CH 27 Thorax and Abdomen

Hemorhoids

(piles) Hemorrhoids are varicosities of the hemorrhoidal venous plexus of the anus. There are both internal and external anal veins. Chronic constipation or straining at the stool may stretch the anal veins, resulting in either a protrusion (prolapse) and bleeding of the internal or external veins or a thrombus in the external veins.

Breast Cancer

- most common type of cancer in women and second leading cause of death by cancer in women - 1 percent of breast cancer occurs in men -

S/S of Rib tip syndrome

- pain localized to upper abdomen or inferior costal area - sharp, stabbing pain - pain with laterally flexes and hyperextends toward oppsite side - popping sensation or slipping movement of ribs

Causes of Appendicitis

. It is caused by a variety of conditions, such as a fecal obstruction, lymph swelling, or even a carcinoid tumor. Its highest incidence is in males between the ages of 15 and 25.

Stich in the side

A "stitch in the side" is the name given to an idiopathic condition that occurs in some patients. The cause is obscure, although several hypotheses have been advanced. Among the possible causes are constipation, intestinal gas, overeating, diaphragmatic spasm as a result of poor conditioning, lack of visceral support because of weak abdominal muscles, distended spleen, breathing techniques that lead to a lack of oxygen in the diaphragm, ischemia of either the diaphragm or the intercostal muscles, and a fluid-engorged gut that tugs on visceral ligaments.

Blow to the solar plexus

A blow to the sympathetic celiac plexus (solar plexus) produces a transitory paralysis of the diaphragm ("wind knocked out"). There may also be a loss of residual volume in the lungs due to the blow, forcing a large amount of air from the lungs. Paralysis of the diaphragm stops respiration and leads to anoxia

Costochondral Seperation and Dislocation

A costochondral separation or dislocation has a higher incidence than do fractures (Figure 27-24). This injury can occur from a direct blow to the anterolateral aspect of the thorax or indirectly from a sudden twist or a fall on some object that compresses the rib cage. The costochondral injury displays many signs that are similar to the rib fracture, with the exception that pain is localized in the junction of the rib cartilage and rib.

Functional heart murmur

A murmur that exists in the absence of any organic disease in the heart is called a functional murmur. Most heart murmurs are functional and are caused by blood flowing through healthy valves in a healthy heart and no treatment is necessary. Functional murmurs arc common in athletes because high cardic output in trained athletes creates high flow velocity and thus a turbulent flow, which results in the presence of murmurs during the ejection phase of the cardiac cycle.

peptic ulcer

A peptic ulcer is a condition in which the acids secreted in the stomach destroy the mucous lining either in the stomach or in the small intestine.

Contraction pattern of the hearts muscle

A single heartbeat consists of a contraction of both atria followed quickly by a contraction of both ventricles. There must be some time between contraction of the atria and contraction of the ventricles to allow for the ventricle to fill with blood. Contraction of the chambers is referred to as systole, relaxation as diastole

Tension pneumothorax

A tension pneumothorax occurs when the pleural sac on one side fills with air and displaces the lung and the heart toward the opposite side, which compresses the opposite lung. There is shortness of breath and chest pain on the side of the injury. There may be absence of breath sounds, cyanosis, and distention of neck veins. The trachea may deviate away from the side of injury. A total collapse of the opposite lung is possible; therefore, medical attention is required immediately.

Abnormal heart murmur

Abnormal heart murmurs can be caused by blood flowing through a damaged heart valve

Adrenal glands

Although part of the endocrine system rather than the urinary system, the adrenal glands, also called the suprarenal glands, are located on top of each kidney. They secrete the hormones epinephrine, norepinephrine, cortisol, estrogen, aldosterone, and androgen, which have a variety of physiological functions throughout the body

Heart Murmur

An abnormal periodic sound that occurs in auscultation of the heart is called a murmur. A murmur does not necessarily mean that a pathogenic condition exists in the heart. There are two types of heart murmurs: functional and abnormal.

