Pathophysiology

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Front Cover IFC_brief contents Evolve page Pathophysiology Copyright Page Dedication Contributors Reviewers Preface Organization Features Ancillaries Student Learning Resources on Evolve Study Guide Instructor Learning Resources on Evolve Acknowledgments Table Of Contents Unit I Pathophysiologic Processes 1 Introduction to Pathophysiology Chapter Outline Key Questions Framework for Pathophysiology Etiology Pathogenesis Clinical Manifestations Stages and Clinical Course Treatment Implications Concepts of Normality in Health and Disease Statistical Normality Reliability, Validity, and Predictive Value Individual Factors Influencing Normality Cultural Considerations Age Differences Gender Differences Situational Differences Time Variations Patterns of Disease in Populations Concepts of Epidemiology Endemic, Pandemic, and Epidemic Diseases Aggregate Factors Age. Ethnic group. Gender. Socioeconomic factors and lifestyle considerations. Geographic location. Levels of Prevention Primary prevention. Secondary prevention. Tertiary prevention. Summary Resources General Concepts of Pathophysiology Normal Variations and Statistical Analysis Patterns of Disease and Epidemiology 2 Homeostasis, Allostasis, and Adaptive Responses to Stressors Chapter Outline Key Questions Homeostasis and Allostasis Homeostasis Allostasis Stress as a Concept The General Adaptation Syndrome and Allostasis Alarm Stage Resistance or Adaptation Stage Exhaustion Stage Stressors, Gender and Developmental Influences, and Risk Factors Neurohormonal Mediators of Stress and Adaptation Catecholamines: Norepinephrine and Epinephrine Adrenocortical Steroids: Cortisol and Aldosterone Endorphins, Enkephalins, and Immune Cytokines Sex Hormones: Estrogen, Testosterone, and Dehydroepiandrosterone Growth Hormone, Prolactin, and Oxytocin Adaptation, Coping, and Illness Adaptation, Coping, and Resilience Allostatic Overload and Illness Summary Resources Homeostasis and Allostasis Neurohormones and Concepts of Stress Adaptation and Coping Unit II Cellular Function 3 Cell Structure and Function Chapter Outline Key Questions Plasma Membrane Membrane Structure Lipid Bilayer Membrane Proteins Organization of Cellular Compartments Cytoskeleton Nucleus Endoplasmic Reticulum Golgi Apparatus Lysosomes and Peroxisomes Mitochondria Cellular Metabolism Glycolysis Citric Acid Cycle Oxidative Phosphorylation Functions of the Plasma Membrane Membrane Transport of Macromolecules Endocytosis and Exocytosis Membrane Transport of Small Molecules Active Transport Pumps Sodium–potassium ion pump. Membrane calcium transporters. ABC transporters. Membrane Transport Carriers Na+-driven carriers. Passive transport carriers. Membrane Channel Proteins Cellular Membrane Potentials Resting Membrane Potential Action Potential Intercellular Communication and Growth Cell Signaling Strategies Cell Surface Receptor–Mediated Responses Intracellular Receptor–Mediated Responses Regulation of Cellular Growth and Proliferation Summary Resources General Cell Structure and Function Cellular Energy Metabolism Cellular Electrical Potentials Cell Growth Regulation 4 Cell Injury, Aging, and Death Chapter Outline Key Questions Reversible Cell Injury Hydropic Swelling Intracellular Accumulations Cellular Adaptation Atrophy Hypertrophy Hyperplasia Metaplasia Dysplasia Irreversible Cell Injury Necrosis Apoptosis Etiology of Cellular Injury Ischemia and Hypoxic Injury Nutritional Injury Infectious and Immunologic Injury Chemical Injury Physical and Mechanical Injury Cellular Aging Cellular Basis of Aging Physiologic Changes of Aging Somatic Death Summary Resources Cellular Responses to Injury Types and Causes of Cell Injury Cellular Aging and Death 5 Genome Structure, Regulation, and Tissue Differentiation Chapter Outline Key Questions Structure and Function of DNA Structure of DNA DNA Replication Genetic Code Transcription Translation Regulation of the Genome Transcriptional Controls Differentiation of Tissues Cell Diversification and Cell Memory Mechanisms of Development Differentiated Tissues Epithelial Tissue Connective Tissue Muscle Tissue Nervous Tissue Summary Resources Genome Structure and Regulation Differentiation of Tissues 6 Genetic and Developmental Disorders Chapter Outline Key Questions Principles of Inheritance DNA Mutation and Repair Genetic Disorders Chromosomal Abnormalities Aberrant Number of Chromosomes Abnormal Chromosome Structure Examples of Autosomal Chromosome Disorders Trisomy 21 (Down Syndrome) Trisomy 18 (Edwards Syndrome) and Trisomy 13 (Patau Syndrome) Cri du Chat Syndrome Examples of Sex Chromosome Disorders Klinefelter Syndrome Turner Syndrome Multiple X Females and Double Y Males Mendelian Single-Gene Disorders Autosomal-Dominant Disorders Marfan Syndrome Huntington Disease Autosomal-Recessive Disorders Albinism Phenylketonuria Cystic Fibrosis Sex-Linked (X-Linked) Disorders Hemophilia A Nonmendelian Single-Gene Disorders Anticipation Mitochondrial Gene Mutations Genomic Imprinting Polygenic and Multifactorial Disorders Environmentally Induced Congenital Disorders Periods of Fetal Vulnerability Teratogenic Agents Chemicals and Drugs Infectious Agents Radiation Other Disorders of Infancy Diagnosis, Counseling, and Gene Therapy Prenatal Diagnosis and Counseling Genetic Analysis and Therapy Recombinant DNA Technology Summary Resources Principles of Inheritance and Genetic Disorders 7 Neoplasia Chapter Outline Key Questions Benign Versus Malignant Growth Characteristics of Benign and Malignant Tumors Tumor Terminology The Malignant Phenotype Epidemiology and Cancer Risk Factors Tobacco Use Nutrition Antioxidants Genetic Mechanisms of Cancer Proto-Oncogenes Growth Factors (Mitogens) Growth Factor Receptors Cytoplasmic Signaling Pathways Transcription Factors From Proto-Oncogene to Oncogene Tumor Suppressor Genes The Rb Gene The P53 Gene BRCA1 and BRCA2 Genes Multistep Nature of Carcinogenesis Initiation Promotion Progression Metastasis Patterns of Spread Angiogenesis Grading and Staging of Tumors Effects of Cancer on the Body Cancer Therapy Surgery Radiation Therapy Drug Therapy Immunotherapy Gene and Molecular Therapy Stem Cell Transplantation Summary Resources Cancer Epidemiology Cancer Biology Unit III Defense 8 Infectious Processes Chapter Outline Key Questions Host–Microbe Relationship The Human Microbiome Host Characteristics Physical and Mechanical Barriers Impaired Immune Function Nutritional status. Age. Chronic illness. Immunization status. Pathogen Characteristics Adherence and Invasion Bacterial Endotoxin Bacterial Exotoxins and Enzymes Evasion of Immune Cells Endospore Formation Antimicrobial Resistance Transmission of Infection Routes of Transmission Emerging Infectious Diseases Weapons of Bioterrorism Types of Pathogenic Organisms Bacteria Viruses Fungi Parasites Summary Resources Commensal and Infectious Organisms Emerging Infectious Diseases 9 Inflammation and Immunity Chapter Outline Key Questions Components of the Immune System Epithelial Barriers Mononuclear Phagocyte System Lymphoid System Primary Lymphoid Organs Secondary Lymphoid Organs Tonsils Spleen Lymph Nodes and Lymphatics Peyer Patches Leukocytes Neutrophils Eosinophils Basophils and Mast Cells Monocytes and Macrophages Dendritic Cells Lymphocytes Natural Killer Cells T Lymphocytes B Lymphocytes Chemical Mediators of Immune Function Complement Kinins Clotting Factors Cytokines and Chemokines Innate Defenses and Inflammation Inflammation Increased Vascular Permeability Emigration of Leukocytes Phagocytosis Chronic Inflammation Healing Inflammatory Exudates Systemic Manifestations of Inflammation Specific Adaptive Immunity Major Histocompatibility Complex Antigen Presentation by MHC MHC Class I Presentation MHC Class II Presentation Mechanisms of Cell-Mediated Immunity T Helper Cells (CD4+) Cytotoxic T Cells (CD8+) Mechanisms of Humoral Immunity Antigen Recognition by B Cells Antibody Structure Class Switching and Affinity Maturation Antibody Functions Passive and Active Immunity Passive Immunity Active Immunity Integrated Function and Regulation of the Immune System Integrated Response to Microbial Antigen Integrated Response to Viral Antigen Regulation of Immune Function Summary Resources Immunology 10 Alterations in Immune Function Chapter Outline Key Questions Excessive Immune Responses Autoimmunity Genetic Factors Environmental Triggers Pharmacotherapies Hypersensitivity Type I Hypersensitivity Etiology Pathogenesis Clinical Manifestations Treatment Prevention Pharmacotherapeutic Prevention Type IIa Hypersensitivity Etiology and Pathogenesis Transfusion Reaction Hemolytic Disease of the Newborn Myasthenia Gravis Hyperacute Graft Rejection Type IIb Hypersensitivity Graves Disease Type III Hypersensitivity Etiology Pathogenesis Tissue Deposition Immune Complex Glomerulonephritis Etiology. Clinical manifestations and treatment. Systemic Lupus Erythematosus Etiology. Clinical manifestations. Treatment. Type IV