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2The Body: an Open System with an Internal Environment1 Fundamentals 1 and and Cell Cell Physiology“... If we break up a living organism by isolating its different parts, it is only for the sake of ease inanalysis and by no means in order to conceive them separately. Indeed, when we wish to ascribe to aphysiological quality its value and true significance, we must always refer it to the whole and drawour final conclusions only in relation to its effects on the whole.”Claude Bernard (1865)The existence of unicellular organisms is theepitome of life in its simplest form. Evensimple protists must meet two basic but essentiallyconflicting demands in order to survive.A unicellular organism must, on the one hand,isolate itself from the seeming disorder of itsinanimate surroundings, yet, as an “open system”( p. 40), it is dependent on its environmentfor the exchange of heat, oxygen,nutrients, waste materials, and information.“Isolation” is mainly ensured by the cellmembrane, the hydrophobic properties ofwhich prevent the potentially fatal mixing ofhydrophilic components in watery solutionsinside and outside the cell. Protein moleculeswithin the cell membrane ensure the permeabilityof the membrane barrier. They mayexist in the form of pores (channels) or as morecomplex transport proteins known as carriers( p. 26 ff.). Both types are selective for certainsubstances, and their activity is usuallyregulated. The cell membrane is relatively wellpermeable to hydrophobic molecules such asgases. This is useful for the exchange of O 2 andCO 2 and for the uptake of lipophilic signal substances,yet exposes the cell to poisonous gasessuch as carbon monoxide (CO) and lipophilicnoxae such as organic solvents. The cell membranealso contains other proteins—namely,receptors and enzymes. Receptors receive signalsfrom the external environment and conveythe information to the interior of the cell(signal transduction), and enzymes enable thecell to metabolize extracellular substrates.Let us imagine the primordial sea as the externalenvironment of the unicellular organism( A). This milieu remains more or lessconstant, although the organism absorbsnutrients from it and excretes waste into it. Inspite of its simple structure, the unicellular organismis capable of eliciting motor responsesto signals from the environment. This isachieved by moving its pseudopodia orflagella, for example, in response to changes inthe food concentration.The evolution from unicellular organisms tomulticellular organisms, the transition fromspecialized cell groups to organs, the emergenceof the two sexes, the coexistence of individualsin social groups, and the transitionfrom water to land have tremendously increasedthe efficiency, survival, radius of action,and independence of living organisms.This process required the simultaneous developmentof a complex infrastructure within theorganism. Nonetheless, the individual cells ofthe body still need a milieu like that of theprimordial sea for life and survival. Today, theextracellular fluid is responsible for providingconstant environmental conditions ( B), butthe volume of the fluid is no longer infinite. Infact, it is even smaller than the intracellularvolume ( p. 168). Because of their metabolicactivity, the cells would quickly deplete theoxygen and nutrient stores within the fluidsand flood their surroundings with waste productsif organs capable of maintaining a stableinternal environment had not developed. Thisis achieved through homeostasis, a process bywhich physiologic self-regulatory mechanisms(see below) maintain steady states inthe body through coordinated physiologicalactivity. Specialized organs ensure the continuousabsorption of nutrients, electrolytesand water and the excretion of waste productsvia the urine and feces. The circulating bloodconnects the organs to every inch of the body,and the exchange of materials between theblood and the intercellular spaces (interstices)creates a stable environment for the cells. Organssuch as the digestive tract and liver absorbnutrients and make them available byprocessing, metabolizing and distributingthem throughout the body. The lung is responsiblefor the exchange of gases (O 2 intake,CO 2 elimination), the liver and kidney for the Cardiovascular, renal, and respiratory failure
