1. Injuries to Skeletal System and Joints

2. Classification of Bones Long –femur, humerus Short –carpals, tarsals Flat –frontal, sternum Irregular –vertebral

4. Bones of the Cranium

5. Bones of the Rib Cage

6. Bones of the Vertebral Column

7. Bones of the Upper Extremity

8. Bones of the Lower Extremity

9. Anatomy of Long Bones Epiphysis –ends Metaphysis –“growth plate” area –epiphysis meets diaphysis Diaphysis –Shaft or axis

12. Fractures Fractures (fx) –Break or crack in bones 2 types –Compound Breaks the skin –Simple Does not break the skin Most fx in sports are simple

13. Types of Fractures Oblique - goes at angle to the axis Comminuted - many relatively small fragments - “blow out” fx Spiral - fracture which runs around axis of bone - “s” shaped

14. Types of Fractures Greenstick - incomplete fracture where the bone bends Transverse - goes across the bone's axis

15. Fractures Avulsion –fragment of bone is pulled away where tendon attaches –Common site Superior pelvic bone Stress –small crack in bone caused by repeated stress over time –Common site Tibia 5 th metatarsal

16. Treatment of Fractures Compound 1. Medical emergency 2.Control bleeding 3.Call EMS 4.Apply splint if can 5.Avoid any unnecessary movement 6.Will require surgery

17. Compound Fracture

18. Fracture of Forearm

19. Greenstick Fracture

20. Displaced Fracture

21. Transverse Fracture

22. Oblique Fracture

23. Stress Fracture

24. Avulsion Fracture

25. Treating a Fx Determine if EMS is needed –Compound fx ? –Severe deformity ? Splint fx –Type of splint based on severity of fx Apply ice if can Send to ER or Dr. office for x-ray

26. Types of Splints Splints –Sam splints –Vacuum splints –Air splints –Traction splints

27. Joints / Articulations Articulations –a joint; the point at which two bones meet –Over 230 articulations in the body

28. Joints / Articulations 3 categories –Fibrous –Cartilaginous –Synovial

29. Categories of Joints 1.Fibrous –Immovable joints –Examples bones in the cranium (sutures) syndesmosis –connective tissue between tibia and fibula AND radius and ulna

30. Categories of Joints 2. Cartilaginous –Slightly moveable –Examples Vertebrae Joint between clavicle and sternum Ribs and sternum Pubis Symphysis –Between pelvic bones

31. Categories of Joints 3. Synovial –Freely movable –Most common joint in the body –Examples elbow knee fingers shoulder

32. Classification of Joints Classification of Joints

33. Motion Groups for Synovial Joints Ball and socket –Shoulder –Hip Pivot –Atlas & axis (1 st & 2 nd cervical vertebra)

34. Motion Groups for Synovial Joints Hinge –Elbow –Knee –Phalangeal joints Saddle –Thumb

35. Motion Groups for Synovial Joints Condyloid –Wrist (carpal and radius) –Metacarpals and proximal phalange Gliding –Carpals –Tarsals

36. Motion Groups of Synovial Joints Synovial Joints

37. Anatomy of a Synovial Joint Ligaments –connects bone to bone Synovial Membrane –encloses joint capsule Synovial Fluid –colorless fluid within the joint capsule Meniscus –cartilaginous disc inside the joint

38. Anatomy of a Synovial Joint Bursa –sac of synovial fluid between tendons, bones, and ligaments Articular cartilage –on end of long bones Synovial fluid, meniscus, and bursa sacs: 1. reduce friction between joints 2. cushions 3. acts as a shock absorber

39. Anatomy of Synovial Joints

40. Bursa Sacs

41. Ligament or Capsular Sprains Sprain –overstretching and/or tearing of ligaments or other connective tissue Mechanism of injury –traumatic twisting –can include joint capsule or synovial membrane

42. Symptoms of Joint Sprain 1. Deformity 2. Crepitation – cracking or grating sound 3. Point Tenderness 4. Immediate Swelling

43. Degrees of Joint Sprains 1 st degree – –minor tearing of ligaments –mild point tenderness –mild loss of strength –no joint laxity –no decrease in range of motion (ROM) Range of Motion (ROM) –the max range through which a joint can move

44. Degrees of Joint Sprains 2 nd Degree – –partial tearing of ligaments –swelling and tenderness –decreased range of motion –moderate loss of strength –some joint laxity

45. Degrees of Joint Sprains 3 rd Degree –complete tearing of ligaments –complete loss of function –severe swelling –increased laxity –immobilize and send to physician –will be in walking boot

46. Degrees of Sprains

47. Treatment of Sprains PRICE 1. Protect –avoids further injury 2. Rest 3. Ice –20 minutes on / 45 minutes off 4. Compression – use elastic wrap 5. Elevate –raise above level of heart

48. Treatment of Sprains Follow-up strengthening exercises –ROM exercises –Therabands –Wobble boards wrapping and bracing

49. Common Sites for Sprains Shoulder Elbow Wrist Knee Ankle

50. Dislocations and Subluxations Dislocation –separation of a joint and malposition of an extremity –joint goes beyond normal limits Subluxation –partial dislocation –“slipped out and went back in”

51. Symptoms of Dislocation 1. Point tenderness 2. Loss of Strength 3. Complete loss of ROM 4. Swelling and Deformity

52. Treatment of Dislocations 1. Check area below for pulse 2. If pulse impaired, call 911 3. Splint injury in most comfortable position 4. Apply ice 5. All cases have athlete see physician Follow-up - strengthening and flexibility exercises MOI for Elbow Dislocations

53. Dislocated Humeral Head

54. Dislocated Thumb

55. Dislocated Tibia / Fx Fibula

56. Dislocated Ulna

57. Dislocated Thumb

58. Synovitis and Bursitis Bursitis –inflammation of bursa sac Synovitis –inflammation of synovial membrane (lining of joint) *** Both caused by repetitive motions (overuse injuries)

59. Treatment of Synovitis and Bursitis 1. If swelling is present -- ICE technique 2. No swelling – deep heating Follow-up – stretching ROM exercises pain persists, see physician

60. Bursitis of the Elbow

61. Petallar and Calcaneal Brusitis

62. Calcaneal Bursitis

63. Bursitis Health Byte Elbow (Olecrenon) BursitisElbow (Olecrenon) Bursitis Knee Bursitis (Prepatellar bursitis)Knee Bursitis (Prepatellar bursitis) Synovitis of the Shoulder