PORTH PATHOPHYSIOLOGY CONCEPTS OF ALTERED HEALTH STATES FIRST CANADIAN EDITION【2025|PDF下载-Epub版本|mobi电子书|kindle百度云盘下载】

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UNITⅠCONCEPTS OF HEALTH AND DISEASE1

CHAPTER 1Concepts of Health and Disease&Carol M. Porth2

CONCEPTS OF HEALTH AND DISEASE2

Health2

Disease3

HEALTH AND DISEASE IN POPULATIONS5

Epidemiology and Patterns of Disease5

Determination of Risk Factors6

Natural History7

Levels of Prevention8

Evidence-Based Practice and Practice Guidelines8

CHAPTER 2 Concepts of Altered Health in Children&Judy Wright Lott10

GROWTH AND DEVELOPMENT11

Prenatal Growth and Development11

Birth Weight and Gestational Age13

INFANCY15

Growth and Development16

Health Problems of the Neonate18

Health Problems of the Infant24

EARLY CHILDHOOD26

Growth and Development27

Common Health Problems27

MIDDLE TO LATE CHILDHOOD28

Growth and Development28

Common Health Problems29

ADOLESCENCE30

Growth and Development31

Common Health Problems32

CHAPTER 3Concepts of Altered Health in OlderAdults&Janice Kuiper Pikna35

THE ELDERLY AND THEORIES OF AGING35

Who Are the Elderly?35

Theories of Aging37

PHYSIOLOGIC CHANGES OF AGING37

Integumentary Changes39

Stature and Musculoskeletal Function39

Cardiovascular Function39

Respiratory Function40

Neurologic Function40

Special Sensory Function41

Immune Function41

Gastrointestinal Function42

Renal Function42

Genitourinary Function43

FUNCTIONAL PROBLEMS ASSOCIATED WITH AGING43

Functional Assessment44

Urinary Incontinence44

Instability and Falls45

Sensory Impairment46

Depression and Cognitive Impairment47

DRUG THERAPY IN THE OLDER ADULT50

UNITⅡ CELL FUNCTION AND GROWTH55

CHAPTER 4 Cell and Tissue Characteristics&Edward W. Carroll56

FUNCTIONAL COMPONENTS OF THE CELL56

Protoplasm56

The Nucleus58

The Cytoplasm and Its Organelles58

The Cytoskeleton61

The Cell （Plasma） Membrane63

INTEGRATION OF CELL FUNCTION AND REPLICATION64

Cell Communication64

Cell Receptors65

The Cell Cycle and Cell Division67

Cell Metabolism and Energy Sources68

MOVEMENT ACROSS THE CELL MEMBRANE AND MEMBRANE POTENTIALS71

Movement of Substances Across the Cell Membrane71

Movement Across Capillary Membranes74

Membrane Potentials74

BODY TISSUES78

Cell Differentiation78

Embryonic Origin of Tissue Types79

Epithelial Tissue80

Connective or Supportive Tissue83

Muscle Tissue84

Nervous Tissue87

Extracellular Tissue Components88

CHAPTER 5 Cellular Adaptation, Injury,and Death&Carrie J. Merkle91

CELLULAR ADAPTATION91

Atrophy92

Hypertrophy92

Hyperplasia93

Metaplasia94

Dysplasia94

Intracellular Accumulations94

Pathologic Calcifications95

CELL INJURY AND DEATH96

Causes of Cell Injury96

Mechanisms of Cell Injury100

Reversible Cell Injury and Cell Death102

Cellular Aging105

CHAPTER 6Genetic Control of Cell Functionand Inheritance&Edward W. Carroll108

GENETIC CONTROL OF CELL FUNCTION108

DNA Structure and Function109

From Genes to Proteins112

CHROMOSOMES117

Cell Division118

Chromosome Structure119

PATTERNS OF INHERITANCE120

Definitions120

Genetic Imprinting121

Mendel's Laws121

Pedigree122

GENE TECHNOLOGY122

Genetic Mapping123

Recombinant DNA Technology124

RNA Interference Technology126

CHAPTER 7Genetic and Congenital Disorders&Carol M. Porth128

GENETIC AND CHROMOSOMAL DISORDERS128

Single-Gene Disorders129

Multifactorial Inheritance Disorders134

Chromosomal Disorders135

Mitochondrial Gene Disorders140

DISORDERS DUE TO ENVIRONMENTAL INFLUENCES141

Period of Vulnerability141

Teratogenic Agents141

DIAGNOSIS AND COUNSELLING145

Genetic Assessment145

Prenatal Screening and Diagnosis145

CHAPTER 8Neoplasia&Carrie J. Merkle Adapted by Otto H. Sanchez150

CONCEPTS OF CELL DIFFERENTIATION AND GROWTH150

The Cell Cycle151

Cell Proliferation154

Cell Differentiation154

CHARACTERISTICS OF BENIGN AND MALIGNANT NEOPLASMS156

Terminology156

Benign Neoplasms156

Malignant Neoplasms157

ETIOLOGY OF CANCER162

Genetic and Molecular Basis of Cancer163

Host and Environmental Factors167

CLINICAL MANIFESTATIONS171

Tissue Integrity171

Systemic Manifestations171

Anemia172

Paraneoplastic Syndromes173

SCREENING, DIAGNOSIS, AND TREATMENT174

Screening174

Diagnostic Methods174

Cancer Treatment176

CHILDHOOD CANCERS183

Incidence and Types183

Biology of Childhood Cancers184

Diagnosis and Treatment184

Adult Survivors of Childhood and Adolescent Cancer185

UNITⅢ DISORDERS OF INTEGRATIVE FUNCTION189

CHAPTER 9 Stress and Adaptation&Mary Pat Kunert190