Hypersensitivity Type IVa — Granulomatous Hypersensitivity Type IVa – Tuberculin-Type Hypersensitivity Type IVa – Allergic Contact Dermatitis Type IVb – Persistent Asthma Type IVc – Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis Type IVd – Pustular Psoriasis Deficient Immune Responses Primary Immunodeficiency Disorders B-Cell and T-Cell Combined Disorders Severe Combined Immunodeficiency Disorders Etiology and pathogenesis. Clinical manifestations and treatment. Wiskott–Aldrich Syndrome Etiology and pathogenesis. Clinical manifestations and treatment. T-Cell Disorders 22q11.2 Deletion Syndrome (DiGeorge Syndrome) Etiology and pathogenesis. Clinical manifestations and treatment. Chronic Mucocutaneous Candidiasis Disease Etiology and pathogenesis. Clinical manifestations and treatment. B-Cell Disorders IgA Deficiency Etiology and pathogenesis. Clinical manifestations and treatment. X-Linked Agammaglobulinemia Etiology and pathogenesis. Clinical manifestations and treatment. Transient Hypogammaglobulinemia Common Variable Immunodeficiency Disease Clinical manifestations and treatment. Secondary Immunodeficiency Disorders Summary Resources Autoimmune and Hypersensitivity Disorders Deficient Immune Responses 11 Malignant Disorders of White Blood Cells Chapter Outline Key Questions Classification of Hematologic Neoplasms Etiology of Myeloid and Lymphoid Neoplasms General Principles of Management Diagnosis of Hematologic Neoplasms Principles of Treatment Prevention and Management of Complications Myeloid Neoplasms Chronic Myeloid Leukemia Pathogenesis and clinical manifestations. Prognosis and treatment. Acute Myeloid Leukemia Pathogenesis and clinical manifestations. Prognosis and treatment. Lymphoid Neoplasms Chronic Lymphoid Leukemia Pathogenesis and clinical manifestations. Prognosis and treatment. Acute Lymphoblastic Leukemia/Lymphoma Pathogenesis and clinical manifestations. Prognosis and treatment. Hairy Cell Leukemia Pathogenesis and clinical manifestations. Prognosis and treatment. Plasma Cell Myeloma (Multiple Myeloma) Pathogenesis and clinical manifestations. Prognosis and treatment. Hodgkin Disease Pathogenesis and clinical manifestations. Prognosis and treatment. B-Cell, T-Cell, and NK-Cell Lymphoma (Non-Hodgkin) Pathogenesis and clinical manifestations. Prognosis and treatment. Summary Resources Etiology and Classification of Hematologic Neoplasms Myeloid Neoplasms Lymphoid Neoplasms 12 HIV Disease and AIDS Chapter Outline Key Questions Epidemiology History Types of HIV Transmission Prevention of Transmission Etiology HIV Structure HIV Binding and Infection Pathogenesis Effect of HIV on Immune Cells at the Cellular Level Viral Production and Cell Death Progression of HIV Infection From Seroconversion to AIDS CDC HIV Classification System Diagnostic Testing Monitoring the Progression of HIV Clinical Manifestations Systemic Manifestations Gastrointestinal Manifestations Pulmonary Manifestations Mucocutaneous Manifestations Gynecologic Manifestations Neurologic Manifestations Ocular Manifestations Cardiovascular Manifestations Manifestations in Other Systems Manifestations in Children Treatment Antiretroviral Therapy Recommendations Nucleoside Reverse Transcriptase Inhibitors Nucleotide Reverse Transcriptase Inhibitors Nonnucleoside Reverse Transcriptase Inhibitors Protease Inhibitors Fusion Inhibitors CCR5 Inhibitors Integrase Strand Transfer Inhibitors Other Treatments and Vaccines Summary Resources HIV Epidemiology HIV Biology Pathogenesis, Clinical Manifestations, and Management Unit IV Oxygen Transport, Blood Coagulation, Blood Flow, and Blood Pressure 13 Alterations in Oxygen Transport Chapter Outline Key Questions Composition of Blood Organic and Inorganic Components Cellular Components Erythrocytes Leukocytes Platelets Structure and Function of Red Blood Cells Hematopoiesis Hemoglobin Synthesis Hemoglobin Synthesis in Infants Nutritional Requirements for Erythropoiesis Energy and Maintenance of Erythrocytes Red Cell Production Red Cell Destruction Gas Transport and Acid–Base Balance Oxygen Transport Carbon Dioxide Transport Alterations in Oxygen Transport Anemia General Effects of Anemia Anemia Related to Decreased Red Cell Production Aplastic Anemia Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Anemia of Chronic Renal Failure Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Anemia Related to Vitamin B12 (Cobalamin) or Folate Deficiency Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Iron Deficiency Anemia Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Anemia Related to Inherited Disorders of the Red Cell Thalassemia Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Sickle Cell Anemia Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Hereditary Spherocytosis Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Glucose-6-Phosphate Dehydrogenase Deficiency Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Anemia Related to Extrinsic Red Cell Destruction or Loss Hemolytic Disease of the Newborn Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Antibody-Mediated Drug Reactions Etiology and pathogenesis. Hapten mechanisms. Neoantigen formation. Membrane modification. Autoantibody induction. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Acute Blood Loss Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Other Extrinsic Abnormalities Transfusion Therapy Polycythemia Polycythemia Vera Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Secondary Polycythemia Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Relative Polycythemia Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Summary Resources Red Cell Production and Laboratory Analysis Anemias Blood Transfusion Therapy Polycythemia 14 Alterations in Hemostasis and Blood Coagulation Chapter Outline Key Questions The Process of Hemostasis Stages of Hemostasis Platelets Blood Coagulation Factors Fibrin Clot Fibrinolysis Evaluation of Hemostasis and Coagulation Clinical Assessment Laboratory Tests Vascular and Platelet Disorders Vascular Disorders Vascular Purpura Etiology. Pathogenesis. Clinical manifestations. Diagnosis and treatment. Hereditary Hemorrhagic Telangiectasia Etiology. Pathogenesis. Clinical manifestations. Diagnosis and treatment. Platelet Disorders Thrombocytopenia Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Thrombocytosis Etiology. Pathogenesis. Clinical manifestations. Diagnosis and treatment. Qualitative Platelet Disorders Etiology. Pathogenesis. Clinical manifestations. Diagnosis and treatment. Coagulation Disorders Hemophilia Etiology. Pathogenesis. Clinical manifestations. Diagnosis and treatment. von Willebrand Disease Etiology. Pathogenesis. Clinical manifestations. Diagnosis and treatment. Vitamin K Deficiency Bleeding in Infancy Etiology. Pathogenesis. Clinical manifestations. Diagnosis and treatment. Acquired Vitamin K Deficiency Etiology. Pathogenesis. Clinical manifestations. Diagnosis and treatment. Disseminated Intravascular Coagulation (DIC) Etiology. Pathogenesis. Clinical manifestations. Diagnosis and treatment. Hepatic Disease Etiology. Pathogenesis. Clinical manifestations. Diagnosis and treatment. Summary Resources Platelet Function and Hemostasis Vascular and Platelet Disorders Coagulation Disorders 15 Alterations in Blood Flow Chapter Outline Key Questions Organization of the Circulatory and Lymphatic Systems Vessel Structure Anatomy of Arteries and Veins Anatomy of Capillaries Lymphatic Structure Principles of Flow Hemodynamics of the Circulatory System Blood Flow, Pressure, and Resistance Velocity and Laminar and Turbulent Flow Wall Tension and Compliance Dynamics in the Microcirculation: Capillaries and Lymphatics Control of Flow Control of Blood Flow Extrinsic Mechanisms Intrinsic Mechanisms Control of Lymphatic Flow General Mechanisms That Cause Altered Flow Blood Vessels: Obstructions Thrombus Etiology. Pathogenesis Arterial. Venous. Clinical manifestations and treatment. Embolus Etiology and pathogenesis. Clinical manifestations. Treatment. Emboli produced by other causes. Vasospasm Inflammation Mechanical Compression Blood Vessels: Structural Alterations Types of Structural Alterations Valvular incompetence. Arteriosclerosis/atherosclerosis. Aneurysms. Arteriovenous fistulas. Lymphatic Vessels Alterations in Arterial Flow Arteriosclerosis/Atherosclerosis Etiology and Pathogenesis Risk Factors Modifiable risk factors. Nonmodifiable risk factors. Clinical Manifestations and Diagnosis Treatment Thromboangiitis Obliterans (Buerger Disease) Raynaud Syndrome Aneurysms Classifications Clinical Manifestations and Diagnosis Treatment Acute Arterial Occlusion Alterations in Venous Flow Valvular Incompetence Etiology and Pathogenesis Clinical Manifestations and Treatment Varicose Veins Etiology and Pathogenesis Clinical Manifestations and Treatment Chronic Venous Insufficiency Etiology and Pathogenesis Clinical Manifestations and Treatment Deep Vein Thrombosis Etiology and Pathogenesis Clinical Manifestations and Treatment Alterations in Lymphatic Flow