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Go to evolve.elsevier.com/html/shop-promo.html to search and browse for products. 2015v1.0 B R I E F C O N T E N T S UNIT I UNIT V Pathophysiologic Processes Cardiac Function 1 Introduction to Pathophysiology, 1 17 Cardiac Function, 354 2 Homeostasis, Allostasis, and Adaptive Responses 18 Alterations in Cardiac Function, 382 to Stressors, 12 19 Heart Failure and Dysrhythmias: Common Sequelae of Cardiac Diseases, 411 UNIT II 20 Shock, 434 Cellular Function UNIT VI 3 Cell Structure and Function, 26 Respiratory Function 4 Cell Injury, Aging, and Death, 59 5 Genome Structure, Regulation, and Tissue 21 Respiratory Function and Alterations Differentiation, 77 in Gas Exchange, 451 6 Genetic and Developmental Disorders, 94 22 Obstructive Pulmonary Disorders, 478 7 Neoplasia, 117 23 Restrictive Pulmonary Disorders, 499 UNIT III UNIT VII Defense Fluid, Electrolyte, and Acid-Base Homeostasis 8 Infectious Processes, 141 24 Fluid and Electrolyte Homeostasis and Imbalances, 521 9 Inflammation and Immunity, 158 25 Acid–Base Homeostasis and Imbalances, 541 10 Alterations in Immune Function, 194 11 Malignant Disorders of White Blood Cells, 215 UNIT VIII 12 HIV Disease and AIDS, 233 Renal and Bladder Function UNIT IV 26 Renal Function, 551 Oxygen Transport, Blood Coagulation, 27 Intrarenal Disorders, 575 Blood Flow, and Blood Pressure 28 Acute Kidney Injury and Chronic Kidney Disease, 593 13 Alterations in Oxygen Transport, 259 29 Disorders of the Lower Urinary Tract, 609 14 Alterations in Hemostasis and Blood Coagulation, 298 15 Alterations in Blood Flow, 313 16 Alterations in Blood Pressure, 337 UNIT IX UNIT XII Genital and Reproductive Function Neural Function 30 Male Genital and Reproductive Function, 626 43 Structure and Function of the Nervous System, 850 31 Alterations in Male Genital and Reproductive 44 Acute Disorders of Brain Function, 891 Function, 641 45 Chronic Disorders of Neurologic Function, 915 32 Female Genital and Reproductive Function, 656 46 Alterations in Special Sensory Function, 936 33 Alterations in Female Genital and Reproductive 47 Pain, 955 Function, 671 34 Sexually Transmitted Infections, 689 UNIT XIII Neuropsychological Function UNIT X Gastrointestinal Function 48 Neurobiology of Psychotic Illnesses, 971 49 Neurobiology of Nonpsychotic Illnesses, 989 35 Gastrointestinal Function, 697 36 Gastrointestinal Disorders, 720 UNIT XIV 37 Alterations in Function of the Gallbladder and Musculoskeletal Support and Movement Exocrine Pancreas, 742 38 Liver Diseases, 754 50 Structure and Function of the Musculoskeletal System, 1001 51 Alterations in Musculoskeletal Function: Trauma, UNIT XI Infection, and Disease, 1020 Endocrine Function, Metabolism, and Nutrition 52 Alterations in Musculoskeletal Function: Rheumatic 39 Endocrine Physiology and Mechanisms of Disorders, 1042 Hypothalamic-Pituitary Regulation, 783 40 Disorders of Endocrine Function, 799 UNIT XV 41 Diabetes Mellitus, 815 Integumentary System 42 Nutritional and Metabolic Disorders, 838 53 Alterations in the Integumentary System, 1058 54 Burn Injuries, 1093 PATHOPHYSIOLOGY 6 TH EDITION JACQUELYN L. BANASIK, PhD, ARNP LEE-ELLEN C. COPSTEAD, PhD, RN Associate Professor Professor Emerita College of Nursing Department of Nursing Washington State University College of Nursing and Health Sciences Spokane, Washington University of Wisconsin—Eau Claire Eau Claire, Wisconsin 3251 Riverport Lane St. Louis, Missouri 63043 PATHOPHYSIOLOGY, SIXTH EDITION ISBN: 978-0-323-35481-3 Copyright © 2019 by Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds or experiments described herein. Because of rapid advances in the medical sciences, in particular, independent verification of diagnoses and drug dosages should be made. To the fullest extent of the law, no responsibility is assumed by Elsevier, authors, editors or contributors for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Previous editions copyrighted 2013, 2010, 2005, 2000, and 1995. International Standard Book Number: 978-0-323-35481-3 Executive Content Strategist: Kellie White Content Development Specialist: Jennifer Wade Publishing Service Manager: Jeffrey Patterson Book Production Specialist: Carol O’Connell Book Designer: Renee Duenow Printed in Canada Last digit is the print number: 9 8 7 6 5 4 3 2 1 To: Loved ones, past and present, who give meaning to the work. JLB This page intentionally left blank C O N T R I B U TO R S Brent A. Banasik, PhD, MA, BS Roberta J. Emerson, PhD, RN Faith Young Peterson, BSN, MSN, Scientist Associate Professor, Retired MPA, CFNP Chemistry Washington State University Family Nurse Practitioner Banasik Consulting College of Nursing Marsing, Idaho Seattle, Washington Spokane, Washington Cheryl Rockwell, RN, MSN Brianne N. Banasik, BS Environmental Linda Felver, PhD, RN Clinical Assistant Professor Science, MS Marine Resources Associate Professor Nursing Department Management