Thorax and Abdomen Flashcards
When palpating the abdomen for injury, how do you differentiate between abdominal injury, irritation or bleeding in the abdominal cavity, and rebound tenderness
- 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
Where do the Liver and gallbladder refer pain
- Right Shoulder
Where do the heart and spleen refer pain
- Left shoulder and arm
Where does the appendix refer pain
- R Lower quadrant
Where do the kidneys refer pain
- The Low back
Where does the pancreas refer pain
- Left Upper quadrant
What four regions do you auscultate for heart sounds
- 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
What are adventitious breath sounds
- 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
Describe abnormal breathing patterns
- 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
What is Flail Chest
- Fracture of 3 or more consecutive ribs on the same side
What clinical differences might you see between rib contusion and rib fracture
- Both present with sharp pain and point tenderness over the ribs
- X ray will be positive in fracture
- Fracture may have crepitus
What are signs/ symptoms and treatment for Costochondral Separation and dislocation
- 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
What are signs/ symptoms and treatment for Rib Tip Syndrome
- 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
What are signs/ symptoms and treatment for Sternum Fracture
- 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
What are signs/ symptoms and treatment for Breast Injury
- 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
- Women should wear supportive bra to prevent Breast Cancer
- 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
What are signs/ symptoms and treatment for Pneumothorax
- Pain
- Difficulty breathing
- anoxia
What are signs/ symptoms and treatment for Tension pneumothorax
- 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
What are signs/ symptoms and treatment for Hemothorax
- Presence of blood within the pleural cavity
- Pain, difficulty breathing, coughing up frothy blood, signs of shock
- Immediate medical attention