Physiology and Anatomy for Nurses and Healthcare Practitioners : a homeostatic approach

738 Pages·2009·30.71 MB·English

by  Clancy

PHYSIOLOGY
ANATOMY
AND
FOR NURSES AND HEALTHCARE PRACTITIONERS
A HOMEOSTATIC APPROACH
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PHYSIOLOGY
ANATOMY
AND
FOR NURSES AND HEALTHCARE PRACTITIONERS
A HOMEOSTATIC APPROACH
Third edition
John Clancy
BSc(Hons), PGCE
Senior Lecturer
Human Applied Sciences
School of Nursing and Midwifery
University of East Anglia
Norwich, UK
Andrew J McVicar
BSc(Hons), PhD
Reader
Department of Mental Health and Learning Disabilities
Faculty of Health & Social Care
Anglia Ruskin University
Chelmsford, UK
AN HACHETTE UK COMPANY
CRC Press
Taylor & Francis Group
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Contents
Preface vii
Acknowledgements ix
Authors of Case Studies x
SECTION I: AN INTRODUCTION TO THE HUMAN BODY 1
Chapter 1 Introduction to physiology and homeostasis 3
Chapter 2 Cell and tissue functions 22
Chapter 3 The skeleton 61
SECTION II: THE NEED FOR REGULATION 89
Chapter 4 Chemical reactions in cells: Fundamentals of metabolism 91
Chapter 5 Nutrients and nutrition 105
Chapter 6 Body fluids 121
SECTION III: SENSING CHANGE AND COORDINATING RESPONSES 137
Chapter 7 The senses 139
Chapter 8 The nervous system 162
Chapter 9 The endocrine system 204
SECTION IV: EFFECTORS OF HOMEOSTASIS 227
Chapter 10 The digestive system 229
Chapter 11 The cardiovascular system 1: Blood 269
Chapter 12 The cardiovascular system 2: Heart and circulation 304
Chapter 13 The lymphatic system, immunity and microbiology 360
Chapter 14 The respiratory system 397
Chapter 15 The kidneys and urinary tract 421
Chapter 16 The skin 446
Chapter 17 Skeletal muscle: Posture and movement 462
Chapter 18 The reproductive systems 485
SECTION V: INFLUENCES ON HOMEOSTASIS 519
Chapter 19 Genes in embryo development and ageing 521
Chapter 20 Pain 560
Chapter 21 Stress 587
Chapter 22 Circadian rhythms 609
SECTION VI: HEALTHCARE PRACTICE: A HOMEOSTATIC APPROACH 627
Introduction 629
Case 1. Introduction: Healthcare practitioners as external agents of homeostatic control 629
Case 2. The case of a woman with breast cancer 630
Case 3. The case of a woman with rheumatoid arthritis 632
Case 4. The case of a child with insulin-dependent diabetes – Type 1 634
Case 5. The case of a boy who is obese 636
Case 6. The case of a 25-year-old man undergoing emergency surgery 639
Case 7. The case of a woman with cataracts 641
Case 8. The case of a woman with depression 644
Case 9. The case of a woman with hypothyroidism 646
Case 10. The case of an infant with hypertrophic pyloric stenosis 649
Case 11. The case of a woman with deep vein thrombosis (DVT) 651
Case 12. The case of a woman with myocardial infarction 654
Case 13. The case of the young man with symptomatic HIV/AIDS 656
Case 14. The case of a boy with asthma 659
Case 15. The case of a man presenting for haemodialysis 661
Case 16. The case of Cassius, a febrile toddler 664
Case 17. The case of a person with impaired mobility following a stroke 666
Case 18. The case of a man with benign prostatic hyperplasia (BPH) 669
Case 19. The case of a family with Huntington’s disease 671
Case 20. The case of a 53-year-old man undergoing laparoscopic cholecystectomy 674
Case 21. The cases of (a) a woman with occupational hyperstress, and 676
(b) a man with occupational hypostress
Case 22. The case of a man with learning disabilities leaving a long-stay hospital 678
APPENDICES 681
Appendix A Units of measurements 683
Appendix B Blood values and urinalysis 685
Appendix C Common prefixes, suffixes and roots 689
Appendix D Symbols and common clinical abbreviations 693
Index 695
This book has a companion website available at:
http://www.hodderplus.co.uk/physiologyandanatomy
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Preface
The new edition of this popular text continues to present • More case studies to illustrate the health carer’s role as an
homeostasis as a dynamic concept that provides the basis for external agent of homeostatic control.
