chest wall


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Related to chest wall: chest wall pain

wall

 [wawl]
a structure bounding or limiting a space or a definitive mass of material; called also paries.
cell wall a rigid structure that lies just outside of and is joined to the plasma membrane of plant cells and most prokaryotic cells, which protects the cell and maintains its shape.
chest wall the structures bordering the thorax that move during breathing, including the rib cage, diaphragm, and abdomen.

chest wall

in respiratory physiology, the total system of structures outside the lungs that move as a part of breathing; it includes the rib cage, diaphragm, abdominal wall, and abdominal contents.
Synonym(s): thoracic wall

non-cardiac chest pain

Internal medicine Chest pain that simulates cardiac nosologies, but is unrelated to cardiovascular disease; 50% of Pts with NCCP have known reflex and may have postprandial or noctural Sx. See Gastroesophageal reflux disease.
Non-cardiac chest pain shamelessly taken, virtually verbatim from www.vnh.org/GMO/
ClinicalSection/08Chestpain.html, from Dept Navy, Bureau of Med & Surg; Internally Peer Reviewed
Sources of chest pain The heart, great vessels, pericardium; GI tract; lungs & pleura; chest wall
How to minimize YOUR risks of managing Acute chest pain Identification of ischemic chest pain requires a high index of suspicion; when the diagnosis of acute MI is overlooked and Pts are sent home–the mortality during the next 72 hrs is about 25%–how did you spell  that phrase again, “…out-of-court settlement.”–vs ± 6% for Pts with infarction who are hospitalized; being liberal in admissions for evaluation of CAD; incidence of acute MI in Pts hospitalized with acute chest pain is between 25 and 30%; despite conservative admission rates, clinicians misdiagnose ±5-10% of Pts with acute MI–ie, you're in good company if you screw up
History The Hx rules decision making; elements of the Hx important in discriminating cardiac from noncardiac chest pain are quality, severity, duration and frequency; knowledge of exacerbating features and maneuvers that ameliorate the discomfort are helpful; cardiac risk factors should not overly influence clinical thinking; the presence of risk factors simply implies that a person is more likely to develop overt signs of ASHD in the future, but are not exclusionary criteria
Pain character Chest pain due to coronary ischemia is classically a dull heavy pressure–but Pts have been pretty colorful in use of adjectives to describe this pain; they may have classic pain, DON'T expect a classic description of anginal pain; the pain may be confined to the chest or accompanied by aching in one or both arms, more often the left; neck or mandibular pain or aching confined to the shoulder, wrist, elbow, or forearm may manifest solely or with typical chest pressure; small zones of pain are generally not of myocardial origin; radiation of pain to the digits, brief zaplets of pain or discomfort that persists for days are not due to myocardial ischemia; effort or emotional stress commonly provokes angina; angina may occur at rest if perfusion is compromised; pain subsides within 1 to 5 mins if the triggering activity is discontinued; nitroglycerin hastens this relief
EKG The 12-lead ECG has limited value in excluding the presence of CAD; excluding the Dx of angina pectoris or acute MI because of a normal ECG is as great an error as inferring a diagnosis of CAD from the incorrect interpretation of nonspecific electrocardiographic abnormalities
Cocaine Cocaine causes ↓ coronary blood flow due to vasoconstriction; rhabdomyolysis, a complication of cocaine use, provides another mechanism for the chest pain; all chest painers should be questioned about cocaine use and, when appropriate, have a urine drug screen
GI tract Pain from the GI tract, especially the esophagus, may give rise to angina-like chest discomfort; GERD is the most common esophageal cause of noncardiac chest pain; it is described as a burning sensation or squeezing pain located in the retrosternal area between the xyphoid and suprasternal notch; listen for clues about association of Sx with meals, posture, and relief by belching or antacids; medical management involves dietary modifications, smoking cessation, and histamine type 2 (H2) antagonists or antacids; GI referral is warranted when these interventions are unsuccessful in alleviating Sx; the pain of peptic ulcer disease may also occur high in the epigastrium or lower chest; relationship
to meals and relative nonresponse to nitroglycerine helps distinguish this pain from
angina pectoris
Esophagus spasm Diffuse esophageal spasm is a neuromuscular disorder characterized by chest pain and difficulty in swallowing; NOTE Nitroglycerin promptly relieves esophageal spasm causing confusion in the diagnosis; vigorous disordered contractions in the body of the esophagus are induced by ingestion of cold liquids or normal swallowing during a meal; anxiety and stress are also common precipitating factors; there is usually no exertional component but ↑ abdominal pressure from lifting, sit-ups, or running can cause reflux; diagnosis rests on history and verification of esophageal spasm by manometric studies
Pulmonary origin Pain of pulmonary origin characteristically has a distinct pleuritic quality varying with the respiratory cycle; intercostal nerves supply sensory afferents to the costal parietal pleura; inflammation arising from this region is appreciated in the adjacent chest wall; referred pain originating in the diaphragm is appreciated in the ipsilateral shoulder; differentiating features of pulmonic from musculoskeletal pain are the more intense nature of pleuritic pain and the worsening of musculoskeletal pain by extension, abduction, or adduction of the arm and shoulder; pain centered around involved muscle groups may also distinguish musculoskeletal from pleuritic chest pain; (a) Spontaneous pneumothorax tends to occur in young adult males producing sharp pleuritic chest discomfort and dyspnea; (b) Pulmonary embolus may produce pleuritic pain, however, dyspnea, and tachypnea are most frequent. Inciting factors for pulmonary embolus include the post-operative period after long recumbent or inactive periods and following trauma where the same immobility may result in venous stasis and thrombosis.
Chest wall Tietze's syndrome or costochondritis is a self-limiting discomfort. Its quality is sharp or burning and is exacerbated by mechanical activity of the chest wall, specifically respiration; the second or third costal cartilages on either side are the most common area of involvement, but any of the costochondral articulations can be involved; NSAIDs or aspirin may offer temporary relief but reassurance tends to be as useful.
Etc Rarely, no etiology is found on standard evaluation of chest pain from the cardiology or GI consultation; one should then rule out panic disorder, visceral hypersensitivity in irritable bowel syndrome, and other exotica

