Clinical manifestations and diagnosis of obstructive airway disease

Details

• Personal Author:
  Hall DR ; Morgan WKC
• Description:
  The term "obstructive airway disease" includes several different disease entities of which the most important are asthma, chronic bronchitis, and emphysema. Often included in the group is bronchiectasis. Although obstruction of the airways occurs in this disease, obstruction is certainly not the preeminent feature; bronchiectasis has therefore been omitted from this section. Physiologically these diseases fall into two groups: those with reversible obstruction, viz, asthma, and those with irreversible obstruction, viz, chronic bronchitis and emphysema. Reversible obstruction implies a 20 percent or more improvement in one or more of the several tests used to measure ventilatory capacity, eg, the forced expiratory volume in one second (FEV1) or the maximal voluntary ventilation (MVV). Despite the relative precision which the physiologist brings to the study of respiratory impairment, the differentiation of the various types of obstructive airway disease still depends mainly on the history and, to a lesser extent, the physical examination. Although relatively pure forms of chronic bronchitis and emphysema exist, more often there are features of both diseases in the same person. While the ensuing description deals with each disease in its pure form, only occasionally does one find one without some of the features of the other. Despite this admixture, there is a tendency for the clinical features of either emphysema or bronchitis to predominate. Dornhorst has coined the term "blue bloater" for the person whose symptoms and signs are predominantly those of chronic bronchitis and "pink puffer" for the person whose clinical features are mainly those of emphysema. Until recently the major impediment to an understanding of obstructive lung disease lay in the fact that not only did different countries use different terms for what was often the same disease, but also a language barrier existed between different disciplines in the same country. The term "emphysema," for example, had, and unfortunately sometimes still has, a different connotation in the minds of the radiologist, pathologist, internist, and pulmonary physiologist. Thus, in the past the physiologist maintained that any condition associated with a significant increase in the residual volume denoted emphysema. The internist, on the other hand, felt that the physiologist's definition was too far removed from clinical medicine, since it ignored the patient's airway obstruction and dyspnea. The radiologist diagnosed (and unfortunately many still diagnose) emphysema on the basis of hypertranslucency of the lung fields. None of these restricted viewpoints is satisfactory. Because of the obvious limitations, various organizations, including the American Thoracic Society and World Health Organization, have seen fit to take upon themselves the task of defining the various types of obstructive airway disease. Fortunately, and perhaps surprisingly, the definitions proposed by the various organizations are essentially similar. For the sake of convenience, the writer employs those adopted by the American Thoracic Society. [Description provided by NIOSH]
• Subjects:
  Asthma Asthma, Occupational Occupational Health Safety
• Keywords:
  Aetiology Chronic Bronchitis Emphysema Obstructive Ventilatory Impairment Symptoms
• Publisher:
  Harper and Row
• Document Type:
  Text
• Genre:
  Book
• Place as Subject:
  Maryland ; OSHA Region 3 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  ALFORD - Appalachian Laboratory for Occupational Respiratory Disease
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-10
• Volume:
  5
• NIOSHTIC Number:
  nn:20047000
• Citation:
  Tice's practice of medicine. Tice F, Sanford JP, eds. New York: Harper and Row, 1978 Jan; 5:1-10
• Editor(s):
  Tice F; Sanford JP
• Federal Fiscal Year:
  1970
• Peer Reviewed:
  False
• Source Full Name:
  Tice's practice of medicine
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:1a558e39a59eefdac9f96e1c1f04e8d145e4fae1412b26e982106ef9c0d781838737530276cc49bea985213389b1d85217018e5d1f8ee36954b216db972f1135
• Download URL:
  https://stacks.cdc.gov/view/cdc/202240/cdc_202240_DS1.pdf
• File Type:
  [PDF - 4.95 MB ]