Causes of Shoulder injury
Shoulder injury Causes: Book Excerpts
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Retractions, costal and sternal:
Medical causes
(Handbook of Signs & Symptoms (Third Edition))
Asthma attack
Intercostal and suprasternal retractions may accompany an asthma attack. They’re preceded by dyspnea, wheezing, a hacking cough, and pallor. Related features include cyanosis or flushing, crackles, rhonchi, diaphoresis, tachycardia, tachypnea, a frightened, anxious expression and, in patients with severe distress, nasal flaring.
Epiglottiditis. Epiglottiditis is a life-threatening bacterial infection that may precipitate severe respiratory distress with suprasternal, substernal, and intercostal retractions; stridor; nasal flaring; cyanosis; and tachycardia. Early features include a sudden onset of a barking cough and high fever, a sore throat, hoarseness, dysphagia, drooling, dyspnea, and restlessness. The child becomes panicky as edema makes breathing difficult. Total airway occlusion may occur in 2 to 5 hours.
Heart failure
Usually linked to a congenital heart defect in children, heart failure may cause intercostal and substernal retractions along with nasal flaring, progressive tachypnea, and — in severe respiratory distress — grunting respirations, edema, and cyanosis. Other findings include a productive cough, crackles, jugular vein distention, tachycardia, right upper quadrant pain, anorexia, and fatigue.
Laryngotracheobronchitis (acute)
With laryngotracheobronchitis, a viral infection, substernal and intercostal retractions typically follow a low to moderate fever, runny nose, poor appetite, a barking cough, hoarseness, and inspiratory stridor. Associated signs and symptoms include tachycardia; shallow, rapid respirations; restlessness; irritability; and pale, cyanotic skin.
Pneumonia (bacterial)
Pneumonia begins with signs and symptoms of acute infection, such as a high fever and lethargy, which are followed by subcostal and intercostal retractions, nasal flaring, dyspnea, tachypnea, grunting respirations, cyanosis, and a productive cough. Auscultation may reveal diminished breath sounds, scattered crackles, and sibilant rhonchi over the affected lung. GI effects may include vomiting, diarrhea, and abdominal distention.
Respiratory distress syndrome
Substernal and subcostal retractions are an early sign of respiratory distress syndrome, a life-threatening syndrome, which affects premature neonates shortly after birth. Associated early signs include tachypnea, tachycardia, and expiratory grunting. As respiratory distress worsens, intercostal and suprasternal retractions typically occur, and apnea or irregular respirations replace grunting. Other effects include nasal flaring, cyanosis, lethargy, and eventual unresponsiveness as well as bradycardia and hypotension. Auscultation may detect crackles over the lung bases on deep inspiration and harsh, diminished breath sounds. Oliguria and peripheral edema may occur.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Retractions, costal and sternal:
Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))
Asthma attack
Intercostal and suprasternal retractions may accompany an asthma attack. They’re preceded by dyspnea, wheezing, a hacking cough, and pallor. Related features include cyanosis or flushing, crackles, rhonchi, diaphoresis, tachycardia, tachypnea, a frightened, anxious expression and, in patients with severe distress, nasal flaring.
Bronchiolitis
Most common in children younger than age 2, this acute lower respiratory tract infection may cause intercostal and subcostal retractions, nasal flaring, tachypnea, dyspnea, cough, restlessness and a slight fever. Periodic apnea may occur in infants younger than age 6 months.
Croup (spasmodic)
This disorder causes attacks of a barking cough, hoarseness, dyspnea, and restlessness. As distress worsens, the child may display suprasternal, substernal, and intercostal retractions; nasal flaring; tachycardia; cyanosis; and an anxious, frantic expression. Croup attacks usually subside within a few hours but tend to recur.
Epiglottiditis
This life-threatening bacterial infection may precipitate severe respiratory distress with suprasternal, substernal, and intercostal retractions; stridor; nasal flaring; cyanosis; and tachycardia. Early features include sudden onset of a barking cough and high fever, sore throat, hoarseness, dysphagia, drooling, dyspnea, and restlessness. The child becomes panicky as edema makes breathing difficult. Total airway occlusion may occur in 2 to 5 hours.
Heart failure
Usually linked to a congenital heart defect in children, this disorder may cause intercostal and substernal retractions along with nasal flaring, progressive tachypnea, and—in severe respiratory distress—grunting respirations, edema, and cyanosis. Other findings include productive cough, crackles, jugular vein distention, tachycardia, right-upper-quadrant pain, anorexia, and fatigue.
Laryngotracheobronchitis (acute)
With this viral infection, substernal and intercostal retractions typically follow a low to moderate fever, runny nose, poor appetite, a barking cough, hoarseness, and inspiratory stridor. Associated signs and symptoms include tachycardia; shallow, rapid respirations; restlessness; irritability; and pale, cyanotic skin.
