Fundamentals of Applied Pathophysiology E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Serie: Fundamentals
• Sprache: Englisch

Seitenzahl: 1253

Veröffentlichungsjahr: 2021

Beschreibung

Fundamentals of Applied Pathophysiology delivers a highly visual and accessible introduction to pathophysiology for nursing and healthcare students, guiding readers through the subject matter with case studies, exercises, key words, and additional resources to support learning and retention.

The new edition of Fundamentals of Applied Pathophysiology includes brand-new content on homeostasis, systematic approach to assessment, and key terminology. The book features links to clinical observations, vital signs to observe, investigation boxes, clinical red flags, medication alerts, and the latest, contemporary evidence for care management, including National Early Warning Score 2 (NEWS2).

• Presents comprehensive treatment guidance for all fundamental pathophysiology categories, including disorders of the central nervous system, heart, vascular and renal systems, and more
• Aligns with the latest NMC standards
• Full-colour illustrations throughout that brings the subject to life

Fundamentals of Applied Pathophysiology belongs on the bookshelves of all pre-registration nursing students, midwifery students, healthcare assistants, and assistant practitioners. Professionals in allied healthcare areas such as physiotherapy, radiotherapy, and occupational therapy will also benefit from the material contained in this comprehensive resource.

Leseprobe

Table of Contents

Cover

Title Page

Copyright Page

Dedication Page

Preface

The fourth edition

References

Acknowledgements

Contributors

About the companion website

Chapter 1: Learning the language: Terminology

Introduction

Anatomy and physiology

Terminology

Pathophysiology

The determinants of health

Using a nursing/medical dictionary: hints and tips

Searching for definitions on the Internet and hand‐held devices

Conclusion

Multiple choice questions

Further resources

References

Chapter 2: Cell and body tissue physiology

Introduction

Anatomy of the cell

The cell membrane

Cytoplasm

Role of cytoplasm

Nucleus

Mitosis and meiosis

The organelles

Types of cells

Tissue repair

Conclusion

Multiple choice questions

Glossary of terms

References

Chapter 3: Homeostasis

Introduction

Cell stability

Stable psychological conditions

Homeostatic processes

Set points

Vital signs and homeostasis

Conclusion

Multiple choice questions

References

Chapter 4: Cancer

Introduction

Biology of cancer

Causes of cancer

Staging of cancers

Signs and symptoms of cancer

Treatment of cancer

Prevention of cancer

Examples of cancers

Conclusion

Multiple choice questions

Conditions

Further resources

Glossary of terms

References

Chapter 5: Inflammation, immune response and healing

Introduction

Infectious microorganisms

Spread of infection

Types of infectious microorganisms

The immune system

Inflammatory response

Conclusion

Multiple choice questions

Conditions

Further resources

Glossary of terms

References

Chapter 6: Shock

Introduction

Types of shock

Pathophysiology of shock

Stages of shock

Pharmacological management of shock

Conclusion

Multiple choice questions

Conditions

Further resources

Glossary of terms

References

Chapter 7: The nervous system and associated disorders

Introduction

Structure of the nervous system

Disorders of the nervous system

Conclusion

Multiple choice questions

Conditions

Further resources

Glossary of terms

References

Chapter 8: The heart and associated disorders

Introduction

Location of the heart

Structures of the heart

Blood flow through the heart

Conducting systems of the heart

Nerve supply of the heart

Diseases of the heart

Conclusion

Multiple choice questions

Further resources

Glossary of terms

References

Chapter 9: The vascular system and associated disorders

Introduction

Overview of blood vessels

Structure of the blood vessels

Blood pressure

Diseases of the blood vessels

Conclusion

Multiple choice questions

Conditions

Further resources

Glossary of terms

References

Chapter 10: The blood and associated disorders

Introduction

Composition of blood

Formed elements of blood

Haemostasis

Blood groups

Diseases of the blood

Anaemia

Conclusion

Multiple choice questions

Conditions

Further resources

Glossary of terms

References

Chapter 11: The renal system and associated disorders

Introduction

The renal system

Disorders of the renal system

Conclusion

Multiple choice questions

Further resources

Glossary of terms

References

Chapter 12: The respiratory system and associated disorders

Introduction

Anatomy and physiology

Disorders of the respiratory system

Conclusion

Multiple choice questions

Conditions

Further reading

Glossary of terms

References

Chapter 13: The gastrointestinal system and associated disorders

Introduction

The digestive system

The upper gastrointestinal tract and its accessory organs

Accessory organs of digestion

Disorders of the digestive system

Conclusion

Multiple choice questions

Conditions

Further resources

Glossary of terms

References

Chapter 14: Nutrition and associated disorders

Introduction

Macronutrients

Micronutrients

Nutritional disorders

Malnutrition

Conclusion

Multiple choice questions

Conditions

Further resources

Glossary of terms

References

Chapter 15: The endocrine system and associated disorders

Introduction

Hormones

The physiology of the endocrine glands

Disorders of the endocrine system

Conclusion

Conditions

Further resources

Glossary of terms

References

Chapter 16: The reproductive systems and associated disorders

Introduction

Reproductive health

The pelvis

The female reproductive tract

The menstrual cycle

The female breast

Menstrual disorders

The male reproductive tract

Male reproductive disorders

Conclusion

Multiple choice questions

Conditions

Further resources

Glossary of terms

References

Chapter 17: Pain and pain management

Introduction

The physiology of pain

Pain classification

The pain experience

Pain theories

Pain pathophysiology and management

Conclusion

Multiple choice questions

Conditions

Further resources

Glossary of terms

References

Chapter 18: The musculoskeletal system and associated disorders

Introduction

The musculoskeletal system

The nervous system

Assessing the patient with a musculoskeletal disorder

Disorders of the MSK system

Conclusion

Multiple choice questions

Conditions

Further resources

Glossary of terms

References

Chapter 19: Fluid, electrolyte balance and associated disorders

Introduction

Body fluid compartments

Composition of body fluid

Body fluid balance

Disorders associated with fluid and electrolyte imbalance

Conclusion

Multiple choice questions

Conditions

Further resources

Glossary of terms

References

Chapter 20: The skin and associated disorders

Introduction

The anatomy and physiology of the skin

Disorders of the skin

Conclusion

Multiple choice questions

Further resources

Glossary of terms

References

Chapter 21: The ear, nose and throat, and eyes, and associated disorders

Introduction

Physiology of the ear, nose and throat

Conclusion

Activities

Multiple choice questions

Conditions

Further resources

Glossary of terms

References

Appendix A: Reference values in venous serum (adults)

Index

End User License Agreement

List of Tables

Chapter 1

Table 1.1 Anatomical descriptive terms.

