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Sports med class information related to the thorax and abdomen. Includes information on anatomy, injuries, and how to deal with injuries.
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Chapter 9
THE THORAX AND ABDOMEN
ANATOMY
Bones
Sternum & Manubrium Ribs - 12
– Costocartilage Vertebrae
– Thoracic -12– Lumbar - 5– Sacral - 5– Coccyx - 4 (fused)
ORGANS
Heart Lungs Abdomen
– 4 Quadrants • Right Upper Quadrant (RUQ)• Left Upper Quadrant (LUQ)• Right Lower Quadrant (RLQ)• Left Lower Quadrant (LLQ)
Right Upper Quadrant
Liver ** Adrenal Gland Gallbladder ** Stomach Pancreas Kidney Small Intestine Colon
Left Upper Quadrant
Stomach Spleen ** Adrenal gland Pancreas Colon Small intestine Kidney
Right Lower Quadrant
Appendix ** Small intestine Large intestine Colon Urinary and reproductive organs
Left Lower Quadrant
Small intestine Large intestine Colon Urinary and reproductive organs
Normal Abdomen
http://health.allrefer.com/pictures-images/normal-abdominal-anatomy-1.html
Evaluation of Thorax and Abdomen Slightly varies from HOPS assessment. Follow Primary and Secondary survey
Primary Survey
Check ABC’s Assist athlete in maintaining an open
airway by removing any blood or vomit from the airway.
Secondary Survey
History and Physical Examination History:
– MOI– Location of inj– Onset of s/s– PQRST– Nausea– Weakness– Dyspnea– Movements that make the s/s better or worse.
Physical Examination– VITAL SIGNS
VITAL SIGNS Abnormal nerve
response BP Movement Pulse Respiration Skin Color Level of consciousness Temperature
After you check the vital signs progress to: – Inspection– Auscultation– Percussion– Palpation and Special Tests
INSPECTION
Cyanosis Flail chest Tracheal deviation Jugular vein
distension PEARL Vomiting
Position Respiratory
rate/rhythm Chest appearance Hemoptysis Hematemesis Ecchymosis
Auscultation
Listening for sounds determined in the thoracic and abdominal cavities
Completed by a medical professional Used to determine:
– Normal/abnormal chest sounds– Breathing equality– Depth of breaths
Percussion
Tapping on various parts of the body and noting the sound it produces
Requires extensive training
Palpation
Looking for…– Areas of tenderness– Deformities– Swelling– Air Crepitus - air caught in subcutaneous
tissue– Bony Crepitus - bones rubbing together– Asymmetry
– Muscle Rigidity– Abdominal Rebound Tenderness
• Tender when you “let go”
Inspiration/Expiration Test
Instruct the athlete to breathe in as much air as possible; hold inspiration.
Then, expire as much as possible; hold expiration.
Observe:– Inability to fully inspire– Pain during breathing– Guarding or apprehension with respirations
Chest Compression Tests
A test for fractures to the ribs, sternum, or costocartilages.
Anterior/Posterior and Lateral Compression Test– Have athlete sit or stand– Compress on the ant and post aspect of chest– + Test = pain or bony crepitus– - Test = may indicate a contusion or muscle
spasm
Pancreas
Gallbladder
Spleen
Large/Small Intestine
Stomach