HOMEOSTASIS191

Constancy of the Internal Environment191

Control Systems191

STRESS AND ADAPTATION192

The Stress Response192

Coping and Adaptation to Stress197

DISORDERS OF THE STRESS RESPONSE200

Effects of Acute Stress200

Effects of Chronic Stress200

Post-traumatic Stress Disorder200

Treatment and Research of Stress Disorders202

CHAPTER 10Alterations in Temperature Regulation&Mary Pat Kunert206

BODY TEMPERATURE REGULATION206

Mechanisms of Heat Production208

Mechanisms of Heat Loss208

INCREASED BODY TEMPERATURE210

Fever210

Hyperthermia215

DECREASED BODY TEMPERATURE218

Hypothermia218

CHAPTER 11Activity Tolerance and Fatigue&Mary Kay Jiricka222

EXERCISE AND ACTIVITY TOLERANCE222

Types of Exercise223

Physiologic and Psychological Responses224

Assessment of Activity and Exercise Tolerance228

Exercise and Activity Tolerance in the Elderly228

ACTIVITY INTOLERANCE AND FATIGUE229

Mechanisms of Fatigue230

Acute Physical Fatigue230

Chronic Fatigue230

BED REST AND IMMOBILITY233

Physiologic Effects of Bed Rest234

Psychosocial Responses238

Time Course of Physiologic Responses238

Interventions239

UNIT Ⅳ DISORDERS OF THE HEMATOPOIETIC SYSTEM243

CHAPTER 12 Blood Cells and the Hematopoietic System&Kathryn J. Gaspard244

COMPOSITION OF BLOOD AND FORMATION OF BLOOD CELLS244

Plasma245

Blood Cells245

Formation of Blood Cells （Hematopoiesis）248

DIAGNOSTIC TESTS250

Blood Count250

Erythrocyte Sedimentation Rate250

Bone Marrow Aspiration and Biopsy251

CHAPTER 13Disorders of Hemostasis&Kathryn J. Gaspard252

MECHANISMS OF HEMOSTASIS252

Vessel Spasm252

Formation of the Platelet Plug253

Blood Coagulation254

Clot Retraction255

Clot Dissolution258

HYPERCOAGULABILITY STATES258

Hypercoagulability Associated With Increased Platelet Function259

Hypercoagulability Associated With Increased Clotting Activity259

BLEEDING DISORDERS260

Bleeding Associated With Platelet Disorders261

Bleeding Associated With Coagulation Factor Deficiencies263

Bleeding Associated With Vascular Disorders264

Disseminated Intravascular Coagulation265

CHAPTER 14Disorders of Red Blood Cells&Kathryn J. Gaspard268

THE RED BLOOD CELL268

Hemoglobin Synthesis270

Red Cell Production270

Red Cell Destruction271

Red Cell Metabolism and Hemoglobin Oxidation272

Laboratory Tests272

ANEMIA274

Blood Loss Anemia274

Hemolytic Anemias275

Anemias of Deficient Red Cell Production279

TRANSFUSION THERAPY282

ABO Blood Groups284

Rh Types284

Blood Transfusion Reactions284

POLYCYTHEMIA285

AGE-RELATED CHANGES IN RED BLOOD CELLS285

Red Cell Changes in the Neonate286

Red Cell Changes With Aging287

CHAPTER 15Disorders of White Blood Cells and Lymphoid Tissues&Carol M. Porth290

HEMATOPOIETIC AND LYMPHOID TISSUES290

Leukocytes （White Blood Cells）290

Bone Marrow and Hematopoiesis291

Lymphoid Tissues292

NON-NEOPLASTIC DISORDERS OF WHITE BLOOD CELLS293

Neutropenia （Agranulocytosis）293

Infectious Mononucleosis295

NEOPLASTIC DISORDERS OF HEMATOPOIETIC AND LYMPHOID ORIGIN297

Malignant Lymphomas297

Leukemias301

Plasma Cell Dyscrasias306

UNITⅤ INFECTION, INFLAMMATION, AND IMMUNITY311

CHAPTER 16 Mechanisms of Infectious Disease&W. Michael Dunne, Jr. and Nathan A. Ledeboer312

INFECTIOUS DISEASES312

Terminology312

Agents of Infectious Disease313

MECHANISMS OF INFECTION320

Epidemiology of Infectious Diseases320

Portal of Entry321

Source322

Symptomatology322

Disease Course322

Site of Infection323

Virulence Factors323

DIAGNOSIS AND TREATMENT OF INFECTIOUS DISEASES325

Diagnosis325

Treatment328

BIOTERRORISM AND EMERGING GLOBAL INFECTIOUS DISEASES331

Bioterrorism331

Global Infectious Diseases332

CHAPTER 17Innate and Adaptive Immunity&Cynthia Sommer334

IMMUNITY AND THE IMMUNE SYSTEM334

Innate and Adaptive Immunity335

Cells of the Immune System335

Cytokines That Mediate and Regulate Immunity338

INNATE IMMUNITY341

Epithelial Barriers341

Cells of Innate Immunity342

Pathogen Recognition342

Soluble Mediators of Innate Immunity344

The Complement System345

ADAPTIVE IMMUNITY347

Antigens348

Cells of Adaptive Immunity349

B Lymphocytes and Humoral Immunity352

T Lymphocytes and Cellular Immunity355

Lymphoid Organs357

Active Versus Passive Immunity359

Regulation of the Immune Response360

DEVELOPMENTAL ASPECTS OF THE IMMUNE SYSTEM360

Transfer of Immunity from Mother to Infant361

Immune Response in the Elderly361

CHAPTER 18Inflammation, Tissue Repair,and Wound Healing&Carol M. Porth and Cynthia Sommer363

