Friday, March 11, 2011

Coughing up Phlegm

Coughing up Phlegm, At this opportunity we are faced with a man came into poly disease with symptoms of cough with phlegm in thick and many since 3 months and not reduced despite already treated with a variety of cough medicine. Cough has been going on for 2 years but sometimes subside, and this time gain weight. Previously people with a heavy smoker and worked in chemical plants. On physical examination: an impression of the thorax and the images thorax emfisematous hiperlusen impression.

Coughing up Phlegm, Coughing is a symptom of the most common respiratory disease, functioning, especially for lung defense against the entry of foreign objects. Both the healthy and the sick, the cough can be realized (volunteers) or unconscious (involuntary). Coughing is a conscious response to the feeling of something in the airway. Coughing that occurs due to an unconscious reflex that is triggered by stimulation of sensory receptors larynx, trachea, or bronchi to the alveoli are large or loss of lung compliance. Cough said if there are huge numbers of abnormal and not suitable or formed sputum. (Stark, 1990; Rumende, 2007)

Diekspektorasi sputum is the material of lower respiratory tract by coughing, which is mixed saliva. Normal bronchial secretion not enough to diekspektorasi, usually applied to the larynx by the action of cilia and swallowed. Views sputum may help the diagnosis, although the food or drink that has just swallowed may contaminate the sputum. Sputum can be distinguished from saliva. Spit (saliva) will form clear bubbles on the top of the liquid in the container for sputum, sputum was on this rarely happens except in pulmonary edema. (Stark, 1990)

In this case, the hypothesis writers tend to patients experiencing chronic bronchitis. It is found in cough with phlegm thick persistent, getting worse despite treatment. Chronic cough (cough smoker) and mukoid sputum (phlegm thick) are the only symptoms of chronic bronchitis (stark, 1990). Possible if the symptoms are more thoroughly searched, the nature of cough, bronchitis chronic persistent cough with phlegm every morning on a smoker's bronchitis and sputum are mukoid with clear sputum grayish (Rumende, 2007).

In certain circumstances a narrow bronchial lumen may become narrowed because of mucus and bronchial muscle contraction. Mucus is secreted to retrieve the trapped pathogens and dirt particles. Cilia carry the mucus from the epithelium lining the esophagus to be swallowed.

Because the cilia can not push a thick mucus, electrolyte solution is usually issued to encourage the mucus from the cilia so that mucus can move forward into the esophagus in a thin layer of liquid. Lumen narrowing due to bronchial muscle work, which increases the likelihood of arrest by mucosal pathogens. But its loss causes resistance to increase (obstructive lung disease) (Lang, 2007).

Bronchitis is a clinical disorder characterized by excessive mucus formation in bronchial and manifests as chronic cough and sputum formation for at least 3 months in a year, at least in 2 consecutive years. Pathological findings in chronic bronchitis are bronchial mucous gland hypertrophy and increased number and size of goblet cells with infiltration of inflammatory cells and bronchial mucosal edema. Increased mucus formation which resulted in typical symptoms of productive cough.

Chronic cough is accompanied by increased bronchial secretions appear to affect the small bronchioles to become damaged and the walls are widening. The main etiologic factor is cigarette smoking and industrial air pollution.

Air pollution continues to be the predisposing recurrent infections due to pollution slows cilia activity and phagocytosis, thus increasing pile of mucus and weakened defense mechanisms (Wilson, 2006). This diagnosis should be suspected in older smokers (Stark, 1990). On physical examination, thorax emfisematosa impression because there is a pathological collection of air (Dorland, 2009).

Thoracic emphysema (barrel-shape) has a characteristic form of: (1) Dada bulge, (2) Antero-posterior diameter greater than the diameter of the latero-lateral, (3) The backbone costa kifosis and angle> 90 ˚ (Rumende, 2007). Photo thorax hiperlusen impression because of how much air collects in the lungs than normal.

Sputum: Material that is driven out of the trachea, bronchi, and lungs through the mouth

Mucus: Mucus free mucous membrane, composed of glandular secretion, various salts, which berdeskuamasi cells, and leukocytes.

Kifosis: Curvatura vertebrae excessively curved toward the anterior.

Mukoporulen: Containing mucus and pus

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