i ~:kj owledgements "dace r \\'ord to the second edition P-l{e,sor Peter Hutton Clr word to the first edition.'" Tom E. Peck page xii xiii xv xvii '1troduction Section 1. Mathematical principles. lathematical relationships :_'\ponential relationships and logarithms Integration and differentiation Ph;'sical measurement and calibration. he 51 units _ on-51 units and conversion factors Signal to noise ratio 5 7 9 16 19 23 26 27 Section 2. Physical principles Simple mechanics The gas laws l.aminar flow Turbulent flow B rnoulli, Venturi and Coanda H at and temperature Humidity Latent heat Isotherms.'vlechanisms of heat loss Solubility and diffusion Osmosis and colligative properties Principles of surface tension Resistors and resistance Capacitors and capacitance h<!uctors and inductance ~o:-a'~10 e bridge "ance and damping ~l!ig, disinfection and sterilization 29 31 34 36 37 38 40 43 46 48 50 53 55 57 59 60 63 65 66 70
VIII Section 3. Principles of special equipment Magnetic resonance imaging Refraction and fibre optics Laser principles Surgical diathermy Medical ultrasound The Doppler effect Oesophageal doppler Cardiac output measurement Goal-directed fluid therapy Defibrillators Breathing systems Ventilator profiles Pulse oximetry Capnography Absorption of carbon dioxide Neuromuscular blockade monitoring Thromboelastography 73 75 79 81 84 87 89 90 92 97 98 100 103 109 112 117 119 124 Section 4. Pharmacological principles Atomic structure Oxidation and reduction Chemical bonds Inorganic and organic chemistry Isomerism Enzyme kinetics G-proteins and second messengers The Meyer-Overton hypothesis The concentration and second gas effects Drug interactions Adverse drug reactions Pharmacogenetics 127 129 131 132 135 138 141 144 146 148 150 151 153 Section 5. Pharmacodynamics Drug-receptor interaction Affinity, efficacy and potency Agonism and antagonism Hysteresis Tachyphylaxis and tolerance Drug dependence 155 157 160 164 170 171 173
ix Section 6. Pharmacokinetics Absorption, distribution and redistribution First-pass metabolism and bioavailability Volume of distribution Clearance Time constant and half life Non-compartmental modelling Compartmental modelling Physiological modelling Context-sensitive half time Target controlled infusions 175 177 179 181 183 185 187 188 193 194 196 Section 7. Respiratory physiology 201 Lung volumes 203 Spirometry 205 Flow-volume loops 207 The alveolar gas equation 211 The shunt equation 212 Pulmonary vascular resistance 214 Distribution of pulmonary blood flow 216 Ventilation/perfusion mismatch 218 Dead space 219 Fowler's method 220 The Bohr equation 221 Oxygen delivery and transport 223 Classification of hypoxia 226 The oxyhaemoglobin dissociation curve 228 Carriage of carbon dioxide 230 \ \'ork of breathing 232 Control and effects of ventilation 233 Compliance and resistance 236 Section 8. Cardiovascular physiology 239 Finthoven's triangle and axis 241 Cardiac action potentials 244 The cardiac cycle 246 Flcctrocardiographic changes 249 :lressure and flow calculations 254 Central venous pressure 257 Pulmonary capillary wedge pressure 258 1 he Frank-Starling relationship 260 '.enous return and capillary dynamics 262
x Ventricular pressure-volume relationship Systemic and pulmonary vascular resistance The Valsalva manoeuvre Control of heart rate Materno-fetal and neonatal circulations Shock Section 9. Renal physiology Acid-base balance Buffers and the anion gap Glomerular filtration rate and tubulo-glomerular feedback Autoregulation and renal vascular resistance The loop of Henle Glucose handling Sodium handling Potassium handling Section 10. Neurophysiology Action potentials Muscle structure and function Muscle reflexes The Monro-Kelly doctrine Cerebral blood flow Flow-metabolism coupling Formation and circulation of cerebrospinal fluid Pain Section 11. Applied sciences The stress response Cardiopulmonary exercise testing Pregnancy Paediatrics Ageing Obesity Section 12. Statistical principles Types of data Indices of central tendency and variability Types of distribution Methods of data analysis Error and outcome prediction Receiver operating characteristic curve 267 272 274 276 278 280 281 283 285 289 291 293 295 296 297 299 301 305 308 310 313 316 319 320 323 325 328 331 337 340 344 347 349 351 355 357 366 369
xi Clinical trials Evidence-based medicine Kaplan Meier curves AppendL"'( Index 370 374 376 377 404