Table Of ContentCardiopulmonary
Anatomy
& Physiology
EssEntials of REspiRatoRy CaRE
Seventh Edition
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To
Katherine, Alexander, Destinee, Ashley, and Jax
The Next Generation
Grandpa T
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Cardiopulmonary
Anatomy
& Physiology
EssEntials of REspiRatoRy CaRE
Seventh Edition
Terry Des Jardins, MEd, RRT
Professor Emeritus
Former Director
Department of Respiratory Care
Parkland College
Champaign, Illinois
Faculty/Staff Member
University of Illinois College of Medicine
at Urbana-Champaign
Australia ● Brazil ● Japan ● Korea ● Mexico ● Singapore ● Spain ● United Kingdom ● United States
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Cardiopulmonary Anatomy & Physiology – © 2020, 2013, Cengage Learning, Inc.
Essentials of Respiratory Care Unless otherwise noted, all content is © Cengage.
Seventh Edition
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Printed in the United States of America
Print Number: 01 Print Year: 2018
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Contents
List of Tables ● xiii
List of Clinical Connections ● xv
Foreword ● xxi
Preface ● xxiii
Acknowledgments ● xvii
Section One
The Cardiopulmonary System—The Essentials 1
Chapter 1
The Anatomy and Physiology of the Respiratory System 3
The Airways 4 The Lungs 52
● ●
The Upper Airways 4 The Mediastinum 56
● ●
The Lower Airways 26 The Pleural Membranes 56
● ●
The Sites of Gas Exchange 40 The Thorax 59
● ●
The Pulmonary Vascular System 43 The Muscles of Ventilation 61
● ●
The Lymphatic System 46 Chapter Summary 70
● ●
Neural Control of the Lungs ● 48 Review Questions ● 71
Chapter 2
Ventilation 75
Introduction 75 The Effect of Airway Resistance and Lung
●
Mechanisms of Pulmonary Ventilation 76 Compliance on Ventilatory Patterns 136
● ●
Elastic Properties of the Lung and Chest Wall 94 Overview of Specific Breathing
●
Dynamic Characteristics of the Lungs 115 Conditions 139
● ●
Ventilatory Patterns 127 Chapter Summary 143
● ●
How Normal Pleural Pressure Differences Review Questions 147
●
Cause Regional Differences in Normal Clinical Application Questions 149
●
Lung Ventilation 135
●
Chapter 3
Pulmonary Function Measurements 151
Lung Volumes and Capacities 151 Chapter Summary 176
● ●
Pulmonary Mechanics 155 Review Questions 181
● ●
Factors Affecting Predicted Normal Values 168 Clinical Application Questions 182
● ●
How the Effects of Dynamic Compression
Decrease Expiratory Flow Rates 170
●
vii
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viii Contents
Chapter 4
The Diffusion of Pulmonary Gases 185
Introduction 185 Oxygen and Carbon Dioxide Diffusion across
●
Dalton’s Law 186 the Alveolar-Capillary Membrane 192
● ●
Partial Pressures of Atmospheric Gases 186 Gas Diffusion According to Fick’s Law 195
● ●
Gas Diffusion—Pressure Gradients versus Perfusion-Limited Gas Flow 198
●
Diffusion Gradients 188 Diffusion-Limited Gas Flow 200
● ●
The Partial Pressures of Gases in the Air, Alveoli, How Oxygen Can Be Either Perfusion
and Blood 189 or Diffusion Limited 202
● ●
The Ideal Alveolar Gas Equation 190 Chapter Summary 205
● ●
The Diffusion of Pulmonary Gases 191 Review Questions 208
● ●
Clinical Application Questions 209
●
Chapter 5
The Anatomy and Physiology of the Circulatory System 211
Introduction 211 The Cardiac Cycle and Its Effect on
●
The Blood 212 Blood Pressure 234
● ●
The Heart 216 The Distribution of Pulmonary Blood Flow 237
● ●
The Pulmonary and Systemic Chapter Summary 249
●
Vascular Systems 228 Review Questions 252
● ●
Pressures in the Pulmonary and Systemic Clinical Application Questions 254
●
Vascular Systems 233
●
Chapter 6
Oxygen and Carbon Dioxide Transport 257
Introduction 257 Cyanosis 292
● ●
Oxygen Transport 258 Carbon Dioxide Transport 294
● ●
Oxyhemoglobin Dissociation Curve 263 Chapter Summary 302
● ●
Oxygen Transport Calculations 274 Review Questions 306
● ●
Hypoxia 287 Clinical Application Questions 307
● ●
Chapter 7
Acid–Base Balance and Regulation 309
Introduction 309 The Renal System and Acid–Base Balance 317
● ●
Basic Principles of Acid–Base The Role of the P /HCO2/pH Relationship in
CO 3
2
Reactions and pH 310 Acid–Base Balance 317
● ●
Chemical Buffer Systems and Chapter Summary 343
●
Acid–Base Balance 313 Review Questions 346
● ●
The Respiratory System and Clinical Application Questions 347
●
Acid–Base Balance 316
●
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Contents ix
Chapter 8
Ventilation-Perfusion Relationships 351
Ventilation-Perfusion Ratio 351 Chapter Summary 362
● ●
Respiratory Quotient 357 Review Questions 364
● ●
Respiratory Exchange Ratio 359 Clinical Application Questions 365
● ●
Chapter 9
Control of Ventilation 367
Introduction 367 Miscellaneous Factors That May Influence
●
Control of Respiration 367 Breathing 378
● ●
Factors That Influence the Rate and Depth of Chapter Summary 381
●
Breathing 370 Review Questions 384
● ●
Other Important Factors That Influence Breathing 377 Clinical Application Questions 385
● ●
Chapter 10
Fetal Development and the Cardiopulmonary System 387
Fetal Lung Development 387 Clinical Parameters in the Normal Newborn 403
● ●
Placenta 391 Chapter Summary 405
● ●
Fetal Circulation 394 Review Questions 407
● ●
Birth 397 Clinical Application Questions 408
● ●
Control of Ventilation in the Newborn 402
●
Chapter 11
Aging and the Cardiopulmonary System 411
Introduction 411 Effects of Aging on the Cardiovascular
●
Effects of Aging on the Respiratory System 411 System 418
● ●
Pulmonary Gas Exchange 416 Chapter Summary 423
● ●
Arterial Blood Gases 416 Review Questions 424
● ●
Section two
Advanced Cardiopulmonary Concepts
and Related Areas—The Essentials 425
Chapter 12
Electrophysiology of the Heart 427
Introduction 427 Chapter Summary 433
● ●
Five Phases of the Action Potential 428 Review Questions 433
● ●
Properties of the Cardiac Muscle 429
●
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