Salutary effect of fall in abdominal pressure during diaphragm paralysis

1984 ◽  
Vol 56 (5) ◽  
pp. 1320-1324
Author(s):  
S. Kelly ◽  
W. A. Zin ◽  
M. Decramer ◽  
A. De Troyer
Keyword(s):  
Tidal Volume ◽  
Abdominal Wall ◽  
Diaphragmatic Paralysis ◽  
Emg Activity ◽  
Abdominal Pressure ◽  
Quiet Breathing ◽  
Lung Inflation ◽  
Rib Cage ◽  
Before And After ◽  
Salutary Effect

To examine the mechanical effects of the fall in abdominal pressure (Pab) that occurs during inspiration in diaphragmatic paralysis, we studied lung inflation and rib cage expansion before and after the abdomen was opened in nine spontaneously breathing dogs with bilateral phrenicotomy . We measured Pab, tidal volume, and parasternal electromyographic (EMG) activity during quiet breathing and CO2-induced hyperpnea. In six dogs, we also measured changes in anteroposterior and transverse rib cage diameters, the resting length of the parasternal intercostal muscles, and the amount of shortening of these muscles during inspiration. Opening the abdomen caused a marked reduction in the fall in Pab during inspiration and invariably resulted in a decrease in tidal volume (mean decrease, 13%), which contrasted with marked increases in inspiratory rib cage expansion and in the amount of parasternal intercostal shortening. The procedure, however, did not affect the resting length or inspiratory EMG activity of the parasternals . These findings indicate that although the fall in Pab, which occurs during inspiration in diaphragmatic paralysis, causes paradoxical inward displacement of the ventral abdominal wall, it has a salutary effect on tidal volume. This phenomenon is probably due to the fact that the diaphragm is part of the abdominal wall.

Coordination between rib cage muscles and diaphragm during quiet breathing in humans

1984 ◽  
Vol 57 (3) ◽  
pp. 899-906 ◽  
Author(s):  
A. De Troyer ◽  
M. Estenne
Keyword(s):  
Tidal Volume ◽  
Marked Reduction ◽  
Emg Activity ◽  
Quiet Breathing ◽  
Rib Cage ◽  
Intercostal Muscles ◽  
Inspiratory Activity ◽  
Normal Humans ◽  
Volume Range

The pattern of activation of the scalenes and the parasternal intercostal muscles was studied in relation to the pattern of rib cage and abdominal motion during various respiratory maneuvers in the tidal volume range in five normal humans. Electromyograms (EMG) of the scalenes and parasternal intercostals were recorded with bipolar needle electrodes, and changes in abdominal and rib cage displacement were measured using linearized magnetometers. The scalenes and parasternal intercostals were always active during quiet breathing, and their pattern of activation was identical; in both muscles the EMG activity usually started together with the beginning of inspiration, increased in intensity as inspiration proceeded, and persisted into the early part of expiration. In addition, like the parasternal activity the scalene inspiratory activity persisted until the tidal volume was trivial, increased during tidal inspirations performed with the rib cage alone, and was nearly abolished during diaphragmatic isovolume maneuvers. However, attempts to perform tidal inspiration with the diaphragm alone, while causing an increase in parasternal EMG activity, were associated with a marked reduction or a suppression of scalene EMG activity and a reduced substantially distorted rib cage expansion. In particular, the upper rib cage was then moving paradoxically.(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals Neuromechanical matching of drive in the scalene muscle of the anesthetized rabbit

2009 ◽  
Vol 107 (3) ◽  
pp. 741-748 ◽  
Author(s):  
Alexandre Legrand ◽  
Melanie Majcher ◽  
Emma Joly ◽  
Adeline Bonaert ◽  
Pierre Alain Gevenois
Keyword(s):  
Muscle Length ◽  
Emg Activity ◽  
Quiet Breathing ◽  
Lung Inflation ◽  
Scalene Muscle ◽  
Resistive Loading ◽  
Before And After ◽  
Residual Capacity ◽  
The Mean ◽  
Effective Part

