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

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

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

THE SKELETON Skull Mandible (Hinge- Jt.)

THE SKELETON Clavicle Ribs Scapula (12 pairs) Sternum

THE SKELETON Humerus Ulna Radius Carpals Metacarpals Phalanx

THE SKELETON Femur Patella Tibia Fibula

THE SKELETON Tarsals Phalanx Metatarsals

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

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

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

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)

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

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

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

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

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

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

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)

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

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

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

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)

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

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

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

STRAINS & SPRAINS

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

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

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

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

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

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

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

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