1. Abdominal Injuries Chapter 12

2. Anatomy of the Abdomen ► The abdominal cavity consists of these boundaries:  Posteriorly – the lumbar spine  Superiorly – the diaphragm  Anteriorly – the abdominal musculature  Inferiorly – the pelvis ► You can separate the abdomen into four quadrants. Draw a line down from the sternum and across the umbilicus.

3. Organ Placement ► Upper right quadrant: liver, part of the pancreas, right kidney, gall bladder, large and small intestine. ► Upper left quadrant: stomach, portion of the liver, portion of the pancreas, left kidney, spleen, large and small intestine. ► Lower right quadrant: large and small intestine, appendix, portion of the bladder, uterus, and right ovary (f), prostate (m). ► Lower left quadrant: large and small intestine, portion of the bladder, uterus, and left ovary (f), prostate (m).

5. Solid vs. Hollow Organs ► Injuries to hollow organs rarely cause rapid death. ► Hollow organs: bladder, intestines, stomach, and appendix. ► Solid organs: liver, kidneys, and spleen. ► These organs aid in body chemistry and can cause rapid death because of the large blood supply.

6. Digestive Organs ► Stomach: secretes gastric juices that assist in breaking down food before it enters the intestines. ► Liver: detoxifies chemicals that the body perceives as poisons (ex. Alcohol), stores several vitamins, produces bile, and assists with food metabolism. ► Gall bladder: storage tank for bile, which assists with fat digestion in the small intestine. ► Pancreas: produces insulin and enzymes for digestion.

7. Digestive Organs Continued ► Small Intestine: completes the digestive process of breaking down food. ► Large Intestine: absorbs the water from the digested material so that solid waste can be expelled from the body. ► Appendix: located at the end of the large intestine, it has no known function. ► Spleen: produces and destroys red blood cells, assists in the destruction of harmful microorganisms, and stores blood.

8. Urinary Organs ► Kidneys: responsible for maintaining the acid- base balance changes within the body, filter blood and remove metabiolic waste products. ► Kidneys can cause hypertension (high blood pressure) if there is an injury or illness. ► Ureters: tubes attached to the kidneys that transport urine to the bladder. ► Bladder: holding tank for liquid waste products.

9. Reproductive Organs ► Ovaries: produce eggs for possible fertilization and the hormone estrogen (which stimulates the development of and maintains feminine characteristics). ► Uterus: where the fertilized egg develops (the lining releases during menstruation if a fertilized egg is not present). ► Seminal Vesicles and Prostate Gland: are both responsible for adding fluid and nutrients of seminal fluid.

10. Preventing Abdominal Injuries ► Abdominal trauma can quickly cause death. ► Wear protective equipment such as a cup, athletic supporter, abdominal protector, rib protector, etc. ► Tighten abdominal muscles. ► Follow rules such as not tackling or checking from behind or hitting below the belt. ► Empty bladder before games to prevent a rupture.

11. Treating Abdominal Injuries and Conditions ► Assess any blow to the abdomen, especially if there is abdominal pain, signs of shock, muscle spasms, or blood in the urine. ► Ruptured Spleen  May occur if the spleen is enlarged from an infection (such as mononucleosis).  Pain may radiate into the left shoulder (Kehr’s sign) due to pressure on the diaphragm from the bleeding.  S & S = nausea, cramping, weakness, passing out, abdominal spasms, vomiting, rapid heart rate, decreased blood pressure, and shock.  Call 911, a ruptured spleen is a medical emergency!  A ruptured spleen must be removed surgically.

12. Abdominal Injuries Continued ► Pancreas Injury  Prone to injury during deceleration.  S & S = pain in he middle of the abdomen to the back, nausea, vomiting, and signs of shock.  Refer to the hospital, a rupture must be surgically repaired. ► Kidney Injury  A blow over the kidney can cause a contusion, laceration, or rupture.  Pain will be just under the ribs to the side of the spine, and may radiate to the bladder.  Pain increases with trunk extension

13. Hernias ► Is a lump of tissue (usually intestine) that bulges through a weak spot in the abdominal wall, due to increased abdominal pressure. ► Pressure increases when going to the bathroom, or holding your breath while lifting weights. ► The athlete may or may not have pain. ► This needs to be surgically repaired.

14. More Abdominal Injuries ► Liver Contusions  Caused by a blow to the right upper abdomen.  Pain will be over that area and radiate to the right shoulder.  S & S = shock, rapid weak pulse, decreased blood pressure.  Refer to a physician immediately. ► Bladder Injuries  A ruptured bladder causes urine to leak into the surrounding area.  Urination may be painful, a contusion may be visible, and there may be blood in the urine.  S & S = shock, rapid heart rate, decreased blood pressure, anxiety, and sweating.

15. Side Stitch ► Side Stitch  Pain in the upper abdomen just below the ribs.  Could be due to lack of oxygen to the abdominal muscles, improper breathing technique, eating just before exercise, air trapped in the organs, or muscle spasms.  Stop exercising, press on the area, and raise the arms over head.