Pulmonology is a medical speciality that deals with diseases involving
the respiratory tract. The term is derived from the
pulmō, pulmōnis ("lung") and the Greek suffix -λογία, -logia
Pulmonology is synonymous with pneumology (from Greek
πνεύμων ("lung") and -λογία), respirology and respiratory
Pulmonology is known as chest medicine and respiratory medicine in
some countries and areas.
Pulmonology is considered a branch of
internal medicine, and is related to intensive care medicine.
Pulmonology often involves managing patients who need life support and
mechanical ventilation. Pulmonologists are specially trained in
diseases and conditions of the chest, particularly pneumonia, asthma,
tuberculosis, emphysema, and complicated chest infections. 
1 Variations in nomenclature
3.1 Surgical procedures
4 Treatment and therapeutics
5 Education and training
5.1 Pediatric pulmonologist
6 Scientific research
7 Journals of pulmonology
8 History of pulmonology
Variations in nomenclature
In the United Kingdom, Ireland, South Africa[dubious – discuss], and
Australia the term "respiratory physician" is used (rather than
pulmonologist) to distinguish a physician that practices pulmonology.
In Canada, respirology and respirologist are used .
Surgery of the
respiratory tract is generally performed by specialists in
cardiothoracic surgery (or thoracic surgery), though minor procedures
may be performed by pulmonologists. As mentioned above, pulmonology is
closely related to critical care medicine when dealing with patients
who require mechanical ventilation. As a result, many pulmonologists
are certified to practice critical care medicine in addition to
pulmonary medicine. There are fellowship programs that allow
physicians to become board certified in pulmonary and critical care
Interventional pulmonology is a relatively
new field within pulmonary medicine that deals with the use of
procedures such as bronchoscopy and pleuroscopy to treat several
Interventional pulmonology is increasingly
recognized as a specific medical specialty.
The pulmonologist begins the diagnostic process with a general review
hereditary diseases affecting the lungs (cystic fibrosis, alpha
exposure to toxins (tobacco smoke, asbestos, exhaust fumes, coal
exposure to infectious agents (certain types of birds, malt
an autoimmune diathesis that might predispose to certain conditions
(pulmonary fibrosis, pulmonary hypertension)
Physical diagnostics are as important as in the other fields of
Inspection of the hands for signs of cyanosis or clubbing, chest wall,
and respiratory rate.
Palpation of the cervical lymph nodes, trachea and chest wall
Percussion of the lung fields for dullness or hyper-resonance.
Auscultation (with a stethoscope) of the lung fields for diminished or
unusual breath sounds.
Rales or rhonchi heard over lung fields with a stethoscope.
As many heart diseases can give pulmonary signs, a thorough cardiac
investigation is usually included.
Laboratory investigation of blood (blood tests). Sometimes arterial
blood gas measurements 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 Tests
Pulmonary Function Tests spirometry, as above, plus response to
bronchodilators, lung volumes, and diffusion capacity, the latter a
measure of lung oxygen absorptive area
Bronchoscopy with bronchoalveolar lavage (BAL), endobronchial and
transbronchial biopsy and epithelial brushing
Scintigraphy and other methods of nuclear medicine
Positron emission tomography
Positron emission tomography (especially in lung cancer)
Polysomnography (sleep studies) commonly used for the diagnosis of
Major surgical procedures on the heart and lungs are performed by a
thoracic surgeon. Pulmonologists often perform specialized procedures
to get samples from the inside of the chest or inside of the lung.
They use radiographic techniques to view vasculature of the lungs and
heart to assist with diagnosis.
Treatment and therapeutics
Cardiothoracic surgery and Pulmonary rehabilitation
Medication is the most important treatment of most diseases of
pulmonology, either by inhalation (bronchodilators and steroids) or in
oral form (antibiotics, leukotriene antagonists). A common example
being the usage of inhalers in the treatment of inflammatory lung
conditions such as asthma or chronic obstructive pulmonary disease.
