3. DEFINITION
Cough is an explosive expiration that
provides a normal protective mechanism
for clearing the tracheobronchial tree of
secretions and foreign material, which is
associated with a characteristic sound.
6. The shearing forces that develop
aid in the elimination of mucus
and foreign materials
7. IMPORTANCE
1) Defense mechanism (physiological natural reflex):
Providing a normal protective mechanism for clearing the
tracheobronchial tree free of secretions and foreign material
2) Complication of its force:
Excessive coughing can be exhausting; can be complicated by
vomiting, syncope, muscular pain or rib fractures; and can aggravate
abdominal or inguinal hernias , urinary incontinence and Uterine
prolapse
3) Symptom of disease:
Associated with many medical diseases and conditions
8. 4) Transmit infections to others by air droplets diseases that
are commonly spread by coughing or sneezing include:
− Bacterial Meningitis
− Chickenpox
− Common cold
− Influenza
− Mumps
− Strep throat
− Tuberculosis
− Measles
− Rubella
− Whooping cough
9. HISTORY
1) Onset and Duration:
Acute: < 3weeks
Subacute: 3-8 weeks
Chronic: > 8 weeks
2) Character :
Bovine with Hoarsness: Left recurrent laryngeal nerve palsy
causing left vocal cord paralysis due to CA Lung
Barking with Hoarsness and Stridor: Acute Epiglottitis,
Laryngitis, CA Larynx
Wheezy: COPD, Asthma
10. 3) Timing and associated features:
Nocturnal: Asthma, CHF
Early Morning: Bronchiectasis, Chronic Bronchitis, Asthma
Recumbent: Postnasal drip (PND), CHF,
Gastroesophageal reflux disease (GERD)
Change position (Standing): Bronchiectasis
11. 4) With or without sputum:
Dry cough - without sputum:
Causes of dry cough (Asthma, Viral infection of respiratory
system, Interstitial Lung Disease)
Productive cough - with sputum:
Causes of productive cough (Respiratory Infections, COPD,
Bronchiectasis)
• With or without blood:
Hemoptysis - with blood
12. Hemoptysis (bloody sputum):
If with purulent and long standing sputum:
Chronic bronchitis (small amount of blood)
Bronchiectasis (large amount of sputum)
If with fever, recent, recent onset, SOB:
Pneumonia
If + LOA, LOW, H/O smoking:
Bronchial carcinoma
If sputum is pink in color and frothy:
Pulmonary edema
If sudden onset:
Pulmonary embolism, acute RT infections
16. TESTS AND
DIAGNOSIS
The medical history and physical examination help to
determine which tests should be ordered.
− Imaging tests
CXR: lung cancer and pneumonia
CT: cavities for pockets of infection
17. − Lung function tests:
These simple, noninvasive tests measure how much air your lungs can
hold and how fast you can exhale. This test is required to diagnose
asthma.
− Lab tests:
If the mucus that is coughed up is discolored, the doctor may want to test
a sample of it for bacteria.
− Scope tests:
• cellular abnormalities
• as well as biopsy
22. 2) Subacute Cough:
− Postinfectious:
A cough that begins with an cute respiratory tract infection
and is not complicated * by pneumonia
• * Not complicated = normal lung exam normal chest
X-ray
• Resolve without treatment
• Cause: PND or tracheobronchitis
• Indication for CXR: with automated biopsy needle (ABN)
lung exam
− Sinusitis
− Asthma
31. Coughs can be treated in a variety of ways, depending on the
cause of the cough. For most healthy adults, most treatments
will involve self-care.
TREATMENT:
32. Self-Treatment
A cough that is cased by virus cannot be treated with antibiotics. You can,
however, soothe it in the following ways:
− Use decongestant sprays to unblock the nose and ease breathing
− Elevate your head with extra pillows when sleeping
− Use cough drops to soothe the throat
− Avoid irritations, including smoke and dust
33. − Gargle hot saltwater regularly to remove mucus and soothe the
throat
− Keep hydrated by drinking plenty of water
− Add honey or ginger to hot tea to relieve the cough and clear the
airway
34. AntihisMedications used to treat cough may include:
tamines and decongesta:
These drugs are standard treatment for allergies and postnasal .
Inhaled asthma drugs:
The most effective treatments for asthma-related cough are inhaled
medications that reduce inflammation and widen the airways.
Antibiotics:
If a bacterial infection is causing the cough, antibiotics will be prescribed.
35. Acid blockers:
When lifestyle changes don't take care of acid reflux, patient may be
treated with medications that block acid production. Some people need
surgery to resolve the problem.
Cough suppressants:
If the reason for your cough can't be determined, the doctor may
prescribe a cough suppressant, especially if the cough is interfering with
your sleep.