THE INFLAMMATORY RESPONSE363

Acute Inflammation364

Chronic Inflammation373

Systemic Manifestations of Inflammation375

TISSUE REPAIR AND WOUND HEALING376

Tissue Repair376

Wound Healing378

CHAPTER 19Disorders of the Immune Response&Carol M. Porth385

IMMUNODEFICIENCY DISORDERS385

Humoral （B-Cell） Immunodeficiencies387

Cell-Mediated （T-Cell） Immunodeficiencies390

Combined T -Cell and B-Cell Immunodeficiencies391

Disorders of the Complement System392

Disorders of Phagocytosis393

Stem Cell Transplantation394

HYPERSENSITIVITY DISORDERS395

Type I, Immediate Hypersensitivity Disorders395

Type Ⅱ, Antibody-Mediated Disorders398

Type Ⅲ, Immune Complex-Mediated Disorders399

Type IV, Cell-Mediated Hypersensitivity Disorders400

Latex Allergy402

TRANSPLANTATION IMMUNOPATHOLOGY403

Mechanisms Involved in Transplant Rejection403

AUTOIMMUNE DISEASE405

Immunologic Tolerance405

Mechanisms of Autoimmune Disease407

Diagnosis and Treatment of Autoimmune Disease408

CHAPTER 20Acquired Immunodeficiency Syndrome&Jason Faulhaber and Judith A. Aberg411

THE AIDS EPIDEMIC AND TRANSMISSION OF HIV INFECTION411

Emergence of the AIDS Epidemic412

Transmission of HIV Infection412

PATHOPHYSIOLOGY AND CLINICAL COURSE414

Molecular and Biologic Features of HIV414

Classification and Phases of HIV Infection416

Clinical Course417

PREVENTION, DIAGNOSIS, AND TREATMENT422

Prevention422

Diagnostic Methods423

Early Management424

Treatment424

PsychosocialIssues426

HIV INFECTION IN PREGNANCY AND IN INFANTS AND CHILDREN427

UNITⅥ DISORDERS OF CARDIOVASCULAR FUNCTION431

CHAPTER 21 Structure and Function of the Cardiovascular System&Carol M. Porth and Glenn Matfin432

ORGANIZATION OF THE CIRCULATORY SYSTEM432

Pulmonary and Systemic Circulations433

Volume and Pressure Distribution434

PRINCIPLES OF BLOOD FLOW435

Relationships Between Blood Flow, Pressure,and Resistance435

Wall Tension, Radius, and Pressure438

Distension and Compliance438

THE HEART AS A PUMP439

Functional Anatomy of the Heart439

Cardiac Cycle442

Regulation of Cardiac Performance444

THE SYSTEMIC CIRCULATION AND CONTROL OF BLOOD FLOW447

Blood Vessels447

Arterial System448

Venous System449

Local and Humoral Control of Blood Flow450

THE MICROCIRCULATION AND LYMPHATIC SYSTEM452

Structure and Function of the Microcirculation452

Capillary-Interstitial Fluid Exchange453

The Lymphatic System454

NEURAL CONTROL OF CIRCULATORY FUNCTION456

Autonomic Nervous System Regulation456

Central Nervous System Responses456

CHAPTER 22Disorders of Blood Flow in the Systemic Circulation&Glenn Matfin Adapted by Anna Barkman and Charlotte Pooler458

BLOOD VESSEL STRUCTURE AND FUNCTION458

Endothelial Cells459

Vascular Smooth Muscle Cells459

DISORDERS OF THE ARTERIAL CIRCULATION460

Hyperlipidemia461

Atherosclerosis466

Vasculitis469

Arterial Disease of the Extremities472

Aneurysms and Dissection475

DISORDERS OF THE VENOUS CIRCULATION478

Venous Circulation of the Lower Extremities478

Disorders of the Venous Circulation of the Lower Extremities479

CHAPTER 23Disorders of Blood Pressure Regulation&Carol M. Porth Adapted by Anna Barkman485

THE ARTERIAL BLOOD PRESSURE485

Mechanisms of Blood Pressure Regulation486

Blood Pressure Measurement491

HYPERTENSION492

Essential Hypertension492

Secondary Hypertension499

Malignant Hypertension501

Hypertension Disorders in Pregnancy501

High Blood Pressure in Children and Adolescents503

High Blood Pressure in the Elderly503

ORTHOSTATIC HYPOTENSION505

Pathophysiology and Causative Factors506

Diagnosis and Treatment507

CHAPTER 24Disorders of Cardiac Function&Toni Balistrieri and Kathy Mussatto Adapted by Anna Barkman and Charlotte Pooler511

DISORDERS OF THE PERICARDIUM511

Acute Pericarditis512

Pericardial Effusion and Cardiac Tamponade513

Constrictive Pericarditis514

CORONARY ARTERY DISEASE515

Coronary Circulation515

Acute Coronary Syndrome522

Chronic Ischemic Heart Disease530

CARDIOMYOPATHIES532

Primary Card iomyopathies532

Secondary Card iomyopathies536

INFECTIOUS AND IMMUNOLOGIC DISORDERS537

Infective Endocarditis537

Rheumatic Heart Disease539

VALVULAR HEART DISEASE541

Hemodynamic Derangements541

Mitral Valve Disorders542

Aortic Valve Disorders545

HEART DISEASE IN INFANTS AND CHILDREN546

Embryonic Development of the Heart547

Fetal and Perinatal Circulation548

Congenital Heart Defects549

Kawasaki Disease557

CHAPTER25Disorders of Cardiac Conduction and Rhythm&Jill Winters Adapted by Anna Barkman and Charlotte Pooler562

CARDIAC CONDUCTION SYSTEM562

Action Potentials564

Electrocardiography567

DISORDERS OF CARDIAC RHYTHM AND CONDUCTION568

Mechanisms of Arrhythmias and Conduction Disorders569

Types of Arrhythmias and Conduction Disorders570

Diagnostic Methods577

Treatment578

CHAPTER 26 Heart Failure and Circulatory Shock&Anna Barkman and Charlotte Pooler583

