Case

A 51 year old patient comes into your clinic complaining of mild chest pain. The patient describes that the mild pain is worse when inhaling deeply and when twisting their torso. A CT scan shows no evidence of fractures. On physical examination the space between the patient’s 5th and 6th ribs on the right anterolateral side is also sore to the touch. The patient notices that whenever they breath there is bulging or depression between those ribs.

Question 2/2 - What would happen when you ask the patient to inhale?

Click on your selected option(s) below  (correct = 1, over-thinking = 2+)

Case Complete

Correct. Due to negative thoracic pressure when inhaling and lack of a taut intercostal space the tissue will 'suck in' slightly in inhalation.

Incorrect. When inhaling there is negative thoracic pressure and the tissue of the intercostal space will 'suck in' rather than bulge. 

Incorrect. When inhaling there is negative thoracic pressure and the tissue of the intercostal space will 'suck in'. Only at a pressure equal to the ambient pressure (i.e. when holding a breath) will the chest wall be flat. 

Incorrect, although technically there is a extremely small (i.e. essentially unmeasurable) reduction in the ability of the lung to fill due to the decrease in volume from the lack of a taught intercostal space. The difference introduced by a single intercostal space is negligible and would have no functional or clinical significance.

Incorrect. The volumetric difference introduced by a single intercostal space is negligible and if present would not yield additional thoracic volume. Indeed, if anyting it woudl be an extremely small reduction in the ability of the lung to fill due to the decrease in volume from the lack of a taught intercostal space.