Abstract
The function of the respiratory muscles in health and disease is currently receiving increased and long overdue interest. Points of practical as well as theoretical interest are the following:
-
1.
The diaphragm, by far the most important of the respiratory muscles, has unique mechanical and metabolic characteristics which probably represent advantageous adaptations to its function.
-
2.
Both the length-tension properties of the diaphragm and its distinctive curved geometry (i.e. in relation to Laplace’s law) are important in the diaphragm’s function in human health and disease.
-
3.
Pioneering recent work by Goldman and Mead indicate that in most circumstances the diaphragm moves the rib cage effectively and that the other muscles of respiration usually act to optimize the length-tension conditions of the diaphragm’s function.
-
4.
There is mounting evidence that tonic as well as phasic activity of respiratory muscles is a major determinant of lung volume in many circumstances in both health and disease.
-
5.
Fatigue of respiratory muscles is being recognized as an important contributor to respiratory disability and failure, and several methods of recognizing fatigue are being developed.
-
6.
The relief from dyspnea experienced by some severe emphysema patients when they lean forward or lie supine is, we believe, related to the improved length-tension state of the diaphragm which the more comfortable postures favor.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Agostoni E, Fenn WO (1960) Velocity of muscle shortening as a limiting factor in respiratory air flow. J Appl Physiol 15:349–353
Andersen JB, Kann T, Rasmussen JP, Howardy P, and Mitchell J (1978) Respiratory thoraco-abdominal coordination and muscle fatigue in acute respiratory failure. Am Rev Respir Dis 117 (Supplement to No 4):89 (Abstract)
Barach AL (1974) Chronic obstructive lung disease: postural relief of dyspnea. Arch Phys Med Rehabil 55:494–504
Campbell EJM, Howell JBL (1963) The sensation of breathlessness. Br Med Bull 19:36–40
Danon J, Druz WS, Goldberg NB, Sharp JT (1977) Function of the isolated paced diaphragm and the cervical accessory muscles in C-1 quadriplegics. Am Rev Respir Dis 119:909–919
Duchenne (1867) Physiologie des Mouvements démonstrée à l’aide de l’expérimentation électrique et de l’observation clinique, et applicable à l’étude des paralysies et des déformations. Baillière, Paris
Glenn WWL, Holcomb WG, McLaughlin AJ, O’Hare JM, Hogan JF, Yasuda R (1972) Total ventilatory support in quadriplegic patients with radiofrequency electrophrenic respiration. N Engl J Med 286:513–516
Glenn WWL, Holcomb WG, Shaw RK, Hogan JF, Holschuch KR (1976) Long term ventilatory support by diaphragm pacing in quadriplegia. Ann Surg 183:566–576
Goldman MD, Mead J (1973) Mechanical interaction between the diaphragm and rib cage. J Appl Physiol 35:197–204
Goldman MD, Grassino A, Mead J, and Sears TA (1978) Mechanics of the human diaphragm during voluntary contraction: dynamics. J Appl Physiol: Respir Environ Exercise Physiol 44:840–848
Grassino A, Goldman MD, Mead J, Sears TA (1978) Mechanics of the human diaphragm during voluntary contraction: statics. J Appl Physiol: Respir Environ Exercise Physiol 44:829–839
Grimby G, Goldman MD, Mead J (1976) Respiratory muscle action inferred from rib cage and abdominal V-P partitioning. J Appl Physiol 41:739–751
Gross D, Grassino A, Ross WRD, Macklem PT (1979) Electromyogram pattern of diaphragmatic fatigue. J Appl Physiol: Respir Environ Exercise Physiol. 46:1–7
Henderson-Smart DJ, Read DJ (1978) Depression of intercostal and abdominal muscle activity and vulnerability to asphyxia during active sleep in the newborn. In: Guilleminault, Dement (eds) Sleep Apnea Syndromes. Liss, New York
Hoover, CF (1913) The functions of the diaphragm and their diagnostic significance. Arch Intern Med 12:214–224
