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Accessory muscles are those that are not primarily responsible for movement but do provide assistance. They are typically understood as the muscles that provide assistance to the main breathing muscles, namely the diaphragm and intercostal muscles, when additional power is needed, for example during exercise or in those with airway pathologies. Accessory muscles are also used in infants, who cannot control their breathing to the same extent as adults, and in people with certain medical conditions, such as COPD, that make breathing more difficult.
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What You'll Learn
- Accessory muscles are used for breathing in certain medical conditions
- They are also used in deep breathing or vigorous physical activity
- Accessory muscles are an anatomical variation where duplication of a muscle may appear
- They can be found in the pectoral region, including the axillary arch
- Accessory muscles are used in the evaluation of acute dyspnea
Accessory muscles are used for breathing in certain medical conditions
Accessory muscles are additional muscles that the body can activate to help inhale and exhale air into the lungs. They are generally not used during quiet, relaxed breathing but are increasingly recruited as the demand for oxygen increases or when there is a compromise in lung function. The accessory muscles of breathing are located in various regions of the upper body, including the neck, chest, and abdominal regions.
The primary muscles involved in breathing are the diaphragm and the intercostal muscles, which are responsible for most of the air movement in and out of the lungs during normal breathing. However, in certain medical conditions, the body may need to recruit accessory muscles to support breathing. This activation of accessory muscles is often a sign that immediate medical evaluation is warranted.
One such medical condition is Chronic Obstructive Pulmonary Disease (COPD), an umbrella term for conditions that make it difficult to breathe. COPD can cause the lungs to over-inflate and trap air, leaving the diaphragm and intercostal muscles at a disadvantage and unable to move enough air in and out of the lungs. As a result, people with COPD may need to rely on accessory muscles to facilitate breathing.
Other respiratory conditions that can lead to the use of accessory muscles include asthma, pneumonia, and Acute Respiratory Distress Syndrome (ARDS). In addition, accessory muscles may be used in situations of intense physical exertion or high emotional stress. For example, they can be involved when swimming underwater or forcefully expelling air.
Furthermore, accessory muscles can be used to compensate for respiratory conditions leading to hypoxemia (low blood oxygen levels) or hypercapnia (high blood carbon dioxide levels). They can also be utilised in systemic conditions resulting in metabolic acidosis, characterised by excessive acid in bodily fluids.
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They are also used in deep breathing or vigorous physical activity
Accessory muscles are additional muscles that the body activates to help inhale and exhale air into the lungs. They are not primarily responsible for respiration but can assist in the act of breathing when there is an increased demand for oxygen or when there is a compromise in lung function.
The primary muscles involved in breathing are the diaphragm and the intercostal muscles. These muscles are crucial for the fundamental act of breathing and are responsible for most of the air movement in and out of the lungs during quiet, relaxed breathing. The diaphragm is a dome-shaped muscle that separates the thoracic cavity, which houses the lungs and heart, from the abdominal cavity.
Accessory muscles are generally not used during normal breathing but are increasingly recruited as the demand for oxygen increases, such as during deep breathing or vigorous physical activity. They are also used when there is a compromise in lung function, such as during respiratory distress due to medical conditions like asthma or COPD. During physical exertion, accessory muscles assist in expanding and contracting the thoracic cavity to facilitate adequate gas exchange.
Accessory muscles of inspiration, such as the scalene, sternocleidomastoid, trapezius, and pectoralis major muscles, are used when breathing in. They contract to lift up the breastbone, upper ribs, and collarbones, causing the upper part of the chest to rise, making the lungs bigger, and allowing more air to enter. Accessory muscles of expiration, such as the abdominal wall muscles, are used when breathing out. They contract to push up against the diaphragm, helping to expel air more forcefully.
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Accessory muscles are an anatomical variation where duplication of a muscle may appear
Accessory muscles are a relatively rare anatomical variation where a duplication of a muscle may appear anywhere in the muscular system. Accessory muscles are not active during regular breathing in healthy people, but they may be used when taking a deliberately deep breath, such as when swimming underwater or blowing out birthday candles. They are also used when a person has a condition that makes breathing more difficult, such as COPD, or during different life stages, such as in infancy.
Accessory muscles that aid in breathing include the sternocleidomastoid, scalene, intercostal, abdominal, and pectoralis minor muscles. The sternocleidomastoid muscle, located in the neck, lifts the sternum, allowing for increased expansion of the chest cavity and deeper inhalation. The scalene muscles, also found in the neck, assist in elevating the second and third ribs, further contributing to chest expansion during intensive breathing efforts. The pectoralis minor, situated in the upper chest and front of the shoulders, helps to elevate the third, fourth, and fifth ribs, enhancing chest expansion and increasing lung capacity during inhalation. The intercostal muscles, which include the external, internal, and innermost intercostal muscles, assist the diaphragm in breathing.
