Book Review Respiratory Physiology The Essentials Eight Edition John B West, M.D., Ph.D, DSc, FRCP, FRACP 2008 192 pp 99illus ISBN 9-078-4.

Figure 2 Respiratory plethysmography with the Respitrace. On the left-hand side, rib cage (RC) and abdomen (ABD) movements are plotted as a function of time, and the right-hand side graphically represents the phase angles and direction of the loop. Note the usual situation where the diaphragm leads inspiration. As breathing moves from synchronous to asynchronous, the size of the phase-angle loop widens, although preserving anticlockwise rotation.

However, with diaphragm paralysis (paradoxical), the RC and ABD are exactly 180° out of phase, with clockwise movement. Figure 5 Flow–pressure curve for a child with croup. Flow and pressure curves plotted against time. Top panel: before epinephrine – traces demonstrating inspiratory flow limitation. During initial inspiration there is a positive increase in inspiratory flow associated with a change in oesophageal pressure ( left of solid arrow).

To the right of the solid arrow, until inspiratory effort decreases ( open arrow), there is virtually no further increase in inspiratory flow despite a large increase in negative pressure. During expiration, there is also evidence of flow limitation, with oesophageal pressure higher and flows lower than those seen in the patient after epinephrine inhalation. Lower panel: after epinephrine.

From the beginning of inspiration, flow increases markedly up to the point marked by the solid arrow as pressure decreases. Thereafter, there is a further small decline in oesophageal pressure to its minimum but modest negative value ( open arrow). During expiration, very modest increases in pressure are associated with relatively high flows. Motorola Phone Tools V 2355 Hydrocodone.

General paediatricians will encounter myriad respiratory abnormalities during their careers. A basic knowledge of essential respiratory physiology, its subsequent derangements due to disease states and how to assess these abnormalities will help in the proper care of children. This paper will begin with an overview of normal respiratory physiology and how to monitor the efficiency of gas exchange.

It will also discuss common methods of non-invasive monitoring including pulse oximetry, carbon dioxide monitoring, pulmonary function tests and respiratory impedance plethysmography. Finally, paediatric disease states will be used to illuminate the intersection between pathophysiology, clinical symptoms and monitoring capabilities.

As the listener will immediately recognize, these lectures were not read but delivered 'on the fly'. This makes them less formal. However there are a number of slips of the tongue. For example in the description of the central chemoreceptors, the term blood-gas barrier should really be blood-brain barrier. In the short section on turbulent flow, I should have said that the pressure is approximately equal to the square of the flow, not that flow is related to the square of the pressure. In the section on exercise, the systemic vascular resistance (not the systemic pressure) falls during dynamic exercise but rises during static exercise.

The pulmonary function experiment done by the astronaut takes 31 minutes (as shown in the image) not an hour. There are probably other slips of the tongue but the meaning should be clear in the context of the lectures. Credits for Images. 2, 3, 4, 5, 6, 7, 8, 11, 12, 13, 14, 17, 18, 20 - West J.B. Respiratory Physiology: The Essentials. Philadelphia: Lippincott Williams and Wilkins, 2008.

19 - West J.B. Pulmonary Pathophysiology: The Essentials, 7th ed. Philadelphia: Lippincott Williams and Wilkins, 2007. 9, 10 - West J. Non Us Citizen Drivers License Texas.

Regional Differences in the Lung. New York: Academic Press, 1977. 19, 21 - West J.B. Pulmonary Pathophysiology: The Essentials, 7th ed. Philadelphia: Lippincott Williams and Wilkins, 2007. Mechanics of Breathing I.