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CATA 263 > Lecture 7: Thorax, Visceral and Genital Conditions > Flashcards

Lecture 7: Thorax, Visceral and Genital Conditions Flashcards

1
Q

What structures get injured (contusions/fractures) from hyperextension of the neck?

A
  • Trachea
  • Larynx
  • Hyoid bone
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2
Q

S/S of contusions/fractures of the neck? What is the time frame?

A
  • swelling, trouble breathing, bleeding
  • Swelling+breathing: usually within max 6hrs, but can go to 48hrs
  • laryngospasms: patient can recover on site and develop breathing problems later on
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3
Q

How do you manage an obvious deformity or severe anterior throat trauma?

A
  • maintain airway (trauma jaw thrust)
  • treat as a spinal
  • manually re-align trachea to maintain airway if necessary
  • apply ice if appropriate
  • reduce anxiety and panic attack/shock
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4
Q

What is a stitch in the side?

A

sharp pain or spasm in chest wall (usually lower right side during exertion)

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5
Q

What causes a stitch in the side?

A
  • trapped colonic gas bubbles
  • diaphragmatic hypoxia w/ spasm
  • liver congestion
  • poor conditioning
  • drinking too much water or eating too much before exercise
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6
Q

How to manage a stitch in the side

A
  • forceful exhalation through lips
  • forceful deep and regular breathing to focus on diaphragm
  • trying to stretch away from painful side
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7
Q

Cause breast contusions

A
  • excessive breast motion or direct trauma can lead to hemorrhage and edema formation
  • may appear similar to malignant tumour on mammogram
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8
Q

What are causes of nipple irritation?

A
  • runner’s nipples: friction
  • cyclist nipples: wind and perspiration
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9
Q

What are red flags from thoracic injuries?

A
  • shortness of breath
  • deviated trachea
  • anxiety, fear, confusion or restlessness
  • distended neck veins
  • bloodshot eyes
  • suspected fractures
  • severe chest pain; aggravated by deep inspiration
  • asynchronuous/unequal breathing or chest movement
  • coughing blood
  • abnormal chest sounds
  • rapid but weak pulse
  • low bp
  • cyanosis
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10
Q

What are 2 types of costochondral injuries?

A

Costochondritis and costochondral sprains

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11
Q

What are the causes and symptoms of a costochondral injury

A
  • collision and or twisting of thorax
  • pop sound, sharp pain, clicking sound
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12
Q

What is the management for costochondral injuries?

A
  • pain management + rest
  • supportive taping can reduce pain (discomfort usually felt for 3 to 12 weeks)
  • physician may inject cortisone or local anesthesia
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13
Q

Describe a sternal fracture

A
  • most common fx: transverse fx of rib 5 to 9
  • can cause immediate loss of breath
  • localized pain and pressure over sternum
  • MOI: high impact w/ object or acute flexion that can cause top of sternum to fracture
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14
Q

What is the management of a sternal fx and what should you also assess?

A
  • usually non-operative unless displaced
  • assess: cardiac contusion, mammary vessels, pulmonary laceration/contusion
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15
Q

What organs to the lower limbs protect?

A
  • spleen, pancreas, liver
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16
Q

Describe rib fractures (causes)

A
  • caused by: direct force, muscle contractions
  • anterolateral stress fx: rowers/golfers
  • non displaced most common
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17
Q

How do you manage a rib fx?

A

6inch wrap around ribs to stabilize and reduce pain

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18
Q

S/S of rib fx

A
  • leaning to affected side
  • stabilizing area w/ hand to prevent mvmt
  • local discoloration/swelling/deformity
  • pain on palpation
  • crepitus
  • pain w/ deep inhalation>exhalation
  • pain w/ trunk rotation
  • shallow breathing
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19
Q

What are causes of hyperventilation?

A
  • linked to pain, stress or trauma
  • altitude, asthma, pulmonary embolism, alcohol withdrawal, axiety or panic, CNS disorders
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20
Q

What happens during hyperventilation?

A

Too much CO2 being exhaled

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21
Q

How do you manage hyperventilation?

A

Help the patient to regulate their breathing

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22
Q

What is pneumothorax?

A

Air trapped in pleural space causing portion of lung to collapse

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23
Q

What makes a spontaneous pneumothorax more likely?

A

Cigarette smoke, pneumonia, asthma, cystic fibrosis, male gender

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24
Q

How does a traumatic pneumothorax present itself?

