Thyroarytenoid muscle activity during hypocapnic central apneas in awake nonsedated lambs

1994 ◽  
Vol 76 (3) ◽  
pp. 1262-1268 ◽  
Author(s):  
I. Kianicka ◽  
J. F. Leroux ◽  
J. P. Praud
Keyword(s):  
Face Mask ◽  
Adductor Muscle ◽  
Emg Activity ◽  
Central Apnea ◽  
Upper Airways ◽  
Cricothyroid Muscle ◽  
Posterior Cricoarytenoid Muscle ◽  
Posterior Cricoarytenoid ◽  
Central Apneas ◽  
Arterial Po2

In this study, we examined whether the glottis is open or closed during central apnea and the effect of arterial PO2 (PaO2) on this control. We hyperventilated nine 11- to 30-day-old awake nonsedated lambs via a tracheostomy for 1 min to induce central apnea. Four gas mixtures (8, 15, 21, and 30% O2) were used. At the end of the hyperventilation period, the lambs were allowed to breathe spontaneously through intact upper airways. Using a pneumotachograph attached to a face mask, we measured airflow, and we continuously recorded electromyographic (EMG) activity of the thyroarytenoid (TA), the main glottic adductor muscle. We also studied the lateral cricoarytenoid muscle (LCA, laryngeal adductor), the posterior cricoarytenoid muscle (PCA, laryngeal abductor), the cricothyroid muscle (CT), and the diaphragm. We found that hyperventilation consistently induced hypocapnic central apnea in all nine lambs in hyperoxic conditions [30% inspiratory fraction of O2 (FIO2)], in eight of nine lambs in normoxia or mild hypoxia (15 and 21% FIO2), and in four of seven lambs in hypoxia (8% FIO2). During baseline room air breathing, there was no glottic adductor muscle expiratory EMG activity or expiratory airflow braking. Continuous TA EMG activity began early during hyperventilation and continued throughout the central apnea, regardless of PaO2. The first subsequent breathing efforts were marked by expiratory flow braking and expiratory activity of the TA. The LCA and the TA demonstrated the same EMG activity pattern.(ABSTRACT TRUNCATED AT 250 WORDS)

Respiratory Activity of the Rat Posterior Cricoarytenoid Muscle

1997 ◽  
Vol 106 (11) ◽  
pp. 897-901 ◽  
Author(s):  
Robert G. Berkowitz ◽  
John Chalmers ◽  
Qi-Jian Sun ◽  
Paul M. Pilowsky
Keyword(s):  
Phrenic Nerve ◽  
Muscle Activity ◽  
Electrophysiological Study ◽  
Emg Activity ◽  
Diaphragmatic Muscle ◽  
Posterior Cricoarytenoid Muscle ◽  
Inspiratory Activity ◽  
Intramuscular Nerve ◽  
Posterior Cricoarytenoid ◽  
Nerve Discharge

An anatomic and electrophysiological study of the rat posterior cricoarytenoid (PCA) muscle is described. The intramuscular nerve distribution of the PCA branch of the recurrent laryngeal nerve was demonstrated by a modified Sihler's stain. The nerve to the PCA was found to terminate in superior and inferior branches with a distribution that appeared to be confined to the PCA muscle. Electromyography (EMG) recordings of PCA muscle activity in anesthetized rats were obtained under stereotaxic control together with measurement of phrenic nerve discharge. A total of 151 recordings were made in 7 PCA muscles from 4 rats. Phasic inspiratory activity with a waveform similar to that of phrenic nerve discharge was found in 134 recordings, while a biphasic pattern with both inspiratory and post-inspiratory peaks was recorded from random sites within the PCA muscle on 17 occasions. The PCA EMG activity commenced 24.6 ± 2.2 milliseconds (p < .0001) before phrenic nerve discharge. The results are in accord with findings of earlier studies that show that PCA muscle activity commences prior to inspiratory airflow and diaphragmatic muscle activity. The data suggest that PCA and diaphragm motoneurons share common or similar medullary pre-motoneurons. The earlier onset of PCA muscle activity may indicate a role for medullary pre-inspiratory neurons in initiating PCA activity.

