CHEST Guidelines-Anatomy-and-Neurophysiology-of-Cough

Anatomy-and-Neurophysiology-of-Cough_chest

Pdf Summary

The CHEST Guideline and Expert Panel Report provides an in-depth exploration of the anatomy and neurophysiology of cough, centralizing on bronchopulmonary C-fibers and acid-sensitive myelinated sensory nerves that play crucial roles in regulating this reflex. These nerves are largely located in the larynx, trachea, and bronchi, emphasizing their roles in the cough reflex. The report underscores the complexity of the brainstem and higher brain control systems involved in sensory processing, pertinent to clinical phenomena such as the urge to cough and psychological treatments for cough suppression. Modern imaging has helped identify potential neural substrates linked to cough reflexes in humans.<br /><br />The report discusses peripheral interactions such as the dual-sensory neuron model, highlighting the role of C-fiber nociceptors sensitive to chemical mediators and mechanoreceptors responsive to physical stimuli. It also examines the interactions among various afferent nerves linked to cough sensitivity and examines central nervous system translations of these processes, such as creational convergence and integrated responses at the brainstem level.<br /><br />The clinical annotations consider the implications of cough reflexes in conditions like asthma, COPD, GERD, and rhinosinusitis, where cough can become excessive and harmful, affecting quality of life. This complexity leads to discussions about therapeutic strategies that balance addressing cough while preserving its defensive respiratory functions. Moreover, the understanding of how various stimuli trigger cough can guide medical approaches for effective cough management.<br /><br />In conclusion, the report considers both central and peripheral neural pathways, analyzing how cough is not just a reflex but also modulated by various sensory inputs and interactions within the nervous system. The identified patterns and interactions are critical elements for advancing strategies to treat and manage cough, informing both clinical applications and future research directions.

Keywords

cough reflex

bronchopulmonary C-fibers

acid-sensitive nerves

larynx

brainstem control

imaging

C-fiber nociceptors

asthma

COPD

therapeutic strategies