Unit # 3 Basics of Tissue Injury

Soft Tissue Injuries Often called- Wounds –The tissue may bleed, become inflamed or produce extra fluid.

Sprain Is an injury to a ligament.

Strains Is an injury to a muscle or tendon.

Learn to treat a strained Muscle! Oh my aching latissimus dorsie...

Sprains and Strains Categorized by severity: –1 st degree: no loss of function, tenderness –2 nd degree: some loss of function, partial tear of the tissue –3 rd degree: unable to move, complete tear of the tissue

Nerve Tissue Allows communication between brain and spinal cord to all other parts of the body. –Nerves can sense touch, pain, hot, cold Nocioceptor (Pain) Mechanoreceptor (Vibration, touch, pressure, stretch and tension) Thermoreceptors (Hot and cold) Photoreceptors (eyes to light) –Nerves tell the muscle when to relax and when to contract.

Types of Tissue Injuries Incisions- Open wound, made by a cutting object like a scalpel Abrasion- Layer of skin is scrapped off Contusion- Bleeding under the skin, aka “bruise” Laceration- jagged, irregular open wound Avulsion- a partial tearing away of a body part Puncture- when a pointed object enters the body Countrecoup- occurs opposite side of initial injury

Incision

Laceration

Abrasion

Contusion

Avulsion Fracture

Puncture Wound

Contrecoup Injury

Stages of Healing: Soft Tissue Stage 1: Acute Inflammatory stage (0-2 or 3 days) Cells around injury die- ripping apart, cutting off blood supply Phagocytes- engulf + eat dead cells Leukocytes- infection fighting white blood cells Platelets- carry blood-clotting materials

Stages of Healing: Soft Tissue Stage 2 : Repair Fibroblasts- begin building fibers across injured area and forms scar tissue( 6 weeks to 3 months)

Stages of Healing: Soft Tissue Stage 3 : Remodeling ( 1 yr. or more) Building tissue strength to withstand the stresses applied to it. (Wolf’s Law)

Healing Healing time depends on several things: –Degree of injury –Location –Blood flow to area –Age –Nutrition –Illness, Infection –Medication

Healing 3 things that may delay the healing process are: –Excessive scar tissue –Large wounds whose edges are far apart –Resuming activity too soon

Bone Injuries Dislocation: –Significant force applied causing two bones in a joint to not line up Fractures: –Broken bone

Types of Fracture Avulsion- is when a ligament or tendon pulls a part of the bone away Stress- occurs in the bone that endures repetitive stress Spiral- torsional force on the bone Longitudinal- runs the length of the bone, caused by impact at one end of the bone Compression- when opposing forces are applied on the bone from opposite directions ( usually in vertebrae )

Indicative of Stress Fracture

Spiral Fracture

Types of Fractures cont… Oblique- a diagonal line across the bone, very easily displaced even in a cast Comminuted- bone is crushed into smaller pieces Greenstick- in adolescents when the bones are not mature enough the bone will bend and fracture part way Transverse- across the bone perpendicular to that bone Depressed- direct impact to the skull Blow-out- when an eye is pushed hard backwards and down into the eye socket Pathological- a disease process like a tumor will weaken the bone causing a fracture

Blowout Fracture

Transverse Fracture

Pathological Fracture

Types of Fractures cont…. Epiphyseal- it is the weakest part of bone which in return makes it the most susceptible to fracture. ( x-rays do not show an epiphysis fracture because they are clear)

1. Growth Plate 2. Fracture Site

Stages of Healing: Bone Stage 1: Acute –Osteoclasts eat debris and osteoblast add new layers to outside of bone tissue.

Stages of Healing: Bone Stage 2: Repair –A fibrous callus, which expand bone internally and externally. Callus turning into bone begin about week 3 to 3 months.

Stages of Healing: Bone Stage 3: Remodeling –Takes several years to complete, nonunion fracture (common on a scaphoid bone)