Table 1.2 Anatomical regions of the head and neck.

Table 1.3 Anatomical regions of the trunk (thorax and abdomen).

Table 1.4 Anatomical regions of the upper limbs.

Table 1.5 Anatomical regions of the lower limbs (legs).

Table 1.6 Basic components.

Table 1.7 Some prefixes, suffixes, their meaning and examples.

Table 1.8 Terms and definitions related to pathophysiology.

Table 1.9 Confusing terminology.

Chapter 2

Table 2.1 Stages of meiosis.

Chapter 3

Table 3.1 Systems and homeostasis.

Table 3.2 The SBAR communication tool.

Chapter 5

Table 5.1 Other types of infectious microorganisms.

Chapter 6

Table 6.1 Common causes of anaphylaxis (Turner

et al

., 2015).

Table 6.2 Sepsis red flags.

Table 6.3 Types of shock and common causative factors.

Table 6.4 A summary of clinical presentation of different types of shock.

Table 6.5 Physiological changes that occur at each stage of shock.

Table 6.6 Sepsis Six care bundle.

Table 6.7 Common drugs used to manage shock.

Table 6.8 Additional management of shock according to type.

Chapter 7

Table 7.1 The lobes of the cerebral hemispheres.

Table 7.2 Cranial nerves.

Table 7.3 Physiological effects of the sympathetic and parasympathetic nervou...

Table 7.4 The Glasgow Coma Scale.

Table 7.5 Signs and symptoms of stroke according to side of brain affected.

Table 7.6 Stages of Alzheimer’s disease.

Table 7.7 Classification of seizures.

Chapter 8

Table 8.1 Summary of the vessels and their functions (Nair and Peate, 2017).

Chapter 9

Table 9.1 Effects of atherosclerosis on different sites.

Table 9.2 Comparison between an arterial and venous insufficiency.

Chapter 10

Table 10.1 Blood clotting factors.

Table 10.2 Blood groups.

Chapter 11

Table 11.1 Summary of the composition of urine.

Table 11.2 Summary of aetiology of acute kidney injury.

Table 11.3 Staging of acute kidney injury.

Table 11.4 Chronic kidney disease staging.

Chapter 12

Table 12.1 Important terminology of breathing.

Table 12.2 The main investigations of pneumonia.

Table 12.3 Summary of bronchodilator therapies given in asthma and chronic ob...

Table 12.4 Summary of main corticosteroids used in the treatment of respirato...

Table 12.5 FEV

1

as an assessment of airway obstruction (NICE, 2018).

Table 12.6 Signs and symptoms of pleural disorders.

Chapter 14

Table 14.1 Summary of vitamins and their functions

Table 14.2 Minerals and their functions.

Chapter 15

Table 15.1 The hormones of the hypothalamus and the anterior pituitary gland.

Table 15.2 Investigation – common laboratory test findings in the diagnosis o...

Chapter 16

Table 16.1 Primary and secondary dysmenorrhoea – distinctions.

Table 16.2 Drugs that may be used in the treatment of HMB

Table 16.3 Potential surgical treatments for women with heavy periods.

Chapter 17

Table 17.1 Size and speed of first‐order sensory fibres.

Table 17.2 Effects of pain and stress on four major body systems.

Table 17.3 Types of cancer pain, their source, causes and descriptions.

Table 17.4 Actions of opiate receptors.

Table 17.5 Common weak opiates and their routes of delivery.

Table 17.6 Common strong opiates and their routes of delivery.

Chapter 18

Table 18.1 Clinical flags.

Table 18.2 Pain characteristics and possible causes associated with the MSK s...

Table 18.3 Osteology (

Source:

Adapted from McRae, 2016).

Table 18.4 Pharmacological agents that may be used in the treatment for osteo...

Chapter 19

Table 19.1 Fluid intake and output.

Table 19.2 Principal electrolytes and their functions.

Chapter 20

Table 20.1 Problems that patients with skin conditions may experience.

Table 20.2 The functions of melanocytes, Langerhans and Merkel cells.

Table 20.3 Some intrinsic and extrinsic factors that can predispose a person ...

Table 20.4 Assessing changes in moles (lesions).

Table 20.5 Skin types.

List of Illustrations

Chapter 1

Figure 1.1 Standard anatomical position.

Figure 1.2 Directional anatomical positions.

Figure 1.3 Anatomical planes.

Figure 1.4 The cavities of the body.

Figure 1.5 Word roots are the foundation of most medical terms and describe ...

Figure 1.6 The determinants of health

Source:

World Health Organization, 202...

Chapter 2

Figure 2.1 Simplified structure of a cell.

Figure 2.2 The cell membrane.

Figure 2.3 Endocytosis.

Figure 2.4 Osmosis.

Figure 2.5 Osmosis and movement of solute.

Figure 2.6 Prophase.

Figure 2.7 Metaphase.

Figure 2.8 Anaphase.

Figure 2.9 Telophase.

Figure 2.10 Cell cycle.

Figure 2.11 Endoplasmic reticulum (ER).

Figure 2.12 Types of cells.

Figure 2.13 Simple epithelium.

Figure 2.14 Stratified epithelium.

Figure 2.15 Epithelial cells classified according to shape.

Figure 2.16 Peristalsis.

Chapter 3

Figure 3.1 Homeostatic cycle.

Figure 3.2 Regulation through feedback, a feedback system (

Source:

Tortora a...

Figure 3.3 Homeostatic regulation of blood pressure by a negative feedback s...

Figure 3.4 Positive feedback control of labour contractions during the birth...

Chapter 4

Figure 4.1 Apoptosis.

Source:

Cell Migration Lab, University of Reading, htt...

Figure 4.2 Molecular biology model

Figure 4.3 Clinical model

Figure 4.4 Common sites and symptoms of cancer metastasis.

