Mechanical interaction between the diaphragm and rib cage.

Goldman, Michael; Mead, J.

doi:10.1152/jappl.1973.35.2.197

Cited by 154 publications

(52 citation statements)

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“…The height of ZOA decreases by about 15mm, while the dome of the diaphragm remains relatively constant in size and shape. At maximum inspiratory capacity of the lungs, ZOA is almost zero [22,23].…”

Section: Mechanical Action Of the Diaphragmmentioning

confidence: 99%

Network of Breathing. Multifunctional Role of the Diaphragm: A Review

Kocjan

Adamek

Gzik-Zroska

et al. 2017

Advances in Respiratory Medicine

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The diaphragm is the primary muscle involved in active inspiration and serves also as an important anatomical landmark that separates the thoracic and abdominal cavity. However, the diaphragm muscle like other structures and organs in the human body has more than one function, and displays many anatomic links throughout the body, thereby forming a 'network of breathing'. Besides respiratory function, it is important for postural control as it stabilises the lumbar spine during loading tasks. It also plays a vital role in the vascular and lymphatic systems, as well as, is greatly involved in gastroesophageal functions such as swallowing, vomiting, and contributing to the gastroesophageal reflux barrier. In this paper we set out in detail the anatomy and embryology of the diaphragm and attempt to show it serves as both: an important exchange point of information, originating in different areas of the body, and a source of information in itself. The study also discusses all of its functions related to breathing.

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Section: Mechanical Action Of the Diaphragmmentioning

confidence: 99%

Network of Breathing. Multifunctional Role of the Diaphragm: A Review

Kocjan

Adamek

Gzik-Zroska

et al. 2017

Advances in Respiratory Medicine

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“…In a seminal study, Goldman and Mead 13 showed how the superior diaphragm surface is in straight relation with the entire chest wall. As consequence, the lower rib cage behaves during tidal breathing as if it is driven by transabdominal rather than trans-thoracic pressure.…”

Section: Diaphragm Physiologymentioning

confidence: 99%

“…The abdominal respiratory muscles are regarded as expiratory muscles that augment the passive recoil of the lungs. A few studies 13,[15][16][17] have demonstrated how the accessory respiratory muscles have the primary role to stabilize the chest wall and convert diaphragm contraction into intrathoracic pressure and volume changes. For these reasons, it should always be taken into account that the evaluation of single diaphragm function could be insufficient in the evaluation of the weaning process.…”

Section: Diaphragm Physiologymentioning

confidence: 99%

Ultrasonographic Assessment of Diaphragm Function in Critically Ill Subjects

Umbrello

Formenti

2016

Respir Care

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The majority of patients admitted to the ICU require mechanical ventilation as a part of their process of care. However, mechanical ventilation itself or the underlying disease can lead to dysfunction of the diaphragm, a condition that may contribute to the failure of weaning from mechanical ventilation. However, extended time on the ventilator increases health-care costs and greatly increases patient morbidity and mortality. Nevertheless, symptoms and signs of muscle disease in a bedridden (or bed rest-only) ICU patient are often difficult to assess because of concomitant confounding factors. Conventional assessment of diaphragm function lacks specific, noninvasive, time-saving, and easily performed bedside tools or requires patient cooperation. Recently, the use of ultrasound has raised great interest as a simple, noninvasive method of quantification of diaphragm contractile activity. In this review, we discuss the physiology and the relevant pathophysiology of diaphragm function, and we summarize the recent findings concerning the evaluation of its (dys)function in critically ill patients, with a special focus on the role of ultrasounds. We describe how to assess diaphragm excursion and diaphragm thickening during breathing and the meaning of these measurements under spontaneous or mechanical ventilation as well as the reference values in health and disease. The spread of ultrasonographic assessment of diaphragm function may possibly result in timely identification of patients with diaphragm dysfunction and to a potential improvement in the assessment of recovery from diaphragm weakness.

