Acta Physiologica Hungarica
Volume/Issue:
Volume 87: Issue 3
The expiration reflex from the vocal folds
Authors: J. Korpas 1 and J. Jakus 1
View More View Less
  • 1 Department of Pathophysiology, Jessenius Medical School 037 53 Martin, P.O. Box 34, Slovakia
DOI:
https://doi.org/10.1556/aphysiol.87.2000.3.1
Page Count:
201–215
Publication Date:
01 Sep 2000
Online Publication Date:
22 Jul 2005
Article Category:
Research Article
Restricted access

Purchase article

USD  $25.00

1 year subscription (Individual Only)

USD  $752.00
Purchase Online Subscription

  • Purchase article

    USD  $25.00

  • 1 year subscription (Individual Only)

    USD  $752.00

The authors present their 30 years’ experience with expiration reflex. The reflex can be elicited from vocal folds by mechanical, chemical or electrical stimulation of the superior laryngeal nerve of man and laboratory animals, except mice and rats. It manifests itself by a short, forcible expiratory effort without a preceding inspiration which is indispensable for cough effort. The role of expiration reflex is to prevent penetration of foreign bodies into airways, expelling phlegm and detritus from subglottal area. The initial inspiration before expiration is undesired and could lead to inspiration pneumonia. The reflex is well known to laryngologists as „laryngeal cough.” Its receptors are small in number, localised mainly in medial margin of vocal folds deep in mucosa which can explain their stability in pathological conditions of the larygx. Afferentiation of the reflex is via laryngeal nerve similarly to sneezing and cough. Expiration reflex is not co-ordinated by a single „centre” but rather by a network system in the brain stem. Its motor pattern is supposedly produced by „multifunctional” population of medullar neurones in Bötzinger complex and the rostral ventral respiratory group involved also in the genesis of breathing and cough. However, in cats also other neurones may play a vital role in production, shaping and mediation of the motor pattern of respiratory reflex, localised in rostral pons, lateral tegmental field or in the raphe medullar midline.

  • Bongianni, F., Corda, M., Fontana, G., Paantaleo, T.: Electrophysiological properties of rostral medullar respiratory neurones in the cat: an intracellular study. J. Appl. Physiol. 65, 385-392 (1988).

    'Electrophysiological properties of rostral medullar respiratory neurones in the cat: an intracellular study ' () 65 J. Appl. Physiol. : 385 -392.

    • Search Google Scholar

  • Shannon, R., Bolser, D. C., Lindsey, B. G.: Neural control of coughing and sneezing. pp. 213-222. In: Neural Control of Respiratory Muscles, eds Miller, A. D., Bianchi, A. L., Bishop, B. P., CRC, Boca Raton 1997.

    Neural control of coughing and sneezing , () 213 -222.

  • Shannon, R., Baekey, D. M., Kendall, F. M., Lindsey, B. G.: Ventrolateral medullary respiratory network and a model of cough motor pattern generation. J. Appl. Physiol. 84, 2020-2035 (1998).

    'Ventrolateral medullary respiratory network and a model of cough motor pattern generation ' () 84 J. Appl. Physiol. : 2020 -2035.

    • Search Google Scholar

  • Stehaelin, R.: Respirationskrankheiten. Jahreskurse ärztl. Forb. 5, 32-43 (1914).

    'Respirationskrankheiten ' () 5 Jahreskurse ärztl. Forb. : 32 -43.

  • Stránsky, A., Tomori, Z.: Changes in laryngeal motoneurone activity and in laryngeal calibre during the expiration reflex. Physiol. Bohemoslov. 28, 365-373 (1979).

    'Changes in laryngeal motoneurone activity and in laryngeal calibre during the expiration reflex ' () 28 Physiol. Bohemoslov. : 365 -373.

    • Search Google Scholar

  • Sullivan, C. E., Murphy, E., Kozar, L. F., Phillipson, E. A.: Waking and ventilatory responses to laryngeal stimulation in sleeping dogs. J. Appl. Physiol. 45, 681-689 (1978).

    'Waking and ventilatory responses to laryngeal stimulation in sleeping dogs ' () 45 J. Appl. Physiol. : 681 -689.

