RHINORRHOEA
R
Rhinoplasty usually causes considerable
bruising and swelling and the results
may not be clearly visible for a number
of weeks or months.
rh in o rrh o e a
The discharge of watery mucus from
the nose, usually due to
rh in it is .
Rarely,
the discharge consists of
c e r e b r o s p in a l
f lu id
and is the result of a head injury.
(See also
n a s a l d is c h a r g e .)
rh in o v iru s
Any one of a group of
R N A
-containing
viruses
that
cause
infections
of the
upper
respiratory tract, typically the
common cold (see
c o ld , c o m m o n ).
rh y th m m e th o d
See
c o n tra c e p tio n , n a tu ra l m e t h o d s of.
rib
Any of the flat, curved bones that form
a framework for the chest and a protec-
tive cage around the heart, lungs, and
other underlying organs.
There are
12
pairs of ribs, each joined
at the back of the ribcage to a vertebra
in the spine
(see
A n a to m y o f th e r ib s ,
right). The upper seven pairs, known as
“true ribs” , link directly to the
s te rn u m
(breastbone) at the front of the body by
flexible costal cartilage (connective tis-
sue formed of collagen). The next two
or three pairs of “false ribs” connect
indirectly to the sternum by way of car-
tilage attached to the cartilage of the
ribs above. The lowest two pairs of ribs
are not attached to the sternum at the
front and, therefore, they are known as
“floating ribs” . Between and attached to
the ribs are thin sheets of muscle (called
intercostal muscles)
that expand and
relax the chest during
b re a t h in g .
The
spaces between the ribs also contain
nerves and blood vessels.
DISORDERS
The ribs can easily be fractured by a fall
or blow (see
rib , fra c tu re o f ).
A rib is also
a common site for a noncancerous
b o n e
t u m o u r
or for a
m e t a s t a s is
(a secondary
cancerous tumour that has spread from
elsewhere in the body).
T ie tz e ’s s y n -
d ro m e
is a condition in w hich chest
pain is caused by inflammation of one
or more areas of rib cartilage.
In rare cases a person is born with
one or more extra ribs, known as
c e r v i-
c a l r ib s ,
above the uppermost normal
rib. Cervical ribs may cause a variety of
problems, such as putting pressure on
nerves supplying the arm.
rib a v irin
An
an tivira l d ru g ,
also called tribavfrin, used
to treat children with severe
b ro n ch io litis
caused by respiratory syncytial virus. Rib-
avirin is administered by aerosol inhalation
or by a
n e b u liz e r.A d v e rs e
effects are rare.
rib , fra c tu re o f
A crack or break in one or more of the
r ib
bones. Such a fracture may be caused
by a fall or blow or by stress on the
ribcage, such as that produced by pro-
longed coughing.
The fracture of a rib causes severe
pain, w hich worsens during periods of
deep breathing, as well as tenderness
and swelling of the overlying tissue.
Pain may be relieved by
a n a lg e s ic d ru g s
(painkillers) or by an injection of a local
anaesthetic (see
a n a e s t h e s ia , lo c a l). X -ra y s
may be used to confirm a diagnosis.
Most rib fractures are undisplaced
(the bone ends remain in alignment)
and usually heal without specific treat-
ment. Strapping is rarely used because it
hinders chest expansion and thereby
increases the risk of
p n e u m o n ia .
Instead,
the patient is encouraged to take deep
breaths while holding the injured side.
A fracture that is displaced or splintered
may pierce a lung, thereby causing lung
collapse
(see
p n e u m o th o ra x
).
Multiple
rib fractures can result in
f la il c h e s t
(a
chest injury in w hich part of the chest
wall moves in the direction opposite to
normal during breathing).
rib o fla v in
The chemical name of vitamin B2 (see
v it-
a m in B c o m p le x
).
rib o n u c le ic a c id
See
R N A
.
ric k e ts
A disease caused by nutritional deficiency
that results in
b o n e
deformities in child-
hood. Bones become deformed because
inadequate amounts of
c a lciu m
and
p h o s -
p h a te
are incorporated into them as they
grow. A similar deficiency of calcium and
phosphate in adults results in
o ste o m a la c ia
.
CAUSES
The most common cause of rickets is
deficiency of
v ita m in D
,
which is vital for
the
absorption
of calcium
from
the
intestines into the blood and for its
incorporation into bone. Vitamin D is
ANATOMY OF THE RIBS
There are seven true ribs attached to the sternum; three false ribs, each attached to
a rib above; and two floating ribs, attached only to the spine, on each side. Every
rib is attached to the spine at the back. The intercostal muscles (between the ribs)
pull the ribs up, expanding the chest and drawing air into the lungs. The front ends
of the true ribs are linked to the sternum by cartilages.
Right lung
Spine
F ix e d
__
ribs
. Sternum
Floating ribs
666
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