Medical Physiology

Citation

Boron, W. F., & Boulpaep, E. L. (2017). Medical Physiology (3rd ed.). Elsevier.

Chapter Summary

The book has sixty-two chapters in ten parts. The publisher describes it as a textbook that goes from molecules to systems, with an emphasis on depth of information for medical students and for clinical and research professionals. Chapter titles below follow the publisher's table of contents.

Part I (Chapter 1): Foundations of Physiology

A single introductory chapter that frames the subject before the cellular material begins.

Part II (Chapters 2–9): Functional Organization of the Cell; Signal Transduction; Regulation of Gene Expression; Transport of Solutes and Water; Electrophysiology of the Cell Membrane; Electrical Excitability and Action Potentials; Synaptic Transmission and the Neuromuscular Junction; Cellular Physiology of Skeletal, Cardiac, and Smooth Muscle

The cellular and molecular foundation: cell organization, signalling, gene expression, transport across membranes, membrane electrophysiology, action potentials, the neuromuscular junction and the three muscle types. Later parts draw on these chapters.

Part III, The Nervous System (Chapters 10–16): Organization of the Nervous System; The Neuronal Microenvironment; Physiology of Neurons; Synaptic Transmission in the Nervous System; The Autonomic Nervous System; Sensory Transduction; Circuits of the Central Nervous System

The nervous system from organization and the neuronal environment through neurons and synapses to the autonomic nervous system, sensory transduction and central circuits.

Part IV, The Cardiovascular System (Chapters 17–25): Organization of the Cardiovascular System; Blood; Arteries and Veins; The Microcirculation; Cardiac Electrophysiology and the Electrocardiogram; The Heart As a Pump; Regulation of Arterial Pressure and Cardiac Output; Special Circulations; Integrated Control of the Cardiovascular System

The cardiovascular system from blood and vessels to the heart as electrical organ and pump, ending with regulation of pressure and output, special circulations and integrated control.

Part V, The Respiratory System (Chapters 26–32): Organization of the Respiratory System; Mechanics of Ventilation; Acid-Base Physiology; Transport of Oxygen and Carbon Dioxide in the Blood; Gas Exchange in the Lung; Ventilation and Perfusion of the Lungs; Control of Ventilation

Ventilation mechanics, acid-base physiology, gas transport and exchange, matching of ventilation and perfusion, and control of breathing.

Part VI, The Urinary System (Chapters 33–40): Organization of the Urinary System; Glomerular Filtration and Renal Blood Flow; Transport of Sodium and Chloride; Transport of Urea, Glucose, Phosphate, Calcium, Magnesium, and Organic Solutes; Transport of Potassium; Urine Concentration and Dilution; Transport of Acids and Bases; Integration of Salt and Water Balance

Eight chapters on the kidney, organized by what is filtered and then transported, and ending with integration of salt and water balance.

Part VII, The Gastrointestinal System (Chapters 41–46): Organization of the Gastrointestinal System; Gastric Function; Pancreatic and Salivary Glands; Intestinal Fluid and Electrolyte Movement; Nutrient Digestion and Absorption; Hepatobiliary Function

Gastrointestinal organization, the stomach, the pancreatic and salivary glands, intestinal fluid and electrolyte movement, digestion and absorption, and liver and biliary function.

Part VIII, The Endocrine System (Chapters 47–52): Organization of Endocrine Control; Endocrine Regulation of Growth and Body Mass; The Thyroid Gland; The Adrenal Gland; The Endocrine Pancreas; The Parathyroid Glands and Vitamin D

Part IX, The Reproductive System (Chapters 53–57): Sexual Differentiation; The Male Reproductive System; The Female Reproductive System; Fertilization, Pregnancy, and Lactation; Fetal and Neonatal Physiology

Part X (Chapters 58–62): Metabolism; Regulation of Body Temperature; Exercise Physiology and Sports Science; Environmental Physiology; The Physiology of Aging

The closing chapters treat whole-body topics: metabolism, temperature regulation, exercise, the physiology of environmental stress and aging.

Key Concepts

Part II: cell and membrane physiology (Chapters 2–9)

• Signal transduction and gene expression: cellular signalling and its control (Chapters 3–4).
• Transport of solutes and water: movement across membranes (Chapter 5).
• Action potentials and the neuromuscular junction: Chapters 7–8.

Parts III–V: nervous, cardiovascular and respiratory systems (Chapters 10–32)

• Cardiac electrophysiology and the electrocardiogram: Chapter 21.
• Regulation of arterial pressure and cardiac output: Chapter 23.
• Acid-base physiology: Chapter 28.
• Ventilation and perfusion of the lungs: Chapter 31.

Parts VI–X: kidney, gut, endocrine, reproduction and whole body (Chapters 33–62)

• Glomerular filtration and renal transport: Chapters 34–37 and 39.
• Urine concentration and dilution: Chapter 38.
• Endocrine glands: thyroid, adrenal, endocrine pancreas and parathyroid (Chapters 49–52).
• Temperature regulation, exercise and aging: Chapters 59, 60 and 62.

Critical Analysis

Strengths

• Molecules to systems in one design. Part II sets out cell and membrane physiology before any organ system, and the later parts begin with an "organization" chapter for the system, which is consistent with the publisher's description.
• Depth across many disciplines. A student reviewer quoted by the publisher (University of Glasgow) says that a topic gives anatomy, histology, physiology and biochemistry in one chapter, and praises the colour illustrations and tables.
• Consistent authorship. The editors, from Yale and Case Western Reserve, are quoted in a review of the previous edition (Comprehensive Therapy) as having recast contributors' manuscripts into a uniform style.
• Detailed kidney and cardiovascular sections. The kidney receives eight chapters and the cardiovascular system nine, which gives these systems far more room than a general physiology text.

Limitations

• Scale. Sixty-two chapters is a reference-level text; it exceeds a single physiology course and suits selective use.
• Prerequisites. The site lists undergraduate anatomy and physiology plus introductory biochemistry, cell biology and physics.

Where It Fits in the Course

Medical Physiology is the comprehensive, molecule-to-system text in the physiology list. Anatomy and Physiology 2e is a free introduction for a two-semester sequence, and Ross & Wilson Anatomy and Physiology in Health and Illness is a compact, illustrated text that adds common disorders; both come before Boron. Human Physiology: An Integrated Approach is an intermediate text that builds every system on four recurring themes and opens each chapter with a running problem, so it is the usual bridge to a text of this depth. Animal Physiology (Hill, Cavanaugh and Anderson) is comparative and ecological in outlook, and Plant Physiology and Development is about plants; neither replaces a human physiology text.

Use Boron as the reference text in a medical or upper-level human physiology course, or after Human Physiology: An Integrated Approach when more depth is wanted.

How to Use This Book

It suits medical, graduate and advanced undergraduate students with prior anatomy and physiology and introductory biochemistry, cell biology and physics.

• Core: Part II first (Chapters 2–9); it is the foundation for the system chapters. Then follow the order of the course through Parts III–VII.
• System by system: for each system read the organization chapter first, then the mechanisms, and finish with the integrated-control chapters (for example Chapters 25 and 40).
• Selective: Parts VIII–X are well suited to targeted reading, for example Chapter 58 on metabolism alongside the endocrine pancreas.
• Study: pair the text with a short course text for first-pass reading and use this book to resolve questions about mechanism.