Figure 4.5 Bone marrow biopsy.

Figure 4.6 Diagram of breast showing lobules and ducts.

Figure 4.7 Symptoms of breast cancer.

Chapter 5

Figure 5.1 Shapes of bacteria.

Figure 5.2 Bacterial reproduction – simple fission.

Figure 5.3 Viral replication.

Figure 5.4 Typical fungi shapes.

Figure 5.5 The lymphatic system.

Figure 5.6 Lymph node.

Figure 5.7 Phagocytosis.

Figure 5.8 The inflammatory process.

Chapter 6

Figure 6.1 Hypovolaemic shock.

Figure 6.2 Distributive shock.

Figure 6.3 Stages involved in an anaphylactic reaction.

Figure 6.4 Renin angiotensin mechanism.

Chapter 7

Figure 7.1 Divisions of the human nervous system.

Figure 7.2 The four main parts of the human brain.

Figure 7.3 The circle of Willis.

Figure 7.4 The spinal cord and the location of the 31 pairs of spinal nerves...

Figure 7.5 The process of demyelination.

Chapter 8

Figure 8.1 Location of the heart.

Figure 8.2 The cardiac muscle.

Figure 8.3 The chambers and valves of the heart.

Figure 8.4 The vessels of the heart.

Figure 8.5 Blood flow through the heart. The arrows indicate the direction o...

Figure 8.6 The conducting system of the heart.

Figure 8.7 The cardioregulatory centre.

Figure 8.8 Myocardial infarction.

Figure 8.9 Vicious cycle of cardiogenic shock.

Figure 8.10 Blockage of the coronary arteries.

Chapter 9

Figure 9.1 Blood flow.

Figure 9.2 Structures of an artery and a vein.

Figure 9.3 Elastic recoil of the aorta.

Figure 9.4 Capillaries.

Figure 9.5 Bicuspid valves of a vein.

Figure 9.6 Atheroma build‐up in an artery.

Figure 9.7 (a) A dissecting aneurysm, (b) a fusiform aneurysm, and (c) a sac...

Figure 9.8 Dacron graft for an abdominal aortic aneurysm. Synthetic graft us...

Figure 9.9 Dacron graft for peripheral vascular disease. Synthetic graft use...

Figure 9.10 Varicose veins.

Figure 9.11 Calf‐muscle pump.

Figure 9.12 Veins of the leg susceptible to varicosity.

Figure 9.13 (a) Venous ulcer; (b) venous eczema; and (c) lipodermatosclerosi...

Figure 9.14 Formation of thrombosis.

Figure 9.15 Formation of a platelet plug.

Source:

Nair and Peate, 2013.

Figure 9.16 Formation of a clot.

Chapter 10

Figure 10.1 Components of clotted blood separated by centrifugation.

Figure 10.2 Cells of the blood.

Figure 10.3 Red blood cell.

Figure 10.4 Haemoglobin molecule.

Figure 10.5 Formation of blood cells.

Figure 10.6 Haemolysis of red blood cells and bilirubin metabolism. In point...

Figure 10.7 ABO blood groups.

Figure 10.8 Sickled red blood cell.

Figure 10.9 Sickle cell in microcirculation.

Chapter 11

Figure 11.1 Renal system.

Figure 11.2 External layers of the kidney. Nephron artificially inserted out...

Figure 11.3 Internal structures showing blood vessels.

Figure 11.4 Nephron produces dilute urine after the distal tubules and colle...

Figure 11.5 Bowman’s capsule.

Figure 11.6 Nephron with capillaries.

Figure 11.7 Common iliac vessels and ureter.

Figure 11.8 Layers of the urinary bladder.

Figure 11.9 Sagittal section pelvis showing the location of the female ureth...

Figure 11.10 Renal calculi.

Figure 11.11 Cystoscopy.

Chapter 12

Figure 12.1 The main structures of the upper respiratory tract.

Figure 12.2 Gross anatomy of the lower respiratory tract.

Figure 12.3 The bronchial tree.

Figure 12.4 Microscopic anatomy of a lobule.

Figure 12.5 Muscles involved in pulmonary ventilation.

Figure 12.6 Movements of inspiration and expiration.

Figure 12.7 External and internal respiration.

Figure 12.8 The respiratory centres of the brainstem.

Figure 12.9 Actions of the central and peripheral chemoreceptors.

Figure 12.10 Spirometry – a normal forced vital capacity compared to an obst...

Figure 12.11 Cellular structure of the airways.

Figure 12.12 Airway pathophysiology, normal compared to status asthmaticus....

Figure 12.13 Comparison of a normal bronchiole and alveoli to those in an em...

Figure 12.14 Comparison of a normal bronchiole to that in a chronic bronchit...

Figure 12.15 Pleural effusion and a pneumothorax.

Chapter 13

Figure 13.1 The gastrointestinal tract.

Figure 13.2 The oral cavity.

Figure 13.3 The milk teeth.

Figure 13.4 The permanent teeth.

Figure 13.5 The salivary glands.

Figure 13.6 The pharynx.

Figure 13.7 Swallowing action.

Figure 13.8 The stomach.

Figure 13.9 Layers of the stomach.

Figure 13.10 The small intestine.

Figure 13.11 The mesentery of the small intestine.

Figure 13.12 Section of the small intestine showing the villi.

Figure 13.13 The large intestine.

Figure 13.14 The liver.

Figure 13.15 Production and storage of bile.

Figure 13.16 Common sites for peptic ulcer

Chapter 14

Figure 14.1 A lipoprotein.

Figure 14.2 An example of plaque.

Figure 14.3 Food groups and recommended portions

Figure 14.4 Gastric bypass surgery.

Chapter 15

Figure 15.1 Hormone release and transport.

Figure 15.2 Position of the endocrine glands and organs that produce hormone...

Figure 15.3 Control of hormone release by the negative feedback system.

Figure 15.4 The pituitary gland.

Figure 15.5 The negative feedback control of thyroid hormone production. TSH...

Figure 15.6 Anatomy of an adrenal gland.

Figure 15.7 Mechanisms for the control of aldosterone secretion.

Figure 15.8 Response of the endocrine system to stress.

