Cough is the most common symptom of lower respiratory tract disease.

It
is caused by the mechanical or chemical stimulation of the cough receptors in
the epithelium of the pharynx, larynx, trachea and bronchi. Afferents receptors
go to the cough centre in the medulla where efferent signals are generated to
the expiratory musculature.
(Parveen Kumar, Michael Clark, Clinical Medicine 6 th Edition, Elsevier Saunders,
London, UK, 2005, page 882)
Coughing occurs when the airways are irritated. Respiratory infections usually
bacterial or viral, irritate the airways and are a common cause of coughing.
Allergies can irritate the airways as well. People who smoke often cough. Smoke
not only irritates the airways but also damages the cells that line the airways,
including the hairlike projections that normally cleanse the airways of debris
(cilia). Coughing may also result from postnasal drip, in which nasal secretions
drain down the back of the nose into the throat and sometimes into the trachea
and other airways, where they produce irritation. Coughing may result from
gastroesophageal reflux, in which stomach or esophageal contents flow
backward from the esophagus into the trachea and airways, producing irritation.
Another cause of cough can be drugs, for example, angiotensin-converting
enzyme (ACE) inhibitors. Narrowing of the airways below the windpipe
(bronchoconstriction), foreign bodies, or tumors in the airway can cause cough,
wheezing, or both. Bronchoconstriction occurs in asthma, in chronic obstructive
pulmonary disease, and heart failure (when fluid accumulates in the lungs).
Coughs vary considerably. A cough may be distressing, especially if coughing
episodes are accompanied by chest pain, shortness of breath, blood, or
unusually large amounts of or very sticky sputum. However, if coughing
increases slowly over decades, as it may in a smoker, the person may hardly be
aware of it.

Mechanism of cough

The bronchi and trachea are so sensitive to light touch that very slight amounts
of foreign matter or other causes of irritation initiate the cough reflex.

Afferent nerve impulses pass from the respiratory passages mainly through the
vagus nerves to the medulla of the brain

Deep and rapidly inspired

Epiglottis closes and the vocal cords shut tightly to entrap the air within the
lungs.

The abdominal muscles contract forcefully, pushing against the diaphragm while
other expiratory muscles such as the internal intercostals, also contract
forcefully.

The pressure in the lungs rises rapidly to as much as 100mmHg or more.

The vocal cords and the epiglottis suddenly open widely.

Air under this high pressure in the lungs explodes outward.

The rapidly moving air usually carries with it any foreign matter that is present in
the bronchi or trachea.

airway iritation

inflammation of the cavity

stimulate cough receptor on the airway

Via afferent vagus nerve to the brain(medulla oblangata-cough center)

impuls to efferent recurrent laryngeal nerve and spinal nerve also phrenic nerve and
muscle contraction against closed epiglottis

intrathoracic pressure increase and cause narrowing of trachea

suddenly glottis opened

cough(explosive expiration and aid in elimination of foreign materials and mucus)