About the authors |
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xv | |
A note to the reader |
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xvi | |
Part One: Basic concepts in physiology |
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1 | (44) |
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3 | (11) |
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3 | (1) |
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1.2 The organization of the body |
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3 | (1) |
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1.3 Terms used in anatomical descriptions |
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4 | (2) |
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1.4 The principal organ systems |
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6 | (3) |
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9 | (5) |
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2 Key concepts in chemistry |
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14 | (13) |
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14 | (2) |
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2.2 Molecules are specific combinations of atoms |
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16 | (3) |
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19 | (8) |
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3 The chemical constitution of the body |
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27 | (18) |
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27 | (1) |
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28 | (1) |
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29 | (1) |
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30 | (3) |
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3.5 The amino acids and proteins |
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33 | (3) |
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3.6 The nucleosides, nucleotides, and nucleic acids |
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36 | (9) |
Part Two: The organization and basic functions of cells |
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45 | (54) |
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4 Introducing cells and tissues |
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47 | (19) |
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47 | (1) |
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4.2 The structure and functions of the cellular organelles |
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48 | (5) |
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53 | (1) |
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54 | (4) |
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58 | (2) |
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4.6 Energy metabolism in cells |
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60 | (6) |
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5 The transport functions of the plasma membrane |
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66 | (17) |
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66 | (1) |
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5.2 The permeability of cell membranes to ions and uncharged molecules |
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67 | (2) |
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5.3 The active transport of ions and other molecules across cell membranes |
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69 | (4) |
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5.4 The potassium gradient determines the resting membrane potential of cells |
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73 | (3) |
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5.5 Secretion, exocytosis, and endocytosis |
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76 | (7) |
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6 Principles of cell signalling |
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83 | (16) |
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83 | (1) |
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6.2 Cells use diffusible chemical signals for paracrine, endocrine, and synaptic signalling |
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83 | (3) |
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6.3 Chemical signals are detected by specific receptor molecules |
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86 | (3) |
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6.4 Second messenger activation of signalling cascades |
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89 | (3) |
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6.5 Some local mediators are synthesized as they are needed |
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92 | (3) |
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6.6 Steroid and thyroid hormones bind to intracellular receptors to regulate gene transcription |
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95 | (1) |
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6.7 Cells use specific cell surface molecules to assemble into tissues |
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96 | (1) |
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6.8 Gap junctions permit the exchange of small molecules and ions between neighbouring cells |
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96 | (3) |
Part Three: The excitable tissues-nerve and muscle |
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99 | (46) |
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7 Nerve cells and their connections |
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101 | (19) |
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101 | (1) |
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7.2 The structure of the neurons and their axons |
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101 | (2) |
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7.3 Axons transmit information via a sequence of action potentials |
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103 | (5) |
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108 | (6) |
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7.5 Neuromuscular transmission is an example of fast synaptic signalling at a chemical synapse |
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114 | (6) |
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120 | (25) |
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120 | (1) |
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8.2 The structure of skeletal and cardiac muscle |
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120 | (4) |
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8.3 How does a skeletal muscle contract? |
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124 | (3) |
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8.4 The activation and mechanical properties of skeletal muscle |
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127 | (5) |
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132 | (5) |
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137 | (8) |
Part Four: The nervous system and special senses |
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145 | (148) |
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9 Introduction to the nervous system |
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147 | (11) |
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147 | (1) |
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9.2 The organization of the brain and spinal cord |
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147 | (6) |
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9.3 The cellular constituents of the nervous system |
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153 | (5) |
