COUGH & EXPECTORATION - PowerPoint Presentation

Slide1

COUGH & EXPECTORATION

DR.N.SANKARSlide2

COUGH

Defensive mechanism to clear lower air passages.

Deeper the inspiration- more effective the cough

Glottis close, soft palate raised, all accessory muscles in addition to ordinary are tensed for forced expiration.

Then glottis relaxed & contents are expelled from the mouthSlide3

CLASSIFICATION OF COUGH

DUE TO

1. INFECTIONS

2. MECHANICAL IRRITATION

3. REFLEX CONDITIONSSlide4

INFECTIONS

COMMON COLD- SHORT COUGH, DRY AT FIRST AND LATER PAROXYSMAL

PHARYNGITIS-PERSISTENT, GENERALLY DRY

LARYNGITIS- NOISY, HUSKY, STRIDULOUS

TRACHEITIS- INTENSELY IRRITATING, PAROXYSMAL; + WHEEZING

BRONCHITIS- PRODUCTIVE, FREE OR PAROXYSMALSlide5

PNEUMONIA- 1

ST

DAY- DRY, THEN RUSTY SPUTUM, THEN FROTHY

TUBERCULOSIS- FREQ, SHORT, SHARP DRY –EARLY; LATER ON- COPIOUS PURULENT

PLEURISY- SOLITARY, DRY HACKING COUGH SUPPRESSED AS MUCH AS POSSIBLE TO AVOID PAIN.

BRONCHIECTASIS- CONSTANT WITH COPIOUS OFFENSIVE PURULENT MORE ON MORN OR CHANGE OF PLACESlide6

LUNG ABCESS- LOOSE COUGH, OFFENSIVE BLOOD STAINED; AFFECTED BY CHANGE OF POSTURE

PERTUSSIS- LONG DRAWN SRIDULOUS INSPIRATION

 SERIES OF SHORT, SHARP, EXPIRATORY COUGH WITH VOMITING OFTEN; FACE CONGESTEDSlide7

MECHANICAL IRRITATION

ENLARGED UVULA-

SINUSITIS

SMOKING

PRESSING UPON TRACHEA

ENLARGED HEARTSlide8

REFLEX CONDITIONS

IRRITATION OF PERIPHERAL NERVES

ENLARGED LIVER AND DIAPHRAGMATIC DISORDERS

NERVOUSNESS- SINGLE SHORT DRY AND EXPLOSIVE

HYSTERIA- LOUD BARKING WITH APHONIASlide9

SUDDEN COUGH- TRACHEITIS, BRONCHITIS, BRONCHOPNEUMONIA

COUGH WITH PAIN- PNEUMONIA, PLEURISY,

COUGH ON LYING DOWN- ENLARGED UVULA, ENLARGED HEART

COUGH WITH VOMITING- WHOOPING COUGH

DRY COUGH- PHTHISIS, LARYNGITIS, NEUROSIS

LOOSE COUGH- BRONCHITIS, BRONCHIECTASIS, PTHISIS

SUDDEN PAROXYSM IN A CHILD- FOREIGN BODY, IF WITH FEVER---- LARYNGEAL DIPTHERIA

SHORT AND SUPPRESSED- DRY PLEURISYSlide10

IRRITABLE- EARLY PTHISIS, PHARYNGITIS

PAROXYSMAL- ASTHMA, BRONCHITIS, PERTUSSIS

EXPLOSIVE- NEUROSIS, LARYNGITIS

BRASSY- ANEURYSM, MEDIASTINAL GROWTH

BOVINE- PROLONGED WITH WHEEZING- RL.N INVOLVEMENT

BARKING- HYSTERIA

HACKING- PHTHISIS, LARYNGITIS, PHARYNGITIS

STRIDOR- PERSISTENT THYMUS, LARYNGEAL DIPHTHERIASlide11

EXPECTORATIONSlide12

LOOK FOR

QUANTITY

QUALITY & COLOUR

CONSISTENCY

ODOUR

MICROSCOPIC EXAMINATIONSlide13

QUANTITY(24 HRS)

MODERATE(2 OUNCES)- ACUTE BRONCHITIS

LITTLE LARGER AMOUNT- CHRONIC BRONCHITIS, RESOLVING PNEUMONIA, B.CA

LARGER QUANTITY(OVER 10 OUNCES)- LUNG ABSESS, EMPYEMA, BRONCHIECTASIS

FROTHY- ACUTE PULMONARY CONGESTION

SUDDEN SEVERAL OUNCES-LUNG ABSCESS, SUBPHRENIC ABSCESS, EMPYEMA

SUDDEN CLEAR WATERY SALT TASTING- HYDATID CYSTSlide14

QUALITY & COLOUR

MUCOID

SEROUS

FIBRINOUS

FROTHY

PURULENT

MUCOPURULENT

BLOOD STAINED

BLACK

RUSTY

RED CURRANT JELLY

ANCHOVY SAUCE PUS

GREENISHSlide15

CONSISTENCY

METHOD ---

LOOK FOR FOLLOWING:

BRONCHIAL CASTS

DITTRICH’S PLUGS

CURSCHMANN’S SPIRALS

LUNG STONES

LAYER FORMATIONSlide16

ODOUR

OFFENSIVESlide17

MICROSCOPIC EXAMINATION

CELLULAR STRUCTURES

PUS CELLS

EPITHELIUM(HEART FAILURE CELLS)

RED CELLS

EOSONOPHIL CELLS

ELASTIC FIBRES

DESTRUCTION OF LUNG TISSUE- ABSCESS, PTHISIS, GANGRENESlide18

ORGANISMS

PARASITES(HYDATID CYST, LUNG FLUKE, ECHINICOCCI)

TB BACILLI

COCCI AND BACILLI

CURSCHMANN’S SPIRALS

ASTHMA

CHARCOT LEYDEN CRYSTALS

ASTHMA

NEOPLASTIC CELLS- CA

ASBESTOSIS- GOLDEN YELLOW DUMBELLSSlide19

Bibliography

How to examine a patient; a guide for student of medicine

menino

de

souzaSlide20

THANK YOU