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Information about Cough

Name of Symptom/Sign:
Cough
Classifications and external resources
ICD-10R05.
ICD-9786.2
A cough, also known as tussis is a sudden, often repetitive, spasmodic contraction of the thoracic cavity, resulting in violent release of air from the lungs, and usually accompanied by a distinctive sound.

Coughing is an action the body takes to get rid of substances that are irritating the air passages. A cough is usually initiated to clear a buildup of phlegm in the trachea. Coughing can also be triggered by a bolus of food entering the trachea rather than the esophagus due to a failure of the epiglottis. Frequent or chronic coughing usually indicates the presence of a disease. Provided the patient is a non-smoker and has a normal chest X-ray, the cause of chronic cough in 93% of all patients is due to asthma, heartburn or post-nasal drip. Other causes of chronic cough include chronic bronchitis and medications such as ACE inhibitors. Coughing can happen voluntarily as well as involuntarily.

Physiology

A cough is a protective, primitive reflex in healthy individuals. The cough reflex is initiated by stimulation of two different classes of afferent nerves, namely the myelinated rapidly adapting receptors, and nonmyelinated C-fibers with endings in the lungs.

Cause

A persistent cough can be debilitating, socially distressing, and adversely impair quality of life.[1] One of the more common presentations to a medical practitioner is a dry cough. The common causes of chronic dry coughing include post-nasal drip, gastroesophageal reflux disease, asthma, post viral cough and certain drugs such as beta blockers, ACE inhibitors and aspirin. If a cough lasts for more than three weeks, multiple causes are likely and symptoms will abate only when all the causes are treated will the patient be symptom free. Individuals who smoke often have a smoker's cough, a loud, hacking cough which often results in the expiration of phlegm.

Coughing may also be used for psychological or social reasons, such as the coughing before giving a speech. This is known as psychogenic, habit or tic coughing, and may increase in frequency in social situations featuring conflict.[2]

Given its irritant nature to mammal tissues, capsaicin is widely used to determine the cough threshold and as a tussive stimulant in clinical research of cough suppressants.

Complications

The complications of coughing can be classified as either acute or chronic. Acute complications include cough syncope (fainting spells due to decreased blood flow to the brain when coughs are prolonged and forceful), insomnia, cough-induced vomiting, rupture of blebs causing spontaneous pneumothorax, subconjunctival hemorrhage or "red eye", coughing defecation and in women with a prolapsed uterus, cough urination. Chronic complications are common and include abdominal or pelvic hernias, fatigue fractures of lower ribs and costochondritis.

Treatment

Coughs can be treated with cough medicines. Dry coughs are treated with cough suppressants (antitussives) that suppress the body's urge to cough, while productive coughs (coughs that produce phlegm) are treated with expectorants that loosen mucus from the respiratory tract. Centrally acting cough suppressants, such as codeine and dextromethorphan reduce the urge to cough by inhibiting the response of the sensory endings by depolarization of the vagus nerve. A recent study indicates that, because of the presence of theobromine in chocolate, 50 grams of dark chocolate may be an effective treatment for a persistent cough.[1]

Gargling with salt and warm water can also be helpful by reducing phlegm.

During injections

Coughing during an injection can lessen the pain of the needle stick caused by a sudden, temporary rise in pressure in the chest and spinal canal, inhibiting the pain-conducting structures of the spinal cord.[3]

See also

References

1. ^ Omar S. Usmani, Maria G. Belvisi, Hema J. Patel, Natascia Crispino, Mark A. Birrell, Marta Korbonits, Dezso Korbonits, and Peter J. Barnes (2005). "Theobromine inhibits sensory nerve activation and cough." (in english) (pdf). The FASEB Journal 19: 231-233. 
2. ^ Arella, A. (nd), Coughing as an Indicator of Displacement Behaviour, <[1] (Unpublished thesis)
3. ^ Usichenko, TI; Pavlovic D, Foellner S & Wendt M. (2004). "Reducing venipuncture pain by a cough trick: a randomized crossover volunteer study". Anesthesia and Analgesia 99 (3): 952-3. PMID 14742367. Retrieved on 2007-07-16. 
  • McCool F (2006). "Global physiology and pathophysiology of cough: ACCP evidence-based clinical practice guidelines.". Chest 129 (1 Suppl): 48S-53S. PMID 16428691. Full text

