CHEST Guidelines-Anatomy and Neurophysiology of Cough

Anatomy and Neurophysiology of Cough

Pdf Summary

The CHEST Guideline and Expert Panel Report titled "Anatomy and Neurophysiology of Cough" provides an extensive examination of the neurological and anatomical mechanisms that regulate the cough reflex. It highlights the key roles played by bronchopulmonary C-fibers and a specific subset of mechanical and acid-sensitive myelinated sensory nerves in triggering cough. The report explains how these vagal sensory nerves predominantly terminate in the larynx, trachea, and bronchi, and describes the various pathways through which the cough reflex is modulated both in the brainstem and higher brain regions.<br /><br />Furthermore, the study discusses the interactions between different afferent nerve subtypes, both peripheral and central, which can modulate the cough response. This involves the roles of pulmonary stretch receptors and their distinction from rapidly adapting receptors that may be associated with coughing mechanisms. The report also identifies the influence of conditions like GERD, asthma, and rhinosinusitis on cough, emphasizing the importance of maintaining a balance in treatment to preserve the protective function of the cough reflex while mitigating its harmful effects.<br /><br />Emphasized in the report is the complexity of the central and peripheral interactions through sensory pathways, which elucidate how certain conditions heighten cough sensitivity and change the pattern of coughing. Insights from this comprehensive study are crucial for understanding the anatomy and neurophysiology of cough, aiding in better diagnosis and targeted treatment approaches for chronic cough and related disorders. The research underscores the potential of using targeted therapies that address specific nerve pathways and interactions in both peripheral and central systems to enhance cough treatment efficacy.

Keywords

cough reflex

bronchopulmonary C-fibers

vagal sensory nerves

pulmonary stretch receptors

GERD

asthma

rhinosinusitis

chronic cough

sensory pathways

targeted therapies