Theme of lecture: Symptoms and syndromes in diseases of respiratory organs based on data of inquiry and general inspection of a patient, palpation and percussion of a chest
N. Bilkevych
The most typical complaints of the patient with respiratory pathology
•dyspnoea,
•cough,
•bloody expectorations,
•pain in the chest.
•Fever, asthenia, indisposition and loss of appetite (secondary complaints)
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Dyspnoea in its manifestation can be |
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objective, or subjective and |
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subjective, |
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objective simultaneously. |
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Subjective dyspnoea - the subjective feeling of |
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difficult or laboured breathing. |
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Objective dyspnoea is determined by objective |
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examination and is characterized by changes in |
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the respiration rate, depth, or rhythm, and also |
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the duration of the inspiration or expiration. |
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Diseases of the respiratory system are often accompanied by |
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mixed (i.e. subjective and objective) dyspnoea. It is often |
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associated with rapid breathing (tachypnoea). These |
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symptoms occur in pneumonia, bronchogenic cancer, and in |
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tuberculosis. Cases with purely subjective dyspnoea (in |
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hysteria, thoracic radiculitis) or purely objective dyspnoea (in |
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pulmonary emphysema or pleural obliteration) occur less |
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frequently. |
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Three types of dyspnoea are
differentiated by the prevalent breathing phase: inspiratory dyspnoea, expiratory dyspnoea and mixed dyspnoea when both expiration and
inspiration become difficult.
Dyspnoea may be physiological
(caused by heavy exercise) and pathological (associated with
pathology of the respiratory organs, diseases of the cardiovascular and haemopoietic systems, and poisoning).
Aetiology of dyspnoea in respiratory pathology
obstruction of the respiratory ducts (expiratory) due to inflammatory oedema and swelling of fine bronchi and bronchioles mucosa, or else in spasms in the smooth muscles (bronchial asthma), mechanical obstruction in the upper respiratory ducts (larynx, trachea)
contraction of the respiratory surface of the lungs due to
their compression by liquid or air accumulated in the pleural cavity,
decreased pneumatization of the lung in pneumonia, atelectasis, infarction
decreased elasticity of the lungs.
Pronounced dyspnoea which develops suddenly is called asphyxia. Paroxysmal attacks of dyspnoea are called asthma.
Bronchial asthma, in which an attack of dyspnoea occurs as a result of spasms of smaller bronchi and is accompanied by difficult, lengthy and noisy expiration, is differentiated from cardiac asthma which is secondary to left heart failure and is often accompanied by lung oedema with very difficult expiration.
Cough is a complicated reflex act which is actually a defence reaction aimed at clearing the larynx, trachea, or bronchi from mucus or foreign material. An inflamed bronchial mucosa produces a secretion which acts on the sensitive reflexogenic zones in the respiratory mucosa to stimulate the nerve endings and to activate the coughing reflex.
Cough may be: dry and moist
Morning, evening and night permanent and periodic.