Specificity of esophageal electrode recordings of posterior cricoarytenoid muscle activity

1989 ◽  
Vol 66 (3) ◽  
pp. 1501-1505 ◽  
Author(s):  
G. Insalaco ◽  
G. Sant'Ambrogio ◽  
F. B. Sant'Ambrogio ◽  
S. T. Kuna ◽  
O. P. Mathew
Keyword(s):  
Marked Decrease ◽  
Upper Airway ◽  
Emg Activity ◽  
Small Reduction ◽  
Posterior Cricoarytenoid Muscle ◽  
Intramuscular Electrodes ◽  
Inspiratory Activity ◽  
Recorded Activity ◽  
Posterior Cricoarytenoid ◽  
The Right

Esophageal electrodes have been used for recording the electromyographic (EMG) activity of the posterior cricoarytenoid muscle (PCA). To determine the specificity of this EMG technique, esophageal electrode recordings were compared with intramuscular recordings in eight anesthetized mongrel dogs. Intramuscular wire electrodes were placed in the right and left PCA, and the esophageal electrode was introduced through the nose or mouth and advanced into the upper esophagus. On direct visualization of the upper airway, the unshielded catheter electrode entered the esophagus on the right or left side. Cold block of the recurrent laryngeal nerve (RLN) ipsilateral to the esophageal electrode was associated with a marked decrease in recorded activity, whereas cold block of the contralateral RLN resulted only in a small reduction in activity. After supplemental doses of anesthesia were administered, bilateral RLN cold block essentially abolished the activity recorded with the intramuscular electrodes as well as that recorded with the esophageal electrode. Before supplemental doses of anesthesia were given, especially after vagotomy, the esophageal electrode, and in some cases the intramuscular electrodes, recorded phasic inspiratory activity not originating from the PCA. Therefore, one should be cautious in interpreting the activity recorded from esophageal electrodes as originating from the PCA, especially in conditions associated with increased respiratory efforts.

Surgical Anatomy of the Recurrent Laryngeal Nerve: Implications for Laryngeal Reinnervation

2003 ◽  
Vol 112 (5) ◽  
pp. 434-438 ◽  
Author(s):  
Edward J. Damrose ◽  
Robert Y. Huang ◽  
Gerald S. Berke ◽  
Ming Ye ◽  
Joel A. Sercarz
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Adductor Muscle ◽  
Surgical Anatomy ◽  
Laryngeal Nerve ◽  
Main Trunk ◽  
Posterior Cricoarytenoid Muscle ◽  
Laryngeal Reinnervation ◽  
Human Cadavers ◽  
Muscle Groups ◽  
Posterior Cricoarytenoid

Functional laryngeal reinnervation depends upon the precise reinnervation of the laryngeal abductor and adductor muscle groups. While simple end-to-end anastomosis of the recurrent laryngeal nerve (RLN) main trunk results in synkinesis, functional reinnervation can be achieved by selective anastomosis of the abductor and adductor RLN divisions. Few previous studies have examined the intralaryngeal anatomy of the RLN to ascertain the characteristics that may lend themselves to laryngeal reinnervation. Ten human larynges without known laryngeal disorders were obtained from human cadavers for RLN microdissection. The bilateral intralaryngeal RLN branching patterns were determined, and the diameters and lengths of the abductor and adductor divisions were measured. The mean diameters of the abductor and adductor divisions were 0.8 and 0.7 mm, while their mean lengths were 5.7 and 6.1 mm, respectively. The abductor division usually consisted of one branch to the posterior cricoarytenoid muscle; however, in cases in which multiple branches were seen, at least one dominant branch could usually be identified. We conclude that the abductor and adductor divisions of the human RLN can be readily identified by an extralaryngeal approach. Several key landmarks aid in the identification of the branches to individual muscles. These data also indicate the feasibility of selective laryngeal reinnervation in patients who might be candidates for laryngeal transplantation after total laryngectomy.

