The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic...
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Transcript of The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic...
The Thorax and Abdomen Injuries
Anatomy of the Thorax
• Known as chest • Contains:
– Thoracic vertebrae– 12 pairs of ribs – Sternum
• Main function:– Protect vital respiratory and circulatory organs– Assist lungs in inspiration and expiration
Anatomy of the Abdomen
• Abdominal cavity lies between diaphragm and pelvis
• Abdominal muscles– Rectus abdominis– External oblique– Internal oblique– Transversus abdominis
• Abdominal viscera
– Hollow organs• Stomach - storage and mixing chamber • Intestines - digestion• Gallbladder - storage resevoir for bile • Urinary bladder - stores urine
– Solid organs• Kidneys - filters metabolic wastes, ions, drugs
from blood • Spleen - resevoir for RBC’s; regulates number
of RBC’s; destroys ineffective; produces antibodies for immunological function
• Liver - absorbs and stores excess glucose; processes nutrients; detoxifies harmful chemicals
• Pancreas - digestion of fats, carbs, proteins; produces insulin
• Adrenal glands - secretes hormones: epinephrine, norepinephren, cortisol, estrogen
Recognition and Management of Thoracic Injuries
• Rib contusions
Cause: blow to rib cage can contuse intercostal muscles between the ribs or if severe enough cause fracture
S&S: sharp pain during breathing; point tenderness; pain with rib compression
Care: RICE; NSAIDs; xray; rest!
• Rib fracture
Cause: direct blow; highest incidence in football and wrestling; ribs 5-9 most common; possible lung puncture
S&S: severe pain during inspiration; sharp pain and point tenderness during palpation
Care: xray; support; rest; simple fracture will heal in 3-4 wks
• Costal cartilage injury
Cause: direct blow to thorax; indirect from sudden twist or fall; signs are similar to rib fracture except pain is localized in the junction of the rib and rib cartilage
S&S: sharp pain during sudden trunk movement; difficulty breathing deeply; pt. tenderness; swelling; possible rib deformity and crepitus
Care: immediate cold and compression; immobilization
• Injury to the lungs
Cause: rare
• Pneumothorax - pleural cavity fills with air that has entered through an opening in the chest. As the pleural cavity fills with air, the lung on that side collapses
– Pain, difficulty breathing, anoxia
• Tension pneumothorax - pleural cavity on one side fills with air and displaces the lung and heart toward the other side, thus compressing the opposite lung
– Shortness of breath, chest pain on side of injury, cyanosis, distention of neck veins
• Hemothorax - blood in pleural cavity. Results from tearing or puncturing of the lung or pleural tissue
– Difficulty breathing, cyanosis, pain, coughing up blood, shock
Traumatic asphyxia - violent blow to rib cage causing cessation of breathing and medical attention
– Purple discoloration of upper trunk and head, bright red color of eyes
– Care: each of these conditions is a medical emergency that requires immediate physician attention
Recognition and Management of Abdominal Injuries
• Blow to the solar plexus
Cause: blow to middle of abdomen producing transitory paralysis of the diaphragm - “wind knocked out”
S&S: paralysis of diaphragm stops respiration and leads to anoxia
Care: talk in confident manner; loosen tight clothing; bend knees; encourage athlete to relax by inhaling short inspirations and long expirations
• Hernia– Protrusion of abdominal viscera through
abdominal wall
Cause: most often occur in groin area
Inguinal = men, femoral = women
Intra-abdominal tension produced in these areas muscles produce contraction around canal
openings and if muscles fail to reactthe abdominal contents may be pushed through
these openings
• S&S: previous history of a blow or strain to the groin area that has produced pain and prolonged discomfort; superficial protrusion in groin area increased by coughing; weakness; pulling sensation
• Care: no hard physical activity until after surgery; 2-4 wks recovery
• Kidney contusion
Cause: external force applied to back of athlete which will cause abnormal extension of engorged kidney resulting in an injury
S&S: shock; nausea; vomiting; rigidity of back muscles; hematuria; referred pain around trunk and lower abdomen;
Care: look for blood in urine; referral; 24 hr hospital observation; possible surgery
• Spleen Injuries
Cause: fall/direct blow to upper left quadrant of the abdomen; infectious mononucleosis
S&S: history of severe blow to abdomen and possible signs of shock; abdominal rigidity; nausea; vomiting; pain radiating to left shoulder and 1/3 down the arm (kehr’s sign); hemorrhaging profusely into abdominal cavity causing death days or weeks after injury
Care: conservative; nonoperative treatment is recommended initially with a week of hospitalization and return to activity within 4 wks; with surgery the athlete will require 3-6 months of recovery
• Appendicitis
Cause: chronic or acute; fecal obstruction; lymph swelling; carcinoid tumor; mistaken for gastric complaint; bacterial infection is a complication of rupture of the inflamed appendix
S&S: mild to severe pain in lower abdomen; nausea; vomiting; fever; McBurney’s point (abnormal rigidity and point tenderness on the right side at the anterior superior spine of the ilium and umbilicus)
Care: ER; surgery