SIGNS AND SYMPTOMS OF
RESPIRATORY DISEASES
LEARNING OBJECTIVES:
By the end of this session, students should be able to:
 Enumerate the various symptoms of respiratory
disorders.
 Enumerate the different signs ellicitied after a clinical
examination of a patient with respiratory disorders.
 Correlate the symptoms with the signs of respiratory
distress.
 Determine the cause of respiratory distress in a patient
with particular sign or symptom
SYMPTOM:
• Patient’s subjective assessment of disease or physical
disturbance
• Problems the patient complains about or seeks relief from.
SIGN:
• Objective evidence of the presence of a disease or
disorder, as elicited by the doctor
Symptoms
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Cough
Breathlessness / dysnea
Chest pain
Hemoptysis
Syncope
Palpitations
Weight loss
Fatigue
SIGNS
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Tachypnea
Tachycardia
Cachexia
Wheezing
Sputum
Use of accessory muscles of respiration
Decreased chest expansion
Vocal Resonance
Decreased breath sounds
crepitations
COUGH
• To expel air suddenly and noisily from the lungs through the
glottis, either as the result of an involuntary muscular spasm in
the throat or to clear the air passages
Causes:
• Asthma
• Allergies
• COPD (chronic obstructive pulmonary disease)
• GERD (gastroesophageal reflux disease)
• Smoking
• Throat disorders, such as croup in young children
• Some medicines
SPUTUM
Sputum is matter that is expectorated from the respiratory tract, such
as mucus or phlegm, mixed with saliva
Types and causes:
– Serous e.g., Pulmonary edema
– Mucous e.g., chronic bronchitis, COPD, asthma
– Mucopurulent (brown, yellow, green) e.g.,
Infection
– Rusty e.g., pneumococcal pneumonia
BREATHLESSNESS
Shortness of breath; difficult or labored breathing.
 Associated sign:
Tachypnea (increased respiratory rate)
o Normal: 12/min

Causes: increased ventilatory drive and decreased ventilatory
capacity
Dyspnea with CVS patholgy:
Ischemic heart Disease
Dyspnea with Respiratory pathology:
Asthma
COPD
Emphysema
Infections (pneumonia and T.B.)
Hypoxia
Acidosis/ metablic disorders
Disorder
Acute cause Chronic cause Association
of dyspnea
of dyspnea
with exercise
Asthma
Acute on
chronic
yes
Increased
(exercise
induced)
COPD
No
Yes
Increased
Emphysema
Maybe
Yes
Increased
Lung Infections
Yes
Yes (T.B.)
(pneumonia)
Increased
Hypoxia
Yes
Yes (COPD)
Increased
Acidosis
Yes
Yes
Increased
CHEST PAIN
Chest pain is a manifestation of a number of serious conditions
and is generally considered a medical emergency.
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Associated sign:
– Tenderness on palpation (bone or muscular pathology)
– Decreased chest expansion (respiratory or cardiovascular
pathology)
CAUSES:
CENTRAL: CVS pathology, e.g, IHD
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PERIPHERAL: Respiratory pathology e.g.,
• Pneumothorax
• pulmonary embolism
• Pleurisy
• lung cancer
HEMOPTYSIS
• Spitting or coughing up blood or bloodystained sputum
Causes:
• T.B.
• Lung carcinoma
• Pneumonia
SYNCOPE
•
Temporary loss of consciousness due to generalized
cerebral ischemia
Causes:
• Pulmonary embolism
• Emphysema
• Internal bleeding
• High grade fever
• Vasovagal shock
PALPITATIONS and TACHYCARDIA
• TACHYCARDIA: A rapid heart rate, usually defined
as greater than 100 beats per minute.
• PALPITATIONS: A sensation in which a person is aware of an
irregular, hard, or rapid heartbeat.
WEIGHT LOSS
• A reduction in body mass characterized
by a loss of adipose tissue (body fat) and
skeletal muscle
• Associated sign:
– Cachexia
Causes:
• T.B.
• Lung carcinoma
• Chronic diseases e.g., COPD, asthma etc
FATIGUE
Fatigue is physical and/or mental exhaustion that can be triggered
by stress, medication, overwork, or mental and physical illness or
disease.
CAUSES:
• Infection
• Inflammation
• Trauma
• malignancy
• chronic disease e.g., COPD
• autoimmune diseases
TRACHEAL DEVIATION
Towards the side of lesion:
• Lung collapse (with or without pneumothorax on opposite
side)
• Fibrosis e.g., in bronhiectasis or cavitation
Away from the side of lesion:
• Space occupying lesion
• Fluid in the space: plueral effusion or empyema
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Air in the space: pneumothorax
USE OF ACCESSORY MUSCLES OF
RESPIRATION
ACCESSORY MUSCLES OF
RESPIRATION:
• Scalene muscles
• Sternocleidomastoid
• Trapezius
• Serratius anterior
• Pectoralis major and minor
• Latissimus dorsi
Causes:
• COPD
• Decreased vital capacity (Emphysema)
• Spinal cord injury (cervical)
DECREASED CHEST EXPANSION
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Consolidation
Lung collapse
Fibrosis
Cavitation
Pleural effusion
Empyema
pneumothorax
PERCUSSION NOTE
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DULL:
Consolidation
Collapse
Pleural effusion (stony dull)
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IMPAIRED:
Fibrosis
Cavitation
Bronchopneumonia
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HYPER-RESONANT (presence of air):
Pneumothorax
emphysema
VOCAL RESONANCE
The prolongation and intensification of sound
produced by transmission of its vibrations to a
cavity
• Increased:
Air present in the alveoli/ consolidation/ fibrosis in the
lung parenchyma e.g, Pneumonia, bronhiectasis
• Decreased:
Fluid or air present in pleural space e.g, pleural effusion,
pneumothorax
BREATH SOUNDS
Increased:
• Consolidation
• Interstitial lung disease (prolonged expiration)
Decreased:
• Collapse
• Local fibrosis
• Pleural effusion or empyema
Vesicular (prolonged expiration):
• Bronchitis
• Asthma
• Pneumonia
• emphysema
WHEEZING
• Wheezing is a high-pitched whistling sound during breathing.
• It occurs when air flows through narrowed breathing tubes
Inspiratory wheeze:
• Bronchitis
• Pneumonia
Expiratory wheeze:
• Asthma
• Emphysema
CREPITATIONS
A noise produced by pressure upon tissues
containing abnormal amounts of air, the rubbing
of fractured ends of bones, and by cracking joints
Causes:
• Consolidation
• Localized fibrosis
• Cavitation
• Pneumothorax
• Pneumonia
REFERENCES
• Davidson’s Principles and Practice of Medicine
• Hutchison’s Clinical Methods
• Medlineplus.com
• Britannica online dictionary
• Merriam-Webster dictionary