Essentials of Pathophysiology: Concepts of Altered States Fourth, North American Edition
As the 21st century unfolds, more information is available to more people at a faster pace than ever before. This ever-evolving ability to communicate has produced phenomenal advances in the ability to understand and treat disease. Yet despite these advances, we are also reminded that illness and disease continue to occur and impact the physiologic, social, psychological, and economic well-being of individuals, their families, the community, and the world.
As a nurse–physiologist, my major emphasis with this edition, as in previous editions, is to relate normal body functioning to the physiologic changes that participate in disease production and occur as a result of disease, as well as the body’s remarkable ability to compensate for these changes. The beauty of physiology is that it integrates all of the aspects of human genetics, molecular and cellular biology, and organ anatomy and physiology into a functional whole that can be used to explain both the physical and psychological aspects of altered health. Indeed, it has been my philosophy to share the beauty of the human body and to emphasize that in disease, as in health, there is more “going right” in the body than is “going wrong.”
With the creation of this text, I focused on presenting information that is fundamental to understanding the physiologic processes of altered health states; information that necessary to support an understanding pathophysiology. One of the strengths of Essentials of Pathophysiology is that it is a book to grow with. Although intended as a course textbook for students, it is also designed to serve as a reference book that students can take with them and use in their practice once the course is nished.
Updated to re ect state-of-the-art science, content remains organized in a manner that is logical, understandable, and draws readers into the wonders of the human body. Concepts build on one another, with concepts from physiology, biochemistry, physics, and other sciences reviewed as deemed appropriate. A conceptual model that integrates the developmental and preventative aspects of health has been used. Selection of content was based on common health problems, including the special needs of children, pregnant women, and elderly persons. The fourth edition expands the art program, increasing the number of photographs depicting clinical manifestations of selected disorders while also providing more than 500 full-color illustrations, many created speci cally to supplement and expand the concepts presented. Newly created Summary Concepts follow each section and provide a review of material that focuses on integrating and linking concepts rather than fostering rote memorization. Once again, the “Understanding” feature depicts physiologic processes and phenomena, breaking them down into an easy-to-follow sequence for easier learning. “Clinical Features” are illustrations that depict the clinical features of persons with selected diseases. As with other types of illustrations in this edition, they are designed to help the reader develop a visual memory—in this case, the memory of the entire spectrum of clinical manifestations that are associated with a disease state.
Review exercises appear at the end of each chapter and assist the reader in using the conceptual approach to solving problems related to chapter content. The glossary de nes the specialized terms of pathophysiology. Tables of normal laboratory values provide a handy reference of conventional and SI units, as well as conversion units.
As with previous editions, every effort has been taken to make the text as accurate and up to date as possible. This was accomplished through an extensive review of the literature and through the use of critiques provided by students, faculty, and content specialists. This book
is an extension of my career and, as such, of my philosophy. It is my hope that readers will learn to appreciate the marvelous potential of the body, incorporating it into their own philosophy and ultimately sharing it with their clients.
Carol Mattson Porth
A Comprehensive Package for Teaching and Learning To further facilitate teaching and learning, a carefully designed ancillary package has been developed to assist faculty and students.
Instructor Resources Tools to assist you with teaching your course are available upon adoption of this text at http://thePoint.lww. com/PorthEssentials4e.
• A thoroughly revised and augmented Test Generator contains more than 1,100 NCLEX-style questions mapped to chapter learning objectives.
• An extensive collection of materials is provided for each book chapter:
• Pre-Lecture Quizzes (and answers) allow you to check students’ reading.
• PowerPoint Presentations provide an easy way to integrate the textbook with your students’ classroom experience; multiple-choice questions are included to promote class participation.
• Guided Lecture Notes offer corresponding PowerPoint slide numbers to simplify preparation for lecture.
• Discussion Topics (and suggested answers) can be used in the classroom or in online discussion boards to facilitate interaction with your students.
• Assignments (and suggested answers) include group, written, clinical, and Web assignments to engage students in varied activities and assess their learning.
• Case Studies with related questions (and suggested answers) give students an opportunity to apply their knowledge to a client case similar to one they might encounter in practice.
• A QSEN Competency Map identi es content and special features in the book related to competencies identied by the QSEN Institute.
• An Image Bank lets you use the photographs and illustrations from this textbook in your course materials.
• Strategies for Effective Teaching provide general tips for instructors related to preparing course materials and meeting student needs.
