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Journal of Applied Physiology, Vol 76, Issue 5 1888-1895, Copyright © 1994 by American Physiological Society
ARTICLES |
T. Oshima, M. Sakamoto and H. Arita
Department of Anesthesiology, Tokyo Medical and Dental University, School of Medicine, Japan.
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.
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