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Intercostal retractions

Definition:

Intercostal retractions occur when the muscles between the ribs pull inward. The movement is most often a sign that the person has a breathing problem.

Intercostal retractions are a medical emergency.



Alternative Names:

Retractions of the chest muscles



Considerations:

The wall of your chest is flexible. This helps you breathe normally. Stiff tissue called cartilage attaches your ribs to the breast bone (sternum).

The intercostal muscles are the muscles between the ribs. During breathing, these muscles normally tighten and pull the rib cage up. Your chest expands and the lungs fill with air.

Intercostal retractions are due to reduced air pressure inside your chest. This can happen if the upper airway (trachea) or small airways of the lungs (bronchioles) become partially blocked. As a result, the intercostal muscles are sucked inward, between the ribs, when you breathe. This is a sign of airway obstruction . Any diseases or condition that causes a blockage in the airway will cause intercostal retractions.



When to Contact a Medical Professional:

Seek medical attention right away if intercostal retractions occur. This can be a sign of airway blockage obstruction, which can quickly become life threatening.

Also seek medical care if the skin, lips, or nailbeds turn blue, or if the person becomes confused , drowsy , or is hard to wake up.



What to Expect at Your Office Visit:

In emergency situations, the health care team will first take steps to help you breathe. You may receive oxygen, medicines to reduce swelling, and other treatments.

When you can breathe better, the doctor or nurse will examine you and ask questions about your medical history and symptoms, such as:

  • When did the problem start?
  • Is it getting better, worse, or staying the same?
  • Does it occur all the time?
  • Did you notice anything significant that might have caused an airway obstruction?
  • What other symptoms are there, such as blue skin color, wheezing, high-pitched sound when breathing, coughing or sore throat?
  • Has anything been breathed into the airway?

Tests that may be done include:



References:

Watts KD, Goodman DM. Wheezing, bronchiolitis, and bronchitis. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 383.




Review Date: 5/14/2014
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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Atlantic Medical Group
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Morristown Medical Center

100 Madison Avenue
Morristown, NJ 07960
973-971-5000

Overlook Medical Center

99 Beauvoir Avenue
Summit, NJ 07901
908-522-2000

Newton Medical Center

175 High Street
Newton, NJ 07860
973-383-2121

Chilton Medical Center

97 West Parkway
Pompton Plains, NJ 07444
973-831-5000

Goryeb Children's Hospital

100 Madison Avenue
Morristown, NJ 07960
973-971-5000

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