Cough Flashcards
What is the major afferent pathway in the cough reflex arc?
vagus nerve
w. in the vagus nerve: 3 main subtypes
1. Rapidly adapting receptors (RARs)
2. Slowly adapting stretch receptors (SARs)
3. C-fibers
- cough is initiated in areas supplied by the vagus (ear, pharynx, lungs, trachea, heart, and esophagus), or voluntary
Which subtype of the vagus nerve is sensitive to mechanical stimuli?
Noxious chemical stimuli?
mechanical: RARs and SARs
- bronchial obstruction, lung inflation
chemical: C-fibers
Cough according to duration
acute
subacute
chronic
acute 8 weeks
In kids: chronic >4 weeks
if its subacute, ask yourself if its post-infectious?
What disease is this? hOw to treat it?
Inflamed nasal mucosa, secretions in posterior oropharynx, can be absent.
Tickle in throat, throat clearing, hoarseness, nasal congestion, cough. Cough only symptom 20%
Upper airway cough
aka
“post nasal drip syndrome”
treatment: 1st gen antihistamine or decongestant combo
What disease is this? hOw to treat it?
Expiratory wheezing on chest exam, often absent
Intermittent wheeze, chest tightness, cough.
Can have cough variant asthma - just cough.
Asthma
Inhaled corticosteroid and bronchodilator (beta 2 agonist) for >8 weeks
What disease is this? hOw to treat it?
Edema and erythema of larynx
Heartburn, sour taste in mouth, dysphagia, cough, none
GERD
Proton pump inhibitor > 2 months, diet and lifestyle modification
What disease is this? hOw to treat it?
Nl Spirometry, Methacholine challenge. Induced sputum >3% eosinophils. No wheezing.
Inhaled corticosteroid >4 weeks
Recurrent laryngeal nerve innervates all muscles in the larynx except _________ which is controlled by the _________
cricothyroid , superior laryngeal
inspiratory vs expiratory vs biphasic stridor
inspiratory - upper airway
expiratory - lower airway
biphasic - fix obstruc. immediately subglottic
Internal branch of superior laryngeal nerve does what?
sensation
External branch of superior laryngeal nerve does what?
motor to the cricothyroid muscle
