Injuries to the rib cage or sternum is also a common cause of chest pain. It is generally felt when deep breaths are taken or during a cough.
Non-cardiac causes of chest pain
Thorax
Thorax | Non-cardiac causes of chest pain
Injuries to this region, including rib cage and sternum is also a common cause of chest pain. Thorax is also known as the chest. Chest pain can be the result of multiple issues, including respiratory problems, digestive issues, and musculoskeletal complications. The pain can be caused by birth defects, trauma or infections.
what is ypresiomyrma?
user
It is an extinct genus of ants in the subfamily Myrmeciinae.
assistant
how are they classified?
user
As "incertae sedis"
assistant
who described them for thr first time?
user
Bruce Archibald, Stefan Cover and Corrie Moreau
assistant
who is the first person?
user
Sorry. I cannot find the answer based on the context.
assistant
how do they look like?
user
The waist connecting the thorax and the abdomen is composed of a single segment, the head is in various shapes, and mandibles are a distinct triangular shape and shorter than the head.
assistant
what is thorax?
user
It is the part of the anatomy of humans, mammals, other tetrapod animals located between the neck and the abdomen.
assistant
from where did it get its name?
user
The word comes from the Greek θώραξ "thorax" "breastplate, cuirass, corslet.
assistant
how does one experience pain in this part of the body?
user
Cardiac arrest - feelings of sudden pressure in the chest or a crushing pain in the back, neck, and arms; noncardiac issues - burning feeling along the digestive tract or pain when deep breaths are attempted.
assistant
how is its structure?
user
Humans and hominids - the chest region of the body between the neck and the abdomen, along with its internal organs and other contents; protected and supported by the rib cage, spine, and shoulder girdle.
assistant
what are the injuries one can have in this part of the body?
user
Major pathophysiologies encountered in blunt chest trauma involve derangements in the flow of air, blood, or both in combination.
assistant
how is this part of the body in arthropods?
user
It is the area where the wings and legs attach in insects, or an area of multiple articulating plates in trilobites.
assistant
and in tetrapods?
user
The heart and the lungs reside in the thoracic cavity, as well as many blood vessels; inner organs are protected by the rib cage and the sternum.
assistant
describe the relationship between chest pain and thorax?
user
The thorax or chest is a part of the anatomy of humans, mammals, other tetrapod animals located between the neck and the abdomen. In insects, crustaceans, and the extinct trilobites, the thorax is one of the three main divisions of the creature's body, each of which is in turn composed of multiple segments. The human thorax includes the thoracic cavity and the thoracic wall. It contains organs including the heart, lungs, and thymus gland, as well as muscles and various other internal structures. Many diseases may affect the chest, and one of the most common symptoms is chest pain.
Thorax | Introduction
Chest pain can be the result of multiple issues, including respiratory problems, digestive issues, and musculoskeletal complications. The pain can trigger cardiac issues as well. Not all pain that is felt is associated with the heart, but it should not be taken lightly either. Symptoms can be different depending on the cause of the pain. While cardiac issues cause feelings of sudden pressure in the chest or a crushing pain in the back, neck, and arms, pain that is felt due to noncardiac issues gives a burning feeling along the digestive tract or pain when deep breaths are attempted. Different people feel pains differently for the same condition.
Thorax | Pain
Injuries to the rib cage or sternum is also a common cause of chest pain. It is generally felt when deep breaths are taken or during a cough.
Thorax | Non-cardiac causes of chest pain
In mammals, the thorax is the region of the body formed by the sternum, the thoracic vertebrae, and the ribs. It extends from the neck to the diaphragm, and does not include the upper limbs. The heart and the lungs reside in the thoracic cavity, as well as many blood vessels. The inner organs are protected by the rib cage and the sternum. Thoracic vertebrae are also distinguished in birds, but not in reptiles.
Thorax | In tetrapods
It is important that these patients and their caregivers have a good understanding of heart attack symptoms.
Thorax | Pain
In the human body, the region of the thorax between the neck and diaphragm in the front of the body is called the chest. The corresponding area in an animal can also be referred to as the chest. The shape of the chest does not correspond to that part of the thoracic skeleton that encloses the heart and lungs. All the breadth of the shoulders is due to the shoulder girdle, and contains the axillae and the heads of the humeri. In the middle line the suprasternal notch is seen above, while about three fingers' breadth below it a transverse ridge can be felt, which is known as the sternal angle and this marks the junction between the manubrium and body of the sternum.
Thorax | The chest
Another non cardiac cause of chest pain is atelectasis. It is a condition that suffered when a portion of the lung collapses from being airless. When bronchial tubes are blocked, this condition develops and causes patients to feel shortness of breath. The most common cause of atelectasis is when a bronchi that extends from the windpipe is blocked and traps air. The blockage may be caused by something inside the bronchus, such as a plug of mucus, a tumour, or an inhaled foreign object such as a coin, piece of food, or a toy. It is possible for something outside of the bronchus to cause the blockage.
Thorax | Atelectasis
Just like with a heart attack, not all chest pain is suffered because of a condition involving the heart. Chest wall pain can be experienced after an increase in activity. Persons who add exercise to their daily routine generally feel this type of pain at the beginning. It is important to monitor the pain to ensure that it is not a sign of something more serious. Pain can also be experienced in persons who have an upper respiratory infection. This virus is also accompanied by a fever and cough. Shingles is another viral infection that can give symptoms of chest or rib pain before a rash develops.
Thorax | Non-cardiac causes of chest pain
The word "thoracic" means pertaining to the chest, and the thoracic spine comprises the upper portion of the spine that corresponds to the chest area. The upper spine includes twelve vertebrae, and each of the upper nine vertebrae in this section attach to a rib on either side of the spine. Each of the ribs then curves around the side of the body and attaches to the breastbone in front. This forms a sturdy structure (the thoracic cage) that supports and protects the internal organs — the heart, lungs and liver.
Middle back pain | Mechanism
Level with this line the second ribs join the sternum, and when these are found the lower ribs can often be counted. At the lower part of the sternum, where the seventh or last true ribs join it, the ensiform cartilage begins, and above this there is often a depression known as the pit of the stomach.
