ANATOMICAL SPECIALIZATIONS OF THE HUMAN PHARYNX

人类咽部的解剖学特点

• 批准号: 6703163
• 负责人: LIANCAI MU
• 金额: $ 25.43万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-02-01 至 2005-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6703163
• 关键词: acetylcholinesterase; age difference; anatomy; cranial nerves; gender difference; human tissue; immunocytochemistry; innervation; isozymes; myosins; pharynxs; postmortem; racial /ethnic difference

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.

描述（申请人的摘要）：神经肌肉中有哪些变量 人类咽部的特性使一些患者更容易受到感染 误吸、阻塞性睡眠呼吸暂停 (OSA)、胃酸反流、环咽痉挛 以及咽部其他疾病？在大多数哺乳动物（和新生儿 人类）呼吸系统通过重叠会厌得到保护， 软腭，然而，随着这些结构的分离，人类面临着以下风险： 误吸，这往往是老年人和老年人的死亡原因 神经功能受损。目前的基本神经肌肉专业 人们对人类的咽部知之甚少。前期工作中多部小说 进行了观察，一个例子是人类环咽肌（CP） 肌肉; CP 接受多条神经的神经支配，每条神经 它提供肌肉内的一个独特区域，并且它包含 专门的肌纤维。其中之一，慢强直肌纤维 (STMF) 具有 独特的生理学。 STMF 在哺乳动物中极为罕见，但初步工作已经完成 研究表明它们广泛存在于人类上呼吸道结构中，包括 舌头和喉咙。此外，这些纤维的特殊分布表明 它们与不同的生物力学直接相关。拟议的工作将 重点阐明人体的外围组织模式 咽丛并表征 CP 和 咽周围的肌肉回答问题：什么解剖学 存在似乎针对人类和可能针对语音的专业化 和吞咽有关吗？这些专业的变化与哪些相关 某些种族（黑人男性 OSA）、性别（男性回流，OSA），尤其是 老年人（CP 痉挛和误吸）对特定疾病的易感性？全部 研究将在人类死后组织中进行。运动神经和感觉神经 将使用 Sihler 染色来研究咽部区域的供应。一个 需要测试的另一个假设是人类舌咽神经 (IX) 不仅提供传统描述的运动神经支配 茎咽肌，还包括 CP 和咽缩肌 我们的初步研究证明了这一点。这将由三重研究 方法：Sihler 染色全封样乙酰胆碱酯酶 (AChE) 和银 染色法和卡诺夫斯基-鲁茨法。另一个需要检验的假设是 大多数与吞咽相关的肌肉都是专门的，由神经肌肉组成 隔室（NMC）作为功能要求。我们的初步研究提供了 人类 CP 下大蟒内存在 NMC 的证据 和颏舌骨肌。此外，人类CP似乎是一种专门的 骨骼肌，因为它含有慢速强直和α-心肌肌球蛋白重链 通常不存在于肢体肌肉中的亚型。肌肉发达的 食管上括约肌、咽缩肌和 将使用多种组织化学方法来探索舌骨上肌， 免疫组织化学、电泳和免疫印迹技术 纤维结构、纤维类型的分布以及主要和不常见的纤维 将研究肌球蛋白重链亚型。