External links

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Symptoms and signs (R00-R69, )
Circulatory and
respiratory systems		Tachycardia - Bradycardia - Palpitation - Heart murmur - Nosebleed - Hemoptysis - Cough - abnormalities of breathing (Dyspnea, Orthopnoea, Stridor, Wheeze, Cheyne-Stokes respiration, Hyperventilation, Mouth breathing, Hiccup, Bradypnea, Hypoventilation) - Chest pain - Asphyxia - Pleurisy - Respiratory arrest - Sputum - Bruit
Digestive system and abdomenAbdominal pain - Acute abdomen - Nausea - Vomiting - Heartburn - Dysphagia - Flatulence - Burping - Fecal incontinence - Encopresis - Hepatomegaly - Splenomegaly - Hepatosplenomegaly - Jaundice - Ascites - Fecal occult blood - Halitosis
Skin and subcutaneous tissuedisturbances of skin sensation (Hypoesthesia, Paresthesia, Hyperesthesia) - Rash - Cyanosis - Pallor - Flushing - Petechia - Desquamation - Induration
Nervous and
musculoskeletal systems		abnormal involuntary movements (Tremor, Spasm, Fasciculation, Athetosis) - Gait abnormality - lack of coordination (Ataxia, Dysmetria, Dysdiadochokinesia, Hypotonia) - Tetany - Meningism - Hyperreflexia
Urinary systemDysuria - Vesical tenesmus - Urinary incontinence - Urinary retention - Oliguria - Polyuria - Nocturia
Cognition, perception,
emotional state and behaviour		Anxiety - Somnolence - Coma - Amnesia (Anterograde amnesia, Retrograde amnesia) - Dizziness/Vertigo - smell and taste (Anosmia, Ageusia, Parosmia, Parageusia)
Speech and voicespeech disturbances (Dysphasia, Aphasia, Dysarthria) - symbolic dysfunctions (Dyslexia, Alexia, Agnosia, Apraxia, Acalculia, Agraphia) - voice disturbances (Dysphonia, Aphonia)
General symptoms and signsFever (Hyperpyrexia) - Headache - Chronic pain - Malaise - Fatigue - Fainting (Vasovagal syncope) - Febrile seizure - Shock (Cardiogenic shock) - Lymphadenopathy - Edema (Peripheral edema, Anasarca) - Hyperhidrosis (Sleep hyperhidrosis) - Delayed milestone - Failure to thrive - food and fluid intake (Anorexia, Polydipsia, Polyphagia) - Cachexia - Xerostomia - Clubbing
The term symptom (from the Greek σύμπτωμα meaning 'chance', 'mishap' or 'casualty', itself derived from συμπιπτω
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Simply, a sign is an indication of some fact or quality; and, in everyday English, a medical sign is an "objective" indication of some medical fact or quality that is detected by a physician during a physical examination of a patient—such as elevated
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For other uses of "ICD", see ICD (disambiguation).


The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD
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List of ICD-10 codes. The version for 2007 is available online at [1]

Chapter Blocks Title
I Certain infectious and parasitic diseases
II Neoplasms
III Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
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For other uses of "ICD", see ICD (disambiguation).


The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD
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The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. These codes are in the public domain.

See also


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Muscle spasm
Classifications and external resources

ICD-10 R 25.2
ICD-9 728.85

A spasm is a sudden, involuntary contraction of a muscle, a group of muscles, or a hollow organ, or a similarly sudden contraction of an orifice.
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The thoracic cavity (or chest cavity) is the chamber of the human body (and other animal bodies) that is protected by the thoracic wall (thoracic cage and associated skin, muscle, and fascia).
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lungs flank the heart and great vessels in the chest cavity.[1]]]

