The Respiratory System at a Glance E-Book

Jeremy P. T. Ward

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Serie: At a Glance
• Sprache: Englisch
• Veröffentlichungsjahr: 2015

Seitenzahl: 279

Beschreibung

The Respiratory System at a Glance has been thoroughly updated in line with current practice guidelines and new techniques to provide a highly illustrated and comprehensive guide to normal lung structure and function, as well as associated pathophysiology. Each topic has been fully revised and is accompanied by clear diagrams to encapsulate essential knowledge. Reflecting changes to the content, teaching and assessment methods used in medical education, this new edition now includes more information on acid base and its clinical ramifications, further detail on defence mechanisms and immunology, and also features online access to clinical cases and flashcards. The Respiratory System at a Glance: * Integrates basic and clinical science - ideal for integrated and systems-based courses * Includes both the pathophysiology and clinical aspects of the respiratory system * Is fully revised and updated to reflect current practice guidelines and new therapies * Provides online clinical cases, brand new flashcards, and MCQs * Includes a companion website at www.ataglanceseries.com/respiratory featuring interactive multiple choice questions and digital flashcards

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This edition first published 2015 © 2015 by John Wiley & Sons Ltd. Previous editions 2002, 2006, 2010 by J.P.T. Ward, J. Ward, R.M. Leach

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Library of Congress Cataloging-in-Publication Data

Ward, Jeremy P. T., author. The respiratory system at a glance / Jeremy P.T. Ward, Jane Ward, Richard M. Leach. — Fourth edition. p. ; cm. — (At a glance series) Includes index. ISBN 978-1-118-76107-6 (pbk.) I. Ward, Jane, 1952– , author. II. Leach, Richard M. (Haematologist), author. III. Title. IV. Series: At a glance series (Oxford, England) [DNLM: 1. Respiratory Physiological Phenomena. 2. Respiratory System – physiopathology. 3. Respiratory Tract Diseases. WF 102] RC731 616.2—dc23 2015004640

A catalogue record for this book is available from the British Library.

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Cover image: istock © Nerthuz

CONTENTS

Preface to fourth edition

Units and symbols

List of abbreviations

About the companion website

Part 1: Structure and function

Chapter 1: Structure of the respiratory system: lungs, airways and dead space

Lungs

Airways

Dead space

Chapter 2: The thoracic cage and respiratory muscles

Thoracic cage

Muscles of respiration

Chapter 3: Pressures and volumes during normal breathing

Functional residual capacity

Intrapleural pressure

Pressures, flow and volume during a normal breathing cycle

Lung volumes

Chapter 4: Gas laws

Fractional concentration and partial pressure of gases in a gas mixture

Water vapour pressure

The effect of pressure and temperature on gas volumes

Gases dissolved in liquids

Note on time-derivative symbols

Chapter 5: Diffusion

The alveolar–capillary membrane

Diffusion and perfusion limitation

Factors affecting diffusion across a membrane (Fick’s and Graham’s laws)

Factors affecting D_LCO (T_LCO)

