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Behr M, Pérès J, Llari M, Godio Y, Jammes Y, Brunet C. A Three-Dimensional Human Trunk Model for the Analysis of Respiratory Mechanics. J Biomech Eng 2009; 132:014501. [DOI: 10.1115/1.4000308] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Over the past decade, road safety research and impact biomechanics have strongly stimulated the development of anatomical human numerical models using the finite element (FE) approach. The good accuracy of these models, in terms of geometric definition and mechanical response, should now find new areas of application. We focus here on the use of such a model to investigate its potential when studying respiratory mechanics. The human body FE model used in this study was derived from the RADIOSS® HUMOS model. Modifications first concerned the integration and interfacing of a user-controlled respiratory muscular system including intercostal muscles, scalene muscles, the sternocleidomastoid muscle, and the diaphragm and abdominal wall muscles. Volumetric and pressure measurement procedures for the lungs and both the thoracic and abdominal chambers were also implemented. Validation of the respiratory module was assessed by comparing a simulated maximum inspiration maneuver to volunteer studies in the literature. Validation parameters included lung volume changes, rib rotations, diaphragm shape and vertical deflexion, and intra-abdominal pressure variation. The HUMOS model, initially dedicated to road safety research, could be turned into a promising, realistic 3D model of respiration with only minor modifications.
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Affiliation(s)
- Michel Behr
- LBA, Faculté de Medecine Nord, UMRT24, INRETS/Université de la Méditerranée, Boulevard Pierre Dramard, Marseille F-13916, France
| | - Jeremie Pérès
- LBA, Faculté de Medecine Nord, UMRT24, INRETS/Université de la Méditerranée, Boulevard Pierre Dramard, Marseille F-13916, France
| | - Maxime Llari
- LBA, Faculté de Medecine Nord, UMRT24, INRETS/Université de la Méditerranée, Boulevard Pierre Dramard, Marseille F-13916, France
| | - Yves Godio
- LBA, Faculté de Medecine Nord, UMRT24, INRETS/Université de la Méditerranée, Boulevard Pierre Dramard, Marseille F-13916, France
| | - Yves Jammes
- Faculté de Médecine Nord, UMR MD2 P2COE, IFR Jean Roche/Université de la Méditerranée, Boulevard Pierre Dramard, Marseille F-13916, France
| | - Christian Brunet
- LBA, Faculté de Medecine Nord, UMRT24, INRETS/Université de la Méditerranée, Boulevard Pierre Dramard, Marseille F-13916, France
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52
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Legrand A, Majcher M, Joly E, Bonaert A, Gevenois PA. Neuromechanical matching of drive in the scalene muscle of the anesthetized rabbit. J Appl Physiol (1985) 2009; 107:741-8. [PMID: 19608926 DOI: 10.1152/japplphysiol.91320.2008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
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.
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Affiliation(s)
- Alexandre Legrand
- Department of Physiology and Pharmacology, University of Mons, 7000 Mons, Belgium.
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53
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A prototype percutaneous transhepatic cholangiography training simulator with real-time breathing motion. Int J Comput Assist Radiol Surg 2009; 4:571-8. [PMID: 20033333 DOI: 10.1007/s11548-009-0367-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2009] [Accepted: 05/18/2009] [Indexed: 10/20/2022]
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54
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De Troyer A, Wilson TA. Effect of acute inflation on the mechanics of the inspiratory muscles. J Appl Physiol (1985) 2009; 107:315-23. [PMID: 19265064 DOI: 10.1152/japplphysiol.91472.2008] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
When the lung is inflated acutely, the capacity of the diaphragm to generate pressure, in particular pleural pressure (Ppl), is impaired because the muscle during contraction is shorter and generates less force. At very high lung volumes, the pressure-generating capacity of the diaphragm may be further reduced by an increase in the muscle radius of curvature. Lung inflation similarly impairs the pressure-generating capacity of the inspiratory intercostal muscles, both the parasternal intercostals and the external intercostals. In contrast to the diaphragm, however, this adverse effect is largely related to the orientation and motion of the ribs, rather than the ability of the muscles to generate force. During combined activation of the two sets of muscles, the change in Ppl is larger than during isolated diaphragm activation, and this added load on the diaphragm reduces the shortening of the muscle and increases muscle force. In addition, activation of the diaphragm suppresses the cranial displacement of the passive diaphragm that occurs during isolated intercostal contraction and increases the respiratory effect of the intercostals. As a result, the change in Ppl generated during combined diaphragm-intercostal activation is greater than the sum of the pressures generated during separate muscle activation. Although this synergistic interaction becomes particularly prominent at high lung volumes, lung inflation, either bilateral or unilateral, places a substantial stress on the inspiratory muscle pump.
