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Applied Respiratory Physiology - 3rd Edition - ISBN: 9780407003422, 9781483162331

Applied Respiratory Physiology

3rd Edition

Author: J. F. Nunn
eBook ISBN: 9781483162331
Imprint: Butterworth-Heinemann
Published Date: 1st January 1987
Page Count: 600
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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


Principles of Measurement of Oxygen Levels

11 Non-Respiratory Functions of the Lung


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


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


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)


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



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


25 Pulmonary Embolism

Air Embolism


Fat Embolism

26 Adult Respiratory Distress Syndrome


Clinical Course

Predisposing Conditions and Risk Factors

Incidence and Mortality



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


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



No. of pages:
© Butterworth-Heinemann 1987
1st January 1987
eBook ISBN:

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

Ratings and Reviews