The pathophysiological basis for insufficiency of cough seen in senile patients was examined. Flow-volume curve for patients with chronic lung disease was obtained d uring cough and maximal expiratory effort . The flow during cough was equal to maximal expiratory flow (Vmax) and Vmax decreased with an age . The chest wall configuration during cough was evaluated by Konno-Mead diagram which suggested expiratory muscle weakness and insufficient closure of vocal cords in senile patients .

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... nal shape of trachea obtained by magnetic resonance imaging (MRI) and cross sectional area of trachea obtained by CT sca n were evaluated. Longitudinal shape of trachea more curved with an age . These results suggested that deformation of trachea also contributed to the decrease in the flow during cough in senile patients.