Respiratory Physiology: A Clinical Approach

Cover......Page 1
Half Title Page......Page 3
Title Page......Page 5
Copyright......Page 6
Dedication......Page 7
Content......Page 9
Pedagogy......Page 10
Acknowledgments......Page 13
Contents......Page 15
LEARNING OBJECTIVES......Page 17
A Systems Approach to Respiratory Physiology......Page 18
A Clinical Approach to Respiratory Physiology......Page 20
THOUGHT QUESTIONS......Page 21
REVIEW QUESTIONS......Page 22
Summary Points......Page 23
Answers TO THOUGHT QUESTIONS......Page 24
LEARNING OBJECTIVES......Page 25
REQUIREMENTS OF THE CONTROLLER......Page 26
AUTOMATIC CONTROL: THE CENTRAL PATTERN GENERATOR......Page 27
REQUIREMENTS OF THE VENTILATORY PUMP......Page 29
BONES......Page 30
MUSCLES......Page 31
PERIPHERAL NERVES......Page 33
AIRWAYS......Page 35
LARGE SURFACE AREA FOR DIFFUSION......Page 39
STABILIZING THE GAS-EXCHANGING UNIT......Page 41
MATCHING VENTILATION AND BLOOD FLOW......Page 42
PUTTING IT TOGETHER......Page 44
Summary Points......Page 45
Answers TO THOUGHT QUESTIONS......Page 46
Review Questions......Page 48
LEARNING OBJECTIVES......Page 50
DEFINING THE FORCES: CHEST WALL AND LUNGS......Page 51
PRESSURE–VOLUME CHARACTERISTICS OF THE CHEST WALL, LUNGS, AND RESPIRATORY SYSTEM......Page 52
THE FORCES: ADDITIONAL FACTORS TO CONSIDER......Page 54
LUNG VOLUMES: A CLOSER LOOK......Page 59
Measurement of Lung Volume......Page 61
TRANSMURAL AND TRANSPULMONARY PRESSURE......Page 64
ALVEOLAR STABILITY......Page 65
PUTTING IT TOGETHER......Page 71
Summary Points......Page 72
Answers TO THOUGHT QUESTIONS......Page 73
Review Questions......Page 76
LEARNING OBJECTIVES......Page 77
LAMINAR VERSUS TURBULENT FLOW......Page 78
AIRWAY SIZE AND THE DISTRIBUTION OF RESISTANCE IN THE LUNGS......Page 81
BERNOULLI’S PRINCIPLE......Page 85
LUNG RESISTANCE......Page 86
DETERMINANTS OF THE CROSS-SECTIONAL AREA OF THE AIRWAY......Page 87
TRANSMURAL PRESSURE AND THE SIZE OF AIRWAYS DURING FORCED EXHALATION......Page 90
THE VOLUME–TIME PLOT......Page 92
MAXIMAL EXPIRATORY FLOW: THE FORCES TO BE CONSIDERED......Page 94
EXPIRATORY FLOW LIMITATION......Page 95
PRESENCE OF FLOW LIMITATION ON THE FLOW–VOLUME LOOP......Page 98
TIME CONSTANTS......Page 103
PUTTING IT TOGETHER......Page 104
Summary Points......Page 105
Answers TO THOUGHT QUESTIONS......Page 107
Review Questions......Page 109
LEARNING OBJECTIVES......Page 111
COMPONENTS OF VENTILATION: DEAD SPACE AND ALVEOLAR VENTILATION......Page 112
DETERMINANTS OF DISTRIBUTION OF VENTILATION......Page 116
EFFECT OF THE ALVEOLI ON PULMONARY BLOOD FLOW......Page 118
PULMONARY VASCULAR RESISTANCE AND DISTRIBUTION OF FLOW......Page 119
CARBON DIOXIDE AND HEMOGLOBIN......Page 121
PHYSIOLOGICAL CAUSES OF HYPERCAPNIA......Page 123
OXYGEN BINDING TO HEMOGLOBIN......Page 124
OXYGENATION......Page 126
Summary Points......Page 135
