Soft Tissue Injuries Part 4

The Soft Tissues Soft tissues include the layers of the skin The outer layer is called the epidermis, followed by the dermis Epidermis - provides a barrier to protect against bacteria that can cause infection Dermis - contains nerves, sweat glands, oil glands, and blood vessels The subcutaneous layer, also called the hypodermis, is located beneath the dermis Contains adipose (fat) tissue, blood vessels, and connective tissue

Wounds A wound is any physical injury involving soft tissues Closed wounds Skin’s surface is not broken Tissue damage and bleeding occur beneath the skin Simplest type of closed wound is a contusion (bruise) Open wounds Skin’s surface is broken Blood may come through the break in the skin Types include abrasion, laceration, avulsion, amputation, puncture, and crash injury

Open Wounds Abrasion Most common type of open wound Skin has been rubbed or scraped away Laceration A cut with jagged or smooth edges Usually bleed freely and heavily Avulsion Serious injury in which a portion of skin is partially or completely torn away Bleeding is usually significant

Open Wounds Amputations Puncture/Penetration Crash Injuries A body part is severed and damage to the tissue is severe Bleeding may not be as bad as you might expect Blood vessels constrict and retract (pull in) at the point of injury Puncture/Penetration Skin is pierced with a pointed object External bleeding is generally not severe because the skin usually closes around the object An object that remains in the open wound is called an embedded object Crash Injuries A body part, usually an extremity, being subjected to a high degree of pressure Can result in serious damage to underlying tissue Compartment syndrome is swelling and an increase in pressure within a limited space that presses on an compromises blood vessels, nerves, and tendons

Dressings Occlusive dressing Closes a wound or damaged area of the body and prevents it from being exposed to air or water Bandage Material used to wrap or cover any part of the body Pressure bandage - applied snugly to create pressure on a wound or injury Adhesive compress - small pad of non-stick gauze on a strip of adhesive tape; minor wounds Bandage compress - thick gauze dressing attached to a bandage that is tied in place Roller bandage - gauze or gauze-like material available in all sizes; used to wrap an injury Elastic roller bandage - designed to keep continuous pressure on a body part

Types of Burns Burns are classified by depth; the deeper the burn, the more sever it is. Superficial - also referred to as first degree Involve only the top layer of skin, usually heals within a week Partial-thickness - also referred to as second degree Involves the top two layers of skin (epidermis and dermis), heals in 3-4 weeks and may scar Full-thickness - also referred to as third degree May destroy all layers of the skin, healing requires medical assistance Burns are also classified by their source Heat (thermal) Chemical Electrical Radiation (usually from the sun)

Injuries to the Extremities Upper extremity refers to the arm Includes clavicle, scapula, humerus, radius, ulna, carpals, metacarpals, phalanges The upper arm is the area that extends from the shoulder to the elbow The forearm is the area between the elbow and the wrist Lower extremity refers to the leg Includes the femur, patella, tibia, fibula, tarsals, metatarsals, and phalanges The thigh is part of the lower extremity between the pelvis and knee The femoral arteries are the major supplier of blood to the lower extremities The lower leg is the area between the knee and the ankle

Head, Neck, and Spinal Cord The spine, also called the vertebral column, is a strong, flexible column of small bones called vertebrae Extends from the base of the skull to the tip of the tailbone Broken up into four sections: Cervical (7 vertebrae) Thoracic (12 vertebrae) - the largest section of the vertebral column Lumbar (5 vertebrae) Sacral (9 fused vertebrae) Concussion - temporary loss of brain function due to a blow to the head If an injury to the head, neck, or spinal cord is suspected, use manual stabilization to minimize movement Technique used to achieve spinal motion restriction by manually supporting the person’s head and neck in the position found without the use of equipment