 61 Regulation of Protein Synthesis 63 Mutation 64 3.6 Protein Degradation 65 3.7 Protein Secretion 66 S E C T I O N C Interactions Between Proteins and Ligands 68 3.8 Binding Site Characteristics 68 Chemical Specificity 68 Affinity 68 Saturation 70 Competition 70 3.9 Regulation of Binding Site Characteristics 71 Allosteric Modulation 71 Covalent Modulation 72 SECTION 4.1 Diffusion 97 Magnitude and Direction of Diffusion 97 Diffusion Rate Versus Distance 98 Diffusion Through Membranes 98 4.2 Mediated-Transport Systems 101 Facilitated Diffusion 102 Active Transport 103 4.3 Osmosis 107 Extracellular Osmolarity and Cell Volume 109 4.4 Endocytosis and Exocytosis 110 Endocytosis 111 Exocytosis 113 4.5 Epithelial Transport 113 Chapter Clinical Case Study 116 ASSORTED ASSESSMENT QUESTIONS 117 ANSWERS TO PHYSIOLOGICAL INQUIRIES 119 D Enzymes and Chemical Energy 73 3.10 Chemical Reactions 73 Determinants of Reaction Rates 73 Reversible and Irreversible Reactions 74 Law of Mass Action 74 3.11 Enzymes 75 Receptors and Their Interactions with Ligands 121 Regulation of Receptors 123 3.12 Regulation of Enzyme-Mediated Reactions 76 Substrate Concentration 76 Enzyme Concentration 76 Enzyme Activity 77 5.2 Signal Transduction Pathways 123 Pathways Initiated by Lipid-Soluble Messengers 124 Pathways Initiated by Water-Soluble Messengers 124 Other Messengers 131 Cessation of Activity in Signal Transduction Pathways 133 3.13 Multienzyme Reactions 77 E Metabolic Pathways 79 3.14 Cellular Energy Transfer 79 Glycolysis 79 Krebs Cycle 81 Oxidative Phosphorylation 82 Chapter Clinical Case Study 135 ASSORTED ASSESSMENT QUESTIONS 136 ANSWERS TO PHYSIOLOGICAL INQUIRIES 137 3.15 Carbohydrate, Fat, and Protein Metabolism 85 Carbohydrate Metabolism 85 Fat Metabolism 87 Protein and Amino Acid Metabolism 88 Metabolism Summary 90 3.16 Essential Nutrients 90 Vitamins 91 Chapter Clinical Case Study 93 ASSORTED ASSESSMENT QUESTIONS 94 ANSWERS TO PHYSIOLOGICAL INQUIRIES 95 vi Control of Cells by Chemical Messengers 120 5.1 Receptors 121 Cofactors 76 SECTION Movement of Molecules Across Cell Membranes 96 SECTION 6.1 6.2 6.3 6.4 Neuronal Signaling and the Structure of the Nervous System 138 A Neural Tissue 139 Structure and Maintenance of Neurons 139 Functional Classes of Neurons 140 Glial Cells 142 Neural Growth and Regeneration 143 Table of Contents wid78305_fm_i-xxiv.indd vi 14/02/13 5:16 PM Rev Confirming Pages SECTION 6.5 6.6 6.7 B Membrane Potentials 145 Basic Principles of Electricity 145 The Resting Membrane Potential 146 Graded Potentials and Action Potentials 150 Graded Potentials 151 Action Potentials 152 SECTION C Synapses 160 6.8 Functional Anatomy of Synapses 161 6.9 Mechanisms of Neurotransmitter Release 161 6.10 Activation of the Postsynaptic Cell 162 Excitatory Chemical Synapses 162 Inhibitory Chemical Synapses 163 6.11 Synaptic Integration 163 6.12 Synaptic Strength 165 Modification of Synaptic Transmission by Drugs and Disease 166 6.13 Neurotransmitters and Neuromodulators 167 Acetylcholine 168 Biogenic Amines 169 Amino Acid Neurotransmitters 170 Neuropeptides 171 Gases 172 Purines 172 6.14 Neuroeffector Communication 172 SECTION D Structure of the Nervous System 173 6.15 Central Nervous System: Brain 174 Forebrain 175 Cerebellum 177 Brainstem 177 Central Nervous System: Spinal Cord 177 Peripheral Nervous System 178 Autonomic Nervous System 180 Blood Supply, Blood–Brain Barrier, and Cerebrospinal Fluid 184 Chapter Clinical Case Study 187 ASSORTED ASSESSMENT QUESTIONS 188 ANSWERS TO PHYSIOLOGICAL INQUIRIES 189 SECTION 7.1 Sensory Physiology 191 A General Principles 192 Sensory Receptors 192 The Receptor Potential 193 7.2 Factors That Affect Perception 200 SECTION B Specific Sensory Systems 203 7.5 Somatic Sensation 203 Touch and Pressure 203 Senses of Posture and Movement 203 Temperature 204 Pain 204 Neural Pathways of the Somatosensory System 206 7.6 Vision 207 Light 207 Overview of Eye Anatomy 208 The Optics of Vision 208 Photoreceptor Cells and Phototransduction 211 Neural Pathways of Vision 213 Color Vision 216 Color Blindness 216 Eye Movement 217 7.7 Hearing 217 Sound 217 Sound Transmission in the Ear 218 Hair Cells of the Organ of Corti 221 Neural Pathways in Hearing 222 7.8 Vestibular System 223 The Semicircular Canals 224 The Utricle and Saccule 224 Vestibular Information and Pathways 225 7.9 Chemical Senses 225 6.16 6.17 6.18 6.19 7.3 Ascending Neural Pathways in Sensory Systems 198 7.4 Association Cortex and Perceptual Processing 200 Primary Sensory Coding 194 Stimulus Type 195 Stimulus Intensity 195 Stimulus Location 195 Central Control of Afferent Information 197 Taste 226 Smell 227 Chapter Clinical Case Study 230 ASSORTED ASSESSMENT QUESTIONS 231 ANSWERS TO PHYSIOLOGICAL INQUIRIES 233 Consciousness, the Brain, and Behavior 234 8.1 States of Consciousness 235 Electroencephalogram 235 The Waking State 236 Sleep 236 Neural Substrates of States of Consciousness 238 Coma and Brain Death 240 8.2 Conscious Experiences 241 Selective Attention 241 Neural Mechanisms of Conscious Experiences 242 8.3 Motivation and Emotion 243 Motivation 243 Emotion 244 Table of Contents wid78305_fm_i-xxiv.indd vii vii 14/02/13 5:16 PM Revised Pages Glomerular capillaries, 494, 495f, 496f, 497, 499 Glomerular filtrate, 496 Glomerular filtration, 494, 497–99, 498f Glomerular filtration rate (GFR), 498–99, 499f, 503, 513–14, 513f Glomerular membranes, 495f Glomerulus, 493f, 494, 521t Glossopharyngeal nerves, 178t Glottis, 548, 549f Glucagon, 322t, 348, 578, 582–83, 584t, 586 Glucagon-like peptide -1 (GLP-1), 322t, 581 Glucocorticoids, 326, 347 Gluconeogenesis, 86, 87f, 492, 577, 578t, 584t Glucose absorbed carbohydrate, 574 capillaries, 399 carbohydrates, 29, 85–86 diffusion, 97, 98f, 102–3 filtration and reabsorption in kidney, 500t, 501, 501f homeostasis, 7, 7f plasma concentration during exercise, 584–85 sources of in blood, 576–77 structure, 31, 31f synthesis, 86–87 Glucose-counterregulatory controls, 582, 584, 584t Glucose-dependent insulinotropic peptide (GIP), 322t, 546, 547t, 581 Glucose sparing, 577–78 Glucose transporter (GLUT-4), 541, 580, 580f Glucosuria, 501 Glutamate, 170–71 Glutamic acid, 89f Gluten, 545 Gluten-sensitive enteropathy, 545 Glycerol, 32, 33f Glycine, 171 Glycocalyx, 50 Glycogen, 31, 85 Glycogen phosphorylase, 580 Glycogen storage, 85–86, 86f Glycogen synthase, 580 Glycogenolysis, 86, 576–77, 584t Glycolysis, 79–80, 80f–81f, 83t, 86f, 275, 275f Glycolytic fibers, 277 Glycolytic pathway, 81f Glycoprotein, 35 Goblet cells, 536 Goiter, 341, 343, 343f, 694, 694f Goldman-Hodgkin-Katz (GHK) equation, 148–49 Golgi apparatus, 54, 55f, 66–67, 66f, 112 Golgi tendon organ, 306–7, 307f Gonad(s), 322t, 324, 326–27, 327f, 605, 608 Gonadal steroids, 605 Gonadotropic hormones, 335 functions and sources of, 323t Gonadotropin-releasing hormone (GnRH) anterior pituitary, 337 control of testes, 620 follicle development, 628 functions of, 322t mechanisms of action, 612 pregnancy, 641 puberty, 635 Gonadotropins, 612–13, 631, 632 Gonadotropins-follicle-stimulating hormone (FSH), 612–13 G-protein-coupled receptors, 125t, 127 G proteins, 125t, 126f, 127, 130–31, 131t Graafian follicle, 627 Graded potential, 150–52, 151f–53f, 151t, 159, 159t, 193 Graft rejection, 680 Gram atomic mass, 22 Granulocyte colony-stimulating factor (G-CSF), 432 Granulosa cells, 626, 627f, 629–30, 631t Grapefruit, 93 Graves’ disease, 343, 695, 696 Gravity, and posture, 313, 313f–14f, 417, 417f Gray matter, 175, 176f Growth See also Development bone, 349, 349f, 352, 353 environmental factors, 349–50, 353 follicles, 626–27 hormonal influences on, 350–52 metabolic rate, 587t secondary sex characteristics, 612 thyroid hormones, 342–43 Growth cone, 143 Growth factors, 323t, 350 Growth hormone, 323t, 335, 336f, 348, 350–52, 351f, 351t, 352t, 584, 584t Growth hormone-insensitivity syndrome, 350 Growth hormone-releasing hormone (GHRH), 322t, 337, 351 Growth-inhibiting factors, 350 Guanine, 38, 39, 39f, 40f Guanosine diphosphate (GDP), 82 Guanosine triphosphate (GTP), 82 Guanylyl cyclase, 125, 212, 213f, 619 Gustation, 226 Gustatory cortex, 199 Gymnastics, 585 Gynecomastia, 622 Gyrus, 175, 176f H zone, 260 H1-ATPase, 105, 551, 552f H1/K1-ATPase, 105 HAART (highly active anti-retroviral therapy), 679 Habituation, 241–42 Hair cells, 221–22, 222f Harvey, William, 364 Hashimoto’s disease, 343 Hbuffer, 524 Head trauma, 252–53 Health See also Disease cardiovascular system, 415–28 essential nutrients, 90–91 Hearing, and sensory system, 217–23, 229 Hearing aids, 223 Heart See also Cardiac muscle anatomy of, 368–70, 385 arterioles, 396t autonomic nervous system, 183t cardiac cycle, 377–81, 386 cardiac output, 381–85, 386 heartbeat coordination, 370–76, 386 hormones, 322t measurement of cardiac function, 385, 386 overview of cardiovascular system, 367t Heart attacks, 424–27 Heart disease, 376 Heart failure, 392, 422–24, 424t, 427 congestive, 422, 521–22 Heart murmurs, 381 Heart rate cardiac output, 381–82, 382f exercise, 418, 418f, 420t heart failure, 423 sequence of excitation, 371 Heart sounds, 381, 381f Heart valve defects, 381f Heartbeat coordination, 370–76, 386 Heartburn, 550 Heat acclimatization, 595 Heat exhaustion, 596 Heat intolerance, 343, 693–97, 706 Heat loss and gain, 592–93, 593f Heat production, 593–94 Heat stroke, 596–97 Heavy chains, 260, 260f Hedonistic appetite, for salt, 519, 519f, 522 Helicobacter pylori, 562 Helicotrema, 220, 220f Helper T cells (CD4 cells) antigen presentation, 668–70 antigen recognition, 671–72 functions of, 655t, 664–66, 666f HIV, 679 MHC restriction of, 668t role of in immune responses, 685t viral infection, 677t, 679 Hematocrit, 363, 364f, 366 Hematoma, 433 Hematopoietic growth factors (HGFs), 432, 432t Heme, 467 Hemochromatosis, 429, 545 Hemodialysis, 