呼吸系統(tǒng)

內(nèi)容概要

　　“以器官系統(tǒng)為中心”的醫(yī)學(xué)教學(xué)模式是國際醫(yī)學(xué)教育的趨勢。本系列書是世界著名醫(yī)藥衛(wèi)生出版集團(tuán)愛思唯爾公司出版的一套“以器官系統(tǒng)為中心”的醫(yī)學(xué)基礎(chǔ)課程教材。該套教材第1版出版后受到世界各地許多醫(yī)學(xué)院校的歡迎，并被多家進(jìn)行“以器官系統(tǒng)為中心”教學(xué)的醫(yī)學(xué)院校選定為教材。第2版根據(jù)第1版出版后教師和學(xué)生的反饋意見，結(jié)合醫(yī)學(xué)知識的更新進(jìn)行了全新修訂。在編寫內(nèi)容上，該系列教材強(qiáng)調(diào)基礎(chǔ)與臨床的整合。每一章節(jié)都是圍繞著一個臨床病例展開，通過對病人問題的呈現(xiàn)以及解決過程引出對相關(guān)知識的探究，從而使與器官系統(tǒng)結(jié)構(gòu)、功能以及疾病相關(guān)的重要的基礎(chǔ)醫(yī)學(xué)知識得到了完善的整合。在版式安排上，圖框中的病例資料與正文中的醫(yī)學(xué)知識完美匹配，一步一步地激起讀者的求知欲望。本冊為《呼吸系統(tǒng)》。

作者簡介

作者：（英國）戴維斯（Andrew Davies） （英國）穆瑞斯（Carl Moores）

書籍目錄

1　INTRODUCTION
 Introduction
 What is respiration?
 The need for respiration
 Diffusion in respiration and the circulation
 Timing in the circulation and respiration
 Basic science of respiration
 Drugs
2 STRUCTURE OF THE RESPIRATORY SYSTEM,RELATED TO
FUNCTION
 Introduction
 The upper airways
 The intrathoracic airways
 Blood vessels
 Pulmonary hypertension
 The lymphatics
 The nerves
 Gross structure of the respiratory system
 Pleurisy
 The diaphragm and chest wall
 How breathing is brought about
 Embryology
 Air-conditioning
 Metabolic activity
 Metabolism of circulating biologically active
substances
 Non-respiratory functions
3 ELASTIC PROPERTIES OF THE RESPIRATORY SYSTEM
 Introduction
 Intrapleural pressure (Ppl)
 Static lung compliance (CL)
 The effect of disease
 The physical basis of lung compliance
4 AIRFLOW IN THE RESPIRATORY SYSTEM
 Introduction
 How airflow is brought about
 The nature of airflow
 The major determinant of flow - radius
 Airways resistance and obstructive pulmonary disease
 The clinical situation
 Sites of airways resistance
 Asthma and airways smooth muscle
 Bronchomotor tone
 Pharmacological treatment of asthma
 Clinical definitions
 Bronchitis and mucus
 Emphysema and radial traction
 Intrapleural pressure and cough
 Clinical tests for changes in resistance
 Work of breathing
5 VENTILATION OF THE RESPIRATORY SYSTEM: THE IMPORTANCE OF
ITS LACK OF UNIFORMITY IN DISEASE
 Introduction
 Spirometric abnormalities in disease
 Uneven distribution
 Dead space.
 Alveolar dead space in disease
 The Bohr equation
 Factors affecting physiological dead space
 Alveolar ventilation and respiratory exchange
 The alveolar gas equation
 Distribution of inspired gas
 Other factors influencing distribution
6 GAS EXCHANGE BETWEEN AIR AND BLOOD:DIFFUSION
 The path from air to tissue
 Lung disease and diffusion
 Fick's Law of Diffusion
 Measuring transfer factor
 Treating diffusion difficulties
 Carbon dioxide and other gases
7 THE PULMONARY CIRCULATION: BRINGING BLOOD AND GAS
TOGETHER
 The functions of the pulmonary circulation
 The anatomy of the pulmonary circulation
 Matching ventilation and perfusion
 Distribution of blood flow through the lungs
 Regional differences in ventilation in the lungs
 Ventilation/perfusion matching and its effect on blood
 O and CO content
 Shunt
8 CARRIAGE OF GASES BY THE BLOOD AND ACID/BASE BALANCE
 Introduction
 Oxygen transport
 Dissolved oxygen: do we really need Hb and why
 keep it in red cells?
 Carbon dioxide transport
 Acid-base balance
9 CHEMICAL CONTROL OF BREATHING
 Introduction
 Oxygen lack
 Carbon dioxide excess
10　NERVOUS CONTROL OF BREATHING
 Introduction
 The rhythm generator
 Pattern of breathing in COPD
 The respiratory 'centres'
 The medullary groups
 Conscious control of breathing
 Respiratory muscle innervation
 Neuromuscular disorders
 Vagal reflexes
 Dyspnoea
 Other reflexes
11 LUNG FUNCTION TESTS: MEASURING DISABILITY
 Introduction
 Spirometry
 Flow measurements
 Plethysmography
 Lung mechanics
 Transfer factor (diffusing capacity)
 Blood gases
 Gas washouts
 Exercise testing
 Challenge tests
Appendix: some basic science
Glossary
Index