Chapter 6: Lung mechanics: elastic forces

Assessing the stiffness of the lungs: lung compliance

Dynamic pressure–volume loops and dynamic compliance

The air–fluid interface lining the alveoli

Surfactant

Chapter 7: Lung mechanics: airway resistance

Factors affecting airway resistance

RAW in disease

Chapter 8: Carriage of oxygen

Anaemia and carbon monoxide poisoning

Other respiratory pigments

Chapter 9: Carriage of carbon dioxide

Hypoventilation and hyperventilation

Respiratory gas exchange ratio

Chapter 10: Acid–base balance

Sources of acid

Buffers

Control of acid–base balance

Chapter 11: Acid–base disorders

Respiratory and metabolic disorders

Anion gap and base excess

Chapter 12: Control of breathing I: chemical mechanisms

Ventilatory response to changes in P_ACO_2 and P_AO_2

The central chemoreceptor

The peripheral chemoreceptors

Adaptation: chronic respiratory disease and altitude

Chapter 13: Control of breathing II: neural mechanisms

Brainstem and central pattern generator

Lung receptors and reflexes

Chapter 14: Pulmonary circulation and anatomical right-to-left shunts

Pulmonary circulation compared with the systemic circulation

Anatomical or true right-to-left shunts

Effect of right-to-left shunts on arterial blood gases

Chapter 15: Ventilation–perfusion mismatching

Effect of the upright posture on perfusion, ventilation and V_A/Q

Ventilation–perfusion matching in disease

Effect of ventilation–perfusion mismatching on arterial blood gases

Assessment of ventilation–perfusion mismatching

Chapter 16: Exercise, altitude and diving

Exercise

Altitude

Diving

Chapter 17: Development of the respiratory system and birth

Fetal circulation and birth

Chapter 18: Complications of development and congenital disease

Problems associated with premature birth

Congenital diseases

Chapter 19: Lung defence mechanisms

Physical and physiological defences

Airway fluids and mucus

Phagocytes and natural killers

Chapter 20: Immunology of the lung

Immunoglobulin basics

Lymphocytes

Adaptive response

Part 2: History, examination and investigation

Chapter 21: History and examination

History

Examination

General examination

Chest examination

Chapter 22: Pulmonary function tests

Forced expiratory tests

Lung volumes

Chapter 23: Chest imaging and bronchoscopy

Part 3: Diseases and treatment

Chapter 24: Public health and smoking

Factors associated with respiratory disease

Smoking cessation

Management

Chapter 25: Respiratory failure

Mechanisms leading to hypoxia and hypercapnia

Effects of hypoxia and hypercapnia

Respiratory failure in asthma

Respiratory failure in chronic obstructive pulmonary disease

Management

Chapter 26: Asthma: pathophysiology

Prevalence

Classification

Atopic asthma

Drug-associated asthma

Chapter 27: Asthma: treatment

Assessment

Therapy

Severe uncontrolled asthma

Chapter 28: Chronic obstructive pulmonary disease

Diagnosis and pathophysiology

Management

Chapter 29: Pulmonary hypertension

Types of pulmonary hypertension

Clinical features

Diagnosis

Management

Chapter 30: Venous thromboembolism and pulmonary embolism

Deep venous thrombosis

Pulmonary embolism

Clinical features

Diagnosis

Treatment

Chapter 31: Pulmonary vasculitis

Collagen vascular diseases

Vasculitides

Chapter 32: Diffuse parenchymal (interstitial) lung diseases

Clinical features

Classification

Diagnosis

Management

Chapter 33: Sarcoidosis

Chapter 34: Pleural diseases

The pleurae

Pathophysiology

Specific conditions

Chapter 35: Occupational and environmental-related lung disease

Response to acute lung irritants

Inhalation of mineral dusts (pneumoconiosis)

