Transcript Basics of Tissue Injury

Basics of Tissue Injury
Injury Types
Soft Tissue
• Affects Skin, muscle,
ligaments, and tendons,
and nerves
• When soft tissue is
injured it may:
• Bleed
• Become inflamed
• Produce extra fluid
Bone Injuries
• Affects Skeletal system
• Fractures
• Dislocations
Types of Soft Tissue Injuries
Sprains
• Bleed internally
• Injury to ligaments
Strains
• Bleed Internally
• Injury to muscle or tendon
Sprains and strains are categorized in order of severity.
•First Degree – No loss of motion in the injured area, stability intact
•Second Degree – Some loss of motion, some signs of instability
•Third Degree – Cannot move affected body part, and major instability
Incision
Open wound made by a
cutting instrument.
Very straight and clean
cut
Not seen often in
athletics
Abrasion
Scraping off a layer of
skin
May or not bleed,
depending on the
amount of skin removed.
Contusion
•Closed wound
•Also known as a “Bruise”
•Causes bleeding under the skin,
causing swelling and discoloration
Laceration
Jagged, Irregular open
wound
Caused by something
irregular
Avulsion
•Partial tearing away of a
body part
•Can be opened or
closed
Amputation
•Open wound in which a
part is completely cut
away from the body.
•Traumatic or Surgical
Puncture
•Injury occurs when a
pointed object enters the
body.
•Do not bleed much
•More likely to become
infected
Contrecoup
•Occurs on opposite side
of initial injury.
•Usually occurs in the
brain when the head hits
an unyielding object
•The impact forces the
brain against the
opposite side
Stages of soft tissue healing
• Stage I: Acute inflammation
– Increased flow of blood to the injured area bring cells and
chemicals to begin healing.
• Phagocytes – specialize in eating up the dead cells
• Leukocytes – infection fighting WBC’s
• Platelets – carry blood clotting material
– This stage lasts for approx. 2-3 days.
Stages of soft tissue healing
• Stage II: Repair
– Injured area is filled with blood, cells, and chemicals to
aid in repairing damaged tissue.
• Fibroblasts begin building fibers across the area of injury
– Form the scar which can take from 6 weeks to as long as 3 months
Stages of soft tissue healing
• Stage III: Remodeling
– Body’s way of building tissue strength in tendons,
muscles, and ligaments to withstand stress.
– Can take up to a year or more
Healing Time
• Depends on several factors.
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Severity of injury
Location and blood supply
Age
Nutrition
Illnesses (ie. Diabetes)
Medications
Infections
Complications
• Scar Tissue
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Necessary component
Excessive scar tissue can delay healing
Not as pliable as normal tissue
May develop inside of joint, requiring surgical removal
• Too early of a return to activity
– Causing further cellular damage
Types of
BONE INJURIES
Dislocation
•Occurs when a force displaces
bone so that the two bone ends in
the same joint no longer line up.
•Cause deformity and pain
•Not easily moved
•Subluxation: is a slight dislocation
that might return back to previous
position without tx.
•A temporary Dislocation
Avulsion Fracture
A ligament or tendon pulls so hard
at its attachment that a portion of
the bony is torn away.
Common with Sprains, strains, and
dislocations
Stress Fracture
•Also known as Fatigue Fracture
•Occurs where there is a repetitive
stress.
•Microscopic and may not be
picked up on a x-ray
•Incomplete fracture
Spiral Fracture
•Torsional force along the length of
a bone.
•Ex: foot moves to the right while
the rest of your body goes to the
left.
Longitudinal Fracture
A Fx that runs the length of the
bone.
Usually caused by impact.
Ex: Basketball hits tip of finger
Compression Fracture
Opposing forces are applied from
both ends at the same time.
Commonly occur in the spine, due
to landing on feet from a height.
(Impact from ground is one force,
body weight is the other)
Oblique Fracture
Diagonal fracture from one side to
the other.
Comminuted
Crushing injury, breaking
bone into smaller pieces.
Greenstick Fracture
Bones bend and fracture only
partway through.
Children’s bones have cartilage like
qualities.
Transverse Fracture
• Fracture that travels across a
bone, perpendicular.
•Ex. Falling on a stick
Depressed
Fracture
•Direct impact to the
skull, which indents.
•This indent is called a
depression
Blowout Fracture
Occurs when the eye is pushed
hard backwards and down into the
eye socket.
Small bones under the eye are
crushed and embedded into the
muslces of the eye.
Pathological Fracture
•Disease process weakens the
bone
•Tumor
Epiphyseal Fracture
Fracture that occurs where bone
growth occurs, the Epiphysis.
Once growth plates are closed
bone is uniformly strong.
Stages of Healing
Bone Fracture Healing
Bone Fracture Healing
• Stage I: Acute
– Bone breaks, and bleeding occurs.
– Osteogenesis – Process of laying down new bone
• Oseoclasts begin to remove the debris and resorb it into body.
• Osteoblasts add new layers to the outside of the bone.
– Continues for approx. 4 days
Bone Fracture Healing
• Stage II: Repair
– Osteoblasts and Osteoclasts continue to regenerate
bone.
– Bony splint, called a fibrous Callus, holds the bone ends
together.
– Process of turning callus into bone begins
about week 3 and continues for 3 months.
– Usually able to return to activity
around 6-8 weeks.
Bone Fracture Healing
• Stage III: Remodeling
– Callus is reabsorbed and replaced with a fibrous cord of
bone
– Can take several years to complete.
– If bone never heals, it is referred to as a Nonunion FX.
• Most common in the Scaphoid bone in the wrist.
• Leads to arthritis and loss of function