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Affiliation(s)
- André De Troyer
- Laboratory of Cardiorespiratory Physiology, Brussels School of Medicine, and Chest Service, Erasme University Hospital, Brussels, Belgium.
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55
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Zhang XJ, Yu G, Wen XH, Lin ZC, Yang FQ, Zheng ZG, Chen RC, Zhong NS. Effect of propofol on twitch diaphragmatic pressure evoked by cervical magnetic stimulation in patients. Br J Anaesth 2009; 102:61-4. [DOI: 10.1093/bja/aen327] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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56
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Ratnovsky A, Elad D, Halpern P. Mechanics of respiratory muscles. Respir Physiol Neurobiol 2008; 163:82-9. [DOI: 10.1016/j.resp.2008.04.019] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2008] [Revised: 04/26/2008] [Accepted: 04/29/2008] [Indexed: 11/26/2022]
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57
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58
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Butler JE. Drive to the human respiratory muscles. Respir Physiol Neurobiol 2007; 159:115-26. [PMID: 17660051 DOI: 10.1016/j.resp.2007.06.006] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2007] [Revised: 06/07/2007] [Accepted: 06/07/2007] [Indexed: 11/24/2022]
Abstract
The motor control of the respiratory muscles differs in some ways from that of the limb muscles. Effectively, the respiratory muscles are controlled by at least two descending pathways: from the medulla during normal quiet breathing and from the motor cortex during behavioural or voluntary breathing. Neurophysiological studies of single motor unit activity in human subjects during normal and voluntary breathing indicate that the neural drive is not uniform to all muscles. The distribution of neural drive depends on a principle of neuromechanical matching. Those motoneurones that innervate intercostal muscles with greater mechanical advantage are active earlier in the breath and to a greater extent. Inspiratory drive is also distributed differently across different inspiratory muscles, possibly also according to their mechanical effectiveness in developing airway negative pressure. Genioglossus, a muscle of the upper airway, receives various types of neural drive (inspiratory, expiratory and tonic) distributed differentially across the hypoglossal motoneurone pool. The integration of the different inputs results in the overall activity in the muscle to keep the upper airway patent throughout respiration. Integration of respiratory and non-respiratory postural drive can be demonstrated in respiratory muscles, and respiratory drive can even be observed in limb muscles under certain circumstances. Recordings of motor unit activity from the human diaphragm during voluntary respiratory tasks have shown that depending on the task there can be large changes in recruitment threshold and recruitment order of motor units. This suggests that descending drive across the phrenic motoneurone pool is not necessarily consistent. Understanding the integration and distribution of drive to respiratory muscles in automatic breathing and voluntary tasks may have implications for limb motor control.
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Affiliation(s)
- Jane E Butler
- Prince of Wales Medical Research Institute, University of New South Wales, Sydney, NSW 2031, Australia.
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59
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Abstract
Survival requires adequate pulmonary ventilation which, in turn, depends on adequate contraction of muscles acting on the chest wall in the presence of a patent upper airway. Bulbospinal outputs projecting directly and indirectly to 'obligatory' respiratory motoneurone pools generate the required muscle contractions. Recent studies of the phasic inspiratory output of populations of single motor units to five muscles acting on the chest wall (including the diaphragm) reveal that the time of onset, the progressive recruitment, and the amount of motoneuronal drive (expressed as firing frequency) differ among the muscles. Tonic firing with an inspiratory modulation of firing rate is common in low intercostal spaces of the parasternal and external intercostal muscles but rare in the diaphragm. A new time and frequency plot has been developed to depict the behaviour of the motoneurone populations. The magnitude of inspiratory firing of motor unit populations is linearly correlated to the mechanical advantage of the intercostal muscle region at which the motor unit activity is recorded. This represents a 'neuromechanical' principle by which the CNS controls motoneuronal output according to mechanical advantage, presumably in addition to the Henneman's size principle of motoneurone recruitment. Studies of the genioglossus, an obligatory upper airway muscle that helps maintain airway patency, reveal that it receives simultaneous inspiratory, expiratory and tonic drives even during quiet breathing. There is much to be learned about the neural drive to pools of human inspiratory and expiratory muscles, not only during respiratory tasks but also in automatic and volitional tasks, and in diseases that alter the required drive.
