Guyton and Hall Textbook of Medical Physiology

Citation

Hall, J. E., & Hall, M. E. (2020). Guyton and Hall Textbook of Medical Physiology (14th ed.). Elsevier.

Chapter Summary

The 14th edition contains 85 short chapters grouped into 15 units. The units begin with the cell and general physiology, run through the heart, circulation, kidneys, blood, respiration and the nervous system, and end with gastrointestinal physiology, metabolism, endocrinology and reproduction, and sports physiology. The publisher describes the book as organized around how the body maintains homeostasis.

Unit I: Introduction to Physiology: The Cell and General Physiology (Chapters 1–3)

The unit opens with "Functional Organization of the Human Body and Control of the 'Internal Environment'", then turns to "The Cell and Its Functions" and "Genetic Control of Protein Synthesis, Cell Function, and Cell Reproduction".

Unit II: Membrane Physiology, Nerve, and Muscle (Chapters 4–8)

Chapters cover transport through cell membranes, membrane and action potentials, skeletal muscle contraction, neuromuscular transmission and excitation–contraction coupling, and the excitation and contraction of smooth muscle.

Unit III: The Heart (Chapters 9–13)

The heart as a pump and the function of the valves, rhythmical excitation, the normal electrocardiogram, electrocardiographic interpretation of cardiac muscle and coronary blood flow abnormalities using vectorial analysis, and cardiac arrhythmias.

Unit IV: The Circulation (Chapters 14–24)

From pressure, flow and resistance and the arterial and venous systems, through the microcirculation and lymphatics, local and humoral control of blood flow, nervous regulation and the kidneys' role in long-term control of arterial pressure, to cardiac output, exercise and coronary circulation, cardiac failure, heart valves and heart sounds, and circulatory shock.

Unit V: The Body Fluids and Kidneys (Chapters 25–32)

Fluid compartments and edema lead into the urinary system, glomerular filtration, tubular reabsorption and secretion, urine concentration and dilution, renal regulation of potassium, calcium, phosphate and magnesium, acid–base regulation, and diuretics and kidney diseases.

Units VI–VIII: Blood Cells, Immunity, and Blood Coagulation; Respiration; Aviation, Space, and Deep-Sea Diving Physiology (Chapters 33–45)

Red blood cells and anemia, the two chapters on resistance to infection, blood types and transplantation, and hemostasis; then pulmonary ventilation, circulation, gas exchange, transport of oxygen and carbon dioxide, regulation of respiration and respiratory insufficiency; and finally two chapters on high altitude, space and hyperbaric conditions.

Units IX–XI: The Nervous System (Chapters 46–62)

The nervous system is split into three units: general principles and sensory physiology (synapses, receptors, somatic sensation, pain); the special senses (the eye in three chapters, hearing, taste and smell); and motor and integrative neurophysiology (spinal and cortical motor control, cerebellum and basal ganglia, cortex, learning and memory, limbic system, sleep, autonomic nervous system and cerebral blood flow).

Units XII–XIII: Gastrointestinal Physiology; Metabolism and Temperature Regulation (Chapters 63–74)

Chapters on motility, secretion, digestion and absorption and gastrointestinal disorders precede carbohydrate, lipid and protein metabolism, the liver as an organ, dietary balances and obesity, energetics and metabolic rate, and body temperature regulation and fever.

Units XIV–XV: Endocrinology and Reproduction; Sports Physiology (Chapters 75–85)

Endocrine chapters take the pituitary, thyroid, adrenal cortex, insulin and glucagon, and parathyroid hormone with calcium and bone, followed by male and female reproductive physiology, pregnancy and lactation, and fetal and neonatal physiology. A single chapter on sports physiology closes the book.

Key Concepts

Units I–V

• Internal environment and homeostasis: the control of the "internal environment", the subject of Chapter 1.
• Membrane and action potentials: the electrical basis of nerve and muscle (Chapters 4–8).
• Cardiac output and venous return (Chapter 20) and long-term arterial pressure control by the kidneys (Chapter 19): integrated, whole-system treatments of the circulation.
• Body fluid compartments and acid–base regulation (Chapters 25 and 31).

Units VI–XV

• Gas exchange and its regulation: from the respiratory membrane to the control of breathing (Chapters 40–42).
• Synaptic function and sensory processing as the entry to the nervous system (Chapters 46–47).
• Metabolic and endocrine regulation: energetics, feeding, and hormone systems (Chapters 72–79).
• Physiology under stress: high altitude, diving and exercise (Chapters 44, 45 and 85).

Critical Analysis

Strengths

• Clear, deliberate presentation. The publisher highlights a clear presentation style and short, concise chapters. Core material appears in larger type; supporting information and clinical examples are in smaller type highlighted in pale blue, so a reader can skim the essentials or go deeper.
• Physiology tied to disease. The publisher stresses a clinically oriented perspective that bridges basic physiology and pathophysiology. The table of contents backs this up with chapters on cardiac failure, circulatory shock, respiratory insufficiency, kidney diseases and gastrointestinal disorders.
• Illustrations and online material. The edition has more than 1,200 full-colour drawings and diagrams, with online interactive figures, audio of heart sounds, animations and self-assessment questions.
• Whole-body integration. Chapter titles signal an integrated treatment: the kidneys' role in long-term arterial pressure control is presented as an integrated system, cardiac output is paired with venous return, and renal mechanisms are tied to blood and extracellular fluid volume.

Limitations

• Large, with some specialised units. Eighty-five chapters is more than a single course usually covers; units on aviation, space and deep-sea diving physiology and on sports physiology are the obvious candidates to skip.
• Physiology first, medicine second. The publisher frames the disease coverage as bridging physiology and pathophysiology; a student who needs full clinical management of a condition will still need a clinical text.
• Two kinds of text on one page. The two-tone layout helps skimming, but a reader aiming for complete understanding must read the smaller-type material as well.

Where It Fits in the Course

Guyton and Hall is the long, systems-based reference in the physiology list. Human Physiology: A Very Short Introduction is a brief account built around the body's main tasks, suited to a first look before any medical course. Physiology at a Glance presents each topic on a two-page spread of diagram and text, useful as an overview or for revision. Costanzo Physiology is a single-author textbook that builds each topic step by step with worked equations, sample problems and clinical cases, and Ganong's Review of Medical Physiology is a denser, concise review that treats cellular and molecular mechanisms before organ systems and assumes some biochemistry.

Guyton and Hall sits between the short introductions and the review texts: it explains mechanisms in more narrative depth than a review book and covers the whole subject. It is a reasonable main text for a first-year medical or allied-health course, with Costanzo as an alternative of a similar level and Ganong's for revision.

How to Use This Book

The publisher names first- and second-year medical and allied-health students, and undergraduate or graduate physiology students, as the readership. Basic biology, chemistry and some physics (pressure, flow, gas laws) are enough to start.

• Core path: Unit I; Unit II (Chapters 4–8); Units III–V in order; then Units VI–VII and the nervous system units as the course demands.
• Read the larger type first, then return to the pale-blue passages for clinical examples and supporting detail.
• Use the online material: interactive figures, heart-sound audio and self-assessment questions.
• Plan to skip or defer: Units VIII and XV unless the course covers altitude, diving or exercise.
• Pair it with a clinical text for diagnosis and treatment of the diseases whose physiology the book explains.