Ailments Of The Chest Wall

By Author: Albert Alan
Total Articles: 16
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The integrity of the chest wall and muscular action of the diaphragm and the intercostals muscles are required to make sure there is proper ventilation. Although minor deformities might not be functionally vital, muscular paralysis and gross bony deformities impair ventilation and causes respiratory embarrassment.

Kyphoscoliosis: Kyphosis is the abnormal curvature of the thoracic spine with convexity directed scoliosis and posteriorly denotes gradual lateral curvature of the thoracic spine, with rotation of the vertebrae in their longitudinal axis. These deformities coexist in most situations. Almost 1% of the general population is impacted and in 25%, it is hereditary. Kyphoscoliosis might be acquired or congenital. Acquired Kyphoscoliosis is caused from myopathies, poliomyelitis and acquired diseases of the vertebrae. Basic respiratory diseases such as atelectasis and pulmonary fibrosis might be associated with this deformity.

The lung on the narrowed side is compressed. The opposite lung shows compensatory emphysema. Cardio-respiratory embarrassment might develop in serious Kyphosis where the angle of the curvature ...
... crosses 20 degrees and in serious scoliosis with the angle more than 100 degrees. The main finding is reduction of the important capacity and complete lung capacity with maintenance of FEV1. Breathing is rapid and shallow. The ventilation-perfusion ration is grossly lessened and this causes hypoxemia. These subjects are vulnerable to develop repeated respiratory infections. In serious cases, respiratory failure might develop. Kyphoscoliosis might lead to chronic Cor Pulmonate. Management comprises of early surgical rectification by a thoracic surgeon New Delhi in suitable cases, respiratory physiotherapy to enhance ventilation and prevention of respiratory infection.

Ankylosing spondylitis: In this situation, there is marked flexion and rigidness of the thoracic spine. Ventilation is executed mainly by diaphragmatic movement. Although the important capacity is lessened, signs of frank respiratory embarrassment are few.

Pectus excavation: In this situation, there is a sharp posterior displacement of the body of the sternum from above to downwards. A furrow develops in front of the chest, which is deepest just above the Xiphoid process. Pectus excavatum is generally congenital. Although present at birth, the deformity progresses to become more conspicuous as the body fat fades away. The deformity might aggravate during adolescence. The heart is rotated and displaced towards the left. This might give rise to systolic murmurs, specifically along the left sterna border. Impairment of cardiac functionality is rare.

Pigeon chest: In this deformity, this is a continuation of the childhood rickets in most cases. In most situations, the sternum protrudes forwards with the ribs sloping steeply on the either side. There is an enhanced incidence of respiratory infections in these subjects. No particular therapy is pointed.

Management

In flail chest injury, as a first aid, the chest wall should be stabilized to avoid suffocation. Stabilization can be maintained by weight traction. Internal fixation is done surgically in serious cases by the best thoracic surgeon in India .