1 / 28

Respiratory Symptoms

Respiratory Symptoms. Zhao Li, M.D. Common symptoms. Cough Expectoration Hemoptysis Chest pain Cyanosis Dyspnea. Cough ( a protective reflex ): causes. Respiratory diseases___ the most common causes Airway agents

johana
Download Presentation

Respiratory Symptoms

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Respiratory Symptoms Zhao Li, M.D.

  2. Common symptoms • Cough • Expectoration • Hemoptysis • Chest pain • Cyanosis • Dyspnea

  3. Cough (a protective reflex): causes • Respiratory diseases___ the most common causes • Airway agents • Bronchitis, bronchiectasis, asthma, endobronchial tuberculosis, tumor, pharyngitis • Lung agents • Infection, edema, fibrosis, tumor • Pleural agents • Pleurisy, pneumothorax, mesothelioma of pleura • Cardiovascular diseases • Cardiogenesis edema, pulmonary embolism • Central nervous system agents • Initiative cough, encephalitis, meningitis

  4. Cough : manifestations • Characteristics • Dry cough (non-sputum: non-infectious) • Productive cough (sputum: infectious, edema) • Attack • Time • season • motivation • Tone • Hoarseness • High pitch • Weak • Brassy

  5. Cough: accompany signs • Fever (infection) • Chest pain (infection, tumor, pleurisy, pneumothorax, pulmo embolism) • Dyspnea • Hemoptysis (bronchietasis, tuberculosis, tumor) • Bulk pus sputum (bronchietasis, lung abscess) • Wheezing (asthma, foreign body) • Clubbing fingers (bronchietasis, lung cancer, chronic lung abscess)

  6. Sputum: amount • Bulk frothy sputum • Pulmo edema • Bulk serofluid sputum • Alveolar carcinoma • Bulk pus sputum • Bronchiectasis • Lung abscess Layering upper: frothy, middle: mucoid or mucopus, lower: necrosis substance

  7. Sputum: consistency • Mucoid sputum • Bronchitis (without bacterial infection) • Asthma • Early stage of pneumonia • Serofluid sputum • Pulmo edema • Pus sputum • Any bacterial infection • Bloody sputum

  8. Sputum: color • White • mucoid or serofluid sputum • Yellow • general bacterial infection • Green • aeruginosus Bacillus infection • Grey or black • dust inhalation • Rusty • Lobar pneumonia • Pink • cardiac edema • Red • hemoptysis Grey or black

  9. Sputum: foul odor • anaerobic bacterium infection

  10. Hemoptysis • Bleeding from lower respiratory tract • The amount varies from blood-strained sputum to several hundreds ml pure blood • Mild: 100ml/d • Moderate: 100-500/d • Severe: >500ml/d, or 100-500/time • Differential diagnosis • Bleeding from upper respiratory tract • Hematemesis

  11. Distinguished hemoptysis from hematemesis

  12. Hemoptysis: causes • Bronchial disorders • Bronchiectasis • Bronchogenic carcinoma • endobronchial TB • Chronic bronchitis • Pulmo Disorders • Pulmo TB • Peumonia • Lung abscess • Pulmo embolism • Cardiovascular disorders • Acute left heart failure • Mitral stenosis • Others • Hematologic disease, leptospirosis (钩端螺旋体病),epidemic hemorrhagic fever,endometriosis (子宫内膜异位症)

  13. Hemoptysis: accompany signs • Fever • Infection or carcinoma • Chest pain • Infection, Pulmo Embolism,Carcinoma • Pus sputum • Bronchiectasis,Lung abscess • Clubbing fingers • Bronchiectasis,Lung abscess,Carcinoma • Hemorrhagic spots • Hematologic disease, leptospirosis, epidemic hemorrhagic fever

  14. Chest pain: causes • Chest wall • herpes zoster, rib fracture • Cardiovascular • angina pectoris, myocardial infarction, pericarditis, dissecting aneurysm (夹层动脉瘤) • Respiratory • Pleural disorders, pneumothorax, carcinoma • Mediastinal • Mediastinitis, mediastinal emphysema, mediastinal tumor • Others • esophageal carcinoma, liver abscess, subdiaphragmatic abscess, hiatal hernia (食道裂孔疝)

