lecture 7: throat thorax, and visceral conditions Flashcards
where are the commonly injured structures near the face
trachae
larynx
hyoid bone
when trac., larynx, and hyoid bone are contsed or fractured what is the common MOI
hyperextension of the neck
what are the expected signs and symtpoms of continous and fractures of the throat
edema? Difficulty breathing, bleeding, difficulty swallowing, spasmodic coughing, point tenderness, cyanosis, loss of voice
what happens with laryngospasm
patient can recover on site and still develop breathing problems later on
what is imporant to do with contusions and fractures of the thorat
monitor because swelling and bleeding is usually maximal within 6 hours but can occur as late as 48h
if there is an obvious deformity or sever anterior thorat trauma, what are the required management steps
Maintain airway (ex: trauma jaw thrust) Treat as a spinal injury (board, 911) Manually re-align the trachea to maintain airway if necessary Apply ice if appropriate Reduce anxiety and panic attack/ shock
what are the visceral organs
liver stomach gall bladder large and small intestine spleen lungs heart
where do you get a stitch in the side
thorax/abdomen
what are the signs and sympoms for stich in the side./cramp
sharp pain or spasm in chest wall (
where do you usually feel the stitch in the side
usually in lower right side during exertion
what are some possible reasons for a stich in the side
Trapped colonic gas bubbles Diaphragmatic hypoxia with spasm Liver congestion Poor conditioning Could also be due to drinking too much water or eating too much before exercising
explain why eating too much or drinking before exertion can cause a stitch i nthe side
after eating and drinking there are going to be heavier which will put strain and streth on ligaments and tendons
what is the management for a stich on the side
Forceful exhalation through lips
Forceful deep and regular breathing to focus on diaphragm
Trying to stretch away from the painful side
what are two common breast condition
contusion
nipple irritation
explain breast contusions
Excessive breast motion or direct trauma can lead to hemorrhage and edema formation
May appear similar to malignant tumour on mammogram
what may appear similar to malignant tumour on mammogram
contusions
what are 2 examples of nipple irritation
runners nipple (friction) cyclist nipples (wind and respiration)
what can you use for breast nipple irritation
use second skin and preventative taping for protection
what are red flags for thoracic injuries
Shortness of breath Deviated trachea Axiety, fear, confusion or restlessness Distended neck veins Bloodshot eyes Suspected fractures Severe chest pain; aggravated by deep inspiration Asynchronus/ unequal breathing or chest movement Coughing blood Abnormal chest sounds Rapid but weak pulse Low BP cyanosis
why are suspected fractures a red flag for thoracic injuries
cause they could punture visceral organs
true or false: costochondral injuries are easy to injury and very hard to heal
they are hard to heal
give 2 examples of costochondral injuries
costochondritis and chostochrondral sprains
if you have a chostochondral injury where will the pain be
anterior and medial
what is the MOI of chostochondral injuries
collision / twists of thorax
what will you hear/feel witth costochondral injury
pop sound, sharp pain, clicking sound
what is a visual sign of a costochondral injury
assymtry
what is the management for a costochondral injury
pain management and rest. Supportive taping can help to reduce the pain but discomfort is usually felt for 3 to 12 weeks. A physician may choose to inject cortisone or local anesthesia to reduce pain.
what ribs are more likely to have costochondral injuries
frequently involves ribs 8,9,10 because they have the most cartilage connection
what is the most common fracture of stertnal fractures
rib 5-9
true or false: sternal fractures can cause immediate loss of breath
true
what will you feel if you have a strernal fracture
immediate loss of breath
localize pain and pressure over sternum
if there is a suspected sternal; fracture, what else should you assess
Cardiac contusion
Mammary vessels
Pulmonary laceration/contusion
what is the MOI for sternal fractures
high impact with object or acute flexion that can cause the top of the sternum to fracture
what is management for sternal fracture
usually non-operative unless displaced.
