Файл: BRS_Physiology_6E_2014_1.pdf

A

A band, 17, 17 a wave, 85

A–a (alveolar–arterial) gradient, 130, 142Q, 146E A-alpha nerve fibers, 37t

Abdominal muscles, in expiration, 118 A-beta nerve fibers, 37t Abetalipoproteinemia, 217

Absolute refractory period (ARP), 11, 11, 25Q, 30E cardiac, 74, 74–75

Absorption, 92, 93

of bile acid, 213, 213, 215t of calcium, 215t, 219

of carbohydrates, 214, 215t, 216 of electrolytes, 218

of iron, 215t, 219 of K+, 218

of lipids, 215t, 217 of NaCl, 217–218

of proteins, 215t, 216, 216 in small intestine, 202

of vitamins, 215t, 218–219 of water, 218

Accessory muscles, in breathing, 117 Accommodation, 11

ACE (angiotensin-converting enzyme) in arterial pressure regulation, 89

in regulation of angiotensin II production, 89, 90, 244

ACE (angiotensin-converting enzyme) inhibitors, 89

and glomerular filtration rate, 152 and renal blood flow, 152

Acetazolamide, 138

Acetylcholine (ACh)

and atrial contractility, 78

in autonomic nervous system, 32 in gallbladder contraction, 213–214 in gastric H+ secretion, 209, 209

at neuromuscular junction, 12–14, 13, 25Q, 29E

in pancreatic secretion, 212 receptors, muscarinic, 35 receptors, nicotinic, 13, 35 Acetylcholinesterase (AChE), 14

Acetylcholinesterase (AChE) inhibitors, 14, 24Q, 29E

Acetylcholinesterase (AChE) receptors, in myasthenia­ gravis, 14, 24Q, 29E

ACh (see Acetylcholine (Ach)) Achalasia, 201

Acid(s)

nonvolatile, 172–173 production of, 172–173 titratable, 167, 173, 176

H+ excretion as, 176, 176 volatile, 172

weak, 158

Acid–base balance, 172–177 acid production, 172–173 buffers, 172–174, 175 and K+ secretion, 165–166 renal, 174–177, 175, 176

Acid–base disorder(s), 177–181, 177t causes of, 178t

compensatory responses to, 180t metabolic acidosis as, 177, 177t, 178t, 180 metabolic alkalosis as, 177t, 178–179, 178t respiratory acidosis as, 179–180 respiratory alkalosis as, 180–181

Acid–base map, 179 Acidemia, 177 Acidic urine pH, 158 Acidosis, 164t

due to diabetes mellitus, 250, 251 effect on K+ secretion, 166

lactic, 138, 178t metabolic

acid–base map of, 179 anion gap in, 177 causes of, 178t

due to chronic renal failure, 187Q, 192E due to diabetes mellitus, 187Q, 192E–193E due to diarrhea, 183, 186Q, 189E

due to hypoaldosteronism, 181 hyperchloremic, 177

respiratory compensation for, 177, 177t, 183, 186Q, 191E

respiratory

acid–base map of, 179 causes of, 178t

due to COPD, 187Q, 192E

renal compensation for, 177t, 179–180, 186Q, 191E

Acromegaly, 235

ACTH (adrenocorticotropic hormone) actions of, 228t

in adrenal hormone synthesis, 243, 265Q, 268E, 269E

deficiency of, 245–246

excess, 246, 247, 264Q, 265Q, 268E, 269E in regulation of adrenocortical hormone

secretion, 243–244, 244

in regulation of aldosterone secretion, 244 synthesis of, 234, 234, 264Q, 268E

Actin, 18

in excitation–contraction coupling, 18, 19 Action potential(s), 10–12, 11, 12, 22t

cardiac, 72, 72–74, 73, 78 characteristics of, 10

conduction velocity of, 12, 12, 25Q, 29E defined, 10

depolarization of, 10, 12 ionic basis of, 10, 11 overshoot of, 10 plateau phase of, 73

294 Index

Action potential(s) (Continued ) propagation of, 11–12, 12 refractory periods, 11, 11 repolarization of, 10, 25Q, 29E in skeletal muscle, 18, 18–19, 19 undershoot of, 10

upstroke of, 10, 28E, 29E, 74, 105Q, 112E Activation gate, of Na+ channel, 7

Active hyperemia, 94 Active tension, 20 Active transport

primary, 2t, 3–4, 26Q, 31E secondary, 2t, 4, 4–5, 5, 26Q, 31E

Acute respiratory acidosis, 180, 180t Acute respiratory alkalosis, 180

Addison disease, 245, 246, 246t, 264Q, 268E A-delta nerve fibers, 37t

Adenoma, parathyroid, 253

Adenosine, and coronary circulation, 96 Adenosine diphosphate (ADP), in excitation–­

contraction coupling, 18, 19 Adenosine triphosphate (ATP)

in active transport, 3–4, 26Q, 31E

in excitation-contraction coupling, 18, 19 and rigor, 18, 26Q, 31E

Adenylate cyclase, 230, 230 norepinephrine and, 59Q–60Q, 63E parathyroid hormone and, 187Q, 192E

