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Biomedical subjects

A Brancatisano

Publications and source records attributed to A Brancatisano.

27 records · Page 2Linked to original sources

Respiratory-related activity of cricothyroid muscle in awake normal humans.

The role of the cricothyroid muscle (CT) in respiration is unclear. To examine the respiratory-related electrical activity of the CT, we measured its electromyogram (EMG) and compared it with that of the alae nasi (AN) in eight healthy subjects. During quiet breathing the CT EMG phasing was inspiratory in seven subjects. This pattern was similar to the AN with respect to phasing and shape of the integrated EMG. The onset of phasic CT and AN activity related to inspiration preceded flow by 173 +/- 39 and 570 +/- 76 (SE) ms, respectively (P less than 0.01). We measured the duration from onset of phasic activity to peak of the EMG (TA) and the total cycle duration (TT). TA/TT of the CT was 0.29 +/- 0.02, similar to that of the AN (0.28 +/- 0.03). Inspiratory resistive loading, panting, and voluntary hyperventilation increased CT activity above the peak level seen during tidal breathing. Voluntary glottic closure increased CT activity to a level above tonic but below peak tidal activity. The findings suggest that the phasic electrical activity of the CT simulates predominantly that of an upper airway dilator.

Adult↗

Cricothyroid muscle responses to increased chemical drive in awake normal humans.

To examine the response of the cricothyroid muscle (CT) to increased chemical drive, we measured its electromyogram simultaneously with that of the alae nasi (AN) in seven normal awake subjects. During both progressive hyperoxic hypercapnia and hypoxia, peak integrated inspiratory activity (moving time average, MTA) of the CT and AN increased as a power function of mean inspiratory flow (ratio of tidal volume to inspiratory time, VT/TI), given by MTA = a(VT/TI)b + c (where a, b, and c are constants). The exponent b varied from 0.009 to 3.4 among subjects but was correlated between CT and AN both during hypercapnia (r = 0.86) and hypoxia (r = 0.81). The onset of inspiratory activity of the CT and AN preceded that of inspiratory flow. Expressed as a percentage of expiratory time, the CT lead time rose from 7% at rest to 20% during hyperpnea. The corresponding values for the AN were from 22 to 52% (both P less than 0.03). Thus the pattern of response of the CT and AN is similar and related to that of the inspiratory muscles in a curvilinear manner. The findings suggest that during chemical stimulation the electrical activity of the CT is analogous to that of the AN, an upper airway dilator.

Adult↗

Influence of posterior cricoarytenoid muscle activity on pressure-flow relationship of the larynx.

We examined the effect of posterior cricoarytenoid (PCA) muscle activity on the pressure-flow (PV) relationship of the larynx in five anesthetized tracheostomized dogs. The PCA activity was recorded using bipolar fine-wire electrodes, expressed as a percentage of the quiet breathing level and altered by mechanical ventilation, changes in lung volume, and chest wall compression. Subglottic pressure was recorded while a constant flow of air was passed through the upper airway. In the absence of PCA activity the PV relationship was alinear and could be described by a power function (P = K0Va, where K0 and a are constants). The slope of the log P-log V plots in the absence of PCA and thyroarytenoid activity was 1.83 +/- 0.02 (SD), whereas with increasing PCA activity it was 1.88 +/- 0.11. An effective hydraulic diameter (DH) was calculated for 20% increments of PCA activity, and in two dogs glottic diameter (Dg) was calculated from glottic area measurements obtained by fiber-optic laryngoscopy. Both DH and Dg increased linearly with increasing PCA activity. Denervation of the cricothyroid muscle had no systematic effect on laryngeal resistance. The results indicate that the PV relationship of the larynx may be described by a power function with a single exponent, the magnitude of which is independent of glottic dilator muscle activity and consistent with orifice flow. However, laryngeal diameter increases linearly with PCA activity in the range studied.

Airway Resistance↗

Blood flow distribution within the rib cage muscles.

