[Electromyography of the infrahyoid muscles - part 1: normal findings]

Palpation and Ultrasonography Reveal an Ignored Function of the Inferior Belly of Omohyoid: A Case Series and a Proof-of-Concept Study

BACKGROUND

Palpation, a traditional haptic ability, is used daily by practitioners of all medical and surgical specialties to assess patients. In the current study, one of the authors, in a routine clinical setting, was able to deduce the dynamic features of the putative inferior belly of omohyoid. This led to a proof-of-concept study that yielded results consistent with the clinical findings.

METHODS

The first part of the study involved a survey of 300 rheumatic disease patients in whom the greater supraclavicular fossa was explored by palpation. While the patient kept the head straight, the clinician placed his middle three fingers 2.5-3 cm dorsal to the clavicle in the window between the sternocleidomastoid and trapezius clavicular insertions, explored the supraclavicular fossa, and palpated the paired contractile inferior belly of the assumed omohyoid during flexion in the three orthogonal planes. In the second part of the study, five normal subjects were examined in a similar manner by the same clinician and had independent ultrasonography performed on the dominant side. Descriptive statistics were used, and Yates' corrected chi-squared test was applied to certain nominal variables. Additionally, a comparative anterolateral bilateral neck dissection was performed in a cadaveric specimen.

RESULTS

Both studies showed that the contractile structure was the inferior belly of omohyoid and that its contraction occurred during anterior neck flexion and was opposite to the side of neck rotation, resembling the sternocleidomastoid.

CONCLUSIONS

Palpation uncovered a previously unknown function of the inferior belly of omohyoid, suggesting that physical examination of the musculoskeletal system based on palpation may lead to hypotheses worthy of exploration.

Ultrasonographic measurements of the omohyoid muscle during shoulder muscles contraction

BACKGROUND

The main function of the omohyoid muscle is to depress and withdraw the hyoid bone. This is an integral part of the swallowing process facilitating hyoid stabilization for tongue movement. Although the muscle is inferiorly attached to the scapula bone, its function during shoulder or scapula muscles contraction has yet not been studied.

AIM

To investigate whether changes occur in omohyoid muscle morphology during shoulder muscles contraction.

METHODS

The study included 40 healthy subjects (20 males and 20 females, Mean age: 25.68 (± 2.90) years) examined via diagnostic ultrasound. Omohyoid muscle morphology measurements (thickness and cross-sectional area) during different shoulder position (0°, 90° abduction and elevation) in rest and during isomteric contraction were evaluated.

RESULTS

The omohyoid muscle was activated when the shoulder was isometrically abducted at 90° abduction. Thickness and the cross-sectional area of the lower belly increased during contractions at 90° abduction compared with a resting position at 90° (p value < 0.01). No changes occurred at 0° isometric abduction. The CSA of the muscle was found to be significantly larger (p < 0.001) during contraction at 90° abduction compared with contraction at 0° abduction.

CONCLUSION

Omohyoid muscle was most contracted during abduction position with abduction shoulder muscles isometric contraction. Changes of the scapula position might influence omohyoid muscle function.

Effect of passive jaw opening on the electromyographic activity of the temporalis, masseter, digastric, and infrahyoid muscles in healthy adults

OBJECTIVE

To investigate the surface electromyography (EMG) activity of the temporalis, masseter, digastric, and infrahyoid muscles during passive jaw opening in healthy adults.

METHODS

The EMG activity of the masseter, temporalis, digastric anterior belly, and infrahyoid muscles on the right side was recorded during the four jaw-opening tasks: active opening to 20 mm (AO20); active opening to 40 mm (AO40); passive opening to 40 mm with a rubber mouth prop on the right posterior teeth (POR40); and passive opening to 40 mm with a mouth prop on the left posterior teeth (POL40).

RESULTS

The EMG amplitude of the digastric anterior belly and infrahyoid muscles in either POL40 or POR40 was significantly less than that in AO20 or AO40, respectively.