530, 530f Hemodynamics, 364 Hemoglobin erythrocytes, 428 iron, 545 structure of, 38f transport of oxygen, 467–71, 467t, 473t Hemolytic anemia, 690 Hemolytic disease of the newborn, 681 Hemolytic jaundice of the newborn, 564 Hemophilia, 435 Hemorrhage, 410, 415–16, 416f, 416t, 427 Hemostasis, 432–39, 439 Henry’s law, 463, 467 Heparin, 437, 438, 699 Hepatic functions, 539 See also Liver Hepatic lobules, 557, 558f Hepatic portal vein, 537 Hepatitis, 674 Hepatocytes, 557–58 Hering-Breuer reflex, 474 Heroin, 185, 248t Hexoses, 31 High-density lipoproteins (HDLs), 426, 575–76 High-frequency fatigue, 276 Hilum, 492 Hippocampus, 176f, 246, 249 Histamine biogenic amines as neurotransmitters, 168t defined, 684t edema, 402 immediate hypersensitivity, 683 inflammation of lungs, 482 local inflammatory mediators, 657t receptors and binding, 123 Histones, 58 Histotoxic hypoxia, 480 Homeostasis defined, as defining feature of physiology, 6–7, 15, 16 endocrine control of calcium, 353–57, 357 of energy in exercise and stress, 584–85, 586 intercellular chemical messengers, 11–12, 12f, 16 motivation, 243 processes related to, 12–15, 13f, 14f, 16–17 Homeostatic control systems components of, 10–11, 10f, 11f, 16 feedback systems, 8–9, 9f feedforward regulation, 9–10 general characteristics of, 7–10, 8f, 9t, 16 kidneys, 525, 528 resetting of set points, 9, 9t Homeotherms, 592 Homocysteine, 426 Horizontal cells, 214 Index wid78305_idx_I1-I20.indd I-9 20/02/13 5:10 PM Revised Pages Hormone(s) See also Endocrine system; Estrogen; Follicle-stimulating hormone; Gonadotropinreleasing hormone; Insulin; Luteinizing hormone; Testosterone amine, 321, 321f arterioles, 394–95, 394f blood and transport of, 327, 327t, 332 control of secretion, 329–31, 332 defined, 320 gastrointestinal regulation, 546–47, 547t growth, 350–52, 352, 353 homeostasis, 11 male reproductive functions, 620–21, 620f, 623 mechanisms of action, 328–29, 332 metabolic rate, 587t metabolism and excretion, 327–28, 332, 342 neurotransmitters, 180 ovarian, 628 peptide, 321, 323, 324f, 327t, 328–29 pituitary gland, 333–40 pregnancy, 640–41, 640f, 642t smooth muscles, 290–91 steroid, 324–27, 327t, 329 structures and synthesis, 321–27, 332 tropic, 330–31 Hormone-receptor binding, 328–29 Hormone receptors, 121, 328–29 Hormone-replacement therapy, 648 Hormone-sensitive lipase (HSL), 583 Hot flashes, 648 Human chorionic gonadotropin (hCG), 323t, 641 Human immunodeficiency virus (HIV), 679 Human physiology, scope of, 2, 16 See also Physiology Human placental lactogen (hPL), 323t, 641 Humoral hypercalcemia of malignancy, 357 Humoral responses, 664 Hydrocephalus, 184, 705 Hydrochloric acid, 29, 534, 550, 551–53, 551f, 553t Hydrogen atoms, 22 hemoglobin saturation, 470–71 transport between tissues and lungs, 472–73, 472f, 484 Hydrogen bonds, 24, 24f, 25–26, 25t, 26f, 39, 40f Hydrogen ions, 23t, 29–30, 474–78, 484, 524–28, 524t Hydrogen peroxide, 658 Hydrogen sulfide, 172 Hydrolysis, 27, 268f, 269, 269t Hydrophilic molecules, 28 Hydrophobic molecules, 28 Hydrostatic pressure, 364 Hydroxyapatite, 354 Hydroxychloroquine, 690 Hydroxyl group, 24, 25t Hydroxyl radical, 27 Hymen, 625, 625f Hyperalgesia, 205 Hypercalcemia, 356–57 Hypercapnea, 480 Hypercoagulability, 437, 699 Hyperemia, 392–93, 392f Hyperkalemia, 519 Hyperopic vision, 211 Hyperosmotic solutions, 110, 111t, 509 Hyperpolarization, of graded potentials, 151, 151f Hyperprolactinemia, 623, 651 Hyperresponsiveness, 331–32 Hypersecretion, 331 Hypersensitivity, 681–83, 682f, 682t Hypertension See also Blood pressure categories and causes of, 421–22, 427 defined, 421, 427 diuretics, 422, 422t, 424t, 521–22, 523 drugs used to treat, 422t renal system, 516 stress, 347 I-10 Hyperthermia, 596, 596f, 597 Hyperthyroidism, 343–44, 694, 696 Hypertonia, 312 Hypertonic medullary interstitium, 511–12, 511f Hypertonic solutions, 110, 110f, 111t, 555 Hypertrophic cardiomyopathy, 424, 427 Hypertrophy, 259, 280, 341 Hyperventilation alveolar gas pressures, 465 hydrogen ion concentration and reflexively induced, 478f pulmonary embolism, 699 voluntary control of breathing, 479 Hypnic jerks, 237 Hypocalcemia, 283, 356, 357 Hypocalcemic tetany, 282–83, 357 Hypocretins, 239 Hypoglossal nerves, 178t Hypoglycemia, 276, 582, 583, 584, 586, 705 Hypogonadism, 622–23, 622f, 623 Hypokalemia, 519 Hypoosmotic solutions, 110, 111t, 509 Hypoperfusion hypoxia, 480 Hypophysiotropic hormones, 322t, 335, 336–38, 336f–38f Hypophysis, 333, 335 Hypopituitarism, 623 Hyporesponsiveness, 331 Hyposecretion, 331 Hypotension, 347, 415–16, 427 See also Blood pressure Hypothalamo-hypophyseal portal vessels, 333 Hypothalamus body rhythms, 14 brain anatomy, 176f endocrine system, 322t, 333–40 functions of, 14, 175t, 176 motivation, 244 sleep-wake cycles, 239 temperature regulation, 593 Hypothyroidism, 342–43, 343f, 696 Hypotonia, 313 Hypotonic solutions, 110, 110f, 111t Hypoventilation, 465, 481t, 525 Hypovolemic shock, 417 Hypoxemia, 480, 697, 699 Hypoxia, 480–82, 518 Hypoxic hypoxia, 480, 481t, 484, 697 I band, 260 Identical twins, 591, 637 IgA antibodies, 672, 674, 684t IgD antibodies, 672, 684t IgE antibodies, 672, 684t IgE-mediated hypersensitivity, 682 IgG antibodies, 672, 674, 684t IgM antibodies, 672, 684t Ileocecal sphincter, 560 Ileocecal valve, 560 Ileum, 538 Immediate hypersensitivity, 682–83, 682f, 682t Immune cells, 653–54 Immune-complex hypersensitivity, 682, 682t Immune surveillance, 652 Immune system adaptive immune responses, 662–76, 686–87 autoimmune diseases, 346, 683, 683t breastfeeding, 646 cell mediating immune defenses, 653–54, 655t, 686 cells, 685t chemical mediators, 684t–85t cortisol, 345 harmful immune responses, 680–84, 687 infection, 676–78, 687 innate immune responses, 654, 656–60, 686 primary functions of, 5t Immune tolerance, 670–71 Immunogen, 662 Immunoglobulins, 667, 667f, 673, 684t Immunology, 652 Immunosuppression, 347 Implantation, of fertilized egg, 638, 638f Implicit memory, 249 Impotence, 619 Inactivation gate, 153 Incontinence, 504 Increased sensitivity, of receptors, 122t Incretins, 581 Incus, 219f–20f, 220 Indirect G-protein gating, 131 Induced-fit substrate model, 75, 75f Infection bacterial, 656t, 671–74, 672f, 701 fever, 595, 676 immune system, 676–78, 687 metabolic rate, 587t pregnancy, 646 resistance to, 678–80 systemic manifestations of, 676–78 viruses, 653, 671–74, 677t Inferior vena cava, 364, 368f Infertility, 648 Inflammation, 346, 654, 656–60, 657f, 657t, 677t Inflammatory bowel disease, 569, 684 Infundibulum, 333 Inhibin, 322t, 613, 628, 629t, 632 Inhibitory postsynaptic potential (IPSP), 163, 163f, 164, 164f, 263 Inhibitory synapses, 160, 163, 165f Initial segment, of neuron, 139 Initiation factors, 62 Injury and edema, 402, 414 head trauma, 252–53 tissue, 394, 660 Innate immune response, 677t, 686 bacterial infections, 654, 656t defenses at body surfaces, 654 defined, 652 inflammation, 654, 656–60, 656t, 686 interferons, 660–61, 661f, 686 toll-like receptors, 661–62 Inner cell mass, 637, 638f Inner ear, 220, 220f Inner emotions, 244 Inner hair cells, 221, 221f Inner segment, 211 Innervation, 370, 370f Inositol, 91, 91t Inositol triphosphate (IP3), 130, 130f, 133t Insensible water loss, 506, 594 Insomnia, 240 Inspiration, 447, 454, 454f–56f, 473 Inspiratory reserve volume (IRV), 459 Insufficiency, and heart murmurs, 381 Insulin See also Diabetes mellitus facilitated diffusion, 103 functions of, 322t growth, 352, 352t organic metabolism, 578–82, 579f resistance, 598, 599 stress, 348 Insulin-dependent diabetes mellitus, 598 Insulin-like growth factor-1 (IGF-1), 280, 322t, 336, 350–52, 351f Insulin-like growth factor-2 (IGF-2), 352 Insulin resistance, 598, 599 Integral membrane proteins, 49, 50f Integrating center, 10, 10f, 11f Integrative physiology, 692, 696, 698–99, 701–2, 704–6 Integrins, 51 Index wid78305_idx_I1-I20.indd 10 20/02/13 5:10 PM Revised Pages Integumentary system, primary functions of, 5t Intention tremor, 311 Intercalated disks, 292 Intercellular chemical messengers, 11–12, 12f, 16 Intercellular clefts, 397 Intercostal muscles, 450 Interferon(s), 656t, 660–61, 661f, 684t–85t Interferon-gamma, 656t, 661, 685t Interleukin (IL-1), 669, 678t, 685t Interleukin (IL-2), 671, 685t Interleukin (IL-6), 678, 685t Interleukins antigen recognition, 671 endogenous pyrogens, 595 functions of, 656t hematopoietic growth factors, 432t role of in immune responses, 678t viral infections, 676, 678 Intermediate filaments, 56f, 57 Internal anal sphincter, 561 Internal environment, of the body, Internal genitalia, 608 Internal urethral sphincter, 503, 504f Internal work, 587 Internalization, of receptors, 123 Interneurons, 140, 141–42, 141f, 142t, 303–4, 303f Internodal pathways, 371 Interstitial cells of Cajal, 560 Interstitial fluid, 5, 6, 399 Interstitium, Interventricular septum, 368, 368f Intestinal phase, of gastrointestinal control, 548, 552, 553t Intestine and autonomic nervous system, 183t large, 534f, 538, 539t, 547t, 560–62, 561f small, 534f, 538, 539t, 540, 547t, 559–60 Intestino-intestinal reflex, 560 Intracellular buffer, 525 Intracellular fluid, 5, 6, 47, 49f, 98, 99, 99f, 102f, 106t Intracellular receptors, 124f, 125t Intracranial hemorrhage, 254 Intracranial pressure, 414 Intrafusal fibers, 304, 304f Intrapleural fluid, 450 Intrapleural pressure, 450, 454, 455f Intrarenal baroreceptors, 515 Intrauterine device (IUD), 647 Intrinsic factor, 430, 545 Intrinsic pathway, 435, 436f Intrinsic tone, 392 Introns, 60, 61f Inulin, 502, 503f In vitro fertilization, 648 Involuntary movement, 302–3 Involuntary nervous system, 184 Iodide trapping, 340 Iodine, 341, 342–43, 697 Ion(s), 23, 23t, 146–47, 147t, 329 hydrogen, 23t, 29–30, 474–78, 484, 524–28, 524t Ion channels, 35t, 99, 100f, 101, 101f, 130–31, 131t, 153, 153f Ionic bond, 25, 25f Ionic