he text, which is based on the eighth edition of Patho-physiology: Concepts of Altered Health, has been

prepared specifically for those students who do not needthe extensive breadth or detail of content provided in thelarger book. To accomplish this task, content deemed tobe less essential has been omitted, while essential contenthas been reorganized, revised, and condensed.

The integration of full color into the design and illus-trations from the eighth edition has been carried overinto the third edition of the essentials version. Over 200of the illustrations that appear in this edition are new orhave been extensively modified. The illustrations—linedrawings of anatomic structures and pathophysiologicprocesses, flow charts, and photographic illustrations ofdisease states—have been carefully chosen to support theconcepts that are presented in the text. This offers not onlyvisual appeal but also enhances conceptual learning, link-ing text content to illustration content A new element, the“clinical feature,” uses illustration to depict the clinicalmanifestations of selected disease states.

The third edition also retains the list of suffixes andprefixes, the glossary, and the table of normal laboratoryvalues that were in the previous edition. The table of lab-oratory values includes conventional and SI units, as wellas conversion units and internet addresses for additionalinformation. The key concept boxes have been retainedwithin each chapter. They are intended to help the readerretain and use text information by providing a mecha-nism to incorporate the information into a larger con-ceptual unit as opposed to merely memorizing a stringof facts. Review exercises appear at the end of each chap-ter and assist the reader in using the conceptual approachto solving problems related to chapter content.

Along with the extensive changes and revision, everyattempt has been made to present content in a manner thatis logical, understandable, and that inspires reader interest.The content has been arranged so that concepts build onone another, with concepts from physiology, biochemistry,physics, and other sciences reviewed as deemed appropri-ate. A conceptual model that integrates the developmen-tal and preventative aspects of health has been used.Selection of content was based on common health prob-lems, including the special needs of children, pregnantwomen, and elderly persons. Although first and foremostintended as a course textbook, it also serves as a referencebook that students can take with them and use in theirpractice once the course is finished.

And finally, as a nurse–physiologist, my major empha-sis with each edition has been to relate normal bodyfunctioning to the physiologic changes that participatein disease production and occur as a result of disease, aswell as the body’s remarkable ability to compensate forthese changes. The beauty of physiology is that it inte-grates all of the aspects of human genetics, molecular andcellular biology, and organ anatomy and physiology intoa functional whole that can be used to explain both the

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physical and psychological aspects of altered health.Indeed, it has been my philosophy to share the beauty ofthe human body and to emphasize that in disease as inhealth, there is more “going right” in the body than is“going wrong.” This book is an extension of my careerand, as such, of my philosophy. It is my hope that read-ers will learn to appreciate the marvelous potential of thebody, incorporating it into their own philosophy and ulti-mately sharing it with their clients.

Carol Mattson Porth

Student and Instructor Resources

Student ResourcesThe student resource DVD accompanying this text con-tains several useful study resources including

• Animations of selected pathophysiologic processes• Student Review Questions for every chapter

Resources are also available online at thePoint.lww.com!

Instructor ResourcesThe instructor resource DVD available to accompany thistext is a comprehensive resource including the following:

• Test Generator containing over 900 multiple-choicequestions

• PowerPoint presentations with incorporated imagesfrom the book

• Image Bank featuring all of the figures from each chapter• Lecture Outlines for presenting key information to

your students• Assignments and Quizzes for gauging student under-

standing• Discussion Topics to encourage critical thinking• Case Studies providing real life application of concepts• WebCT- and Blackboard-ready materials for use with

your institution’s Learning Management System.

Resources are also available online at thePoint.lww.com!

To the Reader

This book was written with the intent of making the sub-ject of pathophysiology an exciting exploration thatrelates normal body functioning to the physiologicchanges that occur as a result of disease, as well as thebody’s remarkable ability to compensate for thesechanges. Indeed, it is these changes that represent manyof the signs and symptoms of disease.

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Using a book such as this can be simplified by takingtime out to find what is in the book and how to locateinformation when it is needed. The table of contents atthe beginning of the book provides an overall view of theorganization and content of the book. The index, whichappears at the end of the book, can be viewed as a roadmap for locating content. It can be used to quickly locaterelated content in different chapters of the book or toanswer questions that come up in other courses.

Organization

The book is organized into units and chapters. The unitsidentify broad areas of content, such as alterations in thecirculatory system. Many of the units have introductorychapters that contain information about the normalstructure and function of the body systems that are beingdiscussed in the unit. These chapters, which are intendedas a review of content from previous courses as well as anupdate on recent scientific advances in genetic and molec-ular biology, provide the foundation for understandingthe pathophysiology content presented in the subsequentchapters. The disorder chapters focus on specific areasof pathophysiology content, such as heart failure and cir-culatory shock. The chapter outline that appears at thebeginning of each chapter provides an overall view of thechapter content and organization. Icons identify specificcontent related to infants and children , pregnantwomen , and older adults .

Reading and Learning Aids

In an ever-expanding world of information you will notbe able to read, let alone remember, everything that is inthis book, or in any book, for that matter. With this inmind, we have developed a number of special featuresthat will help you focus on and master the essential con-tent for your current as well as future needs.