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Affiliation(s)
- Jane E Butler
- Prince of Wales Medical Research Institute and University of New South Wales, Sydney, Australia
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60
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Gandevia SC, Hudson AL, Gorman RB, Butler JE, De Troyer A. Spatial distribution of inspiratory drive to the parasternal intercostal muscles in humans. J Physiol 2006; 573:263-75. [PMID: 16556657 PMCID: PMC1779709 DOI: 10.1113/jphysiol.2005.101915] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The human parasternal intercostal muscles are obligatory inspiratory muscles with a diminishing mechanical advantage from cranial to caudal interspaces. This study determined whether inspiratory neural drive to these muscles is graded, and whether this distribution matches regional differences in inspiratory mechanical advantage. To determine the neural drive, intramuscular EMG was recorded from the first to the fifth parasternal intercostals during resting breathing in six subjects. All interspaces showed phasic inspiratory activity but the onset of activity relative to inspiratory flow in the fourth and fifth spaces was delayed compared with that in cranial interspaces. Activity in the first, second and third interspaces commenced, on average, within the first 10% of inspiratory time, and sometimes preceded inspiratory airflow. In contrast, activity in the fourth and fifth interspaces began after an average 33% of inspiratory time. The peak inspiratory discharge frequency of motor units in the first interspace averaged 13.4 +/- 1.0 Hz (mean +/- s.e.m.) and was significantly greater than in all other interspaces, in particular in the fifth space (8.0 +/- 1.0 Hz). Phasic inspiratory activity was sometimes superimposed on tonic activity. In the first interspace, only 3% of units had tonic firing, but this proportion increased to 34% in the fifth space. In five subjects, recordings were also made from the medial and lateral extent of the second parasternal intercostal. Both portions showed phasic inspiratory activity which began within the first 6% of inspiratory time. Motor units from the lateral and medial portions fired at the same peak discharge rate (10.4 +/- 0.7 versus 10.7 +/- 0.6 Hz). These observations indicate that the distribution of neural drive to the parasternal intercostals in humans has a rostrocaudal gradient, but that the drive is uniform along the mediolateral extent of the second interspace. The distribution of inspiratory neural drive to the parasternal intercostals parallels the spatial distribution of inspiratory mechanical advantage, while tonic activity was higher where mechanical advantage was lower.
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Affiliation(s)
- Simon C Gandevia
- Prince of Wales Medical Research Institute, Barker St Randwick, NSW 2031 Australia.
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61
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Leduc D, De Troyer A. The effect of lung inflation on the inspiratory action of the canine parasternal intercostals. J Appl Physiol (1985) 2006; 100:858-63. [PMID: 16293705 DOI: 10.1152/japplphysiol.00739.2005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Inflation induces a marked decrease in the lung-expanding ability of the diaphragm, but its effect on the parasternal intercostal muscles is uncertain. To assess this effect, the phrenic nerves and the external intercostals were severed in anesthetized, vagotomized dogs, such that the parasternal intercostals were the only muscles active during inspiration, and the endotracheal tube was occluded at different lung volumes. Although the inspiratory electromyographic activity recorded from the muscles was constant, the change in airway opening pressure decreased with inflation from −7.2 ± 0.6 cmH2O at functional residual capacity to −2.2 ± 0.2 cmH2O at 20-cmH2O transrespiratory pressure ( P < 0.001). The inspiratory cranial displacement of the ribs remained virtually unchanged, and the inspiratory caudal displacement of the sternum decreased moderately. However, the inspiratory outward rib displacement decreased markedly and continuously; at 20 cmH2O, this displacement was only 23 ± 2% of the value at functional residual capacity. Calculations based on this alteration yielded substantial decreases in the change in airway opening pressure. It is concluded that, in the dog, 1) inflation affects adversely the lung-expanding actions of both the parasternal intercostals and the diaphragm; and 2) the adverse effect of inflation on the parasternal intercostals is primarily related to the alteration in the kinematics of the ribs. As a corollary, it is likely that hyperinflation also has a negative impact on the parasternal intercostals in patients with chronic obstructive pulmonary disease.
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Affiliation(s)
- Dimitri Leduc
- Laboratory of Cardiorespiratory Physiology, Brussels School of Medicine, Saint-Pierre University Hospital, Brussels, Belgium.
