#6. Thoracic and Abdominal Injuries

Question 1

Why is it a good idea to encourage kids to pee before they play?

Answer 1

You want to empty hollow organs prior to participation incase rupture occurs.

Question 2

Where does the first rib lie?

Answer 2

below the clavicle, best palpated form a superior approach

Question 3

The spleen is protected by the ___ rib on the ___ side.

Answer 3

10th; left

Question 4

The kidney is protected by the ___ rib.

Answer 4

12th

Question 5

During ____ the ribs are pulled up and forward.

Answer 5

inspiration

Question 6

During inspiration, ribs 1-6 increase in the ____ dimension and ribs 7-10 increase in the ____ dimension.

Answer 6

anteroposterior; lateral

Question 7

If an athlete has pain in their right lower quadrant of the abdominal, what can this mean?

Answer 7

• appendicitis
• inguinal hernia
• constipation
• groin/pelvic pain

Question 8

Referral patterns for the heart are where?

Answer 8

Right chest and down the medial side of the left arm all the way down the pinky

Question 9

Referral patterns for the Liver and Gallbladder are where?

Answer 9

Right shoulder (posterior and superior) as well as below scapula and top of right iliac crest

Question 10

Cyanosis (bluish color of lips, skin and fingernails) can be a sign of?

Answer 10

Chest (thoracic) problems

Question 11

What is a rib contusion?

Answer 11

When the rib is bruised - causes pain, tenderness, swelling, and purplish tint to the skin

Question 12

Pain with inspiration, point tenderness and deformity with palpation and coughing up blood are signs and symptoms of?

Answer 12

Rib Fractures

Question 13

Management for rib fractures?

Answer 13

Xrays and support and rest

Question 14

“pleural cavity becomes filled with air, negatively pressurizing the cavity, causing a lung to collapse”

Answer 14

pneumothorax

Question 15

“pleural sac on one side fills with air displacing lung and heart, compressing the opposite lung”

Answer 15

tension pneumothorax

Question 16

“blood in pleural cavity causes tearing or puncturing of the lungs or pleural tissue”

Answer 16

hemothorax

Question 17

“result of a violent blow or compression of the rib cage”

Answer 17

traumatic asphyxia

Question 18

Difficulty breathing (dyspnea) or breathing cessation (apnea), cyanosis (turning blue), pain, hemoptysis and shock are all S&S of?

Answer 18

lung injuries

Question 19

What is syncope?

Answer 19

passing out

Question 20

How do you manage hyperventilation?

Answer 20

• calm them down

- breathe through one nostril or pursed lips

Question 21

“thickening of cardiac muscle with no increase in chamber size”

Answer 21

hypertrophic cardiomyopathy - sudden cardiac death syndrome in athletes

Question 22

What 4 things do you look for when palpating for an abdominal injury?

Answer 22

• any protrusion, bloating or swelling?
• symmetry?
• are the abdominals tight and guarding?
• is the patient splinting?

Question 23

“abnormality in connective tissue results in weakening of aorta and cardiac vessels”

Answer 23

Marfan’s Syndrome

Question 24

In which type of people does Marfan’s Syndrome usually occur?

Answer 24

ppl who have a wing span that is larger then their height

Question 25

“extra electrical pathway; resulting in supraventricular tachycardia”

Answer 25

Wolf-Parkinson-White Syndrome

Question 26

Coronary artery and peripheral artery disease, right ventricular displasia, cardiac conduction abnormalities, and aortic stenosis are all etiology for?

Answer 26

Sudden Cardiac Death syndrome

Question 27

S&S of sudden cardiac death syndrome?

Answer 27

most don’t exhibit signs; might exhibit chest pain, heart palpation, syncope, nausea, profuse sweating, and shortness of breath.

Question 28

“syndrome resulting in cardiac arrest due to traumatic blunt impact to chest - unfortunate timing; young athletes are at a higher risk because their rib cage is still in the ‘squishy’ growing phase”

Answer 28

Commotio Cordis

Question 29

Result of an external orce or contra-coup type of injury - S&S = shock, nausea, vomiting, muscle guarding, referred pain around the posterior trunk. What is this?

Answer 29

Kidney Contusion

Question 30

Etiology: direct blow or mononucleosis
S&S : shock, abdominal rigidity and spasm, pain, nausea, vomiting, Kehr’s sign
What is it?

Answer 30

Ruptured spleen

Question 31

What is Kehr’s Sign?

Answer 31

When the spleen refers pain up the left shoulder

Question 32

Etiology: direct blow to the abdomen (blunt or penetrating) or indirectly due to falling - results in diaphragm going into spasm. What is it?

Answer 32

Contusion of Abdominal - Solar Plexus “wind knocked out”

Question 33

If someone has a solar plexus injury, do you pump their legs into their abdomen?

Answer 33

NO

Question 34

How to manage “side stitch”?

Answer 34

• stop activity and stretch arm overhead

- forced expiration through pursed lips

Question 35

“protrusion of abdominal viscera through portion of abdominal wall”

Answer 35

hernia

Question 36

S&S for sports hernia?

Answer 36

half the pelvic floor and half the scrotum go numb

Question 37

Etiology: Chronic or acute inflammation, in the early stages it presents as a gastric complaint that gradually develops from red swollen vessel to a gangrenous structure that can rupture into bowels and cause peritonitis. What is it?

Answer 37

appendicitis

Question 38

S&S: mild to severe pain in the lower abdomen, associated with nausea, vomiting and low grade fever; pain may localize in the lower right abdomen (McBurney’s point). What is it?

Answer 38

appendicitis

Question 39

S&S: hemorrhaging, fluid effusion, muscle spasm, severe pain (disabling), nausea/vomiting, and shock. What is it?

Answer 39

scrotal contusions

Question 40

How do you manage scrotal contusions?

Answer 40

• flex knees up
• short breaths until pain recedes
• ice if necessary
• athlete should check to see if both testes are there
• BE AWARE OF SPERMATIC CORD TORSION

Question 41

Etiology: blunt force to the lower abdomen, hematuria (peeing blood) is often associated with this.

Answer 41

Ruptured bladder