molecules, 26 Ionotropic receptors, 162 Ipsilateral leg, 307, 308f Iris, 208, 209f Iron composition of blood, 429–30, 430f digestion and absorption, 545 Iron deficiency, 429 Iron-deficiency anemia, 431t Irreversible reaction, 74, 75t Ischemia, 424, 702 Ischemic hypoxia, 480 Islets of Langerhans, 578, 582 Isometric contraction, 269, 271, 272 Isometric tension, 272, 273, 287 Isometric twitch, 271, 271f, 272 Isoosmotic solutions, 110, 111t, 509 Isotonic contraction, 269–70 Isotonic solutions, 110, 110f, 111t Isotonic twitch, 271–72, 271f–72f Isotopes, 22 Isovolumetric ventricular contraction, 377, 377f Isovolumetric ventricular relaxation, 377f, 378 Janus kinases (JAKs), 125t, 126f, 127 Japan, and puffer fish, 156 Jaundice, 564 Jejunum, 538 Jet lag, 240 Jogging, 419, 420 J receptors, 479–80 Junctional feet, 266 Juvenile diabetes, 598 Juxtacrine, 12 Juxtaglomerular apparatus (JGA), 494, 495f–96f Juxtaglomerular (JG) cells, 494, 495f Juxtamedullary nephrons, 493f, 494 Kallikrein, 393 Kallmann syndrome, 228 Kaposi’s sarcoma, 679 Karyotype, 607 K complexes, 236 Keto acid, 89 alpha-ketoacids, 576 Ketones, 578, 586 Kidney(s) See also Renal physiology arterioles, 396t autonomic nervous system, 183t calcium balance, 14 calcium homeostasis, 354 diuretics, 521–22 division of labor in, 502, 521, 521t functions of, 492t gluconeogenesis, 86–87 homeostatic controls, 525, 528 hormones, 322t hydrogen ion regulation, 524–28 potassium regulation, 519–20, 522–23 pregnancy, 642t regulation of calcium and phosphate, 520–21, 523 regulation of ion and water balance, 506–23 regulation of sodium, 513–16, 522 renal mechanisms, 525–27, 528 section of human, 496f structure of, 492–94, 504–5 thirst and salt appetite, 518–19, 522 Kidney disease, 529–30 Kidney transplantation, 530–31 Kilocalorie (kcal), 73, 587 Kinesins, 140, 141f Kinesthesia, 204 Kinin(s), 657t, 685t Kininogen, 393 Kisspeptin, 613 Klinefelter’s syndrome, 622, 622f Knee jerk, 141, 304–6, 306f Korotkoff’s sounds, 391 Krebs cycle, 80, 80f, 81–82, 83f, 83t, 86f, 576, 578 Kwashiorkor, 402 Labeled lines, 196 Laboratory tests, 694, 694t, 697–98, 697t, 700, 700t, 703f, 704 Labyrinth, 224 Lactase, 564 Lactate, 29, 80, 820f Lactation, 645–46, 645f Lacteal vessel, 537 Lactic acid, 29, 276 Lactoferrin, 656 Lactogenesis, 645 Lactose, 31 Lactose intolerance, 564 Lamina propria, 535, 536f Laminar blood flow, 381, 381f Language, and cerebral dominance, 250–52, 253 Lansoprazole, 562 Laplace, Law of, 457f Large intestine, 534f, 538, 539t, 547t, 560–62, 561f Larynx, 447 Latch state, 288 Late antral follicle, 645t Late phase reaction, 683 Latent period, 270 Lateral inhibition, 197, 198f–99f Lateral sacs, 261, 262f Lateral traction, 458 Lateral ventricle, 176f Law of Laplace, 457, 457f Law of mass action, 74–75 Laxatives, 565 L-dopa, 169, 169f, 310 Leak potassium channels, 149 Leakiness, of capillaries, 398–99 Learned reflexes, 10 Learning, 10, 249–50, 250t, 253 Left hemisphere, 252 Left ventricular hypertrophy, 421 Length-monitoring system, 304, 304f Length-tension relation, 273–74, 274f Lengthening contraction, 269 Lens, 208, 209f–10f Leptin, 240, 322t, 589, 590, 591 Leukocytes composition of blood, 363, 364f description and functions of, 429f, 431–32, 432t, 653, 655t Leukotrienes, 131, 132f Lever action, of muscles and bones, 281–82, 281f–82f Levitra, 619 Levodopa (L-dopa), 169, 169f, 310 Lexapro, 246 Leydig cells, 615, 615f LH surge, 628, 631, 631f, 631t Libido, 621 Lidocaine, 155, 295 Ligand, 68, 68f Ligand-gated channels, 101, 153 Ligand-gated ion channels, 125, 125t, 126f Light, and vision, 207, 208f Light adaptation, 212–13 Light chains, 260, 260f Light-dark cycle, 13–14 Light microscope, 46 Limbic system, 175t, 176, 176f Lingual papillae, 226, 226f Linoleic acid, 91 Linolenic acid, 91 Lipase, 542, 557t Lipid(s) characteristics of, 30t, 31–32, 33f membrane proteins, 49–50 protein synthesis, 63 Lipid bilayer, 99, 107t Lipid rafts, 51 Lipid-soluble messengers, 124, 124f Lipolysis, 577, 578t, 584t Lipoprotein lipase, 574 Lipoproteins, 574 Index wid78305_idx_I1-I20.indd 11 I-11 20/02/13 5:10 PM Revised Pages Lipoxygenase, 132, 132f Liquids, diffusion of gases in, 463–64 Lisinopril, 515 Lithium, 247 Lithobid, 247 Liver absorbed carbohydrate, 574 arterioles, 396t autonomic nervous system, 183t bile secretion, 557–59 capillaries, 399 cholesterol homeostasis, 575 clotting, 436, 437f electron micrograph of cell, 47f epinephrine secretion, 583 functions, 534f, 539–40, 539t gluconeogenesis, 86–87 hormones, 322t, 547t protein and amino acid metabolism, 89 Load, muscle, 269 Load-velocity relation, 272, 272f Lobes, of brain, 174f, 175, 176f frontal lobes, 174f, 175, 176f, 251f Local afferent input, 304 Local anesthetics, 155 Local controls, of arterioles, 392–94, 392f, 395f Local factors, in smooth muscle tension, 291 Local homeostatic responses, 11 Lock-and-key arrangement, molecular interaction with, 26 Lock-and-key substrate model, 75, 75f Lockjaw, 316 Locus ceruleus, 242 Long-loop negative feedback, 338–39, 339f Long neural pathways, 174 Long reflexes, 546 Long-term depression (LTD), 250 Long-term memory, 249, 250 Long-term potentiation (LTP), 170, 170f, 250 Longitudinal muscle, 536, 536f Loop diuretics, 521 Loop of Henle “division of labor” in renal tubules, 502, 521t structure of kidneys and urinary system, 493f, 494 urine concentration, 509, 510 Loose connective tissue, Losartan, 515 Low-density lipoproteins (LDLs), 426, 575–76 Low-resistance shock, 417, 701 Lower esophageal sphincter, 548, 549f, 550 Lower motor neurons, 312 LSD (lysergic acid diethylamide), 170 L-type calcium channels, 292, 293, 373 Luminal membrane, 3, 4f, 113, 501, 507 Lunelle, 647 Lung(s) See also Respiratory system arterioles, 396t autonomic nervous system, 183t mechanics of, 450–61, 483 nonrespiratory functions of, 482, 484 thorax, 450 transport of hydrogen ions between tissues and, 472–73, 472f, 484 Lung capacities, 459, 460f Lung compliance, 455–58, 457f Lung volumes, 459, 460f Luteal phase, 627, 628f, 631–32 Luteinizing hormone (LH) anterior pituitary, 335, 336f, 613 control of testes, 620–21 follicle development, 628–30 functions of, 323t luteal phase of menstrual cycle, 632 pregnancy, 641 Lymph, 404, 573, 663 I-12 Lymph flow, 404–5 Lymph nodes, 404, 663, 664f Lymphatic capillaries, 404 Lymphatic system, 5t, 404–5, 405f, 406 Lymphatic vessels, 404 Lymphocyte activation, 662 Lymphocyte(s) defined, 429f, 432, 685t origins of, 663 receptors, 666–68 role in immune response, 655t specific immune defenses, 653 Lymphoid organs, 662–63 Lysosomes, 48f, 55–56 Macromolecules, 30 Macrophage(s), 432 bacteria, 657f defined, 653 functions of, 655t role in immune responses, 678t, 685t viral infections, 676, 676f, 677t–78t Macrophage-like cells, 653 Macula densa, 493f, 494, 495f–96f, 515 Macula lutea, 208, 209f Macular degeneration, 217 Magnesium ions, 23t Magnetic resonance imaging (MRI), 236, 704, 704f–5f Magnitude, of diffusion, 97–98 Major histocompatibility complex (MHC), 668 Malabsorption, of vitamins, 544–45 Malar rash, 689, 690f Malaria, 431, 653 Male climacteric, 623 Male pattern baldness, 621 Male reproductive physiology, 614–24 Malignant hyperthermia, 295–96 Malleus, 219f–20f, 220 Malnutrition, 349–50, 639–40 Maltose, 31 Mammary glands, 645 Mania, 246 Mannitol, 521 Margination, 658 Marijuana, 248t Masculinization, 326–27 Mass action, law of, 74–75 Mass movement, 561 Mast cells, 654, 655t, 685t Matrix, 55, 55f Maximal oxygen consumption, and endurance training, 420–21, 421f Mean arterial pressure (MAP) arterioles, 392 baroreceptor reflexes, 412f defined, 389–90 elevated intracranial pressure, 414 equation for, 410 exercise, 418f, 420t Measurement of cardiac function, 385, 386 of systemic arterial pressure, 390–91 Mechanically-gated channels, 101, 153 Mechanoreceptors, 193 Median eminence, 333 Mediated transport, 101, 102f Mediated-transport systems, 101–7, 115, 398, 501 Medical physiology See also Pathophysiology abdominal pain, fever, and circulatory system, 699–703, 706–7 chest pain after airplane flight, 697–99, 706 nausea, flushing, and sweating, 703–6, 707 palpitations and heat intolerance, 693–97, 706 Medications See Drugs Medulla oblongata, 174, 174f Medullary cardiovascular center, 411 Medullary circulation, 511 Medullary collecting duct, 492, 493f, 509, 510, 510f, 511, 512, 521t Medullary respiratory center, 473, 474f Megakaryocytes, 429f, 432 Meiosis, 605, 606f Meiotic arrest, 625 Meissner’s corpuscle, 203f Melanopsin, 215 Melatonin, 14, 240, 323t Membrane(s) apical, 3, 4, 4f, 113 basilar, 220, 221f basolateral, 3, 4, 4f, 113, 501, 507 diffusion through, 98–101 excitable, 149 glomerular, 495f plasma, 47, 48f, 49, 49f, 57 semipermeable, 109 structure of cell, 48–51, 57 tectorial, 221, 221f tympanic, 218, 219f–20f Membrane activation, 289–92, 289t Membrane attack complex (MAC), 659, 673, 685t Membrane excitation, 262–65 Membrane junctions, 51, 52f Membrane potential, 100, 101f, 145–60, 151t Memory, 249–50, 249f, 250t, 253 Memory cells, 662, 685t Memory encoding, 249 Menarche, 635 Ménière’s disease, 231 Meninges, 184, 185f Meningitis, 184 Menopause, 356, 576, 648, 649 Menstrual cycle, 624, 628, 632–33, 633f, 633t, 649 Menstrual phase, 632 Menstruation description of, 624 exercise and amenorrhea, 585, 635 metabolic rate, 587t Menthol, 204 Merkle’s corpuscle, 203f Mesangial cells, 494, 496f Mescaline, 247f Mesolimbic dopamine pathway, 243, 244f Messenger RNA (mRNA), 59–61, 62, 62f Metabolic acidosis, 477, 527–28, 527t Metabolic actions, of thyroid hormones, 342 Metabolic alkalosis, 477, 527–28, 527t Metabolic bone diseases, 356–57, 357–58 Metabolic pathways, 77, 79–92 Metabolic rate, 587–88, 587t Metabolism capillaries, 399 carbohydrate, 85–87, 92 control and integration of carbohydrate, protein, and fat, 573–85 cortisol and