Chapter 27 - Thorax and Abdomen Flashcards Preview

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Flashcards in Chapter 27 - Thorax and Abdomen Deck (213):
1

sternal/true ribs

7 upper ribs (joined to sternum by costal cartilage)

2

false ribs

ribs 8-10 (common cartilage that joins 7th rib before attaching to sternum)

3

floating ribs

ribs 11-12

(unattached to sternum, do have muscular attachments)

4

external intercostals __________ the diaphragm during ________

external intercostals elevate the diaphragm during inspiration

5

internal intercostals _________ the rib cage to assist with _____

internal intercostals depress the rib cage to assist with expiration

6

what nerve innervates the diaphragm

phrenic nerve

7

Right lung, # of lobes

3

8

left lung, # of lobes

2

9

Air transportation system

Trachea--> R&L primary bronchi --> secondary bronchi --> alveoli

10

what happens during diaphragm contraction

dome flattens, increases volume of thorax, causes inspiration

11

flow of blood

deoxygenated blood
to right atrium
to tricuspid valve
to right ventricle
to pulmonary valve
to pulmonary artery & lungs
to pulmonary vein
to left atrium
to mitral valve
to left ventricle
to aortic valve to aorta

12

thymus function

produces lymphocytes, which migrate to other lymphatic tissue to respond to foreign substances

13

kidneys (location, function)

slightly above iliac crest (T12-L3)

fx: filter metabolic wastes, ions, drugs from blood and expels via urination

contains adrenal glands on top

14

adrenal glands

secrete epinephrine, norepinephrine, cortisol, estrogen, aldosterone, androgen

15

ureters and urinary bladder (location)

bladder lies posterior to pubic symphysis

16

liver (location and functions)

upper right quadrant, 2 major right and left lobes

digestive and excretory functions, absorbs and stores excessive glucose, processes nutrients, detoxifies harmful chemicals, secretes bile (neutralize and dilute stomach acid & digest fat)

17

gallbladder (location and function)

inferior surface of liver

stores bile

18

pancreas (location and function)

located between small intestine and spleen

secretes pancreatic juice (critical in digestion), produces insulin and glucagon

19

stomach location

upper left quadrant

makes chyme

20

small intestine

duodenum to jejunum to ileum

digestion and absorption

21

large intestine

cecum to colon to rectum

22

appendix

extends off of cecum

it is where chyme is converted to feces

23

spleen

upper left quadrant, below diaphragm

lymphatic organ

resevoir for RBC's, regulates # of RBC's in circulation, destroys ineffective cells, produces antibodies and lymphocytes

24

prevention of injuries to thorax and abdomen

protective equipment,
strengthen core
empty hollow organs prior to practice

25

important questions to ask in a history

difficulty breathing? blood in urine? difficulty or pain with urination?

26

observations you should notice

breathing, symmetry of chest movement, swelling, deformity, cyanotic, guarding ab muscles, lowered BP, rapid weak pulse

27

Upper Right Quadrant

liver, pancreas, kidney, lung

28

Upper Left Quadrant

heart, spleen, kidney, stomach, lung

29

Lower Right

Appendix, ureter, bladder, colon, gonads

30

Lower Left

ureter, bladder, colon, gonads

31

bleeding or irritation inside abdomen cavity causes

board like rigidity in the abdomen, not voluntarily relaxable

32

cardiac/lung/splenic refers pain

left shoulder

33

diaphragmatic pain refers to

shoulders

34

liver/gallbladder refers pain to pain

right shoulder, upper left quadrant

35

appendix refers pan to

McBurney's point

36

S1-S2 (heart)

systole (blood to body/lungs)

37

S2-S1 (heart)

diastole (filling of heart)

38

S1 (heart)

closing of atrioventricular valves (mitral and tricuspid)

39

S2 (heart)

closing of semilunar valves (aortic & pulmonic)

40

Aortic valve (where is it located)

2-ICS, RSB

2nd intercostal space, right sternal border

41

tricuspid

LLSB

lower left sternal border

42

Pulmonic valve

2ICS, LSB

2nd intercostal space, left sternal border

43

mitral

cardiac apex
5ICS, LSB

5th intercostal space, left sternal border

44

blood flow

body tissues
superior/inferior vena cava
right atrium
tricuspid valve
right ventricle
pulmonary semilunar valves
pulmonary trunk
pulmonary arteries
lung tissue
pulmonary veins
left atrium
bicuspid valve
left ventricle
aortic semilunar valves
aorta
-body tissues-->vena cava
-(coronary arteries-->heart tissue, coronary sinus cardiac veins, right atrium)

