2.15. SOB = shortness of breath

We all have a little, upside-down tree in our chests--the bronchial tree. It holds between its branches a pulsating heart, and delivers to it fresh, oxygenated blood to supply the rest of the body. It provides oxygen not through photosynthesis, but rather, gas exchange.
In assessing a patient with breathing difficulty, a simple visual scale of a singular, horizontal line is used: indicate the severity of your symptoms on a scale of "no shortness of breath" to "shortness of breath as bad as can be."

Bronchial sounds, auscultated over the trachea or primary bronchi, have a harsh, hollow, blowing sound. Vesicular sounds, heard with a stethoscope over peripheral lung fields, rustle like the wind in the trees. Abnormal sounds range from fine crackles, like hair rolled between fingers near the ear; rales ("velcro" sounds); squeaky, "musical" wheezing; rhonchi (low, coarse, snoring); to pleural friction rub (scratching sounds). These may indicate atelectasis (partial/complete collapse of lung), pneumonia, bronchitis, tuberculosis, lung cancer, pulmonary infarction, or other issues.

Chronic obstructive pulmonary disease, COPD, is the fourth leading cause of morbidity (illness) and mortality (death) in the U.S. COPD patients are known for their barrel chests that are sometimes longer front-to-back than left-to-right. They are generalized into two archetypes, pink puffers (emphysema) and blue bloaters (chronic bronchitis), though one can be both. A patient who struggles to breathe may sit in a forward-bending posture known as the orthopneic or tripod position. Much like the cat pose in yoga, the domed back accommodates hardworking lungs.

A whole menagerie of additional yoga moves are good for stretching the chest and stimulating the lungs: cow pose, cobra pose, half frog, king pigeon, upward dog, and locust (okay, that one's a crazed insect). Diaphragmatic or abdominal breathing and breathing through pursed lips also help with shortness of breath.

One can live awhile without food and water, but within minutes of oxygen deprivation brain cells begin to die, followed by other systems. In this way, the bronchial tree is quite literally the tree of life, one that can be immortalized posthumously through injection with silicone in all the colors of the rainbow.


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