    • Search Google Scholar

  • Sullivan, C. E., Kozar, L. F., Murphy, E., Phillipson, E. A.: Arousal, ventilatory and airway responses to bronchopulmonary stimulation in sleeping dogs. J. Appl. Physiol. 47, 17-25 (1979).

    'Arousal, ventilatory and airway responses to bronchopulmonary stimulation in sleeping dogs ' () 47 J. Appl. Physiol. : 17 -25.

    • Search Google Scholar

  • Tagaito, Y., Isono, S., Nishino, T.: Upper airway reflex during a combination of proposal and fentanyl anaesthesia. Anaesthesiology 88, 1459-1466 (1998).

    'Upper airway reflex during a combination of proposal and fentanyl anaesthesia ' () 88 Anaesthesiology : 1459 -1466.

    • Search Google Scholar

  • Bianchi, A. L., Grelot, L., Iscoe, S., Remmers, J. E.: Electrophysiological properties of rostral medullar respiratory neurones in the cat: an intracellular study. J. Physiol. (Lond.) 407, 293-310 (1988).

    'Electrophysiological properties of rostral medullar respiratory neurones in the cat: an intracellular study ' () 407 J. Physiol. (Lond.) : 293 -310.

    • Search Google Scholar

  • Bolser, D. C., Hey, J. A., Chapman, R. W.: Influence of central antitussive drugs on the cough motor pattern. J. Appl. Physiol. 86, 1017-1024 (1999).

    'Influence of central antitussive drugs on the cough motor pattern ' () 86 J. Appl. Physiol. : 1017 -1024.

    • Search Google Scholar

  • Tatár, M., Korpáš, J., Polaček, H., Záhradný, V.: Changes induced by severe hypoxia in respiratory defence reflexes in anaesthetised cats. Respir. 49, 114-121 (1986).

    'Changes induced by severe hypoxia in respiratory defence reflexes in anaesthetised cats ' () 49 Respir. : 114 -121.

    • Search Google Scholar

  • Tomori, Z., Stránsky, A.: Electroneurographic and pneumotachographic analysis of the expiration reflex. Physiol. Bohemoslov. 22, 589-601 (1973).

    'Electroneurographic and pneumotachographic analysis of the expiration reflex ' () 22 Physiol. Bohemoslov. : 589 -601.

    • Search Google Scholar

  • Tomori, Z., Stránsky, A.: Mechanisms of the expiration reflex. Bull. Physiopathol. Resp. 9, 1281 (1973).

    'Mechanisms of the expiration reflex ' () 9 Bull. Physiopathol. Resp. : 1281.

  • Tomori, Z., Lemáková, S., Gromysz, H., Stránsky, A.: Changes in the respiratory centre activity elicited by mechanical stimulation of the airways. Bull. Physiopathol. Resp. 12, 76P-78P (1976).

    'Changes in the respiratory centre activity elicited by mechanical stimulation of the airways ' () 12 Bull. Physiopathol. Resp. : 76P -78P.

    • Search Google Scholar

  • Tomori, Z., Lemáková, S., Holéczyová, A.: Defensive reflexes of the respiratory tract in dogs. Physiol. Bohemoslov. 26, 49-54 (1977).

    'Defensive reflexes of the respiratory tract in dogs ' () 26 Physiol. Bohemoslov. : 49 -54.

    • Search Google Scholar

  • Jakuš, J., Stránsky, A., Poliaček, I., Bárányi, H., Bošel'ová, L.: Effects of medullary midline lesions on cough and other airway reflexes in anaesthetised cats. Physiol. Res. 47, 203-213 (1998).

    'Effects of medullary midline lesions on cough and other airway reflexes in anaesthetised cats ' () 47 Physiol. Res. : 203 -213.

    • Search Google Scholar

  • Jakuš, J., Stránsky, A., Poliaček, I., Bárányi, H., Bošel'ová, L'.: Kainic acid lesions to the lateral tegmental field of medulla: effect on cough, expiration and aspiration reflexes in anaesthetised cats. Physiol. Res. 49, 387-398 (2000).