45

Cheyne-Stokes

rate speeds up and then slows down over a 1-3 minute period

46

Biots

a series of breaths at a normal rate are followed by a complete cessation of breathing

47

Apneustic

pauses in the respiratory cycle at full inspiration

48

thoracic

occurs without diaphragmatic breathing

49

wheezes/rhonchi

continuous music-like sounds with a high pitch

50

rales

crackling/bubbly sounds

51

positions for auscultation of lower lung lobes

bottom 3/4 of posterior fields

52

positions for auscultation for left axilla

lingula

53

positions for auscultation for right axilla

right middle lobe

54

positions for auscultation upper lobes

anterior chest and top 1/4 of posterior fields

55

normal bowel sounds

liquid like gurgling sounds created by peristaltic actions

about 8 gurgles per minute

56

absent or diminished bowel sounds

paralytic lieus or peritonitis, swelling

57

high pitched tinkling bowel sounds

intestinal obstruction

58

Rib contusion etiology

blow to ribcage may contuse intercostal muscles or produce a fracture. Breathing is very painful

59

rib contusion s/sx

sharp pain during breathing, point tenderness and pain elicited when rib cage is compressed

60

rib contusion management

rule out fx (x-ray), RICE and anti-inflammatory agents

61

Rib Fx etiology

direct blow, violent muscle contractions, compression of ribcage,
most common: ribs 5-9

stress fx: repeated arm movements/ coughing/laughing

62

flail chest

fracture 3+ consecutive ribs on the same side

63

rib fx s/sx

pn w/ breathing, point tender, crepitus w/ palpation

64

rib fx management

x-ray, rest, bracing or ace wrap,

65

hypostatic pneumonia

occurs when an individual does not take full inspiration because of pain

66

costochondral separation & dislocation etiology

direct blow to anterolateral aspect of thorax or indirectly sudden twist or fall on a ball that compresses the rib cage

pn is localized in junction of rib cartilage and rib

67

costochondral separation s/sx

sharp pain, hard to breathe, point tender, swelling, rib deformity, crepitus

68

costochondral separation/dislocation management

rest and immobilization (healing takes 1-2 months)

69

sternum fx etiology

high-impact blow to the chest (more likely to occur in car accidents than athletics)

may also cause contusion to the underlying cardiac muscle

70

sternum s/sx

point tender at site of fx, exacerbated by deep inspiration or forceful expiration.

signs of shock, weak rapid pulse, could indicate internal injury

71

sternum management

x-rays, monitor for signs of heart trauma

72

muscle injury etiology

direct blows, sudden torsion

73

muscle injury s/sx

pain w/ active motion, pain during breathing, laughing, coughing, or sneezing

74

muscle injury management

apply cold, immobilize

75

Breast injury etiology

violent up and down lateral movements of the breasts can bruise or strain them

stretch cooper's ligaments

76

Runner's nipples

shirt causes abrasion when running

77

bicyclist's nipples

combination of cole and evaporation of sweat

78

breast injury management

wear a sports bra

79

breast cancer

self examinations every month

clinical exams every 3 years

80

pneumothorax

pleural cavity becomes filled with air that has entered through an opening in the chest

may cause pain, difficulty breathing, anoxia

81

anoxia

absence of oxygen

82

tension pneumothorax

pleural sac on one side fills with air and displaces the lung and the heart toward the opposite side, which compresses the opposite lung.

SOB, chest pain on one side of the injury, absence of breath sounds, cyanosis, distention of the neck veins, deviated trachea, total lung collapse

83

hemothorax

presence of blood within pleural cavity

caused by tearing or puncturing

pain, difficulty breathing, cyanosis, violent blow/compression,

84

traumatic asphyxia

violent blow/compression of the rib cage

causes cessation of breathing

s/sx: purple discoloration of upper trunk/head, bright red eye color, mouth-to-mouth resuscitation and medical attention

85

hyperventilation etiology

rapid rate of ventilation due to anxiety-induced stress or asthma

causes decreased CO2 in blood

86

hypcapnia

decreased CO2 in the blood

87

Hyperventilation S/sx

struggling to breathe

88

hyperventilation management

help them concentrate on breathing in and out
DO NOT BREATHE IN A PAPER BAG

89

heart contusion etiology

heart is compressed between sternum and spine by strong outside force

90

heart contusion s/sx

severe shock and heart pain possibly arrhythmias that cause a decrease cardiac output - can be followed by death

