Medical Issues Exam 1

Commotio Cordis

cardiac arrest from a low impact, blunt blow to the chest. Upon impact, collapse may be instantaneous or preceded by brief periods of consciousness and physical activity Mx: immediate application of AED

pulmonary contusion

chest pain, rapid breathing, shortness of breath, rales, and coughing. Breathing may be compromised and hypoxia may appear 2-4 hrs after trauma

pneumothorax

air is trapped in the pleural space - causing a portion of the lung to collapse - spontaneous pneumothorax: occurs unexpectedly with or without an apparent cause -non-spontaneous or traumatic: occurs due to chest trauma

Deviated septum

MOI: -acute: nasal trauma -congenital S&S: consistent difference in airflow between the 2 sides of the nose - visible deviation Mx: refer

Appendicitis

MOI: an obstruction can form (from feces) that leads to increased bacterial growth and the formation of pus. An inflamed appendix can lead to ischemia and gangrene. If it ruptures, feces and bacteria are sprayed over the abdominal contents, causing peritonitis S&S: abdominal pain 2-7 days prior to the actual presentation of the condition. Rebound pain at McBurney's point. Other symptoms may include: loss of apetite, nausea, vomiting, diarrhea, and low grade fever Mx: refer

Detached Retina

MOI: blunt or penetrating trauma S&S: blurred vision, flashes of light or floaters, presence of a curtain or veil Mx: refer immediately cover eyes with patches

Hyphema

MOI: blunt trauma *often associated with other types of orbital or occular damage such as a corneal abrasion, orbital fx, eyelid contusion, and open globe injuries S&S: - impaired vision - pain - increases w pressure - blood pooling in the interior chamber - possible drowsiness Mx: refer

Facial Fracture

MOI: direct blow S&S: depends on the fracture site - pain, deformity, swelling - vision problems - malocclusion Mx: refer

Nasal Fracture

MOI: direct blow S&S: pain, and difficulty breathing, bony deformity, crepitus, swelling, bleeding, point tenderness Mx: refer

Kidney contusion

MOI: direct blow or a countercoup injury from a collision * blunt trauma can result in a minor contusion or damage to internal organs S&S: pain, tenderness, hematuria. Pain can be referred posteriorly to the low back region, to the sides of the butt, and anteriorly to the lower abdomen. Possible hypovolemic shock Mx: depends on the severity

Liver contusion and rupture

MOI: direct blow to the upper right quadrant S&S: significant palpable pain, point tenderness, hypotension (low BP) and shock. Pain may be referred to the inferior angle of the scapula Mx: immediate referral

Orbital blowout fx

MOI: direct trauma to the eye that forces the eye against the orbit creating a sudden increase in pressure in the orbit - orbit contnt, including the eyeball, are displaced posteriorly, towards the back of the orbit S&S: diplopia - absent eye movements - numbness on the side of the fx below the eye - recessed, downward displacement of the globe Mx: refer immediately

TMJ Dysfunction

MOI: grinding or clinching teeth at night S&S: -pain at the jaw -crepitus in the joint of the jaw -mouth can open and close, but teeth don't meet when closed -pain is persistent Mx: -refer to a dentist w/ maxillofacial expertise -address the cause the of the problem

Tympanic membrane rupture

MOI: infection, changes in pressure, foreign objects in the ear, direct trauma, loud, sudden noises S&S: - extreme pain - tinnitus - clear, pus-filled fluid or bloody drainage from the ear - hearing loss Mx: immediately refer

otitis externa

MOI: inflammation or infection of the external auditory canal and tympanic membrane caused by bacteria from water in the ear. - common in water sport athletes S&S: - pain increased with pressure or pulling - early: mild pain, possible itching - later: severe pain possible discharge - tenderness: whole ear - canal: red and swollen - feeling of fullness in the ear - possible hearing loss Mx: clean, antibiotics

otitis media

MOI: localized infection of the middle ear - often occurs secondary to respiratory infections S&S: pain, feeling of "fullness" in the ear, possible hearing loss Mx: refer: antibiotics

Hyperventilation

MOI: often linked to pain, stress, or trauma in sports *other causes: altitude, asthma, numbness in the lips and hands, spasm of the hands, chest pain, dry mouth, dizziness S&S: inability to catch ones breath, numbness in the lips and hands, spasm of the hands, chest pain, dry mouth, dizziness, and occasionally fainting. Mx: calm the individual - have the pt concentrate on slow inhalations through the nose and exhalations through the mouth until the symptoms have stopped

Subconjunctival Hemorrhage

*refers to bright red blood appearing in the eye MOI: direct trauma S&S: white sclera of the eye is red, blotchy, and inflamed Mx: usually resolves on its own

