Laryngeal response during forced vital capacity maneuvers in normal adult humans.
Laryngeal response during forced vital capacity maneuvers in normal adult humans.
复制标题
正常成年人用力肺活量操作期间的喉部反应。
DOI：
10.1164/ajrccm.150.3.8087344
复制
发表时间：
1994
影响因子：
24.7
通讯作者：
Vanoye,CR
中科院分区：
文献类型：
--
作者：
Kuna,ST;Vanoye,CR
以前的调查人员曾报道过，短暂的强迫呼气伴随着声带的外展。为了进一步研究自主用力肺活量动作时喉的反应，对25例正常成人进行了三块喉内肌的肌内肌电记录：声带外展肌环状后肌(PCA)和声带内收肌甲状旁肌(TA)和颧骨肌(AR)。在用力呼气的大部分时间里，这三块肌肉都表现出持续的激活。来自残余量的强迫吸气与PCA活性的进一步增加和内收肌活性的显著降低有关。为了确定这些肌电变化对声带位置的净影响，对其中5名受试者进行了声带运动的同步光纤记录。声带在前连合处形成的角度被用来评估声门孔的大小。声门角从最大呼气流量到用力呼气末逐渐减小。呼气峰流速为56+/-13度(SD)，90%肺活量用力呼气后为34+/-4度，呼气末为7+/-7度。结果表明，强迫呼气不仅与PCA有关，而且与喉内收肌的显着激活有关。在用力呼气期间，声门在安静呼吸时不会缩小到其大小以下，直到呼出约75%的用力肺活量。
Previous investigators have reported that transient forced expiration is accompanied by abduction of the vocal cords. To further investigate the laryngeal response during voluntary forced vital capacity maneuvers, intramuscular electromyographic recordings were obtained in 25 normal adult humans from three intrinsic laryngeal muscles: the posterior cricoarytenoid (PCA), a vocal cord abductor, and the thyroarytenoid (TA) and arytenoideus (AR), both vocal cord adductors. All three muscles exhibited sustained activation throughout most of forced expiration from total lung capacity. Forced inspiration from residual volume was associated with a further increase in PCA activity and a marked decrease in adductor muscle activity. To determine the net effect of these electromyographic changes on vocal cord position, simultaneous fiberoptic recordings of vocal cord movement were obtained in five of the subjects. The angle formed by the vocal cords at the anterior commissure was used to assess glottic aperture size. Glottic angle progressively decreased from peak expiratory flow to the end of forced expiration. The angle was 56 +/- 13 degrees (SD) at peak expiratory flow, 34 +/- 4 degrees after forced expiration of 90% of the vital capacity, and 7 +/- 7 degrees at end-expiration. The results indicate that forced expiration is associated with marked activation of not only the PCA but also laryngeal adductor muscles. During forced expiration, the glottis does not decrease below its size during quiet breathing until exhalation of about 75% of forced vital capacity.