The chest is the part of the torso between the abdomen and the neck. It plays a very important role - it protects internal organs (mainly the heart and lungs) against injuries. The chest also allows breathing. The thorax consists of the ribs, sternum and thoracic vertebrae. What possible diseases of the chest are?
The chest ( Latin thorax )has protective functions. The heart and lungs are one of the most important organs in the human body, and the main role of the chest skeleton is to protect these organs. In addition, based on the topographic knowledge of the individual elements that make up the chest, the doctor knows where to put the stethoscope head to hear, for example, the work of the aortic valve, or knows where to place the electrodes during an ECG.
Chest - structure
The elements that make up the thorax are: ribs, sternum and thoracic vertebrae. All these components form a functional whole. Man usually has 12 pairs of ribs in which we distinguish the so-called real ribs that connect on both sides with the sternum and pseudo-ribs connecting indirectly with the sternum or ending "freely", otherwise known as free ribs.
We have 7 pairs of true ribs and 5 pairs of false ribs. The eighth, ninth, and tenth ribs connect to the seventh and form the right and left ribs, respectively.
Each rib has a vertebral end, a sternal end, and a body in between. The first pair of ribs is the widest, while the twelfth pair of ribs is the narrowest, i.e. the so-called free ribs ending freely between the abdominal muscles.
The next element that forms the chest is the sternum, which is located in the middle of the anterior wall of the chest, consisting of three elements, i.e. the handle, the shaft and the xiphoid process. All three parts of the sternum are connected with each other through the cartilage layers, thanks to which they can, to some extent, remain mobile in relation to each other.
The ribs are connected with the thoracic vertebrae through the cost-vertebral joints consisting of the joints of the heads of the ribs and rib-transverse joints. They form a single, functional whole.
The above joints are strengthened by ligaments:
- radial ligament of the rib head,
- intra-articular ligament of the rib head,
- cost-transverse ligament,
- upper-transverse-cost ligament,
- cost-transverse-lateral ligament,
- lumbar-costal ligament.
The ribs from 2 to 7 are connected through the sternocostal joints, the so-called True joints, while the first rib is connected to the handle of the sternum through cartilage growth. The above-mentioned joints are strengthened by the anterior and posterior radial-sternocostatic ligaments, the sternocostural intra-articular ligament and the costico-xibular ligament.
Chest - Features
The chest primarily provides mechanical protection for the heart, lungs and esophagus. This is made possible by the high elasticity created by the so-called rib rings consisting of a pair of ribs transversely connected to the sternum. Thanks to this, each, even the strongest blow is distributed to the double-sided rib rings.
In addition to mechanical protection, the chest remains somewhat mobile, which allows it to breathe. During inhalation, the diaphragm lowers, the ribs and sternum rise, which increases the capacity of the chest. On exhalation, the ribs and diaphragm return to their original state, and the chest shrinks.
Chest - diseases
In order to make an initial diagnosis of a given disease involving the chest, an appropriate examination of the chest should be performed, consisting of: viewing, palpation, tapping, auscultation.
The physiological chest is well arched and symmetrical. Depending on the physiological discrepancy, we can distinguish:
- barrel-shaped chest - short, wide, the angle between the costal arches is obtuse, set by inspiration. This appearance of the chest is characteristic of emphysema,
- shoemaker (funnel-shaped) chest - a characteristic collapse of the lower part of the sternum in the form of a funnel, which causes pressure on the heart and lungs, usually as a congenital defect,
- chicken's chest (rickets) - characterized by a crest-like protrusion of the sternum.
Adult breathing rate is 14-18 / min, movement is regular and rhythmic, inhaling is 3 times longer than exhalation. With metabolic acidosis and uremia, the respiratory rate increases and worsens, this type of breathing is called Kussmaul's breathing.
In the case of damage to the respiratory center in the medulla in brain diseases, there are alternating periods of apnea and gradual deepening and shallowing of respiratory movements. This type of breathing is called Cheyne's breath.Stokes.
In meningitis, Biot's breathing occurs and is characterized by an unchanging depth of respiratory movement with irregular periods of apnea.
If there is a visible reduction in the mobility of the chest on one side, we may suspect pneumonia, pleural effusion, pleural adhesions, pneumothorax.
During auscultation of the chest we can find the presence of additional respiratory murmurs. wheezing, rattles, crackles, pleural rubbing. Some of them may occur in the case of pneumonia, pulmonary edema, in the case of residual discharge, bronchial constriction, rubbing of the pleural plaques.
Thanks to the knowledge of the chest topography, we can also auscultate the appropriate heart valves and find, for example, mitral valve insufficiency.
Auscultation site:
- mitral valve - apex of the heart,
- aortic valve - in the second right intercostal space at the sternum,
- pulmonary valve - in the second left intercostal space at the sternum,
- tricuspid valve - at the site of attachment of the fifth right costal cartilage to the sternum.
- Chest pain - causes
- Rib pain: causes and treatment