PART Ⅰ 1
1．INTRODUCTION TO PULMONARY PHYSIOLOGY 1
2．THE LUNG VOLUMES 7
A．Vital Capacity and Its Subdivisions 7
B．Residual Volume and Functional Residual Capacity；Thoracic Gas Volume 13
C．Total Lung Capacity 23
3．PULMONARY VENTILATION 27
Ⅰ．Volume of Pulmonary Ventilation 34
A．Frequency(Rate)of Breathing 34
B．Tidal Volume(Depth of Breathing) 34
C．Respiratory Dead Space 37
D．Alveolar Ventilation Per Minute 42
E．Hypoventilation of the Lungs 44
F．Hyperventilation of the Lungs 49
G．Diagnosis of Hypo-and Hyperventilation 50
H．The O2-CO2 Diagram 51
I．Regulation of Ventilation 51
J．Pulmonary Ventilation During Exercise 58
Ⅱ．Uniformity of Alveolar Ventilation 60
A．Tests of Uneven Distribution of Inspired Gas 65
B．Causes of Uneven Ventilation 72
C．Effects of Uneven Ventilation 74
4．THE PULMONARY CIRCULATION AND VENTILATION/BLOOD FLOW RATIOS 77
Ⅰ Pressures，Resistance，Flow and Volume 78
A．Pressures 78
B．Resistance to Flow in Pulmonary Circulation 82
C．Flow 84
D．Volume 86
Ⅱ．Distribution of Pulmonary Capillary Blood Flow：Ventilation/Blood Flow Ratios 87
A．Causes of Uneven Pulmonary Capillary Blood Flow 87
B．Effects of Uneven Distribution of Inspired Gas and Pulmonary Capillary Blood Flow 89
C．Tests of Uneven Ventilation in Relation to Blood Flow 101
5．DIFFUSION 111
A．Factors Influencing Diffusing Capacity 114
B．Measurement of Pulmonary Diffusing Capacity 117
C．Normal Values for Pulmonary Diffusing Capacity 133
D．Laboratory Diagnosis of Impairment of Diffusion 135
E．Diffusing Capacity in Patients with Cardiopulmonary Disease 137
6．ARTERIAL BLOOD OXYGEN，CARBON DIOXIDE AND pH 140
Ⅰ．Arterial Blood Oxygen 140
A．The Oxygen-Hemoglobin Dissociation Curves 140
B．Methods of Estimating or Measuring Blood O2 143
C．Causes of Anoxemia 146
D．Differential Diagnosis of Anoxemia Caused by Respiratory or Cardiopulmonary Disease 147
E．Non-Pulmonary and Non-Respiratory Causes of Anoxia 149
F．Effects of Anoxemia and Anoxia 150
Ⅱ．Arterial Carbon Dioxide and pH 151
A．CO2 Transport 152
B．Methods for Measuring CO2 and pH 155
C．Significance of Changes in Arterial Blood PCO2 156
D．Effects of Marked Deviations in Arterial Blood PCO2 157
E．Carbon Dioxide，pH and Acid-Base Balance 158
7．MECHANICS OF BREATHING 162
A．Compliance of Lungs and Thorax 163
B．Airway Resistance 178
C．Tissue Resistance：Pulmonary Resistance 189
D．Cohesion 190
E．Inertia 191
F．The Work of Breathing 191
G．Maximal Inspiratory and Expiratory Forces 195
Tests of Over-All Mechanical Function of Lungs and Thorax 196
PART Ⅱ CLINICAL APPLICATIONS 204
8．A PRACTICAL APPROACH TO EVALUATION OF PULMONARY FUNCTION 204
9．PATTERNS OF PULMONARY FUNCTION IN CARDIOPULMONARY AND RESPIRATORY DISORDERS 211
Pattern of Aging 212
Pattern of Hypoventilation 213
Pattern of Diffuse Obstruction of Small Airways 220
Pattern of Impaired Diffusion 232
Pattern of Restriction 238
Pattern of Right-to-Left Shunt 243
Pattern of Uneven Pulmonary Capillary Blood Flow 246
Pattern of Pulmonary Vascular Congestion 252
Pattern of Precapillary Obstruction in Pulmonary Circulation 253
10．PULMONARY DISABILITY 256
Causes of Pulmonary Disability 256
Dyspnea 257
Compensation for Pulmonary Disability 263
Preoperative Evaluation of Pulmonary Function 270
11．RESPIRATORY PROBLEMS BEFORE，DURING AND AFTER ANESTHESIA 276
12．PHYSIOLOGIC THERAPY 281
Ⅰ．Respiratory Disorders with Apnea or Severe Alveolar Hypoventilation 281
A．Speed in Initiating Therapy 282
B．Open Airway 282
C．Non-Mechanical Methods for Producing Pulmonary Ventilation 284
D．Mechanical Methods for Producing Pulmonary Ventilation 285
E．Stimulation of the Respiratory Center 289
Ⅱ．Cardiopulmonary Disease 291
A．Therapy for Intermittent or Chronic Bronchiolar Obstruction 291
B．Correction of Decreased Compliance 301
C．Direct Increase in Alveolar Ventilation 302
D．Oxygen Therapy 305
E．Treatment of Disorders of the Pulmonary Circulation 316
PART Ⅲ(Appendix) 323
USEFUL DATA，EQUATIONS AND CALCULATIONS 323
Ⅰ．General 323
A．Typical Values for Pulmonary Function Tests 323
B．Predicted and Normal Values for Pulmonary Function Tests 325
C．Symbols and Abbreviations Used by Pulmonary Physiologists 330
D．The Gas Laws 331
Ⅱ．Alveolar Ventilation and Pulmonary Blood Flow 334
Ⅲ．Alveolar-Capillary Diffusion 349
Ⅳ．Alveolar Gas-Arterial Blood Po2 and PCO2 Differences 358
Ⅴ．Mechanics of Breathing 360
Selected References 365
Index 379