scholarly journals Digestive and respiratory tract motor responses associated with eructation

2013 ◽  
Vol 304 (11) ◽  
pp. G1044-G1053 ◽  
Author(s):  
Ivan M. Lang ◽  
Bidyut K. Medda ◽  
Reza Shaker
Keyword(s):  
Respiratory Tract ◽  
Striated Muscle ◽  
Smooth Muscles ◽  
Upper Esophageal Sphincter ◽  
Gastric Distension ◽  
Thoracic Esophagus ◽  
Striated Muscles ◽  
Motor Responses ◽  
Esophageal Sphincter ◽  
Secondary Peristalsis

We studied the digestive and respiratory tract motor responses in 10 chronically instrumented dogs during eructation activated after feeding. Muscles were recorded from the cervical area, thorax, and abdomen. The striated muscles were recorded using EMG and the smooth muscles using strain gauges. We found eructation in three distinct functional phases that were composed of different sets of motor responses: gas escape, barrier elimination, and gas transport. The gas escape phase, activated by gastric distension, consists of relaxation of the lower esophageal sphincter and diaphragmatic hiatus and contraction of the longitudinal muscle of the thoracic esophagus and rectus abdominis. All these motor events promote gas escape from the stomach. The barrier elimination phase, probably activated by rapid gas distension of the thoracic esophagus, consists of relaxation of the pharyngeal constrictors and excitation of dorsal and ventral upper esophageal sphincter distracting muscles, as well as rapid contraction of the diaphragmatic dome fibers. These motor events allow esophagopharyngeal air movement by promoting retrograde airflow and opening of the upper esophageal sphincter. The transport phase, possibly activated secondary to diaphragmatic contraction, consists of a retrograde contraction of the striated muscle esophagus that transports the air from the thoracic esophagus to the pharynx. We hypothesize that the esophageal reverse peristalsis is mediated by elementary reflexes, rather than a coordinated peristaltic response like secondary peristalsis. The phases of eructation can be activated independently of one another or in a different manner to participate in physiological events other than eructation that cause gastroesophageal or esophagogastric reflux.

PS01.087: SINGLE STEP TREATMENT OF ESOPHAGEL PERFORATION CAUSED BY HUGE FOREIGN BODY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 74-74
Author(s):  
Soohwan Choi ◽  
Jae Kil Park ◽  
Seungkeun Yoon
Keyword(s):  
Foreign Body ◽  
Neck Pain ◽  
Operating Room ◽  
Esophageal Perforation ◽  
Foreign Bodies ◽  
Upper Esophageal Sphincter ◽  
Single Step ◽  
Thoracic Esophagus ◽  
Endoscopic Assistance ◽  
Esophageal Sphincter

Abstract Background If a clinician encounters a foreign body in thoracic esophagus, flexible endoscopy is the first treatment modality that comes up in mind. But if the foreign body is too huge to pass the upper esophageal sphincter or stuck in esophageal wall, removal is not easy and could result in iatrogenic injury. Furthermore, esophageal perforation is clinically fatal situation and mandates prompt surgical intervention. Here, we report our successful single step treatment of esophageal perforation caused by huge foreign body. The procedure proceeded in operating room with endoscopic assistance. Methods Medical chart review. Results 69 years old male patient admitted to emergency department complaining of neck pain. About 4 days ago, he had ingested a crab. Since then, foreign body sensation and neck pain had been persisted. Computed Tomography (CT) and endoscopy revealed perforation of cervical esophagus. We performed a surgical exploration. With left cervical collar incision, we were able to exposure the injured esophagus. Simultaneously, a gastroenterologist performed an endoscopic inspection. Foreign bodies had migrated to the thoracic esophagus. With endoscopic forceps, most of foreign bodies were removed through the patient's mouth (including the longest one, about 4centimeter; cm). But, 2.8cm sized foreign body was not able to pass the upper esophageal sphincter. Thus, the gastroenterologist pulled the foreign body to level of perforated esophagus and we removed it without difficulty. Finally, the gastroenterologist checked the total length of esophagus. There was no other perforation. Then, we did primary repair of esophagus. The patient discharged at post operation day 11 without complication. Conclusion In our case, some of foreign body was situated perpendicularly in thoracic esophagus. Therefore, it couldn’t pass the upper esophageal sphincter, which the longer one could. With endoscopic assistance in operating room, single step treatment (foreign body removal and perforation repair) was possible. In addition, full inspection of total length of esophagus was possible, simultaneously. We think this single step approach is feasible in terms of avoiding unnecessary thoracic approach and multistep procedures (endoscopy followed by surgery). Disclosure All authors have declared no conflicts of interest.

