Diaphragm Diseases, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

This book describes Diaphragm Diseases, Diagnosis and Treatment and Related Diseases
The diaphragm that separates the thoracic and abdominal cavities is the main muscle involved in breathing.
Similar to any organ or muscle, the diaphragm is prone to disorders and anomalies, which come in many different forms and can result from injury or illness.
Diaphragm disorders can result from nerve damage, primary muscle problems, or problems with the muscle's interaction with the chest wall.
Causes

Causes of diseases of the diaphragm differ, but they are normally an effect of disorders with the anatomy or the neurological system, such as:

1.Congenital defects, which happen at birth and have no known cause
2.Acquired defects, which occur as the result of an injury, accident or surgery
a.Stroke
b.Muscular disorders, such as muscular dystrophy
c.Multiple sclerosis
d.Thyroid disorders
Symptoms
Unilateral diaphragmatic paralysis or weakness rarely causes symptomatic dyspnea at rest, but may result in dyspnea on exertion or the patient's voluntary restriction of activity.
It can occasionally cause dyspnea when lying on one's back
Frequently, unilateral diaphragmatic paralysis is detected incidentally on a chest X-ray obtained for other purposes.
Bilateral diaphragmatic paralysis often produces dyspnea at rest, during exertion, when lying supine (need sleeping in a recliner), bending over, or when swimming in water above waist level.
Sleep disorders are also frequently in these patients
Repeat occurrences of pneumonias (possibly due to basilar collapse of the lung) and repeat occurrences of respiratory failure are also possible.
Many people with diaphragmatic paralysis compensate well when at rest and are not acutely ill.
Symptoms differ based on the disorder, but may be:
1.Discomfort or difficulty breathing
2.Pain in the chest, shoulder or abdominal area
3.Hypoxemia (a lack of oxygen in the blood)
4.Fewer breath sounds
Diagnosis
Chest X-rays in diaphragm paralysis may reveal elevated hemi-diaphragms and basal sub-segmental atelectasis
Fluoroscopy of the diaphragm (“sniff test”): The patient sniffs vigorously during fluoroscopy;
Descent of the diaphragm is the normal reaction.
Pulmonary function tests show restriction, which may be moderate to severe (30-50% forecasted total lung capacity) in bilateral diaphragmatic paralysis.
The limitation becomes worse when supine, with a proven drop in vital capacity of 30 to 50% in bilateral diaphragm paralysis.
Ultrasound can be very useful in evaluating diaphragmatic function.
The diaphragm should thicken with inspiration, indicating the shortening of the diaphragmatic muscles
Treatment
Treatment for diaphragmatic dysfunction normally comprises:
1.Watchful waiting,
2.Treating underlying causes, with mechanical ventilation if respiratory failure occurs.
Supportive treatment for Diaphragm
This is diaphragmatic pacing, which is the same as a heart pacemaker but the electrodes are implanted on the diaphragm to guide respiration
Surgery
This may require removing part of the diaphragm or abnormal tissue, folding the diaphragm, or repairing the muscle.
Repair may involve the phrenic nerve
Many patients with severe diaphragmatic dysfunction require ventilatory support.
Medical Care:
1.Any obvious contributing factors (hypo-kalemia, hypophosphatemia, high-dose steroids, neurotoxic drugs, neuromuscular blockers) should be removed.
2. Nocturnal noninvasive ventilation of people is used with:
An awake pCO2 of 45+ mm Hg;
Nocturnal hypoxemia (SaO2 < 88% of >5 consecutive min); or
3.Any sleep-disordered breathing, if present, should be treated with continuous positive airway pressure (CPAP) or nocturnal noninvasive ventilation

TABLE OF CONTENT
Introduction
Chapter 1 Diaphragm Diseases
Chapter 2 Causes

• Language: English
• Publisher: Kenneth Kee
• Release date: Feb 14, 2018
• ISBN: 9781370481569

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Diaphragm Diseases,

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2018 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Diaphragm Diseases, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What The patient Need to Treat Diaphragm Diseases)

This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If the patient would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 1000 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Diseases of the Diaphragm

What are the diseases of Diaphragm?

The diaphragm that separates the thoracic and abdominal cavities is the main muscle involved in breathing.

When a person inhales, it decreases pressure in the lungs and helps expand the rib cage.

Similar to any organ or muscle, the diaphragm is prone to disorders and anomalies, which come in many different forms and can result from injury or illness.

Diaphragm disorders can result from nerve damage, primary muscle problems, or problems with the muscle's interaction with the chest