Symptoms of respiratory diseases. Dry cough.

The main complaints of patients with the development of respiratory diseases are complaints of shortness of breath, coughing, hemoptysis, pain in the chest area. In addition, in the presence of certain diseases of the respiratory system, fever, general weakness, lethargy, loss of appetite, headache, poor sleep, etc. can be observed.

Shortness of breath is one of the important symptoms of respiratory diseases, as well as some other diseases, especially cardiovascular diseases. Under shortness of breath is understood as a violation of the frequency, depth, and sometimes the rhythm of respiratory movements, depending on the disorder of the mechanisms of breathing regulation or on the body's need for increased gas exchange.

Subjectively, with shortness of breath, a person feels a shortage of air, which causes the need to breathe more often and deeper. If in this case there is a more difficult breathing, then this dyspnea is called inspiratory, it arises from the narrowing of the larynx, trachea, bronchi (foreign body, swelling, swelling). In the presence of bronchial asthma, emphysema of the lungs, obstructive bronchitis, dyspnea occurs, with a more difficult exhalation (expiratory dyspnea ). With the development of a number of lung diseases (croupous pneumonia, tuberculosis, etc.), heart failure, when oxygen supply is disrupted and carbon dioxide is eliminated from the body, it is difficult both for inhalation and exhalation. Such shortness of breath is called mixed. In patients with lung diseases, the cause of dyspnea is a violation of ventilation of the pulmonary alveoli, which leads to a change in the exchange of gases and blood arterialization in the lungs (oxygen starvation). Increase in the blood level of carbon dioxide, as well as other acids (milk, etc.) leads to irritation of the respiratory center and the appearance of dyspnea. Shortness of breath can be subjective and objective, physiological (during physical exertion) and pathological (in the presence of respiratory, cardiovascular and hemopoietic diseases, certain poisonings, etc.). It can develop due to a decrease in the respiratory surface of the lungs (pneumonia, pleurisy, pneumothorax, atelectasis, emphysema, high diaphragm position, etc.).

Attacks of intense dyspnoea, which occur suddenly, are called asphyxiation. It can occur with bronchial asthma, embolism or pulmonary thrombosis, pulmonary edema, acute edema of the vocal cords. Attacks of suffocation are also observed in the presence of cardiac asthma due to a weakening of the left ventricle, which sometimes leads to pulmonary edema.

Cough - a complex reflex-protective act that arises from the ingress of foreign bodies into the respiratory tract and the accumulation of secret (sputum, mucus, blood) caused by the development of various inflammatory processes. Reflexogenic (tussive) zones, the irritation of which causes a cough, located in the areas of the branching of the bronchi, in the region of the bifurcation of the trachea. Cough can appear reflexively in patients with dry pleurisy.

The development of various diseases of the respiratory system is characterized by a cough, having an appropriate character. Interrogating patients, it is necessary to find out the nature of the cough, the time of its appearance, duration, etc. By its nature, the cough can be dry (without sputum) and moist, with the allocation of a different amount of sputum. It is also important to find out whether the cough is permanent, occurs in the form of attacks, whether it is intense or insignificant (coughing), its character (barking, rough, loud, quiet, hoarse, hoarse, hampered, soft, loose), at what time it appears (at night, in the morning, evenly during the day, during cooling), etc.

Sometimes the so-called "nervous" cough is noted, it is formed by the increased excitability of separate parts of the reflex arc, as a result of which the cough reflex can be caused by a slight irritation. In other cases, the impulse, which causes the onset of a "nervous" cough, can come from the cerebral cortex (with hysteria). The onset of a "cardiac" cough, which is observed in the presence of various heart diseases, is due to the development of concomitant congestive bronchitis or pleurisy, as well as reflex irritation that comes from the heart.

Dry cough is observed in the development of laryngitis, tracheitis, pneumosclerosis, bronchial asthma, dry pleurisy, bronchitis, if the bronchus lumen contains astringent sputum, the isolation of which is difficult. A wet cough occurs in the presence of chronic bronchitis, when the bronchi contain a liquid secret, as well as inflammation, tuberculosis, lung abscess (in case of breakthrough) and bronchiectasis. The amount of sputum depends on the nature of the disease (from 10-15 ml to 2 liters). In some patients, sputum may be clear, white, in others greenish, dirty, and also rusty, bloody. Some patients indicate a difficult sputum discharge. Sometimes it goes away in small amounts (liquid or thick), sometimes it is allocated "full mouth" (in case of breakthrough of lung abscess, development of bronchiectasis disease). Sputum can have a very unpleasant odor (in the presence of abscess and gangrene of the lungs).

Persistent coughing occurs in patients with chronic diseases of the respiratory tract and lungs (chronic laryngitis, tracheitis, bronchitis, pulmonary tuberculosis, ingress of foreign bodies). Periodic cough is observed in people. which are sensitive to cold, in the morning in smokers and patients with alcoholism, in patients with cavities in the lungs or bronchiectasis, and also after a change in body position, when sputum enters the bronchus, irritates the mucosa and causes a cough reflex. Periodic cough in the form of an attack is observed in patients with whooping cough. In the case of swelling of the vocal cords (laryngitis, whooping cough), the cough has a barking character. In patients with damage to the vocal cords (tuberculosis, syphilis, paresis due to compression from the outside of the recurrent nerve), the cough can be soundless, hoarse. Quiet cough (coughing) occurs in the first stage of croupous pneumonia, with the development of dry pleurisy and at the initial stage of tuberculosis. Night cough is observed in the presence of tuberculosis, lymphogranulomatosis, malignant tumors, when enlarged lymph nodes of the mediastinum irritate the reflexogenic zones of the trachea bifurcation, especially at night during the increase in the tone of the vagus nerve, which causes a cough reflex. Sometimes, due to irritation of the vomiting center, which is in the medulla oblongata near the cough center, a strong convulsive cough causes vomiting.