scholarly journals Effortful Pitch Glide: A Potential New Exercise Evaluated by Dynamic MRI

2014 ◽  
Vol 57 (4) ◽  
pp. 1243-1250 ◽  
Author(s):  
Keri Vasquez Miloro ◽  
William G. Pearson ◽  
Susan E. Langmore
Keyword(s):  
Dynamic Mri ◽  
Anatomical Landmarks ◽  
Laryngeal Elevation ◽  
Pharyngeal Wall ◽  
Pharyngeal Muscles ◽  
Nonsignificant Difference ◽  
Kinematic Analyses ◽  
Young Subjects ◽  
Swallowing Muscles ◽  
Potential Use

Purpose The purpose of this study was to compare the biomechanics of the effortful pitch glide (EPG) with swallowing using dynamic MRI. The EPG is a combination of a pitch glide and a pharyngeal squeeze maneuver for targeting laryngeal and pharyngeal muscles. The authors hypothesized that the EPG would elicit significantly greater structural excursions of anterior hyoid, superior hyoid, hyolaryngeal approximation, laryngeal elevation, and lateral pharyngeal wall medialization compared with swallowing. Method Eleven healthy, young subjects with a mean age of 25 were recruited. The EPG was first taught and verified via laryngoscopy. Then 2-planar (coronal and sagittal) dynamic MRI acquisitions captured 10 repeated swallows and 3 EPGs. Kinematic analyses of minimum and maximum excursion of anatomical landmarks were calculated. Results Results showed a nonsignificant difference between the 2 tasks for range of excursion with all measured biomechanics except for superior hyoid, where the swallow showed significantly greater excursion. This indicated that swallowing and EPG biomechanics were comparable, lending support for the potential use of the EPG as another nonswallowing exercise. Conclusion Findings suggest EPG may be an effective exercise to target several important swallowing muscles, especially the long pharyngeal muscles that elevate the larynx and shorten the pharynx in swallowing.

Unilateral associated laryngeal paralysis due to varicella-zoster virus: virus antibody testing and videofluoroscopic findings

2007 ◽  
Vol 122 (2) ◽  
pp. 170-176 ◽  
Author(s):  
S-I Chitose ◽  
H Umeno ◽  
S Hamakawa ◽  
T Nakashima ◽  
H Shoji
Keyword(s):  
Varicella Zoster Virus ◽  
Enzyme Immunoassay ◽  
Antiviral Therapy ◽  
Immunoglobulin M ◽  
Virus Antibody ◽  
Antibody Testing ◽  
Laryngeal Elevation ◽  
Pharyngeal Wall ◽  
Varicella Zoster ◽  
Laryngeal Paralysis

AbstractThe relationship between varicella-zoster virus and idiopathic associated laryngeal paralysis was examined in five patients, using complement fixation or enzyme immunoassay testing. In all cases, significant changes in serum levels of varicella-zoster virus antibody were observed. Videofluoroscopy was useful in assessing the severity of the dysphagia and in making an accurate diagnosis; both laryngeal elevation and weakness of pharyngeal wall contraction were also observed. In two cases in which antiviral therapy was delayed, the outcome was poor, with increased levels of varicella-zoster virus immunoglobulin M found on enzyme immunoassay. The outcome of the condition may thus depend both on the speed of antiviral therapy commencement following onset of symptoms, and on the levels of varicella-zoster virus immunoglobulin M antibody (measured by enzyme immunoassay). Our study suggests that varicella-zoster virus should be considered in the differential diagnosis of patients with idiopathic associated laryngeal paralysis, and rapid antiviral therapy should be initiated when necessary.

Mechanisms of airway protection during retching, vomiting, and swallowing

2002 ◽  
Vol 283 (3) ◽  
pp. G529-G536 ◽  
Author(s):  
Ivan M. Lang ◽  
Nicole Dana ◽  
Bidyut K. Medda ◽  
Reza Shaker
Keyword(s):  
Muscle Activation ◽  
Smooth Muscles ◽  
Upper Esophageal Sphincter ◽  
Striated Muscles ◽  
Airway Protection ◽  
Laryngeal Elevation ◽  
Glottal Closure ◽  
Adductor Muscles ◽  
Pharyngeal Muscles ◽  
Subglottal Pressure

