The doctor can use the bronchoscope to examine the lungs and airways. In addition, the method helps in the treatment, for example, to extract viscous mucus. During lung reflection, the doctor introduces a bronchoscope into the airway via the mouth or nose. Modern bronchoscopes consist of a soft, flexible tube with a diameter of two to six millimeters. At the top of the tube sits a camera with the light source. This camera sends its images in real time to a monitor on which the doctor examines the patient’s airways.

In addition, the bronchoscope can inject and aspirate liquid and thereby perform a so-called bronchial lavage. In addition, very small pliers or brushes can be advanced through the tube and tissue samples taken. These biopsy specimens will be examined later by the doctor under a microscope. In addition, a miniature ultrasound head can image the environment of the airways.

For what reasons does the doctor perform a bronchoscopy?

A bronchoscopy may be necessary for both treatment and diagnosis, for example, if there is suspicion of lung cancer in the room or if treatment is to be scheduled for a known lung tumor. Doctors can also use this method to introduce radioactive substances into the lungs in order to irradiate tumors locally. Restrictions of the respiratory tract can be clarified by bronchoscopy. Similarly, the doctor can investigate reduced ventilation of partial areas of the lung, so-called atelectasis. With the lung reflection and bronchial lavage cells and germs can also be extracted from the lungs.

Doctors also use lung plasmas to look for and remove foreign bodies. In ventilated patients, the position of the breathing tube can also be corrected with it. In addition, secretions such as mucus plugs can be washed away with the bronchoscope and inserted so-called stents, which seemed to the airways from the inside and keep them open.

the-bronchoscope-to-examine-the-lungs

How is an examination with the bronchoscope going?

On the day of the examination, the patient comes sober. He receives a spray that stuns the throat and suppresses the gagging. Then, the patient is virtually always injected with a short narcotic into the vein, so that he feels nothing at all from the examination. If necessary, sedatives are also used.

The doctor introduces the bronchoscope through the mouth or nose into the trachea. Afterward, he examines the mucous membrane of the airways, which can be imagined as a “bronchial tree” with more and more ramifications. The doctor examines all bronchi to a maximum of the third or fourth diversion. This usually takes 10 to 15 minutes. The airways themselves are insensitive to pain.

If a bronchial lavage is needed, the doctor injects about 20-100 milliliters of sterile fluid into the lower respiratory tract and then sucks it off. It extracts bacteria and cells from the surface of the respiratory tract and subsequently examines them in the laboratory.

After the examination, the patient should abstain from eating and drinking for about two hours until the anesthetic of the throat has subsided. Otherwise, there is a risk of swallowing. If the patient has been given tranquilizers or anesthesia, they are not allowed to drive the same day.

What other types of bronchoscopy are there?

In addition to the lung reflection with a flexible tube, there is still the investigation with a rigid tube. This tube can, for example, better remove foreign matter from the lungs. Even if a tumor severely restricts the airways, rigid bronchoscopy has advantages. Sometimes the doctor can remove tumors directly using laser devices or argon bombers. Argon beamer is coagulation devices that transfer energy via argon gas and soil the tissue two to three millimeters deep. The doctor uses them to destroy tissue and stop bleeding. If he has to use stents to stretch a constriction, it works better with the rigid bronchoscope.

Is a bronchoscopy dangerous?

The bronchoscope may cause nosebleeds or sore throat with difficulty swallowing, hoarseness or coughing, and very rarely injure the larynx. Even short-term fever sometimes occurs afterwards, especially in lavages. Severe incidents are very rare in bronchoscopy.

Removing the tissue samples may cause slight bleeding. Therefore, one should expect in the first two days that you abhustet blood to a small extent. Every now and then, the bleeding is so severe that they have to be breastfed by the endoscope.