Answers TO THOUGHT QUESTIONS......Page 138
Review Questions......Page 140
LEARNING OBJECTIVES......Page 142
THE AUTOMATIC CENTERS......Page 144
VOLITIONAL BREATHING......Page 146
SOURCES OF INFORMATION THAT MODULATE THE CONTROL OF BREATHING......Page 147
THE VENTILATORY RESPONSE TO HYPOXEMIA......Page 153
THE VENTILATORY RESPONSE TO HYPERCAPNIA......Page 155
Exercise and Ventilatory Control......Page 156
Ventilatory Control in Acute on Chronic Respiratory Failure......Page 157
PUTTING IT TOGETHER......Page 158
Summary Points......Page 159
Answers TO THOUGHT QUESTIONS......Page 161
Review Questions......Page 163
LEARNING OBJECTIVES......Page 165
Definitions......Page 166
Carbon Dioxide–Carbonic Acid–Bicarbonate Buffer System......Page 167
The Kidneys and Acid Elimination......Page 168
RESPIRATORY ACIDOSIS......Page 169
RESPIRATORY ALKALOSIS......Page 171
METABOLIC ACIDOSIS......Page 172
METABOLIC ALKALOSIS......Page 174
Compensatory Mechanisms for Primary Acid–Base Disorders......Page 175
Analyzing Acid–Base Disorders: An Initial Approach......Page 176
Summary Points......Page 180
Answers TO THOUGHT QUESTIONS......Page 182
Review Questions......Page 183
LEARNING OBJECTIVES......Page 185
Respiratory Sensations and Ventilatory Control......Page 187
The Lungs As Sensory Organs......Page 188
Efferent–Reafferent Dissociation: The Relationship Between Neural Output from the Controller and the Response of the Ventilatory Pump......Page 189
The Dyspnea of Asthma: A Model of Multiple Sensations......Page 190
PUTTING IT TOGETHER......Page 193
Summary Points......Page 194
REFERENCES......Page 195
Answers TO THOUGHT QUESTIONS......Page 196
Review Questions......Page 197
LEARNING OBJECTIVES......Page 199
AEROBIC METABOLISM......Page 200
ANAEROBIC METABOLISM......Page 201
THE CONTROLLER......Page 202
THE VENTILATORY PUMP......Page 205
The Cardiovascular System During Exercise......Page 207
BASIC PHYSIOLOGY OF THE CARDIOVASCULAR SYSTEM......Page 208
OXYGEN DELIVERY TO THE TISSUES......Page 209
INCREASING CARDIAC OUTPUT: THE CARDIOVASCULAR CONTROLLER AND PUMP DURING EXERCISE......Page 211
THE CARDIOVASCULAR GAS EXCHANGER: REDISTRIBUTION OF BLOOD FLOW......Page 214
LIMITS OF THE RESPIRATORY SYSTEM......Page 215
PUTTING IT TOGETHER......Page 216
Summary Points......Page 217
Answers TO THOUGHT QUESTIONS......Page 219
Review Questions......Page 221
CHAPTER 2: FORM AND FUNCTION: THE PHYSIOLOGICAL IMPLICATIONS OF THE ANATOMY OF THE RESPIRATORY SYSTEM......Page 223
CHAPTER 4: DYNAMICS: SETTING THE SYSTEM IN MOTION......Page 224
CHAPTER 5: THE GAS EXCHANGER: MATCHING VENTILATION AND PERFUSION......Page 225
CHAPTER 6: THE CONTROLLER: DIRECTING THE ORCHESTRA......Page 226
CHAPTER 8: THE PHYSIOLOGY OF RESPIRATORY SENSATIONS......Page 228
CHAPTER 9: EXERCISE PHYSIOLOGY: A TALE OF TWO PUMPS......Page 229
Glossary of Terms......Page 231
Index......Page 241