中国医科大学：《诊断学》课程教学课件（PPT讲稿）Respiratory Symptoms

Respiratory Symptoms Bhao Li.m.D

Respiratory Symptoms Zhao Li, M.D

Common symptoms Cough ▣Expectoration ▣Hemoptysis ▣Chest pain ▣Cyanosis ▣Dyspnea

Common symptoms  Cough  Expectoration  Hemoptysis  Chest pain  Cyanosis  Dyspnea

Cough (a protective reflex):causes Respiratory diseases the most common causes ■Airway agents Bronchitis,bronchiectasis,asthma.endobronchial tuberculosis,tumor,pharyngitis ■Lung agents Infection,edema,fibrosis,tumor Pleural agents Pleurisy,pneumothorax,mesothelioma of pleura Cardiovascular diseases Cardiogenesis edema,pulmonary embolism Central nervous system agents Initiative cough,encephalitis,meningitis

Cough (a protective reflex): causes  Respiratory diseases___ the most common causes ◼ Airway agents  Bronchitis, bronchiectasis, asthma, endobronchial tuberculosis, tumor, pharyngitis ◼ Lung agents  Infection, edema, fibrosis, tumor ◼ Pleural agents  Pleurisy, pneumothorax, mesothelioma of pleura  Cardiovascular diseases ◼ Cardiogenesis edema, pulmonary embolism  Central nervous system agents ◼ Initiative cough, encephalitis, meningitis

Cough manifestations Characteristics Dry cough (non-sputum:non-infectious) Productive cough (sputum:infectious,edema) ▣Attack Time ■season motivation ▣Tone ■Hoarseness High pitch Weak ■Brassy

Cough : manifestations  Characteristics ◼ Dry cough (non-sputum: non-infectious) ◼ Productive cough (sputum: infectious, edema)  Attack ◼ Time ◼ season ◼ motivation  Tone ◼ Hoarseness ◼ High pitch ◼ Weak ◼ Brassy

Cough:accompany signs ▣Fever(infection) Chest pain (infection,tumor,pleurisy, pneumothorax,pulmo embolism) ▣Dyspnea Hemoptysis (bronchietasis,tuberculosis,tumor) Bulk pus sputum (bronchietasis,lung abscess) Wheezing (asthma,foreign body) Clubbing fingers (bronchietasis,lung cancer, chronic lung abscess)

Cough: accompany signs  Fever (infection)  Chest pain (infection, tumor, pleurisy, pneumothorax, pulmo embolism)  Dyspnea  Hemoptysis (bronchietasis, tuberculosis, tumor)  Bulk pus sputum (bronchietasis, lung abscess)  Wheezing (asthma, foreign body)  Clubbing fingers (bronchietasis, lung cancer, chronic lung abscess)

Sputum:amount ▣Bulk frothy sputum Pulmo edema Bulk serofluid sputum ■Alveolar carcinoma ▣Bulk pus sputum ■Bronchiectasis ■Lung abscess Layering upper:frothy, middle:mucoid or mucopus, lower:necrosis substance

Sputum: amount  Bulk frothy sputum ◼ Pulmo edema  Bulk serofluid sputum ◼ Alveolar carcinoma  Bulk pus sputum ◼ Bronchiectasis ◼ Lung abscess 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: 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 or black dust inhalation 口Rusy Lobar pneumonia 口Pink ■cardiac edema ▣Red ■hemoptysis

Sputum: color  White ◼ mucoid or serofluid sputum  Yellow ◼ general bacterial infection  Green ◼ aeruginosus Bacillus infection  Grey or black ◼ dust inhalation  Rusty ◼ Lobar pneumonia  Pink ◼ cardiac edema  Red ◼ hemoptysis Grey or black

Sputum:foul odor anaerobic bacterium infection

Sputum: foul odor  anaerobic bacterium infection

Hemoptysis Bleeding from lower respiratory tract The amount varies from blood-strained sputum to several hundreds ml pure blood Mild:500ml/d,or 100-500/time Differential diagnosis Bleeding from upper respiratory tract Hematemesis

Hemoptysis  Bleeding from lower respiratory tract  The amount varies from blood-strained sputum to several hundreds ml pure blood ◼ Mild: 100ml/d ◼ Moderate: 100-500/d ◼ Severe: >500ml/d, or 100-500/time  Differential diagnosis ◼ Bleeding from upper respiratory tract ◼ Hematemesis