Plate 1.1Internal and External Environment3A. Unicellular organism in the constant external environment of the primordial seaPrimordialseaWaterMotilityHeatSignal receptionGenomeDigestionSubstance absorptionand excretionCO 2O 2Ion exchangeExchangeof gases1 Fundamentals and Cell PhysiologyExcretionB. Maintenance of a stable internal environment in humansExternal signalsIntegration throughnervous systemand hormonesO 2CO2Emission ofheat(water, salt)InternalsignalsBehaviorExchangeof gasesRegulationLungsSkinBlood ExtracellularInterstice spaceIntracellular spaceKidneyDistributionUptakeof nutrients,water, salts,etc.Excretionof excess– water– salts– acidsWaste andtoxinsLiverDigestivetractExcretion ofwaste and toxins
Page 2 and 3: IAt a Glance1 Fundamentals and Cell
Page 4 and 5: IVLibrary of Congress Cataloging-in
Page 6 and 7: VIPreface to the First EditionIn th
Page 8 and 9: IXTable of Contents1 Fundamentals a
Page 10 and 11: Table of ContentsXIReabsorption and
Page 12 and 13: Table of ContentsXIIICentral Proces
Page 16 and 17: 4The Body: an Open System with an I
Page 18 and 19: 6The Body: an Open System with an I
Page 20 and 21: 8The Cell1 Fundamentals and Cell Ph
Page 22 and 23: 10The Cell (continued)1 Fundamental
Page 28 and 29: 16Transport In, Through and Between
Page 30 and 31: 18Transport In, Through and Between
Page 32 and 33: 20Passive Transport by Means of Dif
Page 34 and 35: 22Passive Transport by Means of Dif
Page 36 and 37: 24Osmosis, Filtration and Convectio
Page 38 and 39: 26Active Transport1 Fundamentals an
Page 40 and 41: 28Active Transport (continued)1 Fun
Page 42 and 43: 30Active Transport (continued)1 Fun
Page 44 and 45: 32Electrical Membrane Potentials an
Page 46 and 47: 34Electrical Membrane Potentials an
Page 48 and 49: 36Role of Ca 2+ in Cell Regulation1
Page 50 and 51: 38Energy Production and Metabolism1
Page 52 and 53: 40Energy Production and Metabolism
Page 54 and 55: 42Neuron Structure and Function2 Ne
Page 56 and 57: 44Resting Membrane Potential2 Nerve
Page 58 and 59: 46Action Potential2 Nerve and Muscl
Page 60 and 61: 48Propagation of Action Potentials
Page 62 and 63: 50Artificial Stimulation of Nerve C
Page 64 and 65:
52Synaptic Transmission (continued)
Page 66 and 67:
54Plate 2.7 Synaptic Transmission I
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56Motor End-plate2 Nerve and Muscle
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58Motility and Muscle Types2 Nerve
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60Contractile Apparatus of Striated
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62Contraction of Striated Muscle2 N
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64Contraction of Striated Muscle (c
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66Mechanical Features of Skeletal M
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68Mechanical Features of Skeletal M
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70Smooth Muscle2 Nerve and Muscle,
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72Energy Supply for Muscle Contract
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74Physical Work2 Nerve and Muscle,
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76Physical Fitness and Training2 Ne
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78Organization of the Autonomic Ner
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80Plate 3.2 Functions of ANS3 Auton
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82Acetylcholine and Cholinergic Tra
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84Catecholamines, Adrenergic Transm
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86Catecholamines, Adrenergic Transm
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88Composition and Function of Blood
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90Iron Metabolism and Erythropoiesi
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92Flow Properties of Blood4 BloodTh
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94Immune System4 BloodFundamental P
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96Immune System (continued)4 Blood
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98Immune System (continued)4 Blood
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100Hypersensitivity Reactions (Alle
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102Hemostasis4 BloodThe hemostatic
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104Hemostasis (continued)4 Blood va
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106Lung Function, Respiration5 Resp
Page 120 and 121:
108Mechanics of Breathing5 Respirat
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110Purification of Respiratory Air5
Page 124 and 125:
112Lung Volumes and their Measureme
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114Dead Space, Residual Volume, Air
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116Pressure-Volume Curve, Respirato
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118Surface Tension, Surfactant5 Res
