ANATOMICAL SPECIALIZATIONS OF THE HUMAN PHARYNX

描述(申请人摘要)：神经肌肉中的哪些变量 人类咽部的特性使一些患者更容易患上 吸入、阻塞性睡眠呼吸暂停(OSA)、酸反流、环咽痉挛 以及咽部的其他疾病？在大多数哺乳动物(和新生儿)中 人类)呼吸系统通过重叠会厌和 软腭部，然而，随着这些结构的分离，人类有可能 这通常是老年人死亡的原因， 神经学受损。目前，神经肌肉的基本专业知识 人们对人类的咽部知之甚少。在前期工作中，有许多小说 进行了观察，其中一个例子是人类环咽吸虫(CP)。 肌肉；CP接受来自多条神经的神经支配，每条神经 它在肌肉中提供了一个独特的区域，它包含 特化的肌肉纤维。其中一种是慢速紧张性肌肉纤维(STMF)。 独特的生理学。STMF在哺乳动物中极其罕见，但初步研究已经 研究表明，它们广泛存在于人类上呼吸道结构中，包括 舌头和喉头。此外，这些纤维的特殊分布表明 它们与不同的生物力学有直接关系。拟议的工作将 重点阐明人类的外围组织模式 咽神经丛的形成及CP和Cp的内在特性 咽部周围的肌肉来回答问题：什么解剖学 出现了似乎特定于人类和可能是语音的专门化 和吞咽有关吗？这些专业化认证中的哪些变化与 某些种族(黑人男性OSA)、性别(男性反流，OSA)，特别是 老年人(脑瘫痉挛和吸入)对特定疾病的易感性？全 研究将在人类死后组织中进行。运动神经和感觉神经 咽部的供应将使用Sihler‘s染色进行研究。一个 另一个需要检验的假设是，人类舌咽神经 (Ix)不仅为传统上描述的 茎咽肌，也以CP和咽缩肌为 我们的初步研究证明。这将分三个阶段进行研究 方法：Sihler‘s染色、乙酰胆碱酯酶(AChE)和银染色法 和Karnovsky-Roots的方法。另一个需要检验的假设是 大多数吞咽相关肌肉都是专门化的，由神经肌肉组成。 作为功能要求的舱室(NMC)。我们的初步研究提供了 人CP下缩肌内存在NMC的证据 和颧舌骨肌。此外，人类CP似乎是一种专门的 骨骼肌，因为它含有慢速张力和α-心肌肌球蛋白重链 通常在四肢肌肉中不存在的异构体。肌肉发达的 上食道括约肌、咽缩肌和 舌骨上肌将使用广泛的组织化学方法进行研究， 肌肉的免疫组织化学、电泳法和免疫印迹技术 纤维结构、纤维类型的分布以及主要的和不寻常的 肌球蛋白重链亚型将被研究。

DESCRIPTION (Applicant's abstract): What variables in the neuromuscular properties of the human pharynx make some patients more susceptible to aspiration, obstructive sleep apnea (OSA), acid reflux, cricopharyngeal spasm and other disorders of the pharyngeal region? In most mammals (and neonatal humans) the respiratory system is protected by overlapping the epiglottis and soft palate, however with separation of these structures the human at risk of aspiration, and this is often the cause of death in the elderly and neurologically impaired. At present the basic neuromuscular specializations of the human pharynx are poorly understood. In preliminary work numerous novel observations were made, one example is that of the human cricopharyngeus (CP) muscle; That the CP receives its innervation from multiple nerves, each of which supplies a distinct region within the muscle, and that it contains specialized muscle fibers. One of these, slow tonic muscle fibers (STMF) has a unique physiology. STMF are extremely rare in mammals but preliminary work has shown that they are widespread in human upper airway structures including the tongue and larynx. Moreover the particular distribution of these fiber suggests that they are directly related to distinct biomechanics. The proposed work will focus on clarifying the peripheral organization patterns of the human pharyngeal plexus and characterizing the intrinsic properties of the CP and the muscles surrounding the pharynx to answer the questions: what anatomic specializations are present that appear specific to humans and possibly speech and swallowing related? What variations in these specializations correlate with certain ethnic (black males OSA), genders (males reflux, OSA) and especially geriatric (CP spasm and aspiration) susceptibility to specific disorders? All studies will be done in human post-mortem tissue. The motor and sensory nerve supply to the pharyngeal region will be studied using Sihler's stain. An additional hypothesis to be tested is that the human glossopharyngeal nerve (IX) provides motor innervation not only to the traditionally described stylopharyngeus, but also to the CP and pharyngeal constrictor muscles as demonstrated by our preliminary studies. This will be studied by triple approaches: Sihler's stain whole-mount acetylcholinesterase (AChE) and silver stain, and Karnovsky-Roots' method. Another hypothesis to be tested is that most swallowing-related muscles are specialized and composed of neuromuscular compartments (NMC) as functional requirements. Our preliminary studies provided evidence for the existence of the NMC within the human CP inferior constrictor and geniohyoid muscles. In addition, the human CP appears to be a specialized skeletal muscle as it contains slow tonic and a-cardiac myosin heavy chain isoforms that are not normally present in limb muscles. The muscular specializations of the upper esophageal sphincter, pharyngeal constrictor and suprahyoid muscles will be explored using a wide variety of histochemical, immunohistochemical, electrophoretic and immunoblotting techniques The muscle fiber architecture, distribution of the fiber types and the major and unusual myosin heavy chain isoforms will be studied.