Figure 15.9 Causes of hypopituitarism and its effects on hormone release. GH...

Figure 15.10 Cushing’s syndrome (http://www.bmb.leeds.ac.uk/teaching/icu3/le...

Figure 15.11 (a) Primary adrenal insufficiency and (b) secondary adrenal ins...

Chapter 16

Figure 16.1 The female pelvis.

Figure 16.2 The female external genitalia (also known as the pudendum or vul...

Figure 16.3 The uterus and associated structures.

Figure 16.4 The cervix.

Figure 16.5 The menstrual cycle (ovarian).

Figure 16.6 A cross‐section of the female breast.

Figure 16.7 The male reproductive system.

Chapter 17

Figure 17.1 Pathway of pain transmission and interpretation.

Figure 17.2 The ascending pain pathway.

Figure 17.3 Basic structure of myelinated and unmyelinated nerve fibres.

Figure 17.4 Cross‐section of the spinal cord. Note that both sides are ident...

Figure 17.5 The spinothalamic tract.

Figure 17.6 The limbic system.

Figure 17.7 Example of a reflex arc working in response to pain.

Figure 17.8 Location of the thalamus, hypothalamus and reticular formation....

Figure 17.9 The gate control theory of pain.

Figure 17.10 The gate control theory and the influence of T (transmission), ...

Figure 17.11 Examples of referred pain and the origin of the tissue damage....

Figure 17.12 An example of a verbal rating scale.

Figure 17.13 An example of a numerical rating scale.

Figure 17.14 An example of a visual analogue scale.

Figure 17.15 The McGill Pain Questionnaire.

Figure 17.16 The prostaglandin‐enhancing action of cyclo‐oxygenase‐2 (COX‐2)...

Figure 17.17 The World Health Organization analgesic ladder.

Figure 17.18 Transcutaneous electrical nerve stimulation (TENS) machine.

Chapter 18

Figure 18.1 The skeleton.

Figure 18.2 Bone production

Figure 18.3 Bone structure.

Figure 18.4 A synovial joint.

Figure 18.5 Muscle.

Figure 18.6 The four types of fractures: (a) simple, (b) incomplete (greenst...

Figure 18.7 A knee joint with osteoarthritis.

Chapter 19

Figure 19.1 Fluid compartments.

Figure 19.2 Fluid distribution.

Figure 19.3 Electrolytes of intracellular and extracellular compartments.

Figure 19.4 Simple diffusion.

Figure 19.5 Carrier protein (facilitated diffusion).

Figure 19.6 Adrenal glands.

Figure 19.7 Cross‐section of the adrenal gland.

Figure 19.8 A fluid balance chart.

Chapter 20

Figure 20.1 The structure of the skin.

Figure 20.2 The layers of the epidermis.

Figure 20.3 The structure of the dermis.

Figure 20.4 Sweat gland.

Figure 20.5 The pilosebaceous unit.

Figure 20.6 The structure of the nail.

Chapter 21

Figure 21.1 The ear.

Figure 21.2 The nose.

Figure 21.3 The throat.

Figure 21.4 The eye.

Figure 21.5 Temporary tracheostomy.

Figure 21.6 Laryngectomy.

Guide

Cover Page

Title Page

Copyright Page

Dedication Page

Preface

Acknowledgements

Contributors

About the companion website

Table of Contents

Begin Reading

Reference values in venous serum (adults)

Index

Wiley End User License Agreement

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FOURTH EDITION

Fundamentals of Applied Pathophysiology

An Essential Guide for Nursing and Healthcare Students

EDITED BY

IAN PEATE OBE FRCN

Principal

School of Health Studies

Gibraltar

This edition first published 2021© 2021 John Wiley & Sons Ltd

Edition History©(1e, 2009), (2e, 2013), (3e, 2018) by John Wiley & Sons Ltd.

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Library of Congress Cataloging‐in‐Publication Data

Names: Peate, Ian, editor. Title: Fundamentals of applied pathophysiology : an essential guide for nursing and healthcare students / edited by Ian Peate. Description: Fourth edition. | Hoboken, NJ : Wiley‐Blackwell, 2021. | Includes bibliographical references and index. Identifiers: LCCN 2021003661 (print) | LCCN 2021003662 (ebook) | ISBN 9781119699491 (paperback) | ISBN 9781119699545 (Adobe PDF) | ISBN 9781119699477 (epub) Subjects: MESH: Pathologic Processes | Nursing Care–methods | Physiological Phenomena Classification: LCC RB113 (print) | LCC RB113 (ebook) | NLM QZ 140 | DDC 616.07–dc23 LC record available at https://lccn.loc.gov/2021003661LC ebook record available at https://lccn.loc.gov/2021003662

Cover Design: WileyCover Image: © Stocktrek Images/Getty Images

This text is dedicated to my late sister, Maureen Ann Paterson (nee Peate).

Preface

The fourth edition

Being in a position to write the preface for the fourth edition of Fundamentals of Applied Pathophysiology: An Essential Guide for Healthcare Students is an absolute privilege. We have listened to feedback from a wide range of sources. This edition brings with it a number of changes; however, we have tried to retain the user‐friendly approach that readers tell us they enjoy.

I have introduced a series of new activities, including website activities, that are intended to help you learn in an engaged way and to apply your learning when you are in the care setting, wherever this may be. This edition has been updated; the pathophysiology and important issues related to care have been reviewed. The illustrations are there to assist in understanding and appreciating the complex conditions that are being discussed. By using a fundamental approach to the subject, this can help readers acquire a key understanding of applied pathophysiology.

This edition retains its nursing and healthcare focus and considers the wider context of care provision. An essential requirement for those who offer care and support to people in contemporary care environments is an integrated, multidisciplinary approach. The healthcare student is an important participant within the multidisciplinary care team. In this book, a multidisciplinary approach is acknowledged as well as the recognition that care is delivered in dynamic environments to a diverse groups of people and communities.

This text has been written with the intention of making the subject of pathophysiology understandable and stimulating. Our bodies have astonishing capacity as they respond to illness in a number of physiological and psychological ways; we are able to compensate for the changes that occur as result of the disease process, the pathophysiological processes and the impact they can have on a person. This text can help in developing critical thinking, encouraging innovation and creativity in relation to the health and well‐being of the people that you have the privilege to care for.

