mechanism of blo。dc。 angulation 459 ChaPter 3 8 Conversion of prothrom bin to thrombin 459 Conversion of Fibrinogen to Fibrin- Pulmonary Circulation, Pulmonary Formation of the clot 460 Edema, Pleural Fluid 48 Vicious Circle of Clot Formation 460 Physiologic Anatomy of the Pulmonary Initiation of Coagulation: Formation of Circulatory System Prothrombin Activator 461 Pressures in the Pulmonary System Prevention of Blood Clotting in the Blood Volume of the Lungs Normal vascular System-Intravascular Blood Flow Through the Lungs and anticoagulants 463 Its Distribution Lysis of Blood Clots-Plasmin 464 Effect of Hydrostatic Pressure Conditions that cause excessi Gradients in the Lungs on Regional Bleeding in Human Beings 4 Pulmonary Blood Flow Decreased Prothrombin Factor vil Zones 1, 2, and 3 of Pulmonary Blood Flow 485 Factor IX, and Factor X Caused by Effect of Increased Cardiac Output on Vitamin K Deficiency Pulmonary Blood Flow and Pulmonary Arterial Pressure During Heavy Exercise Thrombocytopenia Function of the Pulmonary circulation Thromboembolic Conditions in the When the left atrial pressure rises as a 465 Result of Left-Sided Heart Failure Femoral venous thrombosis and massive Pulmonary Capillary Dynamics Pulmonary Embolism 466 Capillary Exchange of Fluid in the Lungs, Disseminated Intravascular coagulation 466 and Pulmonary Interstitial Fluid Dynamics 487 nticoagulants for Clinical Use Pulmonary Edema Heparin as an Intravenous Anticoagulant 466 Fluid in the Pleural Cavity Coumarins as Anticoagulants 466 Prevention of Blood Coagulation Outside he Bod 466 ChAPTer 39 Blood Coagulation Tests 467 Physical Principles of Gas Exchange; 467 Diffusion of Oxygen and Carbon Clotting Time Prothrombin Time 467 Dioxide Through the Respiratory Membrane Physics of Gas Diffusion and Gas UNIT VII Partial Pressures R Molecular basis of as diffusion espiration Gas Pressures in a mixture of gases- CHAPTER 3 7 “ Partial Pressures” of individual gases Pressures of gases dissolved in Water Pulmonary Ventilation 471 nd Tissues 492 Mechanics of Pulmonary Ventilation 471 Vapor Pressure of Water Muscles That Cause Lung Expansion and Diffusion of Gases Through Fluids- Contraction Pressure difference causes net Movement of Air In and Out of the Lungs Diffusion 493 and the pressures that cause the Diffusion of Gases Through Tissues Movement Composition of Alveolar Air-its Relation Effect of the Thoracic Cage on Lung to atmo eric air 493 Expansibility 474 Rate at Which Alveolar Air Is Renewed by Pulmonary Volumes and capacities Atmospheric Air 494 Recording Changes in Pulmonary Volume- Oxygen Concentration and Partial Pressure Abbreviations and symbols used in CO2 Concentration and Partial Pressure in Pulmonary Function Tests 476 Determination of functional residual Expired Air Capacity, Residual Volume, and Total Diffusion of Gases Through the Lung Capacity-Helium Dilution Method 476 Respirat Membrane Minute Respiratory Volume Equals Factors That Affect the rate of Gas Respiratory Rate Times Tidal Volu Diffusion Through the Respirat Alveolar Ventilation Membrane "Dead space"and its Effect on Alveolar Diffusing Capacity of the Respiratory Effect of the ventilation-Perfusion Functions of the Respiratory Ratio on Alveolar Gas Concentration 499 POz-PCO2, VA/Q Diag Trachea, Bronchi and Bronchioles Concept of the“ Physiological Shunt” Normal Respiratory Functions of the When VA/Q Is Greater than normal Nose 480 Abnormalities of ventilation-Perfusion ratio
Table of Contents xxiii Mechanism of Blood Coagulation 459 Conversion of Prothrombin to Thrombin 459 Conversion of Fibrinogen to Fibrin— Formation of the Clot 460 Vicious Circle of Clot Formation 460 Initiation of Coagulation: Formation of Prothrombin Activator 461 Prevention of Blood Clotting in the Normal Vascular System—Intravascular Anticoagulants 463 Lysis of Blood Clots—Plasmin 464 Conditions That Cause Excessive Bleeding in Human Beings 464 Decreased Prothrombin, Factor VII, Factor IX,and Factor X Caused by Vitamin K Deficiency 464 Hemophilia 465 Thrombocytopenia 465 Thromboembolic Conditions in the Human Being 465 Femoral Venous Thrombosis and Massive Pulmonary Embolism 466 Disseminated Intravascular Coagulation 466 Anticoagulants for Clinical Use 466 Heparin as an Intravenous Anticoagulant 466 Coumarins as Anticoagulants 466 Prevention of Blood Coagulation