 A cough is initiated by a deep inhalation through the vocal folds, followed by the elevation of the larynx and the tight adduction (closing) of the vocal folds.The forced expiration that follows, assisted by tissue recoil and the muscles of expiration, blows the vocal folds apart, and the high pressure expels the irritating object out of the throat.Throat clearing is less violent than coughing, but is a similar increased respiratory effort countered by the tightening of the laryngeal musculature.