上海交通大学：《诊断学》课程PPT教学课件（英语版）Concept

Cough Expectoration Zhengcuixia

Cough & Expectoration Zhengcuixia

Concept a protective reflex that can be controlled consciously Remove excessive secretion foreign material from the airway Initiated by miscellaneous stimuli or by voluntary exertion The most common respiratory symptom

Concept • A protective reflex that can be controlled consciously • Remove excessive secretion & foreign material from the airway • Initiated by miscellaneous stimuli or by voluntary exertion. • The most common respiratory symptom

Cough reflex Irritant type: mechanical, chemical inflammation Afferent inform from: larynx, trachea bifurcation of the bronchi Afferent fibers are in the vague nerve cough center

Cough reflex: •Irritant type: mechanical, chemical, inflammation •Afferent inform.from: larynx, trachea, bifurcation of the bronchi. •Afferent fibers are in the vague nerve cough center

Cough reflex Efferent signals larynx muscles of diaphragm, chest wall, abdomen A coordinated series of movement complete the cough. Deep inspiration -expiration effort with glottis closed-glottis open abruptly- high velocity of airflow brings out secretions from airways

Cough reflex • Efferent signals larynx muscles of diaphragm,chest wall, abdomen • A coordinated series of movement complete the cough. Deep inspiration – expiration effort with glottis closed- glottis open abruptly – high velocity of airflow brings out secretions from airways

Influencing factors depressed afferent or efferent nerve function Failed glottis function Diminished muscle force Obstructed airway seen in severe COPD Trachea intubation Chest or abdominal pain limit cough movement

Influencing factors • depressed afferent or efferent nerve function • Failed glottis function • Diminished muscle force • Obstructed airway seen in severe COPD • Trachea intubation • Chest or abdominal pain limit cough movement

Causes Airway stimulation by chemicals foreign material Airway infection inflammation Afferent nerve fiber Lung parenchyma disorders

Causes • Airway stimulation by chemicals & foreign material • Airway infection & inflammation • Afferent nerve fiber • Lung parenchyma disorders

Causes Pleural chest wall disorders Cardiovascular abnormalities Other causes Psychiatric cough

Causes • Pleural & chest wall disorders • Cardiovascular abnormalities • Other causes Psychiatric cough

classification Non production( dry cough Production(with sputum

classification • Non production ( dry cough ) • Production (with sputum)

Clinical appearance in common diseases Acute respiratory infection Exacerbation of chronic infectious illnesss COPD Bronchyactesis Chronic cough: postualnasal drip syndrom, cough type asthma smoker

Clinical appearance in common diseases • Acute respiratory infection • Exacerbation of chronic infectious illnesss COPD Bronchyactesis •Chronic cough: postualnasal drip syndrom, cough type asthma, smoker

Clinical appearance in common Iseases ° Neoplasms Pleural disease Cardiovascular diseases General disease affecting the respiratory system

Clinical appearance in common diseases • Neoplasms • Pleural disease • Cardiovascular diseases • General disease affecting the respiratory system