Injuries to the Thorax and Abdomen

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

2. 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: • ______________ • ______________ • ______________ • ______________

5. Anatomy Review Muscles of the trunk (posterior view) • Trapezius • Rhomboids • Latissimusdorsi and others

6. Anatomy Review Internal thoracic organs and major blood vessels of the region are: • Heart & pericardium • Lungs & pleura • Thoracic aorta • Pulmonary artery & veins • Vena cava • Trachea & esophagus

7. Anatomy Review Abdominal quadrants • RUQ • LUQ • RLQ • LLQ

8. Abdominal Organs and Structures RUQ contains: _______________________________ RLQ contains: _______________________________ LUQ contains: ________________________________ LLQ contains: ________________ Anatomy Review

9. Common Thoracic Injuries • Fractures can occur to ____, _________, _______, or ______ _________ • Injuries must be treated immediately to avoid _____________ or ___________ • Are not uncommon in sport • Can be either direct or indirect trauma

10. Common Thoracic Injuries 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

11. Common Thoracic Injuries Joint _________ and ___________ of thoracic skeletal joints can occur ___________________ involve disunion of _______ and _____ Have a higher incidence than _________ _____________________

12. Common Thoracic Injuries 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

13. 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

14. Lung Injuries Signs and symptoms include: • Severe pain in chest, sometimes radiating to thoracic spine • Breathing problems (__________) • May have _____________ and _____________

16. Lung Injuries Treatment • Treat for shock • Monitor vital signs • Transport to medical facility immediately

17. 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 ________ _______

18. Heart Injuries • 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 causes • Non-cardiac causes include drugs and alcohol, intracranial bleeding, obstructive respiratory disease • Signs and Symptoms • Most _________________________________ • May exhibit _________, ____________, _______, ________, ___________, _____________, _______ _____________

19. Care • Immediate medical attention is necessary – ___ ____________________ • Prevention • _________________ are critical in ____ ____________ and ________ of sudden death • Screening 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

20. Internal Injuries to the Abdomen • 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 _________

21. 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

22. Internal Injuries to the Abdomen • _____________________ • 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 _____________

23. Internal Injuries to the Abdomen • 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 __________________

24. Internal Injuries to the Abdomen • 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 _____ ____________________________________

26. Internal Injuries to the Abdomen • Treatment • Most 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

27. 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 • ___________________________ ___________________________

28. Internal Injuries to the Abdomen • Kidneys are susceptible to ________ directed at ____________ • Kidneys may also be injured as a result of ___________ • Be alert for _________ • Refer athlete to a physician

29. Internal Injuries to the Abdomen • Injury of the Spleen • Cause of Injury • Result of a _____________ • _________________ (causing an enlarged spleen) • Signs and Symptoms • Indications 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

31. Internal Injuries to the Abdomen • 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 activity • In cases of mononucleosis athlete may resume training in ___________ if spleen not _______ and if there ___________

32. Internal Injuries to the Abdomen • 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 Symptoms • Pain, discomfort of lower abdominal region, _________ _____, nausea, ______, _____, ______________ _________, increased quantity of _____________ • Athlete should be instructed to ____________ • Inability to _____ will present in case of _____________

34. Internal Injuries to the Abdomen • _______________________ • 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

35. 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 ***____________________________