PATHOPHYSIOLOGY:THE BIOLOGIC BASIS FOR DISEASE IN ADULTS AND CHILDREN SIXTH EDITIONPDF电子书下载

PART ONE CENTRAL CONCEPTS OFPATHOPHYSIOLOG： CELLSAND TISSUES 1

UNIT Ⅰ The Cell 1

Chapter 1 Cellular Biology,&Kathyrn L. McCance 1

Prokayotes and Eukayotes, 1

Cellular Functions, 2

Structure and Function of Cellular Components, 2

Nucleus, 2

Cytoplasmic Organelles, 4

Plasma Membranes, 10

Cellular Receptors, 13

Cell-to-Cell Adhesions, 15

Extracellular Matrix, 15

Specialized Cell Junctions, 16

Cellular Communication and Signal Transduction, 18

Signal Transduction, 19

Extracellular Messengers and Channel Regulation, 20

Second Messengers, 20

Cellular Metabolism, 21

Role of Adenosine Triphosphate, 22

Food and Production of Cellular Energy, 23

Oxidative Phosphorylation, 24

Membrane Transport: Cellular Intake and Output, 25

Movement of Water and Solutes, 26

Transport by Vesicle Formation, 30

Movement of Electrical Impulses: MembranePotentials, 32

Cellular Reproduction: The Cell Cycle, 33

Phases of Mitosis and Cytokinesis, 34

Rates of Cellular Division, 35

Growth Factors, 35

Tissues, 35

Tissue Formation, 35

Types of Tissues, 36

Chapter 2 Altered Cellular and Tissue Biology, &Kathryn L. McCance and Todd Cameron GreyCe 46

Cellular Adaption, 47

Atrophy, 47

Hypertrophy, 47

Hyperplasia, 48

Dysplasia: Not a True Adaptive Change, 49

Metaplasia, 50

Cellular Injury, 50

General Mechanisms of Cell Injury, 52

Hypoxic Injury, 52

Free Radicals and Reactive Oxygen Species, 54

Chemical Injury, 55

Unintentional and Intentional Injuries, 62

Infectious Injury, 69

Immunologic and Inflammatory Injury, 69

Injurious Genetic Factors, 69

Injurious Nutritional Imbalances, 69

Injurious Physical Agents, 71

Manifestations of Cellular Injury, 76

Cellular Manifestations: Accumulations, 76

Systemic Manifestations, 81

Cellular Death, 81

Necrosis, 81

Apoptosis, 84

Aging and Altered Cellular and Tissue Biology, 86

Normal Life Span, 86

Somatic Death, 90

Chapter 3 The Cellular Environment: Fluids andElectrolytes, Acids and Bases,Sue E. Huether 96