Runners Nipple

Another condition that occurs to the breasts in both males and females is runner's nipples, in which the shirt rubs the nipples and causes an abrasion. Runner's nipples can be prevented by placing an adhesive bandage over each nipple before participation. Bicyclist's nipples occur as a result of a combination of cold and the evaporation of sweat, which causes the nipples to become painful. Wearing a windbreaker can prevent this problem.5

Athletic Heart Syndrome

Athletic heart syndrome involves both structural and functional changes that occur in the hearts of individuals who train for greater than 1 hour on most days.52 These changes include an increase in the mass of the left ventricle due to increases in left ventricle diastolic cavity dimension, wall thickness, or both. Maximal stroke volume and cardiac output increase, contributing to a lower resting heart rate and longer diastolic filling time. These changes in cardiac morphology are demonstrated using echocardiography (ECG). Despite these changes, systolic and diastolic function remains normal. Differences between athlete and nonathlete populations are generally small, but athletic heart syndrome typically occurs less often in women than in men.

Ausculation

Auscultation involves listening to body sounds through a stethoscope.38 It has been suggested that auscultation should be done prior to obtaining a history

Increasing chances of breast cancer

Breast cancer may occur at any age, though the risk of breast cancer increases with age. Family history has long been known to be a risk factor for breast cancer. The risk is highest if the affected relative developed breast cancer at a young age, had cancer in both breasts, or is a close relative. Hormonal influences play a role in the development of breast cancer. Women who start their periods at 11 years of age or younger and those who experience menopause later than 55 years of age have a higher risk of developing breast cancer. Breast cancer occurs more frequently in women with high dietary intake of fat

Cirrhosis

Cirrhosis is a progressive disease of the liver that results in diffuse scarring, fibrosis, and disruption of hepatic blood flow, which can eventually result in liver failure. Cirrhosis has many causes, but it is most often associated with chronic alcoholism

Abdominal Viscera

Composed of both hollow and solid organs. The solid organs are the kidneys, spleen, liver, pancreas, and adrenal glands. The hollow organs include vessels, tubes, and receptacles, such as the stomach, intestines, gallbladder, and urinary bladder

Cystits

Cystitis is an inflammation or infection of the urinary bladder. When caused by bacteria, it is called a urinary tract infection (UTI).61 Bacterial cystitis, the most common type, is commonly caused by coliform bacteria transferred from the bowel through the urethra into the bladder. In females, it most often occurs from wiping incorrectly from back to front after a bowel movement. It can also occur due to frequent or rough sexual intercourse or other activities that push bacteria into the bladder. Females are much more prone to cystitis than males. Cystitis occurs most often in sexually active females ages 20 to 50. It also may occur in women or teenagers who are not sexually active, or in young girls. Cystitis rarely occurs in men with normal urinary tracts. In men, an enlarged prostate gland can cause bladder infections

Blood flow through the heart

De-oxygenated blood returns from all parts of the body through the venous system to the right atrium and passes through the tricuspid valve to the right ventricle. The right ventricle pumps the blood through the pulmonary valve to the pulmonary artery and into the lungs, where it is oxygenated. Blood returns from the lungs via the pulmonary vein to the left atrium and passes through the mitral valve into the left ventricle. Blood is ejected past the aortic valve into the aorta, which supplies the entire body through the arterial system.

Sternum Fracture

Fracture of the sternum results from a high-impact blow to the chest. Sternum fractures are more likely to occur in automobile accidents than in athletics

S/S of Hemorrhoids

Hemorrhoids are painful, nodular swellings near the sphincter of the anus. They may cause slight bleeding and itching. The majority of hemorrhoids are self-limiting and heal spontaneously within 3 weeks.

Hemothorax

Hemothorax is the presence of blood within the pleural cavity . It results from the tearing or puncturing of the lung or pleural tissue, which involves the blood vessels in the area. Like pneumothorax, hemothorax produces pain, difficulty in breathing, and cyanosis.

