injuries to the thorax and abdomen pe 236 juan cuevas atc n.
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Injuries to the Thorax and Abdomen PE 236 Juan Cuevas, ATC. Anatomy Review. Thoracic cage has 12 pairs of ribs. 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:

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anatomy review
Anatomy Review

Thoracic cage has 12 pairs of ribs.

  • 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.
    • ____________________
anatomy review continued
Anatomy Review (continued)

Muscles of the trunk (posterior view)

  • ______________.
  • Rhomboids.
  • Latissimus dorsi and others.
anatomy review continued1
Anatomy Review (continued)

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

  • ________ & pericardium.
  • Lungs & ________.
    • Thoracic aorta.
    • Pulmonary artery & veins.
    • ___________.
  • Trachea & esophagus.
anatomy review1
Anatomy Review

Abdominal quadrants

  • _______
  • _______
  • RLQ
  • LLQ
anatomy review continued2
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.

Anatomy Review (continued)
common sports injuries
Common Sports Injuries
  • Fractures can occur to ribs, sternum, clavicle, or thoracic vertebrae.
    • 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.
common sports injuries continued
Common Sports Injuries (continued)

Signs and symptoms of rib ____________ include:

  • 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

  • Monitor vital signs and watch for respiratory distress.
  • Transport to medical facility.
common sports injuries continued1
Common Sports Injuries (continued)

Signs and symptoms of subluxations and dislocations include:

  • 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

  • Apply ice and light compression immediately.
  • Treat for ______ and transport to medical facility.
heart injuries
Heart Injuries
  • While rare, contusions to the chest wall can bruise the heart, resulting in death.
    • __________________ can occur.
  • Use of ______ device is the most practical way to save the lives of people experiencing commotio cordis.
Sudden ________ Syndrome in Athletes
    • 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
    • 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
    • ___________ medical attention is necessary – life threatening condition
  • ______________
    • Counseling and screening are critical in early identification and prevention of sudden death
    • Screening questions should address the following
      • 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
lung injuries
Lung Injuries
  • 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).
  • _____________ occurs when fractured rib punctures lung.
    • This condition can be ______________.
lung injuries continued
Lung Injuries (continued)

Signs and symptoms include:

  • Severe _______ in chest, sometimes radiating to thoracic spine.
  • Breathing problems (___________).
  • May have nonproductive _______ and tachycardia.
lung injuries continued1
Lung Injuries (continued)

First Aid

  • Treat for ________.
  • Monitor ____________.
  • Transport to medical facility immediately.
internal injuries to the thorax and abdomen
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.
    • Heavy consumption of ________ and/or use of steroids damages the liver.
internal injuries to the thorax and abdomen continued
Internal Injuries to the Thorax and Abdomen (continued)
  • Kidneys are susceptible to blunt trauma directed at the ______________.
  • Kidneys may also be injured as a result of heat stroke
    • Be alert for ________________.
  • Refer athlete to a physician.
Injury of the ___________
    • Cause of Injury
      • Result of a direct blow to _________
      • Infectious mononucleosis (causing an enlarged spleen)
    • Signs of Injury
      • Indications of a ruptured spleen involve history of a direct blow, signs of _______, abdominal rigidity, nausea, vomiting
    • Be alert for _____________ sign.
      • Referred pain in upper left shoulder
      • Decreased peripheral circulation.
        • Check nail beds and ________
      • Ability to splint self may produce delayed hemorrhaging - easily disrupted resulting in internal bleeding
    • 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
Injuries to the Bladder
    • 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)
    • 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
Scrotal/Testicular Contusion
    • Cause of Injury
      • Result of blunt trauma and______ to the vulnerable and sensitive scrotum
    • Signs and Symptoms
      • Hemorrhaging, fluid effusion, _____________, severe pain (disabling)
      • May cause nauseating, disabling and painful condition
    • Care
      • Place athlete on side with knees to chest
      • Apply ________ as pain subsides
      • If pain persist after 15-20 minutes referral will be necessary
    • Cause of Injury
      • Protrusion of abdominal viscera through portion of abdominal ______ (congenital or acquired)
      • Inguinal vs. ____________ hernias
      • Complications and strangulated hernias
    • Signs of Injury
      • Acquired hernia occur when ______________ is further aggravated by a direct blow or strain
        • History of direct blow to groin area, pain and prolonged discomfort, superficial protrusion with pain increasing with coughing & reported pulling sensation in ________ area
Abdominal Hernia
    • __________ of the abdominal viscera through a portion of the abdominal ________
  • _____________ Hernia
    • Protrusion of the spermatic cord through the inguinal ________-
      • Signs and Symptoms
        • 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.
    • 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
hernias cont
Hernias (cont’)
  • First Aid/ Treatment
    • Refer to MD
    • Surgery!!!
internal injuries
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!!!