Ganong's Review of Medical Physiology. 25 ed.pdf

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A LANGE medical book
Ganong’s Review
of
Medical Physiology
TWENTY-FIFTH EDITION
Kim E. Barrett, PhD
Distinguished Professor, Department of Medicine
Dean of the Graduate Division
University of California, San Diego
La Jolla, California
Scott Boitano, PhD
Professor, Physiology and Cellular and Molecular
Medicine
Arizona Respiratory Center
Bio5 Collaborative Research Institute
University of Arizona
Tucson, Arizona
Susan M. Barman, PhD
Professor, Department of Pharmacology/
Toxicology
Michigan State University
East Lansing, Michigan
Heddwen L. Brooks, PhD
Professor, Physiology and Pharmacology
College of Medicine
University of Arizona
Tucson, Arizona
New York
Chicago San Francisco Athens London Madrid Mexico City
Milan New Delhi Singapore Sydney Toronto
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ISBN: 978-0-07-184897-8
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Dedication to
William Francis Ganong
W
illiam Francis (“Fran”) Ganong was an outstanding
scientist, educator, and writer. He was completely
dedicated to the field of physiology and medical ed-
ucation in general. Chairman of the Department of Physiology
at the University of California, San Francisco, for many years,
he received numerous teaching awards and loved working with
medical students.
Over the course of 40 years and some 22 editions, he was
the sole author of the best selling
Review of Medical Physiology,
and a co-author of 5 editions of
Pathophysiology of Disease: An
Introduction to Clinical Medicine.
He was one of the “deans”
of the Lange group of authors who produced concise medical
text and review books that to this day remain extraordinarily
popular in print and now in digital formats. Dr. Ganong made
a gigantic impact on the education of countless medical stu-
dents and clinicians.
A general physiologist par excellence and a neuroendo-
crine physiologist by subspecialty, Fran developed and main-
tained a rare understanding of the entire field of physiology.
This allowed him to write each new edition (every 2 years!)
of the
Review of Medical Physiology
as a sole author, a feat
remarked on and admired whenever the book came up for dis-
cussion among physiologists. He was an excellent writer and
far ahead of his time with his objective of distilling a complex
subject into a concise presentation. Like his good friend, Dr.
Jack Lange, founder of the Lange series of books, Fran took
great pride in the many different translations of the
Review of
Medical Physiology
and was always delighted to receive a copy
of the new edition in any language.
He was a model author, organized, dedicated, and enthusi-
astic. His book was his pride and joy and like other best-selling
authors, he would work on the next edition seemingly every
day, updating references, rewriting as needed, and always ready
and on time when the next edition was due to the publisher. He
did the same with his other book,
Pathophysiology of Disease:
An Introduction to Clinical Medicine,
a book that he worked on
meticulously in the years following his formal retirement and
appointment as an emeritus professor at UCSF.
Fran Ganong will always have a seat at the head table of
the greats of the art of medical science education and commu-
nication. He died on December 23, 2007. All of us who knew
him and worked with him miss him greatly.
Key Features of the Twenty-Fifth Edition of
Ganong’s Review of Medical Physiology
A concise, up-to-date and clinically relevant review
of human physiology
•
•
•
•
•
•
•
Provides succinct coverage of every important topic without sacrificing
comprehensiveness or readability
Reflects the latest research and developments in the areas of chronic pain,
reproductive physiology, and acid-base homeostasis
Incorporates examples from clinical medicine to illustrate important
physiologic concepts
Section introductions help you build a solid foundation on the given topic
Includes both end-of-chapter and board-style review questions
Chapter summaries ensure
retention of key concepts
CHAPTER 37
Renal Function & Micturition
More clinical cases and flow charts
than ever, along with modern
approaches to therapy
Expanded legends for each
illustration—so you don’t have to
refer back to the text
Introductory materials cover key
principles of endocrine regulation
in physiology
673
A
Proximal tubule
Capsule
Red blood cells
Glomerular basal
lamina
Bowman’s space
B
Podocyte
Mesangial
cell
Capillary
Capillary
•
Granular cells
Podocyte
processes
Efferent
arteriole
Nerve fibers
Afferent
arteriole
Smooth muscle
Distal tubule
Macula densa
Capillary
Capillary
Podocyte
process
Basal
lamina
•
Mesangial cell
Cytoplasm of
endothelial
cell
C
Basal lamina
Endothelium
Podocyte
Basal lamina
Endothelium
D
Foot processes
of podocytes
Filtration slit
Fenestrations
Bowman’s
space
Capillary lumen
Basal lamina
FIGURE 37–2
Structural details of glomerulus. A)
Section through vascular pole, showing capillary loops.
B)
Relation of mesangial cells
and podocytes to glomerular capillaries.
C)
Detail of the way podocytes form filtration slits on the basal lamina, and the relation of the lamina
to the capillary endothelium.
D)
Enlargement of the rectangle in C to show the podocyte processes. The fuzzy material on their surfaces is
glomerular polyanion.
about 12 m
2
. The volume of blood in the renal capillaries at any
given time is 30–40 mL.
glomerular filtration rate (GFR) and is claimed to enhance and
prolong anuria in acute kidney injury (AKI).
More than
600 full-color
illustrations
LYMPHATICS
The kidneys have an abundant lymphatic supply that drains
via the thoracic duct into the venous circulation in the thorax.
INNERVATION OF
THE RENAL VESSELS
The renal nerves travel along the renal blood vessels as they
enter the kidney. They contain many postganglionic sym-
pathetic efferent fibers and a few afferent fibers. There also
appears to be a cholinergic innervation via the vagus nerve,
but its function is uncertain. The sympathetic pregangli-
onic innervation comes primarily from the lower thoracic
CAPSULE
The renal capsule is thin but tough. If the kidney becomes
edematous, the capsule limits the swelling, and the tissue
pressure
(renal interstitial pressure)
rises. This decreases the
Barrett_CH37_p669-694.indd 673
6/18/15 4:54 PM

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