Essentials of Human Physiology and Pathophysiology for Pharmacy and Allied Health

Cover......Page 1
Half Title......Page 2
Title Page......Page 4
Preface — page 26
Authors — page 28
Chapter 1: The cell — page 30
1 1 1 Structure and function of the plasma membrane Page 31
1 1 2 Membrane transport — page 35
1 2 Membrane — page 40
1 2 1 Development of the resting membrane potential — page 41
1 3 1 Graded potentials — page 44
1 3 2 Action potentials — page 46
1 3 3 Conduction of the action potential — page 49
1 4 1 Chemical synapses — page 55
1 4 2 Summation — page 59
1 4 3 Interconnections between neurons — page 61
1 4 4 1 Altered release of a neurotransmitter — page 62
1 4 4 2 Altered interaction of a neurotransmitter with its receptor — page 63
1 5 Cell injury — page 64
1 5 1 Cellular adaptation — page 65
1 5 2 Mechanisms of cell injury — page 67
1 5 3 Manifestations of cellular injury — page 69
1 5 4 Cell death — page 70
1 5 5 Tissue repair — page 72
1 5 6 Steps in tissue (wound) repair — page 73
Medical terminology — page 76
Bibliography — page 78

2 1 Homeostasis — page 80
2 1 1 Negative feedback Page 83
2 1 2 Positive feedback
— page 84
Medical terminology
— page 85
Bibliography — page 86

3 1 Overview of immune function — page 88
3 1 1 Agents of infectious disease — page 89
3 1 3 Immune responses — page 91
3 1 4 Innate immune system — page 92
3 1 5 Adaptive immune system — page 94
3 1 5 1 Classification of antibodies — page 95
3 1 5 2 Structure of antibodies — page 96
3 1 5 3 Actions of antibodies — page 97
3 1 5 4 Clonal selection theory — page 99
3 1 5 5 Primary versus secondary responses — page 100
3 1 5 6 Active versus passive immunity — page 101
3 1 5 7 Types of T cells — page 103
3 1 5 8 Actions of T cells — page 104
3 1 5 9 MHC molecules — page 106
3 2 1 1 Type I hypersensitivity reaction — page 107
3 2 1 2 Type II hypersensitivity reaction — page 109
3 2 1 4 Type IV hypersensitivity reaction — page 112
3 2 2 Autoimmune disease — page 113
Medical terminology — page 114
Bibliography — page 116

Chapter 4: Inflammation — page 118
4 1 1 Histamine and mast cells — page 124

Chapter 5: Blood and hemostasis — page 128
5 1 1 Plasma
— page 129
5 1 2 Erythrocytes — page 130
5 1 3 Leukocytes — page 134
5 1 4 Platelets — page 136
5 2 Hemostasis — page 137
5 3 1 2 von Willebrand disease — page 143
5 3 2 1 Thrombocytopenia — page 144
5 3 3 Conditions leading to increased blood coagulation (hypercoagulability) — page 145
5 3 4 2 Treatment of DIC — page 146
5 4 1 Hematopoiesis
— page 147
5 4 2 1 General manifestations of anemia — page 148
5 4 3 2 Blood loss anemia — page 149
5 4 4 1 Sickle cell disease — page 150
5 4 4 2 Thalassemia — page 154
5 4 4 4 Aplastic anemia — page 155
5 4 4 5 Polycythemia — page 156
Bibliography — page 157