In some cases, injury to the alveoli causes the lungs to leak and form a so-called pneumothorax. This means that air flows into space between the lungs and the surrounding lung cavity and causes the feeling of being short of air. Then, if necessary, the application of a chest tube is necessary: This plastic tube through the chest wall conveys the infiltrated air to the outside.

bronchoscope-to-examine-the-lungs

Possible exclusion reasons

Bronchoscopy can be problematic in generally very poor condition or serious comorbidities: If a heart failure or an acute

Persistent coughing with sputum indicates chronic bronchitis. Smoking is the most important risk factor. Those who ignore the signs risk serious lung disease.

In short, what is chronic bronchitis?

Chronic bronchitis means that the bronchi are permanently inflamed. According to the World Health Organization (WHO), bronchitis is considered to be chronic if the symptoms of cough and sputum persist for two consecutive years for at least three months each year.

The bronchi are the continuation of the trachea. It divides into two main bronchi at the lower end. These lead the breathing air into the two lungs. There, the bronchi branch out ever finer until they end in the microscopic small alveoli, where the actual gas exchange, ie the vital intake of oxygen and release of carbon dioxide takes place.

Approximately ten percent of the population suffers from chronic bronchitis during their lifetime. Smoking is considered the biggest risk factor (colloquially “smoker’s cough”), but there are also many other triggers, which is why a reduction in smoking behavior falls short.

The most important therapy measure for smokers is the smoke stop. Various medications, adapted sports and special breathing techniques can help additionally.

Chronic bronchitis can lead to COPD – a chronic obstructive pulmonary disease. The airways are then permanently constricted and alveoli are broken down (emphysema).

Causes and risk factors: How does chronic bronchitis develop?

Risk of tobacco smoke: Smoking is the leading cause of chronic bronchitis. Tobacco smoke damages the respiratory tract in different ways: First, it destroys the cilia in the bronchial mucosa. These normally transport mucus and pollutant particles contained therein and thus exercise a cleaning function. On the other hand, tobacco smoke promotes inflammatory processes, weakens the immune system and causes more mucus to be formed in the bronchi. Especially at night while lying down secretions accumulate, which leads to a morning cough with sputum. Passive smoking also increases the risk of chronic bronchitis.

Air pollutants: Certain gases, dusts, and vapors pollute some people in the workplace. These pollutants can also cause lung problems and cause chronic bronchitis.

Common respiratory infections: Bacterial and viral infections are more common in chronic bronchitis. It often remains unclear whether they are the cause or the consequence of the respiratory disease.

Genetic causes: A certain genetic component can be identified in chronic bronchitis and its consequences. Alpha-1-antitrypsin deficiency, which increases the risk of pulmonary emphysema and may be associated with symptoms of chronic bronchitis, cystic fibrosis, where lung involvement often begins as chronic bronchitis, and ciliary disorder, in which mutations are either missing or defective, are well-characterized Formation of the cilia on the bronchial mucosa leads.

Other underlying diseases: Certain diseases are associated with chronic bronchitis. It is usually hard to recognize cause and impact. Examples are asthma, chronic sinusitis, and pulmonary tuberculosis. A hyperreactive bronchial system, as is typical in people with an allergy, may in rare cases favor chronic bronchitis.

Is chronic bronchitis contagious?

Chronic bronchitis is not intrinsically contagious – unlike acute bronchitis, which is often the case. If respiratory tract infections occur as part of chronic bronchitis, they can be contagious.

Symptoms: How is chronic bronchitis noticeable?

The classic symptom of chronic bronchitis is coughing with expectoration of viscous mucus. The cough occurs, especially in the morning.

Chronic bronchitis often begins insidiously and may initially go unnoticed. Because a clogged cough that lasts for a long time, sufferers often lead back to a supposedly harmless, perhaps “abducted” cold. They do not take the symptom seriously.

Chronic bronchitis can be fluent in COPD. If there is shortness of breath and tightness of the chest during physical exertion, this is a possible sign that COPD has already developed. However, there may be other causes behind such symptoms, such as angina pectoris.

Everything-About-Chronic-Bronchitis

When is a bronchitis chronic?

According to the WHO definition, it is chronic bronchitis if the symptoms of coughing and expectoration occur for two consecutive years for at least three months a year most days of the week.

What is an exacerbation?