Lymphedema Etiology and Pathogenesis Clinical Manifestations, Diagnosis, and Treatment Summary Resources Physiology of Blood Flow Alterations in Blood Flow and Atherosclerosis Venous and Lymphatic Disorders 16 Alterations in Blood Pressure Chapter Outline Key Questions Arterial Blood Pressure Determinants of Systemic Blood Pressure Measurement of Blood Pressure Components of Blood Pressure Measurement Direct Measurement of Blood Pressure Indirect Measurement of Blood Pressure Mechanisms of Blood Pressure Regulation Short-Term Regulation of Systemic Blood Pressure Long-Term Regulation of Systemic Blood Pressure Normal Fluctuations in Systemic Blood Pressure Hypertension Definition and Classification Primary Hypertension Subtypes Risk Factors Outcomes End-organ damage. Treatment Interventions Secondary Hypertension Hypertensive Emergencies and Urgency Low Blood Pressure Summary Resources Measuring Blood Pressure and Definitions of Hypertension Mechanisms, Risks and Treatment of High Blood Pressure Secondary Hypertension Low Blood Pressure Unit V Cardiac Function 17 Cardiac Function Chapter Outline Key Questions Cardiovascular Anatomy Heart Circulatory System Cardiac Cycle Isovolumic Contraction Ventricular Ejection Isovolumic Relaxation Atrial Events Aortic and Pulmonary Artery Events Coronary Circulation Anatomy of the Coronary Vessels Regulation of Coronary Blood Flow Cardiac Myocytes Myocyte Structure Structure of the Contractile Apparatus Characteristics of Contractile Filaments Molecular Basis of Contraction Overview of Contraction Sliding Filament/Cross-Bridge Theory of Muscle Contraction Role of Calcium in Muscle Contraction Energy of Muscle Relaxation Cardiac Energy Metabolism Oxygen Utilization Substrate Utilization Cardiac Electrophysiology Cardiac Resting Potential Cardiac Action Potential Phase 0 Phase 1 Phase 2 Phase 3 Phase 4 Rhythmicity of Myocardial Cells Specialized Conduction System of the Heart Autonomic Regulation of Rhythmicity Electrocardiography Determinants of Cardiac Output Determinants of Heart Rate Determinants of Stroke Volume Volume of Blood in the Heart (Preload) Contractile Capabilities of the Heart (Contractility) Impedance to Ejection From the Ventricle (Afterload) Cardiac Workload Endocrine Function of the Heart Tests of Cardiac Function Electrocardiography Magnetic Resonance Imaging and Computed Tomography Echocardiography Nuclear Cardiography Cardiac Catheterization/Coronary Angiography Summary Resources 18 Alterations in Cardiac Function Chapter Outline Key Questions Coronary Heart Disease Etiology of Coronary Heart Disease Risk Factors and Mechanisms of Coronary Atherosclerosis Pathophysiology of Ischemia Clinical Features and Management of Coronary Syndromes Angina Pectoris Stable angina. Prinzmetal variant angina. Acute Coronary Syndrome Etiology and pathogenesis. Diagnosis of MI. Electrocardiographic changes. Serum biomarkers. Clinical course. Prognosis and treatment. Sudden Cardiac Arrest Chronic Ischemic Cardiomyopathy Endocardial and Valvular Diseases Disorders of the Mitral Valve Mitral Stenosis Mitral Regurgitation Mitral Valve Prolapse Disorders of the Aortic Valve Aortic Stenosis Aortic Regurgitation Diseases of the Endocardium Rheumatic Heart Disease Infective Endocarditis Myocardial Diseases Myocarditis Cardiomyopathy Dilated Cardiomyopathy Hypertrophic Cardiomyopathy Restrictive Cardiomyopathy Pericardial Diseases Pericardial Effusion Cardiac Tamponade Pericarditis Acute Pericarditis Chronic Pericarditis Congenital Heart Diseases Embryologic Development Etiology and Incidence of Congenital Heart Disease Pathophysiology of Congenital Heart Disease Acyanotic Congenital Defects Atrial Septal Defect Ventricular Septal Defect Patent Ductus Arteriosus Coarctation of the Aorta Pulmonary Stenosis or Atresia Aortic Stenosis or Atresia Cyanotic Congenital Defects Tetralogy of Fallot Transposition of the Great Arteries Truncus Arteriosus Tricuspid Atresia Summary Resources 19 Heart Failure and Dysrhythmias Chapter Outline Key Questions Heart Failure Pathogenesis and Diagnosis Systolic Dysfunction With Low Ejection Fraction Diastolic Dysfunction With Preserved Ejection Fraction Compensatory Mechanisms, Remodeling, and Progression Sympathetic Nervous System Activation Increased Preload Myocardial Remodeling and Progression Clinical Manifestations Left-Sided Heart Failure Right-Sided Heart Failure Biventricular Heart Failure Class and Stage of Heart Failure Treatment Cardiac Dysrhythmias Dysrhythmia Mechanisms Automaticity Triggered Activity Reentry Dysrhythmia Analysis Normal Sinus Rhythm Abnormal Rates of Sinus Rhythm Sinus Tachycardia Sinus Bradycardia Sinus Arrhythmia Sinus Arrest Abnormal Site of Impulse Initiation Escape Rhythms Atrial Dysrhythmias Premature atrial complexes and tachycardia. Atrial flutter and fibrillation. Junctional Dysrhythmias Ventricular Dysrhythmias Premature ventricular complexes. Ventricular tachycardia. Ventricular fibrillation. Conduction Pathway Disturbances Disturbances of Atrioventricular Conduction Abnormal Conduction Pathways Intraventricular Conduction Defects Treatment Summary Resources Heart Failure Dysrhythmias 20 Shock Chapter Outline Key Questions Pathogenesis of Shock Impaired Tissue Oxygenation Compensatory Mechanisms and Stages of Shock Types of Shock Cardiogenic Shock Etiology and Pathogenesis Clinical Manifestations Treatment Pharmacotherapy Mechanical Assist Devices Obstructive Shock Etiology and Pathogenesis Clinical Manifestations Treatment Hypovolemic Shock Etiology and Pathogenesis Classification Clinical Manifestations Treatment Distributive Shock Anaphylactic Shock Etiology and pathogenesis. Clinical manifestations. Prevention and treatment. Neurogenic Shock Septic Shock Etiology. Pathogenesis. Clinical manifestations. Treatment. Assessment and Hemodynamic Monitoring Cardiac Output Arterial Oxygen Content Distribution of Blood Flow Hemodynamic Monitoring Complications of Shock Acute Respiratory Distress Syndrome Disseminated Intravascular Coagulation Acute Renal Failure Multiple Organ Dysfunction Syndrome Summary Resources Pathophysiology of Shock Cardiogenic and Hypovolemic Shock Septic Shock Unit VI Respiratory Function 21 Respiratory Function and Alterations in Gas Exchange Chapter Outline Key Questions Functional Anatomy Development of the Pulmonary System Upper Airway Structures Lower Airway Structures Pulmonary Circulation Age-Related Variations Ventilation Lung Volumes and Capacities Dead Space Minute Ventilation Alveolar Ventilation/Oxygenation Mechanics of Breathing Airway Resistance Lung Compliance Distribution of Ventilation Neurologic Control of Ventilation Pulmonary Blood Flow Pulmonary Vasculature Distribution of Blood Flow Ventilation–Perfusion Ratios Hypoxic Vasoconstriction Diffusion and Transport of Respiratory Gases Barriers to Diffusion Oxygen Transport Carbon Dioxide Transport Alterations in Pulmonary Function Hypoventilation and Hyperventilation Hypoxemia and Hypoxia Acute Respiratory Failure Etiology Pathogenesis. Clinical Manifestations Diagnosis Treatment Diagnostic Tests Pulmonary Function Testing Bronchial Provocation Tests Alterations in Pulmonary Vasculature Pulmonary Hypertension Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Pulmonary Venous Thromboembolism Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Pulmonary Malignancies Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Summary Resources Pulmonary System Development and Physiology Pulmonary Disorders Pulmonary Malignancies 22 Obstructive Pulmonary Disorders Chapter Outline Key Questions Obstruction From Conditions in the Wall of the Lumen Asthma Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Acute Bronchitis Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Chronic Bronchitis Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Obstruction Related to Loss of Lung Parenchyma Emphysema Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Obstruction of the Airway Lumen Bronchiectasis Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Bronchiolitis Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Cystic Fibrosis Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Acute Tracheobronchial Obstruction Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Epiglottitis Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Croup Syndrome Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Summary Resources Asthma and Acute Obstruction Chronic Obstructive Pulmonary Disease Cystic Fibrosis and Pulmonary Infections 23 Restrictive Pulmonary Disorders Chapter Outline Key Questions Lung Parenchyma Disorders Fibrotic Interstitial Lung Diseases Diffuse Interstitial Lung Disease Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Sarcoidosis Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Hypersensitivity Pneumonitis Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Occupational Lung Diseases Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Atelectatic Disorders Acute (Adult) Respiratory Distress