stress, 345–46 defined, 73 fat, 87–88, 90, 573–85 hormones, 327–28, 332, 342 hyperventilation, 465 kidney tubules, 502 pregnancy, 642t protein and amino acid, 88–90, 92 skeletal muscle, 274–76, 284–85 Metabotropic receptors, 162 Metarterioles, 397 Methamphetamine, 247f Methane, 24, 24f Methimazole, 696 Index wid78305_idx_I1-I20.indd 12 20/02/13 5:10 PM Revised Pages Methionine, 91t Methylphenidate, 242 MHC proteins, 668 Micelles, 543, 544f Microbes, 652 Microcirculation, 364, 397, 397f Microfilaments, 56 Microglia, 143, 143f Micromoles, 29 Microscope, and observation of cells, 46–48, 46f–47f, 57 Microtubules, 56f, 57 Microvilli, 536, 537f–38f Micturition, 503–4, 505 Midbrain, 174, 174f Middle ear, 218, 220f Mifepristone, 647 Migrating myoelectrical complex (MMC), 560 Milk breast, 646 and lactose intolerance, 564 Milk ejection reflex, 646 Milk letdown, 646 Millimoles, 29 “Mind-body” interactions, 678 Mineral elements, 21t, 23, 90–91, 91t, 545 Mineralization, 354 Mineralocorticoids, 326, 347 Minute ventilation, 459–60, 461 Miscarriage, 639 Mitochondria, 54–55, 55f, 56, 56f Mitogen, 350 Mitosis, 605 Mitral valve, 368 M line, 260 Modality, 195 Modulation, and neurotransmitters, 167 Modulator molecule, 71, 71f Mole, 29 Molecular shape, 26, 26f, 27f Molecular solubility, 28, 28f Molecular weight, 29, 108 Molecules, 23, 41 thermal motion of, 97, 97f Monoamine oxidase (MAO), 169 Monoamine oxidase inhibitors, 246 Monocular vision, 215, 215f Monocytes, 429f, 432, 653, 655t, 685t Monoglycerides, 542, 543 Monoiodotyrosine (MIT), 340 Monomers, 30, 34 Monosaccharides, 31, 541, 541t Monosodium glutamate (MSG), 226 Monosynaptic reflex, 306 Monounsaturated fatty acids, 32 Mood, 246 Mood disorders, 246 Morning sickness, 641 Morphine, 172, 185, 206 Motilin, 322t, 560 Motility, of gastrointestinal system, 535, 559–60, 561–62 Motion sickness, 225 Motivation, 243–44, 252 Motor axons, 262, 263f Motor control hierarchy, 301–3, 301f, 303t, 314 Motor cortex, 308, 309f Motor end plate, 262 Motor neuron(s) body movement, 301–12, 316 local control of, 303–8, 314–15 motor control hierarchy, 301–3, 301f, 303t, 314 peripheral nervous system, 179 skeletal muscle contraction, 262, 270t, 279 Motor neuron pool, 300–301 Motor program, 302 Motor units, 262, 263f, 278, 278f, 300 Mountain sickness, 482 Mouth, 534f, 538, 539t, 548 Movement See also Body movement eye, 217, 218f ion, 100–101, 101f mass, 561 semicircular canals and head, 224, 224f sense of, 203–4 MPTP (1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine), 310 Mucosa, 535, 536f Mucus, and immune responses, 656 Müller cells, 211 Müllerian ducts, 608, 609f Müllerian-inhibiting substance (MIS), 322t, 608, 609f Multienzyme reactions, 77–78, 79 Multimeric proteins, 37 Multiple sclerosis (MS), 187, 683 Multisensory neurons, 242 Multisynaptic pathway, 174 Multiunit smooth muscle, 292 Muscarinic receptors, 168 Muscle cardiac, 292–94, 295 defined, 259–60 metabolic rate and activity of, 587t, 588 skeletal, 258–86 smooth, 286–92, 294, 295 Muscle cells, 2, 3, 293f Muscle cramps, 282 Muscle fatigue, 275–76, 276f Muscle fiber, 259, 259f Muscle spindle, 304, 304f Muscle-spindle stretch receptors, 304, 305f Muscle stretch, 305f Muscle tension, 278–79, 279t Muscle tissue, 2, Muscle tone, 312–13, 315 Muscular dystrophy, 280, 283, 283f Muscularis externa, 535, 536f Muscularis mucosa, 535, 536f Musculoskeletal system, 5t Mutagens, 64 Mutation, 38, 64–65 Myasthenia gravis, 283–84, 683, 695 Myelin, 140, 140f, 158 Myenteric plexus, 536, 536f Myoblasts, 259 Myocardial infarction, 424, 697 Myocardium, 368, 368f Myoepithelial cells, 645 Myofibrils, 259f, 260, 261f Myogenic responses, 393 Myoglobin, 277 Myometrium, 632, 640f Myopia, 210 Myosin, 260 filaments, 260, 267, 268f, 280 skeletal muscle contraction, 267, 268, 268f, 269, 270t structure of skeletal muscle, 260 structure of smooth muscle, 286, 287 Myosin light-chain kinase, 287, 288f Myosin light-chain phosphatase, 288 Myostatin, 280 Myxedema, 343 NA1/K-ATPase(s), 342, 519 NA1/K-ATPase pump action potential, 155 epithelial transport, 113–14, 114f extracellular osmolarity, 109 primary active transport, 103–5, 104f–5f resting membrane potential, 149, 150f secondary active transport, 106, 107f NAD1 (nicotinamide adenine dinucleotide), 76, 80, 82, 82f, 87 NADH1, 80, 84 Nanomoles, 29 Narcolepsy, 239 National Institutes of Health, 590 National Research Council, 592t Natriuresis, 516 Natural antibodies, 685t Natural killer cells See NK cells Natural selection, 65 Nausea, 518, 703–6, 707 Nearsightedness, 210, 210f Necrosis, 700 Negative balance, 14 Negative feedback, 8, 9f See also Feedback systems action potential, 154, 155f homeostasis and feedback systems, Negative nitrogen balance, 89 Neoplasm, 704 Nephritis, 689 Nephrogenic diabetes insipidus, 508 Nephrons, 492, 493f, 494, 496f Nernst equation, 148 Nerve(s), 141, 174, 290–91, 290f Nerve cells, Nerve fiber, 139, 141 Nervous system See also Central nervous system autonomic, 179, 180–84, 180f–82f, 183t, 186, 385t enteric, 180, 546 peripheral, 139, 174f, 178–79, 179f, 179t, 186 primary functions of, 5t somatic, 179, 179f, 179t structure of, 173–86 Nervous tissue, 2, Net filtration pressure (NFP), 400 Net flux, 97, 98, 99f, 107t Net glomerular filtration pressure, 498 Neural growth and regeneration, 143–44 Neural mechanisms and control of absorptive and postabsorptive states, 578–84, 586 of conscious experiences, 242–43, 243f hypophysiotropic hormones, 337f, 338 regulation of gastrointestinal systems, 546–47, 546f rhythmic breathing, 473–74 for selective attention, 242 Neural pathways hearing, 222–23 sensory systems, 198–200, 202 somatosensory system, 206–7 vision, 213–16, 214f–15f Neural substrates, of states of consciousness, 238–40 Neural tissue, 139–45 Neuroeffector communication, 172, 173 Neuromodulators, 167–72, 168t, 172, 173 Neuromuscular junction, 262–65, 263f Neuromuscular signaling, 264–65 Neurons See also Motor neurons cell categories, conscious experiences, 242 defined, 3, 139 functional classes of, 140–42, 142t, 144 hormone secretion, 330, 330f neural growth and regeneration, 143–44 structure and maintenance of, 139–40, 144 Neuropeptide(s), 168t, 171–72 Neuropeptide Y, 589 Neurotransmitters See also Receptor(s) amino acids, 168t, 170–71 defined, 12, 12f hair cells, 222, 222f mechanisms of release, 161–62, 162f, 172 nervous system, 139, 142 neuromodulators, 167–72, 168t, 172, 173 smooth muscle contraction, 290, 291 Index wid78305_idx_I1-I20.indd 13 I-13 20/02/13 5:10 PM Revised Pages Neurotrophic factors, 143 Neutral solutions, 29 Neutralization, of bacterial toxins and viruses, 673–74 Neutrons, 21 Neutrophils, 429f, 432, 653, 655t, 685t Nicotine, 168, 184, 185 Nicotinic receptors, 168 Nitric oxide (NO) active hyperemia, 393 erection of penis, 619 free radical, 27 hemoglobin and transport of, 473 hemostasis and platelet plug, 434 as neurotransmitter, 172 phagocytes and immune response, 658 smooth muscle contraction, 291 Nitrogen, 24, 25t Nitroglycerin, 426 NK (natural killer) cells defined, 685t functions of, 655t, 663 MHC restriction of, 668t role in immune defenses, 653 specific immune responses, 670 virus-infected and cancer cells, 676, 676f, 677t, 678 NMDA receptors, 170–71, 170f Nociceptors, 193, 204 Nodes of Ranvier, 140, 140f Noise levels, and ear damage, 222 Non-insulin-dependent diabetes mellitus, 598 Nonadrenergic autonomic neurons, 180, 394 Noncholinergic autonomic neurons, 180, 394 Nonpenetrating solutes, 109 Nonpolar covalent bonds, 25, 25t Nonpolar molecules, 25, 25t, 99 “Nonsequence” hormones, 339 Nonshivering thermogenesis, 593 Nonspecific ascending pathways, 200, 200f Nonspecific immune response See Innate immune response Nonsteroidal anti-inflammatory drugs (NSAIDs), 132f, 133 Nontropical sprue, 545 Nonverbal memories, 252 Nonvolatile acids, 524 Norepinephrine arterioles, 394, 394f heart rate, 382 as hormone, 12, 321, 322t locus ceruleus and selective attention, 242 as neurotransmitter, 12, 168t, 169, 169f production and functions of, 322t receptors and binding, 122, 123, 182t Norpramin, 246 Novocaine, 155 NREM (non-rapid eye movement) sleep, 236–37, 237f, 238t Nuclear bag fibers, 304 Nuclear chain fibers, 304 Nuclear envelope, 51, 53, 53f, 61f Nuclear pores, 53, 53f, 61f Nucleic acids, 30t, 38–39, 39f Nucleolus, 53, 53f Nucleosomes, 58 Nucleotides, 38, 39f Nucleus, 47, 48f, 51, 53, 53f, 61f, 174 Nutrients and nutrition See also Diet; Fasting control of food intake, 589–91 digestion, 534, 535, 540–45, 566 essential, 90–91, 91t, 92 growth, 349–50 heart attacks, 426 hormone secretion, 332 malnutrition, 349–50, 639–40 pregnancy, 642t Nystagmus, 225 I-14 Obesity causes and treatment of, 590–91 deep vein thrombosis, 699 defined, 590 diabetes mellitus, 599 hypertension, 422 sleep apnea, 486 Obligatory water loss, 509 Obstructive lung diseases, 458 Obstructive sleep apnea, 486, 486f Occipital lobes, 174f, 175, 251f Oculomotor nerves, 178t Odorant, 228 “Off-pathways,” 213, 214f Ohm’s law, 145 Olfaction, 227 Olfactory bulbs, 176f, 227f, 228 Olfactory cortex, 199 Olfactory epithelium, 227–28, 227f Olfactory nerves, 178t Oligodendrocytes, 140, 140f Omeprazole, 562 “ON center/OFF surround” or “OFF center/ON surround” ganglion cells, 214, 214f “On-pathways”, 213, 214f On-responses/on-off responses, and sensory receptors, 194 Oncogenes, 670 One-way fluxes, 97–98, 99f 1,25-dihydroxyvitamin D, 322t, 324, 355–56, 356f, 357 Oogenesis, 625–26, 626f Oogonia, 625, 626f Ophthalmoscope, 208 Opponent color cells, 216 Opsins, 211 Opsonins, 658, 660, 685t Optic chiasm, 215 Optic disc, 208, 209f Optic nerves, 178t, 208, 209f Optic tracts, 215 Optics, of vision, 208–11 Optimal length (L0), 274 Oral anticoagulants, 438 Oral contraceptives, 647 Oral glucose tolerance test, 598 Orexins, 239 Organ(s) See also Body; specific