Chapter 13Chapter 13Muscle and Bone InjuriesMuscle and Bone Injuries

By: Ryan and ConnorBy: Ryan and Connor

IntroductionIntroduction

The The musculoskeletal systemmusculoskeletal system is is made up of made up of musclesmuscles, , tendonstendons and and ligamentsligaments, and bones that , and bones that form the skeleton. form the skeleton.

They They provideprovide the body with the body with shapeshape, , formform, , stabilitystability, and , and movementmovement..

Goals/ObjectivesGoals/Objectives

Gain fundamental Gain fundamental knowledge of knowledge of anatomy and anatomy and function of function of musculoskeletal musculoskeletal system system

Identify/treat open Identify/treat open and closed wounds, and closed wounds, as well as painful, as well as painful, swollen, and swollen, and deformed deformed extremitiesextremities

Key Terms Key Terms

BoneBone: A dense, hard tissue that forms the skeleton.: A dense, hard tissue that forms the skeleton.DislocationDislocation: The displacement of a bone from its normal : The displacement of a bone from its normal position at a position at a joint.joint.FractureFracture: A break or disruption in bone tissue.: A break or disruption in bone tissue.ImmobilizeImmobilize: To use a splint or other method to keep an : To use a splint or other method to keep an injured body injured body part from moving.part from moving.JointJoint: A structure where two or more bones are joined.: A structure where two or more bones are joined.LigamentLigament: A barbarous band that holds bones together at a : A barbarous band that holds bones together at a joint.joint.

Muscle: A tissue that lengthens and shortens to create Muscle: A tissue that lengthens and shortens to create movement. Painful, swollen, deformed extremities movement. Painful, swollen, deformed extremities

(PSD (PSD extremity): All injuries to the extremities caused by a extremity): All injuries to the extremities caused by a force.force.Skeletal musclesSkeletal muscles: Muscles that attach to bones.: Muscles that attach to bones.SplintSplint: a device used to immobilize body parts.: a device used to immobilize body parts.SprainSprain: The excessive stretching and tearing of ligaments and : The excessive stretching and tearing of ligaments and other other soft tissue structures at a joint.soft tissue structures at a joint.StrainStrain: The excessive stretching and tearing of muscles and : The excessive stretching and tearing of muscles and tendons.tendons.TendonTendon: A fibrous band that attaches muscle to bone.: A fibrous band that attaches muscle to bone.

Injuries to Bones and Injuries to Bones and Joints Joints

Mechanism of Mechanism of Injury Injury There are three There are three

basic types basic types Direct forceDirect force Indirect force Indirect force Twisting Force Twisting Force

Signs and Symptoms Signs and Symptoms

Common signs and symptoms Common signs and symptoms associated with musculoskeletal associated with musculoskeletal injuries:injuries:

Pain and tendernessPain and tenderness SwellingSwelling GratingGrating Deformity Deformity Bruising (dislocation)Bruising (dislocation) Exposed bone endsExposed bone ends Joint locked into positionJoint locked into position Inability to move an affected partInability to move an affected part

SwellingSwelling

DeformityDeformity

BruisingBruising

General Care for Bone and General Care for Bone and Joint Injuries Joint Injuries

Remember Remember proper protectionproper protection and and BSIBSI

Assess ABC’sAssess ABC’s and life-threatening and life-threatening conditions firstconditions first

Summon more Summon more advanced advanced medical personnel medical personnel

General care for all skeletal General care for all skeletal injuries injuries

RICERICE RestRest: avoiding movement and : avoiding movement and

activities that cause painactivities that cause pain IceIce: Apply ice or a cold pack - : Apply ice or a cold pack -

reduces swelling and eases pain reduces swelling and eases pain and and discomfortdiscomfort

CompressionCompression ElevationElevation: raise injured are above : raise injured are above

heart level to restrict blood flowheart level to restrict blood flow

Immobilization Immobilization

Serious skeletal injuries Serious skeletal injuries require require immediate immobilizationimmediate immobilization. This . This lessens painlessens pain, , prevents further damageprevents further damage, , reduces riskreduces risk of serious of serious bleedingbleeding, , reduces the possibility of reduces the possibility of loss of loss of circulationcirculation to the injured part, to the injured part, prevents prevents PSD extremity injuriesPSD extremity injuries..

Immobilize an injured area with a Immobilize an injured area with a splintsplint, a device that maintains an , a device that maintains an injured injured part in place. part in place.

Splinting Splinting

Splint only if it can be done Splint only if it can be done without causing further pain.without causing further pain.

Splint an injury in the position Splint an injury in the position you find it.you find it.

Splint the injured area and the Splint the injured area and the joints above and below the injury joints above and below the injury site.site.

Check for proper circulation and Check for proper circulation and sensation prior to splinting.sensation prior to splinting.

