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Throat and Thorax Injuries Chapter 7 Chapter 7 Objectives • Understand the basic anatomy of the throat and thorax. • Understand how to prevent injuries of the throat and thorax. • Know the care necessary to treat an injury within the throat or thorax. • Understand the implications of illness or injury related to a specific organ in the thorax. Throat Anatomy • • • • • Carotid artery Jugular vein Larynx Trachea Esophagus Throat Anatomy • Esophagus – Passageway for food – In front of cervical vertebrae, behind trachea and larynx • Trachea – Made up of circular rings of cartilage – Main passageway for air to get to and from lungs • Larynx – Modified portion of upper trachea, contains vocal cords Throat Anatomy • Carotid artery – One on each side of the trachea – Carries oxygenated blood to the brain • Jugular vein – One on each side of the trachea – Carries unoxygenated blood away from the brain • Deadly if either are severed Thorax Anatomy • Thoracic Vertebrae • 12 Ribs on each side (2 floating) • Sternum – These bones function to protect the organs Thoracic organs • Heart • Lungs • Diaphragm Thorax Anatomy • Heart – Size of your fist – Pumps blood to all parts of body – Blood carries nutrients and oxygen to cells and carbon dioxide and waste away from cells Heart • Chambers • Left and right atrium • Left and right ventricle – Thicker due to function of pumping blood throughout the body Heart • Function-pumps blood to lungs and entire body • Path – Right atrium(RA) fills with deoxygenated blood from body – Goes to right ventricle (RV) and out to lungs to receive oxygen Heart • Path (continued) – Left atrium (LA) receives oxygenated blood from the lungs – Goes to left ventricle (LV)…largest chamber of the heart and sends it to the rest of the body through the aorta to other major arteries – Once oxygen is used, blood returns to heart through veins Lungs • Function: to exchange oxygen and carbon dioxide and dissipate body heat Lungs • Bronchi – Branches of the trachea • Bronchioles – Divisions of the bronchi • Alveoli – Ends of the bronchioles where oxygen-carbon dioxide exchange occurs Diaphragm • Separates thorax and abdominal cavities • Contracts and pulls down to assist inhalation and moves up to push air out Injury Prevention • Protective equipment • Rules • Always buy best protective equipment Treating throat injuries and conditions • Most injuries to throat are contusions caused by a blow from sticks, feet, or arms • Treat with ice • Most response to throat injury is coughing, spitting, difficulty breathing, and pain Throat lacerations • Superficial lacerations can be controlled with direct pressure • Deep are medical emergencies – Apply direct pressure, treat for shock – Must respond quickly Cartilage fracture • Caused by severe blow to throat • Can be life threatening • Causes difficulty breathing, gasping, spitting blood, pain, difficulty talking, appear anxious • May turn blue (lack of oxygen) • Treat with extreme care due to possible cervical spine injury • Treat as medical emergency (call 911) and backboard to transport • Ice area, keep athlete calm, keep airway free of blood Pneumothorax • Air in the pleural cavity (collapsed lung) • Can occur with or without trauma • Traumatic caused by punctured lung (rib fracture, gunshot, severe laceration) • Non-traumatic caused by weakness of lung tissue Pneumothorax • When occurs, injured lung moves toward center of chest, puts pressure on heart and other organs • Causes difficulty breathing and athlete will gasp for air • Inhaled air escapes through hole and into chest cavity which causes further compression on organs Spontaneous pneumothorax • Can happen in healthy athlete • Caused by weakness in lung tissue • Difficulty breathing, chest pain, possible blue skin (cyanotic) • Place athlete on ground with injured lung closest to ground, treat for shock and treat as medical emergency (911) • Usually heals itself without surgery Tension Pneumothorax • Air leaking out forces lung into other lung and heart • Tracheal deviation possible causing more respiratory distress • Death can occur if not treated rapidly • If there is an external puncture would, partially cover it leaving one side unsealed to prevent tension from getting worse Tension Pneumothorax • Sign/symptoms – – – – – – Respiratory distress Absent breath sounds on injured side Anxiety Bluish skin color Pulse rapid and weak Blood pressure will drop • Injury requires physician to insert a chest tube and possible surgical intervention Flail chest • Multiple ribs fractured in 2 or more places • Occurs from direct impact • Entire fractured portion moves in and out when athlete breathes, but opposite normal • Very painful, possible other internal injuries Flail chest • Treatment- decrease movement of fracture • Treat athlete for shock • Call 911 immediately Pulmonary contusions • Bruised lung • Direct impact (usually blunt object) • Causes bleeding and swelling • Difficulty breathing and bluish skin color • Call 911, ice if athlete allows Sucking chest wounds • Puncture of chest wall, air from outside is drawn noisily into cavity • Lung is not punctured • Air coming in causes pressure on lungs causing distress • Difficulty breathing, circulation impairment (cyanotic) • Seal wound with cellophane or plastic bag • Call EMS immediately Hyperventilation • Quick breathing >24 breaths per min • Causes abnormal loss of carbon dioxide from the blood • Caused by becoming overly excited, anxiety, or diabetes • Can become dizzy, experience numbness in extremities, and/or loss of consciousness • Treat by encouraging athlete to breath slowly, calming the athlete