Cough: A Review of Anatomy and Physiology Cough is an airway protective reflex, which is responsible for the clearance of mucus, particulates, and foreign materials from the lower and upper airways. Normal cough production relies upon intact sensory innervation to initiate the behavior and adequate airflow to create the necessary forces for the shearing of material ... Article
Article  |   March 01, 2011
Cough: A Review of Anatomy and Physiology
Author Affiliations & Notes
  • Teresa E. Pitts
    Department of Neurology and Department of Physiological Sciences, University of Florida, Gainesville, FL
  • Donald C. Bolser
    Department of Physiological Sciences, University of Florida, Gainesville, FL
Article Information
Hearing Disorders / Swallowing, Dysphagia & Feeding Disorders / Special Populations / Older Adults & Aging / Attention, Memory & Executive Functions / Articles
Article   |   March 01, 2011
Cough: A Review of Anatomy and Physiology
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), March 2011, Vol. 20, 3-8. doi:10.1044/sasd20.1.3
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), March 2011, Vol. 20, 3-8. doi:10.1044/sasd20.1.3
Cough is an airway protective reflex, which is responsible for the clearance of mucus, particulates, and foreign materials from the lower and upper airways. Normal cough production relies upon intact sensory innervation to initiate the behavior and adequate airflow to create the necessary forces for the shearing of material from the airway wall (Ebihara et al., 2003; Fontana & Lavorini, 2006; McCool & Leith, 1987; Murty, Lancaster, & Kelly, 1991; Ross, Gramiak, & Rahn, 1955).
Cough is a three phase behavior: inspiratory, compression, and expiratory. All three phases are necessary for an effective cough. Figure 1 is a diagram of innervation of the respiratory muscles. The inspiratory phase is produced primarily by inspiratory chest wall and diaphragmatic muscle activity (Bach, Goncalves, Paez, Winck, Leitao, & Abreu, 2006; Fontana & Lavorini, 2006; Schiermeier, Schafer, Schafer, Greulich, & Schlafke, 2001) and requires coordinated action between inspiratory muscle contraction and posterior cricoarytenoid and cricothyroid intrinsic laryngeal muscle activation. The action of the diaphragm and inspiratory chest wall muscles expands the thoracic cavity—thereby increasing lung volume—and enables inspiratory airflow (Bach et al.; Fontana & Lavorini; Schiermeier et al.). The inspiratory phase lasts approximately 0.65 seconds, with the inspiratory volume varying from 50% of tidal volume to approximately 50% of vital capacity (Finnegan, Luschei, Gordon, Barkmeier, & Hoffman, 1999; Pryor, 1999; von Leden, 1965). A decreased ability to inflate the lungs decreases the potential expiratory airflow for cough (Fontana & Lavorini; Harris & Lawson, 1968) by creating a suboptimal length-tension relationship for contraction of the expiratory muscles contraction. The suboptimal length-tension relationship decreases the potential for force generation during the expiratory phase of cough.
First Page Preview
First page PDF preview
First page PDF preview ×
View Large
Become a SIG Affiliate
Pay Per View
Entire SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia) content & archive
24-hour access
This Issue
24-hour access
This Article
24-hour access
We've Changed Our Publication Model...
The 19 individual SIG Perspectives publications have been relaunched as the new, all-in-one Perspectives of the ASHA Special Interest Groups.