Additional Information
Book Details
Abstract
Nunn’s Applied Respiratory Physiology, Eighth Edition, is your concise, one-stop guide to all aspects of respiratory physiology in health, disease, and in the many physiologically challenging situations and environments into which humans take themselves – with coverage from basic science to clinical applications.
This most comprehensive single volume on respiratory physiology will be invaluable to those in training or preparing for examinations in anaesthesia, intensive care, respiratory medicine or thoracic surgery – as well as an essential quick reference for the range of practitioners requiring ready access to current knowledge in this field.
Now fully revised and updated, this eighth edition includes a new full-colour format to improve clarity and understanding – and it also comes with access to the complete, downloadable eBook version for the first time. This incorporates bonus chapters, handy topic summaries and new, interactive, self-assessment material. The result is a more flexible, engaging and complete resource than ever before.
Enhancements to this edition include:
- New full colour format - enhances the 250+ diagrams and allows a much clearer portrayal of physiological concepts
- New figures reflect modern functional imaging techniques - which are now able to generate detailed pictures of lung ventilation and perfusion in humans
- A new section on the aims, effects and physiological basis of respiratory physiotherapy - to help both physiotherapists and doctors better understand this common intervention for treating patients’ respiratory disease
- Additional information on the significant impact of obesity on respiratory physiology in both health and disease
- New sections on comparative respiratory physiology and respiratory physiology in veterinary practice - understanding respiration in less complex animals and the place of human respiration within the animal kingdom will be of interest to students/practitioners in biology, zoology or veterinary medicine, as well as enlightening in other contexts
- Bonus eBook access – (printed book) includes access to the complete, fully searchable electronic text, via Expert Consult – incoporating extra chapters, handy chapter summaries and new self-assessment material to aid exam preparation
Key features include:
- The three-part structure of pure physiology (basic principles), applied physiology and physiology of respiratory disease is retained
- Use of clear, simple diagrams to illustrate the material.
- Duplication of US and rest-of-the-world units
- References to recent research material to allow readers to explore topics in more depth
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Nunn's Applied Respiratory Physiology | i | ||
| Copyright Page | iv | ||
| Table Of Contents | v | ||
| Foreword | ix | ||
| Preface to the Eighth Edition | xi | ||
| 1 Basic Principles | 1 | ||
| 1 Functional Anatomy of the Respiratory Tract | 3 | ||
| Key Points | 3 | ||
| Mouth, Nose and Pharynx | 3 | ||
| The Larynx | 5 | ||
| Speech | 5 | ||
| Effort Closure | 5 | ||
| The Tracheobronchial Tree | 5 | ||
| Trachea (Generation 0) | 6 | ||
| Main, Lobar and Segmental Bronchi (Generations 1 to 4) | 6 | ||
| Small Bronchi (Generations 5 to 11) | 7 | ||
| Bronchioles (Generations 12 to 14) | 7 | ||
| Respiratory Bronchioles (Generations 15 to 18) | 7 | ||
| Alveolar Ducts (Generations 19 to 22) | 7 | ||
| Alveolar Sacs (Generation 23) | 9 | ||
| Pulmonary Acinus | 9 | ||
| Respiratory Epithelium | 9 | ||
| Ciliated Epithelial Cells10 | 9 | ||
| Goblet Cells11 | 10 | ||
| Submucosal Secretory Cells | 10 | ||
| Basal Cells | 10 | ||
| Mast Cells | 10 | ||
| Nonciliated Bronchiolar Epithelial (Clara) Cells | 10 | ||
| Neuroepithelial Cells | 10 | ||
| The Alveoli | 10 | ||
| The Alveolar Septa | 10 | ||
| The Fibre Scaffold | 11 | ||
| Alveolar Cell Types | 13 | ||
| Capillary Endothelial Cells | 13 | ||
| Alveolar Epithelial Cells: Type I | 13 | ||
| Alveolar Epithelial Cells: Type II | 13 | ||
| Alveolar Macrophages | 13 | ||
| The Pulmonary Vasculature | 14 | ||
| Pulmonary Arteries | 14 | ||
| Pulmonary Arterioles | 14 | ||
| Pulmonary Capillaries | 14 | ||
| Pulmonary Venules and Veins | 15 | ||
| Bronchial Circulation | 15 | ||
| Pulmonary Lymphatics | 15 | ||
| References | 15 | ||
| Chapter 1 Functional Anatomy of the Respiratory Tract | 16.e1 | ||
| 2 Elastic Forces and Lung Volumes | 17 | ||
| Key Points | 17 | ||
| Elastic Recoil of the Lungs | 17 | ||
| The Nature of the Forces Causing Recoil of the Lung | 18 | ||
| The Alveolar Surfactant | 18 | ||
| Synthesis of Surfactant | 19 | ||
| Action of Surfactant | 20 | ||
| Other Effects of Surfactant | 20 | ||
| Alternative Models to Explain Lung Recoil | 20 | ||
| Transmural Pressure Gradient and Intrathoracic Pressure | 21 | ||
| Time Dependence of Pulmonary Elastic Behaviour | 22 | ||
| Hysteresis | 23 | ||
| Causes of Time Dependence of Pulmonary Elastic Behaviour | 24 | ||
| Factors Affecting Lung Compliance | 25 | ||
| Elastic Recoil of the Thoracic Cage | 25 | ||
| Factors Influencing Compliance of the Thoracic Cage | 26 | ||
| Pressure/Volume Relationships of the Lung Plus Thoracic Cage | 26 | ||
| Relationship between Alveolar, Intrathoracic and Ambient Pressures | 26 | ||
