Throat, Thorax and Visceral Condition

Pleural cavity

narrow space between pleural membranes filled with pleural fluid... enables lungs to move against thoracic wall with minimal friction during breathing

What are signs and symptoms of blunt scrotal trauma

nausea and pain

What are traumatic throat conditions?

neck laceration and contusions and fractures

What can happen to the intercostal nerve with a costochondral sprain?

puts pressure on intercostal nerve

What can happen even if the spleen is splinted?

can re-bleed with the slightest trauma

What can happen if air is sucked into jugular vein during neck laceration?

carried to hear as an air embolism... fatal

What is the dividing line for the abdominal cavity quadrants?

centre line of rectus abdominus

Sideline Assessmenet for kidney injury

check for rib fracture, ask for urine sample (check for blood)... less hematuria needs laboratory dip sticks, pain referred posteriorly to low back region... sides of buttocks, lower abdomen

Can you live without the liver?

no

Physical examination tests

ROM, Vital Signs, Urinalysis, Neurologic tests

What should you check for with rib fractures?

coughing up blood, abnormal breath sounds, rate and depth of respiration

fracture to lower 2 ribs may be associated with

damage to the kidneys, liver or spleen

What causes dyspnea during solar plexus contusion?

diaphragmatic spasm... celiac plexus

Ruptured bladder

difficult to rupture an empty bladder with concussive force to the lower abdomen

Liver contusion and rupture MOI

direct blow to upper right quadrant

What are solar plexus contusion signs and symptoms?

dyspnea (shortness of breath)... fear and anxiety

If 3 or more ribs are fractured...

each in two locations (flail chest)... other serious signs such as pneumothorax

Signs and symptoms of liver contusion and rupture can be _____ or _____.

early or late

Splenic rupture

enlarged splene, most recent cause of death from abdominal blunt trauma in sport

Why are kidneys not injured that often?

location (under ribs) plus large deposits of fat

Hollow organs have what type of blood flow

low blood flow

Pelvis stabilizes ____ _____ while motion occurs in the extremities

lower trunk

Solid organs have what type of blood flow

major flow of blood

Sternum

manubrium: attaches to 1st & 2nd ribs body: attaches to 2nd-7th ribs xiphoid process: hyaline cartilage that ossifies around age 40

Why does liver contusion and rupture require nonoperative management?

massive bleeding, but is often stopped by the time the wound is exposed

Pelvis provides a _____ ____ between upper and lower extremities.

mechanical link

Injuries to vulva MOI

straddling or penetration trauma

Spontaneous pneumothorax

strongly associated with smoking... tall lean males teens and early 20s

What can pneumothorax develop into?

tension pneumothorax

Hemothorax

Loss of blood into pleural cavity

How can you immobilize chest?

circumferential tensor wrap, apply tape on affected side... start posterior at spine, bring tape from posterior to anterior ending at sternum

What should you look for when looking for hematuria?

clarity of urine, not necessarily colour

Costochondral sprain cause

collison force, severe twisting of thorax

MOI of splenic rupture

concussive blow to upper left quadrant resulting in bleeding

What are signs and symptoms of costochondral sprain?

hear or feel a "pop", localized sharp pain; changes to stabbing pain, visible deformity, sever pain

Penile injuries requires physical referral if

hemorrhage persists or swelling impairs the function of urethra

What are the two types of tones?

hollow or solid

What is hyperventilation?

rapid deep inhalations, drawing too much O2, long exhalations, too much Co2 being exhaled

Hyperventilation cause

pain, stress, trauma

In what quadrant is the appendix?

right lower

How to manage hemothorax

treat for shock

What ribs are most commonly acutely fractured?

5-9

How can fractured ribs be treated?

6-inch elastic bandage wrapped around thorax with circular motions

Solar plexus contusion is also known as

"wind knocked out"

What are the four vital functions of the spleen?

1) cleansing the blood of foreign matter, bacteria, viruses, and toxins 2)storing excess red blood cells for later reuse and releasing others into the blood for processing by the liver 3) producing red blood cells in the fetus; and 4) storing blood platelets

What ribs are the most commonly involved in slipping rib syndrome?

10th, 9th, 8th

Small intestine

2m in length, responsible for most of the digestion and absorption of food

How long does it take for costochondral sprain to heal?

3-4 weeks with rest and anti-inflammatory meds but may persist for 9-12 weeks

Tension pneumothorax

Air accumulates in pleural space during inspiration and cannot escape on exhalation; expansion compresses .... decreases cardiac output

Costal cartilages

First 7 attach to sternum, 8-10 attach to superior ribs, 11-12 are floating

Management of solar plexus contusion

Have athlete take a deep breath and hold it... repeat several times, whistle

Stomach

J-shaped bag positioned between esophagus and small intestine

What are three internal complication to the lungs?

Pneumothorax, hemothorax, tensionpneumothorax

What are the two types of visceral organs in the cavity

Solid and hollow

Thoracic cage and pleura consists of

Sternum, ribs, costal cartilage, thoracic vertebrae (cage around lungs), pleural and pleural cavity

Visceral organs

Stomach, liver, spleen, kidneys

How to manage trauma to abdomen

activate EMS, treat for shock, monitor vitals

Symptoms of appendicitis

acute pain in lower right quadrant, loss of appetite, nausea and vomiting, low grade fever

Laryngospasm

adductor muscles of the vocal cords pull together in a shutter-like fashion, and the upper surface of the vocal cords closes over the top... complete obstruction

What is pneumothorax?

air trapped in pleural space, causing portion of lung to collapse... lung can't fully expant

Hollow organs

allow for passage of large amounts of substances from one part of body to another

