Week 6 [not including lab] Flashcards
How many thoracic vertebrae are there?
12
How many pairs of ribs are there? Describe them
12 pairs
- 1 to 7 attach to the sternum (true ribs)
- 8 to 10 share one attachment (false ribs)
- 11 to 12 do not attach to the sternum (false ribs)
What do the intercostal muscles do?
elevate the sternum which opens up the rib cage
Define: mediastinum
central compartment of the thoracic cavity contains: - heart - aorta and various branches - superior vena cava and tributaries - Azygous vein - Trachea - Esophagus - Vagus nerves and others
Describe thorax muscle strains
- common in ____?
- SSx
- Tx
- common in running
- intercostals, diaphragm, others
- Ssx: pain on deep inspiration, dyspnea, tenderness
- Tx: rest, analgesics
Define: dyspnea
shortness of breath
Describe rib fractures
- Hx
- SSx
- Tx
- Hx: direct blow; compression (tackle)
- SSx: severe inspiratory pain and dyspnea, tenderness, maybe crepitus, (xray doesn’t help most of the time)
- Tx: rest, analgesics
Describe a costochondral sprain or dislocation?
- common in running
- intercostals, diaphragm, others
- Ssx: pain on deep inspiration, dyspnea, tenderness, crepitus, deformity
- Tx: rest, analgesics, surgery, prolotherapy (injecting a sugar solution to encourage scar tissue to form which will stabilize the joints)
Define: pneumothorax
- give Ssx
- give Tx
- explain open vs closed pneumothorax
pneumothorax: collapsed lung
- Ssx: severe dyspnea, shock, cyanosis, rapid RR (respiratory rate), Hx of puncture if open
- Tx: cover opening, NPO, hospital ASAP
- open: air accumulates between the chest wall and the lung as the result of an open chest wound or other physical defect
- closed: blunt chest trauma causes lung tissue to rupture, resulting in air leakage from the lung into the pleural space
Define: flail chest
- Ssx
- Tx
flail chest: multiple rib fractures which causes paradoxical motion of part of the chest wall
- Ssx and Tx = same as pneuomothroax
- Ssx: severe dyspnea, shock, cyanosis, rapid RR (respiratory rate), Hx of puncture if open
- Tx: cover opening, NPO, hospital ASAP
The inguinal ligament attaches to what?
ASIS to pubic tubercle
- anterior superior iliac spine
Where is the site of inguinal herniation?
Inguinal canal
What is the inguinal canal?
- passage in the lower part of the anterior abdominal wall for spermatic cord in males or round ligament of uterus in females
List the location of the femoral triangle; what injury can occur here?
- below the inguinal ligament
- femoral herniation
Blow to the coeliac (solar) plexus
- mechanism
- Ssx
- Tx
- mechanism: trauma to the central abdomen leads to nerve concussion; transient paralysis of the diaphragm
- Ssx: ache, shortness of breathing/dyspnea, anxiety
- Tx: relaxation (short inhalation, long exhalation), reassurance, observe!
Side stitch
- define
- Ssx
- Tx
- strain or contusion of abdominal muscle
- SSx: crampy pain, worse with inspiration
- Tx: stretching, analgesics, rest
Herniae
- definition
- mechanism
- degrees
- Protrusion of abdominal contents through defect in muscle/fascia
- mechanism: predisposition (weakness), valsalva, direct blow
- degrees: reducible, incarcerated, strangulated (emergency, nausea, vomiting, intense pain, NPO, transport ASAP)
Types of herniae
- inguinal (majority, male or female)
- femoral (uncommon; more common in females)
Herniae
- SSx
- Tx
- SSx: pull or weakness, aching pain, swelling or tenderness above or below inguinal ligament, pain and swelling worsen with cough or repeated valsalva
- Tx: strengthen abdomen, surgery
Athletic pubalgia/sports hernia - Define
- Ssx
- Ax
- Tx
- tear of abdominal muscles or tendon (rectus abdominis, external oblique, internal oblique) at attachment to pubic tubercle
- entrapment of inguinal or genitofemoral nerve
- often labral tear and adductor strain associated with it
- SSx: Chronic groin pain, pain with twisting, hip extension, possible pain into testicle
- Ax: pt history, physical exam, MRI
- Tx: rest, surgery
What is an enlarged spleen indicative of?
mononucleosis
Give the name for the C1 vertebrae and the head movement it is responsible for
atlas
- skull flexion and extension
Give the name for the C2 vertebrae
axis
- C1 pivots on the C2
Give the name for the C7 vertebrae
vertebra prominens
Where do the spinal nerves exit on for the C1-C7 vertebrae?
exit above same vertebrae
Where do the spinal nerves exit on for the C8 vertebrae?
exits between C7 and T1
The spinal nerves on the C5-T1 vertebrae form what?
brachial plexus
The C3-C7 vertebrae nerves innervate what?
the diaphragm
Which facial bone is not fragile?
mandible
How should you manage neck injuries?
- stabilize and get a physician to assess it
- if Hx of severe trauma, or neurological SSx exist, assume fracture and nerve damage
- rest
- soft collar?
- NSAID
- physiotherapy/ massage therapy
Define: concussion
immediate, transient (temporary) neurological dysfunction due to trauma to brain; involves tearing of axons; brain must recover by finding new pathways to use
Physical symptoms of a concussion
headache dizziness ringing in the ears pressure in the head neck pain/stiffness see stars/flashing lights vision problems balance problems nausea/vomitting
Behavioural/emotional symptoms of a concussion
personality changes concentration problems confusion disorientation sleeping more or less than usual trouble falling asleep or staying asleep drowsiness/fatigue emotional/irritable/anxious/depressed
Thinking/cognitive symptoms of a concussion
memory problems (events leading up to injury and events after the injury) concentration problems mental fog slow to respond to questions trouble finding words confusion/disorientation
What is the very well known concussion assessment tool?
SCAT5 (sport concussion assessment tool)
Concussion treatment
- if unconscious, stabilize and get to hospital ASAP
- ABCD serial assessment 24 hours
- limit mental activity, gradually increase physical activity
- no sports until SSx absent for weeks
What are some concussion complications?
- Epidural haematoma (arterial)
- Subdural haematoma (venus)
- Airway obstruction
- Skull fracture (leads to infection)
Mandibular fracture or/and temporomandibular dislocation
- Hx
- SSx
- Tx
Hx: direct blow
Sx: deformity, spasm (threatens airway)
Tx: ABCD’s, stabilize, hospital ASAP
Nasal injury (fracture)
- Hx
- SSx
- Tx
- Hx: direct blow
- SSx: pain, swelling, crepitus, deformity, epistaxis, uneven air entry
- Tx: cold compress; to MD soon
Nasal injury (epistaxis)
- define
- Hx
- Tx
- define: bloody nose
- Hx: direct blow, sinusitis, picking your nose too much
- Tx: elevation, cold, pressure
- MD assess and Tx if persists or recurs
External ear contusion
- Hx
- SSx
- complications
- Tx
- prevention
- Hx: direct blow
- SSx: swelling, bruising, tenderness
- complications: deformity
- Tx: cold pack, compress, MD may aspirate
- prevention: ear protection
How can an eye injury occur?
contusion foreign body laceration abrasion infection
What to do if you have a tooth fracture
save fragment (cold milk) see dentist within 2 hours
