The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic...

21
The Thorax and Abdomen Injuries

Transcript of The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic...

Page 1: The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic vertebrae –12 pairs of ribs –Sternum Main function: –Protect.

The Thorax and Abdomen Injuries

Page 2: The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic vertebrae –12 pairs of ribs –Sternum Main function: –Protect.

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

Page 3: The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic vertebrae –12 pairs of ribs –Sternum Main function: –Protect.
Page 4: The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic vertebrae –12 pairs of ribs –Sternum Main function: –Protect.

Anatomy of the Abdomen

• Abdominal cavity lies between diaphragm and pelvis

• Abdominal muscles– Rectus abdominis– External oblique– Internal oblique– Transversus abdominis

Page 5: The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic vertebrae –12 pairs of ribs –Sternum Main function: –Protect.

• Abdominal viscera

– Hollow organs• Stomach - storage and mixing chamber • Intestines - digestion• Gallbladder - storage resevoir for bile • Urinary bladder - stores urine

Page 6: The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic vertebrae –12 pairs of ribs –Sternum Main function: –Protect.

– 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

Page 7: The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic vertebrae –12 pairs of ribs –Sternum Main function: –Protect.
Page 8: The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic vertebrae –12 pairs of ribs –Sternum Main function: –Protect.

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!

Page 9: The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic vertebrae –12 pairs of ribs –Sternum Main function: –Protect.

• 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

Page 10: The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic vertebrae –12 pairs of ribs –Sternum Main function: –Protect.

• 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

Page 11: The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic vertebrae –12 pairs of ribs –Sternum Main function: –Protect.

• 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

Page 12: The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic vertebrae –12 pairs of ribs –Sternum Main function: –Protect.

• 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

Page 13: The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic vertebrae –12 pairs of ribs –Sternum Main function: –Protect.

• Hemothorax - blood in pleural cavity. Results from tearing or puncturing of the lung or pleural tissue

– Difficulty breathing, cyanosis, pain, coughing up blood, shock

Page 14: The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic vertebrae –12 pairs of ribs –Sternum Main function: –Protect.

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

Page 15: The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic vertebrae –12 pairs of ribs –Sternum Main function: –Protect.

Recognition and Management of Abdominal Injuries

Page 16: The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic vertebrae –12 pairs of ribs –Sternum Main function: –Protect.

• 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

Page 17: The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic vertebrae –12 pairs of ribs –Sternum Main function: –Protect.

• Hernia– Protrusion of abdominal viscera through

abdominal wall

Cause: most often occur in groin area

Inguinal = men, femoral = women

Page 18: The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic vertebrae –12 pairs of ribs –Sternum Main function: –Protect.

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

Page 19: The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic vertebrae –12 pairs of ribs –Sternum Main function: –Protect.

• 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

Page 20: The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic vertebrae –12 pairs of ribs –Sternum Main function: –Protect.

• 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

Page 21: The Thorax and Abdomen Injuries. Anatomy of the Thorax Known as chest Contains: –Thoracic vertebrae –12 pairs of ribs –Sternum Main function: –Protect.

• 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