Contractility of the ventilatory pump muscles

Abstract

The ventilatory muscles are striated skeletal muscles, and their in situ function is governed by the same relationships that determine the contractile force of muscles in vitro. The ventilatory muscles, however, are functionally distinct from limb skeletal muscles in several aspects, the most notable being that the ventilatory muscles are the only skeletal muscles upon which life depends. Among the muscles that participate in ventilation, the diaphragm is closest to its optimal resting length at functional residual capacity (FRC) and has the greatest capacity for shortening and volume displacement, making it the primary muscle of inspiration. All inspiratory muscles shorten when the lung is inflated above FRC, but interactions among the various inspiratory muscles make for a wider range of high force output than could be achieved by any one muscle group acting in isolation. The velocity of inspiratory muscle shortening, especially diaphragmatic shortening, causes maximal dynamic inspiratory pressures to be substantially lower than maximal static pressures. This effect is especially pronounced during maximal voluntary ventilation, maximal exercise, and maximal inspiratory flow, volume maneuvers over the full vital capacity. During quiet breathing, the ventilatory muscles operate well below the limits of their neural activation and contractile performance. During intense activity, however, the diaphragmatic excursion approaches its limits over the entire vital capacity, and respiratory pressures may near their dynamic maximum. Because the system may operate near its available capacities during increased ventilatory demands, multiple strategies are available to compensate for deficits. For example, if the diaphragm is acutely shortened, it can still generate the required respiratory pressure if it receives more neural drive. Alternatively, other muscles can be recruited to take over for an impaired diaphragm. Thus, the whole system is highly versatile.