Thorax | The chest
Only a patient truly knows if the symptoms are mild or serious. Chest pain may be a symptom of myocardial infarctions ('heart attack'). If this condition is present in the body, discomfort will be felt in the chest that is similar to a heavy weight placed on the body. Sweating, shortness of breath, lightheadedness, and irregular heartbeat may also be experienced. If a heart attack occurs, the bulk of the damage is caused during the first six hours, so getting the proper treatment as quickly as possible is important. Some people, especially those who are elderly or have diabetes, may not have typical chest pain but may have many of the other symptoms of a heart attack.
Thorax | Pain
In humans and other hominids, the thorax is the chest region of the body between the neck and the abdomen, along with its internal organs and other contents. It is mostly protected and supported by the rib cage, spine, and shoulder girdle.
Thorax | Structure
Different types of diseases or conditions that affect the chest include pleurisy, flail chest, atelectasis, and the most common condition, chest pain. These conditions can be hereditary or caused by birth defects or trauma. Any condition that lowers the ability to either breathe deeply or to cough is considered a chest disease or condition.
Thorax | Clinical significance
The anatomy of the chest can also be described through the use of anatomical landmarks. The nipple in the male is situated in front of the fourth rib or a little below; vertically it lies a little external to a line drawn down from the middle of the clavicle; in the female it is not so constant. A little below it the lower limit of the great pectoral muscle is seen running upward and outward to the axilla; in the female this is obscured by the breast, which extends from the second to the sixth rib vertically and from the edge of the sternum to the mid-axillary line laterally.
Thorax | Anatomical landmarks
The contents of the thorax include the heart and lungs (and the thymus gland); the (major and minor pectoral muscles, trapezius muscles, and neck muscle); and internal structures such as the diaphragm, the esophagus, the trachea, and a part of the sternum known as the xiphoid process). Arteries and veins are also contained – (aorta, superior vena cava, inferior vena cava and the pulmonary artery); bones (the shoulder socket containing the upper part of the humerus, the scapula, sternum, thoracic portion of the spine, collarbone, and the rib cage and floating ribs). External structures are the skin and nipples.
Thorax | Contents
The thorax is the human chest, or division of an animal's body that lies between the head and the abdomen. Thorax may also refer to:
Thorax (disambiguation) | Introduction
Chest pain is pain or discomfort in the chest, typically the front of the chest. It may be described as sharp, dull, pressure, heaviness or squeezing. Associated symptoms may include pain in the shoulder, arm, upper abdomen or jaw or nausea, sweating or shortness of breath. It can be divided into heart-related and non-heart-related pain. Pain due to insufficient blood flow to the heart is also called angina pectoris. Those with diabetes or the elderly may have less clear symptoms. Serious and relatively common causes include acute coronary syndrome such as a heart attack (31%), pulmonary embolism (2%), pneumothorax, pericarditis (4%), aortic dissection (1%) and esophageal rupture.
Chest pain | Introduction
The thoracic cavity is a chamber within the chest, containing the lungs, heart, and numerous major blood vessels. Thin sheets of tissue known as the pleural membranes or pleura line the chest and cover the lungs - the chest wall is lined by the parietal pleura, while the visceral pleura covers the outside of the lungs. The visceral and parietal pleura are normally separated by only a thin layer of fluid, forming the pleural cavity. When a hemothorax occurs, blood enters the pleural cavity. The blood loss has several effects. Firstly, as blood builds up within the pleural cavity, it begins to interfere with the normal movement of the lungs, preventing one or both lungs from fully expanding and thereby interfering with the normal transfer of oxygen and carbon dioxide to and from the blood.
Hemothorax | Mechanisms
Reduced movement of the ribcage during breathing, reduced breath sounds on the affected side(s), and a dull feeling when the chest is pressed are common signs observed during examination for fibrothorax. Sharp chest pain with deep breaths or coughing may be seen in some cases. Severe cases of fibrothorax can lead to respiratory failure due to inadequate ventilation and cause abnormally high levels of carbon dioxide in the bloodstream.
Fibrothorax | Signs
They are attached to the vertebrae only, and not to the sternum or cartilage coming off of the sternum. In general, human ribs increase in length from ribs 1 through 7 and decrease in length again through rib 12. Along with this change in size, the ribs become progressively oblique (slanted) from ribs 1 through 9, then less slanted through rib 12. The rib cage is separated from the lower abdomen by the thoracic diaphragm which controls breathing. When the diaphragm contracts, the thoracic cavity is expanded, reducing intra-thoracic pressure and drawing air into the lungs. This happens through one of two actions (or a mix of the two): when the lower ribs the diaphragm connects to are stabilized by muscles and the central tendon is mobile, when the muscle contracts the central tendon is drawn down, compressing the cavity underneath and expanding the thoracic cavity downward.
Rib | Rib cage
Injury to the chest (also referred to as chest trauma, thoracic injury, or thoracic trauma) results in up to ¼ of all deaths due to trauma in the United States. The major pathophysiologies encountered in blunt chest trauma involve derangements in the flow of air, blood, or both in combination. Sepsis due to leakage of alimentary tract contents, as in esophageal perforations, also must be considered. Blunt trauma commonly results in chest wall injuries (e.g., rib fractures). The pain associated with these injuries can make breathing difficult, and this may compromise ventilation. Direct lung injuries, such as pulmonary contusions (see the image below), are frequently associated with major chest trauma and may impair ventilation by a similar mechanism.
Thorax | Injury
Pectus excavatum is initially suspected from visual examination of the anterior chest. Auscultation of the chest can reveal displaced heart beat and valve prolapse. There can be a heart murmur occurring during systole caused by proximity between the sternum and the pulmonary artery. Lung sounds are usually clear yet diminished due to decreased base lung capacity. Many scales have been developed to determine the degree of deformity in the chest wall. Most of these are variants on the distance between the sternum and the spine. One such index is the "Backer ratio" which grades severity of deformity based on the ratio between the diameter of the vertebral body nearest to xiphosternal junction and the distance between the xiphosternal junction and the nearest vertebral body.
