v Table of Contents anglia-Their Motor Functions Hypothalamus, a Major Control on of the Basal Ganglia in Executing Headquarters for the Limbic System erns of Motor Activity-The Putamen Vegetative and Endocrine Control Circuit 708 Functions of the Hy pothalamus 733 Role of the Basal Ganglia for Cognitive Behavioral Functions of the Hypothalamus Control of Sequences of Motor Patterns- and Associated Limbic Structures 734 The Caudate Circuit 709 Reward" and"Punishment"Function of unction of the Basal Ganglia to Change the Limbic System 735 e Timing and to scale the Intensity of Importance of Reward or Punishment in Movements 709 Behavio Functions of Specific Neurotransmitter Specific Functions of other Parts of Substances in the Basal Ganglial System 710 Functions of the Hippocampus Integration of the Many Parts of the Functio f the Amygdala 737 Total Motor Control System 712 Function of the Limbic Cortex 738 Spinal Level 712 Hindbrain level Motor Cortex Level 712 CHA P ter 5 9 What Drives Us to Action? 713 States of Brain Activity-Sleep, Brain Waves, Epilepsy, Psychoses CHAPTER 57 Sleep Cerebral Cortex, Intellectual functions Slow-Wave Sleep REM Sleep(Paradoxical Sleep of the Brain, Learning and Memory 714 Desynchronized sleep Physiologic Anatomy of the Cerebral Basic Theories of slee 714 Physiologic Effects of Sleep Functions of Specific Cortical Areas 715 Brain Waves 741 Association Areas 716 Origin of Brain Waves Comprehensive Interpretative Function of Effect of Varying Levels of Cerebral the Posterior Superior Temporal Lobe Activity on the Frequency of the EEG 743 Wernicke,'s Area"(a General Changes in the EEG at Different Stages of Interpretative Area) 7l8 Wakefulness and sleep 743 Functions of the Parieto-occipitotemporal Pille Cortex in the Nondominant Hemisphere 719 Grand Mal Epilepsy Higher Intellectual Functions of the Petit Mal Epilepsy Prefrontal Association areas 719 Focal Epileps Function of the brain in Psychotic Behavior and Dementia- Communication-Language Input Roles of Specific Neurotransmitter and Language Output Systems Function of the Corpus Callosum and Depression and Manic-Depressive Anterior Commissure to Transfer Psychoses-Decreased Activity of the Thoughts, Memories, Training, and Norepinephrine and serotonin Other Information between the Two Neurotransmitter Systems 745 Cerebral Hemispheres Schizophrenia-Possible Exaggerated Thoughts, Consciousness, and Memory 723 Function of Part of the Dopamine Memory-Roles of Synaptic Facilitation and Synaptic Inhibition Alzheimer's Disease-Amyloid Plaques Short-Term Memory and Depressed Memory Intermediate Long-Term Memory Long-Term Memor 25 Consolidation of Memory 725 CHAPTER 60 The Autonomic Nervous System and the adrenal medulla 748 CHAPTER 5 8 General Organization of the Autonomic Behavioral and motivational Nervous System 748 Mechanisms of the brain -Th Physiologic Anatomy of the Sympathetic Limbic System and the Nervous System 748 Hypothalamus Preganglionic and Postganglionic 28 Sympathetic Neurons 748 Activating- Driving Systems of the Brain Physiologic Anatomy of the Control of Cerebral Activity by Continuous Parasympathetic Nervous System Excitatory Signals from the Brain Stem 728 Basic Characteristics of Sympathetic Neurohormonal Control of Brain Activity and Parasympathetic Function Limbic System Cholinergic and Adrenergic Fibers- Functional Anatomy of the Limbic Secretion of Acetylcholine or System; Key Position of the Hypothalamus Receptors on the Effector Organs 752
xxviii Table of Contents Basal Ganglia—Their Motor Functions 707 Function of the Basal Ganglia in Executing Patterns of Motor Activity—The Putamen Circuit 708 Role of the Basal Ganglia for Cognitive Control of Sequences of Motor Patterns— The Caudate Circuit 709 Function of the Basal Ganglia to Change the Timing and to Scale the Intensity of Movements 709 Functions of Specific Neurotransmitter Substances in the Basal Ganglial System 710 Integration of the Many Parts of the Total Motor Control System 712 Spinal Level 712 Hindbrain Level 712 Motor Cortex Level 712 What Drives Us to Action? 