Thorax and Abdomen

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Thorax and Abdomen
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On-Field Assessment Primary Survey
Observe surroundings and athlete.
Establish consciousness.
Check airway, breathing, and circulation.
Assess vitals early (pulse, respirations, blood
pressure).
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On-Field Assessment Secondary Survey
Historynote symptoms
Nausea
Chest or abdominal pain
Difficulty breathing
Pain increase on inspiration
Observationnote overall response
Pain
Respiratory or cardiac distress
Shock
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On-Field Assessment Secondary Survey
Palpate to assess potential structures involved
Chest wall (tenderness, deformity, swelling,
asymmetry)
Bony and soft tissue landmarks
Abdomen (distension, guarding, rebound tenderness)
Pulse
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Cardinal Signs of Internal Injury
Decreased blood pressure
Rapid and weak pulse
Wet, white, and weak appearance
Rapid and shallow respirations
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Sideline and Off-Field Assessment History
Chief complaint
Mechanism of injury
Onset, duration, and change in symptoms
Pain profile
Presence and location of referred pain
(continued)
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Sideline and Off-Field Assessment History
Nausea, vomiting, difficulty breathing
Presence of hematuria
General health and previous injury history
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Sideline and Off-Field Assessment Observation
Response, position and posture
Skin coloration and moisture
Thorax (breathing pattern, signs of cardiac
distress)
Abdomen (rigidity, guarding, distension)
(continued)
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Sideline and Off-Field Assessment Observation
Genitalia (swelling or abnormal appearance)
Hematuria and hemoptysis
Swelling, discoloration, lacerations, deformity,
asymmetry
Vital signs
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Sideline and Off-Field Assessment Palpation
Pulse
Chest (tenderness, deformity, crepitus, asymmetry)
Bony landmarks
Soft tissue
(continued)
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Sideline and Off-Field Assessment Palpation
Abdomen
Muscle guarding
Ridigity and distension
Rebound tenderness
Deep organ palpation (liver, spleen, kidney)
Testicles (swelling, tenderness, masses,
abnormalities)
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Abdominal quadrants
anterior view
posterior view
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Liver palpation
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Spleen palpation
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Anatomical position of the kidneys
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Kidney palpation
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Abdominal Sideline and Off-Field Assessment
Special Tests
Anterior-posterior rib compression
Lateral rib compression
Auscultation (heart, lungs, bowel)
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Anterior-posterior rib compression
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Lateral rib compression
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Auscultation
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Sideline and Off-Field Assessment ROM and
Strength
Range of motion
Active for trunk, scapular, and shoulder motions
Bilateral comparisons
Strength
Same motions as for ROM
Note weaknesses and bilateral differences
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Sideline and Off-Field Assessment Neurological
Tests
Neurological assessment is primarily sensory.
Thoracic dermatomes
Visceral pain referral patterns
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Functional Assessment
Cardiorespiratory (aerobic exercise)
Musculoskeletal (active sport-related movements)
Reassess signs and symptoms during and after each
functional activity.
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Follow-Up Assessment
Signs and symptoms may not be present until hours
or days postinjury. Ongoing follow-up care is
important along with frequent evaluation and
instruction.