Pulmonary Medicine

Ahmed

Abdulwahab UG: 1330095

Mustafa Firas Hasan

UG: 1330181

Pulmonology• Is a medical specialty that deals with diseases involving the respiratory tract.•Pulmonology is known as chest medicine and respiratory medicine in some countries and areas.• Pulmonologists are specially trained in diseases and conditions of the chest, particularly pneumonia, asthma, tuberculosis, emphysema, and complicated chest infections.

Variations in nomenclature• In the United Kingdom, Ireland, South Africa and Australia the

term "respiratory physician" is used (rather than pulmonologist) to distinguish a physician that practices pulmonology. • In Canada, respirology and respirologist are used. • Surgery of the respiratory tract is generally performed by

specialists in cardiothoracic surgery (or thoracic surgery), though minor procedures may be performed by pulmonologists.

DiagnosisThe pulmonologist begins the diagnostic process with a general review focusing 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)

DiagnosisPhysical diagnostics are as important as in the other fields of medicine.• Inspection of the hands for signs of cyanosis or clubbing, chest

wall, and respiratory rate.• Palpation of the cervical lymph nodes, trachea and chest wall

movement.• Percussion of the lung fields for dullness or hyper-resonance.• 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.

Procedures• Laboratory investigation of blood (blood tests)• Spirometry the determination of maximum airflow at a given lung volume.• Pulmonary Function Tests spirometry, plus response to bronchodilators, lung

volumes, and diffusion capacity.• Bronchoscopy with bronchoalveolar lavage (BAL), endobronchial and

transbronchial biopsy and epithelial brushing.• Chest X-rays• CT scanning• Scintigraphy and other methods of nuclear medicine• Positron emission tomography (especially in lung cancer)• Polysomnography (sleep studies) commonly used for the diagnosis of Sleep apnea

Surgical procedures

• Major surgical procedures on the heart and lungs are performed by a thoracic surgeon. • Pulmonologists often perform specialized procedures to get

samples from the inside of the chest or inside of the lung. • They use radiographic techniques to view vasculature of the

lungs and heart to assist with diagnosis.

Treatment and therapeutics• Medication is the most important treatment of most diseases of

pulmonology, either by inhalation (bronchodilators and steroids) or in oral form (antibiotics, leukotriene antagonists).

A common example being the usage of inhalers in the treatment of inflammatory lung conditions such as asthma or chronic obstructive pulmonary disease. Oxygen therapy is often necessary in severe respiratory disease (emphysema and pulmonary fibrosis). • Pulmonary rehabilitation is intended to educate the patient, the

family, and improve the overall quality of life and prognosis for the patient.

Education and training

In the United States, pulmonologists are physicians who, after receiving a medical degree (MD or DO), complete residency training in internal medicine, followed by at least two additional years of subspecialty fellowship training in pulmonology, After take the board certification examination in pulmonary medicine, After, the physician is then board certified as a pulmonologist.

Pediatric pulmonologist

In the United States, pediatric pulmonologists are physicians who, after receiving a medical degree (MD or DO), complete residency training in pediatrics, followed by at least three additional years of subspeciality fellowship training in pulmonology.

Scientific researchPulmonologists are involved in both clinical and basic research of the respiratory system, ranging from the anatomy of the respiratory epithelium to the most effective treatment of pulmonary hypertension. Scientific research also takes place to look for causes and possible treatment in diseases such as pulmonary tuberculosis and lung cancer.

History of pulmonology• One of the first major discoveries relevant to the field of

pulmonology was the discovery of pulmonary circulation. • it was thought that blood reaching the right side of

the heart passed through small 'pores' in the septum into the left side to be oxygenated, as theorized by Galen;, the discovery disproves this theory, which had previously been accepted since the 2nd century. • Thirteenth century anatomist and physiologist Ibn Al-

Nafis accurately theorized that there was no 'direct' passage between the two sides (ventricles) of the heart. • He believed that the blood must have passed through

the pulmonary artery, through the lungs, and back into the heart to be pumped around the body.

THANK YOU FOR YOUR ATTENTION