Medical Physiology: Principles for Clinical Medicine Fifth, North American Edition

Book Preface

Human physiology is the science that explains how cells, tissues, and organs interact and function as an integrated system. The fifth edition of Medical Physiology: Principles for Clinical Medicine provides the latest information of how the body’s different systems work to allow it to cope with changes in its internal and external environment. In so doing, it addresses how the body maintains optimal health and ensures survival. Although the emphasis of the fifth edition is on normal physiology, discussion of pathophysiology is also undertaken to show how altered functions are involved in disease processes. We have also created a new type of chapter essay for this edition that highlights how physiology integrates with others medical sciences, such as those involving pharmacology, biochemistry, genetics, and clinical diagnostics. This enrichment of basic physiology reinforces fundamental physiologic principles while also demonstrating how basic concepts in physiology connect to clinical medicine.
Our mission for this edition has developed out of our decades of teaching and mentoring medical students and the feedback we have received from them. We have created a multicomponent learning resource to address three questions that medical students have told us most concern them in their academic training; these are, “What should I know?”, “How do I know that I know it well?”, and “How does what I learn fit into medicine?” Each component of this textbook presents a learning opportunity with these questions in mind. We have attempted to maximize those opportunities to the fullest, while providing a clear, accurate, and up-to-date introduction to medical physiology.
Arrow Image AUDIENCE AND FUNCTION

This book, like the previous edition, is written for medical students but will be useful to dental, graduate nursing, and veterinary students as well. This is neither an encyclopedic textbook nor is it intended to be a condensed, descriptive review. Rather, the fifth edition focuses on the basic key physiologic principles necessary to understand human function and its fundamental context in clinical medicine. An additional important objective for the fifth edition is to demonstrate to the student that physiology is key to understanding other medical sciences such as pharmacology and pathophysiology. Although the book is written primarily with the student in mind, the fifth edition will also be a clear, concise, and helpful reference for physicians and other health care professionals.
All chapters were substantially revised, updated, and edited to achieve unity of voice and to be as concise and lucid as possible. In the fifth edition, each chapter is written to eliminate minutia and minimize the compilation of isolated facts. The chapters are written by medical school faculty members who are experts in their field and who have had decades of experience teaching physiology. They have focused their material on what is important for medical students to know. We have purposefully avoided discussion of research laboratory methods and/or historical material. Although such issues are important in other contexts, most medical students are too busy to be burdened by such information and prefer to focus on the essentials. We have also avoided topics that are as yet unsettled, while recognizing that new research constantly provides fresh insights and sometimes challenges old ideas.
Arrow Image CONTENT AND ORGANIZATION

This book begins with a discussion of basic physiological concepts, such as homeostasis and cell signaling, in Chapter 1. Chapter 2 covers the cell membrane, membrane transport, and the cell membrane potential. Most of the remaining chapters discuss the different organ systems: nervous (Chapters 3–7), muscle (Chapter 8), cardiovascular (Chapters 11–17), respiratory (Chapters 18–21), renal (Chapters 22–23), gastrointestinal (Chapters 25–26), endocrine (Chapters 30–35), and reproductive physiology (Chapters 36–38). Special chapters on the blood (Chapter 9) and immunology (Chapter 10) are included. The immunology chapter emphasizes physiological applications of immunology. Chapters on acid–base regulation (Chapter 24), temperature regulation (Chapter 28), and exercise (Chapter 29) discuss these complex, integrated functions. The order of presentation of topics follows that of most United States medical school courses in physiology. After the first two chapters, the other chapters may be read pretty much as stand-alone units, and some chapters may be skipped if the subjects are taught in other courses (e.g., neurobiology or immunology).
Arrow Image CHANGES FOR THE FIFTH EDITION

For the fifth edition, new expert contributing authors have been brought on board to update and rewrite major sections of the text and their associated ancillary learning tools. The entire Neurophysiology, Gastrointestinal, and Renal physiology sections of the text, as well as the chapters on Blood and Immunology, have been revised by these new authors.
In addition, in response to requests from students and instructors from around the globe, we have moved a portion of our formative assessment tools, formally only available online, into the print copy of the fifth edition of Medical Physiology: Principles for Clinical Medicine. Annotated, multiple choice review questions, in which explanations for the right and wrong answers are provided, as well as similar, annotated Clinical Application Exercises have been moved into the print copy of the new edition. The print copy, however, also retains links to additional online review questions, clinical application exercises, and advanced clinical problem-solving exercises.
Finally, we have replaced the Bench to Bedside essays found in the previous edition with new Integrated Medical Sciences essays. This new feature for the fifth edition is designed to highlight for the novice student the connections between physiology and the other basic medical sciences they are studying, such as pharmacology, pathology, and introductory clinical medicine.