1 injuries to the thorax and abdomen pe 236 juan cuevas, atc
TRANSCRIPT
11
Injuries to the Injuries to the Thorax and Thorax and AbdomenAbdomen
PE 236PE 236Juan Cuevas, ATCJuan Cuevas, ATC
22
Anatomy ReviewAnatomy Review
Thoracic cage has 12 pairs of ribs.Thoracic cage has 12 pairs of ribs.
The first ___ pairs connect directly to sternum. The first ___ pairs connect directly to sternum. Pairs 8 through 10 connect via common costal cartilage.Pairs 8 through 10 connect via common costal cartilage. Pairs 11 and 12 are “______________”Pairs 11 and 12 are “______________”
Major thoracic joints include:Major thoracic joints include:
Intervertebral.Intervertebral.________________________________________Sternocostal. Sternocostal. ________________________________________
33
44
55
Anatomy Review Anatomy Review (continued)(continued)
Muscles of the trunk Muscles of the trunk (posterior view)(posterior view) ______________.______________. Rhomboids.Rhomboids. Latissimus dorsi and Latissimus dorsi and
others.others.
66
Anatomy Review Anatomy Review (continued)(continued)
Internal thoracic organs Internal thoracic organs and major blood vessels and major blood vessels of the region are:of the region are:
________ & pericardium.________ & pericardium. Lungs & ________.Lungs & ________.
Thoracic aorta.Thoracic aorta.Pulmonary artery & Pulmonary artery & veins.veins.___________.___________.
Trachea & esophagus.Trachea & esophagus.
77
Anatomy ReviewAnatomy Review
Abdominal Abdominal quadrantsquadrants ______________ ______________ RLQRLQ LLQLLQ
88
Anatomy Review Anatomy Review (continued)(continued)
Abdominal Organs and StructuresAbdominal Organs and Structures
RUQ contains:RUQ contains:_______, gallbladder, and right kidney._______, gallbladder, and right kidney.
RLQ contains:RLQ contains:_____________ and ascending colon._____________ and ascending colon.
LUQ contains:LUQ contains:Stomach, __________, left kidney, and pancreas.Stomach, __________, left kidney, and pancreas.
LLQ contains: LLQ contains: Descending colon.Descending colon.
99
Common Sports Common Sports InjuriesInjuries
Fractures can occur to ribs, Fractures can occur to ribs, sternum, clavicle, or thoracic sternum, clavicle, or thoracic vertebrae.vertebrae. Injuries must be treated immediately Injuries must be treated immediately
to avoid to avoid ____________________________ or or ____________________________________. .
Joint dislocations and Joint dislocations and subluxations of thoracic skeletal subluxations of thoracic skeletal joints can occur. joints can occur. _________________separations _________________separations involve disunion of sternum and involve disunion of sternum and ribs.ribs.
1010
Common Sports Common Sports Injuries (continued)Injuries (continued)Signs and symptoms of rib Signs and symptoms of rib
____________ include:____________ include: Extreme localized pain that is Extreme localized pain that is
aggravated by sneezing, ________, aggravated by sneezing, ________, and forced inhalation.and forced inhalation.
Athlete grasps chest wall at point of Athlete grasps chest wall at point of injury.injury.
Mild swelling at site; there may be Mild swelling at site; there may be bony __________.bony __________.
Breathing difficulties; rapid _______ Breathing difficulties; rapid _______ breathing.breathing.
First AidFirst Aid Monitor vital signs and watch for Monitor vital signs and watch for
respiratory distress.respiratory distress. Transport to medical facility.Transport to medical facility.
1111
Common Sports Common Sports Injuries (continued)Injuries (continued)
Signs and symptoms of subluxations and Signs and symptoms of subluxations and dislocations include:dislocations include:
History of snap or _________ sensations.History of snap or _________ sensations. Pain and tenderness over costochondral junction.Pain and tenderness over costochondral junction. Palpable ________ may be felt, and swelling in the Palpable ________ may be felt, and swelling in the
localized area.localized area. Maximum or near-maximum inhalation may be Maximum or near-maximum inhalation may be
very difficult.very difficult.
First AidFirst Aid Apply ice and light compression immediately.Apply ice and light compression immediately. Treat for ______ and transport to medical facility.Treat for ______ and transport to medical facility.
1212
Heart InjuriesHeart Injuries
While rare, contusions to the chest While rare, contusions to the chest wall can bruise the heart, resulting wall can bruise the heart, resulting in death.in death.
____________________________________ can occur. can occur.
Use of ______ device is the most Use of ______ device is the most practical way to save the lives of practical way to save the lives of people experiencing commotio people experiencing commotio cordis. cordis.
