Pathophysiology - E-Book

"Develop a strong understanding of pathophysiology. Pathophysiology, 6th Edition explores the etiology, pathogenesis, clinical manifestations, and treatment of diseases and disorders. Each section focuses on the major alterations in the homeostasis of the body systems in order to provide you with a unifying framework. Current scientific findings and relevant global research are integrated throughout the book, with chapters organized by body system, beginning with an illustrated review of anatomy and normal physiology. Each chapter includes a discussion on the disease processes and abnormalities that may occur, with a focus on the pathophysiologic concepts involved. Written by leading educators, this text simplifies a rigorous subject with practical learning resources, an emphasis on critical thinking, and coverage of the latest scientific findings and relevant research. Plus, more than 1,000 updated, full color illustrations and photos throughout, give you a chance to visualize disease and disease processes and gain a clearer understanding of the material."--Provided by publisher Front Cover IFC_brief contents Evolve page Pathophysiology Copyright Page Dedication Contributors Reviewers Preface Organization Features Ancillaries Student Learning Resources on Evolve Study Guide Instructor Learning Resources on Evolve Acknowledgments Table Of Contents Unit I Pathophysiologic Processes 1 Introduction to Pathophysiology Chapter Outline Key Questions Framework for Pathophysiology Etiology Pathogenesis Clinical Manifestations Stages and Clinical Course Treatment Implications Concepts of Normality in Health and Disease Statistical Normality Reliability, Validity, and Predictive Value Individual Factors Influencing Normality Cultural Considerations Age Differences Gender Differences Situational Differences Time Variations Patterns of Disease in Populations Concepts of Epidemiology Endemic, Pandemic, and Epidemic Diseases Aggregate Factors Age. Ethnic group. Gender. Socioeconomic factors and lifestyle considerations. Geographic location. Levels of Prevention Primary prevention. Secondary prevention. Tertiary prevention. Summary Resources General Concepts of Pathophysiology Normal Variations and Statistical Analysis Patterns of Disease and Epidemiology 2 Homeostasis, Allostasis, and Adaptive Responses to Stressors Chapter Outline Key Questions Homeostasis and Allostasis Homeostasis Allostasis Stress as a Concept The General Adaptation Syndrome and Allostasis Alarm Stage Resistance or Adaptation Stage Exhaustion Stage Stressors, Gender and Developmental Influences, and Risk Factors Neurohormonal Mediators of Stress and Adaptation Catecholamines: Norepinephrine and Epinephrine Adrenocortical Steroids: Cortisol and Aldosterone Endorphins, Enkephalins, and Immune Cytokines Sex Hormones: Estrogen, Testosterone, and Dehydroepiandrosterone Growth Hormone, Prolactin, and Oxytocin Adaptation, Coping, and Illness Adaptation, Coping, and Resilience Allostatic Overload and Illness Summary Resources Homeostasis and Allostasis Neurohormones and Concepts of Stress Adaptation and Coping Unit II Cellular Function 3 Cell Structure and Function Chapter Outline Key Questions Plasma Membrane Membrane Structure Lipid Bilayer Membrane Proteins Organization of Cellular Compartments Cytoskeleton Nucleus Endoplasmic Reticulum Golgi Apparatus Lysosomes and Peroxisomes Mitochondria Cellular Metabolism Glycolysis Citric Acid Cycle Oxidative Phosphorylation Functions of the Plasma Membrane Membrane Transport of Macromolecules Endocytosis and Exocytosis Membrane Transport of Small Molecules Active Transport Pumps Sodium–potassium ion pump. Membrane calcium transporters. ABC transporters. Membrane Transport Carriers Na+-driven carriers. Passive transport carriers. Membrane Channel Proteins Cellular Membrane Potentials Resting Membrane Potential Action Potential Intercellular Communication and Growth Cell Signaling Strategies Cell Surface Receptor–Mediated Responses