Causes of Hernia

Hernias most often occur in the groin area. Inguinal hernias, which occur in men (more than 75 percent), and femoral hernias, most often occurring in women, are the most prevalent types. Externally, the inguinal and femoral hernias appear similar because of the groin protrusion, but a considerable difference is indicated internally. The inguinal hernia results from an abnormal enlargement of the opening of the inguinal canal, through which the vessels and nerves of the male reproductive system pass. In contrast, the femoral hernia arises in the canal that transports the vessels and nerves that go to the thigh and lower limb.

Management of stitch in side

Immediate care of a stitch in the side demands relaxation of the spasm, for which three methods have proved beneficial. First, the patient is instructed to stretch the arm on the affected side as high as possible. If this method is inadequate, flexing the trunk forward on the thighs while tightening the abdominal muscles may prove of some benefit. A third technique, which has been suggested but not confirmed, is to have the patient walk and exhale while stepping on the opposite foot—that is, if there is a stitch in the left side, the patient exhales while stepping on the right foot.

Management of Scrotal Contusion

Immediately following a scrotal contusion, the patient must be put at ease and testicular spasms must be reduced. Several techniques have been proposed to help reduce testicular pain following contusion. The first of these techniques is to place the patient in a kneeling position and have him bounce up and down. The second technique is to place the patient supine with knees and hips flexed to 90 degrees and have him perform a Valsalva maneuver. These maneuvers aid in reducing discomfort and relaxing the muscle spasm. After the pain has diminished, a cold pack is applied to the scrotum. Increasing or unresolved pain after 15 to 20 minutes requires prompt referral to a physician for evaluation.

aortic sclerosis,

In aortic sclerosis, there is scarring, thickening, or stiffening of the aortic valve, which is usually seen in older people with atherosclerosis, or hardening of the arteries. This condition is generally not dangerous; the valve can function for years after the murmur is detected.

S/S of breast cancer

In the early stages, breast cancer usually has no symptoms and is not painful. Quite often, breast cancer is discovered before symptoms are present, either by feeling a lump on the breast or in the armpit or by finding an abnormality on mammography. Other possible symptoms are breast discharge, nipple inversion (in instead of out), and redness and/or puckering in the skin overlying the breast.

Appendicitis

Inflammation of the vermiform appendix can be chronic or acute. It is caused by a variety of conditions Appendicitis can be mistaken for a common gastric complaint. In early stages, the appendix becomes red and swollen; in later stages, it may become gangrenous, rupturing into the bowels or peritoneal cavity and causing peritonitis. Bacterial infection is a complication of rupture of the inflamed appendix.

Injury to the spleen

Injuries to the spleen are relatively uncommon. If injury does occur, it is most often due to a fall or a direct blow to the left upper quadrant of the abdomen when an existing medical condition has caused splenomegaly (enlargement of the spleen). Infectious mononucleosis is the most likely cause of spleen enlargement. Athletes with mononucleosis should not engage in any activity for 3 weeks because approximately 50 percent of sufferers exhibit splenomegaly, which is difficult to diagnose clinically

Where is the heart located in relation to the ribs

It extends from the first rib to the space between the fifth and sixth ribs.

Function of Rectus abdominis

It functions in trunk flexion, rotation, and lateral flexion and in compression of the abdominal cavity.

Main function of thoracic cavity

Its main functions are to protect the vital respiratory and circulatory organs and to assist the lungs in inspiration and expiration during the breathing process. Within the thoracic cage lie the lungs, the heart, and the thymus.

Function of external oblique

Its principal functions are trunk flexion, rotation, lateral flexion, and compression.

Metastatic cancers

Metastatic cancers spread from the place where they started into other tissues. The most common place for breast cancer to metastasize is into the lymph nodes under the arm or to the brain, the bones, and the liver.

Causes of peptic ulcer

Peptic ulcers occur most often in people who experience severe anxiety for long periods of time.66 H. pylori is a type of bacteria thought to be responsible for the majority of peptic ulcers. H. pylori weakens the mucous lining of the stomach and small intestine, allowing acid to penetrate the wall, irritating the lining and causing a sore or ulcer.

