Throat and Thorax Injuries Chapter 13

Anatomy of the Throat Esophagus – passageway for food going from the mouth to the stomach. Trachea – made up of circular rings of cartilage, main trunk leading to lungs. Larynx – upper part of trachea, contains the vocal cords. Carotid Artery and Jugular Vein – one of each pass on each side of the trachea, carry oxygenated blood to and from the brain.

Anatomy of the Thorax Heart – about the size of a fist, pumps oxygenated blood to all parts of the body. It has four chambers.  Left and right atrium which are smaller (where blood enters from the body and lungs)  Left and right ventricles which are larger (pump blood to lungs and throughout the body)

The Lungs Exchange oxygen and carbon dioxide and dissipate body heat. Trachea splits into two bronchi, the bronchi divide into bronchioles, and each bronchiole ends in an alveolus. Alveoli – where the exchange of oxygen and carbon dioxide occurs. The right lung has three lobe, and the left lung has two lobes.

Lungs Continued… The respiratory passages are lined with phlegm which is a thick mucous secreted due to an allergy or infection. The body expels this by coughing. The diaphragm is the muscle that separates the thorax and the abdominal cavity. It contracts and relaxes to push air in and out of the lungs during inhalation and exhalation.

Preventing Throat and Thorax Injuries Wear throat protectors  Softball, baseball, lacrosse, field hockey, & ice hockey. Wear shoulder pads, chest protectors, and sternal pads (especially for goalies)  Field hockey, lacrosse, football, ice hockey, softball and baseball. Have a 15 ft. clearance between playing surface and bleachers, scorers tables, benches, spectators, etc. Pad any objects an athlete may come in contact with. Buy the best possible equipment, and make sure it is certified.

Treating Throat Injuries and Conditions Throat laceration – apply direct pressure, if it is deep enough to cut the carotid artery or jugular vein, call 911 immediately. Cartilage fracture (from a severe blow to the throat) – S & S = difficulty breathing, gasping for air, spitting up blood, complaining of pain, trouble talking, and increased anxiety. Skin may turn blue due to lack of oxygen. Call 911 and spine board the athlete until a cervical fracture can be ruled out.

Specific Conditions and Treatment Considerations for the Thorax Rib Fracture – caused by direct impact or chest compression. A blow to the lateral aspect of the rib cage may cause inward penetration leading to internal bleeding or a punctured lung. Athlete will have pain and trouble breathing. Pain will increase with inhalation and decrease with exhalation. There may be deformity. Treat with PRICE, restrict play until pain is gone, or for 6 weeks if playing a contact sport. Wear protective padding upon return to play.

More Thorax Injuries Sternal fractures – if suspected, ice and send to the hospital for X-ray. It may just be a contusion. Pneumothorax – the presence of air in the pleural cavity (collapsed lung). Can be traumatic (rib puncture, gunshot wound) or non-traumatic (weakness of lung tissue). Listen for breath sounds. Spontaneous pneumothorax – caused by an imperfection in the lung tissue. Lay the athlete with the injured lung closest to the ground.

More Thorax Injuries Tension Pneumothorax – when the pressure builds in the chest cavity and pushes the lung against the heart and moves the trachea. If there is a puncture wound, partially cover it leaving one side unsealed so inner air can escape. Treat for shock and call 911 for any pneumothorax. Flail Chest – when several consecutive ribs are fractured in two or more places. The ribs move in during exhalation, causing severe pain. Call 911. Pulmonary contusion – from a direct blow from a ball, call 911 immediately.

More Thorax Injuries Hemothorax – blood in the chest cavity from an internal injury or an external wound. Call 911. Sucking Chest Wound – when the chest is punctured and air is drawn noisily into the cavity. The lung is not punctured, but there is still pressure on the lungs and heart. Seal the wound with plastic wrap and call 911. Hyperventilation – more than 24 breaths per minute. Athlete will become lightheaded, dizzy, numbness of the fingers, toes, and lips, and possibly lose consciousness. Calm the athlete down, have them breathe in through their nose and out through their mouth.