ABSTRACT
This chapter aims to approach other respiratory symptoms besides dyspnea. Starting with the incidence of each symptom in the palliative medicine population, moving into physiology, pathogenesis, and discusses the assessment and management options. Sensory nerves from larynx, pharynx, and upper respiratory tract join the vagus nerve, and then enter the nerves system near the respiratory center, terminating in the medullary cough center. The efferent part of the reflex arc is a cholinergic pathway going to the effectors, located on pharyngeal and respiratory muscles. The ineffectiveness of the cough reflex may occur when respiratory and laryngeal muscles are weakened or uncoordinated, decreasing the driving pressure, which will result in a low expiratory volume and flows during cough. The accumulation of secretions within the respiratory tract of a patient around the later stages of a terminal disease can become a burden for the patient and the caregiver(s); it is also known as “death rattle” due to its association with imminent death.