Doctors speak of an exacerbation when the patient’s complaints suddenly worsen. This occurs especially in advanced disease and during the cold season. In the majority of cases, respiratory infections are the trigger. If very severe COPD is present, an exacerbation can be life-threatening.

Important: Take respiratory symptoms seriously. See the doctor if symptoms persist like coughing persistently or if shortness of breath occurs.

Chronic bronchitis: What are the consequences of the disease?

Anyone who is healthy breathes automatically – without thinking about what the lungs do. Some even blame the vital organ for exertions such as smoking. This can lead to mortal danger in diseases of the lungs and respiratory tract.

The human lungs: every day in adults, around 10 000 liters of air flow through.

Without realizing it, adult, healthy people breathe at rest about 12 to 16 times a minute. Each time, about half a liter of air flows through the airways into the lungs and out again.

Construction and location

Physicians refer to all parts of the body, which are traversed by the inhalation and exhalation of air as airways: Through the mouth and nose, the air passes through the throat into the trachea. The trachea lies behind the breastbone and divides in the thorax into a left and a right main bronchus. These lead together with the respective pulmonary vessels to the left or right lung.

The lung (Latin: Pulmo) is in fact paired. Each of the two lungs is supplied with its own blood vessels and, with the respective main bronchus, also has its own air supply, which enters the lungs together with the veins and arteries at the so-called pulmonary hilum. The left lung is slightly smaller than the right and consists of only two instead of three lobes because in its vicinity the heart is located and thus less space available. Each main bronchus divides according to the number of lung lobes in so-called lobe bronchi and then branches out into Segementbronchien and ever smaller bronchi and bronchioli until at the end of the small alveoli, the so-called alveoli.

They are the place where the lung performs its most important function, the gas exchange, giving the lung tissue its spongy appearance.

What are the job of the lungs and respiratory system?

The airways not only carry air into the lungs, but cilia on their walls also purify the air. Foreign matter such as bacteria and dust particles remain hanging in it and are transported along with the lying on the cilia on the pharynx throat direction. He is either swallowed unnoticed or – for example, if the cilia are unable to afford the transport – coughed off.

The most important task of the lung is the gas exchange. Since our body needs a lot of oxygen and has to excrete corresponding amounts of carbon dioxide, a large area is necessary for this. These provide the alveoli. They have very thin walls that almost directly border the blood vessels. This makes it possible for the oxygen from the respiratory air to pass through these walls into the oxygen-poor blood of the pulmonary vessels, while the carbon dioxide passes from the blood into the alveoli.

lungs-and-respiratory-diseases

Pulmonary and respiratory diseases

If the lungs become infected, it can hinder breathing and even have life-threatening consequences. It is not for nothing that lung and bronchial cancers, chronic obstructive pulmonary diseases and pneumonia are among the ten leading causes of death in Germany. One of the most important risk factors for lung disease is smoking. Because tobacco smoke not only favors the development of malignant diseases such as lung cancer but also damages, among other things, the cilia, which transport phlegm and pathogens outside. This increases the risk of infection. Certain lung diseases such as Chronic Obstructive Pulmonary Disease (COPD) are very often the result of many years of smoking. If you want to do something good for your lungs, then you should do without cigarettes and similar tobacco products.

A vicious circle – the best way to describe the interaction of blood pressure with nicotine. At the end of the cycle, in addition to numerous organ diseases, there is also a heart attack. Although the summary of the problem can be expressed very simply, the actual process is highly complex. In addition, smoking addiction can also act as an enhancer of existing blood pressure problems.

The interaction of the organs

The causes of the rise in blood pressure caused by smoking addiction are three main factors. Specifically, they would be bad enough in and of themselves, but their inevitable interaction within body mechanisms makes them even more of a threat.

Sympathetic activity: The sympathetic nervous system is that part of the autonomic nervous system that controls the regulation of blood pressure as well as metabolic and respiratory functions. Under the influence of nicotine, however, this control mechanism gets out of balance and among other things causes an increase in heart activity and resistance within the blood vessels. The result is cardiac arrhythmia and partial to complete occlusion of the vessels.