Hoover CF (1917) Diagnostic signs from the scaleni, intercostal muscles and the diaphragm in lung ventilation. Arch Intern Med 20:701–715
Hoover CF (1920) The diagnostic significance of inspiratory movements of the costal margins. Am J. Med Sci 159:633–646
Hyatt RE, Flath RE (1966) Relationship of air flow to pressure during maximal respiratory effort in man. J Appl Physiol 21:477–482
Kim MJ, Druz WS, Danon J, Machnach W, Sharp JT (1976) Mechanics of the canine diaphragm. J Appl Physiol 41:369–382
Lopata M, Freilich RA, Onal E, Pearle J, Lourenco RV (1979) Ventilatory control and the obesity hypoventilation syndrome. Am Rev Respir Dis 119 (No 2, part 2):165–168
Levine S, Huckabee WE (1975) Ventilatory response to drug induced hypermetabolism. J Appl Physiol 38:827–833
Levine S (1977) Role of tissue hypermetabolism in stimulation of ventilation by dinitrophenol. J Appl Physiol 43:72–74
Levine S (1979) Ventilatory response to muscular exercise: observations regarding a humoral pathway. J Appl Physiol: Respir Environ Exercise Physiol, 47:126–137
Marshall R (1962) Relationships between stimulus and work of breathing at different lung volumes. J Appl Physiol 17:917–921
Moisan T, Wicks MS, Druz WS, Sharp JT (1978) Diaphragmatic function and body position in chronic obstructive pulmonary disease. Am Rev Respir Dis 117 (No 4 part 2):378
Muller N, Francis P, Gurwitz D, Levison H, Bryan AD (1979) Mechanism of haemoglobin desaturation during rapid eye motion sleep in normals and patients with cystic fibrosis. Am Rev Respir Dis 119 (No 4 part 2):339 (Abstract)
Muller N, Volgyesi G, Becker L, Bryan MH, Bryan AC (1979) Diaphragmatic muscle tone. J Appl Physiol: Respir Environ Exercise Physiol 47:279–284
Rahn H, Otis AB, Chadwick LE, Fenn WO (1946) The pressure-volume diagram of the thorax and lung. Am J Physiol 146:161–178
Ramsy AG (1955) Muscle metabolism and the regulation of breathing. J Physiol (London) 127:30 (Abstract)
Ramsy AG (1959) Effects of metabolism and anesthesia on pulmonary ventilation. J Appl Physiol 14:102–104
Robertson CH Jr, Foster GH, Johnson RL Jr (1977) The relationship of respiratory failure to the oxygen consumption of lactate production by and distribution of blood flow among respiratory muscles during increasing inspiratory resistance. J. Clin Invest 59:31–42
Robertson CH Jr, Pagel MA, Johnson RL Jr (1977) The distribution of blood flow, oxygen consumption, and work output among the respiratory muscles during unobstructed hyperventilation. J Clin Invest 59:43–50
Robertson CH Jr, Eschenbacker WL, Johnson RL (1977) Respiratory muscle blood flow distribution during expiratory resistance. J. Clin Invest 60:473–480
Rochester DF, Pradel-Guena (1973) Measurement of diaphragmatic blood flow in dogs from Xenon 133 clearance. J. Appl Physiol 34:68–74
Rochester DF (1974) Measurement of diaphragmatic blood flow and oxygen consumption in the dog by the Kety-Schmidt technique. J Clin Invest 53:1216–1225
Roussos C, Fixley M, Gross D, Macklem PT (1979) Fatigue of inspiratory muscles and their synergic behavior. J Appl Physiol: Respir Environ Exercise Physiol 46:897–904
Schweitzer TW, Fitzerald JW, Bowden JA, Lynne-Davies P (1979) Spectral analysis of human inspiratory diaphragmatic electromyograms. J Appl Physiol: Respir Environ Exercise Physiol 46:152–165
Sharp JT, Goldberg NB, Druz WS, Fishman HC, Danon J (1977) Thoracoabdominal motion in chronic obstructive pulmonary disease. Am Rev Respir Dis 115:47–56
Author information
Authors and Affiliations
Additional information
Supported in part by USPHS Research Grant #HL 08789 and the Veterans Administration Research Service.
Rights and permissions
About this article
Cite this article
Sharp, J.T. Respiratory muscles: A review of old and newer concepts. Lung 157, 185–199 (1979). https://doi.org/10.1007/BF02713618
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02713618