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Review
. 2006 Jan;129(1 Suppl):33S-47S.
doi: 10.1378/chest.129.1_suppl.33S.

Anatomy and neurophysiology of the cough reflex: ACCP evidence-based clinical practice guidelines

Brendan J Canning
Review

Anatomy and neurophysiology of the cough reflex: ACCP evidence-based clinical practice guidelines

Brendan J Canning. Chest. 2006 Jan.

Abstract

Objectives: To describe the anatomy and neurophysiology of the cough reflex.

Methods: A review of the literature was carried out using PubMed and the ISI Web of Knowledge from 1951 to 2004. Most of the referenced studies were carried out in animals

Conclusions: Studies carried out in animals provide suggestive but inconclusive evidence that C-fibers and rapidly adapting receptors (RARs) arising from the vagus nerves mediate coughing. Recent studies also have suggested that a vagal afferent nerve subtype that is not readily classified as a RAR or a C-fiber may play an important role in regulating cough. Afferent nerves innervating other viscera, as well as somatosensory nerves innervating the chest wall, diaphragm, and abdominal musculature also likely play a less essential but important accessory role in regulating cough. The responsiveness and morphology of the airway vagal afferent nerve subtypes and the extrapulmonary afferent nerves that regulate coughing are described.

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