Outside the Body 466 Blood Coagulation Tests 467 Bleeding Time 467 Clotting Time 467 Prothrombin Time 467 UNIT VII Respiration CHAPTER 37 Pulmonary Ventilation 471 Mechanics of Pulmonary Ventilation 471 Muscles That Cause Lung Expansion and Contraction 471 Movement of Air In and Out of the Lungs and the Pressures That Cause the Movement 472 Effect of the Thoracic Cage on Lung Expansibility 474 Pulmonary Volumes and Capacities 475 Recording Changes in Pulmonary Volume— Spirometry 475 Abbreviations and Symbols Used in Pulmonary Function Tests 476 Determination of Functional Residual Capacity, Residual Volume, and Total Lung Capacity—Helium Dilution Method 476 Minute Respiratory Volume Equals Respiratory Rate Times Tidal Volume 477 Alveolar Ventilation 477 “Dead Space” and Its Effect on Alveolar Ventilation 477 Rate of Alveolar Ventilation 478 Functions of the Respiratory Passageways 478 Trachea, Bronchi, and Bronchioles 478 Normal Respiratory Functions of the Nose 480 CHAPTER 38 Pulmonary Circulation, Pulmonary Edema, Pleural Fluid 483 Physiologic Anatomy of the Pulmonary Circulatory System 483 Pressures in the Pulmonary System 483 Blood Volume of the Lungs 484 Blood Flow Through the Lungs and Its Distribution 485 Effect of Hydrostatic Pressure Gradients in the Lungs on Regional Pulmonary Blood Flow 485 Zones 1, 2, and 3 of Pulmonary Blood Flow 485 Effect of Increased Cardiac Output on Pulmonary Blood Flow and Pulmonary Arterial Pressure During Heavy Exercise 486 Function of the Pulmonary Circulation When the Left Atrial Pressure Rises as a Result of Left-Sided Heart Failure 487 Pulmonary Capillary Dynamics 487 Capillary Exchange of Fluid in the Lungs, and Pulmonary Interstitial Fluid Dynamics 487 Pulmonary Edema 488 Fluid in the Pleural Cavity 489 CHAPTER 39 Physical Principles of Gas Exchange; Diffusion of Oxygen and Carbon Dioxide Through the Respiratory Membrane 491 Physics of Gas Diffusion and Gas Partial Pressures 491 Molecular Basis of Gas Diffusion 491 Gas Pressures in a Mixture of Gases— “Partial Pressures” of Individual Gases 491 Pressures of Gases Dissolved in Water and Tissues 492 Vapor Pressure of Water 492 Diffusion of Gases Through Fluids— Pressure Difference Causes Net Diffusion 493 Diffusion of Gases Through Tissues 493 Composition of Alveolar Air—Its Relation to Atmospheric Air 493 Rate at Which Alveolar Air Is Renewed by Atmospheric Air 494 Oxygen Concentration and Partial Pressure in the Alveoli 494 CO2 Concentration and Partial Pressure in the Alveoli 495 Expired Air 495 Diffusion of Gases Through the Respiratory Membrane 496 Factors That Affect the Rate of Gas Diffusion Through the Respiratory Membrane 498 Diffusing Capacity of the Respiratory Membrane 498 Effect of the Ventilation-Perfusion Ratio on Alveolar Gas Concentration 499 PO2-PCO2, V . A/Q . Diagram 500 Concept of the “Physiological Shunt” (When V. A/Q . Is Greater Than Normal) 500 Abnormalities of Ventilation-Perfusion Ratio 501
xlv Table of Contents CHAPTER 40 Chronic Breathing of Low Oxygen Stimulates Transport of Oxygen and Carbon Respiration Even More-The Phenomenon of“ Acclimatization” 519 Dioxide in blood and tissue fluids 50 Composite Effects of PCO2, pH, and PO2 on Transport of Oxygen from the Lungs to 519 the body Tissues 502 Regulation of Respiration During Diffusion of oxygen from the Alveoli to the Exercise Pulmonary Capillary Blood Other Factors That Affect Respiration Transport of Oxygen in the Arterial Blood Sleep Apnea iffusion of Oxygen from the Peripheral Capillaries into the tissue Fluid Diffusion of Oxygen from the Peripheral PTE R Capillaries to the tissue cells Diffusion of Carbon Dioxide from the Respiratory Insufficiency- Peripheral Tissue Cells into the Pathophysiology, Diagnosis, Oxygen THera Capillaries into the Alveoli Useful Methods for Studying Respiratory ole of Hemoglobin in Oxygen trans Reversible Combination of Oxygen Study of Blood Gases and Blood pH Hemoglobin Measurement of Maximum Expiratory Flow 525 Effect of Hemoglobin to“ Buffer”the Forced Expiratory Vital Capacity and Forced Tissue PO2 Expiratory Volume 526 Factors That Shift the Oxygen-Hemoglobin Physiologic Peculiarities of Specific Dissociation Curve-Their Importance for xygen Transport Chronic Pulmonary Emphysema Metabolic Use of oxygen by the cells Pneumonia Transport of Oxygen in the Dissolved Stat Atelectasis