The chest
The chest is a cage of breastbone, ribs and vertebrae, covered with muscles, ligaments and skin. In its external aspect, the chest includes the breasts, ribs, breastbone and upper spine, while internally it houses and protects the heart, lungs and esophagus.
Examination of the External Chest
Stand unclothed to the waist before a full-length mirror, breathe normally and make the following observations:
1. The breastbone has a bony ridge two inches from its top, called the sternal angle, but is otherwise flat from top to bottom where the ribs join. A small tender bone called the “ziphoid process,” can be felt here. Deformities may result
in pigeon breast, funnel chest or emphysema.
2. The rib cage is somewhat bell-shaped, and breathing should produce painless and equal rib motion on both
sides. Limited or painful motion on one side may mean lung diseases, such as tuberculosis, lung abscess, bronchi-
ectasis, pneumonia, pleurisy, or disease of the rib joint itself- Tietze’s Syndrome.
3. In right-handed people, the right shoulder is lower than the left, but a great difference in shoulder level may mean curvature of the spine.
4. With the fingertips, press tightly against the ribs along the sides of the breastbone; painful spots in this region may indicate Tietze’s Syndrome, a form of arthritis. *
Fig. 33. The chest is a most vital region. The breast, heart, lungs, giant blood vessels, rib cage and swallowing tube may cause difficulties here. Disease in this region is hard to hide because pain and other symptoms are noticeable early.