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120Pulmonary Gas Exchange5 Respirat
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122Pulmonary Blood Flow, Ventilatio
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124CO 2 Transport in Blood5 Respira
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126CO 2 Binding in Blood, CO 2 in C
Page 140 and 141:
128Binding and Transport of O 2 in
Page 142 and 143:
130Internal (Tissue) Respiration, H
Page 144 and 145:
132Respiratory Control and Stimulat
Page 146 and 147:
134Effects of Diving on Respiration
Page 148 and 149:
136Effects of High Altitude on Resp
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138pH, pH Buffers, Acid-Base Balanc
Page 152 and 153:
140Bicarbonate/Carbon Dioxide Buffe
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142Acidosis and Alkalosis6 Acid-Bas
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144Acidosis and Alkalosis (continue
Page 158 and 159:
146Assessment of Acid-Base Status6
Page 160 and 161:
148Kidney Structure and Function7 K
Page 162 and 163:
150Renal Circulation7 Kidneys, Salt
Page 164 and 165:
152Glomerular Filtration and Cleara
Page 166 and 167:
154Transport Processes at the Nephr
Page 168 and 169:
156Transport Processes at the Nephr
Page 170 and 171:
158Reabsorption of Organic Substanc
Page 172 and 173:
160Excretion of Organic Substances7
Page 174 and 175:
162Reabsorption of Na + and Cl -7 K
Page 176 and 177:
164Reabsorption of Water, Formation
Page 178 and 179:
166Reabsorption of Water, Formation
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168Body Fluid Homeostasis7 Kidneys,
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170Salt and Water Regulation7 Kidne
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172Salt and Water Regulation (conti
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174Salt and Water Regulation (conti
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176The Kidney and Acid-Base Balance
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178The Kidney and Acid-Base Balance
Page 192 and 193:
180Reabsorption and Excretion of Ph
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182Potassium Balance7 Kidneys, Salt
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184Potassium Balance (continued)7 K
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186Tubuloglomerular Feedback, Renin
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188Overview8 Cardiovascular System8
Page 202 and 203:
190Blood Vessels and Blood Flow8 Ca
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192Cardiac Cycle8 Cardiovascular Sy
Page 206 and 207:
194Cardiac Impulse Generation and C
Page 208 and 209:
196Cardiac Impulse Generation and C
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198Electrocardiogram (ECG)8 Cardiov
Page 212 and 213:
200Electrocardiogram (ECG) (continu
Page 214 and 215:
202Cardiac Arrhythmias8 Cardiovascu
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204Ventricular Pressure-Volume Rela
Page 218 and 219:
206Regulation of Stroke Volume8 Car
Page 220 and 221:
208Arterial Blood Pressure8 Cardiov
Page 222 and 223:
210Endothelial Exchange Processes8
Page 224 and 225:
212Myocardial Oxygen Supply8 Cardio
Page 226 and 227:
214Regulation of the Circulation8 C
Page 228 and 229:
216Regulation of the Circulation (c
Page 230 and 231:
218Regulation of the Circulation (c
Page 232 and 233:
220Circulatory Shock8 Cardiovascula
Page 234 and 235:
222Fetal and Neonatal Circulation8
Page 236 and 237:
224Thermal Balance9 Thermal Balance
Page 238 and 239:
226Thermoregulation9 Thermal Balanc
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228Nutrition10 Nutrition and Digest
Page 242 and 243:
230Energy Metabolism and Calorimetr
Page 244 and 245:
232Energy Homeostasis and Body Weig
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234Gastrointestinal (GI) Tract: Ove
Page 248 and 249:
236Neural and Hormonal Integration1
Page 250 and 251:
238Saliva10 Nutrition and Digestion
Page 252 and 253:
240Deglutition10 Nutrition and Dige
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242Stomach Structure and Motility10
Page 256 and 257:
244Gastric Juice10 Nutrition and Di
Page 258 and 259:
246Small Intestinal Function10 Nutr
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248Pancreas10 Nutrition and Digesti
Page 262 and 263:
250Bile10 Nutrition and DigestionBi
Page 264 and 265:
252Excretory Liver Function, Biliru
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254Lipid Digestion10 Nutrition and
Page 268 and 269:
256Lipid Distribution and Storage10
Page 270 and 271:
258Lipid Distribution and Storage (
Page 272 and 273:
260Digestion and Absorption of Carb
Page 274 and 275:
262Vitamin Absorption10 Nutrition a
