What is pectus excavatum deformity of chest?

Appeared in: JIPMER Nursing Officer - 2020

Explanation

Pectus excavatum, also known as funnel chest, is a congenital deformity where the sternum (breastbone) and associated cartilages grow inward.
This inward depression of the sternum directly reduces the distance between the front and back of the chest wall.
This results in the characteristic sunken appearance of the chest and a measurably narrowed anterior-posterior (AP) diameter.

Option A: While the sternum is depressed in pectus excavatum, the transverse (side-to-side) diameter is not narrowed. It often appears normal or relatively wide in comparison to the reduced AP diameter.
Option B: A 1:1 ratio of the anterior-posterior to transverse diameter is the definition of a barrel chest, not pectus excavatum.
Option D: A protruding sternum and an increased anterior-posterior diameter are the defining features of pectus carinatum (pigeon chest), which is the opposite deformity of pectus excavatum.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Assessment and identification of congenital and acquired chest wall deformities as background academic context rather than a clinical decision trigger.
Nurses must be able to identify different chest deformities during physical assessment as they can indicate underlying conditions (e.g., Marfan syndrome, rickets) or cause significant cardiopulmonary compromise.
A key nursing assessment is the inspection of the chest for symmetry, shape, and respiratory movement. Any deviation from normal should be documented and reported.
In severe cases, pectus excavatum can compress the heart and lungs, leading to symptoms like shortness of breath, chest pain, and decreased exercise tolerance, which require careful monitoring.

How to Approach the Question

This is a factual recall question that tests your knowledge of medical terminology for physical assessment findings.
First, identify the key term in the question: 'pectus excavatum'.
Recall the meaning of the term. 'Pectus' refers to the chest, and 'excavatum' suggests a hollowed-out or excavated shape.
Based on this definition, deduce that the sternum must be sunken or depressed.
Evaluate the options: A depressed sternum would logically decrease the front-to-back (anterior-posterior) space in the chest.
Eliminate the options that describe other conditions: a 1:1 ratio (barrel chest) and a protruding sternum (pectus carinatum).

Concept Tested & Keywords

Concept Tested: Assessment and identification of congenital and acquired chest wall deformities.
Stem keywords: pectus excavatum, deformity, chest
Lead-in keywords: What is
Negative lead-in flag: false

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 501-503

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