The motor and premotor cortical brain regions can voluntarily initiate a cough by descending pathways that may bypass brainstem integrative centers ( 7).
Afferent inputs to the brain stem are also relayed to higher brain regions, where inputs are integrated in pontine, subcortical, and cortical nuclei ( 6). The efferent pathway of the reflex arc involves impulses that travel from the cough center via the vagus, phrenic, and spinal motor nerves to the diaphragm, abdominal wall, and muscles ( 5). Afferent impulses from these sensory fibers travel to the medulla where they are coordinated in the cough center. Elmer's tale reflects some of what we felt and how we reacted.ĭestined to Become a Collector's Item.Stimulation of sensory nerve fibers (branches of the vagus nerve) located in the ciliated epithelium of the upper airways and cardiac and esophageal branches from the diaphragm by infection, inflammation, or irritation provokes cough ( 5). Years from now others may wonder how it felt to live through those first six weeks of the pandemic. Who would have thought nearly two years after Elmer stocked up on Lysol and hand wipes we'd still be talking about "the great sickness"? Elmer's story makes for a great (maybe) nostalgic read of how it all began. If you enjoy finding silver linings in clouds and seeing the good in others, you may enjoy Elmer's efforts to practice the Golden Rule. you know, "the plague."Įlmer's story is one of hope, helping others, and finding the "light-hearted" moments in the midst of tragedy. and chronicles the first few weeks of the outbreak through the eyes of Elmer, a widower who avoids technology like it's. The Day The World Sneezed begins at the start of "the great sickness" in the U.S.
During the summer of 2020 one man traveled miles.
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