New features have been added, along with two new chapters: Learning the Language and Homeostasis. These two chapters are provided earlier on in the text so as to help prepare the reader for some of the more complex discussions to follow. Each chapter concludes with questions that aim to trigger reflection and encourage further thought. In the snapshots (case studies), pseudonyms are used to maintain confidentiality. Nurses and those who offer care owe a duty of confidentiality to all those they care for (Nursing and Midwifery Council, 2018).

Where appropriate, we have included boxed information that will help you when you are providing care. Red flags are incorporated that contain significant information alerting you to be cautious in your approach, and orange flags alert the reader to psychological considerations and also information regarding the management of medicines as related to the chapter.

The snapshots have been developed further and usually include data concerning the patient’s vital signs and blood analysis. This can help relate important concepts to care, offering more insight into the patient’s condition and therefore needs. Some of the snapshots include a NEWS2 score (national early warning score) where applicable (Royal College of Physicians, 2017).

Many of the values cited are a range, and blood pressure in respect of the NEWS2 score is noted as systolic. Local policy and procedure should be adhered to when using NEWS2.

Although an elevated blood pressure is an important risk factor for cardiovascular disease, it is low or falling systolic blood pressure that is most significant in the context of assessing acute illness severity. We have adopted the Royal College of Physician’s (2017) stance on this parameter related to a range of systolic blood pressure.

Each chapter provides questions that are there to test your pre‐ and post‐knowledge. There are a range of self text multiple choice questions at the end of each chapter. Selected chapters provide a list of further resources that the reader may wish to access in order to increase and advance learning.

Pathophysiology considers the cellular and organ changes that occur when disease is present, as well as the effects these changes have on the ability to function. When something interrupts normal physiological functioning, such as illness, this then becomes a pathophysiological issue. It must always be remembered that normal health is not and can never be exactly the same in any two people, and as such the term normal has to be treated with caution. An understanding of pathophysiology ‘normal’ and ‘abnormal’ can assist the student help the patient in a competent, compassionate safe and effective manner.

This text is a foundation text that can help the reader grow personally and professionally with regards to the provision of care, and is primarily intended for nursing students who come into contact with those who may have a number of physical healthcare problems, in the hospital and community setting. The text focuses on the adult person. Illness and disease are discussed explicitly, highlighting the fact that people do become ill and they do experience disease.

You need not read the text from cover to cover, you are encouraged to dip in and out of it. The aim is to entice and encourage you, whet the appetite, so you may read further, and in so doing we hope to instil a sense of curiosity in you. The first six chapters set the scene, and you may want to think about reading these first and then move on to a more specific area of interest.

We have enjoyed putting this new edition together, and we truly hope that you enjoy reading it and applying it to practice situations.

Ian Peate

Gibraltar

March 2021

References

Nursing and Midwifery Council (2018).

The Code. Professional Standards of Practice and Behaviour for Nurses, Midwives and Nursing

Associates

https://www.nmc.org.uk/globalassets/sitedocuments/nmc‐publications/nmc‐code.pdf

last accessed June 2020.

Royal College of Physicians (2017).

National Early Warning Score (NEWS)

2

standardising the assessment of acute illness severity in the NHS

https://www.rcplondon.ac.uk/projects/outputs/national‐early‐warning‐score‐news‐2

last accessed January 2021.

Acknowledgements

Thank you to all of my colleagues, who have been so supportive in providing their expertise and time contributing to this new edition of this well‐established text. I am grateful to you all for your commitment, particularly during the COVID‐19 pandemic. I would like to also thank those who contributed to chapters in the previous edition.

I would like to thank my partner, Jussi Lahtinen, for his support and encouragement and my dear friend Mrs Frances Cohen.

Thank you to all of my colleagues, who have been so supportive in providing their expertise and time contributing to this new edition of this well‐established text.

Contributors

Jim Blanchflower, BSc Pharmacology, PGCE, MSc (Health Practice)Senior Lecturer, School of Nursing and Midwifery, University of Salford, Manchester, UK

Jim Blanchflower is lecturer in physiology, pharmacology and pathophysiology in the School of Nursing and Midwifery at Salford University.

He has been involved in educating healthcare professionals for over 25 years. This includes advanced practitioners, nurses, midwives, pharmacists and physiotherapists.

He has several publications in the area of non‐medical prescribing, and has presented at conferences for non‐medical prescribing, sepsis and antibiotic resistance.

He also works with strength athletes, particularly powerlifters, helping them to upgrade their performance by improving training practices and nutrition. He is the president of the North‐West Powerlifting Federation.

Carl Clare, RN DipN, BSc (Hons), MSc (Lond), PGDE (Lond)Programme Lead MSc Nursing, Senior Lecturer, Department of Adult Nursing and Primary Care, School of Health and Social Work, University of Hertfordshire, Hatfield, Hertfordshire, UK

Carl began his nursing career in 1990 as a Nursing Auxiliary. He later undertook three years of student nurse training at Selly Oak Hospital (Birmingham), moving to The Royal Devon and Exeter Hospitals, then Northwick Park Hospital, and finally The Royal Brompton and Harefield NHS Trust as a Resuscitation Officer and Honorary Teaching Fellow of Imperial College (London). Since 2006, he has worked at the University of Hertfordshire as a Senior Lecturer in Adult Nursing. His key areas of interest are long‐term illness, physiology, sociology and cardiac care. Carl has previously published work in cardiac care, resuscitation and pathophysiology.

Louise Henstock, BSc (Hons) Physiology, BSc (Hons) Physiotherapy, MSc Sports & Exercise Management, SFHEA, PGCAP, HCPC, MSCPLecturer & Admissions Tutor, School of Health and Society, University of Salford, Greater Manchester, UK; Visiting Lecturer Cambridge University, Cambridge, UK

Louise began her career at St. James’s University Hospital, Leeds, before becoming a senior musculoskeletal physiotherapist working at Leeds General Infirmary. She has worked as a physiotherapy lecturer since 2003, initially at York St. John University, gaining her master’s degree in Sports and Exercise Management and a Postgraduate Certificate in Academic Practice. She moved to the University of Salford in 2010, where she is currently employed as a physiotherapy lecturer and admissions tutor. Her key areas of interest are musculoskeletal physiotherapy and physiology. In 2017, Louise was awarded Best Teacher in the Health School & Best Overall Teacher at Salford University, and was also the winner of a VC Distinguished Teaching Award in 2014. In 2017, Louise became a Senior Fellow of the Higher Education Academy. Louise has also guest‐lectured at the University of Cambridge.

