1. BONE JOINT & MUSCLE INJURIES
CHAPTER 7
To assess the victim’s condition quickly & calmly
To steady & support the injured part of the body
To minimize shock
To call 911 for emergency help if you suspect a serious injury
To comfort & reassure the victim
To be aware of your own needs

2. THE SKELETON Framework of bones
Supports muscles, blood vessels & nerves
Protects organs
206 bones
Skull= protects brain & supports structures of the face
Jawbone= Mandible
Collarbone= clavicle
Shoulder blade= scapula
Breastbone= sternum
12 ribs
Shoulder girdle

3. THE SKELETON Humerus= upper arm bone Forearm Ulna Radius
Femur= thigh bone
Patella= knee cap
Tibia= shin bone
Fibula= splint bone
Wrist bones= carpals
Hand bone= metacarpal
Ankle bones= tarsals
Foot bones= metatarsals
Finger/ toes= phalanx
Forearm
Lower leg bones

4. THE SKELETON
Skull
Mandible
(Hinge- Jt.)

5. THE SKELETON
Clavicle
Ribs
Scapula
(12 pairs)
Sternum

6. THE SKELETON
Humerus
Ulna
Radius
Carpals
Metacarpals
Phalanx

7. THE SKELETON
Femur
Patella
Tibia
Fibula

8. THE SKELETON
Tarsals
Phalanx
Metatarsals

9. THE SPINE Backbone 26 vertebrae Intervertebral discs Functions:
Fibrous tissue which helps make the spine flexible
Shock absorption
Functions:
Supports head
Makes upper body flexible
Supports body’s weight
Protects spinal cord

10. SPINAL COLUMN Vertebrae form 5 groups: Cervical (7) Thoracic (12)
Support head & neck
Thoracic (12)
Anchor for the ribs
Lumbar (5)
Supports body’s weight & gives stability
Sacrum (5 fused)
Supports the pelvis
Coccyx (4 fused)
Forms the end of the spine

11. THE SKULL Protects the brain & the top of the spinal cord
Supports eyes & other facial structures
Made up of several bones, most fused at joints called sutures

12. BONES Bone= living tissue containing calcium and phosphorus
Minerals that make bone hard, rigid, & strong
Able to generate new tissue after injury
Certain diseases can weaken bones
Inherited problems/ Bone disorders (rickets, cancers, infections)
Age
Adolescence= can shorten/ impair movement
Older= bones can lose density making them brittle (osteoporosis)

13. Bone marrow (center cavity
PARTS OF A BONE
Each bone is covered by a membrane called the periosteum
Compact bone
Spongy bone (core)
Bone marrow (center cavity

15. MUSCLES Cause various parts of the body to move Skeletal muscles
Voluntary
Control movement & posture
Attached to bones by strong bands of fibrous tissue= tendons
Involuntary
Operate internal organs & work constantly
Ex: heart
Controlled by autonomic nervous system

16. JOINTS Where one bone meets another Immovable joints Movable joints
Bone joints are fused
Skull (sutures) & pelvis
Movable joints
Bone ends are joined by fibrous tissue called ligaments
Capsule lining= synovial membrane
Lubricates the joint

17. Surfaces are flat & slide over each other.
Ex: Foot & wrist
Bone ends meet at right angles
Ex: Base of thumb
Allows bending & straightening in only 1 plane.
Ex: Knees & elbows
One bone rotates within a fixed collar formed by another.
Ex: Base of the skull
Movement can occur in most directions
Ex: Wrist
Allows movement in all directions.
Ex: Hip & Shoulder

18. FRACTURES Stable fracture Unstable fracture Break/crack in a bone
Ends of injury remain in place
Not completely broken
Unstable fracture
Broken bone ends can easily be displaced
May damage blood vessels, nerves & organs
Break/crack in a bone
Twist/ wrench
Heavy blow
Old/ disease
Open fracture
Bone is exposed
May suffer bleeding & shock
High risk of infection
Closed fracture
Skin is not broken
Internal bleeding is a risk

19. FRACTURES Recognition:
Deformity, swelling, & bruising at fracture site
Pain/ difficulty in moving the area
Course grading (crepitus)
Signs of shock

20. TREATING A CLOSED FRACTURE
Aims:
Prevent movement at the injury site
To arrange transportation to the hospital
Caution:
Do not move victim until injured part is secured & supported
Unless immediate danger
Do not allow victim to eat/ drink anything
Advise victim to keep still; support joints above & below injury with your hands until immobilized with sling/ bandages
Place padding around injury for extra support; take/send victim to hospital
Arm injury may be transported by car
For further support= secure injured part with unaffected part
Always tie knots on the uninjured side
Treat for shock if necessary; monitor/record vital signs; check circulation (10 minutes)
DO NOT raise an injured leg (elevate uninjured leg if necessary)