Pneumonia (bacterial)
This disorder begins with signs and symptoms of acute infection, such as high fever and lethargy, which are followed by subcostal and intercostal retractions, nasal flaring, dyspnea, tachypnea, grunting respirations, cyanosis, and a productive cough. Auscultation may reveal diminished breath sounds, scattered crackles, and sibilant rhonchi over the affected lung. GI effects may include vomiting, diarrhea, and abdominal distention.
Respiratory distress syndrome
Substernal and subcostal retractions are an early sign of this life-threatening syndrome, which affects premature infants shortly after birth. Associated early signs include tachypnea, tachycardia, and expiratory grunting. As respiratory distress worsens, intercostal and suprasternal retractions typically occur, and apnea or irregular respirations replace grunting. Other effects include nasal flaring, cyanosis, lethargy, and eventual unresponsiveness as well as bradycardia and hypotension. Auscultation may detect crackles over the lung bases on deep inspiration and harsh, diminished breath sounds. Oliguria and peripheral edema may occur.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Retractions, costal and sternal:
Medical causes
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Asthma attack
Intercostal and suprasternal retractions may accompany an asthma attack. They’re preceded by dyspnea, wheezing, a hacking cough, and pallor. Related features include cyanosis or flushing, crackles, rhonchi, diaphoresis, tachycardia, tachypnea, a frightened, anxious expression and, in patients with severe distress, nasal flaring.
Bronchiolitis
Most common in children younger than age 2 years, bronchiolitis is an acute lower respiratory tract infection that may cause intercostal and subcostal retractions, nasal flaring, tachypnea, dyspnea, cough, restlessness, and slight fever. Periodic apnea may occur in infants younger than age 6 months.
Croup (spasmodic)
Croup causes attacks of a barking cough, stridor, inspiratory crackles, expiratory wheezing, hoarseness, dyspnea, and restlessness. As distress worsens, the child may display suprasternal, substernal, and intercostal retractions accompanied by nasal flaring, tachycardia, cyanosis, and an anxious, frantic expression. Croup attacks usually subside within a few hours but tend to recur and may require intubation.
Epiglottiditis
A life-threatening bacterial infection, epiglottiditis may precipitate severe respiratory distress with suprasternal, substernal, and intercostal retractions as well as stridor, nasal flaring, cyanosis, and tachycardia. Early features include the sudden onset of a barking cough and high fever, sore throat, hoarseness, dysphagia, drooling, dyspnea, and restlessness. The child becomes panicky as edema makes breathing difficult. Total airway occlusion may occur in 2 to 5 hours.
Heart failure
Usually linked to a congenital heart defect in children, heart failure may cause intercostal and substernal retractions along with nasal flaring, progressive tachypnea and, in severe respiratory distress, grunting respirations, edema, and cyanosis. Other findings include productive cough, crackles, jugular vein distention, tachycardia, right upper quadrant pain, anorexia, and fatigue.
Laryngotracheobronchitis (acute)
A viral infection, substernal and intercostal retractions typically follow low to moderate fever, runny nose, poor appetite, barking cough, hoarseness, and inspiratory stridor. Associated signs and symptoms include shallow, rapid respirations as well as tachycardia, restlessness, irritability, and pale, cyanotic skin.
Pneumonia (bacterial)
Bacterial pneumonia begins with signs and symptoms of acute infection, such as high fever and lethargy, which are followed by subcostal and intercostal retractions, nasal flaring, dyspnea, tachypnea, grunting respirations, cyanosis, and a productive cough. Auscultation may reveal diminished breath sounds, scattered crackles, and sibilant rhonchi over the affected lung. GI effects may include vomiting, diarrhea, and abdominal distention.
Respiratory distress syndrome
Substernal and subcostal retractions are an early sign of respiratory distress syndrome — a life-threatening condition that affects premature neonates shortly after birth. Associated early signs include tachypnea, tachycardia, and expiratory grunting. As respiratory distress worsens, intercostal and suprasternal retractions typically occur, and apnea or irregular respirations replace grunting. Other effects include nasal flaring, cyanosis, lethargy, and eventual unresponsiveness as well as bradycardia and hypotension. Auscultation may detect crackles over the lung bases on deep inspiration and harsh, diminished breath sounds. Oliguria and peripheral edema may occur.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Retractions, costal and sternal:
Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Asthma attack
Intercostal and suprasternal retractions may accompany an asthma attack. They’re preceded by dyspnea, wheezing, a hacking cough, and pallor. Related features include cyanosis or flushing, crackles, rhonchi, diaphoresis, tachycardia, tachypnea, a frightened, anxious expression and, in patients with severe distress, nasal flaring.
Bronchiolitis
Most common in children younger than age 2, bronchiolitis — an acute lower respiratory tract infection — may cause intercostal and subcostal retractions, nasal flaring, tachypnea, dyspnea, cough, restlessness and a slight fever. Periodic apnea may occur in infants younger than age 6 months.
Croup (spasmodic)
Spasmodic croup causes attacks of a barking cough, hoarseness, dyspnea, and restlessness. As distress worsens, the child may display suprasternal, substernal, and intercostal retractions; nasal flaring; tachycardia; cyanosis; and an anxious, frantic expression. Croup attacks usually subside within a few hours but tend to recur.
