Ganong's Review of Medical Physiology

Citation

Barrett, K. E., Barman, S. M., Yuan, J., & Brooks, H. L. (2019). Ganong's Review of Medical Physiology (26th ed.). McGraw Hill.

Chapter Summary

The twenty-sixth edition is a one-volume review of human and mammalian physiology with more than 600 full-colour illustrations. The contents are arranged in sections that move from cells and nerve and muscle to the senses and the brain, then to endocrine and reproductive physiology, the gastrointestinal tract, the cardiovascular system, respiration and the kidney. The headings below follow that order and use the chapter titles.

Cellular and molecular foundations: General Principles and Energy Production in Medical Physiology; Overview of Cellular Physiology; Immunity, Infection, and Inflammation

The book begins with general principles and energy production, then an overview of cellular physiology and a chapter on immunity, infection and inflammation. These chapters set the cell-level vocabulary used by the organ-system chapters that follow.

Nerve, muscle and synapses: Excitable Tissue: Nerve; Excitable Tissue: Muscle; Synaptic and Junctional Transmission; Neurotransmitters and Neuromodulators

Four chapters cover the electrical and chemical basis of excitable tissue: nerve, muscle, transmission at synapses and junctions, and the neurotransmitters and neuromodulators involved.

Sensory and central neurophysiology: Somatosensory Neurotransmission: Touch, Pain, and Temperature; Smell and Taste; Vision; Hearing and Equilibrium; Reflex and Voluntary Control of Posture and Movement; Autonomic Nervous System; Electrical Activity of the Brain, Sleep-Wake States, and Circadian Rhythms; Learning, Memory, Language, and Speech

These chapters run from the senses through the control of posture and movement and the autonomic nervous system to brain rhythms, sleep and higher functions such as learning, memory, language and speech. The publisher singles out chronic pain among the areas updated for this edition.

Endocrine and reproductive physiology: Basic Concepts of Endocrine Regulation; Hypothalamic Regulation of Hormonal Functions; The Pituitary Gland; The Adrenal Medulla and Adrenal Cortex; The Thyroid Gland; Hormonal Control of Calcium and Phosphate Metabolism and the Physiology of Bone; Reproductive Development and Function of the Female Reproductive System; Functions of the Male Reproductive System; Endocrine Functions of the Pancreas and Regulation of Carbohydrate Metabolism

The endocrine block begins with general concepts, then covers the hypothalamus and pituitary, adrenal, thyroid, calcium and bone, the female and male reproductive systems, and the endocrine pancreas with the regulation of carbohydrate metabolism. Reproductive physiology is another area the publisher names as updated.

Gastrointestinal physiology: Overview of Gastrointestinal Function and Regulation; Digestion, Absorption, and Nutritional Principles; Gastrointestinal Motility; Transport and Metabolic Functions of the Liver

Four chapters cover the digestive tract, from overall function and regulation through digestion, absorption and nutrition and motility to the transport and metabolic functions of the liver.

Cardiovascular physiology: Origin of the Heartbeat and the Electrical Activity of the Heart; The Heart as a Pump; Blood as a Circulatory Fluid and the Dynamics of Blood and Lymph Flow; Cardiovascular Regulatory Mechanisms; Circulation Through Special Regions

The cardiovascular chapters move from the heartbeat and its electrical activity to the heart as a pump, the dynamics of blood and lymph flow, regulatory mechanisms and circulation in particular regions.

Respiratory physiology: Introduction to Pulmonary Structure and Mechanics; Gas Transport and pH in the Lung; Regulation of Respiration

Three chapters cover pulmonary structure and mechanics, gas transport and pH, and the control of breathing.

Renal physiology: Renal Function and Micturition; Regulation of Extracellular Fluid Composition and Volume; Acidification of the Urine and Bicarbonate Excretion

The final chapters deal with renal function and micturition, the regulation of extracellular fluid composition and volume, and the acidification of the urine and excretion of bicarbonate. Acid-base homeostasis is a third area the publisher names as updated.

Key Concepts

Cells and excitable tissue

• Energy production and cellular physiology: the general principles underlying the organ systems.
• Excitable tissue and synaptic transmission: how nerve and muscle generate signals and how they pass between cells.

Nervous system

• Sensory transduction and motor control: from touch, pain and temperature to vision, hearing and posture.
• Autonomic nervous system, sleep and circadian rhythms.

Endocrine and reproductive

• Hormonal regulation: the hypothalamus and pituitary, adrenal, thyroid, pancreas, calcium and bone.
• Reproductive function in the female and the male.

Visceral systems

• Gastrointestinal motility, digestion and absorption, and the liver's transport and metabolic functions.
• Cardiac electrical activity, the heart as a pump, and regulation of circulation.
• Gas transport and pH; regulation of respiration.
• Regulation of extracellular fluid and acidification of the urine.

Critical Analysis

Strengths

• Concise one-volume coverage. The book surveys the full range from the cell to the kidney in a single volume and puts the cell and molecular foundations first, so later chapters can build on them.
• Study aids built in. The publisher lists end-of-chapter review questions and board-style questions, more clinical cases and flow charts in this edition, improved figure legends, a frequently-asked-questions feature and video tutorials from the author.
• Clinical orientation without losing the mechanisms. The publisher says the text incorporates examples from clinical medicine to illustrate physiological concepts and has been updated in areas such as chronic pain, reproductive physiology and acid-base homeostasis.
• Established title. The book has been in use for more than four decades, according to the publisher, which also notes that it was named a Doody's Core Title for 2022.

Limitations

• Compressed treatment. As a review, it condenses material; a student meeting a system for the first time may need a fuller or more gradual text first.
• Review format. The publisher presents it as a concise review for students preparing for the USMLE as well as a text, so it favours summary over extended narrative explanation of each system.

Where It Fits in the Course

Ganong sits between the beginner overviews and the larger textbooks. Human Physiology: A Very Short Introduction and Physiology at a Glance are brief and visual, useful as a first look at the body or as a map before the longer books. Costanzo Physiology is a single-author text that builds each topic step by step with worked equations, problems and clinical cases, and is an easier first full course.

Guyton and Hall Textbook of Medical Physiology is the larger systems-based account. Ganong is described by its publisher as a concise review, a good choice for revision and for readers who want a one-volume summary; Guyton and Hall suits readers who want a systems-based account built up at length. A sensible pattern is one of the gentler books or Costanzo for a first pass and Ganong for revision.

How to Use This Book

The book is for medical, dental, pharmacy and graduate students and for advanced undergraduates in physiology or biomedical science who have introductory biology and biochemistry with some cell biology. It is also suited to examination review.

A practical plan:

• Core: the opening chapters on cellular physiology and excitable tissue, which supply concepts used throughout; then the system that matches the current course block.
• By system: read each block as a unit (nervous system, endocrine, gastrointestinal, cardiovascular, respiratory, renal) and finish it with the end-of-chapter questions.
• For examinations: use the board-style questions and the clinical cases to test recall, and go back to the relevant figures and flow charts for integrative topics such as acid-base balance.
• Alongside a fuller text: when a chapter feels condensed, read the same topic in a longer physiology book before returning to Ganong for review.