Two of the symptoms of<unk>  are<unk>  pain and shortness of breath. The characteristic paradoxical motion of the<unk>  segment occurs due to pressure changes associated with respiration that the rib cage normally resists: * During normal inspiration, the diaphragm contracts and intercostal muscles pull the rib cage out. Pressure in the thorax decreases below atmospheric pressure, and air rushes in through the trachea. The<unk>  segment will be pulled in with the decrease in pressure while the rest of the rib cage expands. * During normal expiration, the diaphragm and intercostal muscles relax increasing internal pressure, allowing the abdominal organs to push air upwards and out of the thorax. However, a<unk>  segment will also be pushed out while the rest of the rib cage contracts. Paradoxical motion is a late sign of<unk>  segment; therefore, an absence of paradoxical motion does not mean the patient does not have a<unk>  segment. The constant motion of the ribs in the<unk>  segment at the site of the fracture is extremely painful, and, untreated, the sharp broken edges of the ribs are likely to eventually puncture the pleural sac and lung, possibly causing a pneumothorax. The concern about "mediastinal flutter" (the shift of the mediastinum with paradoxical diaphragm movement) does not appear to be merited. Pulmonary contusions are commonly associated with<unk>  and that can lead to respiratory<unk> ure. This is due to the paradoxical motions of the<unk>  wall from the fragments interrupting normal breathing and<unk>  movement. Typical paradoxical motion is associated with stiff lungs, which requires extra work for normal breathing, and increased lung resistance, which makes air flow difficult. The respiratory<unk> ure from the<unk>  requires mechanical ventilation and a longer stay in an intensive care unit. It is the damage to the lungs from the<unk>  segment that is life-threatening.
Flail chest
Diaphragmatic rupture
Hemothorax
Urinothorax
Pulmonary contusion
Chylothorax
Pneumopericardium
Hydropneumothorax