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Sports Med- Ch. 7-12

Thorax anatomy and injuries from the book Fundamentals of Athletic Training

QuestionAnswer
Pharynx Connects mouth and nasal passages to trachea or esophagus- epiglottis closes over trachea when food is swalloed
Carotid Artery Delivers deoxygenated blood to brain/away from heart
Jugular Vein Takes deoxygenated blood back to heart/away from brain
Arteries Deliver oxygenated blood to body
Veins Take deoxygenated blood back to heart
Heart 4 chambers- left and right atria (on top) and ventricles (on bottom), used to pump blood throughout body
How blood goes through body involving 4 parts of heart Deoxygenated blood from veins (vena cava superior and inferior) into the right atrium, which goes into the left ventricles, which sends the blood to the lungs to be oxygenated through the pulmonary artery, which sends the blood to the left atrium through
Lungs Exchange O and CO2 (in alveoli, sacs connected to bronchi in lungs) and get rid of heat, right has 3 lobes, left has 2
Trachea Tube allowing air flow- connected to larynx and lungs
Larynx Contains vocal chords, connected to mouth and trachea
Esophagus Tube that moves food from mouth to stomach
Diaphragm Separates thorax and abdominal cavity, inhalation= contacts down to make room for expanding lungs, exhalation= moves upward to relax
Throat Laceration Jagged, irregular cut in the neck region Must apply direct pressure, monitor for shock, and send to ER
Cartilage Fracture in Throat Severe blow to area causing tear in tracheal rings Difficulty breathing, gasping for air, spitting up blood, pain, difficulty talking, anxiety, and cyanosis Ice over the area, spine board and transport
Rib Fracture Direct impact or chest compression Pain that is increased with inhalation, difficulty breathing, self-splinting, and possible deformity from swelling Ice, x-rays, and protective padding
Pneumothorax Air in pleural cavity causing lung to move to center, putting pressure on other long Traumatic= rib puncture, gun shot, severe laceration Non-traumatic= weakness of lung tissue
Spontaneous Pneumothorax Lung tissue breaks and lung collapses (collapsed lung) Difficulty breathing, chest pain, cyanosis (blue skin from bad oxygenation)
Tension Pneumothorax Air leaks out of collapsed lung into chest cavity causing other lung to press against organs, trachea is moved to side of injury (respiratory distress), and heart must work harder to maintain blood flow Excessive respiratory distress, absent breath sound
Flail Chest Multiple rib fractures Extreme pain, anxiety, cyanosis and difficulty breathing Place pillow or sandbag around ribs to keep from moving- risk of puncture, place on affected side, monitor for shock, send to ER
Hemothorax Blood in chest cavity from internal injury- blood puts pressure on lungs and heart has reduced normal function Difficulty breathing, sweating, shock, weak, rapid pulse, cyanosis, possible unconsciousness Control breathing, transport to ER, CPR if help d
Hyperventilation Quick, deep breathing (more than 24 bpm) leading to abnormal loss of CO2 from blood Feeling lightheaded, numbness in toes, fingers, and lips, loss of consciousness Calm the person and encourage normal breathing
Preventing Throat and Thorax Injuries Throat protectors, shoulder pads, chest protectors, sternal pads, PADDING ON WALLS/TABLES/FENCES
Abdominal Cavity Contains most of the vital organs; surrounded by lumbar spine posteriorly, diaphragm superiorly, abdominal muscles anteriorly, and pelvis inferiorly; four quadrants, upper and lower left and right
Right upper quadrant Gallbladder, liver, right kidney, NO LARGE INTESTINE, head of pancreas
Left upper quadrants Stomach, spleen, liver (left lobe), body of pancreas, left kidney
Right lower quadrant Right ovary and uterus OR prostate, bladder
Lower left quadrant NO SMALL INTESTINE, left ovary OR prostate, bladder
Hollow Organs Transport substances from one organ to another; include bladder, both intestines, stomach, and appendix
Solid Organs Aid in body chemistry, injury= rapid death from bleeding; include pancreas, gallbladder, liver, kidneys, and spleen
Stomach LUQ Secretes gastric juices that partially break down food before entering intestines
Liver RUQ (left lobe in LUQ) Detoxifies chemicals, stores bile, assists in food metabolism
Gallbladder RUQ Produces bile which helps digest fat
Pancreas LUQ (head in RUQ) Produces insulin (regulates metabolism of glucose and other nutrients) and enzymes for digestion
Small Intestines NOT LLQ Break down food
Large Intestines NOT RUQ Store waste before being removed from body
Appendix RLQ No function
Spleen LUQ Regulates red blood cells
Kidneys UQ Maintain acid-base balance in body by removing waste products
Ureters UQ Attached to kidney, passes urine to bladder
Bladder LQ Holds liquid waste products
Ovaries LQ Produce eggs and estrogen
Uterus RLQ Where fertilized eggs develop
Seminal Vesicles and Prostate Gland LQ Add fluid and nutrients to seminal fluid