Intracellular Receptor–Mediated Responses Regulation of Cellular Growth and Proliferation Summary Resources General Cell Structure and Function Cellular Energy Metabolism Cellular Electrical Potentials Cell Growth Regulation 4 Cell Injury, Aging, and Death Chapter Outline Key Questions Reversible Cell Injury Hydropic Swelling Intracellular Accumulations Cellular Adaptation Atrophy Hypertrophy Hyperplasia Metaplasia Dysplasia Irreversible Cell Injury Necrosis Apoptosis Etiology of Cellular Injury Ischemia and Hypoxic Injury Nutritional Injury Infectious and Immunologic Injury Chemical Injury Physical and Mechanical Injury Cellular Aging Cellular Basis of Aging Physiologic Changes of Aging Somatic Death Summary Resources Cellular Responses to Injury Types and Causes of Cell Injury Cellular Aging and Death 5 Genome Structure, Regulation, and Tissue Differentiation Chapter Outline Key Questions Structure and Function of DNA Structure of DNA DNA Replication Genetic Code Transcription Translation Regulation of the Genome Transcriptional Controls Differentiation of Tissues Cell Diversification and Cell Memory Mechanisms of Development Differentiated Tissues Epithelial Tissue Connective Tissue Muscle Tissue Nervous Tissue Summary Resources Genome Structure and Regulation Differentiation of Tissues 6 Genetic and Developmental Disorders Chapter Outline Key Questions Principles of Inheritance DNA Mutation and Repair Genetic Disorders Chromosomal Abnormalities Aberrant Number of Chromosomes Abnormal Chromosome Structure Examples of Autosomal Chromosome Disorders Trisomy 21 (Down Syndrome) Trisomy 18 (Edwards Syndrome) and Trisomy 13 (Patau Syndrome) Cri du Chat Syndrome Examples of Sex Chromosome Disorders Klinefelter Syndrome Turner Syndrome Multiple X Females and Double Y Males Mendelian Single-Gene Disorders Autosomal-Dominant Disorders Marfan Syndrome Huntington Disease Autosomal-Recessive Disorders Albinism Phenylketonuria Cystic Fibrosis Sex-Linked (X-Linked) Disorders Hemophilia A Nonmendelian Single-Gene Disorders Anticipation Mitochondrial Gene Mutations Genomic Imprinting Polygenic and Multifactorial Disorders Environmentally Induced Congenital Disorders Periods of Fetal Vulnerability Teratogenic Agents Chemicals and Drugs Infectious Agents Radiation Other Disorders of Infancy Diagnosis, Counseling, and Gene Therapy Prenatal Diagnosis and Counseling Genetic Analysis and Therapy Recombinant DNA Technology Summary Resources Principles of Inheritance and Genetic Disorders 7 Neoplasia Chapter Outline Key Questions Benign Versus Malignant Growth Characteristics of Benign and Malignant Tumors Tumor Terminology The Malignant Phenotype Epidemiology and Cancer Risk Factors Tobacco Use Nutrition Antioxidants Genetic Mechanisms of Cancer Proto-Oncogenes Growth Factors (Mitogens) Growth Factor Receptors Cytoplasmic Signaling Pathways Transcription Factors From Proto-Oncogene to Oncogene Tumor Suppressor Genes The Rb Gene The P53 Gene BRCA1 and BRCA2 Genes Multistep Nature of Carcinogenesis Initiation Promotion Progression Metastasis Patterns of Spread Angiogenesis Grading and Staging of Tumors Effects of Cancer on the Body Cancer Therapy Surgery Radiation Therapy Drug Therapy Immunotherapy Gene and Molecular Therapy Stem Cell Transplantation Summary Resources Cancer Epidemiology Cancer Biology Unit III Defense 8 Infectious Processes Chapter Outline Key Questions Host–Microbe Relationship The Human Microbiome Host Characteristics Physical and Mechanical Barriers Impaired Immune Function Nutritional status. Age. Chronic illness. Immunization status. Pathogen Characteristics Adherence and Invasion Bacterial Endotoxin Bacterial Exotoxins and Enzymes Evasion of Immune Cells Endospore Formation Antimicrobial Resistance Transmission of Infection Routes of Transmission Emerging Infectious Diseases Weapons of Bioterrorism Types of Pathogenic Organisms Bacteria Viruses Fungi Parasites Summary Resources Commensal and Infectious Organisms Emerging Infectious Diseases 