1. THE ABDOMEN
Chapter 16

2. THE ABDOMEN
Abdominal injuries occur infrequently; however, they might be life-threatening
Many times even serious injuries to the abdomen do not become apparent for days.

3. The abdominal cavity lies between
Anatomy of the Abdomen
The abdominal cavity lies between
The lumbar spine posteriorly
The diaphragm superiorly
The abdominal musculature anteriorly
The pelvis inferiorly

4. I. It is divided into four quadrants by an imaginary horizontal line through the navel and an imaginary vertical line running from the sternum, through the navel to the area between the legs.

6. 1. located just below the ribs on person‘s right side
4 Quadrants
A. Upper Right Quadrant
1. located just below the ribs on person‘s right side

7. 2. Houses the:
a. Bulk of liver
b. Part of the pancreas
c. Right kidney
d. Gallbladder
e. Small & large intestine

8. 1. Lies just below the ribs on person‘s left side
4 Quadrants
B. Upper Left Quadrant
1. Lies just below the ribs on person‘s left side

9. 2. It contains the
a. Stomach
b. Part of the liver
c. Portion of the pancreas
d. Left kidney
e. Spleen
f. Small and large intestine

10. Just above the pelvis on the right side of the body
4 Quadrants
C. Lower Right Quadrant
Just above the pelvis on the right
side of the
body

11. 2. Contains the
a. Small and large intestine
b. Appendix
c. Part of the bladder
d. Uterus and right ovary in females
e. Prostate in males

12. 1,500-3,000 sperm produced every second
4 Quadrants
D. Lower Left Quadrant
~ Houses the
a. Small and large intestine
b. Portion of the bladder
c. Uterus and left ovary in females
d. Prostate in males
Fun Fact:
1,500-3,000 sperm produced every second

13. II. Some of these organs are hollow and some are solid.
Anatomy of the Abdomen
II. Some of these organs are hollow and some are solid.
A. Hollow organs are basically tubes that assist in transporting substances

14. Fun Fact: Small Int = 22 feet
1. Bladder, intestines, stomach, and appendix
2. Usually move to the side when hit, therefore injuries to these organs rarely causes rapid death
Fun Fact: Small Int = 22 feet
Large Int = 5 ft

15. Anatomy of the Abdomen
B. Solid organs are composed of the liver, kidneys, pancreas, and spleen
1. Injuries to these organs present a medical emergency

16. 2. Contain large amounts of blood which means that a person can bleed to death rapidly.

18. III. Abdominal organs can be divided into three categories
A. Digestive organs
Stomach, small and large intestine, appendix
Liver, Pancreas, Gallbladder
Dont actually touch the food
produce enzymes to aid in digestive process

19. Kidneys, ureters, & bladder C. Reproductive Organs
Fun Fact:Male sperm is the smallest cell in the body and the female egg is the largest.
B. Urinary organs
Kidneys, ureters, & bladder
C. Reproductive Organs
~Males: prostate & seminal vessicles
~Females: ovaries & uterus

20. Fun Fact: Filter 3 pints of blood per minute
Organs of the Abdomen
Fun Fact: Filter 3 pints of blood per minute
I. KIDNEYS:
A. Located approximately in the center of the back.

21. B. They are BEAN SHAPED with the right kidney usually being slightly lower than the left because of the pressure of the liver.
C. Function:
Filter blood and remove waste products of metabolism

23. Anatomy of the Abdomen
II. SPLEEN
A. Located under the diaphragm on left side and behind ribs 9, 10, and 11.

24. B. Main functions of the spleen: Reservoir of blood
Anatomy of the Abdomen
B. Main functions of the spleen:
Reservoir of blood
1. Regulate number of Red Blood Cells
Production of new RBC
Destruction of ineffective RBC
2. Production of antibodies

26. Fun Fact: Liver is thought to have 100 functions.
III. LIVER
A. Functions of the Liver
1. Detoxification of chemicals (eg.alcohol)
2. Storage of vitamins
3. Production of bile
~ Assistance w/food metabolism
Fun Fact: Liver is thought to have 100 functions.

28. A. Functions of the Stomach
Anatomy of the Abdomen
IV. STOMACH
A. Functions of the Stomach
1. Secretion of gastric jiuces to break down food before it enters the intestines

30. V. Gall Bladder A. Located at the liver Anatomy of the Abdomen
1. Storage tank for bile which is passed into small intestine to assist in digestion of fats

32. A. Produces insulin and enzymes important for digestion
Anatomy of the Abdomen
VI. Pancreas
A. Produces insulin and enzymes important for digestion

34. VII. MUSCULATURE
A. Although the liver & the spleen are protected in part by the inferior portion of the ribs, the abdominal musculature & fat provide most of the protection for the abdominal organs.

