Pulmonary Toilet
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Pulmonary Toilet
Pulmonary hygiene, formerly referred to as pulmonary toilet, is a set of methods used to clear mucus and secretions from the airways. The word ''pulmonary'' refers to the lungs. The word ''toilet'', related to the French ''toilette'', refers to body care and hygiene; this root is used in words such as ''toiletry'' that also relate to cleansing. Respiratory health (pulmonary hygiene) depends on consistent clearance of airway secretions. Normal airway clearance is accomplished by two important mechanisms: the mucociliary clearance system and the ability to cough. Impaired mucociliary clearance is linked to poor lung function in a broad range of diseases and disabilities. Pulmonary hygiene prevents atelectasis (the collapse of the alveoli of the lungs) and rids the respiratory system of secretions, which could cause respiratory infections. It can also decrease pulmonary shunting, increase the functional reserve capacity of the lungs, and prevent respiratory infection after chest ...
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Mucus
Mucus ( ) is a slippery aqueous secretion produced by, and covering, mucous membranes. It is typically produced from cells found in mucous glands, although it may also originate from mixed glands, which contain both serous and mucous cells. It is a viscous colloid containing inorganic salts, antimicrobial enzymes (such as lysozymes), immunoglobulins (especially IgA), and glycoproteins such as lactoferrin and mucins, which are produced by goblet cells in the mucous membranes and submucosal glands. Mucus serves to protect epithelial cells in the linings of the respiratory, digestive, and urogenital systems, and structures in the visual and auditory systems from pathogenic fungi, bacteria and viruses. Most of the mucus in the body is produced in the gastrointestinal tract. Amphibians, fish, snails, slugs, and some other invertebrates also produce external mucus from their epidermis as protection against pathogens, and to help in movement and is also produced in fish to line the ...
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Bronchoscopy
Bronchoscopy is an endoscopic technique of visualizing the inside of the airways for diagnostic and therapeutic purposes. An instrument (bronchoscope) is inserted into the airways, usually through the nose or mouth, or occasionally through a tracheostomy. This allows the practitioner to examine the patient's airways for abnormalities such as foreign bodies, bleeding, tumors, or inflammation. Specimens may be taken from inside the lungs. The construction of bronchoscopes ranges from rigid metal tubes with attached lighting devices to flexible optical fiber instruments with realtime video equipment. History The German laryngologist Gustav Killian is attributed with performing the first bronchoscopy in 1897. Killian used a rigid bronchoscope to remove a pork bone. The procedure was done in an awake patient using topical cocaine as a local anesthetic. From this time until the 1970s, rigid bronchoscopes were used exclusively. Chevalier Jackson, refined the rigid bronchoscope in the 19 ...
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Physiotherapy
Physical therapy (PT), also known as physiotherapy, is one of the allied health professions. It is provided by physical therapists who promote, maintain, or restore health through physical examination, diagnosis, management, prognosis, patient education, physical intervention, rehabilitation, disease prevention, and health promotion. Physical therapists are known as physiotherapists in many countries. In addition to clinical practice, other aspects of physical therapist practice include research, education, consultation, and health administration. Physical therapy is provided as a primary care treatment or alongside, or in conjunction with, other medical services. In some jurisdictions, such as the United Kingdom, physical therapists have the authority to prescribe medication. Overview Physical therapy addresses the illnesses or injuries that limit a person's abilities to move and perform functional activities in their daily lives. PTs use an individual's history and physic ...
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Dorland's Medical Dictionary
''Dorland's'' is the brand name of a family of medical reference works (including dictionaries, spellers and word books, and spell-check software) in various media spanning printed books, CD-ROMs, and online content. The flagship products are ''Dorland's Illustrated Medical Dictionary'' (currently in its 33rd edition) and ''Dorland's Pocket Medical Dictionary'' (currently in its 30th edition). The principal dictionary was first published in 1890 as the ''American Illustrated Medical Dictionary'', including 770 pages. The pocket edition, called the ''American Pocket Medical Dictionary'', was first published in 1898, consisting of just over 500 pages. With the death of the editor William Alexander Newman Dorland, AM, MD in 1956, the dictionaries were retitled to incorporate his name, which was how they had generally come to be known. The illustrated dictionary had grown to 2144 pages for the 33rd edition. The dictionaries were historically published by Saunders. List of products ...
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Vertebrate Trachea
The trachea, also known as the windpipe, is a cartilaginous tube that connects the larynx to the bronchi of the lungs, allowing the passage of air, and so is present in almost all air-breathing animals with lungs. The trachea extends from the larynx and branches into the two primary bronchi. At the top of the trachea the cricoid cartilage attaches it to the larynx. The trachea is formed by a number of horseshoe-shaped rings, joined together vertically by overlying ligaments, and by the trachealis muscle at their ends. The epiglottis closes the opening to the larynx during swallowing. The trachea begins to form in the second month of embryo development, becoming longer and more fixed in its position over time. It is epithelium lined with column-shaped cells that have hair-like extensions called cilia, with scattered goblet cells that produce protective mucins. The trachea can be affected by inflammation or infection, usually as a result of a viral illness affecting other parts ...
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Abscess
An abscess is a collection of pus that has built up within the tissue of the body. Signs and symptoms of abscesses include redness, pain, warmth, and swelling. The swelling may feel fluid-filled when pressed. The area of redness often extends beyond the swelling. Carbuncles and boils are types of abscess that often involve hair follicles, with carbuncles being larger. They are usually caused by a bacterial infection. Often many different types of bacteria are involved in a single infection. In many areas of the world, the most common bacteria present is ''methicillin-resistant Staphylococcus aureus''. Rarely, parasites can cause abscesses; this is more common in the developing world. Diagnosis of a skin abscess is usually made based on what it looks like and is confirmed by cutting it open. Ultrasound imaging may be useful in cases in which the diagnosis is not clear. In abscesses around the anus, computer tomography (CT) may be important to look for deeper infection. Standa ...
