Oshima T, Sakamoto M, Arita H
Department of Anesthesiology, Tokyo Medical and Dental University, School of Medicine, Japan.
J Appl Physiol (1985). 1994 May;76(5):1888-95. doi: 10.1152/jappl.1994.76.5.1888.
To identify the site for triggering hiccup, we recorded activities from the diaphragm (DIA), posterior cricoarytenoid muscle (PCA) of the larynx, and abdominal muscle (ABD) along with intrapleural pressure (Ppl) in anesthetized spontaneously breathing cats. To directly access the epipharynx and to observe glottic movement, we made a submental opening at the level rostral to the epiglottis. Mechanical stimulation of the epipharynx evoked a fixed motor pattern of hiccup: DIA showed spasmodic discharge, and Ppl exhibited spiky negative pressure swing; phasic (inspiratory) discharge of PCA was inhibited, and glottic adduction was revealed by direct observation; and ABD remained suppressed during this response. Chlorpromazine hydrochloride or CO2 inhalation suppressed the response, and the intensity of the response varied according to phase of the respiratory cycle, being largest at midinspiration and least at midexpiration. These are compatible with clinical data on human hiccup. Mechanical stimulation of various parts other than the epipharynx failed to evoke the hiccuplike response. The triggering site was located in the dorsal wall of the epipharynx overlying the occipital bone. These results indicate that mechanical irritation of the dorsal epipharynx is essential for triggering hiccup.
为了确定引发打嗝的部位,我们在麻醉状态下自主呼吸的猫身上记录了膈肌(DIA)、喉后环杓肌(PCA)和腹肌(ABD)的活动以及胸膜腔内压(Ppl)。为了直接进入下咽并观察声门运动,我们在会厌上方的水平处做了一个颏下开口。对下咽进行机械刺激会引发一种固定的打嗝运动模式:膈肌表现出痉挛性放电,胸膜腔内压呈现出尖峰状负压波动;喉后环杓肌的阶段性(吸气性)放电受到抑制,通过直接观察发现声门内收;在此反应过程中腹肌一直受到抑制。盐酸氯丙嗪或吸入二氧化碳可抑制该反应,并且反应强度根据呼吸周期的阶段而变化,在吸气中期最大,在呼气中期最小。这些与关于人类打嗝的临床数据相符。对下咽以外的各个部位进行机械刺激未能引发类似打嗝的反应。触发部位位于覆盖枕骨的下咽后壁。这些结果表明,下咽后壁的机械性刺激对于引发打嗝至关重要。