It is essential for any professional to use and under-stand the vocabulary of his or her profession. Throughoutthe text, you will encounter terms in italics. This is a sig-nal that a word and the ideas associated with it are impor-tant to learn. In addition, in the back of the book are twoaids that can be used to help you expand your vocabularyand improve your comprehension of what you are read-ing: the glossary and the list of prefixes and suffixes.

The glossary contains concise definitions of frequentlyencountered terms. If you are unsure of the meaning ofa term you encounter in your reading, check the glossaryin the back of the book before proceeding. The list ofprefixes and suffixes, found in the inside back cover, is atool to help you derive the meaning of words you may beunfamiliar with and increase your vocabulary. Many dis-ciplines establish a vocabulary by affixing one or moreletters to the beginning or end of a word or base to forma derivative word. Prefixes are added to the beginning ofa word or base, and suffixes are added to the end. If youknow the meanings of common prefixes and suffixes, you

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can usually derive the meaning of a word, even if youhave never encountered it before.

Boxes

Boxes are used throughout the text to summarize andhighlight key information. You will frequently encountertwo types of boxes: Key Concept Boxes and SummaryBoxes. One of the ways to approach learning is to focus onthe major ideas or concepts rather than trying to memorizesignificant amounts of information. As you have probablyalready discovered, it is impossible to memorize everythingthat is in a particular section or chapter of the book. Notonly does your brain have a difficult time trying to figureout where to store all the different bits of information, yourbrain doesn’t know how to retrieve the information whenyou need it. Most important of all, memorized lists of con-tent can seldom, if ever, be applied directly to an actualclinical situation. The Key Concept Boxes guide you inidentifying the major ideas or concepts that form the foun-dation for truly understanding the major areas of content.When you understand the concepts in the Key ConceptBoxes, you will have a framework for remembering andusing the facts given in the text.

The Summary Boxes at the end of each section pro-vide a review and a reinforcement of the main contentthat has been covered. Use the summaries to assure thatyou have covered and understand what you have read.

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Illustrations and Photos

The full-color illustrations will help you to build yourown mental image of the content that is being presented.Each drawing has been developed to fully support andbuild upon the ideas in the text. Some illustrations are usedto help you picture the complex interactions of the multi-ple phenomena that are involved in the development of aparticular disease; others can help you visualize normalfunction or understand the mechanisms whereby the dis-ease processes exert their effects. In addition, photographsof pathologic processes and lesions provide a realistic viewof selected pathologic processes and lesions.

Tables and Charts

Tables and charts are designed to present complex infor-mation in a format that makes it more meaningful andeasier to remember. Tables have two or more columns,and are often used for the purpose of comparing or con-trasting information.

In summary, heart failure occurs when the heart fails topump sufficient blood to meet the metabolic needs ofbody tissues. The physiology of heart failure reflects theinterplay between a decrease in cardiac output thataccompanies impaired function of the failing heart and thecompensatory mechanisms that preserve the cardiacreserve. Compensatory mechanisms include the Frank-Starling mechanism, sympathetic nervous system activa-tion, the renin-angiotensin-aldosterone mechanism,natriuretic peptides, endothelins, and myocardial hypertro-phy and remodeling. In the failing heart, early decreases incardiac function may go unnoticed because these com-pensatory mechanisms maintain the cardiac output.Unfortunately, the mechanisms were not intended forlong-term use, and in severe and prolonged heart failurethe compensatory mechanisms no longer are effective,and instead contribute to the progression of heart failure.

Charts have one column and are used to summarizeinformation.

Clinical Features

New to this edition is a new type of illustration thatdepicts the clinical features of persons with selected dis-eases. This feature is designed to help you visualize theentire spectrum of clinical manifestations that are asso-ciated with these disease states.

Epicanthal folds,slanted eyes,

and flat facial profile

Growth failureMental retardation

Flat occiput

Congenitalheart disease

Intestinalmalformations

Malformedears Big, protruding,

wrinkled tongue

Short, broadhands with

simian crease

Acutelymphoblastic

leukemia

Wide gapbetween 1stand 2nd toes

Glomerular damage

Increased permeability to proteinsProteinuria ( 3.5 g/24 h)

Hypoproteinemia

Edema Hyperlipidemia

Compensatory synthesisof proteins by liver

Decreased plasmaoncotic pressure

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Material for Review

An important feature has been built into the text to helpyou verify your understanding of the material presented.After you have finished reading and studying the chapter,work on answering the review exercises at the end of the

Appendix

The Lab Values table in the appendix of your book pro-vides rapid access to normal values for many laboratorytests in conventional and SI units, as well as a descriptionof the prefixes, symbols, and factors (e.g., micro, �, 10�6)used for describing these values. Knowledge of normalvalues can help you put abnormal values in context.

We hope that this guide has given you a clear picture ofhow to use this book. Good luck and enjoy the journey!

chapter. They are designed to help you integrate, con-ceptualize, and apply material from the text. If you areunable to answer a question, reread the relevant sectionin the chapter.

Understanding PhysiologicProcesses

Included in a number of chapters is an “Understanding”feature that focuses on the physiologic processes andphenomena that form the basis for understanding disor-ders presented in the text. This feature breaks a processor phenomenon down into its component parts and pres-ents them in a sequential manner, providing an insightinto the many opportunities for disease processes to dis-rupt the sequence.

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