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Friday, November 23, 2012

Barrel shaped chest


Barrel shaped chest is commonly encountered in the clinical setting. It is seen in emphysema, hence also called as emphysematous chest. The anteroposterior diameter is increased (normally transverse:AP diameter is 7:5). The subcostal angle is wide (usually it is acute at around 70 degrees). The angle of Louis is unduly prominent with the sternum more arched. The spine is concave forwards and the ribs are less oblique.

The respiratory movements are diminished bilaterally, with the mediastinum remaining in the central position. On percussion, the lung is hyper-resonant. On auscultation, there is a diminished vesicular breathing with a prolonged expiration. Rhonchi may be present.

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