what is the MOI of rib fractures
direct force
muscle contractions
rowers and golfers get what type of rib fractures often
anterolateral stress frcatures
what ribs are most commonly injured for rowers and golfers
4 and 5 ribs
non displaced or displaced rib fractures are most common
non displaced
what do the lower ribs protect
spleen, pancrease, liver
what is the management for rib fracures
6 inch wrap around ribs to stavilize and reduec pain
what part of ribs are most susceptible for fractures
occurs at ribs weakest point
thereofre at the smallest diameter/where it changes direction
what are signs and symtpoms of rib fractures
Patient leaning to the affected side Stabilizing the area with a hand to prevent any movement Local discoloration/ swelling/ deformity Pain on palpation Crepitus Pain with deep inhalation > exhalation Pain with trunk rotation Shallow breathing
is hyperventilation considered a lung injury
yes
what is hyperventialation linked to
pain, stress or traums
what are some cuses of hyperventilation
Altitude, asthma, pulmonary embolus, alcohol withdrawal, anxiety or panic, CNS disorders
what is the characteristic of hyperventialiation
too much carbon dioxide being expelling
what is management for hyperventialtion
help patient to regulate the breathing
should you make someone who is hyperventilitated breathe from a bag
no , just help regulate breathing
what is a pneumothorax
air or blood trapped in pleural space causin portion of lung to collapse
pneumothorax can only be spontaneous
no it can also be traumatic
what are some causes of sponteanous pneumothorax
Cigarette smoke, pneumonia, asthma, cystic fibrosis, male gender
what percentage of those with a chest injury that usually get a traumatic pneumotorax
40-50%
what is the presentation of a traumatic pneumothroax
Deviated trachea, cyanosis, chest pain on affect side, fatigue, anxiety, restlessness, decreased BP
true or false: if the pneumothorax is not severe you dont have to send to hospital
false, you alwasys have to
what is management for pnemothoriax
Medical emegercy – 911
Help patient to stay calm and breathe slowly
Keep the patient seated if possible
what are the 2 types of pneumothorax
open and tension
explain open pneumothorax
comes from open wound
when you inhale, air comes in the cavity and compresses lung
when you exhale, ;lung pushes out the air
trachae will devitte to injured side on inhalitaion and ooption)
where will trachea deviate in open pneumothoriac
during inhalation it will deviate towards injured side
during exhalation to uninjured side
explain tension pneumothorax
air will continue to accumulate without escaping
trachae always remains displaced to injured side
where does trachae deviate in tension pneumo.
towards injured side
what is the MOI of cardiac tamponade
direct trauma
what is cardiac tamponade
a build up of blood or other fluid in the pericardial sac whoch puts pressure on the heart and may prevent it from pumping efficiently
where does a cardiac tamponade compress
compress haard ebtween sternum and spine
what is the leading cause of traumatic death in youth basemball
cardiac tamponade
in a heart contusion, what structure is usually injured
right ventricle
what does a heart contusion cause
Decreased circulation to heart muscles
Can lead to necrosis of heart tissue
Can lead to cardiac arrest in certain cases
true or false: athleteitc heart syndrome is common
true
what is athletic heart syndrom
Benign condition associated with physiological changes to the heart muscle via intensive physical training
what is assocaited with atheletic heart syndrome
Left ventricular enlargement, increased wall thickness, increases left ventricular mass that leads to maximal stroke volume and cardiac output
true or false and explain: atheletic heart syndrome is mainly asymptomatic
true but they also may have bradycardia (30-40 beats, sinus arrythm(
what can athletic heart syndrome be a sign of
hyperttrophic cardiomyopathy (HCM)
it is genetic where heart grows too fast
what is the most common cause of cardiac youth arrest
hypertrophic cardiomyopathy
what is a heart murmur most often caused by
defective heart valves
what is aortic stenosis
valve unable to open complete;y
too rigid
what is aortic regurgitation
blood leakes backwards
=too lose
what are two examples of conditions of defective hert valves
aortic stenosis and regurgitation
what are some signs you will hear with heart murmur
clicking, whooshing, swishing
what is the management of heart conditions
help patient stay calm
treat for shock (blanket, o2, calm, reassure)
be prepared for CPR in case of cardiac arrest
what is the fancy name for wind knocked out
solar plexus contusion
what is MOI of solar plexus contusion
blow to abdomen with muscles relaxed
what is the cause of solar plexus contusion
Thought to be caused by diaphragmatic spasm and transient contusion of the sympathetic celiac plexus
what is the managment of solar plexus contusion
keep the breath in, bring knees to the chest and try to regulate breathing.
why bring knees to chest in solar plexus contusion
it pushes the organs on diaphram to force exhalattion
what are hernias
Protrusion of the abdominal viscera through a weakened portion of the abdominal wall
what are the hernias AT eal with the most
acquired
how to get acquired hernias
Direct blow, strain or abnormal abdominal pressure (heavy lifting)
true or false: you do not need to refer with hernias
flalse ypu do because they probably need surgery
what is the recovery period of an athelte before returning to conntact sports after hernia
8-10 weeks
what are the 3 most common types of hernias
femoral
umbiliac
inguinal
if you have BLANK you are more at risk of splenic rupture
infectious mononeclosis because they enlarge organ
if you have mono, how long are you out from sports
3 weeks
what is the most commonly injuried abdominal organ in sport
spleen
true or false and why: spleens do not lose blood rapidly
false, they do beacuse they are filled with alot of blood
what does the spleen do that is good for recovery
it splints itse;f
=delayed hemmorage
what is the reffered pain for splenic rupture
kehrs sign
pain in upper L quad, L lower chest and L shoulder
kehr is present in what ercentage of splenic ruptures
kehrs sign 60
what is management of splenic rupture
surgery may be required. If the conservative approach is chosen; strict bed rest, additional immunization meds, return to sport after 3 months.
