
Accessory muscles are those that are not primarily responsible for movement but do provide assistance. They are typically used when taking a deliberately deep breath, during strenuous exercise, or when a health condition makes breathing more difficult. Accessory muscle use can be indicative of certain health conditions, such as chronic obstructive pulmonary disease (COPD), where the diaphragm and intercostal muscles are at a disadvantage due to over-inflation of the lungs. Accessory muscles can also refer to a rare anatomical variation where duplication of a muscle may appear anywhere in the muscular system, although treatment is usually not necessary unless the accessory muscle interferes with normal function.
| Characteristics | Values |
|---|---|
| Definition | Accessory muscles are those that are not primarily responsible for movement but do provide assistance. |
| Use | Accessory muscles are used when additional power is needed, such as during exercise or in cases of airway pathologies. |
| Activation | Accessory muscles are typically activated during inhalation, but they may also be used during exhalation. |
| Muscles Involved | Sternocleidomastoid, scalene, pectoralis major, trapezius, external intercostals, and abdominal oblique muscles. |
| Health Implications | Accessory muscle use is associated with severe obstructive disease, respiratory conditions, and metabolic acidosis. |
| Treatment | Treatment is generally not required unless the accessory muscle interferes with normal function. |
| Examples | Accessory soleus muscle in the calf, extensor digitorum brevis manus in the hand, and epitrochleoanconeus muscle of the upper arm. |
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What You'll Learn
- Accessory muscles are used during inspiration and expiration
- Accessory muscle use is associated with severe obstructive disease
- Accessory muscles of ventilation include the scalene, sternocleidomastoid, pectoralis major, trapezius, and external intercostals
- Accessory muscles are typically asymptomatic
- Accessory muscles may be used during deliberate breathing practices, strenuous exercise, or due to a health condition

Accessory muscles are used during inspiration and expiration
Accessory muscles are those that are not primarily responsible for movement but do provide assistance. They are typically used during inspiration (breathing in) and expiration (breathing out).
During normal breathing, the diaphragm is the only muscle used. It contracts during inspiration, while expiration is a passive process that relies on the elastic recoil of the lungs. Accessory muscle use refers to the contraction of muscles other than the diaphragm during inspiration or expiration.
Accessory muscles of inspiration include the sternocleidomastoid and scalene muscles, which lift the third, fourth, and fifth ribs to increase space for air in the lungs. Accessory muscles of respiration also include the pectoralis major, trapezius, and external intercostals.
Accessory muscles of expiration include the abdominal oblique muscles. In healthy individuals, accessory muscles are not active during regular breathing. However, they may be used during deep breathing, such as when swimming underwater or forcefully expelling air. They may also be activated in people with respiratory conditions, such as chronic obstructive pulmonary disease (COPD), where the diaphragm and intercostal muscles are at a disadvantage due to over-inflation of the lungs.
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Accessory muscle use is associated with severe obstructive disease
Accessory muscles are those that are not primarily responsible for movement but do provide assistance. They are usually activated during deliberate breathing practices, strenuous exercise, or due to a health condition. In the case of a person with normal lungs, accessory muscles of inspiration become active when a person tries to take in a big breath, such as when swimming underwater or blowing out birthday candles.
In patients with obstructed airways, the abdominal muscles help to expel air across the airways. In patients with respiratory muscle fatigue, the abdominal muscles contract at the end of expiration to compress the lungs so that the early part of the subsequent inspiration can occur passively. Accessory muscle use is a common finding in patients with chronic obstructive lung disease or respiratory muscle fatigue.
Pursed-lip breathing is a technique that may help improve the ability to breathe out and decrease accessory muscle use.
An accessory muscle can also refer to a rare anatomical variation where duplication of a muscle may appear anywhere in the muscular system. Examples 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.
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Accessory muscles of ventilation include the scalene, sternocleidomastoid, pectoralis major, trapezius, and external intercostals
Accessory muscles are those that are not primarily responsible for movement but do provide assistance. They are typically recruited during strenuous exercise or when a person takes a deliberately deep breath, such as when swimming underwater or blowing out birthday candles. They can also be used in the case of respiratory conditions that make breathing more difficult, such as chronic obstructive pulmonary disease (COPD).
