1 Injuries to the Thorax and Abdomen PE 236 Amber Giacomazzi MS, ATC.

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Injuries to the Thorax and Abdomen

PE 236

Amber Giacomazzi MS, ATC

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Anatomy Review

Thoracic cage has 12 pairs of ribs.

The first 7 pairs connect directly to sternum Pairs 8 through 10 connect via common costal cartilage Pairs 11 and 12 are “_________”

Major thoracic joints include:

________________________________________________________

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Anatomy Review

Muscles of the trunk (posterior view)

Trapezius Rhomboids Latissimus dorsi and

others

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Anatomy Review

Internal thoracic organs and major blood vessels of the region are:

Heart & pericardium Lungs & pleura

Thoracic aortaPulmonary artery & veinsVena cava

Trachea & esophagus

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Anatomy Review

Abdominal quadrants RUQ LUQ RLQ LLQ

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Anatomy Review

Abdominal Organs and Structures

RUQ contains:_______________________________

RLQ contains:_______________________________

LUQ contains:________________________________

LLQ contains: ________________

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Common Thoracic Injuries

Fractures can occur to ____, _________, _______, or ______ _________

Injuries must be treated immediately to avoid _____________ or ___________

Are not uncommon in sportCan be either direct or indirect trauma

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Signs and symptoms of rib fractures include:

Extreme ___________ that is aggravated by _______, _______, and _____________

Athlete _____________ at point of injury

Mild swelling at site; there may be ____________

Breathing difficulties; _________ _________________

First Aid Monitor vital signs and watch for

respiratory distress Transport to medical facility

Joint _________ and ___________ of thoracic skeletal joints can occur ___________________ involve disunion of _______ and _____Have a higher incidence than ______________________________

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Signs and symptoms of subluxations and dislocations include:

History of _________________ sensations Pain and tenderness over __________________ _____________________, and swelling in the

localized area Maximum or near-maximum ________ may be

very difficult

Treatment Apply ice and light compression immediately Treat for shock and transport to medical facility

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Lung Injuries

__________________ may occur as complication of a rib fracture, contusion, or other type of lung injury

Fractured rib can _______________, causing ______________

___________________ can occur ___________ (reported in weight lifters and runners)

____________ occurs when _____________________

This condition can be life threatening

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Lung Injuries

Signs and symptoms include:

Severe pain in chest, sometimes radiating to thoracic spine

Breathing problems (__________) May have _____________ and

_____________

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Lung Injuries

Treatment

Treat for shock Monitor vital signs Transport to medical facility immediately

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Heart Injuries

While rare, contusions to the chest wall can bruise the heart, resulting in death

_______________ can occur

Use of ___________ is the most practical way to ____________ of people experiencing ________ _______

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Sudden Death Syndrome in Athletes Cause of Condition

________________- thickening of cardiac muscle w/ no increase in chamber size___________- abnormality in connective tissue results in __________________________Series of additional cardiac causesNon-cardiac causes include drugs and alcohol, intracranial bleeding, obstructive respiratory disease

Signs and SymptomsMost _________________________________May exhibit _________, ____________, _______, ________, ___________, _____________, _______ _____________

Heart Injuries

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CareImmediate medical attention is necessary – ___ ____________________

Prevention _________________ are critical in ____ ____________ and ________ of sudden deathScreening questions should address the following

History of ____________ ____________________ Periods of ________ during exercise Family history Thickening of heart or history of Marfan’s syndrome

Cardiac screening - electrocardiograms and echocardiograms may be needed to determine existing pathology

Appendicitis The importance of _____________ could

save the athletes life Inflammation of the appendix can be chronic

(clears itself) or acute Caused by _________________ from a

variety of causes Highest incidence is between _________

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Internal Injuries to the Abdomen

Signs and Symptoms Mild to severe cramp in ___________ ____________________ Low-grade fever Pain in _______________ Positive ______________ Elevated white blood cell count

Treatment Refer to physician

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_____________________ Can lead to ____________ of the _________

and unconsciousness “___________________________” Signs and Symptoms

Athlete is unable to inhale Treatment

Loosed athletes belt and clothing around abdomen

Tell athlete to _____________

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Hernia Cause of Injury

Protrusion of abdominal viscera through portion of ____________ (_________________)

The danger of a hernia is the possibility that it may become ______________________

Inguinal vs. femoral hernias Inguinal– __________________ Femoral—__________________

Complications __________________


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Abdominal Hernia Protrusion of the _______________ through a

portion of the abdominal wall

Inguinal Hernia Protrusion of the ____________ through the

_____________

Signs and Symptoms Previous history of a blow or strain to the groin/lower

abdomen region that produces pain and prolonged discomfort

_________________________ Reported feeling of ____________ and _____

____________________________________


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TreatmentMost physicians prefer athlete to __________ _______________________________

Mechanical devices are not suitable for athletics due to _______________ they produce

While exercise is thought to be beneficial with regards to strengthening, that is not the case


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Internal Injuries to the Thorax and Abdomen

Liver, Kidneys, Spleen and Bladder Injuries

Although fairly safe, the liver is susceptible to ____________

Diseases such as __________ make liver more vulnerable

___________________________ ___________________________

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Kidneys are susceptible to ________ directed at ____________

Kidneys may also be injured as a result of ___________

Be alert for _________

Refer athlete to a physician

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Injury of the Spleen Cause of Injury

Result of a ______________________________ (causing an enlarged spleen)

Signs and SymptomsIndications of a ruptured spleen involve history of a ________, __________, ___________, ________, _________

Be alert for ____________Referred pain in ________________

____________________________ Check nail beds and eyelids

________________ may produce delayed hemorrhaging - easily disrupted resulting in internal bleeding


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Treatment Conservative treatment involves 1 wk of hospitalization and a ____________________Surgery will result in three months of recovery while removal of spleen will result in a 6 month removal from activityIn cases of mononucleosis athlete may resume training in ___________ if spleen not _______ and if there ___________


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Injuries to the Bladder Cause of Injury

Blunt force to the lower abdomen may cause injury to urinary bladder if distended with urine

__________ is often associated with _________ of bladder during running (_________________)

Signs and SymptomsPain, discomfort of lower abdominal region, _________ _____, nausea, ______, _____, ______________ _________, increased quantity of _____________

Athlete should be instructed to ____________

Inability to _____ will present in case of _____________


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_______________________ Cause of Injury

Result of blunt trauma and contusion to the vulnerable and sensitive scrotum

Signs and Symptoms________________________________________ _________________

May cause nauseating, disabling and painful condition Treatment

Place athlete _______________________

Apply cold pack as pain subsides

If pain persist after ________________ will be necessary

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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 ___________________ after injury

***____________________________

1 Injuries to the Thorax and Abdomen PE 236 Amber Giacomazzi MS, ATC.

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