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Harrison's Principles of Internal Medicine, 18e
| Part 2. Cardinal Manifestations and Presentation of Diseases > Section 5. Alterations in Circulatory and Respiratory Functions > |
Chapter 34. Cough and Hemoptysis
Sections: Cough, Hemoptysis, Further Readings.
Topics Discussed: cough; hemoptysis.
Excerpt:"Cough provides an essential protective function for human airways and lungs. Without an effective cough reflex, we are at risk for retained airway secretions and aspirated material, predisposing to infection, atelectasis, and respiratory compromise. At the other extreme, excessive coughing can be exhausting; can be complicated by emesis, syncope, muscular pain, or rib fractures; and can aggravate abdominal or inguinal hernias and urinary incontinence. Cough is often a clue to the presence of respiratory disease. In many instances, cough is an expected and accepted manifestation of disease, such as during an acute respiratory tract infection. However, persistent cough in the absence of other respiratory symptoms commonly causes patients to seek medical attention, accounting for as many as 10–30% of referrals to pulmonary specialists.Spontaneous cough is triggered by stimulation of sensory nerve endings that are thought to be primarily rapidly adapting receptors and C-fibers. Both chemical (e.g., capsaicin) and mechanical (e.g., particulates in air pollution) stimuli may initiate the cough reflex. A cationic ion channel, called the type-1 vanilloid receptor, is found on rapidly adapting receptors and C-fibers; it is the receptor for capsaicin, and its expression..."
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