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The thorax

Written by , Evelin Mercedes Maza Guia is a physician from the University of Oriente in Anzoátegui, Venezuela.

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The goal of this newsletter is to provide you with enough information to be useful, but not more than can be learned within the busy schedule of a health care worker. You’ll find anatomy charts, additional vocabulary, occasional feedback from subscribers, and more! Feel free to read them now and save them for later use such as with a patient or as a study guide for coursework.

anatomy of rib cage

flail chest during respiration

Thorax — tórax

  1. Clavicle
  2. Sternum: manubrium and body
  3. Scapula or shoulder blade
  4. Ribs
  5. Rib cartilages
  6. Xiphoid process
  7. Floating ribs
  8. Flail segment
  9. Inspiration
  10. Expiration
  11. Flail chest: Two adjacent ribs fractured in at least two places, detaching the segment from the rest of the chest wall.
  1. Clavícula
  2. Esternón: manubrio y cuerpo
  3. Omóplato
  4. Costillas
  5. Cartílagos costales
  6. Apéndice xifoides
  7. Costillas flotantes
  8. Segmento móvil
  9. Inspiración
  10. Espiración
  11. Volet costal o toráx inestable: Dos costillas se fracturan en al menos dos lugares, desconectando así el segmento del resto de la pared torácica.

mobile segment of ribs while breathing

Flail chest

Flail chest is a life-threatening medical condition that occurs when a segment of the rib cage breaks and becomes detached from the rest of the chest wall. It consists of two or more fractures in two or more adyacent ribs, usually caused by blunt trauma such as in car accidents.

The flail segment moves in the opposite direction as the rest of the chest wall. This paradoxical breathing can increase the work and pain involved in breathing and is due to pressure changes associated with respiration that the rib cage normally resists.

The constant motion of the ribs at the site of the fractures cause the main symptoms: chest pain and dyspnea, and, if left untreated, the sharp broken edges of the ribs are likely to eventually puncture the pleural sac and lung, possibly causing a pneumothorax.

Flail chest is invariably accompanied by pulmonary contusion, a bruise of the lung tissue that can interfere with blood oxygenation. Often, it is the contusion, not the flail segment, that is the main cause of respiratory failure in patients with both injuries.

El tórax inestable

El tórax inestable es una condición médica potencialmente mortal que se produce cuando un segmento de la caja torácica se fractura y separa del resto de la pared torácica. Se compone de dos o más fracturas en dos o más costillas adyacentes, por lo general causada por un traumatismo cerrado, como en accidentes de tráfico.

El segmento móvil o volet costal se mueve en la dirección opuesta que el resto de la pared torácica. Esta respiración paradójica puede aumentar el trabajo y el dolor implicado en la respiración y es debido a los cambios de presión asociados con la respiración que la caja torácica normalmente resiste .

El constante movimiento de las costillas en el lugar de las fracturas causan los principales síntomas: dolor torácico y disnea, y, si no se trata, los bordes rotos afilados de las costillas con el tiempo son propensos a perforar el saco pleural y el pulmón, lo que puede causar un neumotórax .

El tórax inestable es invariablemente acompañado por una contusión pulmonar, una morado en el tejido pulmonar que puede interferir con la oxigenación de la sangre. A menudo, es la contusión, no el segmento móvil, que es la principal causa de insuficiencia respiratoria en pacientes con ambas lesiones.


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