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10 The physiology of motor systems |
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158 | (24) |
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158 | (1) |
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10.2 The hierarchical nature of motor control systems |
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159 | (1) |
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10.3 Organization of the spinal cord |
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159 | (3) |
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10.4 Reflex action and reflex arcs |
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162 | (2) |
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10.5 The role of muscle proprioceptors in voluntary motor activity |
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164 | (1) |
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10.6 Effects of injury to the spinal cord |
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165 | (2) |
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10.7 Descending pathways involved in motor control |
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167 | (2) |
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10.8 The control of posture |
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169 | (1) |
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10.9 Goal-directed movements |
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170 | (3) |
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10.10 The role of the cerebellum in motor control |
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173 | (4) |
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177 | (2) |
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179 | (3) |
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11 The autonomic nervous system |
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182 | (11) |
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182 | (1) |
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11.2 Organization of the autonomic nervous system |
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182 | (4) |
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11.3 Chemical transmission in the autonomic nervous system |
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186 | (4) |
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11.4 Central nervous control of autonomic activity |
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190 | (1) |
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11.5 Disorders of autonomic function |
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191 | (2) |
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12 General principles of sensory physiology |
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193 | (8) |
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193 | (1) |
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12.2 Principles of sensory transduction |
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194 | (3) |
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12.3 The organization of sensory pathways in the CNS |
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197 | (4) |
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13 The somatosensory system |
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201 | (17) |
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201 | (2) |
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13.2 Skin mechanoreceptors |
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203 | (3) |
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13.3 Skin thermoreceptors |
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206 | (2) |
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13.4 Somatosensory pathways |
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208 | (2) |
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210 | (5) |
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215 | (3) |
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14 The eye and visual pathways |
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218 | (21) |
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218 | (1) |
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14.2 The anatomy of the eye |
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218 | (3) |
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14.3 The general physiology of the eye |
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221 | (3) |
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14.4 The optics of the eye-image formation |
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224 | (5) |
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14.5 The neurophysiology of vision |
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229 | (4) |
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233 | (2) |
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235 | (4) |
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15 The ear and auditory pathways |
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239 | (14) |
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239 | (1) |
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15.2 The physical nature of sound |
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239 | (2) |
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15.3 Structure of the auditory system |
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241 | (2) |
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15.4 Mechanism of sound transduction |
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243 | (5) |
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15.5 Central auditory processing |
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248 | (1) |
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15.6 Hearing deficits and their clinical evaluation |
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249 | (4) |
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16 The vestibular system and the sense of balance |
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253 | (7) |
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253 | (1) |
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16.2 Structure of the vestibular system |
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253 | (1) |
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16.3 The semicircular canals |
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254 | (2) |
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16.4 The otolith organs: the utricle and saccule |
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256 | (1) |
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16.5 The nervous pathways of the vestibular system |
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256 | (1) |
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16.6 Disorders of the vestibular system |
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257 | (3) |
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17 The chemical senses-smell and taste |
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260 | (8) |
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260 | (1) |
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17.2 The sense of smell (olfaction) |
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260 | (3) |
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17.3 The sense of taste (gustation) |
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263 | (5) |
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18 Emotion, learning, and memory |
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268 | (10) |
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268 | (1) |
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18.2 The physiological basis of emotion |