organs and systems cell differentiation, organization of body, 4–5 Organ of Corti, 220–22, 221f Organ systems, 2, 2f, 3, 4, 5t Organ transplantation, 530–31 Organic molecules, classes of, 30–40, 30t, 41–42 Organophosphates, 264 Orgasm, 620, 635 Orienting response, 241 Osmol, 108 Osmolarity, 108, 109–10, 512–13, 512f Osmoreceptors, 516–17, 517f Osmosis, 107, 107–10, 115 Osmotic diuresis, 508 Osmotic diuretics, 521 Osmotic force, 498 Osmotic pressure, 109 Osteoblasts, 349, 354f Osteoclasts, 354, 354f Osteocytes, 354, 354f Osteoid, 353–54 Osteomalacia, 356 Osteoporosis, 347, 356, 648 Otoliths, 225, 225f Outer hair cells, 221, 221f Outer segment, 211 Ova (ovum), 605 Oval window, 219f–20f, 220 Ovarian functions, 625–28, 648 Ovaries, 322t, 605 Overshoot, and membrane potential, 151, 151f Overweight, definition of, 590 Ovulation, 624, 627, 628, 631 Oxidative deamination, 89, 89f Oxidative fibers, 276 Oxidative phosphorylation, 79, 80, 80f, 82, 84–85, 85t, 86f, 275, 275f Oxybutynin, 504 Oxygen blood and transport of, 467–71, 483–84 capillaries, 399 gas exchange in respiratory system, 465–66, 465f molecules, 23, 25t respiratory rate, 476 ventilation-perfusion abnormalities, 481 Oxygen-carrying capacity, 468 Oxygen debt, 275 Oxygen-hemoglobin dissociation curve, 468–70, 468f–69f Oxyhemoglobin, 467 Oxymetazoline, 123 Oxyntic cells, 550 Oxytocin feedback systems, functions of, 323t, 334–35 parturition, 9, 644 posterior pituitary hormones, 333–35 Pacemaker, 14 Pacemaker potential action potentials and SA node, 373 cardiac muscle cells, 294, 373 defined, 151t, 158, 290 smooth muscle fibers, 290f Pacinian corpuscles, 203f Pain, and sensory system, 204–6, 204f–5f Palpitations, 693–97, 706 Pancreas arterioles, 396t autonomic nervous system, 183t digestive enzyme secretion, 555–57, 556f–57f, 557t functions, 534f, 538–39, 539t gastrointestinal hormones, 547t hormones, 322t Papilla, 492, 492f Papillary muscles, 368f, 369 Paracellular pathway, 113 Paracrine substances/agents, 12, 12f, 395 Paradoxical sleep, 237, 237f, 238t Parasympathetic division, of autonomic nervous system, 180, 181f, 183t Parasympathetic nervous system, 382, 384, 385t, 394 Parathormone, 322t Parathyroid glands, 322t, 355, 355f, 642t Parathyroid hormone (PTH), 134, 322t, 330, 354–55, 355f, 357, 520–21 Parietal cells, 550, 550f–51f, 551 Parietal lobe(s), 174f, 175, 251f Parietal-lobe association cortex, 308, 309f Parietal pleura, 450 Parkinson disease, 144, 310, 311 Paroxetine, 170, 246 Partial pressures, of gases, 462–64 Parturition, 9, 641–44, 643f–44f Passive immunity, 674 Pathogen-associated molecular patterns (PAMPs), 661 Pathogens, 652 Pathophysiology, See also Disease; Medical physiology defined, 7, 692 of gastrointestinal tract, 562–65, 567 Pathway, and central nervous system, 174 Pattern-recognition receptors (PRRs), 662 Index wid78305_idx_I1-I20.indd 14 20/02/13 5:10 PM Revised Pages Pavlov response, 249, 548 Paxil, 170, 246 Pendrin, 340 Penicillin, 679 Penis, 616f, 619–20 Pentoses, 31 Pepsin, 541, 553–54, 553f Pepsinogen, 541, 551, 553, 553f Peptide, 35 Peptide bond, 34, 35f Peptide hormones, 321, 323, 324f, 327t, 328–29 Peptidergic neurotransmitters, 171 Percent hemoglobin saturation, 467 Perception, 192, 200–201, 242 Perforated gastric ulcer, 563f Perforation, 700 Perforin, 675, 685t Pericarditis, 440 Pericardium, 368, 368f Perilymph, 220 Perimenopause, 648 Peripheral chemoreceptors acclimatization to altitude, 482t control of ventilation and hydrogen ion concentration, 474–75, 475t, 476, 477, 478 Peripheral membrane proteins, 50, 50f Peripheral nervous system (PNS), 139, 174f, 178–79, 179f, 179t, 186 See also Neurons Peripheral thermoreceptors, 593 Peripheral veins, 402 Peristalsis, 535 Peristaltic waves, 549, 554, 554f Peritoneal dialysis, 530–31 Peritonitis, 700 Peritubular capillaries, 493f, 494, 496 Permeability coefficient P, 99 Permissive actions, of thyroid hormones, 342 Permissiveness, and hormone receptors, 328, 329f Pernicious anemia, 430, 545 Peroxisomes, 56 Persistent vegetative state, 241 Pesticides, 264 PET (positron emission tomography), 22, 22f, 236 Peyer’s patches, 538 pH, 29 Phagocytes, 654, 658, 660f Phagocytosis, 111, 112f, 653, 659f, 673, 673f Phagolysosome, 658 Phagosomes, 111, 658 Phantom limb, 201, 207, 207f Pharmacological effects of cortisol, 329 of hormones, 329 Pharynx chewing and swallowing, 548, 549f functions of gastrointestinal organs, 534f, 538, 539t organization of respiratory system, 447, 447f Phase-shift rhythms, 13 Phenotype, 607 Phenyl-N-methyltransferase (PNMT), 321 Phenylephrine, 123 Phenytoin (Dilantin), 706 Phlebotomy, 545 Phosphate, renal regulation of, 520–21, 523 Phosphodiesterase, 127 Phosphodiesterase type (PDE5), 619 Phosphoenolpyruvate, 86 Phospholipase A2, 132, 132f Phospholipase C, 130, 130f Phospholipids, 33f, 34, 49, 542–43 Phosphoprotein phosphatases, 72 Phosphorylation, 72, 104, 131, 288, 288f Photopigments, 211 Photoreceptors, 193, 208, 211–13, 212f Phototherapy, 247 Phototransduction, 211–13, 213f Phrenic nerves, 454 Physical dependence, 248 Physical examination, 693, 697, 700, 703–74 Physiological dead space, 461 Physiology See also Pathophysiology compartmentalization as general principle, defined, female reproductive, 624–50 general principles of, 15–16, 17 homeostasis as defining feature, 6–7, 15, 17 male reproductive, 614–24 renal, 491–505 Pia matter, 184, 185f Pigment epithelium, 211 Pineal gland, 14, 176 Pinocytosis, 111 Pituitary disease, 347 Pituitary gland anatomy of brain, 176f control systems involving, 333–40 hormones produced by, 323t hypothalamus, 176 pregnancy, 642t Placebo, 206 Placenta, 323t, 638, 640f, 642t Plasma angiotensin II concentration, 514–15 bicarbonate concentration, 525–27 cortisol, 346 defined, 5, 363, 367t, 428, 439 hormone secretion, 330, 330f hormone transport, 327, 327t Plasma cells, 653, 655t, 677t, 685t Plasma membrane, 47, 48f, 49, 49f Plasma membrane receptors, 121, 121f, 125t, 126f, 133, 134 Plasma osmolarity, 518 Plasma proteins, 428 Plasmapheresis, 284 Plasmin, 438 Plasminogen, 438 Plasminogen activators, 438 Plasmodium, 653 Plasticity, 143, 166, 250 Platelet(s), 363, 429f, 432 Platelet activating factor, 657t Platelet activation, 433 Platelet aggregation, 433, 438t Platelet factor (PF), 435 Platelet plug, 433–34, 433f–34f Pleura, 450 Pleural sac, 450 Pluripotent hematopoietic stem cells, 428, 429f Pneumotaxic center, 473 Pneumothorax, 453, 453f Podocytes, 494, 495f–96f Point mutation, 64 Polar covalent bonds, 24–25, 25t Polar molecules, 24–25, 99 Poliomyelitis, 282 Polycythemia, 431 Polymers, 30, 34 Polymodal neurons, 200, 204 Polypeptide(s), 35–36, 36f, 59, 59f, 100f Polypeptide synthesis, 61–63, 61f Polysaccharides, 31, 32f, 541t Polyspermy, 636f–37f Polysynaptic reflex, 306 Polyunsaturated fatty acids, 32, 33f Pons, 174, 174f Pontine respiratory group, 473 Pool, and homeostasis, 14, 14f Portal system, 364 Portal triads, 557, 558f Portal veins, 333 Positive balance, 14 Positive feedback, 8–9 See also Feedback systems action potential, 153 ovulation, 631 Positive nitrogen balance, 89 Positron emission tomography (PET), 22, 22f, 236 Postabsorptive state endocrine and neural control of, 578–84, 579f, 586 exercise, 585 metabolic pathways, 573, 576–78, 577f, 578t, 585–86 Posterior pituitary gland, 323t, 333–35, 642t Postganglionic neurons, 180, 182f Postsynaptic cell, 162–63, 163f, 172 Postsynaptic density, 161, 161f Postsynaptic mechanisms, 166 Postsynaptic neuron, 142, 142f Postural reflexes, 313 Posture balance and maintenance of upright, 313, 313f–14f, 316 cardiovascular patterns, 417–18, 417f, 427 somatic sensation, 203–4 vestibular information, 225 Potassium ions, 23t NA1/K1-ATPase pump, 104–5, 107f renal regulation, 519–20, 519f–20f, 522–23 resting membrane potential, 146–50 Potassium-sparing diuretics, 521 Potential difference, 145, 151t Potentiation, 546 Potocytosis, 112 Power stroke, 268 Pralidoxime, 264 Pre-Bötzinger complex, 473 Pre-mRNA, 60, 61f Preattentive processing, 241 Precapillary sphincter, 397 Precocious puberty, 635 Prednisone, 329 Preeclampsia, 641 Preganglionic neurons, 180, 182f Pregnancy female reproductive system, 635–48, 649 gastrointestinal system, 550 metabolic rate, 587t Rh factor, 681 Pregnancy sickness, 641 Preinitiation complex, 63 Preload, and stroke volume, 382 Premenstrual dysphoric disorder (PMDD), 634 Premenstrual syndrome (PMS), 634 Premenstrual tension, 634 Premotor area, 308, 309f Presbyopia, 210 Pressure See also Blood pressure and sensory system, 203 venous, 402–3, 403f–4f Pressure natriuresis, 516 Presynaptic facilitation, 165, 165f Presynaptic inhibition, 165, 165f Presynaptic neuron, 142, 142f Presyncope, 231 Primary active sodium reabsorption, 506–7 Primary active transport, 103–5, 104f–5f, 107f, 107t Primary adrenal insufficiency, 347 Primary hyperparathyroidism, 356, 696 Primary hypersecretion, 331 Primary hypertension, 421–22 Primary hypoparathyroidism, 357 Primary hyposecretion, 331 Primary lymphoid organs, 663 Index wid78305_idx_I1-I20.indd 15 I-15 20/02/13 5:10 PM Revised Pages Primary motivated behavior, 243 Primary motor cortex, 308, 309f Primary oocytes, 605, 625, 626f Primary protein structure, 36, 36f, 37f Primary RNA transcript, 60, 60f–61f Primary sensory coding, 194–98, 202 Primary spermatocytes, 605, 616 Primordial follicles, 626, 627f Procaine, 155 Procedural memory, 249, 249f Processes, and neurons, 139, 139f Procoagulants, 437t Progesterone corpus luteum, 632 feedback effects of, 629t major functions of, 322t, 323t, 327, 634, 634t, 649 major sex hormones, 605 uterine changes in menstrual cycle, 632–33 Prognathism, 359 Prohormones, 323, 324f Prokaryotic cells, 47 Prolactin, 323t, 335, 336, 336f, 645, 646f Prolactin-releasing factor (PRF), 645 Prolactinomas, 651 Prolapse, of AV valves, 369 