We used 15-microns radiolabeled microspheres to study the regional distribution of blood flow (Q) among parasternal (PS), transversus thoracis, and external (EI) and internal intercostal muscles (II) in nine anesthetized supine mongrel dogs. We measured Q (ml.min-1.100 g-1) in each intercostal space (ICS) during spontaneous breathing, inspiratory resistive loading, and mechanical ventilation following paralysis. At necropsy the EI, II, and PS were excised and sampled separately for each ICS. During paralysis there was no consistent gradient in Q among the PS, II, and EI muscles. During spontaneous breathing, Q to PS increased linearly by 125% between the first and fourth to sixth ICS, Q to EI decreased progressively from the first/second ICS to the fifth/sixth ICS, whereas Q to the II was uniform. During inspiratory resistive loading, in which mouth pressures of -16 +/- 4 cmH2O were generated, the PS gradient was similar to that during spontaneous breathing. Also, Q to the EI increased in the cranial interspaces (P less than 0.02), whereas Q to the II of the seventh/eighth ICS was greater than that of the first/second ICS (P less than 0.001). Furthermore, with loading, ventrodorsal gradients in Q appeared within both EI and II interspaces. There was no consistent gradient in Q within the transversus thoracis muscle during any of the interventions. Our results demonstrate nonuniform Q within PS, EI, and II during both spontaneous and inspiratory resistive loaded breathing. On the assumption that changes in Q reflect changes in activation, our results suggest systematic topographical patterns of recruitment of rib cage respiratory muscles.

Animals↗

Regional distribution of blood flow within the diaphragm.

We investigated the regional distribution of blood flow (Q) within the costal and crural portions of the diaphragm in a total of eight anesthetized supine mongrel dogs. Q was measured with 15-microns microspheres, radiolabeled with three different isotopes, injected into the left ventricle during spontaneous breathing (SB), inspiratory resistive loading (IR), and mechanical ventilation after paralysis (P). At necropsy, the costal and crural portions of each hemidiaphragm were arbitrarily subdivided along a sagittal plane into five to seven and three sections, respectively. During P, there was a dorsoventral Q gradient within the costal part of the diaphragm. During SB there was a fourfold increase in the gradient of Q. Furthermore, during IR, in which mouth pressures of -16 +/- 4 cmH2O were generated, there was a further increase in the gradient of Q. During both SB and IR, Q to the most ventral portion of the costal diaphragm was 26 +/- 6% less than the peak value. In two dogs, studied prone and supine, there was no difference in the Q gradients between the two postures. Over the dorsal 80% of the costal diaphragm there was also a dorsoventral gradient of muscle thickness, such that the most dorsal part was 54 +/- 2% (n = 5) that of the ventral portion. In contrast, there was no consistent gradient of Q or muscle thickness within the crural diaphragm. Our results demonstrate a topographical gravity-independent distribution of Q in the costal, but not the crural, diaphragm.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia↗

Posterior cricoarytenoid activity and glottic size during hyperpnea in humans.

We measured the electromyographic activity of the posterior cricoarytenoid (PCA) muscle simultaneously with glottic width (dg) in five normal human subjects during hyperpnea induced by hypoxia (7% CO2 in N2) or hypercapnia (9% CO2 in 50% O2). The glottic aperture was measured during inspiration at the time corresponding to peak inspiratory PCA activity and during expiration at the time corresponding to the minimum tonic activity. During hyperpnea, peak and tonic PCA activity increased simultaneously with widening of the vocal cords in both phases of the respiratory cycle. The PCA activity during both inspiration and expiration showed a single curvilinear relationship with dg of the form dg = A - Be-k.PCA (where A, B, and k are constants) in three of the five subjects. At 50% of maximum PCA activity, dg already reached 95% of its maximum value, which was less than that recorded during a voluntary forced expiratory maneuver. The single curvilinear relationship between PCA activity and dg could be due to the length-tension relationship of the PCA muscle and/or changes in its mechanical coupling, as well as simultaneous agonist and antagonist laryngeal muscle activity during progressive chemical stimulation. Also, further widening of the glottis during forced expiration suggests recruitment of additional muscles, e.g., the arytenoideus.

Adult↗

Relationship between thyroarytenoid activity and laryngeal resistance.