• Access to all Student Resources is provided so that you can understand the student experience and use these resources in your course as well.
Introduction to Pathophysiology x viii
UNIT 1 • Cell and Tissue Function 1
CHAPTER 1 Cell Structure and Function 1
CHAPTER 2 Cellular Responses to Stress, Injury, and Aging 31
CHAPTER 3 In ammation, the In ammatory Response, and Fever 49
CHAPTER 4 Cell Proliferation and Tissue Regeneration and Repair 71
CHAPTER 5 Genetic Control of Cell Function and Inheritance 87
CHAPTER 6 Genetic and Congenital Disorders 106
CHAPTER 7 Neoplasia 129
UNIT 2 • Integrative Body Function s 15 9
CHAPTER 8 Disorders of Fluid, Electrolyte, and Acid–Base Balance 159
CHAPTER 9 Stress and Adaptation 206
CHAPTER 10 Disorders of Nutritional Status 223
UNIT 3 • Hema topoietic Function 2 4 1
CHAPTER 11 Disorders of White Blood Cells and Lymphoid Tissues 241
CHAPTER 12 Disorders of Hemostasis 261
CHAPTER 13 Disorders of Red Blood Cells 277
UNIT 4 • Infection and Immunity 2 9 7
CHAPTER 14 Mechanisms of Infectious Disease 297
CHAPTER 15 Innate and Adaptive Immunity 318
CHAPTER 16 Disorders of the Immune Response 344
UNIT 5 • Circulatory Function 3 7 5
CHAPTER 17 Control of Cardiovascular Function 375
CHAPTER 18 Disorders of Blood Flow and Blood Pressure 402
CHAPTER 19 Disorders of Cardiac Function 444
CHAPTER 20 Heart Failure and Circulatory Shock 486
UNIT 6 • Respiratory Function 5 13
CHAPTER 21 Control of Respiratory Function 513
CHAPTER 22 Respiratory Tract Infections, Neoplasms, and Childhood Disorders 539
CHAPTER 23 Disorders of Ventilation and Gas Exchange 565
UNIT 7 • Kidney and Urinary Tract Function 5 9 9
CHAPTER 24 Structure and Function of the Kidney 599
CHAPTER 25 Disorders of Renal Function 617
CHAPTER 26 Acute Kidney Injury and Chronic Kidney Disease 639
CHAPTER 27 Disorders of the Bladder and Lower Urinary Tract 656
UNIT 8 • Gastroin test in aland Hepat obiliary Function 6 7 5
CHAPTER 28 Structure and Function of the Gastrointestinal System 675
CHAPTER 29 Disorders of Gastrointestinal Function 696
CHAPTER 30 Disorders of Hepatobiliary and Exocrine Pancreas Function 724
UNIT 9 • Endocrine System 7 5 3
CHAPTER 31 Mechanisms of Endocrine Control 753
CHAPTER 32 Disorders of Endocrine Control of Growth and Metabolism 767
CHAPTER 33 Diabetes Mellitus and the Metabolic Syndrome 793
UNIT 10 • Nervous System 8 2 1
CHAPTER 34 Organization and Control of Neural Function 821
CHAPTER 35 Somatosensory Function, Pain, and Headache 854
CHAPTER 36 Disorders of Neuromuscular Function 880
CHAPTER 37 Disorders of Brain Function 916
CHAPTER 38 Disorders of Special Sensory Function: Vision, Hearing, and Vestibular Function 955
UNIT 11 • Gen it o u r in a ry a n d Re p ro d u c t ive Fu n c t io n 9 9 3
CHAPTER 39 Disorders of the Male Genitourinary System 993
CHAPTER 40 Disorders of the Female Genitourinary System 1017
CHAPTER 41 Sexually Transmitted Infections 1049
UNIT 12 • Mu s c u lo s ke le t a l Fu n c t io n 10 6 3
CHAPTER 42 Structure and Function of the Skeletal System 1063
CHAPTER 43 Disorders of the Skeletal System: Trauma, Infections, Neoplasms, and Childhood Disorders 1078
CHAPTER 44 Disorders of the Skeletal System: Metabolic and Rheumatic Disorders 1111
UNIT 13 • In t e g um e n t a ry Fu n c t io n 114 1
CHAPTER 45 Structure and Function of the Integumentum 1141
CHAPTER 46 Disorders of Skin Integrity and
Appendix A: Lab Values 1197
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