9 Inflammation and Immunity Chapter Outline Key Questions Components of the Immune System Epithelial Barriers Mononuclear Phagocyte System Lymphoid System Primary Lymphoid Organs Secondary Lymphoid Organs Tonsils Spleen Lymph Nodes and Lymphatics Peyer Patches Leukocytes Neutrophils Eosinophils Basophils and Mast Cells Monocytes and Macrophages Dendritic Cells Lymphocytes Natural Killer Cells T Lymphocytes B Lymphocytes Chemical Mediators of Immune Function Complement Kinins Clotting Factors Cytokines and Chemokines Innate Defenses and Inflammation Inflammation Increased Vascular Permeability Emigration of Leukocytes Phagocytosis Chronic Inflammation Healing Inflammatory Exudates Systemic Manifestations of Inflammation Specific Adaptive Immunity Major Histocompatibility Complex Antigen Presentation by MHC MHC Class I Presentation MHC Class II Presentation Mechanisms of Cell-Mediated Immunity T Helper Cells (CD4+) Cytotoxic T Cells (CD8+) Mechanisms of Humoral Immunity Antigen Recognition by B Cells Antibody Structure Class Switching and Affinity Maturation Antibody Functions Passive and Active Immunity Passive Immunity Active Immunity Integrated Function and Regulation of the Immune System Integrated Response to Microbial Antigen Integrated Response to Viral Antigen Regulation of Immune Function Summary Resources Immunology 10 Alterations in Immune Function Chapter Outline Key Questions Excessive Immune Responses Autoimmunity Genetic Factors Environmental Triggers Pharmacotherapies Hypersensitivity Type I Hypersensitivity Etiology Pathogenesis Clinical Manifestations Treatment Prevention Pharmacotherapeutic Prevention Type IIa Hypersensitivity Etiology and Pathogenesis Transfusion Reaction Hemolytic Disease of the Newborn Myasthenia Gravis Hyperacute Graft Rejection Type IIb Hypersensitivity Graves Disease Type III Hypersensitivity Etiology Pathogenesis Tissue Deposition Immune Complex Glomerulonephritis Etiology. Clinical manifestations and treatment. Systemic Lupus Erythematosus Etiology. Clinical manifestations. Treatment. Type IV Hypersensitivity Type IVa — Granulomatous Hypersensitivity Type IVa – Tuberculin-Type Hypersensitivity Type IVa – Allergic Contact Dermatitis Type IVb – Persistent Asthma Type IVc – Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis Type IVd – Pustular Psoriasis Deficient Immune Responses Primary Immunodeficiency Disorders B-Cell and T-Cell Combined Disorders Severe Combined Immunodeficiency Disorders Etiology and pathogenesis. Clinical manifestations and treatment. Wiskott–Aldrich Syndrome Etiology and pathogenesis. Clinical manifestations and treatment. T-Cell Disorders 22q11.2 Deletion Syndrome (DiGeorge Syndrome) Etiology and pathogenesis. Clinical manifestations and treatment. Chronic Mucocutaneous Candidiasis Disease Etiology and pathogenesis. Clinical manifestations and treatment. B-Cell Disorders IgA Deficiency Etiology and pathogenesis. Clinical manifestations and treatment. X-Linked Agammaglobulinemia Etiology and pathogenesis. Clinical manifestations and treatment. Transient Hypogammaglobulinemia Common Variable Immunodeficiency Disease Clinical manifestations and treatment. Secondary Immunodeficiency Disorders Summary Resources Autoimmune and Hypersensitivity Disorders Deficient Immune Responses 11 Malignant Disorders of White Blood Cells Chapter Outline Key Questions Classification of Hematologic Neoplasms Etiology of Myeloid and Lymphoid Neoplasms General Principles of Management Diagnosis of Hematologic Neoplasms Principles of Treatment Prevention and Management of Complications Myeloid Neoplasms Chronic Myeloid Leukemia Pathogenesis and clinical manifestations. Prognosis and treatment. Acute Myeloid Leukemia Pathogenesis and clinical manifestations. Prognosis and treatment. Lymphoid Neoplasms Chronic Lymphoid Leukemia Pathogenesis and clinical manifestations. Prognosis and treatment. Acute Lymphoblastic Leukemia/Lymphoma Pathogenesis and clinical manifestations. Prognosis and treatment. Hairy