Modulation of upper airway muscle activities by bronchopulmonary afferents.

Here we review the influence of bronchopulmonary receptors (slowly and rapidly adapting pulmonary stretch receptors, and pulmonary/bronchial C-fiber receptors) on respiratory-related motor output to upper airway muscles acting on the larynx, tongue, and hyoid arch. Review of the literature shows that all muscles in all three regions are profoundly inhibited by lung inflation, which excites slowly adapting pulmonary stretch receptors. This widespread coactivation includes the recruitment of muscles that have opposing mechanical actions, suggesting that the stiffness of upper airway muscles is highly regulated. A profound lack of information on the modulation of upper airway muscles by rapidly adapting receptors and bronchopulmonary C-fiber receptors prohibits formulation of a conclusive opinion as to their actions and underscores an urgent need for new studies in this area. The preponderance of the data support the view that discharge arising in slowly adapting pulmonary stretch receptors plays an important role in the initiation of the widespread and highly coordinated recruitment of laryngeal, tongue, and hyoid muscles during airway obstruction.     

Modulation of laryngeal and respiratory pump muscle activities with upper airway pressure and flow.

The hypothesis that upper airway (UA) pressure and flow modulate respiratory muscle activity in a respiratory phase-specific fashion was assessed in anesthetized, tracheotomized, spontaneously breathing piglets. We generated negative pressure and inspiratory flow in phase with tracheal inspiration or positive pressure and expiratory flow in phase with tracheal expiration in the isolated UA. Stimulation of UA negative pressure receptors with body temperature air resulted in a 10--15% enhancement of phasic moving-time-averaged posterior cricoarytenoid electromyographic (EMG) activity above tonic levels obtained without pressure and flow in the UA (baseline). Stimulation of UA positive pressure receptors increased phasic moving-time-averaged thyroarytenoid EMG activity above tonic levels by 45% from baseline. The same enhancement of posterior cricoarytenoid or thyroarytenoid EMG activity was observed with the addition of flow receptor stimulation with room temperature air. Tidal volume and diaphragmatic and abdominal muscle activity were unaffected by UA flow and/or pressure, whereas respiratory timing was minimally affected. We conclude that laryngeal afferents, mainly from pressure receptors, are important in modulating the respiratory activity of laryngeal muscles.     

Cardiorespiratory responses to hypoxia in intact and bilaterally vagotomized pigeons

Bilateral, cervical vagotomy in birds denervates, among other receptors, the carotid bodies. To test whether such neural section removes sensitivity to hypoxia, we measured respiratory, cardiovascular, and blood gas responses to hypoxia at 84-, 70-, and 49-Torr inspiratory O2 partial pressure (PIO2) in five pigeons with intact vagi and in five bilaterally, cervically vagotomized pigeons. Normoxic respiratory frequency (fresp) and expiratory flow rate (VE) were decreased after vagotomy. Intact pigeons showed large increases in VE in response to hypoxia, effected mostly by increases in fresp. VE also increased greatly in response to hypoxia in vagotomized pigeons, but increases were largely the result of tidal volume. O2 consumption, CO2 production, and respiratory exchange ratio increased slightly in all pigeons during hypoxia. Normoxic heart rate was greater after vagotomy; cardiac output increased in all pigeons in response to hypoxia, but stroke volume increased only in intact pigeons. During normoxia, arterial and mixed venous O2 partial pressure, O2 concentration, and pH were lower and arterial and mixed venous CO2 partial pressure was higher, after vagotomy. In all pigeons during hypoxia, arterial and mixed venous O2 and CO2 partial pressure and O2 concentration decreased and arterial and mixed venous pH increased; changes were roughly parallel in intact and vagotomized pigeons. The arteriovenous O2 concentration differences during normoxia and hypoxia were similar in all pigeons. We conclude that bilateral, cervical vagotomy in the pigeon causes hypoventilation and tachycardia during normoxia, but strong respiratory and cardiovascular responses to hypoxia are still present.     

