Thorax and Abdomen Flashcards
1
Q
When palpating the abdomen for injury, how do you differentiate between abdominal injury, irritation or bleeding in the abdominal cavity, and rebound tenderness
A
- Abdominal injury: pnt will voluntarily contract muscles to guard
- Bleeding in abdominal cavity: cannot voluntarily relax muscles, abdomen exhibits boardlike rigidity
- Rebound Tenderness: Elicited by pressing firmly on the abdomen and quickly releasing
2
Q
Where do the Liver and gallbladder refer pain
A
- Right Shoulder
3
Q
Where do the heart and spleen refer pain
A
- Left shoulder and arm
4
Q
Where does the appendix refer pain
A
- R Lower quadrant
5
Q
Where do the kidneys refer pain
A
- The Low back
6
Q
Where does the pancreas refer pain
A
- Left Upper quadrant
7
Q
What four regions do you auscultate for heart sounds
A
- Mitral Region; Left 5th intercostal space
- Tricuspid Region; Left 4th intercostal space at sternal border
- Pulmonary Region; 2nd left intercostal space
- Aortic Region; 2nd Right intercostal space
8
Q
What are adventitious breath sounds
A
- Sounds not normally heard
- Wheezes: continuous musiclike sounds with a high pitch
- Crackles: popping sounds
- Stridor: continuous wheezes
- Stertor: harsh, crackling sounds
- Ronchi: snoring like sounds
- Rales: crackling and bubbling sounds
9
Q
Describe abnormal breathing patterns
A
- Cheyne Stokes: the rate speeds up and then slows down over a 1-3 minute period
- Biots- a series of breaths at a normal rate are followed by a cessation of breathing
- Apneustic: there are pauses in the respiratory cycle at full inspiration
- Thoracic: occurs without diaphragmatic breathing
10
Q
What is Flail Chest
A
- Fracture of 3 or more consecutive ribs on the same side
11
Q
What clinical differences might you see between rib contusion and rib fracture
A
- Both present with sharp pain and point tenderness over the ribs
- X ray will be positive in fracture
- Fracture may have crepitus
12
Q
What are signs/ symptoms and treatment for Costochondral Separation and dislocation
A
- Presents similarly to rib fracture but the site of pain is at junction of rib cartilage and rib
- Pain with breathing, sometimes rib deformity and crepitus
- Managed with rest and immobilization with rib brace
- Healing takes 1-2 months
13
Q
What are signs/ symptoms and treatment for Rib Tip Syndrome
A
- Ribs 8, 9, and 10 may slip and impinge intercostal nerve
- Pain in upper abdomen, occurs when patient laterally flexes away from injury
- Sometimes popping sensation and can reproduce by hooking fingers under ribs and pull anteriorly
- Treat with compression wrap or manipulation
14
Q
What are signs/ symptoms and treatment for Sternum Fracture
A
- Impact severe enough to cause this may also damage underlying cardiac tissue
- Point tenderness over sternum, exacerbated by deep inspiration or forced expiration
- Signs of shock or a weak, rapid pulse may indicate more severe internal injury
- Send for x rays and should be monitored for signs of heart trauma
15
Q
What are signs/ symptoms and treatment for Breast Injury
A
- Uncontrolled movement of breast can cause coopers ligament to stretch
- Women should wear supportive bra to prevent
- Also runners nipple is possible
- Can place band aid over nipple to prevent runners nipple
16
Q
- Women should wear supportive bra to prevent Breast Cancer
A
- May have lump on the breast or armpit
- May have breast discharge, inverted nipple, and redness or puckering of skin overlying breast tissue
- Should conduct normal breast self exam
- Treat with surgery, chemo, radiation, etc
17
Q
What are signs/ symptoms and treatment for Pneumothorax
A
- Pain
- Difficulty breathing
- anoxia
18
Q
What are signs/ symptoms and treatment for Tension pneumothorax
A
- Occurs when pleural sac on one side fills with air and displaces the lung and heart toward the opposite side
- Shortness of breath, chest pain on side of injury
- May be absence of breath, cyanosis, and distension of neck veins, Trachea may deviate away from side of injury
- Medical attention required immediately
19
Q
What are signs/ symptoms and treatment for Hemothorax
A
- Presence of blood within the pleural cavity
- Pain, difficulty breathing, coughing up frothy blood, signs of shock
- Immediate medical attention
