Barrel chest

Observation of the patient may reveal use of accessory muscles of respiration (manifested as paradoxical movements of the chest and abdomen, in a "see-saw"-type motion), pursed-lips breathing, and hyperinflation of the chest with increased anterior-posterior diameter ("barrel chest"). 

Signs of obstructive airway disease include tachypnea, dyspnea, cyanosis, wheezes, crackles, sternal retractions, digital clubbing, and barrel chest. 

Increase in the anteroposterior diameter of the thoracic cage (observed as a barrel chest)... 

Initial symptoms of COPD include chronic cough and sputum production patients may have these symptoms for several years before dyspnea develops. The physical examination is normal in most patients who present in the milder stages of COPD. When airflow limitation becomes severe, patients may have cyanosis of mucosal membranes, development of a barrel chest due to hyperinflation of the lungs, an increased resting respiratory rate, shallow breathing, pursing of the lips during expiration, and use of accessory respiratory muscles. 

A man approaches you with his hand on his gun. He stands six feet tall, with a barrel chest and rock-hard belly to match. His cheeks look as if they d been sandblasted. The arms of his camouflage suit are torn off, revealing muscular arms decorated with faded green tattoos that run from his wrists to his biceps. His huge hands are scarred and soaked with sweat. With slow, deliberate movements, the man removes a black head-band from his pocket and ties it around his forehead. 

In patients with chronic obstructive lung disease, air becomes trapped in the lung and total lung volume gradually increases. As the disease progresses, the chest permanently enlarges and the shoulders rise this shape is often referred to as a barrel chest. 

In a chapter titled Gardens and Gardening, Clark observed that the Hunza diet was deficient in oils and vitamin D, as a result of which they have soft teeth, with about half the population exhibiting barrel chests and rheumatic knees, the mark of subclinical rickets (Clark, 1956, p. 205). He offers the sarcasm, Happy healthy Hunza, where everyone has just enough Nowhere, apparently, does Clark mention the long life spans usually attributed to the Hunzas. 

Observation of the chest wall will reveal any asymmetry of its structures. One should note the typical barrel chest of chronic pulmonary diseases. Retraction of the intercostal muscles or use of the accessory muscles of respiration [scalenes, sternocleldomastolds] can Indicate the severity of respiratory difficulty, especially In status asth-matlcus. The rate of respiration and the degree to which the patient uses abdominal versus thoracic breathing should be noted. The physician should Inspect for any signs of trauma to the thoracic cage, as well as any surgical scars. 

On physical examination, he appeared moderately distressed with a rapid respiratory rate. A.L. s thorax was "barrel-chested," with the anteroposterior diameter of his chest equal to the transverse diameter. His lungs exhibited scattered crackles throughout the lung fields bilaterally. The heart rhythm was regular, with a rate of eighty. Otherwise his physical examination was within normal limits for a person his age. 

Protuberant abdomen with exaggerated lumbar lordosis, usually an asthenic appearance with rather long extremities and tapered fingers, and frequently a barrel-shaped chest... 

Spumes of flame lanced out from the barrel and the miniature warheads exploded deep in each man s chest plate, sending them staggering back, rifles and arms flailing. Razum had his man in a neck-hold and finished him with a bone-crunching twist. Magnesium flame licked around the rims of each crater in Angel s two victims. 

The sieve is hung on straps from the ceiling and is kept in oscillating motion by means of an eccentric driven from a compartment adjacent to that in which the screening installation is located. The end product is transported in leakproof chests or in paper-lined barrels. 

Musculoskeletal changes occur during the course of the disease. The chest assumes a barrel shape in which the anteroposterior (AP) diameter equals the transverse diameter. The accessory muscles of respiration gradually hypertrophy. Hypertrophic scalene muscles may impinge on neurovascular structures passing between or near them. Rib motion is markedly restricted and eventually contributes to the dyspnea. The thoracic spine becomes kyphotic and immobile. Motion of the diaphragm is restricted. 

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