The scalene is a primary respiratory muscle in humans; however, in dogs, EMG activity recorded from this muscle during inspiration was reported to derive from underlying muscles. In the present studies, origin of the activity in the medial scalene was tested in rabbits, and its distribution was compared with the muscle mechanical advantage. We assessed in anesthetized rabbits the presence of EMG activity in the scalene, sternomastoid, and parasternal intercostal muscles during quiet breathing and under resistive loading, before and after denervation of the scalene and after its additional insulation. At rest, activity was always recorded in the parasternal muscle and in the scalene bundle inserting on the third rib (medial scalene). The majority of this activity disappeared after denervation. In the bundle inserting on the fifth rib (lateral scalene), the activity was inconsistent, and a high percentage of this activity persisted after denervation but disappeared after insulation from underlying muscle layers. The sternomastoid was always silent. The fractional change in muscle length during passive inflation was then measured. The mean shortening obtained for medial and lateral scalene and parasternal intercostal was 8.0 ± 0.7%, 5.5 ± 0.5%, and 9.6 ± 0.1%, respectively, of the length at functional residual capacity. Sternomastoid muscle length did not change significantly with lung inflation. We conclude that, similar to that shown in humans, respiratory activity arises from scalene muscles in rabbits. This activity is however not uniformly distributed, and a neuromechanical matching of drive is observed, so that the most effective part is also the most active.

Human respiratory muscle actions and control during exercise

1997 ◽  
Vol 83 (4) ◽  
pp. 1256-1269 ◽  
Author(s):  
A. Aliverti ◽  
S. J. Cala ◽  
R. Duranti ◽  
G. Ferrigno ◽  
C. M. Kenyon ◽  
...  
Keyword(s):  
Lung Volume ◽  
Respiratory Muscle ◽  
Abdominal Muscle ◽  
Abdominal Pressure ◽  
Abdominal Muscles ◽  
Quiet Breathing ◽  
Rib Cage ◽  
Velocity Of Shortening ◽  
And Control ◽  
Muscle Actions

Aliverti, A., S. J. Cala, R. Duranti, G. Ferrigno, C. M. Kenyon, A. Pedotti, G. Scano, P. Sliwinski, Peter T. Macklem, and S. Yan. Human respiratory muscle actions and control during exercise. J. Appl. Physiol. 83(4): 1256–1269, 1997.—We measured pressures and power of diaphragm, rib cage, and abdominal muscles during quiet breathing (QB) and exercise at 0, 30, 50, and 70% maximum workload (W˙max) in five men. By three-dimensional tracking of 86 chest wall markers, we calculated the volumes of lung- and diaphragm-apposed rib cage compartments (Vrc,p and Vrc,a, respectively) and the abdomen (Vab). End-inspiratory lung volume increased with percentage of W˙max as a result of an increase in Vrc,p and Vrc,a. End-expiratory lung volume decreased as a result of a decrease in Vab. ΔVrc,a/ΔVab was constant and independent ofW˙max. Thus we used ΔVab/time as an index of diaphragm velocity of shortening. From QB to 70%W˙max, diaphragmatic pressure (Pdi) increased ∼2-fold, diaphragm velocity of shortening 6.5-fold, and diaphragm workload 13-fold. Abdominal muscle pressure was ∼0 during QB but was equal to and 180° out of phase with rib cage muscle pressure at all percent W˙max. Rib cage muscle pressure and abdominal muscle pressure were greater than Pdi, but the ratios of these pressures were constant. There was a gradual inspiratory relaxation of abdominal muscles, causing abdominal pressure to fall, which minimized Pdi and decreased the expiratory action of the abdominal muscles on Vrc,a gradually, minimizing rib cage distortions. We conclude that from QB to 0% W˙max there is a switch in respiratory muscle control, with immediate recruitment of rib cage and abdominal muscles. Thereafter, a simple mechanism that increases drive equally to all three muscle groups, with drive to abdominal and rib cage muscles 180° out of phase, allows the diaphragm to contract quasi-isotonically and act as a flow generator, while rib cage and abdominal muscles develop the pressures to displace the rib cage and abdomen, respectively. This acts to equalize the pressures acting on both rib cage compartments, minimizing rib cage distortion .

Mechanism of the increased rib cage expansion produced by the diaphragm with abdominal support

2015 ◽  
Vol 118 (8) ◽  
pp. 989-995 ◽  
Author(s):  
André De Troyer ◽  
Theodore A. Wilson
Keyword(s):  
Abdominal Wall ◽  
Pleural Pressure ◽  
Vector Analysis ◽  
Abdominal Pressure ◽  
Mechanical Support ◽  
Rib Cage ◽  
Intercostal Muscles ◽  
Anesthetized Dogs ◽  
External Forces