Syndrome Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Infant Respiratory Distress Syndrome Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Pleural Space Disorders Pneumothorax Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Pleural Effusion Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Neuromuscular, Chest Wall, and Obesity Disorders Neuromuscular Disorders Poliomyelitis Amyotrophic Lateral Sclerosis Muscular Dystrophies Guillain–Barré Syndrome Myasthenia Gravis Chest Wall Deformities Kyphoscoliosis Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Ankylosing Spondylitis Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Flail Chest Etiology. Pathogenesis. Clinical manifestations. Diagnosis and treatment. Disorders of Obesity Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Infection or Inflammation of the Lung Pneumonia Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Severe Acute Respiratory Syndrome Middle East Respiratory Syndrome Pulmonary Tuberculosis Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Summary Resources Disorders of Parenchyma Disorders of Chest Wall and Pleura Pulmonary Infections Unit VII Fluid, Electrolyte, and Acid-Base Homeostasis 24 Fluid and Electrolyte Homeostasis and Imbalances Chapter Outline Key Questions Body Fluid Homeostasis Fluid Intake and Absorption Fluid Distribution Fluid Excretion Fluid Loss Through Abnormal Routes Fluid Imbalances Extracellular Fluid Volume Volume Deficit Etiology. Clinical manifestations. Volume Excess Etiology. Clinical manifestations. Body Fluid Concentration Hyponatremia Etiology. Clinical manifestations. Hypernatremia Etiology. Clinical manifestations. Both Volume and Concentration Clinical Dehydration Etiology. Clinical manifestations. Interstitial Fluid Volume Edema Principles of Electrolyte Homeostasis Electrolyte Intake and Absorption Electrolyte Distribution Electrolyte Excretion Electrolyte Loss Through Abnormal Routes Electrolyte Imbalances Plasma Potassium Hypokalemia Etiology. Clinical manifestations. Hyperkalemia Etiology. Clinical manifestations. Plasma Calcium Hypocalcemia Etiology. Clinical manifestations. Hypercalcemia Etiology. Clinical manifestations. Plasma Magnesium Hypomagnesemia Etiology. Clinical manifestations. Hypermagnesemia Etiology. Clinical manifestations. Plasma Phosphate Hypophosphatemia Etiology. Clinical manifestations. Hyperphosphatemia Etiology. Clinical manifestations. Summary Resources Fluid, Water, and Sodium Potassium Calcium Magnesium and Phosphate 25 Acid–Base Homeostasis and Imbalances Chapter Outline Key Questions Acid–Base Homeostasis Buffers Respiratory Contribution Renal Contribution Acid–Base Imbalances Metabolic Acidosis Etiology. Clinical manifestations. Compensatory response. Respiratory Acidosis Etiology. Clinical manifestations. Compensatory response. Metabolic Alkalosis Etiology. Clinical manifestations. Compensatory response. Respiratory Alkalosis Etiology. Clinical manifestations. Compensatory response. Mixed Acid–Base Imbalances Summary Resources Unit VIII Renal and Bladder Function 26 Renal Function Chapter Outline Key Questions Renal Anatomy Renal Parenchyma Renal Lymphatics and Innervation Renal Blood Supply Overview of Nephron Structure and Function Glomerulus Proximal Convoluted Tubule Loop of Henle Distal Convoluted Tubule Collecting Duct Regulation of Glomerular Filtration Physics of Filtration Factors Affecting Filtration Pressure Tubuloglomerular Feedback Effects of Glucose and Amino Acids Role of Mesangial Cells Transport Across Renal Tubules Reabsorption of Glucose Regulation of Acid–Base Balance Renal Compensation Process Secretion of Potassium Regulation of Blood Volume and Osmolality Antidiuretic Hormone Aldosterone, Angiotensin II, Natriuretic Peptides, Urodilatin, Uroguanylin, and Guanylin Diuretic Agents Endocrine Functions Erythropoietin Vitamin D Age-Related Changes in Renal Function Infant Adult and Elderly Tests of Renal Structure and Function Urine and Blood Studies Urinalysis Serum Creatinine and Blood Urea Nitrogen Measures of Glomerular Filtration Rate Diagnostic Tests Kidney, Ureter, and Bladder Roentgenography Intravenous Urography/Pyelography Radionuclide Studies Ultrasonography Computed Tomography Magnetic Resonance Imaging Renal Biopsy Summary Resources 27 Intrarenal Disorders Chapter Outline Key Questions Common Manifestations of Kidney Disease Pain Abnormal Urinalysis Findings Other Diagnostic Tests Congenital Abnormalities Renal Agenesis and Hypoplasia Cystic Kidney Diseases Autosomal-Recessive Polycystic Kidney Disease Autosomal-Dominant Polycystic Kidney Disease Neoplasms Benign Renal Neoplasms Diagnosis and treatment. Renal Cell Carcinoma Etiology and pathogenesis. Clinical manifestations. Diagnosis and treatment. Nephroblastoma (Wilms Tumor) Etiology and pathogenesis. Clinical manifestations. Diagnosis and treatment. Infection Acute Pyelonephritis Etiology and pathogenesis. Clinical manifestations. Diagnosis and treatment. Chronic Pyelonephritis Etiology and pathogenesis. Clinical manifestations. Diagnosis and treatment. Obstruction Renal Calculi (Nephrolithiasis) Etiology and pathogenesis. Clinical manifestations. Diagnosis and treatment. Glomerular Disorders (Glomerulopathies) Glomerulonephritis Acute Glomerulonephritis Crescentic Glomerulonephritis/Rapidly Progressive Glomerulonephritis (RPGN) Chronic Glomerulonephritis Nephrotic Syndrome Membranous Nephropathy (MN) Focal Segmental Glomerulosclerosis (FSGS) Minimal Change Disease (MCD) Summary Resources Congenital and Polycystic Kidney Disease Renal Cancer Pyelonephritis and Urinary Tract Infection Glomerulopathy 28 Acute Kidney Injury and Chronic Kidney Disease Chapter Outline Key Questions Acute Kidney Injury Etiology and Pathophysiology Prerenal Kidney Injury Postrenal Kidney Injury Intrinsic/Intrarenal Kidney Injury Clinical Presentation of Acute Kidney Injury Prodromal Phase Oliguric Phase Postoliguric Phase Chronic Kidney Disease Risk Factors Pathophysiology of Progression of Chronic Kidney Disease Stages of Chronic Kidney Disease Complications of Chronic Kidney Disease Hypertension and Cardiovascular Disease Uremic Syndrome Metabolic Acidosis Electrolyte Imbalances Mineral and Bone Disorders Malnutrition Anemia Pain Depression Clinical Management Acute Kidney Injury Chronic Kidney Disease Hypertension and Cardiovascular Disease Metabolic Acidosis Fluid and Electrolyte Imbalances Bone and Mineral Disorders Malnutrition Anemia Pain Depression Acute-on-Chronic Kidney Disease Dialysis Kidney Transplant Chronic Kidney Disease in Older Adults Summary Resources Chronic Kidney Disease Acute Kidney Injury 29 Disorders of the Lower Urinary Tract Chapter Outline Key Questions Lower Urinary Tract Functional Anatomy Physiology of Micturition Nervous System Innervation of the Lower Urinary Tract Mechanism of Micturition Diagnostic Tests Lower Urinary Tract Symptoms and Syndromes Incontinence Pathogenesis. Diagnosis. Treatment. Enuresis Pathogenesis. Diagnosis. Treatment. Overactive Bladder Syndrome Pathogenesis. Diagnosis and clinical manifestations. Treatment. Bladder Pain Syndrome/Interstitial Cystitis Pathogenesis. Diagnosis and clinical manifestations. Treatment. Neurogenic Bladder Congenital Disorders Primary Vesicoureteral Reflux Pathogenesis. Diagnosis and clinical manifestations. Treatment. Obstruction of the Ureteropelvic Junction Pathogenesis. Diagnosis and clinical manifestations. Treatment. Ureteral Ectopy Pathogenesis. Diagnosis and clinical manifestations. Treatment. Ureterocele Etiology and pathogenesis. Diagnosis and clinical manifestations. Treatment. Neoplasms Bladder Cancer Risk factors. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Inflammation and Infection Urethritis Cystitis Etiology and pathogenesis. Clinical manifestations. Diagnosis and treatment. Obstruction Lower Urinary Tract Calculi Ureteral Calculi Bladder (Vesical) Calculi Summary Resources Urinary Physiology and Diagnostic Testing Urinary Incontinence and Overactive Bladder Bladder Pain, Dysfunction and Congenital Anomaly Bladder Cancer Urinary Tract Infections Urinary Stones Unit IX Genital and Reproductive Function 30 Male Genital and Reproductive Function Chapter Outline Key Questions Anatomy Upper Genitourinary Tract Lower Genitourinary Tract Bladder Urethra Auxiliary Genital Glands Prostate Seminal Vesicles Bulbourethral Glands External Genitalia Scrotum Testes Epididymis and Ductus Deferens Penis Embryology Nephric System Vesicourethral Unit Gonads Genital Duct System External Genitalia Male Reproductive Physiology Hypothalamic-Pituitary-Testicular Axis Spermatogenesis Anatomy of Spermatozoa Transport of Spermatozoa Erection, Emission, and Ejaculation Capacitation Acrosome Reaction Summary Resources 31 Alterations in Male Genital and Reproductive Function Chapter Outline Key Questions Disorders of the Penis and Male Urethra Congenital Anomalies Micropenis Etiology and pathogenesis. Diagnoses and treatment. Urethral Valves Etiology. Clinical manifestations. Treatment. Urethrorectal