MODIFIED RESPIRATORY ACTS. 



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irritation of the vasomotor center, and consequent contraction of the small arteries 

 This will cause an increased amount of blood to enter the veins and the right 

 heart, whose driving power increases the pulmonary edema. 



v. Basch believes that an overfilling of the pulmonary capillaries diminishes 

 the elasticity of the alveoli, thus making the latter to a certain extent more rigid 

 The expansibility, therefore, of the lungs is diminished. 



MODIFIED RESPIRATORY ACTS. 



There are a number of characteristic, partly involuntary, partly voluntary, 

 variations of the respiratory movements, to which the not altogether suitable 

 term abnormal respiratory acts has been applied. 



Coughing consists in a sudden violent expiratory effort, usually succeeding 

 a deep inspiration and closure of the glottis, during which effort the glottis is 

 sprung open, and any solid, fluid or gaseous substance that may be irritating the 

 respiratory mucous membrane is expelled. The lips are parted during this act. 

 It may be a voluntary or a reflex act, in the latter case being subject to the will 

 only to a certain degree. 



Hawking consists in a rather long expiratory effort through the narrow 

 space between the root of the tongue and the depressed soft palate for the purpose 

 of removing foreign bodies. If the hawking be accomplished in an intermittent 

 fashion, it is accompanied by a springing open of the glottis (mild, voluntary 

 coughing) . This act is performed only voluntarily. 



Sneezing consists in a sudden expiratory effort through the nose, accom- 

 panied by a sudden opening of the naso-pharynx, previously closed by the soft 

 palate. The purpose is to expel mucus or foreign bodies. It is very seldom per- 

 formed with the mouth open, and is preceded by a single or by repeated spas- 

 modic inspiration. The glottis is always wide open. This act occurs only as a 

 reflex through irritation of the sensory nerves of the nose, or as a result of a 

 bright light suddenly falling upon the retina. The reflex may be to a certain 

 extent inhibited by marked excitation of sensory nerves, such as rubbing the 

 nose, or pressing the hyoid bone forcibly upward. Habitual use of nasal irritants, 

 such as snuff, blunts the sensory nerves against reflex excitation. Coughing and 

 sneezing rarely occur simultaneously. 



Snorting and Blowing the Nose ; Snuffing ; Sniffing. Noisy, forced breathing 

 through the nose is designated snorting. Blowing the nose consists in a strong, 

 noisy, expiratory effort made through nostrils that have been narrowed, either by 

 the fingers or by the muscles of the nose and the upper lip, the object being to 

 remove either foreign bodies or mucus. Snuffing consists of drawing substances 

 up into the nose by a noisy inspiration, the mouth being closed, and the nostrils 

 often being narrowed by the action of the muscles of the nose and the upper lip. 

 Sniffing consists in drawing air up into the nose by a succession of short 

 inspiratory efforts, for the purpose of smelling. The act is frequently accompanied 

 by rustling noises and movements of the nostrils, while the mouth is held closed. 

 All these actions are voluntary. 



Snoring results from breathing with the mouth open, the current of air 

 during both inspiration and expiration causing noisy, vibrating movements of the 

 relaxed soft palate. It usually occurs involuntarily during sleep, but it may also 

 be produced voluntarily. 



Gargling consists in the noisy slow escape of the expired air in the form 

 of bubbles through a mass of fluid held between the root of the tongue and the 

 soft palate, while the head is thrown back. The act is voluntary. 



Crying is called forth by the emotions, and consists in short, deep inspira- 

 tions, with prolonged expirations, the glottis being narrowed, and the muscles of 

 the face and jaw being relaxed (with contraction of the zygomaticus minor) ; tears 

 are secreted, and lamenting, inarticulate sounds are often emitted. In conjunction 

 with intense, prolonged crying there often arise sudden, spasmodic, involuntary 

 contractions of the diaphragm, which, when attended with valve-like approxima- 

 tion of the vocal bands, give rise to the inspiratory sound known as sobbing. This 

 act is purely involuntary. The sobbing that occurs so frequently during the 

 agonal period may be explained by the electrical influence of the contraction of 

 the heart on the phrenic nerves, which become highly irritable in the act of dying. 



Sighing is a prolonged respiratory movement, usually accompanied by a 

 mournful sound, often aroused involuntarily by painful emotions. 



Laughing consists in a quick succession of short expirations through vocal 

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