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Physiology of the Cough Reflex: Sensory and Mechanical Features

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Cough: Pathophysiology, Diagnosis and Treatment

Abstract

Cough is one of the most important airway defensive mechanisms. Reflex cough shares similar features with the corresponding voluntary or behavioral motor acts. It is triggered by nociceptive stimulation of cough-related vagal afferents arising from rapidly adapting receptors and from C-fiber endings located in the larynx and tracheobronchial tree. Rapidly adapting receptors of the upper airways probably comprise a subgroup of “cough receptors” specifically sensitive to punctate mechanical stimuli and acid. The central terminus of cough-related afferents is the nucleus tractus solitarii, where also bronchopulmonary sympathetic afferents terminate. Cough can be considered a modified respiratory act that involves upper airway and chest wall muscles, and displays three or four phases. The role of respiratory muscles during normal breathing and coughing is described and the mechanical characteristics of each cough phase and related expiratory flow are illustrated.

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Authors and Affiliations

  1. Dipartimento di Medicina Sperimentale e Clinica, Sezione Scienze Fisiologiche, Università degli Studi di Firenze, Florence, Italy

    Donatella Mutolo, Ludovica Iovino, Elenia Cinelli, Fulvia Bongianni & Tito Pantaleo

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  1. Donatella Mutolo
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  2. Ludovica Iovino
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  3. Elenia Cinelli
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  4. Fulvia Bongianni
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  5. Tito Pantaleo
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Correspondence to Donatella Mutolo .

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Editors and Affiliations

  1. Cough Study and Treatment Centre, S.I.S.Me.R., Bologna, Italy

    Alessandro Zanasi

  2. Department of Critical Care, Medicine and Surgery, University of Florence, Florence, Italy

    Giovanni A. Fontana

  3. Department of Experimental and Clinical Medicine - Section of Physiology, University of Florence, Florence, Italy

    Donatella Mutolo

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Mutolo, D., Iovino, L., Cinelli, E., Bongianni, F., Pantaleo, T. (2020). Physiology of the Cough Reflex: Sensory and Mechanical Features. In: Zanasi, A., Fontana, G., Mutolo, D. (eds) Cough: Pathophysiology, Diagnosis and Treatment. Springer, Cham. https://doi.org/10.1007/978-3-030-48571-9_1

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