Cell Leukemia Pathogenesis and clinical manifestations. Prognosis and treatment. Plasma Cell Myeloma (Multiple Myeloma) Pathogenesis and clinical manifestations. Prognosis and treatment. Hodgkin Disease Pathogenesis and clinical manifestations. Prognosis and treatment. B-Cell, T-Cell, and NK-Cell Lymphoma (Non-Hodgkin) Pathogenesis and clinical manifestations. Prognosis and treatment. Summary Resources Etiology and Classification of Hematologic Neoplasms Myeloid Neoplasms Lymphoid Neoplasms 12 HIV Disease and AIDS Chapter Outline Key Questions Epidemiology History Types of HIV Transmission Prevention of Transmission Etiology HIV Structure HIV Binding and Infection Pathogenesis Effect of HIV on Immune Cells at the Cellular Level Viral Production and Cell Death Progression of HIV Infection From Seroconversion to AIDS CDC HIV Classification System Diagnostic Testing Monitoring the Progression of HIV Clinical Manifestations Systemic Manifestations Gastrointestinal Manifestations Pulmonary Manifestations Mucocutaneous Manifestations Gynecologic Manifestations Neurologic Manifestations Ocular Manifestations Cardiovascular Manifestations Manifestations in Other Systems Manifestations in Children Treatment Antiretroviral Therapy Recommendations Nucleoside Reverse Transcriptase Inhibitors Nucleotide Reverse Transcriptase Inhibitors Nonnucleoside Reverse Transcriptase Inhibitors Protease Inhibitors Fusion Inhibitors CCR5 Inhibitors Integrase Strand Transfer Inhibitors Other Treatments and Vaccines Summary Resources HIV Epidemiology HIV Biology Pathogenesis, Clinical Manifestations, and Management Unit IV Oxygen Transport, Blood Coagulation, Blood Flow, and Blood Pressure 13 Alterations in Oxygen Transport Chapter Outline Key Questions Composition of Blood Organic and Inorganic Components Cellular Components Erythrocytes Leukocytes Platelets Structure and Function of Red Blood Cells Hematopoiesis Hemoglobin Synthesis Hemoglobin Synthesis in Infants Nutritional Requirements for Erythropoiesis Energy and Maintenance of Erythrocytes Red Cell Production Red Cell Destruction Gas Transport and Acid–Base Balance Oxygen Transport Carbon Dioxide Transport Alterations in Oxygen Transport Anemia General Effects of Anemia Anemia Related to Decreased Red Cell Production Aplastic Anemia Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Anemia of Chronic Renal Failure Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Anemia Related to Vitamin B12 (Cobalamin) or Folate Deficiency Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Iron Deficiency Anemia Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Anemia Related to Inherited Disorders of the Red Cell Thalassemia Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Sickle Cell Anemia Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Hereditary Spherocytosis Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Glucose-6-Phosphate Dehydrogenase Deficiency Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Anemia Related to Extrinsic Red Cell Destruction or Loss Hemolytic Disease of the Newborn Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Antibody-Mediated Drug Reactions Etiology and pathogenesis. Hapten mechanisms. Neoantigen formation. Membrane modification. Autoantibody induction. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Acute Blood Loss Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Other Extrinsic Abnormalities Transfusion Therapy Polycythemia Polycythemia Vera Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Secondary Polycythemia Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Relative Polycythemia Etiology and pathogenesis. Laboratory features. Clinical manifestations. Treatment. Course and prognosis. Summary Resources Red Cell Production and Laboratory Analysis Anemias Blood Transfusion Therapy Polycythemia 14 Alterations in Hemostasis and Blood Coagulation Chapter Outline Key Questions The Process of Hemostasis Stages of Hemostasis Platelets Blood Coagulation Factors Fibrin