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Crural and costal diaphragm function during emesis.

Jasmine J Park1, Giovanni Tagliabue1, Michael Ji2

  • 1Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada.

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|May 17, 2025
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Summary

The crural diaphragm, unlike the costal diaphragm, shifts from respiratory to sphincter function during emesis. This study reveals the crural diaphragm

Keywords:
costal diaphragmcrural diaphragmdiaphragmemesisesophageal sphincter

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Area of Science:

  • Physiology
  • Gastroenterology
  • Respiratory Medicine

Background:

  • The diaphragm, a primary respiratory muscle, comprises distinct costal and crural segments.
  • The crural diaphragm plays a role in esophageal sphincter function, distinct from its respiratory role.
  • The coordinated action of diaphragm segments during emesis (vomiting) is not fully understood.

Purpose of the Study:

  • To investigate the distinct mechanical and electrical activities of the costal and crural diaphragm during the process of emesis.
  • To elucidate the functional divergence of the crural diaphragm during the expulsion phase of emesis.

Main Methods:

  • Measurements of electrical activity (EMG) and muscle shortening in the costal and crural diaphragm of six awake canines.
  • Induction of emesis using apomorphine, with data collected at five distinct phases: rest, early, mid, and late prodrome, and expulsion.
  • Analysis of neuromechanical coupling and segment-specific contractility during emesis.

Main Results:

  • Both diaphragm segments showed increased EMG and decreased length from rest through prodrome.
  • During expulsion, the crural diaphragm abruptly lengthened, while the costal diaphragm's activity changed minimally.
  • Crural diaphragm shortening and EMG activity increased significantly at expulsion, surpassing the costal segment's contractility.

Conclusions:

  • The crural diaphragm exhibits a divergent action during emesis, converting from a respiratory muscle to an esophageal sphincter.
  • The costal diaphragm maintains its respiratory function throughout the emesis process.
  • These findings highlight the specialized roles of diaphragm segments in both respiration and gastrointestinal function.