Epiglottiditis
Epiglottiditis, a life-threatening bacterial infection, may precipitate severe respiratory distress with suprasternal, substernal, and intercostal retractions; stridor; nasal flaring; cyanosis; and tachycardia. Early features include sudden onset of a barking cough and high fever, sore throat, hoarseness, dysphagia, drooling, dyspnea, and restlessness. The child becomes panicky as edema makes breathing difficult. Total airway occlusion may occur in 2 to 5 hours.
Heart failure
Usually linked to a congenital heart defect in children, heart failure may cause intercostal and substernal retractions along with nasal flaring, progressive tachypnea, and — in severe respiratory distress — grunting respirations, edema, and cyanosis. Other findings include productive cough, crackles, jugular vein distention, tachycardia, right-upper-quadrant pain, anorexia, and fatigue.
Laryngotracheobronchitis (acute)
With acute laryngotracheobronchitis (a viral infection), substernal and intercostal retractions typically follow a low to moderate fever, runny nose, poor appetite, a barking cough, hoarseness, and inspiratory stridor. Associated signs and symptoms include tachycardia; shallow, rapid respirations; restlessness; irritability; and pale, cyanotic skin.
Pneumonia (bacterial)
Bacterial pneumonia begins with signs and symptoms of acute infection, such as high fever and lethargy, which are followed by subcostal and intercostal retractions, nasal flaring, dyspnea, tachypnea, grunting respirations, cyanosis, and a productive cough. Auscultation may reveal diminished breath sounds, scattered crackles, and sibilant rhonchi over the affected lung. GI effects may include vomiting, diarrhea, and abdominal distention.
Respiratory distress syndrome
Substernal and subcostal retractions are an early sign of respiratory distress syndrome, a life-threatening disorder that affects premature neonates shortly after birth. Associated early signs include tachypnea, tachycardia, and expiratory grunting. As respiratory distress worsens, intercostal and suprasternal retractions typically occur, and apnea or irregular respirations replace grunting. Other effects include nasal flaring, cyanosis, lethargy, and eventual unresponsiveness as well as bradycardia and hypotension. Auscultation may detect crackles over the lung bases on deep inspiration and harsh, diminished breath sounds. Oliguria and peripheral edema may occur.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Retractions, costal and sternal:
Medical causes
(Nursing: Interpreting Signs and Symptoms)
Asthma.Intercostal and suprasternal retractions may accompany an asthma attack. They're preceded by dyspnea, wheezing, a hacking cough, and pallor. Related features include cyanosis or flushing, crackles, rhonchi, diaphoresis, tachycardia, tachypnea, a frightened, anxious expression and, in patients with severe distress, nasal flaring.
Epiglottiditis.Epiglottiditis is a life-threatening bacterial infection that may precipitate severe respiratory distress with suprasternal, substernal, and intercostal retractions; stridor; nasal flaring; cyanosis; and tachycardia. Early features include a sudden onset of a barking cough and high fever, a sore throat, hoarseness, dysphagia, drooling, dyspnea, and restlessness. The child becomes panicky as edema makes breathing difficult. Total airway occlusion may occur in 2 to 5 hours.
Heart failure.Usually linked to a congenital heart defect in children, heart failure may cause intercostal and substernal retractions along with nasal flaring, progressive tachypnea, and—in severe respiratory distress—grunting respirations, edema, and cyanosis. Other findings include a productive cough, crackles, jugular vein distention, tachycardia, right upper quadrant pain, anorexia, and fatigue.
Laryngotracheobronchitis (acute).With laryngotracheobronchitis, substernal and intercostal retractions typically follow a low to moderate fever, runny nose, poor appetite, a barking cough, hoarseness, and inspiratory stridor. Associated signs and symptoms include tachycardia; shallow, rapid respirations; restlessness; irritability; and pale, cyanotic skin.
Pneumonia (bacterial).Pneumonia begins with signs and symptoms of acute infection, such as a high fever and lethargy, which are followed by subcostal and intercostal retractions, nasal flaring, dyspnea, tachypnea, grunting respirations, cyanosis, and a productive cough. Auscultation may reveal diminished breath sounds, scattered crackles, and sibilant rhonchi over the affected lung. GI effects may include vomiting, diarrhea, and abdominal distention.
Respiratory distress syndrome.Substernal and subcostal retractions are an early sign of respiratory distress syndrome, a life-threatening syndrome, which affects premature neonates shortly after birth. Associated early signs include tachypnea, tachycardia, and expiratory grunting. As respiratory distress worsens, intercostal and suprasternal retractions typically occur, and apnea or irregular respirations replace grunting. Other effects include nasal flaring, cyanosis, lethargy, and eventual unresponsiveness as well as bradycardia and hypotension. Auscultation may detect crackles over the lung bases on deep inspiration and harsh, diminished breath sounds. Oliguria and peripheral edema may occur.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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