Coordination between Palatal and Laryngeal Muscle Activities in Response to Rebreathing and Lung Inflation

1996 ◽  
Vol 33 (6) ◽  
pp. 459-462 ◽  
Author(s):  
Hidehiko Koizumi ◽  
Mikihiko Kogo ◽  
Tokuzo Matsuya
Keyword(s):  
Upper Airway ◽  
Adductor Muscle ◽  
The Other ◽  
Sodium Pentobarbital ◽  
Abductor Muscle ◽  
Lung Inflation ◽  
Laryngeal Muscle ◽  
Levator Veli Palatini ◽  
Posterior Cricoarytenoid Muscle ◽  
Posterior Cricoarytenoid

The soft palate and larynx play an important role in respiration and phonation, regulating the airflow in the upper airway. The levator veli palatini muscle (LVP) is the principal muscle responsible for generating palatal movements. The lateral cricoarytenoid muscle (LCA) is a laryngeal adductor muscle, and the posterior cricoarytenoid muscle (PCA) is a laryngeal abductor muscle. This study was designed to define, by electromyographic techniques, the coordination between palatal and laryngeal muscle activities in response to rebreathing and lung inflation. We performed tracheotomies on 12 mongrel dogs anesthetized with sodium pentobarbital and compared the effects of rebreathing and lung inflation on LVP activities with those on LCA and PCA activities. During rebreathing, expiratory LVP and inspiratory PCA activities were progressively augmented, but expiratory LCA activity was inhibited. On the other hand, lung inflation caused augmentation of LVP and LCA activities. In contrast, lung inflation inhibited PCA activity. We thus concluded that LVP activity coordinates with PCA activity in response to alternation of Paco2 and Pao2 levels, while it coordinates with LCA activity in response to lung inflation.

scholarly journals Obesity accentuates circadian variability in breathing during sleep in mice but does not predispose to apnea

2013 ◽  
Vol 115 (4) ◽  
pp. 474-482 ◽  
Author(s):  
Eric M. Davis ◽  
Landon W. Locke ◽  
Angela L. McDowell ◽  
Patrick J. Strollo ◽  
Christopher P. O'Donnell
Keyword(s):  
Sleep Apnea ◽  
Rem Sleep ◽  
Central Sleep Apnea ◽  
Diaphragm Muscle ◽  
Emg Activity ◽  
Central Apnea ◽  
Obese Mice ◽  
Obstructive Sleep ◽  
Central Apneas ◽  
The Impact

Obesity is a primary risk factor for the development of obstructive sleep apnea in humans, but the impact of obesity on central sleep apnea is less clear. Given the comorbidities associated with obesity in humans, we developed techniques for long-term recording of diaphragmatic EMG activity and polysomnography in obese mice to assess breathing patterns during sleep and to determine the effect of obesity on apnea generation. We hypothesized that genetically obese ob/ob mice would exhibit less variability in breathing across the 24-h circadian cycle, be more prone to central apneas, and be more likely to exhibit patterns of increased diaphragm muscle activity consistent with obstructive apneas compared with lean mice. Unexpectedly, we found that obese mice exhibited a greater circadian impact on respiratory rate and diaphragmatic burst amplitude than lean mice, particularly during rapid eye movement (REM) sleep. Central apneas were more common in REM sleep (42 ± 17 h−1) than non-REM (NREM) sleep (14 ± 5 h−1) in obese mice ( P < 0.05), but rates were not different between lean and obese mice in either sleep state. Even after experimentally enhancing central apnea generation by acute withdrawal of hypoxic chemoreceptor activation during sleep, central apnea rates remained comparable between lean and obese mice. Last, we were unable to detect patterns of diaphragmatic burst activity suggestive of obstructive apnea events in obese mice. In summary, obesity does not predispose mice to increased occurrence of central or obstructive apneas during sleep, but does lead to a more pronounced circadian variability in respiration.

