An open wound in the chest wall through which air passes, causing the lung on that side to collapse.
Severe breathlessness and a life-threatening lack of oxygen result.
Severe breathlessness and a life-threatening lack of oxygen result.
Contents The trachea divides into right and left main bronchi which go to the two LUNGS. The left lung is slightly smaller than the right. The right has three lobes (upper, middle and lower) and the left lung has two lobes (upper and lower). Each lung is covered by two thin membranes lubricated by a thin layer of ?uid. These are the pleura; similar structures cover the heart (pericardium). The heart lies in the middle, displaced slightly to the left. The oesophagus passes right through the chest to enter the stomach just below the diaphragm. Various nerves, blood vessels and lymph channels run through the thorax. The thoracic duct is the main lymphatic drainage channel emptying into a vein on the left side of the root of the neck. (For diseases affecting the chest and its contents, see HEART, DISEASES OF; LUNGS, DISEASES OF; CHEST, DEFORMITIES OF.)... chest
Emergency treatment consists of turning the person on to the affected side or supporting the flail segment by firm strapping.
In severe cases, artificial ventilation is needed until the chest wall is stable.... flail chest
Wounds can be divided into the following categories: an incised wound; an abrasion (or graze); a laceration; a penetrating wound; and a contusion. wound infection Any type of wound is susceptible to the entry of bacteria; the resultant infection can delay healing, result in disability, and may even cause death. Infection of a wound is indicated by redness, swelling, warmth, pain, and sometimes by the presence of pus or the formation of an abscess. Infection may spread locally to adjacent organs or tissue, or to more distant parts of the body via the blood.
The type of infection depends upon how the wound occurred. For example, wounds brought into contact with soil can result in tetanus. STAPHYLOCOCCI, including MRSA, are also common wound infections.
Once infection is discovered, a sample of blood or pus is taken and the patient is given an antibiotic drug. Any abscess should be drained surgically.... wound
Barrel chest is found in long-standing ASTHMA or chronic BRONCHITIS and EMPHYSEMA, when the lungs are chronically enlarged. The anterio-posterior dimension of the chest is increased and the ribs are near horizontal. In this position they can produce little further expansion of the chest, and breathing often relies on accessory muscles in the neck lifting up the whole thoracic cage on inspiration.
Pigeon chest is one in which the cross-section of the chest becomes triangular with the sternum forming a sort of keel in front. It may be related to breathing problems in early life.
Rickety chest is uncommon now and is caused by RICKETS in early life. There is a hollow down each side caused by the pull of muscles on the softer ribs in childhood. The line of knobs produced on each side where the ribs join their costal cartilages is known as the rickety rosary.
Pectus excavatum, or funnel chest, is quite a common abnormality where the central tendon of the diaphragm seems to be too short so that the lower part of the sternum is displaced inwards and the lower ribs are prominent. When severe, it may displace the heart further to the left side.
Local abnormalities in the shape of the chest occur when there is a deformity in the spine such as scoliosis which alters the angles of the ribs. The chest wall may be locally ?attened when the underlying lung is reduced in size locally over a prolonged period. (See SPINE AND SPINAL CORD, DISEASES AND INJURIES OF.) This may be seen over a scarred area of lung such as that observed in pulmonary TUBERCULOSIS.... chest, deformities of
Varieties These are classi?ed according to the immediate e?ect produced: INCISED WOUNDS are usually in?icted with some sharp instrument, and are clean cuts, in which the tissues are simply divided without any damage to surrounding parts. The bleeding from such a wound is apt to be very free, but can be readily controlled. PUNCTURE WOUNDS, or stabs, are in?icted with a pointed instrument. These wounds are dangerous, partly because their depth involves the danger of wounding vital organs; partly because bleeding from a stab is hard to control; and partly because they are di?cult to sterilise. The wound produced by the nickel-nosed bullet is a puncture, much less severe than the ugly lacerated wound caused by an expanding bullet, or by a ricochet, and, if no clothing has been carried in by the bullet, the wound is clean and usually heals at once. LACERATED WOUNDS are those in which tissues are torn, such as injuries caused by machinery.
Little bleeding may occur and a limb can be torn completely away without great loss of blood. Such wounds are, however, especially liable to infection. CONTUSED WOUNDS are those accompanied by much bruising of surrounding parts, as in the case of a blow from a cudgel or poker. There is little bleeding, but healing is slow on account of damage to the edges of the wound. Any of these varieties may become infected.
First-aid treatment The ?rst aim is to check any bleeding. This may be done by pressure upon the edges of the wound with a clean handkerchief, or, if the bleeding is serious, by putting the ?nger in the wound and pressing it upon the spot from which the blood is coming.
If medical attention is available within a few hours, a wound should not be interfered with further than is necessary to stop the bleeding and to cover it with a clean dry handkerchief or bandage. When expert assistance is not soon obtainable, the wound should be cleaned with an antiseptic such as CHLORHEXIDINE or boiled water and the injured part ?xed so that movement is prevented or minimised. A wounded hand or arm is ?xed with a SLING, a wounded leg with a splint (see SPLINTS). If the victim is in SHOCK, he or she must be treated for that. (See also APPENDIX 1: BASIC FIRST AID.)... wounds
Internal use of Arnica and Comfrey root would appear to be justified in serious chest injuries. ... chest injuries
Alternatives. Teas. Boneset, Yarrow, Angelica. White Horehound, Hyssop.
