Athletic InjuriesATC 222

Thorax and Abdomen

Chapter 24

Abdominal Cavity• Muscles

– rectus abdominus– external oblique– internal oblique– transverse abdominus

• Viscera– kidneys– liver– spleen– GI tract– appendix– urinary system

Abdominal Injuries• Muscle contusions

– not common– internal trauma?

• Strains– very disabling

• Hernia– protrusion of abdominal viscera– congenital Vs. acquired– types

• inguinal (males)

• femoral (female)

– Signs and Symptoms• pain, protrusion

• pain with coughing

• history of a “strain”

Abdominal Injuries• “Stitch in the Side”

– Possible Causes• ischemia

• constipation/gas

• overeating

• weak abdominal muscles

• spasm of diaphragm (poor conditioning level)

– Treatment• stretch arm overhead

• flexion of trunk

• study possible causes

Abdominal Injuries• Appendicitis

– ages 15-24– bacterial infection– S/S

• cramping/pain at McBurney’s Point• nausea/vomiting• low grade fever

• “Blow to Solar Plexus”– “wind knocked out”– temporary paralysis of diaphragm– S/S

• respiratory distress and paranoia

– Treatment• calm athlete, loosen belt, flex knees• prevent hyperventilation, Consider int.

trauma

Abdominal Injuries• Spleen Laceration

– most commonly injured organ from blunt trauma

– High risk with which illness?– S/S

• direct blow

• shock

• abdominal rigidity

• nausea/vomiting

• positive ________ sign

– Spleen splinting and delayed hemorrhage

Abdominal Injuries• Liver Contusion/Laceration

– High risk due to what disease?– S/S

• shock

• pain URQ

• referred pain posterior right shoulder

• Kidney Contusion/Laceration– S/S

• shock

• nausea/vomiting

• back rigidity

• hematuria

Abdominal Injuries• Hollow Organs

– low risk– meals 3-4 hrs. before activity– use restroom before activity

• Scrotal Contusion– S/S

• self-explanatory

– Treatment• flex knees, drop 3-4”, jump

– decrease cremasteric spasm

Thoracic Cavity• Ribs

– attach to thoracic vert. and sternum– protection, respiration– types

• 7 sternal (true)

• 3 false

• 2 floating

• Costal Cartilage– joins ribs to sternum– joins false ribs to true ribs

Rib Injuries• Contusion Vs. Fracture Vs.

Costochondral Separation– S/S

• location of pain

• pain with respiration

• crepitus?

• deformity?

• positive compression test

– Possible internal trauma– Treatment

• contusion

• fracture

• costochondral separation

Goodbye