Distribution of Body Fluids, 96

Aging and Distribution of Body Fluids, 97

Water Movement Between ICF and ECF, 97

Water Movement Between Plasma and Interstitial Fluid, 98

Alterations in Water Movement, 98

Edema, 98

Sodium, Chloride, and Water Balance, 101

Sodium and Chloride Balance, 101

Water Balance, 102

Alterations in Sodium, Chloride, and Water Balance, 102

Isotonic Alterations, 102

Hypertonic Alterations, 103

Hypotonic Alterations, 104

Alterations in Potassium, Calcium, Phosphate, andMagnesium Balance, 106

Potassium, 106

Calcium and Phosphate, 111

Magnesium, 114

Acid-Base Balance, 114

Hydrogen Ion and pH, 114

Buffer Systems, 115

Acid-Base Imbalances, 117

UNIT Ⅱ Genes and Gene-EnvironmentInteraction 126

Chapter 4 Genes and Genetic Diseases,Lynn B. Jorde 126

DNA, RNA, and Proteins: Heredity at the MolecularLevel, 129

DNA, 129

From Genes to Proteins, 132

Chromosomes, 134

Chromosome Aberrations and Associated Diseases, 135

Elements of Formal Genetics, 143

Phenotype and Genotype, 145

Dominance and Recessiveness, 145

Transmission of Genetic Diseases, 145

Autosomal Dominant Inheritance, 146

Autosomal Recessive Inheritance, 151

X-Linked Inheritance, 152

Evaluation of Pedigrees, 155

Linkage Analysis and Gene Mapping, 155

Classical Pedigree Analysis, 155

Assigning Loci to Specific Chromosomes, 157

Complete Human Gene Map: Prospects and Benefits, 157

Chapter 5 Genes, Environment, and CommonDiseases,Lynn B.Jorde 164

Factors Influencing Incidence of Disease inPopulations, 164

Concepts of Incidence and Prevalence, 164

Analysis of Risk Factors, 165

Principles of Multifactorial Inheritance, 165

Basic Model, 165

Threshold Model, 166

Recurrence Risks and Transmission Patterns, 167

Nature and Nurture: Disentangling the Effects of Genesand Environment, 169

Twin Studies, 170

Adoption Studies, 170

Genetics of Common Diseases, 172

Congenital Malformations, 172

Multifactorial Disorders in the Adult Population, 172

UNIT Ⅲ Mechanisms of Self-Defense 183

Chapter 6 Innate Immunity: Inflammation,Neal S. Rote and Sue E. Huether 183

Human Defense Mechanisms, 184

First Line of Defense: Physical, Mechanical, andBiochemical Barriers, 184

Physical and Mechanical Barriers, 184

Biochemical Barriers, 184

Second Line of Defense: The Inflammatory Response, 186

Vascular Response, 186

Plasma Protein Systems, 187

Cellular Mediators of Inflammation, 192

Cellular Products, 203

Local Manifestations of Inflammation, 205

Systemic Manifestations of Acute Inflammation, 205

Fever, 206

Leukocytosis, 206

Plasma Protein Synthesis, 206

Chronic Inflammation, 206

Resolution and Repair, 208

Reconstructive Phase, 208

Maturation Phase, 210

Dysfunctional Wound Healing, 211

Pediatrics and Mechanisms of Self-Defense, 212

Aging and Mechanisms of Self-Defense, 213

Chapter 7 Adaptive Immunity,Neal S. Rote 217

General Characteristics of Adaptive Immunity, 217

Humoral and Cell-Mediated Immunity, 219

Active vs. Passive Immunity, 220

Recognition and Response, 220

Antigens and Immunogens, 221

Molecules That Recognize Antigen, 222

Molecules That Present Antigen, 226

Molecules That Hold Cells Together, 228

Cytokines and Their Receptors, 228

Generation of Clonal Diversity, 229

T-Cell Maturation, 230

B-Cell Maturation, 233

Induction of an Immune Response: Clonal Selection, 235

Secondary Lymphoid Organs, 235

Antigen Processing and Presentation, 235

Helper T Lymphocytes, 237

B-Cell Activation: The Humoral Immune Response, 240

T-Cell Activation: The Cellular Immune Response, 243

Effector Mechanisms, 244

Antibody Function, 244

T-Lymphocyte Function, 247

Fetal and Neonatal Immune Function, 250

Aging and Immune Function, 251

Chapter 8 Alterations in Immunity andInflammation,Neal S. Rote 256

Hypersensitivity: Allergy, Autoimmunity, andAlloimmunity, 256

Mechanisms of Hypersensitivity, 258

Antigenic Targets of Hypersensitivity Reactions, 264

Autoimmune and Alloimmune Disease, 271

Deficiencies in Immunity, 275

Initial Clinical Presentation, 275

Primary Immune Deficiencies, 275

Secondary Immune Deficiencies, 284

Clinical Evaluation of Immunity, 286

Replacement Therapies for Immune Deficiencies, 287

Chapter 9 Infection,Neal S. Rote and Sue E. Huether 293

Microorganisms and Humans: A Dynamic Relationship, 295

Microorganisms and Infections, 295

Process of Infection, 295

Clinical Infectious Disease, 296

Classes of Infectious Microorganisms, 297

Acquired Immunodeficiency Syndrome （AIDS）, 318

Transmission, 318

Pathogenesis, 319

Clinical Manifestations, 321

Treatment and Prevention, 322

Pediatric AIDS and Central Nervous SystemInvolvement, 324

Countermeasures Against Pathogens, 326

Infection Control Measures, 326

Antimicrobials, 327

Active Immunization: Vaccines, 329

Passive Immunotherapy, 332

Chapter 10 Stress and Disease,Beth A. Forshee, Margaret F. Clayton,and Kathryn L. McCance 336

Concepts of Stress, 337

General Adaptation Syndrome, 338

Psychologic Mediators and Specificity, 338

Psychoneuroimmunologic Mediators of Stress, 339

Stress Response, 339

Central Stress Response, 339

Stress and the Immune System, 347

Stress, Personality, Coping, and Illness, 352

Aging and Stress: Stress-Age Syndrome, 355

UNIT Ⅳ Cellular Proliferation: Cancer 360

Chapter 11 Biology, Clinical Manifestations, andTreatment of Cancer,David M. Virshup 360

