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A De Troyer

Publications and source records attributed to A De Troyer.

At least 19 recordsLinked to original sources
PubMed1995

Inhomogeneous activation of the parasternal intercostals during breathing.

Recent computations of the mechanical advantage of the canine intercostal muscles have suggested that the inspiratory advantage of the parasternal intercostals is not uniform. In the present studies, we have initially tested this hypothesis. Using a caliper and markers implanted in the costal cartilages, we have thus measured, in four supine paralyzed dogs, the length of the medial, middle, and lateral parasternal fibers at functional residual capacity and after a 1-liter mechanical inflation. With inflation, the medial fibers always shortened more than did the middle fibers (-9.8 +/- 0.8 vs. -6.0 +/- 0.8%; P < 0.001), whereas the lateral fibers remained virtually constant in length (-0.2 +/- 0.8%). This gradient of mechanical advantage agreed well with the gradient of orientation of the muscle fibers. Therefore, we have also recorded the electromyograms of the medial, middle, and lateral parasternal bundles during spontaneous breathing in nine anesthetized animals (20 interspaces); each activity was expressed as a percentage of the activity recorded during tetanic, supramaximal stimulation of the internal intercostal nerve (maximal activity). The medial bundle was invariably more active than was the middle bundle during resting breathing (57.3 +/- 3.3 vs. 25.5 +/- 3.4% of maximum; P < 0.001), and in 10 interspaces, medial activity consistently preceded middle activity at the onset of inspiration. These differences persisted during hypercapnia, during inspiratory resistive loading, as well as after phrenicotomy. Activity was never recorded from the lateral bundle.(ABSTRACT TRUNCATED AT 250 WORDS)

Airway Resistance↗
PubMed1995

Rib cage distortion in a canine model of flail chest.

Although blunt chest injuries frequently lead to respiratory failure, the effects of flail chest on the mechanics of breathing have not been evaluated. In the present studies, we have measured the respiratory displacements of the ribs and sternum and the electromyograms (EMG) of the parasternal and external intercostal muscles in eight supine, anesthetized, spontaneously breathing dogs before and after the third to sixth ribs on the right side of the chest were fractured both dorsally and ventrally. After flail, the fractured ribs moved inward, rather than outward, during inspiration, but their inspiratory cranial displacement remained unchanged. The inspiratory outward and caudal displacement of the sternum, the inspiratory EMG activity of the parasternal intercostals, the pattern of breathing, and the arterial blood gases were also unaltered. However, the inspiratory EMG activity recorded from the external intercostals increased consistently to 327 +/- 101% of control (p < 0.05). These observations indicate that with flail chest, the disconnected segment of the rib cage shows paradoxical motion exclusively along the lateral axis; the increased external intercostal activation may account, at least in part, for the persistent inspiratory cranial motion of the ribs. These observations also suggest that the harmful effects of blunt chest injuries are related to pulmonary contusion and pain, rather than to flail chest per se.

Animals↗
PubMed1994

Intercostal muscle compensation for parasternal paralysis in the dog: central and proprioceptive mechanisms.

1. Denervation of the parasternal intercostal muscles in the dog is known to cause a substantial reduction in the inspiratory cranial displacement of the ribs and a compensatory increase in the activation of the other inspiratory intercostal muscles, namely the external intercostals and the levator costae. The present studies were designed to assess the mechanism(s) of that compensation. 2. Denervating the parasternal intercostals bilaterally caused a reduction in tidal volume and an increase in arterial PCO2 (Pa, CO2). Severing the parasternal intercostals selectively produced similar changes. The concomitant increases in external intercostal and levator costae activity, however, were much greater than predicted on the basis of the increased Pa, CO2. 3. Denervating the parasternal intercostals on one side of the chest produced large increases in ipsilateral, but not contralateral external intercostal activity. 4. Manipulating the ribs after the parasternal intercostals were inactivated so as to reproduce the normal inspiratory cranial displacement of the ribs elicited immediate, clear-cut reductions in external intercostal and levator costae activities. 5. The increases in external intercostal and levator costae activities that occur after inactivation of the parasternal intercostals thus result partly from the increased hypercapnic drive but mostly from proprioceptive reflexes, presumably muscle spindle reflexes.

Animals↗
PubMed1994

Contribution of the rib cage inspiratory muscles to breathing in baboons.

