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Airway Protective Mechanisms, Reciprocal Physiology of the Deglutitive Axis

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Principles of Deglutition

Abstract

In the setting of shared embryonic origin and anatomical continuity, the upper airway, aerodigestive tract and the esophagus participate in an elaborate stimulatory mechanism that in response to either mechanical or acid stimulation enhances the barriers against entry of gastric content into the pharynx and trachea, clear the pharyngeal content and closes the glottis, and increases the tracheal mucus secretion whereby enhancing the airway protection. Parallel to this stimulatory mechanism there exist a number of inhibitory reflexes. This results in relaxation of the lower esophageal sphincter and inhibition of primary and secondary esophageal peristalsis potentially weakening the airway protection against aspiration of gastric contents. Overall balance of these mechanisms and conditions associated with the recruitment of involved reflexes comprise the reciprocal physiology of the upper airway and upper GI tract which are the topic of ongoing investigations.

This chapter provides a concise description of these mechanisms which are involved in protection of the airway against aspiration during transit of material through deglutitive axis.

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Author information

Authors and Affiliations

  1. Internal Medicine/Division of Gastroenterology, Washington University School of Medicine/Barnes Jewish Hospital, 660 S. Euclid Avenue Campus, 8124, St. Louis, MO, 63105, USA

    Anisa Shaker MD

  2. Division of Gastroenterology and Hepatology, Digestive Disease Center, Clinical and Translational Science Institute, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI, 53226, USA

    Reza Shaker MD

Authors
  1. Anisa Shaker MD
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  2. Reza Shaker MD
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Corresponding author

Correspondence to Reza Shaker MD .

Editor information

Editors and Affiliations

  1. Div. Gastroenterology & Hepatology, Medical College of Wisconsin, West Wisconsin Avenue 9200, Milwaukee, 53226, Wisconsin, USA

    Reza Shaker

  2. , Dpt Otolaryngology/Head & Neck Surg., UC Davis Medical Center, Stockton Blvd. 2521, Sacramento, 95817, California, USA

    Peter C. Belafsky

  3. Ctr for Voice, Airway & Swallowing Disor, Department of Otolaryngology, Georgia Health Sciences University, 15th Street 1120, Augusta, 30912, Georgia, USA

    Gregory N. Postma

  4. , Dpt of Communication Sciences & Disorder, University of Wisconsin-Milwaukee, East Hartford Ave 2400, Milwaukee, 53201, Wisconsin, USA

    Caryn Easterling

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Shaker, A., Shaker, R. (2013). Airway Protective Mechanisms, Reciprocal Physiology of the Deglutitive Axis. In: Shaker, R., Belafsky, P., Postma, G., Easterling, C. (eds) Principles of Deglutition. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3794-9_4

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  • DOI: https://doi.org/10.1007/978-1-4614-3794-9_4

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-3793-2

  • Online ISBN: 978-1-4614-3794-9

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