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EDITORS:
Vedprakash Mishra Dr BC Roy National Awardee DSc (Honoris Causa) by four Universities and DMSc (Honoris Causa) Professor Emeritus Chancellor, Krishna Institute of Medical Sciences, Karad, Maharashtra, India
Pages: 2691
Contents:
Section 1 – General Physiology
1. Cell
2. Cell Junctions
3. Transport Through Cell Membrane
4. Homeostasis
Section 2 – Blood and Body Fluids
5. Body Fluids
6. Blood
7. Plasma Proteins
8. Red Blood Cells
9. Erythropoiesis
10. Hemoglobin and Iron Metabolism
11. Erythrocyte Sedimentation Rate, Packed Cell
Volume and Blood Indices
12. Anemia
13. Hemolysis and Fragility of Red Blood Cells
14. White Blood Cells
15. Immunity
16. Platelets
17. Hemostasis
18. Coagulation of Blood
19. Blood Groups
20. Blood Transfusion
21. Blood Volume
22. Reticuloendothelial System and Tissue
Macrophage
23. Spleen
24. Lymphatic System and Lymph
25. Tissue Fluid and Edema
Section 3 – Muscle Physiology
26. Classification of Muscles
27. Structure of Skeletal Muscle
28. Properties of Skeletal Muscle
29. Changes During Muscular Contraction
30. Neuromuscular Junction
31. Smooth Muscle
32. Electromyogram and Disorders of Skeletal
Muscle
33. Endurance of Muscle
Section 4 – Digestive System
34. Overview of Digestive System
35. Salivary Secretion
36. Gastric Secretion
37. Pancreatic Secretion
38. Liver and Biliary System
39. Functions and Secretions of Small Intestine
40. Functions and Secretions of Large Intestine
41. Movements of Gastrointestinal Tract
42. Gastrointestinal Hormones
43. Digestion, Absorption and Metabolism of
Carbohydrates
44. Digestion, Absorption and Metabolism of
Proteins
45. Digestion, Absorption and Metabolism of Lipids
Section 5 – Renal Physiology and Skin
46. Overview of Kidney
47. Nephron
48. Juxtaglomerular Apparatus
49. Renal Circulation
50. Urine Formation
51. Concentration of Urine
52. Acid-base Balance
53. Acidification of Urine and Role of Kidney in
Acid-base Balance
54. Renal Function Tests
55. Renal Failure
56. Micturition
57. Dialysis and Artificial Kidney
58. Diuretics
59. Skin
60. Body Temperature
Section 6 – Endocrinology
61. Overview of Endocrine System
62. Hormones
63. Pituitary Gland
64. Thyroid Gland
65. Parathyroid Glands and Physiology of Bone
66. Endocrine Functions of Pancreas
67. Adrenal Cortex
68. Adrenal Medulla
69. Endocrine Functions of Other Organs
70. Local Hormones
Section 7 – Reproductive System
71. Male Reproductive System
72. Seminal Vesicles
73. Prostate Gland
74. Semen
75. Female Reproductive System
76. Ovary
77. Menstrual Cycle
78. Ovulation
79. Menopause
80. Fertility and Infertility
81. Pregnancy and Parturition
82. Placenta
83. Pregnancy Tests
84. Mammary Glands and Lactation
85. Fertility Control
Section 8 – Cardiovascular System
86. Overview of Cardiovascular System
87. Properties of Cardiac Muscle
88. Cardiac Cycle
89. Heart Sounds
90. Cardiac Murmur
91. Electrocardiogram
92. Vector
93. Arrhythmia
94. Effect of Changes in Electrolyte Concentration
on Heart
95. Cardiac Output
96. Heart-lung Preparation
97. Cardiac Function Curves
98. Heart Rate
99. Hemodynamics
100. Arterial Blood Pressure
101. Venous Blood Pressure
102. Capillary Blood Pressure
103. Arterial Pulse
104. Venous Pulse
105. Coronary Circulation
106. Cerebral Circulation
107. Splanchnic Circulation
108. Capillary Circulation
109. Circulation Through Skeletal Muscle
110. Cutaneous Circulation
111. Fetal Circulation and Respiration
112. Hemorrhage
113. Circulatory Shock and Heart Failure
114. Exercise, Yoga and Meditation
Section 9 – Respiratory System and
Environmental Physiology
115. Overview of Respiratory System
116. Pulmonary Circulation
117. Mechanics of Respiration
118. Pulmonary Function Tests
119. Ventilation and Dead Space
120. Inspired Air, Alveolar Air and Expired Air
121. Exchange of Respiratory Gases
122. Transport of Respiratory Gases
123. Regulation of Respiration
124. Diseases and Disorders of Respiration
125. High Altitude and Space Physiology
126. Deep Sea Physiology
127. Effects of Exposure to Cold and Heat
128. Artificial Respiration
129. Effects of Exercise on Respiration
Section 10 – Nervous System
130. Overview of Nervous System
131. Neuron
132. Classification of Nerve Fibers
133. Properties of Nerve Fibers
134. Degeneration and Regeneration of Nerve Fibers
135. Neuroglia
136. Receptors
137. Synapse
138. Neurotransmitters and Neuromodulators
139. Reflex Activity
140. Spinal Cord
141. Somatosensory System and Somatomotor
System
142. Physiology of Pain
143. Brainstem
144. Thalamus
145. Internal Capsule
146. Hypothalamus
147. Cerebellum
148. Basal Ganglia
149. Cerebral Cortex
150. Limbic System
151. Reticular Formation
152. Preparations of Animals for Experimental
Studies
153. Proprioceptors
154. Maintenance of Posture and Equilibrium
155. Vestibular Apparatus
156. Electroencephalogram
157. Physiology of Sleep
158. Epilepsy
159. Higher Intellectual Functions
160. Cerebrospinal Fluid
161. Autonomic Nervous System
Section 11 – Special Senses
162. Eye
163. Visual Process
164. Field of Vision
165. Visual Pathway
166. Pupillary Reflexes
167. Color Vision
168. Refractive Errors
169. Ear
170. Auditory Pathway
171. Mechanism of Hearing
172. Auditory Defects
173. Sensation of Taste
174. Sensation of Smell
Preface
Two decades have passed since the first edition of Essentials of
Medical Physiology was published in 1999. Now we are glad to
bring out its Eighth Edition. This edition strives to keep the core
subject matter in physiology up-to-date.