  15. Chest pain: characteristics • location • Referred pain • Level or feature • Burning pain, pressing pain, bursting pain, pricking pain • Duration • Influential factors • Exertional, respiration, foodintake, administration

  16. Chest pain: accompany signs • Cough, sputum and/or fever • Respiratory disease • Dyspnea • Severe pneumonia, pneumothorax, pleurisy, pulmo embolism • Hemoptysis • Carcinoma, pulmo embolism • Shock • myocardial infarction, dissecting aneurysm (rupture ), large area pulmo embolism • Dysphagia (吞咽困难) • Esophageal disease

  17. Cyanosis • An excess of desaturated hemoglobin causes a blue coloration of the skin or mucosae. • methemoglobinemia (高铁血红蛋白血症) • Poisoning by nitrite (Methylthioninium Chloride iv, 亚甲兰)

  18. Cyanosis: classification • Central (warm) • Deficient oxygenation • Right-to-left shunt • Peripheral (cold) • Reduced cardiac output • Local vasoconstriction • Mixed • Heart failure

  19. Cyanosis: accompany signs • Dyspnea • Severe cardiac or respiratory disorder • Clubbing fingers • Congenital heart disease • Chronic respiratory disease • Unconsciousness • Poisoning, shock, Severe cardiac or respiratory disorder

  20. Dyspnea: causes • Respiratory system • Obstruction: asthma, COPD, tumor • Pulmo Diseases: pneumonia, interstitial lung disease, • Chest wall or pleura: pleurisy, pneumothorax, trauma • neuro-muscles: poliomyelitis ( 脊髓灰质炎), myasthenia gravis (重症肌无力) • Diaphragma movement disorder: obviously elevated pressure in abdominal cavity • Cardiovascular system • Heart failure • Pulmo embolism • Poisoning • ketoacidosis • Central nervous system • cerebral tumor , trauma, abscess, hemorrhage, encephalitis, meningitis • hematological system • Severe anemia

  21. Respiratory Dyspnea • Inspiratory dyspnea ____obstruction in large airway • Three depression sign • depression in suprasternal fossa, supraclavicular fossa, intercostal space • Expiratory dyspnea ____obstruction in small airway or alveolar elasticity decreased • Prolonged expiratory time • Expiratory rhonchi • Mixed dyspnea ____deficient gas exchange • Respiratory rate increased • Shallow breathing

  22. Mechanism of left heart failure • Pulmo edema diffusion capacity decreased • Alveolar tension increased stimulating stretch receptor excitation of vagus nerve excitation of respiratory center • Alveolar elasticity decreased vital capacity decreased • Increased pressure of pulmo circulation stimulating respiratory center Cardiac dyspnea ____ Heart failure

  23. Features of left heart failure • Underlying diseases • Mixed dyspnea • Position related dyspnea • Moist crackles or rhonchi in both lungs • Relief of symptoms after digitalis, diuretic, vasodilator agent used

  24. Nocturnal paroxysmal dyspnea Characteristics • Awoken due to chest tightness or dyspnea • Forced sitting position or orthopnea • Severe sweat • Tachycardia • Moist crackles or rhonchi in both lungs • Pink frothy sputum

  25. Mechanism • Elevated excitation of vagus nerve • Contraction of coronary artery myocardium ischemia • Contraction of bronchiole decreased alveolar ventilation • Vital capacity decreased in supine position • Returned blood volume increased pulmo edema • Sensitivity of respiratory center decreasedreaction after obvious hypoxia Nocturnal paroxysmal dyspnea

  26. Poisoning dyspnea • Underlying diseases of metabolic acidosis (uremia, diabetic ketoacidosis ) • deep breathing (Kussmaul breathing)

  27. Dyspnea: accompany signs (1) • Rhonchi • Asthma • Acute left heart failure (cardiac asthma) • Foreign body in large airway • Acute laryngeal edema • Chest pain • Infection • Pneumothorax • Pulmo embolism • Lung cancer • Acute myocardial infarct

  28. Dyspnea: accompany signs (2) • Fever • Infection • Cough and sputum • COPD • Infection • Left heart failure • Unconsciousness • CNS disorder • Uremia • diabetic ketoacidosis

More Related