Cancer Characteristics and Terminology, 360

Tumor Classification and Nomenclature, 361

The Biology of Cancer Cells, 362

Tumor Markers, 367

The Genetic Basis of Cancer, 367

Cancer-Causing Mutations in Genes, 367

Types of Genes Misregulated in Cancer, 368

Oncogenes and Tumor-Suppressor Genes: Acceleratorsand Brakes, 370

Guardians of the Genome, 375

Inflammation, Immunity, and Cancer, 377

The Immune System Protects Us Against Viral-Associated Cancers, 378

Viral Causes of Cancer, 378

Bacterial Cause of Cancer, 380

Cancer Invasion and Metastasis, 381

Only Rare Cells in a Cancer are Able to Metastasize, 382

Detachment and Invasion, 382

Survival and Spread in the Circulation, 382

Selective Adherence in Favorable Sites, 383

Escape from the Circulation and Development of a NewMicroenvironment, 384

Clinical Manifestations and Treatment of Cancer, 384

Clinical Manifestations of Cancer, 384

Cancer Treatment, 387

Chapter 12 Cancer Epidemiology,Kathryn L. McCance 396

Genes, Environmental-Lifestyle Factors, and RiskFactors, 396

Epigenetics and Genetics, 401

Tobacco Use, 404

Diet, 404

Alcohol Consumption, 415

Ionizing Radiation, 416

Ultraviolet Radiation, 422

Electromagnetic Radiation, 424

Sexual and Reproductive Behavior: HumanPapillomaviruses, 425

Other Viruses and Microorganisms, 425

Physical Activity, 425

Chemicals and Occupational Hazards as Carcinogens, 426

Air Pollution, 426

Chapter 13 Cancer in Children,Nancy E. Kline 436

Incidence and Types of Cancer, 436

Etiology, 437

Genetic Factors, 438

Environmental Factors, 439

Prognosis, 440

PART TWO PATHOPHYSIOLOGICALTERATIONS: ORGANS ANDSYSTEMS 442

UNIT Ⅴ The Neurologic System 442

Chapter 14 Structure and Function of theNeurologic System,Richard A. Sugerman 442

Overview and Organization of the Nervous System, 442

Cells of the Nervous System, 443

Neuron, 443

Neuroglia and Schwann Cells, 444

Nerve Injury and Regeneration, 445

Nerve Impulse, 446

Synapses, 446

Neurotransmitters, 447

Central Nervous System, 449

Brain, 449

Spinal Cord, 456

Motor Pathways, 458

Sensory Pathways, 458

Protective Structures, 459

Blood Supply, 462

Peripheral Nervous System, 465

Autonomic Nervous System, 467

Anatomy of the Sympathetic Nervous System, 467

Anatomy of the Parasympathetic Nervous System, 467

Functions of the Autonomic Nervous System, 470

Aging and the Nervous System, 471

Tests of Nervous System Function, 474

Skull and Spine Roentgenograms, 474

Computed Tomography, 474

Magnetic Resonance Imaging, 474

Magnetic Resonance Angiography, 475

Positron-Emission Tomography Scan, 475

Brain Scan, 475

Cerebral Angiography, 476

Myelography, 476

Echoencephalography （Ultrasound）, 476

Electroencephalography, 476

Evoke Potentials, 476

Cerebrospinal Fluid Analysis, 476

Chapter 15 Pain, Temperature Regulation, Sleep,and Sensory Function,Sue E. Huether 481

Pain, 482

Theories of Pain, 482

Neuroanatomy of Pain, 482

Neuromodulation of Pain, 486

Clinical Description of Pain, 490

Pediatrics and Perception of Pain, 495

Aging and Perception of Pain, 495

Temperature Regulation, 496

Hypothalamic Control of Temperature, 496

Pediatrics and Changes in Temperature Regulation, 498

Aging and Changes in Temperature Regulation, 498

Pathogenesis of Fever, 498

Benefits of Fever, 498

Disorders of Temperature Regulation, 500

Sleep, 502

Non-Rapid Eye Movement （NREM） Sleep, 503

Pediatrics and Sleep Patterns, 504

Aging and Sleep Patterns, 504

Sleep Disorders, 504

Sleep Disorders Associated with Mental, Neurologic,or Medical Disorders, 505

Special Senses, 506

Vision, 506

Aging and Vision, 508

Hearing, 512

Aging and Hearing, 514

Olfaction and Taste, 515

Aging and Olfaction and Taste, 516

Somatosensory Function, 517

Touch, 517

Proprioception, 517

Chapter 16 Alterations in Cognitive Systems,Cerebral Hemodynamics, and MotorFunction,Barbara J. Boss 525

