SECTION I GENERAL PHYSIOLOGY 1

1. Cell: A Structural and Functional Unit 3

Introduction 4

The Principal Organ Systems 4

Homeostasis 5

Structure and Function of a Cell 6

2. Transport across Cell

Membrane 22

Passive Transport 23

Osmoles, Osmolarity and Osmolality 27

Tonicity 28

Active Transport (Uphill Transport) 28

Vesicular Transport 31

Epithelial Transport 33

3. Body Water and Body Fluids 36

Total Body Water 36

Body Fluid Compartments 37

Composition of Extra- and Intracellular

Fluids 38

Measuring the Fluid Volumes in the

Different Body Fluid Compartments 39

Measures of Concentration 39

Acid, Base and pH 40

Acidosis and Alkalosis 41

Buffers 41

4. Membrane Potentials 43

Ion Channels 43

Types of Gates 44

Diffusion Potential 44

Equilibrium Potential 44

Resting Membrane Potential 45

Genesis of Resting Membrane Potential

(Transmembrane Potential) 46

Measurement of Resting Membrane

Potential 46

SECTION II PHYSIOLOGY

OF NERVE AND

MUSCLE 49

5. Nerve Physiology 51

Structure of a Neuron 52

Myelinated and Unmyelinated Axon 53

Types of Neuron 54

Ionic Basis of Action Potential 58

Properties of Action Potential 59

Conductivity (Propagation of Action

Potential) 60

6. Muscle Physiology 64

Types of Muscle 65

General Function of Muscles 65

Skeletal Muscles 65

Myofi laments 67

Other Structural Proteins 68

Molecular Basis of Muscular

Contraction of Skeletal Muscle 69

Excitation Contraction Coupling 69

Sequence of Events in Muscular

Contraction 71

Energy for Muscular Contraction 71

Isometric, Isotonic and Eccentric

Contraction 72

Classifi cation of Skeletal Muscle

Fibre Type 73

Electrical Activity of Skeletal Muscle 74

Effect of Repeated Stimulus to Muscle 74

Heat Production in Muscles 75

The Oxygen Debt 75

Motor Unit 75

Muscle Fatigue 76

Rigor Mortis 76

Cardiac Muscle 76

Properties of Cardiac Muscle 77

Mechanical Properties 77

Smooth Muscle 78

7. Neuromuscular Junction 83

Structure of Neuromuscular Junction 83

Mechanism of Transmission of Nerve

Impulse Across Neuromuscular

Junction 84

Degradation of Acetylcholine 86

SECTION III BLOOD 89

8. Blood and Plasma Proteins 91

Plasma and Serum 91

Composition of Blood 92

Diseases and Plasma Proteins 94

9. Haemopoiesis and Red Blood

Corpuscle (RBC) 96

Haemopoiesis 96

Erythrocytes (RBC) 99

10. Haemoglobin and Anaemia 102

Haemoglobin 102

Anaemias 107

11. White Blood Corpuscles 112

Granulocytes 112

Different White Blood Cells 112

Agranulocytes 114

12. Thrombocytes 118

Platelets 118

Haemostasis 119

Purpura 121

13. Blood Coagulation and

Bleeding Disorders 122

Mechanism of Blood Clotting 122

Deep Vein Thrombosis 124

Haemostatic Function Tests 125

Fibrinolysis 125

Acquired and Inherited Clotting

Disorders 125

Prevention of Intravascular Clotting 126

Anticoagulants In Vivo and In Vitro 126

14. Blood Groups and

Transfusion 128

Blood Groups 128

Transfusion of Blood 130

15. Lymphatic and Immune

System 133

The Lymphatic System 133

Tissue Macrophage System 134

Immunity 135

Immunoglobulins 139

Mechanism of Action of Antibodies 139

SECTION IV CARDIOVASCULAR

SYSTEM 143

16. Structure of the Heart and

Conducting System 145

Atria and Ventricle 145

Valves in the Heart 146

Conducting System of Heart 148

Pacemaker Potential 149

Innervation of the Heart and

Peripheral Vessels 149

17. Electrocardiogram 152

Normal ECG 152

18. Cardiac Cycle 158

Cardiac Cycle 158

Heart Sounds 162

19. Cardiac Output 164

Cardiac Output 164

Regulation of Cardiac Output 165

20. General Principles

of Circulation 170

Introduction 170

Functions of Different Components

of Vessels 172

Structure of Vessels 172

Cross-sectional Area of Different

Vessels 174

Pressure Changes in Vascular System 174

Haemodynamics 175

21. Cardiovascular Regulatory

Mechanisms 178

Local Regulatory Mechanisms 178

Systemic Regulatory Mechanisms 179

Systemic Regulation by Nervous

System 180

Atrial Stretch Receptors 181

22. Arterial Blood Pressure 184

Systolic and Diastolic Blood Pressure 184

23. Circulation through

