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The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Gurses MS, Eren F, Trkmen Inanir N, Eren B, etin S. Mehrotra AK, Vaishnav K, Gupta PR, Khublani TK, Anupam, Soni S, Feroz A. Han KY, Bang HJ. Phrenic nerve stimulation testing shows the nerve does not work Although the diaphragm performs most of the work, normal ventilation also requires the simultaneous contraction of respiration accessory muscles (ie, scalene, parasternal portion of the internal and external intercostal muscles, sternocleidomastoid, trapezius). Unilateral diaphragmatic paralysis in a diabetic patient: a case of trepopnea. [QxMD MEDLINE Link]. 1991 Jun. Surg Clin North Am. and transmitted securely. J Thorac Cardiovasc Surg. Fluoroscopy. Does Pneumonia Always Show on Chest X-rays. If you have a paralyzed diaphragm, your breaths may be less audible on one side of your chest. Turk J Anaesthesiol Reanim. The fluoroscopic sniff test, also known as diaphragm fluoroscopy, is a quick and easy real time fluoroscopic assessment of diaphragmatic motor function (excursion). It is usually measured at residual volume (RV) because inspiratory muscle strength is inversely related to lung volume (in a curvilinear fashion). Enter a Fellowship A mass anywhere along the course of the phrenic nerve requires further workup, usually with neck and chest CT. A hilar mass due to lung cancer is the most common finding on CT and a classic exam case. Patchy, Read More Patchy Ground Glass Opacities in the LungsContinue, Please read the disclaimer A mass in the lungs is most commonly found on X-rays and CTs of the chest. [QxMD MEDLINE Link]. Bilateral diaphragm paralysis is a severe form of respiratory muscle weakness that needs prompt evaluation and management. This is called paradoxical motion. Miller JM, Moxham J, Green M. The maximal sniff in the assessment of diaphragm function in man. Paralyzed Diaphragm | Saint John's Cancer Institute - Thoracic 2014 Oct;31(4):421-2. doi: 10.4103/0970-2113.142098. [QxMD MEDLINE Link].