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Understanding Symptoms of Chest Disorders and Cough Reflex in Respiratory Health

Learn about the symptoms of chest disorders and the cough reflex in respiratory health. Discover the main causes, classifications, clinical appearances, and complications of chronic cough. Explore sputum expectoration, hemoptysis, and chest pain, including common causes and differential diagnoses. Gain insight into laboratory examinations, investigation protocols, and distinguishing features. Enhance your knowledge on cardiovascular, pleural, and chest wall diseases, as well as other conditions leading to chest pain.

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Understanding Symptoms of Chest Disorders and Cough Reflex in Respiratory Health

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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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