We investigated the mechanisms of airway protection and bolus transport during retching and vomiting by recording responses of the pharyngeal, laryngeal, and hyoid muscles and comparing them with responses during swallowing and responses of the gastrointestinal tract. Five dogs were chronically instrumented with electrodes on the striated muscles and strain gauges on smooth muscles. Retching and vomiting were stimulated by apomorphine (5–10 ug/kg iv). During retching, the hyoid and thyroid descending and laryngeal abductor muscles were activated; between retches, the hyoid, thyroid, and pharyngeal elevating, and laryngeal adductor muscles were activated. Vomiting always occurred during the ascending phase of retching and consisted of three sequential phases of hyoid and pharyngeal muscle activation culminating in simultaneous activation of all recorded elevating and descending laryngeal, hyoid, and pharyngeal muscles. Retrograde activation of esophagus and pharyngeal muscles occurred during the later phases, and laryngeal adductor was maximally activated in all phases of the vomit. During swallowing, the laryngeal adductor activation was followed immediately by brief activation of the laryngeal abductor. We concluded that retching functions to mix gastric contents with refluxed intestinal secretions and to impart an orad momentum to the bolus before vomiting. During retches, the airway is protected by glottal closure, and between retches, it is protected by ascent of the larynx and closure of the upper esophageal sphincter. The airway is protected by maximum glottal closure during vomiting. During swallowing, the airway is protected by laryngeal elevation and glottal closure followed by brief opening of the glottis, which may release subglottal pressure expelling material from the laryngeal vestibule.

scholarly journals The Test-Retest Reliability of Anatomical Co-Ordinate Axes Definition for the Quantification of Lower Extremity Kinematics During Running

2012 ◽  
Vol 35 (1) ◽  
pp. 15-25 ◽  
Author(s):  
Jonathan Sinclair ◽  
Paul John Taylor ◽  
Andrew Greenhalgh ◽  
Christopher James Edmundson ◽  
Darrell Brooks ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Lower Extremities ◽  
Camera Motion ◽  
Anatomical Landmarks ◽  
Kinematic Parameters ◽  
Paired Samples ◽  
Kinematic Analyses ◽  
Analysis System ◽  
Test Retest Reliability ◽  
Camera Motion Analysis

Three-dimensional (3-D) kinematic analyses are used widely in both sport and clinical examinations. However, this procedure depends on reliable palpation of anatomical landmarks and mal-positioning of markers between sessions may result in improperly defined segment co-ordinate system axes which will produce in-consistent joint rotations. This had led some to question the efficacy of this technique. The aim of the current investigation was to assess the reliability of the anatomical frame definition when quantifying 3-D kinematics of the lower extremities during running. Ten participants completed five successful running trials at 4.0 m·s-1 ± 5%. 3-D angular joint kinematics parameters from the hip, knee and ankle were collected using an eight camera motion analysis system. Two static calibration trials were captured. The first (test) was conducted prior to the running trials following which anatomical landmarks were removed. The second was obtained following completion of the running trials where anatomical landmarks were re-positioned (retest). Paired samples t-tests were used to compare 3-D kinematic parameters quantified using the two static trials, and intraclass correlations were employed to examine the similarities between the sagittal, coronal and transverse plane waveforms. The results indicate that no significant (p>0.05) differences were found between test and retest 3-D kinematic parameters and strong (R2≥0.87) correlations were observed between test and retest waveforms. Based on the results obtained from this investigation, it appears that the anatomical co-ordinate axes of the lower extremities can be defined reliably thus confirming the efficacy of studies using this technique.

scholarly journals Bulbar Signs in Normal Population

2009 ◽  
Vol 36 (1) ◽  
pp. 60-64 ◽  
Author(s):  
K S Lim ◽  
Y C Hew ◽  
H K Lau ◽  
T S Lim ◽  
C T Tan
Keyword(s):  
Normal Population ◽  
Posterior Pharyngeal Wall ◽  
The Elderly ◽  
Published Data ◽  
Healthy Population ◽  
Pharyngeal Wall ◽  
Young Males ◽  
Wide Range ◽  
Young Subjects ◽  
Systemic Examination

Background and Objectives:There is lack of published data on bulbar signs among the healthy population. This study aims to determine the range of normality of bulbar signs particularly among the elderly.Methods:Systemic examination of bulbar signs was carried out according to a predetermined protocol on a cohort of young and elderly healthy subjects.Results:A total of 206 subjects were recruited in the study, 104 young adults with mean age of 20 years, and 102 elderly with mean age of 73 years. Uvula deviation was seen in 28 (26.9%) young subjects and 22 (21.6%) elderly. Irregular tongue border was seen in 17 subjects, unilateral in 4 subjects. Fourteen (6.8%) subjects had deviation on tongue protrusion. Occasional tremor of tongue on protrusion is common in both young and old. Persistent (severe) tongue tremor on protrusion was seen in 18.6% of the elderly, and 4.8% of the young. None of the subjects had tremor of tongue at rest. In gag reflex, absence of gagging response was common in elderly, seen in two thirds of the subjects on stimulation of the posterior pharyngeal wall. However, all the subjects had uvular movement. Habituation or suppression of gagging response was seen in close to 90% of young males.Conclusion:There is wide range of normality in bulbar signs in normal population, particularly among the elderly.