Vessel constriction: As a result of the imbalance in the sympathetic or as a direct effect of smoking addiction, the narrowing of the blood vessels forms the core aspect of nicotine-related hypertension. Responsible for the vascular closure is not only the nicotine per se. Also contained in cigarette smoke additives may favor the arterial closure. Furthermore, the circulation and pumping capacity of the heart and blood vessels are severely impaired by the harmful substances, which offers hypertension further bases for manifestation. In this context, the danger of blood thickening caused by the smoke should not be underestimated, which may lead to further blockage of the vessels.

Lack of oxygen: Since the cigarette smoke a large amount of carbon monoxide gets into the blood, with permanent nicotine consumption and the supply of organs, especially the heart, with oxygen at risk. Now O2 is of essential importance for the integrity of the organs and their functionality. A deficiency supply, therefore, brings about serious organ damage. Heart attacks and strokes are thus the worst danger when smoking, while hypertension in this area, merely ‘a precursor to the complete failure of the heart.

Hypertension-and-Smoking-Addiction

The interaction of risk factors

The exact value of systolic blood pressure increase is between 7 mmHg and 10 mmHg when smoking. However, further increases may be added if smoking is associated with one of the following aspects.

  • Smoking due to stress in most cases implies that high blood pressure is already present before consumption. This results from the increased heart activity that results from stressful situations.
  • The same applies to cigarette consumption in combination with obesity. In addition, weight-related arteriosclerosis and vasoconstrictive substances meet and, together, provide even greater resistance within the blood vessels.
  • Smoking addiction in concert with alcohol can not only increase the risk of hypertension but also of cardiac arrhythmia. As nicotine constricts the vessels, alcohol temporarily expands them so that the pumping intervals of the heart become completely out of balance.

Also in connection with lack of exercise or a wrong diet, the risk of high blood pressure by smoking is greater than normal. In addition to the dysfunctional properties of nicotine here are still added to a nutrient deficiency or resilience problems that affect the activity of the heart and organs. Already existing dysfunctions of the organs, such as those caused by unhealthy foods or too little exercise, are further expanded by smoking cigarettes.

Fluid in the lungs is a broad term to describe two possible states that can give characteristic symptoms, such as a bubbling noise in the lungs (rattling) when breathing. Fluid accumulation may be in the lungs (pulmonary edema) or outside the lungs (pleural effusion), in the space between the lungs and the chest wall. The term fluid in the lungs is also used in the lungs to refer to mucus. Mucus or phlegm is really a thick, sticky secretion even though lung water is a thin fluid. Other fluid accumulation can be the result of blood or pus.

The lungs enter the thorax (chest) and lie on either side of the heart. Air travels through the air passages that surround the nose, throat (neck), trachea (trachea) and bronchi. The lung tissue is made up of small air sacs, known as alveoli, which is thin and surrounded by blood capillaries. The structure of the respiratory system allows an exchange of gases, so that essential oxygen is taken into the body and waste products, along with gases, are excreted by the exhaled air. The lung is enclosed in an airtight pleural cavity, with a small pleural space separating the lungs from the chest wall. This cavity is lined by the pleural lining, which also creates a small pleural fluid to reduce the friction between the chest wall and lungs while breathing.

Fluid in the lungs

The most common cause of fluid in the lungs is mucus or mucous produced by the lining of the airways. The airway is lined with a mucous membrane that produces a specialized tissue that produces mucus. This mucus lubricates the lining, which can dry out due to the movement of air and out of the channels as well as stopping dust or microorganisms in the air. However, under certain conditions, the mucous membranes of the respiratory tract can generate excessive amounts of mucus and this can slowly sink down the air ducts until it settles in the lungs. The cough reflex or even spontaneous coughing will usually expel most mucus through the mouth (sputum), but in cases of excessive mucus production, obstructive airway disease or diminished cough, the build-up of mucus will quickly settle in the lungs.

