scholarly journals Ponto-medullary nuclei involved in the generation of sequential pharyngeal swallowing and concomitant protective laryngeal adductionin situ

2014 ◽  
Vol 592 (12) ◽  
pp. 2605-2623 ◽  
Author(s):  
Tara G. Bautista ◽  
Mathias Dutschmann
Keyword(s):  
Pharyngeal Swallowing ◽  
Medullary Nuclei

Functional Anatomy Underlying Pharyngeal Swallowing Mechanics and Swallowing Performance Goals

2019 ◽  
Vol 4 (4) ◽  
pp. 648-655
Author(s):  
William G. Pearson ◽  
Jacline V. Griffeth ◽  
Alexis M. Ennis
Keyword(s):  
Functional Anatomy ◽  
Neuromuscular Control ◽  
Upper Esophageal Sphincter ◽  
Performance Goals ◽  
Laryngeal Elevation ◽  
Port Closure ◽  
Swallowing Dysfunction ◽  
Hyoid Movement ◽  
Pharyngeal Swallowing ◽  
Pharyngeal Constriction

Purpose Rehabilitation of pharyngeal swallowing dysfunction requires a thorough understanding of the functional anatomy underlying the performance goals of pharyngeal swallowing. These goals include the safe and efficient transfer of a bolus through the hypopharynx into the esophagus. Penetration or aspiration of a bolus threatens swallowing safety. Bolus residue indicates swallowing inefficiency. Several primary mechanics, or elements of the swallowing mechanism, underlie these performance goals, with some elements contributing to both goals. These primary mechanics include velopharyngeal port closure, hyoid movement, laryngeal elevation, pharyngeal shortening, tongue base retraction, and pharyngeal constriction. Each element of the swallowing mechanism is under neuromuscular control and is therefore, in principle, a potential target for rehabilitation. Secondary mechanics of pharyngeal swallowing, those movements dependent on primary mechanics, include opening the upper esophageal sphincter and epiglottic inversion. Conclusion Understanding the functional anatomy of pharyngeal swallowing underlying swallowing performance goals will facilitate anatomically informed critical thinking in the rehabilitation of pharyngeal swallowing dysfunction.

Videofluoroscopic Swallow Study Findings and Correlations in Infancy of Children with Cerebral Palsy

2021 ◽  
pp. 000348942110267
Author(s):  
Amit Narawane ◽  
Christina Rappazzo ◽  
Jean Hawney ◽  
James Eng ◽  
Julina Ongkasuwan
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Demographic Data ◽  
Early Infancy ◽  
Gross Motor ◽  
Laryngeal Penetration ◽  
Swallowing Dysfunction ◽  
Swallow Study ◽  
Pharyngeal Swallowing ◽  
Tracheal Aspiration

Objectives: Cerebral palsy (CP) in infants can affect global motor function and lead to swallowing difficulties. This study aims to characterize oral and pharyngeal swallowing dynamics in infancy of patients later diagnosed with CP and to determine if swallow study performance in early infancy is associated with later CP severity and characteristics. Methods: This is a retrospective chart review of infants who underwent videofluoroscopic swallow studies (VFSS) between 6/2008 and 10/2018 at a tertiary children’s hospital, and were later diagnosed with CP. Demographic data, CP characteristics and metrics, and VFSS findings were collected and analyzed. Results: There were 66 patients included in this study. The average age at the time of VFSS was 4 months (range: 0.3-12 months), 42% of patients were female, and 50% of patients were born premature. In our sample, 86% of patients presented with oral dysphagia, and 76% with pharyngeal dysphagia. Laryngeal penetration in isolation was seen in 39% of patients, and tracheal aspiration was seen in 38% of patients. Of these tracheal aspiration events, 64% were silent. At the time of VFSS, 58% of patients had a nasogastric tube, 12% had a gastrostomy tube, and 3% had a prior hospitalization for pneumonia. Rates of penetration and aspiration in early infancy did not consistently correlate with prematurity, type of CP (spastic, non-spastic, or mixed), degree of paralysis (quadriplegic, hemiplegic, or diplegic), or severity of Gross Motor Function Classification System (GMFCS) score. Conclusion: While there was not a consistent correlation of swallowing dynamics in infancy with later gross motor categorizations of CP, the results of this retrospective review highlight the essential role of early clinical and videofluoroscopic swallowing evaluations to identify oral and pharyngeal swallowing dysfunction in this patient population.