Rectus Abdominus Attaches at hip bones and extends to lower ribs and sternum, aid in flexion of trunk
Obliques Attach laterally around lower ribs and run diagonally to hip bone (side abs)
Spleen Rupture Heavy blow to the spleen, esp. common in enlarged spleens (mononucleosis) Abdominal pain, Kehr's sign, nausea, vomiting, cramps, weakness, abdominal spasm, possibly fainting, rapid heart rate, decrease in blood pressure, and shock ER- if ruptured, remov
Pancreas Injury Occurs during deceleration, i.e. running into a wall; pancreas wall shifts forward and tears Abdominal pain, nausea, vomiting, signs of shock ER- if ruptured, must be repaired
Kidney Injury Direct blow to the back Pain under ribs, increased pain with trunk extension and decreased pain with knee or hip flexion, nausea, vomiting, hematuria (blood in pee) and shock Hospitalization (possible complications are kidney scarring and hypertension)
Hernia A lump of tissue bulging through abdominal wall caused by a tear in the wall usually from an increase in pressure May or may not feel pain Must be surgically repaired; if not, bulge can get stuck, causing strangulation, or cut off of blood supply to the
Liver Contusion Caused by blow to RUQ Pain over area or pain radiating to the right shoulder and shock (weak, rapid pulse and a decrease in blood pressure) Refer to physician immediately
Bladder Injury Blow to LLQ, causing urine to leak to surrounding area Painful urination, hematuria (blood in pee) and sometimes shock Refer to physician for evaluation
Side Stitch Pain in upper abdominal region; theories include lack of 02 to abdominal muscles, improper breathing technique, bad eating before exercise, air trapped in abdominal organs, and/or muscle spasms Treatment: reverse those possible theories; side bend away f
Spine Column used to support upright posture when walking, has four parts from top to bottom: cervical (7), thoracic (12), lumbar (5), sacral (fused) (5)
Spinal disk Lie between vertebrae, functions: absorb shock, resist compression, provide space for nerves to exit spinal cord, and separate vertebrae to allow movement, consist of nucleus pulposus (jellylike core) and annulus fibrosus (several layers of cartilage)
Rectus Abdominus (six pack) Helps with posture and flexing lumbar spine/trunk
Obliques Muscle used for trunk rotation and side bend
Erector spinae Muscle used for trunk extension
Trapezius Muscle used for scapular elevation, retraction and depression
Scalenes Muscle used for cervical flexion
Sternocleidomastoid Cervical side bend and rotation
Normal Posture Achieved with normal curvature of upper three sections of spine; gets maximum shock absorption and flexibility; markers on the straight plumb line used to determine it are behind the ear, through the center of the shoulder, through the middle of the great
Forward Head Posture Ear ahead of plumb line
Kyphosis (think Shrek) Excessive flexion of the thoracic spine (think Shrek)
Lordosis Excessive extension in the lumbar spine
Scoliosis Excessive side to side curvature of the spine
Lumbar Ligament Injury Forced, excessive trunk extension or flexion with rotation causing separation Localized pain on one side of spine, limited movement due to pain and muscle spasm Spineboard and transport to hospital for x-rays
Spondylolysis Stress fracture or bone degeneration of vertebrae (lamina, thin plate of bone) caused by too much extension
Spondylolithesis Vertebral body slipping forward Lumbar brace and extensive strengthening to help keep spine neutral
Lumbar Disk Injury Compression causing the nucleus pulposus to push through annulous fibrosus Disk often boulges posteriorly, which may cause it to press against nerve Numbness, tingling and pain down the leg if disk pushes on nerve and lower back pain is increased with s
Cervical Ligament Injury Hyperextension of hyperflexion of neck (whiplash) Arm and neck pain, pain between the scapula and possible numbness and tingling in arms Ice, neck brace, rest, ROM exercises and strengthening exercises (isometrics)
Cervical Muscle injury Hyperflexion or hyper extension Muscle spasm, pain, restricted ROM, weakness against resistance and tenderness along muscle Ice, neck brace, rest, ROM exercises and strengthening exercises (isometrics)
Cervical Bone Injury Axial load fracture or hyperflexion with rotation (dislocation) Pain at cervical vertebrae, weakness, numness and tingling down the arms, and visible deformity with dislocation Neck immobilization, spineboard, and transport to the hospital
Brachial Plexus Cervical Injury- excessive sidebend Burning, tingling, sting and numbing sensation down the arm Neck strengthening, R"OM stretching and neck roll
Preventing Spinal Injuries Spinal stability exercises, flexibility programs, proper posture, proper lifting techniques
Shoulder Diarthodial/synovial joint (permitting free or maximum motion) that consists of the scapula, the clavicle, and the humerus bones and the acromioclavicular, glenohumeral, sternoclavicular, and scapulothoracic joint.
