Smooth nail surface is a sign of health. Once a number of prismatic stripes are raised on the nails, it means that the body is abnormal, and the already sick or latent diseases will break out.
Some people have several prismatic vertical paths on their nails, which is also a sign of abnormal body. Such people are depressed, tired and weak, and generally suffer from nervous system weakness, brain system diseases and alcohol and drug poisoning.
1, healthy people's nails are beautiful pink.
2, the nails are pale and bloodless, suggesting anemia, blood cold, qi and blood loss, and hypotension.
3, blue nails, suggesting insufficient blood supply, hypoxia, arteriosclerosis, hyperlipidemia.
For people who are close to death, their nails often turn black from the fingertips of the roots, grow into a straight line, and finally die.
5, blue nails lack oxygen, too green, blue may be congestion or cardiac stagnation, is a malignant nail.
6, blue nails are severe cold syndrome, blood stasis. Blue and black indicate critical illness.
7, yellow nails are jaundice, hepatobiliary diseases, this person may be a smoker, there are signs of chronic diseases.
8, there are white spots on the nail bed, suggesting that the body lacks calcium, silicon, or parasites. Drug or nicotine poisoning can also lead to leukoplakia. People with white nails are prone to fatigue or chronic habitual constipation. White spots appear in the middle finger, suggesting that the spine is calcium deficient and osteoporosis, which is prone to waist and leg diseases or fractures.
The diagnosis of rib fracture is mainly based on the history of trauma, clinical manifestations and chest X-ray examination.
1. Symptoms
Occasionally, due to severe coughing or sneezing, the pectoral muscles suddenly contract strongly, resulting in rib fracture, which is called spontaneous rib fracture. Mostly in the sixth to ninth ribs of the armpit. When the rib itself is diseased, such as primary tumor or metastatic tumor, rib fracture can also occur with little or no external force, which is called pathological rib fracture.
Rib fractures mostly occur in the 4 th to 7 th ribs; 1 ~ 3 rib is protected by clavicle, scapula and shoulder strap muscles and is not easy to break; The 8th ~10 rib gradually becomes shorter, connecting the cartilaginous costal arch, which has elastic cushioning and reduces the chance of fracture. Ribs 1 1 and 12 are floating ribs, with high fluidity and few fractures. However, when the violence is strong, these ribs may be broken.
Only 1 rib fracture is called single rib fracture, and two or more rib fractures are called multiple rib fractures. Rib fractures can occur on both sides of the chest at the same time. Only one rib fracture is called a single fracture, and more than two rib fractures are called double fractures or multiple fractures. Causes sequential multiple rib fractures or multiple rib fractures with multiple costal cartilage epiphysis detachment or bilateral multiple costal cartilage fractures or epiphysis detachment.
Local pain is the most obvious symptom of rib fracture, which is aggravated with coughing, deep breathing or body rotation. Sometimes patients can hear or feel the bone friction at the rib fracture at the same time, and the pain and thoracic stability are destroyed, which can limit breathing activities, breathe shallowly and reduce alveolar ventilation.
Patients dare not cough, phlegm retention, resulting in lower respiratory tract secretion obstruction, lung dampness or atelectasis, in the elderly and frail patients or patients with original lung diseases should pay special attention. Flail chest, the negative pressure of chest cavity increases when inhaling, and the softened part of chest wall is depressed inward; When exhaling, the chest pressure increases and the injured chest wall floats, which is contrary to the movement of other chest walls and is called "abnormal breathing movement".
Abnormal respiratory movement can make the pressure on both sides of the chest unbalanced, and the mediastinum moves back and forth with breathing, which is called "mediastinal swing", which affects blood return and causes circulatory dysfunction, and is one of the important factors that lead to and aggravate shock. Flail chest pain and chest stability are more seriously damaged. Abnormal respiratory movement makes respiratory movement more restricted, cough is weak, vital capacity and functional residual capacity (FRC) are reduced, lung compliance and tidal volume are reduced, and it is often accompanied by severe dyspnea.
In the past, it was thought that part of the gas in the flail chest flowed back and forth between the healthy side and the injured side with inhalation and exhalation, and could not be exchanged with the atmosphere, which was called residual gas convection or swinging gas, which was the main cause of respiratory dysfunction. At present, it is considered that there is no swaying qi, and lung contusion often accompanied by flail chest can cause alveolar and interstitial bleeding, edema, alveolar rupture and atelectasis, which is an important cause of respiratory dysfunction.
A rib fracture without injury is called a simple rib fracture. In addition to pleural and lung injuries and hemothorax or (and) pneumothorax caused by them, other chest injuries or chest injuries are often combined. In the diagnosis, we should pay special attention to 1 or the fracture of the second rib often complicated with clavicle or scapula fracture, and may be complicated with chest organ and great blood vessel injury, bronchial or tracheal fracture, or cardiac contusion, and often complicated with brain injury. Lower thoracic rib fracture may be complicated with abdominal organ injury, especially rupture of liver, spleen and kidney, and fracture of spine and pelvis should also be paid attention to. However, when the rib below the seventh rib is fractured, the intercostal nerve at the fracture site is stimulated to produce conductive abdominal pain, which should be distinguished from the indicative abdominal pain caused by abdominal organ injury.
2. Auxiliary inspection
Most rib fractures can be shown on X-ray chest films. However, for rib cartilage fracture, "willow branch fracture, dislocation-free fracture, or middle rib fracture are not easy to find on chest radiograph because of overlapping ribs on both sides, and should be judged according to clinical manifestations to avoid missed diagnosis."
If you have a history of chest trauma, local pain and tenderness in the chest wall, and the chest compression test is positive, you can think of the possibility of chest fracture by X-ray examination. If the tenderness point can touch the fricative sound, the diagnosis can be established. If there is abnormal respiratory movement in the chest wall, it means that there are multiple rib fractures.