Cardiopulmonary Anatomy & Physiology: Essentials of Respiratory Care 7th Edition

Book Preface

Overview

It is important to emphasize that knowledge of an anatomic structure is essential to the understanding of the function of that structure. It therefore makes little sense to present students with physiologic details without first establishing a solid foundation in anatomy. Because most college-level anatomy courses spend only a limited amount of time on the cardiopulmonary system, respiratory therapy educators generally need to cover this subject themselves. In addition, with regard to a good textbook, respiratory educators usually find the cardiopulmonary section of the college-level anatomy and physiology texts too introduc-tory in nature for the future respiratory therapist’s needs.

As a solution to this problem, this book is designed to provide students of cardiopulmonary anatomy and physiology with the most accurate and complete information essential for respiratory care. It is as-sumed that the student has no previous knowledge of respiratory anatomy or physiology. Great efforts have been made to present a comprehensive overview of the subject matter in an organized, interesting, and readable manner. The organization of this book is based on my experiences as an educator of respi-ratory anatomy and physiology since 1973—and the countless things I have learned from my students and fellow colleagues. In response to these personal experiences and helpful suggestions, the following pedagogic approach is used in this book.

Organization

The seventh edition of this book is divided into three major sections. Section 1, The Cardiopulmonary System—The Essentials, consists of Chapters 1 through 11. Chapter 1 provides the student with a thor-ough discussion of anatomic structures associated with the respiratory system. This chapter also features a large number of colorful illustrations. The visual impact of this chapter is intended to (1) stimulate interest in the subject under discussion, (2) facilitate the rapid visualization of anatomic structures, and (3) help the student relate classroom knowledge to clinical experiences.
Chapters 2 through 9 cover the major concepts and mechanisms of respiratory physiology. The dis-cussions are comprehensive, logically organized, and, most importantly, presented at a level suitable for the average college student. When appropriate, anatomic and physiologic principles are applied to com-mon clinical situations to enhance understanding and retention (e.g., the gas transport calculations and their clinical application to the patient’s hemodynamic status). In addition, a large number of colorful line drawings and tables appear throughout these chapters to assist in the understanding of various concepts and principles.

Chapters 2, 3, 6, 7, and 8 feature several unique line drawings that relate familiar visual concepts to standard graphs and nomograms. While I have found that the types of graphs and nomograms presented in this book are often (at first) difficult for students to understand, it is important to stress that the “physi-ology literature” uses these items extensively. The student must understand how to read every graph and nomogram in this book to comprehend its contents fully!
Chapter 10 covers the major anatomic structures and physiologic mechanisms associated with fetal and newborn gas exchange and circulation. It presents the basic cardiopulmonary foundation required to understand fetal and neonatal respiratory disorders. Chapter 11 describes changes that occur in the cardiopulmonary system with age. Because the older age groups are expected to increase each year until about the year 2050, basic knowledge of this material will become increasingly important to respiratory care practitioners.

Section 2, Advanced Cardiopulmonary Concepts and Related Areas—The Essentials, consists of Chapters 12 through 17. Chapter 12 covers the essential electrophysiology of the heart required for ECG interpretation, Chapter 13 presents the major components of the standard 12-ECG lead system, and Chapter 14 provides a systematic approach to ECG interpretation and the major cardiac dysrhythmias seen by the respiratory care practitioner. Chapter 15 gives the reader the essential knowledge founda-tion required for hemodynamic measurements and interpretations.

Chapter 16 presents the structure and function of the renal system and the major cardiopulmonary problems that develop when the renal system fails. This chapter is particularly important for respiratory therapist working with patients in the critical care unit. Chapter 17 presents sleep physiology and its relationship to the cardiopulmonary system. During the past few years, there has been a tremendous increase in the demand for sleep medicine care services. Many of these sleep care centers are staffed with respiratory therapists who work routinely with patients who have various sleep-related disorders that adversely impact the cardiopulmonary system, such as obstructive sleep apnea.

Section 3, The Cardiopulmonary System during Unusual Environmental Conditions, consists of Chapters 18, 19, and 20. Chapter 18 presents the effects of exercise on the cardiopulmonary system. Dur-ing heavy exercise, the components of the cardiopulmonary system may be stressed to their limits. Car-diac patients involved in exercise training after myocardial infarction demonstrate a significant reduction in mortality and major cardiac mishaps. As our older population increases, cardiovascular rehabilitation programs will become increasingly more important to respiratory care practitioners.
Chapter 19 describes the effects of high altitude on the cardiopulmonary system. It provides a better understanding of chronic oxygen deprivation, which can then be applied to the treatment of chronic hypoxia caused by lung disease.
Chapter 20 provides an overview of high-pressure environments and their profound effect on the cardiopulmonary system. The therapeutic administration of oxygen at increased ambient pressures (hy-perbaric medicine) is commonly used to treat a number of pathologic conditions.

Finally, at the end of each chapter there is a set of review questions designed to facilitate learning and retention. In addition, at the end of Chapters 2 through 10 and 15, 16, and 17, the reader is provided with a clinical application section. In this part of the chapters, one or two clinical scenarios are presented that apply several of the concepts, principles, or formulas that are presented in the chapter to actual clinical situations. These clinical scenarios are flagged throughout the chapters—in the form of abbreviated Clini-cal Connections (see description of Clinical Connections below)—to help highlight important points or concepts as they appear in the chapter. This feature further facilitates the transfer of classroom material to the clinical setting. Following the clinical applications are related questions to facilitate the development of critical thinking skills.

A glossary is included at the end of the text that further defines many of the key terms that are bolded throughout the textbook. Not all the bolded key terms in the textbook appear in the glossary. This is because, oftentimes, certain terms and phrases are bolded in the text to emphasize certain anatomic structures, concepts, and relationships to enhance the readability of the text.

The glossary is followed by appendices that cover symbols, abbreviations, and units of measurement commonly used in respiratory physiology. Also included is a nomogram that can be copied and laminated for use as a handy clinical reference tool in the interpretation of specific arterial blood gas abnormalities. Finally, the answers to the chapter review questions appear in the last appendix.