Irish Moss. 1 teaspoon to 2 cups water gently simmered 20 minutes. Do not strain but eat with a spoon, sweetened with honey.
Tablets/capsules. Lobelia. Iceland Moss.
Foot-bath. Immerse feet in hot infusion of Chamomile or Mustard to divert blood to lower extremities. Supplementation: Vitamin C, 2-3 grams daily. ... cold – on the chest
Avoid overstocking; some herbs lose their potency on the shelf in time, especially if exposed. Do not keep on a high shelf out of the way. Experts suggest a large box with a lid to protect its contents, kept in a cool dry place away from foods and other household items. Store mixtures containing Camphor separately elsewhere. Camphor is well-known as a strong antidote to medicinal substances. Keep all home-made ointments in a refrigerator. However harmless, keep all remedies out of reach of children. Be sure that all tablet containers have child-resistant tops.
Keep a separate box, with duplicates, permanently in the car. Check periodically. Replace all tablets when crumbled, medicines with changed colour or consistency. Always carry a large plastic bottle of water in the car for cleansing dirty wounds and to form a vehicle to Witch Hazel and other remedies. Label all containers clearly.
Health care items: Adhesive bandages of all sizes, sterile gauze, absorbant cotton wool, adhesive tape, elastic bandage, stitch scissors, forceps (boiled before use), clinical thermometer, assorted safety pins, eye-bath for use as a douche for eye troubles, medicine glass for correct dosage.
Herbal and other items: Comfrey or Chickweed ointment (or cream) for sprains and bruises. Marshmallow and Slippery Elm (drawing) ointment for boils, abscesses, etc. Calendula (Marigold) ointment or lotion for bleeding wounds where the skin is broken. An alternative is Calendula tincture (30 drops) to cupful of boiled water allowed to cool; use externally, as a mouth rinse after dental extractions, and sipped for shock. Arnica tincture: for bathing bruises and swellings where the skin is unbroken (30 drops in a cup of boiled water allowed to cool). Honey for burns and scalds. Lobelia tablets for irritating cough and respiratory distress. Powdered Ginger for adding to hot water for indigestion, vomiting, etc. Tincture Myrrh, 5-10 drops in a glass of water for sore throats, tonsillitis, mouth ulcers and externally, for cleansing infected or dirty wounds. Tincture Capsicum (3-10 drops) in a cup of tea for shock, or in eggcup Olive oil for use as a liniment for pains of rheumatism. Cider vinegar (or bicarbonate of Soda) for insect bites. Oil Citronella, insect repellent. Vitamin E capsules for burns; pierce capsule and wipe contents over burnt area. Friar’s balsam to inhale for congestion of nose and throat. Oil of Cloves for toothache. Olbas oil for general purposes. Castor oil to assist removal of foreign bodies from the eye. Slippery Elm powder as a gruel for looseness of bowels. Potter’s Composition Essence for weakness or collapse. Antispasmodic drops for pain.
Distilled extract of Witch Hazel deserves special mention for bleeding wounds, sunburn, animal bites, stings, or swabbed over the forehead to freshen and revive during an exhausting journey. See: WITCH HAZEL.
Stings of nettles or other plants are usually rendered painless by a dock leaf. Oils of Tea Tree, Jojoba and Evening Primrose are also excellent for first aid to allay infection. For punctured wounds, as a shoemaker piercing his thumb with an awl or injury from brass tacks, or for shooting pains radiating from the seat of injury, tincture or oil of St John’s Wort (Hypericum) is the remedy. ... first aid and medicine chest
Internally: Marigold petal tea freely.
Externally: Marigold (Calendula) ointment, cream or fomentation with petals. During the Coup d’etat in Paris in 1849, a Dr Jahr saved many limbs with Marigold. Echinacea to allay infection. See entry: WOUNDS. ... gunshot wounds
chest X-ray One of the most frequently performed medical tests, usually carried out to examine the heart or lungs to confirm diagnoses of heart disorders and lung diseases. (See also X-rays.)... chest thrust
wall. In Tietze’s syndrome, inflammation at the junctions of the rib cartilages causes pain on the front of the chest wall.
Pain within the chest may be caused by pleurisy, as a result of bronchitis, pneumonia, or, rarely, pulmonary embolism. Cancerous tumours of the lung (see lung cancer; mesothelioma) may cause pain as they grow and press on the pleura and ribs. Acid reflux may lead to heartburn, a burning pain behind the sternum. The common heart disorder angina pectoris causes pain in the centre of the chest that may spread outwards to the throat, jaw, or arms. Myocardial infarction (heart attack) and acute pericarditis both also produce severe pain in the centre of the chest. Mitral valve prolapse may cause sharp chest pain, usually on the left side. Chest pain may also be a result of anxiety and emotional stress (see hyperventilation; panic attack).... chest pain
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