Respiratory Muscle Disorders in Chest Wall Diseases

A. Casas, J. Pavía, D. Maldonado

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.