Pneumothorax

Pneumothorax is a condition in which the pleural cavity becomes filled with air that has entered through an opening in the chest. As the negatively pressured pleural cavity fills with air, the lung on that side collapses. The loss of one lung may produce pain, difficulty in breathing, and anoxia.

Rib Tip Syndrome

Rib tip syndrome involves ribs 8, 9, and 10. Because these ribs are attached to each other by fibrous tissue and not by costal cartilage, if these connections are damaged or even ruptured as a result of trauma, the ribs can slip and impinge on the intercostal nerve, producing pain. It is most common in contact sports.

Constipation

Some individuals are subject to constipation, which is the failure of the bowels to evacuate feces.

Stress fracture of the ribs causes

Stress fracture of the first rib is becoming more prevalent. It can result from repeated arm movements, such as those used in pitching or in rowing. Stress fractures to other ribs have resulted from repeated coughing or laughing. Injury to the pectoral muscles may mask signs of a rib fracture.

How do you reproduce rib tip syndrome

Symptoms can be reproduced by hooking the fingers under the inferior rib and pulling anteriorly. A positive test produces a click.

Self examination of the testes

Testicles can differ slightly in size. A normal testicle is smooth, oval, and uniformly firm to the touch. Learn what the epididymus at the back of the testicle feels like. The best time to examine testicles is right after a hot bath or shower. The scrotal skin is most relaxed at this time and the testicles can be felt more easily. Start by placing the index and middle fingers on the underside of the testicle and the thumb on top. Gently roll the testicle between the thumb and fingers, feeling for any small lumps about the size of a pea. Continue by examining the vas deferens, the tube that runs along the back of the testicle.

Percussion

The athletic trainer performs percussion by placing a finger of one hand over an organ and then using one or two fingers from the other hand to strike that finger. The resulting sound may provide some indication as to the status of the organ being percussed. A solid organ, such as the liver, produces a dull sound, whereas a hollow organ, such as a lung, produces a tympanic or resonant sound.

Urinary Bladder

The bladder is a hollow container that lies posterior to the symphysis pubis. In the male, the bladder is anterior to the rectum; in the female, it is anterior to the vagina and inferior to the uterus.

Function of the thymus

The function of the thymus is to mature lymphocytes into T cells, which migrate to other lymphatic tissues to respond to foreign substances.

Gall Bladder

The gallbladder is a pear-shaped, saclike structure located on the inferior surface of the liver. It serves as a storage reservoir for bile secreted from the liver. Shortly after a meal, the gallbladder secretes the stored bile into the small intestine.

Dangers with ruptured spleen

The great danger with a ruptured spleen lies in its ability to splint itself and then produce a delayed hemorrhage. Splinting of the spleen is effected by a loose hematoma formation and the constitution of the supporting and surrounding structures. Any slight strain may disrupt the splinting effect and allow the spleen to hemorrhage profusely into the abdominal cavity, causing the patient to die of internal bleeding days or weeks after the injury.

s/s of spleen injury

The gross indications of a ruptured spleen must be recognized, so that an immediate medical referral can be made. Indications include a history of a severe blow to the abdomen and possibly signs of shock, abdominal rigidity, nausea, and vomiting. There may be a reflex pain occurring approximately 30 minutes after injury, called Kehr's sign, which radiates to the left shoulder and one-third of the way down the left arm.

Muscle strains of thorax

The intercostals are especially vulnerable. Traumatic injuries occur most often from direct blows or sudden torsion of the athlete's trunk.

Kidneys

The kidneys lie posterior to the abdominal cavity. Their primary function is to filter metabolic wastes, ions, and drugs from the blood and expel them from the body via urination.

