Applied Respiratory Physiology (eBook)

Front Cover 1
Applied Respiratory Physiology: With Special Reference to Anaesthesia 4
Copyright Page 5
Table of Contents 12
FOREWORD 8
PREFACE 10
CHAPTER 1. PHYSICAL AND STRUCTURAL FEATURES OF GAS EXCHANGE 14
THE GAS LAWS 14
LUNG VOLUMES AND CAPACITIES 17
RELATION OF PULMONARY STRUCTURE TO FUNCTION 19
CHAPTER 2. CONTROL OF BREATHING 29
THE ORIGIN OF THE RESPIRATORY RHYTHM 29
MOTOR PATHWAYS CONCERNED IN BREATHING 35
CHEMICAL CONTROL OF BREATHING 37
REFLEX CONTROL OF BREATHING 50
BREATH HOLDING 53
EXERCISE 55
ARTIFICIAL VENTILATION 56
OUTLINE OF CLINICAL METHODS OF ASSESSMENT OF FACTORS IN CONTROL OF BREATHING 56
CHAPTER 3. ELASTIC RESISTANCE TO VENTILATION 58
THE FUNCTIONAL RESIDUAL CAPACITY (F.R.C.)* 59
ELASTIC RECOIL OF THE LUNGS 63
ELASTIC RECOIL OF THE THORACIC CAGE 79
STATIC PRESSURE/VOLUME RELATIONSHIPS OF THE LUNG PLUS CHEST WALL 80
PRINCIPLES OF MEASUREMENT OF COMPLIANCE 84
CHAPTER 4. RESISTANCE TO GAS FLOW 87
LAMINAR FLOW 87
TURBULENT FLOW 91
THRESHOLD RESISTORS 93
QUANTIFICATION OF 'RESISTANCE' WHEN GAS FLOW IS PARTLY LAMINAR AND PARTLY TURBULENT 95
MINOR SOURCES OF RESISTANCE TO GAS FLOW 98
INCREASED AIRWAY RESISTANCE 98
THE EFFECTS OF INCREASED RESISTANCE TO BREATHING 108
PRINCIPLES OF MEASUREMENT OF FLOW RESISTANCE 117
CHAPTER 5. MECHANISMS OF PULMONARY VENTILATION 125
PHASES OF THE RESPIRATORY CYCLE 125
VENTILATION BY INTERMITTENT STEP INCREASES IN MOUTH PRESSURE (CONSTANT PRESSURE GENERATORS) 127
VARIABLE OR FLOW-LIMITED PRESSURE GENERATORS 135
CHOICE OF MANNER OF ARTIFICIAL VENTILATION BY INTERMITTENT POSITIVE PRESSURE 139
SPONTANEOUS RESPIRATION 145
ARTIFICIAL VENTILATION PRODUCED BY FORCES ACTING DIRECTLY ON THE THORAX 151
CHAPTER 6. THE MINUTE VOLUME OF PULMONARY VENTILATION 157
DEFINITION OF ADEQUACY OF VENTILATION 157
THE EFFECT OF DIFFERENT LEVELS OF VENTILATION ON ALVEOLAR GAS TENSIONS* 166
CAUSES OF FAILURE OF VENTILATION 169
THE WORK OF BREATHING 173
MEASUREMENT OF VENTILATION 181
CHAPTER 7. RESPIRATORY DEAD SPACE AND DISTRIBUTION OF THE INSPIRED GAS 190
ANATOMICAL DEAD SPACE* 192
ALVEOLAR DEAD SPACE 197
PHYSIOLOGICAL DEAD SPACE 204
APPARATUS DEAD SPACE AND REBREATHING 208
DISTRIBUTION OF THE INSPIRED GAS 209
MEASUREMENT OF DEAD SPACE AND DISTRIBUTION OF INSPIRED GAS 221
CHAPTER 8. THE PULMONARY CIRCULATION 222
PULMONARY BLOOD VOLUME 222
PULMONARY VASCULAR PRESSURES 226
PULMONARY BLOOD FLOW 232
PULMONARY VASCULAR RESISTANCE 232
PRINCIPLES OF MEASUREMENT OF PULMONARY CIRCULATION 238
CHAPTER 9. DISTRIBUTION OF THE PULMONARY BLOOD FLOW 245
ANATOMICAL MALDISTRIBUTION OF PULMONARY BLOOD FLOW 245
VENOUS ADMIXTURE 248
VENOUS ADMIXTURE ASSOCIATED WITH ANAESTHESIA 268
PRINCIPLES OF ASSESSMENT OF DISTRIBUTION OF PULMONARY BLOOD FLOW 273
CHAPTER 10. DIFFUSION 279
FUNDAMENTALS OF THE DIFFUSION PROCESS 279
DIFFUSION OF OXYGEN WITHIN THE LUNGS 282
DIFFUSION OF GARBON MONOXIDE WITHIN THE LUNGS 290
DIFFUSION OF CARBON DIOXIDE WITHIN THE LUNGS 294
DIFFUSION OF 'INERT' GASES WITHIN THE LUNGS 295
DIFFUSION OF GASES IN THE TISSUES 296
PRINCIPLES OF METHODS OF MEASUREMENT OF CARBON MONOXIDE DIFFUSING CAPACITY 299
CHAPTER 11. CARBON DIOXIDE 301
CARRIAGE OF CARBON DIOXIDE IN BLOOD 301
FACTORS INFLUENCING THE CARBON DIOXIDE TENSION IN THE STEADY STATE 313
CARBON DIOXIDE STORES AND THE UNSTEADY STATE 319
APNOEIC MASS-MOVEMENT OXYGENATION (formerly known as DIFFUSION RESPIRATION) 323
THE EFFECTS OF CHANGES IN THE CARBON DIOXIDE TENSION 324
CLINICAL RECOGNITION OF HYPERCAPNIA 334
OUTLINE OF METHODS OF MEASUREMENT OF CARBON DIOXIDE 335
CHAPTER 12. OXYGEN 339
THE ROLE OF OXYGEN IN THE CELL 339
DILUTION OF INSPIRED OXYGEN BY WATER VAPOUR 345
FACTORS INFLUENCING ALVEOLAR TENSION OF OXYGEN 346
THE ALVEOLAR/ARTERIAL Po2 DIFFERENCE 350
TRANSPORT OF OXYGEN FROM THE LUNGS TO THE CELL 360
THE CARRIAGE OF OXYGEN IN THE BLOOD 361
OXYGEN STORES AND THE STEADY STATE 370
HYPOXIA 372
HYPEROXIA 377
THE 'NORMAL ARTERIAL OXYGEN TENSION 385
OXYGEN LEVELS DURING ANAESTHESIA 385
CYANOSIS 389
PRINCIPLES OF MEASUREMENT OF OXYGEN LEVELS 391
APPENDIX A: PHYSICAL QUANTITIES AND UNITS OF MEASUREMENT 397
APPENDIX B: CONVERSION FACTORS FOR GAS VOLUMES AND UNITS OF PRESSURE 401
APPENDIX C: SYMBOLS, ABBREVIATIONS AND DEFINITIONS 403
APPENDIX D: THE EXPONENTIAL FUNCTION* 405
BIBLIOGRAPHY AND REFERENCES 417
INDEX 445