Basic Tissue Injuries

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29 Νοε 2013 (πριν από 3 χρόνια και 10 μήνες)

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Basic Tissue Injuries

Chapter 14

Introduction


Play sports
-
injuries occur


Most common
-
Tissues


Cuts, abrasions, contusions, muscle strains,
ligament sprains, inflammation of tendons,
joint dislocations, fractures, injuries to
specific organs


Repetitive motions
-
overuse injuries


As an ATC:


Need to recognize different injuries


Distinguish between levels of injury severity


Apply appropriate treatment

Introduction


Tissue:


A collection of similar
cells and their
intercellular substances
that work together to
perform a particular
function


Anatomy:


The study of
structure

of the body
-
how the
body is put together


Physiology:


The study of the
function

of the body
-
how the body works



Tissues
-
specialized cells


Cell
: the basic unit of life


Four Categories:


Epithelial tissue


Connective tissue


Nerve tissue


Muscle tissue


Cells in a particular
category of tissue are
specialized to perform a
certain function


Ex. Muscle
-
contract

Introduction


Cells combine

tissue


Tissue combine

organ


Organ (Viscera):


A structure within the body made up of
tissues that allow it to perform a particular
function


Lungs, heart, stomach, liver


Organs combine

system


Circulatory System, Respiratory System,
Nervous System

Cell Anatomy


Cells
-
cytoplasm


Jelly
-
like material


Water, carbon,
hydrogen,
calcium, nitrogen,
oxygen,
phosphorus, food
particles, pigment,
organelles


14
-
4


Tissues


Composed of similar cells that are
specialized to perform a particular
function


Four types


Epithelial


Connective


Nerve


Muscle

Tissues


Epithelial


Main tissue of skin


Lines cavities of the body


Lines principal tubes and passageways that
lead to the outside


Protect the internal organs


Regulates body temperature


Injuries: abrasions, laceration, punctures,
avulsions


Infection, inflammation, disease

Tissues


Connective


Supports and connects tissues and parts


Two types


Soft: Adipose
-
fatty tissue


Stores fat
-
food reserve, insulator, energy
source


Forms fibrous connective tissue that supports
joints


Ex. Tendons: muscle to bone


Ligaments: bone to bone

Tissues


Connective


Hard


Bone


Osseous Tissue
-
Skeletal system


Cartilage: dense, elastic tissue


Found in moveable joints


Ex: knee, between discs, nose,
ears

Tissues


Nerve


Pathway for communication from the central
nervous system to the muscles and organs


Composed of neurons
-
carry commands and
info between the brain and rest of the body


Contusions
: short
-
term damage
-
temporarily
impairing sensations/movement


Nerve crushed/severed: paralysis
-
long term

Tissues


Muscle


Tiny muscle fibers that contract =
movement and power


Three types:


Skeletal
-
bones/permits movement


Cardiac
-
heart to contract


Smooth/Visceral
-
in organs


Tissues


TOD


List one place where each of the
following can be found in the body or
an example of each tissue:


Epithelial Tissue


Connective Tissue


Muscle Tissue


What is nerve tissue made up of?



Superficial Injuries to Soft
Tissues


Involve damage to one or more of the
tissues surrounding the bones and
joints


Can involve skin, cartilage, muscles,
tendons, ligaments, veins, or arteries


Injuries can occur alone or they may
accompany a fracture or blunt trama

Superficial Injuries to Soft
Tissues


Wounds: open or
closed


Closed
: do not
break skin


Open:

break in
skin


Require first aid


Control bleeding
and prevent
infection


Superficial Injuries to Soft Tissues


Abrasions


Caused by sliding
or skidding on
pavement,
concrete, dirt, or
sand


Happen in any
sport


Different sizes,
usually not deep



Lacerations


Caused by tearing
motion, resulting
in jagged edges


Minor or deep


Deep


Nerve, blood
vessel, muscle,
tendon, ligament

Superficial Injuries to Soft Tissues


Puncture Wound


Pointed object
directly pierces
soft tissue


Most susceptible
to infection
-
tetanus


Embedded
-
MD
referral



Incisions


Caused by knife
-
like
objects


Clean cuts
-
very
deep


May involve muscle,
tendons, ligaments


Occur on hard, bony
area that are poorly
padded

Superficial Injuries to Soft
Tissues


Avulsions


Loss of tissue


Tissue still
attached


Flap avulsion




Calluses


the skin
becomes
thickened due to
high friction area
or pressure


Shoe doesn’t fit
properly


Superficial Injuries to Soft
Tissues


Blisters


Build
-
up of fluid
that collects under
the skin due to
friction



Bites


Occur from
insects, reptiles,
animals and
even people


Puncture
wounds,
lacerations,
avulsions


Superficial Injuries to Soft
Tissues


Contusions


Bruise received
from a sudden
blow to the body


Causes bleeding
in the tissue


discoloration

Severity: depends
on amount of soft
tissue and force


Hematoma


Closed wound


Blood
-
filled
swollen area
caused by
bleeding of the
tissues


Blood blister

Treatment


Abrasions and
Lacerations


First aid
treatment: Clean,
antibiotic
ointment,
bandage


Lacerations:
Stitches??
-
send
to MD


Treatment


Puncture


Stabilize object in
place: gauze/tape


Minor


First Aid


Incision


First Aid


Pull edges of
wound together
-
use butterfly
strips/steri
-
strips


MD

Treatment


Avulsions


First Aid


MD


Large flap is torn
away
-
locate it



Calluses


File off thick skin
with pumice stone

Treatment


Blisters


Clean area


Donut pad
-
disperse pressure


If it pops
--
DO
NOT PEEL OFF
SKIN!!


Bites


First Aid


Do not scratch


Allergic
-
MD
Immediately!!

Treatment


Hematoma


Ice, compression,
elevation (ICE)


MD


Contusions


Ice, compression,
elevation (ICE)


Muscle needs to
be lengthened


Ex. Quad
-
knee
flexed


Donut maybe
applied


TOD


Make sure your chart is filled out



Scenario:


An athlete who has had a contusion under
his toenail notices that the nail is pulling
away from the nail bed. He says the nail is
getting stuck on his sock. He has heard that
pulling the nail off will make the new nail
grow faster. He hands you a pair of pliers
and asks you to pull it off.


GET WITH PARTNER #3 AND WRITE
DOWN WHAT WOULD YOU DO.



Warm
-
up: Tic
-
Tac
-
Know


Please pick up handouts
from the table by the door
.


Get with the people in your
row.


Write one word on each
index card.


Abrasions


Lacerations


Puncture Wound


Incisions


Avulsions


Calluses


Blisters


Hematoma


Contusions


Shuffle cards and lay
cards down: 3 across
and 3 down



Write a single
statement for each
group of three cards
across, down, and
diagonally showing
the relationship
between the cards

Muscular System


Types of
Movement


Rotation


Adduction


Abduction


Flexion


Extension


Dorsiflexion


Plantarflexion


Types of
Movement


Supination


Pronation


Radial deviation


Ulnar deviation


Inversion


Eversion


Muscular System


Origin and Insertion


Origin:

movement
does not occur


Insertion
: movement
occurs


Ex. Quadriceps



Muscles remain
partially contracted at
all times


Muscle tone
: partial
state of contraction


Muscles are ready for
action


When muscles are not
used over a period of
time
-
atrophy

Muscular System

Injuries to Muscle Tissues


Muscle Strain


Overstretching or
tearing of the
muscles and/or
tissues


Occurs where
tendon meets
muscle


Hamstrings/


quadriceps



Strain Classifications


Complete tear

Decreased to increased

Moderate to severe

None to mild

Initial Treatment


Mild and Moderate


RICE (Rest, Ice, Compression,
Elevation)


Moderate
-
observe swelling (edema)


Severe


RICE


Immobilize


May require surgery


Follow up Treatment


Mild


Stretching
-
maintain ROM


Hold 20
-
30 seconds/3 sets


3x day



Moderate


Monitor swelling


Injuries to Muscle Tissues


Myositis Ossificans


Condition in which
bone forms in and
replaces muscle
tissue as a result of
trauma


Calcium is produced


S/S


Pain
-
primary


Can be palpable


X
-
rays
-
visible 3
-
4
wks after injury


Tx:


MD


Donut pad

Injuries of Muscle Tissues


Tendonitis


Inflammation of a
tendon


Repeated stress
resulting in
microtearing of the
tendon sheath


Swimming, baseball,
water polo, football
(some positions),
tennis


Improper body
mechanics/poor
conditioning



S/S


General soreness


Point tenderness


Mild swelling


Tx:


