Chest wall configuration in supine man: Wakefulness and sleep

doi:10.1016/0034-5687(78)90022-1

Respiration Physiology

Volume 35, Issue 2, November 1978, Pages 201-213

Respiration Physiolo...

https://doi.org/10.1016/0034-5687(78)90022-1 Get rights and content

Abstract

We measured the anteroposterior and lateral diameter of the rib cage (RC), the anteroposterior diameter of the abdomen (ABD) and the cranio caudal abdominal dimension during breathing in supine posture, in order to analyze the shape of the chest wall in both awake and sleep conditions. By comparing the active breath holding and relaxation curves, it appeared that during activity of the respiratory muscles the RC is both expanded and distorted at the highest volumes and mainly distorted at the lowest volumes. During sleep the abdominal protrusion is smaller and the lateral sides of the rib cage expand more than during wakefulness. This might explain the higher rib cage motion during sleep found by some authors who measured the rib cage circumference and not confirmed by others who measured only its anteroposterior diameter. The motion of the rib cage is similar during sleep and wakefulness, its lateral parts leading the anteroposterior ones, showing that the pattern of motion of the rib cage is not affected by the different activation of the respiratory muscles. The possibility of a distorsion within the front part of the rib cage has been also discussed.

References (20)

E. Agostoni et al.
An analysis of the chest wall motions at high values of ventilation
Respir. Physiol.
(1967)
E. Agostoni et al.
Statics features of the passive rib cage and abdomen-diaphragm
J. Appl. Physiol.
(1965)
E. Agostoni et al.
Relation between changes of rib cage circumference and lung volume
J. Appl. Physiol.
(1965)
E. Agostoni et al.
Deformation of the chest wall during breathing effects
J. Appl. Physiol.
(1966)
E. Agostoni
Knematics
E. D'Angelo et al.
Direct action of contracting diaphragm on the rib cage in rabbits and dogs
J. Appl. Physiol.
(1974)
H.H. Jasper
The ten twenty electrode system of the International Federation
Electroenceph. Clin. Neurophysiol.
(1958)
R. Knill et al.
Respiratory load compensation in infants
J. Appl. Physiol.
(1976)
K. Konno et al.
Measurement of the separate volume changes of rib cage and abdomen during breathing
J. Appl. Physiol.
(1967)
J. Mead et al.
Pulmonary ventilation measured from body surface movements
Science
(1967)

There are more references available in the full text version of this article.

Cited by (18)