Proliferative phase, of menstrual cycle, 632 Promoter, 60, 60f Proprioception, 225, 302 Proptosis, 693, 694f Propylthiouracil, 696 Prosody, 251 Prostacyclin (PGI), 395, 433, 434f Prostaglandins, 131, 132f, 433, 645t Prostate cancer, 621 Prostate gland, 616, 616f Proteases, 88 Proteasome, 65, 65t Protective reflexes, 479 Protein(s) See also Amino acids acid secretion and, 553–54 binding sites, 68–71 characteristics of, 30t, 34, 34–38, 35f–38f, 35t degradation, 65–66, 65t, 67 digestion and absorption, 541–42, 542f genetic code and synthesis of, 59–65 metabolism, 88–90, 92, 573–85 receptor, 121 ribosomes, 53 secretion, 66–67 synthesis of, 59–65, 67 in urine and kidney disease, 529 vasodilation and increased permeability to, 657–58 Protein assembly, 62–63 Protein C, 437 Protein channels, 99–100, 100f, 107t Protein hormones, 321, 323 Protein kinase, 72, 125 Protein kinase A, 127 Protein kinase C, 130, 130f Protein synthesis, 59–65, 67 Proteolysis, 88 Proteome, 60 Prothrombin, 435 Protons, 21 Proximal convoluted tubule, 493f Proximal tubule, 494, 495f, 502, 521t Prozac, 246 Pseudohypoparathyroidism, 135, 357 Psilocybin, 247f Psychoactive substances, 247–48 Psychological dependence, 248 Psychological stress, 348 Psychoneuroimmunology, 678 PTH-related peptide (PTHrp), 357 I-16 Puberty defined, 621 female reproductive system, 635, 649 hormonal changes during, 621–22, 623 male reproductive system, 621–22 precocious, 635 Puffer fish, 156 Pulmonary arteries, 364 Pulmonary circulation, 364, 365f, 380, 380f–81f Pulmonary edema, 423, 466, 702 Pulmonary embolism, 480, 698, 698f Pulmonary function tests, 459 Pulmonary hypertension, 486 Pulmonary stretch receptors, 474 Pulmonary trunk, 364 Pulmonary valves, 368f–69f, 369 Pulmonary veins, 364 Pulse pressure, 389, 418, 420t Punishment, and behavior, 243 Pupil, 208, 209f Purines, 38, 168t, 172 Purkinje fibers, 372 Pus, 700 P wave, 374 Pyloric sphincter, 550f, 554, 554f Pyramidal cells, 175 Pyramidal system, 311 Pyramidal tracts, 311 Pyridostigmine, 284 Pyrimidine, 38 Pyruvate, 80, 81f, 82, 86 Pyruvic acid, 89f QRS complex, 374 Quaternary protein structure, 37–38, 37f Radiation, of heat, 592, 593f, 594 Radioactive iodine, 697 Radioisotopes, 22 Rapidly adapting receptors, 194, 194f Rate-limiting reaction, 78 Reabsorption, in kidney, 506–9, 507f sodium reabsorption, 506–7, 507f, 514–16 tubular reabsorption, 500–501, 500t water reabsorption, 507–9, 507f Reactant concentration, 74 Reactive hyperemia, 393 Receptive field, 194, 194f Receptive relaxation, 554 Receptor(s) See also Neurotransmitters catecholamine, 169 chemical messengers, 121–23, 134 endocytosis, 111 hormones, 328–29 ionotropic, 162 lymphocytes, 666–68 metabotropic, 162 muscarinic, 168 nicotinic, 168 reflexes, 10, 11f sensory, 140, 141f, 192–94, 192f Receptor activation, 123 Receptor desensitization, 166 Receptor-mediated endocytosis, 111–12, 112f Receptor potential, 151t, 158, 193–94, 193f–94f Receptor proteins, 121, 122t Receptor tyrosine kinases, 125 Reciprocal innervation, 306 Recombinant t-PA, 439 Recombinant tissue plasminogen activator (rec-tPA), 699 Recreational drugs, 247 Recruitment of motor units in muscle, 279 of sensory receptors, 195 Rectum, 540 Recycling, of urea and hypertonic medullary interstitium, 511–12, 511f Red blood cells, 49f Red muscle fibers, 277 Referred pain, 205, 205f Reflex(es) cross-extensor, 307, 308f homeostatic control systems, 10–11, 10f, 11f local afferent input and withdrawal, 307 monosynaptic, 306 polysynaptic, 306 postural, 313 salivary secretion, 548 stretch reflex, 304–6, 306f temperature regulating, 593–95 ventilatory responses and protective, 479–80 voluntary and involuntary actions, 303 withdrawal, 307, 308f Reflex arc, 10, 10f Reflexive memory, 249 Refraction, of light, 208, 209f Refractory period, 156, 156f, 376, 376f Regulation binding sites, 71–73 body temperature, 592–95 calcium and phosphate (renal), 521–22, 523 enzyme-mediated reactions, 76–77, 78 gastrointestinal system, 545–62, 566–67 potassium (renal), 519–20, 519f–20f, 522–23 protein synthesis, 63–65 receptors, 123 sodium (renal), 513–16, 522 total-body energy balance, 587–97, 597 tubular reabsorption, 502 water (renal), 516–18, 522 Regulatory salt appetite, 518–19 Regulatory site, 71, 71f Regulatory T cells, 664, 666 Relative refractory period, 156, 156f Relaxation, of muscle fiber, 262 Relaxed wakefulness and drowsiness, 238t Relaxin, 322t, 642 REM (rapid eye movement) sleep, 236–37, 237f, 238t, 486 Renal artery, 492, 492f Renal clearance, 502–3, 505 Renal corpuscle, 492, 493f, 495f, 496f Renal cortex, 492, 492f, 494, 496f Renal hypertension, 422, 529–30 Renal medulla, 492, 492f, 494, 496f Renal pelvis, 494, 496f Renal physiology See also Kidneys basic renal processes, 494–502, 505 calcium and phosphate regulation, 521–22, 523 micturition, 503–4, 505 renal clearance, 502–3, 505 renal functions, 491–92, 492t, 504 renal processes for sodium and water, 506–13, 522 sodium regulation, 513–16, 522 structure of kidneys and urinary system, 492–94, 504–5 water regulation, 516–18, 522 Renal plasma flow, 503 Renal vein, 492, 492f Renin, 514 Renin-angiotensin system, 514–16, 515f Repetitive transcranial magnetic stimulation (rTMS), 247 Repolarizing, of membrane potential, 151, 151f Reproductive system autonomic nervous system, 183t female reproductive physiology, 624–50 gametogenesis, 605, 606f, 607 male reproductive physiology, 614–24 primary functions of, 5t reproductive function, 611–13, 612f–13f, 613t sex determination and differentiation, 607–11 Index wid78305_idx_I1-I20.indd 16 20/02/13 5:10 PM Revised Pages Residual volume (RV), 459 Resistance to antibiotics, 680 blood flow and pressure, 364–67, 367 electrical, 145 Resistance (R), 365 Respiration, control of, 473–80, 484 Respiratory acidosis, 473, 527, 527t Respiratory alkalosis, 473, 527, 527t Respiratory bronchioles, 447 Respiratory cycle, 447, 455f Respiratory distress syndrome of the newborn, 458 Respiratory physiology, 446–47 Respiratory pump, 403 Respiratory quotient (RQ), 462 Respiratory rate, 474–78 Respiratory rhythm generator, 473 Respiratory system See also Lungs control of respiration, 473–80, 484 functions of, 482t gas exchange, 461–67, 483 homeostatic role, 525 hypoxic hypoxia, 480, 484 nonrespiratory functions of lungs, 482, 484 organization of, 447–50, 483 pregnancy, 642t primary functions of, 5t transport of carbon dioxide in blood, 471–72, 471f, 484 transport of hydrogen ions between tissues and lungs, 472–73, 472f, 484 transport of oxygen in blood, 467–71, 483–84 ventilation and lung mechanics, 450–61, 483 Respiratory zone, 448 Response element, 124 Rest-or-digest state, 184 Resting membrane potential, 146–50, 146f–50f, 147t, 151t, 159 Restrictive lung diseases, 459 Retching, 563 Rete testis, 615, 615f Reticular activating system (RAS), 239, 239f Reticular formation, 177 Reticulocyte, 429 Retina, 208, 209f, 212f, 215 Retinal, 211 Retrograde amnesia, 250 Retrograde movement, and axonal transport, 140 Retropulsion, 554 Retroviruses, 679 Reuptake, 162 Reuptake inhibitors, 170 Reversible reaction, 74, 75t Reversing, of metabolic pathways, 78 Rewards, and behavior, 243 Rh factor, 681 Rhabdomyolysis, 296 Rheumatoid arthritis, 683 Rhodopsin, 211, 212 Rhythm method, of contraception, 647 Rhythmic breathing, 473–74 Ribonuclease, 557t Ribonucleic acid See RNA Ribose, 40, 40f Ribosomal RNA (rRNA), 61 Ribosomes, 53, 60, 61, 62f, 67 Rickets, 356 Right hemisphere, 252 Rigidity, 312 Rigor mortis, 268f, 269 Ritalin, 242 RNA polymerase, 60, 61 RNA (ribonucleic acid) See also Genetics compared to DNA, 38 defined, 40 genetic code and classes of, 59 messenger RNA, 59–61, 62, 62f molecular structure, 39f ribosomal RNA, 61 transfer RNA, 61–62, 62f vaults, 56 Rocuronium, 264 Rods, 211 Rough endoplasmic reticulum, 53, 54f Round window, 220, 220f RU 486, 647 Ruffini corpuscle, 203f Ryanodine receptor, 266 Saccades, 217 Saccule, 223f, 224–25 Sacral nerves, 181f Saliva, 538, 539t, 548 Salivary glands, 183t, 534f, 538, 539t Salt appetite, 518–19, 519f, 522 depletion, 514, 515 Saltatory conduction, 158 Sarcolemma, 261 Sarcomere, 260, 270 Sarcoplasmic reticulum, 261, 262f, 288 Sarin, 168 Satellite cells, 259 Satiety signals, 589, 591 Saturated fatty acids, 32, 33f Saturation messenger-receptor interactions, 122, 122t, 123f protein binding sites, 70, 70f Scala tympani, 220, 220f–21f Scala vestibuli, 220, 220f–21f Schizophrenia, 201, 246 Schwann cells, 140, 140f Sciatic nerve, 179f Sclera, 208, 209f Scrotum, 614 Seasonal affective depressive disorder (SADD), 247 Second messengers, 125, 126f, 131, 131t, 133t Second-order neurons, 198 Second polar body, 607 Secondary active transport, 103, 105–7, 105f–7f, 107t, 115 Secondary adrenal insufficiency, 347 Secondary amenorrhea, 651 Secondary hyperparathyroidism, 357 Secondary hypersecretion, 331 Secondary hypertension, 421, 422 Secondary hyposecretion, 331 Secondary lymphoid organs, 663 Secondary oocyte, 607, 626, 626f Secondary peristalsis, 549 Secondary protein structure, 36–37, 37f Secondary sexual characteristics, 612, 621–22 Secondary spermatocytes, 607, 616–17 Secretin, 239, 322t, 546, 547f, 559 Secretion antibodies, 672–73 bile, 557–59 defined, 534 of hormones, 329–31, 329f, 332, 546 hydrochloric acid, 551–53, 551f, 553t of insulin, 581–82, 581f–82f pancreas, 555–57, 557t pepsin, 553–54 of proteins, 66–67 small intestine, 559 Secretory phase, of menstrual cycle, 632 Secretory vesicles, 54 Segmentation, 560, 560f Seizures, 703, 705 Selective attention, 241–42 Selective estrogen receptor modulators (SERMs), 356, 648 “Self” antibodies, 690 Semen, 616 Semicircular canals, 223–24, 223f–24f Seminal vesicles, 616, 616f Seminiferous tubules, 615, 615f Semipermeable membrane, 109 Sensation, 192 Sensitization, and allergy, 681 Sensorimotor cortex, 308, 309f