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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 th ...
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Gustav Killian
Gustav Killian (2 June 1860 – 24 February 1921) was a Germans, German Laryngology, laryngologist and founder of the bronchoscopy. Life and death His father Johann Baptist Caesar Killian (1820–1889), the son of a ''städtischen Wegeaufsehers'' an urban way overseer, was a ''doctor of philosophiae'' and high school teacher born in Mainz and later living in Bensheim. His mother Apollonia (1833–1865), née Höpfel died early, at age 31 of cholera. He was also born in Mainz, and educated at the Albert Ludwigs University of Freiburg, University of Freiburg-im-Breisgau. He made revolutionary advances in the diagnosis and treatment of affections of the infralaryngeal passages, especially in the diagnosis and removal of foreign bodies in the Bronchus, bronchial tubes, by means of his new art of bronchoscopic control. His first college appointment was as assistant to Professor Hack of the chair of otolaryngology in Mainz. The sudden death of Wilhelm Hack (1851–1887) led to his suc ...
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Endoscopy
An endoscopy is a procedure used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are inserted directly into the organ. There are many types of endoscopies. Depending on the site in the body and type of procedure, an endoscopy may be performed by a doctor or a surgeon. During the procedure, a patient may be fully conscious or anaesthesia, anaesthetised. Most often, the term ''endoscopy'' is used to refer to an examination of the upper part of the human gastrointestinal tract, gastrointestinal tract, known as an esophagogastroduodenoscopy. Similar instruments are called borescopes for nonmedical use. History Adolf Kussmaul was fascinated by sword swallowers who would insert a sword down their throat without gagging. This drew inspiration to insert a hollow tube for observation; the next problem to solve was how to shine light th ...
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Hemoptysis
Hemoptysis or haemoptysis is the discharge of blood or blood-stained sputum, mucus through the mouth coming from the bronchi, larynx, vertebrate trachea, trachea, or lungs. It does not necessarily involve coughing. In other words, it is the airway bleeding. This can occur with lung cancer, infections such as tuberculosis, bronchitis, or pneumonia, and certain cardiovascular conditions. Hemoptysis is considered massive at . In such cases, there are always severe injuries. The primary danger comes from choking, rather than bleeding, blood loss. Diagnosis * Past history, history of present illness, family history ** history of tuberculosis, bronchiectasis, chronic bronchitis, mitral stenosis, etc. ** history of cigarette smoking, occupational diseases by exposure to silica dust, etc. * Blood ** duration, frequency, amount ** Amounts of blood: large amounts of blood, or there is blood-streaked sputum ** Probable source of bleeding: Is the blood coughed up, or vomited? * Bloody sput ...
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Shigeto Ikeda
was a Japanese physician, regarded as the "father" of fiberoptic bronchoscopy. He graduated from Keio University School of Medicine in 1952 and joined the Thoracic Surgery department. In 1966, he developed the first flexible bronchoscope in conjunction with Machida Endoscope Co. Ltd (later taken over by Pentax) and Olympus Optical Co., Ltd. This allowed better visualisation of the upper lobe bronchi A bronchus ( ; : bronchi, ) is a passage or airway in the lower respiratory tract that conducts air into the lungs. The first or primary bronchi to branch from the trachea at the carina are the right main bronchus and the left main bronchus. Thes ... than is possible with the rigid bronchoscope. Successive improvements under his supervision included the development of video-bronchoscopy. His motto was "there is more hope with the bronchoscope". References 1925 births 2001 deaths Japanese thoracic surgeons 20th-century surgeons Keio University alumni {{japan-med-bi ...
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Bronchoalveolar Lavage
Bronchoalveolar lavage (BAL), also known as bronchoalveolar washing, is a diagnostic method of the lower respiratory system in which a bronchoscope is passed through the mouth or nose into an appropriate airway in the lungs, with a measured amount of fluid introduced and then collected for examination. This method is typically performed to diagnose pathogenic infections of the lower respiratory airways (e.g. pneumonia and COVID-19), though it also has been shown to have utility in diagnosing interstitial lung disease. Bronchoalveolar lavage can be a more sensitive method of detection than nasal swabs in respiratory molecular diagnostics, as has been the case with SARS-CoV-2 where bronchoalveolar lavage samples detect copies of viral RNA after negative nasal swab testing. In particular, bronchoalveolar lavage is commonly used to diagnose infections in people with immune system problems, pneumonia in people on ventilators, and acute respiratory distress syndrome (ARDS). It is th ...