HEART FAILURE583

Pathophysiology of Heart Failure584

Manifestations of Heart Failure593

Diagnosis and Treatment594

CIRCULATORY FAILURE （SHOCK）598

Pathophysiology of Circulatory Shock598

Cardiogenic Shock600

Hypovolemic Shock601

Distributive Shock603

Obstructive Shock606

Complications of Shock606

HEART FAILURE IN CHILDREN AND THE ELDERLY607

Heart Failure in Infants and Children607

Heart Failure in the Elderly609

UNITⅦ DISORDERS OF RESPIRATORY FUNCTION613

CHAPTER 27 Structure and Function of the RespiratorySystem&Adapted by Charlotte Pooler614

STRUCTURAL ORGANIZATION OF THE RESPIRATORY SYSTEM614

Conducting Airways615

Lungs and Respiratory Airways618

Pulmonary Vasculature and Lymphatic Supply621

Innervation621

Pleura622

EXCHANGE OF GASES BETWEEN THE ATMOSPHERE AND THE LUNGS622

Basic Properties of Gases623

Ventilation and the Mechanics of Breathing623

Lung Volumes627

Pulmonary Function Studies628

Work of Breathing629

EXCHANGE AND TRANSPORT OF GASES630

Ventilation631

Perfusion632

Ventilation-Perfusion Mismatch633

Diffusion633

Oxygen and Carbon Dioxide Transport635

CONTROL OF BREATHING638

Respiratory Centre639

Regulation of Breathing639

Cough Reflex640

Dyspnea641

CHAPTER 28 Respiratory Tract Infections, Neoplasms,and Childhood Disorders&Carol M. Porth Adapted by Charlotte Pooler643

RESPIRATORY TRACT INFECTIONS643

The Common Cold644

Rhinosinusitis645

Influenza646

Pneumonias649

Tuberculosis653

Fungal Infections657

CANCER OF THE LUNG659

Histologic Subtypes and Pathogenesis659

Clinical Features660

RESPIRATORY DISORDERS IN CHILDREN662

Lung Development662

Alterations in Breathing664

Respiratory Disorders in the Neonate665

Respiratory Infections in Children666

CHAPTER 29Disorders of Ventilation and Gas Exchange&Charlotte Pooler672

PHYSIOLOGIC EFFECTS OF VENTILATION AND DIFFUSION DISORDERS672

Hypoxemia673

Hypercapnia674

DISORDERS OF LUNG INFLATION675

Disorders of the Pleura675

Atelectasis679

OBSTRUCTIVE AIRWAY DISORDERS680

Physiology of Airway Disease680

Bronchial Asthma680

Chronic Obstructive Pulmonary Disease686

Bronchiectasis691

Cystic Fibrosis692

CHRONIC INTERSTITIAL （RESTRICTIVE） LUNG DISEASES694

Etiology and Pathogenesis of Interstitial Lung Diseases694

Occupational Lung Disease695

Drug- and Radiation-Induced Lung Diseases696

Sarcoidosis696

DISORDERS OF THE PULMONARY CIRCULATION697

Pulmonary Embolism697

Pulmonary Hypertension699

Cor Pulmonale701

ACUTE RESPIRATORY DISORDERS702

Acute Lung Injury/Acute RespiratoryDistress Syndrome702

Acute Respiratory Failure703

UNIT Ⅷ DISORDERS OF RENAL FUNCTION AND FLUIDS AND ELECTROLYTES709

CHAPTER 30 Structure and Function of the Kidney&Carol M. Porth Adapted by Charlotte Pooler710

KIDNEY STRUCTURE AND FUNCTION710

Gross Structure and Location711

Renal Blood Supply711

The Nephron711

Urine Formation714

Regulation of Renal Blood Flow720

Elimination Functions of the Kidney721

Drug Elimination723

Endocrine Functions of the Kidney723

Action of Diuretics724

TESTS OF RENAL FUNCTION725

Urine Tests726

Glomerular Filtration Rate726

Blood Tests727

Cystoscopy728

Ultrasonography728

Radiologic and Other Imaging Studies728

CHAPTER 31 Disorders of Fluid and Electrolyte Balance&Glenn Matfin and Carol M. Porth Adapted by Linda Slater-MacLean and Charlotte Pooler730

COMPOSITION AND COMPARTMENTAL DISTRIBUTION OF BODY FLUIDS730

Introductory Concepts731

Compartmental Distribution of Body Fluids733

Capillary-Interstitial Fluid Exchange734

SODIUM AND WATER BALANCE739

Body Water Balance739

Sodium Balance740

Mechanisms of Regulation740

Disorders of Thirst and Antidiuretic Hormone741

Disorders of Sodium and Water Balance744

POTASSIUM BALANCE751

Regulation of Potassium Balance752

Disorders of Potassium Balance753

CALCIUM, PHOSPHOROUS, AND MAGNESIUM BALANCE758

Mechanisms Regulating Calcium, Phosphorous,and Magnesium Balance758

Disorders of Calcium Balance760

Disorders of Phosphorous Balance764

Disorders of Magnesium Balance767

CHAPTER 32 Disorders of Acid-Base Balance&Carol M. Porth and Kim Litwack Adapted by Linda Slater-MacLean and Charlotte Pooler772

MECHANISMS OF ACID-BASE BALANCE772

Acid-Base Chemistry773

Metabolic Acid and Bicarbonate Production773

Calculation of pH774

Regulation of pH774

Laboratory Tests779

DISORDERS OF ACID-BASE BALANCE781

Metabolic Versus Respiratory Acid-Base Disorders781

Compensatory Mechanisms781

Metabolic Acidosis782

Metabolic Alkalosis786

Respiratory Acidosis787

Respiratory Alkalosis789

CHAPTER 33Disorders of Renal Function &Carol M. Porth Adapted by Linda Slater-MacLean and Charlotte Pooler792