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62
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Abstract
The mechanical advantages of the external and internal intercostals depend partly on the orientation of the muscle but mostly on interspace number and the position of the muscle within each interspace. Thus the external intercostals in the dorsal portion of the rostral interspaces have a large inspiratory mechanical advantage, but this advantage decreases ventrally and caudally such that in the ventral portion of the caudal interspaces, it is reversed into an expiratory mechanical advantage. The internal interosseous intercostals in the caudal interspaces also have a large expiratory mechanical advantage, but this advantage decreases cranially and, for the upper interspaces, ventrally as well. The intercartilaginous portion of the internal intercostals (the so-called parasternal intercostals), therefore, has an inspiratory mechanical advantage, whereas the triangularis sterni has a large expiratory mechanical advantage. These rostrocaudal gradients result from the nonuniform coupling between rib displacement and lung expansion, and the dorsoventral gradients result from the three-dimensional configuration of the rib cage. Such topographic differences in mechanical advantage imply that the functions of the muscles during breathing are largely determined by the topographic distributions of neural drive. The distributions of inspiratory and expiratory activity among the muscles are strikingly similar to the distributions of inspiratory and expiratory mechanical advantages, respectively. As a result, the external intercostals and the parasternal intercostals have an inspiratory function during breathing, whereas the internal interosseous intercostals and the triangularis sterni have an expiratory function.
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Affiliation(s)
- André De Troyer
- Laboratory of Cardiorespiratory Physiology, Brussels School of Medicine and Chest Service, Erasme University Hospital, Belgium.
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63
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64
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Iizuka M. Rostrocaudal distribution of spinal respiratory motor activity in an in vitro neonatal rat preparation. Neurosci Res 2005; 50:263-9. [PMID: 15488289 DOI: 10.1016/j.neures.2004.07.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2004] [Accepted: 07/20/2004] [Indexed: 10/26/2022]
Abstract
The distribution of inspiratory and expiratory activities among rib-cage muscles was examined using isolated brainstem-spinal cord-rib preparations from neonatal rats. Expiratory activity was evoked by decreasing perfusate pH from 7.4 to 7.1. All internal intercostal muscles (IIMs) in the first to eleventh intercostal spaces showed expiratory bursts. Although the IIMs in the more caudal interspaces exhibited expiratory bursts for as long as the low pH solution was present in all preparations, the expiratory bursts obtained from the IIMs in the rostral interspaces gradually disappeared even under low pH conditions in about half the preparations, suggesting that the more caudal IIMs play the greater role in expiration. All thoracic ventral roots examined from T1VR-T11VR, but not T13VR, exhibited overt inspiratory bursts under normal pH conditions. Low pH solution induced additional expiratory bursts in all thoracic VRs. The ratio of the integral of the absolute electrical voltage during the expiratory phase to that during the inspiratory phase increased progressively and significantly from the rostral to the caudal interspaces. These results accord well with previous ones in mammals in vivo. Hence, the neuronal mechanisms necessary for a rostrocaudal gradient in spinal respiratory motor outputs seem to be preserved in this in vitro preparation.
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Affiliation(s)
- Makito Iizuka
- Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Ibaraki 300-0394, Japan.
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65
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Abstract
The mechanisms of respiratory action of the intercostal muscles were studied by measuring the effect of external forces (F) applied to the ribs and by modeling the effect of F exerted by the intercostal muscles. In five dogs, with the airway occluded, cranial F were applied to individual rib pairs, from the 2nd to the 11th rib pair, and the change in airway opening pressure (Pao) was measured. The ratio Pao/F increases with increasing rib number in the upper ribs (2nd to 5th) and decreases in the lower ribs (5th to 11th). These data were incorporated into a model for the geometry of the ribs and intercostal muscles, and Pao/F was calculated from the model. For interspaces 2-8, the calculated values agree reasonably well with previously measured values. From the modeling, two mechanisms of intercostal muscle action are identified. One is the well-known Hamberger mechanism, modified to account for the three-dimensional geometry of the rib cage. This mechanism depends on the slant of an intercostal muscle relative to the ribs and on the resulting difference between the moments applied to the upper and lower ribs that bound each interspace. The second is a new mechanism that depends on the difference between the values of Pao/F for the upper and lower ribs.
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Affiliation(s)
- Theodore A Wilson
- Department of Aerospace Engineering and Mechanics, University of Minnesota, Minneapolis, Minnesota 55455, USA.
