In this article focused the chest and lungs.  Examining a patient’s chest is a lot like beating a drum or trying to locate a stud in a wall. Using a technique called “percussion,” the doctor places his fingers on your skin and taps them with fingers of the other hand. He repeats the tapping several times as he moves methodically around the upper torso, listening carefully to the subtly different sounds the tapping makes. To his trained ear, the nature of the sound reveals much about the organs in the chest cavity.

Healthy, air-filled lungs resonate or sound hollow. A lung with enlarged air sacs due to the disease called emphysema also resounds, but the resonance is greater than normal. By contrast, when tapped, a lung partially filled with fluid, or one that has collapsed, produces a dull sound.

What Does “Palpation” Indicate About Your Chest and Lungs?

Doctor-Thump-Your-ChestExamination by touch, called palpation, may begin when the doctor places his hands symmetrically on both sides of the chest. He then will ask you to breathe deeply in order to set your chest in motion. If your lungs and thorax are in healthy working order, he should feel equal movement on the two sides.

The doctor may also ask you to say “99,” A test term chosen for its resonation sound. Normally, the vibrations of the vocal cords are transmitted into the lungs and from there to the surface of the chest, where the doctor feels them through his fingers. Changes in transmission may be a sign of chest disease.

What is a Stethoscope?

If you know how to interpret them, many noises inside the chest can reveal a lot about a person’s physical condition. Several diseases produce characteristic, identifying sounds.

In order to hear these sounds, a physician uses a simple sound conductor called a stethoscope. (This instrument is also quite useful for listening to other parts of the body.)

In the examination that is known as “auscultation,” the doctor places the sound-gathering end of the instrument against your chest and listens through the attached earpieces. What he hears is the air you breathe as it moves through your respiratory system. There is a rushing sound over the larger airways and a gentle whiff over the smaller ones in the normal individual. The stethoscope picks up abnormalities as distinctly different sounds consisting or a decrease in the normal sounds.

What Does a Bronchoscope Do?

This thin, flexible tube, with fiber-optic light source and viewer allows the doctor to see the body’s dark air passages all the way down to the small tubes that lead to the lungs; areas of irritation, growths, or blockages become visible. The patient is given a local anesthetic, and the instrument is inserted through the nose or mouth.

A suction device, bronchial brushes, and small forceps make it possible for the physician to remove foreign objects or to withdraw samples of tissue. A separate channel delivers medication to the precise site where it is needed. Admirably versatile, the bronchoscope thus performs a number of functions that once were possible only through surgery.

How Often Should You have a Chest X ray?

Chest X rays were once part of a regular physical examination, but today, doctors order far fewer routine X rays than they used to, the precise frequency depending on the reason for the examination. The reason for the change in policy is that X-ray examinations expose patients to radiation. Although the doses are very low, doctors now believe that risks may outweigh benefits except in certain situations – for instance, cardiac conditions and to monitor heavy smokers and people whose occupations put them at risk of lung cancer.

In most other cases, X-ray photography is now used mainly to give doctors more information about an already-diagnosed disease or injury, or to check on the results of surgery. For purely diagnostic purposes, pulmonary function tests and other tests are often simpler, less expensive, and more informative, and they have replaced routine X rays.

What are Pulmonary Function Tests?

There is one thing most people don’t have to worry about – being able to breathe in enough air. You have an enormous “respiratory reserve” – that is, you can breathe in much more air than you need at rest, and your breathing increases with exercise. Even when a lung is removed, patients may not feel short of breath, unless they are exercising.

When people do complain of chronic shortness of breath at rest or during mild exercise or when lung disease is suspected, a physician may prescribe pulmonary function tests. These tests measure the respiratory capacities of healthy people of the same sex and age.

One test measures “tidal volume,” the amount of air – normally only about a pint (.55 liter) – that moves in and out of the lungs with each breathing cycle of a resting subject.

Another test measures “maximal breathing capacity,” the considerably larger volumes of air that you can move when you force yourself to inhale or exhale deeply. The normal range is about 33 to 45 gallons (125 to 170 liters) per minute in healthy young male adults and about 26.4 to 37 gallons (100 to 140 liters) in healthy young female adults.

Since even healthy people tend to lose some lung elasticity over the years, reductions of 20 percent by age 60 and of 40 percent by age 75 are considered normal. Confinement to bed for several days reduces breathing capacity; regular exercise increases it.

Pulmonary function tests are performed with a spirometer, which collects and measures the air and records the findings on a graph. Some physicians have such equipment in their offices; others refer patients to a hospital or specialized clinic.

The Breathless Fashions of Yesteryear

The women of ancient Greece and Rome wore a three-part corset of linen wrappings, restraining the figure much as a full-body corset does today. The female waistline has been relocated upward and downward over the centuries, with varying degrees of discomfort. But this fashion did not become a real health hazard until whalebone corsets came into widespread use in the late 19th and early 20th centuries, with even more constriction.

Wasp-waisted women of the Victorian era swooned frequently. The cry would go up, “Cut her laces!” Allowed sufficient air, the woman would come to.

How Much Air Can Your Lungs Hold?

For an average adult male, breathing normally, the amount of air in the chest is about. 7 gallon (2.5 liters). The term tidal volume is given to the amount of air that flows in and out of the lungs with each breath; this amounts to about 15 ounces (500 milliliters). There is always some air left in the lungs after exhalation.

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