Signs and Symptoms
The characteristic paradoxical motion of the flail segment occurs due to pressure changes associated with respiration that the rib cage normally resists:
- During normal inspiration, the diaphragm contracts and intercostal muscles push the rib cage out. Pressure in the thorax decreases below atmospheric pressure, and air rushes in through the trachea. However, a flail segment will not resist the decreased pressure and will appear to push in while the rest of the rib cage expands.
- During normal expiration, the diaphragm and intercostal muscles relax, allowing the abdominal organs to push air upwards and out of the thorax. However, a flail segment will also be pushed out while the rest of the rib cage contracts.
The constant motion of the ribs in the flail segment at the site of the fracture is extremely painful, and, untreated, the sharp broken edges of the ribs are likely to eventually puncture the pleural sac and lung, possibly causing a pneumothorax. The concern about "mediastinal flutter" (the shift of the mediastinum with paradoxical diaphragm movement) does not appear to be merited.
Read more about this topic: Flail Chest
Famous quotes containing the words signs and, signs and/or symptoms:
“For Jews demand signs and Greeks desire wisdom, but we proclaim Christ crucified, a stumbling block to Jews and foolishness to Gentiles...”
—Bible: New Testament, 1 Corinthians 1:22-3.
“[Christianity] endeavors equally to establish these two things: that God has set up in the Church visible signs to make himself known to those who should seek him sincerely, and that he has nevertheless so disguised them that he will only be perceived by those who seek him with all their heart.”
—Blaise Pascal (1623–1662)
“Murderous desire, hatred, distrust are nowadays the accompanying signs of physical illness: so thoroughly have we embodied our moral prejudices.—Perhaps cowardice and pity appear as symptoms of illness in savage ages. Perhaps even virtues might be symptoms.”
—Friedrich Nietzsche (1844–1900)