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Bronchiectasis
Bronchiectasis is a disease in which there is permanent enlargement of parts of the bronchi, airways of the lung. Symptoms typically include a chronic cough with sputum, mucus production. Other symptoms include shortness of breath, hemoptysis, coughing up blood, and chest pain. Wheezing and nail clubbing may also occur. Those with the disease often get lung infections. Bronchiectasis may result from a number of infection, infectious and acquired causes, including measles, pneumonia, tuberculosis, immune system problems, as well as the genetic disorder cystic fibrosis. Cystic fibrosis eventually results in severe bronchiectasis in nearly all cases. The cause in 10–50% of those without cystic fibrosis is unknown. The mechanism of disease is breakdown of the airways due to an excessive inflammatory response. Involved airways (bronchi) become enlarged and thus less able to clear secretions. These secretions increase the amount of bacteria in the lungs, resulting in airway blockage ...
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Postural Drainage
Postural drainage (PD) is the drainage of lung secretions using gravity. It is used to treat a variety of conditions that cause the build-up of secretions in the lungs. Uses Postural drainage is used to treat any condition that causes the build-up of secretions in bronchopulmonary segments. These include: * bronchiectasis * lung abscesses * cystic fibrosis * atelectasis * chronic obstructive pulmonary disease (COPD) * pneumonia * postoperative lung damage (after some thoracic surgery) * Covid 19 Patients must receive physiotherapy to learn to tip themselves into a position in which the lobe can be drained. Contraindications Postural drainage is often not suitable for infants in the neonatal intensive care unit, who may have lots of equipment attached to them. Postural drainage is more difficult if patients experience poor mobility, poor posture, pain, anxiety, and skin damage, usually requiring adaptations to the technique. Trendelenburg position which is head down ...
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Prone Position
Prone position () is a body position in which the person lies flat with the chest down and the back up. In anatomical terms of location, the dorsal side is up, and the ventral side is down. The supine position is the 180° contrast. Etymology The word ''prone'', meaning "naturally inclined to something, apt, liable," has been recorded in English since 1382; the meaning "lying face-down" was first recorded in 1578, but is also referred to as "lying down" or "going prone." ''Prone'' derives from the Latin ', meaning "bent forward, inclined to," from the adverbial form of the prefix ''pro-'' "forward." Both the original, literal, and the derived figurative sense were used in Latin, but the figurative is older in English. Anatomy In anatomy, the prone position is a position of the body lying face down. It is opposed to the supine position which is face up. Using the terms defined in the anatomical position, the ventral side is down, and the dorsal side is up. Concerning the ...
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Cilia
The cilium, plural cilia (), is a membrane-bound organelle found on most types of eukaryotic cell, and certain microorganisms known as ciliates. Cilia are absent in bacteria and archaea. The cilium has the shape of a slender threadlike projection that extends from the surface of the much larger cell body. Eukaryotic flagella found on sperm cells and many protozoans have a similar structure to motile cilia that enables swimming through liquids; they are longer than cilia and have a different undulating motion. There are two major classes of cilia: ''motile'' and ''non-motile'' cilia, each with a subtype, giving four types in all. A cell will typically have one primary cilium or many motile cilia. The structure of the cilium core called the axoneme determines the cilium class. Most motile cilia have a central pair of single microtubules surrounded by nine pairs of double microtubules called a 9+2 axoneme. Most non-motile cilia have a 9+0 axoneme that lacks the central pair of mi ...
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Tracheotomy
Tracheotomy (, ), or tracheostomy, is a surgical airway management procedure which consists of making an incision (cut) on the anterior aspect (front) of the neck and opening a direct airway through an incision in the trachea (windpipe). The resulting stoma (hole) can serve independently as an airway or as a site for a tracheal tube or tracheostomy tube to be inserted; this tube allows a person to breathe without the use of the nose or mouth. Etymology and terminology The etymology of the word ''tracheotomy'' comes from two Greek words: the root ''tom-'' (from Greek τομή ''tomḗ'') meaning "to cut", and the word ''trachea'' (from Greek τραχεία ''tracheía''). The word ''tracheostomy'', including the root ''stom-'' (from Greek στόμα ''stóma'') meaning "mouth," refers to the making of a semi-permanent or permanent opening, and to the opening itself. Some sources offer different definitions of the above terms. Part of the ambiguity is due to the uncertainty of ...
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Sedation
Sedation is the reduction of irritability or agitation by administration of sedative drugs, generally to facilitate a medical procedure or diagnostic procedure. Examples of drugs which can be used for sedation include isoflurane, diethyl ether, propofol, etomidate, ketamine, pentobarbital, lorazepam and midazolam. Medical uses Sedation is typically used in minor surgical procedures such as endoscopy, vasectomy, or dentistry and for reconstructive surgery, some cosmetic surgeries, removal of wisdom teeth, or for high-anxiety patients. Sedation methods in dentistry include inhalation sedation (using nitrous oxide), oral sedation, and intravenous (IV) sedation. Inhalation sedation is also sometimes referred to as ''relative analgesia''. Sedation is also used extensively in the intensive care unit so that patients who are being ventilated tolerate having an endotracheal tube in their trachea. It can also be used during a long term brain EEG to help patient relax. Risks There are ...
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