We have measured the electromyograms of the rib cage inspiratory muscles, including the neck muscles, in five lightly anesthetized baboons breathing at rest in the supine and head-up postures. When supine, the animals did not have any activity in the scalene (three heads) or sternomastoid muscles. In contrast, a phasic inspiratory electrical activity was invariably recorded from the parasternal intercostals, external intercostals, and levator costae. Measurements of the changes in length of the parasternal intercostals indicated that these muscles also shortened during inspiration, and they further showed that this inspiratory shortening was eliminated after selective muscle denervation. Similar observations were made in the head-up posture, although the inspiratory shortening of the parasternal intercostals was smaller in this posture. These observations thus indicate that: (1) the inspiratory expansion of the rib cage in baboons results entirely from the actions of the inspiratory intercostal muscles and mostly from the action of the parasternal intercostals; and (2) the load imposed on these muscles is greater in the head-up posture, presumably because of the action of gravity on the chest wall.

Animals↗
PubMed1994

Do canine scalene and sternomastoid muscles play a role in breathing?

To assess the respiratory function of the scalene and sternomastoid muscles in the dog, we studied the effect of graded increases in inspiratory airflow resistance and single-breath airway occlusion on the electrical activity of these muscles in 18 supine anesthetized spontaneously breathing animals. The sternomastoids never showed any activity, and the scalenes showed some inspiratory activity during occlusion in only two animals. The adoption of the prone position and bilateral cervical vagotomy did not affect this pattern. Hypercapnia also did not elicit any sternomastoid activity and induced scalene inspiratory activity during occlusion in only four of nine animals. On microscopic examination, however, both muscles were found to contain large numbers of spindles, suggesting that they have the capacity to respond to stretch. In addition, with increases in inspiratory resistance, both the sternum and ribs were displaced in the caudal direction. As a result, the scalenes demonstrated a gradual inspiratory lengthening and the normal inspiratory lengthening of the sternomastoids was accentuated. Additional studies in three unanesthetized animals showed consistent activity in the scalene and sternomastoid muscles during movements of the trunk and neck but no activity during breathing, including occluded breathing. These observations thus indicate that the alpha-motoneurons of the scalene and sternomastoid muscles in the dog have very small central respiratory drive potentials with respect to their critical firing threshold. In this animal, these muscles do not have a significant respiratory function.

Action Potentials↗
PubMed1994

Neck muscle activity in patients with severe chronic obstructive pulmonary disease.

The present studies were designed to assess the pattern of activity and the frequency of activation of the neck muscles in patients with chronic obstructive pulmonary disease (COPD). Using concentric needle electrodes, we thus recorded the electromyograms of the scalene, sternocleidomastoid, and trapezius muscles during resting breathing in 40 stable patients with severe chronic airflow obstruction (FEV1 = 0.69 +/- 0.18 L) and hyperinflation (FRC = 228 +/- 40% of predicted); 17 patients were hypercapnic at rest. When breathing in the seated posture, all patients (100%) had strong inspiratory contraction of the scalenes. In contrast, no patient showed inspiratory activity in the trapezius, and only four patients (10%) showed definite, invariable inspiratory activity in the sternocleidomastoid. These two muscles were silent in the supine posture as well, even though the adoption of this posture was associated with an increase in dyspnea in most patients. We conclude, therefore, that in contrast to conventional thinking, most stable patients with severe COPD do not use the sternocleidomastoids or the trapezii when breathing at rest. Additional measurements indicated that the sternocleidomastoid inspiratory activity previously recorded in such patients was in general caused by a cross-contamination from surrounding muscles.

Adult↗
PubMed1994

Evidence of dynamic airway compression during cough in tetraplegic patients.

Although all the well-recognized muscles of expiration are paralyzed after traumatic transection of the lower cervical cord, tetraplegic subjects can still empty their lungs actively by contracting the clavicular portion of the pectoralis major. It is not known, however, whether contraction of this muscle bundle may raise pleural pressure enough to cause dynamic compression of the intrathoracic airways, which is critical for the production of an effective cough. To investigate this question, we measured expiratory flow rate and esophageal pressure during a series of forced expiratory vital capacity (VC) maneuvers in twelve subjects with C5-8 traumatic tetraplegia and constructed isovolume-pressure flow (IVPF) curves. The curves were interpretable with certainty in nine patients. Three of them did not show any plateau of flow. On the other hand, six patients had clearcut plateaus of flow on all IVPF curves between 80-60 and 20% VC, suggesting they had dynamic airway compression. Videoendoscopic recordings in two patients confirmed trachea and main bronchi collapse during forced expiration and cough. We conclude, therefore, that contraction of the pectoralis major causes dynamic airway compression during expiratory efforts in a substantial proportion of tetraplegic subjects. Increasing the pressure-generating capacity of this muscle might thus improve the effectiveness of cough and reduce the prevalence of bronchopulmonary infections.

Adult↗
PubMed1993

Lung volume restriction in patients with chronic respiratory muscle weakness: the role of microatelectasis.

