Thoracic examination

The thorax is one of the important checks in the chest examination. Thoracic abnormalities are important for the diagnosis of clinical diseases. Through auscultation, visual inspection, percussion, palpation, etc., observe the normality of the chest to determine the symptoms. Basic Information Specialist Category: Respiratory Examination Category: Other Inspections Applicable gender: whether men and women apply fasting: not fasting Tips: Poor rest, improper diet, excessive fatigue. Normal value The normal thorax profile is symmetrical on both sides and is oval. The clavicle is slightly protruding, and the upper and lower clavicle are slightly concave. The shoulders are on the same horizontal line, the sternum is straight, and the sternal angle can be seen. The shape of the thorax can vary from age to age. The anteroposterior diameter of the adult thorax is shorter than the transverse diameter, and the ratio of the anteroposterior diameter to the transverse diameter is approximately 1:1.5. The anteroposterior diameter of children and the elderly is slightly less than or equal to the transverse diameter. Clinical significance Abnormal result Common thoracic abnormalities (a) flat chest The thorax is flat and the anteroposterior diameter is shorter than half of the transverse diameter. Found in elongated body shape, can also be seen in chronic wasting diseases, such as tuberculosis. (two) barrel chest The thorax is in the shape of a barrel, and the anterior-posterior diameter is increased. It can be equal to or exceed the transverse diameter. The ribs are raised horizontally, the rib space is widened, and the ventral angle is increased. Can be seen in the elderly, children, short stature body and severe emphysema patients. (c) rickets The thoracic changes caused by rickets are more common in children. The ribs on both sides of the sternum and the costal cartilage are bulged at the junction of the ribs and are beaded, called rickets. The ribs in the front of the lower chest are everted, and the grooved belt formed by the inward depression of the chest wall along the site where the ankle is attached is called a rib groove. The sternum xiphoid is invaginated and has a funnel shape called the funnel chest. The anteroposterior diameter of the thorax is slightly longer than the transverse diameter. The upper and lower distances are shorter, the lower end of the sternum is protruding, and the ribs of the anterior wall of the thorax are concave, which is called chicken breast. (4) Deformation of the thoracic side One side of the thoracic bulge is more common in a large number of pleural effusions, pneumothorax or severe compensatory emphysema on one side. The flat or concave side of the thorax is common in atelectasis, pulmonary fibrosis, extensive adhesion of the pleura, thickening, and the like. One side of the rib fracture on one side can also show one side of the thoracic deformation. (5) Local thigh uplift Commonly seen in the obvious enlargement of the heart, a large number of pericardial effusions, rheumatic valvular heart disease in childhood, aortic aneurysm and intrathoracic or chest wall tumors. Also seen in the cold abscess of the ribs and sternum, subcutaneous emphysema. In addition, it can also be seen in costal cartilage inflammation and rib fractures, etc., at this time there is often local tenderness. When the rib is fractured, if the thoracic cage is squeezed before and after, the bone rubbing can be found at the fracture. (6) Thoracic changes caused by spinal deformity Abnormalities in the spine, especially thoracic deformities, can cause chest deformation. Such as severe lordosis, kyphosis, etc., the chest is asymmetrical, the rib space is widened or narrowed, the relationship between the internal organs of the thoracic cavity and the chest wall is changed, and the position of the visceral cavity can be changed to cause respiratory and circulatory dysfunction. Common in spinal tuberculosis, developmental deformity and so on. People who need to be examined for group inspections and people with abnormal thoracic abnormalities. Precautions Taboo before the examination: poor rest, improper diet, excessive fatigue. Requirements for inspection: Actively cooperate with the doctor's work. Inspection process Through auscultation, visual inspection, percussion, palpation, etc., observe the normality of the chest to determine the symptoms. Not suitable for the crowd Inappropriate crowd: None.