713 CHAPTER 57 Cerebral Cortex, Intellectual Functions of the Brain, Learning and Memory 714 Physiologic Anatomy of the Cerebral Cortex 714 Functions of Specific Cortical Areas 715 Association Areas 716 Comprehensive Interpretative Function of the Posterior Superior Temporal Lobe— “Wernicke’s Area” (a General Interpretative Area) 718 Functions of the Parieto-occipitotemporal Cortex in the Nondominant Hemisphere 719 Higher Intellectual Functions of the Prefrontal Association Areas 719 Function of the Brain in Communication—Language Input and Language Output 720 Function of the Corpus Callosum and Anterior Commissure to Transfer Thoughts, Memories, Training, and Other Information Between the Two Cerebral Hemispheres 722 Thoughts, Consciousness, and Memory 723 Memory—Roles of Synaptic Facilitation and Synaptic Inhibition 723 Short-Term Memory 724 Intermediate Long-Term Memory 724 Long-Term Memory 725 Consolidation of Memory 725 CHAPTER 58 Behavioral and Motivational Mechanisms of the Brain—The Limbic System and the Hypothalamus 728 Activating-Driving Systems of the Brain 728 Control of Cerebral Activity by Continuous Excitatory Signals from the Brain Stem 728 Neurohormonal Control of Brain Activity 730 Limbic System 731 Functional Anatomy of the Limbic System; Key Position of the Hypothalamus 731 Hypothalamus, a Major Control Headquarters for the Limbic System 732 Vegetative and Endocrine Control Functions of the Hypothalamus 733 Behavioral Functions of the Hypothalamus and Associated Limbic Structures 734 “Reward” and “Punishment” Function of the Limbic System 735 Importance of Reward or Punishment in Behavior 736 Specific Functions of Other Parts of the Limbic System 736 Functions of the Hippocampus 736 Functions of the Amygdala 737 Function of the Limbic Cortex 738 CHAPTER 59 States of Brain Activity—Sleep, Brain Waves, Epilepsy, Psychoses 739 Sleep 739 Slow-Wave Sleep 739 REM Sleep (Paradoxical Sleep, Desynchronized Sleep) 740 Basic Theories of Sleep 740 Physiologic Effects of Sleep 741 Brain Waves 741 Origin of Brain Waves 742 Effect of Varying Levels of Cerebral Activity on the Frequency of the EEG 743 Changes in the EEG at Different Stages of Wakefulness and Sleep 743 Epilepsy 743 Grand Mal Epilepsy 743 Petit Mal Epilepsy 744 Focal Epilepsy 744 Psychotic Behavior and Dementia— Roles of Specific Neurotransmitter Systems 745 Depression and Manic-Depressive Psychoses—Decreased Activity of the Norepinephrine and Serotonin Neurotransmitter Systems 745 Schizophrenia—Possible Exaggerated Function of Part of the Dopamine System 745 Alzheimer’s Disease—Amyloid Plaques and Depressed Memory 746 CHAPTER 60 The Autonomic Nervous System and the Adrenal Medulla 748 General Organization of the Autonomic Nervous System 748 Physiologic Anatomy of the Sympathetic Nervous System 748 Preganglionic and Postganglionic Sympathetic Neurons 748 Physiologic Anatomy of the Parasympathetic Nervous System 750 Basic Characteristics of Sympathetic and Parasympathetic Function 750 Cholinergic and Adrenergic Fibers— Secretion of Acetylcholine or Norepinephrine 750 Receptors on the Effector Organs 752
Table of Contents Excitatory and Inhibitory Actions of ysiological Anatomy of the Sympathetic and Parasympathetic Gastrointestinal wall 77 Stimulation Neural control of gastrointestin Effects of Sympathetic and Parasympathetic Function-Enteric Nervous System Stimulation on Specific Organs 753 Differences Between the Myenteric and Function of the Adrenal Medullae 755 774 Relation of Stimulus Rate to Degree of Types of Neurotransmitters Secreted by Sympathetic and Parasympathetic Effect 756 Enteric Neurons 775 Sympathetic and Parasympathetic"Tone 56 Hormonal Control of gastrointestinal Denervation Supersensitivity of Sympathetic y 776 and Parasympathetic Organs after Functional Types of Movements in the Denervation Gastrointestinal Tract Autonomic Reflexes 757 Propulsive Movements-Peristalsis Stimulation of Discrete Organs in Some Mixing Movements Instances and mass stimulation in Gastrointestinal blood flow. other Instances by the Sympathetic Splanchnic Circulation and Parasympathetic Systems 757 Anatomy of the Gastrointestinal Blood “Aarm,or“ Stress" Response of the 778 Sympathetic Nervous System 758 Effect of Gut Activity and Metabolic Medullary, Pontine, and Mesencephalic Factors on Gastrointestinal Blood Control of the autonomic nervous Flow System 758 Nervous Control of gastrointestinal blood harmacology