20
Q
What are signs/ symptoms and treatment for Hyperventilation
A
- Struggling to breathe
- Treatments
1. have patient breath through nose out mouth
2. breathe in and out of one nostril while pinching the other nostril and closing mouth
3. breathe into bag
21
Q
What are signs/ symptoms and treatment for Sudden Cardiac Death Syndrome (SCD)
A
- Most common causes are
1. Hypertrophic Cardiomyopathy
2. Anomalous origin of coronary artery
3. Marfans Syndrome - Most have no symptoms before death but may have some similar to heart attack
- May prevent with increased screening for risk factors
22
Q
What are signs/ symptoms and treatment for heart murmur
A
- Clicking, Whooshing, or swishing on auscultation
- May require no surgery, medications, or even surgery depending on severity
23
Q
What are signs/ symptoms and treatment for Athletic Heart Syndrome
A
- Occurs in individuals who train for greater than 1 hour on most days; causes low heart rate and systolic murmur
- Asymptomatic but on workup should be distinguished from other problems that may also cause low heart rate and systolic murmur such as hypertrophic cardiomyopathy
24
Q
What are signs/ symptoms and treatment for Commotio Cordis
A
- Cardiac arrest that occurs due to blunt impact to the chest
- Immediate death occurs in half the cases, in others there is a brief period of consciousness before collapse
- Resuscitation unsuccessful
- Defibrillation is essential
25
What are signs/ symptoms and treatment for Heart Contusion
- Caused by blow to chest
- Injury produces severe shock and heart pain
- Heart may exhibit arrhythmia's that cause decrease in cardiac output
- Followed by death if medical attention not administered immediately
26
What are signs/ symptoms and treatment for Kidney Contusion
- May display signs of shock, nausea, vomiting, rigidity of back muscles, and hematuria (blood in urine)
- May cause low back pain, high in costovertebral angle and radiated around trunk into abdomen
- Patient who has received a blow to region should be instructed to monitor urine for blood
- Most treated with rest and increased fluid intake, if hemorrhage doesn't stop may need surgery
27
What are signs/ symptoms and treatment for Kidney Stones
- Onset of pain is sudden, severe, sharp and later becomes intermittent as stone moves
- Pain referred to low back and flank and shoots toward groin on same side
- Cool, Clammy skin, and burning with frequent urination and blood in urine
- Drink plenty of water, Most stones are passed, some need to be broken up or surgically removed
28
What are signs/ symptoms and treatment for Contusions of the Ureters, Bladder, and Urethra
- Pain and discomfort in lower abdomen, abdominal rigidity, nausea, vomiting, signs of shock, blood coming from urethra and blood in urine
- Bladder contusions can still urinate, bladder ruptures cannot
- Bladder injury causes referred pain to lower trunk, upper thigh anteriorly and suprapubically
- Monitor for blood in urine
- To prevent, empty bladder before playing
29
What are signs/ symptoms and treatment for Cystitis and Urinary Tract Infections
- May have frequent, strong urge to urinate, burning while urinating, frequent small amounts of urine, hematuria, cloudy or strong smelling urine, feeling of pressure in the abdomen, or low grade fever
- Treat with oral antibiotics, drink plenty of liquids
- Cranberry juice might help
30
What are signs/ symptoms and treatment for Urethritis
- Burning and pain with urinating, urge to urinate more often, may also be itching, tenderness, swelling of penis, pain with sex, ulcers on genitals, discharge from penis, blood in urine or semen
- Infection can spread and cause systemic symptoms
- Antibiotics, fluid, NSAIDs for pain
31
What are signs/ symptoms and treatment for Gastrointestinal bleeding
- Bloody stools, abdominal pain with colic, watery stools that contain pus, dehydration, intermittent fever, possible hemorrhage and perforation
- Require immediate medical attention
32
What are signs/ symptoms and treatment for Liver Contusion
- Hard blow to right side of rib cage
- Referred pain just below right scapula, right shoulder, and substernal area with occasional left sided chest pain
- Requires immediate medical attention
33
What are signs/ symptoms and treatment for Pancreatitis