Oxygen therapy is often necessary in severe respiratory disease
(emphysema and pulmonary fibrosis). When this is insufficient, the
patient might require mechanical ventilation.
Pulmonary rehabilitation has been defined as multidimensional
continuum of services directed to persons with pulmonary disease and
their families, usually by an interdisciplinary team of specialists,
with the goal of achieving and maintaining the individual's maximum
level of independence and functioning in the community. Pulmonary
rehabilitation is intended to educate the patient, the family, and
improve the overall quality of life and prognosis for the patient.
Interventions can include exercise, education, emotional support,
oxygen, noninvasive mechanical ventilation, optimization of airway
secretion clearance, promoting compliance with medical care to reduce
numbers of exacerbations and hospitalizations, and returning to work
and/or a more active and emotionally satisfying life. These goals are
appropriate for any patients with diminished respiratory reserve
whether due to obstructive or intrinsic pulmonary diseases
(oxygenation impairment) or neuromuscular weakness (ventilatory
impairment). A pulmonary rehabilitation team may include a
rehabilitation physician, a pulmonary medicine specialist, and allied
health professionals including a rehabilitation nurse, a respiratory
therapist, a physical therapist, an occupational therapist, a
psychologist, and a social worker among others. Additionally breathing
games are used to motivate children to perform pulmonary
Education and training
Physician performing a bronchoscopy.
Doctor of Osteopathic
Bachelor of Medicine, Bachelor of
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. 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.
In the United States, pediatric pulmonologists are physicians who,
after receiving a medical degree (MD or DO), complete residency
training in pediatrics, followed by at least three additional years of
subspeciality fellowship training in pulmonology.
Pulmonologists are involved in both clinical and basic research of the
respiratory system, ranging from the anatomy of the respiratory
epithelium to the most effective treatment of pulmonary hypertension.
Scientific research also takes place to look for causes and possible
treatment in diseases such as pulmonary tuberculosis and lung cancer.
Journals of pulmonology
American Association for Respiratory Care
American College of
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 pulmonary circulation. Originally, it
was thought that blood reaching the right side of the heart passed
through small 'pores' in the septum into the left side to be
oxygenated, as theorized by Galen; however, the discovery of pulmonary
circulation disproves this theory, which had previously been accepted
since the 2nd century. Thirteenth century anatomist and physiologist
Ibn Al-Nafis accurately theorized that there was no 'direct' passage
between the two sides (ventricles) of the heart. He believed that the
blood must have passed through the pulmonary artery, through the
lungs, and back into the heart to be pumped around the body. This is
believed by many to be the first scientific description of pulmonary
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, the National
Association for the Study and Prevention of Tuberculosis. The care,
treatment, and study of tuberculosis of the lung is recognised as a
discipline in its own right, phthisiology. 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
^ ACP: Pulmonology: Internal
Medicine Subspecialty. Acponline.org.
Retrieved on 2011-09-30.
^ Sengupta, Nandini; Sahidullah, Md; Saha, Goutam (August 2016). "Lung
sound classification using cepstral-based statistical features".
Computers in Biology and Medicine. 75 (1): 118–129.
^ Luis M. Seijo & Daniel H. Sterman (2001). "Interventional
Pulmonology". N. Engl. J. Med. 344 (10): 740–49.
doi:10.1056/NEJM200103083441007. PMID 11236779.
^ Sharif Kaf A-Ghazal (2002). "The discovery of the pulmonary
circulation – who should get the credit: ibn Al-Nafis or William
Harvey" (PDF). JISHIM. 2: 46.
^ History of the Division. Hopkinsmedicine.org. Retrieved on
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Allergy / Immunology
Obstetrics and gynaecology
Reproductive endocrinology and infertility
Physical medicine and rehabilitation
Physical medicine and rehabilitation (PM&R)
Bachelor of Medicine, Bachelor of Surgery
Bachelor of Medical Sciences
Master of Medicine
Master of Surgery
Doctor of Medicine
Doctor of Osteopathic Medicine
History of medicine