Diseases that constrict the skeletal structure of the chest wall and the spine with its articulations may interfere with the functional capacity of the diaphragmatic pump, facilitating the development of respiratory insufficiency and failure. The present article discusses the response of the respiratory muscles to mechanical overload.
Following a brief examination of the force these muscles are required to exert in normal conditions, we review the pathophysiology of some characteristic alterations brought about by a) chest wall diseases such as kyphoscoliosis; b) other diseases involving the bony structure of the chest wall such as ankylosing spondylitis and pectus excavatum; and c) extreme obesity. Systemic disorders of a neuromuscular type will be dealt with in a different chapter of the series.
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Escrito por MartinJ. Tobin, M.D.; Tejvir S. Chadha, M.D.; GilbertJenouri, BA; StephenJ. Birch, B.S.; Hacik B. Gazeroglu, B.S.; and Marvin A. Sackner, M.D., F.C.C.P.
Escrito por Alana Bortolan Sacon1 Ana Paula Pillatt2 Laura Wuttig Berbam3 Vanessa Zardin Fengler4 Darlene Costa de Bittencourt5 Adriane Schmidt Pasqualoto6
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
