Department of Medicine, University of Toronto, Toronto, Canada.
Compr Physiol. 2012 Jan;2(1):479-535. doi: 10.1002/cphy.c110023.
The various neural mechanisms affecting the control of the upper airway muscles are discussed in this review, with particular emphasis on structure-function relationships and integrative physiological motor-control processes. Particular foci of attention include the respiratory function of the upper airway muscles, and the various reflex mechanisms underlying their control, specifically the reflex responses to changes in airway pressure, reflexes from pulmonary receptors, chemoreceptor and baroreceptor reflexes, and postural effects on upper airway motor control. This article also addresses the determinants of upper airway collapsibility and the influence of neural drive to the upper airway muscles, and the influence of common drugs such as ethanol, sedative hypnotics, and opioids on upper airway motor control. In addition to an examination of these basic physiological mechanisms, consideration is given throughout this review as to how these mechanisms relate to integrative function in the intact normal upper airway in wakefulness and sleep, and how they may be involved in the pathogenesis of clinical problems such obstructive sleep apnea hypopnea.
本文综述了影响上气道肌肉控制的各种神经机制，特别强调了结构-功能关系和整合生理运动控制过程。特别关注的焦点包括上气道肌肉的呼吸功能，以及它们控制的各种反射机制，特别是对气道压力变化的反射反应、来自肺受体的反射、化学感受器和压力感受器反射，以及对上气道运动控制的姿势影响。本文还讨论了上气道塌陷的决定因素以及对上气道肌肉神经驱动的影响，以及乙醇、镇静催眠药和阿片类药物等常见药物对上气道运动控制的影响。除了检查这些基本生理机制外，本文还考虑了这些机制如何与清醒和睡眠状态下完整正常上气道的整合功能相关，以及它们如何参与阻塞性睡眠呼吸暂停低通气等临床问题的发病机制。
