
Applied Respiratory Physiology
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Applied Respiratory Physiology, Third Edition focuses on the applications of respiratory physiology and is designed to bridge the gap between applied respiratory physiology and the treatment of patients. This book is divided into two parts; the first of which is confined to general principles and the second deals with the various applied situations. This text is comprised of 29 chapters. After giving a general introduction to human respiratory physiology, including the functional anatomy of the respiratory tract, this book turns to the topic of the elastic resistance afforded by lungs and chest wall, along with its effect on the resting end-expiratory lung volume or functional residual capacity. The role of anesthesia in the control of breathing and the relative distribution of ventilation and perfusion are then examined. The section on artificial ventilation covers the techniques of ventilation and extracorporeal gas exchange. The reader is also introduced to special forms of lung pathology that have a major effect on lung function, including the adult respiratory distress syndrome, pulmonary oedema, embolus, and collapse. Sleep, smoking, diving, and drowning are also examined in this book. In addition, this text provides substantial coverage of exercise, high altitude, children, and neonates. This book will be of interest to clinicians and practitioners of applied respiratory physiology.
Table of Contents
Foreword to the First Edition
Preface to the First Edition
Preface to the Third Edition
Part I Basic Principles
1 Functional Anatomy of the Respiratory Tract
Mouth and Pharynx
The Larynx
The Trachobronchial Tree
The Alveoli
The Pulmonary Vasculature
2 Elastic Forces and Lung Volumes
Elastic Recoil of the Lungs
Elastic Recoil of the Thoracic Cage
Pressure/Volume Relationships of the Lung plus Thoracic Cage
Lung Volumes
Principles of Measurement of Compliance
Principles of Measurement of Lung Volumes
3 Resistance to Gas Flow and Airway Closure
Laminar Flow
Turbulent Flow
Threshold Resistors
Minor Sources of Resistance to Gas Flow
Increased Airway Resistance
Causes of Increased Airway Resistance
Compensation for Increased Resistance to Breathing
Principles of Measurement of Flow Resistance
4 Control of Breathing
The origin of the Respiratory Rhythm
Motor Pathways Concerned in Breathing
Chemical Control of Breathing
Reflex Control of Breathing
Breath Holding
Ventilatory Response to Loaded Breathing
Outline of Methods of Assessment of Factors in Control of Breathing
5 Pulmonary Ventilation
Mechanisms of Breathing
The Work of Breathing
The Minute Volume of Pulmonary Ventilation
Measurement of Ventilation
Measurement of Ventilatory Capacity
6 The Pulmonary Circulation
Pulmonary Blood Volume
Pulmonary Vascular Pressures
Pulmonary Blood Flow
Pulmonary Vascular Resistance
Principles of Measurement of the Pulmonary Circulation
7 Distribution of Pulmonary Ventilation and Perfusion
Distribution of Ventilation
Distribution of Perfusion
Ventilation in Relation to Perfusion
Dead Space
The Concept of Venous Admixture
Principles of Assessment of Distribution of Ventilation and Pulmonary Blood Flow
8 Diffusion and Alveolar/Capillary Permeability
Fundamentals of the Diffusion Process
Diffusion of Oxygen within the Lungs
Diffusion of Carbon Monoxide within the Lungs
Diffusion of Carbon Dioxide within the Lungs
Diffusion of 'Inert' Gases within the Lungs
Diffusion of Gases in the Tissues
Alveolar/Capillary Permeability
Principles of Methods of Measurement of Carbon Monoxide Diffusing Capacity
9 Carbon Dioxide
Carriage of Carbon Dioxide in Blood
Transfer of Carbon Dioxide Across Cell Membranes
Factors Influencing the Carbon Dioxide Tension in the Steady State
Causes of Hypocapnia (Respiratory Alkalosis)
Causes of Hypercapnia (Respiratory Acidosis)
Carbon Dioxide Stores and the Unsteady State
Apnoeic Mass-Movement Oxygenation (Formerly Known as Diffusion Respiration)
Therapeutic Uses of Carbon Dioxide
Outline of Methods of Measurement of Carbon Dioxide
10 Oxygen
The Role of Oxygen in the Cell
The Oxygen Cascade
The Carriage of Oxygen in the Blood
The 'Normal' Arterial Oxygen Tension
Oxygen Stores and the Steady State
Control of the Inspired Oxygen Concentration
Cyanosis
Principles of Measurement of Oxygen Levels
11 Non-Respiratory Functions of the Lung
Filtration
Oxidative Metabolism of the Lung
Protease Transport System
Synthesis of Surfactant
Processing of Hormones and Other Vasoactive Compounds