We examined the relationship between subglottic pressure (P), flow (V), and thyroarytenoid (TA) muscle activity in six anesthetized tracheostomized dogs while a constant flow (0.05-1.2 l/s) of warmed humidified air was passed through the upper airway in an expiratory direction. The TA activity was recorded by fine bipolar wire electrodes and was reflexly altered by changes in lung volume and chest wall compression. The integrated muscle activity was expressed as a percentage of a maximal peak integrated TA activity (%max). In the absence of TA activity the pressure-flow relationship was alinear and could be described by a power function. Log-log P-V plots at varying levels of TA activity were linear, with a slope a of 1.84 +/- 0.07 (SD). When TA activity increased, laryngeal resistance increased exponentially. An effective hydraulic diameter was calculated for increments in %max TA and decreased linearly with %max TA. In three dogs the glottic diameter was computed from glottic area measured by fiber-optic laryngoscopy, and it also decreased linearly as TA increased. Sectioning of the external motor branch of the superior laryngeal nerve to the cricothyroid muscle demonstrated no consistent effect on laryngeal resistance over a range of TA activity. The results indicate that laryngeal dimensions decrease linearly with TA activity. However, the P-V relationship of the larynx may be described by a power function, with a single exponent consistent with an orifice flow regimen. Spontaneous activity of the cricothyroid muscle does not measurably influence this relationship.

Airway Resistance↗

Postural changes in spontaneous and evoked regional diaphragmatic activity in dogs.

We addressed the question whether gravity-dependent differences in passive tension and length of the diaphragm are associated with differences in its regional activation. By using intramuscular electrodes, we measured the electromyographic activity of different parts of the diaphragm (Edi) during quiet breathing in several postures in 13 anesthetized mongrel dogs. The Edi of the left and right costal hemi-diaphragm was compared between the left and right lateral decubitus postures, whereas that from the substernal and crural regions was compared between the supine and prone positions. On changing posture, the Edi of the dependent part of the diaphragm decreased in both cases, whereas that of the non-dependent part increased. The results were consistent with reflex modulation of regional diaphragm activation in response to postural changes in local resting length. However, these changes in Edi persisted after bilateral vagotomy, cordotomy (C7-T1) and dorsal rhizotomy of the C5-C7 roots. Compound muscle action potentials, recorded in different regions of the diaphragm and evoked by supramaximal stimulation of the phrenic nerves, were altered with changes in posture in the same direction as Edi. Because the stimuli were supramaximal, these changes reflected systematic changes in the recording conditions with posture, possibly because of a combination of 1) changes in the electrical environment surrounding the intramuscular electrodes and 2) passive changes in muscle length. Our results demonstrate systematic, reproducible, posture-dependent changes in regional Edi that may not be due to different neural drive.(ABSTRACT TRUNCATED AT 250 WORDS)

Action Potentials↗

Effect of expiratory glottic constriction on lung volume and pattern of breathing in adult dogs.

We examined the effect of laryngeal constriction on the pattern of breathing in 4 anaesthetized adult mongrel dogs. By means of a T-shaped tracheostomy tube the larynx could be repeatedly excluded or included in the breathing circuit. Marked expiratory activity of the thyroarytenoid muscle (TA), the main glottic constrictor, was induced by injection of 100-400 ml of air into the pleural space or by inhalation of histamine aerosol (2 dogs) which resulted in rapid shallow breathing. In 21 pairs of runs in the 4 dogs switching from tracheostomy breathing to oral breathing decreased mid-expiratory flow and frequency by 85 +/- 2% (P less than 0.001) and 48 +/- 4% (P less than 0.001), respectively. Although expiratory duration (TE) increased, end-expiratory lung volume also increased by 40 +/- 8 ml or 21 +/- 4% of the tidal volume (VT) during tracheostomy breathing (P less than 0.001). In contrast, VT remained unchanged (P = 0.9). Instantaneous ventilation decreased due to both the prolongation of TE and an increase in inspiratory duration. Our results indicate that laryngeal braking can be recruited in adult dogs and interacts with reflex mechanisms that modulate respiratory timing, thereby significantly influencing end-expiratory lung volume, ventilation and the pattern of breathing. Simulation of the laryngeal mechanism by expiratory resistive loading at the tracheostomy below the larynx points to a non-reflex mechanical effect of the larynx as a resistance in series.

Aerosols↗