Pectus excavatum | Diagnosis
Chest pain may present in different ways depending upon the underlying diagnosis. Chest pain may also vary from person to person based upon age, sex, weight, and other differences. Chest pain may present as a stabbing, burning, aching, sharp, or pressure-like sensation in the chest. Chest pain may also radiate, or move, to several other areas of the body. This may include the neck, left or right arms, cervical spine, back, and upper abdomen. Other associated symptoms with chest pain can include nausea, vomiting, dizziness, shortness of breath, anxiety, and sweating. The type, severity, duration, and associated symptoms of chest pain can help guide diagnosis and further treatment.
Chest pain | Signs and symptoms
The thoracic cavity (or chest cavity) is the chamber of the body of vertebrates that is protected by the thoracic wall (rib cage and associated skin, muscle, and fascia). The central compartment of the thoracic cavity is the mediastinum. There are two openings of the thoracic cavity, a superior thoracic aperture known as the thoracic inlet and a lower inferior thoracic aperture known as the thoracic outlet. The thoracic cavity includes the tendons as well as the cardiovascular system which could be damaged from injury to the back, spine or the neck.
Thoracic cavity | Introduction
Pectus excavatum is a structural deformity of the anterior thoracic wall in which the sternum and rib cage are shaped abnormally. This produces a caved-in or sunken appearance of the chest. It can either be present at birth or develop after puberty. Pectus excavatum can impair cardiac and respiratory function and cause pain in the chest and back. People with the condition may experience severe negative psychosocial effects and avoid activities that expose the chest.
Pectus excavatum | Introduction
Changes in volume of the thoracic cavity can also be inferred from displacements of the rib cage and diaphragm. Motion of the rib cage can be directly assessed, whereas the motion of the diaphragm is indirectly assessed as the outward movement of the anterolateral abdominal wall. However, accuracy issues arise when trying to assess accurate respiratory volumes from a single respiration band placed either at the thorax, abdomen or midline. Due to differences in posture and thoraco-abdominal respiratory synchronization it is not possible to obtain accurate respiratory volumes with a single band. Furthermore, the shape of the acquired waveform tends to be non-linear due to the non-exact co-ordination of the two respiratory compartments.
Respiratory inductance plethysmography | Single Band Respiration
An arbitrary division can be made between the intrathoracic and cervical trachea at the thoracic inlet, an opening at the top of the thoracic cavity. Anatomical structures that surround and protect the tracheobronchial tree include the lungs, the esophagus, large blood vessels, the rib cage, the thoracic spine, and the sternum. Children have softer tracheas and a more elastic tracheobronchial trees than adults; this elasticity, which helps protect the structures from injury when they are compressed, may contribute to the lower incidence of TBI in children.
Tracheobronchial injury | Anatomy
The first thoracic segment (Prothorax), which is the segment closest to the head, is nearly heart-shaped (sub-cordate) and hairless (glabrous). The Prothorax is broad as long, curved like a bow (arcuate) on the side (laterally) from apex to base, but broader in the front (anterior) than in the back part (posterior) where it does not have any curvilinear indentations (not sinuate), but the basal angle is sharp and projects, the outer margin is bent backward (reflexed). On the Prothorax the side groove (lateral sulcus) is narrow and reaches from the front (anterior) angle to the basal pore and is not continued along the basal margin to the basal longitudinal groove (sulcus), the space along the base between the grooves (sulci) and the median longitudinal line is not punctured (impunctate), the front part of the disk which is broadest across the median part is slightly convex and the sides of the rear (posterior) are not depressed or bent backwards (reflexed) on the site (laterally).
Abacetus emeritus | Thorax
The sudden impact on the thorax causes an increase in intrathoracic pressure. In order for traumatic asphyxia to occur, a Valsalva maneuver is required when the traumatic force is applied. Exhalation against the closed glottis along with the traumatic event causes air that cannot escape from the thoracic cavity. Instead, the air causes increased venous back-pressure, which is transferred back to the heart through the right atrium, to the superior vena cava and to the head and neck veins and capillaries.
Traumatic asphyxia | Pathophysiology
Knowledge of the surface anatomy of the thorax (chest) is particularly important because it is one of the areas most frequently subjected to physical examination, like auscultation and percussion. In cardiology, Erb's point refers to the third intercostal space on the left sternal border where S2 heart sound is best auscultated. Some sources include the fourth left interspace. Human female breasts are located on the chest wall, most frequently between the second and sixth rib.
Surface anatomy | Surface anatomy of the thorax
The thoracic cavity is the space inside the chest that contains the lungs, heart, and numerous major blood vessels. On each side of the cavity, a pleural membrane covers the surface of lung (visceral pleura) and also lines the inside of the chest wall (parietal pleura). Normally, the two layers are separated by a small amount of lubricating serous fluid. The lungs are fully inflated within the cavity because the pressure inside the airways is higher than the pressure inside the pleural space. Despite the low pressure in the pleural space, air does not enter it because there are no natural connections to an air-containing passage, and the pressure of gases in the bloodstream is too low for them to be forced into the pleural space.
Pneumothorax | Mechanism
Furthermore, complications such as pleural effusion or hemothorax can occur if the chest tubes fail to drain the fluid around the lung in the pleural space after a thoracotomy. Clinicians should be on the look out for chest tube clogging as these tubes have a tendency to become occluded with fibrinous material or clot in the post operative period, and when this happens, complications ensue. In the long term, post-operative chronic pain can develop, known as thoracotomy pain syndrome, and may last from a few years to a lifetime. Treatment to aid pain relief for this condition includes intra-thoracic nerve blocks/opiates and epidurals, although results vary from person to person and are dependent on numerous factors.
Thoracotomy | Complications
There are several proposed mechanisms for referred pain. Currently there is no definitive consensus regarding which is correct. The cardiac general visceral sensory pain fibers follow the sympathetics back to the spinal cord and have their cell bodies located in thoracic dorsal root ganglia 1-4(5). As a general rule, in the thorax and abdomen, general visceral afferent (GVA) pain fibers follow sympathetic fibers back to the same spinal cord segments that gave rise to the preganglionic sympathetic fibers. The central nervous system (CNS) perceives pain from the heart as coming from the somatic portion of the body supplied by the thoracic spinal cord segments 1-4(5).