Handling of Foreign Substances by the Lungs
Conclusion
Part II The Applications
12 Respiratory Aspects of Exercise
Levels of Exercise
Oxygen Consumption
Anaerobic Metabolism
Response of the Oxygen Delivery System
Control of Ventilation
13 Respiratory Aspects of Sleep
Normal Sleep
The Sleep Apnoea Syndrome
The Postoperative Period
Relationship to Sudden Infant Death Syndrome (SIDS)
14 Respiratory Aspects of High Altitude
Acute Exposure to Altitude
Acute Mountain Sickness
Adaptation to Altitude
Exercise at High Altitude
15 Respiratory Aspects of High Pressure and Diving
Exchange of Oxygen and Carbon Dioxide
Effects Attributable to the Composition of the Inspired Gas
Special Circumstances of Exposure to Pressure
Avoidance of Exposure of Man to Pressure
16 Drowning
Drowning without Aspiration
Aspiration of Fresh Water
Sea Water Drowning
Other Material Contaminating the Lungs
Tests of Drowning
The Role of Hypothermia
Principles of Treatment of Near-Drowning
17 Smoking
Smoking and Lung Function
Constituents of Tobacco Smoke
Individual Smoke Exposure
Respiratory Effects of Smoking
18 Respiration in Neonates and Children
The Lungs Before Birth
Events at Birth
Neonatal Lung Function
Development of Lung Function during Childhood
Respiratory Distress Syndrome
Artificial Ventilation of the Neonate and Young Child
19 Respiratory Aspects of Anesthesia
Control of Breathing
Pattern of Contraction of Respiratory Muscles
Changes in Lung and Trunk Volumes
Consequences of the Change in FRC
Metabolic Rate
Gas Exchange
Minute Volume of Ventilation
The Three-Compartment Model of Gas Exchange
Effect of Hypoxic Pulmonary Vasoconstriction
Special Conditions Arising during Anaesthesia
20 Ventilatory Failure
Pattern of Changes in Arterial Blood Gas Tensions
Causes of Failure of Ventilation
Relationship between Rentilatory Capacity and Ventilatory Failure
Breathlessness
Treatment of Ventilatory Failure
21 Artificial Ventilation
Methods Used for Resuscitation
Intermittent Positive Pressure Ventilation (IPPV)
Special Techniques for IPPV
Interaction Between Patient and Ventilator
Positive EndEexpiratory Pressure (PEEP)
Negative (Subatmospheric) End-Expiratory Pressure (NEEP)
Weaning
22 Extracorporeal Gas Exchange
Factors in Design
Types of Extracorporeal Gas Exchangers
Damage to Blood
Prolonged Extracorporeal Oxygenation for Respiratory Failure
Extracorporeal Removal of Carbon Dioxide
23 Pulmonary Oedema
Anatomical Factors
Stages of Pulmonary Oedema
The Mechanism of Pulmonary Oedema
Aetiology
Pathophysiology
Physiological Principles of Treatment
Clinical Measurement
24 Pulmonary Collapse and Atelectasis
Loss of Forces Opposing Retraction of the Lung
Absorption of Trapped Gas
The Effect of Collapse
Diagnosis of Pulmonary Collapse
Treatment
25 Pulmonary Embolism
Air Embolism
Thromboembolism
Fat Embolism
26 Adult Respiratory Distress Syndrome
Definition
Clinical Course
Predisposing Conditions and Risk Factors
Incidence and Mortality
Histopathology
Pathophysiology
Mechanisms of Causation of ARDS
Principles of Management
Problems of Research into ARDS
27 The Effects of Changes in the Carbon Dioxide Tension
Effects upon the Nervous System
Effects upon the Respiratory System
Effects upon the Circulatory System
Effect upon the Kidney
Effect on Blood Electrolyte Levels
Effect upon Drug Action
Bedside Recognition of Hypercapnia
28 Hypoxia
Biochemical Changes in Hypoxia
PO2 Levels and Hypoxia
Compensatory Mechanisms in Hypoxia
Organ Survival Times
29 Hyperoxia and Oxygen Toxicity
Hyperoxia
Hyperbaric Oxygenation
Oxygen Toxicity
Clinical Oxygen Toxicity
Other Hazards of Oxygen
Appendix A
Physical Quantities and Units of Measurement
Appendix B
The Gas Laws
Appendix C
Conversion Factors for Gas Volumes
Appendix D
Symbols, Abbreviations and Definitions
Appendix E
Nomograms and Correction Charts
Appendix F
The Exponential Function
The Tear-Away Exponential Function
The Wash-out or Die-Away Exponential Function
The Wash-in Exponential Function
References and Further Reading
Index
Product details
- No. of pages: 600
- Language: English
- Copyright: © Butterworth-Heinemann 1987
- Published: January 1, 1987
- Imprint: Butterworth-Heinemann
- eBook ISBN: 9781483162331
About the Author
J. F. Nunn
Affiliations and Expertise
Formerly Head of Division of Anaesthesia, MRC Clinical Research Centre; Honorary Consultant Anaesthetist, Northwick Park Hospital, UK; Previously Professor of Anaesthesia, University of Leeds; Dean of Faculty of Anaesthetists, 1979 - 1982, Royal College of Surgeons of England, UK
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