Cough

The Cough it is the most common symptom of chest disease and represents a defensive mechanism aiming at expulsion of secretions or inhaled particles from the respiratory tract.

I The reflex cough-due to stimulation of the sensory nerves of the respiratory mucosa.
Respiratory causes:
-pharyngeal diseases:pharyngitis,post-nasal discharge,tonsillitis,tumours.Features: painful,persist and may be accompanied by nausea and vomiting.
-laryngeal diseases:laryngitis,foreign body,tumours.Features:painful,paroxysmal,harsh and may be accompanied by stridor and hoarseness of voice
-tracheal diseases:tracheitis.Features:painful,dry.
-bronchial diseases:bronchitis,bronchial asthma,bronchial tumours,bronchiectasis.features:dry or productive plus specific features to each disease.
-pleural diseases:pleurisy,pleural effusion.Features:dry cough plus specific features to each disease.
Extra-respiratory causes:
-cardiovascular diseases:pulmonary congestion,left sided heart failure(dry or productive cough),pulmonary embolism
-mediastinal causes:causes of mediastinal syndrome(brassy cough)
-abdominal diseases:subpharenic abscess
-aural causes:otitis medianor externa
-meningeal causes:meningitis.

II Central cough- due to stimulation of the cough center.
-brain tumours,ecephalitis.

III Hysterical cough
-appearce usully in young neurotic females and is presentas dry and barking cough in front of the audiance.

Hazard of cough
1.Thoracic:
-rupture of a pleural bleb
-rupture of branchial varices
-rupture of an aneurysm
-stress fracture of a rib
2.Extrathoracic:
-increased intra-abdominal pressure:hernia,rectal prolapse,stress incontinence of urine
-increased intra-ocular pressure:retinal and subconjunctival hemorrages,retinal detachement
-increased intra-cranial pressure:subarachnoid hemorrage.