Muscle most resistant to non depolarizing block is
## **Core Concept**
The question tests understanding of the pharmacodynamics of non-depolarizing neuromuscular blockers. Non-depolarizing blockers work by competitively inhibiting the **nicotinic acetylcholine receptors** at the neuromuscular junction, preventing acetylcholine from triggering muscle contraction. Different muscles have varying sensitivities to these blockers.
## **Why the Correct Answer is Right**
The diaphragm is known for being the most resistant muscle to non-depolarizing neuromuscular blockers. This resistance is crucial clinically because the diaphragm is the primary muscle used for breathing. The **duration and intensity of blockade** can vary among muscles, but the diaphragm consistently shows a higher resistance to the effects of non-depolarizing agents compared to peripheral muscles like the adductor pollicis or the corrugator supercilii.
## **Why Each Wrong Option is Incorrect**
- **Option A:** While specific muscles can be mentioned here, without the actual text, we can infer that muscles less critical for vital functions like breathing are generally more sensitive to non-depolarizing blockers.
- **Option B:** Similarly, another muscle that might be listed here would likely be more susceptible to blockade than the diaphragm.
- **Option C:** This option would represent another incorrect muscle; for instance, the adductor pollicis is often used as a standard monitoring site for neuromuscular blockade but is more sensitive than the diaphragm.
## **Clinical Pearl / High-Yield Fact**
A key point to remember is that the **diaphragm is the last muscle to recover** from non-depolarizing neuromuscular blockade. Clinicians often monitor the recovery of neuromuscular function using a peripheral nerve stimulator on a peripheral muscle (like the adductor pollicis), but the diaphragm's recovery is critical for ensuring adequate respiratory function.
## **Correct Answer: D. Diaphragm**