Updates and Additions

In addition to updating material throughout the text to reect cutting-edge changes in physiology and medicine, the authors:

have added a new case study to Chapter 19, bringing the total to four case studies that require the student to think critically and apply what has been learned throughout the semester to novel clinical situations. have now incorporated shorter, chapter-specic case studies to each of the other 18 chapters. This feature, called Clinical Case Studies, appears at the end of each chapter; all Clinical Case Studies are based on real-life examples, and provide compelling examples of what may happen when homeostasis is disrupted. have roughly doubled the number of Physiological Inquires. This feature was introduced in the eleventh edition and was associated with key gures in chapters 4-18. Feedback from users of the text indicated that this learning tool was extremely valuable.

We believe that these additions, and those described below, make the twelfth edition of Vanders Human Physiology the most extensive, detailed, and integrative text available for students interested in learning about physiology.

Chapter 1 Homeostasis: A Framework for Human Physiology

Expanded description and illustration of cell and tissue types, particularly epithelial and connective tissue; addition of Physiological Inquiries; Clinical Case Study of an individual who develops heatstroke on a summer day.

of a young person with a G-protein-related disorder (pseudohypoparathyroidism).

Chapter 6 Neuronal Signaling and the Structure of the Nervous System

Expanded discussion of neural plasticity; description of new ndings on the genetic basis of Alzheimer disease; Clinical Case Study of a woman with multiple sclerosis.

Chapter 2 Chemical Composition of the Body

Expanded discussion of atomic structure, including s - and p -orbitals and energy shells; electronegativity and its importance for bond formation; greater tie-in of chemical and physiological principles; new art depicting multiple levels of protein structure; Clinical Case Study of a person with a mutation resulting in a change in protein structure and function.

Chapter 7 Sensory Physiology

New discussion of the role of transient receptor
proteins (TRPs) in temperature perception; new gures explaining ON and OFF ganglion cell visual pathways and binocular visual elds; new table and description of decibel levels of common sounds and hearing loss; Clinical Case Study of a man with benign paroxysmal positional vertigo (BPPV).

Chapter 3 Cell Structure, Proteins, and Metabolism

Description and new gure of the mitochondrial reticulum; new gure depicting oxidative phosphorylation and the role of ATP synthase; Clinical Case Study describing the consequence of a dietary change (grapefruit juice) on gut enzyme function and, therefore, the absorption of medication.

Chapter 8 Consciousness, the Brain, and Behavior

Expanded discussion and new gures on EEG patterns during sleep; Clinical Case Study of a young athlete who sustains a concussion.

Chapter 4 Movement of Molecules Across Cell Membranes

Clinical Case Study of exercise-associated hyponatremia in a woman running a marathon.

Chapter 9 Muscle
Expanded discussion of the role of satellite cells in muscle repair and hypertrophy; new discussion of neuromuscular blocking agents used in surgery; Clinical Case Study of a boy who develops malignant hyperthermia during a surgical procedure.

Chapter 5 Control of Cells by Chemical Messengers

Improved description and illustrative depiction of G-protein structure and function; Clinical Case Study

Chapter 10 Control of Body Movement

Discussion of Parkinson-disease-like condition caused by MPTP; Clinical Case Study of a gardener who contracts tetanus following a puncture wound.

Chapter 16 Regulation of Organic Metabolism and Energy Balance

New discussion of incretins and their current and potential therapeutic uses; Clinical Case Study of an individual with blurry vision who is diagnosed with type 2 diabetes melllitus.

Chapter 11 The Endocrine System

Expanded and improved presentation of steroid hormone synthesis and mechanism of action; functions of progesterone; clarication of differential diagnosis of hyposecretion syndromes; expanded discussion of the functions of oxytocin; increased emphasis on metabolic actions of growth hormone; control of growth hormone now depicted in two separate gures illustrating stimulatory and inhibitory pathways; Clinical Case Study of a middle-aged man who develops acromegaly.

Chapter 17 Reproduction
Reorganization of introductory section on terminology and general principles; new gures on fertilization, ovulation, and implantation; Clinical Case Study of a woman with a pituitary gland tumor whose menstrual periods stop.

Chapter 18 The Immune System

Specic and nonspecic immune responses replaced with adaptive and innate immune responses; new section on pathogen-associated molecular patterns, pattern-recognition receptors, and toll-like receptors; clarication and updates of roles of B and T cells in mediating responses to pathogens; expansion of discussion of dendritic cells and regulatory T cells; addition of CD4 and CD8 proteins to relevant gures; discussion of the two families of interferons; discussion of gene therapy for SCID; Clinical Case Study of a teenage girl who develops a rash across her cheeks and nose and is later diagnosed with systemic lupus erythematosus.

Chapter 12 Cardiovascular Physiology

Expanded discussion of the lengthtension mechanism in cardiac muscle; new gure showing structural variations by region in the vascular system; in-depth discussion of possible mechanisms of primary and secondary hypertension; Clinical Case Study of a woman with pericarditis.

Chapter 13 Respiratory Physiology

Clinical Case Study of an obese man who snores and has sleep apnea.

Chapter 14 The Kidneys and Regulation of Water and Inorganic Ions

Improved presentation of the control of clearance; expanded discussion and new gure on water channels (aquaporins); new section on non-osmotic control of vasopressin; Clinical Case Study of a woman with diabetic nephropathy.

Chapter 19 Medical Physiology: Integration Using Clinical Cases

A new case of a college student with nausea, ushing, sweating, and seizures.

Chapter 15 The Digestion and Absorption of Food

New description of incretins; additional detail and new gure on hepatic structure and function; new gures and expanded discussion on carbohydrate and protein digestion and absorption; Clinical Case Study of a college student with abdominal pain and Crohns disease.