Cough

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Name of Symptom/Sign:
Cough
Classifications and external resources
ICD-10 R05
ICD-9 786.2

A cough 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; air may move through this passage at up to 480 km/h (300 mph) during a contraction. [citation needed] Coughing can also be triggered by a bolus of food going down the trachea instead of the esophagus, due to a failure of the epiglottis, although this may result in choking instead. 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, reflux (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.

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.[1]

Contents

[edit] Cause

The physiological action of coughing is responsible in part to the vagus nerve, which runs through the lungs to the brain. The vagus nerve is activated when capsaicin is released, which stimulates the sensory nerve endings. Centrally acting cough suppressants, such as codeine and dextromethorphan, reduce the urge to cough by inhibiting the capsaicin-induced sensory nerve by depolarization of the vagus nerve. One of the common presentations to the medical practitioner is dry cough. The common causes of chronic dry cough include post-nasal drip; Gastroesophageal reflux disease; Cough variant asthma; Drugs like beta blockers, ACE inhibitors, Aspirin, which should be investigated in people above 40 years; Post viral bronchial hyperresponsiveness; and Habitual Cough. When cough lasts for more than a few weeks multiple causes are likely and only when all the causes are treated will the patient be symptom free.

Beyond the physiological reasons for coughing there are also psychological reasons for coughing otherwise known as psychogenic or habit coughing. (Such as one who coughs or clears their throat before a public speech as a means to gain the attention of the audience or perhaps relieve their own nervousness) Steruphilia is a condition of loving the sound of coughing or sneezing. If one has ever sat next to someone who seems to enjoy coughing or sneezing loudly they might have hay-fever, or they might possibly be a steruphiliac.

[edit] Complications

The complications of coughing can be classified as either acute or chronic. Acute complications include cough syncope, fainting spells when coughs are prolonged and forceful due to decreased blood flow to the brain, secondary to raised intrathoracic pressure due to cough. Other acute complications include inability to sleep, cough induced vomiting, chest pain due to muscular strain of incessant coughing, rupture of bulla causing pneumothorax.In severe cases, prolonged coughing can cause fatigue fractures of lower ribs and costochondritis, an inflammation of the connective tissue between the breastbone and the ribs. Chronic complications are common. In certain cases, it can even lead to abdominal or pelvic hernias. In women with prolapse uterus, cough micturition (urination) can result, which can be a major social nuisance. Cough defecation can also occur.

[edit] 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. 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.

[edit] See also

[edit] References

  1. ^ http://health.msn.com/menshealth/articlepage.aspx?cp-documentid=100119940&GT1=7538
  • 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

[edit] External links

Retrieved from "http://en.wikipedia.org../../../c/o/u/Cough.html"