Barrel Chest is the medical term used to describe a condition in which a person’s chest is inflated as if taking a deep breath. Normally, a person’s ribcage is bilaterally wide and anteroposteriorly narrow with an anterior to posterior/bilateral size ratio of 0.7 to 0.75. In a person with a barrel-shaped ribcage, an increased anterior posterior dimension causes this ratio to rise above 0.9 .

I. Definition

– Is the ratio between the anterior and posterior diameters of the transverse diameter > 0.9. Normal The anteroposterior diameter is smaller than the transverse diameter and the ratio ranges from 0.7 to 0.75.

– Lowered diaphragm (on radiograph).

– The sternum is pushed forward.

– The ribs are horizontal.

2. Cause:

The ribcage has two opposing forces that expand the ribcage, participate in the breathing process and create the shape of the ribcage. A force that causes the ribcage to expand due to contraction of the sternocleidomastoid, external intercostal, and trapezius muscles. A force that makes the chest smaller is created by the internal intercostal muscles, the rectus abdominis muscle, the elastic tissues in the chest, and the lung parenchyma. Pathological or physiological changes of these two forces, increasing the anteroposterior size of the thorax, can all cause a barrel-shaped rib cage. Some causes include:

1. Common causes:

– Asthma

– Chronic bronchitis

– Emphysema gas

2. Uncommon causes:

– Bronchiectasis

– Cystic fibrosis

– Alpha 1 antitrypsin deficiency

Lutz-Rhichter-Landolt . syndrome

– Kniesta dysplasia

– Dyggve-Melchior-Clausen syndrome

– Diaphragm hernia

– Silicon lung dust

– Osteoarthritis

Type VIII vitreous bone

– Barrel ribcage can also be seen in people who live long in places with low atmospheric pressure such as in high mountains above 5500m.

3. Mechanism:

– First: the chest always expands during inhalation and exhalation. When the thorax has to be stretched too much for a long time (maximum inspiration), it makes the accessory respiratory muscles such as the trapezius and sternocleidomastoid overwork, the levator rib and sternum muscles. This long-term operation causes structural changes of the thorax –> an increase in the anterior and posterior dimensions of the thorax can cause a barrel-shaped rib cage.

– Second: Because of the air in, we cannot breathe out completely, making the patient try to breathe harder to maintain ventilation (as in emphysema). A lot of air enters the lungs, but the exhalation is not complete, causing stagnation, day after day, eventually causing the patient’s chest to expand in an anteroposterior direction.

See also: Drumstick finger (Hippocratic finger)

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