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Encyclopedia of Energy, Natural Resource, and Environmental Respiratory System First and second edition authors: Angus Jeffries Andrew Turley Pippa McGowan Third edition authors: Harish Patel Catherine Gwilt 4 th Edition CRASH COURSE SERIES EDITOR: Dan Horton-Szar BSc(Hons) MBBS(Hons) MRCGP Northgate Medical Practice, Canterbury, Kent, UK FACULTY ADVISOR: Omar S Usmani MBBS PhD FHEA FRCP NIHR Career Development Fellow, Clinical Senior Lecturer & Consultant Physician in Respiratory & Internal Medicine, National Heart and Lung Institute, Imperial College London and Royal Brompton Hospital, RespirLondon,a UK tory System Sarah Hickin BSc(Hons) MBBS F2, Heatherwood and Wexham Park Hospitals NHS Trust, Slough, UK James Renshaw BSc(Hons) MBBS F2, Whipps Cross University Hospital, Barts Health NHS Trust, London, UK Rachel Williams BSc(Hons) MBBS F2, West Middlesex University Hospital, London, UK Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2013 Commissioning Editor: Jeremy Bowes Development Editor: Helen Leng Project Manager: Andrew Riley Designer/Design Direction: Christian Bilbow Icon Illustrations: Geo Parkin Illustration Manager: Jennifer Rose © 2013 Elsevier Ltd. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the publisher (other than as may be noted herein). First edition 1999 Second edition 2003 Third edition 2008 Fourth edition 2013 ISBN 9780723436270 e-book ISBN 9780723437925 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data A catalog record for this book is available from the Library of Congress Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. The Publisher's policy is to use paper manufactured from sustainable forests Printed in China Series editor foreword The Crash Course series was first published in 1997 and now, 16 years on, we are still going strong. Medicine never stands still, and the work of keeping this series relevant for today’s students is an ongoing process. These fourth editions build on the success of the previous titles and incorporate new and revised material to keep the series up to date with current guidelines for best practice and recent developments in medical research and pharmacology. We always listen to feedback from our readers, through focus groups and student reviews of the Crash Course titles. For the fourth editions, we have completely rewritten our self-assessment material to keep up with today’s ‘single-best answer’ and ‘extended matching question’ formats. The artwork and layout of the titles have also been largely reworked to make the text easier on the eye during long sessions of revision. Despite fully revising the books with each edition, we hold fast to the principles on which we first developed the series. Crash Course will always bring you all the information you need to revise in compact, manageable volumes that integrate basic medical science and clinical practice. The books still maintain the balance between clarity and conciseness, and provide sufficient depth for those aiming at distinction. The authors are medical students and junior doctors who have recent experience of the exams you are now facing, and the accuracy of the material is checked by a team of faculty advisors from across the UK. I wish you all the best for your future careers! Dr Dan Horton-Szar v Intentionally left as blank Prefaces Authors Firstly, thank you for taking the time to open this latest version; we are very proud of this publication and we really hope you will find it as beneficial and user-friendly as we set out to make it. Our aim was to add to the strengths of the previous edition but also to update the text to reflect changing medical school syllabuses and assessment styles. We have once again revamped the layout, splitting the text into three sections following a ‘bench to bedside’ approach to respiratory medicine. Whilst each topic is accessible as a standalone resource, taken together we have tried to provide a coherent journey from basic science to clinical assessment of a patient and finally respiratory pathology. Cross referencing suggestions between sections and also up to date guidelines will enable you quickly to link relevant aspects of science and clinical medicine in an evidence-based manner. Lastly, you will find a range of multiple choice questions of the SBA and EMQ format in place of previous short answer and essay based assessments. We stronglyfeel this book has a wide scope ofapplication, whether you are revisingfor basic science exams, or are on the wards looking for clinical information with a pathophysiological focus, there is something for you. We hope you find this edition valuable in both study and working life and wish you all the best for your assessments! Sarah Hickin, James Renshaw and Rachel Williams Faculty Advisor Crash Course is a unique series. The authors themselves have just completed their final year exams and are preparing for their first postgraduate exams and so, have a heightened knowledge and are experienced with the current requirements of the ever changing medical curriculum. Sarah, Rachel and James have brought their own vision to this edition, focusing firmly on integrating basic science with clinical practice to make Respiratory Medicine an essential and enjoyable read. This edition has updated clinical guidelines and is extensively cross referenced, reinforcing the complementary information in the different chapters. It has been a pleasure to work with the authors, whose momentum in keeping focused on this book was admirable, particularly in their first foundation year and especially after undertaking stretches of night’s on-call, in order to keep to our deadlines! I do hope you enjoy this edition. Omar S Usmani vii Intentionally left as blank Acknowledgements FIGURE ACKNOWLEDGEMENTS Fig. 1.3 adapted with permission from Hlastala MP, Berger AJ (2001) Physiology of Respiration, 2nd edn. Oxford: Oxford University Press. Fig. 1.5 adapted with permission from West JB (2001) Pulmonary Physiology and Pathophysiology: An Integrated, Case-Based Approach. Philadelphia: Lippincott Williams & Wilkins. Figs 2.13 and 4.19 reproduced from Widdicombe JG, Davies A (1991) Respiratory Physiology (Physiological Principles in Medicine), 2nd edn. London: Hodder Arnold. Fig. 2.14 reproduced from http://academic.kellogg.edu/herbrandsonc/bio201_ mckinley/f25-9a_bronchioles_and__c.jpg © Copyright 1999, Kellogg Community College. Learning the Respiratory System Chapter 25 Fig. 2.15B adapted from StudyBlue, Australia, University of Queensland, Health & Disease, Respiratory System (II) Flashcards, How are the lungs innervated by the SNS? ©2012 STUDYBLUE Inc. Figs 4.3, 16.2, 16.3 and 19.1 reproduced from Criner GJ, D’Alonzo GE (eds) (1999) Pulmonary Pathophysiology. Madison, WI: Fence Creek Publishing. Figs 4.14, 4.16, 5.7, 5.8, 5.9 and 6.6 reproduced from Berne RM, Levy MN (1993) Physiology, Human Physiology – The Mechanisms of Body Function, 3rd edn. St Louis: Mosby. Fig. 9.20 after Burton, Hodgkin & Ward (1977) Lippincott-Raven. Fig. 9.21 reproduced from Munro & Campbell 2000, with permission of Churchill Livingstone. Fig. 10.8 Reproduced from NICE guidelines http://www.nice.org.uk/usingguidance/ commissioningguides/pulmonaryrehabilitationserviceforpatientswithcopd/mrc_ dyspnoea_scale.jsp. Adapted from Fletcher CM, Elmes PC, Fairbairn MB et al. (1959) The significance of respiratory symptoms and the diagnosis of chronic bronchitis in a working population. British Medical Journal 2:
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