Domiciliary noninvasive ventilation for chronic respiratory diseases
2022, Medical Journal Armed Forces India
Citation Excerpt :
The reduction on capacity can be due to intrinsic weakness of respiratory muscles like in neuromuscular diseases or can be acquired due to mechanical disadvantage from chest wall deformity or due to COPD-related hyperinflation. Increased load can be due to airway obstruction, reduced lung compliance due to loss of lung elasticity and reduced chest wall compliance.2–7 The dysfunction of load, drive and capacity in various chronic lung diseases is elaborated in Table 1.
Patients with chronic respiratory diseases, including chronic obstructive pulmonary disease (COPD), neuromuscular diseases, kyphoscoliosis and obstructive sleep apnoea-obesity hypoventilation syndrome (OSA-OHS), are at a higher risk of decompensation in the form of hypercapnic respiratory failure leading to intensive care unit (ICU) admission and increased mortality. This article reviews the evidence of role of domiciliary noninvasive ventilation (NIV) in patients with diseases with chronic ventilatory failure, including the mechanism of the effect of (NIV).
Respiratory sinus arrhythmia during a mental attention task: the role of breathing-specific heart rate
2020, Respiratory Physiology and Neurobiology
Citation Excerpt :
These transducers, which respond linearly to changes in length, recorded the breathing-related ribcage and abdomen movements (Fig. 1, channels 1 and 2). In the supine position the chest wall moves as if comprising two compartments (rib cage and abdomen) arranged in series, with minimal distortion (Mortola and Anch, 1978). Therefore, at any lung volume the volumetric decrease of one corresponds to the expansion of the other compartment and the sum of rib cage and abdomen linear expansions is an excellent approximation of tidal volume (Konno and Mead, 1967; Mead et al., 1967) (channel 6).
It is known that a mental attention task (MAT) can modify the magnitude of the increase in instantaneous heart rate (HR) with inspiration, or Respiratory Sinus Arrhythmia (RSA). Here, we asked whether the RSA changes were mediated by the changes in HR, breathing frequency (f) or HR/f (‘breathing specific heart rate’). This latter reflects the degree of coupling between pulmonary blood and air flows, the optimization of which may be the function of RSA. RSA (computed as the difference between peak and trough instantaneous HR of each breath, in percent of mean HR) was measured breath-by-breath in 119 young men and women (19.6 ± 0.1 year old) during spontaneous breathing and during a MAT, which consisted in finger tapping at acoustic cues delivered in various patterns. During MAT, breathing became more rapid (+2.2 breaths/min, P < 0.001) and shallow (78% of rest, P < 0.001) and HR decreased slightly (-1 beats/min, P < 0.05). RSA dropped from 13.4 ± 0.7 to 11.6 ± 0.7% (P < 0.0001), because of the drop in the inspiratory peak of instantaneous HR, and so did HR/f, from 5.8 ± 0.2 to 4.9 ± 0.2 beats/breath (P < 0.0001).The results were very similar between genders. The magnitude of the changes in HR/f correlated linearly with those of RSA, so that those subjects who decreased HR/f the most also had the largest decrease in RSA and the few who increased HR/f during MAT also increased RSA. We conclude that this type of mental task changed RSA by a magnitude that depended on its effect on HR/f. The results support the concept that RSA is a central cardio-respiratory mechanism to ameliorate the matching between pulmonary blood and air flows, whether the ventilatory drive originates spontaneously or is under cortical influences.
Thoracoabdominal asynchrony and paradoxical motion in middle stage amyotrophic lateral sclerosis
2019, Respiratory Physiology and Neurobiology
Citation Excerpt :
Firstly, the sample size was small and TAA was only assessed at 45° trunk inclination. It is known that the supine position by itself has an effect on breathing mechanics (i.e. weight of abdominal content upon the diaphragm that increases intra-abdominal pressure and lengthens the diaphragm’s fibers, thereby modifying the ability to generate a given trans-diaphragmatic pressure, limiting the costal movement during inspiration due to the weight of the thorax, changes in inspiratory muscle action distribution and mechanics with muscles of the ribcage acting mainly on its lateral sides) (Mortola and Anch, 1978; Vellody et al., 1978; Ibanez and Raurich, 1982; Vilke et al., 2000), thus the effects of other postures on TAA during coughing need to be properly addressed in future studies. Secondly, OEP data were not acquired during the MIP, MEP and SNIP measurements.