of the Autonomic Flow Nervous System Drugs That Act on adr Organs-Sympathom Drugs That Act on Chol 如mm CHAPTER 63 raans Propulsion and Mixing of Food in the Drugs That Stimulate or Block Sympathetic Alimentary Tract staan Neurons 759 Mastication(chewing) 78l 782 CHAPTER 61 Motor Functions of the stomach 784 Cerebral Blood Flow, Cerebrospinal Storage Function of the Stomach 784 Fluid and brain metabolism 761 Mixing and Propulsion Of Food in the Stomach-The Basic Electrical Rhythm Cerebral Blood Flow 76l of the stomach wal 784 Normal rate of cerebral blood flow 76l 785 Regulation of Cerebral Blood Flow 76l Regulation of Stomach Emptying 785 Cerebral Microcirculation 763 Cerebral Stroke Occurs When Cerebral Mixing Contractions(Segmentation Blood vessels are blocked 763 Contractions) 786 Cerebrospinal Fluid System 763 Propulsive Movements 787 Cushioning Function of the Cerebrospinal Function of the ileocecal valve 788 763 nts of the colon Formation, Flow, and Absorption of Cerebrospinal Fluid 764 ther Autonomic reflexes that Affect Cerebrospinal Fluid Pressure 765 Bowel Activity 79 Obstruction to Flow of Cerebrospinal Fluid Can Cause Hydrocephalus 766 Blood-Cerebrospinal Fluid and Blood-Brain Barriers 766 CHAPTER 64 Brain Edema 766 Secretory Functions of the Alimentary Brain Metabolism Tract 791 General Principles of Alimentary Tract U X I natomical Ty pes of Glands Gastrointestinal Physiology Basic Mechanisms of stimulation of the Alimentary Tract Glands 791 CHAPTER 62 asic Mechanism of Secretion by Glandular 791 General Principles of Gastrointestinal Lubricating and Protective Properties of Function-Motility, Nervous Control, Mucus, and Importance of Mucus in the Gastrointestinal Tract 793 and Blood Circulation Secretion of saliva General Principles of Gastrointestinal Nervous Regulation of Salivary Secretion Motility Es。 phageal Secretion 795
Table of Contents xxix Excitatory and Inhibitory Actions of Sympathetic and Parasympathetic Stimulation 753 Effects of Sympathetic and Parasympathetic Stimulation on Specific Organs 753 Function of the Adrenal Medullae 755 Relation of Stimulus Rate to Degree of Sympathetic and Parasympathetic Effect 756 Sympathetic and Parasympathetic “Tone” 756 Denervation Supersensitivity of Sympathetic and Parasympathetic Organs after Denervation 756 Autonomic Reflexes 757 Stimulation of Discrete Organs in Some Instances and Mass Stimulation in Other Instances by the Sympathetic and Parasympathetic Systems 757 “Alarm” or “Stress” Response of the Sympathetic Nervous System 758 Medullary, Pontine, and Mesencephalic Control of the Autonomic Nervous System 758 Pharmacology of the Autonomic Nervous System 759 Drugs That Act on Adrenergic Effector Organs—Sympathomimetic Drugs 759 Drugs That Act on Cholinergic Effector Organs 759 Drugs That Stimulate or Block Sympathetic and Parasympathetic Postganglionic Neurons 759 CHAPTER 61 Cerebral Blood Flow, Cerebrospinal Fluid, and Brain Metabolism 761 Cerebral Blood Flow 761 Normal Rate of Cerebral Blood Flow 761 Regulation of Cerebral Blood Flow 761 Cerebral Microcirculation 763 Cerebral Stroke Occurs When Cerebral Blood Vessels are Blocked 763 Cerebrospinal Fluid System 763 Cushioning Function of the Cerebrospinal Fluid 763 Formation, Flow, and Absorption of Cerebrospinal Fluid 764 Cerebrospinal Fluid Pressure 765 Obstruction to Flow of Cerebrospinal Fluid Can Cause Hydrocephalus 766 Blood–Cerebrospinal Fluid and Blood-Brain Barriers 766 Brain Edema 766 Brain Metabolism 767 UNIT XII Gastrointestinal Physiology CHAPTER 62 General Principles of Gastrointestinal Function—Motility, Nervous Control, and Blood Circulation 771 General Principles of Gastrointestinal Motility 771 Physiological Anatomy of the Gastrointestinal Wall 771 Neural Control of Gastrointestinal Function—Enteric Nervous System 773 Differences Between the Myenteric and Submucosal Plexuses 774 Types of Neurotransmitters Secreted by Enteric Neurons 775 Hormonal Control of Gastrointestinal Motility 776 Functional Types of Movements in the Gastrointestinal Tract 776 Propulsive Movements—Peristalsis 776 Mixing Movements 777 Gastrointestinal Blood Flow— “Splanchnic Circulation” 777 Anatomy of the Gastrointestinal Blood Supply 778 Effect of Gut Activity and Metabolic Factors on