35. B. Main muscles include:
1. Rectus Abdominis
2. Obliques (internal and external)

36. 1. Rectus Abdominis MUSCULATURE
a. Extends from the sternum and lower ribs to the pelvis
b. Action = trunk flexion
c. When well developed appears in form of a washboard or 6-pack

37. MUSCULATURE
2. Obliques
a. Run from the side of the ribs to the anterior pelvis
b. Perform rotation and lateral flexion of the trunk, and assist in trunk flexion
c. Internal are deeper than external

38. INJURIES TO THE ABDOMEN
Contusions can occur through direct blows
Strains can follow sudden twisting of the trunk or reaching overhead.
Both these injuries can be very disabling

39. INJURIES TO THE ABDOMEN
Injuries w/in the abdominal cavity, especially to the hollow organs, are rare
The solid organs can be injured, resulting in internal bleeding and a possibly life-threatening condition

40. Signs and Symptoms of serious abdominal injury are:
Abdominal pain, signs of shock, muscle rigidity (spasms), or blood in urine

41. INJURIES TO THE ABDOMEN
I. Spleen Injuries
A. A blow to the abdomen can cause the spleen to rupture

42. B. Signs and Symptoms
Abdominal pain; pain in left shoulder (referred pain) called KEHR‘S SIGN; possibly nausea, vomiting, cramping and weakness; abdominal rigidity; signs of shock

43. C. Treatment
Call 911
Athlete may bleed severly internally,causing rapid blood loss and a drop in blood pressure, which can lead to death

44. INJURIES TO THE ABDOMEN
II. Pancreas Injury
A. The pancreas is prone to tearing during deceleration, eg. an athlete hitting a wall
The body stops suddenly but the internal organs are still shifting forward (like whiplash)

45. B. Signs and Symptoms
Pain in middle of abdomen to the back, nausea and vomiting, signs of shock
C. Treatment
~ Call 911
~ Ruptured pancreas must be surgically repaired

46. INJURIES TO THE ABDOMEN
III. Kidney Injury
A. A direct blow to the area of the kidneys can cause contusion, laceration, or rupture

47. B. Signs and Symptoms
Pain just under the posterior ribs to the side of the spine, which may radiate to the bladder

48. Pain will increase with trunk extension and decrease with knee and hip flexion
Possibly nausea, vomiting , or blood in urine
C. Treatment
~ Call 911

49. INJURIES TO THE ABDOMEN
IV. Hernias
A. A lump of tissue, usually in the intestine, that bulges through a weakness in the abdominal wall.

50. B. Caused by increased pressure (holding your breath while weight-lifting or going to the bathroom)

51. INJURIES TO THE ABDOMEN
C. If untreated, the hernia can get stuck which may lead to strangulation
Cuts off blood supply, therefore the tissue will eventually die

52. D. If the intestine is involved a bowel obstruction can result
Obstruction prevents waste material from passing through the body, causing pain and illness

53. INJURIES TO THE ABDOMEN
E. Signs and Symptoms
Possibly pain
Possibly a lump in the groin area, which may disappear when lying down and re-appear when standing up

54. When untreated, gangerine and possible death may occur

55. INJURIES TO THE ABDOMEN
Treatment
Surgical Repair
Temporarily a truss can be worn to apply external pressure to keep the bulge inside the abdomen
Pictures are next!

57. INJURIES TO THE ABDOMEN
V. Liver Injuries
A. A blow to the right upper quadrant can lead to a liver contusion or rupture
Fun Fact: liver weighs 3-5 pounds

58. B. Signs and Symptoms
Pain in right upper quadrant which might radiate into right shoulder, signs of shock
C. Treatment
Call 911

59. INJURIES TO THE ABDOMEN
VI. Side Stich
A. Pain in upper abdominal region, just below the ribs

60. 1. a lack of O2 to abdominal muscles
B. Typically caused by:
1. a lack of O2 to abdominal muscles
2. improper breathing technique
3. eating just before exercising
4. trapped air in abdominal organs, or
5. muscle spasms
6. Dehydration

61. C. Usually occurs more frequently in unfit indviduals
D. May be resolved by stopping exercise and applying direct pressure over the area and controlled breathing

62. Chapter 16
Special Tests

63. Appendicitis Test PT: laying supine
EX: standing at the right side of pt.
Find ASIS and move 1 inch towards belly button. (McBurney’s Point)
Push straight down and hold 1-2 seconds
Release quickly
Positive – Pain on release

64. Abdominal Palpation PT – lying supine with knees bent Positive
rigidity of muscles
Muscle guarding, accumulation of blood
pain
rebound tenderness
EX: appendicitis
tissue density
Accumulation of blood (internal bleeding)
Specific organ issue

65. Vital Signs Heart Rate Blood pressure Breathing Rate Facial Color
Temperature

66. Rib Compression PT: standing, lying, or sitting with good posture
EX: standing next to patient
1. Hands on front and back right then left
2. Hands on sides
Positive: excess movement and/or pain