TABLE 64 Deformities of the Thorax

Thorax Examination

Expiration Inspiration

Cross Section of Thorax

Normal Adult

The thorax in the normal adult is wider than it is deep. Its lateral diameter is larger than its anteroposterior diameter.

Cross Section of Thorax

Expiration Inspiration

Traumatic Flail Chest

If multiple ribs are fractured, paradoxical movements of the thorax may be seen. As descent of the diaphragm decreases intrathoracic pressure on inspiration, the injured area caves inward; on expiration, it moves outward.

Cross Section of Thorax

Barrel Chest

A barrel chest has an increased anteroposterior diameter. This shape is normal during infancy, and often accompanies normal aging and chronic obstructive pulmonary disease.

Cross Section of Thorax

Cross Section of Thorax

Cross Section of Thorax

Pectus Excavatum Lower Ribs

Funnel Chest (Pectus Excavatum)

A funnel chest is characterized by a depression in the lower portion of the sternum. Compression of the heart and great vessels may cause murmurs.

Pigeon Chest (Pectus Carinatum)

In a pigeon chest, the sternum is displaced anteriorly, increasing the anteroposterior diameter. The costal cartilages adjacent to the protruding sternum are depressed.

Ribs widely separated

Thoracic Kyphoscoliosis

In thoracic kyphoscoliosis, abnormal spinal curvatures and vertebral rotation deform the chest. Distortion of the underlying lungs may make interpretation oflung findings very difficult.

Depressed costal cartilages

Anteriorly displaced sternum

Spinal convexity to the right (patient bending forward)

Spinal convexity to the right (patient bending forward)

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