The lung is the essential respiration organ in air-breathing vertebrates, the most primitive being the lungfish.
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Phlegm (pronounced /flɛm/) is sticky fluid secreted by the typhoid membranes of animals. Its definition is limited to the mucus produced by the respiratory system, excluding that from the nasal passages, and particularly
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trachea, or windpipe, is a tube that has an inner diameter of about 20-25 mm and a length of about 10-16cm. It extends from the larynx to the primary (main) bronchi in mammals, and from the pharynx to the syrinx in birds, allowing the passage of air to the lungs.
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In digestion, a bolus (from Latin bolus, ball) is a round mass of organic matter moving through the digestive tract. A bolus is initially shaped through chewing and swallowing of food and maintained as peristalsis moves it through the intestines, eventually being released as feces.
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The esophagus (also spelled oesophagus/œsophagus, Greek οἰσοφάγος), or gullet
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The epiglottis is a lid-like flap of elastic cartilage tissue covered with a mucus membrane, attached to the root of the tongue. It projects obliquely upwards behind the tongue and the hyoid bone.
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In medicine, a chronic disease is a disease that is long-lasting or recurrent. The term chronic describes the course of the disease, or its rate of onset and development.
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disease is an abnormal condition of an organism that impairs bodily functions. In human beings, "disease" is often used more broadly to refer to any condition that causes discomfort, dysfunction, distress, social problems, and/or death to the person afflicted, or similar problems
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X-rays (or Röntgen rays) are a form of electromagnetic radiation with a wavelength in the range of 10 to 0.01 nanometers, corresponding to frequencies in the range 30 PHz to 30 EHz. X-rays are primarily used for diagnostic radiography and crystallography.
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Asthma
Classification & external resources

ICD-10 J 45.
ICD-9 493

OMIM 600807
DiseasesDB 1006
MedlinePlus 000141
eMedicine med/177   emerg/43

MeSH C08.127.
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Heartburn
Classifications and external resources

ICD-10 R 12.
ICD-9 787.1

This article is about the medical condition. For the film see Heartburn (film).

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Post-nasal drip (PND) occurs when excessive mucus is produced by the sinuses. The excess mucus accumulates in the throat or back of the nose. It can be caused by rhinitis, sinusitis, or laryngopharyngeal acid reflux.
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Classification

Acute bronchitis

Main article: Acute bronchitis

Chronic bronchitis

Main article: Chronic bronchitis

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ACE inhibitors, or inhibitors of Angiotensin-Converting Enzyme, are a group of pharmaceuticals that are used primarily in treatment of hypertension and congestive heart failure, in most cases as the drugs of first choice.
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ReFLEX is a wireless protocol developed by Motorola which is used for two-way paging. It is based on the one-way FLEX protocol and comes in two variants, ReFLEX25 and ReFLEX50. Later version 2.7 of the ReFLEX protocol was released. Devices compliant with ReFLEX 2.7.
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afferent neurons--otherwise known as sensory or receptor neurons--carry nerve impulses from receptors or sense organs toward the central nervous system. This is the case vice versa as well. This term can also be used to describe relative connections between structures.
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Myelin is an electrically insulating phospholipid layer that surrounds the axons of many neurons. It is an outgrowth of glial cells: Schwann cells supply the myelin for peripheral neurons while oligodendrocytes supply it to those of the central nervous system.
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C-fibers are part of the human sensory system, the part of the nervous system responsible for processing sensory information.

They are unmyelinated and as a result, have a slower conduction velocity than other nerve fibers, lower than 2 m/s.
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lungs flank the heart and great vessels in the chest cavity.[1]]]

The lung is the essential respiration organ in air-breathing vertebrates, the most primitive being the lungfish.
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Post-nasal drip (PND) occurs when excessive mucus is produced by the sinuses. The excess mucus accumulates in the throat or back of the nose. It can be caused by rhinitis, sinusitis, or laryngopharyngeal acid reflux.
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MeSH D005764 Gastroesophageal Reflux Disease (GERD; or GORD when spelling œsophageal, the BrE form) is defined as chronic symptoms or mucosal damage produced by the abnormal reflux in the esophagus[1].
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Asthma
Classification & external resources

ICD-10 J 45.
ICD-9 493

OMIM 600807
DiseasesDB 1006
MedlinePlus 000141
eMedicine med/177   emerg/43

MeSH C08.127.
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