Sensory information, 192, 199, 199f Sensory neglect, 243, 243f Sensory pathways, 198 Sensory receptors, 140, 141f, 192–94, 192f, 202 Sensory system association cortex and perceptual processing, 200–201, 201t chemical senses, 225–29, 229 defined, 192 hearing, 217–23, 229 neural pathways, 198–200, 202 organization, 201t primary sensory coding, 194–98, 202 sensory receptors, 140, 141f, 192–94, 192f, 202 somatic sensation, 203–7, 228 vestibular system, 223–25, 229 vision, 207–17, 228–29 Sensory transduction, 193 Sensory unit, 194, 194f Sepsis, 701 Septal defect, 381 Septal nuclei, 176f Septic shock, 683, 701, 702 Serosa, 536, 536f Serotonin, 168t, 170, 247f Serotonin reuptake inhibitors, 170 Serotonin-specific reuptake inhibitors (SSRIs), 246 Sertoli cell(s), 615, 615f, 618f, 618t Sertoli cell barrier, 617 Sertraline, 246 Serum, 428 Set point, 7, 9, 9t Severe combined immunodeficiency (SCID), 678 Sevoflurane, 295 Sex chromatin, 607 Sex chromosomes, 607 Sex determination, 607, 614 Sex differentiation, 607–11, 614 Sex hormones, 605 Sex steroids, 352 Sexual behavior, 608 Sexual dimorphisms, 611 Sexual response, 635, 649 Sexually transmitted diseases (STDs), 647 Shaft, of bone, 349, 349f Shivering, 8, 9, 593 Shivering thermogenesis, 593 Shock, 417 circulatory, 565 low-resistance, 417, 701 Short-loop negative feedback, 339, 339f Short reflexes, 546 Short stature, 350 Short-term memory, 249 Shortening velocity, 279 Shunt, 466, 481t Sickle-cell disease, 38, 41, 431, 431f Sickle-cell trait, 43 Sigmoidoscopy, 562 Signal sequence, 66 Signal transduction pathways, 123–33, 134 Sildenafil, 394, 619 Simple diffusion, 97, 97f, 103f Simple epithelium, Index wid78305_idx_I1-I20.indd 17 I-17 20/02/13 5:10 PM Revised Pages Sinequan, 246 Single-fiber contraction, 269–74, 284 Single-unit smooth muscle, 291–92, 291f Sinoatrial (SA) node, 370, 371f, 372–74, 385t Sinus, 410, 639 Sjögren’s syndrome, 548 Skeletal muscle arterioles, 396t characteristics of, 294t disorders, 282–84, 285 energy metabolism, 274–76, 284–85 molecular mechanisms of contraction, 262–69, 270t, 284 single-fiber contraction, 269–74, 284 structure of, 258–62, 258f–59f, 284 types of fiber, 276–78, 278t, 285 whole-muscle contraction, 278–82, 285 Skeletal muscle cells, Skeletal muscle pump, 403, 403f Skin arterioles and sympathetic nerves, 394, 396t autonomic nervous system, 183t immune defenses, 656 temperature regulation, 594–95 Skin receptors, 203f Sleep consciousness, 236–38, 237f, 238t metabolic rate, 587t Sleep apnea, 237, 422, 486, 486f Sleep deprivation, 238, 678 Sleep spindles, 236 Sleep-wake cycles, 238–40 Sliding-filament mechanism, of muscle contraction, 267–69, 267f–68f Slow fibers, 276 Slow-oxidative fibers, 277, 277f, 278t Slow-wave sleep, 237, 237f, 238t Slow waves, 290, 290f Slowly adapting receptors, 194, 194f Small intestine, 534f, 538, 539t, 540, 547t, 559–60, 560f Smell, 227–28, 227f Smoking, of tobacco chronic obstructive pulmonary disease, 459, 481 heart disease, 426, 576 hypertension, 422 pregnancy, 640 protective respiratory reflexes, 479 psychological effects of, 184 Smooth endoplasmic reticulum, 54, 54f Smooth muscle characteristics of, 294t contraction, 286–92, 294–95, 392 defined, 258, 258f endothelial cells, 395 lymphatic vessels, 404–5 myogenic responses, 393 structure of, 286–87, 294 types of, 291–92 Smooth muscle cells, Smooth muscle tone, 289 SNARE proteins, 162, 167 Sneeze reflex, 479 Sodium active transport, 103–5, 104f–5f digestion and absorption, 545 filtration and reabsorption in kidney, 500t homeostasis, 7, 14, 14f ions, 23, 23t, 99 NA1/K1-ATPase pump, 104–5, 105f–6f, 109, 113–14, 114f renal processes for water and, 506–13, 522 renal regulation of, 513–16, 522 resting membrane potential, 146–50, 147f–50f thirst and salt appetite, 518–19, 519f, 522 total-body balance of water and, 506, 506t, 522 I-18 Sodium-glucose cotransporter (SGLT), 541 Solutes, 27 Solutions, 27–30, 41, 109, 110 See also Concentrations Solvent, 27 Soma, 139 Somatic motor neurons, 180 Somatic nervous system, 179, 179f, 179t Somatic receptors, 199, 203 Somatic sensation, 203–7, 228 Somatosensory cortex, 199, 199f, 308, 309f Somatosensory system, 206–7 Somatostatin (SS), 551 Somatostatin (SST), 322t, 337 Somatotopic map, 308, 309f Somatotropin, 323t, 335 Sound, and hearing, 217–21, 219f–21f, 223t Sound waves, 220, 220f, 222 Spasms, 313 Spasticity, 312 Spatial summation, 164 Specific ascending pathways, 199, 200f Specific immune response See Adaptive immune response Specificity, of receptors, 121–22, 122f, 122t Spectrum, and light, 207, 208f Sperm, 605, 615f, 617f, 619–20, 623, 636f, 648 Spermatic cord, 616 Spermatids, 607, 617 Spermatogenesis, 615, 616–18, 617f–18f, 618t, 623 Spermatogonia, 616 Spermatozoa, 605 Sphincter, 560 Sphincter muscles, 548 Sphincter of Oddi, 547t, 559 Sphygmomanometer, 390–91, 390f Spinal cord, 174f, 176f, 177–78, 177f, 179f, 186 Spinal injuries, and neural regeneration, 144 Spinal nerve, 177f, 178, 179f Spironolactone, 521 Spleen, 396t, 663 Spliceosome, 61, 61f Splicing, of RNA, 61, 61f, 65t Split-brain, 252 Spontaneous electrical activity, 290, 290f Squamous epithelial cells, SRY gene, 608, 609f, 611f Stabilization, of inhibitory chemical synapses, 163 Stable balance, 14, 452–54 Stapedius, 220 Stapes, 219f–20f, 220 Starch, 541 Starling forces, 400 Starvation, and metabolism, 591 Statins, 93, 426 Steady state, Steatorrhea, 564 Stem cell(s), 143, 144, 637 Stem cell factor, 432t Stenosis, 381 Stents, 425f, 427 Stereocilia, 221, 221f–22f Steroid(s), 34, 34f Steroid hormone(s), 324–27, 324f–26f, 327t, 329 Steroid hormone receptor superfamily, 124 Stethoscope, 390 Stimulation-produced analgesia, 206 Stimulus, 10, 10f, 11f, 192 Stimulus intensity, 195, 195f Stimulus location, 195–97, 196f–97f Stimulus processing, 201t Stimulus type, 195 Stomach autonomic nervous system, 183t functions of, 534f, 538, 539t gastrointestinal hormones, 547t regulation of gastrointestinal processes, 550–55 Stop codon, 63 “Stop” signals, 59, 60f Stratified epithelium, Strength training, 280, 281 Stress blood pressure, 413 cancer, 678 depression, 246 endocrine system, 344–49 energy homeostasis in exercise and, 584–85, 586 immune system, 678 infection, 678 metabolic rate, 587t ulcers, 562 Stress incontinence, 504 Stretch reflex, 304–6, 306f Striated muscle, 258, 258f Strictures, 569 Stroke, 184, 243, 421 Stroke volume (SV) cardiac output, 382 control of, 382–85 defined, 378 exercise, 418, 418f, 420t heart failure, 423 pulse pressure, 389 Strong acids, 29 Strychnine, 171 Subarachnoid space, 184, 185f Subcortical nuclei, 175, 310 Subdural hematoma, 254 Submucosa, 535, 536f Submucosal plexus, 535, 536f Substance dependence, 247–48, 248t Substance P, 172 Substantia nigra, 310 Substrate concentration, 76 Substrate-level phosphorylation, 80 Substrates, 75, 75f Subthreshold potential, 155, 155f Subthreshold stimuli, 155, 155f Succinylcholine, 264 Sucrose, 31, 31f Sulcus, 175, 176f Sulfasalazine, 569 Sulfonylureas, 599 Summation of graded potentials, 152 of muscle tension, 272 spatial, 164 synaptic integration, 164 temporal, 164 “Superfamilies,” of hormone receptors, 121 Superior vena cava, 364, 368f Superoxide anion, 27 Supersensitivity, of receptors, 122t Supplementary motor cortex, 308, 309f Suprachiasmatic nucleus, 215 Surface defenses, 656 Surface tension, 456 Surfactant, 456–57, 458t Swallowing, 548–50, 549f Swallowing center, 548 Sweat glands, 595 Sweating, 518, 518f, 595, 596, 703–6, 707 Swimming, 420, 479 Sylvian fissure, 251, 251f Sympathetic division, of autonomic nervous system, 180, 181f, 183t Sympathetic nervous system arterioles, 394–95 cardiac output, 383–84, 383f, 385t drugs and, 422t epinephrine and, 583 stress, 348, 348t Index wid78305_idx_I1-I20.indd 18 20/02/13 5:10 PM Revised Pages Sympathetic trunks, 180, 181f Symport, 106 Synapses, 142, 160–61, 172 Synaptic cleft, 161, 161f Synaptic delay, 162 Synaptic integration, 163–65, 173 Synaptic potential, 151t, 158 Synaptic strength, 165–67, 167t, 173 Synaptic vesicles, 161, 161f Synaptotagmins, 162 Synchronicity, of EEG patterns, 235 Syncope, 231 Synergistic muscles, 306 Systemic arterial pressure, 390–91, 390f, 407–15 Systemic circulation, 364 Systemic inflammatory response, 701 Systemic lupus erythematosus (SLE), 689, 690f Systole and systolic pressure (SP), 377, 377f, 378, 380, 389, 389f Systolic dysfunction, 423, 423f Table sugar, 31, 31f Tachycardia, 693 Tachypnea, 693 Tacrolimus, 569 Tadalafil, 394, 619 Tamoxifen, 648 Target cells, 12, 12f Taste, 226–27 Taste buds, 226, 226f Taste receptors, 226f T cell(s) defined, 685t functions of, 655t, 664–66 lymphocyte origins, 663 role in immune defenses, 653 role in immune responses, 666f T cell receptors, 668 Tectorial membrane, 221, 221f Temperature homeostasis, 7–8, 17–18 rate of chemical reactions, 74 reflex, 11f regulation of, 592–95 sensory system, 204 Template strand, 60, 60f Temporal lobes, 174f, 175, 251f Temporal summation, 164 Tendons, 260 Tension-monitoring systems, 306–7, 307f Tension, muscle, 269, 278–79 Tensor tympani muscle, 220 Teratogen, 640 Terminal bronchioles, 447 Terminal cisternae, 261, 262f Tertiary protein structure, 37, 37f Testes, 322t, 605, 615f, 620–21 Testicular feminization, 608 Testosterone adrenal cortex, 326 erythropoietin, 430 growth and development, 352, 352t major functions of, 322t major sex hormones, 605 male reproductive functions, 621, 621t Tetanic contraction, 273 Tetanospasmin, 316 Tetanus (disease), 167, 316 Tetanus immune globulin (TIG), 316 Tetanus (muscle contraction), 273 Tetanus toxin, 167 Tetany, 282–83, 357 Tetrodotoxin, 156 Thalamus, 175, 175t, 176, 176f, 206f, 242, 302f Theca, 626 Therapy See also Drugs for abdominal pain, fever, and circulatory system, 702–3 for chest pain after airplane flight, 699 for nausea, flushing, and