Download The Thorax and Abdomen

The Thorax and Abdomen
Chapter 21
Anatomy of Thorax
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Thoracic Cavity
Ribs, Costal
Cartilage, and
Sternum
Thoracic Muscles
Lungs
Respiratory Muscles
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Blood Supply
Heart
– blood supply
Thymus
Abdominal Muscles
Abdominal Viscera
Preventing/Assessing Injuries to
Thorax and Abdomen
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History
Observation
Palpation
– Abdomen - ausculation and percussion
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Special Tests
Preventing Injuries to Thorax and
Abdomen
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Appropriate protective equipment
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Abdominal muscle strengthening
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Empty hollow organs before competition
Assessing Injuries to Thorax and
Abdomen
History
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What happened?
Direct blow or contact?
What was body position
at time of injury?
Type of pain, immediate
or gradual?
Location of pain?
Difficulty breathing?
Position of comfort?
Feel faint?
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Light headed?
Nauseated?
Sounds?
Muscle spasm?
Blood in urine?
Difficulty urinating?
Was bladder empty?
When was last meal?
Look at History of family
and other injuries.
Assessing Injuries to Thorax and
Abdomen
Observations
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Is athlete breathing?
Having difficulty
breathing?
Pain with breathing?
Position of athlete, holding
chest?
Look for symmetry of
chest movement during
breathing.
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deformity,
muscle spasm
coughing up blood?,
cyanosis?
Other colouring of face
or injury area.
Assessing Injuries to Thorax and
Abdomen
Palpations
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Feel surrounding structures.
Bone changes
Muscle and attachments
Ligaments and attachments
Spasm
Bleeding
pulses
Special Tests
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Ausculation
Percussion
Rebound
Recognition and Management of
Specific Injuries
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Rib Contusion
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Sternum Fracture
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Rib Fracture
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Muscle Injuries
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Costochondral
Separation and
Dislocations
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Breast Injury
Rib Contusion
Etiology
Blow to rib cage - bruise to intercostal muscles or to rib or
fracture to rib
Signs and Symptoms
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Pain on inspiration and expiration
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Sharp pain when rib cage is compressed
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Point tenderness (local)
Management
X-ray examination, PIER, anti-inflammatory, rest
Rib Fracture
Etiology
Highest incidence in collision sports, caused by direct and indirect
trauma, may be result of violent muscle contraction, sneezing - ribs
5-9 are commonly injured
Signs and Symptoms
Severe pain on inspiration point tenderness, crepitus,
palpable deformity if spring outward, collapse of lung
Management
X-ray exam, support and rest
Costochondral Separation and
Dislocations
Etiology
direct blow to anterolateral aspect of thorax or indirectly from
sudden twist or fall that compresses rib cage
Signs and Symptoms
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sharp pain during sudden movement
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difficulty breathing deeply
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point tenderness over costal cartilage
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deformity
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crepitus
Management
X-ray, rest, support, PIER
Recognition and Management of
Specific Injuries
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Injuries to the Lungs
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– Pneumothorax
– Hemothorax
– Traumatic Asphyxias
Sudden Death
Syndrome
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Abdominal Injuries
– Kidney Contusions
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Heart Contusion
– Kidney Stones
Pneumothorax
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Etiology
– hole in chest allowing air to fill the pelural cavity
– space between pleural membrane and lung
– causing the lung to be compressed and collaps
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Signs and Symptoms
– Pain
– difficulty breathing
– anoxia
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Management
– EAP
– cover hole on three sides with plastic
Tension Pneumothorax
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Etiology
– air fills pleural sac on one side
– displacing the lung and heart toward the opposite side
– eventually compressing the opposite lung
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Signs and Symptoms
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shortness of breath, chest pain
may have absence of breath,
cyanosis, distension of neck veins,
deviation of trachea away from side of injury
collapse of lungs
Management
– EAP
Heamothorax
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Etiology
– presence of blood within the pleural cavity
– resulting from puncture or tearing of lung or pleural tissue
– may be caused by rib fracture
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Signs and Symptoms
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severe pain
difficulty breathing
Cyanosis
coughing up frothy blood
shock
Management
– EAP
Heart Contusion
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Etiology
– Compression of heart between spine and sternum
– strong outside force.
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Signs and Symptoms
– Severe shock and heart pain.
– May have heart arrhythmias leading to decreased cardiac output.
– death.
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Management
– CPR
– treat for shock
– EAP
Kidney Contusion
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Etiology
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blow to lower back
degree of injury is a result of the degree of engorgement of the kidney
Severe shock and heart pain.
May have heart arrhythmias leading to decreased cardiac output.
death.
Signs and Symptoms
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Shock
Nausea
Vomiting
rigidity in back muscles
blood in the urine
– referred pain into upper back and lower abdomen
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Management
– have athlete urinate two or three times if blood is present refer
immediately to physician, may require surgery
Recognition and Management of
Specific Injuries of the Abdomen
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Contusion of Ureters,
Bladder, and Urethera
Cystitis
Hernia
Urinary Tract Infection
Urethritis
Contusion of Abdominal
Wall
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Gastrointestinal Bleeding
Indigestion (Dyspepsia)
Solar Plexus “stitch in
side”
Food Poisoning
Peptic Ulcer
Recognition and Management of
Specific Injuries of the Abdomen
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Liver Contusion
Pancreatitis
Diarrhea
Hemorrhoids
Constipation
Appendicitis
Spleen Contusion
Recognition and Management of
Specific Injuries of
Reproductive Organs
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Scrotal Contusion
Spermatic Cord Torsion
Contusion of Female Genitalia
Vaginitis