Anatomy and neurophysiology of cough: CHEST Guideline and Expert Panel report.

Anatomy and neurophysiology of cough: CHEST Guideline and Expert Panel report.
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DOI:
10.1378/chest.14-1481
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发表时间:
2014-12
期刊:
影响因子:
9.6
通讯作者:
CHEST Expert Cough Panel
CHEST Expert Cough Panel
中科院分区:
医学1区
文献类型:
--
作者:
Canning BJ;Chang AB;Bolser DC;Smith JA;Mazzone SB;McGarvey L;CHEST Expert Cough Panel

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支气管平滑肌C纤维和一组机械敏感、酸敏感的有髓鞘感觉神经在调节咳嗽中起重要作用。这些迷走感觉神经主要终止于喉、气管、隆突和大的肺内支气管。其他支气管肺感觉神经、支配其他内脏的感觉神经以及支配胸壁、膈肌和腹部肌肉组织的体感神经调节咳嗽模式和咳嗽敏感性。气道迷走感觉神经亚型和肺外感觉神经调节咳嗽的反应性和形态进行了描述。处理这些感觉信息的脑干和高级大脑控制系统是复杂的,但我们目前对它们的理解是相当可观的,而且还在不断增加。这些神经系统与临床现象的相关性很高,例如咳嗽冲动和治疗消化不良的心理学方法,现代成像方法已经揭示了人类咳嗽某些特征的潜在神经基质。
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.
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