
The chest cavity is a complex network of muscles, bones, and organs that work together to facilitate breathing and other vital functions. While the thoracic cage provides a stable framework, it is the action of various muscles that enables ventilation by expanding and contracting the lungs. These muscles include the external intercostals, internal intercostals, innermost intercostals, subcostalis, transversus thoracis, and the diaphragm. The diaphragm, in particular, plays a crucial role by lengthening and shortening the thoracic cavity, thereby expanding and contracting the lungs. Additionally, the sternalis muscle, found in 8% of the population, is believed to influence shoulder movement and chest wall elevation. This complex interplay of muscles and respiratory mechanics is the subject of ongoing research, with studies exploring the relationships between respiratory muscle strength, chest wall expansion, and functional capacity.
| Characteristics | Values |
|---|---|
| Purpose | To determine the relationship between respiratory muscle strength, chest wall expansion, and functional capacity |
| Participants | 76 healthy male and female participants aged 20-59 years with a body mass index of 18.5-22.9 kg/m2 |
| Methodology | Evaluated inspiratory and expiratory muscle strength through maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP), respectively; measured chest wall expansion through thoracic circumferences at upper, middle, and lower levels, including diaphragmatic movement |
| Findings | Respiratory muscle strength is associated with chest wall expansion and functional capacity; inspiratory and expiratory muscle weaknesses impact lung volume; respiratory muscle training can improve recovery and activities of daily living in patients with reduced chest wall expansion and lung volume |
| Additional Info | The thoracic wall is made up of 5 muscles: external, internal, innermost intercostal, subcostalis, and transversus thoracis; other muscles attached to the thoracic wall include pectoralis major and minor, subclavius, serratus anterior, and sternalis |
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What You'll Learn
- The diaphragm is a crucial muscle for breathing and expanding the lungs
- External intercostal muscles are the most important for raising the rib cage
- The sternalis muscle is a rare supernumerary muscle found in 8% of people
- The pectoralis major and minor muscles attach to the thoracic wall
- Inspiratory and expiratory muscle strength impact lung volume

The diaphragm is a crucial muscle for breathing and expanding the lungs
The diaphragm is a thin, dome-shaped muscle located at the base of the lungs, separating the chest cavity from the abdomen. It is the primary muscle of respiration, and its movement is controlled by the phrenic nerve. When the diaphragm contracts and flattens during inhalation, it creates a vacuum, enlarging the chest cavity and pulling air into the lungs. Conversely, upon exhalation, the diaphragm relaxes and returns to its dome shape, forcing air out of the lungs.
The diaphragm is crucial for breathing as it is responsible for expanding the lungs and facilitating the inhalation of air. Its rhythmic and continual movement allows for the efficient intake and expulsion of air, ensuring the body receives an adequate supply of oxygen. Diaphragmatic breathing, or belly breathing, is a technique that involves consciously using the diaphragm to take deep breaths, allowing the lungs to be used at full capacity. This technique can be particularly beneficial for individuals with conditions like chronic obstructive pulmonary disease (COPD), where the diaphragm may not function effectively due to trapped air in the lungs.
Breathing exercises, such as diaphragmatic breathing, can strengthen the diaphragm and improve its functionality. These exercises can be performed while lying down or sitting in a chair. By placing one hand on the upper chest and the other below the rib cage, individuals can feel the diaphragm move as they breathe slowly through the nose, causing the stomach to expand. Such exercises help to improve muscle function during exercises, prevent strain, and promote relaxation.
The diaphragm plays a critical role in maintaining respiratory health. Various conditions, injuries, and diseases can affect the diaphragm's function, leading to symptoms such as difficulty breathing, chest pain, and tightness. Therefore, it is essential to seek medical attention if any symptoms of diaphragm problems are present, as they may also indicate other underlying health issues.
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External intercostal muscles are the most important for raising the rib cage
The external intercostal muscles are the outermost layer of intercostal muscles, lying directly under the skin. They originate from the lower border of the rib above and insert into the upper border of the rib below. These muscles are innervated by intercostal nerves that originate in the thoracic segments of the spinal cord.
The main function of the external intercostal muscles is to raise the rib cage and expand the chest cavity. When these muscles contract, they lift the ribs and rib cage, expanding the anterior-posterior dimensions of the rib cage. This expansion increases the volume of the thoracic cavity and reduces pressure within the lungs, allowing air to move into the lungs during inhalation. The internal intercostal muscles, on the other hand, aid in expiration by helping to collapse the lungs during exhalation.
The external intercostal muscles are relatively small but powerful. They play a crucial role in respiration, and their health and functioning are closely linked to the spine. Their contraction increases the volume of the chest cavity, which, in turn, increases lung volume. This relationship between respiratory muscle strength and chest wall expansion has been studied extensively, particularly in the context of respiratory rehabilitation and neuromuscular disease.
While other muscles in the upper body assist with rib cage adjustments, the external intercostal muscles are the primary drivers of rib cage expansion. Their contraction creates the necessary upward and outward movement of the ribs, accommodating the lungs as they fill with air during inhalation. This unique function makes the external intercostal muscles the most important for raising the rib cage and facilitating respiration.
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The sternalis muscle is a rare supernumerary muscle found in 8% of people
The sternalis muscle is an uncommon accessory muscle in the chest wall, found in around 5% to 7.8% of the population, with a higher prevalence in females. It is considered a rare supernumerary muscle, present in only about 8% of people, and its existence has been recognised since 1604. This muscle has no apparent physiological function, but it can be important in a medical context.