Chapter 6: The circulatory system — page 160
6 1 Blood vessels — page 162
6 2 Blood pressure — page 166
6 3 Blood flow — page 168
6 4 Regulation of arterial pressure — page 170
6 4 1 Vasomotor center — page 174
6 4 2 Baroreceptors — page 175
6 4 3 Chemoreceptors — page 177
6 4 4 Low-pressure receptors — page 178
6 4 5 Vasoconstrictors — page 179
6 4 6 Vasodilators — page 183
6 5 Venous regulation — page 184
6 5 1 Blood volume — page 186
6 5 4 Respiratory activity — page 187
6 6 Effects of gravity on the circulation — page 188
6 7 1 Active hyperemia — page 189
6 8 Effects of acute exercise on the circulatory system — page 190
6 9 Capillary exchange — page 192
6 10 1 Arterial disease — page 197
6 10 2 Atherosclerosis and dyslipidemia — page 198
6 10 3 Inflammatory disease of arteries — page 202
6 10 4 1 Clinical manifestations of aneurysm — page 204
6 10 5 1 Venous thrombosis — page 205
6 10 5 3 Anticoagulant and thrombolytic drug therapy — page 208
6 11 Disorders of blood pressure — page 209
6 11 1 Primary (Essential) hypertension — page 210
6 11 2 Secondary hypertension — page 211
6 11 4 Hypertension in pregnancy — page 212
6 11 5 Effects of chronic hypertension — page 213
6 11 6 Diagnosis and treatment of essential hypertension — page 214
6 11 7 Treatment of hypertension — page 215
6 11 8 1 Manifestations of hypotension — page 216
6 12 1 Hypovolemic shock — page 217
6 12 1 1 Physiologic responses to hypovolemic shock — page 218
6 12 1 3 Treatment of hypovolemic shock — page 219
6 12 2 2 Treatment of distributive shock — page 220
6 12 3 Cardiogenic shock — page 222
6 12 4 Complications of shock — page 223
Medical terminology — page 224
Bibliography — page 225
Chapter 7: The heart — page 228

7 1 Functional anatomy of the heart — page 231
7 1 1 Myocardial wall — page 234
7 2 Electrical activity of the heart — page 238
7 3 Electrocardiogram — page 244
7 4 Cardiac cycle — page 247
7 4 2 Isovolumetric contraction — page 248
7 4 4 Isovolumetric relaxation — page 250
7 5 Cardiac output — page 251
7 6 Control of heart rate — page 253
7 7 Control of stroke volume — page 256
7 8 Effect of exercise on cardiac output — page 261
7 9 1 1 Disorders of the pericardium — page 262
7 9 2 1 Myocarditis — page 264
7 9 2 2 Cardiomyopathies — page 265
7 9 3 1 Infectious endocarditis — page 268
7 9 3 2 Rheumatic heart disease — page 269
7 9 4 Disorders of the heart valves — page 270
7 9 4 1 Mitral valve prolapse — page 272
7 9 4 2 Congenital heart defects — page 274
7 10 Myocardial ischemia — page 275
7 10 1 Manifestations of myocardial ischemia — page 276
7 10 2 1 Rational for treatment of myocardial ischemia — page 277
7 10 2 2 Treatment of myocardial ischemia — page 278
7 11 1 Coronary blood flow and myocardial infarction — page 279
7 11 3 Compensatory mechanisms for myocardial infarction — page 281
7 11 5 Rationale for therapy — page 283
7 11 5 1 Treatment for myocardial infarction — page 284
7 12 1 Classification of heart failure — page 285
7 12 2 1 Manifestations of left-heart failure — page 286
7 12 3 Right heart failure — page 287
7 12 4 Physiologic compensation for heart failure — page 288
7 12 5 Diagnosis of heart failure — page 293
7 12 6 Rationale for treatment of heart failure — page 294
7 13 Cardiac arrhythmia — page 295
7 13 3 Mechanisms of cardiac arrhythmia — page 296
7 13 4 Types of arrhythmia — page 298
7 13 4 2 Atrial arrhythmia — page 299
7 13 4 3 Ventricular arrhythmia — page 300
7 13 5 2 Second-degree heart block — page 301
7 13 7 Rationale for the treatment of cardiac arrhythmia — page 302
7 13 8 1 Pharmacologic — page 303
Medical terminology — page 304
Bibliography — page 306