Clot Fibrinolysis Evaluation of Hemostasis and Coagulation Clinical Assessment Laboratory Tests Vascular and Platelet Disorders Vascular Disorders Vascular Purpura Etiology. Pathogenesis. Clinical manifestations. Diagnosis and treatment. Hereditary Hemorrhagic Telangiectasia Etiology. Pathogenesis. Clinical manifestations. Diagnosis and treatment. Platelet Disorders Thrombocytopenia Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Thrombocytosis Etiology. Pathogenesis. Clinical manifestations. Diagnosis and treatment. Qualitative Platelet Disorders Etiology. Pathogenesis. Clinical manifestations. Diagnosis and treatment. Coagulation Disorders Hemophilia Etiology. Pathogenesis. Clinical manifestations. Diagnosis and treatment. von Willebrand Disease Etiology. Pathogenesis. Clinical manifestations. Diagnosis and treatment. Vitamin K Deficiency Bleeding in Infancy Etiology. Pathogenesis. Clinical manifestations. Diagnosis and treatment. Acquired Vitamin K Deficiency Etiology. Pathogenesis. Clinical manifestations. Diagnosis and treatment. Disseminated Intravascular Coagulation (DIC) Etiology. Pathogenesis. Clinical manifestations. Diagnosis and treatment. Hepatic Disease Etiology. Pathogenesis. Clinical manifestations. Diagnosis and treatment. Summary Resources Platelet Function and Hemostasis Vascular and Platelet Disorders Coagulation Disorders 15 Alterations in Blood Flow Chapter Outline Key Questions Organization of the Circulatory and Lymphatic Systems Vessel Structure Anatomy of Arteries and Veins Anatomy of Capillaries Lymphatic Structure Principles of Flow Hemodynamics of the Circulatory System Blood Flow, Pressure, and Resistance Velocity and Laminar and Turbulent Flow Wall Tension and Compliance Dynamics in the Microcirculation: Capillaries and Lymphatics Control of Flow Control of Blood Flow Extrinsic Mechanisms Intrinsic Mechanisms Control of Lymphatic Flow General Mechanisms That Cause Altered Flow Blood Vessels: Obstructions Thrombus Etiology. Pathogenesis Arterial. Venous. Clinical manifestations and treatment. Embolus Etiology and pathogenesis. Clinical manifestations. Treatment. Emboli produced by other causes. Vasospasm Inflammation Mechanical Compression Blood Vessels: Structural Alterations Types of Structural Alterations Valvular incompetence. Arteriosclerosis/atherosclerosis. Aneurysms. Arteriovenous fistulas. Lymphatic Vessels Alterations in Arterial Flow Arteriosclerosis/Atherosclerosis Etiology and Pathogenesis Risk Factors Modifiable risk factors. Nonmodifiable risk factors. Clinical Manifestations and Diagnosis Treatment Thromboangiitis Obliterans (Buerger Disease) Raynaud Syndrome Aneurysms Classifications Clinical Manifestations and Diagnosis Treatment Acute Arterial Occlusion Alterations in Venous Flow Valvular Incompetence Etiology and Pathogenesis Clinical Manifestations and Treatment Varicose Veins Etiology and Pathogenesis Clinical Manifestations and Treatment Chronic Venous Insufficiency Etiology and Pathogenesis Clinical Manifestations and Treatment Deep Vein Thrombosis Etiology and Pathogenesis Clinical Manifestations and Treatment Alterations in Lymphatic Flow Lymphedema Etiology and Pathogenesis Clinical Manifestations, Diagnosis, and Treatment Summary Resources Physiology of Blood Flow Alterations in Blood Flow and Atherosclerosis Venous and Lymphatic Disorders 16 Alterations in Blood Pressure Chapter Outline Key Questions Arterial Blood Pressure Determinants of Systemic Blood Pressure Measurement of Blood Pressure Components of Blood Pressure Measurement Direct Measurement of Blood Pressure Indirect Measurement of Blood Pressure Mechanisms of Blood Pressure Regulation Short-Term Regulation of Systemic Blood Pressure Long-Term Regulation of Systemic Blood Pressure Normal Fluctuations in Systemic Blood Pressure Hypertension Definition and Classification Primary Hypertension Subtypes Risk Factors Outcomes End-organ damage. Treatment Interventions Secondary Hypertension Hypertensive Emergencies and Urgency Low