Electrically Stimulated Glottal Opening Combined with Adductor Muscle Botox Blockade Restores Both Ventilation and Voice in a Patient with Bilateral Laryngeal Paralysis

2002 ◽  
Vol 111 (6) ◽  
pp. 500-506 ◽  
Author(s):  
David L. Zealear ◽  
Cheryl R. Billante ◽  
Geraldo D. Sant'anna ◽  
Mark S. Courey ◽  
James L. Netterville
Keyword(s):  
Vocal Fold ◽  
Voice Quality ◽  
Adductor Muscle ◽  
Perceptual Judgments ◽  
Optimum Parameters ◽  
Bilateral Vocal Fold Paralysis ◽  
Posterior Cricoarytenoid Muscle ◽  
Posterior Cricoarytenoid ◽  
Marginal Improvement ◽  
Stimulation Of

The purpose of this study was to determine whether paced electrical stimulation of the posterior cricoarytenoid muscle with an implantable device could restore ventilation in a patient with bilateral vocal fold paralysis without disturbing voice. In the first US case of a multi-institutional study, this patient was implanted with an Itrel II stimulator (Medtronic, Inc). In monthly postoperative sessions over an 18-month period, an effective stimulus paradigm was derived, the magnitude of stimulated vocal fold abduction and ventilation was measured, and perceptual judgments of voice quality were made. After identification of optimum parameters, posterior cricoarytenoid muscle stimulation produced a moderately large vocal fold abduction of 4 mm, but only marginal improvement in mouth ventilation, with no change in voice quality. After adductor muscle blockade with botulinum toxin, the patient's voice improved with increased phonatory airflow, but ventilation through the passive airway was still inadequate. However, by combining these Two therapeutic strategies, dynamic abduction increased to 7 mm, ventilation through the mouth surpassed that through the tracheotomy (allowing decannulation), and voice quality was restored to normal.

Posterior Cricoarytenoid Myoplasty with Medialization Thyroplasty in the Management of Refractory Abductor Spasmodic Dysphonia

2003 ◽  
Vol 112 (4) ◽  
pp. 303-306 ◽  
Author(s):  
Gary Y. Shaw ◽  
Phillip R. Sechtem ◽  
Benji Rideout
Keyword(s):  
Gold Standard ◽  
Spasmodic Dysphonia ◽  
Satisfaction Survey ◽  
Cricothyroid Muscle ◽  
Medialization Thyroplasty ◽  
Laryngeal Dystonia ◽  
Posterior Cricoarytenoid Muscle ◽  
Speech Pathologist ◽  
Posterior Cricoarytenoid ◽  
Uniform Reduction

Of the approximately 100,000 Americans with primary (idiopathic) laryngeal dystonia, 10% to 15% are thought to have the abductor form. Botulinum A toxin injected into the posterior cricoarytenoid muscle and/or cricothyroid muscle has been employed as the “gold standard” for therapeutic management; however, successful results are significantly less frequent than with injections for the adductor form. This report describes a new phonosurgical procedure, posterior cricoarytenoid myoplasty with medialization thyroplasty, designed for these refractory patients. Posterior cricoarytenoid myoplasty with medialization thyroplasty has been performed on 3 patients with abductor laryngeal dystonia. All patients had failed at least 5 previous botulinum A injections to the posterior cricoarytenoid and cricothyroid muscles. All patients underwent preoperative and 3 postoperative (2 weeks, 3 months, and 1 year) phonatory analyses. Analysis consisted of recording an aloud reading of a standard passage while a blinded trained speech pathologist counted prolonged voiceless consonants. The patients also completed a satisfaction survey at 1 year. The results demonstrated significant, long-lasting, uniform reduction in breathy breaks in all subjects. The participants all judged their symptoms as greatly improved. Bilateral procedures may be necessary, but should be staged to prevent possible airway compromise. When applied appropriately, posterior cricoarytenoid myoplasty with medialization thyroplasty is a viable tool in the management of refractory abductor laryngeal dystonia.