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66
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Abstract
The coupling between the ribs and the lung in dogs increases with increasing rib number in the cranial part of the rib cage and then decreases markedly in the caudal part. The hypothesis was raised that this non-uniformity is primarily related to differences between the areas of the lung subtended by the different ribs, and in the current study we tested this idea by assessing the effects of passive lung inflation. Thus, by causing a descent of the diaphragm, inflation would expand the area of the lung subtended by the caudal ribs and improve the coupling between these ribs and the lung. The axial displacements of the ribs and the changes in airway opening pressure (DeltaP(ao)) were measured in anaesthetized, pancuronium-treated, supine dogs while loads were applied in the cranial direction to individual rib pairs at functional residual capacity (FRC) and after passive inflation to 10 and 20 cm H(2)O transrespiratory pressure. In agreement with the hypothesis, inflation caused an increase in DeltaP(ao) for ribs 9 and 10. The most prominent alteration, however, was a marked decrease in DeltaP(ao) for ribs 2-8; at 20 cm H(2)O, DeltaP(ao) for these ribs was only 30% of the value at FRC. Additional measurements indicated that this decrease in DeltaP(ao) results partly from the increase in diaphragmatic compliance but mostly from the reduction in outward rib displacement. This alteration in the pattern of rib motion should add to the decrease in muscle length to reduce the lung expanding action of the external intercostal muscles at high lung volumes.
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Affiliation(s)
- André De Troyer
- Chest Service, Erasme University Hospital, Route de Lennik 808, 1070 Brussels, Belgium.
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67
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Bellemare F, Jeanneret A, Couture J. Sex differences in thoracic dimensions and configuration. Am J Respir Crit Care Med 2003; 168:305-12. [PMID: 12773331 DOI: 10.1164/rccm.200208-876oc] [Citation(s) in RCA: 162] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The volume of adult female lungs is typically 10-12% smaller than that of males who have the same height and age. In this study, we investigated how this volume difference is distributed between the rib cage and the diaphragm abdomen compartments. Internal rib cage dimensions, diaphragm position relative to spine, and diaphragm length were compared in 21 normal male and 19 normal female subjects at three different lung volumes using anterior-posterior and lateral chest radiographs. At all lung volumes examined, females had smaller radial rib cage dimensions in relationship to height than males, a greater inclination of ribs, a comparable diaphragm dome position relative to the spine, and a shorter diaphragm length. Female subjects exhibited a greater inspiratory rib cage muscle contribution during resting breathing than males, presumably reflecting an improved mechanical advantage conferred to these muscles by the greater inclination of ribs. Because of a greater inclination of ribs, female rib cages could accommodate a greater volume expansion. The results suggest a disproportionate growth of the rib cage in females relative to the lung, which would be well suited to accommodate large abdominal volume displacements as in pregnancy.
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Affiliation(s)
- François Bellemare
- Departments of Pneumology and Anesthesiology, Hôtel-Dieu du CHUM, Montréal, PQ, Canada.
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68
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Abstract
The act of breathing depends on coordinated activity of the respiratory muscles to generate subatmospheric pressure. This action is compromised by disease states affecting anatomical sites ranging from the cerebral cortex to the alveolar sac. Weakness of the respiratory muscles can dominate the clinical manifestations in the later stages of several primary neurologic and neuromuscular disorders in a manner unique to each disease state. Structural abnormalities of the thoracic cage, such as scoliosis or flail chest, interfere with the action of the respiratory muscles-again in a manner unique to each disease state. The hyperinflation that accompanies diseases of the airways interferes with the ability of the respiratory muscles to generate subatmospheric pressure and it increases the load on the respiratory muscles. Impaired respiratory muscle function is the most severe consequence of several newly described syndromes affecting critically ill patients. Research on the respiratory muscles embraces techniques of molecular biology, integrative physiology, and controlled clinical trials. A detailed understanding of disease states affecting the respiratory muscles is necessary for every physician who practices pulmonary medicine or critical care medicine.
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Affiliation(s)
- Franco Laghi
- Division of Pulmonary and Critical Care Medicine, Edward Hines, Jr. VA Hospital, 111 N. 5th Avenue and Roosevelt Road, Hines, IL 60141, USA.