    'Kainic acid lesions to the lateral tegmental field of medulla: effect on cough, expiration and aspiration reflexes in anaesthetised cats ' () 49 Physiol. Res. : 387 -398.

    • Search Google Scholar

  • Jeffery, P. K., Korpáš, J., Widdicombe, J. G.: Intraepithelial nerve fibres of the cat larynx and the expiration reflex. J. Physiol. (Lond.) 275, 35P-36P (1978).

    'Intraepithelial nerve fibres of the cat larynx and the expiration reflex ' () 275 J. Physiol. (Lond.) : 35P -36P.

    • Search Google Scholar

  • Kade, F., Bucher, K.: Charakteristik der exspiratorischer Anfalle bei der Traube. Helv. Physiol. Acta 25, 241-248 (1967).

    'Charakteristik der exspiratorischer Anfalle bei der Traube ' () 25 Helv. Physiol. Acta : 241 -248.

    • Search Google Scholar

  • Kandarazki, M.: Ueber den Husten nebst einigen Bemerkungen ueber den Einfluss des Chloroforms auf die Atmung der Tiere. Pflugers Arch. ges. Physiol. 26, 470-479 (1881).

    'Ueber den Husten nebst einigen Bemerkungen ueber den Einfluss des Chloroforms auf die Atmung der Tiere ' () 26 Pflugers Arch. ges. Physiol. : 470 -479.

    • Search Google Scholar

  • Korpáš, J., Tomori, Z.: Über den Einfluss der Hypothermie auf den Husten und die Atmung. Physiol. Bohemoslov. 4, 487-493 (1957).

    'Über den Einfluss der Hypothermie auf den Husten und die Atmung ' () 4 Physiol. Bohemoslov. : 487 -493.

    • Search Google Scholar

  • Korpáš, J., Bilčik, P., Fraenkel, E.: Changes in coughing in cats with experimental or spontaneous inflammation of the respiratory tract. Physiol. Bohemoslov. 14, 488-494 (1965).

    'Changes in coughing in cats with experimental or spontaneous inflammation of the respiratory tract ' () 14 Physiol. Bohemoslov. : 488 -494.

    • Search Google Scholar

  • Korpáš, J.: Differentiation of the expiration and cough reflex. Physiol. Bohemoslov. 21, 677-680 (1972).

    'Differentiation of the expiration and cough reflex ' () 21 Physiol. Bohemoslov. : 677 -680.

    • Search Google Scholar

  • Korpáš, J., Kalocsayová, G.: Mechanoreception of the cat respiratory tract on the first days of the postnatal life. Physiol. Bohemoslov. 22, 365-373 (1973).

    'Mechanoreception of the cat respiratory tract on the first days of the postnatal life ' () 22 Physiol. Bohemoslov. : 365 -373.

    • Search Google Scholar

  • Korpáš, J., Mišík, A., Kalocsayová, G.: The expiration reflex in man. Physiol. Bohemoslov. 24, 253-256(1975).

    'The expiration reflex in man ' () 24 Physiol. Bohemoslov. : 253 -256.

  • Korpáš, J., Tatár, M.: The expiration reflex during ontogenesis in the rat. Physiol. Bohemoslov. 24, 257-261 (1975).

    'The expiration reflex during ontogenesis in the rat ' () 24 Physiol. Bohemoslov. : 257 -261.

    • Search Google Scholar

  • Korpáš, J., Mišík, A., Kalocsayová, G.: The expiration reflex during pathological conditions in man. Bull. Physiopath.Resp. 11, 107P-109P (1975).

    'The expiration reflex during pathological conditions in man ' () 11 Bull. Physiopath.Resp. : 107P -109P.

    • Search Google Scholar

  • Korpáš, J., Tomori, Z.: Cough and other respiratory reflexes. S. Karger, Basel-Munchen-Paris- London-New York-Sydney 1979, p. 368.

    Cough and other respiratory reflexes , () 368.

  • Kuhn, H. N., Friebel, H.: Zur Einordnung des Hustenstosses in den Atemrhythmus. Med. exp. 3, 329-335 (1960).