CONGENITAL AND INHERITED DISORDERS OF THE KIDNEYS792

Congenital Disorders of the Kidneys793

Cystic Kidney Diseases794

OBSTRUCTIVE DISORDERS796

Mechanisms of Renal Damage797

Renal Calculi798

URINARY TRACT INFECTIONS801

Etiologic Factors802

Clinical Features803

Diagnosis and Treatment803

Infections in Special Populations804

DISORDERS OF GLOMERULAR FUNCTION806

Etiology and Pathogenesis of Glomerular Injury806

Types of Glomerular Disease807

Glomerular Lesions Associated With Systemic Disease812

TUBULOINTERSTITIAL DISORDERS813

Renal Tubular Acidosis813

Pyelonephritis814

Drug-Related Nephropathies815

MALIGNANT TUMOURS OF THE KIDNEY816

Wilms Tumour816

Renal Cell Carcinoma816

CHAPTER 34Acute Renal Failure and Chronic Kidney Disease&Carol M. Porth Adapted by Linda Slater-MacLean and Charlotte Pooler820

ACUTE RENAL FAILURE820

Types of Acute Renal Failure821

Diagnosis and Treatment823

CHRONIC KIDNEY DISEASE824

Definition and Classification824

Assessment of Glomerular Filtration Rate and Other Indicators of Renal Function825

Clinical Manifestations827

Treatment831

CHRONIC KIDNEY DISEASE IN CHILDREN AND ELDERLY PERSONS835

Chronic Kidney Disease in Children835

Chronic Kidney Disease in Elderly Persons836

CHAPTER 35Disorders of the Bladder and Lower Urinary Tract&Carol M. Porth Adapted by Charlotte Pooler839

CONTROL OF URINE ELIMINATION839

Bladder Structure839

Neural Control of Bladder Function840

Diagnostic Methods of Evaluating Bladder Function843

ALTERATIONS IN BLADDER FUNCTION844

Lower Urinary Tract Obstruction and Stasis845

Neurogenic Bladder Disorders846

Urinary Incontinence849

CANCER OF THE BLADDER853

Etiology and Pathophysiology854

Manifestations854

Diagnosis and Treatment854

UNITIⅨ DISORDERS OF GASTROINTESTINAL FUNCTION857

CHAPTER 36Structure and Function of the Gastrointestinal System&Carol M. Porth STRUCTURE AND ORGANIZATION OF THE858

GASTROINTESTINAL TRACT858

Upper Gastrointestinal Tract859

Middle Gastrointestinal Tract860

Lower Gastrointestinal Tract860

Gastrointestinal Wall Structure861

MOTILITY863

Control of Gastrointestinal Motility863

Swallowing and Esophageal Motility865

Gastric Motility867

Small Intestinal Motility867

Colonic Motility and Defecation868

HORMONAL, SECRETORY, AND DIGESTIVE FUNCTIONS869

Gastrointestinal Hormones869

Gastrointestinal Secretions869

Intestinal Flora872

DIGESTION AND ABSORPTION873

Carbohydrate Absorption874

Fat Absorption874

Protein Absorption875

ANOREXIA, NAUSEA, AND VOMITING876

Anorexia876

Nausea877

Retching and Vomiting877

CHAPTER37Disorders of Gastrointestinal Function&Carol M. Porth879

DISORDERS OF THE ESOPHAGUS879

Congenital Anomalies880

Dysphagia880

Esophageal Diverticulum881

Tears （Mallory-Weiss Syndrome）881

Hiatal Hernia881

Gastroesophageal Reflux881

Cancer of the Esophagus883

DISORDERS OF THE STOMACH884

Gastric Mucosal Barrier884

Gastritis885

Peptic Ulcer Disease887

Cancer of the Stomach889

DISORDERS OF THE SMALL AND LARGE INTESTINES890

Irritable Bowel Syndrome890

Inflammatory Bowel Disease891

Infectious Enterocolitis894

Diverticular Disease896

Appendicitis897

Alterations in Intestinal Motility898

Alterations in Intestinal Absorption903

Neoplasms905

CHAPTER 38Disorders of Hepatobiliary and Exocrine Pancreas Function&Carol M. Porth911

THE LIVER AND HEPATOBILIARY SYSTEM911

Metabolic Functions of the Liver914

Bile Production and Cholestasis916

Bilirubin Elimination and Jaundice916

Tests of Hepatobiliary Function918

DISORDERS OF HEPATIC AND BILIARY FUNCTION919

Hepatotoxic Disorders919

Viral Hepatitis921

Autoimmune Hepatitis925

Intrahepatic Biliary Disorders926

Alcohol-Induced Liver Disease926

Cirrhosis, Portal Hypertension, and Liver Failure928

Cancer of the Liver933

DISORDERS OF THE GALLBLADDER AND EXOCRINE PANCREAS935

Disorders of the Gallbladder and Extrahepatic Bile Ducts935

Disorders of the Exocrine Pancreas938

CHAPTER 39Alterations in Nutritional Status&Joan Pleuss and Glenn Matfiin Adapted by Lesley L. Moisey943