chest wall

(chest wawl)
respiratory physiology the total system of structures outside the lungs that move as a part of breathing; it comprises the rib cage, diaphragm, abdominal wall, and abdominal contents.
Synonym(s): thoracic wall.
References in periodicals archive ?
Our data indicate that although L-type calcium channels may exhibit mechanosensitive properties and maybe activated by forceful chest wall impact, they do not play an integral role in the initiation of VF in commotio cordis.
Fibrous hamartomas of the chest wall are unusual subcutaneous lesions most commonly affecting infants.
In our case, the patient developed a large mass in the left anterior chest wall. CT scans of the chest revealed bony involvement of the sternum and pleural invasion.
The above devices are considered direct competitors to the device that is featured in this article, which, Mr Aaron Casha, cardiothoracic surgeon, Mater Dei Hospital, and lecturer, University of Malta, points out: "can be extended to stabilising the chest wall in operations repairing pigeon chest and funnel chest deformities: and also for repair of broken sternotomy incisions after cardiac surgery when the sternal bone is in pieces and cannot hold wires." * http://www.ctsnet.org/sections/clinicalresources/thoracic/expert_tech-43
There are geometric differences in the breast tissue structures of patients who have been diagnosed with left-sided breast cancer and whose chest wall radiotherapy is applied; and these differences may have an impact on the resulting dose distribution (14).
The patient had neither chest wall instability nor infectious complications postoperatively and no local recurrence has been noted over 43 months of follow-up (Figure-3).
(1) published an analysis of 100 cases based on evaluation of preoperative photographs, and they reported asymmetries of the nipple areola position in 53%, breast mound volume in 44%, and chest wall in 9% of the cases.
Robicsek (21) questioned the safety of the Nuss procedure in young children and maintained that the transfixion of the anterior chest wall with rigid metal bars in children might indeed cause the same damage as radical cartilage resection in the Ravitch technique through restricting the growth and expansion of the thoracic cage.
Keywords: Chest Wall Reconstruction, Chest Wall Tumors, Latissimus dorsi flap, Pedicled flap, Polypropylene mesh.
Her husband reached a year clear of cancer this week, surviving an aggressive melanoma which was removed from his chest wall in a five-hour operation last year.
A GRANDFATHER has become the first person in Wales to have his chest wall rebuilt with a 3D-printed prosthesis.