#2. Respiratory Symptoms
#2. Respiratory Symptoms
#2. Respiratory Symptoms
Common symptoms
Cough
Expectoration
Hemoptysis
Chest pain
Cyanosis
Dyspnea
Cough (a protective reflex): causes
Respiratory diseases___ the most common c
auses
Airway agents
Bronchitis,
bronchiectasis, asthma, endobronchial
tuberculosis, tumor, pharyngitis
Lung agents
Infection, edema, fibrosis, tumor
Pleural agents
Pleurisy, pneumothorax, mesothelioma of pleura
Cough (a protective reflex): causes
Cardiovascular diseases
Cardiogenesis edema, pulmonary em
bolism
Central nervous system agents
Initiative cough, encephalitis, mening
itis
Cough : manifestations
Characteristics
Dry cough (non-sputum)
Productive cough (sputum: infectious, edema)
Attack
Time (morning, midnight, early morning)
Season (spring, summer, fall and/or winter)
Motivation (fume inhalation, exertion)
Tone
Hoarseness
High pitch
Weak
Brassy
Cough: accompany signs
Fever (infection)
Chest pain (infection, tumor, pleurisy, pneum
othorax, pulmo embolism)
Dyspnea
Hemoptysis (bronchietasis, tuberculosis, tum
or)
Bulk pus sputum (bronchietasis, lung absces
s)
Wheezing (asthma, foreign body)
Clubbing fingers (bronchietasis, lung cancer,
chronic lung abscess)
Sputum: amount
Bulk frothy sputum
Pulmo edema
Layering
upper: frothy,
middle: mucoid or mucopus,
lower: necrosis substance
Sputum: consistency
Mucoid sputum
Bronchitis (without bacterial infection)
Asthma
Early stage of pneumonia
Serofluid sputum
Pulmo edema
Pus sputum
Any bacterial infection
Bloody sputum
Sputum: color
White
mucoid or serofluid sputum
Yellow
general bacterial infection
Green
aeruginosus Bacillus infection
Grey oror
Grey black
black
dust inhalation
Rusty
Lobar pneumonia
Pink
cardiac edema
Red
hemoptysis
Sputum: foul odor
pH alkality acidity
Tarry stools - or + +
Pulmo Disorders
Pulmo TB
Peumonia
Lung abscess
Pulmo embolism
Hemoptysis: causes
Cardiovascular disorders
Acute left heart failure
Mitral stenosis
Others
Hematologic disease, leptospirosis (钩端螺旋
体病), epidemic hemorrhagic fever , endom
etriosis (子宫内膜异位症)
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 h
emorrhagic fever
Chest pain: causes
Chest wall
herpes zoster, rib fracture
Cardiovascular
angina pectoris, myocardial infarction, pericarditis, dissecti
ng aneurysm (夹层动脉瘤)
Respiratory
Pleural disorders, pneumothorax, carcinoma
Mediastinal
Mediastinitis, mediastinal emphysema, mediastinal tumor
Others
esophageal carcinoma, liver abscess, subdiaphragmatic ab
scess, hiatal hernia (食道裂孔疝)
Chest pain: characteristics
location
Referred pain
feature
Burning pain, pressing pain, bursting pain, pri
cking pain
Duration
Influential factors
Exertional, respiration, food intake, administra
tion
Chest pain: accompany signs
Cough, sputum and/or fever
Respiratory disease
Dyspnea
Severe pneumonia, pneumothorax, pleurisy, pulmo embolis
m
Hemoptysis
Carcinoma, pulmo embolism
Shock
myocardial infarction, dissecting aneurysm (rupture
), large area pulmo embolism
Dysphagia ( 吞咽困难 )
Esophageal disease
Cyanosis
Poisoning by nitrite
Cyanosis: classification
Central (warm)
Deficient oxygenation
Right-to-left shunt
Peripheral (cold)
Reduced cardiac output
Local vasoconstriction
Mixed
Heart failure
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
Dyspnea: causes
Respiratory system
Obstruction: asthma, COPD, tumor
Pulmo Diseases: pneumonia, interstitial lung diseas
e,
Chest wall or pleura: pleurisy, pneumothorax, traum
a
neuro-muscles: poliomyelitis ( 脊髓灰质炎 ), myasth
enia gravis ( 重症肌无力 )
Diaphragma movement disorder: obviously elevated
pressure in abdominal cavity
Dyspnea: causes
Cardiovascular system
Heart failure
Pulmo embolism
Poisoning
ketoacidosis
Expiratory rhonchi
Shallow breathing
Cardiac dyspnea ____ Heart failure
Underlying diseases
Mixed dyspnea
Characteristics
Awoken due to chest tightness or dyspnea
Severe sweat
Tachycardia
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 decreased reaction aft
er obvious hypoxia
Poisoning dyspnea
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
Dyspnea: accompany signs (2)
Fever
Infection
Cough and sputum
COPD
Infection
Unconsciousness
CNS disorder
Uremia
diabetic ketoacidosis
Clubbing finger
Labor pneumonia
Symptoms
Chill
Continued fever: 39-40ºC
Chest pain
Tachypnea
Cough
Rusty sputum
Chronic bronchitis with
emphysema
Symptoms
Chronic productive cough
White mucous sputum or pus sputum (infect
ion)
Usually exacerbation in winter
Morning cough
To last more than 3 months
Exertional dyspnea
Breathlessness (dyspnea)
Chest depress
Bronchial asthma
Symptom
Tension pneumothorax
Progressive dyspnea
Severe sweat
Tyckycardia
Tension, agitated
Cyanosis
Respiratory failure
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