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268 | (1) |
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269 | (4) |
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273 | (5) |
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19 The cerebral cortex, sleep, and circadian rhythms |
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278 | (15) |
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278 | (1) |
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19.2 The specific functions of the left and right hemispheres |
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278 | (4) |
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282 | (3) |
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19.4 How the EEG can be used to monitor the activity of the brain |
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285 | (2) |
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287 | (2) |
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289 | (4) |
Part Five: The endocrine system |
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293 | (64) |
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20 Introduction to the endocrine system |
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295 | (5) |
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295 | (1) |
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20.2 The chemical nature of hormones and their carriage in the blood |
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296 | (1) |
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20.3 The mechanism of action of hormones |
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297 | (1) |
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20.4 Measurement of hormone levels in body fluids |
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297 | (1) |
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20.5 Patterns of hormone secretion-circadian rhythms and feedback control |
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298 | (2) |
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21 The pituitary gland and hypothalamus |
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300 | (17) |
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300 | (1) |
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21.2 The hypothalamo-pituitary axis |
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300 | (2) |
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21.3 The hormones of the anterior pituitary gland |
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302 | (4) |
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306 | (3) |
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309 | (1) |
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21.6 Adrenocorticotrophic hormone and melanocyte stimulating hormone |
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310 | (1) |
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21.7 Pituitary glycoprotein hormones: thyroid stimulating hormone (TSH), follicle stimulating hormone (FSH), and luteinizing hormone (LH) |
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311 | (1) |
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21.8 The role of the posterior pituitary gland (neurohypophysis) |
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311 | (6) |
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22 The thyroid and parathyroid glands |
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317 | (16) |
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317 | (1) |
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317 | (9) |
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22.3 The endocrine regulation of plasma calcium: vitamin D, parathyroid hormone, and calcitonin |
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326 | (7) |
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333 | (10) |
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333 | (1) |
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23.2 The adrenal glands-location and gross anatomy |
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333 | (1) |
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334 | (6) |
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340 | (3) |
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24 The endocrine pancreas and the regulation of plasma glucose |
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343 | (14) |
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343 | (1) |
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24.2 Whole body handling of glucose |
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343 | (2) |
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24.3 Insulin and glucagon provide short-term regulation of plasma glucose levels |
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345 | (4) |
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24.4 Other hormones involved in the regulation of plasma glucose |
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349 | (1) |
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24.5 Plasma glucose regulation following a meal |
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350 | (1) |
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24.6 Lack of pancreatic insulin results in diabetes mellitus |
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350 | (7) |
Part Six: Blood and the immune system |
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357 | (52) |
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25 The properties of blood |
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359 | (30) |
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359 | (1) |
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25.2 The physical and chemical characteristics of plasma |
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360 | (1) |
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25.3 The formed elements of the blood |
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361 | (4) |
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25.4 Haematopoiesis-the formation of blood cells |
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365 | (5) |
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370 | (1) |
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25.6 The carriage of oxygen and carbon dioxide by the blood |
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371 | (5) |
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25.7 Major disorders of the red and white blood cells |
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376 | (3) |
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25.8 Mechanisms of haemostasis |
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379 | (6) |
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25.9 Blood transfusions and the ABO system of blood groups |
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385 | (4) |
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26 Defence against infection: the immune system |
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389 | (20) |
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389 | (1) |
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26.2 The principal features of the immune system |
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389 | (1) |
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26.3 Passive barriers to infection |
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390 | (1) |
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26.4 How does the immune system identify an invading organism? |
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391 | (1) |
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26.5 The natural immune system |
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391 | (4) |
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26.6 The acute inflammatory response |
