Close Up Look at The Cough

The cough.

On average, healthy adults do it 18.6 times per day.

Females, however, cough more than males. (Women may have a more sensitive cough reflex than men.)

Alas, if you have a respiratory disease, you might be doing it up to 275 times each day.

Well, we’re not here to discuss all the reasons for the cough. Those are myriad. But a recent spate of coughing had us thinking a simple question. What goes into the act of coughing from an anatomical perspective?

It turns out it’s an intricate act of many muscles and, again, one of those human functions that we all take for granted.

Coughing is your body playing defense. It’s a reflex. A cough removes secretions from the airway and prevents harmful materials from entering. It could be an errant bit of dust, it could be a swallow of water that goes down the wrong way. Suddenly, you cough.

First, the vocal cords open wide to allow more air into the lungs. Second, the epiglottis closes off the windpipe. (Epiglottis is the valve covering the larynx.). Next, those abdominal and rib muscles contract, which increases the pressure behind the epiglottis. Finally, air is forcefully expelled. That’s the rushing sound of air.

Photo by Towfiqu barbhuiya on Unsplash

And Pfizer has reported that the cough droplets can travel up to (wait for it) 500 miles per hour, which is enough force to potentially break a rib. 

If there’s an irritant to be expelled, one or two coughs might do it. If you’re got a respiratory condition going on, the coughing might be something that goes on and on.

And on.

What muscles get engaged?

The diaphragm, of course. The diaphragm (from a Greek word meaning partition) is a dome-shaped muscle and tend that plays a vital role in breathing as well as other bodily functions. It’s located below the lungs and heart. It separates the thoracic cavity (your chest) from the abdomen.

A cough also engages the intercostal muscles. Yes, all of them—the external intercostals, the internal intercostals, the innermost intercostals.

The scalene also get involved in the act.  These are a group of muscles on each side of the neck that get form an isosceles triangle. The anterior and middle scalene help pull up the first rib. The posterior scalene pulls up the second rib. (The muscle names are derived from a Greek word that means uneven.)

Of course, the sternocleidomastoid muscle is right there in the middle of the action. It’s one of the largest and most superficial cervical muscles. The primary actions of the muscle are rotation of the head to the opposite side and flexion of the neck.

There are others, but those are the major players. It’s a heck of a defensive team and, again, it’s something you don’t have to learn as a baby. It’s wired into our essence. Our nature. And, yes, the vast majority of mammals cough (but not whales or dolphins) or display other respiratory reflex.

Okay, we’ll end with something fun: a website devoted to famous coughs (and sneezes) in movie history. It’s here. 

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