and Vesicourethral Fistulas Etiology. Clinical manifestations and treatment. Hypospadias Etiology and treatment. Epispadias Etiology and treatment. Acquired Disorders Priapism Etiology and treatment. Phimosis and Paraphimosis Etiology, clinical manifestations, and treatment. Peyronie Disease Etiology and treatment. Urethral Strictures Etiology. Clinical manifestations and treatment. Erectile Dysfunction Etiology. Treatment. Premature Ejaculation Etiology and treatment. Infectious Disorders Neoplastic Disorders Neoplasms of the Penis Etiology. Treatment. Disorders of the Scrotum and Testes Congenital Disorders Cryptorchidism Treatment. Acquired Disorders Hypogonadism Treatment. Hydrocele Etiology and clinical manifestations. Treatment. Spermatocele Etiology and treatment. Testicular Torsion Clinical manifestations. Treatment. Male Infertility Etiology and pathogenesis. Diagnosis and treatment. Infectious Disorders Epididymitis Etiology. Clinical manifestations and treatment. Fournier Gangrene Etiology, clinical manifestations, and treatment. Neoplastic Disorders Neoplasms of the Testis Etiology. Treatment. Disorders of the Prostate Benign Prostatic Hyperplasia Etiology. Clinical manifestations. Treatment. Prostatitis Clinical manifestations, diagnosis, and treatment. Prostate Cancer Etiology. Diagnosis. Treatment. Summary Resources 32 Female Genital and Reproductive Function Chapter Outline Key Questions Reproductive Structures Organization of the Female Reproductive Organs Ovaries Oviducts Uterus Vagina External Genitalia Menstrual Cycle Breast Structure of the Breast Breast Development Lactation Pregnancy Early Human Development Implantation Fetal Membranes and Placenta Development of the Human Embryo and Fetus First Month Second Month Third Month Second Trimester Third Trimester Parturition Hormonal Changes Mechanical Changes Response of the Mother’s Body to Pregnancy Metabolism During Pregnancy Changes in the Female Reproductive Organs Changes in the Circulatory System Changes in the Respiratory System Changes in the Urinary System Weight Gain and Nutrition During Pregnancy Menopause Summary Resources Reproductive Anatomy and Physiology Pregnancy and Fetal Development Menopause 33 Alterations in Female Genital and Reproductive Function Chapter Outline Key Questions Menstrual Disorders Amenorrhea Etiology and pathogenesis. Treatment. Abnormal Uterine Bleeding Patterns Etiology, clinical manifestations, and treatment. Dysmenorrhea Etiology and clinical manifestations. Treatment. Alterations in Uterine Position and Pelvic Support Uterine Prolapse Etiology. Clinical manifestations. Treatment. Retrodisplacement of the Uterus Etiology and clinical manifestations. Treatment. Cystocele Etiology. Clinical manifestations and treatment. Rectocele Etiology. Clinical manifestations and treatment. Inflammation and Infection of the Female Reproductive Tract Pelvic Inflammatory Disease Etiology. Clinical manifestations. Treatment. Vulvovaginitis Etiology. Clinical manifestations. Treatment. Bartholinitis Clinical manifestations and treatment. Benign Growths and Aberrant Tissue of the Female Reproductive Tract Uterine Leiomyomas Etiology. Clinical manifestations. Treatment. Ovarian Cysts Etiology. Clinical manifestations and treatment. Endometriosis Etiology. Clinical manifestations. Treatment. Cancer of the Female Genital Structures Cancer of the Cervix Etiology. Clinical manifestations. Treatment. Prevention. Endometrial Cancer Clinical manifestations and treatment. Ovarian Cancer Clinical manifestations and treatment. Vaginal Cancer Clinical manifestations and treatment. Cancer of the Vulva Clinical manifestations and treatment. Disorders of Pregnancy Pregnancy-Induced Hypertension Etiology, clinical manifestations, and treatment. Hyperemesis Gravidarum Clinical manifestations and treatment. Placenta Previa and Abruptio Placentae Etiology and clinical manifestations. Treatment. Spontaneous Abortion Etiology. Clinical manifestations and treatment. Disorders of the Breast Reactive-Inflammatory Breast Disorders Mammary Duct Ectasia Pathogenesis. Clinical manifestations and treatment. Breast Abscess Etiology. Clinical manifestations and treatment. Fat Necrosis Clinical manifestations and diagnoses. Reactions to Foreign Material Benign Breast Disorders Fibrocystic Breast Disease Etiology and clinical manifestations. Diagnoses and treatment. Specific Benign Neoplasms Malignant Disorder of the Breast Cancer of the Breast Etiology. Hormonal factors. Reproductive factors. Dietary factors. Family history. Age. Other factors. Clinical manifestations. Treatment. Continuum of care. Summary Resources Menstrual Disorders Disorders of the Pelvis and Uterine Anatomy Benign and Cancerous Gynecologic Tumors Disorders of Pregnancy Disorders of the Breast 34 Sexually Transmitted Infections Chapter Outline Key Questions Urethritis, Cervicitis, Salpingitis, and Pelvic Inflammatory Disease Gonococcal Infection Etiology and clinical manifestations. Nongonococcal Infection Etiology. Treatment. Diseases With Systemic Involvement Syphilis Etiology. Pathogenesis. Treatment. Lymphogranuloma Venereum Etiology and pathogenesis. Treatment. Herpesvirus Infections Etiology. Clinical manifestations. Treatment. Diseases With Localized Lesions Ulcerative Lesions Chancroid Etiology. Pathogenesis and clinical manifestations. Treatment. Granuloma Inguinale Etiology. Pathogenesis and clinical manifestations. Treatment. Nonulcerative Lesions Molluscum Contagiosum Etiology. Pathogenesis and clinical manifestations. Treatment. Human Papilloma Virus Infections Etiology. Pathogenesis and clinical manifestations. Treatment. Enteric Infections Summary Resources Unit X Gastrointestinal Function 35 Gastrointestinal Function Chapter Outline Key Questions Structure and Organization of the Gastrointestinal Tract Embryology Functional Anatomy Oral Cavity and Pharynx Esophagus Stomach Small Intestine Large Intestine Gastrointestinal Motility Characteristics of the Intestinal Wall Neural Control Parasympathetic Innervation Sympathetic Innervation Afferent Nerve Fibers Electrical Activity of Gastrointestinal Smooth Muscle Hormonal Control Movement in the Gastrointestinal Tract Contraction of Gastrointestinal Smooth Muscle Propulsive Movements Mixing Movements Movement of Nutrients Chewing Swallowing Neural control of swallowing. Motor Functions of the Stomach Gastric filling and storage. Emptying. Regulation of gastric emptying. Vomiting. Motility of the Small Intestine Propulsion. Mixing. Control of motility. Ileocecal Sphincter Motility of the Colon Colonic movements. Defecation. Regulation of colonic motility. Secretory Function Secretion of Gastrointestinal Juices Gastrointestinal Hormones Digestion and Absorption Digestion of Carbohydrates Digestion of Lipids Digestion of Proteins Absorption Carbohydrates Lipids Proteins Water and Electrolytes Gastrointestinal Function Across the Life Span Maturation Age-Related Changes Summary Resources 36 Gastrointestinal Disorders Chapter Outline Key Questions Manifestations of Gastrointestinal Tract Disorders Dysphagia Categories Esophageal Pain Abdominal Pain Vomiting Intestinal Gas Alterations in Bowel Patterns Constipation Diarrhea Pathophysiologic mechanisms. Disorders of the Mouth and Esophagus Oral Infections Stomatitis Etiology. Treatment. Esophageal Disorders Gastroesophageal Reflux Disease Pathogenesis. Clinical manifestations. Treatment. Complications. Hiatal Hernia Etiology. Clinical manifestations and treatment. Mallory–Weiss Syndrome Etiology. Clinical manifestations and treatment. Esophageal Varices Alterations in the Integrity of the Gastrointestinal Tract Wall Inflammation of the Stomach and Intestines Gastritis Etiology. Pathogenesis. Clinical manifestations. Gastroenteritis Etiology. Clinical manifestations and treatment. Peptic Ulcer Disease Etiology and pathogenesis. Clinical manifestations and diagnoses. Treatment. Inflammatory Bowel Disease Ulcerative Colitis Etiology and clinical manifestations. Treatment. Crohn Disease Etiology and pathogenesis. Clinical manifestations. Treatment. Enterocolitis Antibiotic-Associated Colitis (Pseudomembranous Colitis) Etiology. Clinical manifestations and treatment. Necrotizing Enterocolitis Etiology. Clinical manifestations and treatment. Appendicitis Etiology. Clinical manifestations and treatment. Diverticular Disease Etiology. Clinical manifestations and treatment. Alterations in Motility of the Gastrointestinal Tract Motility Disorders Irritable Bowel Syndrome Etiology and pathogenesis. Clinical manifestations and treatment. Intestinal Obstruction Etiology and pathogenesis. Clinical manifestations and treatment. Volvulus Intussusception Megacolon Hirschsprung Disease Disorders of Malabsorption Mucosal Disorders Celiac Disease Etiology. Diagnosis and treatment. Tropical Sprue Etiology. Clinical manifestations and treatment. Malabsorption Disorders After Surgical Intervention Dumping Syndrome Etiology. Pathogenesis and clinical manifestations. Treatment. Short-Bowel