Ch 13: Musculoskeletal Injuries Flashcards
Fracture
A partial or complete break in bone tissue
Open Fracture
A fracture involving an open wound
Closed Fracture
A fracture that leaves the skin unbroken
Dislocation
A displacement or separation of a bone from its normal position at a joint.
The displaced bone end often causes an abnormal lump, ridge or depression, sometimes making dislocations easier to identify.
Sprain
The stretching or tearing of ligaments and other tissues at a joint.
Usually results when the bones that form a joint are forced beyond their normal range of motion.
Strain
The excessive stretching and tearing of muscle or tendon fibres. Sometimes called a pulled muscle or tear
Tendonitis
Inflammation of a tendon due to overuse or systemic inflammatory diseases.
Pain and Stiffness in the tendon area or a burning sensation around the whole joint
Signs and Symptoms of Musculoskeletal Injuries
Pain Swelling Deformity Discoloration of skin (Contusions) Inability to use the affected part normally
Signs and Symptoms of Serious Musculoskeletal Injuries
- Significant Deformity
- Moderate or sever swelling and discoloration
- Inability to move or use the affected body part
- Bone fragments protruding from wound
- Crepitus, or a snap or pop at time of injury
- Patient reports a felling of the affect part giving way
- Loss of circulation or feeling in an extremity
- Cause of the injury suggests that the injury may be severe
Obtain Advanced Medical Care When
- Severe Bleeding
- Involves head, neck or back
- Impairs walking or breathing
- Severe angulation with reduction or loss of distal circulation.
- See or suspect multiple fractures.
Care for Musculoskeletal Injuries
R est
I mmobilize
C old
E levate
Rest
Avoid any movements or activities that cause pain
Immobilize
Splint above and below the injury site
Cold
Apply ice or a cold pack with a layer of cloth to protect skin
Elevate
Keep the injury above the level of the heart to reduce swelling by slowing blood flow.
Types of Splints
Soft
Rigid
Anatomical
Traction
Soft Splint
Splints made out of folded blankets, towels, pillows, slings or triangular bandages
Rigid Splint
Splits made from boards, metal strips and folded newspaper or cardboard.
Anatomical Splint
Splints using other parts of the body
Traction Splint
A splint that keeps a constant, steady pull against opposite ends of the leg, stabilizing fractured bone ends.
Rule of Thirds
A method of determining if an injury is a joint or mid shaft injury. Works by dividing the long bones into thirds.
If the injury is located in the upper third, lower third or a joint, assume it is a joint injury.
If the injury is located in the middle third, assume it is a mid-shaft injury
A Single Attempt to Realign Fracture When:
When:
- Loss of distal circulation
- Loss of distal sensation or mobility
- Gross angulation
- Tenting of the skin
- Great discomfort
Grasp the limb above and below the site of injury and pull gently.
Do Not:
- Joint injury
- Firm resistance to movement
- Significant increase in pain
- Crepitus
Transporting a Musculoskeletal Injury
- Splint before moving a patient
- Monitor patient at all times
Upper Extremity Injuries
Shoulder
Upper Arm
Elbow
Forearm, Wrist, and Hand
Shoulder Injuries
Clavicle
Scapula
Clavicle Injuries
- Occurs commonly in children
- Usually result of a fall
- Pain may radiate down arm
- Will support the arm against the chest
- Lies over major blood vessels and nerves to the arm.
- Immobilize to prevent injury to these structures
Scapula Injuries
- Less likely to see deformity
- Extreme pain
- Inability to move the arm
- Takes great force to break, suspect rib or internal organ damage
- Dislocation
Care for Shoulder Injuries
- Control bleeding
- Check CMS
- Apply pressure bandage in figure 8 motion
- Support the arm in the position of comfort
- Splint in position of comfort
- Place something soft to fill the gap between the arm and chest for support
- Check CMS again
Upper Arm Injuries
Humerus
Humerus Injury
- Can be fractured at any point
- Danger of damage to blood vessels and nerves
- Can cause severe deformity
Care for Upper Arm Injuries
- Control bleeding
- Check for CMS
- Immobilize
- Place arm in sling and bind to chest
Elbow
- Can be sprained, fractured, or dislocated
- Cause permanent disability since all the nerves and blood vessels to the forearm and hand go through the elbow
Care for Elbow Injuries
- If they cannot move it, do not move it
- Control Bleeding
- Pressure bandage in a figure 8 motion
- Check CMS
- Immobilize in position of comfort from shoulder to wrist
- Place arm in sling and secure to chest, or with a splint and two triangular bandages
- If the elbow is bent, apply the splint diagonally across the underside of the arm
- Splint should extend beyond the upper arm and the wrist
Forearm, Wrist and Hand Injuries
- Fractures of the radius and ulna are most common
- The radial artery and nerves are near these bones, so sever bleeding or loss of CMS may be present
- The wrist is a common site for sprains
- Injuries to the hands and phalanges involve mostly soft tissue damage but a serious injury may damage nerves, blood vessels and bones
- Deep lacerations to the hand can cause permanent disabling injuries
Care for Forearm, Wrist and Hand Injuries
- Control bleeding
- Bandage hand in a figure 8 pattern with a pressure bandage
- Check for CMS
- Immobilize
- Extend the splint beyond both the hand and elbow
- Place a roll of gauze in the palm to keep hand in normal position
- Secure splint with triangular bandage or roller gauze
- Recheck CMS
- Put the arm in a sling and secure to the chest
- Splint a finger with an adjacent one
- Do not attempt to realign phalanges
- Apply cold
- Elevate
- Seek advanced medical care
Lower Leg Injuries
- Can involve both soft tissue and musculoskeletal damage
- Bones include Femur, patella, tibia, fibula, tarsals, metatarsals, phalanges
- The femoral artery is major, if it is damaged, blood loss can be life threatening
- Bradycardia distal to the injury is a sign of femoral arterial damage
Thigh and Lower Leg Injuries
- Most femur fractures involve the upper end of the bone, where the hip joint is and are called hip fractures
- Femur fractures have a characteristic deformity, because the thigh muscles are so strong they pull broken ends together, causing them to overlap. The injured leg will be shorter and turned outward
- The lower leg may involve one or both bones Tibia and Fibula.
- Open fractures are common
- A blow to the outside of the leg may damage just the fibula.
- May cause sever deformity in which the lower leg is bent at an unusual angle
- Person may also be able to use the lower leg and present no signs of deformity
Care for Thigh and Lower Leg Injuries
- Control bleeding
- Immobilize in position of comfort and splint
- Splint from hip to end of foot, and secure at several places above and below the injury site, using a figure 8 around the joints. Or splint both legs together, using padding between them for support.
- Apply cold
- Check CMS
- Care for shock
- Obtain advanced medical care
Traction Splint Rules
10% of body weight to a maximum of 15 pounds
Knee Injuries
- Includes the lower end of the femur and the upper ends of the tibia and fibula
- Can be cuts, bruises, sprains, dislocations and fractures.
Care for Knee Injuries
- Control bleeding
- Pressure bandage using figure 8
- Support in bent position if it cannot be straightened
- If straightened, splint as you would an injury to the thigh or lower leg
- Apply cold
- Rest
- Treat for shock
Ankle and Foot Injuries
- Commonly caused by twisting forces
- Minor sprains, fractures, dislocations
- Care as if they are serious
- Forces that cause foot fractures can also affect other parts of the leg
Care for Ankle and Foot Injuries
- Control Bleeding
- R E S T
- Ongoing Survey