RICE


brace

The Joints


AKA articulations


The point at which two or more bones
meet


Allow movement according to their
ROM


Three categories


Fibrous
-
Immovable (cranium)


Cartilaginous
-
slightly moveable (vertebra)


Synovial
-
freely moveable (elbow, knee)

The Joints/Articulations


Mobile joints


Most frequently injured


Grouped


Pivot joints
-

rotation on a single axis


Hinge joints
-

flexion/extension


Joints are surrounded by ligaments, tendons, and a
protective capsule
-
filled with synovial fluid


Synovial Fluid
-
shock absorber, cushions both ends of
bone


Bursa:

sac full of synovial fluid that reduces friction
between tendons, bones, ligaments


Meniscus
: cartilaginous disc surrounded with fluid that
also reduces friction during movement and adds
stability


Joints/Articulations


Muscular System
-
Review


Review


Movements


Strains


1
st


2
nd


3
rd


Joints


Fibrous, Cartilaginous, Synovial

Motion Groups for Synovial
Joints


Freely moving


Ball & Socket


A round end of one bone fits into a
cup
-
like end of another bone


Allowing wide range of movement


shoulder and hip


Motion Groups for Synovial
Joints


Pivot


Projection fits through a ring made up
of bone and ligament


1
st

and 2
nd

cervical vertebrae


Atlas and axis

Motion Groups for Synovial
Joints


Hinge


Joint in which the two surfaces are
molded together closely, allowing a
wide range of flexion and extension


Elbow and knee


Motion Groups for Synovial
Joints


Saddle


Two surfaces, one convex and the
other concave, it together


Thumb


Motion Groups for Synovial
Joints


Condyloid (Ellipsoid)


Rounded or oval end of bone fits into
a oval cavity, allowing all types of
movement except pivoting


Wrist joints

Motion Groups for Synovial
Joints


Gliding


Two facing bones surfaces meet


Motion is limited by surrounding
tissues and ligaments


Wrist and ankle


Injuries to the Joints


Excessive Force


Three types


Compression
-
crushes tissue


Tension
-
pulls and stretches


Sheer
-
moves against the organization of
tissue fibers


Tendons/ligaments are made to withstand
tension forces, but do not resist sheer or
compression


Excessive can cause ligament or capsular
sprains or muscle strains


Injuries to Joints


Sprain


Overstretching
and/or tearing of
ligament or
tissues caused by
a traumatic
twisting of a joint


Vary in degrees of
intensity


S/S


Deformity


Crepitation


A crackling or
grating sound
heard with
movement


Point tenderness


Immediate
swelling


Injuries to Joints


Immediate Tx


PRICE


Protect
-
avoid further injury


Ex. Sprained ankle
-
Two person carry


Rest


Ice


Compression


Elevation


Injuries to Joints


Follow
-
up Tx


Rehabilitation


Strengthening Exercises


Braces


Taping

Injuries to Joints


Dislocations


An injury resulting from a force that causes a
joint to go beyond its normal limits


S/S


Point tenderness


Loss of strength


Complete loss of motion


Swelling and deformity


http://www.csmfoundation.org/kneeinjurywe
b.mov

Injuries to Joints


Subluxation


Partial dislocation


“felt it slipped out then back in”


S/S


Dead arm weakness
-
inability to lift arm


pain

Injuries to Joints


Dislocations/Subluxations


Immediate Tx:


Check area below injury for pulse and
sensation


Can not find
-
EMS


If normal, splint injury


Ice


MD

Injuries to Joints


Synovitis


Inflammation of
the synovial
membrane in a
joint


Repetitive
motion/overuse


S/S:


Pain


Swelling


Localized tension


Increase pain with
movement


Injuries to Joints


Bursitis


Inflammation of a bursa


Located between two bones, muscles,
or tendons


Injuries to Joints


Immediate Tx:


No swelling
-
hot pack


Yes Swelling
-
ICE technique


Follow up Tx:


Stretching to promote loss of ROM


Strengthening exercises


Prevention:


Proper mechanics

TOD


One Sentence Summaries

1.
A
Sprain

is a type of _______ that…..

2.
A Hinge joint

and
a pivot joint

are similar in
that they both___________, but a hinge
joint______________, while a pivot
joint________________.

3.
Bursitis

happens because ___________.