Chapter 28-31 Flashcards
What are extremities?
portions of the skeleton that include the clavicles, scapulae, arms, wrists, and hands (upper extremities) and the pelvis, thighs, legs, ankles and feet (lower extremities)
What are bones?
hard but flexible living structures that provide support for the body and protection of vital organs made from dense connective tissue providing body’s framework strong to provide support and protection for internal organs and flexible to withstand stress store salts and metabolic materials providing site for production of red blood cells and are very vascular with blood loss from the bone itself. Bones become more brittle with less calcium stored in them
What is peritoneum?
bones are covered by strong, white, fibrous material. Blood vessels and nerve pass through this membrane as they enter and leave the bone and when it was exposed from injury don’t remove objects hold firmly in place
What are breaks or fractures?
result in swelling of soft tissue and formation of a blood clot in area of fracture due to loss of blood from bone and surrounding tissue causing death to cells at injury site with nearby cells replacing and forming surrounding fracture and making new bone taking weeks or months must be immobilized to properly heal with possibility of more soft tissue damage tkaing longer to heal resulting in possible permanent disability
What are joints?
places where bones articulate, or meet ability to move
What are muscles?
what are the three kinds of muscles?
tissues or fibers that cause movement of body parts and organs
Skeletal- voluntary connected to bone in tongue, pharynx and upper esophagus
Smooth- involuntary walls of organs and digestive structures moving food through this system.
And cardiac- myocardial walls of heart
What is a muscle injury?
what are the different kinds/
Direct force- person struck by something causing crush tissue and fractures (excessive force curhsing or rupturing internal (generally solid organs) ex. Falls direct causes injuries to feet and ankles
Twisting or rotational forces- stretching or tearing of muscles and ligaments and broken bones with sports ex. Falls force causing injureis to knees, femurs, pelvis and spinal column
What is carriage?
tough tissue that covers the joint ends of bones (epiphysis) and helps to form certain flexible structures body parts such as the ear, trachea, and connections between ribs and sternum acts as surface for articulation, with smooth movement at joints
What are tendons?
tissues that connect muscle to bone power of movement across joints
What are ligaments?
tissues that connect bone to bone
What are traction splints?
splint that applies constant pull along the length of a lower extremity to help stabilize the fractured bone and to reduce muscle spasm in the limb. Traction splints are used primarily on femoral shaft fractures
What are fractures?
what are typical extreme fractures?
any break in a bone. breach of bone itself and it can be open or closed.
Pelvis fracture- leads to a loss of 3-4 pints of blood
Femur fracture- leads to 2 pints of blood
Tibia-fibula fracture- 1 pint of blood
What is a comminuted fracture?
fracture in which bone is broken in several places. multiple fractures of the same bone multiple hairline fractures . Compoudnd is usually associated with complete fracture
What is a greenstick fracture?
an incomplete fracture. incomplete break commonly seen on wrists of kids.
What is an angulated fracture?
fracture in which broken bone segments are at an angle to each other. bent at angle one chance to realign fracture and only going to do it if it isnt going to break skin and if multiple people are going to hold depending on standing procedurs if you meet resistance you stop, if you lose CMS you stop, if so painful you stop.
If dont have CMS because of angle want to attempt dont mess with joint injury. Put in pillow splint and give pain meds . do knee like you would do a joint
what is a dislocation?
disruption or “coming apart” of a joint soft tissue of joint capsule and ligaments must be stretched beyond normal range of motion and tear
What is a sprain?
stretching and tearing of ligaments joint injuries. stretching and rearing of ligaments. More painful take longer to heal and feels as intense as fracture
What is a strain?
muscle injury resulting from overstretching or overexertion of the muscle. overstretching or overexertion of muscle
What is a closed extremity injury?
an injury to an extremity with no associated opening in the skin
What is open extremity injury?
an extremity injury in which the skin has been broken or torn through from the inside by an injured bone or from the outside by something that has caused a penetrating wound with associated injury to the bone with increased likelihood of contamination and infection
expose wound, clean surfance, control bleeding, cut away contaminated clothing. Dont walk patient to ambulance and now bleeding under control isnt because of increased heart rate. Stab or gunshot think along potential line. Stab wounds are considered serious if in a vital area of body as how long and serrated or not to tlel you more about what type of internal injuries. Is the offender male or female. Men stab up women stab dwon with less damage.