When the abdomen in quadriplegic subjects is given a passive mechanical support, the expansion of the lower rib cage during inspiration is greater and the inward displacement of the upper rib cage is smaller. These changes have traditionally been attributed to an increase in the appositional force of the diaphragm, but the mechanisms have not been assessed. In this study, the inspiratory intercostal muscles in all interspaces were severed in anesthetized dogs, so that the diaphragm was the only muscle active during inspiration, and the displacements of the ribs 10 and 5 and the changes in pleural and abdominal pressure were measured during unimpeded breathing and during breathing with a plate applied on the ventral abdominal wall. In addition, external forces were applied to the 10th rib pair in the cranial and lateral directions, and the rib trajectories thus obtained were used as the basis for a vector analysis to estimate the relative contributions of the insertional and appositional forces to the rib 10 displacements during breathing. Application of the abdominal plate caused a marked increase in the inspiratory cranial and outward displacement of rib 10 and a decrease in the inspiratory caudal displacement of rib 5. Analysis of the results showed, however, that 1) the insertional and appositional forces contributed nearly equally to the increased inspiratory displacement of rib 10 and 2) the decrease in the expiratory displacement of rib 5 was the result of both the greater displacement of the lower ribs and the decrease in pleural pressure.

Sonomicrometric regional diaphragmatic shortening in awake sheep after thoracic surgery

1989 ◽  
Vol 67 (6) ◽  
pp. 2357-2368 ◽  
Author(s):  
A. Torres ◽  
W. R. Kimball ◽  
J. Qvist ◽  
K. Stanek ◽  
R. M. Kacmarek ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Tidal Volume ◽  
Minute Ventilation ◽  
Respiratory Frequency ◽  
Quiet Breathing ◽  
Transdiaphragmatic Pressure ◽  
Right Thoracotomy ◽  
Before And After ◽  
End Tidal ◽  
End Tidal Co2

Through a right thoracotomy in seven sheep we chronically implanted sonomicrometry crystals and electromyographic electrodes in the costal and crural diaphragmatic regions. Awake sheep were studied during recovery for 4-6 wk, both during quiet breathing (QB) and during CO2 rebreathing. Tidal volume, respiratory frequency, and esophageal and gastric pressures were studied before and after surgery. Normalized resting length (LFRC) was significantly decreased for the costal segment on postoperative day 1 compared with postoperative day 28. Fractional costal shortening both during QB and at 10% end-tidal CO2 (ETCO2) increased significantly from postoperative days 1 to 28, whereas crural shortening did not change during QB but progressively increased at 10% ETCO2. Maximal costal shortening during electrophrenic stimulation was constant at 40% LFRC during recovery, although maximal crural shortening increased from 23 to 32% LFRC. Minute ventilation, tidal volume, and transdiaphragmatic pressure at 10% ETCO2 increased progressively after thoracotomy until postoperative day 28. Our results suggest there is profound diaphragmatic inhibition after thoracotomy and crystal implantation in sheep that requires at least 3-4 wk for stable recovery.

Transdiaphragmatic pressure and rib motion in area of apposition during paralysis

1988 ◽  
Vol 65 (3) ◽  
pp. 1296-1300 ◽  
Author(s):  
E. Agostoni ◽  
L. Zocchi ◽  
P. T. Macklem
Keyword(s):  
Abdominal Pressure ◽  
Transdiaphragmatic Pressure ◽  
Lung Inflation ◽  
Volume Increase ◽  
Rib Cage ◽  
Pleural Surface ◽  
Supine Posture ◽  
Residual Capacity ◽  
Lateral Posture ◽  
Volume Decrease

Changes in pleural surface pressure in area of apposition of diaphragm to rib cage (delta Ppl,ap), changes in abdominal pressure (delta Pab), and redial displacement of the 11th rib have been recorded in anesthetized, paralyzed dogs during lung inflation or deflation. Above functional residual capacity (FRC) changes in transdiaphragmatic pressure in area of apposition (delta Pdi,ap) were essentially nil in intact (INT) dogs either in lateral or supine posture, and in partially eviscerated (EVS) dogs in lateral posture, either in the 10th or 11th intercostal space. Below FRC delta Pdi,ap could be positive (INT lateral and EVS), nil (EVS), or negative (INT supine and EVS); it could be different in the 10th and 11th intercostal spaces. Hence, with stretched (like with contracted) diaphragm, delta Ppl,ap measured at one site often differs from delta Pab and is not representative of average pressure acting on area of apposition. With volume increase above FRC, the 11th rib moved slightly in and then out in EVS and linearly out in INT. With volume decrease below FRC it moved out progressively in EVS, and it moved in and eventually reversed in INT. In paralyzed dogs in lateral posture the factor having the greatest influence on displacement of the abdominal rib cage is Pab. Mechanical linkage with pulmonary rib cage becomes relevant at large volume, whereas insertional traction of diaphragm becomes relevant at low volume.