Blood Pressure Summary Resources Measuring Blood Pressure and Definitions of Hypertension Mechanisms, Risks and Treatment of High Blood Pressure Secondary Hypertension Low Blood Pressure Unit V Cardiac Function 17 Cardiac Function Chapter Outline Key Questions Cardiovascular Anatomy Heart Circulatory System Cardiac Cycle Isovolumic Contraction Ventricular Ejection Isovolumic Relaxation Atrial Events Aortic and Pulmonary Artery Events Coronary Circulation Anatomy of the Coronary Vessels Regulation of Coronary Blood Flow Cardiac Myocytes Myocyte Structure Structure of the Contractile Apparatus Characteristics of Contractile Filaments Molecular Basis of Contraction Overview of Contraction Sliding Filament/Cross-Bridge Theory of Muscle Contraction Role of Calcium in Muscle Contraction Energy of Muscle Relaxation Cardiac Energy Metabolism Oxygen Utilization Substrate Utilization Cardiac Electrophysiology Cardiac Resting Potential Cardiac Action Potential Phase 0 Phase 1 Phase 2 Phase 3 Phase 4 Rhythmicity of Myocardial Cells Specialized Conduction System of the Heart Autonomic Regulation of Rhythmicity Electrocardiography Determinants of Cardiac Output Determinants of Heart Rate Determinants of Stroke Volume Volume of Blood in the Heart (Preload) Contractile Capabilities of the Heart (Contractility) Impedance to Ejection From the Ventricle (Afterload) Cardiac Workload Endocrine Function of the Heart Tests of Cardiac Function Electrocardiography Magnetic Resonance Imaging and Computed Tomography Echocardiography Nuclear Cardiography Cardiac Catheterization/Coronary Angiography Summary Resources 18 Alterations in Cardiac Function Chapter Outline Key Questions Coronary Heart Disease Etiology of Coronary Heart Disease Risk Factors and Mechanisms of Coronary Atherosclerosis Pathophysiology of Ischemia Clinical Features and Management of Coronary Syndromes Angina Pectoris Stable angina. Prinzmetal variant angina. Acute Coronary Syndrome Etiology and pathogenesis. Diagnosis of MI. Electrocardiographic changes. Serum biomarkers. Clinical course. Prognosis and treatment. Sudden Cardiac Arrest Chronic Ischemic Cardiomyopathy Endocardial and Valvular Diseases Disorders of the Mitral Valve Mitral Stenosis Mitral Regurgitation Mitral Valve Prolapse Disorders of the Aortic Valve Aortic Stenosis Aortic Regurgitation Diseases of the Endocardium Rheumatic Heart Disease Infective Endocarditis Myocardial Diseases Myocarditis Cardiomyopathy Dilated Cardiomyopathy Hypertrophic Cardiomyopathy Restrictive Cardiomyopathy Pericardial Diseases Pericardial Effusion Cardiac Tamponade Pericarditis Acute Pericarditis Chronic Pericarditis Congenital Heart Diseases Embryologic Development Etiology and Incidence of Congenital Heart Disease Pathophysiology of Congenital Heart Disease Acyanotic Congenital Defects Atrial Septal Defect Ventricular Septal Defect Patent Ductus Arteriosus Coarctation of the Aorta Pulmonary Stenosis or Atresia Aortic Stenosis or Atresia Cyanotic Congenital Defects Tetralogy of Fallot Transposition of the Great Arteries Truncus Arteriosus Tricuspid Atresia Summary Resources 19 Heart Failure and Dysrhythmias Chapter Outline Key Questions Heart Failure Pathogenesis and Diagnosis Systolic Dysfunction With Low Ejection Fraction Diastolic Dysfunction With Preserved Ejection Fraction Compensatory Mechanisms, Remodeling, and Progression Sympathetic Nervous System Activation Increased Preload Myocardial Remodeling and Progression Clinical Manifestations Left-Sided Heart Failure Right-Sided Heart Failure Biventricular Heart Failure Class and Stage of Heart Failure Treatment Cardiac Dysrhythmias Dysrhythmia Mechanisms Automaticity Triggered Activity Reentry Dysrhythmia Analysis Normal Sinus Rhythm Abnormal Rates of Sinus Rhythm Sinus Tachycardia Sinus Bradycardia Sinus Arrhythmia Sinus Arrest Abnormal Site of Impulse Initiation Escape Rhythms Atrial Dysrhythmias Premature atrial complexes and tachycardia. Atrial flutter and fibrillation. Junctional Dysrhythmias