School of Nursing Indiana University-Purdue University at Research Associate Oregon Health & Science University Fort Wayne; Pediatric Vaccinology Portland, Oregon Staff/Clinical Nurse University of Texas Medical Branch Surgical Trauma Intensive Care Unit Galveston, Texas Rosemary A. Jadack, PhD, RN Parkview Health Systems Professor Fort Wayne, Indiana Jacquelyn L. Banasik, PhD, ARNP Nursing Associate Professor University of Wisconsin—Eau Claire Samantha Cody Russell, Psychology, MA College of Nursing Eau Claire, Wisconsin Graduate Student Washington State University Psychological Sciences Spokane, Washington Debra A. Jansen, PhD, RN Northern Arizona University Associate Dean, Professor Flagstaff, Arizona Robin Y. Beeman, BSN, MSN, PhD College of Nursing and Health Sciences Chair and Professor University of Wisconsin—Eau Claire Jeffrey S. Sartin, MD Nursing Eau Claire, Wisconsin Consulting Physician University of Wisconsin—Eau Claire Infectious Diseases Eau Claire, Wisconsin Marie L. Kotter, PhD, MS, BS Infectious Disease and Epidemiology Professor Emeritus Associates; Cheryl L. Brandt, PhD, RN, ACNS-BC Health Sciences Consulting Physician Professor Weber State University Infectious Diseases College of Nursing and Health Sciences Ogden, Utah Nebraska Medicine; University of Wisconsin—Eau Claire Consulting Physician Eau Claire, Wisconsin Teresa Grigsby Loftsgaarden, MSN, RN, Infectious Diseases OCN,ONN-CG CHI Hospitals Ann Futterman Collier, PhD Oncology Nurse Navigator Omaha, Nebraska Associate Professor and Chair Regional Cancer Center Psychological Sciences Sacred Heart Hospital Lorna L. Schumann, PhD Northern Arizona University Eau Claire, Wisconsin Heritage UGM Women and Children’s Flagstaff, Arizona Clinic Joni D. Marsh, BSN, MN Medical Clinic Lee-Ellen C. Copstead, PhD, RN Advanced Registered Nurse Practitioner Heritage Health Professor Emerita Medical Oncology Coeur d’Alene, Idaho Department of Nursing Summit Cancer Centers College of Nursing and Health Sciences Spokane, Washington Susan G. Trevithick, RN, MS, NE-BC University of Wisconsin—Eau Claire Compliance Officer Eau Claire, Wisconsin Benjamin J. Miller, PhD, ARNP, FNP-C, VA Salt Lake City Healthcare System ACNPC, ENP-C Salt Lake City, Utah Carol L. Danning, MD Assistant Professor Staff Rheumatologist Seattle University Marvin Van Every, MD Rheumatology Department Seattle, Washington Staff Urologist Gundersen Health Systems Urology Department La Crosse, Wisconsin Sarah Ogle, DO, MS Gundersen Health Systems Banner University Medical Center-Phoenix La Crosse, Wisconsin Michael R. Diestelmeier, MD University of Arizona College of Medicine Fellow American Academy of Dermatology Phoenix Linda D. Ward, PhD, FNP-C Dermatologist, Retired Phoenix, Arizona Assistant Professor Mayo Clinic Health System College of Nursing Eau Claire, Wisconsin Nirav Patel, MD Washington State University Assistant Professor, Infectious Diseases and Spokane, Washington Ruth E. Diestelmeier, RN, MSN Critical Care Medicine Clinical Instructor Internal Medicine Department of Nursing Saint Louis University School of Medicine; University of Wisconsin—Eau Claire Chief Medical Officer Eau Claire, Wisconsin SSM Health Saint Louis University Hospital; Infection Control Officer/Director of Antibiotic Stewardship SSM Health Saint Louis University Hospital Saint Louis, Missouri vii R E V I E W E R S Brianne N. Banasik, MS Barbara Hunter, RN, MSN Janet Pinkelman, MSN, RNC-Maternal Research Associate School of Nursing, Klamath Falls Campus Newborn Nursing Pediatric Vaccinology Oregon Health & Science University Professor of Nursing University of Texas Medical Branch Klamath Falls, Oregon Owens Community College Galveston, Texas Toledo, Ohio Sandra L. Kaminski, MS, PA-C Deb Cipali, RN, BSN, MSN, EdD(c) Assistant Professor Linda Turchin, RN, MSN, CNE Des Moines Area Community College Seton Hall University Associate Professor of Nursing Nursing Lab Coordinator/Adjunct Professor School of Health and Medical Sciences; Fairmont State University Ankeny, Iowa Physician Assistant Fairmont, West Virginia VA NJ Healthcare System Janie Corbitt, RN, MLS Medical Service/Infections Disease Kim Webb, MN, RN Milledgville, Georgia Clark, New Jersey Adjunct Nursing Instructor Pioneer Technology Center Maria Fleurdeliz Cuyco, BS Steven Krau, PhD, RN, CNE Ponca City, Oklahoma Instructor Associate Professor Preferred College of Nursing Vanderbilt School of Nursing Janice Williams, RN, ACNS-BC, CDE Los Angeles, California Nashville, Tennessee Professor of Nursing and Program Director Armstrong McDonald School of Nursing Abimbola Farinde, PhD Clarice Perry, MS College of the Ozarks Professor Research Associate Point Lookout, Missouri Columbia Southern University Pediatric Vaccinology Orange Beach, Alabama University of Texas Medical Branch Galveston, Texas Annette Gunderman, DEd, MSN, RN Associate Professor of Nursing Bloomsburg University Bloomsburg, Pennsylvania viii