Injuries to Muscles, Bones and Joints Chapter 8

Muscles Over 600 muscles Tendons: Strong tissues that attach muscle and bones together Muscles are able to shorten and lengthen, contract and relax Contracting and relaxing allows the body to move The brain directs the muscles to move through nerves in the spinal cord Tiny jolts of electricity travel through the nerves to the muscles to cause them to contract When the muscles contract, they pull at the bones, causing motion at a joint Injuries to the brain, spinal cord or nerves can affect muscle contraction. Paralysis: When nerves lose control of muscles When a muscle is injured, a nearby muscle often takes over for the injured ones.

Bones Approximately 200 bones in various shapes and sizes The skeleton protects many of the organs inside the body Bones are hard and dense Bones have a rich supply of blood and nerves Bone injuries can bleed and usually are painful Children have more flexible bones than adults Growth Plate: area of developing cartilage near the ends of a long bone Bones weaken with age Osteoporosis: gradual weakening of the bones

Joints The ends of two or more bones coming together at one place. Ligaments: Strong, tough bands that hold the bones at a joint together. All joints have a normal range of movement in which they can move freely, without too much stress or strain. When joints are forced beyond this range, ligaments stretch and tear.

Fractures Complete break, a chip or a crack in the bone Caused by a fall, blow or twisting movement Open Fracture: involves an open wound when the end of a bone tears through the skin. Carry a risk of infection and severe bleeding. Closed Fracture: Skin is not broken, more common Hard to tell if a person has a fracture, you should consider the cause of the injury

Dislocations Movement of a bone at a joint away from its normal position. This movement is caused by a violent force tearing the ligaments that hold the bones in place When a bone is moved out of place, the joint no longer functions. The displaced end of the bone often forms a bump, a ridge or a hollow that does not normally exist.

Sprains Tearing of ligaments at a joint Mild sprains may swell but usually heal quickly If a person ignores signs and return to quickly, the joint will not heal properly and remain weak A severe sprain also can involve a fracture or dislocation of the bones at the joint. Most easily injured: Ankle, Knee, wrist and fingers

What to Look for Pain (Touch or move) Significant bruising and swelling Deformity (Twisted, strangely bent, lumps, ridges, hollows) Unable to use the affected part normally Bone fragments sticking out of a wound Feels the bones grating or heard snap or pop Area is cold, numb, tingly

When to call 911 Deformity Severe swelling and discoloration Snap or Pop Open wound with bone piercing the skin Cannot move area normally Cold and numb Involves head, neck or spine Trouble breathing Not possible to move person to a vehicle to transport to a hospital

What to do until Help arrives R: REST Do not move or straighten the injured area I: IMMOBILIZE Stabilize the injured area in the position it was found. Splint and transport the person to a medical care without causing more pain. C: COLD Apply ice or damp cloth for periods of 20 mins. E: ELEVATE the area without causing more pain, reduces swelling Some injuries do not need to call 911 but medical attention is needed. Do not allow person to drive

Splinting Method of immobilizing an injured part to minimize movement and prevent further injury and should be used only if you have to move or transport the person to seek medical attention and if it does not cause pain. Splint the injury in the position in which you found it Fractures- Splint the joints above and below the site of injury Sprains or joints- splint the bones above and below the site of injury Splints: Soft or padded for comfort Check for circulation (feeling, warmth, color)

Splints Anatomic splints: Person’s body is in the splint Soft Splints: Soft materials or folded triangle bandage Rigid Splints: Padded boards, magazines, something without sharp edges The Ground: an injured leg stretched out on the ground is supported by the ground After you splint, apply ICE and keep person from getting chilled or overheated

Head, Neck and Spine Each year approximately 12,000 Americans suffer from a spinal cord injury. Most are victims with an average age of 40 Leading causes: vehicle crashes, falls, violence, sports Can cause paralysis, speech, or memory problems Only X-Rays, CAT scans or MRI’s can show severity An injury to the brain can cause bleeding inside the skull Vertebrae: small bones in spinal cord Disks: Cartilage separates the vertebrae Nerves originate in the brain and extends into the vertebrae so if either are injured, it can paralyze a person

What to Look For Assess the scene to see if a head, neck or spine injury could have occurred Motor vehicle crash Significant force Fall from a height Wearing a safety helmet that is broken Complains of neck or back pain Tingling or weakness in the extremities Not fully alert Appears intoxicated Appears frail or older than 65 years or younger than 3

When to Call 911 If you suspect any head, neck or spine you should call 911 immediately

What to do until Help arrives Minimize movement of the person’s head, neck or spine As long as the person is breathing normally, support the head, neck and spine in the position found Place hands on both sides of the person’s head in the position you found it

What to do until Help arrives If the person is wearing a helmet, do not remove it. If person is unconscious, keep the airway open and check breathing Take steps to control severe bleeding Keep the person from getting chilled or overheated

Concussion Type of brain injury that involves a temporary loss of brain function resulting from a blow to the head May not loose consciousness Effects: Sleep, mood, cognitive disturbance, sensitivity to light and noise. May appear immediately or hours/days later

When to Call 911 Every suspected concussion should be treated seriously so call 911 immediately or seek medical care within an hour of injury

What to Look For Confusion Headache Repeated statements Temporary memory loss Brief loss of consciousness Nausea and vomiting Speech problems Blurred vision Light sensitivity

What to do until Help arrives Maintain an open airway Control any bleeding Support the head and neck in the position in which you found it Do not apply direct pressure if signs of skull fracture If there is clear fluid leaking from the ears or wound in the scalp, cover the area loosely with a sterile dressing Monitor the person for any changes Try to calm and reassure person Keep them talking to prevent unconsciousness

Chest Injuries Range from broken rib to serious life-threatening Caused by: Falls, sports, mishaps, crushing or penetrating forces

What to Look For Trouble Breathing Support injured area with hand or arm Skin may appear flushed, pale or ashen Coughing blood May also have a spinal injury Bruising on the chest

When to Call 911 If you think the injury is serious, involves trouble breathing or the spine, do not move the person and call 911 If the person is standing, do not have the person lie down

What to do until Help Arrives Have the person rest in the position that will make breathing easier Bind the upper arm to the chest on the injured side, and it will help support the injured area and make breathing comfortable Use an object (pillow or blanket) to support and immobilize the area Monitor breathing and skin condition Minimize shock

Pelvic Injuries Large, heavy bones of the hip that can range from simple to life threatening.

What to Look for Severe pain Bruising Possible external bleeding Nausea Vomiting Weakness Thirst Tenderness or tight feeling in the abdomen Possible loss of sensation in the legs or inability to move legs Signs of Shock (Indicate internal bleeding or blood loss)

When to Call 911 Call 911 immediately if you suspect a pelvic injury

What to do until Help arrives Due to a pelvic injury being related to the lower spine, it is best not to move the person If possible, try to keep the person lying flat Watch for signals of internal bleeding and minimize shock