Rotator cuff Consists of subscapularis, infraspinatus, teres minor and supraspinatus (SITS); infraspinatus and teres minor responsible for external rotation, subscapularis responsible for inner rotation, and supraspinatus responsible for abduction
Deltoid Abducts, flexes, and extends the shoulder
Pectoralis major and minor Horizontal adduction
Bicep Flexes shoulder and elbow
Tricep Extends shoulder and elbow
AC Sprain Should injury from impact to top of shoulder or falling on an outstretched arm Point tenderness and discomfort, pain with horizontal adduction, more serious cases = noticeable deformity (piano key) Ice and compression, joint mobilization, flexibility an
Impingement Syndrome Compression of supraspinatus tendon, subacromial bursa, and long head of bicep tendon under coracoacromial arch Most often with repetitive overhead activities- throwing, swimming, serving (balls), related to shoulder instability Swelling, painful arc fr
Bicep Tendinitis Repetitive shoulder flexion Crepitus (crispy) along the bicep tendon, pain with shoulder flexion, Speed's test Ultrasound, anti-inflammatory drugs, friction massage, RC strengthening, and electric stim with ice
Bicep Rupture Direct blow or severe contractional force Loud pop, sudden intense pain at point of injury, protruding bulge, and inability to flex or supnate the forearm Ice, sling, refer to physician
Clavicle Fracture Fall on outstretched arm or tip of shoulder or direct impact- generally in middle 1/3 of bone Supporting arm of injured side, head tilted toward injured side, swelling, point tenderness, deformity, and shoulders are uneven heights Sling, refer to physic
Humeral Fracture Direct blow, dislocation, or falling on outstretched arm- can cause hemorrhaging and paralysis because brachial plexus and axillary artery are cut Pain, inability to move arm, swelling, point tenderness and discoloration of superficial tissue Splint, mo
Glenohumeral Dislocation Forced abduction, external rotation and extension Head of humerous goes out of and in socket (anterior or posterior) Deformity at deltoid, pain, feel or hear a pop, able to palpate head of humerus in the axilla, possible numbness and tingling in the arm
Preventing Shoulder Injuries Address muscular weakness, correct posture, shoulder/scapula stabilization exercises, protective padding
Elbow Diarthodial (synovial) joint comprised of the humerus, radius, and ulna bones; the humeradial, humerulnar, and radioulnar joints/articulations; and the ulnar collateral ligament (stabilizes medial aspect), radial collateral ligametn (stabilizes radial col
Wrist Extensors Attach to lateral epicondyle of humerus
Wrist Flexors Attach to medial epicondyle of humerus
Radial Nerve Controls triceps and wrist extensors
Medial Nerve controls wrist flexors
Ulnar Nerve Controls wrist and finger flexors
Brachial Artery Located at cubital fossa (just proximal to shoulder from elbow), which then splits up into ulnar and radial arteries right below elbow joint
Ulnar Collateral Ligament Sprain Valgus/abnormally directed force Pain along medial aspect of elbow, tenderness over ulnar collateral ligament, laxity of the joint, in some cases parasthesia/unusual feeling in distribution of ulnar nerve Conservative- ice, rest, NSAIDs and strengthenin
Lateral Epicondylitis (Tennis Elbow) Repetitive microtrauma from overuse of extensor muscles-extension and supination or heavy lifting Aching pain over lateral epicondyle, pain with resisted wrist extension and decrease elbow ROM RICE, NSAIDs, ROM and strengthening exercises, friction mass
RICE Rest, Ice, Compression, Elevation PRICE= protection + RICE
NSAIDs Non-Steroidal Anti-Inflammatory Drugs