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395 | (1) |
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26.7 The adaptive immune system |
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396 | (7) |
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26.8 Disorders of the immune system |
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403 | (2) |
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26.9 Tissue transplantation and the immune system |
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405 | (4) |
Part Seven: The cardiovascular system |
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409 | (92) |
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27 Introduction to the cardiovascular system |
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411 | (8) |
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411 | (1) |
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27.2 The gross anatomy and organization of the circulation |
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411 | (3) |
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27.3 The structure of the systemic blood vessels |
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414 | (2) |
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27.4 The nerve supply of the cardiovascular system |
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416 | (3) |
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419 | (24) |
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419 | (1) |
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28.2 The initiation of the heartbeat |
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420 | (3) |
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28.3 The heart as a pump-the cardiac cycle |
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423 | (4) |
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427 | (2) |
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28.5 The measurement of cardiac output |
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429 | (3) |
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432 | (5) |
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437 | (6) |
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443 | (17) |
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443 | (1) |
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443 | (5) |
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29.3 How the electrical activity of the heart gives rise to the ECG |
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448 | (1) |
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29.4 Clinical aspects of electrocardiography |
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449 | (8) |
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29.5 Treatment of arrhythmias |
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457 | (3) |
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460 | (30) |
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460 | (1) |
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30.2 Pressure and flow in the circulation |
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460 | (7) |
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30.3 The mechanisms that control the calibre of blood vessels |
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467 | (4) |
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30.4 The role of the central nervous system in the control of the circulation |
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471 | (5) |
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476 | (3) |
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30.6 Regional circulations |
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479 | (11) |
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31 The microcirculation and lymphatic system |
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490 | (11) |
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490 | (1) |
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31.2 The organization of the microcirculation |
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490 | (1) |
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31.3 Solute exchange between the capillaries and the tissues |
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491 | (3) |
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31.4 Exchange of fluid between the capillaries and the interstitium |
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494 | (2) |
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31.5 The organization and role of the lymphatic system |
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496 | (5) |
Part Eight: The respiratory system |
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501 | (78) |
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32 Introduction to the respiratory system |
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503 | (11) |
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503 | (1) |
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32.2 The application of the gas laws to respiratory physiology |
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504 | (2) |
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32.3 The structure of the respiratory system |
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506 | (8) |
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33 The mechanics of breathing |
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514 | (12) |
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514 | (1) |
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514 | (1) |
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33.3 The processes of inspiration and expiration |
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515 | (4) |
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33.4 How much work is done by the respiratory muscles? |
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519 | (3) |
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33.5 Tests of ventilatory function |
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522 | (4) |
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34 Alveolar ventilation and blood gas exchange |
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526 | (10) |
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526 | (1) |
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34.2 Alveolar ventilation and dead space |
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526 | (2) |
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34.3 Alveolar ventilation is not uniform throughout the lung |
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528 | (1) |
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34.4 The bronchial and pulmonary circulations |
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529 | (2) |
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34.5 The matching of pulmonary blood flow to alveolar ventilation |
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531 | (2) |
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34.6 Gas exchange across the alveolar membrane occurs by physical diffusion |
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533 | (1) |
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34.7 Fluid exchange in the lungs |
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533 | (1) |
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34.8 Metabolic functions of the pulmonary circulation |
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534 | (1) |
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34.9 Age-related changes in respiratory function |
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534 | (2) |
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35 The control of respiration |
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536 | (10) |
