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Pulmonary Disease, Chronic Obstructive: A disease of chronic diffuse irreversible airflow obstruction. Subcategories of Copd include Chronic bronchitis and Pulmonary emphysema.
 JoVE Medicine

Chronic Thromboembolic Pulmonary Hypertension and Assessment of Right Ventricular Function in the Piglet

1Surgical Research Lab, Marie Lannelongue Hospital, 2Department of Pathology, Marie Lannelongue Hospital, 3Department of Thoracic and Vascular Surgery, Marie Lannelongue Hospital, 4Thoracic and Cardiovascular Surgery, University Hospital of Rennes, 5INSERM U999 Paris-Sud University


JoVE 53133

 JoVE Medicine

Automated Measurement of Pulmonary Emphysema and Small Airway Remodeling in Cigarette Smoke-exposed Mice

1Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital - Harvard Medical School, 2Department of Respiratory Medicine, University of Cambridge - Addenbrooke's Hospital, 3Lung Transplant Program, Brigham and Women's Hospital - Harvard Medical School, 4COPD and IPF Programs, Lovelace Respiratory Research Institute


JoVE 52236

 JoVE Immunology and Infection

Right Ventricular Systolic Pressure Measurements in Combination with Harvest of Lung and Immune Tissue Samples in Mice

1Department of Environmental Medicine, New York University School of Medicine, Tuxedo, 2Division of Allergy, Pulmonary, & Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, 3Division of Pulmonary Medicine, New York University School of Medicine


JoVE 50023

 Science Education: Essentials of Physical Examinations I

Respiratory Exam I: Inspection and Palpation

JoVE Science Education

Source: Suneel Dhand, MD, Attending Physician, Internal Medicine, Beth Israel Deaconess Medical Center

Disorders of the respiratory system with a chief complaint of shortness of breath are among the most common reasons for both outpatient and inpatient evaluation. The most obvious visible clue to a respiratory problem will be whether the patient is displaying any signs of respiratory distress, such as fast respiratory rate and/or cyanosis. In a clinical situation, this will always require emergent attention and oxygen therapy. Unlike pathology in other body systems, many pulmonary disorders, including chronic obstructive pulmonary disease (COPD), asthma, and pneumonia, can be diagnosed by careful clinical examination alone. This starts with a comprehensive inspection and palpation. Keep in mind that in non-emergency situations the patient's complete history will have been taken already, gaining important insight into exposure histories (e.g., smoking), which could give rise to specific lung diseases. This history can then confirm physical findings as the examination is performed.

 Science Education: Essentials of Physical Examinations I

Respiratory Exam II: Percussion and Auscultation

JoVE Science Education

Source: Suneel Dhand, MD, Attending Physician, Internal Medicine, Beth Israel Deaconess Medical Center

Learning the proper technique for percussion and auscultation of the respiratory system is vital and comes with practice on real patients. Percussion is a useful skill that is often skipped during everyday clinical practice, but if performed correctly, it can help the physician to identify underlying lung pathology. Auscultation can provide an almost immediate diagnosis for a number of acute pulmonary conditions, including chronic obstructive pulmonary disease (COPD), asthma, pneumonia, and pneumothorax. The areas for auscultating the lungs correspond to the lung zones. Each lung lobe can be pictured underneath the chest wall during percussion and auscultation (Figure 1). The right lung has three lobes: the superior, middle, and inferior lobes. The left lung has two lobes: the superior and inferior lobes. The superior lobe of the left lung also has a separate projection known as the lingual. Figure 1. Anatomy of lungs with respect to the chest wall. An approximate projection of lungs and their fissures and lobes

 Science Education: Essentials of Physical Examinations I

Blood Pressure Measurement

JoVE Science Education

Source: Meghan Fashjian, ACNP-BC, Beth Israel Deaconess Medical Center, Boston MA

The term blood pressure (BP) describes lateral pressures produced by blood upon the vessel walls. BP is a vital sign obtained routinely in hospital and outpatient settings, and is one of the most common medical assessments performed around the world. It can be determined directly with the intra-arterial catheter or by indirect method, which is a non-invasive, safe, easily reproducible, and thus most used technique. One of the most important applications of BP measurements is the screening, diagnosis, and monitoring of hypertension, a condition that affects almost one third of the U.S. adult population and is one of the leading causes of the cardiovascular disease. BP can be measured automatically by oscillometry or manually by auscultation utilizing a sphygmomanometer, a device with an inflatable cuff to collapse the artery and a manometer to measure the pressure. Determination of the pulse-obliterating pressure by palpation is done prior to auscultation to give a rough estimate of the target systolic pressure. Next, the examiner places a stethoscope over the brachial artery of the patient, inflates the cuff above the expected systolic pressure, and then auscultates while deflating the cuff and o