Barry Hill MSc, Advanced Practice, PGC Academic Practice, BSc (Hons) Intensive Care Nursing, DipHE Adult Nursing, O.A. Dip Counselling Skills, Registered Nurse (RN), Registered Teacher (NMC RNT/TCH); Senior Fellow (SFHEA), Programme Leader (Senior Lecturer) Adult Nursing, Northumbria University, Clinical Editor British Journal of NursingDirector of Employability, Department of Nursing, Midwifery and Health,Programme Leader, BSc (Hons) Adult Nursing, Northumbria University, Newcastle upon Tyne, UK

Barry Hill leads and teaches on a range of undergraduate and postgraduate healthcare‐related programmes. Clinically, Barry worked at Imperial College NHS Trust across all three adult intensive care units including neuro, trauma, cardiac and general critical care, whilst undertaking a clinical master’s degree in advanced practice. Prior to joining Higher Education, Barry was Matron for Plastics Orthopaedics ENT and Major Trauma division, managing and leading the ENT, Airway, Head and Neck and Plastics, including breast surgery.

Barry has been awarded a GEM Award (Going the Extra Mile) in 2019, Northumbria University; 2019 Finalist – ‘Educator of the Year 2019’ Student Nursing Times Awards; 2018 Student Led Teachers Award (SLTA) Winner of the ‘Best Lecturer Award 2018’ Northumbria University; and 2009 ‘Outstanding Service Care & Research Awards OSCAR’ (Clinical Education), Imperial College. Barry is Clinical Series Editor for British Journal of Nursing (BJN) and on the editorial board. Barry has published books, book chapters, and academic journal articles. He is currently studying a Doctor of Philosophy (PhD) at Northumbria University in his third year.

Noleen P. Jones, EN, RN, DipN, Dip Management, BSc, FHEA, MEdPrincipal Lecturer (Ag), School of Health Studies, Gibraltar

Noleen began her nursing career as a Nursing Auxiliary in 1987 before training to be an Enrolled Nurse, eventually qualifying as a Staff Nurse in 1992. She worked in Critical Care as a newly qualified Registered Nurse until 2013, where she held the posts of Senior Sister and Lead Nurse for Education and Training before she moved into practice development for a year. It was during this time that Noleen’s links to the School of Health Studies strengthened. Noleen became a Lecturer with the School of Health Studies in Gibraltar in 2014. Her key interests are cardiac care, respiratory care and teaching practice skills.

Claire Leader, PGCAP, MA, BSc (Hons), RN, RM, HFEASenior Lecturer (Adult Nursing), Nursing, Midwifery & Health, Northumbria University, Newcastle upon Tyne, UK

Claire began her nursing career in 1998 after graduating from York University. Between 1998 and 2003, Claire worked as an Emergency Nurse in the UK as well as overseas before commencing her Midwifery education and obtaining a first class honours degree at the University of Huddersfield. Claire practised as a midwife in large tertiary referral centres in Sheffield and Newcastle upon Tyne before taking on the role of Research Nurse & Midwife in 2009. During this time Claire worked closely with Principal Investigators in the development and delivery of research sponsored by the National Institute of Health Research (NIHR) in a number of specialties whilst also studying part time for the Masters in Sociology and Social Research, for which she received a distinction. In 2018, Claire moved to her current post at Northumbria University, teaching on programmes of education within the department of Nursing, Midwifery and Health as well as developing research as part of collaborations and through her own PhD on workforce well‐being.

Louise McErlean, RGN, BSc (Hons), MA (Herts)Lecturer, Department of Nursing, School of Health and Social Work, Ulster University, Northern Ireland, UK

Louise is a lecturer in Nursing at Ulster University. Louise commenced her nursing career in Glasgow in 1986, specialising in Intensive Care Nursing. Louise has worked in Glasgow, Belfast, London and Hertfordshire. Louise moved to Higher Education in 2005 and has taught on anatomy and physiology, pathophysiology and skills modules within adult nursing. Her interests include physiology, clinical skills, simulation and nurse education.

Janet G. Migliozzi, DMS, RGN, BSc (Hons), MSc (London), PGDEd, PGCMed.Sim, FHEASenior Lecturer, Department of Nursing, Health and Wellbeing, School of Health and Social Work, University of Hertfordshire, Hatfield, Hertfordshire, UK

Janet completed her initial training in London and commenced her career in 1988. She has worked at a variety of hospitals across London, predominantly in vascular, orthopaedic and high‐dependency surgery before specialising in infection prevention and control and communicable disease. Janet has worked in higher education since 1999 and is involved in teaching across a range of healthcare professions programmes both at an undergraduate and postgraduate level. She is also involved in the research supervision of students undertaking advanced clinical practice pathways. Her key interests include clinical microbiology, particularly in relation to healthcare‐associated infections, global communicable disease and public health. Patient safety at the local and global levels is also an area of interest. Janet has published in journals and books in areas including immunology, minimising risk in relation to healthcare‐associated infection and pathophysiology.

Valerie Nangle, MPhil, FHEA, RGNAssistant Professor, Coventry University (London), Spitalfields, London, UK

Prior to becoming a nurse educator teaching students on undergraduate nursing courses, she worked in coronary care and high‐dependency units in London before specialising and practising for 20 years as a cardiac rehabilitation and secondary prevention nurse specialist.

Valerie’s academic clinical research interests are concerned mainly with migrant health and inequalities in health focusing on the health of refugees and asylum seekers. Her academic research areas of interest include nursing students with dyslexia and disabilities experiences within clinical practice areas. She continues to practice clinically, and volunteers with a migrant health clinic and as a cardiac nurse consultant with the Irish diaspora in the UK, focusing on primary prevention of coronary heart disease and hypertension.

