1. Thorax and abdomen Lecture 17

2. The Thorax and Abdomen
less common than extremities in sport, but can be more serious
the abdomen includes all organs and structures between the pelvic floor and the diaphragm
the solid organs include the , spleen, liver, pancreas, kidneys and adrenal glands
the hollow organs include the stomach, small intestine and large intestines

3. Thorax
Thorax- lungs and Heart

4. Organs
the liver – located in the upper right quadrant – used in digestion
the spleen – largest of the lymphoid organs located in the upper left quadrant
cleans the blood of foreign matter
stores excess RBC
stores blood platelets

5. organs
the pancreas – located in the upper left quadrant – used in digestion, secretes insulin and glucagon – deals with blood sugar levels

6. Organs kidneys – located lower left and right – more posterior
filter and cleans the blood
appendix – lower right quadrant

7. The Thorax
the chest
surrounded by the ribs, spine, sternum. diaphragm , neck
extends from the level of the clavicle down to the diaphragm
12 t-spine and ribs function to protect organs of respiration (lungs) and circulation ( heart)

8. Ribs 7 true ribs attach directly to sternum
8, 9, 1 0 false b/c cartilage joins with 7th rib
11, 12 are floating ribs, only gain attachment at Tl1, Tl2

9. Common Thoracic and Visceral Injuries
account for 10% of sport injuries
most common in contact sports --> direct blow from another player or implement
can be prevented by proper training of abdominal b/c if tensed , reduces chance of injuries
most organ injuries occur to solid rather than hollow

10. Pneumothorax
is a condition whereby air is trapped in the pleural cavity causing a portion of the lung to collapse

11. S/S – shortness of breath, cyanosis, severe chest pain and progressive respiratory collapse ( decreased blood pressure)
First Aid - keep calm , try to control breathing, monitor vitals, treat for shock and transport to nearest hospital
Spontaneous Pneumothorax
Occurs unexpectedly with or with out underlying cause, usually to tall , lean males with conditions of heavy exertion,
First Aid - as above

12. Spontaneous Pneumothorax
Occurs unexpectedly with or with out underlying cause, usually to tall , lean males with conditions of heavy exertion,
First Aid - as above

13. Hemothorax
involves blood in the plueral cavity rather than air- fractured ribs may tear lung tissue
S/S – severe pain , hypoxia, difficulty breathing , cyanosis and coughing up frothy blood
First Aid – as above

15. Stitch in the Side refers to sharp pain or spasm in the chest wall
may run through it by
First Aid- forcibly exhaling through pursed lips
breath deeply and regularly
leaning away from affected side
stretching arm on affected side over head as high as possible

16. Strain of Pectoralis
sudden violent deceleration manoeuvres , or excessive tension from acute overloads of eccentric nature ( bench press)
aching fatigue type pain , with horizontal adduction and internal rotation of shoulder limited
First Aid- PIER

17. Rib fractures sternum rarely fractured in sports
rib fractures may be caused by indirect forces such as a violent muscle contraction
the 4th through the 9th ribs are more commonly injured

18. localised intense pain with deep inspiration coughing, and chest movement
visible bruising and crepitus may be present at impact site
manual compression of rib cage in antro-posterior and lateral direction will produce pain
First Aid
PIER – wrap with tensor .. refer to doctor—protect when return to play

19. Hyperventilation
respiratory condition in which too much carbon dioxide is exhaled , leading to the inability to catch ones breath
chest pain , dizziness, light-headedness, slurred speech ,panic and anxiety
First Aid
calm individual and have them breath in to a paper bag, their hands or have them concentrate on slow inhalations through the nose

20. Abdominal Strains usually the result of a rapid twist or direct trauma
abdominal pain , nausea , tenderness and muscle grading , pain with straight leg raise or sit-ups
First Aid
PIER
difficult to treat due to everyday use and some contraindications

22. Solar Plexus Contusion
wind knocked out
a blow to the abdomen with the muscle relaxed
results in the inability to catch one’s breath
fear and anxiety complicate this injury
First Aid
remove mouth guard, loosen clothing and flex knee to the chest

23. can ask athlete to take a deep breath and hold it and repeat it as many times as possible may aid in restoring the breath sooner
another method is to have the athlete attempt to whistle – this forces the diaphragm to relax

24. Hernias
a protrusion of the abdominal viscera through a weakened portion of the abdominal wall
Congenital - born with weakness
Visible tender swelling and aching feeling in the groin area
Protrusion of hernia usually worsens with coughing
refer to physician

25. Spleen injuries
Located upper left quadrant – blood reservoir and filter
despite being highly protected , it is the second most frequently injured abdominal organ after the kidneys
most frequent cause of death from a blunt trauma in sports because the spleen can splint itself and stop bleeding only to produce delayed bleeding days later

26. usually a blow to the upper left quadrant
resulting in a dull pain in upper left quadrant , left lower chest and left shoulder (Kehrs sign), nausea, vomiting , and sign of shock
CAUTION with Mononucleosis as it can enlarge the spleen , making it more susceptible to injury
First Aid
requires immediate medical attention

27. Appendicitis inflammation of the appendix as a result of blockage
leading to a bacterial infection resulting in an inflamed appendix
then ruptures into the peritoneal cavity spreading bacteria
abdominal pain in lower right quadrant , nausea, loss of appetite, vomiting and low grade fever
First Aid - medical attention ASAP

28. Kidney Contusion
most frequently injured organ in sports related trauma
results from blow to the back just below the ribs
there may be blood in the urine (hematuria) and pain in the lower back and or butt
First Aid medical attention ASAP