PBL Flashcards
Tracheal tug and intercostal recession.
Oliver’s sign, or the tracheal tug sign, is an abnormal downward movement of the trachea during systole that can indicate a dilation or aneurysm of the aortic arch. Increase pull of diaphragm is transmitted as a downwards tug on the trachea during inspiration.
It is an example of a chest retraction.
Chest retractions can be caused by bronchiolitis, or swelling in the smallest airways of the lungs. Buildup of infected pus in the back of the throat.
Chest retractions can happen at any age if something’s blocking your windpipe. In adults they are also caused by:
-asthma
-pneumonia
-bad allergic reaction
-epiglottis, when the tissue that covers your windpipe swells up.
Severe difficulty breathing is associated with supraclavicular retractions, suprasternal retractions, and sternal retractions. There can also be the retractions associated with mild to moderate difficulty.
The breathing difficulty that causes retractions can be of due to three different causes: upper airway obstruction (an example is croup), lower airway obstruction (asthma or bronchiolitis), or lung tissue disease which is also called parenchymal lung disease (for example, pneumonia, pulmonary edema, or acute respiratory distress syndrome).
Intercostal retractions are due to reduced air pressure inside your chest. This can happen if the upper airway (trachea) or small airways of the lungs (bronchioles) become partially blocked. As a result, the intercostal muscles are sucked inward, between the ribs, when you breathe.
Your intercostal muscles attach to your ribs. When you breathe in air, they normally contract and move your ribs up. At the same time, your diaphragm, which is a thin muscle that separates your chest and abdomen, drops lower and your lungs fill with air. When you have a partial blockage in your upper airway or the small airways in your lungs, air can’t flow freely and the pressure in this part of your body decreases. As a result, your intercostal muscles pull sharply inward. These movements are known as intercostal retractions, also called intercostal recession.
Intercostal retractions/recession indicate that something is blocking or narrowing your airway. Asthma, pneumonia, and other respiratory diseases can all cause a blockage.