21. TREATING AN OPEN FRACTURE
Aims:
Prevent blood loss, movement & infection
Arrange removal to hospital with comfortable support
Caution:
Do not move victim until injured part is secured & supported
Unless immediate danger
Do not allow victim to eat/ drink anything
Do not press directly on a protruding bone end
SPECIAL CASE: if a bone end is protruding, build up pads of clean, soft, non- fluffy material around the bone until you can bandage over it without pressing on the injury

22. TREATING AN OPEN FRACTURE
Cover the wound with a sterile dressing; apply pressure around the injury to control bleeding
Carefully place a sterile dressing/ padding over and around dressing
Secure dressing & padding with a bandage
Immobilize injured part as for a closed fracture
Treat victim for shock; monitor/ record vital signs; check circulation every 10 minutes

23. DISLOCATED JOINT
Partially/ completely pulled out of their normal position
Strong force
Abnormal position
Violent muscle contraction
Usually affects shoulder, knee, jaw or thumb/fingers
May be associated with torn ligaments
Recognition:
“sickening” severe pain
Inability to move jt
Swelling/ bruising
Shortening, bending/ deformity
Aims:
Prevent movement at injury site
Arrange removal to hospital with comfortable support

24. DISLOCATED JOINT Caution:
Do not try to replace a dislocated bone into its socket
Do not move the victim until the injured part is secured & supported
Remove bracelets, rings & watches
Do not allow victim to eat/ drink
Advise victim to keep still; help to support injured part in a comfortable position
Immobilize
Extra support- secure limb to body
Arrange to take/ send to hospital; monitor/ record vital signs
Check for circulation (10 minutes)

25. STRAINS & SPRAINS
Injury frequently associated with sports (soft tissue)
Occur when tissues are overstretched & partially/ completely torn (ruptured) by violent/ sudden movements
Strains & sprains should be treated initially by RICE
R- rest
I-ice
C- compression
E- elevation
Any doubt- treat as a fracture

26. Strains & Sprains Strain, ruptured or bruised
Muscle & Tendon Injury
Ligament Injury
Strain, ruptured or bruised
Strain= muscle is overstretched
Example: Gastrocnemius tear
Sprain= stretching/ tearing of a ligament
Sudden/ unexpected wrenching motion
Example= sprained ATF ligament in ankle

27. STRAINS & SPRAINS Recognition: Aims:
Pain & tenderness
Difficulty in moving the injured part
Swelling & bruising
Aims:
Reduce swelling & pain
Obtain medical help if necessary
Help victim sit/ lie down; support injured part (preferably raised)
Cool the area (cold compress)
Apply comfortable support
If pain is severe/ unable to move injured part take/ send to hospital

28. STRAINS & SPRAINS

30. FACIAL INJURY
Fractures of facial bones are usually due to hard impacts
Main danger= blood, saliva, or swollen tissue may obstruct airway
Always assume there is damage to the skull, brain or neck
Recognition:
Pain
Difficulty speaking, chewing or swallowing
Difficulty breathing
Swelling & deformity
Bruising
Clear fluid/ watery blood from nose or ear

31. FACIAL INJURY Aims: Caution: Keep airway open
Minimize pain & swelling (edema)
Arrange urgent removal to hospital
Caution:
Never place bandage around lower part of face/ jaw in case victim vomits or has difficulty breathing
Do not allow victim to eat/ drink
If unconscious but breathing= recovery position
Not breathing= begin CPR
Be aware of the risk of neck injury

32. FACIAL INJURY Call 911 for emergency help
Help the victim sit down & make sure the airway is open & clear
Ask the victim to spit out any blood/ displaced teeth
Gently place a cold compress against victim’s face to help reduce pain & swelling
Monitor/ record vital signs

33. COLLAR BONE INJURY
It is rare for a collar bone to be broken by direct blow
Usually from indirect force transmitted from an impact at the shoulder or passing along the arm
Young people
Recognition:
Pain & tenderness
Swelling & deformity
Aims:
Immobilize jt
Arrange transportation to hospital

34. COLLAR BONE & SHOULDER INJURY
Help victim sit down; gently place injured arm across the body & support the elbow
Support with an arm sling
Extra support= secure arm to chest
Arrange to take to hospital
Upper arm & elbow injury

35. RIB INJURY Direct force or crush injury
Breathing may be seriously impaired
May injure internal organs
Internal bleeding
Recognition:
Bruising & swelling
Pain
Shallow breathing
Signs of internal bleeding & shock
Aims:
Support chest wall
Arrange transportation to hospital

36. HIP & THIGH INJURIES Most serious injury of the femur= fracture
Considerable force
Can pierce major blood vessels
Severe blood loss
Shock
Recognition:
Pain
Inability to walk (antalgic gait)
Signs of shock
Shortening of the leg & turning outward of the knee & foot
Aims:
Immobilize limb
Arrange urgent removal to hospital

37. FRACTURED PELVIS Indirect force
May be complicated by injury to tissues & organs
Shock
Recognition:
Inability to walk/ stand
Pain & tenderness in groin region
Difficulty/ pain with urinating
Signs of shock & internal bleeding
Aims:
Minimize risk of shock
Arrange urgent removal to hospital