THE MECHANICS of a skeletal muscle is essentially determined by the anatomy of the muscle and the structures it displaces when it contracts. Given that the muscle fibers of the costal portion
of the diaphragm run cranially and dorsally from their insertion on the lower ribs, it would therefore be expected that isolated contraction of one hemidiaphragm would both lift these ribs
and pull them backward relative to the upper ribs.
In addition, even though the diaphragm is the main inspiratory muscle, it receives corticospinal inputs (e.g., Gandevia and Rothwell 1987; Murphy et al. 1990) and is involved in a range of nonrespiratory contractions, such as stabilization of the trunk prior to rapid arm movements (Hodges et al. 1997), flexion of the upper and lower extremities (Kolar et al. 2010), and trunk extension (in patients with complete cervical spinal cord injury, Sinderby et al. 1992; see also Hodges et al. 2001).
On these grounds, we hypothesized that the muscle would participate in ipsilateral rotation of the trunk. Thus the right hemidiaphragm would contract during rotation of the trunk to the
right to pull the lower rib cage on the right side dorsally relative to the spine, whereas it would remain silent during rotation of the trunk to the left (contralateral rotation). Conversely, the left hemidiaphragm would contract during rotation of the trunk to the left to pull the lower rib cage on the left side dorsally relative to the spine.
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Escrito por M. Jeffery Mador, M.D., F.C.C.P
Escrito por Martijn A. Spruit, Sally J. Singh, Chris Garvey, Richard ZuWallack, Linda Nici, Carolyn Rochester, Kylie Hill, Anne E. Holland, Suzanne C. Lareau, William D.-C. Man, Fabio Pitta, Louise Sewell, Jonathan Raskin, Jean Bourbeau, Rebecca Crouch, Frits M. E. Franssen, Richard Casaburi, Jan H. Vercoulen, Ioannis Vogiatzis, Rik Gosselink, Enrico M. Clini, Tanja W. Effing, Franc¸ois Maltais, Job van der Palen, Thierry Troosters, Daisy J. A. Janssen, Eileen Collins, Judith Garcia-Aymerich, Dina Brooks, Bonnie F. Fahy, Milo A. Puhan, Martine Hoogendoorn, Rachel Garrod, Annemie M. W. J. Schols, Brian Carlin, Roberto Benzo, Paula Meek, Mike Morgan, Maureen P. M. H. Rutten-van Mo¨lken, Andrew L. Ries, Barry Make, Roger S. Goldstein, Claire A. Dowson, Jan L. Brozek, Claudio F. Donner, and Emiel F. M. Wouters
Escrito por Leandro Marques da Silva , Elizângela de Sousa Monteiro , Bruno Silva Miranda , Clesio Rafael Lopes da Silva , Anne Shirley Menezes Costa