understanding health and well-being. It also recognizes how • New, improved colour design.
failure to respond to homeostatic disturbances results in home- • Photographs of common clinical conditions.
ostatic imbalances responsible for the signs and symptoms of • An accompanying website www.hodderplus.co.uk/ physio
ill health, and how health carers seek to reverse those imbal- logy andanatomy
ances by acting as external agents of homeostatic control.
The book is divided into six major sections:
Why homeostasis? The concept of homeostasis typically is
one of a constant performance or environment, but in physiol- • Section I: An introduction to the human body. This introduc-
ogy such an interpretation is not strictly correct because there tory section considers the construction of the human body
must be scope for adaptation to allow people to achieve devel- and what is meant by cell function. The basic principles of
opmental milestones, or to change performance level accord- homeostasis are explored in depth. Although each chapter
ing to need – for example, when we perform exercise, when a can be read individually, the reader is strongly encouraged to
woman becomes pregnant, when we respond to infection, or read Chapter 1 first since the principles discussed, and in
when we are recovering from an operation. Homeostasis in the particular the inclusion of a simple but unique aid to learn-
physiological sense therefore represents a dynamism that is ing – the homeostatic graph – are the foundations for what
central to human functioning. Nevertheless, the concept remains follows in the other chapters.
about control; few processes in the body occur by chance, and • Section II: The need for regulation. This second section iden-
those that do promote corrective or adaptive responses. tifies the fundamentals of human body functioning, includ-
This book is especially concerned with identifying the adap- ing the composition of the body, its chemical reactions
tive responses illustrated in health, the maladaptive processes (metabolism) and the physiological rationale underlying a
that are illustrated during ill health, and how the healthcare healthy diet.
professional utilises this knowledge in restoring a person’s • Section III: Sensing change and coordinating responses. This
health status or improving the quality of life until death. The third section explains how the internal (and external) envi-
intention is to utilize homeostasis as a framework to aid learn- ronment is identified by individual or sense organ receptors,
ing and so help the healthcare student to appreciate the physi- and how adaptive responses are enabled and coordinated by
ological rationale of practice. the nervous and endocrine systems.
The education of the healthcare professional places empha- • Section IV: Effectors of homeostasis. This section considers fur-
sis on producing students and staff knowledgeable about the ther systems of the human body that are themselves capable
‘holistic’ (physiological, psychological, sociological and spiri- of bringing about change, and so provide the means of cor-
tual) requirements of health. The integration of physiological recting homeostatic disturbances of excess and deficits.
functioning into this model has provided difficult in health- • Section V: Influences on homeostasis. The penultimate section
care education, and the need to describe and explain body considers some of the vital interactive components that pro-
functioning in the context of an interactive framework mote variation in the human body. It discusses the influence
prompted the writing of previous editions of this book, as well of genes and environmental factors in human development
as many subsequent articles on the theme of homeostasis. and ageing, and the nature–nurture interactions associated
This third edition builds on the successful format, providing with the perception of pain and distress, and in the control
nature–nurture interactions as a basis of this interactive frame- of bodily rhythms over the 24-hour period.
work. The book gives an integrated explanation of body func- • Section VI: Healthcare practice: A homeostatic approach. This
tioning, with descriptions of related anatomy in health, illness final section provides numerous examples of case studies that
and health care. This exciting new edition has been updated illustrate homeostatic principles in relation to healthcare
and extended to provides the following new material: problems and how healthcare practitioner may be consid-
ered to be an external agent of homeostatic control.
