RT Book, Section
A1 Tzelepis, George E.
A1 McCool, F. Dennis
A2 Grippi, Michael A.
A2 Antin-Ozerkis, Danielle E.
A2 Dela Cruz, Charles S.
A2 Kotloff, Robert M.
A2 Kotton, Camille Nelson
A2 Pack, Allan I.
SR Print(0)
ID 1195009491
T1 Nonmuscular Diseases of the Chest Wall
T2 Fishman’s Pulmonary Diseases and Disorders, 6e
YR 2023
FD 2023
PB McGraw-Hill Education
PP New York, NY
SN 9781260473988
LK accessmedicine.mhmedical.com/content.aspx?aid=1195009491
RD 2024/04/25
AB The  chest  wall  is  a  major  component  of  the  respiratory  pump  and  consists  of  the  rib  cage  and  abdomen.  It  is  inflated  by  the  inspiratory  muscles  of  the  rib  cage  and  the  diaphragm,  and  its  integrity  is  key  to  sustaining  ventilation.  Disorders  affecting  the  nonmuscular  structures  of  the  chest  wall  (the  thoracic  spine,  ribs,  costovertebral  joints,  abdominal  wall,  and  sternum)  may  lead  to  respiratory  dysfunction.  When  the  integrity  of  these  nonmuscular  components  is  severely  compromised,  respiratory  failure  may  ensue.  The  pathophysiology  of  disorders  affecting  these  nonmuscular  components  is  generally  related  to  the  imposition  of  excessive  elastic  loads  placed  on  the  respiratory  muscles.  In  some  disorders,  such  as  kyphoscoliosis  and  obesity,  the  load  on  the  respiratory  muscles  is  chronic  and  progressive.  By  contrast,  with  flail  chest,  the  load  on  the  respiratory  muscles  is  acute.  If  the  respiratory  muscles  have  not  adapted  or  had  little  time  to  adapt  to  loads  that  increase  the  work  of  breathing,  respiratory  failure  may  quickly  ensue.  Other  disorders,  such  as  ankylosing  spondylitis  and  pectus  excavatum,  have  a  minimal  impact  on  respiratory  function.  The  respiratory  muscles  are  discussed  in  Chapters  3  and  142.