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Cocaine
Cocaine is a tropane alkaloid and central nervous system stimulant, derived primarily from the leaves of two South American coca plants, ''Erythroxylum coca'' and ''Erythroxylum novogranatense, E. novogranatense'', which are cultivated almost exclusively in the Andes. Indigenous peoples of South America, Indigenous South Americans have traditionally used coca leaves for over a thousand years. Notably, there is no evidence that habitual coca leaf use causes addiction or withdrawal, unlike cocaine. Medically, cocaine is rarely employed, mainly as a topical medication under controlled settings, due to its high abuse potential, adverse effects, and expensive cost. Despite this, recreational drug use, recreational use is widespread, driven by its euphoric and aphrodisiac properties. Levamisole induced necrosis syndrome (LINES)-a complication of the common cocaine Lacing (drugs), cutting agent levamisole-and prenatal cocaine exposure is particularly harmful. Street cocaine is ...
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Local Anesthetic
A local anesthetic (LA) is a medication that causes absence of all sensation (including pain) in a specific body part without loss of consciousness, providing local anesthesia, as opposed to a general anesthetic, which eliminates all sensation in the entire body and causes unconsciousness. Local anesthetics are most commonly used to eliminate pain during or after surgery. When it is used on specific nerve pathways ( local anesthetic nerve block), paralysis (loss of muscle function) also can be induced. Classification LAs are of 2 types: *Clinical LAs: ** amino amide LAs ** amino ester LAs *Synthetic LAs **Cocaine derivatives Synthetic cocaine-derived LAs differ from cocaine because they have a much lower abuse potential and do not cause hypertension vasoconstriction (with few exceptions). The suffix "-caine" at the ends of these medication names is derived from the word "cocaine", because cocaine was formerly used as a local anesthetic. Examples Short Duration of Act ...
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Trachea
The trachea (: tracheae or tracheas), 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 animals' 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 annular ligaments of trachea, 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. Its epithelium is lined with columnar epithelium, 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, usua ...
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Inflammation
Inflammation (from ) is part of the biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. The five cardinal signs are heat, pain, redness, swelling, and loss of function (Latin ''calor'', ''dolor'', ''rubor'', ''tumor'', and ''functio laesa''). Inflammation is a generic response, and therefore is considered a mechanism of innate immunity, whereas adaptive immunity is specific to each pathogen. Inflammation is a protective response involving immune cells, blood vessels, and molecular mediators. The function of inflammation is to eliminate the initial cause of cell injury, clear out damaged cells and tissues, and initiate tissue repair. Too little inflammation could lead to progressive tissue destruction by the harmful stimulus (e.g. bacteria) and compromise the survival of the organism. However inflammation can also have negative effects. Too much inflammation, in the form of chronic inflammation, is associated with variou ...
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Electrocautery
Cauterization (or cauterisation, or cautery) is a medical practice or technique of burning a part of a body to remove or close off a part of it. It destroys some tissue in an attempt to mitigate bleeding and damage, remove an undesired growth, or minimize other potential medical harm, such as infections when antibiotics are unavailable. The practice was once widespread for treatment of wounds. Its utility before the advent of antibiotics was said to be effective at more than one level: *To prevent exsanguination *To close amputations Cautery was historically believed to prevent infection, but current research shows that cautery actually increases the risk for infection by causing more tissue damage and providing a more hospitable environment for bacterial growth. Actual cautery refers to the metal device, generally heated to a dull red glow, that a physician applies to produce blisters, to stop bleeding of a blood vessel, and for other similar purposes., page 16. The main fo ...
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Biopsy
A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, an interventional radiologist, or an interventional cardiology, interventional cardiologist. The process involves the extraction of sampling (medicine), sample Cell (biology), cells or Biological tissue, tissues for examination to determine the presence or extent of a disease. The tissue is then Histopathology, fixed, dehydrated, embedded, sectioned, stained and mounted before it is generally examined under a microscope by a pathologist; it may also be analyzed chemically. When an entire lump or suspicious area is removed, the procedure is called an excisional biopsy. An incisional biopsy or core biopsy samples a portion of the abnormal tissue without attempting to remove the entire lesion or tumor. When a sample of tissue or fluid is removed with a needle in such a way that cells are removed without preserving the histological architecture of the tissue cells, the procedure is called a needle as ...
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Lungs
The lungs are the primary organs of the respiratory system in many animals, including humans. In mammals and most other tetrapods, two lungs are located near the backbone on either side of the heart. Their function in the respiratory system is to extract oxygen from the atmosphere and transfer it into the bloodstream, and to release carbon dioxide from the bloodstream into the atmosphere, in a process of gas exchange. Respiration is driven by different muscular systems in different species. Mammals, reptiles and birds use their musculoskeletal systems to support and foster breathing. In early tetrapods, air was driven into the lungs by the pharyngeal muscles via buccal pumping, a mechanism still seen in amphibians. In humans, the primary muscle that drives breathing is the diaphragm. The lungs also provide airflow that makes vocalisation including speech possible. Humans have two lungs, a right lung and a left lung. They are situated within the thoracic cavity of the c ...
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