    'Zur Einordnung des Hustenstosses in den Atemrhythmus ' () 3 Med. exp. : 329 -335.

  • Laitinen, A.: Ultrastructural organisation of intraepithelial nerves in the human airway tract. Thorax 40, 488-492(1985).

    'Ultrastructural organisation of intraepithelial nerves in the human airway tract ' () 40 Thorax : 488 -492.

    • Search Google Scholar

  • Lawson, E. E., Richter, D. W., Czyzyk-Krzeska, M., Bischoff, A., Rude-Sill, R. G.: Respiratory neuronal activity during apnoe and other breathing patterns induced by laryngeal stimulation. J. Appl. Physiol. 70, 2742-2749 (1991).

    'Respiratory neuronal activity during apnoe and other breathing patterns induced by laryngeal stimulation ' () 70 J. Appl. Physiol. : 2742 -2749.

    • Search Google Scholar

  • Miller, A. D., Monaka, S., Siniaia, M. S., Jakuš, J.: Multifunctional ventral respiratory group: bulbospinal expiratory neurones play a role in pudendal discharge during vomiting. J. Autom. Nerv. system 54, 253-260(1995).

    'Multifunctional ventral respiratory group: bulbospinal expiratory neurones play a role in pudendal discharge during vomiting ' () 54 J. Autom. Nerv. system : 253 -260.

    • Search Google Scholar

  • Nishino, T., Honda, Y.: Time dependent responses of expiration reflex in cats. J. Appl. Physiol. 61, 430-435 (1986).

    'Time dependent responses of expiration reflex in cats ' () 61 J. Appl. Physiol. : 430 -435.

    • Search Google Scholar

  • Nishino, T., Hiraga, K., Miyuguchi, T., Honda, Y.: Respiratory reflex responses to stimulation of tracheal mucosa in enflurane-anaesthetised humans. J. Appl. Physiol. 65, 1069-1074 (1988).

    'Respiratory reflex responses to stimulation of tracheal mucosa in enflurane-anaesthetised humans ' () 65 J. Appl. Physiol. : 1069 -1074.

    • Search Google Scholar

  • Nishino, T., Hiraga, K., Honda, Y.: Inhibitory effects of CO2 on airways defensive reflexes in enflurane anaesthetised humans. J. Appl. Physiol. 66, 2643-2646 (1989).

    'Inhibitory effects of CO2 on airways defensive reflexes in enflurane anaesthetised humans ' () 66 J. Appl. Physiol. : 2643 -2646.

    • Search Google Scholar

  • Turčan, J., Korpáš, J., Hanáček, J.: The effect of short-term lung inflation upon the expiration reflex intensity under normal and pathological conditions in ferrets. Physiol. Bohemoslov. 80, 53-59 (1983).

    'The effect of short-term lung inflation upon the expiration reflex intensity under normal and pathological conditions in ferrets ' () 80 Physiol. Bohemoslov. : 53 -59.

    • Search Google Scholar

  • Widdicombe, J. G.: Respiratory reflexes from the trachea and bronchi of the cat. J. Physiol. (Lond.) 123, 55-70 (1954).

    'Respiratory reflexes from the trachea and bronchi of the cat ' () 123 J. Physiol. (Lond.) : 55 -70.

    • Search Google Scholar

  • Widdicombe, J. G.: Laryngeal and tracheal reflexes. pp. 279-282. In : Respiratory Physiology. Vol. 2. ed. Widdicombe, J. G., University Park Press, London-Baltimore 1974, p. 381.

    Laryngeal and tracheal reflexes , () 279 -282.

  • Widdicombe, J. G.: Neurophysiology of the cough reflex. Eur. Resp. J. 8, 1193-1202 (1995).

    'Neurophysiology of the cough reflex ' () 8 Eur. Resp. J. : 1193 -1202.

  • Dyachenko, Y. A., Preobrazhenskij, N. N.: Responses of bulbo-spinal neurones during expiration reflex in cats (Russian). Neirofiziologija 23, 88-98 (1991).

    'Responses of bulbo-spinal neurones during expiration reflex in cats (Russian) ' () 23 Neirofiziologija : 88 -98.

