1. Structures and Injuries Chapter 16
Bones and Soft Tissue
Structures and Injuries
Chapter 16

2. Vocabulary Axial Skeleton Appendicular Skeleton Ossification Diaphysis
Epiphysis
Periosteum
Osteoblast
Osteoclast
Reduction
External Fixation
Internal Fixation
Contractibility
Excitability
Action Potential
Extensibility
Elasticity

3. Vocabulary Origin Insertion Belly Prime mover Antagonist
Muscle Fatigue
Myositis ossificans
Synapse
Myelin sheath
Neuroma

4. October 9, 2017
Bell work: Fall Break POW/WOW

5. Bones
Bones are formed during embryonic development by a process called ossification
Long bones have 3 basic components: the diaphysis (shaft), the epiphysis (each end), and the medullary canal (center of the bone)

6. Bones
Osteoblasts are bone cells that deposit the new bone to increase circumference
Osteoclasts are immense bone cells that secrete enzymes that can digest the bony material

7. Bone Types
Long: arm or leg (humerus, ulna, radius, femur, tibia, and fibula)
Flat: bones of the skull
Irregular: vertebrae
Short: phalanges, carpals, tarsals

8. Function of Bones To serve as framework for the body
Protect the internal structures; brain, spinal cord, etc
Act as a storage area for calcium
Produce blood cells
Allow flexibility when muscles move

9. Injuries to the Bone
People push their bodies to the limit everyday causing stress on bones
Most common injury to bones are fractures
Simple Stress
Compound / open
Greenstick -- Epiphyseal Plate
comminuted

10. Types of Fractures
Simple fracture: occurs when the forces on the bone exceed the bone’s ability to withstand the forces applied

11. Types of Fractures
Compound / Open: results in fractured end penetrating the skin

12. Types of Fractures
Greenstick: analogy of a child’s bone and a young shoot of a plant. Analogy of an adult bone is to a tree’s old branch. More common in children due to the pliability of the child’s bone, can bend further until reaching the breaking point

13. Types of Fractures
Comminuted: forces are so great that the bone shatters into three or more pieces

14. Types of Fractures
Stress Fracture: bone is stressed by overuse, poor muscle balance, lack of flexibility, weakness in soft tissue, or biomechanical problems. Gradual deterioration of the bone occurs due to the body’s inability to compensate for the forces placed on it.

15. Types of Fractures
Epiphyseal plate: “growth plate” fracture

16. What Type of Fracture?

17. What Type of Fracture?

18. What Type of Fracture?

19. What Type of Fracture?

20. Types of Fractures
Lower Extremity Films
Upper Extremity Films

21. BW: 10/11/17 What Type of Fracture?

22. Treatment of Bone Injuries
Often occurs naturally due to remodeling
May sometimes need to be put back into position depending on deformity
Immobilization through the use of a cast
Occasionally may need to have surgery
Timeline varies by age and severity of the fracture
Some bones may heal faster than others

23. Muscles
There 3 types of muscles: skeletal, cardiac, and sphincter muscles
Skeletal muscles are attached to bones
Blinking, talking, breathing, dancing, eating, walking, running, and writing are produced by the motion of muscles

24. Muscles Muscle has many different characteristics:
Contractibility- the ability to shorten or reduce the distance between the parts
Excitability- the ability to respond to stimuli
Extensibility- the ability to lengthen and increase the distance between two parts
Elasticity- the ability to return to original form after being compressed or stretched

25. Injuries to Muscles
Strains- caused by twisting or pulling a muscle or tendon
Acute: caused by trauma or an injury such as a blow to the body, or improperly lifting heavy objects or overstressing the muscles
Chronic: usually the result of overuse/prolonged, repetitive movement of the muscles and tendons

26. Injuries to Muscles Tendonitis- inflammation of the tendon
Tendons are the attachment of muscle to the bone. When a muscle contracts, it pulls on a bone to cause movement.
When tendons become irritated, the action of pulling the muscle becomes difficult. The tendon will then become inflamed and movement will become painful.
The most common cause of tendonitis is overuse, people who increase exercise levels too quickly, or people who are beginning an exercise program

28. Tennis Elbow

29. Injuries to Muscles
Contusions- a direct blow or blunt trauma that does not break the skin
A bruise may be visible due to damage to blood vessels
Ecchymosis is also a visible sign with muscle contusions
Accumulation of blood in the skin and subcutaneous tissues more than one centimeter in diameter

30. Soft Tissue Injuries
These injuries affect the skin, muscles, ligaments, and tendons
Classified as open or closed
Open injuries include abrasions, lacerations, avulsions, and puncture wounds
Closed injuries include contusions, hematomas, and ecchymoses. May also include sprains, strains, tendonitis, bursitis, and stress-related injuries

31. Muscle Related Injury Bursitis- inflammation of a bursa
The bursa decreases friction between two surfaces, such as where muscles, ligaments, and tendons glide over bones
Most commonly seen in hip, knee, elbow, and heel
Bursitis is usually a result of repetitive movement, prolonged excessive pressure, or blount trauma to the site of a bursa

32. Injuries to Ligaments
Sprains- can result from a fall, a sudden twist, or a blow to the body that forces a joint out of its normal position.
Sprains are damage to ligaments that support that joint
Ligaments are connective tissue that joins bone to bone

33. Sprains: Signs and Symptoms
1st degree (mild):
One or more of the supporting ligaments and surrounding tissues are stretched
Minor discomfort, point tenderness, and little or no swelling
No abnormal movement in the joint to indicate lack of stability

34. Ankle Sprains: Signs and Symptoms
2nd degree (moderate):
A portion of one or more ligaments is torn
There is pain, swelling, point tenderness, disability, and loss of function
Slight abnormal movement
May walk with a slight limp

35. Ankle Sprains: Signs and Symptoms
3rd degree (severe):
One or more ligaments have been completely torn; obvious joint instability
Can have either extreme or little pain (depends on nerve damage), loss of function, point tenderness, and rapid swelling
Possible to have a fracture associated

36. Injuries to Ligaments
Sprains can occur in either the upper body or the lower body
The most common sprain is found in the ankle