Chapter 8: The respiratory system — page 308
8 1 Blood-gas interface — page 310
8 2 1 Cartilage — page 311
8 2 2 Epithelium — page 312
8 4 2 Inspiration — page 313
8 4 4 Lung volume — page 314
8 4 5 Pulmonary pressures Page 315
8 6 Airway resistance — page 322
8 6 2 Airway obstruction — page 323
8 6 3 Bronchial smooth muscle tone — page 324
8 7 1 Standard lung volumes — page 326
8 7 3 Alveolar ventilation — page 329
8 7 4 Dead space — page 330
8 8 Diffusion — page 331
8 9 Partial pressures — page 333
8 10 1 Transport of oxygen — page 338
8 10 2 Factors affecting the transport of oxygen — page 341
8 10 3 Transport of carbon dioxide — page 343
8 11 Regulation of ventilation — page 344
8 11 1 Chemoreceptor response to decreased arterial PO2 — page 348
8 11 2 Chemoreceptor response to increased arterial PCO2 — page 349
8 12 Ventilatory response to exercise — page 350
8 13 Disorders of the respiratory system — page 351
8 13 1 1 Infections of the upper respiratory tract — page 352
8 13 1 2 Infections of the lower respiratory tract — page 355
8 13 2 2 Lung cancer — page 360
8 13 3 Obstructive and restrictive pulmonary disorders — page 361
8 13 4 1 Asthma — page 362
8 13 5 1 Bronchitis — page 366
8 13 5 2 Emphysema — page 367
8 13 6 1 Manifestations of cystic fibrosis — page 371
8 13 6 3 Treatment of cystic fibrosis — page 372
8 13 7 2 Pneumothorax — page 373
8 13 7 3 Atelectasis — page 375
8 13 7 4 Bronchiectasis — page 376
8 13 8 Acute respiratory distress syndrome — page 377
8 13 9 Respiratory distress syndrome of the newborn — page 378
8 13 10 1 Manifestations of interstitial lung disease — page 379
8 13 11 1 Manifestations of respiratory failure — page 380
Medical terminology — page 381
Bibliography — page 383

Chapter 9: The digestive system — page 384
9 1 1 Mucosa — page 386
9 1 3 Muscularis externa — page 387
9 1 4 Serosa — page 388
9 2 1 Intrinsic nerve plexuses — page 389
9 2 3 Gastrointestinal hormones — page 390
9 3 Mouth — page 392
9 4 Pharynx — page 394
9 6 Stomach — page 395
9 6 1 Gastric motility — page 396
9 6 2 Gastric secretion — page 398
9 7 Liver — page 402
9 8 Gallbladder — page 404
9 10 Transport of bile and pancreatic juice — page 405
9 11 Small intestine — page 406
9 11 3 Carbohydrates — page 407
9 11 4 Proteins — page 409
9 11 5 Lipids — page 410
9 12 Large intestine — page 411
9 12 1 Motility of the large intestine — page 412
9 13 1 1 Swallowing disorders—dysphagia — page 413
9 13 1 2 Manifestations of GERD — page 414
9 13 2 1 Gastritis — page 416
9 13 2 2 Peptic ulcers — page 417
9 13 3 2 Inflammatory bowel disease — page 419
9 13 4 2 Constipation — page 425
9 13 4 3 Intestinal malabsorption — page 426
9 14 Hepatobiliary disorders — page 427
9 14 2 1 Viral hepatitis — page 428
9 14 3 Alcoholic liver disease — page 431
9 14 4 1 Manifestations of cirrhosis and liver failure — page 432
9 14 5 Liver cancer — page 434
9 14 6 1 Gallstone formation (Cholelithiasis) — page 435
9 14 7 1 Pancreatitis — page 436
9 14 7 2 Pancreatic cancer — page 437
Medical terminology — page 438
Bibliography — page 439

Chapter 10: The renal system — page 442
10 1 Functional anatomy of the kidneys — page 444
10 1 1 Vascular component — page 446
10 1 2 Tubular component — page 447
10 2 Basic renal processes — page 448
10 3 1 Filtration barrier — page 449
10 3 2 Determinants of filtration — page 450
10 4 Tubular reabsorption — page 452
10 4 1 Sodium reabsorption — page 454
10 4 3 Water reabsorption — page 456
10 4 4 Production of urine of varying concentrations — page 457
10 5 Plasma clearance — page 463
10 6 Renal blood flow — page 465
10 6 2 Myogenic mechanism — page 466
10 6 3 Tubuloglomerular feedback — page 467
10 6 5 Sympathetic nerves — page 468
10 6 6 Angiotensin II — page 470
10 6 7 Prostaglandins — page 471
10 7 Control of sodium excretion — page 472
10 8 Control of water excretion — page 474
10 9 1 Evaluation of renal function — page 477
10 9 2 3 IgA nephropathy (Berger’s disease) — page 478
10 9 3 Nephrotic syndrome — page 479
10 9 5 1 Manifestations of urinary tract infection — page 480
10 9 6 1 Manifestations of renal calculi — page 481
10 9 7 2 Treatment of renal tumors — page 482
10 9 9 Renal failure — page 483
10 9 10 Chronic renal failure — page 484
10 9 10 2 Treatment of renal failure — page 485
10 10 1 Urine reflux — page 488
10 10 2 Neurogenic bladder — page 489
Medical terminology — page 490
Bibliography — page 491