| Static Lung Volumes | 26 | ||
| Factors Affecting Static Lung Volumes | 27 | ||
| FRC in Relation to Closing Capacity | 29 | ||
| Principles of Measurement of Compliance | 29 | ||
| Static Compliance | 30 | ||
| Dynamic Compliance | 30 | ||
| Automated Measurement of Compliance | 30 | ||
| Principles of Measurement of Lung Volumes | 31 | ||
| Measurement of FRC | 31 | ||
| References | 31 | ||
| Chapter 2 Elastic forces and lung volumes | 32.e1 | ||
| 3 Respiratory System Resistance | 33 | ||
| Key Points | 33 | ||
| Physical Principles of Gas Flow and Resistance | 33 | ||
| Laminar Flow | 33 | ||
| Quantitative Relationships | 33 | ||
| Turbulent Flow | 34 | ||
| Quantitative Relationships | 35 | ||
| Reynolds Number | 35 | ||
| Respiratory System Resistance | 36 | ||
| Airway Resistance | 36 | ||
| Tissue Resistance | 36 | ||
| Inertance as a Component of Respiratory System Resistance | 37 | ||
| Factors Affecting Respiratory Resistance | 37 | ||
| Volume-Related Airway Collapse | 37 | ||
| Effect of Lung Volume on Resistance to Breathing | 37 | ||
| Gas Trapping | 38 | ||
| Closing Capacity | 38 | ||
| Flow-Related Airway Collapse | 38 | ||
| Muscular Control of Airway Diameter | 39 | ||
| Neural Pathways | 39 | ||
| Parasympathetic System | 39 | ||
| Sympathetic System | 40 | ||
| Noncholinergic Parasympathetic Nerves | 40 | ||
| Humoral Control | 41 | ||
| Physical and Chemical Effects | 42 | ||
| Local Cellular Mechanisms | 42 | ||
| Drug Effects on Airway Smooth Muscle | 42 | ||
| β2-Agonists | 42 | ||
| The β2-Receptor | 42 | ||
| Phosphodiesterase Inhibitors | 43 | ||
| Anticholinergic Drugs | 44 | ||
| Acetylcholine Receptor | 44 | ||
| Leukotriene Antagonists | 44 | ||
| Compensation for Increased Resistance to Breathing | 45 | ||
| Inspiratory Resistance | 45 | ||
| Expiratory Resistance | 45 | ||
| Principles of Measurement of Respiratory Resistance and Closing Capacity | 45 | ||
| Respiratory System Resistance | 45 | ||
| Pressure–Flow Technique | 46 | ||
| Oscillating Air Flow | 46 | ||
| Body Plethysmograph | 46 | ||
| Interrupter Technique | 47 | ||
| End-Inspiratory Interruption | 47 | ||
| Measurement of Closing Capacity | 48 | ||
| References | 49 | ||
| Chapter 3 Respiratory system resistance | 50.e1 | ||
| 4 Control of Breathing | 51 | ||
| Key Points | 51 | ||
| The Origin of the Respiratory Rhythm | 51 | ||
| Anatomical Location of the ‘Respiratory Centre’ | 51 | ||
| Central Pattern Generator | 52 | ||
| Cellular Mechanisms of Central Pattern Generation | 53 | ||
| Neurotransmitters Involved in Central Pattern Generator and Respiratory Control | 54 | ||
| Efferent Pathways from the Respiratory Centre | 54 | ||
| Central Nervous System Connections to the Respiratory Centre | 55 | ||
| The Pons | 55 | ||
| Cerebral Cortex | 55 | ||
| Ondine’s Curse (Primary Alveolar Hypoventilation Syndrome) | 55 | ||
| Peripheral Input to the Respiratory Centre and Nonchemical Reflexes | 56 | ||
| Reflexes Arising from the Upper Respiratory Tract | 56 | ||
| Nose | 56 | ||
| Pharynx | 56 | ||
| Larynx | 56 | ||
| Cough Reflex | 56 | ||
| Expiration Reflex | 56 | ||
| Reflexes Arising in the Lung | 57 | ||
| Pulmonary Stretch Receptors and Their Associated Reflexes | 57 | ||
| Head’s Paradoxical Reflex | 58 | ||
| Other Pulmonary Afferents | 58 | ||
| Reflexes Arising from Outside the Airway and Lungs | 58 | ||
| Phrenic Nerve Afferents | 58 | ||
| Baroreceptor Reflexes | 58 | ||
| Afferents from the Musculoskeletal System | 58 | ||
| The Influence of Carbon Dioxide on Respiratory Control | 58 | ||
| Localisation of the Central Chemoreceptors | 59 | ||
| Mechanism of Action | 59 | ||
| Compensatory Bicarbonate Shift in the CSF | 59 | ||
| The Pco2/Ventilation Response Curve | 59 | ||
| Time Course of Pco2/Ventilation Response | 60 | ||
| The Influence of Oxygen on Respiratory Control | 61 | ||
| Peripheral Chemoreceptors | 61 | ||
| Histology | 61 | ||
| Decrease of arterial Po2 | 61 | ||
| Decrease of arterial pH | 61 | ||
| Hypoperfusion of the CBs | 61 | ||
| Blood temperature elevation | 61 | ||
| Blood glucose | 61 | ||
| Mechanism of Action of Peripheral Chemoreceptors | 61 | ||
| Other Effects of Stimulation | 62 | ||
| Time Course of the Ventilatory Response to Sustained Hypoxia | 62 | ||
| Acute Hypoxic Response | 62 | ||
| Hypoxic Ventilatory Decline | 63 | ||
| Ventilatory Response to Sustained Hypoxia | 63 | ||
| Ventilatory Response to Progressive Hypoxia | 63 | ||
| Iatrogenic Loss of Peripheral Chemoreceptor Sensitivity | 64 | ||
| Central Hypoxic Depression of Breathing | 65 | ||
| Mechanisms of Hypoxic Depression of Ventilation | 65 | ||
| Integration of the Chemical Control of Breathing | 65 | ||
| Effects of Pco2 and pH on the Hypoxic Ventilatory Response | 65 | ||
| Effects of Pao2 and pH on Central Chemoreceptor Response | 65 | ||
| Periodic Breathing | 66 | ||
| Breath Holding | 66 | ||
| Influence of Pco2 and Po2 | 66 | ||
| Effect of Lung Volume | 66 | ||
| Drug Effects on the Control of Breathing | 67 | ||
| Respiratory Depressants | 67 | ||
| Opioids | 68 | ||
| Benzodiazepines | 68 | ||
| Respiratory Stimulants | 68 | ||
| Methods for Assessment of Breathing Control | 69 | ||
| Sensitivity to Carbon Dioxide | 69 | ||
| 2 Applied Physiology | 215 | ||
| 12 Pregnancy, Neonates and Children | 217 | ||