Referred pain | Mechanism
A left anterolateral thoracotomy is the common method of opening the chest, as it provides rapid access, can be easily extended into the right hemithorax, and provides access to most of the important anatomical structures during resuscitation including the aorta. First an incision is made along the fourth or fifth intercostal space (between the ribs), intercostal muscles and the parietal pleura are divided, and then the ribs are retracted to provide visualization. When the incision covers both the right and left hemithoraxes it is referred to as a "clamshell" thoracotomy. The clamshell thoracotomy is used when there is a right sided pulmonary or vascular injury, or when greater access or visualization is desired.
Resuscitative thoracotomy | Technique
The female nipple is surrounded for half an inch by a more or less pigmented disc, the areola. The apex of a normal heart is in the fifth left intercostal space, three and a half inches from the mid-line.
Thorax | Anatomical landmarks
From this point, the illness can no longer be treated with thoracentesis, since the fluid will return to the cavity maintained by the peel. Over time, generally over the years, the fibrotic scar tissue slowly tightens and thickens, contracting the contents of one or both halves of the chest and reducing the mobility of the ribs. The peel can become deeper than 2 cm. Within the chest, the lung is compressed and unable to expand (trapped lung), making it vulnerable to collapse and causing breathlessness. Restrictive lung disease from fibrothorax may occur when pleural fibrosis is so severe that it involves the diaphragm and ribcage and results primarily from decreased rib movement.
Fibrothorax | Mechanism
There are a number of openings in the diaphragm through which structures pass between the thorax and abdomen. There are three large openings—the aortic, the esophageal, and the caval opening—plus a series of smaller ones. The inferior vena cava passes through the caval opening, a quadrilateral opening at the junction of the right and middle leaflets of the central tendon, so that its margins are tendinous. Surrounded by tendons, the opening is stretched open every time inspiration occurs. However, there has been argument that the caval opening actually constricts during inspiration. Since thoracic pressure decreases upon inspiration and draws the caval blood upwards toward the right atrium, increasing the size of the opening allows more blood to return to the heart, maximizing the efficacy of lowered thoracic pressure returning blood to the heart.
Thoracic diaphragm | Openings
It is estimated that 5-10% of isomeric patients have mesocardia, in which the heart is positioned at the center of the thorax, 25-50% have dextrocardia, in which the apex of the heart is pointed toward the right side of the thorax, and 50 - 70% have levocardia, in which the apex of the heart is pointed toward the left side of the thorax.
Situs ambiguus | Signs and symptoms
A small study in Turkey evaluated patients and found that 59% complained of pain that they had had for more than one month in duration. Estimates of 13% to 24% of patients seen in the emergency department are found to have a pulmonary association with their pain.
Chest pain in children | Epidemiology
Thoracic spinal pain is associated with: concurrent musculoskeletal pain; growth and physical; lifestyle and social; backpack; postural; psychological; and environmental factors. Specific risk factors identified in adolescents included age (being older) and poorer mental health.
Middle back pain | Risk factors
Thorax is a monthly peer-reviewed medical journal specialising in both clinical and experimental research articles on respiratory medicine as well as paediatrics, immunology, pharmacology, pathology, and surgery. It was established in 1946 and is published by the BMJ Group on behalf of the British Thoracic Society. The journal is available online by subscription and archived editions of the journal are available free of charge after 1 year. The editors-in-chief are Alan Smyth, Gisli Jenkins and Nicholas Hart.
Thorax (journal) | Introduction
The bones of the thorax, called the "thoracic skeleton" is a component of the axial skeleton. It consists of the ribs and sternum. The ribs of the thorax are numbered in ascending order from 1-12. 11 & 12 are known as floating ribs because they have no anterior attachment point in particular the cartilage attached to the sternum, as 1-7 are, and therefore are termed "floating". Whereas ribs 8-10 are termed false ribs as their costal cartilage articulates with the costal cartilage of the rib above.
Thorax | Bones
In general, women are more likely than men to present without chest pain (49% vs. 38%) in cases of myocardial infarction.
Chest pain | Epidemiology
Treatment for this condition is the same as for hemothorax and pneumothorax independently: by tube thoracostomy, the insertion of a chest drain through an incision made between the ribs, into the intercostal space. A chest tube must be inserted to drain blood and air from the pleural space so it can return to a state of negative pressure and function normally. Commonly, surgery is needed to close off whatever injuries caused the blood and air to enter the cavity (e.g. stabbing, broken ribs).
Hemopneumothorax | Treatment
In severe cases, surgical action is needed; otherwise, failure to intervene can result in pulmonary damage and eventual fatality. Vertical expandable prosthetic titanium rib (VEPTR) surgery is the most common treatment for severe chest wall deformities. During this procedure, one or more titanium rods are attached to the ribs near the spine, which allow space for the patient’s lungs to develop. Small adjustments are made every four to six months through a small incision in the patient's back. Alternatively, lateral thoracic expansion is used to enlarge the chest wall by separating the ribs from their periosteum and covering them with titanium struts.
Asphyxiating thoracic dysplasia | Surgical care
Other common causes include gastroesophageal reflux disease (30%), muscle or skeletal pain (28%), pneumonia (2%), shingles (0.5%) and anxiety disorders. Determining the cause of chest pain is based on a person's medical history, a physical exam and other medical tests. About 3% of heart attacks, however, are initially missed. Management of chest pain is based on the underlying cause. Initial treatment often includes the medications aspirin and nitroglycerin. The response to treatment does not usually indicate whether the pain is heart-related. When the cause is unclear, the person may be referred for further evaluation. Chest pain represents about 5% of presenting problems to the emergency room.
Chest pain | Introduction
The rib cage is the arrangement of ribs attached to the vertebral column and sternum in the thorax of most vertebrates, that encloses and protects the heart and lungs. In humans, the rib cage, also known as the thoracic cage, is a bony and cartilaginous structure which surrounds the thoracic cavity and supports the shoulder girdle to form the core part of the human skeleton. A typical human rib cage consists of 24 ribs in 12 pairs, the sternum and xiphoid process, the costal cartilages, and the 12 thoracic vertebrae. Together with the skin and associated fascia and muscles, the rib cage makes up the thoracic wall and provides attachments for the muscles of the neck, thorax, upper abdomen, and back.