Combination of Hemoglobin with Carbon Monoxide-Displacement of oxyg ransport of Carbon Dioxide in the Blood 309 oxy Tuberculosis oxia and oxygen Therapy Chemical Forms in which carbon dioxide Oxygen Therapy in Different Types of Is Transported 510 Hypoxia Carbon Dioxide dissociation curve When Oxygen Binds with Hemoglobin Hypercapnia Carbon Dioxide Is Released( the Haldane Effect) to Increase cOz Transport 511 Artificial Respiration Change in Blood Acidity During Carbon ioxide transp Respiratory Exchange Ratio U VII ChAPTER 4 1 Aviation, Space, and Deep-sea Regulation of respiration 514 Diving Physiology 514 Dorsal Respiratory Group of Neurons-Its Control of Inspiration and of Respiratory 514 Aviation, High-Altitude, and Space CHAPTER 4 3 A Pneumotaxic Center Limits the duration of Inspiration and Increases the Physiology 53 Respiratory Rate 5l4 Effects of Low oxygen Pressure on the Ventral Respiratory Group of Neurons- Body Alveolar Po2 at Different Elevations 537 515 Effect of Breathing Pure Oxygen on Alveola Lung Inflation Signals Limit Inspiration PO at Different Altitudes The Hering-Breuer Inflation Reflex Acute Effects of Hypoxia Control of Overall Respiratory Center Acclimatization to Low Poz Natural Acclimatization of Native human Chemical Control of Respiration 516 Beings Living at High Altitudes Direct Chemical Control of Respiratory Reduced Work Capacity at High Altitudes Center Activity by Carbon Dioxide and and positive effect of acclimatization Hydrogen lons 516 Acute Mountain Sickness and High-Altitude Peripheral chemoreceptor System for Control of Respiratory Activity-Role Chronic Mountain sickness 541 of oxygen in Respiratory Control 518 Effects of Acceleratory Forces on the Effect of Low Arterial Po, to stimulate Body in Aviation and Space Physiology 541 Alveolar Ventilation when arterial Carb Centrifugal Acceleratory Forces 541 ioxide and hydrogen lon Concentratio Effects of Linear Acceleratory Forces on the Remain Norm 542
xxiv Table of Contents CHAPTER 40 Transport of Oxygen and Carbon Dioxide in Blood and Tissue Fluids 502 Transport of Oxygen from the Lungs to the Body Tissues 502 Diffusion of Oxygen from the Alveoli to the Pulmonary Capillary Blood 502 Transport of Oxygen in the Arterial Blood 503 Diffusion of Oxygen from the Peripheral Capillaries into the Tissue Fluid 503 Diffusion of Oxygen from the Peripheral Capillaries to the Tissue Cells 504 Diffusion of Carbon Dioxide from the Peripheral Tissue Cells into the Capillaries and from the Pulmonary Capillaries into the Alveoli 504 Role of Hemoglobin in Oxygen Transport 505 Reversible Combination of Oxygen with Hemoglobin 505 Effect of Hemoglobin to “Buffer” the Tissue PO2 507 Factors That Shift the Oxygen-Hemoglobin Dissociation Curve—Their Importance for Oxygen Transport 507 Metabolic Use of Oxygen by the Cells 508 Transport of Oxygen in the Dissolved State 509 Combination of Hemoglobin with Carbon Monoxide—Displacement of Oxygen 509 Transport of Carbon Dioxide in the Blood 510 Chemical Forms in Which Carbon Dioxide Is Transported 510 Carbon Dioxide Dissociation Curve 511 When Oxygen Binds with Hemoglobin, Carbon Dioxide Is Released (the Haldane Effect) to Increase CO2 Transport 511 Change in Blood Acidity During Carbon Dioxide Transport 512 Respiratory Exchange Ratio 512 CHAPTER 41 Regulation of Respiration 514 Respiratory Center 514 Dorsal Respiratory Group of Neurons—Its Control of Inspiration and of Respiratory Rhythm 514 A Pneumotaxic Center Limits the Duration of Inspiration and Increases the Respiratory Rate 514 Ventral Respiratory Group of Neurons— Functions in Both Inspiration and Expiration 515 Lung Inflation Signals Limit Inspiration— The Hering-Breuer Inflation Reflex 515 Control of Overall Respiratory Center Activity 516 Chemical Control of Respiration 516 Direct Chemical Control of Respiratory Center Activity by Carbon Dioxide and Hydrogen Ions 516 Peripheral Chemoreceptor System for Control of Respiratory Activity—Role of Oxygen in Respiratory Control 518 Effect of Low Arterial PO2 to Stimulate Alveolar Ventilation When Arterial Carbon Dioxide and Hydrogen Ion Concentrations Remain Normal 519 Chronic Breathing of Low Oxygen Stimulates Respiration Even More—The Phenomenon of “Acclimatization” 519 Composite Effects of PCO2, pH, and PO2 on Alveolar Ventilation 519 Regulation of Respiration During Exercise 