Syndrome Etiology. Pathogenesis and clinical manifestations. Treatment. Neoplasms of the Gastrointestinal Tract Esophageal, Gastric, and Small Intestinal Cancers Esophageal Cancer Etiology. Pathogenesis and treatment. Gastric Carcinoma Etiology. Clinical manifestations and treatment. Small Intestinal Neoplasms Clinical manifestations and treatment. Colonic Polyps and Colon Cancer Colon Polyps Colon Cancer Etiology and risk factors. Clinical manifestations. Treatment. Psychosocial Aspects of Gastrointestinal Disorders Stress of Lifestyle Changes Summary Resources Manifestations of GI Disorders Disorders of Mouth and Esophagus Disorders of Stomach and Intestinal Wall Disorders of Bowel Motility and Absorption Cancers of the GI Tract 37 Alterations in Function of the Gallbladder and Exocrine Pancreas Chapter Outline Key Questions Structure and Function of the Pancreaticobiliary System Embryology of the Pancreaticobiliary System Physiology of Bile Functional Anatomy of the Pancreas Disorders of the Gallbladder Pathophysiology of Cholesterol Gallstone Formation Cholelithiasis and Cholecystitis Chronic Cholelithiasis Clinical manifestations. Diagnosis and treatment. Acute Cholecystitis Clinical manifestations. Diagnosis. Treatment. Chronic Cholecystitis Clinical manifestations. Biliary Malignancy Disorders of the Pancreas Pancreatitis Acute Pancreatitis Etiology and pathogenesis. Clinical manifestations. Diagnosis. Treatment. Chronic Pancreatitis Etiology and pathogenesis. Clinical manifestations. Diagnosis. Treatment. Pancreatic Cancer Summary Resources Development, Structure, and Function Gallbladder Disorders Pancreatitis 38 Liver Diseases Chapter Outline Key Questions Structure and Function of the Liver General Manifestations of Liver Disease Hepatocellular Failure Jaundice Etiology and pathogenesis. Prehepatic. Hepatic. Posthepatic. Evaluation. Diagnostic tests. Portal Hypertension Gastroesophageal Varices Etiology. Pathogenesis. Clinical features. Treatment. Portal Systemic Encephalopathy Hepatic Encephalopathy Pathogenesis. Clinical manifestations. Treatment. Cerebral Edema Pathogenesis. Clinical manifestations. Treatment. Complications of Advanced Liver Disease Ascites Etiology, pathogenesis, and clinical manifestations. Treatment. Spontaneous Bacterial Peritonitis Pathogenesis and clinical manifestations. Treatment. Hepatorenal Syndrome Etiology and pathogenesis. Prognosis and treatment. Disorders of the Liver Hepatitis Acute Viral Hepatitis Hepatitis A Pathogenesis and clinical manifestations. Diagnosis, treatment, and prevention. Hepatitis B Pathogenesis and clinical manifestations. Diagnosis. Treatment. Prevention. Hepatitis C Pathogenesis and clinical manifestations. Treatment. Hepatitis D (Delta) Pathogenesis and clinical manifestations. Treatment and control. Hepatitis E Pathogenesis and clinical manifestations. Treatment. Chronic Hepatitis Chronic Persistent Hepatitis Chronic Active Hepatitis Pathogenesis and clinical manifestations. Diagnosis. Management of chronic active hepatitis. Autoimmune Hepatitis Diagnosis. Management of autoimmune hepatitis. Cirrhosis Biliary Cirrhosis Etiology and pathogenesis. Diagnosis and treatment. Primary Sclerosing Cholangitis Etiology and pathogenesis. Diagnosis and treatment. Alcoholic Liver Disease Alcoholic Fatty Liver Etiology. Diagnosis and treatment. Alcoholic Hepatitis Pathogenesis and clinical manifestations. Diagnosis and treatment. Toxic Liver Disorders Metal Storage Diseases Hereditary Hemochromatosis Pathogenesis and diagnosis. Clinical manifestations and diagnosis. Treatment. Wilson Disease (Hepatolenticular Degeneration) Etiology. Clinical manifestations. Diagnosis. Treatment. Toxic Metabolic Agents Acetaminophen Poisoning Etiology. Pathogenesis and clinical manifestations. Treatment. Other Structural Liver Conditions Liver Abscess Pathogenesis, clinical manifestations, and diagnosis. Treatment. Trauma Etiology and clinical manifestations. Treatment. Malignancy Etiology. Clinical manifestations and diagnosis. Treatment. Transplantation Evaluation of the Transplantation Patient Posttransplantation Management Age-Related Liver Disorders Liver Diseases and Pediatric Considerations Abnormal Bilirubin Metabolism in the Neonatal Period Infectious and Acquired Hepatitides in Children Congenital Liver Disease Multisystem Enzyme Deficiencies Disorders of Bilirubin Metabolism Inborn Errors of Metabolism Intrahepatic Cholestatic Conditions Extrahepatic Cholestatic Conditions (Biliary Atresia) Liver Diseases and Geriatric Considerations Summary Resources Liver Physiology and Pathophysiology Liver Failure and Portal Hypertension Viral Hepatitis Noninfectious, Toxic Hepatitis, and Cancer Liver Transplantation Liver Disease in Children Unit XI Endocrine Function, Metabolism, and Nutrition 39 Endocrine Physiology and Mechanisms of Hypothalamic-Pituitary Regulation Chapter Outline Key Questions Hormone Structure and Action Chemical Structure of Hormone Classes Mechanisms of Hormone Action Hormones With Cell Membrane Receptors G-Protein–Coupled Receptors. Protein Kinase Receptors. Amplification of Hormone Activity Hormones With Intracellular Receptors Hormone Regulation Hormone Synthesis, Secretion, and Metabolism Factors Affecting Hormone Secretion Feedback Control of Secretion Hormone Metabolism and Excretion Pharmacologic Hormone Concentrations Regulation of Receptor Responses Receptor Specificity and Affinity Receptor Down-Regulation and Up-Regulation Permissiveness Hormone Agonists and Antagonists Hypothalamic-Pituitary Endocrine System Hormones of the Posterior Pituitary Gland Antidiuretic Hormone Oxytocin Hormones of the Hypothalamus and Anterior Pituitary Gland Growth Hormone Prolactin Gonadotropins Thyroid-Stimulating Hormone Adrenocorticotropic Hormone Thyroid Hormones Thyroid Hormone Synthesis and Secretion Thyroid Action on Target Cells Steroid Hormones Steroid Hormone Synthesis and Secretion Steroid Action on Target Cells Categories of Endocrine Disease Hyposecretion Hypersecretion Hyporesponsiveness Summary Resources General Endocrinology Hypothalamic-Pituitary System, Thyroid and Adrenal Glands 40 Disorders of Endocrine Function Chapter Outline Key Questions Basic Concepts of Endocrine Disorders Etiology of Endocrine Disorders Classification of Endocrine Disorders Growth Hormone Disorders Growth Hormone Deficiency Etiology and pathogenesis. Clinical manifestations. Treatment. Growth Hormone Excess Etiology and pathogenesis. Clinical manifestations of acromegaly. Treatment. Thyroid Hormone Disorders Hypothyroidism Etiology and pathogenesis. Clinical manifestations. Treatment. Hyperthyroidism Etiology and pathogenesis. Clinical manifestations. Treatment. Adrenocortical Hormone Disorders Adrenocortical Insufficiency Etiology and pathogenesis. Clinical manifestations. Diagnosis. Treatment. Congenital Adrenal Hyperplasia Hypercortisolism Etiology and pathogenesis. Clinical manifestations. Treatment. Hyperaldosteronism Adrenal Medulla Disorder Pheochromocytoma Etiology and pathogenesis. Clinical manifestations. Treatment. Parathyroid Gland Disorders Regulation and Actions of Parathyroid Hormone Hyperparathyroidism Etiology and pathogenesis. Clinical manifestations. Treatment. Hypoparathyroidism Etiology and pathogenesis. Clinical manifestations. Treatment. Antidiuretic Hormone Disorders Diabetes Insipidus Etiology and pathogenesis. Clinical manifestations and diagnosis. Treatment. Syndrome of Inappropriate Antidiuretic Hormone Secretion Etiology and pathogenesis. Clinical manifestations. Treatment. Summary Resources 41 Diabetes Mellitus Chapter Outline Key Questions Regulation of Glucose Metabolism Hormonal Regulation Neural Regulation Exercise Stress Glucose Intolerance Disorders Classification of Glucose Intolerance Disorders Prediabetes Impaired Glucose Tolerance and Impaired Fasting Glucose Tolerance Diabetes Mellitus Type 1 Diabetes Mellitus Etiology. Pathogenesis and clinical manifestations. Type 2 Diabetes Mellitus Etiology. Pathogenesis and clinical manifestations. Other Specific Types of Diabetes Gestational Diabetes Mellitus Etiology. Treatment. Screening for Diabetes Clinical Manifestations and Complications Acute Hyperglycemia Etiology. Complications. Diabetic Ketoacidosis Nonketotic Hyperglycemic Hyperosmolar Syndrome Chronic Hyperglycemia Vascular Complications Macrovascular Complications Microvascular Complications Neuropathic Complications Complications in Pregnancy Treatment and Education Nutrition Obesity and Eating Disorders Exercise Pharmacologic Agents Oral Antidiabetic Agents Incretin Enhancers, Incretins, and Amylins Insulin Hypoglycemia complications. Other complications of insulin therapy. Stress Management Assessment of Efficacy Pediatric Considerations Goals of Therapy Acute Complications Chronic Complications Treatment Geriatric Considerations Goals of Therapy Acute Complications Chronic Complications Treatment Summary Resources Epidemiology of Diabetes Physiology of Glucose Regulation Pathophysiology