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BONE JOINT & MUSCLE INJURIES
CHAPTER 7• To assess the victim’s condition quickly & calmly• To steady & support the injured part of the body
• To minimize shock• To call 911 for emergency help if you suspect a serious injury
• To comfort & reassure the victim• To be aware of your own needs
THE SKELETON
• Framework of bones1. Supports muscles, blood vessels & nerves2. Protects organs• 206 bones• Skull= protects brain & supports structures of the face• Jawbone= Mandible• Collarbone= clavicle • Shoulder blade= scapula• Breastbone= sternum• 12 ribs
Shoulder girdle
THE SKELETON
• Humerus= upper arm bone• Ulna• Radius• Femur= thigh bone• Patella= knee cap• Tibia= shin bone• Fibula= splint bone• Wrist bones= carpals• Hand bone= metacarpal• Ankle bones= tarsals• Foot bones= metatarsals• Finger/ toes= phalanx
Forearm
Lower leg bones
THE SKELETON
Skull
Mandible(Hinge- Jt.)
THE SKELETON
Scapula
Sternum
Clavicle
Ribs(12 pairs)
THE SKELETON
Humerus
RadiusUlna
Carpals Metacarpals
Phalanx
THE SKELETON
Femur
Tibia
Patella
Fibula
THE SKELETON
Tarsals
Metatarsals
Phalanx
THE SPINE
• Backbone• 26 vertebrae• Intervertebral discs• Fibrous tissue which helps make the spine flexible • Shock absorption
• Functions:1. Supports head2. Makes upper body flexible3. Supports body’s weight4. Protects spinal cord
SPINAL COLUMN
• Vertebrae form 5 groups:1. Cervical (7)
1. Support head & neck2. Thoracic (12)
1. Anchor for the ribs3. Lumbar (5)
1. Supports body’s weight & gives stability4. Sacrum (5 fused)
1. Supports the pelvis5. Coccyx (4 fused)
1. Forms the end of the spine
THE SKULL• Protects the brain & the top of
the spinal cord• Supports eyes & other facial
structures• Made up of several bones, most
fused at joints called sutures
BONES
• Bone= living tissue containing calcium and phosphorus• Minerals that make bone hard, rigid, & strong
• Able to generate new tissue after injury• Certain diseases can weaken bones• Inherited problems/ Bone disorders (rickets, cancers, infections)
• Age• Adolescence= can shorten/ impair movement• Older= bones can lose density making them brittle (osteoporosis)
PARTS OF A BONE
Each bone is covered by a membrane called the periosteum
Compact bone
Spongy bone (core)
Bone marrow (center cavity
MUSCLES
• Cause various parts of the body to move• Skeletal muscles• Voluntary • Control movement & posture• Attached to bones by strong bands of fibrous tissue= tendons
• Involuntary • Operate internal organs & work constantly• Ex: heart• Controlled by autonomic nervous system
JOINTS
• Where one bone meets another• Immovable joints• Bone joints are fused• Skull (sutures) & pelvis
• Movable joints• Bone ends are joined by fibrous tissue called ligaments• Capsule lining= synovial membrane• Lubricates the joint
Surfaces are flat & slide over each other.Ex: Foot & wrist
Allows bending & straightening in only 1 plane.Ex: Knees & elbows
Allows movement in all directions.Ex: Hip & Shoulder
Bone ends meet at right anglesEx: Base of thumb
One bone rotates within a fixed collar formed by another.Ex: Base of the skull
Movement can occur in most directions Ex: Wrist
FRACTURES
• Break/crack in a bone• Twist/ wrench• Heavy blow• Old/ disease
• Open fracture• Bone is exposed• May suffer bleeding & shock• High risk of infection
• Closed fracture• Skin is not broken• Internal bleeding is a risk
• Stable fracture• Ends of injury remain in place• Not completely broken
• Unstable fracture• Broken bone ends can easily be displaced• May damage blood vessels, nerves &
organs
FRACTURES
• Recognition:• Deformity, swelling, & bruising at fracture site• Pain/ difficulty in moving the area• Course grading (crepitus)• Signs of shock
TREATING A CLOSED FRACTURE• Aims:• Prevent movement at the injury site• To arrange transportation to the hospital• Caution:
• Do not move victim until injured part is secured & supported• Unless immediate danger
• Do not allow victim to eat/ drink anything
1. Advise victim to keep still; support joints above & below injury with your hands until immobilized with sling/ bandages
2. Place padding around injury for extra support; take/send victim to hospital1. Arm injury may be transported by car
3. For further support= secure injured part with unaffected part1. Always tie knots on the uninjured side
4. Treat for shock if necessary; monitor/record vital signs; check circulation (10 minutes) 1. DO NOT raise an injured leg (elevate uninjured leg if necessary)
TREATING AN OPEN FRACTURE
• Aims:• Prevent blood loss, movement & infection• Arrange removal to hospital with comfortable support
• Caution:• Do not move victim until injured part is secured & supported
• Unless immediate danger• Do not allow victim to eat/ drink anything• Do not press directly on a protruding bone end