Alterations in Cognitive Systems, 525

Coma, 528

Seizures, 536

Alterations in Awareness, 542

Data Processing Deficits, 546

Alterations in Cerebral Hemodynamics, 557

Cerebral Hemodynamics, 557

Increased Intracranial Pressure, 557

Herniation Syndromes, 559

Cerebral Edema, 559

Hydrocephalus, 560

Alterations in Motor Function, 561

Alterations in Muscle Tone, 562

Alterations in Movement, 564

Alterations in Complex Motor Performance, 575

Extrapyramidal Motor Syndromes, 577

Chapter 17 Disorders of the Central andPeripheral Nervous Systems and theNeuromuscular Junction,Barbara J. Boss 583

Central Nervous System Disorders, 583

Trauma, 583

Degenerative Disorders of the Spine, 596

Cerebrovascular Disorders, 600

Headache, 609

Tumors of the Central Nervous System, 611

Infection and Inflammation of the Central NervousSystem, 620

Demyelinating Disorders, 630

Neurodegenerative Disorders, 633

Peripheral Nervous System and NeuromuscularJunction Disorders, 635

Peripheral Nervous System Disorders, 635

Neuromuscular Junction Disorders, 638

Chapter 18 Neurobiology of Schizophrenia, MoodDisorders, and Anxiety Disorders,&Lorey K. Takahashi 646

Schizophrenia, 647

Etiology and Pathophysiology, 647

Clinical Manifestations, 650

Treatment, 651

Mood Disorders: Depression and Bipolar Disorder, 652

Etiology and Pathophysiology, 652

Clinical Manifestations, 655

Treatment, 657

Anxiety Disorders, 658

Panic Disorder, 659

Generalized Anxiety Disorder, 660

Posttraumatic Stress Disorder, 660

Obsessive-Compulsive Disorder, 661

Chapter 19 Alterations of Neurologic Functionin Children,Barbara J. Boss and Sue E. Huether 665

Structure and Function of the Nervous System in Children, 665

Myelin Sheath, 667

Normal Growth and Development, 668

Structural Malformations, 668

Defects of Neural Tube Closure, 668

Encephalopathies, 675

Statis Encephalopathies, 675

Acute Encephalopathies, 681

Human Immunodeficiency Virus Encephalopathy, 684

Cerebrovascular Disease in Children, 684

Occlusive Cerebrovascular Disease, 685

Hemorrhagic Cerebrovascular Disease, 685

Childhood Tumors, 685

Brain Tumors, 685

Embryonal Tumors, 688

UNIT Ⅵ The Endocrine System 696

Chapter 20 Mechanisms of Hormonal Regulation,Valentina L. Brashers and Robert E. Jones 696

Mechanisms of Hormonal Regulation, 696

Regulation of Hormone Release, 697

Hormone Transport, 698

Cellular Mechanisms of Hormone Action, 699

Structure and Function of the Endocrine Glands, 703

Hypothalamic-Pituitary Axis, 703

Thyroid and Parathyroid Glands, 708

Endocrine Pancreas, 712

Adrenal Glands, 715

Neuroendocrine Response to Stressors, 720

Tests of Endocrine Function, 720

Aging and the Endocrine System, 720

Chapter 21 Alterations of Hormonal Regulation,Robert E. Jones, Valentina L. Brashers,and Sue E. Huether 727

Mechanisms of Hormonal Alterations, 727

Alterations of the Hypothalamic-Pituitary System, 728

Diseases of the Posterior Pituitary, 728

Disease of the Anterior Pituitary, 731

Alterations of Thyroid Function, 736

Hyperthyroidism, 736

Hypothyroidism, 739

Alterations of Parathyroid Function, 742

Hyperparathyroidism, 742

Hypoparathyroidism, 744

Dysfunction of the Endocrine Pancreas: DiabetesMellitus, 745

Types of Diabetes Mellitus, 745

Acute Complications of Diabetes Mellitus, 754

Chronic Complications of Diabetes Mellitus, 758

Alterations of Adrenal Function, 765

Disorders of the Adrenal Cortex, 765

Disorders of the Adrenal Medulla, 772

UNIT Ⅶ The Reproductive Systems 781

Chapter 22 Structure and Function of theReproductive Systems,Angela Deneris and Sue E. Huether 781