ADP (adenosine diphosphate), in excitation–­ contraction coupling, 18, 19

Adrenal cortex

pathophysiology of, 245–247, 246t physiology of, 241–247, 242–244 synthetic pathways in, 243

Adrenal cortical tumors, 244 Adrenal crisis, 245

Adrenal medulla, 15, 32 in hemorrhage, 100 Adrenergic neurons, 32

Adrenergic receptors α1, 34, 34t, 59Q, 63E

drugs that act on, 34t, 58Q, 62E

α2 drugs that act on, 34t β1, 34, 34t, 58Q, 62E

drugs that act on, 35t

β2, 34, 34t

drugs that act on, 34t

and vasodilation, 60Q, 64E Adrenocortical excess, 246–247, 246t Adrenocortical hormones

actions of, 244

regulation of secretion of, 242–244, 244 synthesis of, 241–242, 243

Adrenocortical insufficiency, 245–246, 246t, 265Q, 268E

water shifts between compartments due to, 150t, 151

Adrenocorticotropic hormone (ACTH) actions of, 228t

in adrenal hormone synthesis, 243, 265Q, 268E–269E

deficiency of, 245–246

excess, 246, 247, 264Q, 265Q, 268E, 269E

in regulation of adrenocortical hormones secretion, 243–244, 244

in regulation of aldosterone secretion, 244

synthesis of, 234, 234, 264Q, 268E

Adrenocorticotropic hormone (ACTH)-secreting tumors, 244

Adrenogenital syndrome, 247 Adrenoreceptors, 34 Afferent fibers, 194 Afterload, 19, 20, 20

ventricular, 78

and ventricular pressure–volume loops, 79, 79–80, 80

Afterpotential, hyperpolarizing, 10 A-gamma nerve fibers, 37t

Age, GFR decreases with, 153 Airflow, 120–121

Airway obstruction, (V/Q) ratio in, 134–135, 135 Airway resistance, 121, 140Q, 144E

Alanine

Na+-dependent cotransport, 221Q, 224E in tubular fluid, 188Q, 193E

Albuterol, 35t

Aldosterone

actions of, 228t, 245, 264Q

in colonic secretion of K+, 218 effect on K+ secretion, 165, 165–166 in hemorrhage, 100, 107Q, 113E

in Na+ reabsorption, 162–163 origin of, 241, 242, 264Q, 268E

regulation of secretion of, 244, 265Q, 269E in renal acid–base balance, 176

renal effects of, 173t

in renin–angiotensin–aldosterone system, 89, 90

in saliva production, 205 synthesis of, 243 vomiting and, 183

Aldosterone antagonist, 189E Aldosterone synthase, 243 Aldosterone-secreting tumors, 246t, 247 Alkalemia, 178

Alkaline tide, 208 Alkaline urine pH, 158 Alkalosis

contraction, 183 due to vomiting, 208

effect on K+ secretion, 166 metabolic

acid–base map of, 179 causes of, 178t

compensatory responses, 180t

due to hyperaldosteronism, 186Q, 192E due to vomiting, 182, 182, 187Q, 193E

respiratory compensation for, 178, 186Q, 192E respiratory, 187Q, 192E

acid–base map of, 179 causes of, 178t

renal compensation, 180

renal compensation for, 175, 177t, 180, 186Q, 191E

respiratory compensation for, 186Q, 191E Alpha cells, 248, 249t

Alpha waves, 54

α1 receptor(s), 34, 34t, 59Q, 63E drugs that act on, 35t, 58Q, 62E and vasoconstriction, 105Q, 112E

α2 receptor(s), 34, 34t drugs that act on, 35t

α1 receptor agonists, 35t

α1 receptor antagonists, 35t, 58Q, 62E α-amylases, 214

α-dextrinase, 214

α-motoneurons, 48 convergence on, 51 divergence to, 51

in stretch reflex, 50, 50 Altitude

and hemoglobin–O2 dissociation curve, 141Q, 145E–146E

respiratory effects of, 138, 138t Alveolar gas equation, 130 Alveolar pressure, 122

