Cough and expectoration a Coughing is an essential defense mechanism that it prevents the airways from the foreign substance and clear the excretion of respiratory tract Coughing is a reflex. permanent and frequent coughing indicates an abnormality
Cough and expectoration ◼ Coughing is an essential defense mechanism that it prevents the airways from the foreign substance and clear the excretion of respiratory tract. ◼ Coughing is a reflex. permanent and frequent coughing indicates an abnormality
Mechanism a Extrathoracic cough receptors( located in nose oropharynx larynx and upper trachea) intrathoracic cough receptors( located in low trachea and large central bronchi a Afferent( vague, trigeminal, superior laryngeal glosso-pharyngeal nerves ■ Efferent a recurrent laryngeal nerve -- closure of glottis a corticospinal tract and peripheral nerves ---- contraction of thoracic and abdominal musculature
Mechanism ◼ Extrathoracic cough receptors ( located in nose oropharynx larynx and upper trachea) ◼ intrathoracic cough receptors ( located in low trachea and large central bronchi) ◼ Afferent ( vague , trigeminal , superior laryngeal , glosso-pharyngeal nerves ) ◼ Efferent ◼ recurrent laryngeal nerve --- closure of glottis ◼ corticospinal tract and peripheral nerves ------- contraction of thoracic and abdominal musculature
The cough reflex a deep breath---glottic closure---relaxation of diaphragm, contraction of expiratory muscle- positive thoracic pressure--suddenly release of glottis open---thoracic positive pressure airflow out---cough reflex
The cough reflex A deep breath---glottic closure---relaxation of diaphragm, contraction of expiratory muscle--- positive thoracic pressure--suddenly release of glottis open---thoracic positive pressure airflow out--- cough reflex
Etiology ■ Respiratory pleural disease ■ cardioⅴ ascular disease central nerve system factor
Etiology ◼ Respiratory ◼ pleural disease ◼ cardiovascular disease ◼ central nerve system factor
Respiratory disease Stimulator -- extra and intrathoracic ---from nose, oropharynx ---bronchi---cough reflex such as 1. inhalation of foreign material 2. inflammation of respiratory tract 3. bleeding of respiratory tract 4. tumor of respiratory tract
Respiratory disease Stimulator --- extra and intrathoracic --- from nose,oropharynx --- bronchi --- cough reflex. such as: 1.inhalation of foreign material 2.inflammation of respiratory tract 3.bleeding of respiratory tract 4.tumor of respiratory tract
Pleural Disease Such as pleurisy, thoracic effusion pleural biopsy or pleuracentisis
Pleural Disease Such as: ◼ pleurisy, thoracic effusion ◼ pleural biopsy or pleuracentisis
Cardiovascular disease Mitral stenosis -- left heart failure pulmonary edema ---trausudate or exudate stimulates intra-thoracic-cough receptor cough Embolism of pulmonary can cause pulmonary venous pressure elevate pulmonary edema ---transudate or exudate stimulates intra thoracic cough receptor cough
Cardiovascular Disease ◼ Mitral stenosis --- left heart failure --- pulmonary edema --- trausudate or exudate --- stimulates intra-thoracic-cough receptor --- cough ◼ Embolism of pulmonary can cause pulmonary venous pressure elevate --- pulmonary edema ---transudate or exudate ---stimulates intra thoracic cough receptor ---cough
Central nerve system a Inflammatory of CNs can cause coughing such as: encephalitis and meningitis
Central nerve system ◼ Inflammatory of CNS can cause coughing ◼ such as: encephalitis and meningitis
Expectoration Expectoration is a pathological phenomenon that human being remove the pathological secretion from respiratory system by means of coughing
Expectoration Expectoration is a pathological phenomenon that human being remove the pathological secretion from respiratory system by means of coughing
Expectoration a The daily quantity of bronchial secretions produced by a normal person is unknown But it is sufficiently small to be removed by mucociliary action alone a Cough and expectoration are not required
Expectoration ◼ The daily quantity of bronchial secretions produced by a normal person is unknown. But it is sufficiently small to be removed by mucocillary action alone. ◼ Cough and expectoration are not required