The Respiratory System; Systems of the Body Series

by Davies & Moores

• ISBN13: 9780443062315
• ISBN10: 0443062315
• Edition: 1st
• Format: Paperback
• Copyright: 2003-10-08
• Publisher: Churchill Livingstone

Summary

Part of the Systems of the Body Series, this concise text offers coverage of the core knowledge required on the respiratory system. An ideal text for system-based, integrated courses, it stresses the relevance of basic science to clinical medicine a clinical case is used to derive the learning objectives at the beginning of each chapter. It also prepares the student for early patient contact with a final section covering the major diseases of the system and their diagnosis and treatment. Integrated coverage of the structure, function, and major diseases of the respiratory system highly suitable for systems courses Coverage of the basic science that is clinically driven a common clinical presentation introduces each major topic Clinical cases that are used and explained in the chapter Coverage of major diseases of the respiratory system that equips students for early contact with patients A structure that encourages learning objectives are defined at the beginning of the chapter, and self-assessment questions are provided at the end

Author Biography

Andrew Davies, PhD DSc: Professor of Physiology, University of Glamorgan, Pontyprydd, UK Carl Moores BA BSc MB ChB FRCA: Consultant Anaesthetist, Royal Infirmary of Edinburgh, UK

Table of Contents

Introduction	1	(10)
Introduction	2	(1)
What is respiration?	2	(1)
The need for respiration	2	(1)
Diffusion in respiration and the circulation	3	(1)
Timing in the circulation and respiration	3	(1)
Basic science of respiration	3	(6)
Drugs	9	(1)
Self-assessment questions	9	(2)
Structure of the Respiratory System, Related to Function	11	(20)
Introduction	12	(1)
The upper airways	12	(3)
The intrathoracic airways	15	(4)
Blood vessels	19	(1)
Pulmonary hypertension	19	(1)
The lymphatics	19	(1)
The nerves	20	(1)
Gross structure of the respiratory system	21	(1)
Pleurisy	21	(1)
The diaphragm and chest wall	22	(1)
How breathing is brought about	22	(2)
Embryology	24	(1)
Air-conditioning	25	(3)
Metabolic activity	28	(1)
Metabolism of circulating biologically active substances	28	(1)
Non-respiratory functions	29	(1)
Self-assessment case study: cafe coronary	30	(1)
Self-assessment questions	30	(1)
Elastic Properties of the Respiratory System	31	(14)
Introduction	32	(1)
Intrapleural pressure (Ppl)	32	(1)
Static lung compliance (CL)	33	(1)
The effect of disease	34	(1)
The physical basis of lung compliance	34	(9)
Self-assessment case study: acute respiratory distress system (ARDS)	43	(1)
Self-assessment questions	44	(1)
Airflow in the Respiratory System	45	(20)
Introduction	46	(1)
How airflow is brought about	46	(1)
The nature of airflow	47	(1)
The major determinant of flow -- radius	47	(1)
Airways disease and obstructive pulmonary disease	47	(2)
The clinical situation	49	(1)
Sites of airways resistance	50	(1)
Asthma and airways smooth muscle	51	(2)
Bronchomotor tone	53	(1)
Pharmacological treatment of asthma	54	(1)
Clinical definitions	55	(1)
Bronchitis and mucus	55	(2)
Emphysema and radial traction	57	(1)
Intrapleural pressure and cough	58	(4)
Work of breathing	62	(2)
Self-assessment case study: bronchocarcinoma	64	(1)
Self-assessment questions	64	(1)
Ventilation of the Respiratory System: The Importance of Its Lack of Uniformity in Disease	65	(18)
Introduction	66	(2)
Spirometric abnormalities in disease	68	(1)
Uneven distribution	68	(1)
Dead space	68	(2)
Alveolar dead space in disease	70	(1)
The Bohr equation	70	(1)
Factors affecting physiological dead space	71	(1)
Alveolar ventilation and respiratory exchange	71	(2)
The alveolar gas equation	73	(1)
Distribution of inspired gas	73	(4)
Other factors affecting distribution	77	(3)
Self-assessment case study: flail chest	80	(1)
Self-assessment questions	81	(2)
Gas Exchange Between Air and Blood: Diffusion	83	(10)
The path from air to tissue	84	(1)
Lung disease and diffusion	85	(1)
Fick's Law of Diffusion	85	(2)
Measuring transfer factor	87	(2)
Treating diffusion difficulties	89	(1)
Carbon dioxide and other gases	90	(1)
Self-assessment case study: pulmonary oedema	91	(1)
Self-assessment questions	91	(2)
The Pulmonary Circulation: Bringing Blood and Gas Together	93	(16)
The functions of the pulmonary circulation	94	(1)
The anatomy of the pulmonary circulation	94	(3)
Matching ventilation and perfusion	97	(1)
Distribution of blood through the lungs	97	(6)
Regional differences in ventilation in the lungs	103	(1)
Ventilation/perfusion matching and its effect on blood O2 and CO2 content	104	(3)
Shunt	107	(1)
Self-assessment case study: chronic obstructive pulmonary disease (COPD)	108	(1)
Self-assessment questions	108	(1)
Carriage of Gases by the Blood and Acid/Base Balance	109	(22)
Introduction	110	(1)
Oxygen transport	110	(9)
Dissolved oxygen: do we really need Hb and why keep it in red cells?	119	(1)
Carbon dioxide transport	120	(2)
Acid-base balance	122	(8)
Self-assessment case study: anaemia	130	(1)
Self-assessment questions	130	(1)
Chemical Control of Breathing	131	(10)
Introduction	132	(1)
Oxygen lack	132	(5)
Carbon dioxide excess	137	(3)
Self-assessment case study: altitude sickness	140	(1)
Self-assessment questions	140	(1)
Nervous Control of Breathing	141	(16)
Introduction	142	(1)
The rhythm generator	142	(2)
Pattern of breathing in COPD	144	(1)
The respiratory `centres'	145	(1)
The medullary groups	146	(1)
Conscious control of breathing	147	(1)
Respiratory muscle innervation	148	(1)
Neuromuscular disorders	149	(1)
Vagal reflexes	150	(3)
Dyspnoea	153	(1)
Other reflexes	153	(2)
Self-assessment case study: opioid induced respiratory depression	155	(1)
Self-assessment questions	155	(2)
Lung Function Tests -- Measuring Disability	157	(10)
Introduction	158	(1)
Spirometry	158	(1)
Flow measurements	159	(1)
Plethysmography	160	(1)
Lung mechanics	160	(1)
Transfer factor (diffusing capacity)	161	(1)
Blood gases	162	(1)
Gas washouts	163	(2)
Exercise testing	165	(1)
Challenge tests	166	(1)
Self-assessment questions	166	(1)
Appendix: some basic science	167	(6)
Answers	173	(8)
Glossary	181	(6)
Index	187