Special Regions 192

Coronary Circulation 192

Factors that Affect Coronary

Blood Flow 193

Cerebral Blood Flow 194

Cutaneous Circulation 194

24. Physiology of Shock 196

Types of Shocks 196

Common Symptoms of Shock 196

SECTION V RESPIRATORY

SYSTEM 199

25. Organization of Respiratory

System 201

Tracheobronchial Tree 202

Respiratory Membrane 202

Pleura 203

Non-Respiratory Functions of Lung 203

26. Mechanics of Respiration 205

Inspiration 205

Expiration 206

Pressure Changes during

Ventilation 206

Lung Volume and Capacities 207

Pulmonary Ventilation 208

Maximum Breathing Capacity

(Maximum Voluntary Ventilation,

Maximum Ventilation Volume) 208

Pulmonary Reserve 208

Alveolar Surface Tension 208

Compliance 209

Work of Breathing 209

Airway Resistance 210

Alveolar Ventilation 210

Dead Space 210

Ventilation–Perfusion Ratio 210

Diffusion Capacity 211

27. Transport of Gases 213

Partial Pressure of Gases 213

Oxygen Transport 214

Transport of Carbon Dioxide 216

28. Regulation of Respiration 218

Nervous Regulatory Mechanism 218

Chemical Controlling Mechanisms

of Respiration 2208

929. Hypoxia and Deep

Sea Diving 223

Classifi cation of Hypoxia 223

Effects of Hypoxia 224

Effects of Decreased Barometric

Pressure 224

Cyanosis 225

Decompression Sickness 225

Cardiovascular and Respiratory

Adjustments during Exercise 225

SECTION VI DIGESTIVE

SYSTEM 227

30. Organization and Functions

of Gastrointestinal System 229

Gastrointestinal System 229

31. Deglutition and Salivary

Secretion 236

Mouth 236

Teeth 236

Swallowing 238

Salivary Glands 239

32. Stomach 244

Gastric Mucosa and Glands 244

Gastric Secretion and Its Functions 245

33. Pancreas 251

Composition and Functions

of Pancreatic Juice 251

Mechanism of Formation of

Bicarbonate by Pancreas 253

Pancreatic Enzymes 253

Pancreatic Function Tests 255

34. Liver and Biliary Secretion 256

Liver 256

Biliary Secretion 258

35. Small Intestine 262

Structure 262

Intestinal Secretions 263

Movements of Small Intestine 264

36. Large Intestine 268

Secretions in Large Intestine 269

Movements of Colon 269

Functions of Large Intestine 270

Defaecation 270

37. Digestion and Absorption 272

Digestion and Absorption

of Carbohydrates 272

Digestion and Absorption

of Proteins 273

Digestion and Absorption of Fats 276

Absorption of Water 277

SECTION VII FORMATION AND

EXCRETION OF

URINE 283

38. Structure and Functions

of Kidney 285

Types of Nephron 286

Renal Blood Flow 288

Functions of Kidney 289

39. Mechanism of Urine

Formation 291

Glomerular Filtration 292

Reabsorption and Secretions

in Renal Tubules 295

Proximal Convoluted Tubule (PCT) 295

Loop of Henle 298

Distal Convoluted Tubule (DCT) 299

Collecting Ducts 300

40. The Countercurrent System 302

Countercurrent System 302

Countercurrent Multiplier System 303

Maintenance of Medullary Gradient 304

41. Renal Regulation of

Acid–Base Balance 306

Regulation of Acid–Base Balance

by Renal System 307

Acid–Base Disorders 309

42. Micturition 310

Innervation of Urinary Bladder 310

Micturition Refl ex 311

43. Basal Metabolic Rate

and Body Temperature

Regulation 313

Measurement of BMR 313

Regulation of Body Temperature 314

Thermoregulation 316

SECTION VIII ENDOCRINE

SYSTEM 319

44. Endocrine Glands 321

Endocrine System 321

Endocrine Glands and Hormones 321

Relationship between Hypothalamus

and Pituitary Gland 323

Regulation of Hormonal Secretion 324

45. Pituitary Gland 327

Adenohypophysis 328

Anterior Pituitary Gland 329

Posterior Pituitary (Neurohypophysis) 333

46. Thyroid Gland 339

Functional Unit of Thyroid Gland 339

Mechanism of Synthesis of Thyroid

Hormone 340

Transport of Thyroid Hormones 342

Actions of Thyroid Hormones 343

Regulation of Thyroid Secretions 344

Pathophysiology of Thyroid Gland 344

Thyroid Function Tests 346

47. Adrenal Gland 349

Adrenal Cortex 349

Adrenal Medulla 356

Catecholamines Receptors 357

48. Endocrine Pancreas 362

Islet Cells 362

Insulin Structure 363

Biosynthesis of Insulin 363

