Department of Physical Therapy, University of Florida, Gainesville, FL, United States; McKnight Brain Institute, University of Florida, Gainesville, FL, United States; Breathing Research and Therapeutics Center, University of Florida, Gainesville, FL, United States.
Department of Physical Therapy, University of Florida, Gainesville, FL, United States; McKnight Brain Institute, University of Florida, Gainesville, FL, United States; Breathing Research and Therapeutics Center, University of Florida, Gainesville, FL, United States.
Handb Clin Neurol. 2022;188:393-408. doi: 10.1016/B978-0-323-91534-2.00012-6.
The phrenic neuromuscular system consists of the phrenic motor nucleus in the mid-cervical spinal cord, the phrenic nerve, and the diaphragm muscle. This motor system helps sustain breathing throughout life, while also contributing to posture, coughing, swallowing, and speaking. The phrenic nerve contains primarily efferent phrenic axons and afferent axons from diaphragm sensory receptors but is also a conduit for autonomic fibers. On a breath-by-breath basis, rhythmic (inspiratory) depolarization of phrenic motoneurons occurs due to excitatory bulbospinal synaptic pathways. Further, a complex propriospinal network innervates phrenic motoneurons and may serve to coordinate postural, locomotor, and respiratory movements. The phrenic neuromuscular system is impacted in a wide range of neuromuscular diseases and injuries. Contemporary research is focused on understanding how neuromuscular plasticity occurs in the phrenic neuromuscular system and using this information to optimize treatments and rehabilitation strategies to improve breathing and related behaviors.
膈神经肌肉系统由中颈脊髓的膈运动核、膈神经和膈肌肌肉组成。这个运动系统有助于维持生命中的呼吸，同时也有助于姿势、咳嗽、吞咽和说话。膈神经主要包含传出膈运动轴突和来自膈肌感觉受体的传入轴突，但也是自主纤维的通道。在呼吸的基础上，由于兴奋性的延髓-脊髓突触通路，膈运动神经元发生节律性（吸气性）去极化。此外，一个复杂的本体感觉网络支配膈运动神经元，并可能有助于协调姿势、运动和呼吸运动。膈神经肌肉系统在广泛的神经肌肉疾病和损伤中受到影响。当代研究的重点是了解膈神经肌肉系统中的神经肌肉可塑性是如何发生的，并利用这些信息来优化治疗和康复策略，以改善呼吸和相关行为。