Rib cage | Introduction
Other, less common causes of thoracic back pain include a spinal disc herniation which often may have radicular pain (wrapping around the ribs associated with numbness and burning pain), spinal tumors and rib fractures may mimic thoracic pain/radicular pain. Other possible sources of referral pain into the thoracic region include visceral organs like: lungs, gallbladder, stomach, liver duodenum, pleura and cardiac.
Middle back pain | Causes
The build-up of air into one of the pleural cavities, which causes a mediastinal shift. When this happens, the great vessels (particularly the superior vena cava) become kinked, which limits blood return to the heart. The condition can be recognized by severe air hunger, hypoxia, jugular venous distension, hyperresonance to percussion on the affected side, and a tracheal shift away from the affected side. The tracheal shift often requires a chest x-ray to appreciate (although treatment should be initiated prior to obtaining a chest x-ray if this condition is suspected). This is relieved by a needle thoracotomy (inserting a needle catheter) into the 2nd intercostal space at the mid-clavicular line, which relieves the pressure in the pleural cavity.
Hs and Ts | <a href="Tension%20pneumothorax">Tension pneumothorax</a>
Classically the pain associated with a myocardial infarction is located in the mid or left side of the chest where the heart is actually located. The pain can radiate to the left side of the jaw and into the left arm. Myocardial infarction can rarely present as referred pain and this usually occurs in people with diabetes or older age. Also, the dermatomes of this region of the body wall and upper limb have their neuronal cell bodies in the same dorsal root ganglia (T1-5) and synapse in the same second order neurons in the spinal cord segments (T1-5) as the general visceral sensory fibers from the heart.
Referred pain | Mechanism
The condition affects all major structures within the thorax and abdomen. Generally, the organs are simply transposed through the sagittal plane. The heart is located on the right side of the thorax, the stomach and spleen on the right side of the abdomen and the liver and gall bladder on the left side. The heart's normal right atrium occurs on the left, and the left atrium is on the right. The lung anatomy is reversed and the left lung has three lobes while the right lung has two lobes. The intestines and other internal structures are also reversed from the normal, and the blood vessels, nerves, and lymphatics are also transposed.
Situs inversus | Effect on anatomy
The transversus thoracis muscle () lies internal to the thoracic cage, anteriorly. It is a thin plane of muscular and tendinous fibers, situated upon the inner surface of the front wall of the chest. It is in the same layer as the subcostal muscles and the innermost intercostal muscles. It arises on either side from the lower third of the posterior surface of the body of the sternum, from the posterior surface of the xiphoid process, and from the sternal ends of the costal cartilages of the lower three or four true ribs. Its fibers diverge upward and lateralward, to be inserted by slips into the lower borders and inner surfaces of the costal cartilages of the second, third, fourth, fifth, and sixth ribs.
Transversus thoracis muscle | Introduction
Detailed physiologic testing proving what percentage of pain in the thoracic spine is caused by disc, facet, rib or muscle are yet to be completed so the answer to the question what is causing the pain often is left unanswered. If thoracic pain presents with weakness or numbness of the legs, bowel or bladder incontinence, and/or falling immediate MRI imaging is indicated.
Middle back pain | Diagnosis
The thorax is a series of articulated segments that lie between the cephalon and pygidium. The number of segments varies between 2 and 103 with most species in the 2 to 16 range. Each segment consists of the central axial ring and the outer pleurae, which protected the limbs and gills. The pleurae are sometimes abbreviated or extended to form long spines. Apodemes are bulbous projections on the ventral surface of the exoskeleton to which most leg muscles attached, although some leg muscles attached directly to the exoskeleton. Determining a junction between thorax and pygidium can be difficult and many segment counts suffer from this problem.
Trilobite | Thorax
The thoracic wall or chest wall is the boundary of the thoracic cavity.
Thoracic wall | Introduction
The lower opening of the thorax is formed by the twelfth thoracic vertebra behind, by the eleventh and twelfth ribs at the sides, and in front by the cartilages of the tenth, ninth, eighth, and seventh ribs, which ascend on either side and form an angle, the infrasternal angle or subcostal angle, into the apex of which the xiphoid process projects. Pregnancy causes the angle to increase from 68° to 103°.
Infrasternal angle | Introduction
The thorax is the midsection (tagma) of the insect body. It holds the head, legs, wings and abdomen. It is also called mesosoma or cephalothorax in other arthropods. It is formed by the prothorax, mesothorax and metathorax and comprises the scutellum; the cervix, a membrane that separates the head from the thorax; and the pleuron, a lateral sclerite of the thorax. In dragonflies and damselflies the mesothorax and metathorax are fused together to form the synthorax.
Thorax (arthropod anatomy) | Introduction
Knowing a person's risk factors can be extremely useful in ruling in or ruling out serious causes of chest pain. For example, heart attack and thoracic aortic dissection are very rare in healthy individuals under 30 years of age, but significantly more common in individuals with significant risk factors, such as older age, smoking, hypertension, diabetes, history of coronary artery disease or stroke, positive family history (premature atherosclerosis, cholesterol disorders, heart attack at early age), and other risk factors. Chest pain that radiates to one or both shoulders or arms, chest pain that occurs with physical activity, chest pain associated with nausea or vomiting, chest pain accompanied by diaphoresis or sweating, or chest pain described as "pressure," has a higher likelihood of being related to acute coronary syndrome, or inadequate supply of blood to the heart muscle, but even without these symptoms chest pain may be a sign of acute coronary syndrome.
Chest pain | History taking
Structures within the thoracic cavity include: It contains three potential spaces lined with mesothelium: the paired pleural cavities and the pericardial cavity. The mediastinum comprises those organs which lie in the centre of the chest between the lungs. The cavity also contains two openings one at the top, the superior thoracic aperture also called the thoracic inlet, and a lower inferior thoracic aperture which is much larger than the inlet.