A
  • 40-50% of patients w/ chest injury
  • deviated trachea, cyanosis, chest pain on affected side, fatigue, anxiety, restlessness, decreased BP
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25
How do you manage a pneumothorax?
- medical emergency: 911 - help patient stay calm and breathe slowly - keep patient seated if possible
26
Describe cardiac tamponade
- direct trauma - compress heart btwn sternum and spine - fluid build-up in pericardial sac (prevents from pumping effectively) - leading cause of traumatic death in youth baseball
27
Which chamber is often injured in heart contusions?
Right ventricle
28
Describe heart contusions
- decreased circulation to heart muscles - can lead to necrosis of heart tissue - can lead to cardiac arrest in some cases
29
What is athletic heart syndrome?
- benign condition associated w/ physiological changes to heart muscle via intensive physical training - left ventricular enlargement, inc. wall thickness, inc. left ventricular mass that lead to maximal stroke vol and cardiac output
30
What are the symptoms of athletic heart syndrome?
mainly asymptomatic (may have bradycardia: 30-40bpm, sinus arrhythmia)
31
What are heart murmurs most often caused by?
defective heart valves
32
Heart murmur: what is aortic stenosis?
valve unable to open completely
33
Heart murmur: what is aortic regurgitation?
blood leaks backward
34
What are the sounds heart during diastolic, systolic, and continuous murmurs?
clicking, whooshing, swishing
35
How to manage heart conditions?
- help patient stay calm - treat for shock - prepare for CPR
36
What is another way to say "wind knocked out"
solar plexus contusion
37
What is the cause of a solar plexus contusion?
- blow to abdomen w/ muscles relaxed - could be by diaphragmatic spasm and transient contusion of sympathetic celiac plexus
38
What are the symptoms of solar plexus contusions?
- difficulty breathing - controlled inspiration and expirations
39
What is the management of solar plexus contusions?
- keep breath in, bring knees to chest and try to regulate breathing
40
What is a hernia?
protrusion of abdominal viscera thru a weakened portion of abdominal wall
41
What are acquired hernias from?
- direct blow - strain or abnormal abdominal pressure (heavy lifting)
42
How do you deal with a hernia?
- refer to MD (most require surgery) - athletes can usually rtp (contact sports) after 8 to 10 wks
43
What are the diff types of hernias?
- epigastrica - incisional - umbelical - inguinal direta - inguinal indireta - femoral
44
What is Kehr's sign?
- pain in LUQ, L lower chest, and L shoulder - present in 60% of splenic ruptures
45
What is a splenic rupture?
- type of infectious mononucleosis (enlarges organ) - increased vulnerability: out for 3+ wks - most commonly injured abdominal organ in sport - lose blood rapidly (splints itself: delayed hemorrhage)
46
How do you manage a splenic rupture?
- surgery may be required - strict bed rest - additional immunization meds - RTP after 3 months
47
What happens in liver contusions and ruptures?
- spleen and systematic disorder (hepatitis) can enlarge liver
48
Where do you feel pain in liver contusions/ruptures?
Pain referred to inferior angle of right scapula
49
What is McBurney's point?
- 1/3 distance btwn ASIS and umbilicus - point of pain for appendicitis
50
Describe appendicitis
- appendix: extends from cecum - can be obstructed (hardened fecal material), leading to bacterial growth and pus formation: inflamed appendix - abdominal pain 2-7days prior to initial presentation of condition
51
What is hematuria?
Blood in urine - kidney injury, bladder contusion, UTI, drug/med use, "march" or foot strike hemolysis infection, sickle cell disease, rhabdomyolysis
52
Describe kidney contusions
- vulnerable in contact sports - direct trauma or contrecoup injury - pain, tenderness, hematuria - pain posterolateral back, sides of buttocks and anteriorly to lower abdomen
53
What are kidney stones?
some substances filtered by kidneys have tendency to form crystals: break off and travel to ureter and eventually to bladder
54
What are causes of kidney stones?
- high protein and low fiber diet - inadequate water intake - sedentary life - one kidney - family history - chronic UTIs
55
What are the S/S of kidney stones?
- intense sudden pain in back below ribs, moves ant. to groin - bloody or cloudy urine - nausea - vomiting - fever - chills
56
What is a urinary tract infection?
infection that begins in urinary system - serious if spreads to kidney - escherichia coli: ascend urinary tract from urethra - can be caused by sexually transmitted organisms
57
Why are women at greater risk (x10) for UTIs?
- shorter urethra - sexually active women more susceptible: sexual intercourse transfer bacteria from urethra into bladder (going to toilet after sexual intercourse helps reduce risk of UTI)
58
How do you manage a UTI?
- urinary lab tests to identify infection source + antibiotic medication
59
What is proteinuria? What are the causes?
- high lvl of protein in urine (may indicate early signs of renal disease) - kidney filters blood Causes: dehydration, heat related illness, fever, emotional stress, inflammatory conditions, high protein diets, diabetes
60
What are some superficial wounds for penile injuries?
- contusion, abrasion, laceration, avulsion or penetrating wound - cysts can develop: pressure on pudendal n.
61
What is hydrocele?
- swelling in tunica vaginalis (lines scrotum) - hematocele: blood accumulation
62
How do you manage hydrocele?
- usually testicular spasms: place patient on back w/ knees to chest (can use ice)
63
What is varicocele?
- engorgement of plexus of veins on posterior testicle (bag of worms adjacent to testicle and cord)
64
What is testicular torsion?
- variations in testicular suspension can cause rotational twisting of vascular pedicle and spermatic cord - circulatory compromise - traumatic of congenital
65
When is testicular torsion usually seen?
- around puberty - after physical activity
66
What are the symptoms of testicular torsion?
- rapid of gradual groin pain, sometimes nausea, vomiting (recovery nearly 100% if corrected within 6-8hrs)
67
What is scrotal mass and what can it indicate?
- lump/swelling in scrotum - can be indicative of testicular cancer - dragging, heaviness in lower abdomen and groin - REFER
68
What are injuries to vulva caused by?
Trauma associated with a fall, straddling, penetration: - biking, skiing, horse back riding, sledding, water skiing
69
Can hematoma result from trauma to female genitalia?
yes
70
What can a pubic symphysis injury lead to?
Osteitis pubis (inflammation of jnt)
71
How do you manage female genital injuries?
- ice, compression, bed rest

CATA 263 (9 decks)

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