THE THROAT AND THORAX Unit 17

The throat is made up of 1. Esophagus 2. Trachea 3. Larynx I. THROAT ANATOMY The throat is made up of 1. Esophagus 2. Trachea 3. Larynx 4. Carotid Artery 5. Jugular Vein

TRACHEA ESOPHAGUS THROAT ANATOMY The passageway for food going from the mouth to stomach TRACHEA The passageway for air between the mouth and nasal passage and the lungs

Throat Anatomy 3. LARYNX a. upper part of the trachea, which contains vocal cords 4. CAROTID ARTERY a. Carries oxygenated blood to brain 5. The JUGULAR VEIN a. Carries deoxygenated blood back to heart

Fun Fact: Air flows over folds in larynx (vocal cords) causing vibrations which makes the sound

II. THORAX ANATOMY The THORAX contains 1. Ribs 2. Sternum 3. Thoracic Spine 4. Heart 5. Lungs 6. Diaphragm

1. Ribs There are 24 ribs in the human body, 12 on each side Main function: protect vital organs within the chest cavity assist lungs during breathing attach to thoracic vertebrae posteriorly and sternum anteriorly last two ribs (11 and 12) are FLOATING RIBS

a. attachment site for first 10 ribs 2. Sternum Function: a. attachment site for first 10 ribs 3. Thoracic Spine Function: a. Origin of all 12 ribs

Divided into 4 chambers: 4. Heart Function: Divided into 4 chambers: a. pump blood through the body a. Right atrium b. Left atrium Thump of heart beat is the valves shutting c. Right Ventricle d. Left Ventricle

The anatomy of the heart

Flow of Blood Through Body 2. Vena Cava 3. R. Atrium 4. R. Ventricle 5. Pulmonary arteries 6. Lungs 7. Pulmonary veins 8. L. Atrium 9. L. Ventricle 10. Aorta 11. Body

Vena Cava Right Atrium Right Ventricle Receives deoxygenated blood from the body and passes it on to the right atrium Right Atrium Receives deoxygenated blood from the vena cavas and passes it on to the right ventricle Right Ventricle Pumps blood to the lungs to dispose the carbon dioxide and pick up new oxygen

Pulmonary Arteries Lungs Pulmonary Veins Receives deoxygenated blood from R ventricle & passes to the lungs Lungs Receives deoxygenated blood from pulmonary arteries, exchanges CO2 and O2 w/capillaries, then passes blood to Pulmonary Veins the left atrium Pulmonary Veins Receives oxygenated blood from R ventricle & passes to the lungs

Left Atrium Left Ventricle Aorta Receives oxygenated blood from the pulmonary veins passes it to the left ventricle Left Ventricle Receives oxygenated blood from L atrium & passes to the aorta Largest chamber with the strongest walls Aorta Largest Artery in the body Receives oxygenated blood from L Ventricle, passes it to the body

Fun facts about blood All RBC’s stacked = 31,000 miles high All blood vessels = 100,000 miles long Every drop of blood passes through the heart 1 time each minute 1 drop of blood contains: 12,000 WBC 5 million RBC RBC + O2 = Pink color; + CO2 = dark red

On each side of the heart Main functions: 1. exchange O2 and CO2 5. Lungs On each side of the heart Main functions: 1. exchange O2 and CO2 2. dissipate body heat a. exhale Fun Fact: 300-500 million alveoli in each lung - lining of all alveoli in lungs = ½ football field

Average adult breaths 10-15 x/minute 6. Diaphragm Average adult breaths 10-15 x/minute Infants = 40x Muscle a. separates THORAX and ABDOMINAL CAVITIES 2. Assists in inhalation a. contracts (pull down - make more room for lungs to expand) 3. Assists in exhalation a. push upward (force air out lungs)

Sports INJURY PREVENTION Wear appropriate protective equipment Throat and chest protectors baseball/softball catchers football hockey

III. THROAT and THORAX INJURIES Can be simple or devastating Most common throat injury is a contusion from direct blow Ex: from a stick, elbow,etc.

Common signs and symptoms for all throat injuries are Coughing Spitting Pain Difficulty breathing

A. THROAT LACERATION/INCISION Can occur when e.g. an athletes ice skate goes accross another players throat (additional to those mentioned before): Bleeding https://www.youtube.com/watch?v=P8CZCX42X-o Signs and Symptoms Ask class how else a throat laceration might occur - e.g. A baseball player sliding into base catching opponent‘s metal cleat

Treatment: - If laceration is superficial: direct pressure If laceration is deep: direct pressure and call 911 Carotid artery & jugular vein are big vessels that can lead to the athlete bleeding out quickly

B. Cartilage Fractures of the Trachea Can be caused by a severe blow to the throat (e.g. A baseball pitcher being hit with a batted ball) Signs and Symptoms: - Difficulty breathing and talking Gasping for air Spit up blood Pain Anxiety May turn blue due to lack of O2

Treatment: - Stabilize athlete in position found (possibility of fracture of the cervical spine) call 911 Keep airway free of blood Calm athlete down Apply ice to reduce swelling Ask class why to calm athlete down anybody who has difficulty breathing will panic Needs to stay calm to remain c-spine immobilization

C. Rib Fractures Occur by a direct blow or chest compression Blows to the lateral aspect of the thorax are more likely to result in the rib penetrating inward, possibly causing complications such as internal bleeding or puncturing a lung.

