Breathing Out: Muscles Involved In Expiration

what muscles function during expiration

The diaphragm is the major muscle responsible for breathing and is involved in both inhalation and exhalation. During inhalation, the diaphragm contracts, moving downward and causing the rib cage to expand, which increases the volume of the thoracic cavity. This expansion draws air into the lungs. During exhalation, the diaphragm relaxes, and the elastic recoil of the lungs causes the thoracic cavity to contract, forcing air out of the lungs. In addition to the diaphragm, other muscles that function during expiration include the internal intercostals, subcostals, and abdominal muscles, such as the rectus abdominis, external oblique, internal oblique, and transversus abdominis. These muscles help in forceful expiration by depressing the ribs and sternum, thereby reducing the volume of the thoracic cavity and forcing air out of the lungs.

Characteristics Values
Muscles involved in forceful expiration Internal intercostals, abdominal muscles, subcostals, intercostalis intimi, rectus abdominis, external oblique, internal oblique, and transversus abdominis
Primary inspiratory muscles Diaphragm and external intercostals
Accessory expiratory muscles Rectus abdominis, external oblique, internal oblique, and transversus abdominis
Accessory inspiratory muscles Sternocleidomastoid, scalenus anterior, medius, and posterior, pectoralis major and minor, inferior fibres of serratus anterior and latissimus dorsi, serratus posterior superior, and iliocostalis cervicis

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The diaphragm

During inhalation, the diaphragm contracts and flattens, increasing the vertical diameter of the thoracic cavity. This contraction creates a vacuum, pulling air into the lungs and expanding the lungs. The diaphragm's centre moves caudally (downward), while its edges move cranially (upward), compressing the abdominal cavity and raising the ribs.

Upon exhalation, the diaphragm relaxes and returns to its original dome shape. This relaxation reduces the volume of the thoracic cavity, and air is forced out of the lungs. The diaphragm's role during exhalation is passive, driven by the elastic recoil of the lungs. However, it is important to note that the diaphragm remains active during exhalation, contracting to stabilise peripheral airways and prevent cyclic expiratory lung collapse.

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Intercostal muscles

The intercostal muscles are a group of intrinsic rib cage muscles that occupy the 11 intercostal spaces. They are divided into three groups: external, internal, and innermost intercostal muscles. The external intercostal muscles aid in quiet and forced inhalation by raising the ribs. They originate on ribs 1–11 and have their insertion on ribs 2–12.

The internal intercostal muscles aid in forced expiration by depressing the ribs and bending them inward, thus decreasing the transverse dimensions of the thoracic cavity. They originate on ribs 2–12 and have their insertions on ribs 1–11. Their fibres pass anterior and superior from the upper margin of the rib and costal cartilage to the low.

The innermost intercostal muscles are deep layers of the internal intercostal muscles which are separated from them by a neurovascular bundle. Their fibres are directed downwards, forwards, and laterally, similar to the internal intercostal muscles. They originate from the costal groove of one rib, posteriorly to the origin of the internal intercostals, and insert to the superior border of the immediate rib below.

All three groups of intercostal muscles support the rib cage and participate in the process of forced breathing. The internal and innermost intercostals aid in forced expiration, while the external intercostals facilitate forced inspiration.

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Abdominal muscles

The abdominal muscles are accessory expiratory muscles that function during expiration, also known as exhalation. The diaphragm is the primary muscle responsible for breathing and it drives respiration during quiet breathing. However, during forceful expiration, the abdominal muscles, along with the internal intercostals, play a crucial role in active exhalation.

The abdominal muscles that aid in expiration include the rectus abdominis, external oblique, internal oblique, and transversus abdominis. These muscles contract and work together with the internal intercostal muscles to facilitate active exhalation when needed.

The rectus abdominis is a pair of muscles separated by the linea alba. Its point of origin is the pubic symphysis and pubic crest, and it attaches to the xiphoid process and the 5th to 7th costal cartilages. During active expiration, the rectus abdominis pulls the ribs down, depressing the rib cage and reducing the volume of the thoracic cavity.

The external oblique and internal oblique muscles are also involved in forceful expiration. They work together with the rectus abdominis to press the abdominal organs upward, further reducing the volume of the thoracic cavity and facilitating exhalation.

The transversus abdominis, along with the other abdominal muscles, helps to increase intra-abdominal pressure during active expiration. This increase in pressure pushes the diaphragm upward, contributing to the reduction in thoracic cavity volume and aiding in the exhalation process.

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Sternocleidomastoid

The sternocleidomastoid (SCM) is a neck muscle that functions as an accessory muscle of inspiration. It is a paired superficial muscle in the anterior portion of the neck that binds the skull to the sternum and clavicle. The SCM is an important landmark that divides the neck into an anterior and posterior triangle. It also protects the vertical neurovascular bundle of the neck, branches of the cervical plexus, deep cervical lymph nodes, and soft tissues of the neck from damage.

The SCM is active when there is an increased drive to breathe, such as when taking larger breaths or breathing against an inspiratory load like during a cough. It draws the mastoid process down toward the same side, causing the chin to turn up toward the opposite side. When acting together, the muscles on both sides flex the neck and extend the head. When acting alone, it rotates the head to the opposite side and slightly flexes it to the same side.

During quiet breathing, the SCM is typically inactive, with little to no muscle contraction involved in exhalation. This process is driven by the elastic recoil of the lungs and surface tension. However, with an increase in respiratory volume, the SCM becomes active. During slow expiration, SCM activity decreases, while transversus abdominis and internal oblique muscle activity increases.

The SCM has a variable innervation arrangement, with the "classical anastomotic pattern" observed in about 50% of cases. This muscle is also involved in neck movements, although it is not a prime mover for cervical stabilization. In patients with cervical pain, the SCM may be used dominantly for neck stabilization instead of the local stabilizers (deep cervical flexors), which can be disrupted.

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Scalenes

The scalenes are accessory inspiratory muscles that assist in elevating the rib cage. They are neck muscles and are consistently physically active during quiet breathing. The scalenes include the scalenus anterior (anterior scalene), scalenus medius (middle scalene), and scalenus posterior (posterior scalene). These muscles are found on each side of the neck, spanning between the transverse processes of the cervical vertebrae and the upper two ribs. They belong to the lateral vertebral muscle group.

The scalenus anterior forms the anterior border of the interscalene triangle, while the scalenus medius forms the posterior border, and the first rib forms the inferior border. The scalenus anterior sometimes gives off muscular slips that insert into the suprapleural membrane, known as the scalenus minimus muscle. This muscle arises from the anterior border of the transverse process of the C7 vertebra and is believed to tense the pleural dome.

The scalenes are involved in the flexion, lateral flexion, and rotation of the neck. They are also accessory muscles of respiration, elevating the ribs during forced inspiration. Studies have shown that inflation induces greater shortening of the scalenes than the sternomastoids.

The scalenes receive their nerve supply from the anterior rami of the spinal nerves C4-C6. The blood supply to all scalene muscles comes from the ascending cervical branch of the inferior thyroid artery, which is an indirect branch of the subclavian artery via the thyrocervical trunk.

Frequently asked questions

The diaphragm is the primary muscle used during expiration. It is a thin, dome-shaped muscle that separates the abdominal cavity from the thoracic cavity.

During expiration, the diaphragm relaxes and returns to its dome shape, causing the thoracic cavity to contract and forcing air out of the lungs.

Yes, the accessory expiratory muscles include the abdominal muscles: rectus abdominis, external oblique, internal oblique, and transversus abdominis.

Accessory muscles are used during forceful expiration, such as during exercise or playing a musical instrument.

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