what can enlarge the liver
spleen and systematic disorders
if you have hepititus you are more or less at risk of liver contusion/rupture
more at risk
if you have a liver rupture where is the reffered pain
to inferior angle of right scapula
the appendix is where
extending from cecum (part of intensine)
what gives you an inflammed appendix
cobstructed (hardened fecal material), leading to bacterial growth and pus formation
how many days prior to you get abdomnial pain prior to inittal presentation of appendicitus
2-7 days
where is the mcburneys point
1/3rd distance between ASIS and imbilicus
pain at mcburneys point is a common sign of
appendicitis
what organs make up the urinary system
kidney
ureter
bladder
urethra
which organ is very vulnerable in ocntact sports and why
kidneys because they are located near back
whatt are the MOI for kidney contusions
direct trauma or contrecoup (kidneys bouncing around)
what are some signs of kidney contusion
pain, tenderness, hematuria
where is reffered pain for kidney contusion
Pain posterolateral back, sides of buttocks and anteriorly to the lower abdomen
explain kidney stone
Some substances filtered by kidneys have tendency to form crystals, can break off and travel to ureter and eventually to bladder
what are some causes of kidney stones
High protein and low fiber diet, inadequate water intakes, living a sedentary life, one kidney, family history, chronic urinary tract infections
signs and symtpoms of kidney stones
Intense sudden pain in back below ribs, moves anterior to groin, bloody or cloudy urine, nausea, vomiting, fever, chills
how do you get rid of kidney stones
you will just pee it out (doctors may use shockwaves to break it up)
where do urintary tract infections start
infection that starts in urinary ssytem
are UTI serious
yes if spreads to kidney
what is the main bacterial of UTI
escheriachia coli (it ascends from the urinary tract from the urethra)
UTI can be caused by what
sexually transmitted oeganisms
whos at greater risk of UTI and how much more
women 10x
why are women more at risk
shorter urethra
sexually active
why are sexally active women at greater risk
sexual intercouese transfers bacteria from urethra to bladder
what can you do to prevent uti
go pee after sex
what is management for UTI
urinary lab tests to identify the infection source + antibiotics medication.
what is hematuria
blood in urine
what are the causes of hematuria
Direct kidney injury, bladder contusion, UTI, drug or medication use, “march” or foot strike hemolysis, infection, sickle cell disease, rhabdomyolysis
what is proteinura
protein in urine
what organ filters blood
kidneys
what are sme causes of proteinuria
Dehydration, heat related illness, fever, emotional stress, inflammatory conditions, high protein diets, diabetes
excessive protein in urine may indicate what
early signs of renal disease
penile injuries are affected by what superfical wounds
contusion, abraision, lacerationn, avulsion, or penetrating wound
why do cysts on penile develop and give example
develop by pressure on pudental nerve
ex: cyclists
what is hydrocele
swelling in tunica vaginalis
=blood accumulattion in scrotum
what is management for hydrocele
these conditions are usually causing testicular spasms. Place the patient on their back with the knees to their chest. Ice can be used.
what is varicocele
Plexus of veins on the posterior testicle can become engorged (a bag of worms)
Describes as a bag of worms adjacent to the testicle and cord
what is testicular torsion
Variations in testicular suspension can cause rotational twisting of the vascular pedicle and spermatic cord
Causing circulatory compromise
true or falseL=: testicular torsion can only be traumatic
false, also congenital
when is testicular torsion normally seen and what are the symtpmts
Typically seen around puberty, manifesting itself after physical activity
Rapid or gradual groin pain, sometimes nausea, vomiting
recovery is nearly 100% if testicular torsion is corrected within how many hours
6-8 hours
what is the issue with having testicualr torsion/twisted spermatic cord
compresses vascularity and nerves
comprmosies them
a scrotal mass can be indicative of what
testicular cancer
what is the signs if scrotal mass
dragging, heaviness in lower abdomen and orgin
true or false; you need to refer for a scrotal mass
true
injuries to vulva are usually caused by what and give examples
caused by trauma associated with a fall, straddling, penetration
Biking, skiing, horse back riding, sledding, water skiing
can you get hematoma in vulve
yes from trauma
what is pubic symphesis injury and what can it lead to
when the caritclage disk is subjected to friction and inflammation
leads to osteitis pubis
what is the maangement for female genitalia injuries
Management: ice, compression and bed rest when applicable
