accessory muscles of breathing
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The muscles of respiration are the muscles that contribute to inhalation and
exhalation Exhalation (or expiration) is the flow of the breath out of an organism. In animals, it is the movement of air from the lungs out of the airways, to the external environment during breathing. This happens due to elastic properties of the lungs, ...
, by aiding in the expansion and contraction of the
thoracic cavity The thoracic cavity (or chest cavity) is the chamber of the body of vertebrates that is protected by the thoracic wall (rib cage and associated skin, muscle, and fascia). The central compartment of the thoracic cavity is the mediastinum. There ...
. The diaphragm and, to a lesser extent, the
intercostal muscle Intercostal muscles are many different groups of muscles that run between the ribs, and help form and move the chest wall. The intercostal muscles are mainly involved in the mechanical aspect of breathing by helping expand and shrink the size of ...
s drive respiration during quiet breathing. The elasticity of these muscles is crucial to the health of the respiratory system and to maximize its functional capabilities.


Diaphragm

The diaphragm is the major muscle responsible for breathing. It is a thin, dome-shaped muscle that separates the abdominal cavity from the thoracic cavity. During inhalation, the diaphragm contracts, so that its center moves caudally (downward) and its edges move cranially (upward). This compresses the abdominal cavity, raises the ribs upward and outward and thus expands the thoracic cavity. This expansion draws air into the lungs. When the diaphragm relaxes, elastic recoil of the lungs causes the thoracic cavity to contract, forcing air out of the lungs, and returning to its dome-shape. The diaphragm is also involved in non-respiratory functions, helping to expel
vomit Vomiting (also known as emesis and throwing up) is the involuntary, forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose. Vomiting can be the result of ailments like food poisoning, gastroenterit ...
,
faeces Feces ( or faeces), known colloquially and in slang as poo and poop, are the solid or semi-solid remains of food that was not digested in the small intestine, and has been broken down by bacteria in the large intestine. Feces contain a relati ...
, and
urine Urine is a liquid by-product of metabolism in humans and in many other animals. Urine flows from the kidneys through the ureters to the urinary bladder. Urination results in urine being excreted from the body through the urethra. Cellular ...
from the body by increasing intra-abdominal pressure, and preventing
acid reflux Gastroesophageal reflux disease (GERD) or gastro-oesophageal reflux disease (GORD) is one of the upper gastrointestinal chronic diseases where stomach content persistently and regularly flows up into the esophagus, resulting in symptoms and/ ...
by exerting pressure on the
esophagus The esophagus ( American English) or oesophagus (British English; both ), non-technically known also as the food pipe or gullet, is an organ in vertebrates through which food passes, aided by peristaltic contractions, from the pharynx to ...
as it passes through the
esophageal hiatus In human anatomy, the esophageal hiatus is an opening in the diaphragm through which the esophagus and the vagus nerve pass. Structure It is located in the right crus, one of the two tendinous structures that connect the diaphragm to the spine ...
.


Intercostal muscles

Along with the diaphragm, the intercostal muscles are one of the most important groups of respiratory muscles. These muscles are attached between the ribs and are important in manipulating the width of the rib cage. There are three layers of intercostal muscles. The external intercostal muscles are most important in respiration. These have fibres that are angled obliquely downward and forward from rib to rib. The contraction of these fibres raises each rib toward the rib above, with the overall effect of raising the
rib cage The rib cage, as an enclosure that comprises the ribs, vertebral column and sternum in the thorax of most vertebrates, protects vital organs such as the heart, lungs and great vessels. The sternum, together known as the thoracic cage, is a sem ...
, assisting in inhalation.


