1. Chapter 22
The Chest and Abdomen

2. Objectives Upon completion of this chapter, you should be able to:
Describe the anatomy of the thoracic cavity
Describe the structures and functions of the organs of respiration
Explain the breathing and respiratory process

3. Objectives (cont’d.)
Upon completion of this chapter, you should be able to (cont’d.):
Discuss the significance of chest and abdominal injuries
List and describe the various injuries associated with the thoracic cavity
List and describe the various injuries associated with the abdominal cavity

4. Ribs & Sternum Sternum (“breastbone”)—3 parts Ribs—12 pairs Manubrium
Body
Xiphoid process
Ribs—12 pairs
7 true
3 false ribs—do not connect to sternum directly
2 floating—no connection to sternum at all

5. The Respiratory System
Obtains oxygen for use by body cells
Eliminates carbon dioxide produced in cellular respiration

6. The Respiratory System (cont’d.)
Air moves into the lungs through passageways:
Nasal cavity
Pharynx (throat)
Larynx (voice box)
Trachea (wind pipe)
Bronchi (branches of trachea)
Bronchioles
Alveoli

7. Respiration
Process by which body supplies cells and tissues with oxygen for metabolism and relieves them of carbon dioxide
External respiration
Exchange of oxygen and carbon dioxide between lungs and outside environment—breathing
Internal respiration
Exchange of carbon dioxide and oxygen between cells and lymph, plus oxidative process of energy in cells (cellular respiration)

8. Frequency of Respiration
Adults
14-20 per minute
Children
24-26 per minute

9. Control of Breathing
Rate of breathing is controlled by neural (nervous) and chemical factors
Same goal but function independently
Chemical control of respiration depends on carbon dioxide level in the blood
Chemoreceptors in carotid arteries and aorta are sensitive to blood oxygen levels

10. Lung Capacity and Volume
Factors:
Tidal volume
Inspiratory reserve volume
Expiratory reserve volume
Vital lung capacity
Residual volume
Functional residual capacity
Total lung capacity
Use a spirometer—measures volume & flow of air

11. Disorders of the Respiratory System
Asthma
Muscles around airways tighten and airway lining swells and gets clogged with thick mucus
Symptoms: coughing, wheezing, dyspnea (difficulty in breathing), and chest tightness
Treatment: varies
Exercise-Induced Asthma (EIA)
Increased physical activity causes narrowing of airway

12. Chest (Thorax) Injuries
Rib contusions
Caused by a forceful blow to the ribcage that bruises intercostal muscle
S/S: point tender, pain when breathing
Treatment: removal from activity, ice
Rib fractures
Break in bony structure of thorax
Most often the result of a direct blow to the ribcage

13. Chest (Thorax) Injuries (cont’d.)
Chest contusions
Bruising over central area of chest
Results from a compressive, forceful blow to the body
Myocardial contusion and aortic rupture
Occurs if force applied to sternum is great enough to compress the heart against the spine
Emergency!

14. Chest (Thorax) Injuries (cont’d.)
Sudden death syndrome
Usually caused by some form of heart disease
Pneumothorax
Occurs when air enters thoracic cavity between the chest wall and lung
Sucking chest wound
Spontaneous pneumothorax
Tension pneumothorax

15. Chest (Thorax) Injuries (cont’d.)
Hemopneumothorax
Can occur with both open and closed chest injuries
Often accompanies a pneumothorax
Blood accumulates in pleural space between chest wall and lung
Pulmonary contusion
Bruise on lung caused by a direct blow

16. Chest (Thorax) Injuries (cont’d.)
Blows to the solar plexus
“Having the wind knocked out”
Hyperventilation
Breathing at a rate faster than required for proper exchange of oxygen and carbon dioxide
Side stitches
Occur during vigorous exercises
Usually with novice exercisers

17. Injury Prevention for the Chest
Begins with proper equipment and education
Good, well-maintained, equipment that fits properly will reduce chance of injury
At risk athletes should wear additional protection
Education and use of proper techniques can also minimize risk of trauma

18. The Abdominopelvic Cavity
One large cavity, with no separation between the abdomen and pelvis
Abdominal cavity contains: stomach, liver, gallbladder, pancreas, spleen, small intestine, appendix, and part of the large intestines
Kidneys are close to but behind abdominal cavity
Pelvic cavity contains: urinary bladder, reproductive organs, rectum, remainder of large intestine, and appendix

19. Protection of the Abdominal Organs
Abdominal area is vulnerable to injury
Muscular abdominal wall is most commonly involved
Injury to contents of abdominal cavity are infrequent
Musculature of abdominal wall provides adequate protection from most injuries
Serious injuries to the intra-abdominal contents occur and can be life threatening

20. The 4 Quadrants of the Abdomen

21. Organs of the Abdominopelvic Cavity
Stomach
Small intestine
Pancreas
Liver
Gallbladder
Urinary bladder
Large intestine
Colon
Cecum
Appendix
Kidneys

22. Abdominal Injuries Kidney contusion Liver contusion
Uncommon in athletics
Occurs with a violent blow to upper posterior abdominal wall
Liver contusion
Uncommon but probable life-threatening injury
Occurs with a hard blow to right side of ribcage

23. Abdominal Injuries (cont’d.)
Spleen injuries
Treat as medical emergency
Results from a blow to the left upper quadrant, lower left ribcage, or left side of the back
Kehr’s sign: pain radiates to left shoulder and down left arm
Hernias
Protrusion of abdominal tissue through a portion of the abdominal wall

24. Conclusion The chest and abdomen contain the body’s vital organs
Organs in the chest are protected by the ribcage
Chest contains the heart and lungs
Abdomen contains kidneys, liver, spleen, stomach, urinary bladder, intestines, among others

25. Conclusion (cont’d.)
Chest and abdominal injuries are uncommon in athletics, but do occur
Most internal organs are very vascular and can bleed profusely if injured
Proper recognition and treatment of these injuries are vital to the health and well-being of the athlete