1. Internal Injuries Sports Related Internal Injuries

2. General Overview of Internal Injuries  Any organ in the abdominal cavity can be injured – pancreas, stomach, gall bladder, urinary bladder, intestines.  Typical Symptoms – abdominal pain, tenderness over area, cold, sweaty skin, nausea/vomiting, rapid pulse, low blood pressure, loss of consciousness

3. Rib Contusion  MOI – direct blow to rib cage  S&S:  1. bruising of intercostal muscles  2. pain upon inspiration – expanding rib cage  3. localized tenderness

4. Rib Contusion  Treatment:  Padding with compression wrap  Ice, NSAID, x-ray to rule out fracture

5. Rib Fracture  MOI – direct blow  S&S:  1. pain upon inspiration  2. shallow, rapid breathing  3. feel crepitus over rib

6. Rib Fracture  Treatment  1. x-ray to rule out a pneumothorax  2. protective padding with compression wrap  3. allow 3-4 weeks to heal

7. Pneumothorax  Tearing of lung leading to an accumulation of air between lung and chest wall.  MOI – direct blow  Complication of rib fractures

8. Pneumothorax  S&S  1. cyanosis – bluish tongue, mucous membranes  Shortness of breath\chest pain referred to shoulder  Treatment – emergency!  1. administer oxygen  2. place in a semi-reclining position – 45 degrees

9. Ruptured Spleen  Function: filters almost 10% of the body’s blood supply every minute.  Located in the upper left quadrant, lower left rib cage  MOI – direct blow

10. Ruptured Spleen  S&S  1. pale, due to constricted blood vessels  2. rapid pulse  Dizzy, faint – blood loss  Abdominal pain referred to left shoulder

11. Ruptured Spleen  Complication:  Usually ruptures when spleen is enlarged- mononucleosis.  Can rupture during a relatively innocent movement or direct blow  Tearing of the spleen can cause rapid bleeding – life threating internal bleeding.

12. Hepatic Rupture ( LIVER)  2 nd largest organ of body  Function: filters blood coming from digestive tract, detoxifies chemicals/metabolizes drugs  2 lobes – right lobe usually injured – bigger and presses against ribcage

13. Ruptured liver  MOI – direct blow to upper right quadrant  S&S – same as ruptured spleen due to bleeding in abdominal cavity but pain is referred to right shoulder  Treatment – medical emergency – surgery!

14. Renal Contusion/Rupture(kidney)  MOI: direct blow to lower back ( flank)  S&S – backache, contusion to flank, blood in urine ( immediately refer to doctor)

15. Ruptured Kidney  Treatment  1. some cases the partial rupture will resolve spontaneously  Large rupture needs surgically repaired

16. Contusion to Solar Plexus  Known as “Getting the Wind Knocked Out”  MOI – direct blow to solar plexus or falling forcefully on your back  Causes forceful expiration which inhibits inspiration for a few seconds  Spasm of the diaphragm thus paralysis of breathing

17. Signs and Symptoms Unable to catch breath Treatment – calm athlete and normal breathing should occur in a few seconds.