Reflex effect of esophageal distension on respiratory muscle activity and pressure

1989 ◽  
Vol 66 (2) ◽  
pp. 536-541 ◽  
Author(s):  
A. Oliven ◽  
M. Haxhiu ◽  
S. G. Kelsen
Keyword(s):  
Motor Activity ◽  
Electrical Activity ◽  
Respiratory Muscle ◽  
Abdominal Cavity ◽  
Respiratory Muscles ◽  
Abdominal Pressure ◽  
Lung Inflation ◽  
Rib Cage ◽  
Expiratory Muscles ◽  
Crural Diaphragm

The electrical activity of the respiratory skeletal muscles is altered in response to reflexes originating in the gastrointestinal tract. The present study evaluated the reflex effects of esophageal distension (ED) on the distribution of motor activity to both inspiratory and expiratory muscles of the rib cage and abdomen and the resultant changes in thoracic and abdominal pressure during breathing. Studies were performed in 21 anesthetized spontaneously breathing dogs. ED was produced by inflating a balloon in the distal esophagus. ED decreased the activity of the costal and crural diaphragm and external intercostals and abolished all preexisting electrical activity in the expiratory muscles of the abdominal wall. On the other hand, ED increased the activity of the parasternal intercostals and expiratory muscles located in the rib cage (i.e., triangularis sterni and internal intercostal). All effects of ED were graded, with increasing distension exerting greater effects, and were eliminated by vagotomy. The effect of increases in chemical drive and lung inflation reflex activity on the response to ED was examined by performing ED while animals breathed either 6.5% CO2 or against graded levels of positive end-expiratory pressure (PEEP), respectively. Changes in respiratory muscle electrical activity induced by ED were similar (during 6.5% CO2 and PEEP) to those observed under control conditions. We conclude that activation of mechanoreceptors in the esophagus reflexly alters the distribution of motor activity to the respiratory muscles, inhibiting the muscles surrounding the abdominal cavity and augmenting the parasternals and expiratory muscles of the chest wall.

Role of rib cage elastance in the coupling between the abdominal muscles and the lung

2004 ◽  
Vol 97 (1) ◽  
pp. 85-90 ◽  
Author(s):  
Matteo Cappello ◽  
André De Troyer
Keyword(s):  
Transversus Abdominis ◽  
Abdominal Pressure ◽  
Abdominal Muscles ◽  
Transverse Diameter ◽  
Rib Cage ◽  
Mechanical Coupling ◽  
Before And After ◽  
Airway Opening ◽  
Order Of Magnitude ◽  
Anesthetized Dogs

The abdominal muscles expand the rib cage when they contract alone. This expansion opposes the deflation of the lung and may be viewed as pressure dissipation. The hypothesis was raised, therefore, that alterations in rib cage elastance should affect the lung deflating action of these muscles. To test this hypothesis and evaluate the quantitative importance of this effect, we measured the changes in airway opening pressure (Pao), abdominal pressure (Pab), and rib cage transverse diameter during isolated stimulation of the transversus abdominis muscle in anesthetized dogs, first with the rib cage intact and then after rib cage elastance was increased by clamping the ribs and the sternum. Stimulation produced increases in Pao, Pab, and rib cage diameter in both conditions. With the ribs and sternum clamped, however, the change in Pab was unchanged but the change in Pao was increased by 77% ( P < 0.001). In a second experiment, the transversus abdominis was stimulated before and after rib cage elastance was reduced by removing the bony ribs 3–8. Although the change in Pab after removal of the the ribs was still unchanged, the change in Pao was reduced by 62% ( P < 0.001). These observations, supported by a model analysis, indicate that rib cage elastance is a major determinant of the mechanical coupling between the abdominal muscles and the lung. In fact, in the dog, the effects of rib cage elastance and Pab on the lung-deflating action of the abdominal muscles are of the same order of magnitude.

Influence of global inspiratory muscle fatigue on breathing during exercise

1996 ◽  
Vol 80 (4) ◽  
pp. 1270-1278 ◽  
Author(s):  
P. Sliwinski ◽  
S. Yan ◽  
A. P. Gauthier ◽  
P. T. Macklem
Keyword(s):  
Tidal Volume ◽  
Muscle Fatigue ◽  
Minute Ventilation ◽  
Inspiratory Muscle ◽  
Abdominal Muscles ◽  
Maximal Power Output ◽  
Lung Inflation ◽  
Rib Cage ◽  
Inspiratory Muscles ◽  
Inspiratory Muscle Fatigue