The sternalis muscle lies in front of the pectoralis major, one of the chest's primary muscles, and runs along the anterior aspect of the body of the sternum. It is usually found superficially and parallel to the sternum, with its origin and insertion points varying. The muscle often originates from the upper part of the sternum, with insertions such as the pectoral fascia, lower ribs, costal cartilages, and abdominal external oblique muscle. It can be present on one or both sides of the body.
The sternalis muscle is significant because it can be mistaken for a pathological lesion or tumour if not properly identified. It may cause alterations in electrocardiograms and confusion in mammography, leading to potential misdiagnoses. However, its presence can be beneficial in reconstructive surgery of the head, neck, and anterior chest wall, as it can be used as a flap.
The muscle's embryonic origin and innervation are still debated, with various terminologies used to describe it due to its highly variable morphology. It may be related to the pectoralis major or rectus abdominis, and it can be innervated by external or internal thoracic nerves or intercostal nerves. The sternalis muscle is typically identified through imaging techniques like mammograms, ultrasounds, CT scans, and MRIs.
In summary, the sternalis muscle is a rare accessory muscle in the chest wall, with a variable structure and uncertain function. Its presence can have medical implications, especially in surgical procedures and diagnostic imaging. While it may cause confusion in certain tests, it also offers potential benefits in reconstructive surgery. The muscle's rarity and morphological diversity contribute to its significance in the field of anatomy and medicine.
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The pectoralis major and minor muscles attach to the thoracic wall
The chest includes some of the body's most prominent muscles, which are constantly at work. The pectoralis major and pectoralis minor muscles are two of the four muscles that exert a force on the upper limb in the pectoral region. The pectoralis minor is located underneath the pectoralis major, and both muscles form part of the anterior wall of the axilla region.
The pectoralis major is a broad, fan-shaped, superficial muscle found in the anterior chest wall. It is the biggest and strongest of the chest muscles. In males, it is covered by the deep layer of fascia, subcutaneous tissue, and the adjacent skin. In females, it is covered by the breast. The pectoralis major has three parts: the clavicular part, the sternocostal part, and the abdominal part. All three parts converge laterally and insert into the greater tubercle of the humerus. The main function of this muscle is the adduction and internal rotation of the arm in the shoulder joint. It also facilitates inspiration, which is important during forced breathing in physical distress.
The pectoralis minor is one of the most superficial muscles on the anterior aspect of the chest or thoracic wall. It arises as three separate heads from the anterior surface of the 3rd, 4th, and 5th ribs near the corresponding costal cartilages. The pectoralis minor attaches to and acts on the scapula via the coracoid process, pulling it forward and inferiorly. It also rotates the glenoid cavity inferiorly and causes protraction of the scapula. The pectoralis minor is an important chest muscle, assisting with shoulder movement, particularly rotation.
The pectoralis major and minor muscles work together with other muscles in the region to produce various movements of the scapula. They also play a role in respiration, with the pectoralis minor acting as an accessory muscle. These muscles help to expand chest volume, contributing to lung volume and functional capacity.
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Inspiratory and expiratory muscle strength impact lung volume
Lung volume is determined by chest wall expansion, which is influenced by respiratory muscle strength. The degree of chest expansion is influenced by the movement of the rib cage and the contraction of the diaphragm, which expands the vertical diameter of the thoracic cavity. Maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) are indicators of inspiratory and expiratory muscle strength, respectively.
Inspiratory muscle strength is responsible for generating negative pressure in the pleural cavity, which increases lung volume. Therefore, weakness in either the inspiratory or expiratory muscles can impact lung volume. Inspiratory muscle training (IMT) has been shown to improve inspiratory muscle strength, pulmonary function, and functional capacity in patients undergoing cardiac surgery. It can also be beneficial for individuals with various conditions, such as asthma, COPD, and diabetes.
Respiratory muscle training (RMT) can be performed through resistance training or endurance training methods. Resistance training, specifically inspiratory pressure threshold loading (IPTL), is the most commonly used and researched method. It involves breathing through a device with a pressure-loaded inspiratory valve and an unloaded expiratory flap valve. Endurance training utilizes voluntary isocapnic hyperventilation (VIH), which requires maintaining high levels of respiration for up to 40 minutes.
The evaluation of respiratory muscle strength involves measuring maximum static inspiratory pressure (Pimax) and maximum static expiratory pressure (Pemax). These measurements reflect the pressure developed by the respiratory muscles (Pmus) and the passive elastic recoil pressure of the respiratory system (Prs). Pimax can be a more sensitive measure of respiratory muscle weakness compared to lung volume, as decreases in muscle strength may occur before detectable changes in lung volume.
In summary, inspiratory and expiratory muscle strength impact lung volume, and respiratory muscle training can be employed to improve muscle strength and lung function, particularly in individuals with respiratory or other health conditions.
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Frequently asked questions
The diaphragm, external intercostal muscles, internal intercostal muscles, innermost intercostal muscles, subcostalis, and transversus thoracis all help to expand chest volume.
The diaphragm is a dome-shaped muscle that separates the thoracic and abdominal cavities. It moves up and down to lengthen and shorten the chest cavity, expanding and contracting the lungs.
The external intercostal muscles are the most important muscles for raising the rib cage. They change the anteroposterior diameter of the chest cavity by elevating or depressing the ribs.
To increase chest volume, you can try exercises such as push-ups, bench presses, and chest-pumping plans.























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