flail

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flail

 [flāl]
exhibiting abnormal or pathologic mobility, such as a flail chest or a flail joint.
flail chest a loss of stability of the chest wall due to three or more ribs that are broken in two or more places as a result of a crushing chest injury. The loose chest segment moves in a direction in the reverse of normal; that is, the segment moves inward during inhalation and outward during exhalation (paradoxical respiration). Other manifestations include shortness of breath, cyanosis, and extreme pain in the area of trauma.

Emergency treatment is aimed at stabilizing the loose chest segment to reduce ineffective and exhausting chest movement and provide for adequate ventilation of the lungs. The patient is transported lying on the affected side to further stabilize the chest wall and enable the use of the unaffected side for respiration.
Flail chest. A, Inspiration. As intrapleural pressure becomes increasingly negative, the flail segment and its underlying lung tissue are sucked inward, collapsing the lung on the affected side and shifting the mediastinum toward the unaffected side. B, Expiration. As intrapleural pressure becomes less negative, the flail segment and underlying tissue are pushed outward, and the mediastinum shifts to the affected side. Some air moves between the lungs instead of passing through the upper airways. Large arrows indicate structural movement; dashed arrows indicate abnormal air movement; small arrows indicate normal air movement; open arrows indicate flail segment movement. From Kitt et al., 1995.
References in periodicals archive ?
flailed for months and ultimately failed to arrest him.