Mechanisms of Recovery of Swallow After Supraglottic Laryngectomy

1994 ◽  
Vol 37 (5) ◽  
pp. 965-974 ◽  
Author(s):  
Jeri A. Logemann ◽  
Patricia Gibbons ◽  
Alfred W. Rademaker ◽  
Barbara Roa Pauloski ◽  
Peter J. Kahrilas ◽  
...  
Keyword(s):  
Posterior Pharyngeal Wall ◽  
Normal Subjects ◽  
Tongue Base ◽  
Surgical Patients ◽  
Airway Closure ◽  
Laryngeal Elevation ◽  
Pharyngeal Wall ◽  
Supraglottic Laryngectomy ◽  
Complete Contact ◽  
Base Contact

This study examines oropharyngeal swallow disorders and measures of pharyngeal and laryngeal movement during deglutition from videofluorographic studies of oropharyngeal swallow in 9 patients who had undergone supraglottic laryngectomy and 9 age-matched normal subjects. The swallows of surgical patients were examined at 2 weeks and 3 months postoperatively. Two critical factors in recovery of swallowing were identified: (a) airway closure at the laryngeal entrance, that is, the space between the arytenoid cartilage and the base of the tongue, and (b) the movement of the tongue base to make complete contact with the posterior pharyngeal wall. When patients achieved these two functions, they returned to normal swallowing. The duration of tongue base contact to the posterior pharyngeal wall and extent of anterior movement of the arytenoid increased significantly from 2 weeks to 3 months in the surgical patients. At 2 weeks postsurgery, patients who had undergone supraglottic laryngectomy exhibited significantly shorter airway closure and tongue base to pharyngeal wall contact, reduced laryngeal elevation, increased width of cricopharyngeal (CP) opening, and later onset of airway closure and tongue base movement than normal subjects. These significant differences remained at 3 months postoperatively, although swallow measures were moving toward normal in the patients who had undergone supraglottic laryngectomy. Comparison of patients not eating at 2 weeks with patients at the time of first eating revealed significantly longer duration of tongue base contact to the pharyngeal wall, longer duration of airway closure, and greater movement of the arytenoid in patients who were eating. Results indicate that the focus of swallowing therapy after supraglottic laryngectomy should be on improvement of posterior movement of the tongue base and anterior tilting of the arytenoid to close the airway entrance and improve bolus propulsion (in the case of the tongue base).

scholarly journals Respiratory kinematics and the regulation of subglottic pressure for phonation of pitch jumps – a dynamic MRI study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244539
Author(s):  
Louisa Traser ◽  
Fabian Burk ◽  
Ali Caglar Özen ◽  
Michael Burdumy ◽  
Michael Bock ◽  
...  
Keyword(s):  
Fundamental Frequency ◽  
Posterior Part ◽  
Dynamic Mri ◽  
Movement Direction ◽  
Anatomical Landmarks ◽  
Rib Cage ◽  
Voice Production ◽  
Professional Singers ◽  
Mri Study ◽  
Anterior Direction

The respiratory system is a central part of voice production as it contributes to the generation of subglottic pressure, which has an impact on voice parameters including fundamental frequency and sound pressure level. Both parameters need to be adjusted precisely during complex phonation tasks such as singing. In particular, the underlying functions of the diaphragm and rib cage in relation to the phonation of pitch jumps are not yet understood in detail. This study aims to analyse respiratory movements during phonation of pitch jumps using dynamic MRI of the lungs. Dynamic images of the breathing apparatus of 7 professional singers were acquired in the supine position during phonation of upwards and downwards pitch jumps in a high, medium, and low range of the singer’s tessitura. Distances between characteristic anatomical landmarks in the lung were measured from the series of images obtained. During sustained phonation, the diaphragm elevates, and the rib cage is lowered in a monotonic manner. During downward pitch jumps the diaphragm suddenly changed its movement direction and presented with a short inspiratory activation which was predominant in the posterior part and was associated with a shift of the cupola in an anterior direction. The magnitude of this inspiratory movement was greater for jumps that started at higher compared to lower fundamental frequency. In contrast, expiratory movement of the rib cage and anterior diaphragm were simultaneous and continued constantly during the jump. The data underline the theory of a regulation of subglottic pressure via a sudden diaphragm contraction during phonation of pitch jumps downwards, while the rib cage is not involved in short term adaptations. This strengthens the idea of a differentiated control of rib cage and diaphragm as different functional units during singing phonation.