• Overview of microbiology and principles of infection man-
agement. Each chapter provides frequent cross-referencing to other
• Extended information on pharmacological principles and chapters in a manner that can only provide the reader with a
actions of the major classes of drugs. greater understanding of the integrated functioning of the
• Extended application of physiological functions in relation human body in health and illness.
to specific pathologies, and examples of health care. Although the book assumes some knowledge of physiology,
• Updates on how the Human Genome Project is beginning it identifies and explains the main aspects of function that in
to impact on health care. turn relate to homeostasis, homeostatic disturbance and home-
ostatic imbalances. Application Boxes are used throughout to can always be referred to for further reference when needed.
reinforce how healthcare practitioners act as external agents of Finally, we hope you enjoy reading the book, and that it will
homeostatic control to minimise, or reverse, functional distur- contribute to a better understanding of your role as a health-
bance in their patients. Activities and reflective questions are care practitioner and of your patients, to the ultimate benefit
included within the text and illustrations of each chapter to of both.
test the reader’s understanding.
The authors between them have over 50 years’ experience of John Clancy
teaching physiology to healthcare practitioners, and they Andrew McVicar
understand what an overwhelming subject the student is faced October 2008
with when studying physiology and anatomy. Their objective
is not for the reader to memorise the contents of each chapter
(that would be truly remarkable!), but merely to grasp a PS. We would value comments on the value of this book so
general understanding of homeostasis in action, since the book that the next edition will evolve!
Acknowledgements
For the third edition of Physiology and Anatomy for Nurses and The clinical photographs have been a signature feature of
Healthcare Practitioners: A Homeostatic Approach, we have this third edition, and our particular appreciation goes to
enjoyed the opportunity of collaborating with a group of ded- Simon Dove and his medical illustrators from the Norfolk and
icated talented professionals. Accordingly, we would like to Norwich University Hospital NHS Trust for their help with
take the opportunity to recognize and thank the members of these valuable resources. Also special thanks go to the patients
our book team and also the people who have helped and who have given their permission to use their photographs.
encouraged us along the way. We are grateful too to colleagues for their continued sup-
First, we are extremely grateful to the authors of the case port, for putting up with our enthusiasm when we constantly
studies, whose contributions to the book have richly enhanced talked about the third edition, and also for putting up with our
its healthcare application to the principles of homeostasis. mood swings when we were working to deadlines. Our
Some of these authors are former students who have hopefully employers, the University of East Anglia and Anglia Ruskin
been inspired by our teaching since their application of home- University, in particular our faculties, have given their contin-
ostasis to their practice is in turn becoming infectious to the ued support in this project.
students under their supervision. Please keep spreading the We also appreciate the work of the reviewers of the second
word. edition, whose excellent reviews and evaluative feedback pro-
Special mention must be made of one of the authors – Sue vided the motivation to produce this exciting third edition.
Harry – who unfortunately passed away during the writing of We would like to express our sincere gratitude to Nicola Baird,
this book. This edition is dedicated to the memory of her pro- who provided the perioperative expertise throughout the third
fessionalism, which should be the benchmark to which all edition, and Gary Parlett, who reviewed the coronary care
healthcare professionals should aspire. input in Chapter 12.
The assistance, support enthusiasm, skill and investment in Finally and most importantly, a special thank you to our
the text on the part of the editorial and production teams at families: to Rachel, Penny and our beautiful and wonderful
Hodder Arnold have been equally valuable to make the entire children Lauren, Clare and Lisa for their love, smiles, encour-
project possible and keep the text, art and production pro- agement and support; to our very special parents Ann and
grammes on schedule. Special thanks go to Clare Patterson, Norman Clancy, and James and Mary McVicar; and to our
Joanna Silman, Naomi Wilkinson, Joanna Koster, Claire brothers – all these have made this project extremely worth-
Gordon, Andrew Anderson, Carole Goodall and finally, in while.
anticipation of booming sales figures, Max Espleyand the sales John Clancy
team. Andrew McVicar