of Diabetes Mellitus Diabetes Management and Outcomes 42 Nutritional and Metabolic Disorders Chapter Outline Key Questions Metabolic Processes Anabolism and Catabolism Metabolic Rate Nutrient Metabolism Carbohydrates Lipids Proteins Regulation of Appetite and Nutrient Metabolism Role of Genetics, Epigenetics, and Environment Hormonal Regulation of Nutrient Intake and Appetite Hormonal Regulation of Nutrient Storage, Distribution, and Metabolism Insulin Glucagon Catecholamines Growth Hormone Cortisol Obesity and Metabolic Syndrome Obesity Metabolic Syndrome Metabolic Responses to Starvation and Physiologic Stress Starvation and Protein-Energy Malnutrition Physiologic Stress Nutritional Considerations for Aging and Altered Health States Aging Infection, Sepsis, and Fever Surgery Trauma Burns Cancer Immobility Summary Resources Unit XII Neural Function 43 Structure and Function of the Nervous System Chapter Outline Key Questions Structural Organization Central Nervous System Support and Protection of the Central Nervous System The Brain Cerebrum Diencephalon Cerebellum Brainstem The Spinal Cord Peripheral Nervous System Cranial Nerves Spinal Nerves Autonomic Nervous System Neuronal Structure and Function Neurons and Supportive Cells Neurons Glia Neuronal Communication Membrane Potentials Synaptic Transmission Neurotransmitters Neuronal Circuits Neural Development, Aging, and Injury Development Aging Injury Sensory Function Sensory Receptors Sensory Pathways Somatosensory Cortex Motor Function Motor Neurons Spinal Reflexes Central Control of Motor Function Consciousness, Memory, and Sleep Consciousness and Memory Sleep Summary Resources 44 Acute Disorders of Brain Function Chapter Outline Key Questions Mechanisms of Brain Injury Ischemia and Hypoxia Cellular Energy Failure Excitatory Amino Acids Reperfusion Injury Abnormal Autoregulation Increased Intracranial Pressure Etiology Manifestations Brain Compression and Herniation Management Manifestations of Brain Injury Level of Consciousness Glasgow Coma Scale Cranial Nerve Reflexes Pupil Reflex Oculovestibular Reflex Corneal Reflex Traumatic Brain Injury Epidemiology Types of Traumatic Brain Injury Primary Injury Intracranial Hematomas Epidural Hematoma Subdural Hematoma Subarachnoid Hemorrhage Secondary Injury Treatment Cerebrovascular Disease and Stroke Epidemiology Ischemic Stroke Hemorrhagic Stroke Treatment Stroke Sequelae Motor and Sensory Deficits Language Deficits Cognitive Deficits Crebral Aneurysm and Arteriovenous Malformation Cerebral Aneurysm Etiology Pathogenesis and Manifestations Treatment Arteriovenous Malformation Etiology Pathogenesis and Manifestations Treatment Central Nervous System Infections Meningitis Etiology Pathogenesis and Clinical Manifestations Treatment Encephalitis Etiology Pathogenesis and Manifestations Treatment Brain Abscess Etiology Pathogenesis and Manifestations Treatment Summary Resources Traumatic Brain Injury Stroke Aneurysm and A-V Malformation Brain Infections 45 Chronic Disorders of Neurologic Function Chapter Outline Key Questions Brain and Cerebellar Disorders Seizure Disorder Etiology Pathogenesis Clinical Manifestations Generalized seizures. Partial seizures. Aura/prodrome. Diagnosis and Treatment Dementia Etiology Pathogenesis Clinical Manifestations Diagnosis and Treatment Parkinson Disease Etiology Pathogenesis Clinical Manifestations and Treatment Cerebral Palsy Etiology and Pathogenesis Clinical Manifestations Treatment Hydrocephalus Etiology Pathogenesis and Clinical Manifestations Treatment Cerebellar Disorders Etiology and Clinical Manifestations Spinal Cord and Peripheral Nerve Disorders Multiple Sclerosis Etiology Pathogenesis Clinical Manifestations and Treatment Spina Bifida Etiology and Pathogenesis Clinical Manifestations Treatment. Amyotrophic Lateral Sclerosis Etiology and Pathogenesis Clinical Manifestations and Treatment Spinal Cord Injury Etiology Pathogenesis Clinical Manifestations Treatment Guillain-Barré Syndrome Etiology and Pathogenesis Clinical Manifestations and Treatment Bell Palsy Etiology and Pathogenesis Clinical Manifestations and Treatment Summary Resources Seizures and Epilepsy Dementia and Alzheimers Disease Parkinson Disease Cerebral Palsy and Hydrocephalus Multiple Sclerosis and ALS Spinal Cord and Peripheral Nervous System 46 Alterations in Special Sensory Function Chapter Outline Key Questions Hearing and Balance Structure and Function of the Ear External Ear Middle Ear Inner Ear Balance Vertigo General Manifestations of Hearing Impairment Hearing Impairment Disorders Conductive Hearing Impairment Loss Caused by Cerumen Impaction and Foreign Body Occlusion Etiology. Clinical manifestations and treatment. Otosclerosis Etiology. Diagnosis and treatment. Sensorineural Hearing Impairment Loss Caused by Ototoxic Medications Loss Caused by Trauma Etiology. Clinical manifestations. Presbycusis Etiology. Diagnosis. Meniere Disease Etiology and pathogenesis. Clinical manifestations. Diagnosis and treatment. Otitis Media Acute Otitis Media Chronic Otitis Media Interventions for Individuals With Hearing Impairment Vision Structure of the Eye Visual Pathways General Manifestations of Visual Impairment Disorders of the Eye Errors of Refraction Myopia, Hyperopia, Presbyopia, and Astigmatism Age-Related Disorders Strabismus Amblyopia Cataracts Retinopathy Retinal Detachment Diabetic Retinopathy Etiology and pathogenesis. Clinical manifestations. Diagnosis and treatment. Age-Related Macular Degeneration Etiology and pathogenesis. Clinical manifestations. Diagnosis and treatment. Glaucoma Chronic Open-Angle Glaucoma Etiology and pathogenesis. Diagnosis and treatment. Acute Angle-Closure Glaucoma Etiology and pathogenesis. Diagnosis and treatment. Visual Field Deficits Visual Field Loss Etiology and pathogenesis. Diagnosis and treatment. Interventions for Individuals With Vision Impairment Smell and Taste Disorders of Smell and Taste Etiology and pathogenesis. Clinical manifestations. Diagnosis and treatment. Summary Resources Hearing Vision Smell and Taste 47 Pain Chapter Outline Key Questions Physiology of Pain Transduction Transmission Perception Modulation Types of Pain Acute Pain Headache Etiology and Pathogenesis Clinical Manifestations Diagnosis and Treatment Chronic Pain Fibromyalgia Syndrome Etiology and Pathogenesis Clinical Manifestations Diagnosis and Treatment Cancer-Related Pain Neuropathic Pain Trigeminal Neuralgia Etiology and Pathogenesis Clinical Manifestations Diagnosis and Treatment Diabetic Neuropathy Etiology and Pathogenesis Clinical Manifestations Diagnosis and Treatment Postherpetic Neuralgia Etiology and Pathogenesis Clinical Manifestations Diagnosis and Treatment Ischemic Pain Referred Pain Physiologic Responses to Pain Pain in the Young and the Elderly Treatment Modalities Pharmacologic and Nonpharmacologic Pain Management Interrupting Peripheral Transmission of Pain Modulating Pain Transmission at the Spinal Cord Altering the Perception and Integration of Pain Summary Resources Pain Physiology Pain Syndromes Age Considerations Unit XIII Neuropsychological Function 48 Neurobiology of Psychotic Illnesses Chapter Outline Key Questions Schizophrenia Etiology and Neurobiology Dopamine effects GABAergic interneuron origin Genetic effects Gestational effects Marijuana use in adolescents and schizophrenia Neurologic effects Clinical Manifestations Pharmacologic Treatment Nonpharmacologic Treatment Major Depressive and Persistent Depressive Disorders Etiology and Neurobiology Clinical Manifestations Pharmacologic Treatment Nonpharmacologic Treatment Bipolar Disorder Etiology and Neurobiology Clinical Manifestations Pharmacologic Treatment Nonpharmacologic Treatment Population Considerations Women and Mental Illness Cultural Considerations Geriatric Considerations Summary Resources Epidemiology and Classification Schizophrenia Depression Bipolar Disorder 49 Neurobiology of Nonpsychotic Illnesses Chapter Outline Key Questions Anxiety Disorders Panic Disorder Etiology and Neurobiology Clinical Manifestations Treatment Generalized Anxiety Disorder Etiology and Neurobiology Clinical Manifestations Pharmacologic Treatment Nonpharmacologic Treatment Obsessive-Compulsive Disorder Etiology and Neurobiology Clinical Manifestations Treatment Posttraumatic Stress Disorder Etiology and Neurobiology Clinical Manifestations Pharmacologic Treatment Nonpharmacologic Treatment Neurodevelopmental Disorders Attention-Deficit/Hyperactivity Disorder Etiology and Neurobiology Clinical Manifestations Pharmacologic Treatment Nonpharmacologic Treatment Autism Spectrum Disorder Etiology and Neurobiology Clinical Manifestations Treatment Summary Resources Anxiety and Panic Disorders Obsessive-Compulsive Disorder Post-Traumatic Stress Disorder Attention Deficit Hyperactivity Autism 50 Structure and Function of the Musculoskeletal System Chapter Outline Key Questions Structure and Function of Bone Composition Functional Properties Growth and Ossification Continuous Growth Bone