Safety and Efficay of BION Implant During Radiation Therapy

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P45-P45
Author(s):  
Uttam K Sinha ◽  
Rizwan Masood
Keyword(s):  
Radiation Therapy ◽  
Low Frequency ◽  
Good Clinical Practice ◽  
Oral Feeding ◽  
University Of Southern California ◽  
Laryngeal Elevation ◽  
Ansa Cervicalis ◽  
Specific Complication ◽  
Swallowing Muscles ◽  
The University

Objective To determine the safety and efficacy of BION implants during radiation therapy (XRT) of head and neck cancer (HNC). The implants were placed to treat complications of muscle disuse for swallowing. Methods Three patients who underwent surgery for HNC received BION implants. The study was conducted under rules of good clinical practice under an Investigational Device Exemption from the U.S. FDA and monitored by the University of Southern California IRB. The implant was placed 2–3 mm above and parallel to the hypoglossal nerve just proximal to the origin of the ansa cervicalis. Two patients started XRT 3–4 weeks after surgery. The third patient did not need XRT. Two sets of stimulation protocols are used: low (low frequency, supramaximal twitch) and high (strong, fused contractions - 20–30pps). Results No postoperative or implant specific complication was noted. During radiation therapy, the implants were stimulated. All patients tolerated stimulation without pain or discomfort. Visible contraction of base of the tongue muscles and muscles of laryngeal elevation was observed by using an external coil. All patients received high stimulation. The patients were provided with the coils and they continue to stimulate these muscles at home 3 times a day for a total of 1h/d. All patients maintained their oral feeding and weight during treatment of cancer. Conclusions BION is safe device to implant for stimulation of swallowing muscles. It effectively stimulate the hypoglossal and ansa cervicalis nerves. Robust contraction of swallowing muscles are visible during stimulation.

scholarly journals Anatomy of inferior end of palatopharyngeus: its contribution to upper esophageal sphincter opening

2020 ◽  
Author(s):  
Keiko Fukino ◽  
Masahiro Tsutsumi ◽  
Akimoto Nimura ◽  
Koh Miwa ◽  
Takashi Ono ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Cricoid Cartilage ◽  
Upper Esophageal Sphincter ◽  
Pharyngeal Wall ◽  
Dense Connective Tissue ◽  
Pharyngeal Muscles ◽  
Inner Surface ◽  
Pulling Forces ◽  
Esophageal Sphincter ◽  
Precise Relationship

Abstract Purpose The palatopharyngeus is one of the longitudinal pharyngeal muscles which contributes to swallowing. It is reported that the palatopharyngeus has muscle bundles in various directions and with attachment sites, and each muscle bundle has a specific function. Although previous reports suggest that the palatopharyngeus is partly interlaced with some parts of the inferior constrictor, the precise relationship remains unclear. The purpose of this study was to examine the precise manner of the connection between the palatopharyngeus and inferior constrictor, and to examine the histological characteristics of this connection. Methods We examined 15 halves of nine heads from Japanese cadavers (average age: 76.1 years); 12 halves, macroscopically, and three halves, histologically. Results Our observation suggests that the palatopharyngeus spreads radially on the inner aspect of the pharyngeal wall. The most inferior portion of the palatopharyngeus extended to the inner surface of the cricopharyngeal part of the inferior constrictor. Histological analysis showed that the inferior end of the palatopharyngeus continued into the dense connective tissue located at the level of the cricoid cartilage. The dense connective tissue not only covered the inner surface of the inferior constrictor but also entered its muscle bundles and enveloped them. Conclusion Therefore, the palatopharyngeus interlaced the cricopharyngeal part of the inferior constrictor through the dense connective tissues. The findings of this study show that the palatopharyngeus may act on the upper esophageal sphincter directly and help in its opening with the aid of the pulling forces in the superolateral direction.

The growth of mica polytypes as studied by conventional and high-resolution TEM

1983 ◽  
Vol 41 ◽  
pp. 174-177
Author(s):  
A. Baronnet ◽  
M. Amouric
Keyword(s):  
Water Pressure ◽  
Point Of View ◽  
Temperature Fields ◽  
Natural Occurrence ◽  
Growth Mechanisms ◽  
Long Period ◽  
High Resolution Tem ◽  
Layer Stacking ◽  
Experimental Works ◽  
Potential Use

The origin of mica polytypes has long been a challenging problem for crystal- lographers, mineralogists and petrologists. From the petrological point of view, interest in this field arose from the potential use of layer stacking data to furnish further informations about equilibrium and/or kinetic conditions prevailing during the crystallization of the widespread mica-bearing rocks. From the compilation of previous experimental works dealing with the occurrence domains of the various mica "polymorphs" (1Mr, 1M, 2M1, 2M2 and 3T) within water-pressure vs temperature fields, it became clear that most of these modifications should be considered as metastable for a fixed mica species. Furthermore, the natural occurrence of long-period (or complex) polytypes could not be accounted for by phase considerations. This highlighted the need of a more detailed kinetic approach of the problem and, in particular, of the role growth mechanisms of basal faces could play in this crystallographic phenomenon.

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