Lung water or water in the lungs usually results from the interstitial fluid or blood plasma and may be an indication of a serious underlying condition, usually cardiovascular disease. This fluid in the lungs is known as pulmonary edema and may be accompanied by shortness of breath or shortness of breath (dyspnoea), a feeling of suffocation, anxiety, and restlessness. Abnormal breathing sounds are also present, especially crackling. Pulmonary edema could be considered a medical emergency and really immediate medical intervention is necessary.

Blood can also fill in the lungs, but this usually happens as a result of severe trauma and the cause is evident, as in a shot or puncture wound. In most trauma cases, where blood can fill the lungs, the lungs collapse and the blood in the lungs collects in the chest cavity (hemothorax). Infections such as tuberculosis (TB) or lung cancer can also lead to blood accumulation in the lungs. Depending on the severity of the trauma, blood in the lungs will cause drowning and requires immediate medical attention. Pus can also occur in the lungs due to a lung abscess and also requires immediate urgent medical attention.

Causes of the fluid inside the lung

  • Bronchitis is the most common cause of mucus in the lungs and is often characterized by persistent cough. This respiratory disease can develop after the common

Cancer therapies serve the purpose of curing the patient of the disease (“curative” = healing therapy) or to stop the further growth and spread of the tumor as long as possible, to relieve discomfort and to prolong the lifetime (“palliative” = alleviative) Therapy). An indispensable component of oncological care is the so-called “supportive therapy” (supportive therapy). It treats and prevents complications of cancer and survival-related but often aggressive cancer therapies.

How is lung cancer operated?

If the tumor has not exceeded a certain size and has not yet formed distant metastases, surgery is sought with the aim of completely removing the tumor tissue and the lymph nodes affected by tumor cells. The operation plays an important role especially in non-small cell lung cancer – as small cell lung cancer is often diagnosed at a later stage, then other treatments are in the foreground.

The surgical procedure is preceded by extensive research. In particular, it must be ensured that after the removal of part of the lung, the remaining lung sections are able to sufficiently take over the respiratory function. The condition for the operation is a good general condition of the patient; Severe comorbidities often rule out surgery. Furthermore, removal of the tumor should not pose a risk to neighboring vital organs such as large blood vessels or the esophagus. If the expected burdens and restrictions are too great, a different therapy strategy must be chosen.

During surgery, the tumor-bearing lung section and the adjacent lymph nodes are removed. The most common procedure is the removal of a lung lobe (lobectomy). With very large tumors the removal of an entire lung wing may be necessary (pneumectomy). In many cases, however, it is possible to avoid the removal of the entire lung through special, organ-preserving surgical techniques.

Possible side effects:

As a result of the operation, the available breathing area of the patient is reduced. However, if the lung function before surgery is sufficient, it will not be a major problem for the patient, and he will usually be able to compensate well for the loss of lung tissue. Special breathing exercises in rehabilitation also help to improve lung performance after tumor therapy. The first exercises can already be learned in the clinic under the guidance of a physiotherapist and later be continued at home. For smokers, however, they should stop smoking immediately before the operation to improve their lung function.

What happens during an irradiation?

Radiation therapy is the only therapy for non-small cell lung cancer in stages I and II when surgery is not possible and for selected patients in stage III. Otherwise, it is usually combined with chemotherapy in patients with stage III and small cell lung cancer. If cancer has secondary tumors, called metastases, in other organs such as the brain or the bones, they may also be irradiated.

The high-energy ionizing radiation, which is directed from the outside to the tumor, destroys the cancer cells. The total radiation dose is divided into several single doses, which are administered about five times a week. In the so-called hyperfractionated radiation, which can be used in lung cancer, is even twice a day at intervals of several hours, but then irradiated with lower single doses.

In addition to conventional radiotherapy, the so-called stereotactic radiotherapy is also used. Here, the disease is in a few sessions, sometimes in only one, irradiated with a high dose of radiation. This is possible because the beams are directed to the target area from different directions after computer-controlled irradiation planning. There, all the rays meet at one point and add up to the total dose, which is thus maximum at the site of the disease, while the surrounding healthy tissue is largely spared. For this reason, stereotactic radiotherapy is particularly well suited for small tumors and tumors in delicate environments, such as brain metastases.