Ian Peate, OBE, FRCNVisiting Professor St George’s University of London and Kingston University, London, Visiting Professor Northumbria University, Visiting Senior Clinical Fellow University of Hertfordshire, Head of School, School of Health Studies, Gibraltar

Ian began his nursing a career at Central Middlesex Hospital, becoming an Enrolled Nurse practicing in an intensive care unit. He later undertook three years of student nurse training at Central Middlesex and Northwick Park Hospitals, becoming a Staff Nurse and then a Charge Nurse. He has worked in nurse education since 1989. His key areas of interest are nursing practice and theory. Ian has published widely. He is the editor‐in‐chief of the British Journal of Nursing. He was awarded an OBE in the Queen’s 90th Birthday Honours List for his services to Nursing and Nurse Education and was bestowed a Fellowship from the Royal College of Nursing in 2017.

Hazel Ridgers, RN (Adult), PGCAP, MA, FHEAFreelance Lecturer and Researcher in Nursing and Health, London, UK

Hazel trained as a Nurse with King's College, London, and took up her first staff Nurse post in older people’s care at Guys and St Thomas’ hospital in 2006. She developed an interest in the health and well‐being of older people living with HIV, and undertook sexual health and HIV specialisation courses early in her nursing career. She has worked in HIV and sexual health as a nurse, research nurse and clinical teacher. Hazel began her career in nursing education in 2010 working in both clinical practice and higher education settings with a focus on clinical skills, simulation and sexual health. Hazel was the lead for a Nursing Associate programme and is currently a freelance lecturer and researcher in Nursing and Public Health.

Melanie Stephens, PhDSenior Lecturer in Adult Nursing and Head of Interprofessional Education, School of Health and Society, University of Salford, Manchester, UK

Melanie is a health service researcher and member of the Ageing and Dementia Hub with specific research interests in pressure redistributing properties of seating, postural management, tissue viability and interprofessional working. She has undertaken research in order to provide an evidence base for products used in the 24‐hour management of pressure ulcers and postural care. She co‐led an amendment to the UK Tissue Viability Guidelines for Seating 2017 with service users. She is experienced in using qualitative and mixed methods of enquiry, working with practitioners and commerce to develop research for the use in the clinical environment. Prior to becoming a nurse educator, Melanie worked as a Tissue Viability Nurse Specialist. She has also held nursing posts in Intensive Care, Burns and Plastics Surgery, Gynaecology Oncology, Endocrinology and Care of older adult ward.

Anthony Wheeldon, MSc (Lond), PGDE, BSc (Hons), DipHE, Registered Nurse (RN)Associate Subject Group Lead for Adult Nursing, Department of Adult Nursing and Primary Care, School of Health and Social Work, University of Hertfordshire, Hatfield, Hertfordshire, UK

Anthony began his nursing career at Barnet College of Nursing and Midwifery in 1992. After qualification, he worked as a staff nurse and senior staff nurse in the Respiratory Directorate at the Royal Brompton and Harefield NHS Trust in London. In 2000, he started teaching on post‐registration cardio‐respiratory courses before moving into full‐time nurse education at Thames Valley University in 2002. Anthony has a wide range of interests including the promotion of inclusivity, success and attainment in nurse education, as well as cardio‐respiratory care, anatomy and physiology, respiratory assessment, and the application of bioscience in nursing practice. Since 2006, Anthony has worked at the University of Hertfordshire, where he teaches on pre‐ and post‐registration nursing courses. He is currently an Associate Subject Group Lead for Adult Nursing.

About the companion website

This book is accompanied by a companion website:

www.wiley.com/go/fundamentalsofappliedpathophysiology/student4e

The student website includes:

Interactive multiple choice questions

Interactive true/false exercises

Searchable glossary

Further reading and resources

The instructor website includes:

www.wiley.com/go/fundamentalsofappliedpathophysiology/instructor4e

Image Bank

PowerPoint slides

Chapter 1Learning the language: Terminology

Ian Peate

Principal, School of Health Studies, Gibraltar

Contents

Introduction

Anatomy and physiology

Terminology

Pathophysiology

The determinants of health

Using a nursing/medical dictionary: hints and tips

Searching for definitions on the Internet and hand‐held devices

Conclusion

Multiple choice questions

Further resources

References

Key words

Terminology

Anatomy

Physiology

Pathophysiology

Latin

Greek

Prefix

Suffix

Word roots

Forms

Test your prior knowledge

What do you understand by the term

prefix

?

What do you understand by the term

suffix

?

How is the root word altered by a prefix or a suffix?

List the anatomical planes.

Learning outcomes

On completion of this chapter the reader will be able to:

Discuss the terms

anatomy

,

physiology

and pathophysiology

Further understand prefixes and suffixes used in anatomy, physiology and pathophysiology

Understand directional terms

Describe the anatomical planes, anatomical regions of the body and the body cavities

Don’t forget to visit the companion website for this book (www.wiley.com/go/fundamentalsofappliedpathophysiology/student4e) where you can find self‐assessment tests to check your progress, as well as lots of activities to practise your learning.

Introduction

The terms used in science, especially in nursing and medicine, are saturated with Latin and Greek terminology. Latin names are used for every part of the body, and Greek terms are common since the Greeks are said to be the founders of modern medicine. All healthcare professionals use pathophysiology as they work with the people whom they offer care to and offer treatment for those who are experiencing some type of health condition.

Anatomy and physiology

Anatomy is concerned with the study of the structure and location of body parts, and physiology is the study of the function body parts; these two terms are interlinked. Knowing where the body parts are located can help you understand how they function. McGuiness (2010) explains that thinking of the numerous functions of the heart and the four chambers along with the valves (this is the anatomy) and visualising these various structures can help in comprehending how blood flows through the heart and how the heart beats (this is related to its function and therefore its physiology).

Anatomy

The body map

Learning anatomical terminology is like learning a new language and can help you talk confidently about the body; the anatomical directional terms and body planes present a universally recognised anatomical language. When undertaking the study of anatomy and physiology, it is essential that you have a key or directional terminology in order to give you an accurate description as you or others refer to the precise location of a body part or structure.