Remodeling Calcium Homeostasis Response to Injury, Stress, and Aging Fracture Healing Structure and Function of Joints Synarthroses Fibrous Structure Cartilaginous Structure Diarthroses Synovial Structure Synovial fluid. Range of Movement Structure and Function of Articular Cartilage Composition Functional Properties Response to Injury, Stress, and Aging Structure and Function of Tendons and Ligaments Composition Functional Properties Response to Injury, Stress, and Aging Structure and Function of Skeletal Muscle Composition Contractile Apparatus Mechanics of Muscle Contraction Sliding Filament Theory Role of Calcium Electromechanical Coupling Types of Muscle Contraction Twitch Contraction Concentric, Eccentric, and Isometric Contractions Mechanical Principles Length–Tension Relationship Load–Velocity Relationship Force–Time Relationship Effects of Temperature Change Effects of Fatigue Response to Movement and Exercise Summary Resources Unit XIV Musculoskeletal Support and Movement 51 Alterations in Musculoskeletal Function Chapter Outline Key Questions Soft Tissue Injuries Inert Soft Tissue Injuries Ligament Injuries Clinical Manifestations Treatment Joint Capsule Injuries Adhesive Capsulitis Internal Joint Derangement Injuries to Fasciae and Bursae Fasciae Bursae Injuries to Nerves, Nerve Roots, or Dura Mater Contractile Soft Tissue Injuries Injury to Tendons Muscle and Tendon Strains Blunt Trauma Compartment Syndrome Soft Tissue Healing After Trauma Wound Repair Bone Injuries and Infections Bone and Joint Trauma Types of Bone Fracture Types of Fracture Extent of Fracture Diagnosis of Fracture Treatment of Fracture Healing Process Healing in a cortical bone. Healing in a cancellous bone. Complications of Fractures Delayed healing. Osteonecrosis. Osteomyelitis. Compartment syndrome. Fat emboli syndrome. Deep venous thrombosis and pulmonary embolism. Neurovascular injury. Dislocations and Subluxations Infections of the Bone Osteomyelitis Etiology and Pathogenesis Clinical Manifestations Healing Complications Treatment Tuberculosis Etiology and Pathogenesis Clinical Manifestations Risk Factors Treatment Alterations in Bone Structure and Mass Bone Structure Disorders Scoliosis Etiology and Pathogenesis Clinical Manifestations Treatment Metabolic Bone Diseases Osteoporosis Etiology and Pathogenesis Clinical Manifestations Treatment Calcium and vitamin D. Antiresorptive agents. Other Causes of Osteoporosis Rickets and Osteomalacia Clinical Manifestations Treatment Paget Disease Etiology and Pathogenesis Clinical Manifestations Treatment Bone Tumors Benign Tumors Osteochondroma Etiology, pathogenesis, and clinical manifestations. Chondroma Osteoid Osteoma Giant Cell Tumor Malignant Bone Tumors Osteosarcoma Etiology and pathogenesis. Clinical manifestations. Treatment. Chondrosarcoma Pathogenesis. Clinical manifestations. Ewing Sarcoma Pathogenesis. Clinical manifestations and treatment. Multiple Myeloma Etiology and pathogenesis. Clinical manifestations and treatment. Diseases of Skeletal Muscle Idiopathic Inflammatory Myopathy Polymyositis and Dermatomyositis Clinical Manifestations Treatment Muscular Dystrophy Duchenne Muscular Dystrophy Etiology and Pathogenesis Clinical Manifestations Treatment Becker Muscular Dystrophy Etiology, Pathogenesis, and Clinical Manifestations Facioscapulohumeral Muscular Dystrophy Etiology and Pathogenesis Myotonic Dystrophies Clinical Manifestations Other Disorders of Muscle Myasthenia Gravis Treatment Chronic Muscle Pain Fibromyalgia Syndrome Etiology and Pathogenesis Clinical Manifestations Treatment Summary Resources 52 Alterations in Musculoskeletal Function Chapter Outline Key Questions Local Disorders of Joint Function Osteoarthritis Etiology and Pathogenesis Clinical Manifestations Treatment Infectious Arthritis Etiology and Pathogenesis Clinical Manifestations Treatment Joint Prosthesis Infection Lyme Disease Clinical Manifestations and Treatment Systemic Disorders of Joint Function Immune-Mediated Disorders Rheumatoid Arthritis Etiology and pathogenesis. Clinical manifestations. Diagnosis. Treatment. Systemic Lupus Erythematosus Etiology and pathogenesis. Clinical manifestations. Treatment. Scleroderma Etiology and pathogenesis. Clinical manifestations. Treatment. Ankylosing Spondylitis Etiology and pathogenesis. Clinical manifestations. Treatment. Postinfectious Systemic Disorders Reactive Arthritis (Reiter Syndrome) Clinical manifestations. Treatment. Acute Rheumatic Fever Etiology and pathogenesis. Clinical manifestations. Treatment. Joint Dysfunction Secondary to Other Diseases Psoriatic Arthritis Etiology and Pathogenesis Clinical Manifestations Treatment Enteropathic Arthritis Clinical Manifestations Treatment Neuropathic Osteoarthropathy Clinical Manifestations and Treatment Hemophilic Arthropathy Clinical Manifestations Gout Clinical Manifestations Asymptomatic Hyperuricemia Acute Gouty Arthritis Intercritical Gout Chronic Tophaceous Gout Treatment Adult-Onset Still Disease Clinical Manifestations and Treatment Pediatric Joint Disorders Nonarticular Rheumatism Hypermobility of Joints Juvenile Idiopathic Arthritis Clinical Manifestations Treatment Summary Resources Unit XV Integumentary System 53 Alterations in the Integumentary System Chapter Outline Key Questions Age-Related Changes Epidermis Dermis and Subcutaneous Tissue Appendages Hair Nails Glands Evaluation of the Integumentary System Primary and Secondary Lesions Lesion Descriptors Selected Skin Disorders Infectious Processes Viral Infections Verrucae Etiology and pathogenesis. Herpes Simplex Virus Etiology and pathogenesis. Treatment. Herpes Zoster Virus Etiology and pathogenesis. Clinical manifestations. Treatment. Fungal Infections Superficial Fungal Infections Clinical manifestations. Treatment. Yeast Infections Bacterial Infections Impetigo Etiology and clinical manifestations. Treatment. Syphilis Etiology and clinical manifestations. Treatment. Leprosy Inflammatory Conditions Lupus Erythematosus Seborrheic Dermatitis Clinical manifestations and treatment. Psoriasis Etiology and clinical manifestations. Treatment. Lichen Planus Etiology and pathogenesis. Treatment. Pityriasis Rosea Etiology, pathogenesis, and treatment. Acne Vulgaris Etiology and pathogenesis. Treatment. Pemphigus Allergic Skin Responses Atopic Dermatitis Etiology and clinical manifestations. Treatment. Contact Dermatitis Etiologies and clinical manifestations. Treatment. Drug Eruptions Etiology and clinical manifestations. Treatment. Vasculitis Etiology. Treatment. Parasitic Infestations Scabies Fleas Lice Chiggers Bedbugs Mosquitoes Blood Flukes Ticks Rocky Mountain Spotted Fever Etiology, pathogenesis, and clinical manifestations. Treatment. Lyme Disease Etiology. Pathogenesis, clinical manifestations, and treatment. Other Disorders of the Dermis Scleroderma Localized Scleroderma Diffuse Scleroderma Sunburn and Photosensitivity Effects of Sunlight Ulcers Altered Cell Growth: Epidermal Proliferation Tumors Cancer Pigmentation Alterations Vitiligo Albinism Etiology and pathogenesis. Special Characteristics of Dark Skin Integumentary Manifestations of Systemic Disease Skin Color Sensation Texture Temperature Hair Growth Amount Color Texture Lubrication Nails Shape Color Texture Treatment Implications Topical Treatment Wet Dressings Lotions Gels Creams Ointments Aerosols and Foams Intralesional Injection Selection of a Delivery System Corticosteroids Systemic Steroids Topical Steroids Developmental Considerations Infancy Childhood Skin Disorders Rubella Etiology, pathogenesis, and clinical manifestations. Prevention. Roseola Infantum Pathogenesis and clinical manifestations. Treatment. Measles Etiology, pathogenesis, and clinical manifestations. Prevention and treatment. Chickenpox Etiology, pathogenesis, and clinical manifestations. Prevention and treatment. Scarlet Fever Etiology, clinical manifestations, and treatment. Adolescence and Young Adulthood Geriatric Considerations Summary Resources 54 Burn Injuries Chapter Outline Key Questions Thermal Injury Etiology, Incidence, and Mortality Risk Factors Integument Effects Depth Classification Extent of Injury Severity Classification Acute Management Assessment Burn Shock and Acute Resuscitation Organ Dysfunction Cardiovascular Dysfunction Respiratory Dysfunction Renal Dysfunction Metabolic Changes Cellular Changes Immune Response Elements of Burn Injury Survival Management of Wounds Burn Surgery Excision and Grafting Skin Substitutes Nutritional Support Rehabilitation Phase Wound Healing Electrical Injury Incidence and Mortality Pathophysiology Management and Complications Chemical Injury Management and Complications Common Agents and Treatment Hydrofluoric Acid Anhydrous Ammonia Cement Burns Chemicals Associated With Automobile Airbag Burns Tar and Asphalt Special Populations Introduction Geriatric Pediatric Obese Summary Resources Glossary A B C D E F G H I J K L M N O P R S T U V W X Z Index A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Inside Back Cover