Injuries to the Thorax and Abdomen PE 236

Injuries to the Thorax and Abdomen PE 236 Juan Cuevas, ATC 1

Anatomy Review Thoracic cage has 12 pairs of ribs. n n n The first ___ pairs connect directly to sternum. Pairs 8 through 10 connect via common costal cartilage. Pairs 11 and 12 are “_______” Major thoracic joints include: Intervertebral. __________ Sternocostal. __________ 2

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Anatomy Review (continued) Muscles of the trunk (posterior view) n n n _______. Rhomboids. Latissimus dorsi and others. 5

Anatomy Review (continued) Internal thoracic organs and major blood vessels of the region are: n n ____ & pericardium. Lungs & ____. Thoracic aorta. Pulmonary artery & veins. ______. n Trachea & esophagus. 6

Anatomy Review Abdominal quadrants n n _______ RLQ LLQ 7

Anatomy Review (continued) Abdominal Organs and Structures RUQ contains: _______, gallbladder, and right kidney. RLQ contains: _______ and ascending colon. LUQ contains: Stomach, _____, left kidney, and pancreas. LLQ contains: Descending colon. 8

Common Sports Injuries Fractures can occur to ribs, sternum, clavicle, or thoracic vertebrae. n Injuries must be treated immediately to avoid _______ or _________. Joint dislocations and subluxations of thoracic skeletal joints can occur. _________separations involve disunion of sternum and ribs. 9

Common Sports Injuries (continued) Signs and symptoms of rib ______ include: n n Extreme localized pain that is aggravated by sneezing, ____, and forced inhalation. Athlete grasps chest wall at point of injury. Mild swelling at site; there may be bony _____. Breathing difficulties; rapid _______ breathing. First Aid n n Monitor vital signs and watch for respiratory distress. Transport to medical facility. 10

Common Sports Injuries (continued) Signs and symptoms of subluxations and dislocations include: n n History of snap or _____ sensations. Pain and tenderness over costochondral junction. Palpable ____ may be felt, and swelling in the localized area. Maximum or near-maximum inhalation may be very difficult. First Aid n n Apply ice and light compression immediately. Treat for ______ and transport to medical facility. 11

Heart Injuries n While rare, contusions to the chest wall can bruise the heart, resulting in death. _________ can occur. n Use of ______ device is the most practical way to save the lives of people experiencing commotio cordis. 12

Sudden ____ Syndrome in Athletes n Cause of Condition _______ cardiomyopathy- thickening of cardiac muscle w/ no increase in chamber ___________ syndrome- abnormality in connective tissue results in weakening of _______ and cardiac vessels Series of additional cardiac causes Non-cardiac causes include drugs and alcohol, intracranial _____, obstructive respiratory disease n Signs of Condition Most _______ exhibit any signs prior to death May exhibit chest pain, heart palpitations, _____, nausea, profuse sweating, shortness of breath, malaise and/or fever 13

n Care ______ medical attention is necessary – life threatening condition n _______ Counseling and screening are critical in early identification and prevention of sudden death Screening questions should address the following n n n History of _______ Chest pain during ________ Periods of _______ during exercise Family history Thickening of _____-or history of Marfan’s syndrome Cardiac screening - electrocardiograms and echocardiograms may be needed to determine existing pathology 14

Lung Injuries n n Pulmonary contusions may occur as complication of _____ fracture, contusion, or other type of lung injury. Fractured rib can puncture pleural sac, causing _______. Spontaneous pneumothorax can occur _____ trauma (reported in weight lifters and runners). n _______ occurs when fractured rib punctures lung. This condition can be _______. 15

Lung Injuries (continued) Signs and symptoms include: n n n Severe _______ in chest, sometimes radiating to thoracic spine. Breathing problems (______). May have nonproductive _______ and tachycardia. 16

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Lung Injuries (continued) First Aid n n n Treat for ____. Monitor ______. Transport to medical facility immediately. 18

Internal Injuries to the Thorax and Abdomen Liver, Kidneys, Spleen and Bladder Injuries n Although fairly safe, the liver is susceptible to ________. Diseases such as ______ make liver more vulnerable. Heavy consumption of ____ and/or use of steroids damages the liver. 19

Internal Injuries to the Thorax and Abdomen (continued) n n Kidneys are susceptible to blunt trauma directed at the _______. Kidneys may also be injured as a result of heat stroke Be alert for ________. n Refer athlete to a physician. 20

Injury of the ______ n Cause of Injury Result of a direct blow to _____ Infectious mononucleosis (causing an enlarged spleen) n Signs of Injury Indications of a ruptured spleen involve history of a direct blow, signs of _______, abdominal rigidity, nausea, vomiting n Be alert for _______ sign. Referred pain in upper left shoulder Decreased peripheral circulation. n Check nail beds and ____ Ability to splint self may produce delayed hemorrhaging - easily disrupted resulting in internal bleeding 21

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n Care Conservative treatment involves 1 wk of hospitalization and a gradual return to _______ Surgery will result in three months of recovery while removal of spleen will result in a ___ month removal from activity In cases of mononucleosis athlete may resume training in ____ if spleen not enlarged and if there is no fever 23

Injuries to the Bladder n Cause of Injury Blunt force to the ______ may cause injury to urinary bladder if distended with urine _____ is often associated with contusion of bladder during running (runner’s bladder) n Signs of Injury Pain, discomfort of lower abdominal region, abdominal rigidity, nausea, vomiting, shock, bleeding from the _______, increased quantity of bloody urine Athlete should be instructed to monitor ______ Inability to urinate will present in case of ruptured bladder 24

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Scrotal/Testicular Contusion n Cause of Injury Result of blunt trauma and______ to the vulnerable and sensitive scrotum n Signs and Symptoms Hemorrhaging, fluid effusion, _______, severe pain (disabling) May cause nauseating, disabling and painful condition n Care Place athlete on side with knees to chest Apply ____ as pain subsides If pain persist after 15 -20 minutes referral will be necessary 26

_____ n Cause of Injury Protrusion of abdominal viscera through portion of abdominal ______ (congenital or acquired) Inguinal vs. ______ hernias Complications and strangulated hernias n Signs of Injury Acquired hernia occur when _______ is further aggravated by a direct blow or strain n History of direct blow to groin area, pain and prolonged discomfort, superficial protrusion with pain increasing with coughing & reported pulling sensation in ____ area 27

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Abdominal Hernia n _____ of the abdominal viscera through a portion of the abdominal _____________ Hernia n Protrusion of the spermatic cord through the inguinal ____- Signs and Symptoms n n n Previous history of a blow or strain to the groin/lower abdomen region that produces pain and prolonged _______ Protrusion is increased by ______ Reported feeling of weakness and pulling sensation in the groin/lower abdomen region. 29

n Care Most physicians prefer athlete to refrain from hard physical activity until ______ repaired Mechanical devices are not suitable for athletics due to friction and irritation they produce While exercise is thought to be beneficial with regards to strengthening, that is not the case 30

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Hernias (cont’) First Aid/ Treatment n n Refer to MD Surgery!!! 32

Internal Injuries Always rule out internal injuries whenever there is a blow to the ribs or abdomen. Internal injuries “sneak up” due to no immediate warning signs. Always re-evaluate 20 -30 minutes after injury. ***When in doubt…REFER!!! 33