Pulmonary and respiratory tract receptors.

Nervous receptors in the lungs and respiratory tract can be grouped into four general categories. 1. Deep, slowly adapting end-organs, which respond to stretch of the airway wall and have large-diameter myelinated fibres; those in the lungs are responsible for the Breuer-Hering reflex. 2. Endings in and under the epithelium which respond to a variety of chemical and mechanical stimuli (i.e. are polymodal), usually with a rapidly adapting discharge, and with small-diameter myelinated fibres; they are responsible for defensive reflexes such as cough and sneeze, and for the reflex actions to inhaled irritants and to some respiratory disease processes. 3. Receptors with nonmyelinated nerve fibres which, being polymodal, are stimulated by tissue damage and oedema and by the mediators released in these conditions; these receptors may be similar in function to 'nociceptors' in other viscera, and set up appropriate reflexes as a reaction to respiratory damage. 4. Specialized receptors such as those for taste and swallowing, and those around joints and in skeletal muscle. Stimulation of any group of receptors may cause reflex changes in breathing (including defensive reflexes), bronchomotor tone, airway mucus secretion, the cardiovascular system (including the vascular bed of the airways), laryngeal calibre, spinal reflexes and sensation. The total pattern of motor responses is unique for each group of receptors, although it is probably unusual for one type of receptor to be stimulated in isolation. The variety of patterns of motor responses must reflect the complexity of brainstem organization of these systems.