91

heart contusion management

hopsital ER, CPR, treat for shock

92

Sudden Death Syndrome in Athletes

most common cause is a type of congenital heart disease

93

Hypertrophic cardiomyopathy

thickened cardiac muscle with no chamber enlargement and extensive myocardial scarring

causes increased ventricular arrhythmia

94

Anomalous origin of the coronary artery

one of the arteries originates in an unusual spot, causing flow complications

95

Marfan's Syndrome

abnormality of CT that results in weakening of the structure of the aorta and cardiac valves

can lead to rupture

96

mitral valve prolapse associated with

HCM, and Marfan's

97

Coronary Artery Disease

atherosclerosis

narrowing of the artery due to hypercholesterolemia

98

Right Ventricular Dysplasia

enlargement of the right ventricle causes a disturbance in heart beat

99

Cardiac Conduction System Abnormalities

may result from abnormalities of sinus or AV nodes

100

Aortic Stenosis

usually associated with a heart murmur

can cause a fall in BP and cardiac collapse during exercise

could also be caused by: drugs, vascular event, head trauma, obstructive respiratory disease

101

Sudden Death Syndrome in Athletes s/sx

no sx before death,

cardiac conditions: pain, heart palpitations, syncope, nausea, sweating, heart murmurs, SOB, malice, fever

102

Sudden Death Syndrome in Athletes prevention

counseling, screening, early identification, diagnostic test have found to be ineffective

103

Commotio Cordis Etiology

Cardiac arrest caused by blunt impact to chest

young athletes at risk

depolarization phase - 15-30 sec prior to the peak of the T-wave

104

Commotio Cordis s/sx

ventricular fibrillation
immediate death - 50%
collapsing

105

Commotio cordis management

resuscitation of the, CPR, AED

106

Kidney contusion etiology

external force

107

kidney contusion s/sx

signs of shock, nausea, vomiting, rigidity of black muscles, hematuria

108

kidney contusion management

hospital observation, gradual increase of fluid intake,

controllable contusion - 2 weeks of bed rest w/ close surveillance

109

kidney stones

crystalline mineral salts (calcium, phosphate, uric acid) in the urinary tract

110

Ureters, Bladder and Urethra contusions etiology

only occurs if it is distended by urine.

111

hematuria

usually seen with running
"runner's bladder"

112

Proteinuria

abnormal concentrations of protein in urine.

113

Ureters, bladder, and urethra contusion s/sx

pain/discomfort, rigidity, nausea, vomiting, signs of shock

114

kidney injury s/sx

blood coming from urethra and passing of a great quantity of bloody ruine

115

Bladder contusion refers pain

to lower trunk (upper thigh)

116

Cystitis

inflammation of the bladder (UTI).

acute cystitis (painful urination, chills, fever)

tx with antibiotics

117

Urinary Tract Infection

caused by staphylococcus bacteria or chlamydia

118

UTI s/sx

frequent, burning, painful urination
tx w/ antibiotix

119

Preventing UTI

fluid intake, sanitary habits,

120

Urethritis

inflammation of the urethra, caused by gonorrhea or non-gonococcal organisms.

s/sx: include pain on urination along with urethral discharge

tx w/ antibiotics

121

GI Bleeding

bloody stools;

caused by: gastritis, iron-deficiency anemia, ingestion of aspirin, stress, bowel irrigation, colitis

122

colitis

inflammation of the colon caused by ulceration of the mucosal lining of the colon

123

colitis s/sx

abdominal pain w/ colic, watery stools that contain pus

dehydration, intermittent fever, and possible hemorrhage and perforation

124

liver contusion etiology

hard blow to the right side of the rib cage

can cause tear or contusion (esp if enlarged)

125

hepatitis

inflammation of the liver due to viral infection or alcohol consumption

can lead to cirrhosis

126

liver contusion s/sx

hemorrhage and shock

127

liver contusion refers pain to

pain below right scapula, right shoulder, and substernal area

sometimes to left side of the chest

immediately refer to physician

128

Pancreatitis etiology

may be acute or chronic and often related to blockage of pancreatic duct

129

acute pancreatitis s/sx

necrosis, suppuration, gangrene, hemorrhage

130

suppuration

undergo the formation of pus

131

chronic pancreatitis s/sx

jaundice, diarrhea, mild to moderate pain that radiates to the back

132

acute pancreatitis management

rehydrate, reduce pain, tx for shock, medication, prevention of secondary infection; surgery if duct is blocked