Nicotine stimulates esophageal peristaltic contractions in cats by a central mechanism

1992 ◽  
Vol 262 (3) ◽  
pp. G567-G571 ◽  
Author(s):  
B. Greenwood ◽  
E. Blank ◽  
W. J. Dodds
Keyword(s):  
Smooth Muscle ◽  
Striated Muscle ◽  
Upper Esophageal Sphincter ◽  
Smooth Muscle Contractility ◽  
Muscle Response ◽  
Central Brain ◽  
Site Of Action ◽  
Cervical Vagotomy ◽  
Esophageal Sphincter ◽  
Peristaltic Contractions

The aim of the present study was to 1) characterize nicotine-induced peristalsis in the feline esophagus and 2) determine the site of action of nicotine. Experiments were done on ketamine-sedated cats. Esophageal contractions were measured using a multilumen catheter assembly system. After recording 1 degree and 2 degrees peristaltic sequences nicotine (50-100 micrograms/kg iv) was administered. Nicotine induced a peristaltic contraction through the esophageal striated and smooth muscle part of the esophagus, which was not associated with any mylohyoid electromyogram activity or pharyngeal response, although the upper esophageal sphincter did relax. Addition of either atropine (20-50 micrograms/kg iv) or hexamethonium (10-20 mg/kg iv), a peripherally acting nicotinic antagonist, did not affect the striated muscle portion of the nicotine-induced esophageal contractile response but antagonized the smooth muscle response. However, mecamylamine (0.5-1 mg/kg iv), a ganglionic antagonist that crosses the blood-brain barrier, abolished the esophageal response to nicotine. Succinylcholine (0.5-1 mg/kg iv) abolished the striated muscle response without affecting the nicotine-induced smooth muscle contractility. Finally, the nicotine-induced peristaltic sequence was abolished after bilateral cervical vagotomy. In conclusion, nicotine, administered peripherally, activates central brain stem mechanisms that mediate a peristaltic sequence through the feline esophagus.

Correlation of electrical and contractile activities of the cricopharyngeus muscle in the cat

1997 ◽  
Vol 273 (2) ◽  
pp. G470-G479 ◽  
Author(s):  
B. K. Medda ◽  
I. M. Lang ◽  
W. J. Dodds ◽  
M. Christl ◽  
M. Kern ◽  
...  
Keyword(s):  
Nerve Stimulation ◽  
Striated Muscle ◽  
Strain Energy Function ◽  
Upper Esophageal Sphincter ◽  
Emg Activity ◽  
Active Tension ◽  
Resting Tension ◽  
Esophageal Sphincter ◽  
Decerebrate Cats ◽  
Stimulation Of