520 Other Factors That Affect Respiration 521 Sleep Apnea 522 CHAPTER 42 Respiratory Insufficiency— Pathophysiology, Diagnosis, Oxygen Therapy 524 Useful Methods for Studying Respiratory Abnormalities 524 Study of Blood Gases and Blood pH 524 Measurement of Maximum Expiratory Flow 525 Forced Expiratory Vital Capacity and Forced Expiratory Volume 526 Physiologic Peculiarities of Specific Pulmonary Abnormalities 526 Chronic Pulmonary Emphysema 526 Pneumonia 527 Atelectasis 528 Asthma 529 Tuberculosis 530 Hypoxia and Oxygen Therapy 530 Oxygen Therapy in Different Types of Hypoxia 530 Cyanosis 531 Hypercapnia 531 Dyspnea 532 Artificial Respiration 532 UNIT VIII Aviation, Space, and Deep-Sea Diving Physiology CHAPTER 43 Aviation, High-Altitude, and Space Physiology 537 Effects of Low Oxygen Pressure on the Body 537 Alveolar PO2 at Different Elevations 537 Effect of Breathing Pure Oxygen on Alveolar PO2 at Different Altitudes 538 Acute Effects of Hypoxia 538 Acclimatization to Low PO2 539 Natural Acclimatization of Native Human Beings Living at High Altitudes 540 Reduced Work Capacity at High Altitudes and Positive Effect of Acclimatization 540 Acute Mountain Sickness and High-Altitude Pulmonary Edema 540 Chronic Mountain Sickness 541 Effects of Acceleratory Forces on the Body in Aviation and Space Physiology 541 Centrifugal Acceleratory Forces 541 Effects of Linear Acceleratory Forces on the Body 542
"Artificial Climate" in the sealed rightlessness in Space 、、 CHAPTER46 Sensory Receptors, Neuronal Circuits for Processing Information CHAPTER 4 4 Types of sensory Receptors and the Physiology of Deep-Sea Diving and Differential Sensitivity of Receptor 572 Other Hyperbaric Conditions 545 ransduction of Sensory Stimuli into Effect of High Partial Pressures of 573 Individual Gases on the Body 545 Local Electrical Currents at Nerve Endings- N Receptor Potentials Adaptation of Receptors 575 ressures Oxygen Toxicity at High Pressures 546 Nerve fibers that transmit different Carbon Dioxide Toxicity at Great Depths Types of signals, and Their in the se 547 Physiologic Classification Decompression of the Diver After Excess Transmission of signals of Different Exposure to High Pressure 547 Intensity in Nerve Tracts-Spatial and Scuba(Self-Contained Underwater Temporal Summation Breathing Apparatus) Diving Transmission and Processing of signals pecial Physiologic Problems in 578 Submarines 550 Relaying of Signals Through Neuronal Hyperbaric Oxygen Therapy Pools 579 Prolongation of a signal by a Neuronal Poo“ Afterdischarge Instability and Stability of Neuronal Circuits Inhibitory Circuits as a Mechanism for The Nervous System: A. General Stabilizing Nervous System Function 583 Principles and sensory Physiology Synaptic Fatigue as a Means for Stabilizing he Nervous System 583 CHAPTER 4 5 Organization of the Nervous System, Basic Functions of Synapses, CHAPTER 4 7 "Transmitter Substances?5 555 Somatic Sensations: general General Design of the Nervous System 555 Organization, the Tactile and Central Nervous System Neuron: The Basic Position senses Functional Unit CLASSIFICATION OF SOMATIC SENSES 35 Sensory Part of the Nervous System- Detection and Transmission of Tactile y Motor Part of the Nervous System- Detection of vibration Effector TICKLE AND ITCH Processing of Information-Integrative Sensory Pathways for Transmitting unction of the Nervous System Somatic signals into the Central Storage of Information-Memory Nervous System Major Levels of Central Nervous Systen Dorsal Column-Medial Lemniscal System 588 Function em Anterolateral Syster 588 Spinal cord level 57 Transmission in the Dorsal Column- Lower Brain or Subcortical level Medial Lemniscal System Higher Brain or Cortical Leve Anatomy of the Dorsal Column-Medial Comparison of the Nervous System al System with a Computer 558 Somatosensory Cortex 589 Central Nervous System Synapses Somatosensory Association Areas Types of Synapses-Chemical and Overall Characteristics of Signal ransmission and Analysis in the Dorsal Physiologic Anatomy of the Synapse olumn-Medial Lemniscal System Chemical Substances that Function as Position senses 59 Synaptic Transmitters Electrical Events During Neuronal Excitation 564 Jyc. pretation of Sensory Stimulus Intensity Judgment of Stimulus Intensity Electrical Events During Neuronal Position Transmission of Less Critical Sensory Special Functions of Dendrites for Exciting Signals in the Anterolateral Pathway 595 Neuron Anatomy of the Anterolateral Pathway Relation of state of excitation of the neuron Some Special Aspects of to Rate of Firing Somatosensory Function Some Special Function of the thalamus in Somatic Synaptic Transmission 570