    • Search Google Scholar

  • Engelhorn, R., Weller, E.: Zentrale Repräsentation hustenwirksamer Afferenzen in der Medulla oblongata der Katze. Pflugers Arch. ges. Physiol. 284, 224-239 (1965).

    'Zentrale Repräsentation hustenwirksamer Afferenzen in der Medulla oblongata der Katze ' () 284 Pflugers Arch. ges. Physiol. : 224 -239.

    • Search Google Scholar

  • Fillentz, M., Widdicombe, J. G.: Receptors of the lung and airways. pp. 81-112. In: Handbook of Sensory Physiology, Vol. 3, ed. Antrum, H., Springer Verlag, Berlin 1971, and p. 233.

    Receptors of the lung and airways , () 81 -112.

  • Tomori, Z., Lemáková, S., Gromysz, H., Stránsky, A.: Changes in the respiratory centre activity elicited by mechanical stimulation of the airways. pp. 129-138. In : Respiratory centres and afferent systems, ed. Duron, B., INSERM, Paris 1976, p. 354.

    Changes in the respiratory centre activity elicited by mechanical stimulation of the airways , () 129 -138.

    • Search Google Scholar

  • Trendelenburg, U.: Über die wirkung einiger Hustenmittel auf Hustenreizschwele und Atmung. Acta physiol. scand. 21, 174-186 (1950).

    'Über die wirkung einiger Hustenmittel auf Hustenreizschwele und Atmung ' () 21 Acta physiol. scand. : 174 -186.

    • Search Google Scholar

  • Gestreau, C., Bianchi, A. L., Grélot, L.: Differential brainstem FOS-like immunoreactivity after laryngeal induced coughing and its reductions by codeine. J. Neurosci. 17, 9340-9352 (1997).

    'Differential brainstem FOS-like immunoreactivity after laryngeal induced coughing and its reductions by codeine ' () 17 J. Neurosci. : 9340 -9352.

    • Search Google Scholar

  • Hanáček, J., Korpáš, J., Kulik, A. M., Kondrateva, L. N.: Changes of electrical activity in the respiratory centre during the expiration reflex. Physiol. Bohemoslov. 26, 253-256 (1977).

    'Changes of electrical activity in the respiratory centre during the expiration reflex ' () 26 Physiol. Bohemoslov. : 253 -256.

    • Search Google Scholar

  • Holmer, B. H., Marek, W., Scheid, P.: Der Einfluss laryngealer Afferenzen auf inspiratorische und exspiratorische Nerven und Muskeln der Katze. Atemw. - Lungenkrkh. 12, 327-332 (1986).

    'Der Einfluss laryngealer Afferenzen auf inspiratorische und exspiratorische Nerven und Muskeln der Katze ' () 12 Atemw. - Lungenkrkh. : 327 -332.

    • Search Google Scholar

  • Ivančo, I., Korpáš, J.: K otázke laryngeálneho a tracheálneho kaš'a (in Slovak). Bratisl. Lek. Listy 34, 1391-1396(1954).

    'K otázke laryngeálneho a tracheálneho kaš'a (in Slovak) ' () 34 Bratisl. Lek. Listy : 1391 -1396.

    • Search Google Scholar

  • Jakuš, J., Tomori, Z., Stránsky, A.: Activity of bulbar respiratory neurones during cough and the respiratory tract reflexes in cats. Physiol. Bohemoslov. 34, 127-136 (1985).

    'Activity of bulbar respiratory neurones during cough and the respiratory tract reflexes in cats ' () 34 Physiol. Bohemoslov. : 127 -136.

    • Search Google Scholar

  • Hanáček, J., Korpáš, J.: Modification of the intensity of the expiration reflex during short-term inflation of the lungs in rabbits. Physiol. Bohemoslov. 31, 159-174 (1982).

    'Modification of the intensity of the expiration reflex during short-term inflation of the lungs in rabbits ' () 31 Physiol. Bohemoslov. : 159 -174.

    • Search Google Scholar

  • Hanáček, J., Davies, A., Widdicombe, J. G.: Influence of lung stretch receptors on the cough reflex in rabbits. Respiration 45, 161-168 (1984).

