Swallow Pattern Generator Reconfiguration of the Respiratory Neural Network When the nasal and oral passages converge and a bolus enters the pharynx, it is critical that breathing and swallow motor patterns become integrated to allow safe passage of the bolus through the pharynx. Breathing patterns must be reconfigured to inhibit inspiration, and upper airway muscle activity must be recruited ... Article
Article  |   March 01, 2009
Swallow Pattern Generator Reconfiguration of the Respiratory Neural Network
Author Affiliations & Notes
  • Andrea Vovka
    Department of Physiological Sciences, University of Florida, Gainesville, FL
  • Paul W. Davenport
    Department of Physiological Sciences, University of Florida, Gainesville, FL
  • Karen Wheeler-Hegland
    Department of Physiological Sciences, University of Florida, Gainesville, FL
    Brain Rehabilitation Research Center, Malcom Randall Veterans Administration Hospital, Gainesville, FL
  • Kendall F. Morris
    Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, FL
  • Christine M. Sapienza
    Department of Communication Sciences and Disorders, University of Florida, Gainesville, FL 32610
    Brain Rehabilitation Research Center, Malcom Randall Veterans Administration Hospital, Gainesville, FL
  • Donald C. Bolser
    Department of Physiological Sciences, University of Florida, Gainesville, FL
Article Information
Swallowing, Dysphagia & Feeding Disorders / Articles
Article   |   March 01, 2009
Swallow Pattern Generator Reconfiguration of the Respiratory Neural Network
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), March 2009, Vol. 18, 3-12. doi:10.1044/sasd18.1.3
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), March 2009, Vol. 18, 3-12. doi:10.1044/sasd18.1.3
Abstract

When the nasal and oral passages converge and a bolus enters the pharynx, it is critical that breathing and swallow motor patterns become integrated to allow safe passage of the bolus through the pharynx. Breathing patterns must be reconfigured to inhibit inspiration, and upper airway muscle activity must be recruited and reconfigured to close the glottis and laryngeal vestibule, invert the epiglottis, and ultimately protect the lower airways. Failure to close and protect the glottal opening to the lower airways, or loss of the integration and coordination of swallow and breathing, increases the risk of penetration or aspiration. A neural swallow central pattern generator (CPG) controls the pharyngeal swallow phase and is located in the medulla. We propose that this swallow CPG is functionally organized in a holarchical behavioral control assembly (BCA) and is recruited with pharyngeal swallow. The swallow BCA holon reconfigures the respiratory CPG to produce the stereotypical swallow breathing pattern, consisting of swallow apnea during swallowing followed by prolongation of expiration following swallow. The timing of swallow apnea and the duration of expiration is a function of the presence of the bolus in the pharynx, size of the bolus, bolus consistency, breath cycle, ventilatory state and disease.

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