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胸膜压力在肋间肌与肋骨耦合中的作用。

Role of pleural pressure in the coupling between the intercostal muscles and the ribs.

作者信息

De Troyer André, Leduc Dimitri

机构信息

Laboratory of Cardiorespiratory Physiology, Brussels School of Medicine, Chest Service, Erasme University Hospital, Route de Lennik, 808, 1070 Brussels, Belgium.

出版信息

J Appl Physiol (1985). 2007 Jun;102(6):2332-7. doi: 10.1152/japplphysiol.01403.2006. Epub 2007 Feb 22.

Abstract

The inspiratory intercostal muscles elevate the ribs and thereby elicit a fall in pleural pressure (DeltaPpl) when they contract. In the present study, we initially tested the hypothesis that this DeltaPpl does, in turn, oppose the rib elevation. The cranial rib displacement (Xr) produced by selective activation of the parasternal intercostal muscle in the fourth interspace was measured in dogs, first with the rib cage intact and then after DeltaPpl was eliminated by bilateral pneumothorax. For a given parasternal contraction, Xr was greater after pneumothorax; the increase in Xr per unit decrease in DeltaPpl was 0.98+/-0.11 mm/cmH2O. Because this relation was similar to that obtained during isolated diaphragmatic contraction, we subsequently tested the hypothesis that the increase in Xr observed during breathing after diaphragmatic paralysis was, in part, the result of the decrease in DeltaPpl, and the contribution of the difference in DeltaPpl to the difference in Xr was determined by using the relation between Xr and DeltaPpl during passive inflation. With diaphragmatic paralysis, Xr during inspiration increased approximately threefold, and 47+/-8% of this increase was accounted for by the decrease in DeltaPpl. These observations indicate that 1) DeltaPpl is a primary determinant of rib motion during intercostal muscle contraction and 2) the decrease in DeltaPpl and the increase in intercostal muscle activity contribute equally to the increase in inspiratory cranial displacement of the ribs after diaphragm paralysis.

摘要

吸气时肋间肌收缩会提升肋骨,从而使胸膜腔内压(ΔPpl)下降。在本研究中,我们首先检验了这样一个假设,即这种ΔPpl反过来会对抗肋骨的提升。在犬类中测量了第四肋间胸骨旁肋间肌选择性激活所产生的头侧肋骨位移(Xr),首先是在完整胸廓的情况下,然后是在双侧气胸消除ΔPpl之后。对于给定的胸骨旁收缩,气胸后Xr更大;ΔPpl每下降单位值时Xr的增加量为0.98±0.11 mm/cmH₂O。因为这种关系与在膈肌单独收缩时所获得的关系相似,所以我们随后检验了这样一个假设,即膈肌麻痹后呼吸过程中观察到的Xr增加部分是ΔPpl下降的结果,并且通过在被动充气期间使用Xr与ΔPpl之间的关系来确定ΔPpl差异对Xr差异的贡献。膈肌麻痹时,吸气时的Xr增加约三倍,并且这种增加的47±8%是由ΔPpl下降所致。这些观察结果表明:1)ΔPpl是肋间肌收缩期间肋骨运动的主要决定因素;2)ΔPpl的下降和肋间肌活动的增加对膈肌麻痹后肋骨吸气时头侧位移的增加贡献相等。

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