Pulmonology

Pulmonology (

Pulmonology/respirology departments work especially closely with certain other specialties: cardiothoracic surgery departments and cardiology departments.

Journals of pulmonology

• American Association for Respiratory Care
• American College of Chest Physicians
• American Lung Association
• American Thoracic Society
• British Thoracic Society
• European Respiratory Society

History of pulmonology

One of the first major discoveries relevant to the field of pulmonology was the discovery of

Although pulmonary medicine only began to evolve as a medical specialty in the 1950s, William Welch and William Osler founded the 'parent' organization of the American Thoracic Society,^[5] the National Association for the Study and Prevention of Tuberculosis.^[6] The care, treatment, and study of tuberculosis of the lung is recognised as a discipline in its own right, phthisiology.^[7] When the specialty did begin to evolve, several discoveries were being made linking the respiratory system and the measurement of arterial blood gases, attracting more and more physicians and researchers to the developing field.^[8]

Pulmonology and its relevance in other medical fields

• alpha 1-antitrypsin deficiency
  )
• exposure to toxicants (tobacco smoke,^[17] asbestos, exhaust fumes, coal mining fumes, e-cigarette aerosol,^[18])
• 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^[19] are as important as in other fields of medicine.

• Inspection of the hands for signs of cyanosis or clubbing, chest wall, and respiratory rate.
• Palpation of the
  trachea
  and chest wall movement.
• Percussion of the lung fields for dullness or hyper-resonance.
• breath sounds
  .
  • rhonchi heard over lung fields with a stethoscope
    .

As many heart diseases can give pulmonary signs,^[20] a thorough cardiac investigation is usually included.

Procedures

Clinical procedures

Pulmonary clinical procedures include the following pulmonary tests and procedures:^[21][22]

• Medical laboratory investigation of blood (blood tests). Sometimes arterial blood gas tests are also required.
• Spirometry the determination of maximum airflow at a given lung volume as measured by breathing into a dedicated machine; this is the key test to diagnose airflow obstruction.
• Pulmonary function testing including spirometry, as above, plus response to bronchodilators, lung volumes, and diffusion capacity, the latter being a measure of lung oxygen absorptive area
• Bronchoscopy^[23] with bronchoalveolar lavage (BAL), endobronchial and transbronchial biopsy and epithelial brushing
• Chest X-rays^[24]
• CT scan^[25]
• Scintigraphy and other methods of nuclear medicine
• Positron emission tomography^[26] (especially in lung cancer)
• Polysomnography (sleep studies^[27]) commonly used for the diagnosis of sleep apnea

Surgical procedures

Major surgical procedures on the heart and lungs are performed by a

.

Pulmonary rehabilitation

social worker

among others. Additionally, breathing games are used to motivate children to perform pulmonary rehabilitation.

Education and training

Pulmonologist

Pulmonologist

Physician performing a bronchoscopy.
Occupation
Names	Pulmonologist Pneumologist Respirologist Respiratory physician or chest physician
Occupation type	Specialty
Activity sectors	Medicine
Description
Education required	Doctor of Medicine (M.D.) Doctor of Osteopathic Medicine (D.O.) Bachelor of Medicine, Bachelor of Surgery (MBBS/MBChB)
Fields of employment	Hospitals, clinics

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 subspeciality fellowship training in pulmonology.^[33] After satisfactorily completing a fellowship in pulmonary medicine, the physician is permitted to take the board certification examination in pulmonary medicine. After passing this exam, the physician is then board certified as a pulmonologist. Most pulmonologists complete three years of combined subspecialty fellowship training in pulmonary medicine and critical care medicine.

Pediatric pulmonologist

In the