| Key Points | 217 | ||
| Respiratory Function in Pregnancy | 217 | ||
| The Lungs before Birth | 218 | ||
| Embryology | 218 | ||
| Lung Liquid | 219 | ||
| Lung Development and Lung Function Later in Life | 219 | ||
| Foetal Circulation | 219 | ||
| Events at Birth | 220 | ||
| Factors in the Initiation of Breathing | 221 | ||
| Fate of the Foetal Lung Liquid | 221 | ||
| Changes in the Circulation | 221 | ||
| Mechanism of Reduced Pulmonary Vascular Resistance at Birth | 221 | ||
| Persistent Pulmonary Hypertension of the Newborn | 221 | ||
| Neonatal Lung Function | 222 | ||
| Mechanics of Breathing | 222 | ||
| Ventilation and Gas Exchange | 222 | ||
| Control of Breathing | 222 | ||
| Haemoglobin | 223 | ||
| Premature Birth and the Lungs | 223 | ||
| Respiratory Distress Syndrome | 223 | ||
| Bronchopulmonary Dysplasia | 223 | ||
| Sudden Infant Death Syndrome | 224 | ||
| Development of Lung Function During Childhood | 224 | ||
| References | 225 | ||
| Chapter 12 Pregnancy, neonates and children | 226.e1 | ||
| 13 Exercise | 227 | ||
| Key Points | 227 | ||
| Oxygen Consumption during Exercise | 227 | ||
| Time Course of the Increase in Oxygen Consumption | 227 | ||
| Maximal Oxygen Uptake | 228 | ||
| Response of the Oxygen Delivery System | 229 | ||
| Oxygen Delivery | 229 | ||
| Oxygen Extraction | 229 | ||
| Anaerobic Metabolism | 229 | ||
| Oxygen Debt | 230 | ||
| Excess Postexercise Oxygen Consumption | 230 | ||
| Ventilatory Response to Exercise | 230 | ||
| Time Course | 230 | ||
| Ventilation Equivalent for Oxygen | 231 | ||
| Minute Volume and Dyspnoea | 231 | ||
| Control of Ventilation | 231 | ||
| Neural Factors | 232 | ||
| Arterial Blood Gas Partial Pressures and the Chemoreceptors | 232 | ||
| Humoral Mechanisms | 232 | ||
| Fitness and Training | 232 | ||
| Minute Volume of Ventilation | 233 | ||
| Ventilation Equivalent for Oxygen | 233 | ||
| Exercise-Induced Arterial Hypoxaemia | 233 | ||
| Cardiorespiratory Disease | 233 | ||
| Exercise Testing | 233 | ||
| References | 234 | ||
| Chapter 13 Exercise | 234.e1 | ||
| 14 Sleep | 235 | ||
| Key Points | 235 | ||
| Normal Sleep | 235 | ||
| Respiratory Changes | 235 | ||
| Ventilation | 235 | ||
| Chemosensitivity | 236 | ||
| Effect of Age | 236 | ||
| Pharyngeal Airway Resistance | 236 | ||
| Snoring | 237 | ||
| Sleep-Disordered Breathing | 237 | ||
| The Mechanism of Airway Obstruction | 239 | ||
| Anatomical Factors | 239 | ||
| Respiratory Control and Arousal in SAHS | 239 | ||
| Drug Effects in SAHS | 241 | ||
| Effects of SAHS | 241 | ||
| Principles of Therapy | 241 | ||
| Conservative Treatment | 241 | ||
| Surgical Relief of Obstruction | 242 | ||
| Upper Airway Stimulation | 242 | ||
| References | 242 | ||
| Chapter 14 Sleep | 243.e1 | ||
| 15 High Altitude and Flying | 245 | ||
| Key Points | 245 | ||
| Equivalent Oxygen Concentration | 245 | ||
| Respiratory System Responses to Altitude | 245 | ||
| Physiological Effects of Exposure to Altitude | 247 | ||
| Ventilatory Changes | 247 | ||
| Signs and Symptoms | 247 | ||
| Acclimatization to Altitude | 247 | ||
| Ventilatory Control | 247 | ||
| Blood Gas Partial Pressures | 249 | ||
| Haemoglobin Concentration and Oxygen Affinity | 249 | ||
| Adaptation to Altitude | 250 | ||
| Chronic Mountain Sickness (Monge Disease) | 251 | ||
| Exercise at High Altitude | 251 | ||
| Capacity for Work Performed | 251 | ||
| Ventilation Equivalent of Oxygen Consumption | 251 | ||
| Pco2 and Po2 | 251 | ||
| Altitude Illness | 252 | ||
| Acute Mountain Sickness | 252 | ||
| High-Altitude Pulmonary Oedema | 253 | ||
| Other Medical Problems at Altitude | 253 | ||
| Therapy for Altitude-Induced Illness | 254 | ||
| Flying | 254 | ||
| Altitude Exposure | 254 | ||
| Depressurization | 255 | ||
| Air Travel in Patients with Respiratory Disease | 255 | ||
| Cabin Air Quality | 255 | ||
| References | 256 | ||
| Chapter 15 High altitude and flying | 258.e1 | ||
| 16 High Pressure and Diving | 259 | ||
| Key Points | 259 | ||
| Exchange of Oxygen and Carbon Dioxide | 259 | ||
| Effect of Pressure on Alveolar Pco2 and Po2 | 259 | ||
| Effect on Mechanics of Breathing | 261 | ||
| Effect on Efficiency of Gas Exchange | 261 | ||
| Oxygen Consumption | 262 | ||
| Exercise | 262 | ||
| Effects Attributable to the Composition of the Inspired Gas | 262 | ||
| Air | 262 | ||
| Oxygen | 262 | ||
| Nitrogen | 262 | ||
| Helium/Oxygen Mixtures (Heliox) | 262 | ||
| Helium/Oxygen/Nitrogen Mixtures (Trimix) | 263 | ||
| Types of Diving Activity and Their Respiratory Effects | 263 | ||
| Breath-Hold Diving | 263 | ||
| Lung Volume | 263 | ||
| Alveolar Po2 | 263 | ||
| Alveolar Pco2 | 263 | ||
| Limited Duration Dives | 264 | ||
| Saturation Dives | 264 | ||
| Respiratory Aspects of Decompression Illness | 264 | ||
| Barotrauma | 265 | ||
| Decompression Sickness | 265 | ||
| Altitude Decompression Sickness | 265 | ||
| References | 266 | ||
| Chapter 16 High Pressure and Diving | 266.e1 | ||
| 17 Respiration in Closed Environments and Space | 267 | ||
| Key Points | 267 | ||
| Closed-System Anaesthesia | 267 | ||
| Accumulation of Other Gases in Closed Circuits | 267 | ||
| Submarines | 268 | ||
| Diesel Powered | 268 | ||
| Nuclear Powered | 268 | ||
| Atmosphere Regeneration | 268 | ||