NUTRITIONAL STATUS943

Energy Metabolism and Storage944

Energy Expenditure944

Energy Storage945

NUTRITIONAL NEEDS946

Recommended Dietary Allowances and DietaryReference Intakes946

Nutritional Needs947

Regulation of Food Intake and Energy Storage950

Nutritional Assessment951

OVERWEIGHT AND OBESITY953

Causes of Obesity954

Types of Obesity954

Health Risks Associated With Obesity956

Prevention and Treatment of Obesity956

Childhood Obesity957

UNDERNUTRITION AND EATING DISORDERS959

Malnutrition and Starvation959

Eating Disorders961

UNITⅩ DISORDERS OF ENDOCRINE FUNCTION967

CHAPTER 40 Mechanisms of Endocrine Control&Glenn Matfin968

THE ENDOCRINE SYSTEM968

Hormones969

Control of Hormone Levels974

Diagnostic Tests976

CHAPTER 41Disorders of Endocrine Control of Growth and Metabolism&Glenn Matfin980

GENERAL ASPECTS OF ALTERED ENDOCRINE FUNCTION980

Hypofunction and Hyperfunction980

Primary, Secondary, and TertiaryDisorders981

PITUITARY AND GROWTH DISORDERS981

Pituitary Tumours981

Hypopituitarism982

Assessment of Hypothalamic-Pituitary Function982

Growth and Growth HormoneDisorders982

Isosexual Precocious Puberty988

THYROID DISORDERS989

Control of Thyroid Function989

Hypothyroidism992

Hyperthyroidism994

DISORDERS OF ADRENAL CORTICAL FUNCTION996

Control of Adrenal Cortical Function996

Congenital Adrenal Hyperplasia998

Adrenal Cortical Insufficiency999

Glucocorticoid Hormone Excess（Cushing Syndrome）1001

Incidental Adrenal Mass1002

CHAPTER 42Diabetes Mellitus and the Metabolic Syndrome&Safak Guven, Glenn Matfin, and Julie A. Kuenzi1005

HORMONAL CONTROL OF GLUCOSE, FAT, AND PROTEIN METABOLISM1005

Glucose, Fat, and Protein Metabolism1005

Glucose-Regulating Hormones1006

DIABETES MELLITUS1011

Classification and Etiology1012

Clinical Manifestations of Diabetes1017

Diagnostic Tests1018

Diabetes Management1019

Acute Complications1025

Counter-regulatory Mechanisms and the Somogyi Effect and Dawn Phenomenon1027

Chronic Complications1027

Infections1032

UNITⅪ DISORDERS OF GENITOURINARY AND REPRODUCTIVE FUNCTION1035

CHAPTER 43Structure and Function of the Male Genitourinary System&Glenn Matfin1036

STRUCTURE OF THE MALE REPRODUCTIVE SYSTEM1036

Embryonic Development1036

Testes and Scrotum1037

Genital Duct System1038

Accessory Organs1039

Penis1040

SPERMATOGENESIS AND HORMONAL CONTROL OF MALE REPRODUCTIVE FUNCTION1040

Spermatogenesis1041

Hormonal Control of Male Reproductive Function1041

NEURAL CONTROL OF SEXUAL FUNCTION AND AGING CHANGES1044

Neural Control1044

Aging Changes1045

CHAPTER 44 Disorders of the Male Genitourinary System&Glenn Matfin1048

DISORDERS OF THE PENIS1048

Congenital and Acquired Disorders1048

Disorders of Erectile Function1050

Cancer of the Penis1053

DISORDERS OF THE SCROTUM AND TESTES1054

Congenital and Acquired Disorders1054

Infection and Inflammation1057

Neoplasms1057

DISORDERS OF THE PROSTATE1059

Infection and Inflammation1059

Hyperplasia and Neoplasms1061

CHAPTER 45 Structure and Function of the Female Reproductive System&Patricia McCowen Mehring1068

REPRODUCTIVE STRUCTURES1068

External Genitalia1068

Internal Genitalia1070

MENSTRUAL CYCLE1072

Hormonal Control1073

Ovarian Follicle Development and Ovulation1076

Endometrial Changes1077

Cervical Mucus Changes1077

Menopause1077

BREASTS1080

Structure and Function1080

CHAPTER 46 Disorders of the Female Reproductive System&Patricia McCowen Mehring1084

DISORDERS OF THE EXTERNAL GENITALIA AND VAGINA1084

Disorders of the External Genitalia1085

Disorders of the Vagina1087

DISORDERS OF THE CERVIX AND UTERUS1088

Disorders of the Uterine Cervix1088

Disorders of the Uterus1092

DISORDERS OF THE FALLOPIAN TUBES AND OVARIES1096

Pelvic Inflammatory Disease1096

Ectopic Pregnancy1097

Cancer of the Fallopian Tube1098

Ovarian Cysts and Tumours1098

DISORDERS OF PELVIC SUPPORT AND UTERINE POSITION1102

Disorders of Pelvic Support1102

Variations in Uterine Position1104

MENSTRUAL DISORDERS1105

Dysfunctional Menstrual Cycles1105

Amenorrhea1106

Dysmenorrhea1106

Premenstrual Symptom Disorders1106

DISORDERS OF THE BREAST1108

Galactorrhea1109

Mastitis1109

Ductal Disorders1109

Fibroadenoma and Fibrocystic Changes1109

Breast Cancer1110

INFERTILITY1113

Male Factors1113

Female Factors1113

Assisted Reproductive Technologies （ART）1115

CHAPTER 47 Sexually Transmitted Infections&Patricia McCowen Mehring1119

INFECTIONS OF THE EXTERNAL GENITALIA1119

Condylomata Acuminata （Genital Warts）1120

Genital Herpes1121

Molluscum Contagiosum1123

Chancroid1124

Granuloma Inguinale1124

Lymphogranuloma Venereum1124

VAGINAL INFECTIONS1125

Candidiasis1125

Trichomoniasis1125

Bacterial Vaginosis1126

VAGINAL-UROGENITAL-SYSTEMIC INFECTIONS1127

ChlamydialInfections1127

Gonorrhea1129

Syphilis1130

UNITⅫ DISORDERS OF NEURAL FUNCTION1135

CHAPTER 48 Organization and Control of Neural Function&Edward W. Carroll and Robin Curtis1136

