Injury, Trauma And Classification Of Diseases Flashcards
Starting terms
• Injury - damage to the body caused by external force
• Trauma – an injury that has the potential to cause disability or death
• So its the severity of the injury that differentiates between the two in the case of the T level.
• Initially the body will respond in the same way – the involuntary inflammatory response
Inflammatory response
Increased blood flow-Delivers more white blood cells, and nutrients to the site of the infection so that the
immune response can commence
Increased metabolic rate-Caused by the need to generate white blood cells as well as for the movement of white blood cells to the injured area as well (which takes energy) and as well as the actions of macrophages which need energy to function.
Redness-Caused by an increase in heat and blood flowing to the area.
Pain-Caused by the receptors in the skin signalling via the sensory nerves but also as a result
of pressure being applied from the swelling. The inflammatory mediators also irritate the
pain receptors
Swelling-As the blood flow increase capillaries increase their permeability (action of histamine
and bradykinin - inflammatory mediators) in order to allow the white blood cells to
reach the injury. This also increases the amount of water in the tissue that results in
swelling. This can also cause low blood pressure – hypotension
Involuntary inflammatory response
• This is a healthy and natural event but it can go wrong – allergies and systemic inflammatory response syndrome (SIRS) which can cause organ failure and if unchecked.
• We can present this as a grid to capture this although all the factors are interrelated and linked.
• So, although they are separate they are all part of the same response process
Haemostasis
• The initial stage of wound healing is preventing blood loss.
• The process of haemostasis is the interaction of platelets, adhesive proteins in the skin and circulating fibrin which leads to the formation of a stable platelet plug around which a fibrin network can then be built.
• Coagulation factors such as thrombin, a clotting enzyme, which is released by the liver, support clot formation and wound healing by building the network of fibrin and platelets to plug the wound.
• Factor 8 is an example of a Coagulation factor that you might be familiar with as defects cause
haemophilia A
Summary of injury
• The body reacts to injury in two ways
1. The involuntary inflammation response
2. The proliferation phase
Trauma injuries
• Remember the initial processes and the end processes are the same as injury.
• Due to the severity of the injury there are other actions that can occur in the middle of this process that are different.
• Because of the greater severity of trauma, there will be several additional responses. Depending on the nature of the trauma, these can include:
• loss of organ function (i.e. it stops working in some way or even totally)
• bone structure deformity, damage or loss of structure, e.g. a fracture
• haemorrhaging: – bleeding when the skin is broken and blood vessels are ruptured
• skin bruising (caused by bleeding under intact skin).
• The greater severity of trauma means that the inflammatory response is greater. Once it has begun, inflammation can become a disease process. This can lead to multi organ failure
Ischaemia
• Ischaemia is a lack of blood flowing in an area of the body. This could be due to blood loss from a serious wound or a blockage prevent blood reaching an area of the body.
• As a result, less oxygen and fewer nutrients can be delivered to the tissues and the ability for homeostasis to correct the situation is reduced
Classification system:
• Topographical – by body region or system
• Anatomical – by organ or tissue
• Physiological – by function or affect
Why do we need a common system of language for classification?
• This provides an internationally recognised system so allows different countries to use a common language – the International classification of disease - ICD
• Shared categories leads to common reporting and comparisons within the between countries on global health
• Allows rates and frequencies to be assessed and compared - trends over time so we can see if interventions are effective – links to public health/epidemiology
• Supports the development of possible treatments internationally through collaboration and research
The WHO
• The World Health Organisation is part of the United Nations.
• It was set up in 1948 in order to improve the health of the world.
• They give us the International Classification of Disease – (ICD) – we are now on version 11 of this
Why is the ICD important?
The ICD is important because it provides a common language for recording, reporting and monitoring diseases.
• This allows the world to compare and share data in a consistent and standard way – between hospitals, regions and countries and over periods of time.
• It facilitates the collection and storage of data for analysis and evidence-based decision-making in public health and other health areas
The three classification systems
Topographical-Bodily region or system
Example=Cardiovascular, abdominal, thoracic
Anatomical-By organ or tissue
Example=Liver
Physiological-By function or effect
Example=COPD/Angina