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536 | (1) |
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35.2 The origin of the respiratory rhythm |
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536 | (2) |
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35.3 The reflex regulation of respiration |
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538 | (2) |
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35.4 The blood gases and the control of ventilation |
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540 | (2) |
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35.5 The effects of breathing different mixtures of O2 and CO2 |
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542 | (4) |
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36 Pulmonary defence mechanisms and common disorders of the respiratory system |
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546 | (10) |
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546 | (1) |
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36.2 Airway defence mechanisms |
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546 | (2) |
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36.3 Some common disorders of respiration |
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548 | (3) |
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36.4 Insufficient oxygen supply to the tissues-hypoxia and its causes |
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551 | (2) |
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553 | (3) |
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37 The physiology of high altitude and diving |
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556 | (11) |
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556 | (1) |
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37.2 The physiological effects of high altitude |
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556 | (5) |
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37.3 The effects of high environmental pressure |
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561 | (3) |
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564 | (3) |
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38 The physiology of exercise |
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567 | (12) |
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567 | (1) |
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567 | (1) |
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38.3 Metabolism in exercise |
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568 | (2) |
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38.4 Cardiovascular and respiratory adjustments during exercise |
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570 | (3) |
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38.5 Matching cardiac output and ventilation to the demands of exercise |
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573 | (3) |
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576 | (3) |
Part Nine: The regulation of the internal environment |
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579 | (92) |
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581 | (36) |
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581 | (1) |
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39.2 The anatomical organization of the kidneys and urinary tract |
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582 | (3) |
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39.3 Renal blood flow is kept constant by autoregulation |
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585 | (2) |
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39.4 The nephron regulates the internal environment by ultrafiltration followed by selective modification of the filtrate |
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587 | (7) |
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39.5 Tubular absorption and secretion |
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594 | (7) |
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39.6 Tubular transport in the loop of Henle |
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601 | (1) |
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39.7 The distal tubules regulate the ionic balance of the body |
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602 | (2) |
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39.8 The kidneys regulate the osmolality of the plasma by adjusting the amount of water reabsorbed by the collecting ducts |
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604 | (5) |
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39.9 The collection and voiding of urine |
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609 | (3) |
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39.10 Changes in renal function with age and renal failure |
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612 | (5) |
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40 Fluid and electrolyte balance |
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617 | (18) |
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617 | (1) |
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40.2 The distribution of body water between compartments |
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617 | (2) |
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40.3 Body fluid osmolality and volume are regulated independently |
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619 | (4) |
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40.4 Dehydration and disorders of water balance |
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623 | (1) |
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624 | (3) |
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627 | (4) |
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40.7 Disorders of electrolyte balance |
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631 | (4) |
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635 | (16) |
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635 | (1) |
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41.2 The physical chemistry of acid-base balance |
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636 | (1) |
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41.3 What factors determine the pH of an aqueous solution? |
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637 | (4) |
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41.4 How the body regulates plasma pH |
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641 | (2) |
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41.5 Primary disturbances of acid-base balance |
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643 | (2) |
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41.6 Disorders of acid-base balance are compensated by respiratory and renal mechanisms |
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645 | (2) |
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41.7 Clinical evaluation of the acid-base status of a patient using the pH-[ HCO3-] diagram |
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647 | (4) |
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42 The skin and thermoregulation |
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651 | (20) |
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651 | (1) |
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42.2 The main structural features of the skin |
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652 | (3) |
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42.3 The accessory structures of the skin-hairs, nails, and glands |
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655 | (2) |
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42.4 The cutaneous circulation |