章節(jié)摘錄

版權(quán)頁：插圖：Above the larynx, the airway is held open by the actions ofairway-dilating muscles, including genioglossus and palat-opharyngeus. Were it not for the actions of these muscles, theupper airway would collapse, particularly in the supine posi-tion. During sleep, the tone in skeletal muscles throughoutthe body is reduced and this applies equally to the muscleswhich keep the upper airways patent. It is therefore normalfor the upper airway to become narrowed during sleep. In patients with OSA, the airway narrowing is morepronounced than normal and leads to periods of airwayobstruction. There are a number of reasons why this hap-pens, but obesity is the most important. It is thought that inobese patients, the pressure exerted by the fat in the necktends to cause the airway to collapse. When the tone in thegenioglossus and palatopharyngeus is reduced, as duringsleep, airway obstruction may result.   The airway may remain obstructed for only a few seconds,or it may be well over a minute before the patient takeshis next breath. During this time, the patient may becomehypoxic and will begin to make vigorous efforts to try andbreathe against the obstructed airway. Furthermore, he willbecome increasingly aroused from his sleep. Eventually, heregains the tone in his airway-dilating muscles and the airwayobstruction is relieved. （Patients do not usually waken.） Afterthe obstruction has been relieved, ventilation resumes and thepatient's sleep deepens. This leads to a reduced tone in theairway-dilating muscles and the cycle starts to repeat itself.   Although obesity is probably the most important fac-tor leading to OSA, there are other predisPos！ng factors.These include anatomical variations predisposing to airwaynarrowing, such as enlarged tonsils, airway tumours andabnormalities of the mandible. Sedative drugs, includingalcohol, may also predispose to sleep apnoea, probably byaffecting sleep patterns and by reducing muscle tone. Asmall number of cases of OSA may be explained by abnor-malities of neuromuscular function.

編輯推薦

《呼吸系統(tǒng)(第2版)》：The Systems of the Body series has established itself as a valuable resource for allmedical and other health science students following system-based courses. In thissecond edition all the volumes have been updated to take into account feedback fromreaders of the first edition. Each volume continues to present the core knowledge ofbasic science and clinical conditions that medical students need, offering an integratedview of the system unavailable from standard textbooks. An expanded selection ofself-assessment material is available from www.studentconsult.com/gopaperlessThe Respiratory System explains basic science in the context of clinical casehistories, giving the reader an integrated understanding of the system and itsmajor diseases.Introduction、Structure of the respiratory system, related to function、Elastic properties of the respiratory system、Airflow in the respiratory system、Ventilation of the respiratory system: the importance of its lack of uniformity in disease、Gas exchange between air and blood: diffusion、The pulmonary circulation: bringing blood and gas together、Carriage of gases by the blood and acid/base balance、Chemical control of breathing、Nervous control of breathing、Lung function tests: measuring disability。

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