1313
Sudden ________ Syndrome in AthletesSudden ________ Syndrome in Athletes Cause of ConditionCause of Condition
_____________ cardiomyopathy- thickening of cardiac _____________ cardiomyopathy- thickening of cardiac muscle w/ no increase in chamber _______muscle w/ no increase in chamber _______
___________ syndrome- abnormality in connective ___________ syndrome- abnormality in connective tissue results in weakening of _______ and cardiac tissue results in weakening of _______ and cardiac vesselsvessels
Series of additional cardiac causesSeries of additional cardiac causes
Non-cardiac causes include drugs and alcohol, Non-cardiac causes include drugs and alcohol, intracranial _________, obstructive respiratory diseaseintracranial _________, obstructive respiratory disease
Signs of ConditionSigns of ConditionMost _______ exhibit any signs prior to deathMost _______ exhibit any signs prior to death
May exhibit chest pain, heart palpitations, __________, May exhibit chest pain, heart palpitations, __________, nausea, profuse sweating, shortness of breath, malaise nausea, profuse sweating, shortness of breath, malaise and/or feverand/or fever
1414
CareCare___________ medical attention is necessary – life ___________ medical attention is necessary – life threatening conditionthreatening condition
______________ ______________ Counseling and screening are critical in early Counseling and screening are critical in early identification and prevention of sudden deathidentification and prevention of sudden death
Screening questions should address the followingScreening questions should address the following History of ______________History of ______________ Chest pain during _______________Chest pain during _______________ Periods of _____________ during exercisePeriods of _____________ during exercise Family historyFamily history Thickening of _________-or history of Marfan’s syndromeThickening of _________-or history of Marfan’s syndrome
Cardiac screening - electrocardiograms and Cardiac screening - electrocardiograms and echocardiograms may be needed to determine existing echocardiograms may be needed to determine existing pathologypathology
1515
Lung InjuriesLung Injuries
Pulmonary contusions may occur as Pulmonary contusions may occur as complication of _____ fracture, complication of _____ fracture, contusion, or other type of lung injury.contusion, or other type of lung injury.
Fractured rib can puncture pleural Fractured rib can puncture pleural sac, causing _____________. sac, causing _____________.
Spontaneous pneumothorax can occur Spontaneous pneumothorax can occur _________ trauma (reported in weight _________ trauma (reported in weight lifters and runners). lifters and runners).
_____________ occurs when _____________ occurs when fractured rib punctures lung.fractured rib punctures lung.
This condition can be ______________.This condition can be ______________.
1616
Lung Injuries Lung Injuries (continued)(continued)
Signs and symptoms include:Signs and symptoms include:
Severe _______ in chest, sometimes Severe _______ in chest, sometimes radiating to thoracic spine.radiating to thoracic spine.
Breathing problems (___________).Breathing problems (___________). May have nonproductive _______ and May have nonproductive _______ and
tachycardia.tachycardia.
1717
1818
Lung Injuries Lung Injuries (continued)(continued)
First AidFirst Aid
Treat for ________.Treat for ________. Monitor ____________.Monitor ____________. Transport to medical facility immediately.Transport to medical facility immediately.
1919
Internal Injuries to the Internal Injuries to the Thorax and AbdomenThorax and Abdomen
Liver, Kidneys, Spleen and Bladder Liver, Kidneys, Spleen and Bladder InjuriesInjuries
Although fairly safe, the liver is Although fairly safe, the liver is susceptible to ________________.susceptible to ________________.
Diseases such as ____________ make Diseases such as ____________ make liver more vulnerable.liver more vulnerable.
Heavy consumption of ________ Heavy consumption of ________ and/or use of steroids damages the and/or use of steroids damages the liver.liver.
2020
Internal Injuries to the Internal Injuries to the Thorax and Abdomen Thorax and Abdomen
(continued)(continued)
Kidneys are susceptible to blunt trauma Kidneys are susceptible to blunt trauma directed at the ______________.directed at the ______________.
Kidneys may also be injured as a result of Kidneys may also be injured as a result of heat strokeheat stroke
Be alert for ________________.Be alert for ________________.
Refer athlete to a physician.Refer athlete to a physician.