Gastrointestinal Blood Flow 778 Nervous Control of Gastrointestinal Blood Flow 779 CHAPTER 63 Propulsion and Mixing of Food in the Alimentary Tract 781 Ingestion of Food 781 Mastication (Chewing) 781 Swallowing (Deglutition) 782 Motor Functions of the Stomach 784 Storage Function of the Stomach 784 Mixing and Propulsion Of Food in the Stomach—The Basic Electrical Rhythm of the Stomach Wall 784 Stomach Emptying 785 Regulation of Stomach Emptying 785 Movements of the Small Intestine 786 Mixing Contractions (Segmentation Contractions) 786 Propulsive Movements 787 Function of the Ileocecal Valve 788 Movements of the Colon 788 Defecation 789 Other Autonomic Reflexes That Affect Bowel Activity 790 CHAPTER 64 Secretory Functions of the Alimentary Tract 791 General Principles of Alimentary Tract Secretion 791 Anatomical Types of Glands 791 Basic Mechanisms of Stimulation of the Alimentary Tract Glands 791 Basic Mechanism of Secretion by Glandular Cells 791 Lubricating and Protective Properties of Mucus, and Importance of Mucus in the Gastrointestinal Tract 793 Secretion of Saliva 793 Nervous Regulation of Salivary Secretion 794 Esophageal Secretion 795
xxx Table of Contents Gastric Secretion Diarrhea Characteristics of the gastric secretions Paralysis of Defecation in Spinal Cord yloric Glands-Secretion of Mucus and Injuries 823 Gastrin Surface Mucous cells Stimulation of gastric Acid Secretion 777 General Disorders of the Gastrointestinal Tract Vomiting 823 Regulation of Pepsinogen Secretion 798 Nausea 824 nhibition of Gastric Secretion by other Gastrointestinal obstruction 824 Post-stomach intestinal Factors 798 Chemical Composition of Gastrin And Other Gastrointestinal hormones ancreatic Secretion Pancreatic Digestive Enzymes UNIT XII I Secretion of bicarbonate lons Metabolism and Temperature Regulation of Pancreatic Secretion Secretion of Bile by the Liver; Functions 800 Regulation Physiologic Anatomy of Biliary Secretion 802 unction of Bile Salts in Fat Digestion and CHAPTER 67 bsorp 804 Metabolism of Carbohydrates, Liver Secretion of cholesterol and Gallstone Formation 804 and Formation of Adenosine Secretions of the small Intestine 805 Triphosphate 829 Secretion of Mucus by Brunner's Glands in Release of Energy from Foods, and the the duodeni Concept of"Free Energy 829 Secretion of Intestinal Digestive Juices by Role of Adenosine Triphosphate in the Crypts of Lieberkuhn 829 Regulation of Small Intestine Secretion- Central Role of Glucose in Local stimuli Carbohydrate Metabolism 830 Secretions of the Large Intestine 806 Transport of Glucose Through the Cell Membrane CHAPTER 65 Insulin increases facilitated diffusion of Digestion and Absorption in the Phosphorylation of Glucose Gastrointestinal tract 808 Glycogen Is Stored in Liver and Digestion of the Various Foods b Glycogenesis-The Process of Glycogen Digestion of carbohydrates Formation Digestion of Proteins 810 Removal of Stored Glycogen. Digestion of Fats Glycogenolysis 832 Basic Principles of Gastrointestinal Release of Energy from the Glucose Absorption 812 Molecule by the Glycolytic Pathway 832 Anatomical Basis of Absorption 812 Summary of ATP Formation During the Absorption in the Small Intestine Breakdown of Glucose sorption of Water 814 Control of Energy Release from Stored bsorption of lons 814 Glycogen When the Body Needs Additional Absorption of Nutrients Absorption in the Large Intestine Anaerobic Release of Energy -Anaerobic Formation of Feces 817 Glycolysis Release of Energy from Glucose by the CHAPTER 66 Glucose Conversion to Glycogen or Fat Physiology of Gastrointestinal Formation of Carbohydrates from Disorders Proteins and Fats-“ Glucone。 genesis” 819 Blood Glucose Disorders of Swallowing and of the anus 819 Disorders of the stomach 819 Specific Causes of Peptic Ulcer in the Lipid metabolism 840 Human Being 821 Transport of Lipids in the Body Fluids Disorders of the small Intestine Transport of Triglycerides and other Lipids Abnormal Digestion of Food in the Smal om the Gastrointestinal Tract by Intestine-Pancreatic Failure 821 ymph-The Chylomicrons Malabsorption by the Small Intestine Removal of the Chylomicrons from the Mucosa-Sprue Blood 841 Disorders of the large Intestine "Free Fatty Acids "Are Transported in the Constipate Blood in Combination with Albumin 841