Accessory muscles of respiration

Accessory muscles of respiration are muscles that assist, but do not play a primary role, in breathing. Use of these while at rest is often interpreted as a sign of
respiratory distress Shortness of breath (SOB), also medically known as dyspnea (in AmE) or dyspnoea (in BrE), is an uncomfortable feeling of not being able to breathe well enough. The American Thoracic Society defines it as "a subjective experience of breathing di ...
. There is no definitive list of accessory muscles, but the sternocleidomastoid and the scalenes (anterior, middle, and posterior) are typically included, as they assist in elevating the rib cage.Netter FH. Atlas of Human Anatomy 3rd ed. Icon Learning Systems. Teterboro, New Jersey 2003 - plate 191 The involvement of these muscles seems to depend on the degree of respiratory effort. During quiet breathing, the scalenes are consistently physically active, while the sternocleidomastoids are quiet.Raper, A. J., Thompson, W. T., Shapiro, W., & Patterson, J. L. (1966). Scalene and sternomastoid muscle function. Journal of Applied Physiology, 21, 497-502. With an increase in the respiratory volume, sternocleidomastoids also become active.Campbell, E. J. M. (1955). The role of the scalene and sternomastoid muscles in breathing in normal subjects. An electromyographic study. Journal of Anatomy, 89, 378. Both muscles are simultaneously activated when one breathes in at the maximal flow rate. Apart from the above neck muscles, the following muscles have also been observed contributing to respiration:
serratus anterior The serratus anterior is a muscle that originates on the surface of the 1st to 8th ribs at the side of the chest and inserts along the entire anterior length of the medial border of the scapula. The serratus anterior acts to pull the scapula fo ...
, pectoralis major and
pectoralis minor Pectoralis minor muscle () is a thin, triangular muscle, situated at the upper part of the chest, beneath the pectoralis major in the human body. Structure Attachments Pectoralis minor muscle arises from the upper margins and outer surfaces ...
,
trapezius The trapezius is a large paired trapezoid-shaped surface muscle that extends longitudinally from the occipital bone to the lower thoracic vertebrae of the spine and laterally to the spine of the scapula. It moves the scapula and supports th ...
, latissimus dorsi, erector spinae,
iliocostalis Iliocostalis muscle is the muscle immediately lateral to the longissimus that is the nearest to the furrow that separates the epaxial muscles from the hypaxial. It lies very deep to the fleshy portion of the serratus posterior muscle. It latera ...
, quadratus lumborum, serratus posterior superior,
serratus posterior inferior The serratus posterior inferior muscle, also known as the posterior serratus muscle, is a muscle of the human body. Structure The muscle is situated at the junction of the thoracic and lumbar regions. It has an irregularly quadrilateral form, ...
,
levatores costarum The ''Levatores costarum'' (), twelve in number on either side, are small tendinous and fleshy bundles, which arise from the ends of the transverse processes of the seventh cervical and upper eleven thoracic vertebrae They pass obliquely downward ...
,
transversus thoracis The transversus thoracis muscle (), also known as triangularis sterni, lies internal to the thoracic cage, anteriorly. It is usually a thin plane of muscular and tendinous fibers, however on athletic individuals it can be a thick 'slab of meat', ...
,
subclavius The subclavius is a small triangular muscle, placed between the clavicle and the first rib. Along with the pectoralis major and pectoralis minor muscles, the subclavius muscle makes up the anterior axioappendicular muscles, also known as anter ...
(Kendall et al., 2005). The
levator labii superioris alaeque nasi muscle The levator labii superioris alaeque nasi muscle is, translated from Latin, the "lifter of both the upper lip and of the wing of the nose". It has the longest name of any muscle in an animal. The muscle is attached to the upper frontal process o ...
lifts the sides of the nostrils.


Muscles of exhalation

During quiet breathing, there is little or no muscle contraction involved in exhalation; this process is simply driven by the elastic recoil of the lungs. When forceful exhalation is required, or when the elasticity of the lungs is reduced (as in emphysema), active exhalation can be achieved by contraction of the abdominal wall muscles (
rectus abdominis The rectus abdominis muscle, ( la, straight abdominal) also known as the "abdominal muscle" or simply the "abs", is a paired straight muscle. It is a paired muscle, separated by a midline band of connective tissue called the linea alba. It exte ...
,
transverse abdominis The transverse abdominal muscle (TVA), also known as the transverse abdominis, transversalis muscle and transversus abdominis muscle, is a muscle layer of the anterior and lateral (front and side) abdominal wall which is deep to (layered below) t ...
, external oblique muscle and
internal oblique muscle The abdominal internal oblique muscle, also internal oblique muscle or interior oblique, is an abdominal muscle in the abdominal wall that lies below the external oblique muscle and just above the transverse abdominal muscle. Structure Its fibe ...
). These press the abdominal organs cranially (upward) into the diaphragm, reducing the volume of the thoracic cavity. The internal intercostal muscles have fibres that are angled obliquely downward and backward from rib to rib. These muscles can therefore assist in lowering the rib cage, adding force to exhalation.


References


Further reading

* Kendall, F., McCreary, E., Provance, P., Rodgers, M., Romai, W. (2005). Muscles testing and function with posture and pain (5th ed.). PA, USA: Lippincott Williams & Wilkins. {{Authority control Respiration