BACKGROUND: It is well established that patients with longstanding weakness of the respiratory muscles have a reduction in lung distensibility. Although this occurs in most patients without any radiographic changes suggesting parenchymal lung disease, it has been attributed to the development of microatelectasis. METHODS: A high resolution computed tomographic (CT) scanner was used in eight patients with traumatic tetraplegia and six patients with generalised neuromuscular disorders to look for areas of atelectasis. With the patient in the supine posture scans of 1 mm thickness were obtained at total lung capacity at intervals of 1 cm from the apex to the base of the lung. RESULTS: Vital capacity, total lung capacity, and inspiratory muscle strength were reduced to a mean of 59.5%, 73.9%, and 51.1% of predicted values, respectively. Static expiratory lung compliance was decreased in 12 of the 14 patients and averaged 69.1% of the predicted value. The CT scans revealed only small areas of atelectasis in one tetraplegic patient and in one patient with a generalised neuromuscular disorder; no parenchymal abnormality was seen in the other 12 patients. CONCLUSIONS: In many patients with chronic weakness of the respiratory muscles the reduced lung distensibility does not appear to be caused by microatelectasis. It might be related to alterations in elasticity of the lung tissue.

Adult↗
PubMed1993

Respiratory response to abdominal and rib cage muscle paralysis in dogs.

To assess the respiratory response to abdominal and rib cage muscle paralysis, we measured tidal volume, esophageal and gastric pressures, arterial blood gases, and the electromyogram (EMG) of the diaphragm during progressive epidural anesthesia (lidocaine 2%) in 35 supine anesthetized dogs. The EMG activity of the diaphragm was measured with fine-wire electrodes; the abdominal cavity was thus left intact. Paralysis of the abdominal muscles alone did not produce any alterations. In contrast, when all rib cage muscles were also paralyzed, there were substantial increases in the peak height and the rate of rise of diaphragmatic EMG activity that were associated with a decrease in tidal volume and an increase in arterial PCO2 (PaCO2); swings in transdiaphragmatic pressure, however, were unchanged. The increased diaphragmatic activation due to rib cage muscle paralysis persisted after bilateral cervical vagotomy and was well explained by the increased PaCO2. These observations indicate that in the dog 1) the rib cage muscles contribute significantly to tidal volume, and their paralysis causes, through the increased hypercapnic drive, a compensatory increase in diaphragmatic activation; and 2) the rib cage inspiratory muscles enhance the diaphragm's ability to generate pressure during breathing.

Abdomen↗
PubMed1993

Mechanics of the parasternal intercostals in prone dogs: statics and dynamics.

It is well established that the parasternal intercostal muscles in supine dogs play a major role in causing the inspiratory elevation of the ribs. This posture, however, is not physiological in the dog. In the present study, we measured the electromyographic (EMG) activity and the respiratory changes in length of these muscles in the prone (standing) and supine postures in seven anesthetized spontaneously breathing dogs. With a change from the supine to the prone posture, the parasternal intercostals showed a 3.2% reduction in their relaxation length (Lr), but their mechanical behavior was essentially unchanged. Thus, the muscles continued to shorten below Lr during inspiration and to lengthen beyond Lr during expiration. With the adoption of the prone posture, the amount of parasternal inspiratory EMG activity and the amount of inspiratory muscle shortening each increased by 30-35%. Furthermore, when the parasternal intercostal in a single interspace was selectively denervated, the shortening of the muscle during inspiration in both postures was virtually eliminated. These observations indicate that in the dog the parasternal intercostals still play a major role in causing the inspiratory elevation of the ribs in the prone posture. These observations also suggest that these muscles in prone animals continue to operate on the descending limb of their length-tension curve.

Animals↗
PubMed1993

Sternum dependence of rib displacement during breathing.

The parasternal intercostals are the primary determinant of the inspiratory cranial displacement of the ribs in the dog. When they contract, however, these muscles also cause a caudal displacement of the sternum, presumably an expiratory motion. The present studies were designed to assess the effects of this sternal displacement on the cranial displacement of the ribs and on lung volume. Twelve supine anesthetized animals were studied. We first measured, in four paralyzed animals, the displacement of the ribs and sternum produced by known external forces applied to the ribs, the sternum, or both simultaneously. From these measurements, the elastic coupling between the ribs and sternum was determined. We then studied, in eight animals, the effect of sternal motion on rib motion and tidal volume during spontaneous breathing. Rib and sternal displacements and tidal volume were measured first with the sternum free to move caudally during inspiration and then with the sternum constrained to prevent caudal motion. Preventing the sternum from moving caudally caused a 24% increase in the inspiratory cranial displacement of the ribs; this increased displacement of the ribs agreed well with the elastic coupling between the sternum and the ribs as determined from the force-displacement observations. Tidal volume, however, remained unchanged. These observations indicate that the caudal displacement of the sternum produced by the parasternal intercostals reduces the cranial displacement of the ribs but probably increases the lateral expansion of the rib cage.

