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A morphological aspect of cough mechanism was studied by means of cinebronchography and sequential changes in the glottis and tracheobronchial tree during cough were observed.<BR>The subjects were eleven patients of various chest diseases including seven lung cancer patients. After instillation of opaque medium in the trachea, the recumbent patient was asked to produce violent cough and the motion pictures were taken at a speed of 100-120 frames per second.<BR>We could observe sequential movements of the glottis and trachea corresponding to the reported three phases of cough. During the initial inspiratory phase, the glottis opened and the trachea was widened, and a large amount of air was inspired. The second compressive phase began with a firm closure of the glottis. During this phase the caliber of the trachea almost unchanged in spite of the compression probably due to the firm closure of the glottis.<BR>The third expiratory phase was initiated by the opening of the glottis. Subsequently we could find that the contrast medium was expectorated suddenly and the trachea was compressed and narrowed. The narrowing was considered to be caused by a high pressure gradient between the pleural cavity and airway.<BR>In our study, two patients; one patient with extremely dilated trachea and another with lung cancer invaded to the lower trachea, showed only insignificant change in the tracheal caliber throughout the three phases and could not expectorate the contrast medium effectively. This finding indicated that the change in the tracheal caliber was an important part of cough mechanism as suggested by Ross.
- 特定非営利活動法人 日本気管食道科学会の論文
特定非営利活動法人 日本気管食道科学会 | 論文
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