Urinary System organs

The kidneys, the ureters, and the urinary bladder are the urinary system organs

Liver

The liver is the largest internal organ of the body. It lies in the right upper quadrant of the body against the inferior surface of the diaphragm. It consists of two major lobes, right and left. The liver performs digestive and excretory functions, absorbs and stores excess glucose, processes nutrients, and detoxifies harmful chemicals. It secretes bile, which is essential in neutralizing and diluting stomach acid and for digesting fat in the small intestine during the digestive process.

Digestive system organs

The liver, gallbladder, pancreas, stomach, small intestine, and large intestine are digestive system organs

How do the lungs move

The lungs are elastic and expand and constrict in response to contraction of the diaphragm muscle.

Functions of the transversus abdominis

The main functions of the transversus abdominis are to hold the abdominal contents in place and to aid in forced expiration

Management of Hemorrhoids

The management of hemorrhoids is mostly palliative to eliminate discomfort until healing takes place. The following measures can be suggested: using proper bowel habits, ingesting 1 tablespoon of mineral oil daily to assist in lubricating dry stool, applying an astringent suppository (tannic acid), and applying a local anesthetic to control pain and itching (dibucaine). If palliative measures are unsuccessful, surgery may be required.

Pancreas

The pancreas is located between the small intestine and the spleen. It secretes pancreatic juice, which is critical in the digestion of fats, carbohydrates, and proteins. It also produces insulin and glucagon, which are hormones that control the amount of glucose and amino acids in the blood.

Visceral Peritoneum

The portion of the peritoneum that reflects and covers the surface of internal organs

Describe the Ribs

The ribs are flat bones that are attached to the thoracic vertebrae in the back and to the sternum in the front. The upper seven ribs are called sternal, or true, ribs, and each rib is joined to the sternum by a separate costal cartilage. The 8th, 9th, and 10th ribs (false ribs) have a common cartilage that joins the 7th rib before attaching to the sternum. The 11th and 12th ribs (floating ribs) remain unattached to the sternum but do have muscle attachments. The individual rib articulation produces a slight gliding action.

Hernia

The term hernia refers to the protrusion of abdominal viscera through a portion of the abdominal wall. Hernias may be congenital or acquired. A congenital hernial sac is developed before birth, and an acquired hernia develops after birth. Structurally, a hernia has a mouth, a neck, and a body. The mouth, or hernial ring, is the opening from the abdominal cavity into the hernial protusion; the neck is the portion of the sac that joins the hernial ring and the body. The body is the sac that protrudes outside the abdominal cavity and contains portions of the abdominal organs.

Thymus location

The thymus is located in the thorax just anterior to and above the heart.

Thymus during maturation

The thymus is relatively large in the infant and after puberty gradually decreases in size

Branching anatomy of the lungs

The trachea, or windpipe, branches into right and left primary bronchi, which branch into smaller divisions called bronchioles that control air resistance, and ultimately terminate in clusters of air sacs called alveoli within the lungs

Thoracic Muscles

There are 11 pairs of both external intercostal muscles and internal intercostal muscles between the ribs. They attach on the inferior border of the rib above and the superior border of the rib below.

Causes of Constipation

There are numerous causes of constipation, the most common of which are lack of peristalsis; insufficient moisture in the feces, causing it to be hard and dry; lack of a sufficient proportion of roughage and bulk in the diet to stimulate peristalsis; poor bowel habits; nervousness and anxiety; and overuse of laxatives and enemas.

GERD

This condition occurs when there is a reflux, or backward flow, of the acidic gastric contents into the esophagus,

Tramatic asphyxia

Traumatic asphyxia occurs as a result of a violent blow to or a compression of the rib cage that causes a cessation of breathing. Signs include purple discoloration of the upper trunk and head, and the conjunctivas of the eyes display a bright red color. A condition of this type demands immediate mouth-to-mouth resuscitation and medical attention.

Traumatic Hydrocele of the Tunica Vaginalis

Traumatic hydrocele of the tunica vaginalis is an excess fluid accumulation caused by a severe blow to the testicular region. The venous plexus on the posterior aspect of the testicle can become engorged, creating a varicocele. A rupture of this plexus results in a rapid accumulation of blood in the scrotum, called a hematocele.