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69
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De Troyer A, Cappello M, Meurant N, Scillia P. Synergism between the canine left and right hemidiaphragms. J Appl Physiol (1985) 2003; 94:1757-65. [PMID: 12679346 DOI: 10.1152/japplphysiol.01013.2002] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Expansion of the lung during inspiration results from the coordinated contraction of the diaphragm and several groups of rib cage muscles, and we have previously shown that the changes in intrathoracic pressure generated by the latter are essentially additive. In the present studies, we have assessed the interaction between the right and left hemidiaphragms in anesthetized dogs by comparing the changes in airway opening pressure (DeltaPao) obtained during simultaneous stimulation of the two phrenic nerves (measured DeltaPao) to the sum of the DeltaPao values produced by their separate stimulation (predicted DeltaPao). The measured DeltaPao was invariably greater than the predicted DeltaPao, and the ratio between these two values increased gradually as the stimulation frequency was increased; the ratio was 1.10 +/- 0.01 (P < 0.05) for a frequency of 10 Hz, whereas for a frequency of 50 Hz it amounted to 1.49 +/- 0.05 (P < 0.001). This interaction remained unchanged after the rib cage was stiffened and its compliance was made linear, thus indicating that the load against which the diaphragm works is not a major determinant. However, radiographic measurements showed that stimulation of one phrenic nerve extends the inactive hemidiaphragm toward the sagittal midplane and reduces the caudal displacement of the central portion of the diaphragmatic dome. As a result, the volume swept by the contracting hemidiaphragm is smaller than the volume it displaces when the contralateral hemidiaphragm also contracts. These observations indicate that 1) the left and right hemidiaphragms have a synergistic, rather than additive, interaction on the lung; 2) this synergism operates already during quiet breathing and increases in magnitude when respiratory drive is greater; and 3) this synergism is primarily related to the configuration of the muscle.
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Affiliation(s)
- Andre De Troyer
- Laboratory of Cardiorespiratory Physiology, Brussels School of Medicine, Brussels, Belgium.
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70
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Legrand A, Schneider E, Gevenois PA, De Troyer A. Respiratory effects of the scalene and sternomastoid muscles in humans. J Appl Physiol (1985) 2003; 94:1467-72. [PMID: 12626472 DOI: 10.1152/japplphysiol.00869.2002] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Previous studies have shown that in normal humans the change in airway opening pressure (DeltaPao) produced by all the parasternal and external intercostal muscles during a maximal contraction is approximately -18 cmH(2)O. This value is substantially less negative than DeltaPao values recorded during maximal static inspiratory efforts in subjects with complete diaphragmatic paralysis. In the present study, therefore, the respiratory effects of the two prominent inspiratory muscles of the neck, the sternomastoids and the scalenes, were evaluated by application of the Maxwell reciprocity theorem. Seven healthy subjects were placed in a computed tomographic scanner to determine the fractional changes in muscle length during inflation from functional residual capacity to total lung capacity and the masses of the muscles. Inflation induced greater shortening of the scalenes than the sternomastoids in every subject. The inspiratory mechanical advantage of the scalenes thus averaged (mean +/- SE) 3.4 +/- 0.4%/l, whereas that of the sternomastoids was 2.0 +/- 0.3%/l (P < 0.001). However, sternomastoid muscle mass was much larger than scalene muscle mass. As a result, DeltaPao generated by a maximal contraction of either muscle would be 3-4 cmH(2)O, which is about the same as DeltaPao generated by the parasternal intercostals in all interspaces.
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Affiliation(s)
- Alexandre Legrand
- Laboratory of Cardiorespiratory Physiology, Brussels School of Medicine, and Chest Service and Department of Radiology, Erasme University Hospital, 1070 Brussels, Belgium
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71
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Ribera F, N'Guessan B, Zoll J, Fortin D, Serrurier B, Mettauer B, Bigard X, Ventura-Clapier R, Lampert E. Mitochondrial electron transport chain function is enhanced in inspiratory muscles of patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2003; 167:873-9. [PMID: 12493645 DOI: 10.1164/rccm.200206-519oc] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In chronic obstructive pulmonary disease, inspiratory muscles face increased resistive and elastic workloads and therefore increased energy requirements. The adaptive response of these muscles to this higher energy demand includes increased oxidative enzymes and changes in contractile protein expression but the consequences on mitochondrial function and energy metabolism have not been assessed so far. We investigated the in situ properties of the mitochondria of costal diaphragm and external intercostal muscles using the skinned fiber technique in 9 emphysematous and 11 age-matched control patients. Biopsies obtained during thoracic surgery were placed in an oxygraphic chamber to measure maximal oxygen uptake. We observed that the maximal oxidative capacity of diaphragm and external intercostal muscles increased significantly in the emphysematous group compared with the control group (+135 and +37%, respectively). Significant correlations were found between the maximal oxidative capacity and patients' pulmonary indexes of obstruction (diaphragm: r = -0.637, intercostal: r = -0.667, p < 0.005) and hyperinflation (diaphragm: r = 0.639, p < 0.003, intercostal: r = 0.634, p < 0.01). Slow myosin heavy chain isoform increased in the diaphragm of the emphysematous group, with significant relationships between indexes of obstruction and hyperinflation and activities of biochemical mitochondrial markers. Thus, severe emphysema was associated with increased mitochondrial capacity and efficiency in the inspiratory muscles, supporting an endurance training-like effect.