Alveolar ventilation (VA), 116, 123, 133 Alveoli, surface tension of, 119–120, 120 Amacrine cell, 39, 40

Amine hormone(s), synthesis of, 227 Amino acids

absorption of, 216, 216 free, 216

insulin and, 250

TF/P value for, 161, 161

Ammonia (NH3) synthesis, 176, 176–177 Ammonium cation (NH4+), H+ excretion as, 176,

176–177 Anal canal, 203

Anatomic dead space, 115

Androgen(s), adrenal, 241, 242, 243, 264Q, 268E Androgen insensitivity disorder, 258, 266Q,

270E, 279E

Androgen receptors, deficiency of, 258 Androstenedione, 241, 243, 257, 258, 259, 264Q, 268E Anemia

iron deficiency, 219 pernicious, 219

Angiotensin I, 89 Angiotensin II

and HCO3− reabsorption, 175 in hemorrhage, 100

receptor (AT1) antagonists, 89

in regulation of aldosterone secretion, 243, 244 and renal blood flow, 152

renal effects of, 155t, 173t

in renin–angiotensin–aldosterone system, 89, 90 Angiotensin-converting enzyme (ACE)

in arterial pressure regulation, 89

in regulation of angiotensin II production, 89,

90, 244 Angiotensin-converting enzyme (ACE)

inhibitors, 89

and renal blood flow, 152

Angiotensin receptor (AT1) antagonists, 89 Angular acceleration, 46, 46

Anion(s), and K+ secretion, 166 Anion gap, serum, 177, 180 Anorexigenic neurons, 199 Anosmia, 47, 64E

ANP (atrial natriuretic peptide), 231 and arterial blood pressure, 91 mechanism of action, 229t, 231 renal effects of, 152

ANS (see Autonomic nervous system (ANS)) Anterior pituitary gland, 233

hormones of, 233–237, 234–236, 236t Anticholinergic drugs, and saliva, 206 Antidiuretic hormone (ADH)

actions of, 228t, 237

and arterial blood pressure, 91 in hemorrhage, 100 hypoaldosteronism and, 182 in Na+ reabsorption, 163 origin of, 237

Index 295

pathophysiology, 172t regulation of secretion of, 237t renal effects of, 173t

syndrome of inappropriate, 151, 172 urine production in, 167

vs. water deprivation, 186Q, 191E

water shifts between compartments due to, 150t, 151

and urea reabsorption, 166 in urine production

disorders of, 167–172, 168–170 Anti-inflammatory effects, of glucocorticoids, 245 Anti-müllerian hormone, 255, 256, 256

Antiport, 4, 5

Aortic body, chemoreceptors in, 90–91 hemorrhage and, 100

Aortic pressure

in cardiac cycle, 70, 86, 105Q, 112E QRS complex and, 70, 86, 105Q, 112E and ventricular afterload, 78–79

Aortic valve

closure of, 87, 103Q, 109E opening of, 80, 86

Aphasia, 55 motor, 55 sensory, 55

Apneustic center, 136

Apoprotein B, failure to synthesize, 217 Aquaporin 2 (AQP2), 237

Aromatase, 258

Aromatization, of 18-carbon steroids, 242

ARP (absolute refractory period), 11, 11, 25Q, 30E cardiac, 74, 74–75

Arterial pressure, 70–71

in cardiac cycle, 70, 70–71

and carotid sinus baroreceptors, 104Q, 111E diarrhea and, 107Q, 113E

diastolic, 70, 70 exercise and, 98t

gravitational forces and, 97 hemorrhage and, 100, 101 mean, 70, 71

set point for, 87 pulse, 70, 70

regulation of, 87–91, 88, 90 systolic, 70, 70

Arterial stenosis, 107Q, 113E Arteriolar resistance, 105Q, 111E

and arterial pressure, 105Q, 111E exercise and, 99

Arteriolar vasoconstriction in baroreceptor reflex, 89 in hemorrhage, 100

Arterioles, 66–67

Arteriovenous shunting, in heat loss, 56 Artery(ies), 66

Aspirin

excretion in alkaline urine, 158 for fever, 57

overdose of, 188Q, 193E Asthma, 123, 123t

airway resistance in, 121

β2 agonists for, 59Q, 62E, 139Q, 140E FEV1 in, 117, 117

hypoxemia due to, 139Q, 143E muscles of expiration during, 118

Astigmatism, 40 Ataxia, 53 Atelectasis, 120

296 Index

ATP (adenosine triphosphate)

in active transport, 3–4, 26Q, 31E

in excitation–contraction coupling, 18, 19 and rigor, 18, 26Q, 31E

Atrial natriuretic peptide (ANP) and arterial blood pressure, 91 mechanism of action, 229t renal effects of, 152