- Acute epigastric pain causes vomiting, belching, constipation and potentially shock
- Chronic pancreatitis causes Jaundice, diarrhea, and mild to moderate pain that radiates to back
- Acute treated with rehydration and medication
- Chronic treated with low fat diet, administration of pancreatic enzymes and medication
34
What are signs/ symptoms and treatment for Indigestion
- Increased stomach acid (sour stomach), Nausea, gas, constipation, diarrhea
- eliminate irritating foods
35
What are signs/ symptoms and treatment for Vomiting
- Vomiting
| - Antinausea medication, rehydration by mouth or IV if necessary
36
What are signs/ symptoms and treatment for Food Poisoning
- Nausea, vomiting, diarrhea, cramps, anorexia
| - Replace fluid lost, bed rest, IV if necessary
37
What are signs/ symptoms and treatment for Peptic Ulcer
- Gnawing pain localized in the epigastric region, appears between 1 and 3 hours following a meal
- May have pain, vomiting, heartburn, lasts for only a few minutes
- Antacids help, alter diet, if bacterial then antibiotic
- If hemorrhaging, surgery
38
What are signs/ symptoms and treatment for Gastroesophageal Reflux Disease (GERD)
- Heartburn
- Controlled with medication
- If caused by hiatal hernia, surgery
39
What are signs/ symptoms and treatment for Irritable bowel syndrome
- Abdominal pain that is relieved with defecation
- Should be referred for long term physician management
- Modify diet
40
What are signs/ symptoms and treatment for Appendicitis
- Mild to severe pain in the lower abdomen, associated with nausea, vomiting, low grade fever
- Cramps localize to right side, TTP at mcburneys point
- Surgical removal
41
What are signs/ symptoms and treatment for Hemorrhoids (piles)
- varicosities of veins in anus
- painful, nodular swellings near the sphincter of the anus
- Slight bleeding, itching
- Self limiting, resolve in 3 weeks
- Palliative measures to help deal with the pain they cause
42
What are signs/ symptoms and treatment for Scrotal contusion
- hemorrhage, fluid effusion, muscle spasm
- Reduce muscle spasms, have the patient kneel and bounce up and down, can also place in supine with hips and knees flexed to 90 and perform valsalva
- Cold pack applied
- If not better in 15-20 minutes, refer to physician
43
What are signs/ symptoms and treatment for Spermatic Cord Torsion
- Pain, nausea, vomiting, inflammation in the area
| - Requires immediate medical attention
44
What are signs/ symptoms and treatment for Traumatic Hydrocele of the Tunical Vaginalis
- After severe blow to testicles
- pain, swelling in the testicle, can greatly increase size of testicle
- Cold packs, refer to physician immdeiately
45
What are signs/ symptoms and treatment for Testicular Cancer
- Pain in testicle, lump or enlargement, Sudden collection of fluid, feeling of heaviness in scrotum, dull ache in abdomen or groin, unexplained fatigue, enlargement or tenderness of breasts
- If diagnosed early, highly treatable
46
What are signs/ symptoms and treatment for Contusion of female genitalia
- Hematoma, and possible injury to pubic symphysis possibly causing osteitis pubis
- Ice, if pain persists, refer to rule out fracture to pubic symphysis and osteitis pubis
47
What are signs/ symptoms and treatment for Injury to the Spleen
- Caused by direct blow
- Infectious Mononucleosis can cause spleen enlargement
- History of blow to abdomen, abnormal rigidity
- There may be reflex pain that occurs approx 30 minutes after injury called Kehrs sign, radiates to left shoulder and one third of the way down the arm
- Nonoperative treatment consists of a week hospitalization, recovery in 3-4 weeks
- If surgery performed, Recovery in 6 months
48
What are signs/ symptoms and treatment for Hernia
- Inguinal hernias usually in males, femoral in females
- History of blow or strain to groin, prolonged discomfort, superficial protrusion in the groin area that is increased with coughing, feeling of weakness and pulling in groin area
- Surgery usually performed
49
What are signs/ symptoms and treatment for Blow to Solar Plexus
- Transitory paralysis of the diaphragm, wind knocked out
- Can lead to unconsciousness
- Loosen belt or clothing, kneel down, try to take short inspirations and long exprations
