A biomechanical response of the esophagus participates in swallowing.
A biomechanical response of the esophagus participates in swallowing.
复制标题
食道的生物力学反应参与吞咽。
DOI：
10.1152/ajpgi.00219.2022
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Shaker,Reza
中科院分区：
文献类型：
--
作者：
Lang,IvanM;Medda,BidyutK;Kern,Mark;Shaker,Reza
有证据表明，生物力学过程参与食道功能，但尚未确定这种功能。我们研究了30只失脑猫在吞咽过程中生物力学过程的作用，使用肌电图（EMG）电极、应变式力传感器和压力测量仪进行测量。我们发现颈部食道在咽部吞咽期（CTPP）有短暂的周向张力反应，并伴有肌电反应。CTPP的大小与颏舌肌收缩的大小、喉抬高力和食管伸长力相关。CTPP的大小与伴随食管肌电反应的峰值或曲线下面积无关。通过物理力量或横断舌下神经限制喉部抬高可减少或消除吞咽时的CTPP。颈远端食管的延伸增加了颈食管基底周向张力以及CTPP。横断迷走神经或咽食管神经，或静脉注射己糖胺，对CTPP无显著影响。我们得出结论，CTPP是吞咽咽期喉部抬高时食道伸长的反应，不是由肌肉收缩引起的，也不是由神经系统介导的。CTPP可能在吞咽食管期激活前协助丸体的远端运动，并可能用于防止食管咽反流。我们假设CTPP是由颈食管伸长应力引起的颈食管周缘结缔组织弹性的生物力学下降。咽期吞咽包括咽期吞咽（CTPP）期间颈部食道圆周张力增加。CTPP是由喉抬高时食道伸长引起的生物力学反应，不是由肌肉收缩引起或由神经系统介导的。CTPP可能在吞咽食管期激活前协助丸体的远端运动，并可能用于防止食管咽反流。
Evidence suggests that a biomechanical process participates in esophageal function, but no such function has yet been identified. We investigated the role of a biomechanical process during swallowing in 30 decerebrate cats instrumented using electromyogram (EMG) electrodes, strain gauge force transducers, and manometry. We found that the cervical esophagus has a short-lasting circumferential tension response during the pharyngeal phase of swallowing (CTPP), and a concomitant EMG response. The CTPP magnitude was correlated with magnitudes of contraction of the geniohyoideus, laryngeal elevation force, and esophageal orad elongation force. The magnitude of the CTPP was not correlated with the peak or area under the curve of the concomitant esophageal EMG response. Restricting laryngeal elevation by physical force or transecting the hypoglossal nerves decreased or eliminated the CTPP during swallowing. Elongation of the distal cervical esophagus increased basal circumferential cervical esophageal tension as well as the CTPP. Transecting the vagus or pharyngoesophageal nerves, or administering hexosamine intravenously, had no significant effect on CTPP. We conclude that CTPP is a response to esophageal elongation during laryngeal elevation during the pharyngeal phase of swallowing, which is not caused by muscle contraction or mediated by the nervous system. The CTPP may assist in the distal movement of boluses before activation of the esophageal phase of swallowing, and may serve to prevent esophagopharyngeal reflux. We hypothesize that the CTPP is a biomechanical decrease in elasticity of the circumferential connective tissue of the cervical esophagus caused by the stress of cervical esophageal elongation.NEW & NOTEWORTHYThe pharyngeal phase of swallowing includes increased circumferential tension of the cervical esophagus during the pharyngeal phase of swallowing (CTPP). The CTPP is a biomechanical response caused by elongation of the esophagus during laryngeal elevation, and is not caused by muscle contraction or mediated by the nervous system. The CTPP may assist in the distal movement of boluses before activation of the esophageal phase of swallowing, and may serve to prevent esophagopharyngeal reflux.