Signs and Symptoms Treatment: - Pain with inhalation Difficulty breathing Point tenderness Possibly deformity Swelling Treatment: Ice Rest Send to team physician for X-rays If rib is penetrating lung : CALL 911 To differentiate a contused rib from a fractured rib: Pain on inhalation and exhalation = most likely contusion Increased pain on inhalation only = possible fracture

D. Sternal Fractures Result of a direct impact A force that is great enough to fracture the sternum will possibly also cause damage to the heart and/or lungs Therefore, a suspected sternal fracture should always be treated as a medical emergency

E. Pneumothorax The presence of air in the pleural cavity (= the cavity the lungs sit in), commonly referred to as a collapsed lung A typical pnuemothorax can be caused by an external wound, a fractured rib, or a chest laceration. The injured lung will deflate and move toward the center of the chest, putting pressure onto the heart and other lung A collapsed lung will look somewhat like a balloon that was blown up and then deflated

1. Spontaneous Pneumothorax Occurs without external trauma when there is an imperfection in lung tissue Signs and Symptoms: Treatment: Chest pain Difficulty breathing Possibly bluish skin color Place athlete on side, with injured side closest to the ground Call 911 A collapsed lung will look somewhat like a balloon that was blown up and then deflated

2. Tension Pneumothorax A pneumothorax can cause a tension pneumothorax, which presents a serious problem: ~ As air leaks out of collapsed lung, into pleural cavity. ~ Forces injured lung to press against heart & the other lung. ~ Increasing pressure in pleural cavity, trachea forced away from injured lung, leads to severe respiratory distress & possibly death A collapsed lung will look somewhat like a balloon that was blown up and then deflated

- Respiratory distress Absent breath sounds on involved side Anxiety Signs and Symptoms: - Respiratory distress Absent breath sounds on involved side Anxiety Bluish skin color Signs of shock A collapsed lung will look somewhat like a balloon that was blown up and then deflated

Bulging of intercostal muscles (muscles between the ribs) In severe cases: - Tracheal deviation Neck vein distension Bulging of intercostal muscles (muscles between the ribs)

Place athlete on injured side Treatment: - call 911 Place athlete on injured side If there‘s an external puncture wound cover it partially (not fully, since air can not leak out then) Care for shock

F. Flail Chest Occurs when 2 or more consecutive ribs are fractured in at least 2 places

The entire fractured portion moves in and out with the athlete breathing Occurs as a result of a direct trauma

Possibly bluish skin color Signs and Symptoms: - Extreme pain Difficulty breathing Possible shock Anxiety Possibly bluish skin color

Treatment: Call 911 Splint rib cage with a blanket or pillow to decrease movement of fractured portion Treat for shock

G. Pulmonary Contusion A contusion to the lungs (e.g. A baseball hitting the chest), resulting in bleeding and swelling of the lung

G. Pulmonary Contusion Since bleeding and swelling are fluid accumulating in the lung, a pulmonary contusion is a medical emergency

Difficulty breathing Bluish skin color Treatment: - Call 911 Signs and Symptoms: Difficulty breathing Bluish skin color Treatment: - Call 911

H. Hemothorax An accumulation of blood in the chest cavity is referred to as a hemothorax

Can occur from an internal injury (A blood vessel or lung rupturing) or from an external injury (A javelin penetrating the chest) Similar to a pneumothorax in that the blood puts pressure onto the lung and heart

Possibly coughing up blood Possibly unconsciousness Signs of shock Signs and Symptoms: Difficulty breathing Bluish skin color Possibly coughing up blood Possibly unconsciousness Signs of shock Possible absence of breath sounds on injured side

Control bleeding as best as possible Treat for shock Possibly CPR Treatment: Call 911 Control bleeding as best as possible Treat for shock Possibly CPR

Javelin to Chest - Rome http://www.youtube.com/watch?v=hHj2UJNMd0U Cross off Sucking Chest Wound – not doing it!

Abnormally quick (more than 24 breaths /minute), shallow breathing J. Hyperventilation Abnormally quick (more than 24 breaths /minute), shallow breathing Results in an imbalance of carbon dioxide and oxygen Can occur due to excitement or underlying illnesses such as asthma or diabetes

Numbing of fingers, toes, lips, and cheeks Signs and Symptoms: Lightheadedness Numbing of fingers, toes, lips, and cheeks Possibly loss of consciousness Cramping of the limbs

Calm down the athlete and encourage normal, controlled breathing Treatment: Calm down the athlete and encourage normal, controlled breathing Have athlete breathe into paper bag to balance carbon dioxyde and oxygen

If breathing can not be controlled or athlete passes out call 911