Chapter 11: The endocrine system — page 494
11 1 Biochemical classification of hormones — page 496
11 2 Transport of hormones — page 498
11 3 Functional classification of hormones — page 499
11 5 Mechanisms of hormone action — page 500
11 6 The pituitary gland — page 505
11 7 Relationship between the hypothalamus and the pituitary gland — page 506
11 9 1 Antidiuretic hormone — page 508
11 9 2 Oxytocin — page 511
11 10 1 Gonadotropins — page 512
11 10 4 Prolactin — page 513
11 10 5 Growth hormone (GH) — page 514
11 11 1 Thyroid hormones — page 515
11 12 Parathyroid glands — page 518
11 13 3 Mineralocorticoids — page 520
11 13 4 Glucocorticoids — page 522
11 14 Pancreas — page 524
11 14 1 Insulin — page 525
11 14 2 Glucagon — page 526
11 15 1 Abnormalities of the hypothalamus/pituitary glands — page 527
11 15 2 1 Alterations of growth hormone secretion — page 528
11 15 3 2 Diabetes insipidus — page 531
11 15 4 1 Tests of thyroid function — page 532
11 15 4 2 Hypothyroidism — page 533
11 15 4 3 Hyperthyroidism — page 535
11 15 5 1 Hyposecretion of adrenal hormones — page 536
11 16 Diabetes — page 541
11 16 1 The endocrine pancreas — page 542
11 16 2 1 Types of diabetes — page 543
11 16 2 2 Type 1 diabetes — page 545
11 16 3 Long-term complications of diabetes — page 547
11 16 3 1 Diabetic neuropathy — page 548
11 16 3 2 Diabetic nephropathy — page 549
11 16 3 5 Impaired healing and increased infections risk — page 550
Medical terminology — page 551
Bibliography — page 553

Chapter 12: The reproductive system — page 556
12 1 2 Oogenesis — page 557
12 2 2 Epididymides — page 558
12 2 7 Seminal vesicles — page 559
12 2 8 Bulbourethral glands — page 560
12 3 1 Ovaries — page 561
12 3 4 Vagina — page 562
12 3 5 Follicular phase — page 563
12 3 7 Hormonal regulation of the ovarian cycle — page 564
12 4 1 2 Priapism — page 568
12 4 2 3 Testicular cancer — page 569
12 4 3 2 Benign prostatic hyperplasia (BPH) — page 570
12 4 3 3 Prostate cancer — page 572
12 5 1 2 Cervical lesions and cervical cancer — page 573
12 5 1 3 Endometriosis — page 574
12 5 1 4 Endometrial (Uterine) cancer — page 575
12 5 2 1 Polycystic ovary syndrome — page 576
12 5 2 2 Ovarian cancer — page 577
12 5 3 2 Dysmenorrhea — page 578
12 5 4 1 Mastitis — page 579
12 5 5 1 Risk factors for breast cancer — page 580
12 6 Sexually transmitted diseases — page 581
12 6 2 1 Bacterial STDs — page 582
12 6 2 3 Other STDs — page 583
Medical terminology — page 584
Bibliography — page 585

Chapter 13: The nervous system — page 588
13 1 Neurons — page 590
13 2 Level of CNS function — page 591
13 3 The brain — page 592
13 4 Blood-brain barrier — page 607
13 5 Cerebrospinal fluid — page 609
13 6 The spinal cord — page 610
13 6 1 1 Composition of the spinal cord — page 612
13 6 1 2 Ascending tracts — page 615
13 6 1 3 Descending tracts — page 616
13 6 2 Spinal reflexes — page 619
13 6 2 1 Withdrawal reflex — page 620
13 7 1 1 Brain injury — page 622
13 7 1 3 Intracranial hematoma — page 623
13 7 1 6 Treatment of increased ICP — page 625
13 7 1 9 Manifestations of cerebral ischemia or hypoxia — page 626
13 7 2 Stroke — page 627
13 7 2 1 Symptoms of stroke — page 628
13 7 3 CNS infections — page 629
13 7 4 CNS tumors — page 631
13 7 4 2 Manifestations of CNS tumors — page 632
13 7 5 3 Focal seizures — page 633
13 7 5 4 Generalized seizures — page 634
13 7 5 5 Diagnosis of seizure disorders — page 635
13 7 6 1 Primary headaches — page 636
13 7 7 1 Parkinson’s disease — page 637
13 7 7 2 Alzheimer’s disease — page 640
13 7 7 3 Huntington’s disease — page 644
13 7 7 4 Amyotrophic lateral sclerosis — page 645
13 7 7 5 Multiple sclerosis — page 646
13 7 8 Spinal injury — page 647
Medical terminology — page 648
Bibliography — page 650