Types of SplintsTypes of Splints

SlingSling: (made from a triangular : (made from a triangular bandage) bandage) tied to support an arm, wrist, tied to support an arm, wrist, or handor hand

CravatCravat: folded triangular bandage used : folded triangular bandage used to to hold dressings or splints in placehold dressings or splints in place

Rigid splintsRigid splints: include boards, metal : include boards, metal strips, strips, and folded plastic or and folded plastic or cardboard splintscardboard splints

Anatomic splintsAnatomic splints: refer to the use of the : refer to the use of the body as a splintbody as a splint

Shoulder Injuries Shoulder Injuries

-The most frequent injured bone of the shoulder is -The most frequent injured bone of the shoulder is the clavicle (more so in children than in adults).the clavicle (more so in children than in adults).-Injuries to the shoulder are commonly caused by -Injuries to the shoulder are commonly caused by a fall.a fall.-The victim usually feels pain in the shoulder area -The victim usually feels pain in the shoulder area and it may radiate down the upper arm.and it may radiate down the upper arm.-Dislocations also usually result from falls and -Dislocations also usually result from falls and cause ligaments to tear.cause ligaments to tear.-They cause intense pain and usually deformities.-They cause intense pain and usually deformities.-To care for shoulder injuries, first control external -To care for shoulder injuries, first control external bleeding with direct pressure. Splint the shoulder bleeding with direct pressure. Splint the shoulder in the position it was found in or which causes the in the position it was found in or which causes the least pain. Check circulation and sensation.least pain. Check circulation and sensation.

Upper Arm Injuries Upper Arm Injuries

-The humerus can be fractured at any -The humerus can be fractured at any point, but is usually at the upper end or point, but is usually at the upper end or in the middle of the bone. Regardless, in the middle of the bone. Regardless, there will be a danger of there will be a danger of damage to the blood vessels and damage to the blood vessels and nerves supplying the entire arm.nerves supplying the entire arm.-To care for upper arm injuries, -To care for upper arm injuries, immobilize the upper arm from the immobilize the upper arm from the shoulder to the elbow. Control external shoulder to the elbow. Control external bleeding with direct pressure. Splint bleeding with direct pressure. Splint arm to the chest and apply cold if arm to the chest and apply cold if possible. Check circulation and possible. Check circulation and sensation.sensation.

Elbow Injuries Elbow Injuries

-Like other joints, the elbow is susceptible -Like other joints, the elbow is susceptible to sprains, fractures, and dislocations. All to sprains, fractures, and dislocations. All are serious because all nerves and blood are serious because all nerves and blood vessels go through the elbow.vessels go through the elbow.-To care for an elbow injury, immobilize -To care for an elbow injury, immobilize elbow in position you find it in. Control elbow in position you find it in. Control external bleeding with direct pressure. external bleeding with direct pressure. Place the arm in a sling Place the arm in a sling and secure it to chest (if possible, use two and secure it to chest (if possible, use two cravats). The splint should extend several cravats). The splint should extend several inches beyond the upper arm and the inches beyond the upper arm and the wrist. Check circulation and sensation.wrist. Check circulation and sensation.

Forearm, Wrist, and Hand Forearm, Wrist, and Hand Injuries Injuries

Fractures often occur to the radius and Fractures often occur to the radius and ulna as a result of a fall.ulna as a result of a fall. Hands are especially susceptible to tissue Hands are especially susceptible to tissue

and nerve damage, as well as and nerve damage, as well as blood vessels and bones.blood vessels and bones.

To care for these injuries, first control To care for these injuries, first control external bleeding with direct pressure. external bleeding with direct pressure. Bandage hand by applying a pressure Bandage hand by applying a pressure bandage in a figure- eight bandage in a figure- eight pattern. Support wrist by placing a splint pattern. Support wrist by placing a splint under forearm. Immobilize fingers with soft under forearm. Immobilize fingers with soft splints or a roll of gauze. Check circulation splints or a roll of gauze. Check circulation and and sensation.sensation.

Ankle and Foot InjuriesAnkle and Foot Injuries

-Injuries to this area are commonly -Injuries to this area are commonly caused by twisting forces and range caused by twisting forces and range from minor sprains to fractures an from minor sprains to fractures an dislocations. To care for ankle and foot dislocations. To care for ankle and foot injuries, first control external bleeding injuries, first control external bleeding with direct pressure. Splint by using an with direct pressure. Splint by using an air splint, soft splint, or a custom one air splint, soft splint, or a custom one designed for such injuries. Apply ice or a designed for such injuries. Apply ice or a cold pack. Monitor ABC’s as cold pack. Monitor ABC’s as well as sensation and mobility of injured well as sensation and mobility of injured area. Summon more advanced area. Summon more advanced medical personnel.medical personnel.