Auxiliary respiration (auxiliare Latin = to help) is characterized by turning on auxiliary respiratory muscles to match respiratory movements to needs and improve lung function.
What is auxiliar breathing?
Auxiliary respiratory muscles are turned on to match respiratory movements to demand and improve lung function. In a healthy person, inhalation at rest is accomplished by only the major muscles, the diaphragm and the outer intercostal muscles, which expand the lungs across the chest. Exhalation proceeds under the same conditions, but completely passively. The inhalation muscles relax and the expanded lung retracts back to its original position. It is the same principle as with an inflated balloon: when the air escapes, it contracts without external force. Only when increased breathing is demanded of the body does the auxiliary breathing muscles kick in to assist. This situation occurs, for example, during sports, singing or shouting, but also in respiratory diseases that limit lung function and lead to respiratory distress. Depending on the cause of forced breathing, either the auxiliary muscles of inspiration or expiration may be used, or both groups may be used together.
Function and task
Auxiliary breathing and its intensity depend, among other factors, on the mechanics of breathing. This is shaped by the particular design of the system, in which the lungs follow the movements of the chest and vice versa. During inhalation, the rib cage expands and pulls the lungs along. This creates conditions so that more air can flow in. At rest, only the two main muscles are needed for this. The diaphragm expands the lower chest area, the other muscles the upper. The process is controlled by the respiratory center in the brain. When the receptors in the blood report an increased demand for oxygen to the respiratory center, impulses are sent from there to force inhalation. Such situations occur during physical exertion, mental tension or a disease of the respiratory system. Under these conditions, the main muscles are no longer sufficient, and additional muscles are used to increase inhalation. These basically include all the muscles that can expand the thorax, such as the large pectoral muscle and the muscles that pull from the upper ribs or collarbone to the cervical spine. The basic condition for these muscles to function in this way is that they have their fixed point at the shoulder girdle or cervical spine. When we exhale, the lungs contract again because the tension of the inhalation muscles decreases, taking the chest with it. With increased exhalation, this process no longer occurs passively, but is assisted by muscles that compress the rib cage. These are, for example, the abdominal muscles, the large chest muscle and the hip flexors. They reduce the space between the pelvis and the lower ribs, which compresses the chest. This pressure is transmitted to the lungs and increases exhalation. In this case, the external components, pelvis and shoulder girdle, must be able to move to the thorax, unlike during inhalation. Inhalation and exhalation cannot be functionally separated. Therefore, both components are always included in auxilliary breathing during heavier exertion. The benefit is obvious: the consequences of temporary or manifest respiratory distress can be eliminated, mitigated, or at least made tolerable.
Diseases and ailments
All diseases associated with respiratory distress require auxiliary respiration to meet the body’s oxygen needs and remove carbon dioxide. These include pulmonary diseases in the strict sense, but also impairments of respiratory mechanics. The lung and respiratory diseases are divided into 2 categories. Into the restrictive ones, which are for example the pneumonia and the pulmonary skeleton diseases, and the obstructive ones, which include the chronic obstructive bronchitis and the bronchial asthma. In the restrictive conditions, first of all, inhalation is impaired. Therefore, the auxiliary muscles for inhalation come into play here. This can be observed when people hold their head upright and stretch their arms upward, trying to inhale as deeply as possible. The head and arm position stretches the chest and neck muscles and pulls the chest up a little.The obstructive respiratory diseases initially have a negative effect on exhalation, so the auxiliary muscles of exhalation are brought into use. A typical example of application is the so-called coachman’s seat, in which people who are currently suffering from shortness of breath during exhalation support themselves with their elbows on their thighs. This provides relief because, on the one hand, the upper body weight no longer has to be supported and, on the other hand, the abdominal and chest muscles can better support exhalation. Impairment of respiratory mechanics often affects the expansion of the thorax and thus inhalation. The ability of the thorax to expand is shaped by the mobility of the thoracic spine and ribs. There are several conditions that impede or limit this very function. These include processes that lead to a stiffening of the spine, such as ankylosing spondylitis or osteoporosis, but also inflammatory processes that do not allow the ribs to expand due to pain, such as pleurisy. In these conditions, too, inhalation is promoted by improving thoracic mobility and strengthening the corresponding auxiliary muscles. In the case of inflammatory conditions, the focus is on medical pain management. Affected people usually breathe rapidly and shallowly because deep breaths are too painful.