Upper airway muscle activity and upper airway resistance in young adults during sleep

Henke, Kathe G. Upper airway muscle activity and upperairway resistance in young adults during sleep. J. Appl. Physiol. 84(2): 486-491, 1998.To determinethe relationship between upper airway muscle activity and upper airwayresistance in nonsnoring and snoring young adults, 17 subjects werestudied during sleep. Genioglossus and alae nasi electromyogramactivity were recorded. Inspiratory and expiratory supraglotticresistance (Rinsp and Rexp, respectively) were measured at peak flow,and the coefficients of resistance(K_insp andK_exp,respectively) were calculated. Data were recorded during control,with continuous positive airway pressure (CPAP), and on the breathimmediately after termination of CPAP. Rinsp during control averaged 7 ± 1 and 10 ± 2 cmH₂O · l¹ · sand K_inspaveraged 26 ± 5 and 80 ± 27 cmH₂O · l¹ · s²in the nonsnorers and snorers, respectively(P = not significant). Onthe breath immediately after CPAP,K_insp did notincrease over control in snorers (80 ± 27 for control vs. 46 ± 6 cmH₂O · l¹ · s²for the breath after CPAP) or nonsnorers (26 ± 5 vs. 29 ± 6 cmH₂O · l¹ · s²).These findings held true for Rinsp.K_exp did notincrease in either group on the breath immediately after termination ofCPAP. Therefore, 1) increases inupper airway resistance do not occur, despite reductions inelectromyogram activity in young snorers and nonsnorers, and2) increases in Rexp and expiratoryflow limitation are not observed in young snorers.

     

Effects of tracheal airway occlusion on hyoid muscle length and upper airway volume

Complex relationships exist among electromyograms (EMGs) of the upper airway muscles, respective changes in muscle length, and upper airway volume. To test the effects of preventing lung inflation on these relationships, recordings were made of EMGs and length changes of the geniohyoid (GH) and sternohyoid (SH) muscles as well as of tidal changes in upper airway volume in eight anesthetized cats. During resting breathing, tracheal airway occlusion tended to increase the inspiratory lengthening of GH and SH. In response to progressive hypercapnia, the GH eventually shortened during inspiration in all animals; the extent of muscle shortening was minimally augmented by airway occlusion despite substantial increases in EMGs. SH lengthened during inspiration in six of eight animals under hypercapnic conditions, and in these cats lengthening was greater during airway occlusion even though EMGs increased. Despite the above effects on SH and GH length, upper airway tidal volume was increased significantly by tracheal occlusion under hypercapnic conditions. These data suggest that the thoracic and upper airway muscle reflex effects of preventing lung inflation during inspiration act antagonistically on hyoid muscle length, but, because of the mechanical arrangement of the hyoid muscles relative to the airway and thorax, they act agonistically to augment tidal changes in upper airway volume. The augmentation of upper airway tidal volume may occur in part as a result of the effects of thoracic movements being passively transmitted through the hyoid muscles.     

Upper airway muscle activity and the thoracic volume dependence of upper airway resistance

Although a thoracic volume dependence of upper airway resistance and caliber is known to exist in seated subjects, the mechanisms mediating this phenomenon are unknown. To test the hypothesis that actively altered end-expiratory lung volume (EELV) affects upper airway resistance in the supine position and to explore the mechanisms of any EELV-induced resistance changes, we studied five normal males during wakefulness. Supraglottic upper airway resistance (Ruaw) was calculated at an inspiratory flow of 0.1 l/s. The genioglossal electromyogram was obtained with indwelling wire electrodes and processed as moving time average. End-tidal CO2 was monitored by infrared analyzer. Observations were made during four 20-breath voluntary maneuvers: two at high and two at low EELV in each subject. Each maneuver was preceded by a control period at functional residual capacity. At high lung volume the EELV was increased by 2.23 +/- 0.54 (SD) liters; Ruaw decreased to 67.8 +/- 35.1% of control, while tonic and phasic genioglossal activities declined to 79.0 +/- 23.1 and 72.4 +/- 29.8%, respectively. At low lung volume the EELV was decreased by 0.86 +/- 0.23 liters. Ruaw increased to 178.2 +/- 186.8%, while tonic and phasic genioglossal activities increased to 243.0 +/- 139.3 and 249.1 +/- 146.3%, respectively (P less than 0.0001 for all). The findings were not explained by CO2 perturbations or respiratory pattern. Multiple linear regression analysis indicated that the genioglossal responses blunted the EELV-induced changes in upper airway patency.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effects of continuous positive airway pressure on upper airway and respiratory muscle activity