xxx Table of Contents Gastric Secretion 794 Characteristics of the Gastric Secretions 794 Pyloric Glands—Secretion of Mucus and Gastrin 797 Surface Mucous Cells 797 Stimulation of Gastric Acid Secretion 797 Regulation of Pepsinogen Secretion 798 Inhibition of Gastric Secretion by Other Post-Stomach Intestinal Factors 798 Chemical Composition of Gastrin And Other Gastrointestinal Hormones 799 Pancreatic Secretion 799 Pancreatic Digestive Enzymes 799 Secretion of Bicarbonate Ions 800 Regulation of Pancreatic Secretion 800 Secretion of Bile by the Liver; Functions of the Biliary Tree 802 Physiologic Anatomy of Biliary Secretion 802 Function of Bile Salts in Fat Digestion and Absorption 804 Liver Secretion of Cholesterol and Gallstone Formation 804 Secretions of the Small Intestine 805 Secretion of Mucus by Brunner’s Glands in the Duodenum 805 Secretion of Intestinal Digestive Juices by the Crypts of Lieberkühn 805 Regulation of Small Intestine Secretion— Local Stimuli 806 Secretions of the Large Intestine 806 CHAPTER 65 Digestion and Absorption in the Gastrointestinal Tract 808 Digestion of the Various Foods by Hydrolysis 808 Digestion of Carbohydrates 809 Digestion of Proteins 810 Digestion of Fats 811 Basic Principles of Gastrointestinal Absorption 812 Anatomical Basis of Absorption 812 Absorption in the Small Intestine 813 Absorption of Water 814 Absorption of Ions 814 Absorption of Nutrients 815 Absorption in the Large Intestine: Formation of Feces 817 CHAPTER 66 Physiology of Gastrointestinal Disorders 819 Disorders of Swallowing and of the Esophagus 819 Disorders of the Stomach 819 Peptic Ulcer 820 Specific Causes of Peptic Ulcer in the Human Being 821 Disorders of the Small Intestine 821 Abnormal Digestion of Food in the Small Intestine—Pancreatic Failure 821 Malabsorption by the Small Intestine Mucosa—Sprue 822 Disorders of the Large Intestine 822 Constipation 822 Diarrhea 822 Paralysis of Defecation in Spinal Cord Injuries 823 General Disorders of the Gastrointestinal Tract 823 Vomiting 823 Nausea 824 Gastrointestinal Obstruction 824 UNIT XIII Metabolism and Temperature Regulation CHAPTER 67 Metabolism of Carbohydrates, and Formation of Adenosine Triphosphate 829 Release of Energy from Foods, and the Concept of “Free Energy” 829 Role of Adenosine Triphosphate in Metabolism 829 Central Role of Glucose in Carbohydrate Metabolism 830 Transport of Glucose Through the Cell Membrane 831 Insulin Increases Facilitated Diffusion of Glucose 831 Phosphorylation of Glucose 831 Glycogen Is Stored in Liver and Muscle 831 Glycogenesis—The Process of Glycogen Formation 832 Removal of Stored Glycogen— Glycogenolysis 832 Release of Energy from the Glucose Molecule by the Glycolytic Pathway 832 Summary of ATP Formation During the Breakdown of Glucose 836 Control of Energy Release from Stored Glycogen When the Body Needs Additional Energy 836 Anaerobic Release of Energy—“Anaerobic Glycolysis” 836 Release of Energy from Glucose by the Pentose Phosphate Pathway 837 Glucose Conversion to Glycogen or Fat 838 Formation of Carbohydrates from Proteins and Fats—“Gluconeogenesis” 838 Blood Glucose 839 CHAPTER 68 Lipid Metabolism 840 Transport of Lipids in the Body Fluids 840 Transport of Triglycerides and Other Lipids from the Gastrointestinal Tract by Lymph—The Chylomicrons 840 Removal of the Chylomicrons from the Blood 841 “Free Fatty Acids” Are Transported in the Blood in Combination with Albumin 841
O Lipoproteins-Their Special Function in CHAPTER 7 1 Transporting Cholesterol and 841 Dietary Balances; Regulation of Fat Deposits 842 Feeding; Obesity and Starvation; Adipose Tissue 842 Vitamins and minerals 865 Liver Lipids 842 Energy Intake and Output Are Ba alanced of Triglycerides for Energy Under Steady-State Conditions Formation of Adenosine Triphosphate 86 Dietary Balances Formation of Acetoacetic Acid in the 865 er and Its Transport in the blood 844 Methods for Determining Metabolic Synthesis of Triglycerides from Utilization of proteins ci Carbohydrates 844 and Fats Synthesis of Triglycerides from Proteins 845 Regulation of Food Intake and Energ egulation of Energy Release from Triglycerides Neural Centers Regulate Food Intake Factors That Regulate Quantity of Food hospholipids and