| Physiological Effects of Prolonged Hypercapnia | 269 | ||
| Respiratory Changes | 269 | ||
| Calcium Metabolism | 269 | ||
| Space | 269 | ||
| Atmosphere Composition | 269 | ||
| Oxygen Supply | 270 | ||
| Carbon Dioxide Removal | 271 | ||
| Atmospheric Contamination | 271 | ||
| Long-Term Space Travel | 271 | ||
| Microgravity | 272 | ||
| Lung Volumes | 272 | ||
| Topographic Inequality of Ventilation and Perfusion | 273 | ||
| Other Changes to Respiratory Physiology in Microgravity | 273 | ||
| Biospheres | 273 | ||
| Small-Scale Biological Atmospheric Regeneration | 273 | ||
| Biosphere 2 | 274 | ||
| Outcome from the 2-Year Closure | 274 | ||
| References | 275 | ||
| Chapter 17 Respiration in Closed Environments and Space | 275.e1 | ||
| 18 Drowning | 277 | ||
| Key Points | 277 | ||
| Physiology of Immersion | 277 | ||
| Physiological Mechanisms of Drowning | 277 | ||
| Drowning without Aspiration of Water | 278 | ||
| Drowning with Aspiration of Water | 278 | ||
| Freshwater | 278 | ||
| Seawater | 278 | ||
| Postmortem Tests of Drowning | 278 | ||
| The Role of Hypothermia | 278 | ||
| Principles of Therapy for Near-Drowning | 279 | ||
| Immediate Treatment | 279 | ||
| Hospital Treatment | 279 | ||
| References | 280 | ||
| Chapter 18 Drowning | 280.e1 | ||
| 19 Smoking and Air Pollution | 281 | ||
| Key Points | 281 | ||
| Tobacco Smoke | 281 | ||
| Constituents of Tobacco Smoke | 281 | ||
| Gaseous Phase | 281 | ||
| Particulate Phase | 282 | ||
| Individual Smoke Exposure | 282 | ||
| Quantity of Cigarettes Smoked | 282 | ||
| Pattern of Inhalation | 282 | ||
| e-Cigarettes | 282 | ||
| Respiratory Effects of Smoking | 282 | ||
| Airway Mucosa | 283 | ||
| Airway Diameter | 283 | ||
| Ventilatory Capacity | 283 | ||
| Passive Smoking | 283 | ||
| Maternal Smoking | 283 | ||
| Smoking and Perioperative Complications | 284 | ||
| Mechanisms of Smoking-Related Lung Damage | 285 | ||
| Oxidative Injury | 285 | ||
| Direct Oxidative Damage | 285 | ||
| Cell-Mediated Oxidative Damage | 285 | ||
| Carcinogenesis | 285 | ||
| Immunological Activation | 285 | ||
| Air Pollution | 286 | ||
| Sources of Pollutants | 286 | ||
| Respiratory Effects of Pollutants | 286 | ||
| Indoor Air Pollution | 288 | ||
| Allergens | 288 | ||
| Carbon Monoxide | 288 | ||
| Nitrogen Dioxide | 288 | ||
| References | 288 | ||
| Chapter 19 Smoking and air pollution | 290.e1 | ||
| 20 Anaesthesia | 291 | ||
| Key Points | 291 | ||
| Control of Breathing | 291 | ||
| Unstimulated Ventilation | 291 | ||
| Effect on Pco2/Ventilation Response Curve | 292 | ||
| Effect on Po2/Ventilation Response Curve | 293 | ||
| Implications of the Depression of Acute Hypoxic Ventilatory Response by Anaesthetic Agents | 294 | ||
| Pattern of Contraction of Respiratory Muscles | 294 | ||
| Pharynx | 295 | ||
| Maintenance of Pharyngeal Airway Patency | 296 | ||
| Inspiratory Muscles | 296 | ||
| Expiratory Muscles | 296 | ||
| Change in Functional Residual Capacity | 296 | ||
| Cause of the Reduction in FRC | 297 | ||
| Atelectasis During Anaesthesia | 297 | ||
| Causes of Atelectasis | 298 | ||
| Prevention of Atelectasis | 299 | ||
| Inspired Oxygen Concentration | 299 | ||
| Nitrous Oxide | 300 | ||
| Positive Airway Pressures | 300 | ||
| Reexpansion of Atelectasis | 300 | ||
| Continuous Positive Airway Pressure Manoeuvres | 300 | ||
| Positive End-Expiratory Pressure | 301 | ||
| Respiratory Mechanics | 301 | ||
| Calibre of the Lower Airways | 301 | ||
| Effect of Reduced FRC | 301 | ||
| Inhalational Anaesthetics | 302 | ||
| Other Sites of Increased Airway Resistance | 303 | ||
| Compliance | 303 | ||
| Gas Exchange | 305 | ||
| Dead Space | 305 | ||
| Shunt | 306 | ||
| Magnitude of the Change during Anaesthesia | 306 | ||
| Cause of Venous Admixture during Anaesthesia | 306 | ||
| Ventilation/Perfusion Relationships | 307 | ||
| Effect of Age on Ratios during Anaesthesia | 307 | ||
| Effect of Positive End-Expiratory Pressure | 307 | ||
| Other Factors Affecting Ratio during Anaesthesia | 308 | ||
| Summary | 308 | ||
| Artificial Ventilation during General Anaesthesia | 309 | ||
| Other Effects of General Anaesthesia on the Respiratory System | 310 | ||
| Response to Added Resistance | 310 | ||
| Hypoxic Pulmonary Vasoconstriction | 311 | ||
| Special Conditions Arising during Anaesthesia | 311 | ||
| Obesity | 311 | ||
| Patient Position | 311 | ||
| Lateral | 311 | ||
| Prone | 311 | ||
| Laparoscopic Surgery | 312 | ||
| Respiratory Mechanics | 312 | ||
| Carbon Dioxide Absorption | 312 | ||
| Regional Anaesthesia | 312 | ||
| Control of Breathing | 313 | ||
| Respiratory Function in the Postoperative Period | 313 | ||
| Early Postanaesthetic Recovery | 313 | ||
| Late Postoperative Respiratory Changes | 313 | ||
| References | 314 | ||
| Chapter 20 Anaesthesia | 318.e1 | ||
| 21 Changes in the Carbon Dioxide Partial Pressure | 319 | ||
| Key Points | 319 | ||
| Causes of Hypocapnia | 319 | ||
| Causes of Hypercapnia | 320 | ||
| Effects of Carbon Dioxide on the Nervous System | 320 | ||
| Effects on Consciousness | 320 | ||
| Cerebral Blood Flow | 321 | ||
| Mechanisms | 321 | ||
| Anaesthesia | 321 | ||
| Effects on the Autonomic and Endocrine Systems | 322 | ||
| Effects on Other Physiological Systems | 322 | ||
| Respiratory System | 322 | ||
| Pulmonary Circulation | 322 | ||