To study the effects of continuous positive airway pressure (CPAP) on lung volume, and upper airway and respiratory muscle activity, we quantitated the CPAP-induced changes in diaphragmatic and genioglossal electromyograms, esophageal and transdiaphragmatic pressures (Pes and Pdi), and functional residual capacity (FRC) in six normal awake subjects in the supine position. CPAP resulted in increased FRC, increased peak and rate of rise of diaphragmatic activity (EMGdi and EMGdi/TI), decreased peak genioglossal activity (EMGge), decreased inspiratory time and inspiratory duty cycle (P less than 0.001 for all comparisons). Inspiratory changes in Pes and Pdi, as well as Pes/EMGdi and Pdi/EMGdi also decreased (P less than 0.001 for all comparisons), but mean inspiratory airflow for a given Pes increased (P less than 0.001) on CPAP. The increase in mean inspiratory airflow for a given Pes despite the decrease in upper airway muscle activity suggests that CPAP mechanically splints the upper airway. The changes in EMGge and EMGdi after CPAP application most likely reflect the effects of CPAP and the associated changes in respiratory system mechanics on the afferent input from receptors distributed throughout the intact respiratory system.     

Responses to chemical stimulation of upper airway muscles diaphragm in awake cats

The steady-state and transient effects of hyperoxic hypercapnia on the electromyographic activities of the genioglossus (GG), posterior cricoarytenoid (PCA), and diaphragm (D) were studied in conscious unsedated cats with chronically implanted electrodes. Hypercapnia (inhalation of 3.4 and 7.4% CO2 in O2) increased the phasic electrical activity occurring during inspiration in all three muscles and also increased tonic activity of the GG. The GG responded to steady-state CO2 inhalation alinearly and with larger increases in activity than the PCA and D. Phasic GG activity was present in only 4 of 10 cats breathing 100% O2, whereas phasic PCA and D activity could be observed in all animals studied. When gas mixtures containing CO2 were given, the GG reached its new steady-state level more slowly than the D or PCA, and when CO2 was rapidly removed from the inspired gas mixture, the GG attained its steady state sooner than either the PCA or D. These results suggest that in awake unsedated animals, chemical stimuli do not affect either transient or steady-state responses of the GG in the same way as the D. These differences seem to be explained mainly by different threshold characteristics of hypoglossal and phrenic neurons but also in part by dissimilarities in their steady-state responses.     

Relation between upper airway volume and hyoid muscle length

Previous studies have suggested that the geniohyoid and sternohyoid muscles act to enlarge the upper airway. If correct, there should be an inverse relation between upper airway volume and the length of hyoid muscles. To test this, known volumes of air were injected into or removed from the isolated sealed upper airway of eight pentobarbital sodium-anesthetized cats, and the resultant changes in geniohyoid and sternohyoid length were measured using sonomicrometry. Increases in upper airway volume shortened the geniohyoid in all cats (P less than 0.001) and shortened the sternohyoid in seven of eight cats (P less than 0.01); mean geniohyoid shortening (as a % of resting length) exceeded that of the sternohyoid. Decreases in upper airway volume lengthened the geniohyoid in all cats (P less than 0.001) but caused variable changes in sternohyoid length. Extension of the neck increased the resting lengths of both the geniohyoid (P less than 0.001) and sternohyoid (P less than 0.002). Neck flexion shortened the resting length of both hyoid muscles (P less than 0.001 for both), with the geniohyoid shortening more (as a % of resting length) than the sternohyoid (P less than 0.005). Progressive flexion of the neck from 180 to 90 degrees caused progressive increases in the ratio of changes in muscle length to changes in upper airway volume during airway inflation but did not affect this relation during airway deflation.(ABSTRACT TRUNCATED AT 250 WORDS)     

Correlation structure of end-expiratory lung volume in anesthetized rats with intact upper airway

The correlation structure of breath-to-breath fluctuations of end-expiratory lung volume (EEV) was studied in anesthetized rats with intact airways subjected to positive and negative transrespiratory pressure (i.e., PTRP and NTRP, correspondingly). The Hurst exponent, H, was estimated from EEV fluctuations using modified dispersional analysis. We found that H for EEV was 0.5362 +/- 0.0763 and 0.6403 +/- 0.0561 with PTRP and NTRP, respectively (mean +/- SD). Both H were significantly different from those obtained after random shuffling of the original time series. Also, H with NTRP was significantly greater than that with PTRP (P = 0.029). We conclude that in rats breathing through the upper airway, a positive long-term correlation is present in EEV that is different between PTRP and NTRP.     

