The Diaphragm Muscle
Alan D. Miller, Armand L. Bianchi, Beverly P. Bishop in Neural Control of the Respiratory Muscles, 2019
The diaphragm muscle (DIAm) is a complex structure separating the thoracic and abdominal cavities, hence the Greek meaning “to span a partition”. The DIAm appears rather late in evolution, being present only in mammals, while other vertebrates use different means of ventilation. The DIAm is embryologically derived from the mesoderm, with the muscular and tendonous portions having a composite origin. The central tendon arises from the septum transversum which also contributes to the derivation of the pericardium and connective tissue of the liver, thus the close association between the DIAm and these thoracic and abdominal structures. The muscular portion of the DIAm derives from myotomes of the cervical spinal cord, and then makes its long descent to ultimately gain a broad range of attachment at the thoracic and lumbar levels. The innervation of the DIAm arises from its cervical site of origin and follows the long descent of the muscle. The mechanical actions of the DIAm are as complex as its multiple sites of origin and insertion. Its major function is in inspiration, although the DIAm is also involved in several nonventilatory motor behaviors including coughing, defecation, emesis, micturition, parturition, sneezing, vocalization, and weight lifting.
The Stomach (ST)
Narda G. Robinson in Interactive Medical Acupuncture Anatomy, 2016
Clinical Relevance: Trigger points in the pectoralis muscle refer to the deltoid from the clavicular section and to the left breast/pectoral region and medial elbow from the sternocostal section. Tension in the region of the first and second ribs increases the likelihood of nerve entrapment and brachial plexopathy. Note the nerves and vessels coursing beneath ST 14 in Figure 3-39. The muscles in this region shorten when an individual recruits the accessory muscles of inspiration, or AMI (e.g., the pectoralis and trapezius muscles). This occurs when the demand for oxygen exceeds the pumping ability of the thoracic diaphragm. Patients with chronic obstructive pulmonary disease (COPD) and asthma often utilize their AMI. Intense exercise also activates the AMI; their muscle contraction coincides with that of the diaphragm during inspiration.2
Clinical Toxicology of Conus Snail Stings
Jürg Meier, Julian White in Handbook of: Clinical Toxicology of Animal Venoms and Poisons, 2017
In C. geographus stings, the development of symptoms is relatively rapid 27-29,48. The immediate numbness around the site of stinging spreads rapidly upwards to the rest of the extremity then to the shoulder, throat and lips; within 30 min partial paralysis and difficulty in speaking may develop. The victim feels faint and numbness spreads thoughout the body. In very severe cases, this is followed by a progression of symptoms - from inability to speak, blurring of vision with diplopia, paralysis of most voluntary muscles, cyanosis then unconsciousness within an hour. In less severe cases, there is general muscle weakness, ataxia, diminished reflexes, slurred speech, difficulty in swallowing and breathing. Depending on the severity of the case, coma followed by death may occur in 40 min to 5 hr. Respiratory failure due to paralysis of the diaphragm muscle is believed to be the cause of death 19,49.
Proteomic profiling of fatty acid binding proteins in muscular dystrophy
Published in Expert Review of Proteomics, 2020
Paul Dowling, Stephen Gargan, Margit Zweyer, Dieter Swandulla, Kay Ohlendieck
Systematic mass spectrometric surveys of contractile tissues and muscle cell cultures have identified FABP3 and varying amounts of FABP1, FABP2 and FABP4 to FABP7 proteoforms in various subtypes of animal and human skeletal muscles [51–65], as listed in Table 2. The FABP3 isoform was clearly shown to be of highest abundance in slow skeletal muscles and identified as a proteomic marker of aerobic capacity and fast-to-slow muscle transitions [51–54,58–60], which agrees with greater intra-myocellular lipid droplet accumulation and high levels of oxidative metabolism in slow-twitching fibers [7]. In Mus musculus, the mixed-fiber gastrocnemius muscle contains besides its characteristic heart/muscle FABP3 isoform also adipocyte FABP4 and epidermal FABP5. Of note, the diaphragm muscle contains a larger variety of isoforms, including liver FABP1, intestinal FABP2, heart/muscle FABP3, adipocyte FABP4 and epidermal FABP5 (Table 1). These proteomic surveys demonstrate the complexity of FABP expression patterns, which is evident in the below sections on the effects of muscular dystrophy on the body-wide distribution of FABP proteoforms.
Prospective analysis of a surgical algorithm to achieve ventilator weaning in cervical tetraplegia
Published in The Journal of Spinal Cord Medicine, 2022
Matthew R. Kaufman, Thomas Bauer, Stuart Campbell, Kristie Rossi, Andrew Elkwood, Reza Jarrahy
For the most severe cases of neuromuscular degeneration, muscle replacement may be considered for the potential to wean to a pacemaker. Diaphragm replacement using vascularized muscle flaps is based on the work of Barnhart et al.19 and others, who reported the successful use of abdominal muscle flaps to repair large congenital diaphragmatic hernias.8,9 In the current study both of the patients receiving this treatment had failed prior pacemaker attempts. One of these patients had a pre-operative EMG with evidence of severe neuromuscular degeneration, and the second patient was 48 months post-injury. Both have achieved PW at 2-year follow-up. The application of diaphragm muscle replacement in this patient population is novel and further investigation is necessary to validate these early results.
Motor activity and Becker’s muscular dystrophy: lights and shadows
Published in The Physician and Sportsmedicine, 2020
Giuseppe Lanza, Marcello Pino, Francesco Fisicaro, Carla Vagli, Mariagiovanna Cantone, Manuela Pennisi, Rita Bella, Maria Bellomo
Finally, although numerous investigations have shown improvements in limb muscle function following short-term endurance trainings, their long-term effects are largely unknown. A previous study [7] showed that, despite some improvements, the old mdx mice exhibited significant functional deficits compared to controls, thus supporting the concept that long-term voluntary exercise would have a beneficial effect on control mice and a deleterious effect on mdx mice as they aged. However, although dystrophin-less muscles from sedentary mice displayed significant signs of muscle damage, mdx mice could still respond to low-level voluntary running [7]. A more recent study showed that long-term wheel running impairs the diaphragm function but improves the cardiac and plantar flexor function, suggesting that the dystrophic heart may undergo positive exercise-induced remodeling while limb muscles are largely unaffected. However, these data warn also on the possibility of exercise-mediated injury of dystrophic diaphragm muscle [24].
Related Knowledge Centers
- Urogenital Diaphragm
- Abdominal Cavity
- Pelvic Floor
- Capillary
- Lung
- Heart
- Thoracic Cavity
- Skeletal Muscle
- Mitochondrion
- Muscles of Respiration