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foreign [Music] [Applause] [Music] chest introduction a ratio of anteroposterior to lateral chest diameter of greater than 0.9 is termed barrel chest the normal anteroposterior diameter should be less than the lateral diameter and the ratio of anceroposterior to lateral should lie between .70 and 0.75 etiology chronic bronchitis emphysema also occurs in elderly people without disease pathophysiology it occurs due to overactivity of the scalene and sternocleidomastoid muscles which lift the upper ribs and sternum with time this overuse causes remodeling of the chest in chronic obstructive pulmonary disease theres a chronic airflow limitation that results in increased and expiratory volumes and chronic hyperinflation chronic hyperinflation reduces Airway resistance and improves elastic recoil at the expense of higher lung volumes over time this leads to chest wall Remodeling and barrel chest abnormality note despite long Association of barrel chest with obstructive lung disease not all