1. Injuries to Muscles, Bones and Joints
Chapter 8

2. 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.

4. 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

5. 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.

6. 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

7. 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.

9. 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

10. 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

11. 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

12. 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

13. 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)

14. 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

16. 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

17. 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

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

19. 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

20. 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

21. 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

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

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

24. 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

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

26. 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

27. 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

28. 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

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

30. 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)

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

32. 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