This dissertation represents a series of studies describing mechanisms related to breathing, upper airway behaviors and their coordination in man and animal. Chapter two transformed the cough swallow aspiration protocol from the cat (previous work) to the human introducing a new strategy, volume targeting, in swallow breathing coordination. Chapter three evaluated swallow breathing coordination at increasing altitudes. As respiratory drive altered due to hypoxia and hypocapnia, swallow breathing coordination shifted toward inspiration occurring during the transition from inspiration and expiration. The collection of the two previous studies led to development of an animal model to evaluate volume targeting and mechanisms involved in this strategy. Chapter four highlights presence of vagal spinal feedback on breathing characteristics and chapter five the same for swallow behavior and swallow breathing coordination. Chapter four and five also introduce sex differences in breathing and swallow breathing coordination when vagal and spinal balance is perturbed. In conclusion, this work has furthered the knowledge of swallow breathing coordination and suggested mechanisms responsible for these behaviors. Describing basic swallow parameters in human could lead to potential detection of pathologic changes in the upper airway as well as further the understanding of pulmonary complications such as aspiration pneumonia. The influence of the thoracic cavity spinal feedback could lead to new therapeutic techniques for breathing, swallow and their coordination in spinal cord injured patients.
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Coordination of airway protective behaviors and swallow: effects of afferent feedback and sex.