Table of Contents xxv “Artificial Climate” in the Sealed Spacecraft 543 Weightlessness in Space 543 CHAPTER 44 Physiology of Deep-Sea Diving and Other Hyperbaric Conditions 545 Effect of High Partial Pressures of Individual Gases on the Body 545 Nitrogen Narcosis at High Nitrogen Pressures 545 Oxygen Toxicity at High Pressures 546 Carbon Dioxide Toxicity at Great Depths in the Sea 547 Decompression of the Diver After Excess Exposure to High Pressure 547 Scuba (Self-Contained Underwater Breathing Apparatus) Diving 549 Special Physiologic Problems in Submarines 550 Hyperbaric Oxygen Therapy 550 UNIT IX The Nervous System: A. General Principles and Sensory Physiology CHAPTER 45 Organization of the Nervous System, Basic Functions of Synapses, “Transmitter Substances” 555 General Design of the Nervous System 555 Central Nervous System Neuron: The Basic Functional Unit 555 Sensory Part of the Nervous System— Sensory Receptors 555 Motor Part of the Nervous System— Effectors 556 Processing of Information—“Integrative” Function of the Nervous System 556 Storage of Information—Memory 557 Major Levels of Central Nervous System Function 557 Spinal Cord Level 557 Lower Brain or Subcortical Level 558 Higher Brain or Cortical Level 558 Comparison of the Nervous System with a Computer 558 Central Nervous System Synapses 559 Types of Synapses—Chemical and Electrical 559 Physiologic Anatomy of the Synapse 559 Chemical Substances That Function as Synaptic Transmitters 562 Electrical Events During Neuronal Excitation 564 Electrical Events During Neuronal Inhibition 566 Special Functions of Dendrites for Exciting Neurons 568 Relation of State of Excitation of the Neuron to Rate of Firing 569 Some Special Characteristics of Synaptic Transmission 570 CHAPTER 46 Sensory Receptors, Neuronal Circuits for Processing Information 572 Types of Sensory Receptors and the Sensory Stimuli They Detect 572 Differential Sensitivity of Receptors 572 Transduction of Sensory Stimuli into Nerve Impulses 573 Local Electrical Currents at Nerve Endings— Receptor Potentials 573 Adaptation of Receptors 575 Nerve Fibers That Transmit Different Types of Signals, and Their Physiologic Classification 576 Transmission of Signals of Different Intensity in Nerve Tracts—Spatial and Temporal Summation 577 Transmission and Processing of Signals in Neuronal Pools 578 Relaying of Signals Through Neuronal Pools 579 Prolongation of a Signal by a Neuronal Pool—“Afterdischarge” 581 Instability and Stability of Neuronal Circuits 583 Inhibitory Circuits as a Mechanism for Stabilizing Nervous System Function 583 Synaptic Fatigue as a Means for Stabilizing the Nervous System 583 CHAPTER 47 Somatic Sensations: I. General Organization, the Tactile and Position Senses 585 CLASSIFICATION OF SOMATIC SENSES 585 Detection and Transmission of Tactile Sensations 585 Detection of Vibration 587 TICKLE AND ITCH 587 Sensory Pathways for Transmitting Somatic Signals into the Central Nervous System 587 Dorsal Column–Medial Lemniscal System 588 Anterolateral System 588 Transmission in the Dorsal Column— Medial Lemniscal System 588 Anatomy of the Dorsal Column—Medial Lemniscal System 588 Somatosensory Cortex 589 Somatosensory Association Areas 592 Overall Characteristics of Signal Transmission and Analysis in the Dorsal Column–Medial Lemniscal System 592 Position Senses 594 Interpretation of Sensory Stimulus Intensity 593 Judgment of Stimulus Intensity 594 Position Senses 594 Transmission of Less Critical Sensory Signals in the Anterolateral Pathway 595 Anatomy of the Anterolateral Pathway 595 Some Special Aspects of Somatosensory Function 596 Function of the Thalamus in Somatic Sensation 596