Animals↗
PubMed1993

Respiratory effect of the intercostal muscles in the dog.

In a previous paper (J. Appl. Physiol. 73: 2283-2288, 1992), respiratory effect was defined as the change in airway pressure produced by active tension in a muscle with the airway closed, mechanical advantage was defined as the respiratory effect per unit mass per unit active stress, and it was shown that mechanical advantage is proportional to muscle shortening during the relaxation maneuver. Here, we report values of mechanical advantage and maximum respiratory effect of the intercostal muscles of the dog. Orientations of the intercostal muscles in the third and sixth interspaces were measured. Mechanical advantages of the muscles in these interspaces were computed by computing their shortening from these data and data in the literature on rib displacement. We found that parasternal internal intercostals and dorsal external intercostals of the upper interspace have large inspiratory mechanical advantages and that dorsal internal intercostals of the lower interspace and triangularis sterni have large expiratory mechanical advantages. Mass distributions in the two interspaces were also measured, and maximum respiratory effects of the muscles were calculated from their mass, mechanical advantage, and the value for maximum stress in skeletal muscle. Estimated maximum respiratory effects of the inspiratory and expiratory muscle groups of the entire rib cage were tested by measuring the maximum inspiratory pressures that were generated by the parasternal and external intercostals acting alone. Measured pressures, -13 cmH2O for the parasternals and -11 cmH2O for the external intercostals, agreed well with the computed values.

Animals↗
PubMed1992

The electro-mechanical response of canine inspiratory intercostal muscles to increased resistance: the cranial rib-cage.

1. The effect of graded increases in inspiratory airflow resistance on the electrical activity and the mechanical behaviour of the three groups of inspiratory intercostal muscles (parasternal intercostal, external intercostal, levator costae) situated in the cranial portion of the rib-cage has been studied in ten anaesthetized, spontaneously breathing dogs. The mechanical behaviour of the muscles was determined by measuring the respiratory changes in muscle length and the displacements of the rib. 2. During unloaded inspiration, the three muscles were active, the rib moved in the cranial direction, and the parasternal intercostal and levator costae muscles shortened; in most animals, the external intercostals shortened as well. 3. Graded increases in inspiratory airflow resistance elicited a progressive inhibition of parasternal intercostal activity and a gradual facilitation of external intercostal and levator costae activities. Concomitantly, the parasternal intercostals continued to shorten during inspiration. However, both the external intercostals and the levator costae progressively lengthened, and the rib was gradually displaced in the caudal direction. This pattern persisted after increases in chemical respiratory drive had developed. 4. Sectioning the phrenic nerve roots did not alter the electrical or the mechanical response of the parasternal intercostal muscles to loading, but it markedly affected the response of the external intercostals and levator costae. After phrenicotomy, the external intercostals and levator costae continued to shorten during loaded breaths, the rib continued to be displaced in the cranial direction, and although the rate of inspiratory muscle shortening and of rib motion decreased, the facilitation of external intercostal and levator costae activities was markedly reduced or abolished. 5. Lengthening of the external intercostals and caudal displacement of the rib was reproduced by isolated stimulation of the phrenic nerves. 6. The reflex facilitation of external intercostal and levator costae activities that takes place during inspiratory resistive loading thus results primarily from the collapsing action of the diaphragm on the cranial portion of the rib-cage and the consequent lengthening of these muscles. The mechanical effectiveness of this reflex facilitation, however, appears to be relatively small.

Airway Obstruction↗
PubMed1992

The electro-mechanical response of canine inspiratory intercostal muscles to increased resistance: the caudal rib-cage.