cholesterol Intake 88888 Phospholipids obesity Cholesterol 847 Cellular Structural Functions of Decreased Physical Activity and Phospholipids and Cholesterol Abnormal Feeding Regulation as 872 Especially for Membranes 848 Causes of obesity reatment of obesity 848 Inanition, Anorexia, and Cachexia 873 Atherosclerosis 87 Basic Causes of Atherosclerosis-the Starvation 874 Roles of Cholesterol and Lipoproteins 850 Vitamins 875 Other Major Risk Factors for Vitamin a 875 Atherosclerosis Thiamine (Vitamin B1) 875 Prevention of atherosclerosis Niacin 876 Riboflavin(Vitamin B2) 876 CHAPTEr 69 Vitamin B 876 Folic Acid(Pteroylglutamic Acid) 877 Protein metabolism 852 Pyridoxine 877 Basic p Pantothenic acid 877 Amino acids Ascorbic Acid (Vitamin C) 877 Transport and Storage of Amino Acids Vitamin D 878 Blood Amino acids Vitamin E Storage of Amino Acids as Proteins in the Vitamin K 878 lineal Metabolism 878 Functional roles of the plasma Proteins Essential and nonessential Amino acids 83 CHAPTER 7 2 Obligatory Degradation of Proteins 857 Energetics and Metabolic Rate 88l Hormonal Regulation of Protein Adenosine Triphosphate (ATP) Metabolism Functions as an“ Energy Currency” in Metabolism Phosphocreatine Functions as an CHAPTER 70 Accessory Storage Depot for Energy nd as an“ ATP Buffer The Liver as an Organ 859 Anaerobic Versus Aerobic Energy Physiologic Anatomy of the Liver Summary of Energy Utilization by the Hepatic Vascular and Lymph Cells Control of Energy Release in the Cell Blood Flows Through the Liver from the Metabolic Rate Portal Vein and Hepatic Arte Measurement of the whole-Body Metabolic The Liver Functions as a blood reservoir Rate The Liver Has Very High Lymph Flow 860 Energy Metabolism-Factors That Regulation of Liver Mass-Regeneratiol Infiuence Energy Output Hepatic Macrophage System Serves a Overall Energy Requirements for daily Blood-Cleansing Function 86l Metabolic Functions of the Liver Basal Metabolic Rate(BMR)-The Carbohydrate Metabolism Minimum Energy Expenditure for the Fat Metaboli body to Exist Protein metabolism Energy Used for Physical Activities Other Metabolic functions of the liver Energy Used for Processing Food Measurement of Bilirubin in the bile Thermogenic Effect of Food as a clinical Diagnostic Tool Energy Used for Nonshivering Jaundice-Excess Bilirubin in the Thermogenesis-Role of Sympathetic Extracellular Fluid 863 Stimulation 887
Table of Contents xxxi Lipoproteins—Their Special Function in Transporting Cholesterol and Phospholipids 841 Fat Deposits 842 Adipose Tissue 842 Liver Lipids 842 Use of Triglycerides for Energy: Formation of Adenosine Triphosphate 842 Formation of Acetoacetic Acid in the Liver and Its Transport in the Blood 844 Synthesis of Triglycerides from Carbohydrates 844 Synthesis of Triglycerides from Proteins 845 Regulation of Energy Release from Triglycerides 846 Obesity 846 Phospholipids and Cholesterol 846 Phospholipids 846 Cholesterol 847 Cellular Structural Functions of Phospholipids and Cholesterol— Especially for Membranes 848 Atherosclerosis 848 Basic Causes of Atherosclerosis—The Roles of Cholesterol and Lipoproteins 850 Other Major Risk Factors for Atherosclerosis 850 Prevention of Atherosclerosis 850 CHAPTER 69 Protein Metabolism 852 Basic Properties 852 Amino Acids 852 Transport and Storage of Amino Acids 854 Blood Amino Acids 854 Storage of Amino Acids as Proteins in the Cells 854 Functional Roles of the Plasma Proteins 855 Essential and Nonessential Amino Acids 855 Obligatory Degradation of Proteins 857 Hormonal Regulation of Protein Metabolism 857 CHAPTER 70 The Liver as an Organ 859 Physiologic Anatomy of the Liver 859 Hepatic Vascular and Lymph Systems 859 Blood Flows Through the Liver from the Portal Vein and Hepatic Artery 860 The Liver Functions as a Blood Reservoir 860 The Liver Has Very High Lymph Flow 860 Regulation of Liver Mass—Regeneration 860 Hepatic Macrophage System Serves a Blood-Cleansing Function 861 Metabolic Functions of the Liver 861 Carbohydrate Metabolism 861 Fat Metabolism 861 Protein Metabolism 862 Other Metabolic Functions of the Liver 862 Measurement of Bilirubin in the Bile as a Clinical Diagnostic Tool 862 Jaundice—Excess Bilirubin in the Extracellular Fluid 863 CHAPTER 71 Dietary Balances; Regulation of