Development of the Reproductive Systems, 781

Sexual Differentiation and Hormone Productionin Utero, 781

Puberty, 784

The Female Reproductive System, 784

External Genitalia, 784

Internal Genitalia, 786

Female Sex Hormones, 790

The Menstrual Cycle, 792

The Male Reproductive System, 796

External Genitalia, 796

Internal Genitalia, 799

Spermatogenesis, 800

Male Sex Hormones, 800

Structure and Function of the Breast, 802

The Female Breast, 802

The Male Breast, 805

Tests of Reproductive Function, 805

Infection and Cancer Tests, 805

Fertility Tests, 807

Aging and Reproduction Function, 807

Aging and the Female Reproductive System, 807

Aging and the Male Reproductive System, 811

Chapter 23 Alterations of the ReproductiveSystems,Gwen A. Latendresse, Kathryn L. McCance,and Katherine Morgan 816

Alterations of Sexual Maturation, 816

Delayed Puberty , 817

Precocious Puberty , 818

Disorders of the Female Reproductive System, 819

Hormonal and Menstrual Alterations, 819

Infection and Infl ammation, 828

Pelvic Organ Prolapse （POP）, 833

Benign Growths and Proliferative Conditions, 836

Cancer, 841

Sexual Dysfunction, 848

Impaired Fertity, 849

Disorders of the Male Reproductive System, 850

Disorders of the Urethra, 850

Disorders of the Penis, 850

Disorders of the Scrotum, Testis, and Epididymis, 854

Disorders of the Prostate Gland, 860

Sexual Dysfunction, 869

Impairment of Sperm Production and Quality, 870

Disorders of the Breast, 871

Disorders of the Female Breast, 871

Disorders of the Male Breast, 909

Chapter 24 Sexually Transmitted Infections,Lisa Kaloczi, Gwen Latendresse, and Katherine Morgan 923

Sexually Transmitted Urogenital Infections, 924

Bacterial Infections, 924

Chlamydia Infections, 935

Viral Infections, 938

Parasitic Infections, 942

Sexually Transmitted Infections of Other Body Systems, 946

Gastrointestinal Infections, 946

Systemic Diseases, 947

UNIT Ⅷ The Hematologic System 952

Chapter 25 Structure and Function of the Hematologic System,Neal S. Rote and Kathryn L. McCance 952

Components of the Hematologic System, 952

Composition of the Blood, 952

Lymphoid Organs, 957

Development of Blood Cells, 961

Hematopoiesis, 961

Development of Erythrocytes, 965

Development of Leukocytes, 971

Development of Platelets, 971

Mechanisms of Hemostasis, 972

Function of Blood Vessels, 972

Function of Platelets, 972

Function of Clotting Factors, 976

Control of Hemostatic Mechanisms, 977

Lysis of Blood Clots, 979

Clinical Evaluation of the Hematologic System, 980

Tests of Bone Marrow Function, 980

Blood Tests, 982

Pediatrics and the Hematologic System, 982

Aging and the Hematologic System, 982

Chapter 26 Alterations of Erythrocyte Function,Neal S. Rote and Kathyrn L. McCance 989

Anemia, 989

Classification, 989

Macrocytic-Normochromic Anemias, 990

Microcytic-Hypochromic Anemias, 995

Normocytic-Normochromic Anemias, 1000

Myeloproliferative Red Blood Cell Disorders （Polycythemia）, 1008

Chapter 27 Alterations of Leukocyte, Lymphoid,and Hemostatic Function,Neal S. Rote and Kathyrn L. McCance 1014

Alterations of Leukocyte Function, 1014

Quantitative Alterations of Leukocytes, 1014

Infectious Mononucleosis, 1017

Leukemias, 1019

Alterations of Lymphoid Function, 1030

Lymphadenopathy, 1030

Malignant Lymphomas, 1030

Plasma Cell Malignancies, 1037

Alterations of Splenic Function, 1042

Alterations of Platelets and Coagulation, 1044

Disorders of Platelets, 1044

Disorders of Coagulation, 1049

Chapter 28 Alterations of Hematologic Function in Children,Nancy E. Kline 1062

Fetal and Neonatal Hematopoiesis, 1062

Postnatal Changes in the Blood, 1063

Erythrocytes, 1064

Leukocytes and Platelets, 1064

Disorders of Erythrocytes, 1065

Acquired Disorders, 1065

Inherited Disorders, 1068

Disorders of Coagulation and Platelets, 1078

Inherited Hemorrhagic Disease, 1078

Antibody-Mediated Hemorrhagic Disease, 1081

Leukemia and Lymphoma, 1083

Leukemia, 1083

Lymphomas, 1086

UNIT Ⅸ The Cardiovascular and Lymphatic Systems 1091

Chapter 29 Structure and Function of the Cardiovascular and Lymphatic Systems, &Valentina L. Brashers and Kathryn L. McCance 1091

