Respiratory Diseases Symptoms PDF

symptomes of respiratory diseases Cough Is sound produced by expulsion of air against partially closed glottis.acute cough defined as cough lasting 3 weeks while chronc cough is lasting 8 weeks, cough serves as protective mechanism against forign body ,retained secreations &aspirated material Mechan...

symptomes of respiratory diseases Cough Is sound produced by expulsion of air against partially closed glottis.acute cough defined as cough lasting 3 weeks while chronc cough is lasting 8 weeks, cough serves as protective mechanism against forign body ,retained secreations &aspirated material Mechanism of cough Cough is due to stimulation of cough recepters scattered on respiratory mucosa and lower esophagus, stimulation of these receptors send signals by vagus nerve branches to the medulla oblingata which in turn send impulses to respiratory muscles via phrenic nerve& spinal nerves Aetiology indicates a risk of chronic Acute cough is often viral infection usually is selflimitting while chronic cough deblitating ilness like malignancy tuberclousis or other inflammatory conditions anatomic considration of cough Pharynx Cough originated from pharynx is commonly due to post nasal drips That are secreations trip down on pharangeal mucosa or any irritation to pharanx as in: Infection( viral, bacterial ) GERD Cigarette smoking Allergy Larynx Acute laryngitis usually viral infection infuanza parainfuenza RSV adenovirus or bacterial haemophilus influenzae dyphtheria Chronic laryngitis: Commonly caused by: Cigarette smoking Gastriesophageal reflux GERD TB fungal in immuecompromised patients Larangeal cough has a characterisic sound it called bovine cough , affecting the vocal cord, common causes in thes crcucmstanses are viral larangitis, tumor& smoking Trachea Viral Tracheitis is common cause characterised by retrosternal pain usually dry cough Bronchi Cough originated from bronchi is either acute bronchitis which usually dry or productive worse at morning or due to chronic bronchitis in lonstanding cigarette smoking and it usually productve worsening at morning While cough in asthma is usually worse at night (needs differentiated from orthopnea&Paroxysmal nocturnal dyspnea ( PND) of left sided heart failure Cough due to bronchogenic lung cancer is usually persistent and accompanied by hemoptysis Lung paranchyma Cough in paranchymal lung diseases is often aacompanied by hemoptysis as in pnuemonia or cancer Cough due to Tuberclosis is usually associated with night sweat & fever with or without hemoptysis Impaired cough cough feflex is interrupted and become weak due to: weak respiratory muscles( abdominal intercostal ) Chest wall deformity Abnormal airway secreations Suppresion of repiratory center ( drugs, encephalitis, stroke ) What are the causes of chronic cough with normal chest x ray &clincal examination ACE inhibiters GERD Sinus disease with post nasl drip Cuogh vatiant asthma(90%) Types of cough Dry cough Productive cough Dyspnea(breathlessness) It means a sense of awearness of increased respiratory effort. To desribe dyspnea we need to know the oncet whether sudden oncet or not, ie it takes minutes to trigger lung dysfunction like inhalation of foregin body , severe asthmatic attack or sudden occlusion of pulmonary artery in pulmonary embolism or rapid build of air in pleural space in pneumothorax or ischemic heart disease ( causes rapid pulmonary edema). Dyspnea may experienced less sudden or developed in hours or days this is charectrestic of infectious disease like pneumonia or mucopurulunt exacerbation of COPD or slow inflammatory response in patiens with mild to moderate attack of bronchial asthma other conditions might take weeks or mounths slow progressive pleural effusion or anemia. dyspnea may take years to be seen like pulmonary fibrosis or COPD Aetiology Dyspnea is observed among widespread diseases including systemic diseases or repiratory diseases , cardiac & psycogenic causes it seems to be found in majority of lower respiratory tract diseases while in cardiac also appear in almost of sever cardiac illnesses including pecardial , myocardial& valvular heart diseases. but it does not necessorily have to be a prominent symptom as it may exist in mild form not attract attention )1)systemic causes Anemia Obesity Psycogenic Thyrotoxicosis Metabolic acidosis