| Oxygenation of the Blood | 322 | ||
| Cardiovascular System | 323 | ||
| Myocardial Contractility and Heart Rate | 323 | ||
| Arrhythmias | 323 | ||
| Blood Pressure | 323 | ||
| Effect on the Kidney | 323 | ||
| Effect on Blood Electrolyte Levels | 323 | ||
| Hypercapnia in Clinical Practice | 324 | ||
| Clinical Signs | 324 | ||
| Gross Hypercapnia | 324 | ||
| References | 324 | ||
| Chapter 21 Changes in the carbon dioxide partial pressure | 325.e1 | ||
| 22 Hypoxia | 327 | ||
| Key Points | 327 | ||
| Biochemical Changes in Hypoxia | 327 | ||
| Depletion of High-Energy Compounds | 327 | ||
| End Products of Metabolism | 327 | ||
| Initiation of Glycolysis | 328 | ||
| Mechanisms of Hypoxic Cell Damage | 328 | ||
| Immediate Cellular Responses to Hypoxia | 329 | ||
| Potassium and Sodium Flux | 329 | ||
| Calcium | 329 | ||
| Excitatory Amino Acid Release | 329 | ||
| Delayed Cellular Responses to Hypoxia | 330 | ||
| Hypoxia-Inducible Factor 1 | 330 | ||
| Ischaemic Preconditioning | 330 | ||
| Early Protection | 330 | ||
| Late Protection | 331 | ||
| Remote Ischaemic Preconditioning | 331 | ||
| Agents Used for Preconditioning | 331 | ||
| Po2 Levels at Which Hypoxia Occurs | 331 | ||
| Cellular Po2 | 331 | ||
| Critical Arterial Po2 for Cerebral Function | 331 | ||
| Effects of Hypoxia | 332 | ||
| References | 334 | ||
| Chapter 22 Hypoxia | 334.e1 | ||
| 23 Anaemia | 335 | ||
| Key Points | 335 | ||
| Pulmonary Function | 335 | ||
| Gas Exchange | 335 | ||
| Haemoglobin Dissociation Curve | 335 | ||
| Arterial Oxygen Content | 336 | ||
| Oxygen Delivery | 336 | ||
| Effect of Anaemia on Cardiac Output | 336 | ||
| Acute Anaemia | 336 | ||
| Chronic Anaemia | 337 | ||
| The Influence of Cardiac Output on Oxygen Delivery | 338 | ||
| Relationship between Oxygen Delivery and Consumption | 338 | ||
| Anaemia and Exercise | 338 | ||
| Using Haemoglobin to Enhance Athletic Performance | 339 | ||
| What is the Optimal Haemoglobin Concentration in the Clinical Setting? | 339 | ||
| References | 340 | ||
| Chapter 23 Anaemia | 340.e1 | ||
| 24 Oxygen Toxicity and Hyperoxia | 341 | ||
| Key Points | 341 | ||
| Hyperoxia | 341 | ||
| Oxygen Toxicity | 341 | ||
| The Oxygen Molecule and Reactive Oxygen Species | 341 | ||
| Singlet Oxygen | 342 | ||
| Superoxide Anion | 342 | ||
| Hydroperoxyl Radical | 342 | ||
| Hydrogen Peroxide | 342 | ||
| Three-Stage Reduction of Oxygen | 343 | ||
| Secondary Derivatives of the Products of Dioxygen Reduction | 344 | ||
| Sources of Electrons for the Reduction of Oxygen to Superoxide Anion | 344 | ||
| Mitochondrial Enzyme | 344 | ||
| NADPH Oxidase System | 345 | ||
| Xanthine Oxidoreductase and Reperfusion Injury | 345 | ||
| Ferrous Iron | 345 | ||
| High Po2 | 345 | ||
| Exogenous Compounds | 345 | ||
| Biological Effects of ROS | 346 | ||
| Defences Against Reactive Oxygen Species | 347 | ||
| Antioxidant Enzymes | 347 | ||
| Superoxide Dismutase | 347 | ||
| Endogenous Antioxidants | 348 | ||
| Exogenous Antioxidants | 348 | ||
| Normobaric Hyperoxia | 348 | ||
| Increasing the Inspired Oxygen Concentration | 349 | ||
| Fixed Performance Devices | 349 | ||
| Variable Performance Devices | 350 | ||
| Retinopathy of Prematurity | 350 | ||
| Pulmonary Oxygen Toxicity | 350 | ||
| Symptoms | 351 | ||
| Cellular Changes | 351 | ||
| Limits of Survival | 351 | ||
| Clinical Studies | 351 | ||
| Pulmonary Absorption Collapse | 351 | ||
| Bleomycin Lung Toxicity | 352 | ||
| Hyperoxia in Clinical Practice | 352 | ||
| Therapeutic Use of Normobaric Hyperoxia | 352 | ||
| Oxygen Use in Acute Medicine | 352 | ||
| Hyperbaric Oxygenation | 353 | ||
| Oxygen Convulsions (The Paul Bert Effect) | 353 | ||
| Incidence | 353 | ||
| Therapeutic Hyperbaric Oxygen | 353 | ||
| Clinical Applications of Hyperbaric Oxygenation | 354 | ||
| References | 355 | ||
| Chapter 24 Oxygen Toxicity and Hyperoxia | 356.e1 | ||
| 25 Comparative Respiratory Physiology | 357 | ||
| Key Points | 357 | ||
| Designs of Respiratory System | 357 | ||
| Structural Designs for Gas-Exchange Apparatus | 359 | ||
| Factors Affecting Respiratory System Design | 360 | ||
| Respiratory Medium for Breathing | 360 | ||
| Body Temperature | 361 | ||
| Metabolic Rate | 361 | ||
| Respiratory Systems of Major Phyla | 361 | ||
| Aquatic Respiration | 362 | ||
| Diffusion Respiration in Small Species | 362 | ||
| Echinodermata | 362 | ||
| Mollusca | 362 | ||
| Crustacea | 363 | ||
| Fish | 363 | ||
| Amphibians | 364 | ||
| Air Respiration | 365 | ||
| Annelida | 365 | ||
| Arthropoda | 365 | ||
| Reptiles | 366 | ||
| Mammals | 366 | ||
| Birds | 366 | ||
| Carriage of Gases in Blood | 368 | ||
| Circulation Configurations | 368 | ||
| Fish | 368 | ||
| Amphibians | 368 | ||
| Reptiles | 368 | ||
| Birds and Mammals | 368 | ||
| Oxygen-Carrying Molecules | 369 | ||
| Haemerythrin | 369 | ||
| Haemocyanin | 369 | ||
| Haemoglobin | 369 | ||
| Animals at Physiological Extremes | 369 | ||
| Mammals at Altitude | 369 | ||
| Oxygen Carriage | 369 | ||
| Pulmonary Vasculature | 370 | ||
| Collateral Ventilation | 370 | ||
| Exercising Horses | 370 | ||
| Diving Mammals | 371 | ||
| Pathophysiology of Animal Respiratory Diseases in Veterinary Practice | 372 | ||
| Ruminants | 372 | ||
| Bovine Respiratory Disease (BRD) Complex | 372 | ||
