title: Anatomy and neurophysiology of cough: CHEST Guideline and Expert Panel report.
abstract: Bronchopulmonary C-fibers and a subset of mechanically sensitive, acid-sensitive myelinated sensory nerves play essential roles in regulating cough. These vagal sensory nerves terminate primarily in the larynx, trachea, carina, and large intrapulmonary bronchi. Other bronchopulmonary sensory nerves, sensory nerves innervating other viscera, as well as somatosensory nerves innervating the chest wall, diaphragm, and abdominal musculature regulate cough patterning and cough sensitivity. The responsiveness and morphology of the airway vagal sensory nerve subtypes and the extrapulmonary sensory nerves that regulate coughing are described. The brainstem and higher brain control systems that process this sensory information are complex, but our current understanding of them is considerable and increasing. The relevance of these neural systems to clinical phenomena, such as urge to cough and psychologic methods for treatment of dystussia, is high, and modern imaging methods have revealed potential neural substrates for some features of cough in the human.
authors.affiliation: Johns Hopkins Asthma and Allergy Center, Baltimore, MD.
authors.forename: Brendan J
authors.initials: BJ
authors.lastname: Canning
authors.affiliation: Queensland Children's Respiratory Centre, Royal Children's Hospital, Brisbane, QLD, Australia, Child Health Division, Menzies School of Health, Darwin, NT, Australia.
authors.forename: Anne B
authors.initials: AB
authors.lastname: Chang
authors.affiliation: Department of Physiological Sciences, University of Florida, Gainesville, FL.
authors.forename: Donald C
authors.initials: DC
authors.lastname: Bolser
authors.affiliation: Centre for Respiratory and Allergy, University of Manchester, Manchester, England.
authors.forename: Jaclyn A
authors.initials: JA
authors.lastname: Smith
authors.affiliation: School of Biomedical Sciences, University of Queensland, Brisbane, QLD, Australia.
authors.forename: Stuart B
authors.initials: SB
authors.lastname: Mazzone
authors.affiliation: Centre for Infection and Immunity, The Queen's University of Belfast, Belfast, Northern Ireland. Electronic address: l.mcgarvey@qub.ac.uk.
authors.forename: Lorcan
authors.initials: L
authors.lastname: McGarvey
mesh_terms: D001986:Bronchial Spasm / Q000503:physiopathology; D003371:Cough / Q000503:physiopathology*; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D008465:Mechanoreceptors / Q000502:physiology; D036421:Nerve Fibers, Unmyelinated / Q000502:physiology*; D009424:Nervous System Physiological Phenomena; D012018:Reflex / Q000502:physiology; D015656:Respiratory Mechanics / Q000502:physiology*; D012132:Respiratory Muscles / Q000294:innervation; D012680:Sensitivity and Specificity; D014630:Vagus Nerve / Q000033:anatomy & histology / Q000502:physiology