Which of the following occurs in respiratory distress?

In respiratory distress, the pattern of breathing changes significantly due to increased work of breathing. One of the hallmark findings is the use of accessory muscles and retraction of tissue around the rib cage, particularly the intercostal muscles. When these muscles are engaged, especially during inhalation, you will often observe that the skin between the ribs, or intercostal spaces, moves inward, indicating that the patient is struggling to breathe and relying on these additional muscles to assist.

This inward movement of the skin between the ribs is a clear sign that the patient's respiratory muscles are under strain, often seen in conditions such as asthma exacerbations, pneumonia, or other obstructive pulmonary issues. The presence of retractions signifies that the patient is in respiratory distress and needs immediate assessment and potentially intervention to relieve their difficulty in breathing.

In contrast, speaking in longer sentences might suggest that the patient is not in acute distress, as longer phrases can typically only be articulated when breathing is relatively normal. Relaxed neck muscles are generally indicative of an absence of respiratory distress, and leaning the torso posteriorly does not reflect the common posture seen in respiratory distress, which is typically leaning forward to maximize lung expansion and help ease the work of breathing.