Circulatory System, 1091

The Heart, 1093

Structures That Direct Circulation Through the Heart, 1093

Structures That Support Cardiac Metabolism: The Coronary Vessels, 1096

Structures that Control Heart Action, 1099

Factors Affecting Cardiac Output, 1109

System Circulation, 1113

Structure of Blood Vessels, 1113

Factors Affecting Blood Flow, 1117

Regulation of Blood Pressure （Arterial Pressure）, 1122

Regulation of Coronary Circulation, 1130

Lymphatic System, 1131

Tests of Cardiovascular Function, 1133

Cardiac and Coronary Arterry Evaluation, 1133

Systemic Vascular Evaluation, 1135

Aging and the Cardiovascular System, 1136

Chapter 30 Alterations of Cardiovascular Function,Valentina L. Brashers 1142

Diseases of the Veins, 1142

Varicose Veins and Chronic Venous Insufficiency, 1142

Thrombus Formation in Veins, 1143

Superior Vena Cava Syndrome, 1144

Diseases of the Arteries, 1144

Aneurysm, 1144

Thrombus Formation, 1147

Embolism, 1147

Peripheral Arterial Diseases, 1148

Hypertension, 1149

Orthostatic （Postural） Hypotension, 1156

Atherosclerosis, 1157

Peripheral Artery Disease, 1160

Coronary Artery Disease, Myocardial Ischemia, and Acute Corona Syndromes, 1160

Disorders of the Heart Wall, 1176

Disorders of the Pericardium, 1176

Disorders of the Myocardium: The Cardiomyopathies, 1178

Disorders of the Endocardium, 1181

Cardiac Complications in Acquired Immunodeficiency Syndrome, 1189

Manifestations of Heart Disease, 1189

Heart Failure, 1189

Dysrhythmias, 1196

Chapter 31 Alterations of Cardiovascular Function in Children,Nancy L. McDaniel 1209

Development of the Cardiovascular System, 1209

Developmental Anatomy, 1209

Transitional Circulation, 1211

Postnatal Development, 1213

Congenital Heart Defects, 1213

Classification of Congenital Heart Defects andAssociated Conditions, 1215

Hypoxemia, 1217

Defects Increasing Pulmonary Blood Flow, 1218

Defects Decreasing Pulmonary Blood Flow, 1223

Obstructive Defects, 1226

Mixing Defects, 1230

Acquired Cardiovascular Disorders, 1234

Kawasaki Disease, 1234

Systemic Hypertension, 1235

Childhood Obesity, 1237

UNIT Ⅹ The Pulmonary System 1242

Chapter 32 Structure and Function of the Pulmonary System,Valentina L. Brashers 1242

Structures of the Pulmonary System, 1242

Conducting Airways, 1242

Gas-Exchange Airways, 1244

Pulmonary and Bronchial Circulation, 1247

Chest Wall and Pleura, 1249

Functions of the Pulmonary System, 1249

Ventilation, 1249

Gas Transport, 1255

Control of the Pulmonary Circulation, 1260

Tests of Pulmonary Function, 1261

Aging and the Pulmonary System, 1263

Chapter 33 Alterations of Pulmonary Function,Valentina L. Brashers 1266

Clinical Manifestations of Pulmonary Alterations, 1266

Signs and Symptoms of Pulmonary Disease, 1266

Conditions Caused by Pulmonary Disease or Injury, 1269

Disorders of the Chest Wall and Pleura, 1271

Disorders of the Chest Wall, 1271

Pleural Abnormalities, 1272

Pulmonary Disorders, 1274

Restrictive Lung Disorders, 1274

Obstructive Pulmonary Disease, 1282

Respiratory Tract Infections, 1290

Pulmonary Vascular Disease, 1294

Malignancies of the Respiratory Tract, 1298

Chapter 34 Alterations of Pulmonary Function in Children,Kristi Gott and Deborah K. Froh 1310

Structure and Function, 1310

Upper Airway, 1310

Lower Airways and Lung Parenchyma, 1310

Chest Wall Dynamics, 1311

Metabolic Characteristics, 1312

Immunologic Incompetence, 1312

Physiologic Control of Respiration, 1312

Pulmonary Disorders, 1313

Disorders of the Upper Airways, 1313

Disorders of the Lower Airways, 1320

Sudden Infant Death Syndrome, 1339

UNIT Ⅺ The Renal and Urologic Systems 1344

Chapter 35 Structure and Function of the Renal and Urologic Systems,&Sue E. Huether 1344

