Three concave sign

Introduction The upper airway obstruction of the patient is caused by the movement of the respiratory muscles during inhalation, and the negative pressure in the chest is extremely increased. The upper sternum, the supraclavicular fossa and the intercostal space are obviously depressed, which is called the three concave sign. "Three-concave disease" means that breathing is extremely difficult. The muscles of the auxiliary respiratory muscles, such as the chest and abdomen, are strongly exercised to assist the respiratory activity. At this time, although the attempt to expand the thorax is used to increase the inspiratory volume, it is difficult to inhale due to the gas in the lungs. The expansion causes the sternal fossa, the supraclavicular fossa on both sides, and the lower intercostal space to be concave when inhaling, so it is called "three depressions". It can also be accompanied by dry cough and high-intensity inspiratory throat. Common in the throat, trachea, bronchial stenosis and obstruction. Left heart failure is indicated when accompanied by cyanosis, double lung wet rales, and increased heart rate.

Cause

The upper airway is obstructed, and the negative pressure in the chest is extremely increased due to the movement of the respiratory muscles during inhalation.

an examination

Related inspection

Lung imaging lung examination lung and pleural auscultation

Extremely difficult breathing, assisted respiratory muscles such as the chest and abdomen muscles are strongly exercised to assist breathing activities. At this time, although the attempt to expand the thorax to increase the inspiratory volume, but the lung gas is difficult to inhale, it cannot expand, resulting in inhalation. It can be seen that the upper and lower sternum, the clavicle on both sides and the lower intercostal space are all concave. At this time, dry cough and high-intensity inspiratory throat can also be accompanied. Common in the throat, trachea, bronchial stenosis and obstruction.

Differential diagnosis

Pulmonary dyspnea: caused by respiratory disease, mainly in the following three forms:

1, inspiratory dyspnea: manifested as wheezing, inhalation of the sternum, supraclavicular fossa and rib gap depression - three concave sign. Common in the throat, tracheal stenosis, such as inflammation, edema, foreign bodies and tumors.

2, expiratory breathing difficulties: exhalation prolonged, accompanied by wheezing sound, seen in bronchial asthma and obstructive pulmonary disease.

3, mixed dyspnea: seen in pneumonia, pulmonary fibrosis, a large number of pleural effusion, pneumothorax and so on.

It is characterized by obvious depression of the sternal fossa, supraclavicular fossa and rib space. At this time, it can also be accompanied by dry cough and high-intensity inspiratory throat. Common in the throat, trachea, bronchial stenosis and obstruction.

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