CONCLUSION

Passive jaw opening reduces the EMG activity of the digastric and infrahyoid muscles significantly and could help reduce the load on these muscles during prolonged mouth-opening conditions.

Muscles of Breathing: Development, Function, and Patterns of Activation

This review is a comprehensive description of all muscles that assist lung inflation or deflation in any way. The developmental origin, anatomical orientation, mechanical action, innervation, and pattern of activation are described for each respiratory muscle fulfilling this broad definition. In addition, the circumstances in which each muscle is called upon to assist ventilation are discussed. The number of "respiratory" muscles is large, and the coordination of respiratory muscles with "nonrespiratory" muscles and in nonrespiratory activities is complex-commensurate with the diversity of activities that humans pursue, including sleep (8.27). The capacity for speech and adoption of the bipedal posture in human evolution has resulted in patterns of respiratory muscle activation that differ significantly from most other animals. A disproportionate number of respiratory muscles affect the nose, mouth, pharynx, and larynx, reflecting the vital importance of coordinated muscle activity to control upper airway patency during both wakefulness and sleep. The upright posture has freed the hands from locomotor functions, but the evolutionary history and ontogeny of forelimb muscles pervades the patterns of activation and the forces generated by these muscles during breathing. The distinction between respiratory and nonrespiratory muscles is artificial, as many "nonrespiratory" muscles can augment breathing under conditions of high ventilator demand. Understanding the ontogeny, innervation, activation patterns, and functions of respiratory muscles is clinically useful, particularly in sleep medicine. Detailed explorations of how the nervous system controls the multiple muscles required for successful completion of respiratory behaviors will continue to be a fruitful area of investigation. © 2019 American Physiological Society. Compr Physiol 9:1025-1080, 2019.

Regional differences in length change and electromyographic heterogeneity in sternohyoid muscle during infant mammalian swallowing

A complex sling of muscles moves and stabilizes the hyoid bone during many mammalian behaviors. One muscle in this sling, the sternohyoid, is recruited during food acquisition, processing, and swallowing, and also during nonfeeding behaviors. We used synchronous sonomicrometry and electromyography to investigate regional (intramuscular) changes in length and electromyographic (EMG) activity of the sternohyoid during swallowing in the infant pig. The simple straplike architecture of the sternohyoid led us to hypothesize that limited regional variation in length and muscle activity would be present. We found statistically significant regional differences in EMG activity, and, with respect to length dynamics, the sternohyoid did not behave homogeneously during swallowing. The midbelly region typically shortened while the anterior and posterior regions lengthened, although in a minority of swallows (12.5%) the midbelly lengthened simultaneously with the end-regions. Despite its nonpennate architecture and evolutionarily conservative innervation, the mammalian sternohyoid appears to contain previously unrecognized populations of regionally specialized motor units. It also displays differential contraction patterns, very similar to the sternohyoid of nonmammalian vertebrates.

Pseudodysphagia due to omohyoid muscle syndrome

Omohyoid muscle syndrome (OMS) is a rare clinical condition that has the pathognomonic feature of the appearance of a lateral neck mass when swallowing due to dysfunction of the omohyoid muscle (OH). We present two cases of typical OMS with electrophysiologic and dynamic imaging studies. The study results indicate that OMS is caused mainly by the loosening of the fascial attachment to the intermediate tendon of the OH. The characteristic clinical features and pathomechanism underlying OMS are also discussed.

Unusual origin of the omohyoid muscle

An unusual origin of the right omohyoid muscle was found during cadaveric dissection. The muscle originated from the transverse process of C6 and inserted into the scapula. No other muscular anomalies of the neck were found. Although many anomalies of the omohyoid muscle have been described, a proximal attachment to the cervical spine is apparently quite rare. Knowledge of the many anomalies that can potentially occur in the cervical region is necessary in routine surgical intervention of this area. We believe this to be the first reported instance of the superior belly of the "omo" hyoid originating from the cervical region as we have described.