What you are seeing in this video is paradoxical chest movement due to flail chest, let's explain this more extensively, 🧵:
https://twitter.com/TLHM_MD/status/1572752691335659521
Quick physiology revision:
This is the normal mechanism of breathing:
This is the normal mechanism of breathing:
During inspiration the diaphragm and the external intercostal muscles contract, causing an increase in the thoracic cavity volume. Pressure in the thorax decreases below atmospheric pressure, and air rushes in through the trachea.
However the flail segment will be pulled in with the decrease in pressure while the rest of the rib cage as well as the abdomen (which you can clearly see in the video) expand
During expiration the diaphragm and the external intercostal muscles relax, causing a decrease in the thoracic cavity volume. Pressure in the thorax increases and air rushes out through the trachea.
However, a flail segment will also be pushed out while the rest of the rib cage and abdomen contract
Paradoxical motion is a late sign of flail segment; and thus its absence doesn't mean the patient doesn't have a flail segment.
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.
I hope everyone enjoyed reading this as much as I enjoyed making it, have a great day❤
#MedEd #MedTwitter #Pulmtwitter
#MedEd #MedTwitter #Pulmtwitter
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