133

chronic pancreatitis management

difficult to manage; large doses of analgesics, administer pancreatic enzymes, low fat diet

134

Dyspepsia

indigestion

135

dyspepsia etiology

digestive upset, emotional stress, esophageal and stomach spasms, inflammation of mucosal lining of the esophagus or stomach

136

dyspepsia s/sx

increased secretion of HCl, nausea, flatulence

137

dyspepsia management

eliminate certain foods, avoid stressors,

138

management of vomiting

drink fluids to prevent dehydration, anti nausea medications

139

gastroenteritis

food poisoning

140

food poisoning etiology

infectious organisms from food or drink

141

food poisoning s/sx

nausea, vomiting, cramps, diarrhea, anorexia

142

staph infections can last

3-6 hours

143

salmonella infections may last

24-48 hours

144

food poisoning management

fluid replacement, electrolyte replacement, may need an IV, bed rest,

foods: clear strained broth, bouillon, soft cooked eggs, bland cereals may be given

145

peptic ulcer etiology

acids secreted in the stomach destroy mucous lining (stomach or small intestine); often occur in those people who experience extreme anxiety for a long period of time

146

peptic ulcer s/sx

gnawing pain in the epigastric region (1-3 hours after a meal)

Dyspepsia, heartburn, nausea, vomiting

pain lasts minutes not hours

147

peptic ulcer managment

antacids can help neutralize gastric secretions

surgery

148

Gastroesophageal Reflux

backward flow of acidic gastric contents into the esophagus

malfunction of lower esophageal sphincter

may cause inflammation

149

Gastroesophageal Reflux s/sx

heartburn, retrosternal pain, can progress to gripping chest pain, burning feeling, sour liquid taste in throat

difficulty swallowing

150

Gastroesophageal Reflux management

medication, surgery if medication does not help

151

diarrhea etiology

abnormal stool looseness or passage of a fluid, unformed stool

problems in diet, inflammation of intestinal lining, GI infection, ingestion of certain drugs

152

diarrhea s/sx

abdominal cramps, nausea, vomiting, frequent elimination of stools (3-20/day), loss of appetite, light brown/gray foul smelling stool;

weakness due to dehydrations

153

Constipation etiology

lack of abdominal muscle tone, insufficient moisture in the feces, not enough fiber, poor bowel habits, nervousness

154

constipation s/sx

feeling of fullness, cramping or pain in lower abdomen, straining to defecate, may rupture vessel and cause anal bleeding

155

constipation management

eat cereals, fruits, vegetables, fats

determine cause of emotional stress

avoid laxatives

156

IBS

Irritable Bowel Syndrome

157

IBS etiology

psychological factors often determine how the individual experiences and handles the condition

158

IBS s/sx

abdominal pain relieved with defecation, alteration in stool frequency, form, passage; passage of mucus and abdominal bloating and distention

159

IBS management

modify diet, antidiarrheal or antispasmodic meds, psychological counseling

160

appendicitis etiology

can be chronic or acute
caused by fecal obstruction, lymph swelling, cardioid tumor

often occurs in males age 15-25

could rupture and cause peritonitis

161

appendicitis s/sx

mild to severe pain in the lower abdomen, nausea, vomiting, low grade fever

rigidity at McBurney's point,

162

appendicitis management

surgical removal

163

hemorrhoids etiology

varicosities of the hemorrhoidal venous plexus of the anus

chronic constipation or straining may stretch anal veins resulting in protrusions and bleeding or a thrombus

164

hemorrhoids s/sx

painful nodular swelling swear the sphincter of the anus; slight bleeding and itching;

self limiting will healing 2-3 weeks

165

hemorrhoids management

palliative and serves to eliminate discomfort until healing occurs

166

scrotal contusion etiology

very painful, nauseating, disabling condition

167

scrotal contusion s/sx

hemorrhage, fluid effusion, muscle spasm

168

scotal contusion management

reduce testicular spasm by having athlete in a seated position, apply cold pack

169

spermatic cord torsion etiology

results from the testicle's revolving in the scrotum after a direct blow; or from coughing or vomiting

