Ganong’s Review of Medical Physiology, Twenty sixth Edition

Book Preface

It is difficult to believe that this preface signifies the fourth edition of Ganong’s Review of Medical Physiology that our author group has overseen, and the 26th edition overall of this important reference work aimed at medical and other health professional students. As always, we have tried to maintain the highest standards of excellence that were promulgated by the original author, Fran Ganong, over the 46 years where he served, remarkably, as the sole author of the textbook.

In this new edition, we have cast a fresh eye on the pedagogical approach taken in each chapter and section, and have focused particularly on including only material that is of the highest yield. We have thoroughly revised the learning objectives for every chapter, reorganized and updated the text to ensure that all objectives are clearly addressed in a logical order, aligned chapter summaries so that the take-home messages quickly address each learning objective in turn, and expanded the number of review questions so that readers also have the ability to check their understanding and retention of every objective covered. As a discipline evolves and new information emerges, there is a tendency simply to concatenate these concepts such that chapter structure degrades inevitably over time. With in-depth discussions amongst the author team and significant “spring-cleaning,” we believe we have freshened and simplified the volume while also making sure that important new developments are incorporated. We are immensely thankful to Erica Wehrwein, PhD, Assistant Professor of Physiology and an award-winning instructor at Michigan State University, who took on the task of reviewing the book as a whole and providing specific and detailed feedback to us on each chapter.

This new edition also welcomes a new member to the author team. We are delighted to have been able to recruit Jason X.-J. Yuan, MD, PhD, Professor of Medicine and Physiology as well as Chief of the Division of Translational and Regenerative Medicine and Associate Vice President for Translational Health Sciences at the University of Arizona, who has assumed responsibility for some cell physiology and cardiovascular topics, as well as the respiratory physiology section. We are particularly excited to have a physician-scientist on the team, who can guide us overall to focus on material that is of most benefit to those preparing for a career incorporating patient care. We are most grateful for the past contributions of Scott Boitano, PhD, whose other obligations meant that he could no longer serve as an author.

We continue to be gratified by the many colleagues and students who contact us from all over the world to request clarification of material covered in the text, or to point out errors or omissions. We are especially grateful to Rajan Pandit, Lecturer in Physiology at Nepal Medical College, who has painstakingly offered dozens of suggestions for revision over the years. His efforts, and those of the many others whom we have not named, allow us to engage in a process of continual improvement. While, as always, any errors that remain in the book
(inevitable in a complex project such as this) are the sole responsibility of the authorship team, we greatly value critical input, and urge readers once again to contact us with any suggestions or critiques. We thank you in advance both for such feedback, and also for your support of this new edition.

This edition is a revision of the original works of Dr. Francis Ganong.

Cellular & Molecular Basis for Medical Physiology

Study of physiological system structure and function, as well as pathophysiological alterations, has its foundations in physical and chemical laws and the molecular and cellular makeup of each tissue and organ system. Ganong’s Review of Medical Physiology is structured into seven sections. This first section provides an overview of the basic building blocks or bases that provide the important framework for human physiology. It is important to note here that the seven chapters in this initial section are not meant to provide an exhaustive understanding of biophysics, biochemistry, or cellular and molecular physiology; rather, they are to serve as a reminder of how the basic principles from these disciplines contribute to medical physiology discussed in later sections associated with physiological functions of organs and systems.

In the first two chapters of this section, the following basic building blocks are introduced and discussed: electrolytes; carbohydrates, lipids, and fatty acids; amino acids and proteins; and nucleic acids. Students are reminded of some of the basic principles and building blocks of biophysics and biochemistry and how they fit into the physiologic environment. Examples of direct clinical applications are provided in the clinical boxes to help bridge the gap between basic principles and human cell, tissue, and organ functions. These basic principles are followed up with a discussion of the generic cell and its components. It is important to realize the cell is the basic functional unit within the body, and it is the collection and fine-tuned interactions among and between these fundamental units that allow for proper tissue, organ, and organism function.

In the third to seventh chapters of this introductory section, we take a cellular approach to lay a groundwork of understanding groups of cells that interact with many of the systems discussed in future chapters. The first group of cells presented contribute to inflammatory reactions in the body. These individual players, their coordinated behavior, and the net effects of the “open system” of inflammation in the body are discussed in detail. The second group of cells discussed are responsible for the excitatory responses in human physiological function and include both neuronal and muscle cells. A fundamental understanding of the inner workings of these cells, and how they are controlled by their neighboring cells, helps the student to understand their eventual integration into individual systems discussed in later sections.

This first section serves as an introduction, refresher, and quick source of material to best understand organ functions and systems physiology presented in the later sections. For detailed understanding of any of the chapters within this section, several excellent and current textbooks that provide more in-depth reviews of principles of biochemistry, biophysics, cell physiology, and muscle and neuronal physiology are provided as resources at the end of each individual chapter. Students are encouraged to visit these texts for a more thorough understanding of these basic principles.