Pulmonology
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2008-07-05T01:35:25Z
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robot Adding: [[cs:Pneumologie]]
{{Unreferenced|date=December 2007}}
In [[medicine]], '''pulmonology''' (aka '''pneumology''') is the specialty that deals with [[disease]]s of the [[lung]]s and the [[respiratory tract]]. It is called '''chest medicine''' and '''respiratory medicine''' in some countries and 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 and contains the fields of pulmonology, thoracic surgery, and [[intensive care medicine]]. Pulmonology is concerned with the diagnosis and treatment of [[lung]] diseases, as well as secondary prevention ([[tuberculosis]]). Physicians specializing in this area are called pulmonologists. In the United Kingdom, Ireland, South Africa and Australasia the term "respiratory physician" is used rather than pulmonologist.
== Diagnosis ==
In [[medicine]], 50% of all diagnoses can be made by a thorough medical history {{Fact|date=June 2008}}, and lung diseases are no different. The pulmonologist will conduct a general review and focus on:
* hereditary diseases affecting the lungs ([[cystic fibrosis]], [[alpha 1-antitrypsin deficiency]])
* exposure to [[toxin]]s ([[tobacco smoking|tobacco smoke]], [[asbestos]], [[exhaust fume]]s, [[coal mining]] fumes)
* exposure to [[infectious disease|infectious agents]] (certain types of [[bird]]s, malt processing)
* an [[autoimmunity|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, and respiratory rate.
*Palpation of the [[cervical lymph nodes]], [[Vertebrate trachea|trachea]] and 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 [[cardiology|heart diseases]] can give pulmonary signs, a thorough cardiac investigation is usually included.
Other tools include:
* [[Laboratory]] investigation of [[blood]] ([[blood test]]s). Sometimes [[arterial blood gas]] measurements are also required.
* [[Spirometry]] (the determination of [[lung volumes]] in time by breathing into a dedicated machine; response to [[bronchodilatator]]s and [[diffusion]] of [[carbon monoxide]])
* [[Bronchoscopy]] with [[bronchoalveolar lavage]] (BAL), endobronchial and transbronchial [[biopsy]] and [[epithelium|epithelial]] brushing
* [[X-rays|Chest X-rays]]
* [[Computed tomography|CT scanning]] ([[Magnetic resonance imaging|MRI scanning]] is rarely used)
* [[Scintigraphy]] and other methods of [[nuclear medicine]]
* [[Positron emission tomography]] (especially in [[lung cancer]])
== Treatment ==
[[Surgery|Surgical]] treatment in generally performed by the ([[cardiothoracic surgery|cardio]])[[thoracic surgery|thoracic surgeon]], generally after primary evaluation by a pulmonologist.
[[Medication]] is the most important treatment of most diseases of pulmonology, either by inhalation ([[bronchodilator]]s and [[steroid]]s) or in oral form ([[antibiotic]]s, [[leukotriene antagonist]]s).
[[Oxygen therapy]] is often necessary in severe respiratory disease ([[emphysema]] and [[pulmonary fibrosis]]). When this is insufficient, the patient might require [[mechanical ventilation]].
== Training ==
In the [[United States]], pulmonologists are physicians who, after receiving a medical degree [[Doctor of Medicine|MD]] or [[DO]], complete residency training in internal medicine (3 years), followed by at least 2 additional years of subspeciality fellowship training in pulmonology. <!-- I CAN ONLY SAY THAT FOR US, DON'T KNOW HOW IT WORKS IN OTHER COUNTRIES!!-->Most pulmonologists complete 3 years of combined subspecialty fellowship training in pulmonary medicine and critical care medicine.
In the [[United States]], pediatric pulmonologists are physicians who, after receiving a medical degree [[Doctor of Medicine|MD]] or [[DO]], complete residency training in pediatrics (3 years), followed by at least 3 additional years of subspeciality fellowship training in pulmonology.
== Diseases managed by the pulmonologist ==
*[[Allergic bronchopulmonary aspergillosis]]
* [[Asthma]]
* [[Chronic obstructive pulmonary disease]]: -
** [[Chronic bronchitis]]
** [[Emphysema]]
* [[Cystic fibrosis]] (in adults; [[Pediatrics|pediatricians]] may be involved in the care of children with the disease)
* [[Lung cancer]] diagnosis
* [[Pneumoconiosis]]
* [[Pneumonia]]
* [[Pneumothorax]]
* [[Psittacosis]]
* [[Pulmonary embolism]]
* [[Pulmonary fibrosis]]
* [[Pulmonary hypertension]]
* [[Pulmonary sequestration]]
* [[Sarcoidosis]]
* [[Sleep apnea]]
* [[Tuberculosis]]
== Scientific research ==
Pulmonologists are involved in both clinical and 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).
{{medicine}}
[[Category:Pulmonology|*]]
[[Category:Respiratory system|*]]
[[Category:Subjects taught in medical school]]
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[[es:Neumología]]
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[[he:פולמונולוגיה]]
[[la:Pulmonologia]]
[[nl:Pneumologie]]
[[ne:फोक्सोशास्त्र]]
[[ja:呼吸器学]]
[[nn:Pulmonologi]]
[[pl:Pulmonologia]]
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[[ru:Пульмонология]]
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[[tr:Göğüs hastalıkları]]
[[zh:胸腔醫學]]