The Pathway from Anatomy and Physiology to Diagnosis: A Developmental Perspective on Swallowing and Dysphagia.
The Pathway from Anatomy and Physiology to Diagnosis: A Developmental Perspective on Swallowing and Dysphagia.
复制标题
从解剖学和生理学到诊断的途径：吞咽和吞咽困难的发展视角。
DOI：
10.1007/s00455-022-10449-x
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发表时间：
2023
期刊：
影响因子：
2.6
通讯作者：
German,RZ
中科院分区：
文献类型：
--
作者：
Mayerl,CJ;Gould,FDH;Adjerid,K;Edmonds,C;German,RZ
吞咽困难是由各种不同的病因引起的。从解剖学和生理学到临床诊断的过程是复杂的和层次化的。我们在这篇文章中的方法是展示从潜在的解剖学和生理学到临床表现的联系。特别是，性能、功能、行为和生理学等术语经常互换使用，我们认为这是清楚讨论病理生理学机制的障碍。我们使用儿科人群的例子来强调了解解剖学和生理学为临床实践提供信息的重要性。我们首先讨论在生理学和表现的背景下理解解剖学的重要性。然后，我们以早产儿和吞咽-呼吸协调为例，解释生理学的层次性及其对成绩的影响。我们还强调了我们知识中的漏洞所在，最终目的是提供一个框架，可以增强我们设计干预措施帮助患者的能力。澄清这些术语，以及它们在吞咽困难生物学中扮演的角色，将有助于研究这些问题的研究人员以及临床医生应用这些研究的结果。
Dysphagia results from diverse and distinct etiologies. The pathway from anatomy and physiology to clinical diagnosis is complex and hierarchical. Our approach in this paper is to show the linkages from the underlying anatomy and physiology to the clinical presentation. In particular, the terms performance, function, behavior, and physiology are often used interchangeably, which we argue is an obstacle to clear discussion of mechanism of pathophysiology. We use examples from pediatric populations to highlight the importance of understanding anatomy and physiology to inform clinical practice. We first discuss the importance of understanding anatomy in the context of physiology and performance. We then use preterm infants and swallow-breathe coordination as examples to explicate the hierarchical nature of physiology and its impact on performance. We also highlight where the holes in our knowledge lie, with the ultimate endpoint of providing a framework that could enhance our ability to design interventions to help patients. Clarifying these terms, and the roles they play in the biology of dysphagia will help both the researchers studying the problems as well as the clinicians applying the results of those studies.