Study on Normal Laryngeal Electromyography of Thyroarytenoid Muscle, Cricothyroid Muscle, and Posterior Cricoarytenoid Muscle

2018 ◽  
Vol 127 (11) ◽  
pp. 806-811
Author(s):  
Xinlin Xu ◽  
Pan Yang ◽  
Peiyun Zhuang ◽  
Jiao Yanchao ◽  
Ma Yanli ◽  
...  
Keyword(s):  
Motor Unit ◽  
Physiological Activity ◽  
Motor Unit Potential ◽  
Deep Inspiration ◽  
Laryngeal Electromyography ◽  
Cricothyroid Muscle ◽  
Posterior Cricoarytenoid Muscle ◽  
Intrinsic Laryngeal Muscle ◽  
Posterior Cricoarytenoid ◽  
Thyroarytenoid Muscle

Objective: The aim of this study was to investigate the physiological activity of intrinsic laryngeal muscle under different functional states of larynx by measuring the normal laryngeal electromyography parameters. Methods: Laryngeal electromyography (EMG) was performed in 112 patients with unilateral vocal cord movement disorder. The duration and amplitude of the motor unit potential (MUP) of the thyroarytenoid muscle (TA), posterior cricoarytenoid muscle (PCA), and cricothyroid muscle (CT) were measured when patients were asked to make a deep inspiration and phonate /i/. The normal side of the patients’ vocal chords was used as the research object. Results: (1) The motor unit potential of TA, CT, and PCA were measured when inspiration and phonating /i/. Waveforms were normal. (2) There were significant differences in duration of TA between inspiration and phonating /i/ in comfortable tone. (3) When comparing the duration and amplitude of any 2 of TA, CT, and PCA during inspiration and phonating /i/, there were significant differences in duration between CT and PCA when phonating /i/ only. There were no significant differences in any other comparisons. Conclusions: Under either deep inspiration or pronunciation, the TA, CT, and PCA muscles were activated. The TA may play a major role in phonating. The PCA may play a major role in the action of deep inspiration.

Developmental changes in sequential activation of laryngeal abductor muscle and diaphragm in infants

1992 ◽  
Vol 73 (4) ◽  
pp. 1425-1431 ◽  
Author(s):  
E. C. Eichenwald ◽  
R. G. Howell ◽  
P. C. Kosch ◽  
R. A. Ungarelli ◽  
J. Lindsey ◽  
...  
Keyword(s):  
Premature Infants ◽  
Newborn Infants ◽  
Upper Airway ◽  
Full Term ◽  
Emg Activity ◽  
Term Infants ◽  
Posterior Cricoarytenoid Muscle ◽  
Human Adults ◽  
Sequential Activation ◽  
Posterior Cricoarytenoid

In animals and human adults, upper airway muscle activity usually precedes inspiratory diaphragm activity. We examined the interaction of the posterior cricoarytenoid muscle (PCA), which abducts the larynx, and the diaphragm (DIA) in the control of airflow in newborn infants to assess the effect of maturation on respiratory muscle sequence. We recorded tidal volume, airflow, and DIA and PCA electromyograms (EMG) in 12 full-term, 14 premature, and 10 premature infants with apnea treated with aminophylline. In most breaths, onset of PCA EMG activity preceded onset of DIA EMG activity (lead breaths). In all subjects, we also observed breaths (range 6–61%) in which PCA EMG onset followed DIA EMG onset (lag breaths). DIA neural inspiratory duration and the neuromechanical delay between DIA EMG onset and inspiratory flow were longer in lag than in lead breaths (P < 0.05 and P < 0.01, respectively). The frequency of lag breaths was greater in the premature infants [33 +/- 4% (SE)] than in either the full-term infants (21 +/- 3%, P < 0.03) or the premature infants with apnea treated with aminophylline (16 +/- 2%, P < 0.01). We conclude that the expected sequence of onset of PCA and DIA EMG activity is frequently disrupted in newborn infants. Both maturation and respiratory stimulation with aminophylline improve the coordination of the PCA and DIA.

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