 JoVE Immunology and Infection

Cecal Ligation and Puncture-induced Sepsis as a Model To Study Autophagy in Mice

1Department of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, 2Department of Medicine, Renal Division, Brigham and Women's Hospital, Harvard Medical School, 3First Department of Critical Care Medicine and Pulmonary Services, University of Athens Medical School, Evangelismos Hospital, Athens, Greece


JoVE 51066

 JoVE Bioengineering

Adapting the Electrospinning Process to Provide Three Unique Environments for a Tri-layered In Vitro Model of the Airway Wall

1Division of Drug Delivery and Tissue Engineering, University of Nottingham, 2Laboratory of Biophysics and Surface Analysis, School of Pharmacy, University of Nottingham, 3Division of Immunology and Allergy, School of Molecular Medical Sciences, University of Nottingham, 4Division of Respiratory Medicine, School of Clinical Sciences, University of Nottingham, 5NIHR Respiratory Biomedical Research Unit, University of Leicester, 6School of Sport, Exercise, and Health Sciences, Loughborough University


JoVE 52986

 Science Education: Essentials of Physical Examinations I

Percussion

JoVE Science Education

Source: Jaideep S. Talwalkar, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT

Simply stated, percussion refers to the striking of one object against another to produce sound. In the early 1700s, an Austrian inn-keeper's son, named Leopold Auenbrugger, discovered that he could take inventory by tapping his father's beer barrels with his fingers. Years later, while practicing medicine in Vienna, he applied this technique to his patients and published the first description of the diagnostic utility of percussion in 1761. His findings faded into obscurity until the prominent French physician Jean-Nicolas Corvisart rediscovered his writings in 1808, during an era in which great attention was focused on diagnostic accuracy at the bedside.1 There are three types of percussion. Auenbrugger and Corvisart relied on direct percussion, in which the plexor (i.e. tapping) finger strikes directly against the patient's body. An indirect method is used more commonly today. In indirect percussion, the plexor finger strikes a pleximeter, which is typically the middle finger of the non-dominant hand placed against the patient's body. As the examiner's finger strikes the pleximeter (or directly against the surface of the patient's body)

 Science Education: Essentials of Physical Examinations II

Abdominal Exam II: Percussion

JoVE Science Education

Source: Alexander Goldfarb, MD, Assistant Professor of Medicine, Beth Israel Deaconess Medical Center, MA

Medical percussion is based on the difference in pitch between the sounds elicited by tapping on the body wall. The auditory response to tapping depends on the ease with which the body wall vibrates, and is influenced by underlying organs, strength of the stroke, and the state of the body wall. There are three main medical percussion sounds: resonance (heard over lungs), tympany (heard over the air-filled bowel loops), and dullness (heard over fluid or solid organs). The contrast between dullness vs. tympany or resonance allows for determination of the size and margins of organs and masses, as well as identification of fluid accumulation and areas of consolidation. Percussion remains an intricate part of the physical diagnosis since it was first introduced more than 200 years ago, and is especially useful in examination of the lungs and abdomen. As a part of an abdominal examination, percussion follows visual inspection and auscultation. The examiner should first percuss over each of the nine abdominal regions (epigastric region, right hypochondriac region, left hypochondriac region, umbilical region, right lumbar region, left lumbar region, hypogastric region, right inguinal region, and left

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 JoVE Medicine

Increasing Pulmonary Artery Pulsatile Flow Improves Hypoxic Pulmonary Hypertension in Piglets

1Department of Medicine, Pulmonary Hypertension Research Group (CRIUCPQ), Laval University, 2Institut National de la Recherche Agronomique, 3Université Diderot Paris, Sorbonne Paris Cité, 4Hôpital Lariboisière, Physiologie clinique Explorations Fonctionnelles, 5INSERM U 965, 6Service de Cardiologie, Centre Hospitalier Universitaire Tours


JoVE 52571

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 JoVE Medicine

Bile Duct Ligation in Mice: Induction of Inflammatory Liver Injury and Fibrosis by Obstructive Cholestasis

1Institute of Molecular Pathobiochemistry, Experimental Gene Therapy and Clinical Chemistry, RWTH Aachen University, 2Institute for Laboratory Animal Science and Experimental Surgery, RWTH Aachen University, 3Department of Medicine III, RWTH Aachen University


JoVE 52438

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 JoVE Medicine

Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation

1Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, 2Cardiovascular Research Center and Cardiology Division of the Department of Medicine, Massachusetts General Hospital, 3Cardiovascular Division, Brigham and Women's Hospital, 4Harvard Medical School, 5Department of Anesthesiology, Uniklinik RWTH Aachen, RWTH Aachen University, 6Center for Immunology and Inflammatory Diseases and the Division of Rheumatology, Allergy, and Immunology of the Department of Medicine, Massachusetts General Hospital


JoVE 54017

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