We correlated the electrical and contractile activities of the cricopharyngeus (CP) to better understand the function of the CP and the upper esophageal sphincter (UES). In 40 decerebrate cats, we recorded resting and active tension of the CP and CP force and electromyographic (EMG) activity simultaneously during electrical stimulation of the pharyngoesophageal (PE) nerve, esophageal distension, or swallowing. In six intact cats, the change in diameter of the UES during food swallows was determined in two planes using videofluoroscopy. We found that resting tension of the CP developed quickly with stretch, and the strain-energy function, y = 6.5e3.4(z-1), fit (r = 0.94 +/- 0.06) this relationship. Active tension peaked at 1.68 +/- 0.03 times resting length, which is greater than the maximum distension during swallowing. Activation and relaxation of the CP occurred in approximately 50 and 120 ms, respectively. PE nerve stimulation bilaterally caused a force equal to approximately 90% of the summed force generated by separate stimulation of each PE nerve. The magnitude of the EMG response of the contralateral CP was approximately 18% of the ipsilateral response to unilateral PE nerve stimulation. We conclude that the CP exhibits tension throughout its physiological range of stretch. The CP functions more like a bilateral than a single contiguous muscle, and more like cardiac than striated muscle with regard to its passive elastic properties.

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 An invertebrate smooth muscle with striated muscle myosin filaments

2015 ◽  
Vol 112 (42) ◽  
pp. E5660-E5668 ◽  
Author(s):  
Guidenn Sulbarán ◽  
Lorenzo Alamo ◽  
Antonio Pinto ◽  
Gustavo Márquez ◽  
Franklin Méndez ◽  
...  
Keyword(s):  
Smooth Muscle ◽  
Actin Filaments ◽  
Striated Muscle ◽  
Smooth Muscles ◽  
Structural Similarity ◽  
Striated Muscles ◽  
Muscle Tissues ◽  
Myosin Filaments ◽  
Muscle Myosin ◽  
Surprising Finding

Muscle tissues are classically divided into two major types, depending on the presence or absence of striations. In striated muscles, the actin filaments are anchored at Z-lines and the myosin and actin filaments are in register, whereas in smooth muscles, the actin filaments are attached to dense bodies and the myosin and actin filaments are out of register. The structure of the filaments in smooth muscles is also different from that in striated muscles. Here we have studied the structure of myosin filaments from the smooth muscles of the human parasite Schistosoma mansoni. We find, surprisingly, that they are indistinguishable from those in an arthropod striated muscle. This structural similarity is supported by sequence comparison between the schistosome myosin II heavy chain and known striated muscle myosins. In contrast, the actin filaments of schistosomes are similar to those of smooth muscles, lacking troponin-dependent regulation. We conclude that schistosome muscles are hybrids, containing striated muscle-like myosin filaments and smooth muscle-like actin filaments in a smooth muscle architecture. This surprising finding has broad significance for understanding how muscles are built and how they evolved, and challenges the paradigm that smooth and striated muscles always have distinctly different components.

scholarly journals Anatomy of Cowper’s gland in humans suggesting a secretion and emission mechanism facilitated by cooperation of striated and smooth muscles

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Satoru Muro ◽  
Janyaruk Suriyut ◽  
Keiichi Akita
Keyword(s):  
Smooth Muscle ◽  
Striated Muscle ◽  
Three Dimensional ◽  
Smooth Muscles ◽  
Levator Ani ◽  
Striated Muscles ◽  
External Urethral Sphincter ◽  
Macroscopic Anatomy ◽  
Dimensional Reconstruction ◽  
Perineal Muscle

AbstractThis study presents the detailed anatomy of the Cowper’s gland in humans. Elucidating the mechanism of secretion and emission of the Cowper’s gland requires analysis of the muscles around the Cowper’s gland. We hypothesized that the Cowper’s gland involves not only smooth muscle but also the striated muscles of the pelvic floor. Here, we provide comprehensive and three-dimensional anatomy of the Cowper’s gland and its surrounding structures, which overcomes the current local and planar understanding. In this study, seven male corpses of body donors were used to conduct macroscopic anatomy, histology, and three-dimensional reconstruction. The Cowper’s gland was surrounded laterally and posterosuperiorly by striated and smooth muscles, respectively. The striated muscle bundle was connected from the superficial transverse perineal muscle, levator ani, and external anal sphincter to the external urethral sphincter (rhabdosphincter). The smooth muscle was part of the deep transverse perineal muscle and entered between the bilateral Cowper’s glands and lobules. Our findings indicate that the secretion and emission of the Cowper’s gland in humans are carried out through the cooperation of striated and smooth muscles.