Inhalation of organic material

Chapter 36: Cystic fibrosis and bronchiectasis

Clinical features

Diagnosis

Management

Bronchiectasis

Chapter 37: Pneumothorax

Pneumothorax classification

Clinical assessment

Management

Air leaks

Chapter 38: Community-acquired pneumonia

Classification

Epidemiology

Risk factors

Diagnosis

Management

Chapter 39: Hospital-acquired (nosocomial) pneumonia

Definitions

Epidemiology

Pathogenesis

Aetiology

Diagnosis

Management

Other pneumonias

Chapter 40: Pulmonary tuberculosis

Pathogenesis

Clinical features

Investigation

Drug therapy

Complications

Prevention and contact tracing

Chapter 41: The immune-compromised patient

Respiratory manifestations in the HIV-positive patient

Chapter 42: Lung cancer

Risks

Classification

Presentation

Evaluation

Chapter 43: Acute respiratory distress syndrome

Diagnosis

Epidemiology and prognosis

Pathogenesis and causes

Clinical features

Investigations

Management

Chapter 44: Mechanical ventilation

Types of mechanical ventilation

Non-invasive respiratory support

Chapter 45: Oxygenation and oxygen therapy

Measuring tissue hypoxia

Oxygen therapy

Other techniques to improve oxygenation

Chapter 46: Sleep apnoea

Obstructive sleep apnoea

Central sleep apnoea

Index

EULA

List of Illustrations

Chapter 1

Figure 1

Chapter 2

Figure 2

Chapter 3

Figure 3

Chapter 4

Figure 4

Chapter 5

Figure 5

Chapter 6

Figure 6

Chapter 7

Figure 7

Chapter 8

Figure 8

Chapter 9

Figure 9

Chapter 10

Figure 10

Chapter 11

Figure 11

Chapter 12

Figure 12

Chapter 13

Figure 13

Neural pathways

Chapter 14

Figure 14

Chapter 15

Figure 15

Chapter 16

Figure 16

Chapter 17

Figure 17

Chapter 18

Figure 18

Chapter 19

Figure 19

Chapter 20

Figure 20

Chapter 21

Figure 21

Chapter 22

Figure 22

Chapter 23

Figure 23

Chapter 24

Figure 24

Chapter 25

Figure 25

Chapter 26

Figure 26

Chapter 27

Figure 27

Chapter 28

Figure 28

Chapter 29

Figure 29

Chapter 30

Figure 30

Chapter 31

Figure 31

Chapter 32

Figure 32

Chapter 33

Figure 33

Chapter 34

Figure 34

Chapter 35

Figure 35

Chapter 36

Figure 36

Chapter 37

Figure 37

Chapter 38

Figure 38

Chapter 39

Figure 39

Chapter 40

Figure 40

Chapter 41

Figure 41

Chapter 42

Figure 42

Chapter 43

Figure 43

Chapter 44

Figure 44

Chapter 45

Figure 45

Chapter 46

Figure 46

Guide

Cover

Table of Contents

Preface to fourth edition

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Preface to fourth edition

The medical curriculum is constantly being reviewed, but all modern curricula interleave basic and clinical science, physiology and pathophysiology. Clinical examples and cases provide relevance to and assist understanding of the underlying basic science, and basic science concepts help in the understanding of the pathophysiology and treatment of disease. The Respiratory System at a Glance is designed to support students following all programmes of study that integrate core aspects of basic science, pathophysiology and clinical medicine, including treatment. As such, it should be useful to medical students throughout their training, and also to other healthcare professions, including nursing.

As with other volumes in the At a Glance series, it is based around a two-page spread for each main topic, with figures and text complementing each other to give an overview at a glance. Case studies based on some of the most commonly encountered conditions are also provided on the companion website, and can be used for both basic science and clinical study. Although primarily designed for revision, the book covers all the core elements of the respiratory system and its major diseases, and as such could be used as a main text in the first couple of years of the course. It is advised, however, that additional reference to more detailed textbooks will aid deeper and wider understanding of the subject. This is particularly the case for the pathophysiological chapters, as a book this concise cannot hope to provide a complete guide to clinical practice.

In this fourth edition we have significantly revised the majority of chapters and improved or replaced figures to aid comprehension. In response to requests from readers, we now provide separate chapters on lung defence mechanisms and immunology, in keeping with their importance for most respiratory diseases, and there are now two chapters covering regulation of acid-base balance and acid-base disorders, an area that many find difficult. There are several additional case studies and self-assessment MCQs, now to be found on the companion website. We have hopefully corrected all errors in the last edition. We have been greatly assisted by our many colleagues and students who have kindly advised us and commented on the contents, but any errors and omissions are entirely our responsibility. We also thank the staff at Wiley, without whom we would not have been able to produce this edition.

Jeremy P.T. Ward Jane Ward Richard M. Leach

Acknowledgement

We would like to thank Charles M. Wiener, Professor of Medicine and Physiology at John Hopkins School of Medicine, Baltimore, USA, for his contribution to the original concept and the first and second editions of this book.