Structures of the Renal System, 1344

Structures of the Kidney, 1344

Urinary Structures, 1350

Renal Blood Flow, 1351

Autoregulation, 1351

Neural Regulation, 1351

Hormones and Other Factors, 1352

Kidney Function, 1352

Nephron Function, 1352

Concentration and Dilution of Urine, 1357

Renal Hormones, 1358

Tests of Renal Function, 1360

The Concept of Clearance, 1360

Blood Tests, 1360

Urinalysis, 1361

Aging and Renal Function, 1362

Chapter 36 Alterations of Renal and Urinary Tract Function,Sue E. Huether and Beth A. Forshee 1365

Urinary Tract Obstruction, 1365

Upper Urinary Tract Obstruction, 1365

Lower Urinary Tract Obstruction, 1369

Tumors, 1372

Urinary Tract Infection, 1373

Causes of Urinary Tract Infection, 1373

Glomerular Disorders, 1378

Glomerulonephritis, 1379

Nephrotic Syndrome, 1384

Acute Kidney Injury, 1386

Classification of Kidney Dysfunction, 1386

Acute Kidney Injury, 1386

Chronic Kidney Disease, 1389

Creatinine and Urea Clearance, 1393

Fluid and Electrolyte Balance, 1393

Calcium, Phosphate, and Bone, 1394

Chapter 37 Alterations of Renal and Urinary Tract Function in Children, &Sue E. Huether 1402

Structure and Function of the Urinary System in Children, 1402

Development of the Urinary System, 1402

Fluid and Electrolyte Balance in Children, 1404

Alterations in Renal and Bladder Function in Children, 1404

Congenital Abnormalities, 1404

Glomerular Disorders, 1407

Renal Injury, 1411

Bladder Disorders, 1411

Wilms Tumor, 1413

Enuresis, 1414

UNIT Ⅻ The Digestive System 1420

Chapter 38 Structure and Function of the Digestive System,Sue E. Huether 1420

The Gastrointestinal Tract, 1421

Mouth and Esophagus, 1421

Stomach, 1423

Small Intestine, 1428

Large Intestine, 1435

Intestinal Bacteria, 1437

Accessory Organs of Digestion, 1437

Liver, 1438

Gallbladder, 1442

Exocrine Pancreas, 1443

Tests of Digestive Function, 1444

Gastrointestinal Tract, 1444

Liver, 1446

Gallbladder, 1446

Exocrine Pancreas, 1446

Aging and the Gastrointestinal System, 1447

Chapter 39 Alterations of Digestive Function,Sue E. Huether 1452

Disorders of the Gastrointestinal Tract, 1452

Clinical Manifestations of Gastrointestinal Dysfunction, 1452

Disorders of Motility, 1456

Gastritis, 1463

Peptic Ulcer Disease, 1464

Malabsorption Syndromes, 1470

Inflammatory Bowel Disease, 1471

Appendicitis, 1475

Vascular Insufficiency, 1477

Disorders of Nutrition, 1477

Disorders of the Accessory Organs of Digestion, 1482

Clinical Manifestations of Liver Disorders, 1482

Disorders of the Liver, 1488

Disorders of the Gallbladder, 1494

Disorders of the Pancreas, 1495

Cancer of the Digestive System, 1498

Cancer of the Gastrointestinal Tract, 1498

Cancer of the Accessory Organs of Digestion, 1503

Chapter 40 Alterations of Digestive Function in Children,Sue E. Huether 1516

Disorders of the Gastrointestinal Tract, 1516

Congenital Impairment of Motility, 1516

Esophageal Malformations, 1518

Acquired Impairment of Motility, 1522

Impairment of Digestion, Absorption, and Nutrition, 1524

Diarrhea, 1530

Disorders of the Liver, 1531

Disorders of Biliary Metabolism and Transport, 1531

Inflammatory Disorders, 1532

Portal Hypertension, 1533

Metabolic Disorders, 1534

UNIT ⅩⅢ The Musculoskeletal System 1540

Chapter 41 Structure and Function of the Musculoskeletal System,Christy L. Crowther-Radulewicz 1540

Structure and Function of Bones, 1540

Elements of Bone Tissue, 1540

Types of Bone Tissue, 1545

Characteristics of Bone, 1546

Maintenance of Bone Integrity, 1547

Structure and Function of Joints, 1548

Fibrous Joints, 1549

Cartilaginous Joints, 1549

Synovial Joints, 1550

Structure and Function of Skeletal Muscles, 1554

Whole Muscle, 1555

Components of Muscle Function, 1561

Tests of Musculoskeletal Function, 1563

Tests of Bone Function, 1563

Tests of Joint Function, 1563

Tests of Muscular Function, 1563

Aging and the Musculoskeletal System, 1564

Aging of Bones, 1564

Aging of Joints, 1564

Aging of Muscles, 1564

Chapter 42 Alterations of Musculoskeletal Function, &Christy L. Crowther-Radulewicz and Kathryn L. McCance 1568