Medial Epicondylitis (Golfer's Elbow) Repetitive microtrauma with overuse of flexor muscles- repeated forceful flexion of the wrist Pain over medial epicondyle, pain with resisted wrist flexion and sometimes mild swelling Rest, ice, ultrasound, NSAIDs, counterforce brace and strengthening e
Little Leaguer Elbow Separation of the epiphysis at the medial aspect of the humerus in younger athletes (9-12)- caused by repetitive microtrauma from throwing Flexion contracture (triceps weakness), decreased ROM, locking or catching of elbow RICE, NSAIDs, throwing stopped
Elbow Dislocation Falling on outstretched hand or twist of elbow in flexed position- often dislocates posteriorly Hemorrhaging, swelling, severe pain, noticeable deformity Ice, sling, refer to physician for reduction
Olecranon Bursitis Bursa (fluid filled sac used as a cushion) is inflamed from a direct blow Pain, severe swelling and point tenderness Ice, compression, protective pad when returning to play
RTP (when the athlete can) Return To Play
Wrist/Hand Comprised of 7 carpal bones (wrist), 5 metacarpal bones (first part of fingers) and 14 phalanges (rest of fingers); flexors are anterior muscles and extensors are posterior muscles; radiocarpal and ulnar-carpal joints in wrist and carpometacarpal, metacar
Wrist Sprain Overuse, fall or forceful twist on wrist Pain, some swelling, decreased ROM, and decreased grip strength PRICE, ROM, strengthening exercises, and taping when RTP
Dislocation of Lunate Most commonly dislocated carpal- forceful hyperextension of the wrist Pain, swelling, difficulty with wrist and finger flexion, possible numbness or paralysis of finger flexors- presses on median nerve Refer to physician for reduction
Ganglion Cyst Herniate of joint capsule or synovial sheath of a tendon- contains clear, mucinous fluid Noticeable lump, occasional pain, structure feels soft, rubbery or hard Conservative- compression pad, ultrasound and aspiration (remove fluid) Non-Conservative- s
Gamekeeper's Thumb Sprain of ulnar collateral ligament at metacarpophalangal joint of thumb Forced abduction of proximal phalanx Pain over UCL, tenderness, and swelling over medial aspect of the thumb Stable- x-ray and r/o fracture and thumb splint for 3 weeks Unstable-
DeQuervain's Disease inflammation of synovial sheath in thumb Aching pain which may radiate into the hand or forearm- bad Finklestein (look at picture), point tenderness and weakness during thumb extension and abduction Immobilization, rest, ice, NSAIDs, ultrasound and join
Mallet Finger Avulsion/tear of the extensor tendon from its insertion- direct blow to finger tip Pain at distal interphalangeal joint, inability to extend distal phalanx, DIP in 30 degrees of flexion RICE, if no fracture, splint finger in extension for 6-8 weeks
Jersey Finger Rupture of the flexor tendon from insertion the distal phalanx- generally in ring finger Forced extension of distal phalanx DIP joint cannot flex, point tenderness over DIP joint Surgeory
Boutonniere Deformity Rupture of extensor tendon dorsal to the middle phalanx (top of first joint) Direct blow to the tip of the finger forcing both DIP joint to extend and PIP joint to flex Severe pain, swelling, inability to extend DIP joint and obvious deformity Conserva
Scaphoid Fracture Often mistaken for severe sprain- without proper splinting, often can't heal because of lack of blood supply- from falling on an outstretched hand Swelling, point tenderness of the scaphoid (located close to wrist in line to thumb), and pain with downwar
Carpal tunnel Syndrome Inflammation of tendons and synovial sheaths causing compression of median nerve- repeated wrist flexion or direct trauma to anterior aspect of wrist Tingling, numbness, paresthesia (unusual feeling) over thumb, index and middle fingers and palm of hand,
Created by: jordanwj19