http://medsouls4you.blogspot.com http://medsouls4you.blogspot.com http://medsouls4you.blogspot.com USMLE® STEP 1 Physiology Lecture Notes 2016 http://medsouls4you.blogspot.com http://medsouls4you.blogspot.com USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME), neither of which sponsors or endorses this product. This publication is designed to provide accurate information in regard to the subject matter covered as of its publication date, with the understanding that knowledge and best practice constantly evolve. The pub- lisher is not engaged in rendering medical, legal, accounting, or other professional service. If medical or legal advice or other expert assistance is required, the services of a competent professional should be sought. This publication is not intended for use in clinical practice or the delivery of medical care. To the fullest extent of the law, neither the Publisher nor the Editors assume any liability for any injury and/or damage to persons or property arising out of or related to any use of the material contained in this book. © 2016 by Kaplan, Inc. Published by Kaplan Medical, a division of Kaplan, Inc. 750 Third Avenue New York, NY 10017 All rights reserved. The text of this publication, or any part thereof, may not be reproduced in any manner whatsoever without written permission from the publisher. Printed in the United States of America 10 9 8 7 6 5 4 3 2 1 Course ISBN: 978-1-5062-0771-1 All rights reserved. The text of this publication, or any part thereof, may not be reproduced in any manner whatsoever without written permission from the publisher. This book may not be duplicated or resold, pursuant to the terms of your Kaplan Enrollment Agreement. Retail ISBN: 978-1-5062-0044-6 Kaplan Publishing print books are available at special quantity discounts to use for sales promotions, employee premiums, or educational purposes. For more information or to purchase books, please call the Simon & Schuster special sales department at 866-506-1949. http://medsouls4you.blogspot.com http://medsouls4you.blogspot.com Editor L. Britt Wilson, Ph.D. Professor Department of Pharmacology, Physiology, and Neuroscience University of South Carolina School of Medicine Columbia, SC Contributors Raj Dasgupta M.D., F.A.C.P., F.C.C.P. Assistant Professor of Clinical Medicine Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine Keck School of Medicine of USC, University of Southern California Los Angeles, CA Frank P. Noto, M.D. Assistant Professor of Internal Medicine Site Director, Internal Medicine Clerkship and Sub-Internship Icahn School of Medicine at Mount Sinai New York, NY Hospitalist Elmhurst Hospital Center Queens, NY The authors would like to thank Wazir Kudrath, M.D. for his invaluable commentary, review, and contributions. http://medsouls4you.blogspot.com http://medsouls4you.blogspot.com http://medsouls4you.blogspot.com http://medsouls4you.blogspot.com Contents Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii Section I: Fluid Distribution and Edema Chapter 1: Fluid Distribution and Edema . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Section II: Excitable Tissue Chapter 1: Ionic Equilibrium and Resting Membrane Potential . . . . . . . . 19 Chapter 2: The Neuron Action Potential and Synaptic Transmission . . . . . .27 Chapter 3: Electrical Activity of the Heart . . . . . . . . . . . . . . . . . . . . . . . . .39 Section III: Skeletal Muscle Chapter 1: Excitation-Contraction Coupling . . . . . . . . . . . . . . . . . . . . . . . 57 Chapter 2: Skeletal Muscle Mechanics . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 Section IV: Cardiac Muscle Mechanics Chapter 1: Cardiac Muscle Mechanics . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Section V: Peripheral Circulation Chapter 1: General Aspects of the Cardiovascular System . . . . . . . . . . . 87 Chapter 2: Regulation of Blood Flow and Pressure . . . . . . . . . . . . . . . . 109 Section VI: Cardiac Cycle and Valvular Heart Disease Chapter 1: Cardiac Cycle and Valvular Heart Disease . . . . . . . . . . . . . . 123 Section VII: Respiration Chapter 1: Lung Mechanics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 Chapter 2: Alveolar-Blood Gas Exchange . . . . . . . . . . . . . . . . . . . . . . . . 161 Chapter 3: Transport of O and CO and the Regulation of Ventilation . . 169 2 2 Chapter 4: Causes and Evaluation of Hypoxemia . . . . . . . . . . . . . . . . . . 181 http://medsouls4you.blogspot.com v http://medsouls4you.blogspot.com Section VIII: Renal Physiology Chapter 1: Renal Structure and Glomerular Filtration . . . . . . . . . . . . . . 195 Chapter 2: Solute Transport: Reabsorption and Secretion . . . . . . . . . . .209 Chapter 3: Clinical Estimation of GFR and Patterns of Clearance . . . . . 221 Chapter 4: Regional Transport . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .227 Section IX: Acid-Base Disturbances Chapter 1: Acid-Base Disturbances . . . . . . . . . . . . . . . . . . . . . . . . . . . . .245 Section X: Endocrinology Chapter 1: General Aspects of the Endocrine System . . . . . . . . . . . . . . 261 Chapter 2: Hypothalamic-Anterior Pituitary System . . . . . . . . . . . . . . . .267 Chapter 3: Posterior Pituitary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271 Chapter 4: Adrenal Cortex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .279 Chapter 5: Adrenal Medulla . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307 Chapter 6: Endocrine Pancreas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 311 Chapter 7: Hormonal Control of Calcium and Phosphate . . . . . . . . . . .327 Chapter 8: Thyroid Hormones . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 341 Chapter 9: Growth, Growth Hormone and Puberty . . . . . . . . . . . . . . . .357 Chapter 10: Male Reproductive System . . . . . . . . . . . . . . . . . . . . . . . . . .365 Chapter 11: Female Reproductive System . . . . . . . . . . . . . . . . . . . . . . . . 375 Section XI: Gastrointestinal Physiology Chapter 1: Gastrointestinal Physiology . . . . . . . . . . . . . . . . . . . . . . . . . .395 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 419 http://medsouls4you.blogspot.com vi http://medsouls4you.blogspot.com Preface These volumes of Lecture Notes represent the most-likely-to-be-tested material on the current USMLE Step 1 exam. We want to hear what you think. What do you like about the Notes? What could be improved? Please share your feedback by e-mailing us at [email protected]. Best of luck on your Step 1 exam! Kaplan Medical http://medsouls4you.blogspot.com vii http://medsouls4you.blogspot.com http://medsouls4you.blogspot.com http://medsouls4you.blogspot.com I SECTION Fluid Distribution and Edema http://medsouls4you.blogspot.com