Circulation and Degradation of Insulin 364

Mechanism of Action of Insulin 364

Physiological Actions of Insulin 365

Control of Insulin Secretion 368

Applied Physiology 369

Glucagon 372

Somatostatin 374

Pancreatic Polypeptide 375

49. Parathyroid, Calcitonin

and Vitamin D 378

Calcium 378

Hormonal Regulation of Calcium

Metabolism 382

Pathophysiology of Parathyroid Hormone,

Vitamin D and Bone Diseases 385

Vitamin D Defi ciency 386

50. Thymus and Pineal Glands 390

Thymus 390

Pineal Gland 391

SECTION IX REPRODUCTIVE

SYSTEM 393

51. Sex Determination,

Differentiation and Onset

of Puberty 395

Sex Determination 396

Chromosomal Abnormalities 396

Development of Gonads 396

Puberty (Adolescence) 398

52. Male Reproductive

Physiology 400

Male Reproductive Organs 400

Structure of Testes 400

Spermatogenesis 401

Mature Sperm 402

Sertoli Cells 403

Semen 403

Erection and Ejaculation 403

Endocrine Functions of Testes 404

Pathophysiology of Testes 405

153. Female Reproductive

Physiology 407

Female Reproductive System 407

Structure of Ovary 408

Secretion of Hormones 410

Ovarian Cycle 412

Vaginal Cycle 412

Uterine or Menstrual Cycle 412

54. Pregnancy, Parturition,

Lactation and

Contraception 417

Pregnancy 417

Parturition 419

Process of Lactation 420

Contraception 421

SECTION X NERVOUS

SYSTEM 425

55. Organization of Nervous

System 427

Central Nervous System 427

Peripheral Nervous System 429

56. Synapse 434

Classifi cation of Synapses 434

Electrical Synapse 434

Chemical Synapse 435

57. Receptors 441

Sensory Receptors 441

Modalities of Cutaneous Sensations 442

Generator Potentials 443

Encoding of Sensory Information 445

58. Refl exes 447

Refl ex Action Pathway 447

Classifi cation of Refl exes 447

Monosynaptic Refl ex 448

Polysynaptic Refl ex 452

Properties of Refl exes 453

Muscle Tone 454

59. Sensory System 456

Sensory Tracts in the Spinal Cord 456

Pathway for Fine Touch, Tactile

Localization, Discrimination, Proprioceptive

and Kinaesthetic Sensation, Vibration

and Deep Pressure 457

Pathway for Pain and Temperature

Sensations 458

Pathway for Pain, Temperature,

Proprioception and Vibration from

Head Area 459

Pathway for Crude Touch and Tactile

Localization 460

Pathway for Unconscious Kinaesthetic

Sensations 460

Somatosensory Cortex 460

Types of Sensations 462

60. Motor System 466

Motor Cortex 466

Extrapyramidal System 470

Pathophysiology of Lesions in Pyramidal

and Extrapyramidal Tracts 471

61. Cerebellum, Basal Ganglia

and Reticular Formation 475

Cerebellum 475

Basal Ganglia 479

Reticular Formation 480

62. Thalamus and Hypothalamus 483

Thalamus 483

Hypothalamus 485

63. Cerebrum and Limbic

System 489

Cerebrum 489

Limbic System 493

Emotions 494

64. Vestibular Apparatus

and Control of Posture 496

Vestibular Apparatus 496

Posture 498

65. Autonomic Nervous System 501

Division of ANS 502

Innervation of Organ Systems, Receptor

Types and Responses 506

Neurotransmitters 508

66. Higher Functions of

Nervous System 510

Learning and Memory 510

Speech 512

67. Cerebrospinal Fluid and

Blood–Brain Barrier 514

Cerebrospinal Fluid 514

Blood–Brain Barrier 516

SECTION XI SPECIAL SENSES 519

68. Eye 521

The Organization of the Retina 523

Photoreceptor Cells 524

Visual Pathway 525

Lesions in Optic Tract 525

Refractive Media and their Refractive

Indices 526

Mechanisms of Generation of

Photoreceptor Potential 526

Accommodation 527

Light Refl ex 528

The Visual Field 528

Visual Acuity 528

Errors of Refraction 529

Colour Vision 529

69. Ear 533

Introduction 533

Sound 533

Frequency 534

Anatomy and Physiology of External,

Middle and Internal Ear 534

The Cochlea 538

The Organ of Corti (Receptor

of Hearing) 538

Mechanism of Hearing 539

Auditory Pathway 540

Applied Physiology 543

Audiometry 544

70. Taste and Smell 546

Taste 546

Smell 549

Appendix I Understanding Medical

Terminology 553

Appendix II Units of Measure, Weight

and Symbols 555

Appendix III Abbreviations Used

in the Book 557

Index 559