Thoracic cavity | Structure
The bony skeletal part of the thoracic wall is the rib cage, and the rest is made up of muscle, skin, and fasciae. The chest wall has 10 layers, namely skin, superficial fascia, deep fascia, serratus anterior, layer for ribs (containing intercostal muscles), and endothoracic fascia from superficial to deep. However, the muscular layers vary according to the region of the chest wall. For example, they may include muscles like pectoralis major or latissimus dorsi.
Thoracic wall | Structure
The pleural space is maintained in a constant state of negative pressure (in comparison to atmospheric pressure). If the chest wall, and thus the pleural space, is punctured, blood, air or both can enter the pleural space. Air and/or blood rushes into the space in order to equalise the pressure with that of the atmosphere. As a result, the fluid is disrupted and the two membranes no longer adhere to each other. When the rib cage moves out, it no longer pulls the lungs with it. Thus the lungs cannot expand, the pressure in the lungs never drops and no air is pulled into the bronchi.
Hemopneumothorax | Cause
Though the Neanderthal thorax (where the ribcage is) was similar in size to modern humans, the longer and straighter ribs would have equated to a widened mid-lower thorax and stronger breathing in the lower thorax, which are indicative of a larger diaphragm and possibly greater lung capacity. The lung capacity of Kebara 2 was estimated to have been . The Neanderthal chest was also more pronounced (expanded front-to-back, or antero-posteriorly). The sacrum (where the pelvis connects to the spine) was more vertically inclined, and was placed lower in relation to the pelvis, causing the spine to be less curved (exhibit less lordosis) and to fold in on itself somewhat (to be invaginated).
Neanderthal | Build
The clavicle articulates with the manubrium to form the anterior border of the thoracic inlet. Superior to the thoracic inlet is the root of the neck, and the superior mediastinum is inferiorly related. The brachial plexus is a superolateral relation of the thoracic inlet. The brachial plexus emerges between the anterior and middle scalene muscles, superior to the first rib, and passes obliquely and inferiorly, underneath the clavicle, into the shoulder and then the arm. Impingement of the plexus in the region of the scalenes, ribs, and clavicles is responsible for thoracic outlet syndrome.
Thoracic inlet | Relations
Chest pain is relatively common in children and adolescents. Unlike adults, the cause is rarely cardiac. Approximately 0.3% to 0.6% of emergency department visits by pediatric patients are for chest pain. The emergency department visits are consistent throughout the seasons and times of year. The median age pediatric patients that complain of pain is from 12 to 13 years old both males and females display the symptoms and signs at approximately the same ratio. Those that do complain of the chest pain usually present with acute pain that they have experienced for less than one day. This is not universal though.
Chest pain in children | Epidemiology
The lower side of the chest is formed by gastralia. These belly ribs have a single centre segment and one or two outer segments per side. They are not fused into a real plastron. Usually two gastralia are present per dorsal rib.
Ichthyosaur | Vertebral column
Chest pain that is reproducible during the physical exam with contact of the chest wall is more indicative of non-cardiac chest pain, but still cannot completely rule out acute coronary syndrome. For this reason, in general, additional tests are required to establish the diagnosis. In the emergency department the typical approach to chest pain involves ruling out the most dangerous causes: heart attack, pulmonary embolism, thoracic aortic dissection, esophageal rupture, tension pneumothorax, and cardiac tamponade. By elimination or confirmation of the most serious causes, a diagnosis of the origin of the pain may be made. Often, no definite cause will be found and reassurance is then provided.
Chest pain | Physical examination
The main presentation of the syndrome is significant, acute pain in the chest, along with tenderness and some swelling of the cartilages affected, which is commonly palpable on examination. Perceived pain is often exacerbated with respiration. Although many times it can be extremely painful, to the point of being debilitating, Tietze's syndrome is considered to be a benign condition that generally resolves in 12 weeks. However, it can often be a chronic condition. The associated chest pain may present similarly to angina pectoris, normally associated with heart disease, and can cause hyperventilation, anxiety or panic attacks, syncope (passing out), and temporary hypoesthesia (numbness) paralysis, and due to pain high blood pressure or hypertension.
Tietze syndrome | Signs and symptoms
In vertebrate anatomy, ribs () are the long curved bones which form the rib cage, part of the axial skeleton. In most tetrapods, ribs surround the chest, enabling the lungs to expand and thus facilitate breathing by expanding the chest cavity. They serve to protect the lungs, heart, and other internal organs of the thorax. In some animals, especially snakes, ribs may provide support and protection for the entire body.
Rib | Introduction
This view is obtained to the left of the sternum and views the heart in its long axis. In this view, the mitral valve, aortic valve, right ventricular outflow tract, base of the left ventricle, and the left atrium can be visible. Angulation in this view can bring the right ventricular inflow tract and tricuspid valve into view, and angulation the opposite way can bring the pulmonary valve into view. In this view, it is possible to appreciate the long-axis cross section of the mitral and aortic valves. The classic "hockey stick" shape of rheumatic mitral stenosis can be appreciated in this view.
Transthoracic echocardiogram | Parasternal long axis (PLAX)
A chest injury, also known as chest trauma, is any form of physical injury to the chest including the ribs, heart and lungs. Chest injuries account for 25% of all deaths from traumatic injury. Typically chest injuries are caused by blunt mechanisms such as motor vehicle collisions or penetrating mechanisms such as stabbings.
Chest injury | Introduction
Most TBI that results from blunt trauma occurs within the chest. The most common tracheal injury is a tear near the carina or in the membranous wall of the trachea. In blunt chest trauma, TBI occurs within 2.5 cm of the carina 40–80% of the time. The injury is more common in the right main bronchus than the left, possibly because the former is near vertebrae, which may injure it. Also, the aorta and other tissues in the mid chest that surround the left main bronchus may protect it. Another possibility is that people with left main bronchus injuries are more likely to also have other deadly injuries and therefore die before reaching hospital, making them less likely to be included in studies that determine rates of injuries.
Tracheobronchial injury | Classification
A resuscitative thoracotomy (sometimes referred to as an emergency department thoracotomy (EDT), trauma thoracotomy or, colloquially, as "cracking the chest") is a thoracotomy performed to resuscitate a major trauma patient who has sustained severe thoracic or abdominal trauma and who has entered cardiac arrest because of this. The procedure allows immediate direct access to the thoracic cavity, permitting rescuers to control hemorrhage, relieve cardiac tamponade, repair or control major injuries to the heart, lungs or thoracic vasculature, and perform direct cardiac massage or defibrillation. For most persons with thoracic trauma the procedure is not necessary; only 15% of those with thoracic injury require the procedure.
