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Respiratory Muscle Coordination

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Abstract

The sections in this article are:

1 Physiological Aspects of Respiratory Muscle Coordination
2 Techniques for Evaluating Respiratory Muscle Activity and Coordination
2.1 Electromyography
2.2 Chest Wall Motion‐Pressure Relationships
2.3 Elastic Pressure‐Abdominal Pressure Diagram
3 Breathing at Rest
3.1 Ontogenic Aspects of Respiratory Muscle Coordination
3.2 Resting Breathing in the Awake Adult
3.3 Mechanical Analysis
3.4 Electromyographic Activity of Respiratory Muscles During Quiet Breathing
3.5 Intradiaphragmatic Coordination
3.6 Cortical (Volitional) Influences
3.7 Resting Breathing in Supine Position
4 Resting Breathing During Sleep
5 Stimulated Breathing
Figure 1. Figure 1.

Schematic representation of respiratory neuromuscular control system with neurophysiological and mechanical assessment techniques indicated for each major respiratory muscle group.

Figure 2. Figure 2.

A: length‐tension diagram of muscle. Total tension developed by muscle is sum of tensions resulting from active contraction and from passive stretch of muscle. B: global passive stretch characteristic of respiratory musculature plotted in terms of pressure and volume, equivalent to the chest wall portion of the Rahn diagram. When respiratory muscles are relaxed and respiratory system is subjected to increase in applied pressure, expiratory muscles become passively stretched. When a subatmospheric pressure is applied to respiratory system, inspiratory muscles become passively stretched. Departures from this passive chest wall characteristic reflect active contraction of respiratory muscles.

Figure 3. Figure 3.

Respiratory pressure‐volume (PV) diagrams and their partitioning along volume axis [total volume displacement of chest wall = rib cage‐diaphragm volume (Vrc) + abdomen‐diaphragm volume (Vab)] and along pressure axis [transthoracic pressure (P transthoracic) = transdiaphragmatic pressure (Pdi) + transabdominal pressure (Pab)]. Dashed lines, passive (relaxed) PV relationship; solid lines (closed bops), spontaneous resting breath. A: global chest wall PV relationship (Campbell diagram). PV relationships for the rib cage‐diaphragm (B), abdomen‐diaphragm (C), diaphragm [Pdi vs. Vrc (D) and Pdi vs. Vab (E)], and thoracic or abdominal musculature [Pab vs. Vrc (F) and Pab vs. Vab (G)]. VL, lung volume.

Adapted from Grimby et al.
Figure 4. Figure 4.

Schematic representation of elastic (Pel) vs. transabdominal (Pab) pressures during breathing with different inspiratory efforts. Solid line, relaxation of inspiratory muscles; AB shows inspiration when only the diaphragm contracts. Dashed lines, AC shows inspiration during which transdiaphragmatic pressure remains zero and AD shows inspiration initiated mainly by intercostal/accessory muscle contraction and completed mainly by diaphragmatic action. FRC, functional residual capacity.

Adapted from Macklem et al.
Figure 5. Figure 5.

Variation of respiratory volume and time components in 1 subject over a period of 12 min. Each point represents value of indicated parameter for a single breath. Horizontal axis, time in min. VT, tidal volume; F, frequency (breaths/min); , expired minute ventilation; TI, inspiratory time; TE, expiratory time.

Figure 6. Figure 6.

Patterns of rib cage and abdominal anteroposterior (AP) diameter changes during breathing and voluntary respiratory efforts. MVV, maximal voluntary ventilation; VT, tidal volume; RVT, resting tidal volume.

From Sharp et al.
Figure 7. Figure 7.

Rib cage and abdominal anteroposterior (AP) diameter changes during breathing at low (50–55 Torr; loops originating from open circles) and high (65–70 Torr; loops originating from closed circles) levels of CO2. Isovolume lines separated by 1 liter.

From Grassino et al.
Figure 8. Figure 8.

Rib cage and abdominal musculature pressure‐volume diagrams during resting breathing. A: mild increases in ventilation. B: moderate to severe increases in ventilation. C: increases in ventilation associated with exercise or CO2 stimulation. Pab, abdominal pressure.



Figure 1.

Schematic representation of respiratory neuromuscular control system with neurophysiological and mechanical assessment techniques indicated for each major respiratory muscle group.



Figure 2.

A: length‐tension diagram of muscle. Total tension developed by muscle is sum of tensions resulting from active contraction and from passive stretch of muscle. B: global passive stretch characteristic of respiratory musculature plotted in terms of pressure and volume, equivalent to the chest wall portion of the Rahn diagram. When respiratory muscles are relaxed and respiratory system is subjected to increase in applied pressure, expiratory muscles become passively stretched. When a subatmospheric pressure is applied to respiratory system, inspiratory muscles become passively stretched. Departures from this passive chest wall characteristic reflect active contraction of respiratory muscles.



Figure 3.

Respiratory pressure‐volume (PV) diagrams and their partitioning along volume axis [total volume displacement of chest wall = rib cage‐diaphragm volume (Vrc) + abdomen‐diaphragm volume (Vab)] and along pressure axis [transthoracic pressure (P transthoracic) = transdiaphragmatic pressure (Pdi) + transabdominal pressure (Pab)]. Dashed lines, passive (relaxed) PV relationship; solid lines (closed bops), spontaneous resting breath. A: global chest wall PV relationship (Campbell diagram). PV relationships for the rib cage‐diaphragm (B), abdomen‐diaphragm (C), diaphragm [Pdi vs. Vrc (D) and Pdi vs. Vab (E)], and thoracic or abdominal musculature [Pab vs. Vrc (F) and Pab vs. Vab (G)]. VL, lung volume.

Adapted from Grimby et al.


Figure 4.

Schematic representation of elastic (Pel) vs. transabdominal (Pab) pressures during breathing with different inspiratory efforts. Solid line, relaxation of inspiratory muscles; AB shows inspiration when only the diaphragm contracts. Dashed lines, AC shows inspiration during which transdiaphragmatic pressure remains zero and AD shows inspiration initiated mainly by intercostal/accessory muscle contraction and completed mainly by diaphragmatic action. FRC, functional residual capacity.

Adapted from Macklem et al.


Figure 5.

Variation of respiratory volume and time components in 1 subject over a period of 12 min. Each point represents value of indicated parameter for a single breath. Horizontal axis, time in min. VT, tidal volume; F, frequency (breaths/min); , expired minute ventilation; TI, inspiratory time; TE, expiratory time.



Figure 6.

Patterns of rib cage and abdominal anteroposterior (AP) diameter changes during breathing and voluntary respiratory efforts. MVV, maximal voluntary ventilation; VT, tidal volume; RVT, resting tidal volume.

From Sharp et al.


Figure 7.

Rib cage and abdominal anteroposterior (AP) diameter changes during breathing at low (50–55 Torr; loops originating from open circles) and high (65–70 Torr; loops originating from closed circles) levels of CO2. Isovolume lines separated by 1 liter.

From Grassino et al.


Figure 8.

Rib cage and abdominal musculature pressure‐volume diagrams during resting breathing. A: mild increases in ventilation. B: moderate to severe increases in ventilation. C: increases in ventilation associated with exercise or CO2 stimulation. Pab, abdominal pressure.

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A. E. Grassino, M. D. Goldman. Respiratory Muscle Coordination. Compr Physiol 2011, Supplement 12: Handbook of Physiology, The Respiratory System, Mechanics of Breathing: 463-480. First published in print 1986. doi: 10.1002/cphy.cp030327