Causes and Symptoms (Magill’s Medical Guide, Sixth Edition)
Disorders of the pulmonary system are among the most common diseases. Because it acts as an interface between the external and internal environments, the pulmonary system is subject to continual attacks on its health and integrity. A wide variety of disease-causing agents reach the lung with each breath. Infectious organisms (such as bacteria, viruses, and molds), environmental toxins (such as tobacco smoke and air pollutants), and various airborne allergens are the primary causes of lung disease.
The pulmonary system consists of an intricate bronchial tree terminating in very delicate, thin-walled sacs known as alveoli, each of which is surrounded by blood vessels. The entire network is contained within the supporting tissue of the lungs. These individual parts are perfectly suited to carry out efficiently their two life-sustaining functions: air conduction and the gas exchange between oxygen in the air and carbon dioxide (a waste product) in the bloodstream. Disruption of either function renders the person vulnerable to potentially fatal consequences.
All pulmonary diseases can be categorized in two ways: The first is based on the cause, whether a virus, asbestos, or cigarette smoke; the second is based on the result, the specific loss of structure and its function. Infectious diseases are the most common causes of respiratory problems. Infection usually occurs through inhalation, although it can come from...
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Treatment and Therapy (Magill’s Medical Guide, Sixth Edition)
The most common symptoms associated with pulmonary disease are coughing, chest pain, and shortness of breath. Because each of these symptoms is present in such a wide variety of pulmonary diseases, it often is necessary to use other tools to determine the specific illness present. The most important of these diagnostic tools is the chest X ray, in which nonspecific symptoms can be correlated with structural and functional abnormalities. A critical advancement in the use of X rays is the computed tomography (CT) scan. Using a computer, a large number of detailed X rays are combined to create a very detailed picture, allowing an ambiguous abnormality on a chest X ray to be visualized with much greater accuracy. If further information is needed in order to determine the exact nature of an abnormality revealed by the chest X ray and the CT scan, a sample of lung tissue must be obtained. The bronchoscope, a flexible or rigid fiber-optic tube, is passed through the mouth into the bronchial tree, allowing direct inspection of the pulmonary system. Performed using anesthesia in the hospital operating room, bronchoscopy can be used to remove a small amount of tissue for biopsy. While the procedure has a higher risk than either the chest X ray or the CT scan, it also has a high yield of information.
Once a specific diagnosis is made, treatment is begun that addresses the particular cause or resulting dysfunction. Infectious...
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Perspective and Prospects (Magill’s Medical Guide, Sixth Edition)
Pulmonary diseases have caused an extraordinary number of deaths throughout human history. Whereas lung cancer claims the most lives today, infectious diseases, especially pneumonia, claimed many more lives in the thousands of years before the introduction of antibiotics in the early twentieth century. Many potentially fatal illnesses, particularly those that are viral in origin, are transmitted through the respiratory route. Because of the ease with which they can be spread—person to person through coughs and sneezes—epidemics often occur. Rubella, measles, chickenpox, smallpox, mumps, diphtheria, and pertussis (whooping cough) are among such illnesses. Many of these kill by secondary pneumonias that overwhelm the body’s defense mechanisms. The well-known rashes that occur in several of these illnesses are simply manifestations of viremia, the passage of viruses through the lungs into the bloodstream. Most of the victims of these diseases were children; indeed, these illnesses were among the principal reasons for the high child mortality rates. While antibiotics are ineffective in treating viral diseases (as opposed to bacterial or fungal diseases), vaccinations have proven very successful, reducing or even eliminating them.
Two epidemic diseases that have killed millions of people throughout recorded history have been the pneumonic plague and influenza. Both have been somewhat controlled by improved...
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For Further Information: (Magill’s Medical Guide, Sixth Edition)
American Lung Association. http://www.lungusa.org. Includes in-depth information and recent research findings, a guide to local events and programs, and a section to share personal stories, among other features.
Fishman, Alfred, ed. Fishman’s Pulmonary Diseases and Disorders. 4th ed. New York: McGraw-Hill, 2008. A text frequently consulted by health professionals, it is less complex than Fraser and Paré’s book but well written and comprehensive. An excellent place to find discussions of current diagnosis and treatment, as well as of research and future directions.
Fraser, R. S., et al. Fraser and Paré’s Diagnosis of Diseases of the Chest. 4th ed. Philadelphia: W. B. Saunders, 1999. This bible of pulmonary disease is one of the most extensive textbooks available on the subject. Although used primarily for reference by pulmonary physicians, it is clearly written.
Goldman, Lee, and Dennis Ausiello, eds. Cecil Textbook of Medicine. 23d ed. Philadelphia: Saunders/Elsevier, 2007. This superior textbook of internal medicine has an excellent section on respiratory system disease. A perfect place to start for the reader interested in all aspects of a disease. The text is well supplemented with diagrams and photographs.
Hedrick, Hannah L., and Austin K. Kutscher, eds. The Quiet Killer: Emphysema, Chronic Obstructive Pulmonary Disease. Lanham, Md.: Scarecrow...
(The entire section is 397 words.)