Ventricular Dysrhythmias Premature ventricular complexes. Ventricular tachycardia. Ventricular fibrillation. Conduction Pathway Disturbances Disturbances of Atrioventricular Conduction Abnormal Conduction Pathways Intraventricular Conduction Defects Treatment Summary Resources Heart Failure Dysrhythmias 20 Shock Chapter Outline Key Questions Pathogenesis of Shock Impaired Tissue Oxygenation Compensatory Mechanisms and Stages of Shock Types of Shock Cardiogenic Shock Etiology and Pathogenesis Clinical Manifestations Treatment Pharmacotherapy Mechanical Assist Devices Obstructive Shock Etiology and Pathogenesis Clinical Manifestations Treatment Hypovolemic Shock Etiology and Pathogenesis Classification Clinical Manifestations Treatment Distributive Shock Anaphylactic Shock Etiology and pathogenesis. Clinical manifestations. Prevention and treatment. Neurogenic Shock Septic Shock Etiology. Pathogenesis. Clinical manifestations. Treatment. Assessment and Hemodynamic Monitoring Cardiac Output Arterial Oxygen Content Distribution of Blood Flow Hemodynamic Monitoring Complications of Shock Acute Respiratory Distress Syndrome Disseminated Intravascular Coagulation Acute Renal Failure Multiple Organ Dysfunction Syndrome Summary Resources Pathophysiology of Shock Cardiogenic and Hypovolemic Shock Septic Shock Unit VI Respiratory Function 21 Respiratory Function and Alterations in Gas Exchange Chapter Outline Key Questions Functional Anatomy Development of the Pulmonary System Upper Airway Structures Lower Airway Structures Pulmonary Circulation Age-Related Variations Ventilation Lung Volumes and Capacities Dead Space Minute Ventilation Alveolar Ventilation/Oxygenation Mechanics of Breathing Airway Resistance Lung Compliance Distribution of Ventilation Neurologic Control of Ventilation Pulmonary Blood Flow Pulmonary Vasculature Distribution of Blood Flow Ventilation–Perfusion Ratios Hypoxic Vasoconstriction Diffusion and Transport of Respiratory Gases Barriers to Diffusion Oxygen Transport Carbon Dioxide Transport Alterations in Pulmonary Function Hypoventilation and Hyperventilation Hypoxemia and Hypoxia Acute Respiratory Failure Etiology Pathogenesis. Clinical Manifestations Diagnosis Treatment Diagnostic Tests Pulmonary Function Testing Bronchial Provocation Tests Alterations in Pulmonary Vasculature Pulmonary Hypertension Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Pulmonary Venous Thromboembolism Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Pulmonary Malignancies Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Summary Resources Pulmonary System Development and Physiology Pulmonary Disorders Pulmonary Malignancies 22 Obstructive Pulmonary Disorders Chapter Outline Key Questions Obstruction From Conditions in the Wall of the Lumen Asthma Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Acute Bronchitis Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Chronic Bronchitis Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Obstruction Related to Loss of Lung Parenchyma Emphysema Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Obstruction of the Airway Lumen Bronchiectasis Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Bronchiolitis Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Cystic Fibrosis Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Acute Tracheobronchial Obstruction Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Epiglottitis Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Croup Syndrome Etiology Pathogenesis Clinical Manifestations Diagnosis Treatment Summary Resources Asthma and Acute Obstruction Chronic Obstructive Pulmonary Disease Cystic Fibrosis and Pulmonary Infections 23 Restrictive Pulmonary Disorders Chapter Outline Key Questions Lung Parenchyma Disorders Fibrotic Interstitial Lung Diseases Diffuse Interstitial Lung Disease Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Sarcoidosis Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Hypersensitivity