• SPECIAL CASE: if a bone end is protruding, build up pads of clean, soft, non-fluffy material around the bone until you can bandage over it without pressing on the injury
TREATING AN OPEN FRACTURE
1. Cover the wound with a sterile dressing; apply pressure around the injury to control bleeding
2. Carefully place a sterile dressing/ padding over and around dressing3. Secure dressing & padding with a bandage4. Immobilize injured part as for a closed fracture5. Treat victim for shock; monitor/ record vital signs; check circulation
every 10 minutes
DISLOCATED JOINT• Partially/ completely pulled out of their normal position
• Strong force• Abnormal position• Violent muscle contraction
• Usually affects shoulder, knee, jaw or thumb/fingers• May be associated with torn ligaments• Recognition:
• “sickening” severe pain• Inability to move jt • Swelling/ bruising• Shortening, bending/ deformity
• Aims:• Prevent movement at injury site• Arrange removal to hospital with comfortable support
DISLOCATED JOINT
• Caution: • Do not try to replace a dislocated bone into its socket• Do not move the victim until the injured part is secured & supported• Remove bracelets, rings & watches• Do not allow victim to eat/ drink
1. Advise victim to keep still; help to support injured part in a comfortable position
2. Immobilize 3. Extra support- secure limb to body4. Arrange to take/ send to hospital; monitor/ record vital signs5. Check for circulation (10 minutes)
STRAINS & SPRAINS
• Injury frequently associated with sports (soft tissue)• Occur when tissues are overstretched & partially/ completely torn
(ruptured) by violent/ sudden movements• Strains & sprains should be treated initially by RICE• R- rest• I-ice• C- compression• E- elevation
• Any doubt- treat as a fracture
Strains & Sprains
Muscle & Tendon Injury• Strain, ruptured or bruised• Strain= muscle is overstretched• Example: Gastrocnemius tear
Ligament Injury• Sprain= stretching/ tearing of a
ligament• Sudden/ unexpected wrenching
motion• Example= sprained ATF ligament
in ankle
STRAINS & SPRAINS
• Recognition:• Pain & tenderness• Difficulty in moving the injured part• Swelling & bruising
• Aims:• Reduce swelling & pain• Obtain medical help if necessary
1. Help victim sit/ lie down; support injured part (preferably raised)2. Cool the area (cold compress)3. Apply comfortable support4. If pain is severe/ unable to move injured part take/ send to hospital
STRAINS & SPRAINS
FACIAL INJURY
• Fractures of facial bones are usually due to hard impacts• Main danger= blood, saliva, or swollen tissue may obstruct airway• Always assume there is damage to the skull, brain or neck• Recognition:• Pain • Difficulty speaking, chewing or swallowing• Difficulty breathing• Swelling & deformity • Bruising • Clear fluid/ watery blood from nose or ear
FACIAL INJURY
• Aims:• Keep airway open• Minimize pain & swelling (edema)• Arrange urgent removal to hospital
• Caution: • Never place bandage around lower part of face/ jaw in case victim vomits or
has difficulty breathing• Do not allow victim to eat/ drink• If unconscious but breathing= recovery position• Not breathing= begin CPR
• Be aware of the risk of neck injury
FACIAL INJURY
1. Call 911 for emergency help2. Help the victim sit down & make sure the airway is open & clear3. Ask the victim to spit out any blood/ displaced teeth4. Gently place a cold compress against victim’s face to help reduce
pain & swelling5. Monitor/ record vital signs
COLLAR BONE INJURY
• It is rare for a collar bone to be broken by direct blow• Usually from indirect force transmitted from an impact at the
shoulder or passing along the arm• Young people• Recognition: • Pain & tenderness• Swelling & deformity
• Aims: • Immobilize jt• Arrange transportation to hospital
COLLAR BONE & SHOULDER INJURY
1. Help victim sit down; gently place injured arm across the body & support the elbow
2. Support with an arm sling3. Extra support= secure arm to chest 4. Arrange to take to hospital
Upper arm & elbow injury
RIB INJURY
• Direct force or crush injury• Breathing may be seriously impaired• May injure internal organs• Internal bleeding• Recognition:
• Bruising & swelling• Pain• Shallow breathing• Signs of internal bleeding & shock
• Aims:• Support chest wall• Arrange transportation to hospital
HIP & THIGH INJURIES
• Most serious injury of the femur= fracture• Considerable force• Can pierce major blood vessels• Severe blood loss• Shock
• Recognition: • Pain • Inability to walk (antalgic gait)• Signs of shock• Shortening of the leg & turning outward of the knee & foot
• Aims: • Immobilize limb• Arrange urgent removal to hospital
FRACTURED PELVIS
• Indirect force• May be complicated by injury to tissues & organs• Shock• Recognition:
• Inability to walk/ stand• Pain & tenderness in groin region• Difficulty/ pain with urinating • Signs of shock & internal bleeding
• Aims:• Minimize risk of shock• Arrange urgent removal to hospital