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SYMPTOMS of CHYEST DISORDERS （胸部疾病的症状）

SYMPTOMS of CHYEST DISORDERS （胸部疾病的症状）. Zhengcuixia. Cough ( 咳嗽 ). A protective reflex that uncommon in healthy personal cleanse secretion & foreign material from the airway Initiated by miscellaneous stimuli or by voluntary exertion. The most common respiratory symptom.

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SYMPTOMS of CHYEST DISORDERS （胸部疾病的症状）

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  1. SYMPTOMS of CHYEST DISORDERS（胸部疾病的症状） • Zhengcuixia

  2. Cough (咳嗽) • A protective reflex that uncommon in healthy personal • cleanse secretion & foreign material from the airway • Initiated by miscellaneous stimuli or by voluntary exertion. • The most common respiratory symptom.

  3. Cough reflex（咳嗽反射） Afferent inform.from:ENT, trachea, bifurcation of the bronchi. skin of the face & neck; pleura Irritant type:mechanical, chemical, inflammation Afferent fibers (vague nerve) cough center.

  4. Cough reflex（咳嗽反射） • Efferent signals larynx: glottis close or open Relating muscles ( diaphragm,chest wall, abdomen ) • A coordinated series of action to perform the cough movement. Deep inspiration – expiration effort with glottis closed- glottis open abruptly – high volocity of airflow brings out screations from airways.

  5. Influencing factors（影响因素） • Supressed afferant or efferent nerve function :coma, senior age • Failed glottis function • Diminished muscle force: cachexy(恶液质） • Obstructed airway seen in severe COPD • Trachea intubation • Chest or abdominal pain limit coughmovement

  6. Main Causes（原因） • Airway infection & inflammation • Lung parenchyma disorders • Airway stimulation by chemicals & foreign material • Pleural & chest wall disorders • Cardiovascular abnormalities • Afferent nerve fiber • Other causes Psychiatric cough

  7. Classification (分类） • Non production ( dry cough ，干咳) • Expecteration (with sputum，咳痰)

  8. Clinical appearance in common diseases （常见疾病中的临床表现） • Acute infection or exasperation of chronic infectious illnesss • Neoplasms：insidiously initiation • Pleural disease • Cardiovascular diseases • General disease affecting the respiratory system

  9. Accompanied symptoms(伴随症状） • Fever • Chest pain • Dyspnea & wheezing • Sputum production

  10. Complication（并发症） • Cough syncope syndroma • Fatigue • Fractures due to severe persistent cough • Pneumomediastinum, pneumothorax, and subcutaneous emphysema due to high intrathoracic pressure during cough.

  11. Chronic cough(>3weeks): • postualnasal drip syndroma(鼻后滴漏综合征） • cough type asthma • smoker • Post URW infection • GERD

  12. Sputum expecteration（咳痰） Denote airway secretions being coughed out .

  13. Characters: mucoid, tenasious, purulent, blood stained, with special odor, rusty, serous • Volume: • Accompanied manifestation • Special conditions

  14. Laboratory examination • Rutine • Microbiologic test ( including culture & drug sensitivity) • Cellular

  15. Hemoptysis (咯血) • Blood originate below the level of the larynx that being coughed out. Usually bright red • Degrees: from blood-tinged sputum to massive gross blood,even leading to airway occlusion (apnea ) & shock. The latter is much less seen.

  16. Common causes （常见原因） • Infectious respiratory disease: bronchitis, bronchiectasis, TB • Neoplasm: • Cardiovascular disease: MS, PE, PAH, deformity of blood vessels • Other less seen disease leading to hemoptysis：CTDs & hemologic disorders.

  17. Classification (分级) • Small amount • Moderate • Massive (>600ml/24hrs)

  18. Differentiating from hematemesis

  19. Differentiating from upper airway bleeding by intenssive investigation and examination Post nasal bleeding Mouth and farynxil membrane bleeding

  20. Investigation investigation • whether coughed out or vomitted out • Volume: how much • Time duration • Any accompanied appearances

  21. Chest pain （胸痛） • Character （性质） • Degree （强度） • Location （部位） • Reflection （牵涉痛）

  22. Common causes • Cardiovascular & pulmonary vascular (iscamic) • Pleural • Chest wall • Emanating pains of neighboring abnormalities

  23. Cardiovascular （心血管） • Location blured press like discomfort • Eradiation • Cardiavascular & pulmonary vascular • Angina, MI, aortic stenosis (ischemic), • Myocarditis, pericarditis, (inflamation)

  24. Pleorial （胸膜疾病） • Pleoritis

  25. Chest wall (胸壁疾病）: • Injury • Inflamation • Costal Neuritis

  26. Other diseases causing chest pain • Acute abdominal syndroms

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