2121
Injury of the ___________Injury of the ___________ Cause of Injury Cause of Injury
Result of a direct blow to _________Result of a direct blow to _________Infectious mononucleosis (causing an enlarged Infectious mononucleosis (causing an enlarged spleen)spleen)
Signs of InjurySigns of InjuryIndications of a ruptured spleen involve history of Indications of a ruptured spleen involve history of a direct blow, signs of _______, abdominal a direct blow, signs of _______, abdominal rigidity, nausea, vomitingrigidity, nausea, vomiting
Be alert for _____________ sign.Be alert for _____________ sign.Referred pain in upper left shoulder Referred pain in upper left shoulder
Decreased peripheral circulation.Decreased peripheral circulation. Check nail beds and ________Check nail beds and ________
Ability to splint self may produce delayed Ability to splint self may produce delayed hemorrhaging - easily disrupted resulting in hemorrhaging - easily disrupted resulting in internal bleedinginternal bleeding
2222
2323
CareCareConservative treatment involves 1 wk of Conservative treatment involves 1 wk of hospitalization and a gradual return to _______hospitalization and a gradual return to _______Surgery will result in three months of recovery Surgery will result in three months of recovery while removal of spleen will result in a ___ while removal of spleen will result in a ___ month removal from activitymonth removal from activityIn cases of mononucleosis athlete may resume In cases of mononucleosis athlete may resume training in ________ if spleen not enlarged and training in ________ if spleen not enlarged and if there is no feverif there is no fever
2424
Injuries to the BladderInjuries to the Bladder Cause of InjuryCause of Injury
Blunt force to the ____________ may cause injury to urinary Blunt force to the ____________ may cause injury to urinary bladder if distended with urinebladder if distended with urine
_________ is often associated with contusion of bladder _________ is often associated with contusion of bladder during running (runner’s bladder)during running (runner’s bladder)
Signs of InjurySigns of InjuryPain, discomfort of lower abdominal region, abdominal Pain, discomfort of lower abdominal region, abdominal rigidity, nausea, vomiting, shock, bleeding from the _______, rigidity, nausea, vomiting, shock, bleeding from the _______, increased quantity of bloody urineincreased quantity of bloody urine
Athlete should be instructed to monitor ______ Athlete should be instructed to monitor ______
Inability to urinate will present in case of ruptured bladderInability to urinate will present in case of ruptured bladder
2525
2626
Scrotal/Testicular ContusionScrotal/Testicular Contusion Cause of InjuryCause of Injury
Result of blunt trauma and______ to the Result of blunt trauma and______ to the vulnerable and sensitive scrotumvulnerable and sensitive scrotum
Signs and SymptomsSigns and SymptomsHemorrhaging, fluid effusion, _____________, Hemorrhaging, fluid effusion, _____________, severe pain (disabling)severe pain (disabling)
May cause nauseating, disabling and painful May cause nauseating, disabling and painful conditioncondition
CareCarePlace athlete on side with knees to chestPlace athlete on side with knees to chest
Apply ________ as pain subsidesApply ________ as pain subsides
If pain persist after 15-20 minutes referral will be If pain persist after 15-20 minutes referral will be necessarynecessary
2727
____________________ Cause of InjuryCause of Injury
Protrusion of abdominal viscera through portion of Protrusion of abdominal viscera through portion of abdominal ______ (congenital or acquired)abdominal ______ (congenital or acquired)
Inguinal vs. ____________ hernias Inguinal vs. ____________ hernias
Complications and strangulated herniasComplications and strangulated hernias Signs of InjurySigns of Injury
Acquired hernia occur when ______________ is further Acquired hernia occur when ______________ is further aggravated by a direct blow or strainaggravated by a direct blow or strain
History of direct blow to groin area, pain and prolonged History of direct blow to groin area, pain and prolonged discomfort, superficial protrusion with pain increasing with discomfort, superficial protrusion with pain increasing with coughing & reported pulling sensation in ________ areacoughing & reported pulling sensation in ________ area
2828
2929
Abdominal HerniaAbdominal Hernia __________ of the abdominal viscera through a __________ of the abdominal viscera through a
portion of the abdominal ________portion of the abdominal ________
_____________ Hernia_____________ Hernia Protrusion of the spermatic cord through the Protrusion of the spermatic cord through the
inguinal ________-inguinal ________-
Signs and SymptomsSigns and Symptoms Previous history of a blow or strain to the groin/lower Previous history of a blow or strain to the groin/lower
abdomen region that produces pain and prolonged abdomen region that produces pain and prolonged __________________________
Protrusion is increased by ___________Protrusion is increased by ___________ Reported feeling of weakness and pulling sensation Reported feeling of weakness and pulling sensation
in the groin/lower abdomen region.in the groin/lower abdomen region.
3030
CareCareMost physicians prefer athlete to refrain from Most physicians prefer athlete to refrain from hard physical activity until ___________ hard physical activity until ___________ repairedrepaired
Mechanical devices are not suitable for Mechanical devices are not suitable for athletics due to friction and irritation they athletics due to friction and irritation they produceproduce
While exercise is thought to be beneficial with While exercise is thought to be beneficial with regards to strengthening, that is not the caseregards to strengthening, that is not the case
3131
3232
Hernias (cont’)Hernias (cont’)
First Aid/ TreatmentFirst Aid/ Treatment Refer to MDRefer to MD Surgery!!!Surgery!!!
3333
Internal InjuriesInternal Injuries
Always rule out internal injuries whenever there Always rule out internal injuries whenever there is a blow to the ribs or abdomen.is a blow to the ribs or abdomen.
Internal injuries “sneak up” due to no immediate Internal injuries “sneak up” due to no immediate warning signs.warning signs.
Always re-evaluate 20-30 minutes after injury.Always re-evaluate 20-30 minutes after injury.
***When in doubt…REFER!!!***When in doubt…REFER!!!