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Affiliation(s)
- Florence Ribera
- Department of Physiology, Faculty of Medicine, 11 rue Humann, 67,000 Strasbourg, France
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72
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De Troyer A. Relationship between neural drive and mechanical effect in the respiratory system. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2003; 508:507-14. [PMID: 12171151 DOI: 10.1007/978-1-4615-0713-0_58] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
The actions of the canine external and internal interosseous intercostal muscles on the lung were assessed by applying the Maxwell reciprocity theorem. The external intercostals in the dorsal part of the cranial interspaces were found to have a large inspiratory effect. However, this effect decreases continuously in the caudal and the ventral direction, such that the muscles in the ventral part of the caudal interspaces have an expiratory effect. The internal intercostals also show marked gradients, such that the muscles in the dorsal part of the caudal interspaces have a large expiratory effect and those in the ventral part of the most cranial interspaces have a small inspiratory effect. During breathing, however, inspiratory activity is found only in the external intercostals with an inspiratory effect, and expiratory activity is confined to the internal intercostals with an expiratory effect. The spatial distribution of inspiratory activity among the canine external intercostals closely mirrors the distribution of inspiratory effect, and the distribution of expiratory activity among the internal intercostals closely mirrors the distribution of expiratory effect. Therefore, the external intercostals have a clear-cut inspiratory action on the lung during breathing, whereas the internal intercostals have a definite expiratory action. The distribution of neural drive among these muscles appears to be equally well matched to the distribution of respiratory effect in humans.
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Affiliation(s)
- André De Troyer
- Laboratory of Cardiorespiratory Physiology, Brussels School of Medicine, and Erasme University Hospital, Belgium.
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73
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De Troyer A, Gorman RB, Gandevia SC. Distribution of inspiratory drive to the external intercostal muscles in humans. J Physiol 2003; 546:943-54. [PMID: 12563017 PMCID: PMC2342592 DOI: 10.1113/jphysiol.2002.028696] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The external intercostal muscles in humans show marked regional differences in respiratory effect, and this implies that their action on the lung during breathing is primarily determined by the spatial distribution of neural drive among them. To assess this distribution, monopolar electrodes were implanted under ultrasound guidance in different muscle areas in six healthy individuals and electromyographic recordings were made during resting breathing. The muscles in the dorsal portion of the third and fifth interspace showed phasic inspiratory activity with each breath in every subject. However, the muscle in the ventral portion of the third interspace showed inspiratory activity in only three subjects, and the muscle in the dorsal portion of the seventh interspace was almost invariably silent. Also, activity in the ventral portion of the third interspace, when present, and activity in the dorsal portion of the fifth interspace were delayed relative to the onset of activity in the dorsal portion of the third interspace. In addition, the discharge frequency of the motor units identified in the dorsal portion of the third interspace averaged (mean +/- S.E.M.) 11.9 +/- 0.3 Hz and was significantly greater than the discharge frequency of the motor units in both the ventral portion of the third interspace (6.0 +/- 0.5 Hz) and the dorsal portion of the fifth interspace (6.7 +/- 0.4 Hz). The muscle in the dorsal portion of the third interspace started firing simultaneously with the parasternal intercostal in the same interspace, and the discharge frequency of its motor units was even significantly greater (11.4 +/- 0.3 vs. 8.9 +/- 0.2 Hz). These observations indicate that the distribution of neural inspiratory drive to the external intercostals in humans takes place along dorsoventral and rostrocaudal gradients and mirrors the spatial distribution of inspiratory mechanical advantage.
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Affiliation(s)
- André De Troyer
- Laboratory of Cardiorespiratory Physiology, Brussels School of Medicine and Chest Service, Erasme University Hospital, 1070 Brussels, Belgium.