Page 276 and 277:
264Water and Mineral Absorption10 N
Page 278 and 279:
266Large Intestine, Defecation, Fec
Page 280 and 281:
268Integrative Systems of the Body1
Page 282 and 283:
270Hormones11 Hormones and Reproduc
Page 284 and 285:
272Plate 11.2 Hormones11 Hormones a
Page 286 and 287:
274Humoral Signals: Control and Eff
Page 288 and 289:
276Cellular Transmission of Signals
Page 290 and 291:
Page 292 and 293:
Page 294 and 295:
282Hypothalamic-Pituitary System11
Page 296 and 297:
284Carbohydrate Metabolism and Panc
Page 298 and 299:
286Carbohydrate Metabolism and Panc
Page 300 and 301:
288Thyroid Hormones11 Hormones and
Page 302 and 303:
290Thyroid Hormones (continued)11 H
Page 304 and 305:
292Calcium and Phosphate Metabolism
Page 306 and 307:
294Calcium and Phosphate Metabolism
Page 308 and 309:
296Biosynthesis of Steroid Hormones
Page 310 and 311:
298Adrenal Cortex and Glucocorticoi
Page 312 and 313:
300Oogenesis and the Menstrual Cycl
Page 314 and 315:
302Hormonal Control of the Menstrua
Page 316 and 317:
304Estrogens, Progesterone11 Hormon
Page 318 and 319:
306Hormonal Control of Pregnancy an
Page 320 and 321:
308Androgens and Testicular Functio
Page 322 and 323:
310Sexual Response, Intercourse and
Page 324 and 325:
312Central Nervous System12 Central
Page 326 and 327:
314Stimulus Reception and Processin
Page 328 and 329:
316Sensory Functions of the Skin12
Page 330 and 331:
318Proprioception, Stretch Reflex12
Page 332 and 333:
320Nociception and Pain12 Central N
Page 334 and 335:
322Polysynaptic Reflexes12 Central
Page 336 and 337:
324Central Conduction of Sensory In
Page 338 and 339:
326Movement12 Central Nervous Syste
Page 340 and 341:
328Movement (continued)12 Central N
Page 342 and 343:
330Movement (continued)12 Central N
Page 344 and 345:
332Hypothalamus, Limbic System12 Ce
Page 346 and 347:
334Cerebral Cortex, Electroencephal
Page 348 and 349:
336Circadian Rhythms, Sleep-Wake Cy
Page 350 and 351:
338Consciousness, Sleep12 Central N
Page 352 and 353:
340Consciousness, Sleep (continued)
Page 354 and 355:
342Learning, Memory, Language (cont
Page 356 and 357:
344Glia12 Central Nervous System an
Page 358 and 359:
346Sense of Smell12 Central Nervous
Page 360 and 361:
348Sense of Balance12 Central Nervo
Page 362 and 363:
350Eye Structure, Tear Fluid, Aqueo
Page 364 and 365:
352Optical Apparatus of the Eye12 C
Page 366 and 367:
354Visual Acuity, Photosensors12 Ce
Page 368 and 369:
356Visual Acuity, Photosensors (con
Page 370 and 371:
358Adaptation of the Eye to Differe
Page 372 and 373:
360Retinal Processing of Visual Sti
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362Color Vision12 Central Nervous S
Page 376 and 377:
364Visual Field, Visual Pathway, Ce
Page 378 and 379:
366Eye Movements, Stereoscopic Visi
Page 380 and 381:
368Physical Principles of Sound—S
Page 382 and 383:
370Conduction of Sound, Sound Senso
Page 384 and 385:
372Conduction of Sound, Sound Senso
Page 386 and 387:
374Central Processing of Acoustic I
Page 388 and 389:
376Voice and Speech12 Central Nervo
Page 390 and 391:
378Dimensions and Units13 Appendix1
Page 392 and 393:
380Dimensions and Units (continued)
Page 394 and 395:
Page 396 and 397:
Page 398 and 399:
Page 400 and 401:
388GraphicRepresentationofData (con
Page 402 and 403:
390GraphicRepresentationofData (con
Page 404 and 405:
392Reference Values in Physiology (
Page 406 and 407:
394Important Equations in Physiolog
Page 408 and 409:
396Important Equations in Physiolog
Page 410 and 411:
398Further Reading(continued)13 App
Page 412 and 413:
400Adiuretin (cont.)receptor types
Page 414 and 415:
402ATPS (Ambient temperaturepressur
Page 416 and 417:
404Breathing capacity, maximum(MBC)
Page 418 and 419:
406Ceruloplasmin, iron oxidation 90
Page 420 and 421:
408Control circuit (cont.)system 4C
Page 422 and 423:
410Dwarfism, T 3/T 4 deficiency 290
Page 424 and 425:
412Fat 230, 254, 258, 284absorption
Page 426 and 427:
414Glucagon (cont.)lipolysis 258sec
Page 428 and 429:
416Heart (cont.)electric activity,
Page 430 and 431:
41817-Hydroxylaseadrenal cortex 296
Page 432 and 433:
420JJ (Joule), unit 300, 380JAM (ju
Page 434 and 435:
422Lipogenesis 284Lipolysis 86, 224
Page 436 and 437:
424MHC proteins 96, 98MI (cortex ar
Page 438 and 439:
426Nephron 148, 150cortical 150juxt
Page 440 and 441:
428Oncotic pressure (cont.)influenc
Page 442 and 443:
430Physical activity (cont.)measure
Page 444 and 445:
432Pulmonary artery (cont.)blood fl
Page 446 and 447:
434S (siemens), unit 381SA sinoatr
Page 448 and 449:
436Sperm (cont.)maturation 308motil
Page 450 and 451:
438Thrombocytopathia 104Thrombocyto
Page 452 and 453:
440Vein(s) (cont.)pulmonary 188umbi
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