The diaphragm is the only muscle used in normal breathing, contracting during inspiration. Exhalation, or expiration, is typically a passive process that relies on the elastic recoil of the lungs. Accessory muscles are those that contract during inspiration or expiration to assist with breathing.
The accessory muscles of ventilation include the scalene, sternocleidomastoid, pectoralis major, trapezius, and external intercostals. The scalene and sternocleidomastoid muscles are associated with severe obstructive disease, and their contraction lifts the clavicles and first ribs, helping to expand the thorax of distressed patients. The pectoralis major is a high-variability muscle that may be absent or doubled in some people. The trapezius assists the upper trapezius fibres in the lateral rotation of the scapula. The external intercostals are the most superficial muscle of the intercostal muscles, located in the intercostal spaces between the ribs, and they are the most important muscles for raising the ribcage.
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Accessory muscles are typically asymptomatic
Accessory muscles refer to muscles that assist the primary muscles during breathing, typically during exertion or in those with respiratory conditions. The diaphragm is the primary muscle used during inhalation, while exhalation is a passive process. Accessory muscles are used during inhalation in people with severe obstructive disease, such as chronic obstructive pulmonary disease (COPD). In these cases, the lungs over-inflate and air becomes trapped, leaving the diaphragm and intercostal muscles unable to effectively facilitate breathing.
In newborns, the diaphragm is not yet fully developed and is more prone to fatigue, leading to the recruitment of accessory muscles to support breathing. Young children under general anaesthesia may also experience breathing deterioration due to their inability to control their breathing as effectively as adults. Additionally, their intercostal muscles may not be fully developed, reducing their effectiveness as breathing accessory muscles.
Accessory muscles are also observed in systemic conditions that lead to metabolic acidosis, which is characterised by excessive acid in bodily fluids. During deliberate deep breathing, strenuous exercise, or when swimming underwater, healthy individuals may also engage their accessory muscles.
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Accessory muscles may be used during deliberate breathing practices, strenuous exercise, or due to a health condition
Accessory muscles are those that assist the diaphragm during breathing. They include the scalene, the sternocleidomastoid, the pectoralis major, the trapezius, and the external intercostals. The diaphragm is the primary muscle used during normal breathing, but accessory muscles may be recruited during deliberate breathing practices, strenuous exercise, or due to a health condition.
During deliberate breathing practices, such as a spontaneous breathing trial (SBT), accessory muscles may be activated to cope with an increased respiratory workload. This can occur during weaning from mechanical ventilation, where patients who experience weaning failure demonstrate increased activation of accessory muscles.
Strenuous exercise can also lead to the recruitment of accessory muscles due to the increased metabolic need during physical activity.
Additionally, accessory muscles may be used more prominently due to a health condition or respiratory distress. For example, accessory muscle use is associated with severe obstructive disease, and over 90% of patients hospitalized with acute exacerbations of chronic obstructive lung disease (COPD) exhibit increased accessory muscle use. Bacterial pneumonia, thoracic injury, and acute asthma attacks can also lead to increased accessory muscle use. In older individuals, age-related loss of elasticity in the rib cage may result in accessory muscle use as part of their normal breathing pattern.
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Frequently asked questions
Accessory muscles are those that are not primarily responsible for movement but provide assistance. They are also defined as muscles other than the diaphragm that are used during inspiration or any muscles used during expiration.
Examples of accessory muscles include the scalene, the sternocleidomastoid, the pectoralis major, the trapezius, and the external intercostals.
Accessory muscles are used to provide assistance to the main breathing muscles, usually when additional power is needed, for example during exercise or in those with airway pathologies such as COPD.
In a person in good health, accessory muscles are not active during regular breathing. However, they may be used during a deliberate deep breath, strenuous exercise, or as a result of a health condition that makes breathing more difficult.











