What is painful if you have slipping rib syndrome?

bending (sharp clicks)... hooking fingers under and pulling rib cage anteriorly

Damage to solid organs causes more rapid

bleeding

hematuria

blood in urine (very dark)

Visceral region anatomy

blood vessels (aorta...numerous branches)

Method of injury of kidney injury

blunt trauma to mid to low back region... countercoup injury from a high speed collision

How can you restore oxygen, CO2 balance?

breathing into paper bag

Bronchial tree and lungs consist of

broncheal tubes that branch obliquely downward from trachea and form terminal bronchioles where there are tiny air sacs called alveoli (diffusion champers O2 & CO2)

Blunt scrotal trauma

contusion, hematoma, torsion, dislocation or rupture of the testicle

How can contusions and fractures of throat be fatal?

extravasation of blood into the laryngeal tissues... airway edema and asphyxia

Kidneys

filter and cleanse the blood, return needed substances to the blood

Chemical reactions in solid organs include

filtration of luis, immune fractions, and energy synthesis

Cause of hemothorax

fracture of rib could tear lung tissue or blood vessels in chest

Management for liver injury

ice for pain and inflammation.. medical help

How to manage rib fractures?

immobilize chest

Signs and symptoms of hyperventilation

inability to catch breath, numbness in lips and hands, spasm of hands, chest pain, dry mouth, dizziness

What is a rib stress fracture caused by

indirect force, such as violent muscle contraction

Palpation

individual supine with knees flexed... palpate structures

Solid organs

kidney, spleen, liver, pancreas, supra-renals

What should you look for in other injuries if there is a rib stress fracture

laceration of the intercostal artery

Spleen is the :

largest of the lymphoid organs

If appendix becomes obstructed, what happens?

leads to circulation problems, leads to bacterial growth and formation of pus

In what quadrant is the spleen?

left upper

Thoracic cavity

lies anterior to the spinal column, extends from level of the clavicle down to the diaphragm

Technique for percussion

nondominant hand placed on the individual's abdomen, 2nd and 3rd fingers of dominant hand tap on DIP joint of middle finger with a quick rapid motion

McBurney's point

one third distance between ASIS and the belly button is the appendix ...

What is indicative of damage to an organ in a certain quadrant?

pain

Rib fracture signs and symptoms

pain at site with deep inspiration, localized swelling, discoloration, crepitus

Kidney

paired organs under bottom three ribs inside posterior abdominal wall

Signs and symptoms of liver contusion and rupture

palpable pain, hypotension, referred pain to inferior angle of right scapula

Kehr's sign

persistent dull pain in the upper left quadrant, left lower chest, and left shoulder to third of the arm

How to manage blunt scrotal trauma

placing individual on back and flexing the knees toward the chest; cold compress

What are complications of bladder rupture?

possible pelvic fracture

Transient paresthesia of penis

pressure on the pudendal nerve

Pelvis forms a

protective basin around internal organs of abdomen

Appendix

protrudes from large intestine, accumulation of bacteria, leading to inflammation of the appendix

How to manage contusions and fractures of throat

reassure individual, diminish panic and anxiety... maintain open airway

concern of contusions and fractures of throat

recover on-sit and have respiratory problems a little while later... internal hemmorhage and increased swelling

In what quadrant is the liver?

right upper

What happens if the appendix has bacterial growth and formation of pus?

rupture

What can yield hematuria?

ruptured bladder and damaged kidney can yield hematuria

Pelvic girdle includes

sacrum, ilium, ischium, pubis, functions

What is the result of a costochondral sprain?

separates cartilage at attachment to rib or sternum

Signs and symptoms of hemothorax

severe pain, difficulty breathing, cyanosis, decreased breath sound, coughing blood, percussion of the thoracic area, shock

"red flags" for trauma to abdomen

shallow breathing, rapid, weak pulse, coughing up blood

What are general indicators to watch for ?

shock, pain, hemorrhage

Solid

sites of chemical events in the abdomen

What is a costochondral sprain also called?

slipping rib syndrome

What is another way to treat hyperventilation?

slow inhalations through nose, exhalations through the mouth

Liver

solid organ located in the upper right quadrant of the abdomen

Spleen has ability to "____" itself after injury

splint (forms a clot)

How can rib fractures be diagnosed?

stethoscope used to listen for abnormal or absent breath sounds in lungs. Manual compression of rib cage in an anteroposterior direction and lateral compression

Hollow organs

stomach, intestines, gall bladder, urinary bladder

pelvis transfers loads between

the spine and the lower extremity through the hip joint

Pleura

thin, double-layered membrane that lines thoracic cavity

What can be damaged by direct impact force to the throat while the neck is extended?

thyroid cartilage (Adam's Apple)

Structures to palpate

trachea, clavicle, sternum, costochondral cartilage and ribs, rib cage, abdomen

Where can contusions and fractures of the throat occur?

trachea, larynx, hyoid bone

Signs and symptoms of splenic rupture

trauma to left upper quadrant... Kehr's sign... shock

What is the cause of pneumothorax?

traumting-penetrating wound... spontaneous -unexpected

Neck laceration

uncommon; severe bleeding Management: control hemorrhage; EMS

Spleen

upper left quadrant... major filter of the body, where white blood cells are developed

Where is the liver located?

upper right quadrant under the diaphragm

What are the quadrants of the abdominal cavity?

upper right, lower right, upper left and lower left

Percussion

used to indicate internal complications

Tunica vaginalis rupture

vascular and tubercle components of the testes can be seriously damaged

Most abdominal injures are _____ and ___ injuries

wait see

Injuries to vagina MOI

water being forced into vagina