NERVOUS TISSUE CELLS1136

Neurons1137

Neuroglial Cells1138

Metabolic Requirements of Nervous Tissue1141

NEUROPHYSIOLOGY1141

Action Potentials1141

Synaptic Transmission1142

Messenger Molecules1143

DEVELOPMENTAL ORGANIZATION OF THE NERVOUS SYSTEM1146

Somatic and Visceral Development1146

Segmental Organization1148

STRUCTURE AND FUNCTION OF THE SPINAL CORD AND BRAIN1155

Spinal Cord1155

Spinal Nerves1157

The Brain1158

THE AUTONOMIC NERVOUS SYSTEM1168

Autonomic Efferent Pathways1169

Central Integrative Pathways1172

Autonomic Neurotransmission1173

CHAPTER 49 Somatosensory Function, Pain, and Headache&Kim Litwack1177

ORGANIZATION AND CONTROL OF SOMATOSENSORY FUNCTION1177

Sensory Systems1178

Sensory Modalities1182

Clinical Assessment of Somatosensory Function1184

PAIN1184

Pain Theories1185

Pain Mechanisms and Pathways1186

Pain Threshold and Tolerance1190

Types of Pain1190

Assessment of Pain1193

Management of Pain1194

ALTERATIONS IN PAIN SENSITIVITY AND SPECIAL TYPES OF PAIN1198

Alterations in Pain Sensitivity1198

Special Types of Pain1199

HEADACHE AND ASSOCIATED PAIN1201

Headache1202

Temporomandibular Joint Pain1205

PAIN IN CHILDREN AND OLDER ADULTS1205

Pain in Children1205

Pain in Older Adults1206

CHAPTER 50 Disorders of Motor Function&Serena W. Hung Adapted by Joanna Pierazzo1210

ORGANIZATION AND CONTROL OF MOTOR FUNCTION1210

Organization of Movement1211

The Motor Unit1213

Spinal Reflexes1214

Motor Pathways1214

Assessment of Motor Function1215

DISORDERS OF THE MOTOR UNIT1219

Skeletal Muscle Disorders1219

Disorders of the Neuromuscular Junction1220

Lower Motor Neuron Disorders1222

Peripheral Nerve Disorders1222

DISORDERS OF THE CEREBELLUM AND BASAL GANGLIA1227

Disorders of the Cerebellum1227

Disorders of the Basal Ganglia1228

UPPER MOTOR NEURON DISORDERS1233

Amyotrophic Lateral Sclerosis1233

Demyelinating Disorders of the Central Nervous System1234

Vertebral and Spinal Cord Injury1235

CHAPTER 51 Disorders of Brain Function&Diane S. Book Adapted by Joanna Pierazzo1246

MECHANISMS AND MANIFESTATIONS OF BRAIN INJURY1246

Mechanisms of Injury1247

Traumatic Head Injury1255

Manifestations of Global Brain Injury1257

CEREBROVASCULAR DISEASE1261

Cerebral Circulation1261

Stroke （Brain Attack）1263

INFECTIONS AND NEOPLASMS1270

Infections1270

Brain Tumours1272

SEIZURE DISORDERS1274

Etiology: Provoked and Unprovoked Seizures1275

Classification1275

Diagnosis and Treatment1277

Generalized Convulsive Status Epilepticus1278

CHAPTER 52Sleep and Sleep Disorders&Carol M. Porth1281

NEUROBIOLOGY OF SLEEP1281

Neural Structures and Pathways1281

The Sleep-Wake Cycle1282

Circadian Rhythms1285

Melatonin1285

SLEEP DISORDERS1286

Diagnostic Methods1287

Circadian Rhythm Disorders1287

Insomnia1289

Narcolepsy1290

Sleep-Related Movement Disorders1291

Sleep Apnea1292

Parasomnias1293

SLEEP AND SLEEP DISORDERS IN CHILDREN AND THE ELDERLY1294

Sleep and Sleep Disorders in Children1295

Sleep and Sleep Disorders in the Elderly1295

CHAPTER 53 Disorders of Thought, Mood,and Memory&Sandra Kawczynski Pasch1299

EVOLUTION IN UNDERSTANDING OF MENTAL ILLNESS1299

Historical Perspectives1299

The Role of Heredity in Mental Illness1300

ANATOMIC AND NEUROCHEMICAL BASIS OF BEHAVIOUR1302

Behavioural Anatomy of the Brain1302

Physiology of Perception, Thought, and Memory1304

Disorders of Perception1305

Role of Neuromediators1306

Neuroimaging1307

DISORDERS OF THOUGHT AND VOLITION1308

Schizophrenia1308

DISORDERS OF MOOD1311

Depressive Disorders1311

ANXIETY DISORDERS1314

Panic Disorder1315

Generalized Anxiety Disorder1315

Obsessive-Compulsive Disorder1315

Social Phobia1316

DISORDERS OF ABUSE AND ADDICTION1316

DISORDERS OF MEMORY AND COGNITION1317

Normal Cognitive Aging1317

Dementia1318

UNITⅩⅢ DISORDERS OF SPECIAL SENSORY FUNCTION1327

CHAPTER 54 Disorders of Visual Function&Edward W. Carroll, Scott A. Jens, and Robin Curtis1328