Cardiac Pericarditis , pericardial effusion Cardiomyopathy ischemic heart diseases Mitral valve diseases Respiratory a.airway: larangeal tumour, forign body , asthma, COPD , bronchiactasis bronchogenic cancer , bronchopneumonia b.paranchyma: pnemoconiosis ILD, sarcoidosis, TB, lobar pneumonia& metastatic tumour c.Pulmonary cirulation: pulmonary embolism primary pulmonary hypertension d.Pleura: pneumothorax pleural effusion empyema e.Chest wall: kyphosis kyphoscoliosis Guilian Barre syndrome, myasthenia gravis course, releifing &agrevating factors dyspnea on flat position indicates left sided heart failure ascites pregnancy large pleural effusion respiratory muscle weakness dyspnea on sitting position right to left shunt due to patent foramen ovale or ASD Dyspnea on flat position On one side usually the healthy side seen in DCMP or large compressing tumor to central airway or major vessels Paroxysmal nocturnal dyspnea Characteristic dyspnea observed in left sided heart failure, 1-2 hours after sleep needs to be differentiated from dyspnea experienced in asthmatic patients which usually at 3-5 a.m Severity of dyspnea NYHA classification of symptoms of heart failure Chest pain The pain sensitive structures in the chest are parietal pleura, chest wall &mediastinum innervations of lungs are totally autonomic Pleuritic chest pain is sharp stabbing worsens with inspiration irritations of parietal pleura in upper six ribs causes localized chest pain while irritation of parietal pleura over the diaphragm causes referred pain to neck or shoulder Respiratory cause of chest pain herpetic neuralgia Muscle spasm Rib fracture Chest wall invasion by lung cancer Costochondritis Pleursy pneumothorax Pulmonary infarction pulmonary embolism Hemoptysis Hemoptysis is expectoration of blood from respiratory tract , it may arise from alveoli up to glottis & should be differentiated from hematemesis(from GIT) ,. Hemoptysis may be simple as in acute bronchitis or may be terrifying reasons as lung cancer Etiology at the level of alveoli, the bleeding basically is due to injury to capillary or small sized vessels, this is manifested as diffuse alveolar hemorrhage( DAH) in these circumstances Wegner,s granulomatosis ( granulomatosis and polyangitis ) or autoimmue diseases like SLE were autoantibodies attacks the capillary ( pulmonary cappillaritis ) or to alveolar basement membrane as in Goodpasture,s syndrome DAH is suspected in after bone morrow transplantation alveoli could be the source of direct injury by inhalation of toxic chemical like cocain or fire. haemoptysis is caused or increased severity in patients receiving anticoagulant or antiplalelates or any causes of bleeding tendency like thrombocytopenia owing to a proximity of blood vessels to the bronchial tree. therefore any infection of airway whether viral ,bacterial or even fungal can cause haemoptysis so acute bronchitis, pneumonia, acute mucopurulant exacerbations of COPD. bronchiectasis , lung abscess ,TB, cancer whether primary or metastatic can cause hemoptysis hemoptysis accounts for 10% of presentation of lung cancer small cell carcinoma & squamous cell carcinoma appear more common for the approximity of these tumors to central airway where are eroding the hilar vessels vascular causes of haemoptysis observed in congestive heart failure where causes raise left atrial pressure , pulmonary AV malformations & pulmonary embolism if associated with pulmonary infarction Massive haemoptysis is defined as > 200-600ml /24hours Wheeze Is whistling high pitched expiratory sound due to airway narrowing, wheezing is caused by bronchostatic conditions like COPD or bronchial asthma Mucosal edema ( bronchopneumonia , congestive heart failure ) External compression by tumor or lymph node Partial obstruction by foreign body , tumor, tenacious secretions strider It is high pitched sound due to upper airway partial obstruction it is commonly inspiratory but it can be expiratory or both , strider due to tracheobronchial diseases is often causes expiratory type while inspiratory strider indicates vocal cord narrowing common causes of strider are epiglottitis tumour of trachea or major bronchi , foreign body Cyanosis a bluish discolorations of skin &mucous membranes due to presence of reduced Hb >= 5gm/dl or PaO2 < 85% (4000 m Abnormal hemoglobins: Methemoglobinemia, sulfhemoglobinemia