sweating, 706 for palpitations and heat intolerance, 696–97 Thermal motion, 97, 97f Thermodynamics, first law of, 587 Thermoneutral zone, 595 Thermoreceptors, 191, 204 Thermoregulatory system, 7, Theta rhythm, 236 Thiamine, 91t Thick filaments, 260, 267, 267f Thin filaments, 260, 267, 267f Third-order neurons, 198 Third ventricle, 176f Thirst pregnancy, 642t and salt appetite, 518–19, 519f, 522 Thoracic duct, 537 Thoracic nerves, 179f Thoracolumbar division, 180 Thorax, 450, 454, 454f Threshold potential, 151t, 153, 155f Threshold stimuli, 155, 155f Thrifty genes, 591 Thrombin, 435, 436f, 437, 437t–38t Thrombocytopenia, 690 Thrombolytic therapy, 439 Thrombomodulin, 437 Thrombopoietin, 432t Thromboxanes, 131, 132f, 433 Thrombus, 434, 698 Thymectomy, 284 Thymine, 38, 39, 39f, 40, 40f Thymopoietin, 323t Thymus, 323t, 663 Thyroglobulin, 340 Thyroid disease, 696 Thyroid gland, 696 Thyroid hormone, 696 Thyroid hormones basal metabolic rate, 587t, 588 functions of, 323t growth, 352, 352t mechanisms of action, 327t, 329 structure and synthesis, 321, 340–44 Thyroid peroxidase, 340 Thyroid-stimulating hormone (TSH) anterior pituitary, 335, 336f functions of, 323t, 341, 342f Graves’ disease, 695, 696 Thyroid-stimulating immunoglobulins (TSIs), 695 Thyrotoxicosis, 343, 694 Thyrotropin, 323t, 335 Thyrotropin-releasing hormone (TRH), 322t, 337, 695 Thyroxine (T4) functions of, 323t, 341 Graves’ disease, 695–96 metabolic actions of, 341, 342f synthesis of, 340, 341f–42f Tidal volume, 459, 461, 474–78 Tight junction, 3–4, 4f, 51, 52f Tinnitus, 222 Tip links, 221, 222f Tissue(s) gas exchange between blood and, 467, 483 organization of body, 2, 3–4 transport of hydrogen ions between lungs and, 472–73, 472f, 484 Tissue factor, 435–36 Tissue factor pathway inhibitor (TFPI), 437 Tissue injury See also Injury arterioles, 393 inflammation and repair of, 660 Tissue plasminogen activator (t-PA), 438, 438t Titin, 260 T lymphocytes, 653, 663 Tobacco, 168, 184, 185, 248t Tolerance, and substance dependence, 247–48 Toll-like receptors (TLRs), 661–62 Tolterodine, 504 Tonsils, 663 Total-blood carbon dioxide, 472 Total body balance of energy and temperature, 587–97, 597 of sodium and water, 506, 506t, 522 Total energy expenditure, 587 Total peripheral resistance (TPR) cardiac output, 410 defined, 407 exercise, 418f, 420t intracranial pressure, 414 Totipotent, 637 Touch, and sensory system, 203 Toxemia of pregnancy, 641 Toxins, and antibody-mediated immune responses, 671–74 Trace elements, 21t, 23 Trace metal, 76 Trachea, 447 Tract, and nervous system, 174 Trans fatty acids, 32 Transamination, 89, 89f Transcellular epithelial transport, 501 Transcellular pathway, 113 Transcription amount and activity of cell proteins, 65t defined, 58, 59f plasma membrane receptors, 134 protein synthesis, 59–61, 60f, 64t Transcription factors, 63–64, 65f, 124 Transcutaneous electrical nerve stimulation (TENS), 206 Transcutaneous oxygen monitor, 703 Transducin, 212 Transfer RNA (tRNA), 61–62, 62f Transferrin, 430 Transfusion reactions, 680–81, 681t Transient ischemic attacks (TIAs), 427 Transient receptor potential (TRP) proteins, 204 Translation, 58, 59f, 61–63, 61f, 64t, 65t Transmembrane potential, 151t Transmembrane proteins, 50, 50f, 121 Transmural pressure, 452, 453t Transplantation, kidney, 530–31 Transport maximum, 501, 501f Transporters, 101, 102, 102f Transpulmonary pressure, 452, 453, 455, 455f Transverse tubule (T-tubule), 261, 262f Trauma See also Injury head, 252–53 Traveler’s diarrhea, 565 Triamterene, 521 Tricarboxylic acid cycle, 81 Tricuspid valve, 368, 368f–69f Tricyclic antidepressant drugs, 246 Trigeminal nerves, 178t Trigger zone, of neuron, 139 Triglycerides, 32, 33f, 34, 87, 577 Triiodothyronine (T3), 323t, 340, 341f–42f, 342–43, 694 Triplet code, 59, 64 Trochlear nerves, 178t Trophoblast, 637, 638f, 680 Tropic hormones, 330–31 Tropomyosin, 260, 265, 265f, 270t Troponin, 131, 260, 265, 265f, 270t Index wid78305_idx_I1-I20.indd 19 I-19 20/02/13 5:10 PM Revised Pages Trypsin, 541, 556, 557t Trypsinogen, 556 Tryptophan, 62, 62f, 170 T-type calcium channels, 373 Tuberculosis, 347 Tubular reabsorption, 496, 496f, 500–501, 500t, 505 Tubular secretion, 496, 496f, 501–2, 503, 505 Tubule, of kidney, 492, 493f, 502 Tubulin, 56f, 57 Tumor necrosis factor-alpha (TNF-a), 656t, 669, 685t T wave, 365 Twins, 591, 627, 637 Twitch contractions, 270–72, 271f Tympanic membrane, 218, 219f–20f Type I and type II alveolar cells, 448 Type I interferons, 656t, 660–61, 661f Type I (T1DM) diabetes mellitus, 103, 598–600, 683 Type II interferons, 656t, 661 Type II (T2DM) diabetes mellitus, 331, 598–600 Tyrosine, 169, 169f Ubiquitin, 65 Ulcer(s), 562, 563f Ulcerative colitis, 569 Ultrafiltrate, 496 Ultrafiltration, 400 Umami, 226 Umbilical arteries, 639 Umbilical cord, 639 Umbilical vein, 639 Unfused tetanus, 273, 273f Unsaturated fatty acids, 32, 33f Up-regulation, of receptors, 122t, 123, 328 Upper airways, 447 Upper esophageal sphincter, 548, 549f Upper motor neuron disorders, 312 Upper motor neurons, 312 Upright posture, 313, 313f–14f, 315, 417–18, 417f, 427 Uracil, 39f, 40 Urbach-Wiethe disease, 245 Urea, 89, 491, 500, 500t, 511–12 Uremia, 529 Ureters, 492, 492f, 496f Urethra, 492, 492f, 616f Urge incontinence, 504 Uric acid, 491 Urinary system autonomic nervous system, 183t concentration of urine, 509–11 primary functions of, 5t structure of, 492–94, 492f, 504–5 Urine concentration of, 509–11 control of urine volume and osmolarity, 512–13, 512f in nephron structure, 493f protein in and kidney disease, 529 Uterus, 183t, 624, 625f, 632–33, 633f, 640f, 643f, 644, 645t, 649 Utricle, 223, 223f, 224–25 Vaccine, 674, 679 Vagina, 624, 625f Vagus nerves, 178t Valium, 171, 239 Valsalva maneuver, 562 Van der Waals forces, 37, 38f Vardenafil, 619 Varicosities, 140, 290, 290f Vas deferens, 615–16, 615f–16f I-20 Vasa recta, 493f, 494, 511f Vascular system arteries, 387–91, 405 arterioles, 391–95, 406 capillaries, 395–402, 406 lymphatic system, 404–5, 406 overview of, 367t veins, 402–3, 406 Vasectomy, 619 Vasoconstriction, 392, 395, 466 Vasodilation, 392, 394, 418, 657–58 Vasodilator drugs, 424t Vasopressin arteriolar constriction, 394 baroreceptor control of secretion, 517–18, 517f control of urine volume and osmolarity, 512–13, 512f functions of, 323t, 334, 335 learning and memory, 250 osmoreceptor control of secretion, 516–17, 517f stress, 348 water reabsorption, 508, 508f, 510 Vasovagal syncope, 416 Vault(s), 56 Vault RNA (vRNA), 56 Vecuronium, 264 Veins autonomic nervous system, 183t defined, 364, 367t vascular system, 402–3, 406 Velocity of capillary blood flow, 398, 398f of muscle shortening, 279 Venous pressure, 402–3, 403f–4f Venous return, 383, 419 Ventilation control by respiratory rate, tidal volume, and hydrogen ion concentration, 474–78 control of during exercise, 478–79, 480f lung mechanics, 450–61, 483 matching with blood flow in alveoli, 466 Ventilation-perfusion inequality/abnormalities, 466, 466f, 481, 481t Ventilation-perfusion scan, 698 Ventral horns, 177, 177f Ventral respiratory group (VRG), 473 Ventral roots, 177f, 178 Ventricles, 364, 367t Ventricular ejection, 378 Ventricular excitation, 371f Ventricular fibrillation, 425 Ventricular filling, 378, 380 Ventricular-function curve, 382 Ventricular muscle, 385t Ventricular relaxation, 371f Venules, 364, 367t Verbal memory, 252 Vertigo, 231 Very-low-density lipoproteins (VLDLs), 574 Vesicle transport, 398–99 Vestibular apparatus, 223 Vestibular information, 225 Vestibular system, 223–25, 229 Vestibulocochlear nerves, 178t, 221f, 222 Viagra, 394, 619 Villi, 536, 537f Virilism, 634 Virilization, of XX fetus, 608 Viruses, 653, 671–74, 677t neutralization of bacterial toxins and, 673–74 Visceral pain, 205, 205f Visceral pleura, 450 Viscosity, 366 Visible spectrum, 207 Vision, and sensory system, 207–17, 228–29 Visual cortex, 199, 199f Vital capacity (VC), 459 Vitamin(s), 76, 91, 91t, 544–45 Vitamin A, 91, 544 Vitamin B, 91, 426 Vitamin B complex, 91 Vitamin B12, 430, 545 Vitamin C, 501 Vitamin D, 91, 355–56, 356f, 357, 544 Vitamin D2, 355 Vitamin D3, 355–56 Vitamin E, 91, 544 Vitamin K, 91, 436, 544, 561 Vitreous humor, 208, 209f Vocal cords, 447 Voltage-gated ion channels, 101, 153, 153f Voltmeter, 146f Voluntary control, of breathing, 479 Voluntary movement, 302–3 Vomiting, 562–64 Vomiting center, 562 von Willebrand factor (vWF), 433 Vulva, 624 Waking state, of consciousness, 236, 236f Walking, and body movement, 313–15 Water body fluids, 5, 6f capillaries, 400 chemical properties of, 27–28 chemical reactions, 73, 74 digestion and absorption, 545 essential nutrients, 90, 91t filtration and reabsorption in kidney, 500t molecules, 24, 25, 26f, 98 osmosis, 107, 107–9, 108f–9f, 114, 114f, 115 renal processes for sodium and, 506–13, 522 renal regulation, 516–18, 522 surface tension, 456 total-body balance of sodium and, 506, 506t, 522 Water diuresis, 508 Water-filled channels, 398 Water soluble messengers, 124, 125, 125t, 126f Water-soluble vitamins, 91, 91t, 545 Waveforms, 235 Wavelength, 207, 208f, 216, 216f Weak acids, 29 Weight lifting, 276, 280–81, 420 Weight loss, 589, 591 Wernicke’s area, 251, 251f White matter, 175, 176f White muscle fibers, 277 Whole-muscle contraction, 278–82, 285 “Wiggers” diagram, 379f Withdrawal, and substance dependence, 247–48, 248t Withdrawal reflex, 307, 308f Wolffian ducts, 608, 609f Working memory, 249 Xanax, 171, 239 X chromosome, 283, 607, 622 XX fetus, 608 XXY genotype, 622 Xylocaine, 155 Y chromosome, 607 Z line, 260 Zoloft, 246 Zona pellucida, 626, 627f Zonular fibers, 208, 209f–10f Zygote, 607, 637 Zymogens, 553, 556 Index wid78305_idx_I1-I20.indd 20 20/02/13 5:10 PM Traditional units SI units Glucose 70–110 mg/dL 4–6 mmol/L FFA 72–240 mg/dL 0.3–1.0 mmol/L Triglycerides