Hemturia

Blood in the urine

heart contusion

Bruise to the heart - caused by compression from blunt trauma S&S: extreme pain, increased HR, weakness, excessive fatigue, shortness of breath

Epistaxis

MOI: picking the nose, facial trauma, etc. S&S: bleeding Mx: - apply mild pressure to the nasal bone for 5-15 min - mouth breathing w/ head slightly forward - apply ice at the dorsum of nose

gynecomastia

excessive development of the male breast tissue MOI: steroid use, testicular, pituitary, and edrenal pathologies S&S: excessive development of male breast tissue pain and soreness Mx: refer

solar plexus contusion

getting the "wind knocked out" MOI: direct blow to the abdomen with the muscles relaxed S&S: immediate inability to catch one's breath. Fear and anxiety may complicate the condition Mx: ensure open airway - loosen restrictive clothing - instruct pt to take a deep breath and hold it - instruct pt to flex knees to chest

gingivitis

An anti-inflammatory condition of the gums, caused by bacteria. Bacteria present in food and not removed, because of inadequate brushing and flossing, will produce plaque deposits leading to gingivitis S&S: tender, swollen, or bleeding (darker) gums

Auricular Hematoma

Cauliflower ear MOI: direct blow or extreme frictional rubbing S&S: trauma leads to subcutaneous. bleeding into the ear. cartilage, then to a hematoma, which leads to a keloid Mx: refer if needed

Stitch in Side

MOI: trapped colonic gas bubbles, localized diaphragmatic hypoxia with spasm, liver congestion with stretching of the liver capsule, and poor conditioning S&S: sharp or spasm in the chest wall- usually on the lower right side during exertion Mx: reduce activity

Spleen rupture

MOI: trauma S&S: Kehr's sign: persistent, dull pain in the left shoulder. - pain the upper left quadrant and/or lower left chest - nausea, cold & clammy, & signs of shock Mx: 911

Dental Carries

Multifaceted disease that includes the interaction between the. teeth, the normal microflora, and saliva as well as diet - occurs when bacteria in the mouth accumulate on the enamel surface to form plaque, which collects on the. teeth and then produces acid that causes tooth decay S&S: pain Mx: refer

Conjunctivitis

Pinkeye MOI: commonly caused by bacteria, viruses, allergies, or. dry eye S&S: irritation, burning, photophobia, eye becomes bloodshot Mx: refer (highly contagious)

Hordeolum

Sty MOI: infection of the sebaceous gland at the edge of the eyelid S&S: a red nodule - possible crusting of the eyelid margins , burning in the eyes, droopiness of eyelid, blurred vision, mucous discharge mx: if pustule does not improve within 2 days, refer for antibiotics

periorbital ecchymosis

black eye S&S: swelling and hemorrhage Mx: ice * refer to rule out fx

hemothorax

blood accumulates in the pleural cavity following chest trauma

impacted cerumen

earwax MOI: excessive accumulation of earwax, which clogs the ear canal S&S: hearing loss, tinnitus, possible pain Mx: irrigate with warm water - don't use. q-tip - refer if attempts to clear cerumen fail

cardiac tamponade

massive blunt trauma ruptures the myocardium or lacerates the coronary artery. this causes blood and fluids into the pericardial sac - which leads to diminished cardiac output and may lead to cardiac arrest S&S: becks tirad - decreased arterial BP - distended neck veins - distant, muffled heart sounds Mx: 911 treat for shock

Peridonitis

occurs if gingivitis is left untreated. results in a receding gum line and loss of alveolar bone S&S: swollen. or recessed gums, bad breath, tooth pain

hernia

occurs when an organ pushes through an opening in the muscle or tissue that holds it in place most common in the abdomen but can also appear in the upper thigh, belly button, and groin areas S&S: visible tender swelling and and aching feeling in the groin - protrusion of the hernia increases with coughing Mx: refer

tension pneumothorax

progressive build-up of air within the pleural space, usually due to a lung laceration which allows air to escape into the pleural space but not to return

Proteniuria

protein in the urine

traumatic asphyxia

results from direct, massive trauma to the thorax. an intense compression of the thoracic cavity, can cause venous back-flow from the right side of the heart into the veins of the neck and brain

corneal abrasion

scratch to the surface of the cornea that causes a defect in the most superficial layers of the cells MOI: direct trauma with foreign object S&S: pain or granular feeling, sensation of a foreign body, photophobia, increased visual disturbances, decreased focusing, watering and orbital muscle spasm Mx: refer

cushing's syndrome

too much cortisol in the blood for too long MOI: adrenal, pituitary, or eptopic tumor - or use of glucocorticoid S&S: - upper body obesity, round face and neck, and thinning arms and legs - skin problems, high BP, muscle and bone weakness - moodiness, irritability, or depression - high blood sugars - slow growth rates in children Mx: refer