| Acute Interstitial Pneumonia | 372 | ||
| Vena Caval Thrombosis | 372 | ||
| Equine Respiratory Disease | 373 | ||
| References | 374 | ||
| Chapter 25 Comparative Respiratory Physiology | 375.e1 | ||
| 3 Physiology of Pulmonary Disease | 377 | ||
| 26 Ventilatory Failure | 379 | ||
| Key Points | 379 | ||
| Definitions | 379 | ||
| Pattern of Changes in Arterial Blood GASES | 379 | ||
| Time Course of Changes in Blood Gases in Acute Ventilatory Failure | 379 | ||
| Causes of Ventilatory Failure | 380 | ||
| Increased Dead Space | 383 | ||
| Relationship between Ventilatory Capacity and Ventilatory Failure | 383 | ||
| Metabolic Demand and Ventilatory Failure | 383 | ||
| Breathlessness | 384 | ||
| The Origin of the Sensation | 385 | ||
| Treatment of Breathlessness | 385 | ||
| Principles of Therapy for Ventilatory Failure | 385 | ||
| Treatment of Hypoxaemia due to Hypoventilation by Administration of Oxygen | 385 | ||
| Improvement of Alveolar Ventilation | 386 | ||
| References | 386 | ||
| Chapter 26 Ventilatory failure | 387.e1 | ||
| 27 Airways Disease | 389 | ||
| Key Points | 389 | ||
| Asthma | 389 | ||
| Clinical Features | 389 | ||
| Cellular Mechanisms of Asthma | 391 | ||
| Causes of Airway Obstruction in Asthma | 393 | ||
| Airway Smooth Muscle | 393 | ||
| Inflammation | 393 | ||
| Airway Remodelling | 393 | ||
| Aetiology of Asthma | 394 | ||
| Genetics | 394 | ||
| Allergy | 394 | ||
| Infection | 394 | ||
| Hygiene Hypothesis | 394 | ||
| Smoking and Air Pollution | 395 | ||
| Gastric Reflux | 395 | ||
| Obesity | 395 | ||
| Paracetamol (Acetaminophen) | 395 | ||
| Aspirin-Induced Asthma | 395 | ||
| Mechanism of Aspirin Sensitivity | 396 | ||
| Principles of Therapy | 396 | ||
| Chronic Obstructive Pulmonary Disease | 396 | ||
| Aetiology of Chronic Obstructive Pulmonary Disease | 397 | ||
| Emphysema | 397 | ||
| Airway Obstruction | 398 | ||
| Hyperinflation | 398 | ||
| Respiratory Muscles in Chronic Obstructive Pulmonary Disease | 399 | ||
| Obesity and Chronic Obstructive Pulmonary Disease | 399 | ||
| Principles of Therapy | 399 | ||
| Smoking Cessation | 399 | ||
| Medical Treatment | 399 | ||
| Supplemental oxygen | 399 | ||
| Pulmonary Rehabilitation | 399 | ||
| Oxygen Therapy in Chronic Obstructive Pulmonary Disease | 400 | ||
| Cystic Fibrosis | 400 | ||
| Aetiology of CF | 400 | ||
| Biochemical Abnormality | 400 | ||
| Causes of Lung Disease | 401 | ||
| Principles of Therapy | 402 | ||
| Correcting the Abnormal CFTR | 402 | ||
| Assessment of Airway Disease by Exhaled Breath Analysis | 402 | ||
| Exhaled Nitric Oxide | 402 | ||
| Exhaled Breath Condensate | 402 | ||
| References | 403 | ||
| Chapter 27 Airways disease | 405.e1 | ||
| 28 Pulmonary Vascular Disease | 407 | ||
| Key Points | 407 | ||
| Pulmonary Oedema | 407 | ||
| Anatomical Factors | 407 | ||
| Pulmonary Fluid Dynamics | 407 | ||
| Fluid Exchange across the Endothelium | 408 | ||
| Fluid Dynamics within the Interstitial Space | 409 | ||
| Fluid Exchange across the Alveolar Epithelium | 409 | ||
| Stages of Pulmonary Oedema | 409 | ||
| Stage I: Interstitial Pulmonary Oedema | 409 | ||
| Stage II: Crescentic Filling of the Alveoli | 410 | ||
| Stage III: Alveolar Flooding | 410 | ||
| Stage IV: Froth in the Air Passages | 411 | ||
| Aetiology of Pulmonary Oedema | 411 | ||
| Increased Capillary Pressure (Haemodynamic Pulmonary Oedema) | 411 | ||
| Increased Permeability of the Capillary/EG/Alveolar Barrier (Permeability Oedema) | 411 | ||
| Decreased Osmotic Pressure of the Plasma Proteins | 411 | ||
| Other Causes of Pulmonary Oedema | 411 | ||
| Principles of Therapy | 412 | ||
| Haemodynamic Pulmonary Oedema | 412 | ||
| Permeability Pulmonary Oedema | 412 | ||
| Artificial Ventilation and Positive End-Expiratory Pressure | 412 | ||
| Measurement of Extravascular Lung Water | 412 | ||
| Pulmonary Embolism | 412 | ||
| Thromboembolism | 413 | ||
| Diagnosis of Pulmonary Thromboembolus | 413 | ||
| Pathophysiology | 414 | ||
| Principles of Therapy | 415 | ||
| Air Embolism | 415 | ||
| Detection of Air Embolism | 415 | ||
| Pathophysiology of Air Embolus | 415 | ||
| Paradoxical Air Embolism | 415 | ||
| Fat Embolism | 415 | ||
| Amniotic Fluid Embolism | 416 | ||
| Pulmonary Hypertension | 416 | ||
| Secondary Pulmonary Arterial Hypertension | 416 | ||
| Primary Pulmonary Arterial Hypertension | 416 | ||
| Pathophysiology of Vascular Remodelling | 417 | ||
| Treatment | 417 | ||
| Hepatopulmonary Syndrome | 417 | ||
| References | 417 | ||
| Chapter 28 Pulmonary vascular disease | 418.e1 | ||
| 29 Diseases of the Lung Parenchyma and Pleura | 419 | ||
| Key Points | 419 | ||
| Pulmonary Collapse | 419 | ||
| Loss of Forces Opposing Retraction of the Lung | 419 | ||
| Absorption of Trapped Gas | 420 | ||
| The Effect of Respired Gases | 420 | ||
| Magnitude of the Pressure Gradients | 420 | ||
| Effect of Reduced Ventilation/ Perfusion Ratio | 421 | ||
| Diagnosis of Pulmonary Collapse | 421 | ||
| Principles of Therapy | 422 | ||
| Pulmonary Consolidation (Pneumonia) | 422 | ||
| Effects on Gas Exchange | 423 | ||
| Pathophysiology | 423 | ||
| Margination of Neutrophils | 423 | ||
| Interstitial Lung Disease and Pulmonary Fibrosis | 424 | ||
| Causes of Pulmonary Fibrosis | 425 | ||
