1. Of Respiratory Diseases
Major Manifestations
Of Respiratory Diseases
Dr.Fakhir Yousif

2. Objectives 1-to enumerate the main respiratory features .
2-to discuss each one of them .
3-to make approach of diagnosis .

3. 1- cough 2- sputum 3- haemoptysis 4-chest pain 5- dyspnea 6-cyanosis
Respiratory diseases share the same manifestation from simple diseases like flu to the more serious disease like bronchogenic carcinoma. So we have to concentrate on these manifestation to differentiate between them.
1- cough 2- sputum haemoptysis
4-chest pain 5- dyspnea 6-cyanosis
7-clubbing

4. cough Dry or productive: Painful or painless: Dry >> bronchitis
Productive >> smoker, chronic bronchitis
Painful or painless:
change in the pattern of cough example from normal to
bovine and the patient has horsiness of voice.
If the cough persists for more time 2-3weeks the patient should be send to the chest x-ray (CXR).

6. sputum expectorated secretions which are produced out by coughing.
*quantity: small or large.
*quality: thin or thick(purulent).
*color: white , yellow (mean there is infection) or green (must serious one).
If the sputum mixed with blood called Hemoptysis.
How we deal with sputum?
1.Gross examination.
2. Microscopical examination.

7. Investigation 1. Gram stain: for bacterial examination.
2.AFB(acid fast bacillus) :for tuberculosis.
3.Cytology: for bronchiogenic carcinoma.

8. Hemoptysis
it is coughing of blood whether mixed with the sputum or pure. It may be small in amounts or large in amounts.
The causes of large amounts of hemoptysis:
1. Bronchiectasis.
2. Lung abscess.
3. Tuberculosis.

9. CHEST PAIN
is a frequent manifestation of both cardiac and respiratory disease and is considered in detail on. Pleural or chest wall involvement by lung disease gives rise to peripheral chest pain which is exacerbated by deep breathing or coughing). Central chest pain suggests heart disease but occurs with tumours affecting the mediastinum,
oesophageal disease) or disease
of the thoracic aorta).

10. Chest pain Chest pain : Cardiac Lung Esophagus Aorta
Central :angina pectoris
Peripheral :pneumonia

11. Cardiac
Myocardial ischaemia (angina)
Myocardial infarction
Myocarditis
Pericarditis
Mitral valve prolapse syndrome
Aortic
Aortic dissection
Aortic aneurysm

12. Esophageal
Oesophagitis
Oesophageal spasm
Mallory-Weiss syndrome
Massive pulmonary embolus
Mediastinal
Tracheitis
Malignancy

13. Lungs/pleura
Pulmonary infarct
Pneumonia
Pneumothorax
Malignancy
Tuberculosis
Connective tissue disorders

14. Musculoskeletal2
Osteoarthritis
Costochondritis (Tietze's
Rib fracture/injury syndrome)
Intercostal muscle injury
Epidemic myalgia (Bornholm disease)
Neurological
Prolapsed intervertebral disc
Herpes zoster
Thoracic outlet syndrome

15. Breathlessness or dyspnea
can be defined as the feeling of an uncomfortable need to breathe. It is unusual among sensations in having no defined receptors, no localized representation in the brain, and multiple causes
both in health (e.g. exercise)
and in diseases of the
lungs, heart or muscles.

16. Dysponea : shortness of breath
Heart failure
Respiratory failure
Pneumonia
Asthma
Metabolic :diabetic ketoacidosis –renal failure

18. Asthma
Dyspnea in asthma is associated with episodes of wheeze or chest tightness, varying in severity over time, but usually worse in the morning and often waking the patient overnight. There may be a history of childhood wheeze, or of wheeze or rhinitis provoked by pollens, dusts, household pets or occupational allergens. In exercise-induced asthma, wheeze and chest tightness typically come on immediately after exercise.

19. Impaired left ventricular
Heart disease
Impaired left ventricular
function can cause exertional dyspnoea.
Orthopnea, cough and
wheeze may also be present,
as in lung disease.
A history of angina or hypertension may be useful in implicating a cardiac cause. On examination, an increase in heart size as judged by a displaced apex beat, a raised JVP and cardiac murmurs may indicate cardiac disease (although these signs can occur in severe cor pulmonale). The chest X-ray may show cardiomegaly

21. Cyanosis

22. clubbing loss of the angle between the nail and nail bed.
normally the angle 175 (less than 180 ) and becomes 180 and more in clubbing.
Clubbing characterized by :
1. Increase curvature of the nail.
2. Swelling of the terminal
phalanges (drumstick).
Causes of the clubbing:
1. Lung abscess.
2. Fibrosing alveoli.
3. Bronchiogenic carcinoma.