The Respiratory Muscles: How Is The "Ventilatory Pump" Made?

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The respiratory muscles

How is the “ventilatory pump” made?

From a functional point of view, there are three groups of respiratory


muscles: the diaphragm, the rib cage muscles and the abdominal
muscles. Each group acts on the chest wall and its compartments,
i.e. the lung-apposed rib cage, the diaphragm-apposed rib cage and
the abdomen. Contraction of the diaphragm expands the abdomen
and the lower part of the rib cage (abdominal rib cage). The rib cage
muscles, including the intercostals, the parasternals, the scalene and
the neck muscles, mostly act on the upper part of the rib cage
(pulmonary rib cage) and are both inspiratory and expiratory. The
abdominal muscles act on the abdomen and the abdominal rib cage
and are expiratory. When each muscle group contracts alone or the
contraction is predominant compared to the other groups,
undesirable effects (such as “paradoxical” inward or outward motion
during inspiration and expiration, respectively) occur on at least one
of the compartments. A highly coordinated recruitment of two or
three muscle groups is required to avoid these effects. During
breathing at rest, this is accomplished by the coordinated activity of
the diaphragm and inspiratory rib cage muscles. Normally no
expiratory muscles are used.

How does the ventilatory pump work during exercise?

During exercise the increased ventilatory demands determine an


increased neural drive to the respiratory muscles. This determines an
increased mechanical power developed by the muscles. Muscle
power is equal to velocity of shortening multiplied by pressure.
Differently than rest, during exercise the diaphragm is primarily a
“flow generator”. This means that its mechanical power is mainly
expressed as velocity of shortening rather than pressure. Conversely,
rib cage and abdominal muscles are primarily “pressure generators”,
i.e. develop the pressures required to move the rib cage and
abdomen, respectively [1].

Differently than rest, during exercise the expiratory muscles play an


active role in breathing. Within each single breath their action is
highly coordinated with that of the inspiratory rib cage muscles.
During inspiration, while the rib cage muscles contract, the
abdominal muscles gradually relax, and vice versa during expiration.
This mechanism has several effects: 1) it prevents rib cage distortion;
2) the diaphragm is unloaded and can act as a flow generator; and 3)
the volume of the abdomen is decreased below resting levels [1, 2].
As a result, end-expiratory lung volume is decreased during exercise
(figure 1) and the mechanics of breathing is optimised for several
reasons. Tidal volume occurs in the most compliant part of the
respiratory system; the diaphragm is lengthened and thus works
near its optimal length; at each breath part of the required
inspiratory work is previously stored in the form of elastic energy
during the previous expiration.

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