170

spermatic cord torsion s/sx

acute testicular pain, nausea, vomiting, inflammation

171

spermatic cord torsion management

immediate medical attention (could cause atrophy of testicle)

172

Traumatic Hydrocele of the Tunica Vaginalis etiology

excessive fluid accumulation caused by a severe blow to the testicluar region; venous plexus on posterior aspect of testicle can become engorged, creating a varicocele; rupture of venous plexus results in accumulation of blood in scrotum (hematocele)

173

Traumatic Hydrocele of the Tunica Vaginalis s/sx

pain, swelling in the scrotum

174

Traumatic Hydrocele of the Tunica Vaginalis management

cold packs applied to scrotum, refer to physician

175

Vaginitis etiology

inflammation caused by microorganisms; non STI causes include bacterial infections, strong chemicals from douching, irritation from tampon, poor hygiene habits

176

Vaginitis s/sx

purulent, bloody, vaginal discharge. Strong odor with itching. frequent urination (painful), vagina is red and painful to touch

177

vaginitis management

STI: antibiotic/antifungal meds

educate about correct hygiene and cleanliness

178

Spleen Injury etiology

due to fall or direct blow on spleen,

mono will cause the spleen to enlarge

179

spleen injury s/sx

shock, abdominal rigidity, nausea, voming

180

spleen injury management

conservative, non-op tx w/ a week of hospitalization.

full return at 4 weeks

surgery: 3 months recovery

removal: 6 months recovery

181

Abdominal Muscle strains MOI

sudden twisting of trunk or reaching overhead;

causes severe pain or hematoma formation

182

Abdominal wall contusion etiology

common in collision sports; catchers/goalies

183

abdominal wall contusion s/sx

hematoma, pressure causing pain and tightness

184

abdominal wall contusion management

cold pack, ace wrap,
check for signs of internal injury

185

Hernia etiology

portrusion of abdominal viscera through a portion of the abdominal wall

186

inguinal hernia

most common in males

187

femoral hernia

most common in females

188

hernia s/sx

natural weakness aggravated by either strain or a direct blow

pain and prolonged discomfort, superficial protrusion in groin area, pain increased with coughing, feel weak and pulling sensation in groin area

189

hernia management

surgery

190

blow to solar plexus etiology

transitory paralysis of the diaphragm "wind knocked out"

191

blow to solar plexus s/sx

stops respiration and leads to anoxia, athlete is unable to inhale- may cause hysteria

192

blow to solar plexus management

loosen nothing, talk to athlete, bend athletes knees, encourage them o relax by initiating short inspirations and long expirations

193

stitch in side etiology

constipations, gas, overeating, spasm of diaphragm, poor conditioning, weak abdominal muscles, distended spleen, breathing issue

194

stitch in side s/sx

cramp like pain that develops on either left or right costal angle during hard physical activity

195

management

relaxation of spasm
stretch arm on affected side or flex trunk forward while tightening abdominal muscles

196

hypochondriac region

below cartilage (ribs-costocartilage)
R and L

197

epigastric region

between hypochondriac regions

198

lumbar region

middle L and R
above iliac crests

199

umbilical region

middle section, over umbilicus

200

iliac region

L and R on top of iliac crests

201

hypogastric

below umbilicus

202

accelerated pulse is described as

>150 bpm, casuses pressure on the base of the brain and shock

203

bounding pulse

pulse that quickly reaches a higher intensity than normal then quickly disappears

causes: ventricular systole and reduced peripheral pressure

204

deficit pulse

pulse in which the number of beats counted at the radial pulse is less than that counted over the heart itself

cardiac arrhythmia

205

high tension pulse

force of the beat is increases; increased amount of pressure is required to inhibit the radial pulse

cerebral trauma

206

low tension pulse

short, fast, faint pulse having rapid decline

heart failure; shock

207

rate of fewer than 10 breaths per minute

bradypnea

208

rate of more than 30 breaths per minute

tachypnea

209

labored breathing

dyspnea

210

explain the electrical wiring of the heart

signal starts at SA node - triggers atriums to contract, travels to AV node, triggers the ventricles to contract, signal runs through bundle of His to Purkinje fibers.

211

P wave

represents atria contracting to pump blood into ventricles

212

QRS complex

The QRS complex represents ventricular depolarization and contraction

213

T wave

is normally a modest upwards waveform representing ventricular repolarization