Urethritis

Urethritis is an inflammation of the urethra, most often caused by gonorrhea, chlamydia, the herpes virus, or bacterial infections transmitted during sexual activity. Chemical irritation caused by soaps or lotions, spermicide in condoms, and contraceptive jelly, cream, or foam can also cause inflammation.

Ausculation sequence

When the athletic trainer chooses to perform auscultation in the assessment sequence is a matter of personal preference. If the patient is experiencing respiratory difficulties and for whatever reason is not capable of providing a history, then logic dictates that auscultation should be done immediately to try and identify what is causing the problem

parietal peritoneum

a moist serous membrane that lines the surface of the body wall in the abdominopelvic cavity

Myocarditits

an inflammation of the heart associated with a viral condition

Hepatitis

an inflammation of the liver caused by viral infection or alcohol consumption. If it is not corrected, the cells in the liver may die and be replaced by scar tissue, which can lead to cirrhosis or impaired liver function

Rib Fractures

are not uncommon and have their highest incidence in collision sports, particularly wrestling and football. Fractures can be caused by either direct or indirect traumas and can, infrequently, be the result of violent muscular contractions. A direct injury is caused by a kick or a well-placed block, with the fracture developing at the site of force application. An indirect fracture is produced as a result of general compression of the rib cage, as may occur in football or wrestling. Ribs have also been known to fracture from forces caused by coughing and sneezing. Ribs 5 through 9 are the most commonly fractured. Multiple rib fractures can be severe. A flail chest involves a fracture of three or more consecutive ribs on the same side.

Cheyne Stokes

breathing, in which the rate speeds up and then slows down over a 1- to 3-minute period

External Oblique Muscle

broad, thin muscle that arises from slips attached to the borders of the lower eight ribs. It runs obliquely forward and downward and inserts on the anterior two-thirds of the crest of the ilium, the pubic crest, and the fascia of the rectus abdominis and the linea alba at their lower front

Peritoneal cavity

btw visceral and parietal peritoneum; a potential space where the peritoneal layers face each other and secrete a lubricating serous fluid that reduces any friction resulting from the movement, allowing the abdominal organs to move freely.

What can a direct fracture of the ribs cause

causes the most serious damage, because the external force fractures and displaces the ribs inwardly. Such a mechanism may completely displace the bone and cause an overriding of fragments. The jagged edges of the fragments may cut, tear, or perforate the tissue of the pleurae, causing hemothorax, or they may collapse one lung (pneumothorax)

Stridor

continuous wheezes

rales

crackling or bubbling sounds

Transverse Abdominis

deepest of the abdominal muscles. Its fibers run transversely across the abdominal cavity, arising from the outer third of the inguinal ligament, the iliac crest, the lumbar fascia of the back, and the lower six ribs. It inserts into the linea alba and the front half of the iliac crest.

What do all the abdominal muscles working together perform

defication, urination, and forced experation

External Intercostals vs Internal Intercostals

elevate the diaphragm during inspiration, whereas the internal intercostals depress the rib cage to assist with expiration. The intercostal muscles are innervated by the intercostal nerves

Alveoli

facilitate the exchange of oxygen and carbon dioxide with the capillaries

Internal Oblique

forms the anterior and lateral aspects of the abdominal wall. Its fibers arise from the iliac crest, the upper half of the inguinal ligament, and the lumbar fascia. It runs principally in an obliquely upward direction to the cartilages of the 10th, 11th, and 12th ribs on each side

Stertor

harsh, crackling sounds

What can reduce the chance of injury to hollow organs

in particular, the stomach and bladder—are emptied prior to activity can reduce the chance of injury to those structures. Meals should be eaten at least 3 to 4 hours before activity to allow foods to clear the stomach. Urination immediately before stepping onto the field or court will protect the bladder from injury.