To assess thoracoabdominal asynchrony (TAA) and the presence of paradoxical motion in middle stage amyotrophic lateral sclerosis (ALS) and its relationships with chest wall tidal volume (V_T,CW), breathing pattern and cough peak flow (CPF).
Phase angle (θ) between upper (RCp) and lower ribcage (RCa) and abdomen (AB), as well as percentage of inspiratory time for the lower ribcage (IP_RCa) and abdomen (IP_AB) moving in opposite directions were quantified using optoelectronic plethysmography in 12 ALS patients during quiet breathing and coughing. Paradoxical motion of the compartments was based on threshold values of θ and IP, obtained in twelve age and sex matched healthy persons.
During quiet breathing, significantly higher RCa and AB θ (p < .05), IP_RCa (p = 0.001) and IP_AB (p < 0.05) were observed in ALS patients as compared to controls. In ALS patients, correlations between RCa and AB θ with forced vital capacity (FVC) (r=–0.773, p < 0.01), vital capacity (r=–0.663, p < 0.05) and inspiratory capacity (IC) (r=–0.754, p < 0.01), as well as between RCp and RCa θ with FVC (r=–0.608, p < 0.05) and CPF (r=–0.601, p < 0.05) were found. During coughing, correlations between RCp and AB θ with CPF (r=–0.590, p < 0.05), IC (r=–0.748, p < 0.01) and V_T,CW (r=–0.608, p < 0.05), as well as between RCa and AB θ with CPF (r=–0.670, p < 0.05), IC (r=–0.713, p < 0.05) and peak expiratory flow (r=–0.727, p < 0.05) were also observed in ALS patients. ALS patients with paradoxical motion presented lower vital capacity and FVC_%pred (p < 0.05) compared to those without paradoxical motion.
Middle stage ALS patients exhibit TAA and paradoxical motion during quiet spontaneous breathing and coughing. In addition, diaphragmatic weakness (i.e. decrease in excursion of the RCa and AB compartments) was observed earlier in the lower ribcage rather than the abdominal compartment in this population.
Thinking about breathing: Effects on respiratory sinus arrhythmia
2016, Respiratory Physiology and Neurobiology
Citation Excerpt :
In supine men (and presumably in women) during breathing the chest wall moves with one degree of freedom, so that at any fixed lung volume the expansion of rc is accompanied by a volume-equivalent decrease in abd, and vice versa. Because the distortion between the two compartments is minimal (Mortola and Anch, 1978), chest wall (cw) motion is the algebraic sum of rc and abd and a proxy for tidal volume. Although it is possible to calibrate cw displacement into lung volume units (Konno and Mead, 1967; Mead et al., 1967), this was unnecessary for the purpose of the current study, and cw motion is presented in arbitrary units.
Respiratory sinus arrhythmia (RSA), the increase and decrease in instantaneous heart rate (HR) with inspiration and expiration, is commonly evaluated as function of breathing frequency f. However, to the extent that RSA plays a role in the efficiency of gas exchange, it may be expected to correlate better with HR/f (‘breathing specific heart rate’) than with f, because the former is a better reflection of the cardio-respiratory coupling. We measured RSA breath-by-breath in 209 young men and women during spontaneous breathing and during volitional breathing under auditory cues at vastly different f. In either case, and for both genders, RSA correlated better with HR/f than with f. As HR/f increased so did RSA, in a linear manner. When compared on the basis of HR/f, RSA did not differ significantly between spontaneous and volitional breathing. It is proposed that RSA is a central mechanism that ameliorates the matching between the quasi-continuous pulmonary blood flow and the intermittent airflow, irrespective of the type of ventilatory drive (cortical or autonomic).
Normal Physiology of the Upper and Lower Airways
2010, Principles and Practice of Sleep Medicine: Fifth Edition
Respiratory Physiology: Understanding the Control of Ventilation
2010, Principles and Practice of Sleep Medicine: Fifth Edition

View all citing articles on Scopus

^☆: This work was supported in part by N.I.H. grant HL-20122 and training grant HL-072717.

View full text

Chest wall configuration in supine man: Wakefulness and sleep☆

Abstract

Respir. Physiol.

Statics features of the passive rib cage and abdomen-diaphragm

J. Appl. Physiol.

Relation between changes of rib cage circumference and lung volume

J. Appl. Physiol.

Deformation of the chest wall during breathing effects

J. Appl. Physiol.

Knematics

Direct action of contracting diaphragm on the rib cage in rabbits and dogs

J. Appl. Physiol.

The ten twenty electrode system of the International Federation

Electroenceph. Clin. Neurophysiol.

Respiratory load compensation in infants

J. Appl. Physiol.

Measurement of the separate volume changes of rib cage and abdomen during breathing

J. Appl. Physiol.

Pulmonary ventilation measured from body surface movements

Science