Thorax

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Thorax
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Thorax

• Anatomy
• Injuries
• Evaluation
• Rehabilitation

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Anatomy

• Bones
• Cartilage
• Muscles
• Organs

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Bones

• Ribs
• Sternum
• Xiphoid process

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Ribs

• Ribs 1 through 7 are called true ribs.
• Ribs 8 through 12 are called false ribs.
• Ribs 11 and 12 are also called floating ribs.

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Sternum

• Located in the center of the chest.
• Is the site where the bones attach anteriorly.
• Protects the heart

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Xiphoid process

• Located at inferior aspect of the sternum

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Cartilage

• Ribs 1-7 attach to sternum
• Ribs 8-10 attach to cartilage of 1-7

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Muscles

• Pectoralis major
• Latissimus Dorsi
• Trapezius

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Pectoralis Major

• Largest muscle of chest
• Anterior aspect of the thorax

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Latissimus Dorsi

• Largest muscle of the back
• Located on the posterior aspect of the thorax

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Trapezius

• Muscle of the posterior neck and upper back.

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Organs

• Heart
• Lungs
• Diaphragm

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Heart

• Size of a fist
• Responsible for pumping blood to all parts of
  body

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Lungs

• Site of oxygen/carbon dioxide exchange
• Site of O2 CO2 exchange

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Diaphragm

• Separates the thorax and the abdominal cavity.
• Contraction pulls down to assist with inhalation,
  and moves upward to push air out of the lungs.

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Diaphragm
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Injuries to Thorax

• Strains
• Contusions
• Fractures
• Heart Attack
• Pneumothorax
• Hemothorax
• Asthma

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Rib contusion

• Signs and Symptoms
• point tenderness
• possible ecchymosis
• pain with excessive movement
• Pain with inspiration/expiration

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Rib fractures

• Tremendous forces are necessary
• can cause damage to the liver, spleen, kidney,
  or lung injuries

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Rib fractures
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Rib fractures
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Rib fractures

• Signs and symptoms
• Pain at fracture site aggravated by coughing,
  breathing, movement, and compression tests.
• Dyspnea (shortness of breath)
• Localized tenderness
• Crepitus

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Muscle strains

• Occur due to over use or over stretching.

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Myocardial Infarction

• Heart attack
• occurs when the blood supply to a part of the
  heart is interrupted.
• The resulting oxygen shortage causes damage and
  potential death of heart tissue.

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Myocardial Infarction

• Causes
• Usually due to blockage of one or many of the
  coronary arteries supplying blood to the heart
  (HEART DISEASE)
• MI can also be caused by an electrical shock and
  certain drugs

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Myocardial Infarction

• Signs and Symptoms
• Persistent chest pain or pressure
• Breathing difficulty noisier, shorter, faster
  than normal.
• Irregular pulse rate
• Cyanosis (bluish color of skin)
• Moist face or profuse sweating
• Radiation or pain in the left side (neck,
  shoulder, arm)

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Myocardial Infarction

• Treatment
• If you suspect an MI, Call 9-1-1
• Keep person calm
• Monitor ABCs
• Monitor vital signs

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Pneumothorax

• Air accumulation in the pleural space. This can
  cause the lung to collapse.
• A pneumothorax can be caused by a blunt force or
  sharp trauma to the anterior chest wall.

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Pneumothorax
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Pneumothorax

• SIGNS/SYMPTOMS
• sudden sharp chest pain, especially made worse by
  a deep breath or a cough
• Shortness of breath
• chest tightness
• fatigue
• Rapid heart rate
• cyanosis
• hypotension (low blood pressure)

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Hemothorax

• similar to a pneumothorax but blood, instead of
  air, enters the pleural cavity.

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Hemothorax
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Hemothorax

• If this injury is suspected, call 9-1-1
• Treat person for shock
• Monitor vitals

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Asthma

• Inflammatory respiratory condition characterized
  by bronchospasm and shortness of breath.
• Usually treated with medication (administered
  through an inhaler)

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Asthma
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Evaluation

• History
• Observation
• Palpation
• Stress Tests

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History

• Mechanism of injury
• Onset of symptoms
• Location of injury

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History

• Type and location of any abnormal sensations
• Progression of signs and symptoms
• Activities that make the symptoms better or worse
• Nausea
• Weakness
• Dyspnea (shortness of breath)

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Observation

• Respiratory rate
• Moistness and color of the skin
• Pulse rate
• Tachycardia (rapid pulse)
• Bradycardia (slow pulse)

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Observation

• Blood pressure
• Movement
• Pulse
• Respiration
• Skin Color
• State of consciousness
• Temperature

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Palpation

• Ribs- Side to side and front to back
• Sternum
• Start away from injury site and work towards it.

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Stress tests

• Active Range of Motion