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74
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Gáldiz JB, Palacio J, Alvarez FJ, Hernández N, Mariñán M, Gea J. [Basic structure of respiratory and peripheral muscles in the beagle dog]. Arch Bronconeumol 2002; 38:272-7. [PMID: 12106553 DOI: 10.1016/s0300-2896(02)75212-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The dog is one of the most widely used animals in studies of respiratory physiopathology, mainly because of its physiological characteristics. However, ethical and legal constraints are placed on the use of some species in our context. OBJECTIVE We studied the underlying structural features of respiratory and peripheral muscles in the beagle dog in order to suggest reference values for future studies. METHOD Fourteen young beagles were selected. Samples were taken from the costal diaphragm (DFG), external intercostal (EI) and vastus medialis (VM) muscles. We analyzed fiber percentages and sizes (immunohistochemistry, using myosin heavy chain [MyHC (monoclonal antibodies), percentages and absolute number of MyHC isoforms (electrophoresis and ELISA), and level of membrane damage (immunohistochemistry, using anti-fibronectin monoclonal antibodies). RESULTS In the EI muscle, type I fibers were larger (by 20%) than type II fibers. Fibers resistant to fatigue (type I) predominated greatly over fast contraction fibers (type II) in all three muscles analyzed (DFG 57% 11% vs. 45% 12%; EI 58% 5% vs. 43% 5%; and VM 70% 8% vs. 34% 7 %). Few hybrid fibers (co-expression of fast and slow MyHC) were found and their percentages were similar in all three muscles. The absolute expression of MyHC was greater in the VM than in the respiratory muscles, with a relative predominance of the MyHC I isoform in the DFG and VM muscles and a similar tendency in the EI muscle. Membrane damage was very slight in all three muscles. CONCLUSIONS The phenotype characteristics of respiratory and peripheral muscles in the beagle correspond to what we would expect functionally for a breed initially selected for hunting, with minimal lesions under normal circumstances, a predominance of fibers and proteins that are resistant to fatigue, and larger fibers in the EI, a muscle that plays a role in respiration in dogs.
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Affiliation(s)
- J B Gáldiz
- Servicio de Neumología. Hospital de Cruces. Universidad del País Vasco. Bilbao. Spain
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75
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Abstract
Vocalization is a complex behaviour pattern, consisting of essentially three components: laryngeal activity, respiratory movements and supralaryngeal (articulatory) activity. The motoneurones controlling this behaviour are located in various nuclei in the pons (trigeminal motor nucleus), medulla (facial nucleus, nucl. ambiguus, hypoglossal nucleus) and ventral horn of the spinal cord (cervical, thoracic and lumbar region). Coordination of the different motoneurone pools is carried out by an extensive network comprising the ventrolateral parabrachial area, lateral pontine reticular formation, anterolateral and caudal medullary reticular formation, and the nucl. retroambiguus. This network has a direct access to the phonatory motoneurone pools and receives proprioceptive input from laryngeal, pulmonary and oral mechanoreceptors via the solitary tract nucleus and principal as well as spinal trigeminal nuclei. The motor-coordinating network needs a facilitatory input from the periaqueductal grey of the midbrain and laterally bordering tegmentum in order to be able to produce vocalizations. Voluntary control of vocalization, in contrast to completely innate vocal reactions, such as pain shrieking, needs the intactness of the forebrain. Voluntary control over the initiation and suppression of vocal utterances is carried out by the mediofrontal cortex (including anterior cingulate gyrus and supplementary as well as pre-supplementary motor area). Voluntary control over the acoustic structure of vocalizations is carried out by the motor cortex via pyramidal/corticobulbar as well as extrapyramidal pathways. The most important extrapyramidal pathway seems to be the connection motor cortex-putamen-substantia nigra-parvocellular reticular formation-phonatory motoneurones. The motor cortex depends upon a number of inputs for fulfilling its task. It needs a cerebellar input via the ventrolateral thalamus for allowing a smooth transition between consecutive vocal elements. It needs a proprioceptive input from the phonatory organs via nucl. ventralis posterior medialis thalami, somatosensory cortex and inferior parietal cortex. It needs an input from the ventral premotor and prefrontal cortex, including Broca's area, for motor planning of longer purposeful utterances. And it needs an input from the supplementary and pre-supplementary motor area which give rise to the motor commands executed by the motor cortex.
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Affiliation(s)
- Uwe Jürgens
- German Primate Centre, Kellnerweg 4, 37077 Göttingen, Germany
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