Chapter 22 The Chest and Abdomen

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

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

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

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

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

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)

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

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

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

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

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

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!

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

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

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

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

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

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

The 4 Quadrants of the Abdomen

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

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

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

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

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