Chapter 14: The autonomic nervous system — page 652
14 1 Regulation — page 653
14 2 Pathways — page 654
14 3 Divisions — page 655
14 4 Neurotransmission — page 659
14 5 Receptors — page 662
14 6 Functions — page 665
Medical terminology — page 670
Bibliography — page 671

Chapter 15: Pain — page 674
15 1 Nociceptors — page 675
15 2 Hyperalgesia — page 677
15 4 Pain pathways — page 678
15 5 2 Muscle spasm — page 683
15 5 4 Referred pain — page 684
15 6 1 Nonnarcotic analgesics — page 686
15 6 2 Opioid analgesics — page 687
Bibliography — page 688

Chapter 16: Muscle — page 690
16 1 1 Structure of smooth muscle — page 691
16 1 2 Calcium and the mechanism of contraction — page 693
16 1 3 Smooth muscle contraction is slow and prolonged — page 694
16 1 4 Types of smooth muscle — page 695
16 1 5 Factors influencing the contractile activity of smooth muscle — page 697
16 1 6 Length–tension relationship — page 698
16 2 Skeletal muscle — page 699
16 2 1 Muscle tension and movement — page 700
16 2 2 Structure of skeletal muscle — page 701
16 2 2 2 Thick filaments — page 702
16 2 3 Neuromuscular junction — page 704
16 2 4 Mechanism of contraction — page 705
16 2 4 1 Sources of ATP for muscle contraction — page 709
16 2 5 Muscle fatigue — page 710
16 2 7 Types of muscle fibers — page 711
16 2 8 Muscle mechanics — page 713
16 2 8 1 Number of muscle fibers contracting — page 714
16 2 8 2 Amount of tension developed by each contracting muscle fiber Page 715
16 3 1 Metabolic disorders of skeletal muscle — page 717
16 3 1 2 Pompei disease — page 718
16 3 3 Muscular dystrophy (MD) — page 719
16 3 3 1 Duchenne muscular dystrophy — page 720
16 3 3 4 Limb girdle muscular dystrophy — page 721
16 3 4 2 Diagnosis — page 722
Medical terminology — page 723
Bibliography — page 724

Chapter 17: The skeletal system — page 726
17 2 2 Thrombopoiesis — page 727
17 4 Mineral resorption — page 728
17 6 Disorders of the skeletal system — page 729
17 6 1 Osteoporosis — page 730
17 6 2 1 Clinical manifestations of Paget’s disease — page 731
17 6 3 1 Clinical manifestations of osteomalacia — page 732
17 6 4 1 Manifestations of rheumatoid arthritis — page 733
17 6 4 2 Diagnosis of rheumatoid arthritis — page 734
17 6 5 2 Diagnosis and treatment of SLE — page 735
17 6 7 1 Manifestations of OA — page 736
17 6 8 1 Manifestations of gout — page 738
17 6 8 2 Treatment of gout — page 739

Chapter 18: Oncogenesis
18 2 Cancer terminology — page 740
18 2 1 Specific nomenclature examples — page 742
18 3 1 Mutation of DNA — page 743
18 4 Local effects of cancer — page 744
18 5 Systemic effects of cancer — page 745
18 7 1 Tumor cell markers — page 746
18 7 2 Tumor grading — page 747
18 8 2 Hormonal therapy — page 748
18 8 4 Immune-based therapies (“biologic response modifiers”) — page 749

Chapter 17: Immunodeficiencies
19 1 Introduction — page 750
19 2 HIV structure and lifecycle — page 751
19 3 3 Symptomatic or AIDS stage — page 754
19 5 Laboratory of diagnosis of HIV — page 755
19 6 1 Treatment of HIV — page 756

Index — page 760