scholarly journals Maturation of upstream and downstream esophageal reflexes in human premature neonates: the role of sleep and awake states

2013 ◽  
Vol 305 (9) ◽  
pp. G649-G658 ◽  
Author(s):  
Sudarshan R. Jadcherla ◽  
Chin Yee Chan ◽  
Soledad Fernandez ◽  
Mark Splaingard
Keyword(s):  
Apple Juice ◽  
Upper Esophageal Sphincter ◽  
Sensory Thresholds ◽  
Stimulus Response ◽  
Sensory Motor ◽  
Postmenstrual Age ◽  
Esophageal Sphincter ◽  
Secondary Peristalsis ◽  
Motor Effects

We tested the hypothesis that the sensory-motor characteristics of aerodigestive reflexes are dependent on stimulus type and volumes, sleep or awake states, and maturation. Thirteen neonates were studied at 33.6 ± 0.5 wk ( time 1) and 37.3 ± 0.5 wk ( time 2) postmenstrual age using multimodal provocative esophageal manometry concurrent with video polysomnography. Effects of graded volumes (399 infusions at time 1, 430 infusions at time 2) of midesophageal stimulation with air, water, and apple juice on the sensory thresholds and recruitment frequency of upper esophageal sphincter (UES), esophageal body, and lower esophageal sphincter (LES) reflexes were investigated during sleep and awake states. Sensory thresholds for aerodigestive reflexes between maturational stages were similar. Increased frequency recruitment of UES contractile reflex, LES relaxation reflex, and peristaltic reflexes were noted at time 2 (all, P < 0.05). Graded stimulus-response relationships were evident at time 1 and time 2 during awake and sleep states ( P < 0.05). Secondary peristalsis vs. esophago-deglutition response proportions during sleep at time 1 vs. time 2 ( P = 0.001) and awake vs. sleep at time 2 ( P = 0.02) were distinct. We concluded that sensory-motor effects of esophageal mechanosensitivity, osmosensitivity, and chemosensitivity are advanced in sleep with maturation. Sleep further modulates the frequency recruitment and the type of aerodigestive reflexes.

Biomechanical and sensory parameters of the human esophagus at four levels

1998 ◽  
Vol 275 (2) ◽  
pp. G187-G191 ◽  
Author(s):  
Rig S. Patel ◽  
Satish S. C. Rao
Keyword(s):  
Smooth Muscle ◽  
Striated Muscle ◽  
Upper Esophageal Sphincter ◽  
Distal Esophagus ◽  
Cross Sectional ◽  
Impedance Planimetry ◽  
Biomechanical Parameters ◽  
Esophageal Sphincter ◽  
Four Levels ◽  
Sensory Parameters

The biomechanical and sensory characteristics of the lower esophageal sphincter (LES) and those of the striated and smooth muscle portions of the esophagus have not been compared in humans. Our aim was to determine sensory perception, cross-sectional area (CSA), and biomechanical parameters at different levels of the esophagus. We studied 11 healthy volunteers, using impedance planimetry. Intermittent balloon distensions (5–60 cmH2O) were performed at four sites: 1) the LES, 2) 5 cm above LES (distal), 3) 10 cm above LES (mid), and 4) 5 cm below the upper esophageal sphincter (proximal). During these distensions, CSAs, biomechanical parameters, and sensory responses were measured. The mid-esophagus had a higher ( P < 0.05) CSA than the distal esophagus. The LES had the smallest CSA ( P < 0.05). The LES and the proximal esophagus had greater ( P < 0.05) wall tension and were less ( P < 0.05) deformable than the mid- or distal esophagus. Sensory thresholds were lower ( P < 0.05) in the proximal compared with the mid- or distal esophagus. Biomechanical and sensory parameters are not uniform along the length of the esophagus. The striated muscle portion is more sensitive and less compliant than the smooth muscle portion. These differences could affect the results of balloon distension tests of the esophagus.

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