Pneumonitis Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Occupational Lung Diseases Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Atelectatic Disorders Acute (Adult) Respiratory Distress Syndrome Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Infant Respiratory Distress Syndrome Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Pleural Space Disorders Pneumothorax Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Pleural Effusion Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Neuromuscular, Chest Wall, and Obesity Disorders Neuromuscular Disorders Poliomyelitis Amyotrophic Lateral Sclerosis Muscular Dystrophies Guillain–Barré Syndrome Myasthenia Gravis Chest Wall Deformities Kyphoscoliosis Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Ankylosing Spondylitis Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Flail Chest Etiology. Pathogenesis. Clinical manifestations. Diagnosis and treatment. Disorders of Obesity Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Infection or Inflammation of the Lung Pneumonia Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Severe Acute Respiratory Syndrome Middle East Respiratory Syndrome Pulmonary Tuberculosis Etiology. Pathogenesis. Clinical manifestations. Diagnosis. Treatment. Summary Resources Disorders of Parenchyma Disorders of Chest Wall and Pleura Pulmonary Infections Unit VII Fluid, Electrolyte, and Acid-Base Homeostasis 24 Fluid and Electrolyte Homeostasis and Imbalances Chapter Outline Key Questions Body Fluid Homeostasis Fluid Intake and Absorption Fluid Distribution Fluid Excretion Fluid Loss Through Abnormal Routes Fluid Imbalances Extracellular Fluid Volume Volume Deficit Etiology. Clinical manifestations. Volume Excess Etiology. Clinical manifestations. Body Fluid Concentration Hyponatremia Etiology. Clinical manifestations. Hypernatremia Etiology. Clinical manifestations. Both Volume and Concentration Clinical Dehydr Help students develop a strong understanding of pathophysiology. Pathophysiology, 6th Edition explores the etiology, pathogenesis, clinical manifestations, and treatment of diseases and disorders. Each section focuses on the major alterations in the homeostasis of the body systems in order to provide students with a unifying framework. Current scientific findings and relevant global research are integrated throughout the book, with chapters organized by body system, beginning with an illustrated review of anatomy and normal physiology. Each chapter includes a discussion on the disease processes and abnormalities that may occur, with a focus on the pathophysiologic concepts involved. Written by leading educators, this text simplifies a rigorous subject with practical learning resources, an emphasis on critical thinking, and coverage of the latest scientific findings and relevant research. Plus, more than 1,000 updated, full color illustrations and photos throughout, give students a chance to visualize disease and disease processes and gain a clearer understanding of the material. "Pathophysiology, 6th Edition" explores the etiology, pathogenesis, clinical manifestations, and treatment of diseases and disorders. Each section focuses on the major alterations in the homeostasis of the body systems in order to provide you with a unifying framework. Current scientific findings and relevant global research are integrated throughout the book, with chapters organized by body system, beginning with an illustrated review of anatomy and normal physiology. Each chapter includes a discussion on the disease processes and abnormalities that may occur, with a focus on the pathophysiologic concepts involved. This text simplifies a rigorous subject with practical learning resources, an emphasis on critical thinking, and coverage of the latest scientific findings and relevant research. Plus, more than 1,000 updated, full color illustrations and photos throughout, give you a chance to visualize disease and disease processes and gain a clearer understanding of the material. -- From product description