Biot's breathing

in which a series of breaths at the normal rate are followed by complete cessation of breathing

Wolff- parkinson- white syndrome

in which an abnormality in cardiac rhythm manifests itself as ventricular tachycardia

Right ventricular dysplasia

in which enlargement of the right ventricle causes a potentially lethal disturbance in heartbeat

Apneustic breathing

in which there are pauses in the respiratory cycle at full inspiration

Hypertrophic cardiomyopathy

is a condition in which there is thickened cardiac muscle, with a decrease in the size of the chamber and extensive myocardial scarring. With this condition, there is an increased frequency of ventricular arrhythmia. In an anomalous origin of the coronary artery, one of the two coronary vessels originates in a different site than normal, which compromises or obstructs that artery because of its unusual course. People with Marfan's syndrome have an abnormality of the connective tissue that results in a weakening of the structure of the aorta and cardiac valves, which can lead to a rupture of either a valve or the aorta itself.

Commotio cordis

is a syndrome that occurs from a traumatic blunt impact to the chest, resulting in cardiac arrest. It occurs in healthy, young individuals and is primarily a result of the unfortunate timing of a blow during a narrow window within the repolarization phase of the cardiac cycle, 15 to 30 msec prior to the peak of the T wave. Young athletes are especially at risk because of the pliability of their chest walls. Since 1998, 130 cases have been documented in baseball, lacrosse, hockey, softball, football, basketball, cricket, martial arts, and boxing. The true number of deaths is unknown because of underreporting and misclassification

Rectus Abdominis

is attached to the rib cage above and to the pubis below. It is divided into three segments by transverse tendinous inscriptions; longitudinally it is divided by the linea alba.

Diaphragm

large, dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. When the diaphragm contracts, the dome flattens, which increases the volume of the thorax and results in inspiration of air. Expiration occurs when the diaphragm relaxes and the elastic components of the lungs and thoracic cage passively decrease thoracic volume.

What organs are Ausculations often used to evaluate

listen to heart sounds, breathing sounds, and bowel sounds

Classification of organs in the abdominal cavity

may be classified as being part of the urinary system, the digestive system, the reproductive system, or the lymphatic system.

wheezes

musiclike sounds with a high pitch,

Crackles

popping sounds

Four chambers of the heart

right and left atria, and right and left ventricles

Positions of ausculations

should be over the apex, centrally, and at the base of each lung, both anteriorly and posteriorly, and both sides

Ureters

small tubes that extend inferiorly from the kidneys to the urinary bladder, which stores urine.

Ronchi

snorelike sounds

Mitral valve or aortic stenosis

the mitral and/or aortic valves can become narrowed by scarring from infections, such as rheumatic fever, or may be narrow at birth, forcing the heart to work harder to pump enough blood to satisfy oxygen needs. If untreated, stenosis can lead to heart failure.

Function of Internal oblique

trunk flexion, lateral flexion, and rotation

Causes of GERD

usually due to a malfunction of the lower esophageal sphincter. It can also occur as a result of a hiatal hernia. The incidence is increased with exercise. If this occurs repeatedly, the lower esophagus can become inflamed, and this condition is referred to as esophagitis.

Cardiac conduction system abnormalities

which can result from abnormalities of the sinus or atrioventricular nodes; aortic stenosis, which is usually associated with a heart murmur and can cause a fall in blood pressure and cardiac collapse during exercise

Peripheral artery disease

which involves the dislodgement of relatively large portions of plaques (containing red blood cells, fibrin aggregates, and cholesterol) from arteries in the extremities, which then migrate as an embolus of sufficient size to occlude a major coronary artery

Describe the thoracic cavity

which lies between the base of the neck and the diaphragm. It consists of the thoracic vertebrae, the 12 pairs of ribs with their associated coastal cartilages, and the sternum.

Thoracic breathing

which occurs without diaphragmatic breathing

Coronary Artery Disease

which results from atherosclerosis, in which there is a narrowing of the coronary arteries that is usually due to hypercholesterolemia in the young patient