Ganong’s Review of Medical Physiology 

Preface

 
It is difficult to believe that this preface signifies the fourth edition of Ganong’s
Review of Medical Physiology that our author group has overseen, and the 26th
edition overall of this important reference work aimed at medical and other
health professional students. As always, we have tried to maintain the highest
standards of excellence that were promulgated by the original author, Fran
Ganong, over the 46 years where he served, remarkably, as the sole author of the
textbook.
In this new edition, we have cast a fresh eye on the pedagogical approach
taken in each chapter and section, and have focused particularly on including
only material that is of the highest yield. We have thoroughly revised the
learning objectives for every chapter, reorganized and updated the text to ensure
that all objectives are clearly addressed in a logical order, aligned chapter
summaries so that the take-home messages quickly address each learning
objective in turn, and expanded the number of review questions so that readers
also have the ability to check their understanding and retention of every
objective covered. As a discipline evolves and new information emerges, there is
a tendency simply to concatenate these concepts such that chapter structure
degrades inevitably over time. With in-depth discussions amongst the author
team and significant “spring-cleaning,” we believe we have freshened and
simplified the volume while also making sure that important new developments
are incorporated. We are immensely thankful to Erica Wehrwein, PhD, Assistant
Professor of Physiology and an award-winning instructor at Michigan State
University, who took on the task of reviewing the book as a whole and providing
specific and detailed feedback to us on each chapter.
This new edition also welcomes a new member to the author team. We are
delighted to have been able to recruit Jason X.-J. Yuan, MD, PhD, Professor of
Medicine and Physiology as well as Chief of the Division of Translational and
Regenerative Medicine and Associate Vice President for Translational Health

cell physiology and cardiovascular topics, as well as the respiratory physiology
section. We are particularly excited to have a physician-scientist on the team,
who can guide us overall to focus on material that is of most benefit to those
preparing for a career incorporating patient care. We are most grateful for the
past contributions of Scott Boitano, PhD, whose other obligations meant that he
could no longer serve as an author.
We continue to be gratified by the many colleagues and students who contact
us from all over the world to request clarification of material covered in the text,
or to point out errors or omissions. We are especially grateful to Rajan Pandit,
Lecturer in Physiology at Nepal Medical College, who has painstakingly offered
dozens of suggestions for revision over the years. His efforts, and those of the
many others whom we have not named, allow us to engage in a process of
continual improvement.

Cellular & Molecular Basis for
Medical Physiology

study of physiological system structure and function, as well as
pathophysiological alterations, has its foundations in physical and chemical laws
and the molecular and cellular makeup of each tissue and organ system.
Ganong’s Review of Medical Physiology is structured into seven sections. This
first section provides an overview of the basic building blocks or bases that
provide the important framework for human physiology. It is important to note
here that the seven chapters in this initial section are not meant to provide an
exhaustive understanding of biophysics, biochemistry, or cellular and molecular
physiology; rather, they are to serve as a reminder of how the basic principles
from these disciplines contribute to medical physiology discussed in later
sections associated with physiological functions of organs and systems.
In the first two chapters of this section, the following basic building blocks are
introduced and discussed: electrolytes; carbohydrates, lipids, and fatty acids;
amino acids and proteins; and nucleic acids. Students are reminded of some of
the basic principles and building blocks of biophysics and biochemistry and how
they fit into the physiologic environment. Examples of direct clinical
applications are provided in the clinical boxes to help bridge the gap between
basic principles and human cell, tissue, and organ functions. These basic
principles are followed up with a discussion of the generic cell and its
components. It is important to realize the cell is the basic functional unit within
the body, and it is the collection and fine-tuned interactions among and between
these fundamental units that allow for proper tissue, organ, and organism
function.
In the third to seventh chapters of this introductory section, we take a cellular

 pproach to lay a groundwork of understanding groups of cells that interact with
many of the systems discussed in future chapters. The first group of cells
presented contribute to inflammatory reactions in the body. These individual
players, their coordinated behavior, and the net effects of the “open system” of
inflammation in the body are discussed in detail. The second group of cells
discussed are responsible for the excitatory responses in human physiological
function and include both neuronal and muscle cells. A fundamental
understanding of the inner workings of these cells, and how they are controlled
by their neighboring cells, helps the student to understand their eventual
integration into individual systems discussed in later sections.
This first section serves as an introduction, refresher, and quick source of
material to best understand organ functions and systems physiology presented in
the later sections. For detailed understanding of any of the chapters within this
section, several excellent and current textbooks that provide more in-depth
reviews of principles of biochemistry, biophysics, cell physiology, and muscle and neuronal physiology are provided as resources at the end of each individual
chapter. Students are encouraged to visit these texts for a more thorough
understanding of these basic principles.