In medicine, pulmonology (aka pneumology) is the specialty that deals with diseases of the lungs र the respiratory tract. It is called chest medicine र respiratory medicine in some countries र areas. Pulmonology is generally considered a branch of internal medicine, although it is closely related to intensive care medicine when dealing with patients requiring mechanical ventilation. Surgery of the respiratory tract is generally performed by specialists in cardiothoracic surgery (or thoracic surgery). Chest medicine is not a specialty in itself but is an inclusive term which pertains to the treatment of diseases of the chest र contains the fields of pulmonology, thoracic surgery, र intensive care medicine. Pulmonology is concerned with the diagnosis र treatment of lung diseases, as well as secondary prevention (tuberculosis). Physicans specializing in this area are called pulmonologists.
Diagnosis [सम्पादन गर्ने]
In medicine, 50% of all diagnoses can be made by a thorough medical history, र lung diseases are no different. The pulmonologist will conduct a general review र focus on:
- hereditary diseases affecting the lungs (cystic fibrosis, alpha 1-antitrypsin deficiency)
- exposure to toxins (tobacco smoke, asbestos, exhaust fumes, coal mining fumes)
- exposure to infectious agents (certain types of birds, malt processing)
- an autoimmune diathesis that might predispose to certain conditions (pulmonary fibrosis, pulmonary hypertension)
Physical diagnostics are as important as in the other fields of medicine.
- Inspection of the hands for signs of cyanosis or clubbing, chest wall, र respiratory rate.
- Palpation of the cervical lymph nodes, trachea र chest wall movement.
- Percussion of the lung fields for dullness or hyperresonance.
- Auscultation (with a stethoscope) of the lung fields for diminished or unusual breath sounds.
As many heart diseases can give pulmonary signs, a thorough cardiac investigation is usually included.
Other tools include:
- Laboratory investigation of blood (blood tests). Sometimes arterial blood gas measurements are also required.
- Spirometry (the determination of lung volumes in time by breathing into a dedicated machine; response to bronchodilatators र diffusion of carbon monoxide)
- Bronchoscopy with bronchoalveolar lavage (BAL), biopsy र epithelial brushing
- Chest X-rays
- CT scanning (MRI scanning is rarely used)
- Scintigraphy र other methods of nuclear medicine
- Positron emission tomography (especially in lung cancer)
Treatment [सम्पादन गर्ने]
Training [सम्पादन गर्ने]
Pulmonologists are physicians who after receiving a medical degree MD or DO complete residency training in internal medicine (3 years) followed by at least 2 additional years of subspeciality fellowship training in pulmonology.
Diseases managed by the pulmonologist [सम्पादन गर्ने]
- Allergic bronchopulmonary aspergillosis
- Chronic obstructive pulmonary disease: -
- Cystic fibrosis (adults)
- Lung cancer diagnosis
- Pulmonary embolism
- Pulmonary fibrosis
- Pulmonary hypertension
- Pulmonary sequestration
- Sleep apnea or restless legs syndrome
Scientific research [सम्पादन गर्ने]
Pulmonologists are involved in both clinical र basic research of the respiratory system, ranging from the anatomy of the bronchial epithelium to the most effective treatment of pulmonary hypertension (a disease notoriously resistant to therapy).