West’s Respiratory Physiology: The Essentials Tenth Edition

Book Preface

This book was first published 40 years ago and has served several generations of students. It has been translated into 15 languages. This new 10th  edition incorporates a number of innovations—the most important is that  Andrew Luks, M.D., has come on board as a coauthor. Dr. Luks is a felicitous choice. He obtained his M.D. at the University of California San Diego  (UCSD) School of Medicine and therefore took the course for which the  book was originally written. In fact, he still has his extensively underlined fifth  edition of the book! He has a strong interest in teaching medical students at  the University of Washington School of Medicine, and so he is well poised to  look after the coming generations.

Another innovation of this new edition are clinical vignettes for each of  the first nine chapters of the book. The purpose of these is to emphasize  how the physiology that is described in the main text can be used in a clinical
situation. Also 26 new multiple-choice questions have been added. Some of  these require more reasoning than the traditional questions that rely heavily on factual recall. Another new development has been the production of fourteen 50 minute lectures closely based on the material in the book. These  are freely available on YouTube and have proved to be popular with students.
For example, the first lecture on Structure and Function of the Lung has had  over 100,000 visits. The URL is http://meded.ucsd.edu/ifp/jwest/resp_phys/ index.html. Finally, there has been a change in the title of the book consistent with its coming of age.

In spite of these new features, the objectives of the book have not changed.  First, the book is intended as an introductory text for medical students and  allied health students. As such, it will normally be used in conjunction with a  course of lectures, and this is the case at UCSD. Indeed, the first edition was  written because I believed that there was no appropriate textbook at that time  to accompany the first-year physiology course.

Second, the book is written as a review for residents and fellows in such  areas as pulmonary medicine, anesthesiology, and internal medicine, particularly to help them prepare for licensing and other examinations. Here, the requirements are somewhat different. The reader is familiar with the general  area but needs to have his or her memory jogged on various points, and the  many didactic diagrams are particularly important.

It might be useful to add a word or two about how the book meshes with  the lectures to the first-year medical students at UCSD. We are limited to  about twelve 50-minute lectures on respiratory physiology supplemented by two laboratory demonstrations, three small discussion groups, and a review  session with the whole class present. The lectures follow the individual chapters of the book closely, with most chapters corresponding to a single lecture. The exceptions are that Chapter 5 has two lectures (one on normal gas  exchange, hypoventilation, and shunt; another on the difficult topic of venti lation-perfusion relationships); Chapter 6 has two lectures (one on blood-gas  transport and another on acid-base balance); Chapter 7 has two lectures (on  statics and dynamics). There is no lecture on Chapter 10, “Tests of Pulmonary  Function,” because this is not part of the core course. It is included partly for  interest and partly because of its importance to people who work in pulmonary function laboratories.
The present edition has been updated in many areas including blood flow  and metabolism, gas transport by the blood, and the physiology of high altitude. Appendix B contains discussions of the answers to the questions including the new questions appended to the clinical vignettes. There are several  animations expanding sections of the text, and these are indicated by the symbol . Great efforts have been made to keep the book lean in spite of enormous temptations to fatten it. Occasionally, medical students wonder if the  book is too superficial. Not so. If pulmonary fellows beginning their training  in intensive care units fully understood all the material on gas exchange and  mechanics, the world would be a better place.
Many students and teachers have written to query statements in the book  or to make suggestions for improvements. We respond personally to every  point that is raised and much appreciate the input.

John B. West
[email protected]
Andrew M. Luks
[email protected]