Symptoms & Sign of Resp Pathology

darodri6's version from 2016-09-02 19:20

Causes of COUGH


Upper Airway CauseClinical Characteristics
TracheobronchitisUpper airway symptoms including SORE THROAT
Foreign Body AspirationResp Distress, possible WHEEZE or STRIDOR
Airway TumorNON-PRODUCTIVE cough, possible hemoptysis
AsthmaCHRONIC cough that is DRY w/WHEEZING


Infectious CausesClinical Characteristics
Bacterial PneumoniaPRODUCTIVE PURULENT cough w/FEVER ("hallmark of productive cough")
Non-bacterial PneumoniaParoxysmal (sudden/spasm-like) cough, possiblly productive
Exacerbation of Chronic CoughPRODUCTIVE cough, DYSPNEA, possible WHEEZING
BronchiectasisFOUL SMELLING sputum, possible blood
Lung AbscessFOUL SMELLING & COLORED sputum, w/possible blood streaking
TB or Fungal InfectionPERSISTENT cough, MUCOID sputum, possible blood


Pulmonary Parenchymal Inflammation CausesClinical Characteristics
Pulmonary FibrosisDRY cough, possible DYSPNEA ("Hallmark of Dry/Non-productive cough")
Bronchogenic CarcinomaNonproductive/productive cough, w/possible blood and/or chest pain
Alveolar Cell CarcinomaVariable presentation w/possible sputum


Mediastinal CausesClinical Characteristics
Medistinal TumorCough dependent on POSITION, VARYING levels of DYSPNEA
Aortic AneurysmCough w/BRASSY SOUND


Non-Pulm/CV CauseClinical Characteristics
LV FailureDYSPNEA w/EXERTION, possible cough while SUPINE
Pulmonary InfarctionPossible DRY cough, w/possible CHEST PAIN & HEMOPTYSIS

Causes of DYSPNEA

Structural/Mech Interference w/VentilationOBSTRUCTION of FLOW (Emphysema, Asthma, Chronic Bronchitis, Tracheal, Endobroncheal disease (primary lung cancer, foreign body))
Restriction to Lung/Chest Wall ExpansionIntrinsic (involving Lung Parenchyma) = Interstitial Fibrosis, Acute Respiratory Syndrome, CHF
Extrinsic (NOT Involving Lung Parenchyma) = Kyphosis, Obesity, Ascites, Pregnancy, Pleural Fibrosis, Somatic Dysfunction (Rib Dysfunction)
Increased Dead Space Ventilation (not available for gaseous exchange)Emphysema (obstruction of flow), Pulmonary Embolism (interruption of blood flow)
Respiratory Muscle Weakness (decreased ability to inspire)Poliomyelitis, Neuromuscular Dz, Guillian-Barre Syndrome
Increase in Respiratory DriveHYPOXEMIA (Exercise, Metabolic Acidosis, Decreased Hemoglobin (dec. ability to pick up new O2), Decreased Cardiac Output (dec. gaseous exchange))
Psychological DisturbancesANXIETY (Panic Attacks, Depression)

Causes of HEMOPTYSIS (note: if patient has HIV, think Kaposi's Sarcoma OR other infectious agent like TB)

AIRWAY Disease (most common causes of hemoptysis)Acute/Chronic BRONCHITIS, BRONCHIECSTAIS, BRONCHOGENIC CARCINOMA, Bronchovascular fistula, Foreign Bodies, Airway Trauma
PARENCHYMAL DiseaseTUBERCULOSIS, LUNG ABSCESS, MYCETOMA (fungal infection), Inflammatory & Immune (Goodpasture Syndrome, Wegner's Granulomatosis (GPA), Lupus Pneumonitis)

Clinical Sign of Pulmonary Pathology

Question Answer
Respiratory DistressNasal flarring, Suprasternal/Costal Retrations, Pursed Lipped Breathing, Tripoding, Tachypnea
Lung Consolidation (part of lung(s) has increased fluid over air)DULL sound on percussion (instead of resonant), Spoken whisper is very clear (sound travels faster/better through solids)
Stridorduring INSPIRATION = some type of OBSTRUCTION in the UPPER AIRWAY
Crackles (aka Rales)heard on INSPIRATION, Fine/short/interrupted popping sounds, alveolar origination = high pitched, due to air passing through fluid/mucus, best heard in the BASES or LOWER LUNG LOBES
Rhonchi (aka Gurgles)heard during both EXPIRATION (best)/INSPIRATION, CONTINUOUS/low-pitched/coarse/harsh/louder sound with a MOANING/SNORING quality, due to air passing through NARROWED air passages as a result of SECRETIONS/SWELLING/TUMOR, sound ALTERED by COUGHING, best heard over the TRACHEA & BRONCHI
Friction Rubheard during both EXPIRATION/INSPIRATION, superficial grating/creaking sound, due to RUBBING together of inflamed PLEURAL surfaces, heard best @ areas of large THORACIC EXPANSION (e.g. lower-anterior & lateral chest), NOT altered by cough
Wheezeheard on EXPIRATION, CONTINUOUS/high-pitched/squeaky musical sounds, due to air passing through CONSTRICTED BRONCHI as a result of SECRETIONS, SWELLING/TUMOR, heard @ ANY LUNG FIELD, NOT altered by cough