Other examples of accessory muscles include the accessory soleus muscle in the calf or ankle, the extensor digitorum brevis manus in the hand, and the epitrochleoanconeus muscle of the upper arm. In the hand, there is also the flexor carpi radialis brevis, which can compress the anterior interosseous nerve. On the extensor side, there are muscles such as the extensor digitorum brevis manus, extensor carpi radialis intermedius, and extensor medii proprius muscle. Accessory muscles of the anterior thoracic wall include the sternalis muscle, the axillary arch (Langer's), and variations of pectoralis major such as the pectoralis minimus, pectoralis quartus, and pectoralis intermedius.
The presence of accessory muscles is generally not a cause for concern unless they interfere with normal function. In such cases, treatment may be indicated. These accessory muscles are also clinically significant, with some having potential applications in reconstructive surgery and playing a role in avoiding complications during axillary lymph node removal.
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They can be found in the pectoral region, including the axillary arch
Accessory muscles refer to muscles that are not primarily responsible for movement but do provide assistance. They are typically activated during deep breathing or when a person has a condition that makes breathing more difficult.
Accessory muscles can be found in the pectoral region, including the axillary arch. The pectoral region is subject to a high degree of variability. The pectoralis major or pectoralis minor may be absent, or the pectoralis major may be doubled. Other variants in this region include the chondroepitrochleas, which originate in one or more ribs or directly from the pectoralis major; the costocoracoideus from the 6th to 8th ribs, and a chondrocoracoideus and another variant of this waiting to be named. Most of these accessory muscles are implicated in neurovascular compression.
The axillary arch is an arch-shaped anatomical variant of the latissimus dorsi muscle of the human back. Its defining characteristics are its origin from the latissimus dorsi muscle, its insertion close to or on the upper anterior part of the humerus, and that it crosses the neurovascular bundle associated with the axillary nerve from dorsomedial to ventrolateral. The axillary arch may be seen when the arm is abducted and the palms are put on the back of the head. It can be unilateral or bilateral, with no side preference, and its size may vary from 7 to 10 cm in length and 0.5 to 1.5 cm in width.
The axillary arch was first described by Bugnone in 1783, according to Pitzorno (1912), and later by Alexander Ramsay in 1793 and Karl Langer in 1846. It is considered to have no functional significance, although this is challenged by some authors. The axillary arch plays a role in the entrapment of nearby structures and may alter local anatomy during surgery. It is usually asymptomatic and found accidentally during axillary surgery.
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Accessory muscles are used in the evaluation of acute dyspnea
Accessory muscles are those that are not primarily responsible for movement but do provide assistance. They are typically not active during regular breathing in healthy people but may be used when taking a deliberately deep breath, such as when swimming underwater or blowing out candles.
In the context of acute dyspnea, accessory muscles are those that are recruited during times of respiratory dysfunction to compensate for difficulty in breathing. Acute dyspnea refers to sudden shortness of breath, which can be a symptom of various respiratory conditions, such as chronic obstructive pulmonary disease (COPD) or pulmonary embolism. In people with COPD, the diaphragm and intercostal muscles may be disadvantaged due to over-inflation of the lungs, leading to the use of accessory muscles.
The accessory muscles of respiration include the sternocleidomastoid, scalene (anterior, middle, and posterior), pectoralis major and minor, serratus anterior, and latissimus dorsi. These muscles can be evaluated for their strength and endurance capacity, which may be decreased in patients with respiratory conditions compared to healthy individuals.
The evaluation of accessory muscles in acute dyspnea can provide useful information, although it may be less specific in certain cases. For example, in patients with suspected pulmonary embolism, the finding of accessory muscle use had no diagnostic value in one study. However, in other cases, such as end-of-life care or respiratory distress in young children, the activation of accessory muscles can be a critical physical sign indicating abnormalities in breathing.
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Frequently asked questions
Accessory muscles are muscles that provide assistance to the main breathing muscles when additional power is needed, for example during exercise or in those with airway pathologies. They are also used when taking a deliberately deep breath, such as when swimming underwater.
Examples of accessory muscles include the sternocleidomastoid, the scalene, the pectoralis major, the trapezius, and the external intercostals.
Accessory muscles are crucial when additional respiratory effort is required, such as during deep breathing or in response to respiratory challenges. They optimise lung function by aiding in more significant lung expansion.