Cortical Control of Sensory Sensitivity- Pupillary Diameter Corticofugal"Signals Errors of refraction egmental Fields of Sensation-The Visual Acuity Dermatomes Determination of Distance of an Object Ophthalmoscope Somatic Sensations: Il. Pain Fluid System of the Eye-Intraocular Fluid Headache, and Thermal Sensations 598 Formation of Aqueous Humor by the Ciliary Types of Pain and Their Qualities- Body Fast Pain and slow pain Outflow of Aqueous Humor from the Eye Pain Receptors and Their Stimulation Intraocular Pressure 624 Rate of Tissue Damage as a Stimulus for Pain 599CHAPTER 50 Dual Pathways for Transmission of Pain The eve: ll Receptor and Neural Is into the Central No System Function of the ret Dual Pain pathways in the cord and brain Anatomy and Function of the Stem-The Neospinothalamic Tract and Structural elements of the retina the Paleospinothalamic tract Photochemistry of vision Pain Suppression ("Analgesia")System Rhodopsin-Retinal Visual Cycle, and in the Brain and Spinal Cord 602 Excitation of the rods 629 Brain's Opiate System-Endorphins and Automatic Regulation of Retinal Sensitivity- Enkephalins 602 Light and Dark Adaptation 63l Inhibition of Pain Transmission by Color vision Simultaneous Tactile Sensory Signals 603 Tricolor Mechanism of color detection Treatment of Pain by Electrical Stimulation 603 Color Blindness 633 Referred Pain 603 Neural Function of the retina 633 Visceral Pain 03 Neural Circuitry of the Retina 633 Causes of true visceral Pain 604 Ganglion Cells and Optic Nerve Fibers Parietal Pain"Caused by Visceral Disease 604 Excitation of the Ganglion Cells 637 Localization of visceral Pain -"Visceral" and the "Parietal" Pain Transmission CHAPTER 5 1 Pathways 604 The Eve: IIL. Central Some clinical abnormalities of pain and Other Somatic sensations 605 Neurophysiology of vision 605 Visual Pathways Herpes Zoster(Shingles) 605 Function of the dorsal lateral geniculate Tic Douloureux 605 Nucleus of the thalamus -sequard Syndro 606 Organization and Function of the visual Headache Cortex 641 Headache of Intracranial Origin 606 Layered Structure of the Primary Visual Thermal Sensations 607 Cortex Thermal Receptors and Their Excitation Two Major Pathways for Analysis of visual Transmission of Thermal Signals in the Information-(/)The Fast"Position"and Nervous System 609 Motion"Pathway;(2)The Accurate Color Pathway 643 Neuronal Patterns of Stimulation During UNIT X Analysis of the Visual Image 643 Detection of Color 644 The Nervous System: B Effect of Removing the Primary Vis The Special Senses Cortex 644 Fields of Vision; Perimetry Eye Movements and Their Control CHAPTER 4 9 Fixation Movements of the Eyes 645 The eye: I Optics of vision 613 "Fusion"of the Visual Images from the Two Eyes 647 Physical Principles of Optics 613 Autonomic control of Accommodation Refraction of Lig 6l3 and Pupillary Aperture 648 Application of Refractive Principles to Control of Accommodation(Focusing the Lenses E Focal Length of a Lens Control of Pupillary Diamete Formation of an Image by a Convex Lens Measurement of the refractive Power of a Optics of the Eye 617 The Sense of Hearing 651 The Eye as a Camera 617 Tympanic Membrane and the Ossicular Mechanism of“ Accommodation” 6l7 System 65l
xxvi Table of Contents Cortical Control of Sensory Sensitivity— “Corticofugal” Signals 597 Segmental Fields of Sensation—The Dermatomes 597 CHAPTER 48 Somatic Sensations: II. Pain, Headache, and Thermal Sensations 598 Types of Pain and Their Qualities— Fast Pain and Slow Pain 598 Pain Receptors and Their Stimulation 598 Rate of Tissue Damage as a Stimulus for Pain 599 Dual Pathways for Transmission of Pain Signals into the Central Nervous System 600 Dual Pain Pathways in the Cord and Brain Stem—The Neospinothalamic Tract and the Paleospinothalamic Tract 600 Pain Suppression (“Analgesia”) System in the Brain and Spinal Cord 602 Brain’s Opiate System—Endorphins and Enkephalins 602 Inhibition of Pain Transmission by Simultaneous Tactile Sensory Signals 603 Treatment of Pain by Electrical Stimulation 603 Referred Pain 603 Visceral Pain 603 Causes of True Visceral Pain 604 “Parietal Pain” Caused by Visceral Disease 604 Localization of Visceral Pain—“Visceral” and the “Parietal” Pain Transmission Pathways 604 Some Clinical Abnormalities of Pain and Other Somatic Sensations 605 Hyperalgesia 605 Herpes Zoster (Shingles) 605 Tic Douloureux 605 Brown-Séquard Syndrome 606 Headache 606 Headache of Intracranial Origin 606 Thermal Sensations 607 Thermal Receptors and Their Excitation 607 Transmission of Thermal Signals in the Nervous System 609 UNIT X The Nervous System: B. The Special Senses CHAPTER 49 The Eye: I. Optics of Vision 613 Physical Principles of Optics 613 Refraction