1. The effect of graded increases in inspiratory airflow resistance and airway occlusion on the electrical activity and the mechanical behaviour of the levator costae and external intercostal muscles situated in the caudal interspaces (zone of apposition of the diaphragm to the rib-cage) has been studied in spontaneously breathing dogs. 2. The external intercostal and levator costae muscles in the cranial interspaces were invariably active during unloaded inspiration and showed progressive facilitation of activity with increases in inspiratory resistance. In contrast, whether in the supine or in the prone position, the levator costae muscles of the caudal interspaces did not show any facilitation of activity, and the caudal external intercostal muscles never showed any inspiratory electrical activity, including during airway occlusion. 3. With graded increases in inspiratory airflow resistance, the cranial external intercostals demonstrated a gradual inspiratory lengthening and the cranial ribs were progressively displaced in the caudal direction. The caudal ribs, however, were invariably displaced in the cranial direction. As a result, the caudal external intercostals showed a progressive inspiratory shortening. 4. Shortening of the caudal external intercostals and cranial displacement of the caudal ribs were reproduced by isolated stimulation of the phrenic nerves. Thus, as inspiratory resistance increases, contraction of the diaphragm causes unloading, rather than loading, of the spindles present in the caudal external intercostal muscles. 5. After the phrenic nerves were sectioned, however, the caudal external intercostals invariably lengthened a substantial amount during inspiration, but they still did not show any inspiratory electrical activity. Accentuating the inspiratory lengthening of these muscles by external rib fixation and increasing the chemical respiratory drive did not elicit any inspiratory electrical activity either. The alpha-motoneurones of the external intercostal muscles in the caudal interspaces thus have very small central respiratory drive potentials with respect to their critical firing threshold.

Airway Obstruction↗
PubMed1992

Intercostal muscles are used during rotation of the thorax in humans.

To test the idea that the lateral intercostal muscles may be more suited to aid in rotational than respiratory movements of the thorax, we inserted bipolar fine-wire electrodes in external and internal intercostal muscles in the right midaxillary line in nine sitting subjects and examined the pattern of contraction of these muscles during voluntary axial rotations of the thorax (30-35 degrees), resting breathing, and CO2-induced hyperpnea. The right external intercostal muscles were strongly recruited in rotations to the left but were not active in rotations to the right. In contrast, the right internal intercostal muscles were active in rotations to the right but not in rotations to the left. Rotations completed in 1 or 2 s were associated with an early burst of electromyographic activity, followed by a low plateau that persisted while the rotation was held. Rotations made very gradually over 5-10 s were associated with gradually rising electromyographic activity. The amplitude of activity recorded during 30-35 degrees rotations was equivalent to that measured when minute ventilation was increased by CO2 to 50 l/min. We conclude that the lateral intercostal muscles have a major role in producing axial rotations of the thorax.

Adult↗
PubMed1992

Effect of respiratory muscle tension on lung volume.

The chest wall is modeled as a linear system for which the displacements of points on the chest wall are proportional to the forces that act on the chest wall, namely, airway opening pressure and active tension in the respiratory muscles. A standard theorem of mechanics, the Maxwell reciprocity theorem, is invoked to show that the effect of active muscle tension on lung volume, or airway pressure if the airway is closed, is proportional to the change of muscle length in the relaxation maneuver. This relation was tested experimentally. The shortening of the cranial-caudal distance between a rib pair and the sternum was measured during a relaxation maneuver. These data were used to predict the respiratory effect of forces applied to the ribs and sternum. To test this prediction, a cranial force was applied to the rib pair and a caudal force was applied to the sternum, simulating the forces applied by active tension in the parasternal intercostal muscles. The change in airway pressure, with lung volume held constant, was measured. The measured change in airway pressure agreed well with the prediction. In some dogs, nonlinear deviations from the linear prediction occurred at higher loads. The model and the theorem offer the promise that existing data on the configuration of the chest wall during the relaxation maneuver can be used to compute the mechanical advantage of the respiratory muscles.

Body Weight↗
PubMed1992

Abdominal muscle use during breathing in patients with chronic airflow obstruction.

To assess the pattern of abdominal muscle contraction in stable patients with chronic obstructive pulmonary disease (COPD), we studied electromyograms of the rectus abdominis, external oblique, and transversus abdominis muscles in 40 patients with variable degrees of chronic airflow obstruction (FEV1 between 17 and 82% of predicted); 12 control subjects with normal pulmonary function tests were studied for comparison. The subjects were studied during resting breathing in the supine posture, and the electromyograms were recorded with concentric needle electrodes implanted with the aid of a high-resolution ultrasound. The rectus abdominis and external oblique were silent in virtually all patients. In contrast, 17 patients had invariable phasic expiratory activity in the transversus abdominis, and 11 additional patients had intermittent transversus expiratory activity. Expiratory contraction of the transversus was related to the degree of airflow obstruction (p less than 0.005), and when present, it persisted in the seated posture. We conclude that (1) when breathing at rest, many stable patients with severe chronic airflow obstruction contract the abdominal muscles during expiration, and (2) this expiratory contraction is usually confined to the transversus muscle. These observations also indicate that the physiology of dynamic hyperinflation and intrinsic positive end-expiratory pressure (PEEP) in such patients should be reevaluated.

Abdominal Muscles↗