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“…Contraction of the costal diaphragm, on the other hand, expands the rib cage and displaces the abdomen while inflating the lung (19). The costal diaphragm, however, can lift and expand the rib cage only to the extent that abdominal pressure increases (20). Thus, one could hypothesize that an increase in crural EMG activity, translated into an equivalent degree of mechanical action, would cause an additional rise in abdominal pressure and would augment the rib cage expanding action of the costal diaphragm and, therefore, ventilation during loaded breathing.…”

Section: Discussionmentioning

confidence: 99%

Effect of Hypercapnia and Hypoxia on Costal and Crural Diaphragm Electromyograms in Piglets

et al. 1988

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ABSTRACT. We examined the separate effects of acute hypercapnia and acute hypoxia on the electromyographic activity (EMG) of the costal and crural diaphragm in 6 anesthetized spontaneously breathing piglets (age 12-23 days, weight 3.00-4.37 kg). Bipolar wire electrodes were inserted into the anterior paratendinous costal diaphragm and the midportion of the crural diaphragm. EMG activity was quantified in arbitrary units (au) of peak moving time average while the animals breathed 50% 02/50% N2 (baseline) and after 30 min of either hypercapnia (12% COz) or hypoxia (12% Oz) exposure. After 30 min of hypercapnia, the peak moving time average EMG increased in both parts of the diaphragm with the increase in crural diaphragm EMG activity (from baseline: 20 f 2 au to 30 min 12% C02: 83 f 20 au) not being significantly different from that observed in the costal diaphragm (from baseline: 21 f 2 au to 30 min 12% C02: 72 f 20 au, p = 0.17).Similarly, the peak moving time average EMG increased in both parts of the diaphragm after 30 min of hypoxia with the increase in the crural diaphragm EMG activity (from baseline: 21 f 2 au to 30 min 12% 02: 28 f 6 au) not being significantly different from that observed in the costal diaphragm (from baseline: 21 f 1 au to 30 min 12% 02: 26 f 7 au, p = 0.51). These data indicate that the inspiratory EMG activity of the diaphragm is not differentially distributed between its costal and crural components during chemically stimulated breathing in piglets. (Pediatr Res 23: 54-57,1987 Abbreviations EMG, electromyography PaOz, arterial oxygen partial pressure PaC02, arterial carbon dioxide partial pressure au, arbitrarity unit IRL, inspiratory resistive loaded breathing Experimental evidence from adult animal studies suggest that the costal and crural portions of the diaphragm may be two separate muscles (I -5). Specifically, differences in the mechanical actions (I), fiber composition (2), embryologic development (3), and segmental innervation (4,5) of the costal and crural segments have been documented. Furthermore, investigators have reported differential costal and crural diaphragm electromyographic activity during periods of heightened respiratory drive (6, 7) suggesting that the neural control of the two diaphragmatic segments may be different.In support of this concept, we have recently reported that the inspiratory EMG activity of the diaphragm is differentially distributed between its costal and crural components during inspiratory resistive loaded breathing in piglets (8). Specifically, we observed a greater augmentation in crural EMG activity when compared to its costal counterpart during the period of loaded breathing. The etiology of the greater augmentation in crural when compared with costal activity during inspiratory resistive loaded breathing is not known. However, investigators have reported that hypercapnia (6, 9) (a resultant condition of inspiratory resistive loaded breathing in our study) and hypoxia (9,10) will in and of themselves lead to a preferential augmentation...

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Mechanical interaction between the diaphragm and rib cage.

Cited by 154 publications

References 0 publications

Network of Breathing. Multifunctional Role of the Diaphragm: A Review

Network of Breathing. Multifunctional Role of the Diaphragm: A Review

Ultrasonographic Assessment of Diaphragm Function in Critically Ill Subjects

Effect of Hypercapnia and Hypoxia on Costal and Crural Diaphragm Electromyograms in Piglets

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