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Pulmonary Physiology, 10th Edition

Pulmonary Physiology, 10th Edition PDF

Author: Michael Levitzky

Publisher: McGraw Hill


Publish Date: August 30, 2022

ISBN-10: 1264270046

Pages: 336

File Type: Epub, PDF

Language: English

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Book Preface

The tenth edition of Pulmonary Physiology has been thoroughly updated. New figures and tables have been added and others revised to help students visualize concepts more clearly and learn the material more effectively. New references and clinical correlations have been added to the end of each chapter. It has been more than 40 years since Pulmonary Physiology was first published. The book is now older than most of its readers!

Perhaps the greatest pleasure associated with the first nine editions has been receiving many favorable comments and helpful suggestions from students, readers, and colleagues, and I have used many of these suggestions in the preparation of this new edition.

This book is intended to be used both as an introductory text for beginning students and as a review for residents and fellows in such fields as internal medicine, anesthesiology, pediatrics, and pulmonary medicine. Students who have studied the text should be able to review for licensure and certification examinations by concentrating on the figures, key concepts, tables, and appendices, which summarize nearly all of the material in the book.

My goal in writing this book is to provide first-year medical students (as well as respiratory therapy, nursing, nurse-anesthesia, and other students) with a solid background on the aspects of pulmonary physiology essential for an understanding of clinical medicine. My approach is to encourage self-sufficiency not only in studying pulmonary physiology for the first time, but also in understanding the basic concepts of pulmonary physiology well enough to apply them with confidence to future patients.

I believe that the ways to accomplish this are to inform the reader of the goals of each chapter with clearly stated learning objectives, to give detailed and complete explanations of physiologic mechanisms and demonstrate how they apply to pathologic states, and to give the reader a means of self-testing by providing clinical correlations, problems, and pulmonary function test data to interpret.

The challenge is to write a book that students can read without difficulty in the limited amount of time allocated to pulmonary physiology in the typical curriculum. The material must be presented in a way that discourages memorization without real comprehension, because only those students who understand the basic mechanisms are able to apply them to new situations. The result of this approach should be a book that covers the essentials of the respiratory system as concisely as possible yet raises no questions in students’ minds without answering them. I hope that I have achieved these goals in writing this book.

I would like to thank the many people whose comments have helped me revise the various editions of the book, including my colleagues in respiratory physiology and pulmonary medicine, my colleagues at LSU Health Sciences Center and Tulane University School of Medicine, and my students and readers. I give special thanks to Drs. Andy Pellett and Lisa Harrison-Bernard of Louisiana State University Health Sciences Center and Hershel Raff of the Medical College of Wisconsin. I would also like to thank everyone who has helped me prepare the manuscripts, illustrations, and proofs, including my many editors at McGraw Hill, Betsy Giaimo, and my wife Elizabeth. This book is dedicated in memory of Robert S. Alexander and Jim Miller.

Michael G. Levitzky



Chapter 1 Function and Structure of the Respiratory System

Functions of the Respiratory System

Structure of the Respiratory System

Key Concepts

Suggested Readings

Chapter 2 Mechanics of Breathing

Generation of a Pressure Difference Between Atmosphere and Alveoli

Pressure-Volume Relationships in the Respiratory System

Interaction of Lung and Chest Wall: The Static Pressure-Volume Curve

Airways Resistance

The Work of Breathing

Key Concepts

Clinical Problems

Suggested Readings

Chapter 3 Alveolar Ventilation

The Lung Volumes

Measurement of the Lung Volumes

Anatomic Dead Space and Alveolar Ventilation

Measurement of Alveolar Ventilation

Alveolar Ventilation and Alveolar Oxygen and Carbon Dioxide Levels

Regional Distribution of Alveolar Ventilation

The Closing Volume

The Effects of Aging

Key Concepts

Clinical Problems

Suggested Readings

Chapter 4 Blood Flow to the Lung

The Bronchial Circulation

The Functional Anatomy of the Pulmonary Circulation

Pulmonary Vascular Resistance

The Regional Distribution of Pulmonary Blood Flow: The Zones of the Lung

Hypoxic Pulmonary Vasoconstriction

Effects of Mechanical Ventilation on Pulmonary Blood Flow

Pulmonary Edema

Key Concepts

Clinical Problems

Suggested Readings

Chapter 5 Ventilation-Perfusion Relationships

The Concept of Matching Ventilation and Perfusion

Consequences of High and Low Image

Testing for Nonuniform Distribution of Inspired Gas and Pulmonary Blood Flow

Regional Image Differences and Their Consequences in the Lung

Key Concepts

Clinical Problems

Suggested Readings

Chapter 6 Diffusion of Gases and Interpretation of Pulmonary Function Tests

Fick’s Law for Diffusion

Limitations of Gas Transfer

Diffusion of Oxygen

Diffusion of Carbon Dioxide

Measurement of Diffusing Capacity

Interpretation of Pulmonary Function Tests

Key Concepts

Clinical Problems

Suggested Readings

Chapter 7 Transport of Oxygen and Carbon Dioxide in the Blood

Transport of Oxygen by the Blood

Hemoglobin and the Physiologic Implications of the Oxyhemoglobin Dissociation Curve

Influences on the Oxyhemoglobin Dissociation Curve

Transport of Carbon Dioxide by the Blood

The Carbon Dioxide Dissociation Curve

The Bohr and Haldane Effects Explained

Key Concepts

Clinical Problems

Suggested Readings

Chapter 8 Acid-Base Balance

The Chemistry of Acids, Bases, and Buffers

Buffer Systems of the Human Body

Acidosis and Alkalosis

Respiratory and Renal Compensatory Mechanisms

Clinical Interpretation of Blood Gases and Acid-Base Status

The Causes of Hypoxia

Key Concepts

Clinical Problems

Suggested Readings

Chapter 9 Control of Breathing

The Generation of Spontaneous Rhythmicity

The Medullary Respiratory Center

The Pontine Respiratory Groups

Spinal Pathways

Reflex Mechanisms of Respiratory Control

Influences of Higher Centers

The Response to Carbon Dioxide

The Response to Hydrogen Ions

The Response to Hypoxia

The Response to Exercise

Altered Breathing Patterns

Key Concepts

Clinical Problems

Suggested Readings

Chapter 10 Nonrespiratory Functions of the Lung

Pulmonary Defense Mechanisms

Nonrespiratory Functions of the Pulmonary Circulation

Metabolic Functions of the Lung

Key Concepts

Suggested Readings

Chapter 11 The Respiratory System Under Stress

Exercise and the Respiratory System

Altitude and Acclimatization

Diving and the Respiratory System

Sleep and the Respiratory System

Key Concepts

Clinical Problems

Suggested Readings

Clinical Problem Answers


I. Symbols Used in Respiratory Physiology

II. The Laws Governing the Behavior of Gases

III. Frequently Used Equations

IV. Table of Normal Respiratory and Circulatory Values


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