Feeding; Obesity and Starvation; Vitamins and Minerals 865 Energy Intake and Output Are Balanced Under Steady-State Conditions 865 Dietary Balances 865 Energy Available in Foods 865 Methods for Determining Metabolic Utilization of Proteins, Carbohydrates, and Fats 866 Regulation of Food Intake and Energy Storage 865 Neural Centers Regulate Food Intake 867 Factors That Regulate Quantity of Food Intake 870 Obesity 872 Decreased Physical Activity and Abnormal Feeding Regulation as Causes of Obesity 872 Treatment of Obesity 873 Inanition, Anorexia, and Cachexia 874 Starvation 874 Vitamins 875 Vitamin A 875 Thiamine (Vitamin B1) 875 Niacin 876 Riboflavin (Vitamin B2) 876 Vitamin B12 876 Folic Acid (Pteroylglutamic Acid) 877 Pyridoxine (Vitamin B6) 877 Pantothenic Acid 877 Ascorbic Acid (Vitamin C) 877 Vitamin D 878 Vitamin E 878 Vitamin K 878 Mineral Metabolism 878 CHAPTER 72 Energetics and Metabolic Rate 881 Adenosine Triphosphate (ATP) Functions as an “Energy Currency” in Metabolism 881 Phosphocreatine Functions as an Accessory Storage Depot for Energy and as an “ATP Buffer” 882 Anaerobic Versus Aerobic Energy 882 Summary of Energy Utilization by the Cells 883 Control of Energy Release in the Cell 884 Metabolic Rate 884 Measurement of the Whole-Body Metabolic Rate 885 Energy Metabolism—Factors That Influence Energy Output 885 Overall Energy Requirements for Daily Activities 885 Basal Metabolic Rate (BMR)—The Minimum Energy Expenditure for the Body to Exist 886 Energy Used for Physical Activities 887 Energy Used for Processing Food— Thermogenic Effect of Food 887 Energy Used for Nonshivering Thermogenesis—Role of Sympathetic Stimulation 887
trrl Table of Contents CHAPTER 7 3 Growth Hormone promotes growth of Body Temperature, Temperature Many Body Tissues Growth Hormone has several Metabolic Regulation, and Fever Normal Body Temperatures 889 Growth Hormone Stimulates Cartilage and 922 Effects Body Temperature Is Controlled by Bone growth 23 Balancing Heat Production Against Growth Hormone Exerts much of its Effect eat Loss Through Intermediate Substances called Heat Production Somatomedins"(Also Called"Insulin-Like Heat Loss 890 Growth Factors") Regulation of Body Temperature-Role Regulation of Growth Hormone Secretion of the Hypothal 894 Abnormalities of growth Hormone secretion 926 Neuronal Effector Mechanisms that Posterior Pituitary Gland and Its Decrease or Increase body Temperature 895 Relation to the Hypothalamus 927 Concept of a"Set-Point "for Temperature Chemical Structures of ADH and Oxytocin 928 896 Physiological Functions of ADH 928 Behavioral Control of Body Temperature Oxytocic Hormone 929 Abnormalities of Body Temperature PT E Exposure of the body to Extreme Cold 900 Thyroid Metabolic Hormones Synthesis and Secretion of the Thyroid Metabolic hormones U NITXIⅤ lodine Is Required for Formation of Endocrinology and reproduction lodide Pump(lodide Trapping) Thyroglobulin, and Chemistry of Thyroxine and triiodothyronine formation 932 CHAPTER 74 Release of Thyroxine and Triodothyronine from the thyroid Gland 933 Introduction to Endocrinology 905 Transport of Thyroxine and Triiodothyronine Coordination of Body Functions by 934 Chemical Messengers 905 Physiologic Functions of the Thyroid Chemical Structure and Synthesis of Hormones 906 Thyroid Hormones Increase the Hormone Secretion, Transport, and Transcription of Large Numbers of Genes 934 Clearance from the blood 908 Thyroid Hormones Increase Cellular Feedback Control of hormone secretion 909 Metabolic activity 934 Transport of Hormones in the Blood 909 Effect of Thyroid Hormone on Growth 936 Clearance" of hormones from the blood Effects of Thyroid Hormone on Specific Mechanisms of action of hormones 910 Bodily Mechanisms 936 Hormone Receptors and Their Activation 910 Regulation of Thyroid Hormone Intracellular Signaling After Hormone Secretion 938 Receptor Activation 910 Anterior Pituitary Secretion of TsH Is Second Messenger Mechanisms for Regulated by Thyrotropin-Releasing Mediating Intracellular Hormonal Hormone from the hypothalamus 938 Functions 912 Feed back Effect of thyroid Hormone to Hormones That Act Mainly on the Genetic Decrease Anterior Pituitary Secretion 915 of tsh Measurement of hormone Diseases of the Thyroid Concentrations in the blood 