What is compartment syndrome?
injury caused when tissues such as blood vessels and nerves are constricted within a space as from swelling or from a tight dressing or cast and need to remove pressure or may lose limb may complain of pressure with reduced CMs and may feel hard
severe swelling in extremity as a result of fracture. Causing bleeding and swellin gin extremity and can no longer prefuse tissues against pressure going to immobilize area, document it especially if loss of CMS to area. Blood flow to area is lost and limb may be lost
What appears in a musculoskeletal injury?
six P’s (pain or tenderness, pallor (pale skin or poor cap refill), paresthesia (sensation of pins and needles), pulses diminished or absent in injured extremity, paralysis or inability to move, pressure
Pain and tenderness- pain when part moved will hold it still or guard to minimize pain ask him to point examine injured part to see others
Deformity or angulation- force of trauma causes bones to fracture and become deformed, or angulated out of anatomic position comparing to uninjured side
Grating or crepitus- a grating sensation or sound made when fractured bone ends rub together can be painful to patient.
Swelling- bones break and soft tissue is torn, bleeding causes swelling increasing the proportions of a deformity and things can restrict this tissue cutting them off.
Bruising- ecchymosis large black-and-blue discoloration of the skin, indicates an underlying injury hours or days old with obvious ones needing splinting.
Exposed bone ends- protruding through skin indicate fracture more gruesome appearance ore temptation don’t kill.
Joints locked into position- locking into different positions need to be splinted as found
Nerve and blood-vessel compromise- examine for pulses, sensation, and movement distal to the injury must do before and after splinting
What is manual traction?
the process of applying tension to straighten and realign a fractured limb before splinting in direction of long axis of extremity, if feel resistance or may come through skin stop realignment and splint in position found. Used when painful, swollen, deformed mid-thigh with no joint or lower leg injury and is contraindicated with a pelvis, hip or knee injury if avulsion or partial amputation meaning it could separate or injury to lower third is bad
What is splinting?
immobilize adjacent joints and bone ends minimizing movement of disrupted joints and broken bone ends decreasing patient’s pain prevent additional injury such as nerves, arteries, veins, and muscles preventing closed form becoming open can help minimize blood loss with
What does realigning do?
restoring effective circulation to extremity. IF not realigned splint may be ineffective causing increased pain and possible further injury and increasing nerve artery and vein comprised. Pain is reduced by effective splinting. When do you realign with angulated injuries to tibia, fibula, femur, radius, ulna or humerus cannot fit into rigid splint and realign the bone. Re-aligning long bone when distal extremity is cyanotic or lack pulses indicating compromised circulation
What are rigid splints?
can be used a piece of lumber, cardboard, roll of newspaer, umbrella, cane, broom handle, catcher’s shin guard, or a tongue depressor. Rigid splints require limbed to be moved to anatomic position with greatest support in long=bone injuries with velcro, pneumatic, air splints and vacuum and antishock splints
What is formable splints?
allow for considerable movement immobilizing in position found using pillows and blankets.
What is a shoulder injury?
pain in shoulder indicating several types of injury such as a dropped shoulder holding against sign of chest indicating fracture of clavicle or with scapula injury if blow to that site.
What is a pelvis injury?
pain in pelvis, hips, groin, or back significant if mechanism of injury indicates possible fracture with obvious deformity associated with pain, cannot lift legs, foot on injured side turned outward pressure on bladder and bleeding from urethra, rectum or vaginal in high impact mechanism from injury. Straighten legs, support hips, stabilize lower limbs putting blanket between legs and bind together upper thigh above knee, below knee and above ankl
What is a pelvic wrap?
how do you do one?
applied to patients who have pelvic deformity or instability (upon palpation) without signs of shock. Fold sheet ten inches wide across backboard rolling patient on backboard and center sheet at patient’s greater trochanter (proximal end of femur), bring sides to front tying them around iliac crests
What is hip dislocation?
What are the two kinds of dislocations?
head of femur pulled or pushed from pelvic socket with hit replacements commonly getting them. Use a scoop style stretcher immobilize with pillows or blankets
Anterior dislocation- patient’s entire lower limb is rotated outward, and hip is usually flexed
Posterior (most common)- patient’s leg rotated inward, hip is flexed and knee is bent foot may hang loose unable to flex foot or lift toes may not feel leg
What is a hip fracture?
fracture of proximal femur and pelvis at head neck or below neck of bone with localized pain perhaps down to knee, and sensitive at hip, discovered, swelling unable to move limb unable to stand foot points outward and limb shorter. To treat bind legs together cushion at armpit and crotch padding all voids
What is a knee injury? What is the difference between a knee and patella injury?
knee is bent immobilize knee in position where leg is found trying to thigh and above ankle so held in place using pillow to support leg. Knee is straight or returned to anatomic position- two padded board splints or single padded splint placing one medially and laterally is best.