Musculoskeletal Injuries, 1568

Skeletal Trauma, 1568

Support Structures, 1573

Disorders of Bones, 1576

Metabolic Bone Diseases, 1576

Infectious Bone Disease: Osteomyelitis, 1586

Bone Tumors, 1588

Disorders of Joints, 1592

Osteoarthritis, 1592

Classic Inflammatory Joint Disease, 1596

Disorders of Skeletal Muscle, 1606

Secondary Muscular Dysfunction, 1606

Muscle Membrane Abnormalities, 1609

Metabolic Muscle Diseases, 1610

Inflammatory Muscle Diseases: Myositis, 1611

Myopathy, 1612

Muscle Tumors, 1613

Chapter 43 Alterations of Musculoskeletal Function in Children,Kristen Lee Carroll 1618

Musculoskeletal Development in Children, 1618

Bone Formation, 1618

Bone Growth, 1619

Skeletal Development, 1620

Muscle Growth, 1620

Musculoskeletal Alterations in Children, 1620

Congenital Defects, 1620

Abnormal Density of Modeling of the Skeleton, 1624

Bone Infection: Osteomyelitis, 1628

Juvenile Rheumatoid Arthritis, 1630

Avascular Diseases of the Bone: Osteochondrosis, 1631

Cerebral Palsy, 1632

Muscular Dystrophy, 1633

Musculoskeletal Tumors in Children, 1637

Nonaccidental Trauma, 1640

UNIT ⅩⅣ The Integumentary System 1644

Chapter 44 Structure, Function, and Disorders of the Integument,Noreen Heer Nicol and Sue E. Huether 1644

Structure and Function of the Skin, 1644

Layers of the Skin, 1644

Subcutaneous Layer, 1645

Aging and Skin Integrity, 1646

Tests of Skin Function, 1647

Clinical Manifestations of Skin Dysfunction, 1647

Disorders of the Skin, 1655

Inflammatory Disorders, 1655

Papulosquamous Disorders, 1657

Vesiculobullous Disorders, 1660

Infections, 1662

Vascular Disorders, 1665

Insect Bites, 1667

Benign Tumors, 1668

Cancer, 1669

Frostbite, 1673

Disorders of the Hair, 1673

Alopecia, 1673

Hirsutism, 1674

Disorders of the Nail, 1674

Paronychia, 1674

Onychomycosis, 1674

Chapter 45 Alterations of the Integument in Children,Noreen Heer Nicol and Sue E. Huether 1680

Acne Vulgaris, 1680

Dermatitis, 1681

Atopic Dermatitis, 1681

Diaper Dermatitis, 1682

Infections of the Skin, 1683

Bacterial Infections, 1683

Fungal Infections, 1684

Viral Infections, 1685

Insect Bites and Parasites, 1688

Scabies, 1688

Pediculosis （Lice Infestation）, 1689

Fleas, 1689

Bedbugs, 1689

Hemangiomas and Vascular Malformations, 1690

Hemangiomas, 1690

Vascular Malformations, 1691

Other Skin Disorders, 1692

Miliaria, 1692

Erythema Toxicum Neonatorum, 1692

Toxic Epidermal Necrolysis and Stevens-Johnson Syndrome, 1692

UNIT ⅩⅤ Multiple Interacting Systems 1696

Chapter 46 Shock, Multiple Organ Dysfunction Syndrome, and Burns in Adults,Dennis J. Cheek, Linda L. Martin, and Stephen E. Morris 1696

Shock, 1696

Cellular Alterations, 1697

Impairment of Cellular Metabolism, 1697

Types of Shock, 1699

Treatment for Shock, 1707

Multiple Organ Dysfunction Syndrome, 1707

Burns, 1714

Epidemiology and Etiology, 1714

Burn Wound Depth, 1714

Chapter 47 Shock, Multiple Organ Dysfunction, and Burns in Children,Mary Fran Hazinski, Mary A. Mondozzi, and Rose A. Urdiales Baker 1727

Shock and Multiple Organ Dysfunction, 1727

Types of Shock, 1728

Reperfusion and Inflammatory Injury, 1737

Evaluation and Treatment of Shock, 1737

Burns, 1741

Severity of Injury, 1742

Glossary, 1755

Index, 1778