日本内科学会雑誌
Online ISSN : 1883-2083
Print ISSN : 0021-5384
ISSN-L : 0021-5384
気管支喘息の呼吸筋の筋電図学的研究
池部 一郎
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ジャーナル フリー

1959 年 47 巻 12 号 p. 1549-1569

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Untill now there has been no thorough electromyographical study of asthma attacks. However the author has worked on this subject using a co-axial needle electrode.
I registered discharges of M. intercostalis externus and the intercartilagineous part of M. intercostalis internus, as principal inspiratory muscles, and M. scalenus anterior and M. sternocleidomastoideus as accessory inspiratory muscles, the interossial part of M. intercostalis internus as a principal expiratory muscle, and M. obliquus abdominis and M. rectus abdominis as accessory exspiratory muscles.
I observed the changes in discharges of the above muscles during deep respirations at the time of no attack, dyspnea, attacks provoked by acetylcholine inhalation, and after the administration of Adrenaline by inhalation in the course of an attack.
I made these findings:
1) During an attack all inspiratory muscles, both principal and accessory, showed a rapidly augmenting pattern, and all exspiratory muscles a slowly augmenting pattern.
2) Attacks could be divided from the electromyographical point of view as slight, light, moderate and strong attacks.
a) A slight attack shows an increase of activity in the case of M. scalenus anterior only of the inspiratory muscles, and no increase of activity among the exspiratory muscles.
b) A light attack shows a strong discharge in the cases of M. intercostalis externus, the intercartilagineous part of M. intercostalis internus., M. sternocleidomastoideus and M. scalenus ant. but no discharge in the case of abdominal muscles.
c) A moderate attack shows an increases of activity in the case of all respiratory muscles and M. obliquus abdominis but not of M. rectus abdominis.
d) A strong attack shows strong activity in the case of all inspiratory and expiratory muscles including M. rectus adbominis.
3) I could classify A. B. C. D. E. and F. types according to the form of discharge and show which muscle adopted which type of discharge form in slight, light, moderate and strong attacks.
4) Attacks provoked by acetylcholine showed the same tendency in discharge as natural attacks.
5) When attacks are alleviated the inspiratory muscles adopt a slowly augmenting pattern and the expiratory muscles a rapidly augmenting pattern or a steady state pattern.
6) The author dwelt on the intensive discharges which continued into and sometimes through the expiratory phase in the case of the inspiratory muscles during an attack.
7) The author deliberated on the discharges characteristic to asthma attacks and concluded that the determining factor is the bronchial irritation in the upper part.

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