Possible Side Effects:

Side effects of radiotherapy may be hoarseness and difficulty swallowing. The skin is also sensitive to the treatment. In combination with chemotherapy in particular, mucous membrane inflammation and fungal infections can occur in the oral cavity. A late consequence is a pneumonitis, an inflammation of the irradiated lung tissue. Overall, the severity of side effects depends on the type and intensity of the radiation used.

How does the chemotherapy work?

Chemotherapy uses cell-growth-inhibiting drugs known as cytostatics. They act primarily against fast-growing cells and thus especially against cancer cells. For the treatment of lung cancer several chemotherapeutic drugs are available, which are selected according to individual requirements.

Which medicines are used depends on various factors, including the stage of the disease, the general condition, and concomitant diseases. Usually, two or three substances are combined, with cisplatin or carboplatin as the basic drug in most cases. Commonly used cytostatic drugs in non-small cell

To assist physicians in deciding what type of treatment is more appropriate for lung cancer, there is a recognized numerical staging system that creates benchmarks. At Stage I, the cancer is small and localized in a specific area of the lung. During phases 2 and 3, cancer grows and spreads to the surrounding tissue and possibly the lymph nodes.

Stage 4 of lung cancer is when cancer has spread, or metastasized, from the lungs to other parts of the body. Typically, cancer spreads to the liver, bones, brain or adrenal glands. This is commonly known as secondary or advanced cancer. About 40% of lung cancer patients are diagnosed at stage 4, mainly because the symptoms of lung cancer could include symptoms of other diseases. In Stage 4, the cancer is not curable, but it can be treated. These are some of the symptoms that may help your doctor to diagnose stage 4 of lung cancer.

  • Breathing problems

Lung cancer patients often present with shortness of breath, wheezing, and hoarseness. It is often a persistent cough, and the patient can cough up blood. Sometimes, a chronic cough that the patient may suddenly change for some time may be natural. Because these symptoms may also affect other conditions, they are not sufficient to suggest a diagnosis of lung cancer. However, if a smoker presents with these symptoms, a diagnosis of stage 4 lung cancer is likely to be considered by the doctor.

  • Pain

Patients may experience pain in various areas of the upper body, including the back, chest, arms, ribs, and hips. Deep breathing often intensifies the pain that can be felt in the tissues or bones depending on the spread of cancer. It can also be a pain when swallowing. Some people suffer from frequent headaches, which is an indication that cancer could be affecting the brain.

stage-4-of-lung-cancer

  • Weight Loss

With stage 4 lung cancer, there is often a sudden, unexplained weight loss that is often accompanied by loss of appetite and a general feeling of weakness and fatigue. If this weight loss is significant and you do not have a diet, it should be investigated.

  • “Clubbing”

The nails on the fingers and toes can bulge, and the ends of the fingers change shape. This symptom usually develops in the latter stages of lung cancer, so it is a good indicator of diagnosis.

  • Diagnosis

The diagnostic process for stage 4 lung cancer is usually some form of imaging, such as computed tomography (CAT) or Magnetic Resonance Imaging (MRI). These scans give a detailed picture of the spread of cancer as X-rays, allowing the doctor to determine the cancerous stage. A radionuclide scan can detect if cancer has spread to other organs, while a bone scan will show if the bones are affected.

The doctor may also conduct tests to determine if cancer has spread to the lymph nodes. This involves removing a tissue sample for testing under general anesthesia. This process is called medias or mediastinotomy, depending on whether the tissue is absorbed by the neck or the chest.

While all these symptoms refer to other conditions, if you experience one or more of them for two weeks or more, you should consult your doctor. Lung cancer is particularly dangerous because of it metastases to other parts of the body relatively quickly, making it one of the most life-threatening cancers there is. As with most conditions, the earlier the diagnosis, the more likely that the treatment will succeed. During treatment for stage 4 lung cancer, the condition will not heal, it can prolong life and improve quality of life, so it is important to seek medical advice as soon as possible.