A common problem, especially in the winter, is cough, which is a crucial lung defense mechanism. It self-limits in the majority of patients. Coughing, however, can be concerning and suggest a significant underlying illness due to associated issues (hemoptysis) or because of the cough’s own serious side effects (e.g., syncope and hemorrhage).
Cough is defined as the quick expulsion of air from the lungs, cleaning the throat of foreign objects, bacteria, irritants, fluids, and mucus, as well as the breathing passage. Tussis is another name for cough.
COUGH MECHANISM: The process of coughing comprises-
1. Increased throat and pulmonary pressure when the voice chords are closed.
2. An airburst that occurs as the vocal cords contract
Cough can be broadly classified on the basis of its duration as-
a) Acute cough : < 3 weeks in duration
b) Subacute cough : 3-8 weeks in duration
c) Chronic cough : 8 weeks in duration
It is very much exciting to explore the birth of the word ‘cough’, the so-commonly used term. Let us get an insight into it. The word finds its origin in the Middle High German “Kuchen” which translates as ‘to breathe heavily’, to the French Old English “Cohhian” which means ‘to shout’, to the Middle English “Coughen”.
- Post nasal dripping
- Medications like ACE inhibitors
The presence of pyrexia usually indicates an infective cause; also may be raised with pulmonary
- Inspection and palpation
With COPD the chest may be barrel-shaped. Patients suffering with lung cancer or TB appears
cachectic. Cyanosis is found in pulmonary embolism and COPD. Clubbing is associated with
bronchial carcinoma and bronchiectasis. The supraclavicular nodes is palpable with respiratory
tract infections, TB and lung cancer.
On auscultation, coarse crepitations can be heard in bronchiectasis and pulmonary oedema.
Auscultatory features of pleural effusion (dull to percussion, reduced breath sounds, decreased
vocal resonance). Wheezing is a finding of asthma, and a fixed
inspiratory wheeze may be heard
with bronchial luminal obstruction.
DIAGNOSIS & INVESTIGATIONS:
- X-Ray chest
- Sputum test
Persistent cough or severe bouts of cough can cause complications, and these include:
- Sleep disruption
- Excessive sweating
- Rib fracture
- Urinary incontinence
Hoarse, dry, croupy cough; loud, labored breathing. Child grasps at throat every time he coughs. Very sensitive to inspired air. Shortness of breath. Larynx sensitive. Stitches through chest. Cough, dry, short, hacking; worse at night and after midnight. Hot feeling in lungs. Blood comes up with hawking. Tingling in chest after cough.
Cough worse coming into warm room, with burning sensation in chest, itching of chest, oppression. Loss of voice from becoming overheated. Voice harsh and badly pitched.
Dry, hacking cough from irritation in upper trachea. Cough, dry, at night; must sit up; worse after eating or drinking, with vomiting, with stitches in chest, and expectoration of rust-colored sputa. Coming into warm room excites cough
Tickling, short, dry cough; worse at night. Larynx feels sore. Respiration oppressed, quick, unequal. Cheyne-Stokes respiration (Cocaine; Opium). Hoarse; loss of voice. Painless hoarseness. Cough with pain in left hip.
Hoarseness, hawking, rawness of larynx. Irritable, dry, tickling cough; suffocative tightness of chest, with bitter expectoration in daytime. Rattling of mucus in child’s chest.
Spasmodic, dry irritative cough, like whooping-cough, the paroxysms following each other very rapidly; can scarcely breathe; chokes. Cough very deep and hoarse; worse, after midnight; yellow expectoration, with bleeding from nose and mouth; retching.
Dry cough in evening and at night; must sit up in bed to get relief; and loose cough in the morning, with copious mucous expectoration. Pressure upon the chest and soreness.
Hoarseness; worse evenings. Larynx very painful. Clergyman’s sore throat; violent tickling in larynx while speaking. Aphonia, worse evenings, with rawness. Cannot talk on account of pain in larynx. Cough from tickling in throat; worse, cold air, reading, laughing, talking, from going from warm room into cold air.
- Reid PT, Innes JA.
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