We evaluated the effect of global inspiratory muscle fatigue (GF) on respiratory muscle control during exercise at 30, 60, and 90% of maximal power output in normal subjects. Fatigue was induced by breathing against a high inspiratory resistance until exhaustion. Esophageal and gastric pressures, anteroposterior displacement of the rib cage and abdomen, breathing pattern, and perceived breathlessness were measured. Induction of GF had no effect on the ventilatory parameters during mild and moderate exercise. It altered, however, ventilatory response to heavy exercise by increasing breathing frequency and minute ventilation, with minor changes in tidal volume. This was accompanied by an increase in perceived breathlessness. GF significantly increased both the tonic and phasic activities of abdominal muscles that allowed 1) the diaphragm to maintain its function while developing less pressure, 2) the same tidal volume with lesser shortening of the rib cage inspiratory muscles, and 3) relaxation of the abdominal muscles to contribute to lung inflation. The increased work performed by the abdominal muscles may, however, lead to a reduction in their strength. GF may impair exercise performance in some healthy subjects that is probably not related to excessive breathlessness or other ventilatory factors. We conclude that the respiratory system is remarkably adaptable in maintaining ventilation during exercise even with impaired inspiratory muscle contractility.

Association of chest wall motion and tidal volume responses during CO2 rebreathing

1996 ◽  
Vol 81 (4) ◽  
pp. 1528-1534 ◽  
Author(s):  
Sheng Yan ◽  
Pawel Sliwinski ◽  
Peter T. Macklem
Keyword(s):  
Tidal Volume ◽  
Chest Wall ◽  
Wall Motion ◽  
Forced Expiratory Volume ◽  
Quiet Breathing ◽  
Rib Cage ◽  
Chest Wall Motion ◽  
Variable Recruitment ◽  
The Individual ◽  
End Tidal

Yan, Sheng, Pawel Sliwinski, and Peter T. Macklem.Association of chest wall motion and tidal volume responses during CO2 rebreathing. J. Appl. Physiol. 81(4): 1528–1534, 1996.—The purpose of this study is to investigate the effect of chest wall configuration at end expiration on tidal volume (Vt) response during CO2 rebreathing. In a group of 11 healthy male subjects, the changes in end-expiratory and end-inspiratory volume of the rib cage (ΔVrc,e and ΔVrc,i, respectively) and abdomen (ΔVab,eand ΔVab,i, respectively) measured by linearized magnetometers were expressed as a function of end-tidal[Formula: see text]([Formula: see text]). The changes in end-expiratory and end-inspiratory volumes of the chest wall (ΔVcw,e and ΔVcw,i, respectively) were calculated as the sum of the respective rib cage and abdominal volumes. The magnetometer coils were placed at the level of the nipples and 1–2 cm above the umbilicus and calibrated during quiet breathing against the Vt measured from a pneumotachograph. The ΔVrc,e/[Formula: see text]slope was quite variable among subjects. It was significantly positive ( P < 0.05) in five subjects, significantly negative in four subjects ( P < 0.05), and not different from zero in the remaining two subjects. The ΔVab,e/[Formula: see text]slope was significantly negative in all subjects ( P < 0.05) with a much smaller intersubject variation, probably suggesting a relatively more uniform recruitment of abdominal expiratory muscles and a variable recruitment of rib cage muscles during CO2rebreathing in different subjects. As a group, the mean ΔVrc,e/[Formula: see text], ΔVab,e/[Formula: see text], and ΔVcw,e/[Formula: see text]slopes were 0.010 ± 0.034, −0.030 ± 0.007, and −0.020 ± 0.032 l / Torr, respectively; only the ΔVab,e/[Formula: see text]slope was significantly different from zero. More interestingly, the individual ΔVt/[Formula: see text]slope was negatively associated with the ΔVrc,e/[Formula: see text]( r = −0.68, P = 0.021) and ΔVcw,e/[Formula: see text]slopes ( r = −0.63, P = 0.037) but was not associated with the ΔVab,e/[Formula: see text]slope ( r = 0.40, P = 0.223). There was no correlation of the ΔVrc,e/[Formula: see text]and ΔVcw,e/[Formula: see text]slopes with age, body size, forced expiratory volume in 1 s, or expiratory time. The group ΔVab,i/[Formula: see text]slope (0.004 ± 0.014 l / Torr) was not significantly different from zero despite the Vt nearly being tripled at the end of CO2 rebreathing. In conclusion, the individual Vtresponse to CO2, although independent of ΔVab,e, is a function of ΔVrc,e to the extent that as the ΔVrc,e/[Formula: see text]slope increases (more positive) among subjects, the Vt response to CO2 decreases. These results may be explained on the basis of the respiratory muscle actions and interactions on the rib cage.

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