Comparison of the cortical representation of volitional and reflexive (pharyngeal) swallowing

2000 ◽  
Vol 118 (4) ◽  
pp. A853
Author(s):  
Mark K. Kern ◽  
Ronald C. Arndorfer ◽  
James S. Hyde ◽  
Reza Shaker
Keyword(s):  
Cortical Representation ◽  
Pharyngeal Swallowing

Distribution of vagal cardioinhibitory neurons in the medulla of the cat

1980 ◽  
Vol 238 (1) ◽  
pp. R57-R64 ◽  
Author(s):  
J. Ciriello ◽  
F. R. Calaresu
Keyword(s):  
Nucleus Tractus Solitarius ◽  
Border Region ◽  
Nucleus Ambiguus ◽  
Motor Nucleus ◽  
Dorsal Motor Nucleus ◽  
Antidromic Stimulation ◽  
Low Threshold ◽  
Vagal Bradycardia ◽  
Medullary Nuclei ◽  
Stimulation Of

Experiments were done in cats anesthetized with chloralose, paralyzed and artificially ventilated cats to obtain electrophysiological evidence on the medullary site of origin of vagal cardioinhibitory fibers. The regions of the nucleus ambiguus (AMB), dorsal motor nucleus of the vagus (DMV), nucleus tractus solitarius (NTS), and external cuneate nucleus (ECN) were systematically explored for units responding both to antidromic stimulation of the cardiac branches of the vagus (CBV) and to orthodromic stimulation of the carotid sinus and aortic depressor nerves. Eighty-six single units conforming to these criteria were found in the medulla: 30 in the AMB, 26 in the DMV, 12 in the NTS, 8 in the NTS-DMV border region, and 10 in the ECN. Antidromically evoked spikes had durations of 0.5--2.5 ms and followed stimulation frequencies of 20--500 Hz. The axons of these units conducted at velocities of 3.3--20.8 m/s. The specificity of activation of medullary units by cardioinhibitory fibers was tested in 11 units, which were found to respond consistently with an antidromic spike to stimulation of CBV but not to stimulation of the thoracic vagus. In eight spinal animals low threshold (less than 15 microA) sites eliciting vagal bradycardia were found in the same medullary nuclei where cardioinhibitory units had been located. These results indicate that vagal cardioinhibitory axons, originate in at least three medullary nuclei, the AMB, DMV, and NTS. Unit activity from the ECN may have been recorded from carioinhibitory fibers because of the short duration of the spike potentials.

Pharyngeal swallowing elicited by fluid infusion: role of volition and vallecular containment

1996 ◽  
Vol 270 (2) ◽  
pp. G347-G354 ◽  
Author(s):  
P. Pouderoux ◽  
J. A. Logemann ◽  
P. J. Kahrilas
Keyword(s):  
Spatial Distribution ◽  
Infusion Rate ◽  
Volitional Control ◽  
Flow Rates ◽  
Fluid Infusion ◽  
Water Infusion ◽  
Pharyngeal Swallow ◽  
Pharyngeal Swallowing ◽  
Temperature Water

Nonalimentary swallows minimize aspiration by clearing accumulated fluid from the pharynx. This study aimed to define 1) the pharyngeal sensory field to elicit swallowing and 2) the effect of infusion rate, volition, taste, and temperature on pharyngeal swallows. Test solutions were directed into the valleculae at 6.5, 11.5, and 32 ml/min through a catheter in eight healthy volunteers. Deglutition was signaled with electromyography and electroglottography. Spatial distribution of infusate before swallowing was studied using videofluoroscopy coupled with a video timer. Volitional control was assessed with rapid or restrained swallows. Pharyngeal swallow latency decreased as the instillation rate increased, was potently modified with volition, and was unchanged by infusate taste or temperature. Water infusion into the valleculae did not trigger pharyngeal swallowing until liquids overflowed and reached the aryepiglottic folds or pyriform sinuses. The variation in swallow latency among flow rates was mainly due to the duration of liquid containment within the valleculae. This suggests that the valleculae act to contain pharyngeal secretions and residue and prevent aspiration by diverting their contents around the larynx before swallowing.

Sign in / Sign up

Export Citation Format

Share Document