Atrial pressure, 71

Atrioventricular (AV) delay, 106Q, 113E Atrioventricular (AV) node, pacemaker in,

102Q, 109E

Atrioventricular (AV) valves, closure of, 85, 103Q, 110E

Atrium, action potentials of, 72–73 Atropine

and gastric secretion, 208, 209, 209, 210 increased AV node conduction velocity, 61, 65 and muscarinic receptors, 35

blockage, 65 and saliva, 206 Audition, 44, 44–45 Auditory cortex, 45 Auditory ossicles, 44

Auditory pathways, central, 45

Auditory transduction, by organ of Corti, 44, 45 Auerbach plexus, 195, 195

Augmentation, 15 Autonomic centers, 36 Autonomic ganglia, 32

Autonomic nervous system (ANS), 32–36 autonomic centers in, 36

drugs that effect, 35–36, 35t–36t of GI tract, 194–195 neurotransmitters of, 32 organization of, 32, 33, 33t receptor types in, 34–35, 34t

Autonomic nervous system (ANS) effects on heart rate and conduction velocity,

75–76, 75t

of thyroid hormone, 241

on various organ systems, 36t Autoregulation, of blood flow renal, 152 AV (atrioventricular) delay, 106Q, 113E AV (atrioventricular) node, pacemaker in,

102Q, 109E

AV (atrioventricular) valves, closure of, 85, 103Q, 110E

Axons

myelinated, 12, 12 unmyelinated, 11–12, 12

B

B nerve fibers, 37t “Back-diffusion,” 158 Bacterial overgrowth, 217 Barbiturates, 16 Baroreceptor(s), 87

gravitational forces and, 97 hemorrhage and, 100

Baroreceptor reflex, 87–89, 88, 97, 100, 183 Basal body temperature, 260, 261, 263Q, 267E Basal metabolic rate (BMR), thyroid hormone

and, 241 Base(s), weak, 155

Basilar membrane, of organ of Corti, 45, 58Q, 62E Beta cells, 248, 249, 249t

β1 receptor(s), 34, 34t, 58Q, 62E agonist, 59Q, 63E

drugs that act on, 35t β2 receptor(s), 34, 34t, 121

drugs that act on, 35t

and vasodilation, 60Q, 64E, 96 β2 receptor agonists, 35t, 62E

for asthma, 59Q, 62E

β1 receptor antagonists, 35t

β2 receptor antagonists, 35t, 59Q–60Q, 63E Biconcave lens, 40

Bile, 212–214, 213

composition of, 204t, 212–213 formation of, 213–214 secretion of, 204t, 213

Bile acids absorption of, 215t

cotransport of, 214, 223Q, 226E in lipid digestion, 216–217 primary, 213

recirculation of, 213, 214 secondary, 213

Bile salts, 212–213, 213 Bilirubin metabolism, 219, 220 Bipolar cells, 41

Bladder, effect of autonomic nervous system on, 36t Bleeding (see Hemorrhage)

Blind spot, 41 Blood flow

blood vessel radius and, 68, 102Q, 109E direction of, 66, 67

equation for, 68

hormonal control of, 95–96

laminar vs. turbulent, 69, 103Q, 110E local (intrinsic) control of, 94–95 pulmonary, 132–133

in different regions of lung, 132–133 distribution of, 132–133

during exercise, 138

gravitational forces and, 132, 139Q, 143E regulation of, 133

renal, 152–153, 186Q, 191E resistance and, 68, 102Q, 109E velocity of, 67–68

Blood glucose

and glucagon, 248 and insulin, 249

Blood pressure arterial, 70 diastolic, 70, 70

systolic, 70, 70, 105Q, 112E Blood urea nitrogen (BUN), 153 Blood vessel(s)

autonomic effects on, 75–76, 75t pressure profile in, 69–70

Blood vessel radius

and blood flow, 68, 102Q, 109E and Poiseulle’s equation, 68 and resistance, 68, 102Q, 109E

Blood volume

and aldosterone secretion, 244, 265Q, 269E and mean systemic pressure, 81, 81–82 and venous return curve, 83

