chapter 27 thorax and abdomen

constipation

-numerous causes of constipation, the most common of which are lack of abdominal muscle tone; 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

stitch in the side

-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.

costochondral separation and dislocation

MOI direct blow to anterolateral aspect of thorax or indirectly from a sudden twist or fall on a ball that compresses the rib cage, displays many signs similar to rib fracture, except pain is localized in junction of rib cartilage and rib

flail chest

a fracture of three or more consecutive ribs on the same side

kidney contusion

an external force usually one applied to the patients back

hemothorax

blood enters the pleural space instead of air

what happens with the heart of commotion cordis

blow during a narrow window within the depolarization phase of the cardiac cycle, 15-30 sec prior to the peak of the T wave

Rib contusions

blow to the rib cage can contuse intercostal muscles or if severe enough produce a fracture

contusion of the ureters bladder and urethra

blunt force to the lower abdominal region avulses a ureter or contuses or ruptures the urinary bladder

hernia

can be congenital or acquired hernia occurs when weakness is further aggravated by either a strain or direct blow

appendicitis

caused by a variety of conditions such as a fecal obstruction lymph swelling or carcinoid tumor

abnormal heart

caused by blood flowing through a damaged heart valve

rib fracture

caused by either direct or indirect traumas and can infrequently be the result of violent muscular contractions

diarrhea

caused by problems in the diet, inflammation of the intestinal lining, GI infection, the ingestion of certain drugs and psychogenic factors

scrotal contusion

direct blow

blow to the solar plexus

direct blow- SP

contusion

direct blows or sudden torsion of the athletes trunk

indigestion

emotional stress, esophageal and stomach spasms and inflammation of the mucous lining of the esophagus and stomach

hyperventilation

excessively rapid rate of ventilation usually due to anxiety induced stress or asthma gradually develops a decreased amount of carbon dioxide in the blood

functional murmur

exists in the absence of any organic disease in the heart

injury of the spleen

fall or a direct blow to the left upper quadrant

contusion of the abdominal wall

force is blunt or penetrating

liver contusion

heard blow

sternum fracture

high impact blow to the chest may also cause contusion to the underlying cardiac muscle

open pneumothorax

if pneumothorax is caused by air entering the pleural space through an open wound in the chest wall

runners nipples

in which the shirt rubs the nipples and causes an abrasion

rib tip syndrome

involves ribs 8 9 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

GI bleeding

iron deficiency anemia, ingestion of aspirin or other anti-inflammatory agents stress bowel irritation and colitis

vomitting

irritation stimulates the vomiting center in the brain to cause a sweres of forceful contractions of the diaphragm and abdominal muscles thus compressing the stomach and forcefully expelling the contents

heart concussion

occur when the heart is compressed between the sternum and the spine by a strong outside force

muscle strains

over stretched twisting motion

tension pneumothorax

pressure build up by the trapped air may begin to compress the heart large vessels and opposite lung

commotion cordis

syndrome that occurs from a traumatic blunt impact to the chest resulting in cardiac arrest

kidney stones

unknown

traumatic asphyxia

violent blow to or a compression of the rib cage that causes a cessation of breathing

breast injury

violent up and down and lateral movements of the breast constant uncontrolled movement of the breast over a period of time can stretch the coopers ligament

pneumothorax

when air accumulates in the pleural space the lung collapses

cystitis and UTI

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