DISORDERS OF THE ACCESSORY STRUCTURES OF THE EYE1328

Disorders of the Eyelids1330

Disorders of the Lacrimal System1331

DISORDERS OF THE CONJUNCTIVA, CORNEA,AND UVEAL TRACT1332

Disorders of the Conjunctiva1332

Disorders of the Cornea1334

Disorders of the Uveal Tract1337

The Pupil and Pupillary Reflexes1337

INTRAOCULAR PRESSURE AND GLAUCOMA1338

Control of Intraocular Pressure1338

Glaucoma1339

DISORDERS OF THE LENS AND LENS FUNCTION1341

Disorders of Refraction and Accommodation1341

Cataracts1343

DISORDERS OF THE VITREOUS AND RETINA1344

Disorders of the Vitreous1344

Disorders of the Retina1345

DISORDERS OF NEURAL PATHWAYS AND CORTICAL CENTRES1355

Optic Pathways1355

Visual Cortex1355

Visual Fields1356

DISORDERS OF EYE MOVEMENT1358

Extraocular Eye Muscles and Their Innervation1358

Strabismus1360

Amblyopia1362

Eye Examination in Infants and Children1362

CHAPTER 55 Disorders of Hearing and Vestibular Function&Susan A. Fontana and Carol M. Porth1365

DISORDERS OF THE AUDITORY SYSTEM1365

Disorders of the External Ear1366

Disorders of the Middle Ear and Eustachian Tube1367

Disorders of the Inner Ear1372

Disorders of the Central Auditory Pathways1375

Hearing Loss1375

DISORDERS OF VESTIBULAR FUNCTION1380

The Vestibular System and Vestibular Reflexes1380

Vertigo1382

Motion Sickness1383

Disorders of Peripheral Vestibular Function1383

Disorders of Central Vestibular Function1385

Diagnosis and Treatment of Vestibular Disorders1385

UNITⅩⅣ DISORDERS OF MUSCULOSKELETAL AND INTEGUMENTARY FUNCTION1389

CHAPTER 56 Structure and Function of the Musculoskeletal System&Carol M. Porth1390

BONY STRUCTURES OF THE SKELETAL SYSTEM1390

Bone Structures1391

Bone Tissue1392

Cartilage1394

Hormonal Control of Bone Formation and Metabolism1394

ARTICULATIONS AND JOINTS1397

Tendons and Ligaments1397

Types of Joints1397

CHAPTER 57 Disorders of Musculoskeletal Function: Trauma, Infection, and Neoplasms&Kathleen E. Gunta1400

INJURY AND TRAUMA OF MUSCULOSKELETAL STRUCTURES1400

Athletic Injuries1401

Soft Tissue Injuries1401

Joint （Musculotendinous） Injuries1401

Fractures1406

Complications of Fractures and otherMusculoskeletalInjuries1411

BONE INFECTIONS1416

Osteomyelitis1416

Tuberculosis of the Bone or Joint1418

OSTEONECROSIS1419

NEOPLASMS1420

Characteristics of Bone Tumours1421

Benign Neoplasms1421

Malignant Bone Tumours1421

Metastatic Bone Disease1424

CHAPTER 58 Disorders of Musculoskeletal Function: Developmental and Metabolic Disorders&Kathleen E. Gunta1427

ALTERATIONS IN SKELETAL GROWTH AND DEVELOPMENT1427

Bone Growth and Remodelling1428

Alterations During Normal Growth Periods1429

Hereditary and Congenital Deformities1433

Juvenile Osteochondroses1436

Scoliosis1438

METABOLIC BONE DISEASE1440

Osteopenia1441

Osteoporosis1441

Osteomalacia and Rickets1446

Paget Disease1448

CHAPTER 59 Disorders of Musculoskeletal Function: Rheumatic Disorders&Debra Bancroft Rizzo Adapted by Lynn Miles and Ruth A. Hannon1452

SYSTEMIC AUTOIMMUNE RHEUMATIC DISEASES1453

Rheumatoid Arthritis1453

Systemic Lupus Erythematosus1457

Systemic Sclerosis/Scleroderma1459

Polymyositis and Dermatomyositis1460

SERONEGATIVE SPONDYLOARTHROPATHIES1460

Ankylosing Spondylitis1461

Reactive Arthropathies1463

Psoriatic Arthritis1463

OSTEOARTHRITIS SYNDROME1464

Epidemiology and Risk Factors1465

Pathogenesis1465

Clinical Manifestations1466

Diagnosis and Treatment1467

CRYSTAL-INDUCED ARTHROPATHIES1468

Gout1468

RHEUMATIC DISEASES IN CHILDREN AND THE ELDERLY1470

Rheumatic Diseases in Children1470

Rheumatic Diseases in the Elderly1471

CHAPTER 60 Structure and Function of the Skin&Gladys Simandl1476

STRUCTURE AND FUNCTION OF THE SKIN1476

Functions of the Skin1476

Skin Structures1477

Epidermis1477

Basement Membrane1481

Dermis1481

Subcutaneous Tissue1482

Skin Appendages1482

MANIFESTATIONS OF SKIN DISORDERS1484

Lesions and Rashes1484

Pruritus1484

Dry Skin1486

Variations in Dark-Skinned People1486

CHAPTER 61 Disorders of Skin Integrity and Function&Gladys Simandl1488

PRIMARY DISORDERS OF THE SKIN1488

Pigmentary Skin Disorders1489

Infectious Processes1490

Acne and Rosacea1498

Allergic and Hypersensitivity Dermatoses1501

Papulosquamous Dermatoses1506

Arthropod Infestations1509

ULTRAVIOLET RADIATION, THERMAL, AND PRESSURE INJURY1512

Skin Damage Caused by Ultraviolet Radiation1512

Thermal Injury1514

Pressure Ulcers1517

NEVI AND SKIN CANCERS1519

Nevi1519

Skin Cancer1519

AGE-RELATED SKIN MANIFESTATIONS1523

Skin Manifestations of Infancy and Childhood1524

Skin Manifestations and Disorders in the Elderly1528

APPENDIX A: LAB VALUES1533

APPENDIX B: DIETARY REFERENCE INTAKES （DRIs）1535

GLOSSARY1541

INDEX1551