All parts of the body are described in relation to other body parts, and a standardised body position known as the anatomical position is used in anatomical terminology. An anatomical position is established from an imaginary line that runs down the centre or mid‐line of the body. When in this position, the body is erect and faces forward with the arms to the side, the palms face forward with the thumbs to the side and the feet are slightly apart with the toes pointing forward.

The standard body ‘map’ or anatomical position (just like a map) is that of the body standing upright (orientated with north at the top), with the feet at shoulder width and parallel, toes forward (see Figure 1.1); humans are bilaterally symmetrical. This position is used to describe the body parts and positions of patients irrespective of whether they are lying down, lying on their side or facing down.

As well as understanding the anatomy and the physiology (the structure and function), understanding directional terms and the positions of the various structures is also necessary. Table 1.1 lists common anatomical descriptive terms that you will need to become acquainted with.

Figure 1.2 depicts anatomical positions.

Figure 1.1 Standard anatomical position.

Table 1.1 Anatomical descriptive terms.

Anatomical term

Relationship to the body

Anterior

Front surface of the body or structure

Posterior

Back surface of the body or structure

Deep

Further from the surface

Superficial

Close to the surface

Internal

Nearer the inside

External

Nearer the outside

Lateral

Away from the mid‐line

Median

Mid‐line of the body

Medial

In the direction of the mid‐line

Superior

Located above or towards the upper part

Inferior

Located below or towards the lower part

Proximal

Nearest to the point of reference

Distal

Furthest away from the point of reference

Prone

Lying face down in a horizontal position

Supine

Lying face up in a horizontal position

Figure 1.2 Directional anatomical positions.

Anatomical planes of the body

A plane is an imaginary two‐dimensional surface that passes through the body. There are three planes that are generally referred to in anatomy and healthcare (see Figure 1.3):

Sagittal

Frontal

Transverse

The sagittal plane, the vertical plane, is the plane that divides the body or an organ vertically into the right and left sides. If this vertical plane runs directly down the middle of the body, it is known as the midsagittal, or median, plane. If it divides the body into unequal right and left sides, then it is called a parasagittal plane.

The frontal plane is the plane dividing the body or an organ into an anterior portion and a posterior portion. The frontal plane is often referred to as a coronal plane (the word corona is Latin for ‘crown’).

The transverse plane divides the body or organ horizontally into the upper (superior) and lower (inferior) portions.

Figure 1.3 Anatomical planes.

Anatomical regions of the body

The body is divided up into regions, like a map, and the anatomical regions of the body refer to a particular area/region of the body, which helps to compartmentalise the body. The body is divided into the following:

Head and neck

Trunk (thorax and abdomen)

Upper limbs (arms)

Lower limbs (legs).

Tables 1.2, 1.3, 1.4, and 1.5 present the correct terminology for each region.

Body cavities

Body cavities are spaces within the body that contain the internal organs. The cavity can be filled with air or with organs. Minor body cavities include the oral cavity (mouth), the nasal cavity, the orbital cavity (eye), middle ear cavity and the synovial cavities (these are spaces within the synovial joints).

Table 1.2 Anatomical regions of the head and neck.

Anatomical term

Area of body related to

Cephalic

Head

Cervical

Neck

Cranial

Skull

Frontal

Forehead

Occipital

Back of head

Ophthalmic

Eyes

Oral

Mouth

Nasal

Nose

Table 1.3 Anatomical regions of the trunk (thorax and abdomen).

Anatomical term

Area of body related to

Axillary

Armpit

Costal

Ribs

Mammary

Breast

Pectoral

Chest

Vertebral

Backbone

Abdominal

Abdomen

Gluteal

Buttocks

Inguinal

Groin

Lumbar

Lower back

Pelvic

Pelvis/lower part of abdomen

Umbilical

Navel

Perineal

Between anus and external genitalia

Pubic

Pubis

Table 1.4 Anatomical regions of the upper limbs.

Anatomical term

Area of body related to

Brachial

Upper arm

Carpal

Wrist

Cubital

Elbow

Forearm

Lower arm

Palmar

Palm

Digital

Fingers (also relates to toes)

Table 1.5 Anatomical regions of the lower limbs (legs).

Anatomical term

Area of body related to

Femoral

Thigh

Patellar

Front of knee

Pedal

Foot

Plantar

Sole of foot

Popliteal

Hollow behind knee

Digital

Toes (also relates to fingers)

There are two main cavities in the body:

The dorsal cavity is located in the posterior region of the body.

The ventral body cavity occupies the anterior region of the trunk.

The dorsal cavity is subdivided into two cavities:

Cranial cavity: Encloses the brain and is protected by the cranium (skull)

Vertebral/spinal cavity: Contains the spinal cord and is protected by the vertebrae

The ventral cavity is subdivided into the following:

The thoracic cavity: It is surrounded by the ribs and muscles, the intercostal muscles. The thoracic cavity contains the lungs, heart, trachea, oesophagus and thymus. It is separated from the abdominal cavity by the diaphragm.

The abdominopelvic cavity:

The abdominal cavity: Contains the stomach, spleen, liver, gallbladder, pancreas, small intestine and most of the large intestine. The abdominal cavity is protected by the muscles of the abdominal wall and partly by the diaphragm and ribcage

The abdominopelvic cavity: Contains the urinary bladder, some of the reproductive organs and the rectum

The pelvic cavity is protected by the bones of the pelvis.

Figure 1.4 depicts the body cavities.

Figure 1.4 The cavities of the body.

Physiology

Human physiology concerns itself with the study of the body’s function. Anatomy and physiology therefore are the study of the structure and the function of the human body, respectively.

The human body is organised in a most precise way whereby atoms combine in appropriate ways forming molecules in the chemical organisation of the body. The molecules combine to form cells and cells organise themselves collectively as functioning masses that are known as tissues and then organs and systems. Chapter 2 of this text describes cells and the organisation of tissues within the body

Terminology

Already in this chapter you may have come across some complex terms. It is important to learn the language (the terminology) that is used in the provision of healthcare; this is an important part of safe and effective care. Whilst it is not a pre‐course requirement to be proficient in Latin or Greek in order to learn anatomical terminology to become a nurse or healthcare practitioner, it is essential that you understand and are able to use the terminology.

There are three basic parts associated with medical terms; see Table 1.6.

The word root