Cardiopulmonary Anatomy & Physiology: Essentials for Respiratory Care, 5th Edition

662 Pages·2007·13.54 MB·English

by  Terry Des Jardins

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Cardiopulmonary
Anatomy Physiology
&
Essentials for Respiratory Care
Fifth Edition
To
Katherine, Alexander, Destinee, and Ashley
The Next Generation
Grandpa T
Cardiopulmonary
Anatomy Physiology
&
Essentials for Respiratory Care
Terry Des Jardins, MEd, RRT
Professor Emeritus
Director
Department of Respiratory Care
Parkland College
Champaign, Illinois
Australia • Brazil • Japan • Korea • Mexico • Singapore • Spain • United Kingdom • United States
Cardiopulmonary Anatomy & Physiology: © 2008Delmar Cengage Learning
Essentials for Respiratory Care, Fifth
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3 4 5 6 7 11 10 09 08
CONTENTS
List of Tables • xi
Foreword • xiii
Preface • xv
Acknowledgments • xxiii
How to Use the Text and Software • xxvi
SECTION ONE 1
The Cardiopulmonary System—The Essentials
C H A P T E R 1
The Anatomy and Physiology of the Respiratory System 3
The Airways • 7 The Lungs • 46
The Upper Airway • 7 The Mediastinum • 50
The Lower Airways • 23 The Pleural Membranes • 50
The Sites of Gas Exchange • 36 The Thorax • 51
The Pulmonary Vascular System • 39 The Diaphragm • 52
The Lymphatic System • 43 Chapter Summary • 61
Neural Control of the Lungs • 44 Review Questions • 62
C H A P T E R 2
Ventilation 67
Pressure Differences Across Elastic Properties of the Lung and Chest
the Lungs • 68 Wall • 76
Role of the Diaphragm in Ventilation • 72 Dynamic Characteristics of the Lungs • 92
Positive Pressure Ventilation • 74 Ventilatory Patterns • 104
v
CONTENTS
vi
How Normal Intrapleural Pressure Overview of Specific Breathing
Differences Cause Regional Conditions • 112
Differences in Normal Lung Chapter Summary • 116
Ventilation • 109
Clinical Applications • 119
The Effect of Airway Resistance and
Review Questions • 122
Lung Compliance on Ventilatory
Clinical Application Questions • 125
Patterns • 110
C H A P T E R 3
The Diffusion of Pulmonary Gases 127
Gas Laws—Review • 128 Perfusion-Limited Gas Flow • 141
The Partial Pressures of Atmospheric Diffusion-Limited Gas Flow • 142
Gases • 130 How Oxygen Can Be Either Perfusion
The Ideal Alveolar Gas Equation • 132 Or Diffusion Limited • 145
The Diffusion of Pulmonary Gases • 133 Chapter Summary • 147
Oxygen and Carbon Dioxide Diffusion Clinical Applications • 147
Across the Alveolar-Capillary Review Questions • 150
Membrane • 134
Clinical Application
Gas Diffusion • 138 Questions • 152
C H A P T E R 4
Pulmonary Function Measurements 153
Lung Volumes and Capacities • 154 Chapter Summary • 172
Pulmonary Mechanics • 158 Clinical Applications • 173
How the Effects of Dynamic Review Questions • 177
Compression Decrease Expiratory Clinical Application
Flow Rates • 168 Questions • 179
C H A P T E R 5
The Anatomy and Physiology of the Circulatory System 181
The Blood • 182 The Distribution of Pulmonary
The Heart • 188 Blood Flow • 205
The Pulmonary and Systemic Vascular Chapter Summary • 219
Systems • 195 Clinical Applications • 220
Pressures in the Pulmonary and Systemic Review Questions • 223
Vascular Systems • 200 Clinical Application
The Cardiac Cycle and Its Effect on Questions • 225
Blood Pressure • 201
CONTENTS
vii
C H A P T E R 6
Oxygen Transport 227
Oxygen Transport • 228 Polycythemia • 262
Oxygen Dissociation Curve • 233 Chapter Summary • 263
Oxygen Transport Calculations • 245 Clinical Applications • 263
Hypoxia • 258 Review Questions • 268
Cyanosis • 261 Clinical Application Questions • 270
C H A P T E R 7
Carbon Dioxide Transport and Acid-Base Balance 271
Carbon Dioxide Transport • 272 Chapter Summary • 310
Carbon Dioxide Elimination at Clinical Applications • 312
the Lungs • 275 Review Questions • 315
Carbon Dioxide Dissociation Curve • 276 Clinical Application Questions • 319
Acid-Base Balance and Regulation • 279
The Role of the P /HCO (cid:2)/pH
CO2 3
Relationship in Acid-Base Balance •290
C H A P T E R 8
Ventilation-Perfusion Relationships 321
Ventilation-Perfusion Ratio • 321 Review Questions • 334
Chapter Summary • 330 Clinical Application Questions • 335
Clinical Applications • 331
C H A P T E R 9
Control of Ventilation 337
The Respiratory Components of the Reflexes That Influence
Medulla Oblongata—The Respiratory Ventilation • 349
Centers • 338 Chapter Summary • 352
The Influence of the Pontine Respiratory Clinical Applications • 352
Centers on the Respiratory
Review Questions • 355
Components of the Medulla
Clinical Application Questions • 357
Oblongata • 340
Monitoring Systems That Influence
the Respiratory Components of the
Medulla Oblongata • 342
CONTENTS
viii
C H A P T E R 1 0
Fetal Development and the Cardiopulmonary System 359
Fetal Lung Development • 360 Clinical Parameters in the Normal
Placenta • 362 Newborn • 371
Fetal Circulation • 365 Chapter Summary • 373
Birth • 368 Clinical Applications • 373
Control of Ventilation in the Review Questions • 376
Newborn • 370 Clinical Application Questions • 377
C H A P T E R 1 1
Aging and the Cardiopulmonary System 379
The Effects of Aging on the The Effects of Aging on the
Respiratory System • 381 Cardiovascular System • 387
Pulmonary Gas Exchange • 385 Chapter Summary • 391
Arterial Blood Gases • 385 Review Questions • 391
SECTION TWO 395
Advanced Cardiopulmonary Concepts and
Related Areas—The Essentials
C H A P T E R 1 2
Electrophysiology of the Heart 397
The Five Phases of the Action Chapter Summary • 404
Potential • 399 Review Questions • 405
Properties of the Cardiac Muscle • 400
C H A P T E R 1 3
The Standard 12-ECG System 407
The Standard 12-ECG System • 408 Chapter Summary • 420
Normal ECG Configurations and Their Review Questions • 422
Expected Measurements (Lead II) • 415