915 Radioimmunoassay 915 Symptoms of Hyperthyroidism Enzyme-Linked Immunosorbent Assay Hy pothy roidism 941 (ELISA) 916 Cretinism 942 CHAPTER 75 Adrenocortical hormones Pituitary Hormones and Their Control Synthesis and secretion of by the Hypothalamus 918 Adrenocortical hormones Pituitary Gland and Its Relation to the Functions of the mineralocorticoids. Hypothalamus 98 Aldosterone Hypothalamus Controls Pituitary Renal and circulatory Effects of Secretion 919 Aldosterone 948 Hypothalamic-Hypophysial Portal Blood Aldosterone Stimulates sodium and Vessels of the Anterior Pituitary Glan 920 Potassium Transport in Sweat Glands Physiological Functions of Growth Salivary Glands, and Intestinal Epithelial 921
xxxii Table of Contents CHAPTER 73 Body Temperature, Temperature Regulation, and Fever 889 Normal Body Temperatures 889 Body Temperature Is Controlled by Balancing Heat Production Against Heat Loss 889 Heat Production 889 Heat Loss 890 Regulation of Body Temperature—Role of the Hypothalamus 894 Neuronal Effector Mechanisms That Decrease or Increase Body Temperature 895 Concept of a “Set-Point” for Temperature Control 896 Behavioral Control of Body Temperature 897 Abnormalities of Body Temperature Regulation 898 Fever 898 Exposure of the Body to Extreme Cold 900 UNIT XIV Endocrinology and Reproduction CHAPTER 74 Introduction to Endocrinology 905 Coordination of Body Functions by Chemical Messengers 905 Chemical Structure and Synthesis of Hormones 906 Hormone Secretion, Transport, and Clearance from the Blood 908 Feedback Control of Hormone Secretion 909 Transport of Hormones in the Blood 909 “Clearance” of Hormones from the Blood 909 Mechanisms of Action of Hormones 910 Hormone Receptors and Their Activation 910 Intracellular Signaling After Hormone Receptor Activation 910 Second Messenger Mechanisms for Mediating Intracellular Hormonal Functions 912 Hormones That Act Mainly on the Genetic Machinery of the Cell 915 Measurement of Hormone Concentrations in the Blood 915 Radioimmunoassay 915 Enzyme-Linked Immunosorbent Assay (ELISA) 916 CHAPTER 75 Pituitary Hormones and Their Control by the Hypothalamus 918 Pituitary Gland and Its Relation to the Hypothalamus 918 Hypothalamus Controls Pituitary Secretion 919 Hypothalamic-Hypophysial Portal Blood Vessels of the Anterior Pituitary Gland 920 Physiological Functions of Growth Hormone 921 Growth Hormone Promotes Growth of Many Body Tissues 922 Growth Hormone Has Several Metabolic Effects 922 Growth Hormone Stimulates Cartilage and Bone Growth 923 Growth Hormone Exerts Much of Its Effect Through Intermediate Substances Called “Somatomedins” (Also Called “Insulin-Like Growth Factors”) 923 Regulation of Growth Hormone Secretion 924 Abnormalities of Growth Hormone Secretion 926 Posterior Pituitary Gland and Its Relation to the Hypothalamus 927 Chemical Structures of ADH and Oxytocin 928 Physiological Functions of ADH 928 Oxytocic Hormone 929 CHAPTER 76 Thyroid Metabolic Hormones 931 Synthesis and Secretion of the Thyroid Metabolic Hormones 931 Iodine Is Required for Formation of Thyroxine 931 Iodide Pump (Iodide Trapping) 932 Thyroglobulin, and Chemistry of Thyroxine and Triiodothyronine Formation 932 Release of Thyroxine and Triiodothyronine from the Thyroid Gland 933 Transport of Thyroxine and Triiodothyronine to Tissues 934 Physiologic Functions of the Thyroid Hormones 934 Thyroid Hormones Increase the Transcription of Large Numbers of Genes 934 Thyroid Hormones Increase Cellular Metabolic Activity 934 Effect of Thyroid Hormone on Growth 936 Effects of Thyroid Hormone on Specific Bodily Mechanisms 936 Regulation of Thyroid Hormone Secretion 938 Anterior Pituitary Secretion of TSH Is Regulated by Thyrotropin-Releasing Hormone from the Hypothalamus 938 Feedback Effect of Thyroid Hormone to Decrease Anterior Pituitary Secretion of TSH 939 Diseases of the Thyroid 940 Hyperthyroidism 940 Symptoms of Hyperthyroidism 940 Hypothyroidism 941 Cretinism 942 CHAPTER 77 Adrenocortical Hormones 944 Synthesis and Secretion of Adrenocortical Hormones 944 Functions of the MineralocorticoidsAldosterone 947 Renal and Circulatory Effects of Aldosterone 948 Aldosterone Stimulates Sodium and Potassium Transport in Sweat Glands, Salivary Glands, and Intestinal Epithelial Cells 949