Effects of neurotensin on small bowel propulsion in intact and vagotomized rats

The effects of intravenous infusion of neurotensin on small bowel motility was studied in conscious rats. During 1 h a standardized test meal of glucose, polyethyleneglycol (PEG) 3000, phenol red and ¹²⁵I-labelled polyvinylpyrrolidone was administered via a permanent gastric catheter and simultaneously the bile-excreted radiopharmaceutic ⁹⁹Tc^m-Solco-HIDA was infused intravenously. Immediately after the infusions the gastrointestinal specimen was excised and examined for distribution of radioactivity. Both doses of neurotensin (0.1 and 0.3 μg · kg^?1 · h^?1) resulted in an increase in the neurotensin-like immunoreactivity (NTLI) of plasma to levels similar to that found after a fatty meal. Concurrently the small bowel transport pattern was changed from an interdigestive state to one similar to that found after a meal. In animals not receiving the gastric test meal, neurotensin (0.1–0.5 μg · kg^?1 · h^?) had no effect on motility. Infusion of the gastric test meal alone did not change the interdigestive motility or the NTLI value. This indicates that the presence of gastric infusates potentiates the effect of neurotensin on small bowel motility. The motility response to neurotensin did not differ between intact and vagotomized animals. This contrasts to earlier findings that the small bowel motility response to a fatty meal is dependent on intact vagal function. Thus, a difference in the mechanism responsible for the motility responses between a fatty meal and neurotensin exists. In view of this finding it seems reasonable to assume that neurotensin cannot be the only factor responsible for the shift in motility found after a fatty meal.     

Soft palate muscle responses to negative upper airway pressure

The afferentpathways and upper airway receptor locations involved in negative upperairway pressure (NUAP) augmentation of soft palate muscle activity havenot been defined. We studied the electromyographic (EMG) response toNUAP for the palatinus, tensor veli palatini, and levator veli palatinimuscles in 11 adult, supine, tracheostomized, anesthetized dogs. NUAPwas applied to the nasal or laryngeal end of the isolated upper airwayin six dogs and to four to six serial upper airway sites from the nasalcavity to the subglottis in five dogs. When NUAP was applied at thelarynx, peak inspiratory EMG activity for the palatinus and tensorincreased significantly (P < 0.05) and plateaued at a NUAP of 10cmH₂O. Laryngeal NUAP failed toincrease levator activity consistently. Nasal NUAP did not increase EMGactivity for any muscle. Consistent NUAP reflex recruitment of softpalate muscle activity only occurred when the larynx was exposed to the stimulus and, furthermore, was abolished by bilateral section of theinternal branches of the superior laryngeal nerves. We conclude thatsoft palate muscle activity may be selectively modulated by afferentactivity originating in the laryngeal and hypopharyngeal airway.     

Influence of calcium on myosin thick filament formation in intact airway smooth muscle

Myosin thick filaments have been shown tobe structurally labile in intact smooth muscles. Although the mechanismof thick filament assembly/disassembly for purified myosins in solution has been well described, regulation of thick filament formation inintact muscle is still poorly understood. The present study investigates the effect of resting calcium level on thick filament maintenance in intact airway smooth muscle and on thick filament formation during activation. Cross-sectional density of the thick filaments measured electron microscopically showed that the density increased substantially (144%) when the muscle was activated. Theabundance of filamentous myosins in relaxed muscle was calcium sensitive; in the absence of calcium (with EGTA), the filament densitydeceased by 35%. Length oscillation imposed on the muscle underzero-calcium conditions produced no further reduction in the density.Isometric force and filament density recovered fully after reincubationof the muscle in normal physiological saline. The results suggest thatin airway smooth muscle, filamentous myosins exist in equilibrium withmonomeric myosins; muscle activation favors filament formation, and theresting calcium level is crucial for preservation of the filaments inthe relaxed state.

     

Breathing route dependence of upper airway muscle activity during hyperpnea

Exercise (Ex) and hypercapnia (HC) both lead toincreases in ventilation and upper airway muscle (UAM) activity. Todetermine whether different breathing routes (nasal vs. oral) orstimuli produced differential UAM activation, electromyographic (EMG) activity of the alae nasi (AN) and genioglossus (GG) were measured inseven normal subjects seated on a bicycle ergometer. Subjects performedpaired runs during both progressive Ex and HC while breathing throughthe nose alone (N) or the mouth alone (O). During hyperpnea, AN EMG wasgreater when the subjects were breathing via N [81 ± 6%maximum (HC) and 69 ± 7% maximum (Ex)] than when they werebreathing via O [30 ± 5% maximum (HC) and 27 ± 5%maximum (Ex); both P < 0.01],whereas the GG EMG did not differ between N and O. Both AN and GG EMGwere similar for Ex and HC when the subjects were breathing via thesame route. We conclude that UAM activation was independent of thenature of the stimulus. However, the AN muscle but not the GG muscledemonstrated breathing-route dependence of activity.