| Cellular Mechanisms of Pulmonary Fibrosis | 425 | ||
| Principles of Therapy | 426 | ||
| Lung Cancer | 426 | ||
| Epidemiology | 426 | ||
| Tobacco | 426 | ||
| Radon | 427 | ||
| Carcinogenesis of Lung Cancer | 427 | ||
| Radiation | 427 | ||
| Tobacco Smoke Carcinogens | 427 | ||
| Molecular Mechanisms of Carcinogenesis | 427 | ||
| Target Genes for Pulmonary Carcinogenesis | 430 | ||
| Clinical Aspects | 430 | ||
| Pathology | 430 | ||
| Clinical Features | 431 | ||
| Principles of Therapy for Lung Cancer | 431 | ||
| Pleural Disease | 432 | ||
| Physiology of the Pleural Space | 432 | ||
| Pleural Effusion | 433 | ||
| Pneumothorax | 433 | ||
| Tension Pneumothorax | 433 | ||
| Principles of Therapy for Spontaneous Pneumothorax | 434 | ||
| Absorption of Air from the Pleura | 434 | ||
| Empyema | 436 | ||
| References | 436 | ||
| Chapter 29 Diseases of the lung parenchyma and pleura | 437.e1 | ||
| 30 Acute Lung Injury | 439 | ||
| Key Points | 439 | ||
| Clinical Aspects of Acute Lung Injury | 439 | ||
| Definition | 439 | ||
| Scoring Systems | 439 | ||
| Predisposing Conditions and Risk Factors for Acute Lung Injury | 440 | ||
| Pulmonary and Extrapulmonary Acute Lung Injury | 440 | ||
| Incidence and Mortality | 441 | ||
| Clinical Course | 441 | ||
| Pathophysiology | 441 | ||
| Alveolar/Capillary Permeability | 441 | ||
| Maldistribution of Ventilation and Perfusion | 441 | ||
| Lung Mechanics | 442 | ||
| Mechanisms of Acute Lung Injury | 442 | ||
| Histopathology | 442 | ||
| Acute Stage | 442 | ||
| Fibroproliferative Stage | 442 | ||
| Cellular Mechanisms | 443 | ||
| Principles of Therapy | 445 | ||
| Artificial Ventilation in ARDS | 445 | ||
| Tidal Volume | 445 | ||
| Ventilation Mode | 445 | ||
| Positive End-Expiratory Pressure | 445 | ||
| Protective Ventilation Strategy | 446 | ||
| Prone Positioning | 447 | ||
| Alternative Ventilatory Strategies | 447 | ||
| Other Therapeutic Options | 447 | ||
| References | 448 | ||
| Chapter 30 Acute lung injury | 449.e1 | ||
| 31 Respiratory Support and Artificial Ventilation | 451 | ||
| Key Points | 451 | ||
| Respiratory Physiotherapy | 451 | ||
| Physiology of Respiratory Interventions | 451 | ||
| To Increase Lung Volume | 451 | ||
| To Decrease the Work of Breathing | 452 | ||
| To Clear Secretions | 452 | ||
| Noninvasive Ventilation | 452 | ||
| Negative Pressure Ventilation | 452 | ||
| Noninvasive Positive Pressure Ventilation | 453 | ||
| Clinical Applications | 453 | ||
| Intermittent Positive Pressure Ventilation | 454 | ||
| Phases of the Respiratory Cycle | 454 | ||
| Inspiration | 454 | ||
| Expiration | 454 | ||
| Time Course of Inflation and Deflation | 454 | ||
| Effect of Changes in Inflation Pressure, Resistance and Compliance | 455 | ||
| Effect of Changes in Compliance and Resistance | 455 | ||
| Overpressure | 456 | ||
| Deviations from True Exponential Character of Expiration | 457 | ||
| Alternative Patterns of Application of Inflation Pressure | 457 | ||
| Control of Duration of Inspiration | 458 | ||
| The Inspiratory to Expiratory (I : E) Ratio | 459 | ||
| Clinical Use of IPPV | 459 | ||
| Interactions Between Patient and Ventilator | 459 | ||
| Pressure Sensing | 460 | ||
| Flow Sensing | 460 | ||
| Neurally Adjusted Ventilatory Assist | 460 | ||
| Ventilatory Modes in Common Use | 460 | ||
| Mandatory Minute Volume | 460 | ||
| Assist-Control Ventilation | 460 | ||
| Airway Pressure Release Ventilation | 460 | ||
| Synchronized Intermittent Mandatory Ventilation | 462 | ||
| Pressure Support Ventilation | 462 | ||
| High-Frequency Ventilation | 462 | ||
| Weaning | 463 | ||
| Predicting Successful Weaning | 463 | ||
| Techniques for Weaning | 464 | ||
| Positive End-Expiratory Pressure | 464 | ||
| Intrinsic PEEP | 465 | ||
| Physiological Effects of Positive Pressure Ventilation | 465 | ||
| Respiratory Effects | 465 | ||
| Distribution of Ventilation | 465 | ||
| Apparatus Dead Space | 465 | ||
| Physiological Dead Space | 466 | ||
| Lung Volume | 467 | ||
| Arterial Po2 | 467 | ||
| Valsalva Effect | 467 | ||
| Cardiovascular Effects of Positive Pressure Ventilation | 468 | ||
| Cardiac Output | 468 | ||
| Oxygen Delivery | 469 | ||
| Arterial Blood Pressure | 470 | ||
| Interpretation of Vascular Pressures | 470 | ||
| Transmission of Airway Pressure to Other Intrathoracic Structures | 470 | ||
| Haemodynamic Response in Heart Failure | 470 | ||
| Other Physiological Effects | 470 | ||
| Renal Effects | 470 | ||
| Pulmonary Neutrophil Retention | 470 | ||
| Ventilator-Induced Lung Injury | 471 | ||
| Barotrauma | 471 | ||
| Volutrauma | 471 | ||
| Atelectrauma | 471 | ||
| Prevention of VILI | 472 | ||
| PEEP | 472 | ||
| Artificial Ventilation for Resuscitation | 472 | ||
| Expired Air Ventilation | 472 | ||
| Extrapulmonary Gas Exchange | 473 | ||
| Factors in Design | 473 | ||
| Factors Favouring Performance | 473 | ||
| Unfavourable Factors | 473 | ||
| Bubble Oxygenators | 473 | ||
| Membrane Oxygenators | 474 | ||
| Diffusion Properties. | 474 | ||
| Biocompatibility. | 474 | ||
| Damage to Blood | 474 | ||
| Systems for Extrapulmonary Gas Exchange | 475 | ||
| Extracorporeal Membrane Oxygenation | 475 | ||
| Extracorporeal Carbon Dioxide Removal | 475 | ||
| Intravascular Oxygenators | 475 | ||
| Clinical Applications | 476 | ||