Blood–brain barrier, 55–56, 56t functions of, 55

passage of substances across, 91 Blue bloaters, 123

BMR (basal metabolic rate), thyroid hormone and, 241

Body fluid(s), 147–151, 148, 148t, 150, 150t Body fluid compartments, 147, 148, 148t

measuring volume of, 147–149

shifts of water between, 149–151, 150, 150t Body temperature

basal, 260, 261, 263Q, 267E core, 56–57

and hemoglobin–O2 dissociation curve, 128, 128 hypothalamic set point for, 56–57

Bohr effect, 128 Bombesin, 199 Bone resorption

calcitonin and, 255 PTH and, 253 vitamin D and, 255

Botulinus toxin, and neuromuscular transmission, 13t

Bowditch staircase, 77

Bowman space hydrostatic pressure (PBS), 154 Bowman space oncotic pressure (πBS), 154 Bradykinin, in blood flow regulation, 95 Brain stem

in autonomic nervous system, 36 in control of breathing, 135–136 in posture control, 51–52

Breathing

control of, 135–136 mechanics of

breathing cycle in, 122, 122–123 with lung diseases, 123, 123t muscles of expiration, 117–118 muscles of inspiration, 117

pressure, airflow, and resistance in, 120–121 respiratory compliance in, 118

surface tension of alveoli and surfactant, 119–120, 120

Breathing cycle, 122, 122–123 Broca area, 55

Bromocriptine, 236t, 237, 264Q, 267E Bronchial obstruction, 141Q, 145E Bronchioles, effect of autonomic nervous

system, 36t

Brown fat, in heat generation, 56 Bruits, 69

Brush border, 214 Buffer(s), 173–176, 175

extracellular, 173 intracellular, 173 pK of, 176

titration curves, 174, 175 urinary, 176

Buffer pair, 185Q, 190Q

BUN (blood urea nitrogen), 153

C

C nerve fibers, 37t Ca2+

absorption of, 215t, 219

in excitation–contraction coupling, 18, 19

in gastrointestinal muscle contraction, 27Q, 31E and myocardial contractility, 77, 106Q, 112E renal regulation of, 186Q, 191E

in tetanus, 18, 23Q, 28E Ca2+-ATPase pump, 4

Ca2+-ATPase, sarcoplasmic reticulum, 4 Ca2+ homeostasis, 251

Index 297

Ca2+ metabolism, 251–255, 251t, 252 calcitonin in, 251t, 252, 255

parathyroid hormone in, 252, 252–254, 253t, 265Q, 270E

vitamin D in, 251t, 252, 254, 255 Ca2+ pump, 4

Ca2+ reabsorption

loop diuretics and, 167

thiazide diuretics and, 167, 186Q, 191E Ca2+ release channels, 18

Ca2+-sensing receptor, 252 Calbindin D-28K, 219, 251t, 255 Calcitonin, 228t, 255

in calcium regulation, 251t, 252 Calsequestrin, 18

cAMP (cyclic adenosine monophosphate), 34, 229t Capacitance, vascular, 69

Capillaries, 67, 91–93

fluid exchange across, 92, 92–93 Capillary beds, 91

Capillary colloidosmotic pressure, 92 Capillary hydrostatic pressure, 92

glomerular, 154

Capillary oncotic pressure, 92 glomerular 154, 184Q, 189E

Capillary walls, passage of substances across, 91, 106Q, 113E

Captopril, 89 Carbaminohemoglobin, 131 Carbohydrates

absorption of, 214, 215t, 216 digestion of, 214, 215t metabolism, 219

Carbon dioxide (see CO2)

Carbon monoxide (CO) poisoning, hemoglobin–O2 dissociation curve, 129, 129

Carbonic anhydrase

in acid–base balance, 172 in CO2 transport, 131, 132 inhibitors, 160, 181t

in reabsorption of filtered HCO3−, 174 Carboxypeptidase A, 215 Carboxypeptidase B, 215

Cardiac action potentials, 72, 72–74, 73, 78 Cardiac cycle, 85–87, 86

Cardiac electrophysiology, 71–74, 71–76, 75t action potentials in, 72, 72–74, 73 autonomic effects on heart rate in, 75–76, 75t conduction velocity in, 74

autonomic effects on, 75–76, 75t electrocardiogram in, 71, 71–72 excitability in, 74, 74–75

Cardiac function curve, 80, 80, 82, 83 Cardiac glycosides

cardiac output curve, 82, 83

and myocardial contractility, 77–78, 78 Cardiac muscle, 76–85

comparison of, 22, 22t contractility of, 77–78, 78 depolarization of, 71

excitation–contraction coupling of, 77 length–tension relationship in, 78, 78–79 pressure–volume loops in, 79, 79–80, 80 repolarization of, 72

structure of, 76–77 Cardiac output

equation for, 68, 84 exercise and, 99