Knee- tibia forced anteriorly or posteriorly.
Patella might be injured lower leg and knee twist such as skiing stuck in flexion and kneecap displaced laterally
What is a tibia fracture and what do you do?
treat for shock, applying air-inflated spling sliding over hand until lwoer edge clears wrist grap foot sliding it over the injured leg wrinkle free on injury site and inflate check periodically especially in temperature changes
What is an ankle injury and what do you do?
have three cravats below and tie them over a pillow rapped aorund ankela dn elevate it.
What is the nervous system?
provides overall control of thought, sensation, and the body’s voluntary and involuntary motor functions. The components of the nervous system are the brain and spinal cord as well as the nerves that enter and exit the brain and spinal cord and extend to the various parts of the body. Controls thought, sensations, and motor function. When bones surrounding these areas are injured expect injuries to these sites
What is the central nervous system?
the brain and spinal cord have neurons that are specialized cells transmitting impulses throughout body
What is the peripheral nervous system?
nerves that enter and exit the spinal cord between the vertebrae, the twelve pairs of cranial nerves that travel between the brain and the organs without passing through the spinal cord, and all of the body’s other motor (messages from brain to muscles such as voluntary movement those we control like running or grasping) and sensory nerves (messages from brain to body).
What is the autonomic nervous system?
controls involuntary functions such as heartbeat, breahting, control of diameter of vessels, round sphincter muscles enclosing bladder and bowel, and digestion
What is the cranium?
bony structure making up the forehead, top, back, and upper sides of the skull fused together to form immovable joints called sutures
What is the mandible?
lower jawbone
What are temporal bones?
bones that form part of the side of the skull and floor of the cranial cavity. There are right and left temporal bones
what is the temporomandibular joint?
movable joint formed between the mandible and the temporal bone, TMJ
What is the maxillae?
two fused bones forming the upper jaw
What is the nasal bone?
the bones that form the upper third, or bridge of the nose
Why is the malaria?
cheekbone or zygomatic bone
What are orbits?
bony structures around the eyes; eye sockets
What is the foramen magnum?
the opening at the base of the skull through which the spinal cord passes from the brain
What is cerebrospinal fluid?
fluid that surrounds the brain and spinal cord
What is vertebrae?
the bones of the spinal column (singular vertebra) held together by ligaments and muscles allow for specific movements and rotation but protecting against movements that would threaten integrity of channel. Seven cervical, twelve thoracic, five lumbar, five sacral, and four coccygeal (sacral and cocygeal fused forming posterior protion of pelvis)
What is spinous processes?
the bony bump on a vertebra
What are scalp injuries?
result in profuse bleeding control by applying direct pressure. Open head injury when bones of cranium are fractured. If scalp lacerated but cranium is intact it is a closed head injury
What are the two kinds of brain traumas?
Direct- can occur in open head injureis with brian being lacerated, punctured, or bruised by broken bones or foreign objects like a bullet
Indirect- brain may occur with either closed or open head injuries shock of impact on skull trasnferred to brain creating consussions and contusions
What is a concussion?
mild closed injury without detectable damage to the brain. Complete recovery is usually expected but effects may linger for weeks, months or even years. When hits head certain amount of force is transferred through skull to brain feel groggy have headache, short loss of consciousness possible, staring off into space, loss of memory and repetitive questions, altered level of consciousness feeling sluggish and difficulty concentrating or “feeling off or not right, slurred speech, headache, nausea, blurred or distorted vision, and sensitive to light or loud noises.
What is a contusion?
in brain injuries, a bruised brain caused when the force of a blow to the head is great enough to rupture blood vessels. Collision or blow causing brain to hit inside of skull bounce then rebound bruising on side of blow is coup on opposite side it’s a contercoup
What is a laceration?
in brain injuries, a cut to the brain same forces causing contusion as inner skull has many sharp bony ridges
What is a hematoma?
in a head injury, a collection of blood within the skull or brain named according to location subdural, epidural (dura and skull), intracerebal (within brain)
What is ICL?
inter cranial pressure hematoma develops and increased pressure inside skull increasing pressure inside the skull leading to neurological abnormalities such as decreasing levels of consciouness and one-sided weakness pressure reducing vital perfusion to brain can range in time with increasing blood pressure, and slows heart or from compression of the vagus nerve with more carbon dioxide increasing brain swelling more it goes downward in foramen magnum compressing brainstem which affect breathing creating irregular patterns, decreased heartbeat, and increased blood pressure dilated pupils
What are cheyne strokes breathing?
a distinct pattern of breathing characterized by quickening and deepening respirations followed by a period of apnea