    'Influence of lung stretch receptors on the cough reflex in rabbits ' () 45 Respiration : 161 -168.

    • Search Google Scholar

  • Hayek, H.: Die menschliche Lunge. Springer Verlag, Berlin-Heidelberg-New York 1970, p. 379.

    Die menschliche Lunge , () 379.

  • Jakuš, J., Tomori, Z., Boše'ová, L', Nagyová, B., Kubinec, V.: Respiration and airway reflexes after transversal brain stem lesions in cats. Physiol. Bohemoslov. 36, 329-340 (1987).

    'Respiration and airway reflexes after transversal brain stem lesions in cats ' () 36 Physiol. Bohemoslov. : 329 -340.

    • Search Google Scholar

  • Jakuš, J., Stránsky, A., Poliaček, I., Báráni, H.: Laryngeal patency and expiration reflex following focal cold block of the medulla in cat. Physiol. Res. 45, 107-116 (1996).

    'Laryngeal patency and expiration reflex following focal cold block of the medulla in cat ' () 45 Physiol. Res. : 107 -116.

    • Search Google Scholar

  • During, M., Andres, K., H.: Structure and functional anatomy of visceroreceptors in mammalian respiratory system. pp. 139-154. In: Progress in Brain Research, eds Hamann, W., Iggo, A., Elsevier Science Publishers, Amsterdam 1988.

    Structure and functional anatomy of visceroreceptors in mammalian respiratory system , () 139 -154.

    • Search Google Scholar

  • Dyachenko, Y.: The participation of bulbar “respiratory” and “nonrespiratory” neurones in the development of the expiration reflex (Russian). Neirofiziologija 22, 670-680 (1990).

    'The participation of bulbar “respiratory” and “nonrespiratory” neurones in the development of the expiration reflex (Russian) ' () 22 Neirofiziologija : 670 -680.

    • Search Google Scholar

  • Nishino, T., Sugimori, K., Hiraga, K., Honda, Y.: Influence of CPAP on reflex responses to tracheal irritation in anaesthetised humans. J. Appl. Physiol. 67, 954-958 (1989).

    'Influence of CPAP on reflex responses to tracheal irritation in anaesthetised humans ' () 67 J. Appl. Physiol. : 954 -958.

    • Search Google Scholar

  • Nishino, T., Tagaito, Y., Issono, S.: Cough and other reflexes on irritation of airway mucosa in man. Pulm. Pharmacol. 9, 285-292 (1996).

    'Cough and other reflexes on irritation of airway mucosa in man ' () 9 Pulm. Pharmacol. : 285 -292.

    • Search Google Scholar

  • Pressman, J.J., Kelemen, G.: Physiology of the larynx. Physiol. Rev. 35, 506-554 (1955).

    'Physiology of the larynx ' () 35 Physiol. Rev. : 506 -554.

  • Widdicombe, J. G.: Afferent receptors in the airways and cough. Resp. Physiol. 114, 5-15 (1998).

    'Afferent receptors in the airways and cough ' () 114 Resp. Physiol. : 5 -15.

  • Bucher, K., Jacot, C.: Zum mechanismus des Hustens. Helv. Physiol. pharmacol. Acta 9, 454-462 (1951).

    'Zum mechanismus des Hustens ' () 9 Helv. Physiol. pharmacol. Acta : 454 -462.

  • Bucher, K.: Respiratory changes following reflexogenic expiratory twitches. Agents. Action 3, 61-65 (1973).

    'Respiratory changes following reflexogenic expiratory twitches ' () 3 Agents. Action : 61 -65.

    • Search Google Scholar
Cover Acta Physiologica Hungarica
Acta Physiologica Hungarica
Print ISSN:
0231-424X
Online ISSN:
1588-2683

Monthly Content Usage

Abstract Views Full Text Views PDF Downloads
Aug 2020 4 0 0
Sep 2020 15 0 0
Oct 2020 4 0 0
Nov 2020 24 0 0
Dec 2020 19 0 0
Jan 2021 8 0 0
Feb 2021 0 0 0