Throat and Thorax Injuries

Chapter 7

Chapter 7

Objectives

• Understand the basic anatomy of the throat and thorax.

• Understand how to prevent injuries of the throat and thorax.

• Know the care necessary to treat an injury within the throat or thorax.

• Understand the implications of illness or injury related to a specific organ in the thorax.

Throat Anatomy

• Carotid artery• Jugular vein• Larynx• Trachea• Esophagus

Throat Anatomy• Esophagus

– Passageway for food– In front of cervical

vertebrae, behind trachea and larynx

• Trachea– Made up of circular rings

of cartilage– Main passageway for air

to get to and from lungs

• Larynx– Modified portion of

upper trachea, contains vocal cords

Throat Anatomy• Carotid artery

– One on each side of the trachea

– Carries oxygenated blood to the brain

• Jugular vein– One on each side of

the trachea– Carries

unoxygenated blood away from the brain

• Deadly if either are severed

Thorax Anatomy• Thoracic Vertebrae• 12 Ribs on each

side (2 floating)• Sternum

– These bones function to protect the organs

Thoracic organs

• Heart• Lungs• Diaphragm

Thorax Anatomy• Heart

– Size of your fist

– Pumps blood to all parts of body

– Blood carries nutrients and oxygen to cells and carbon dioxide and waste away from cells

Heart• Chambers• Left and right

atrium• Left and right

ventricle– Thicker due

to function of pumping blood throughout the body

Heart• Function-pumps

blood to lungs and entire body

• Path– Right atrium(RA) fills

with deoxygenated blood from body

– Goes to right ventricle (RV) and out to lungs to receive oxygen

Heart• Path (continued)

– Left atrium (LA) receives oxygenated blood from the lungs

– Goes to left ventricle (LV)…largest chamber of the heart and sends it to the rest of the body through the aorta to other major arteries

– Once oxygen is used, blood returns to heart through veins

Lungs• Function: to

exchange oxygen and carbon dioxide and dissipate body heat

Lungs• Bronchi

– Branches of the trachea

• Bronchioles– Divisions of the

bronchi

• Alveoli– Ends of the

bronchioles where oxygen-carbon dioxide exchange occurs

Diaphragm

• Separates thorax and abdominal cavities

• Contracts and pulls down to assist inhalation and moves up to push air out

Injury Prevention

• Protective equipment

• Rules• Always buy

best protective equipment

Treating throat injuries and conditions

• Most injuries to throat are contusions caused by a blow from sticks, feet, or arms

• Treat with ice• Most response to

throat injury is coughing, spitting, difficulty breathing, and pain

Throat lacerations

• Superficial lacerations can be controlled with direct pressure

• Deep are medical emergencies– Apply direct

pressure, treat for shock

– Must respond quickly

Cartilage fracture

• Caused by severe blow to throat• Can be life threatening• Causes difficulty breathing, gasping, spitting

blood, pain, difficulty talking, appear anxious• May turn blue (lack of oxygen)• Treat with extreme care due to possible

cervical spine injury• Treat as medical emergency (call 911) and

backboard to transport• Ice area, keep athlete calm, keep airway free

of blood

Pneumothorax• Air in the pleural cavity

(collapsed lung)• Can occur with or

without trauma• Traumatic caused by

punctured lung (rib fracture, gunshot, severe laceration)

• Non-traumatic caused by weakness of lung tissue

Pneumothorax• When occurs, injured

lung moves toward center of chest, puts pressure on heart and other organs

• Causes difficulty breathing and athlete will gasp for air

• Inhaled air escapes through hole and into chest cavity which causes further compression on organs

Spontaneous pneumothorax• Can happen in healthy athlete• Caused by weakness in lung tissue• Difficulty breathing, chest pain, possible

blue skin (cyanotic)• Place athlete on ground with injured

lung closest to ground, treat for shock and treat as medical emergency (911)

• Usually heals itself without surgery

Tension Pneumothorax• Air leaking out forces lung into other

lung and heart• Tracheal deviation possible causing

more respiratory distress• Death can occur if not treated rapidly• If there is an external puncture would,

partially cover it leaving one side unsealed to prevent tension from getting worse

Tension Pneumothorax

• Sign/symptoms– Respiratory distress– Absent breath sounds on injured side– Anxiety– Bluish skin color– Pulse rapid and weak– Blood pressure will drop

• Injury requires physician to insert a chest tube and possible surgical intervention

Flail chest• Multiple ribs fractured

in 2 or more places• Occurs from direct

impact• Entire fractured

portion moves in and out when athlete breathes, but opposite normal

• Very painful, possible other internal injuries

Flail chest

• Treatment- decrease movement of fracture

• Treat athlete for shock

• Call 911 immediately

Pulmonary contusions• Bruised lung• Direct impact

(usually blunt object)

• Causes bleeding and swelling

• Difficulty breathing and bluish skin color

• Call 911, ice if athlete allows

Sucking chest wounds

• Puncture of chest wall, air from outside is drawn noisily into cavity

• Lung is not punctured• Air coming in causes pressure on lungs

causing distress• Difficulty breathing, circulation impairment

(cyanotic)• Seal wound with cellophane or plastic bag• Call EMS immediately

Hyperventilation• Quick breathing >24 breaths per min• Causes abnormal loss of carbon dioxide from the blood• Caused by becoming overly excited, anxiety, or

diabetes• Can become dizzy, experience numbness in

extremities, and/or loss of consciousness• Treat by encouraging athlete to breath slowly, calming

the athlete