Resuscitative thoracotomy | Introduction
Trauma can also be a cause for chest pain and has been found to be associated with the pain in 5% of the patients. Children can present with chest pain can have a sudden onset related to vigorous physical activity and coughing. These symptoms seem to be closely associated with asthma. Infection with "Haemophilus influenzae" can cause chest pain.
Chest pain in children | Differential diagnosis
Rembrandt's image is a fiction; in a typical anatomy lesson, the surgeon would begin by opening the chest cavity and thorax because the internal organs there decay most rapidly.
The Anatomy Lesson of Dr. Nicolaes Tulp | Background
Although patients will often mistake the pain of Tietze's syndrome for a myocardial infarction (heart attack), the syndrome does not progress to cause harm to any organs. Other potential causes for chest pain include cardiac, gastrointestinal, or traumatic injury. It is important to rule out a heart attack, as the symptoms may be similar or severe. After assessment, providers often reassure patients that their symptoms are not associated with a heart attack, although they may need to treat the pain, which in some cases can be severe enough to cause significant, though temporary, disability to the patient. Pain relief is achieved with the use of analgesics.
Tietze syndrome | Differential diagnosis
If a bronchus is torn all the way around, the lung may collapse outward toward the chest wall (rather than inward, as it usually does in pneumothorax) because it loses the attachment to the bronchus which normally holds it toward the center. In a person lying face-up, the lung collapses toward the diaphragm and the back. This sign, described in 1969, is called fallen lung sign and is pathognomonic of TBI (that is, it is diagnostic for TBI because it does not occur in other conditions); however it occurs only rarely. In as many as one in five cases, people with blunt trauma and TBI have no signs of the injury on chest X-ray.
Tracheobronchial injury | Diagnosis
Chest pain is a common presenting problem. Overall chest pain is responsible for an estimated 6% of all emergency department visits in the United States and is the most common reason for hospital admission. Chest pain is also very common in primary care clinics, representing 1-3% of all visits. The rate of emergency department visits in the US for chest pain decreased 10% from 1999 to 2008. but a subsequent increase of 13% was seen from 2006–2011. Less than 20% of all cases of chest pain admissions are found to be due to coronary artery disease. The rate of chest pain as a symptom of acute coronary syndrome varies among populations based upon age, sex, and previous medical conditions.
Chest pain | Epidemiology
These changes in posture are supported by the physiological changes in the torso of "Thrinaxodon". Such changes as the first appearance of a segmented rib compartment, in which "Thrinaxodon" expresses both thoracic and lumbar vertebrae. The thoracic segment of the vertebrae contain ribs with large intercostal plates that most likely assisted with either protection or supporting the main frame of the back. This newly developed arrangement allowed for the appropriate space for a diaphragm, however, without proper soft tissue records, the presence of a diaphragm is purely speculative.
Thrinaxodon | Posture
When this pressure exceeds the elasticity of the tissues, they burst; thus the membranous part of the trachea is more commonly affected by this mechanism of injury than cartilaginous portions. The second mechanism may occur when the chest is suddenly decelerated, as occurs in vehicle accidents, producing a shearing force. The lungs are mobile in the chest cavity but their movement is more restricted near the hilum. Areas near the cricoid cartilage and carina are fixed to the thyroid cartilage and the pericardium respectively; thus if the airways move, they can tear at these points of fixation.
Tracheobronchial injury | Mechanism
This creates two very typical, isolated slits. The exoskeleton of "Mesonacis" is about 2⅓× as long as wide, measured between the genal angles. The outer ⅓ of the back (or posterior margin) of the headshield (or cephalon) angles forwards from the tip of the pleural spine to the genal angle. The central area of the cephalon (or glabella) and the frontal margin touch or the distance is as long as the margin at most (in jargon: the preglabellar field is short or absent). The thorax has approximately 25 segments, the pleura about 1½× as wide as the axis, excluding the genal spines.
Mesonacis | Description
The neurological process involved in the perception of heartache is not known, but is thought to involve the anterior cingulate cortex of the brain, which during stress may overstimulate the vagus nerve causing pain, nausea or muscle tightness in the chest. Research by Naomi Eisenberger and Matthew Lieberman of the University of California from 2008 showed that rejection is associated with activation of the dorsal anterior cingulate cortex and right-ventral pre-frontal cortex, areas established as being involved in processing of pain, including empathizing with pain experienced by others. The same researchers mention effect of social stressors on the heart, and personality on perception of pain.
Broken heart | Physiology
The pleural space is located anatomically between the visceral membrane, which is firmly attached to the lungs, and the parietal membrane which is firmly attached to the chest wall (a.k.a. ribcage and intercostal muscles, muscles between the ribs). The pleural space contains pleural fluid. This fluid holds the two membranes together by surface tension, as much as a drop of water between two sheets of glass prevents them from separating. Because of this, when the intercostal muscles move the ribcage outward, the lungs are pulled out as well, dropping the pressure in the lungs and pulling air into the bronchi, when we 'breathe in'.
Hemopneumothorax | Cause
Due to its position separating the thorax and abdomen, fluid abnormally present in the thorax, or air abnormally present in the abdomen, may collect on one side of the diaphragm. An X-ray may reveal this. Pleural effusion, in which there is fluid abnormally present between the two pleurae of the lungs, is detected by an X-ray of the chest, showing fluid collecting in the angle between the ribs and diaphragm. An X-ray may also be used to reveal a pneumoperitoneum, in which there is gas in the abdomen. An X-ray may also be used to check for herniation.
Thoracic diaphragm | Imaging
Injury of the thoracic aorta refers to any injury which affects the portion of the aorta which lies within the chest cavity. Injuries of the thoracic aorta are usually the result of physical trauma; however, they can also be the result of a pathological process. The main causes of this injury are deceleration (such as a car accident) and crush injuries. There are different grades to injuries to the aorta depending on the extent of injury, and the treatment whether surgical or medical depends on that grade. It is difficult to determine if a patient has a thoracic injury just by their symptoms, but through imaging and a physical exam the extent of injury can be determined.
