Thorax and abdomen Lecture 17

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

Thorax Thorax- lungs and Heart

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

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

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

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)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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