The solute concentration of the interstitial fluid increases by high intake of sodium in diet or by the drop in volume of extracellular fluids (such as blood plasma and cerebrospinal fluid) due to loss of water through perspiration, respiration, urination and defecation. The increase in interstitial fluid solute concentration causes water to migrate from the cells of the body, through their membranes, to the extracellular compartment, by osmosis, thus causing cellular dehydration.Clusters of cells (osmoreceptors) in the organum vasculosum of the lamina terminalis (OVLT) and subfornical organ (SFO), which lie outside of the blood brain barrier can detect the concentration of blood plasma and the presence of angiotensin II in the blood. They can then activate the median preoptic nucleus which initiates water seeking and ingestive behavior. Destruction of this part of the hypothalamus in humans and other animals results in partial or total loss of desire to drink even with extremely high salt concentration in the extracellular fluids. In addition, there are visceral osmoreceptors which project to the area postrema and nucleus tractus solitarii in the brain. Salt craving
Because sodium is also lost from the plasma in hypovolemia, the bodys need for salt proportionately increases in addition to thirst in such cases. This is also a result of the renin-angiotensin system activation. Elderly
In adults over the age of 50 years, the bodys thirst sensation reduces and continues diminishing with age, putting this population at increased risk of dehydration.
A rib fracture is a break in a rib bone. This typically results in chest pain that is worse with inspiration. Bruising may occur at the site of the break. When several ribs are broken in several places a flail chest results. Potential complications include a pneumothorax, pulmonary contusion, and pneumonia.Rib fractures usually occur from a direct blow to the chest such as during a motor vehicle collision or from a crush injury. Coughing or metastatic cancer may also result in a broken rib. The middle ribs are most commonly fractured. Fractures of the first or second ribs are more likely to be associated with complications. Diagnosis can be made based on symptoms and supported by medical imaging.Pain control is an important part of treatment. This may include the use of paracetamol (acetaminophen), NSAIDs, or opioids. A nerve block may be another option. While fractured ribs can be wrapped, this may increase complications. In those with a flail chest, surgery may improve outcomes. They are a common injury following trauma. Signs and symptoms
This typically results in chest pain that is worse with inspiration. Bruising may occur at the site of the break. Complications
When several ribs are broken in several places a flail chest results. Potential complications include a pneumothorax, pulmonary contusion, and pneumonia. Causes
Rib fractures can occur with or without direct trauma during recreational activity. Cardiopulmonary resuscitation (CPR) has also been known to cause thoracic injury, including but not limited to rib and sternum fractures.