of Light 613 Application of Refractive Principles to Lenses 613 Focal Length of a Lens 615 Formation of an Image by a Convex Lens 616 Measurement of the Refractive Power of a Lens—“Diopter” 616 Optics of the Eye 617 The Eye as a Camera 617 Mechanism of “Accommodation” 617 Pupillary Diameter 618 Errors of Refraction 619 Visual Acuity 621 Determination of Distance of an Object from the Eye—“Depth Perception” 621 Ophthalmoscope 622 Fluid System of the Eye—Intraocular Fluid 623 Formation of Aqueous Humor by the Ciliary Body 623 Outflow of Aqueous Humor from the Eye 623 Intraocular Pressure 624 CHAPTER 50 The Eye: II. Receptor and Neural Function of the Retina 626 Anatomy and Function of the Structural Elements of the Retina 626 Photochemistry of Vision 628 Rhodopsin-Retinal Visual Cycle, and Excitation of the Rods 629 Automatic Regulation of Retinal Sensitivity— Light and Dark Adaptation 631 Color Vision 632 Tricolor Mechanism of Color Detection 632 Color Blindness 633 Neural Function of the Retina 633 Neural Circuitry of the Retina 633 Ganglion Cells and Optic Nerve Fibers 636 Excitation of the Ganglion Cells 637 CHAPTER 51 The Eye: III. Central Neurophysiology of Vision 640 Visual Pathways 640 Function of the Dorsal Lateral Geniculate Nucleus of the Thalamus 640 Organization and Function of the Visual Cortex 641 Layered Structure of the Primary Visual Cortex 642 Two Major Pathways for Analysis of Visual Information—(1) The Fast “Position” and “Motion” Pathway; (2) The Accurate Color Pathway 643 Neuronal Patterns of Stimulation During Analysis of the Visual Image 643 Detection of Color 644 Effect of Removing the Primary Visual Cortex 644 Fields of Vision; Perimetry 644 Eye Movements and Their Control 645 Fixation Movements of the Eyes 645 “Fusion” of the Visual Images from the Two Eyes 647 Autonomic Control of Accommodation and Pupillary Aperture 648 Control of Accommodation (Focusing the Eyes) 649 Control of Pupillary Diameter 649 CHAPTER 52 The Sense of Hearing 651 Tympanic Membrane and the Ossicular System 651
Table of Contents Conduction of Sound from the Tympanic Reciprocal Inhibition and Reciprocal Membrane to the cochlea 65l Innervation Transmission of Sound Through Bone 652 Reflexes of posture and locomotion Cochlea Postural and locomotive reflexes of Functional anatomy of the Cochlea 652 he cord Transmission of Sound waves in the Scratch Reflex Cochlea-Traveling wave 654 Spinal Cord Reflexes That Cause Function of the Organ of Corti 655 Spasm 68 Determination of Sound Frequency-The Autonomic Reflexes in the Spinal “ Place" Principle 656 Cord 68 Determination of loudness 656 Spinal Cord Transection and Spinal Central Auditory Mechanisms 657 Shock Auditory Nervous Pathways Function of the Cerebral Cortex in Hearing Determination of the direction from which Sound comes 660 CHAPTER 55 Cortical and Brain Stem Control of Centrifugal Signals from the Central Nervous System to Lower Auditory Centers MOTOR CORTEX AND CORTICOSPINAL Hearing Abnormalities Types of Deafness Primary Motor Cortex 685 Premotor Area CHAPTER 5 3 Supplementary Motor Area Some Specialized Areas of Motor Control The Chemical senses-Taste and Found in the human Motor cortex 686 Smell Transmission of Signals from the Motor Sense of taste oming Fiber Pathways to the Motor Sensations of taste 688 Taste Bud and Its Function Red Nucleus Serves as an Alternative Transmission of Taste Signals into the Pathway for Transmitting Cortical Signals entral Nervous System Taste Preference and control of the diet 666 to the Spinal Cord of smell Extrapyramidal" System Olfactory Membrane Excitation of the Spinal Cord Motor Control Stimulation of the olfactory Cells 667 Areas by the Primary Motor Cortex and Transmission of Smell Signals into the Role of the Brain Stem in Controlling Central Nervous system Motor Function Support of the Body Against Gravity- Roles of the reticular and vestibular UNITX I Nuclei 69l Vestibular sensations and maintenance The Nervous System: C Motor and of Equilibrium 692 Integrative Neurophysiology Vestibular Apparatus 692 Function of the utricle and saccule in the Maintenance of Static Equilibrium 694 CHAPTER 5 4 Detection of Head Rotation by the f the Spinal cord; Semicircular Ducts 695 Vestibular Mechanisms for Stabilizing the the Cord Reflexes 673 696 Organization of the Spinal Cord for Motor Other Factors