| Neonates and Infants | 476 | ||
| Adults | 476 | ||
| References | 476 | ||
| Chapter 31 Respiratory support and artificial ventilation | 478.e1 | ||
| 32 Pulmonary Surgery | 479 | ||
| Key Points | 479 | ||
| Physiological Aspects of Common Interventions | 479 | ||
| Bronchoscopy | 479 | ||
| Flexible Bronchoscopy | 479 | ||
| Rigid Bronchoscopy | 480 | ||
| Thoracoscopy | 480 | ||
| Thoracotomy | 481 | ||
| Lung Resection | 482 | ||
| Assessing Patient Fitness for Lung Resection | 482 | ||
| Partial Lung Resection | 482 | ||
| Pneumonectomy | 482 | ||
| Lung Injury following Pneumonectomy | 483 | ||
| Surgery for Emphysema | 484 | ||
| Pleurodesis | 485 | ||
| One-Lung Ventilation | 485 | ||
| Lung Isolation Techniques | 485 | ||
| Physiology of One-Lung Ventilation | 486 | ||
| Patient Position | 487 | ||
| Open Chest | 487 | ||
| Perfusion of the Nonventilated Lung | 488 | ||
| Management of One-Lung Ventilation | 489 | ||
| Artificial Ventilation during One-Lung Ventilation | 489 | ||
| Management of the Nonventilated Lung | 490 | ||
| Summary of the Clinical Management of One-Lung Ventilation | 490 | ||
| Lung Transplantation | 490 | ||
| Clinical Aspects | 490 | ||
| Indications | 490 | ||
| Types of Transplant | 491 | ||
| Outcome Following Transplant | 492 | ||
| Rejection | 492 | ||
| Physiological Effects of Lung Transplant | 492 | ||
| Denervated Lung | 492 | ||
| Relationships | 493 | ||
| Mucociliary Clearance | 493 | ||
| References | 493 | ||
| Chapter 32 Pulmonary Surgery | 495.e1 | ||
| 33 The Atmosphere | e1 | ||
| Key Points | e1 | ||
| Evolution of the Atmosphere | e1 | ||
| Formation of the Earth and the Prebiotic Atmosphere | e1 | ||
| Significance of Mass of Earth and Distance from Sun | e2 | ||
| Origin of Life and the Development of Photosynthesis | e4 | ||
| Appearance of Oxygen in the Atmosphere | e4 | ||
| Biological Consequences of an Oxidizing Environment | e4 | ||
| Changes in Carbon Dioxide Levels | e5 | ||
| Carbon Dioxide and the Ice Ages | e5 | ||
| Recent Changes in Carbon Dioxide Levels | e6 | ||
| Greenhouse Effect | e7 | ||
| Other Greenhouse Gases | e7 | ||
| Turnover Rates of Atmospheric Gases | e7 | ||
| Oxygen, Ozone and Ultraviolet Screening | e8 | ||
| Evolution and Adaptation | e9 | ||
| References | e9 | ||
| 34 The History of Respiratory Physiology | e10 | ||
| Key Points | e10 | ||
| Ancient Civilizations | e10 | ||
| Egyptian Physiology | e10 | ||
| Medical Papyri | e10 | ||
| Ancient Greece | e11 | ||
| Roman Medicine and Galen (ad 129–199) | e11 | ||
| Galen’s System of Physiology and Anatomy | e11 | ||
| Experiments on Respiration | e12 | ||
| Functions of Breathing | e12 | ||
| Galen’s Legacy | e13 | ||
| After Galen | e13 | ||
| The Renaissance | e13 | ||
| Leonardo da Vinci (1452–1519) | e13 | ||
| da Vinci and the Bronchial Circulation | e14 | ||
| Anatomy in the Renaissance | e15 | ||
| Pulmonary Circulation | e15 | ||
| Experimental Physiology in the Seventeeth Century | e16 | ||
| Discoveries to Assist the Respiratory Physiologists | e16 | ||
| Circulation | e16 | ||
| Atmospheric Pressure | e16 | ||
| The Microscope | e16 | ||
| Oxford Physiologists and the ‘Use of Breathing’ | e17 | ||
| Robert Boyle (1627–1691) | e17 | ||
| Robert Hooke (1635–1702) | e17 | ||
| Richard Lower (1631–1691) | e17 | ||
| John Mayow (1641–1679) | e18 | ||
| Physiology Hibernates | e19 | ||
| Chemistry and Respiration | e19 | ||
| Different Types of Air | e19 | ||
| Phlogiston | e19 | ||
| Fixed Air and Vitiated Air | e19 | ||
| Dephlogisticated Air | e20 | ||
| Fire Air | e20 | ||
| Oxygen | e20 | ||
| Early Development of Current Ideas of Respiratory Physiology | e21 | ||
| Tissue Respiration | e21 | ||
| Blood Gases | e21 | ||
| Partial Pressure | e21 | ||
| Haemoglobin and Its Dissociation Curve | e22 | ||
| Oxygen Secretion Controversy | e23 | ||
| Lung Mechanics | e23 | ||
| Control of Ventilation | e25 | ||
| Chemical Control of Breathing | e25 | ||
| References | e25 | ||
| Appendix A Physical Quantities and Units of Measurement | 497 | ||
| SI Units | 497 | ||
| Volume (Dimensions: L3) | 497 | ||
| Fluid Flow Rate (Dimensions: L3/T or L3.T−1) | 497 | ||
| Force (Dimensions: MLT−2) | 498 | ||
| Pressure (Dimensions: MLT−2/L2 or ML−1T−2) | 498 | ||
| Compliance (Dimensions: M−1L4t2) | 498 | ||
| Resistance to Fluid Flow (Dimensions: ML−4T−1) | 499 | ||
| Work (Dimensions: ML2T−2, Derived From MLT−2 × L or ML−1T−2 × L3) | 499 | ||
| Power (Dimensions: ML2T−2/T or ML2T−3) | 499 | ||
| Reference | 499 | ||
| Appendix B The Gas Laws | 501 | ||
| Appendix C Conversion Factors for Gas Volumes | 503 | ||
| Conversion of Gas Volume—ATPS to BTPS | 503 | ||
| Derivation of Conversion Factors | 503 | ||
| Conversion of Gas Volume—ATPS to STPD | 503 | ||
| Appendix D Symbols and Abbreviations | 505 | ||
| Reference | 505 | ||
| Appendix E Mathematical Functions Relevant to Respiratory Physiology | 507 | ||
| Linear Function | 507 | ||
| Index | 515 | ||
| A | 515 | ||
| B | 519 | ||
| C | 520 | ||
| D | 523 | ||
| E | 524 | ||
| F | 525 | ||
| G | 526 | ||
| H | 527 | ||
| I | 529 | ||
| J | 530 | ||
| K | 530 | ||
| L | 530 | ||
| M | 532 | ||
| N | 532 | ||
| O | 533 | ||
| P | 535 | ||
| R | 538 | ||
| S | 540 | ||
| T | 541 | ||
| U | 542 | ||
| V | 543 | ||
| W | 544 | ||
| X | 544 | ||
| Z | 544 |