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The Intercostal Muscles
Published in Alan D. Miller, Armand L. Bianchi, Beverly P. Bishop, Neural Control of the Respiratory Muscles, 2019
During anesthesia, the intercostal muscles, like the limb muscles, are generally inactive.20,21 Consequently, it is difficult to determine the effect of segmental deafferentation on their electrical activity. In the decerebrate preparation, bilateral section of the dorsal roots inactivates the lateral part of the external and internal intercostal muscles at rest. The phasic inspiratory activity of the diaphragm and that of the intercartilaginous muscles remains unchanged. In some experiments, spontaneous inspiratory activity is observed on the lateral part of the external intercostal muscles.
The respiratory system
Published in Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella, Essentials of Human Physiology and Pathophysiology for Pharmacy and Allied Health, 2019
Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella
Assisting the diaphragm with inspiration are the external intercostal muscles. These muscles connect adjacent ribs. When the external intercostal muscles contract, the ribs are lifted upward and outward (much like a handle on a bucket). Therefore, contraction of these muscles causes an increase in the horizontal dimension (front to back) of the thoracic cavity and a further increase in thoracic volume. The external intercostal muscles are supplied by the intercostal nerves.
A randomized placebo-controlled study investigating the efficacy of inspiratory muscle training in the treatment of children with bronchial asthma
Published in Journal of Asthma, 2021
The IMT group exhibited greater increases in the IPmax and EPmax, denoting a higher acquisition of respiratory muscle strength. These results were consistent with those of previous studies including pediatric patients (20) and adult patients (7,14,16,17,29,33–35) suffering from bronchial asthma, where uniform improvements of respiratory muscles strength have been demonstrated. On the contrary, we found only one randomized clinical trial including 18 subjects with stable mild/moderate asthma pointed out there was no difference between the IMT group and the age- and gender-matched control group for the EPmax and asthma symptoms (37). The improvement in respiratory muscle strength herein might be attributed to an improved neuromuscular recruitment pattern of respiratory musculature, and increased diaphragm cross-sectional area, and increased type II muscle fibers in the external intercostal muscles, permitting them to generate higher forces in response to a given level of respiratory muscle drive (38,39). Also, reduced energy costs of respiratory muscles may represent another plausible explanation for improvements in respiratory muscle strength and endurance (40).
Ultrasonographic evaluation of diaphragm thickness and excursion in patients with cervical spinal cord injury
Published in The Journal of Spinal Cord Medicine, 2021
Zhizhong Zhu, Jianjun Li, Degang Yang, Feng Gao, Liangjie Du, Mingliang Yang
Diaphragm excursion was also seen as an index of diaphragmatic contractile activity19,20 and mainly related to the inspired volume.21 Ultrasound imaging measurement is useful to accurately evaluate diaphragm excursions at the end of tidal breathing.22 In tetraplegia, distortion of the respiratory system causes inefficient ventilation. During spontaneous breathing, the lack of activity in the external intercostal muscles causes distortion where the upper anterior rib cage moves inward during inhalation diminishing the extent of rib-cage expansion that the diaphragm can contribute to.23 This study confirms this: at the end of quiet tidal breathing, diaphragm excursion in patients with cervical SCI was greater than control participants when compensating for insufficient tidal volume. Meanwhile, during maximal inspiration, no diaphragm excursion difference was found.
Respiratory disturbances in fibromyalgia: A systematic review and meta-analysis of case control studies
Published in Expert Review of Respiratory Medicine, 2021
Araceli Ortiz-Rubio, Irene Torres-Sánchez, Irene Cabrera-Martos, Laura López-López, Janet Rodríguez-Torres, María Granados-Santiago, Marie Carmen Valenza
Fibromyalgia is a syndrome highly comorbid with other pain conditions, such as myofascial pain syndromes, headache, neck pain, and chronic visceral pain. These comorbidities may have an influence on the respiration function [43,44]. In this line, a recent systematic review concluded that individuals with neck pain have reduced maximum pressures [45]. The authors suggested that a cervical and thoracic spine stabilization is needed for optimal activation of respiratory muscles. Imbalance of neck stabilized and mobilizer muscles in the presence of pain may lead to instability of the cervical and thoracic spine regions as well as changes in rib cage mechanics. Modifications of rib cage movement may also lead to respiratory disturbances by influencing the length-tension curve in the muscles, such as the abdominal muscles, diaphragm, and external intercostal muscles. Further studies should be performed to determine if similar reasons can explain reduced respiratory pressures in fibromyalgia.