Concerned with Equilibrium 696 673 Functions of brain stem nuclei in Muscle Sensory Receptors-M Controlling Subconscious, Stereotyped Spindles and Golgi Tendon Movements 697 And Their Roles in Muscle Receptor Function of the Muscle Spindle Muscle stretch Reflex 676 CHAPTER 5 6 Role of the Muscle Spindle in Voluntary Contributions of the cerebellum and Motor activit Clinical Applications of the Stretch Basal Ganglia to Overall Motor Reflex 678 Control Golgi Tendon Refl Cerebellum and Its Motor Functions Function of the Muscle spindles and Anatomical Functional areas of the Tendon Organs in Conjunction with Cerebellum Control from Higher Levels of the 680 Neuronal Circuit of the cerebellum Flexor reflex and the withdrawal Function of the cerebellum in overall Reflexes Motor Control 703 Crossed Extenso Reflex Clinical abnormalities of the cerebellum 706
Table of Contents xxvii Conduction of Sound from the Tympanic Membrane to the Cochlea 651 Transmission of Sound Through Bone 652 Cochlea 652 Functional Anatomy of the Cochlea 652 Transmission of Sound Waves in the Cochlea—“Traveling Wave” 654 Function of the Organ of Corti 655 Determination of Sound Frequency—The “Place” Principle 656 Determination of Loudness 656 Central Auditory Mechanisms 657 Auditory Nervous Pathways 657 Function of the Cerebral Cortex in Hearing 658 Determination of the Direction from Which Sound Comes 660 Centrifugal Signals from the Central Nervous System to Lower Auditory Centers 660 Hearing Abnormalities 660 Types of Deafness 660 CHAPTER 53 The Chemical Senses—Taste and Smell 663 Sense of Taste 663 Primary Sensations of Taste 663 Taste Bud and Its Function 664 Transmission of Taste Signals into the Central Nervous System 665 Taste Preference and Control of the Diet 666 Sense of Smell 667 Olfactory Membrane 667 Stimulation of the Olfactory Cells 667 Transmission of Smell Signals into the Central Nervous System 668 UNIT XI The Nervous System: C. Motor and Integrative Neurophysiology CHAPTER 54 Motor Functions of the Spinal Cord; the Cord Reflexes 673 Organization of the Spinal Cord for Motor Functions 673 Muscle Sensory Receptors—Muscle Spindles and Golgi Tendon Organs— And Their Roles in Muscle Control 675 Receptor Function of the Muscle Spindle 675 Muscle Stretch Reflex 676 Role of the Muscle Spindle in Voluntary Motor Activity 678 Clinical Applications of the Stretch Reflex 678 Golgi Tendon Reflex 679 Function of the Muscle Spindles and Golgi Tendon Organs in Conjunction with Motor Control from Higher Levels of the Brain 680 Flexor Reflex and the Withdrawal Reflexes 680 Crossed Extensor Reflex 681 Reciprocal Inhibition and Reciprocal Innervation 681 Reflexes of Posture and Locomotion 682 Postural and Locomotive Reflexes of the Cord 682 Scratch Reflex 683 Spinal Cord Reflexes That Cause Muscle Spasm 683 Autonomic Reflexes in the Spinal Cord 683 Spinal Cord Transection and Spinal Shock 684 CHAPTER 55 Cortical and Brain Stem Control of Motor Function 685 MOTOR CORTEX AND CORTICOSPINAL TRACT 685 Primary Motor Cortex 685 Premotor Area 686 Supplementary Motor Area 686 Some Specialized Areas of Motor Control Found in the Human Motor Cortex 686 Transmission of Signals from the Motor Cortex to the Muscles 687 Incoming Fiber Pathways to the Motor Cortex 688 Red Nucleus Serves as an Alternative Pathway for Transmitting Cortical Signals to the Spinal Cord 688 “Extrapyramidal” System 689 Excitation of the Spinal Cord Motor Control Areas by the Primary Motor Cortex and Red Nucleus 689 Role of the Brain Stem in Controlling Motor Function 691 Support of the Body Against Gravity— Roles of the Reticular and Vestibular Nuclei 691 Vestibular Sensations and Maintenance of Equilibrium 692 Vestibular Apparatus 692 Function of the Utricle and Saccule in the Maintenance of Static Equilibrium 694 Detection of Head Rotation by the Semicircular Ducts 695 Vestibular Mechanisms for Stabilizing the Eyes 696 Other Factors Concerned with Equilibrium 696 Functions of Brain Stem Nuclei in Controlling Subconscious, Stereotyped Movements 697 CHAPTER 56 Contributions of the Cerebellum and Basal Ganglia to Overall Motor Control 698 Cerebellum and Its Motor Functions 698 Anatomical Functional Areas of the Cerebellum 699 Neuronal Circuit of the Cerebellum 700 Function of the Cerebellum in Overall Motor Control 703 Clinical Abnormalities of the Cerebellum 706