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Paradoxical Respirations in Diaphragmatic Paralysis Note the paradoxical movement of the abdomen during inspiration. The accessory inspiratory muscles contract, raising the rib cage and lowering the intrathoracic pressure. This change causes the flaccid diaphragm to move in the cephalic direction and the anterior abdominal wall to move inward. #Diaphragmatic #Paralysis #Paradoxical #Respirations #Breathing #Diaphragm #Clinical #Video #PhysicalExam #Pulmonary #Respiratory