1. Musculoskeletal Injuries
Chapter 20, Section 1
Musculoskeletal Injuries

2. Objectives 20.1.1 Describe the functions of the following structures:
bones
cartilage
joints
muscles
synovium
tendons
Describe the physiology of human movement.
continued

3. Objectives
Describe how musculoskeletal tissues heal List the six types of musculoskeletal injuries Compare and contrast sprain and strain Describe two classifications of fractures.
continued

4. Objectives
List the signs and symptoms of sprains and fractures.
Define the following terms:
dislocation
fracture
sprains

5. Topics Anatomy and Physiology Physiology of Human Movement
Common Musculoskeletal Injuries

6. Case Presentation
A male teenager is found on the snow below a jump. He is wearing twin tipped skis and a helmet. He complains that his right thigh hurts “very bad”, and you notice that his right forearm is also angulated. His buddies report that he landed “hard.”

7. Anatomy and Physiology
Bones – the skeleton
Joints – the motion
Muscles – the power

8. The Skeleton Provides structure and protection
Axial skeleton – skull, vertebrae, and thoracic cage
Transfer weight from upper to lower body
Responsible for upright position
Appendicular skeleton – shoulder, arm, pelvis, legs
Responsible for movement
continued

9. The Skeleton continued
(a) The appendicular skeleton. (b) The axial skeleton.
continued

10. The Skeleton Types of Bones
Long: Humerus, radius, ulna, femur, tibia, fibula
Breaks at epiphyseal line (growth plate) can be serious for growing children
Flat: Skull, scapula, ribs, sternum, pelvis
Irregular: Vertebrae, wrist, hands, ankle, feet, patella

11. The Skeleton
Three major types of bones according to shape.

12. Joints
Joint: Two bones and the connective tissues that surround, support, and stabilize it called the joint capsule. Synovial fluid in the joint capsule lubricates joints.

13. Joints Range/type of motion depends on type of joint: Ball and socket
Hinge
Gliding
Pivot
Suture

14. Joints • Types of freely movable joints.
• An example of a suture joint.

15. Ligaments and Tendons
Ligaments connect bone to bone, form part of joint capsule
Restrict the motion of the joint
Tightness/laxity help determine extent of movement
Tendons connect muscle to bone
Both can be stretched or torn
Stability and function suffer

16. Ligaments and Tendons
• The anatomy of the knee. Ligaments connect bone to bone and are an essential part of the skeletal system.
• Flexion and extension are the two main movements of the elbow.

17. Muscles Tissue contracts and relaxes – often work in pairs
Controlled by nervous system – spinal and peripheral
Three types:
Skeletal (voluntary)
Smooth
Cardiac

18. Muscles
The three types of muscle.

19. Physiology of Movement
Skeletal muscle message is “contract”
Signal provided by nerves
May be voluntary or involuntary
Pairs work in coordination to flex and extend joints

20. The Healing Process
Factors are extent of damage, age, nutrition, overall health
Bone healing requires nutrients, oxygen, and immobilization
Muscles and ligaments heal slowly
Tendons need protection during healing
Cartilage does not heal, it is often removed

21. The Healing Process Copyright Nancy Pitstick
An X-ray of a lower leg showing surgical hardware and a surrounding cast.
Copyright Nancy Pitstick

22. Common Musculoskeletal Injuries
Sprain
Stretching or tearing of a ligament
Tears may need surgery
Joint is displaced beyond its normal alignment
continued

23. Common Musculoskeletal Injuries
Strain
Stretched or torn muscle
Overexertion or poor body mechanics
May range from minor to severe
Strain versus Sprain
You strain a muscle or tendon and sprain a ligament.
continued

24. Common Musculoskeletal Injuries
Tendon rupture
Active motion of joint may be lost
Fracture
Break in a bone
May be open or closed
May be displaced or non-displaced
May be associated with internal or external bleeding
continued

25. Common Musculoskeletal Injuries
Two zones of injury. One is at femur fracture site, and the other is at the tibial fracture site.
continued

26. Common Musculoskeletal Injuries
Dislocation
Separation or displacement of bones at a joint
Usually the result of forceful trauma
Multiple structures and surrounding tissues may be injured in a single event
Soft tissues, nerves, and blood vessels may be involved

27. Types of Fractures Butterfly Comminuted Compression Epiphyseal
Greenstick
Impacted
continued

28. Types of Fractures
Oblique
Pathologic
Spiral
Transverse

29. Types of Fractures
Types of fractures.

30. Possible Blood Loss from Fractures
Pelvis ( ml)
Femur ( ml)
Humerus ( ml)
Tibia/Fibula ( ml)

31. Case Update
You perform a primary assessment. The patient states that he caught “way too much air and crashed.” The patient’s respiratory rate is 16 and his left radial pulse is 100 and strong, but the radial pulse in his injured right arm is absent. You immediately call for assistance, a long spine board, a splint for the femur and transportation to the first aid room. Because of the mechanism of injury, the lack of a right radial pulse, and the fact that ground transport to definitive care will take over 2 hours, you radio for air transport.
Discussion Points: Take the students to part 2 of this chapter for discussion.