We are humbled by the popularity and success that the book has
achieved. We would like to thank the students, faculty, doctors and
health professionals around the world for their support, feedback
and appreciation without which we could not have made it where
we are now.
The book has come a long way since its first edition. It would
not have been possible to bring the book to this level without efforts
and hard work of my wife Dr Prema Sembulingam and also coauthor of this book.
Her encouragement, emotional and professional
support have been a driving force for me.
Though we miss her now, the efforts and work rendered by her
for this edition also could not be forgotten. That made me to
mention “We” in this preface also.
We have made some changes in this edition based on our study
and suggestions from our colleagues and fellow teachers from
various institutes and universities of India and abroad. Many tables
and boxes have been added for more clarity and detail.
The book has been updated with recent findings in physiology
and more pathophysiological facts in accordance with modern
curriculum of medical education.
We would like to thank the publishers for their enthusiasm and
support. They worked with us to make the new edition appealing,
easy to browse with rich format and pleasant coloring.
As always, we welcome and appreciate your opinions,
feedback, comments and suggestions. This has and will help us
improve the quality of the book and its contents.
The need for having a simple book with basic principles of medical
physiology has been felt since long. A sincere and maiden attempt
has been made with the idea of fulfilling the requirements of
present-day curriculum. The script of the book is formatted in such
a way that it will be suitable not only for medical students but also
for dental students and the students of allied health subjects, like
Physiotherapy, Occupational Therapy, Pharmacy, Nursing, Speech,
Hearing and Language, etc.
Written in a textbook form, this book encompasses the
knowledge of the basic principles of physiology in each system. An
attempt is also made to describe the applied physiology in each
system.
To give an idea of the matter to be studied, the topics are listed
at the beginning of each chapter. Most of the figures are given in a
schematic form to enable the students understand and reproduce the
facts. The probable questions given for each section will help the
students preparing for their examinations. However, it will be ideal
for the students to read each section thoroughly before referring to
the questions.
We will be very happy to receive opinions, comments and
valuable suggestions from all our senior colleagues, fellow teachers
and students, so that every aspect of the book can be reviewed in the
succeeding editions.
introduction
Physiology is the most fascinating and ancient branch of science. It
is fascinating because it unfolds the mystery of the complicated
functional aspects of the individual organs in the body. It is ancient
because it exists ever since the origin of life. Even before knowing
the language, culture and society, man knew about hunger, thirst,
pain and fear, which are the basics of physiology.
Physiology is defined as the study of functions of various
systems and different organs of the body. Physiology is of different
types, namely Human Physiology, Animal Physiology and Plant
Physiology. Human Physiology and Animal Physiology are very
much inter-related. Knowledge of Human Physiology is essential to
understand the other allied subjects, like Biochemistry,
Pharmacology, Pathology, Medicine, etc. However, it is worthwhile
to have a brief knowledge of anatomy of different systems and
various organs to understand the principles of Human Physiology.
The basic physiological functions include provision of oxygen
and nutrients, removal of metabolites and other waste products,
maintenance of blood pressure and body temperature, hunger and
thirst, locomotor functions, special sensory functions, reproduction
and the higher intellectual functions, like learning and memory.
In the unicellular organisms, all the physiological functions are
carried out by simple diffusion through the cell membrane. Because
of the evolutionary and ecological changes over the years, an
individual system is developed for each function, such as digestive
system, cardiovascular system, respiratory system, excretory
system, etc. Every system in the body is independent structurally
and functionally; yet all the systems are interdependent.
Human Physiology is usually studied under the following
sections:
1. General Physiology
2. Blood and Body Fluids
3. Muscle Physiology
4. Digestive System
5. Renal Physiology and Skin
6. Endocrinology
7. Reproductive System
8. Cardiovascular System
9. Respiratory System and Environmental Physiology
10. Nervous System
11. Special Senses