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657 | (1) |
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42.5 Heat exchange between the skin and surroundings |
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657 | (5) |
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42.6 The role of the hypothalamus in the regulation of body temperature |
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662 | (1) |
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42.7 Thermoregulatory responses to cold |
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663 | (2) |
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42.8 Thermoregulatory responses to heat |
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665 | (1) |
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42.9 Disorders of thermoregulation |
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665 | (2) |
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42.10 Special thermoregulatory problems of the newborn |
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667 | (1) |
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667 | (4) |
Part Ten: The gastrointestinal system |
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671 | (92) |
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43 Introduction to the gastrointestinal system |
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673 | (9) |
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673 | (1) |
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43.2 The general organization of the gastrointestinal system |
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673 | (3) |
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43.3 Nervous and hormonal control of the gastrointestinal tract |
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676 | (4) |
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43.4 General characteristics of the blood flow to the GI tract |
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680 | (2) |
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44 The gastrointestinal tract |
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682 | (41) |
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682 | (1) |
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44.2 Intake of food, chewing, and salivary secretion |
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683 | (6) |
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689 | (2) |
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44.4 The composition of gastric juice |
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691 | (2) |
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44.5 The regulation of gastric secretion |
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693 | (2) |
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44.6 The storage, mixing, and propulsion of gastric contents |
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695 | (4) |
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699 | (4) |
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44.8 Motility of the small intestine |
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703 | (1) |
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44.9 The exocrine functions of the pancreas |
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704 | (6) |
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44.10 The absorption of digestion products in the small intestine |
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710 | (5) |
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44.11 The large intestine |
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715 | (8) |
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45 The liver and gall bladder |
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723 | (16) |
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723 | (1) |
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45.2 The structure of the liver |
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723 | (3) |
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45.3 The hepatic circulation |
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726 | (1) |
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45.4 Bile production by the hepatocytes |
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726 | (3) |
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45.5 The excretory role of bile |
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729 | (3) |
|
45.6 Energy metabolism and the liver |
|
|
732 | (1) |
|
45.7 Endocrine functions of the liver |
|
|
733 | (1) |
|
45.8 Detoxification by the liver |
|
|
734 | (1) |
|
|
735 | (4) |
|
46 Nutrition and the regulation of food intake |
|
|
739 | (15) |
|
|
739 | (1) |
|
46.2 The principal requirements for a balanced diet |
|
|
739 | (9) |
|
46.3 Regulation of dietary intake |
|
|
748 | (2) |
|
46.4 Measurements used to monitor nutritional status |
|
|
750 | (2) |
|
46.5 Enteral and parenteral nutritional support |
|
|
752 | (2) |
|
47 Energy balance and the control of metabolic rate |
|
|
754 | (9) |
|
|
754 | (1) |
|
47.2 The chemical processes of the body produce heat |
|
|
754 | (1) |
|
|
755 | (1) |
|
47.4 How much heat is liberated by metabolism? |
|
|
756 | (3) |
|
47.5 Basal metabolic rate (BMR) and the factors that affect it |
|
|
759 | (1) |
|
47.6 Physiological factors that affect metabolic rate |
|
|
760 | (1) |
|
47.7 The actions of hormones on energy metabolism |
|
|
761 | (2) |
Part Eleven: Reproduction and growth |
|
763 | (100) |
|
48 The physiology of the male and female reproductive systems |
|
|
765 | (25) |
|
|
765 | (1) |
|
48.2 Reproductive physiology of the male |
|
|
766 | (7) |
|
48.3 Reproductive physiology of the female |
|
|
773 | (13) |
|
48.4 Activation and regression of the gonads-puberty and the menopause |
|
|
786 | (4) |
|
49 Fertilization, pregnancy, and lactation |
|
|
790 | (31) |
|
|
790 | (1) |
|
|
790 | (4) |
|
|
794 | (2) |
|
49.4 Implantation and formation of the placenta |
|
|
796 | (3) |
|
49.5 The placenta as an organ of exchange between mother and fetus |
|
|
799 | (2) |
|
49.6 The placenta as an endocrine organ |
|
|
801 | (2) |
|
49.7 The infant is delivered around 38 weeks after conception-what triggers parturition? |
|
|
803 | (2) |
|
49.8 Changes in maternal physiology during gestation |
|
|
805 | (5) |
|
49.9 Nutritional requirements of pregnancy |
|
|
810 | (3) |
|
49.10 Lactation-the synthesis and secretion of milk after delivery |
|
|
813 | (2) |
|
49.11 Lactation is triggered by the fall in steroid secretion that follows delivery |
|
|
815 | (6) |
|
50 Fetal and neonatal physiology |
|
|
821 | (17) |
|
|
821 | (1) |
|
50.2 The fetal circulation is arranged to make the best use of a poor oxygen supply |
|
|
821 | (3) |
|
50.3 Respiratory and cardiovascular changes at birth |
|
|
824 | (3) |
|
50.4 Following delivery, the fetal circulation adapts to pulmonary gas exchange |
|
|
827 | (1) |
|
50.5 The fetal adrenal glands and kidneys |
|
|
828 | (2) |
|
50.6 The gastrointestinal tract of the fetus and neonate |
|
|
830 | (1) |
|
50.7 Temperature regulation in the newborn infant |
|
|
830 | (2) |
|
50.8 Development of the male and female reproductive systems |
|
|
832 | (6) |
|
51 The physiology of bone and the control of growth |
|
|
838 | (25) |
|
|
838 | (3) |
|
51.2 The physiology of bone |
|
|
841 | (3) |
|
51.3 Bone development and growth (osteogenesis) |
|
|
844 | (6) |
|
51.4 The role of growth hormone in the control of growth |
|
|
850 | (3) |
|
51.5 The role of other hormones in the process of growth |
|
|
853 | (2) |
|
51.6 Disorders of the skeleton |
|
|
855 | (1) |
|
51.7 Growth of cells, tissues, and organs |
|
|
856 | (1) |
|
51.8 Alterations in cell differentiation: carcinogenesis |
|
|
857 | (6) |
Appendix 1: Glossary of terms and common abbreviations |
|
863 | (40) |
Appendix 2: SI units |
|
903 | (2) |
Index |
|
905 | |