Intercostal retractions are the inward movement of the muscles between the ribs as a result of reduced pressure in the chest cavity. The movements are usually a sign of difficulty with breathing.

Retractions of the chest muscles

The chest wall is flexible, which allows for normal breathing. Cartilage that attaches the ribs to the sternum (breast bone) allows free movement of bony structures so that the rib cage can expand and contract.

The intercostal muscles are the muscles between the ribs. During breathing, these muscles contract and pull the rib cage upward, while the diaphragm moves downward. This expands the chest and causes air to fill the lungs.

When the upper airway (trachea) or the small airways of the lungs (bronchioles) become partially blocked, air flow is restricted. As a result, the intercostal muscles are sucked inward, between the ribs. This sucking in of the chest muscles is a sign of airway obstruction. Diseases or conditions that cause restriction of the airway will cause intercostal retraction.

• Anaphylaxis
• Asthma
• Bronchiolitis
• Croup
• Epiglottitis
• Foreign body in the windpipe (See: Foreign object aspiration or ingestion)
• Pneumonia
• Respiratory distress syndrome
• Retropharyngeal abscess

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Intercostal retractions Treatment

Review Date: 04/26/2010
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)