Different types of Cough

Learning Objectives
By the end of the lecture, the student should be able to:
1. Describe Cough.
2. Discuss the causes of Cough.
3. Discuss the characteristics of cough
originating at various levels of
Respiratory Tract.
4. Tell us the various types of Cough.

Lecture Outline
Cough:
A cough is a defensive reflex of the body that functions to keep
the airways clear of irritating or
obstructing substances so that breathing
and the intake of oxygen is effective.
It is the most frequent symptom of
respiratory disease.

Causes of Cough:
It is caused by stimulation of sensory nerves in the mucosa of
pharynx, larynx, trachea and bronchi.

Classification of Cough:
A cough can be classified by its duration, character, quality, and
timing.
The duration can be either acute (of sudden onset) if it is present
less than three weeks, subacute if it is present between three and
eight weeks, and chronic when lasting longer than eight weeks
A cough can be dry or productive, depending on whether sputum is
coughed up. It may occur only at night, during both night and day, or
just during the day.

1.

Acute Cough:

The cause of the acute cough is usually determined by the

persons history and physical exam.

If cough is present less than three weeks.

Most commonly relates to
o Viral induced lower respiratory tract
infections.
o Post-nasal drip resulting from rhinitis or
sinusitis.
o Throat - clearing secondary to laryngitis or
pharyngitis.

Post-nasal drip: Mucous accumulation in the back of the nose and

throat leading to or giving the sensation of mucus dripping downward
from the back of the nose.

2.

Subacute Cough: if it is
present between three and
eight weeks.
The most common causes are:
o Post infectious
Cough.
o Acute Sinusitis.
o Asthma.

3. Chronic Cough:

When cough lasting longer than eight weeks.

Patients with chronic cough often represent more

of a diagnostic challenge like individuals with a
normal examination, chest radiograph and
lung function tests.

Most cough can be explained by

o Post-nasal drip secondary to nasal or
sinus disease,
o Asthma , where cough may be the
principal or exclusive clinical manifestation
Or
o Gastro-oesophageal reflux (may require ambulatory
pH monitoring or a prolonged trial of antireflux therapy
to diagnose.

4. Dry Cough:

Cough is dry i.e. there is no phlegm when a person coughs.

The throat feels itchy and scratchy due to

the dryness.

The throat pains due to excessive coughing.

It is difficult to eat due to excessive

coughing.

Fever may accompany the cough but it is not a necessary

symptom.

The dry, hacking cough is caused by:

a virus infection,
cold or dry air, or

Air pollutants such as cigarette

smog and dust. This sometimes feels
tickle at the back of your throat.

Phlegm is a sticky material from your mucous

membranes in your respiratory system. When
you have a cold it might be yellowish brown. If
there's an infection, it might be greenish brown.
Normal phlegm is usually clear.

5. Productive Cough:

Productive cough are coughs that produce phlegm, in

contrast to dry coughs.

smoke,
like a

Usually treated with expectorants that loosen mucus from the

respiratory tract.

Productive cough is associated with tuberculosis, bacterial

pneumonia, and bronchitis .
The loose productive cough is a sign of chest
congestion or infection due to colds or flu. It clears
the lungs and air passages of excess mucus.

Characteristics of cough originating at various levels

of Respiratory Tract:
Origin
Pharynx
Larynx

Causes
Post nasal drip
Laryngitis, tumor,
whooping cough,
croup

Trachea
Bronchi

Tracheitis
Acute Bronchitis and
COPD
Asthma.
Bronchial Carcinoma

Lung Parenchyma

Tuberculosis

Characteristics
Usually Persistent.
Harsh, barking,
painful, persistent,
often associated with
strider.
Painful
Dry or Productive, ,
worse in mornings.
Dry or productive,
worse at night.
Persistent often with
haemoptysis.
Productive, often with
haemoptysis.

Pneumonia

Initially Dry,
Productive later.

Bronchiectasis

Productive

Pulmonary edema

Often at night ( may

be productive)
Interstitial Fibrosis

Dry, irritant and

distressing.

Treatment:
Treatment of a cough generally involves treating the condition
causing it.

An acute infection such as

pneumonia may require antibiotics,

An asthma-induced cough
may be treated with the use of
bronchodilators, or

An antihistamine may be
administered in the case of an
allergy.

Physicians prefer not to

suppress a productive cough, since it aids the body in clearing
respiratory system of infective agents and irritants.
Cough medicines may be if the cough is not productive, as is the
case with most coughs associated with colds or flu.
The two types of drugs used to treat coughs are
antitussives and expectorants.

REFERENCES:

Davidsons Priciples and Practice of Medicine. 20th Edition.

About.com.
Answers.com