Thorax anatomy and injuries from the book Fundamentals of Athletic Training
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| Pharynx | Connects mouth and nasal passages to trachea or esophagus- epiglottis closes over trachea when food is swalloed
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| Carotid Artery | Delivers deoxygenated blood to brain/away from heart
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| Jugular Vein | Takes deoxygenated blood back to heart/away from brain
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| Arteries | Deliver oxygenated blood to body
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| Veins | Take deoxygenated blood back to heart
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| Heart | 4 chambers- left and right atria (on top) and ventricles (on bottom), used to pump blood throughout body
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| 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
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| 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
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| Trachea | Tube allowing air flow- connected to larynx and lungs
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| Larynx | Contains vocal chords, connected to mouth and trachea
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| Esophagus | Tube that moves food from mouth to stomach
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| Diaphragm | Separates thorax and abdominal cavity, inhalation= contacts down to make room for expanding lungs, exhalation= moves upward to relax
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| Throat Laceration | Jagged, irregular cut in the neck region
Must apply direct pressure, monitor for shock, and send to ER
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| 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
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| 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
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| 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
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| Spontaneous Pneumothorax | Lung tissue breaks and lung collapses (collapsed lung)
Difficulty breathing, chest pain, cyanosis (blue skin from bad oxygenation)
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| 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
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| 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
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| 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
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| 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
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| Preventing Throat and Thorax Injuries | Throat protectors, shoulder pads, chest protectors, sternal pads, PADDING ON WALLS/TABLES/FENCES
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| 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
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| Right upper quadrant | Gallbladder, liver, right kidney, NO LARGE INTESTINE, head of pancreas
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| Left upper quadrants | Stomach, spleen, liver (left lobe), body of pancreas, left kidney
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| Right lower quadrant | Right ovary and uterus OR prostate, bladder
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| Lower left quadrant | NO SMALL INTESTINE, left ovary OR prostate, bladder
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| Hollow Organs | Transport substances from one organ to another; include bladder, both intestines, stomach, and appendix
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| Solid Organs | Aid in body chemistry, injury= rapid death from bleeding; include pancreas, gallbladder, liver, kidneys, and spleen
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| Stomach | LUQ Secretes gastric juices that partially break down food before entering intestines
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| Liver | RUQ (left lobe in LUQ) Detoxifies chemicals, stores bile, assists in food metabolism
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| Gallbladder | RUQ Produces bile which helps digest fat
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| Pancreas | LUQ (head in RUQ) Produces insulin (regulates metabolism of glucose and other nutrients) and enzymes for digestion
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| Small Intestines | NOT LLQ Break down food
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| Large Intestines | NOT RUQ Store waste before being removed from body
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| Appendix | RLQ No function
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| Spleen | LUQ Regulates red blood cells
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| Kidneys | UQ Maintain acid-base balance in body by removing waste products
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| Ureters | UQ Attached to kidney, passes urine to bladder
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| Bladder | LQ Holds liquid waste products
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| Ovaries | LQ Produce eggs and estrogen
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| Uterus | RLQ Where fertilized eggs develop
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| Seminal Vesicles and Prostate Gland | LQ Add fluid and nutrients to seminal fluid
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| Rectus Abdominus | Attaches at hip bones and extends to lower ribs and sternum, aid in flexion of trunk
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| Obliques | Attach laterally around lower ribs and run diagonally to hip bone (side abs)
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| 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
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| 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
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| 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)
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| 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
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| 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
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| 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
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| 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
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| 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)
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| 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)
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| Rectus Abdominus | (six pack) Helps with posture and flexing lumbar spine/trunk
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| Obliques | Muscle used for trunk rotation and side bend
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| Erector spinae | Muscle used for trunk extension
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| Trapezius | Muscle used for scapular elevation, retraction and depression
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| Scalenes | Muscle used for cervical flexion
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| Sternocleidomastoid | Cervical side bend and rotation
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| 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
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| Forward Head Posture | Ear ahead of plumb line
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| Kyphosis (think Shrek) | Excessive flexion of the thoracic spine (think Shrek)
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| Lordosis | Excessive extension in the lumbar spine
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| Scoliosis | Excessive side to side curvature of the spine
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| 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
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| Spondylolysis | Stress fracture or bone degeneration of vertebrae (lamina, thin plate of bone) caused by too much extension
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| Spondylolithesis | Vertebral body slipping forward
Lumbar brace and extensive strengthening to help keep spine neutral
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| 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
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| 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)
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| 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)
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| 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
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| Brachial Plexus | Cervical Injury- excessive sidebend
Burning, tingling, sting and numbing sensation down the arm
Neck strengthening, R"OM stretching and neck roll
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| Preventing Spinal Injuries | Spinal stability exercises, flexibility programs, proper posture, proper lifting techniques
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| 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.
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| 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
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| Deltoid | Abducts, flexes, and extends the shoulder
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| Pectoralis major and minor | Horizontal adduction
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| Bicep | Flexes shoulder and elbow
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| Tricep | Extends shoulder and elbow
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| 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
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| 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
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| 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
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| 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
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| 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
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| 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
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| 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
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| Preventing Shoulder Injuries | Address muscular weakness, correct posture, shoulder/scapula stabilization exercises, protective padding
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| 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
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| Wrist Extensors | Attach to lateral epicondyle of humerus
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| Wrist Flexors | Attach to medial epicondyle of humerus
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| Radial Nerve | Controls triceps and wrist extensors
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| Medial Nerve | controls wrist flexors
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| Ulnar Nerve | Controls wrist and finger flexors
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| 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
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| 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
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| 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
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| RICE | Rest, Ice, Compression, Elevation
PRICE= protection + RICE
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| NSAIDs | Non-Steroidal Anti-Inflammatory Drugs
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| 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
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| 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
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| 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
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| 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
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| RTP | (when the athlete can) Return To Play
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| 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
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| 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
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| 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
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| 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
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| 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-
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| 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
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| 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
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| 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
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| 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
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| 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
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| 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,
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