Thoracic aorta injury | Introduction
The symptoms of a hemothorax depend on the quantity of blood that has been lost into the pleural cavity. A small hemothorax usually causes little in the way of symptoms, while larger hemothoraces commonly cause breathlessness and chest pain, and occasionally lightheadedness. Other symptoms may occur in association with a hemothorax depending on the underlying cause. The clinical signs of a hemothorax include reduced or absent breath sounds and reduced movement of the chest wall on the affected side. When the affected side is tapped or percussed, a dull sound may be heard in contrast to the usual resonant note.
Hemothorax | Signs and symptoms
The thorax consists of six short but wide segments, the outline of which is a continuation of the cheeks. The axis is narrow, less than ⅓× as wide as each of the ribs (or pleurae) to its sides. The tailshield, termed pygidium, is small, approximately wide triangular, with the axis narrow triangular, reaching the border. The axial rings and ribs become less conspicuous further to the back.
Trinucleidae | Description
Chest pain in children is usually evaluated in the emergency departments. It can be distressing for parents and children. Pediatric chest pain differs from chest pain in adults because it is most often unrelated to the heart. The causes of pediatric chest pain vary according to the organ or tissue in the child. that generates the pain. Generally, muscular skeletal pain, which includes costochondritis, is the reason for the emergency department visit. Pain that is felt in the chest but is due to muscular skeletal inflammation or an unknown cause and accounts for 7% and 69% visits. Muscular skeletal pain is described and defined differently as a diagnosis of exclusion or is documented as being associated with idiopathic causes.
Chest pain in children | Differential diagnosis
The chest is a part of the anatomy of humans and various other animals located between the neck and the abdomen. Chest may also refer to:
Chest (disambiguation) | Introduction
Management of chest pain varies with the underlying cause of the pain and the stage of care.
Chest pain | Management
This helps the clinician to determine whether or not the cause of pain is related to pulmonary or cardiac causes. Some preliminary diagnosis include:
Chest pain in children | Preliminary
The ribs are sclerotic, truncated, expanded, and featureless. Sclerosis is also present in the sternum, clavicles and scapulae. Pectus carinatum, a chest deformity, is also characteristic of the disease.
Dysosteosclerosis | Chest
Thoracocentesis, pericardiocentesis, pleurodesis, ligation of thoracic duct, pleuroperitoneal shunt, radiation therapy, pleurectomy, pericardial window, pericardiectomy, thalidomide, interferon alpha 2b, Total Parenteral Nutrition (TPN), medium chain triglyceride (MCT) and high protein diet, chemotherapy, sclerotherapy, transplant;
Lymphangiomatosis | Heart and chest
It is not unusual for the mediastinum (the structure between the lungs that contains the heart, great blood vessels, and large airways) to be shifted away from the affected lung due to the pressure differences. This is "not" equivalent to a tension pneumothorax, which is determined mainly by the constellation of symptoms, hypoxia, and shock. The size of the pneumothorax (i.e. the volume of air in the pleural space) can be determined with a reasonable degree of accuracy by measuring the distance between the chest wall and the lung. This is relevant to treatment, as smaller pneumothoraces may be managed differently.
Pneumothorax | Chest X-ray
In addition to pneumothorax, complications from thoracotomy include air leaks, infection, bleeding and respiratory failure. Postoperative pain is universal and intense, generally requiring the use of opioid analgesics for moderation, as well as interfering with the recovery of respiratory function. Paraplegia complicating thoracotomy is rare but catastrophic. In nearly all cases a chest tube, or more than one chest tube is placed. These tubes are used to drain air and fluid until the patient heals enough to take them out (usually a few days). Complications such as pneumothorax, tension pneumothorax, or subcutaneous emphysema can occur if these chest tubes become clogged.
Thoracotomy | Complications
Chest pain is one of the common symptoms of acute pericarditis. It is usually of sudden onset, occurring in the anterior chest and often has a sharp quality that worsens with breathing in or coughing, due to inflammation of the pleural surface at the same time. The pain may be reduced with sitting up and leaning forward while worsened with lying down, and also may radiate to the back, to one or both trapezius ridges. However, the pain can also be dull and steady, resembling the chest pain in an acute myocardial infarction. As with any chest pain, other causes must also be ruled out, such as GERD, pulmonary embolism, muscular pain, etc.
Acute pericarditis | Signs and symptoms
It is almost completely without function, but it separates the thoracic cage from the parietal pleura. It depresses the ribs. Contraction of this muscle aids in exertional expiration by decreasing the transverse diameter of the thoracic cage.
Transversus thoracis muscle | Function
The costal margin is the lower edge of the chest (thorax) formed by the bottom edge of the rib cage. Sometimes referred to as the costal arch, the costal margin is the medial margin formed by the seventh to tenth ribs.
Costal margin | Introduction
Another organ in the thorax, traces of which might be present, is the thymus, which might have contributed to a greyish mass of organic origin visible in the neck base; this also contains connective and muscle tissue.
Scipionyx | Liver, heart, spleen and thymus
Only the left common carotid artery has a substantial presence in the thorax. It originates directly from the aortic arch, and travels upward through the superior mediastinum to the level of the left sternoclavicular joint. During the thoracic part of its course, the left common carotid artery is related to the following structures: In front, it is separated from the manubrium of the sternum by the sternohyoid and sternothyroid muscles, the anterior portions of the left pleura and lung, the left brachiocephalic vein, and the remains of the thymus; behind, it lies on the trachea, esophagus, left recurrent laryngeal nerve, and thoracic duct.
Common carotid artery | In the chest
Males typically have larger tracheae and branching bronchi, with about 56% greater lung volume per body mass. They also have larger hearts, 10% higher red blood cell count, and higher haemoglobin hence greater oxygen-carrying capacity. They also have higher circulating clotting factors (vitamin K, prothrombin and platelets). These differences lead to faster healing of wounds and higher peripheral pain tolerance.
Sex differences in human physiology | Respiratory system